부갑상선 선종 4예의 수술적 치료

양윤수,최승철,전희석,홍기환 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.10

Parathyroid adenoma is an uncommon disease in Korea. However, the frequency of this disease has slowly increased with routine measurement of serum calcium and increasing awarenes by the public of hyperparathyroidism in recent years. We have experi-me of surgical treatment retrospectively. Four cases were diagnosed by persistent elevation of serum calcium and parathyroid hormone. They presented asymptomic clinical symptoms, osteoporosis/ osteodeficiency, or renal stone, gastrointestinal disturbance or neck mass. Parathyroid lesions were detected preoperatively by ultrasonography, thyroid scanning or neck computerized tomographic imaging in three of them. The tumor locations were left lower in two cases and right lower in two cases. Al patients received guideline for beter diagnostic strategies, proper surgical management and follow-up study for recurence in the primary hyperpa-rathyroidism. (Korean J Otolaryngol 2003 ;46 :890-5)

소아에서의 경부심부감염에 대한 임상적 고찰

양윤수,이화욱,이상헌,홍기환 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.12

Backgroud and Objectives:The objective of this study was to clarify the presenting signs and symptoms, clinical course, path-ologic organisms, and management of deep neck infections in children. Subjects and Method:We retrospectively reviewed the in-patient charts of children treated at our ENT department for dep neck infections. Thirty-six such patients were identified Results:During the 4-year period, 36 children with deep neck space infection were diagnosed and treated, including 20 (56% ) boys and 16 (44% ) girls. The ages ranged from 11 months to 15 years, with the mean of 6.9± 4.5 years. The most common site of infection was the peritonsillar space (41.7%), folowed by the parapharyngeal (27.8%) and submandibular (16.6%) space. Six (16.6%)space. The most comonly known associated preceding ilness was viral upper respiratory infection (53% ). Neck sweling, fever, and dysphagia were the most frequent symptoms. The most common pathogens were Streptococcus pyogens (3/10) and Sta-phylococcus aureus (2/10). The mean duration of hospitalization was 7.7 days (range, 2- 15). Leukocytosis (WBC>15000/m3) was found in 13 (36% ) patients. All patients received parenteral antibiotics after admision. Thirteen (36% ) children recovered from the infection with conservative treatment and twenty-three (64% ) children received surgical drainage. No complication and tracheotomy occured. Conclusion:Dep neck space infections in children are rapidly progressive and usually present with neck swelling and fever. Peritonsillar space and Streptococus pyogens infections were most common anatomic sites and pathogen

교정인의 현장경험을 통한 사례 연구

양윤수 한국교정복지학회 2010 교정복지연구 Vol.- No.18

태초 이래로 범죄가 없었던 적은 없다. 우리는 늘 범죄와 함께 살아가고 있지만 막상 범죄에 대하여 어떻게 해야 할지 모르고 있는 것이 문제라 하겠다. 그래서 범죄로부터의 분리와 도피를 부득이하게 선택하게 되지만 이것 역시 한계가 있는 것이다. 그리고 범죄인에 대한 막연한 두려움은 문제 해결에 전혀 도움이 되지 않는다. 그러나 범죄인들도 진정한 사랑의 마음과 실질적인 필요를 제공할 때 진지하게 사람을 대하며 인생을 살펴보는 것을 보게 되었다. 무조건적인 범죄의 매도에 충실할 것이 아니고 아직 한 번도 부여받지 못했을 수 있는 진정한 기회를 이제는 주어야 할 것이다. 범죄로 인한 여러 가지 폐해가 나타나고 있고 수적으로 몇 안되는 범죄인이 사회에 미치는 영향력과 사회적 비용은 실로 막대하다. 이제는 일반인들에게도 범죄를 다룰 수 있는 노하우를 지녀야 한다. 그래서 범죄의 영역이 사회에서 실패하고 힘들게 살아온 이들의 영역으로써 인식되는 생활의 일부가 되어야 한다. 그래서 범죄인이라고 덮어 놓고 비난하는 것이 아니라 개선 가능한 사람을 도와주어 그들이 사회에 일원이 되도록 해야 할 것이다. There have never been without crimes since the beginning. Even though we live with them, the matter is we don't know how to deal them practically. So we have no choice but to separate and escape from the crimes. But there is limit, too. And an obscure afraidness about the criminal isn't helpful to solve the problems. However, I have experienced when the criminal were provided with true lovey hearts and practical needs, they met people earnestly and took their lives seriously. It's time to give them true chances which they have never received instead of unconditional denouncing. As we see many harmful effects through crimes, the criminal have had an enormous impact on the society and generated tremendous social costs. Now, ordinary people should have the knowledge how to deal the crimes. So the field of crime should be accepted as the part of life to the person who has failed in the society and lived with difficulties. So as to help them, we should support improving people to adjust the society as a member rather than denounce them without telling why.

