理中湯과 大承氣湯의 效能에 關한 實驗的 硏究

郭基煥,?逢夏,?基遠 慶熙大學校韓醫科大學韓醫學硏究所 1987 慶熙韓醫大論文集 Vol.10 No.-

Refractory Bilateral Sudden Sensorineural Hearing Loss Associated with Systemic Lupus Erythematosus : Clinical Implication of Plasmapheresis

곽기환,김성희,한승우,임은정 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.2

Sudden sensorineural hearing loss (SNHL) is a rare manifestation of systemic lupus erythematosus (SLE). A 38-year-old female presented headache followed by bilateral SNHL. The hearing threshold level was 75dB in the right and 45dB in the left ear. In spite of high dose steroid treatment, the hearing of both ears became profound hearing loss in several days. Serologic tests showed positive autoimmune markers corresponding to SLE with suspicious antiphospholipid (antibody) syndrome (APS). Follow up hearing tests showed no improvement in spite of anticoagulant, intravenous immunoglobulin and high dose steroid treatment. The patient underwent two cycles of plasmapheresis followed by immunosuppressant, and the hearing level in left side improved to 60dB after plasmapheresis. We presume that elevated blood viscosity and vasculitis due to immune deposits can cause cochlear vessel occlusion, which is responsible for the hearing loss. Prompt immunosuppressive treatment and, in refractory case, plasmapheresis can possibly reverse the hearing loss.

갑상선의 유두상암종과 동반된 Carcinoma Showing Thymus-Like Differentiation(CASTLE) 1예

곽기환,이진걸,이준기,박준호 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.2

Carcinoma showing thymus-like differentiation (CASTLE) is rare carcinoma of the thyroid or surrounding soft tissue of the neck with a histologically resemble to thymic epithelial tumors. It originates from ectopic thymus or branchial pouch remnants. Treatment is surgical excision and prognosis is good. Differential diagnosis is squamous cell carcinoma of thyroid and lymphoepithelioma of thymus. We report a case of CASTLE combined with papillary carcinoma of the thyroid that we treated by surgery, radio-iodine therapy and radiation therapy. The initial FNA showed that the smear was consistent with papillary carcinoma of the thyroid.

Nasal Septal Abscess : Clinical Analysis of 6 Cases

곽기환,이진걸,임은정,박준호,김성희,김태훈 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.2

Objectives:To evaluate the clinical characteristics and management of nasal septal abscess (NSA) of various etiologies among all age groups. Materials and Methods:Between 2010 and 2014, six patients diagnosed with NSA were included. Demographic data, clinical characteristics, culture results, Duration of antibiotics treatment, and complications were reviewed. Results:Of the 6 patients (mean age, 45.33±24.60 years; 4 male and 2 female), 4 were adults (66.7%) and 2 (33.3%) were adolescents. The most common symptom was nasal pain (83.3%), followed by nasal obstruction (66.7%). The etiologies were varied (iatrogenic : 3, idiopathic : 2, trauma : 1). The isolated bacterial organisms included Staphylococcus aureus (2 isolates), Pseudomonas aeruginosa (1 isolate), Staphylococcus epidermidis (1 isolate), and α- hemolytic streptococcus (1 isolate). The therapeutic duration was between 3 and 4 weeks. A saddle nose complication was observed in 3 subjects (50%). Conclusion:Early diagnosis and treatment within one week might prevent the saddle nose complications in NSA.

Valsalva Maneuver후 발생한 자발성 상갑상동맥 파열 1예

이진걸,곽기환,신주현,박준호 대한이비인후과학회 부산,울산,경남 지부회 2016 임상이비인후과 Vol.27 No.2

Spontaneous arterial rupture in the neck resulting in cervical hemorrhage and hematoma is rare and may progress to life-threatening conditions. We describe a case of 59 year old man who visited the emergency department, presenting with acute right neck swelling after repetitive Valsalva maneuver. Computed tomography scans revealed a hematoma in the right upper neck and a leakage of the contrast media at the first branch of the external carotid artery which is the superior thyroid artery. Although the patient developed cervical hemorrhage and hematoma, but spontaneously subsided with no intervention in 4days. Here we report, with a literature review, this extremely rare case of spontaneous superior thyroid artery rupture.

A Case of Middle Ear Actinomycosis Treated by Non-Surgical Method

임은정,곽기환,김태훈,김성희 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.2

Actinomycosis is a chronic suppurative infection by Actinomyces species, which rarely involves the middle ear and seldom diagnosed prior to tympanomastoidectomy. Unlike actinomycosis of the other body part, surgical removal is generally conducted in middle ear actinomycosis. We present the case of a 72-year-old female with 1-month history of otalgia and otorrhea in the left ear. Otoscopic examination revealed voluminous granulation tissue obstructing the ear canal with serous discharge. Excisional biopsy of the granulation tissue revealed actinomycosis. Tympanomastoid surgery was advised to treat presumed residual mastoid disease, but it was refused by the patient. 2 weeks of intravenous antibiotics and 6 months of penicillin was administered, and with a follow-up of 2 years she is free of symptom. Early diagnosis of actinomycosis and proper medication with antibiotics could control the symptoms and disease without surgery in some selected cases.

