거대 장간막 지방종 1 예

최수윤,김홍,홍정,Choi, Su-Yun,Kim, Hong,Hong, Jeong 대한소아외과학회 2004 소아외과 Vol.10 No.1

Visceral lipoma originating from the mesentery is very rare in childhood. A 29-month-old male presented with painless abdominal distension. Abdominal ultrasonography and CT revealed a huge multilobulated hypodense mass in the peritoneal cavity. Exploratory laparotomy showed a $26{\times}25{\times}5cm$ sized encapsulated, lobulated, homogenous mass, which originated from the transverse mesocolon. Histologic examination revealed a lipoma. The postoperative course was uneventful.

선천성 횡격막 탈장 수술 후 장기간 폐기능에 대한 고찰

최수윤(Su Yun Choi),이호원(Ho Won Lee),홍정(Jeong Hong) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.2

Purpose: Congenital diaphragmatic hernia is an uncommon cause of respiratory distress in newborn infants and initially characterized by severe restrictive lung dysfunction. The problems of initial management and short-term prognosis have been well reported. However, long-term outcome has not been clearly defined. We studied the late respiratory problems and lung function after repair of congenital diaphragmatic hernia. Methods: Fourteen patients who had repaired congenital diaphragmatic hernia at Ajou University from January 1995 to August 2009 were included for this study. Results: Six cases (42.8%) showed late respiratory problems including recurrent bronchiolitis, pneumonia, bronchial asthma and prolonged chest wall retraction. Lung perfusion scan showed a perfusion defect in 1 case whose mean perfusion to the operated side was lower than the unaffected lung. Pulmonary function test showed restrictive pulmonary insufficiency in 2 cases. The cases with the late pulmonary problems revealed more restrictive pulmonary insufficiency compared to those without. The prolonged time taken to surgery from diagnosis, prolonged intensive care time, and prolonged ventilator care after surgery have been found to be the determinants of the impaired pulmonary functions. Conclusion: In summary, a portion (about 20%) of the patients with congenital diaphragmatic hernia showed impaired pulmonary function, even when they had no apparent respiratory symptom or limitations of activities. From these results, regular long-term follow-up of lung function is required postoperatively in patients with congenital diaphragmatic hernia, especially in cases with the aforementioned risk factors.

갑상선 협부내 유두암의 임상병리학적 특성

최수윤(Su Yun Choi),김준석(Jun Suk Kim),소의영(Euy Young Soh),박찬흔(Chan Heun Park) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.2

Purpose: Surgical approaches for papillary thyroid carcinoma remain controversial. Moreover, previous reports regarding surgical strategy for papillary carcinoma of thyroid isthmus are very few. The aims of this study are to analyze the clinicopathologic features of papillary thyroid carcinoma of the isthmus and to develop more appropriate surgical strategies. Methods: Prospectively, papillary carcinoma arising thyroid isthmus (n=35) was included in this study from June 2006 to December 2008. All of the patients had total thyroidectomy with bilateral central compartment node dissection performed. Lateral nodes were sampled for frozen biopsy when metastasis was suspected by preoperative study. Thirty-five patients, who had unilateral papillary thyroid carcinoma, had total thyroidectomy with bilateral central compartment node dissection as control group and compared with papillary thyroid carcinoma of isthmus. Results: Lymph node metastasis was higher than control group in patients of isthmus cancer (51% vs 20%, P<0.05). Capsular invasion and multifocality observed in 63% and 23% respectively, but there was no significant difference compared to control group, statistically. Capsular invasion showed a positive correlation with lymph node metastasis by univariate and multivariate analysis. Analysis of ipsilateral nodal metastatic distribution revealed no definite metastatic pattern. Tracheal adhesion was observed in 4 cases of isthmus cancer group. Conclusion: In conclusion, it is recommended that bilateral CCND is needed as an appropriate primary surgical procedure for localized papillary carcinoma of thyroid isthmus.

갑상선 유두암 환자의 추적 관찰의 최근 경향

최수윤 ( Su Yun Choi ),최원혁 ( Won Hyuk Choi ),박찬흔 ( Chan Heun Park ) 대한임상종양학회 2008 Korean Journal of Clinical Oncology Vol.4 No.1

유방암의 골전이에 대한 치료

최수윤 ( Su Yun Choi ),최원혁 ( Won Hyuk Choi ),박찬흔 ( Chan Heun Park ) 대한임상종양학회 2008 Korean Journal of Clinical Oncology Vol.4 No.1

갑상선 여포암의 초기 증상으로서의 단발성 두개골 전이 1예

최수윤(Su-Yun Choi),차진우(jin Woo Cha),송선춘(Sun Chun Song),소의영(Euy Yong Soh),김장희(Hea Kim Jang) 대한두경부종양학회 2007 대한두경부 종양학회지 Vol.23 No.1