경부에 발생한 괴사성 근막염에 대한 임상적 고찰

양윤수,이화욱,김진성,이재근,홍기환 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.8

Background and Objectives:To clarify the presenting signs and symptoms, clinical course, pathologic organisms, and management of cervical necrotizing fasciitis. Subjects and Method:We retrospectively reviewed the inpatient charts treated at our ENT department for cervical necrotizing fasciitis. Seven such patients were identified as having been treated from January 2002 to December 2004. Results:During the 36-months period, 7 adults consisting of 5 males and 2 females with cervical necrotizing fasciitis were diagnosed and treated. The mean age was 45 years ranging from 25 to 59 years. All patients had infections in more than five fascial spaces. The most commonly involved sites of infection were the superficial neck space (100%), followed by submandibular (85.7%), and parapharyngeal and submental space (57.1%). The most commonly known associated preceding illness were tonsillitis and dental abscess (28.5%). Painful neck swelling and difficulty in moving the neck were the most frequent symptoms and signs. The most common pathogen was Streptococcus species (4/7), followed by Staphylococcus epidermidis and Klebsiella pneumoniae (1/6). The mean duration of hospitalization was 17.2 days (range, 8-24). Leukocytosis (WBC>10000/mm3) was found in all patients. All patients received parenteral antibiotics and surgical drainage after admission. Six patients recovered and one patient died after surgical drainage. Tacheotomy was performed on five patients. Conclusion: Cervical necrotizing facilitis is an uncommon but often fatal bacterial infection of the skin, subcutaneous fat, superficial fascia, and deep fascia. It is characterized by marked tissue edema, rapid spread of inflammation, and signs of systemic toxicity. High indexof suspicion, prompt aggressive surgery, appropriate antibiotics, and supportive care are the mainstays of management.

새열낭종에서 기원한 편평세포암종 1예

양윤수,오정기,전희석,홍기환 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.12

The hypothesis that primary branchiogenic carcinoma originates from a branchial cleft cyst is controversial since the entity was first described in 1882. In 1950, stringent criteria were established for the diagnosis of primary branchiogenic carcinoma, the most important criterion being histologic proof of carcinoma arising from a normal cyst epithelium. Only a limited number of cases have successfully fulfilled these criteria. In this article, we describe a case of squamous cell carcinoma arising in the second branchial cleft cyst and also discuss the diagnosis, histopathologic features, and therapeutic options.

일차성 이하선 호지킨스 림프종 1예

양윤수,임현실,이재근,홍기환 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.12

Hodgkins lymphoma with its primary manifestation in the parotid gland is an exceedingly rare entity and seldom described in the of systemic disease processes. This case report describes a parotid gland mas as a first symptom of Hodgkins lymphoma. The patient underwent surgical excision and chemotherapy. The final diagnosis was established after an excisional biopsy and immu-nohistochemical staining. (Korean J Otolaryngol 2003 ;46 :1084-7)

영아의 흑색 신경외배엽성 종양 1예

양윤수,김연우,오정기,홍기환 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.10

The melanotic neuroectodermal tumor of infancy (MNTI) is a rare osteolytic pigmented neoplasm that most frequently course. We present a 5-month-old girl with a melanotic neuroectodermal tumor of infancy of maxilla.

