유소아 기도 이물의 임상 양상과 환기형 기관지 내시경술의 결과 : 서울대 병원의 경험 120례

차원재,최효근,문성중,하정훈,성명훈,김광현,Cha, Won-Jae,Choi, Hyo-Geun,Moon, Sung-Joong,Hah, J.-Hun,Sung, Myung-Whun,Kim, Kwang-Hyun 대한기관식도과학회 2006 大韓氣管食道科學會誌 Vol.12 No.2

Backgroud and Objectives: Inhalation of foreign bodies in respiratory tract can be fatal to infants and child. After ventilating bronchoscopy technique was widelyused, most of the pediatric airway foreign bodies could be managed effectively. In this study, we aimed to analyze clinicalfeatures and outcomes of ventilating bronchoscopic removal of pediatric airway foreign bodies. Materials and Methods: One hundred twenty cases of ventilating bronchoscopy for pediatric airway foreign bodies at Seoul National University Hospital for the past 15 years were analyzed retrospectively. Results: In 120 cases, sex ratio (male: female) was 2.2:1 and mean age was 27.0 months. Most frequent type of airway foreign was peanut (60.2%). One hundred thirteen patients, in whom a foreign body was confirmed in the airway, were successfully managed by ventilating bronchoscopy. Delayed diagnosis and management made a significantly long postoperative hospital stay. Conclusion: Great care must be given when feeding young children, especially younger than 36 months, with nuts. Early intervention with ventilating bronchoscopy following a clinical suspicion is critical to successful treatment.

이차성 부갑상선항진증의 부갑상선절제술 시Methylene Blue 주입술의 유용성

차원재,하정훈,장동엽,정영호,정은정,성명훈,김광현 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.1

Background and Objectives:The localization of parathyroid The purpose of this study was to introduce the intraoperative methylene blue infusion as a localization modality of parathyroid glands and to determine the usefulnes of intraoperative methylene blue infusion for localization of parathyroid glands in secondary hyperparathyroidism. Materials and Method:Seven prospective cases of secondary hyperparathyroidism surgicaly treated from Sep. 2004 to Mar. 2006 were included in this study. In parathyroidectomy, intraoperative methylene blue infusion for localization of parathyroid glands was performed. Results:In six cases of initial operation, four parathyroid glands were well stained and in a case of reoperation, thre parathyroid glands were stained. After the surgery, all patients were well controlled in symptoms and calcium levels in blood serum, and 6 patients reached normal iPTH levels in serum. Conclusion:Intraoperative methylene blue infusion is an efective localization tool in parathyroidectomy for secondary hyperparathyroidism. (Korean J Otolaryngol 2007 ;50 :64-9)

[나의 동화 창작론] 평생, 동화를 잘 쓰고 싶었다 ― 자전적 여담

차원재 아동문학평론사 2019 兒童文學評論 Vol.44 No.4

Post-Processing of High-Speed Video-Laryngoscopic Images to Two-Dimensional Scanning Digital Kymographic Images

차원재,왕수건,장전엽,김근효,이연우,Cha, Wonjae,Wang, Soo-Geun,Jang, Jeon Yeob,Kim, Geun-Hyo,Lee, Yeon-Woo The Korean Society of Laryngology 2017 대한후두음성언어의학회지 Vol.28 No.2

