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김한수,정오,박영규,김동의,류성엽,김영진,Kim, Han-Su,Jeong, Oh,Park, Young-Kyu,Kim, Dong-Yi,Ryu, Seong-Yeop,Kim, Young-Jin 대한위암학회 2008 대한위암학회지 Vol.8 No.4
목적: 위식도접합부선암의 임상병리학적 특성은 서구와 아시아 간의 많은 차이를 보인다고 알려져 있다. 그러나, 한국의 경우 위식도접합부선암의 유병율이 매우 낮고 이에 대한 연구 또한 부족하다. 따라서 저자들은 우식도접합부선암의 Siewert 분류에 따른 임상병리학적 특성을 조사하여 서구와 다른 국내 위식도접합부선암의 특성을 연구하고자 하였다. 대상 및 방법: 2004년 5월부터 2008년 2월까지 본원에서 위암으로 수술을 시행 받은 환자들을 대상으로 수술소견 및 병리 사진을 토대로 Siewert 분류법에 따라 위식도접합부선암을 분류하고, 의무기록을 바탕으로 환자들의 임상병리학적 특성들을 조사하였다. 결과: 위식도접합부선암은 전체 1,778예 중 70예(3.9%)였다. Siewert 1형은 3예(4.3%)로 매우 드물었으며, 2형과 3형이 각각 30예(42.8%) 37예(52.8%)였다. 2형이 3형에 비하여 평균연령이 높았으나(64세 vs 59세, P=0.049), 남녀비에는 차이가 없었다. 2형과 3형간에 Barrett 식도의 발현 정도나 Lauren 분류의 차이는 없었으나, 저분화암의 빈도는 3형에서 유의하게 높았다(P=0.045). 68예(97.1%)에서 근치적 절제가 시행되었으며, 각 아형간에 TNM 병기의 차이는 없었다. 결론: 국내의 위식도접합부선암은 매우 드물며 특히 1형의 유병율이 매우 낮다. 본 연구에서 서구의 보고와 부분적으로 일치하지 않는 병리학적 특성을 보였다. 향후 보다 많은 환자들을 대상으로 한국인의 위식도접합부선암의 특성을 연구할 필요가 있다. Purpose: Siewert's classification of adenocarcinoma of the esophagogastric junction (AEG) has been widely adopted, but there is a wide discrepancy of the clinicopathological features of AEG of the Asian patients as compared to that of the Western patients. The aim of this study was to investigate the clinicopathological characteristics of AEG according to the Siewert classification. Materials and Methods: Among the patients who underwent surgery for gastric carcinoma in our institution between May 2004 and February 2008, the AEG patients were selected based on their operation records and the photographs according to Siewert's classification. Results: There were 70 AEG patients (3.9%) among the total of 1,778 patients. There were 3 patients (4.3%) with type I, 30 patients (42.8%) with type II and 37 patients (52.8%) with type III. Curative resection (R0) was achieved in 68 cases (97.1%). No significant differences in gender, stage, Barrett's esophagus and the proximal margin were found between the patients with type II and type III AEG. The patients with type III were younger than the patients with type II (59 vs 64 years, respectively, P=0.049). Well differentiated histology (P=0.045) and the intestinal type (P=0.055) were significantly more frequent in the patients with type II as compared with that in the patients with type III. Conclusion: There was a striking difference of the Asian patients from the Western patients for the incidence of AEG (and especially type I). Some of the differences between type II and type III patients were similar to those of the previous Western studies. A large study is needed to investigate whether these features are typical in the Korean population.
발성장애: 후두내시경 검사에서 놓치기 쉬운 성대점막질환
김한수,Kim, Han-Su 대한후두음성언어의학회 2010 대한후두음성언어의학회지 Vol.21 No.1
Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,
음성인식프로그램을 이용한 무후두 음성의 말 명료도와 병적 음성의 수술 전후 개선도 측정
김한수,최성희,김재인,임재열,최홍식,Kim, Han-Su,Choi, Seong-Hee,Kim, Jae-In,Lee, Jae-Yol,Choi, Hong-Shik 대한후두음성언어의학회 2004 대한후두음성언어의학회지 Vol.15 No.2
Background and Objectives : The purpose of this study was to examine objectively pre and post operative voice quality evaluation and intelligibility of alaryngeal voice using speech recognition program, HUVOIS. Materials and Methods : 2 laryngologists and 1 speech pathologist were evaluated 'G', 'R', 'B' in the GRBAS sclae and speech intelligibility using NTID rating scale from standard paragraph. And also acoustic estimates such as jitter, shimmer, HNR were obtained from Lx Speech Studio. Results : Speech recognition rate was not significantly different between pre and post operation for pathological vocie samples though voice quality(G, B) and acoustic values(Jitter, HNR) were significantly improved after post operation. In Alaryngeal voices, reed type electrolarynx 'Moksori' was the highest both speech intelligibility and speech recognition rate, whereas esophageal speech was the lowest. Coefficient correlation of speech intelligibility and speech recognition rate was found in alaryngeal voices, but not in pathological voices. Conclusion : Current study was not proved speech recognition program, HUVOIS during telephone program was not objective and efficient method for assisting subjective GRBAS scale.
김한수,Kim, Han Su 대한후두음성언어의학회 2020 대한후두음성언어의학회지 Vol.31 No.2
Vocal fold injections are usually performed with a patient wake in an office under local anesthesia. For comfortable and safe office-based procedures, thorough anesthesia and premedication should be provided to the following three regions; nasal cavity, oropharynx, and larynx. Topical lidocaine is most widely used anesthetics on office based procedure. Lidocaine has a low to intermediate potency, 45 minutes to 60 minutes' duration of action, and onset of sufficient anesthesia within 90 seconds of topical administration. Tetracaine, prilocaine, ropivacaine, and bupivacaine also have been used in the office-based procedures. Nasal decongestant, oxymetazoline, is also used for widening nasal cavity by constriction of nasal mucosa. The amount of topical and local anesthetics used in vocal fold injection rarely exceeds toxic doses. The physician should know proper anesthesia techniques and must be familiar with the safe dose and complication of all anesthetics used.