비배부에 발생한 양성 섬유성 조직구종 1예

조인지,허성재,전범수,김정수 대한비과학회 2010 Journal of rhinology Vol.17 No.2

Fibrous histiocytoma usually develops indiscriminately in skin and any soft tissues of the body. To date, tumors occurring in soft tissues of the head and neck, especially around the nose, have been rarely reported. In most cases, benign fibrous histiocytoma develops as a painless mass lesion and most commonly originates in sun-exposed skin, extremities, and orbital tissue. Recently, we experienced a case of benign fibrous histiocytoma in the nasal dorsum in a 36-year-old woman who complained of a mass in the nasal dorsum. To the best of our knowledge, this is the first reported case of benign fibrous histiocytoma originating in the nasal dorsum in a Korean.

후두 백반증의 임상적 양상 및 장기간 추적관찰 결과

허성재,조인지,안동빈,김재혁,박준식,손진호 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.8

Background and Objectives Leukoplakia is a clinical term solely designating a white patch or a plaque of the mucosa without considering its histological feature. Leukoplakia ranges microscopically from a hyperplasia to an invasive squamous cell carcinoma. This study attempted to find out the clinical progress and characteristics of leukoplakia in the larynx. Subjects and Method Included in the study were 154 patients clinically diagnosed as leukoplakia from 1997 to 2010. We reviewed their medical records retrospectively for age, sex, smoking and drinking history, medical record, histopathologic finding, treatment method, and the follow-up records. Results Histopathologic findings of leukoplakia in the larynx showed hyperkeratosis (101 patients), invasive carcinoma (19 patients), dysplasia (14 patients), nodule (9 patients), papillomatosis (4 patients), chronic inflammation (4 patients) and tuberculosis (3 patients). Of the 128 patients, 39 patients who were diagnosed as hyperkeratosis, dysplasia, nodule or chronic inflammation in the larynx had recurrence and received re-biopsy over 2 times. Eight patients of these 39 who had recurrence had progression to invasive carcinoma. The mean interval between diagnosis of leukoplakia and invasive carcinoma was 53 months (ranged 7-114 month). Heavy smoking (more than 20 pack year) and drinking were significantly associated with recurrence or progression to invasive carcinoma. Age, gastroesophageal reflux disease and treatment method were not associated with recurrence. Conclusion Leukoplakia in the larynx led to various histopathologic diagnoses, high recurrence rate, and progressed to invasive carcinoma even after 5 years. Smoking and drinking should be managed and longterm follow-up is needed.

의미 없는 활동지를 놀이로 전환하는 유아교사의 경험

서혜정,조인지 한국영유아교원교육학회 2015 유아교육학논집 Vol.19 No.5

This qualitative study described the experience of a pre-school teacher trying to change meaningless work-sheets into playful activities in a class of 4-year-olds. The materials were collected by participatory observation, lesson discussion and in-depth interviews from April. 11, 2013 to November. 15, 2013. The findings showed that when the work-sheets were valued as a part of study results, the classroom was just a place where the children were forced to think in the same way since teachers would focus not on the process but on the results. Therefore, when the results didn't turn out the way they expected, they would correct the contents of the sheets. So, the children would consider the sheets stressful work. However, teachers came to realize the problem of the sheets and began to create new activities: constructive play, physical activity and art activity. Through the changing efforts, teachers found the value of children's way of thinking and became active in understanding their perspectives, which led them to the ideal role of teachers. They also tried to set the limit to use of the sheets to only when children needed to express their thoughts in a playful way. This study suggests that the work-sheets are to be utilized as a tool for children's expression in a playful way and thus the true meaning of the sheets should be accepted. 본 연구는 만 4세 교실에서 의미 없이 활용하던 활동지를 놀이로 전환하는 유아교사의 경험에 대한 질적 연구이다. 자료 수집은 2013년 4월 11일에서부터 2013년 11월 15일까지 참여관찰, 심층면담, 반성적 저널을 통해 이루어졌다. 연구 결과, 교사는 과정이 생략된 결과를 중시하며 유아의 ‘다른’ 생각이 아닌 ‘같은’ 생각을 표현하는 장으로서 활동지를 활용하였다. 교사가 원하는 결과로 활동지 내용을 수정하기도 하여 유아들은 ‘일’로서 활동지를 받아들여 스트레스로 활동지를 받아들이고 있었다. 활동지 활용에 있어 문제점을 인식한 교사는 활동지를 놀이로 전환하기 위해 활동지를 구성놀이, 신체활동, 미술활동으로 변화시켰다. 활동지를 놀이로 전환하는 교사의 노력을 통해 교사는 유아의 생각 가치를 깨달으며, 적극적으로 표현되는 유아의 생각을 만났고, 더욱 생각하는 교사로 살아가며 의미 있는 교사 역할을 찾아가고자 하였다. 그리고 놀이와 생각 표현의 장으로서 활동지를 활용하는 것을 구분하여 꼭 필요할 때 유아의 의도가 담긴 표현의 장으로서 활동지를 활용하고자 하였다. 본 연구는 유아들 표현의 장으로 제공되는 활동지를 유아에게 의미를 찾아가고자 한 것으로 유아교실에서 활용하는 활동지에 대한 의미를 되새겨 보도록 하는 데 의미를 시사한다.