A 60 years old female patient presented with 8x6 cm sized painless oval mass in the left parietal region. She had left lobectomy of thyroid gland 10 years ago. Cranial CT, MRI, FGD PET-CT showed a solid mass which invaded left parietal bone. After embolization, craniectomy with tumor excision was performed. Histological examination revealed metastatic follicular cancer originated thyroid gland, with vascular and dura invasion. Postoperatively, neck CT showed right thyroid multiple nodules and right level III multiple lymph node enlargement. Thyroid function test was normal, but level of thyroglobulin was high (72ng/ml). So she had right lobectomy of thyroid gland with lymph node dissection under a diagnosis of follicular carcinoma. But histological examination revealed adenomatous hyperplasia and not lymph node metastasis. After operation, she received radioiodine therapy of 150mCi and then the level of thyroglobulin normalized (8.4ng/ml). The patient is under follow-up since she had operation 4 months ago.

글자책 읽기 후 음운인식 활동이 유아의 음운인식 발달에 미치는 영향

최수윤(Choi, Su Yun),김민진(Kim, Min Jin) 한국어린이미디어학회 2016 어린이미디어연구 Vol.15 No.3

본 연구의 목적은 글자책 읽기 후 음운인식 활동이 유아의 음운인식 발달에 미치는 영향을 알아보는데 있다. 연구 대상은 서울시에 G구에 소재하고 있는 S 유치원과 Y유치원의 만 3세 유아 62명(실험집단 20명, 비교집단 21명, 통제집단 21명)이었다. 실험집단 유아에게는 글자책 읽기 후 음운인식 활동을 실시하였으며, 비교집단 유아에게는 글자책 읽기 활동만 실시하였고, 통제집단 유아에게는 글자책을 읽지 않고 생활주제와 관련된 활동을 실시하였다. 연구결과를 살펴보면, 글자책 읽기 후 음운인식 활동을 실시하는 것이 글자책 읽기만 실시하거나, 글자책을 읽지 않고 생활주제와 관련된 그림책 읽기 활동을 하는 것 보다 유아의 음운인식 발달에 긍정적인 영향을 미치는 것으로 나타났다. 본 연구결과는 통해 글자책 읽기가 만 3세 유아의 음운인식 발달을 촉진할 수 있는 효과적인 방법임을 시사한다. 또한 글자책 읽기만을 하기 보다는 확장활동으로 음운인식활동을 실시할 경우 유아의 음운인식 발달을 극대화할 수 있음을 시사한다. The purpose of this study is to propose available activities at the sites of early childhood education by analyzing effect that phonological awareness activities using letter books have on children’s phonological awareness ability. The test treatments were conducted throughout a total of 16 times for six weeks from Sep. to Oct. in 2014. Young children of the test group conducted phoneme awareness activities after reading letter books. Young children of the comparison group conducted only reading of letter books. Young children of the control group implemented activities according to living subjects. After the test treatments, to find out the effect that phonological activities using letter books have on the phoneme awareness ability, the post-test was conducted. From conducting one-way ANOVA about syllable dropping, syllable distinction, phoneme counting, phoneme dropping, phoneme synthesis, and phoneme distinction as subordinate areas of phoneme awareness, differences among groups were analyzed. When the results of this study are summarized, they are like the next. First, it was shown that to conduct phonological activities using letter books positively influenced the phonological awareness ability of young children more than to conduct only reading letter books or to do activities related with living subjects without reading letter books. It was represented that to only read letter books had more positive effect on the phonological awareness ability than to do activities related with living subjects without reading letter books.

무증상 갈색 세포종

박재호 ( Jae Ho Park ),최수윤 ( Su Yun Choi ),소의영 ( Euy Young Soh ) 대한임상종양학회 2010 Korean Journal of Clinical Oncology Vol.6 No.2