Background and Objectives : High-speed videolaryngoscopy (HSV) is the only technique that captures the true intra-cycle vibratory behavior of the vocal folds by capturing full images of the vocal folds. However, it has problems of no immediate feedback during examination, considerable waiting time for digital kymography (DKG), recording duration limited to a few seconds, and extreme demands for storage space. Herein, we demonstrate a new post-processing method that converts HSV images to two-dimensional digital kymography (2D-DKG) images, which adopts the algorithm of 2D videokymography (2D VKG). Materials and Methods : HSV system was used to capture images of vocal folds. HSV images were post-processed in Kay image-process software (KIPS), and conventional DKG images were retrieved. Custom-made post-processing system was used to convert HSV images to 2D-DKG images. The quantitative parameters of the post-processed 2D-DKG images was validated by comparing these parameters with those of the DKG images. Results : Serial HSV images for all phases of vocal fold vibratory movement are included. The images were converted by the scanning method using U-medical image-process software. Similar to conventional DKG, post-processed 2D DKG image from the HSV image can provide quantitative information on vocal fold mucosa vibration, including the various vibratory phases. Differences in amplitude symmetry index, phase symmetry index, open quotient, and close quotient between 2D-DKG and DKG were analyzed. There were no statistical differences between the quantitative parameters of vocal fold vibratory movement in 2D-DKG and DKG. Conclusion : The post-processing method of converting HSV images to 2D DKG images could provide clinical information and storage economy.

[신작 동화] 똘이와 미미

차원재 아동문학평론사 2019 兒童文學評論 Vol.44 No.4

Clinical Analysis of Acinic Cell Carcinoma in Parotid Gland

차원재,김민수,안재철,조성우,선우웅상,송창면,권택균,성명훈,김광현 대한이비인후과학회 2011 Clinical and Experimental Otorhinolaryngology Vol.4 No.4

Objectives. Acinic cell carcinoma (AciCC) is a rarely encountered malignancy in parotid gland. Because AciCC is rare and was recently recognized as the entity of malignancy, AciCC has been difficult to study. We aimed to analyze the diagnosis and treatment experience for this malignancy in our hospital. Methods. We retrospectively reviewed medical records of the 20 patients with AciCC of parotid gland diagnosed from 1990to 2009. The preoperative computed tomography scan, preoperative fine needle aspiration cytology (FNAC) and intraoperative frozen section results were compared with the final diagnosis. The survival and recurrence were analyzed with the cancer stages and treatment modalities. Results. There were 10 males and 10 females, with a mean age of 44.4 years, ranging 8-77 years. The AJCC tumor stage distributions of the patients were 70%, 15%, and 15% for stages I, II, and IV, respectively. The sensitivity of FNAC and intraoperative frozen section was 26.7% and 50.0% respectively. The 10-year survival rate was 90.9% with a mean follow-up of 111 months, ranging 17-251 months. The 10-year disease free survival rate was 74.2% and the mean duration of recurrence from initial surgery was 92.3 months. Conclusion. AciCC of the parotid gland is a rare malignancy that has features of less aggressive behavior, and good prognosis. Intraoperative frozen section examination may be helpful in the diagnosis of AciCC of the parotid gland because of the low sensitivity of preoperative computed tomography scan and FNAC. Surgery with adjuvant postoperative radiotherapy is satisfactory for disease control.

두경부의 과립세포성 육종 3례의 보고

차원재,박병윤 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.5

Since the relationship between the chloroma and the acute leukemia had been described first by Dock on 1904. Rappaport decided to call the name as the granulocytic sarcoma because it is not always seen greenish, and because is it similar to a sarcoma. Widen field of the plastic and reconstructive surgery made us be interested in the removal and reconstruction of the head and neck tumors. And then patients who has those impression have been visited sometimes, and there has been possibility of confusion with other tumors in the head and neck on diagnosis and of the principle on treatment. In most cases, granulocytic sarcoma develops during the course of acute myelocytic leukemia(AML). Less familiar to the plastic surgern are the clinical findings of granulocytic sarcoma and their contribution towards the early diagnosis and prognosis of this highly aggressive malignant neoplasm. Most leukemias in childhood are of the acute variety which have a survival time of less than 1 year in 95%. Spon taneous temporary clinical remission is seen is about 10% of children and bone marrow remission may occur in 1%. The survival rate in AML is still only approximaterly 25%. Granulocytic sarcomas may cause considerable diagnostic problems if they occur before the clinical manifestations of the AML, because the hematologic status of affected patients in normal, not yet indication imminent or potential dissemination. A lack of lymph node involvement may also complicate the diagnosis.