정상 청력 아동에서의 기도 및 골도 청성뇌간유발반응 검사의 잠복기 비교

임은정,곽기환,이진걸,이준기,김태훈,박준호,김성희 대한이비인후과학회 2015 대한이비인후과학회지 두경부외과학 Vol.58 No.10

Background and Objectives Bone conduction (BC) auditory brainstem response (ABR) is an important factor in determining the type of hearing loss especially in infants and other difficult-to-test populations. However, multiple constraints including technical difficulties make evaluating BC ABR less feasible in the clinic, and there is also lack of information that guides clinicians how to evaluate it. The purpose of this study is to compare the latency of wave V in BC and air conduction (AC) ABR in normal hearing infants and gather reference values for wave V latency of BC ABR. Subjects and Method A total of 210 ears of normal hearing, of those not belong to the hearing loss risk group, were included. All the infants underwent ABR evoked by clicks via AC (3A insert phone) and BC (Radioear B-71, vibrator positioned on the mastoid) under sedation. The latency of wave V at 30 dB nHL by BC and AC was compared and analyzed according to age. Results The results revealed that in every age group in the study, wave V latency at 30 dB nHL of BC ABR was shorter than that of AC ABR. There was a significant decrease in BC and AC latencies with age, but among each consecutive age group, significant latency change was not identified after 6 months old. Conclusion The latency of BC ABR in young children was shorter than that of AC ABR, and it decreased significantly as age increased. However, the reference data should be considered by taking each laboratory’s test parameter into consideration.

비중격에서 발생한 저악성도 비장형 선암종 1례

신주현,곽기환,이진걸,김태훈 대한비과학회 2017 Journal of rhinology Vol.24 No.1

Adenocarcinomas of the sinonasal tract are relatively rare. Such tumors are divided into salivary and nonsalivary types as classified by the World Health Organization. Nonsalivary sinonasal adenocarcinomas are further classified as intestinal (ITAC) and non-intestinal (non-ITAC), which can be separated even further into high-grade and low-grade. Low grade non-ITACs are more uncommon than ITACs. In this study, we present a case of low-grade non-ITAC in a 61-year-old woman who was successfully treated with wide excision without radiotherapy, and we also provide a review of the literature.

돌발성 난청에서 온도안진검사의 의의

임은정,김정수,허성재,이진걸,곽기환,신주현,김성희 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.10

Background and Objectives Dizziness has been known as a prognostic factor in suddensensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjectivesymptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensiveevaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associatedwith disease severity and hearing outcome. Subjects and Method A retrospective chart review was conducted of 488 patients diagnosedas unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis>20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologicfindings and final hearing outcomes were compared between the two groups. Results The initial pure tone averages of SSHL patients of abnormal caloric group and normalcaloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patientsof abnormal caloric test group showed worse hearing outcome across all frequenciescompared to those of the normal caloric group. Also, a significant correlation was noted betweenthe magnitude of hearing recovery and canal paresis (r=-0.223, p<0.001). Conclusion SSHL patients of abnormal caloric test showed worse initial hearing level andpoorer hearing outcome. Evaluation of vestibular function in SSHL patients is important becausesubjective symptoms alone cannot account for vestibular hypofunction patients, and thecaloric test can help in the counseling of patients and prediction of hearing outcome in SSHLpatients.

황연(黃連) 및 건강(乾薑)이 위액분비(胃液分泌).장관운동(腸管運動) 심장박동(心臟搏動)에 미치는 영향(影響)에 관(關)한 연구(硏究)

유기원,박동원,류봉하,곽기환,Yu, Gi-Won,Park, Dong-Won,Ryu, Bong-Ha,Gwak, Gi-Hwan 대한한방내과학회 1986 大韓韓方內科學會誌 Vol.3 No.1

As a result of administration of Coptidis Rhizoma extract and Zingiberis Rhizoma extract to Rat and Rabbit, its effect to the Gastric Juice Volume, Acidity, Pepsin out put of Rat and the movement of Intestine, Pulse Rate of Rabbit was as follows; 1. In the secretion of Gastric Juice, the Juice Volume in Coptidis Rhizoma administered group in contrast to Control Group, has increased in 30mg the increasing rate 21.4%, and has decreased in 300mg the decreasing rate 113.9%. But the Juice Volume in Zingiberis Rhizoma administered group has all decreased in 12, 30, 60, 120mg, and has remarkably decreased in 60mg the decreasing rate 62.9%. 2. The Gastric Acidity in Coptidis Rhizome administered group, in contrast to Control Group, has increased in 30, and 75mg, but no significant value, and has decreased in 300mg the decreasing rate 104.7%. But the Gastric Acidity in Zingiberis Rhizoma administered group has all decreased in 12, 30, 60 120mg, and has remarkably decreased in 60mg the decreasing rate 105.6%. 3. The Pepsin out-put in Coptids Rhizoma administered group, in contrast to Control group, has increased in 30mg the increasing rate 30.3%, and has decreased in 150, 300mg, no significant value. But the Pepsin out-put in Zingiberis Rhizoma administered group has all decreased in 12, 30, 60, 120mg, and has remarkably decreased in 60mg the decreasing rate 86.4%. 4. In the movement of Intestine, the contraction Coptidis Rhizoma administered group, in contrast before the administration, has increased in 12mg, but has begun to decrease in 30mg, and has remarkably decreased in 70mg. The contraction in Zingiberis Rhizoma administered group, in contrast before the administration, has all increased in 30, 60, 120mg. 5. In Pulse Rate, the pulsation, in contrast to Control group after 60, 120 180, 240min. has decreased in Coptidis Rhizoma administered group, and has increased in Zingiberis Rhizoma administered group, but no significant value.