목적: 무증상 갈색세포종은 전체 갈색세포종의 약 1.6-30%를 차지하며 방사선적 검사에서 우연히 발견된다. 본 저자들은 갈색세포종으로 진단된 환자들을 대상으로 무증상 갈색세포종과 증상이 있는 갈색세포종을 비교하여 임상 양상의 특징을 알아보고자 하였다. 대상 및 방법: 본 연구는1988년 4월 1일부터 2009년 9월 30일까지 부신내 종양 및 후복부 종양으로 수술을 시행 후 조직검사상 갈색세포종으로 진단된 57명의 환자를 대상으로 하였다. 무증상 갈색세포종 12예와 전형적 갈색세포종 45예를 비교하여 임상 양상 및 치료 결과에 차이가 있는지 분석하였다. 결과: 무증상 갈색세포종 환자 중 8명(66.7%)에서 cathecolamine 과다분비가 관찰되었다. 전형적 갈색세포종 군과 무증상 갈색세포종 군을 비교하였을 때 catecholamine 및 그 대사물의 평균 수치는 무증상 군에서 모두 낮게 측정되었다. 전체 57명의 환자 중 47명의 환자에게 수술 전 처치를 했음에도 불구하고, 수술 중 수축기 혈압이 160이상 되는 경우가 38명의 환자에서 관찰되었다. 무증상 갈색세포종에서도 수술 중 수축기 혈압이 160mmHg이상 상승한 경우는 6예였다. 양군을 비교하였을 때 고혈압 발작 양상은 전형적 갈색세포종과 의미있는 차이는 없었다. 무증상 갈색세포종 중 1예, 전형적 갈색세포종 중 4예에서 추적 관찰하는 동안 재발되었으며 전형적 갈색세포종 중 1예는 악성 갈색 세포종이었다. 결론: 부신 종양이 진단되었을 경우 catecholamine에 대한 생화학적 검사는 필수적이다. 무증상 갈색세포종이라 하더라도 catecholamine의 과다 분비가 진행되고 있으므로 수술적 치료가 일차적으로 시행되어야 할 것이며 적절한 수술 전 처치도 필요하겠다. 수술 후에도 재발 및 전이 여부를 확인하기 위한 정기적인 추적관찰을 고려해야 할 것이다. Purpose: Approximately 1.6-30% of histologically proven pheochromocytomas are discovered by radiologic examination in the absence of symptoms. The aim of this study was to analyze the asymptomatic pheochromocytoma, to compare with typical pheochromocytoma. Meterials and Methods: Fifty seven patients were reviewed who diagnosed pheochromocytoma at from 1988 to 2009. In the current study, we evaluated the characteristics of asymptomatic pheochromocytoma(AP) in 12 patients and compared with other 45 patients with typical pheochromocytoma(TP). Results: Catecholamine overproduction was observed in 8 (66.7%) of AP patients. In particular, the mean values of biochemical parameters were lower in AP patients compared to TP patients, and single catecholamine overproduction was frequently observed. Despite preoperative preparation in forty seven patients, intraoperative hypertension occurred in thirty eight patients with spiking of >160 mmHg. In the asymptomatic group, there were 6 cases of spiking blood pressure higher then 160 mmHg. Intraoperative hemodynamic changes were not significantly different between AP and TP. During follow-up, there were five cases of recurrent disease (1 in the asymptomatic group and 4 in the typical group), and 1 case of recurrent disease was malignant. Conclusion: Catecholamine screening in all patients with adrenal tumors is essential. Even in asymptomatic pheochromocytoma patients, there exists a likelihood of catecholamine overproduction, the surgical extirpation may offer an advantage. Such patients should be appropriately prepared before surgical intervention and regular and long term follow-up should also be considered to detect recurrent disease.

위암에서 복강경 위절제술의 현황

최원혁 ( Won Hyuk Choi ),최수윤 ( Su Yun Choi ),박찬흔 ( Chan Heun Park ) 대한임상종양학회 2008 Korean Journal of Clinical Oncology Vol.4 No.1

갑상선 휘틀세포암(Hurthle Cell Carcinoma)의 임상적 특징 및 예후인자

이잔디(Jandee Lee),이승환(Seong Hwan Lee),최수윤(Su-Yun Choi),남기현(Kee-Hyun Nam),정웅윤(Woong Youn Chung),소의영(Eui-Young Soh),박정수(Cheong Soo Park) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.2

Purpose: Hurthle cell carcinoma (HCC) of the thyroid gland is a rare disease that represents 3% of all thyroid carcinomas. HCC has been known as a more aggressive disease than the usual differentiated thyroid carcinoma. However, the biologic behavior and optimal treatment have come under considerable debate in recent years. This study was performed to evaluate the clinicopathologic features and treatment outcome of HCC. Methods: From April 1986 to August 2006, 18 patients with HCC and 216 patients with pure follicular carcinoma (PFC) underwent thyroidectomy at our institutions with a mean follow-up of 114 (range: 6∼253) months. The clinicopathologic characteristics and treatment outcome of each group were compared, and the prognostic factors for disease-free survival were analyzed. Results: There were 14 women and 4 men with a mean age of 50 (range: 26∼76) years. Compared with PFC patients, all of clinicopathologic features of HCC patients were different (gender, age, tumor size, multifocality, angioinvaion, invasion to adjacent structures, the subclassification and initial distant metastasis), but the high incidence of bilaterality was similar to the PFC patients (P<0.0001). The causespecific survival (CSS) rates at 10 years were 83.4% in the HCC patients and 89.3% in the PFC patients (P=0.702). Older age (greater than 45) (P=0.0125) and initial distant metastasis (P<0.0001) in the HCC patients, and an older age (P<0.0001), male gender (P=0.0039), angioinvasion (P= 0.0122), invasion to adjacent structures (P<0.0001), a widely invasive type (P=0.004) and initial distant metastasis (P<0.0001) in the PCC patients were independent prognostic factors for survival. Conclusion: After accounting for important biologic behaviors, patients with HCC had similar clinicopathologic characteristics and prognosis compared with that of the PFC patients. Therefore, HCC should be managed using the same treatment strategy as PFC.