Real-Time Light-Guided Vocal Fold Injection via the Cricothyroid Membrane in Unilateral Vocal Fold Paralysis: A Human Pilot Study

허진,차원재,Pil Geun Jang,한승훈,Ramla Talib Mohammad,정우진 대한이비인후과학회 2022 Clinical and Experimental Otorhinolaryngology Vol.15 No.3

Objectives. Vocal fold injection (VFI) via the cricothyroid (CT) membrane is used to treat various diseases affecting the vocal folds. The technical challenges of this technique are mainly related to the invisibility of the needle. Real-time light-guided VFI (RL-VFI) was recently developed for injection under simultaneous light guidance in the CT approach. Herein, we present the first clinical trial of RL-VFI, in which we investigated the feasibility and safety of this new technique in unilateral vocal fold paralysis (VFP). Methods. This prospective pilot study enrolled 40 patients, who were treated with RL-VFI for unilateral VFP between September 2020 and August 2021. Adverse events were monitored during the procedure and for 4 weeks postoperatively. The Voice Handicap Index-10, the GRBAS (grade, roughness, breathiness, asthenia, and strain) scale, aerodynamic studies, and acoustic analyses were evaluated to compare the voice improvement after 4 weeks with the baseline values. Results. The needle tip was intuitively identified by the red light. The mean procedure time was 95.6±40.6 seconds for the initial injection, while the additional injection required 79.2±70.5 seconds. The injection was performed under light guidance without additional manipulation after the needle reached the intended point. No acute or delayed adverse events were reported. Among the 40 patients, 36 completed voice analyses after 4 weeks. Subjective and objective voice parameters, including the Voice Handicap Index-10, GRBAS scale, maximum phonation time, mean expiratory airflow, fundamental frequency, jitter, shimmer, and noise-to-harmonics ratio improved significantly after RL-VFI (P<0.05), while the expiratory volume was maintained. Conclusion. RL-VFI is feasible and safe for treating patients with unilateral VFP. This technique is anticipated to improve the precision and safety of the CT approach in the treatment of unilateral VFP. This study provides a rationale for further structured clinical studies.

감염이 동반된 정중구개낭 1예

신현우,차원재,김인경,진홍률 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.11

to the palatine papilla. Its etiology is generally attributed to the enclavement of remnants of epithelium surrounding the two lateral maxillary proceses that fuse to form the hard palate. The median palatine cyst sometimes poses challenges in the diagnosis due to the diversity and complicated clasifications of the cysts originating from the maxilla and palate. We present a case of large median palatine cyst of a 50-year-old man who had purulent rhinorrhea and foul odor for 1 year. An endonasal endoscopic mar-supialization was performed and pus was drained from the cyst. There was no recurence of symptoms and the ostium was wel maintained at 4 months after the operation. We report this case with a brief literature review. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :1058-61)

실시간 광유도 성대주입술의 개발과 임상적 적용

허진,차원재 대한후두음성언어의학회 2022 대한후두음성언어의학회지 Vol.33 No.1

Vocal fold injection (VFI) is widely accepted as a first line treatment in treating unilateral vocal fold paralysis and other vocal fold diseases. Although VFI is advantageous for its minimal invasiveness and efficiency, the invisibility of the needle tip remains an essential handicap in precise localization. Real-time light-guided vocal fold injection (RL-VFI) is a novel technique that was developed under the concept of performing simultaneous injection with precise placement of the needle tip under light guidance. RL-VFI has confirmed its possibility of technical implementation and the feasibility in injecting the needle from various directions through ex vivo animal studies. Further in vivo animal study has approved the safety and feasibility of the procedure when various transcutaneous approaches were applied. Currently, RL-VFI device is authorized for clinical use by the Ministry of Food and Drug Safety in South Korea and is clinically applied to patients with safe and favorable outcome. Several clinical studies are currently under process to approve the safety and the efficiency of RL-VFI. RL-VFI is expected to improve the complication rate and the functional outcome of voice. Furthermore, it will support laryngologists in overcoming the steep learning curve by its intuitive guidance.