국소마취로 시행된 부비동 내시경 수술과 비중격 교정술: 환자 불편감 비교 분석

허성재,김정수,박지혜,박창묵,조인지 대한비과학회 2013 Journal of rhinology Vol.20 No.1

Objectives : The goal of this study is to compare the degree of patient discomfort between endoscopic sinus surgery (ESS) and septoplasty under local anesthesia. Material and Methods : A total 95 patients that underwent ESS and septoplasty under local anesthesia between July 2009 and January 2010 were enrolled in this study. The patients estimated the parameters of their own discomfort (pain, position, noise, anxiety, and memory). The score of each of the parameters ranged from 0 to 4. We compared the scores of the parameters between the ESS and septoplasty groups. Results : Of the 95 patients, 61 (64%) received ESS, 32 (34%) received septoplasty, and 2 (2%) received both. The scores of all the parameters were not greater than moderate in both groups. There were no significantly statistical differences between the two groups. However, the ESS group had lower scores than the septoplasty group in the parameters of pain, position, noise, and memory. No remarkable complications occurred. Conclusion : The patients in this study had modest discomfort and no noticeable complications during the surgeries under local anesthesia. Although no statistical difference existed between the two groups, the ESS group experienced relatively lower discomfort levels during the surgery under local anesthesia compared to the septoplasty group.

골수이식환자의 부비동 방사선 양성소견의 의의

윤성재,신창민,이혜령,허준영,김정수,김태훈,조인지 대한비과학회 2008 Journal of rhinology Vol.15 No.2

Background:Bone marrow transplantation (BMT) is a beneficial and curative technique used in different hematologic conditions or malignant neoplastic diseases. However, bone marrow transplant patients are at a higher risk of developing infections and complications due to previous chemotherapy, radiotherapy, immunosuppression, antibiotics therapy, multiple viral infections, and GVHD (graft-versus-host disease). Objectives:The purpose of this study is to determine the prevalence and clinical data of rhinosinusitis among patients with BMT. We also investigated whether pre-BMT positive radiologic finding could predispose patients to the development of post-BMT rhinosinusitis or not. Materials and Methods:We reviewed the records of 203 patients who had received BMT in Kyungpook National University’s hospital from September 1998 to August 2006. Result:Sixteen patients (7.8%) had radiologic positive finding before BMT. Fifteen patients had no sinonasal symptoms and did not get any treatment. Only one patient had rhinosinusitis so that BMT was delayed and treated with antibiotics. Among these patients, one patient got newly developed rhinosinusitis after BMT. After BMT, sinusitis developed in ten patients (4.9%), including one patient who had invasive fungal sinusitis. Our study revealed a higher incidence of rhinosinusitis among allogenic BMT patients than among autologous BMT patients. The most common symptoms and signs were fever. Only one patient complained of typical sinonasal symptoms. Conclusion:Even though the prevalence of rhinosinusitis is low (4.9%) among post-BMT patients, maintenance of a high index of suspicion among these patients is necessary because sinonasal symptoms and signs are generally minimized after BMT. The study concluded that pre-BMT positive radiologic findings without sinonasal symptoms is unlikely to develop post-BMT rhinosinusitis. Background:Bone marrow transplantation (BMT) is a beneficial and curative technique used in different hematologic conditions or malignant neoplastic diseases. However, bone marrow transplant patients are at a higher risk of developing infections and complications due to previous chemotherapy, radiotherapy, immunosuppression, antibiotics therapy, multiple viral infections, and GVHD (graft-versus-host disease). Objectives:The purpose of this study is to determine the prevalence and clinical data of rhinosinusitis among patients with BMT. We also investigated whether pre-BMT positive radiologic finding could predispose patients to the development of post-BMT rhinosinusitis or not. Materials and Methods:We reviewed the records of 203 patients who had received BMT in Kyungpook National University’s hospital from September 1998 to August 2006. Result:Sixteen patients (7.8%) had radiologic positive finding before BMT. Fifteen patients had no sinonasal symptoms and did not get any treatment. Only one patient had rhinosinusitis so that BMT was delayed and treated with antibiotics. Among these patients, one patient got newly developed rhinosinusitis after BMT. After BMT, sinusitis developed in ten patients (4.9%), including one patient who had invasive fungal sinusitis. Our study revealed a higher incidence of rhinosinusitis among allogenic BMT patients than among autologous BMT patients. The most common symptoms and signs were fever. Only one patient complained of typical sinonasal symptoms. Conclusion:Even though the prevalence of rhinosinusitis is low (4.9%) among post-BMT patients, maintenance of a high index of suspicion among these patients is necessary because sinonasal symptoms and signs are generally minimized after BMT. The study concluded that pre-BMT positive radiologic findings without sinonasal symptoms is unlikely to develop post-BMT rhinosinusitis.