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단순 코골이와 경증 폐쇄성수면무호흡의 치료 결과와 치료 방법에 대한 임상적 평가
송슬기,송윤재,박한결,김진일,조성동,지정연,김영석,김현직 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.2
Background and Objectives The clinical significance and need for the treatment of primary snoring and mild obstructive sleep apnea have been recently questioned. In this study, we analyzed therapeutic outcome and the methods of treatment of such diseases. Subjects and Method A retrospective review was conducted using the medical records of patients diagnosed with primary snoring or mild obstructive sleep apnea at a single institution from 2013 to 2015 through polysomnography or WATCHPAT. Results Of the 18 patients (37%) with primary snoring, 13 patients (72.2%) underwent surgery, four patients (22.2%) were treated with surgery and mandibular advancement device, and one patient (5.6%) underwent automatic positive airway pressure therapy. Of the 78 patients (61%) with mild obstructive sleep apnea, 35 patients (44.8%) had surgery, 24 patients (30.8%) were treated with mandibular advancement device, 13 patients (16.7%) were treated with surgery and mandibular advancement device and 6 patients (7.7%) received automatic positive airway pressure therapy. For primary snoring, while Epworth Sleepiness Scale and Pittsburg Sleep Quality Index did not improve, the snoring visual analog scale decreased significantly. In patients with mild obstructive sleep apnea, Apnea-Hypopnea Index, snoring decibel, Epworth Sleepiness Scale, and Pittsburg Sleep Quality Index were significantly decreased after treatment and the lowest oxygen saturation was significantly increased after treatment. Conclusion For primary snoring, the direction of treatment should be determined in accordance with the presence of associated diseases related to sleep disturbance breathing. For mild obstructive sleep apnea, active treatment may be helpful.
송슬기,이동한,김효진,정우진 대한갑상선학회 2020 International Journal of Thyroidology Vol.13 No.1
The transformation of papillary thyroid carcinoma (PTC) to anaplastic thyroid carcinoma (ATC) is well documented in the literature but is an exceptionally rare occurrence in metastatic foci outside the primary thyroid lesion. Even rarer is the simultaneous occurrence of PTC and ATC in the cervical lymph nodes. We report the case of an 85–year–old man who presented with a rapidly growing neck mass diagnosed as PTC. Following surgery, multiple ATC foci in the metastatic cervical lymph node were found coexisting with PTC, whereas in the thyroid, only PTC was found. This case is of high clinical significance because transformation of PTC to ATC outside the thyroid gland per se is very rare and because it suggests rapidly growing tumors in an elderly patient. The use of core needle biopsies in cases with suspected rapid tumor growth can aid in proper diagnosis, surgical decision making, and patient counselling.
통일 후 북한지역 영ㆍ유아 대상 예방접종체계 수복을 위한 선행연구
송슬기,방준석 한국임상약학회 2015 한국임상약학회지 Vol.25 No.4
Background: 8,000 children in North Korea died before they reached the 1 year after births in 2013. The high mortality rate of children under five years of age is mainly caused by infectious diseases and malnutrition. The need for national pediatric immunization and supply of vaccines will be vital when the abrupt reunification occurs. Objective: The purpose of this study is to scrutinize the pediatric immunization coverage of North Korea. Additionally it is to estimate the amount and the costs needed to vaccinate. Methods: The target population is the children of North Korea. The method is based on a pre-survey and an interview of North Korea defectors. The target interviewees searched for are as follows; doctors, teachers, and others. The interview includes questions on mortality rates and immunization coverage. The analysis is largely based on the statements of the health care providers within the selected group. Results: The interviewees are 8; 7 female and 1 male. The birth years range from 1956 to 1982. 3 out of 8 are former health care providers; a doctor, a pharmacist, and a nurse. The morbidity rate of infectious diseases exceeds the data from WHO. The immunization coverage is nearly 0% after 1980s. In order to ensure the welfare of North Korean children, at least 8,234,000 vaccine doses, requiring over 105 million U.S. dollars, are needed. Conclusion: The morbidity rate of infectious disease in North Korea is conspicuous. The preparation for supply and expenditure of vaccines is vital.