Warthin씨 종양에 동반된 원발성 결핵성 이하선염 1예

양윤수,김진성,이재근,홍기환 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.2

Warthins tumor is a common neoplasm of the major salivary glands. Tuberculosis of the parotid gland is rare. It may result from the involvement of intraparotid lymph nodes or the infection of parenchyma, either primary or secondary to nodal disease. Clinically, tuberculosis of the parotid may not be distinguishable from a neoplasm. This report presents a patient with a parotid mass that was thought to be a malignancy but, after surgery, was diagnosed to be Warthin’s tumor associated with tuberculosis. (Korean J Otolaryngol 2006;49:228-31)

초음파검사에서 발견된 갑상선 결절내석회화소견의 암종에 대한 상대적 위험성

양윤수,임현실,김연우,오정기,홍기환 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.5

Background and Objectives:The aim of this retrospective study was to evaluate the significance of sonographically detected thyroid calcifications in the diagnosis of thyroid cancer. Subjects and Method:Two hundred ninety-one patients with thyroid disease, including 75 with thyroid cancer and 54 with calcified thyroid nodule, were reviewed during the period of January 2001 to May 2003. Each patient underwent preoperative high resolution sonography to evaluate the thyroid gland for the presence of calcifications. Results:The highest incidence of calcification was found in thyroid cancer (36%), followed by multinodular goiter (20%), follicular adenoma (13%), and single nodular goiter (3%). The incidence of cancer was significantly higher in calcified nodules (50%) than in noncalcified nodules in the entire group (20%) (p<0.001), with a relative risk of 3.9. In the group of solitary thyroid nodules, the incidence of cancer in the calcified nodules (56%) was higher than that in the nodules without calcification (21%) (p=0.002). In the group of multiple thyroid nodules, the incidence of cancer in the calcified nodules (47%) was higher than that in the nodules without calcification (19%) (p=0.001). The relative risk in presence of calcification was 4.6 in the solitary nodules and 3.7 in the multiple nodules. Compared with multiple noncalcified thyroid nodules, the solitary calcified nodules demonstrated a relative risk of 5.2. In patients younger and older than 40 years, the relative risk in the presence of calcification was about the same, around 4. Conclusion:The detection of thyroid calcifications by sonography is diagnostically valuable. The presence of calcifications should raise the suspicion of malignancy.

갑상선 전절제술 후 1시간에 측정한 혈청 부갑상선호르몬의 유용성

양윤수,이은정,소상수,최동일,공일승,홍기환 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.11

Background and Objectives:Hypocalcemia is the most frequent complication following total thyroidectomy. This prospective study examines the predictive value of parathyroid hormone (PTH) levels measured 1 hour after surgery. Materials and Method:Twenty-four patients underwent total or near-total thyroidectomy for benign or malignant thyroid tumor in one year. Serum calcium and PTH levels were measured preoperatively and at 1 hour after surgery. Results:Al patients were clasified into three groups acording to hypocalcemic symptoms and postoperative serum calcium levels. A total of 6 (25% ) patients were found with hypocalcemia, as demonstrated by clinical and laboratory findings. PTH levels at 1 hour were below normal level (100% ) for 6 of the 6 symptomatic hypocalcemia patients, 5 (45% ) of the 11 biochemical hypocalcemia patients, and in 1 (14% ) of 7 normocalcemic patients (p= 0.002). The sensitivity and specificity of postoperative 1 hour PTH asesment to predict symp-tomatic hypocalcemia were 100% and 66%. The positive and negative predictive rate of postoperative 1 hour PTH assesment to predict symptomatic hypocalcemia were 50% and 10%. Conclusion:of transient hypocalcemia after bilateral thyroid surgery. Low PTH level at 1 hour after surgery is therefore a feasible predictor of postoperative symptomatic hypocalcemia and permanent hypoparathyroidism. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :1012-6)