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안순현,김원식 대한이비인후과학회 2020 Clinical and Experimental Otorhinolaryngology Vol.13 No.2
Objectives. Hemithyroidectomy is commonly performed in patients with low- to intermediate-risk papillary thyroid carcinoma. The purpose of this meta-analysis was to evaluate the effect of prophylactic central neck dissection on locoregional recurrence in patients undergoing hemithyroidectomy. Methods. A meta-analysis was performed of full-text publications published in English retrieved from the Embase database. Results. The rate of regional recurrence in the central compartment after hemithyroidectomy, with or without prophylactic central neck dissection, was 0.17% and 1.78%, respectively. This difference was statistically significant. Recurrence in the lateral compartment or contralateral thyroid was not affected by prophylactic central neck dissection; the overall rate of recurrence was 1.3% and 5.4%, respectively. Conclusion. Prophylactic central neck dissection significantly reduced the risk of recurrence in the central compartment in patients undergoing hemithyroidectomy.
안순현,홍현준,권순영,권기환,노종렬,류준선,박준희,백승국,이국행,이세영,이진춘,정만기,주영훈,지용배,하정훈,권민수,박영민,송창면,신성찬,유창환,이도영,이영찬,장재원,정하민,조재근,차원재,전병준,최익준,최효근,이강대 대한이비인후과학회 2017 Clinical and Experimental Otorhinolaryngology Vol.10 No.1
Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.
안순현 대한이비인후과학회 2021 Clinical and Experimental Otorhinolaryngology Vol.14 No.1
Objectives. The usefulness of core needle biopsy (CNB) for the diagnosis of thyroid nodules remains controversial, and preferences vary across hospitals. The purpose of this study was to assess the actual use of CNB in Korea and to analyze the advantages and disadvantages of CNB through a systematic review and meta-analysis of papers published by Korean authors. Methods. A meta-analysis of full-text publications published in English presenting data from Korea retrieved from the Embase literature database was performed. Results. CNB led to a significantly lower proportion of non-diagnostic results than fine-needle aspiration (FNA). However, the frequency of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) did not decrease as a result of performing CNB in nodules with initial AUS/FLUS results, while it increased in consecutive cases. A subcategory analysis of AUS/FLUS showed that the increased frequency of AUS/FLUS findings on CNB was due to more frequent diagnoses of architectural atypia and follicular neoplasm, which resulted in a higher frequency of inconclusive findings in consecutive cases compared to FNA. Hospitals favoring CNB had a higher proportion of AUS/FLUS diagnoses. Although the complication rate did not differ significantly between CNB and FNA, serious complications of CNB did occur. Conclusion. A reduced frequency of non-diagnostic results may be a definite advantage of CNB over FNA. However, the increased frequency of diagnoses of architectural atypia and follicular neoplasm should be considered when selecting CNB as a diagnostic tool.
안순현 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.4
Due to the complexity of the anatomy and function of head and neck region, the reconstruction of ablative defect in this area was always challenging. Also the increasing interest in quality of life makes the role of free flap more important for good functional result. The aim of this study is to review the result of early experience with free flap reconstruction and to show the importance of appropriate reoperation of compromised flaps. Subjects and Method:The medical records of patients who underwent free flap reconstruction from 2004 to 2007 were reviewed retrospectively. There were 37 patients with the average age of 58 years. The applied type of flap, primary tumor required for free flap and result for flap reoperation were analyzed. Results:The overall success rate was 92% with 3 failure cases. Less experience and radical neck dissection sacrificing internal jugular vein were significant risk factor for flap failure. Reoperation due to compromised circulation of flap was performed in 8 patients (21.6%) and seven out of eight flap could be salvaged successfully (87.5%). The average time interval between detection of flap discoloration and reoperation was 54 min. Conclusion:The free flap technique is safe but needs some learning period and careful monitoring. Early intervention is important for saving the free flap and lowering the failure rate. (Korean J Otorhinolaryngol- Head Neck Surg 2008;51:350-4)
안순현(Soon-Hyun Ahn) 대한두경부종양학회 2023 대한두경부 종양학회지 Vol.39 No.1
The primary treatment of oral cavity cancer is still surgery. By discussing the surgical treatment of oral cavity cancer, the basic concept of head and neck surgery could be thoroughly reviewed. The oral cavity is defined as the hard palate and the anterior 2/3 of the tongue. With appropriate reconstruction, most defects can be repaired without a significant change in quality of life, unlike in the oropharynx or hypopharynx, where aspiration problems frequently occur. The selection of a surgical approach that can provide an appropriate field of view to obtain a resection margin of 5 mm or more has become the core of head and neck surgery. The role of prophylactic neck dissection is also well established in oral cavity cancer patients. Mandibulotomy for access to the oral cavity or mandibulectomy due to cancer invasion requires bony surgical techniques, and reconstruction also requires bone tissue reconstruction techniques as well as soft tissue. Therefore, oral cancer surgery is the most important primary area where all techniques of head and neck surgery are mobilized.
이위교,안순현,정민권,진혜영,박일중 대한진단검사의학회 2012 Annals of Laboratory Medicine Vol.32 No.1
In July 2010, we identified an outbreak of vancomycin-resistant enterococci (VRE) in our 26-bed neonatal intensive care unit. We performed an epidemiological investigation after clinical cultures of 2 neonates were positive for VRE. Identification, susceptibility testing, and molecular characterization were performed. Cultures of 3 surveillance stool samples of inpatients and 5 environmental samples were positive for VRE. All isolates were identified as Enterococcus faecium containing the vanA gene. Two distinct clones were identified by performing pulsed-field gel electrophoresis. The 2 clones exhibited different pulsotypes, but they represented identical Tn1546 types. Two sequence types, ST18 and ST192, were identified among all of the isolates with multilocus sequence typing. Our investigation determined that the outbreak in the neonatal intensive care unit was caused by 2 genetically different clones. The outbreak may have occurred through clonal spread and horizontal transfer of the van gene.
정수지,안순현,권성근,원태빈,윤준식,정은재 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.4
For head and neck reconstruction, especially for reconstruction of midfacial structure, weshould consider cosmetic results, functional preservation, and survival of flap. Methods of re-construction vary from skin graft to free flap. Among those, the radial forearm free flap (RFFF)can be a valuable alternative for defects of midfacial structures such as the eyelid, nose and lipbecause of its sufficiently long pedicles, lack of bulk and flexibility, all of which enable sur-geons to shape the flap into the way they want, and also functionally complement it by usingadjacent structures like the palmaris longus muscle tendon. Herein, we introduce variousmethods of employing RFFF with or without the palmaris longus tendon to get better aesthet-ic and functional outcomes in reconstruction of midfacial structure.
임덕환,안순현,노종렬,이승신,박석우 한국뇌학회 2003 한국뇌학회지 Vol.3 No.1
특이음 인식과정에 대한 청신경 경로상의 선택도 증가를 비교적 간단한 금화조 모델의 청신경 경로상에서 청각유발성 전위를 이용하여 객관적으로 분석하고자 하였다. Auditory evoked responses were analyzed to both acoustic and electrical stimuli to understand how selectivity emerges in auditory pathways. Results shows that a lower portion of dynamic range is important in differential stimulation and RA-HVc pathway has been identified as a source of improving selectivity.