• 제목/요약/키워드: 갑상선 수술

검색결과 194건 처리시간 0.025초

전이성 폐암으로 추정된 폐효모균증 (Pulmonary Cryptococcosis That Was Suspected to be Metastatic Lung Cancer)

  • 김종인;조성래;계여곤
    • Journal of Chest Surgery
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    • 제42권1호
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    • pp.123-126
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    • 2009
  • 효모균증은 비둘기의 배설물에 의해 오염된 먼지나 토양에 주로 존재하는 cryptococcus neoformans에 의한 아급성 또는 만성 감염이다. 폐의 효모균증은 건강한 사람에게는 잘 발생하지 않으며 면역이 저하된 환자 특히 후천성 면역결핍증 환자에게서 호발 한다. 일반적으로 증상이 없이 단순 흉부 X-선 검사에서 고립성 또는 다발성 폐 결절이 관찰되며, 이런 경우에는 대부분 절제된 조직의 병리학적 소견으로 진단된다. 본 증례는 갑상선 암으로 수술 받은 32세 여자환자에서 추적관찰 중에 발견된 좌하엽폐의 종괴가 전이성 폐암으로 추정되어 좌하엽폐 절제술을 시행한 후 폐 효모균증으로 확인되었다.

갑상선 수술범위에 따른 음성의 음향적 분석 (Acoustic Analysis of Voice Change According to Extent of Thyroidectomy)

  • 강영애;구본석
    • 말소리와 음성과학
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    • 제7권4호
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    • pp.77-83
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    • 2015
  • Voice complication without the laryngeal nerve injury can occur after thyroidectomy. The purpose of this study is to investigate voice changes according to extent of thyroidectomy with acoustic analysis. Thirty-five female patients with papillary thyroid carcinoma took voice evaluation at before and 1 month, and 3 months after thyroidectomy. Acoustic analysis parameters were speaking fundamental frequency(SFF), min $F_0$, max $F_0$, dynamic range $F_0$, jitter, shimmer, noise-to-harmonic ratio(NHR), and Cepstral prominence peak(CPP). Repeated-measured analysis of variance was applied. Time-related voice changes showed significant differences in all parameters except NHR. At 1 month after surgery, voice quality was worse and pitch was decreasing, but voice quality and pitch were improving at 3-month follow-up. Voice changes according to the extent of surgery were in SFF, max $F_0$, and dynamic range $F_0$. Time by surgery-related voice change existed only in min $F_0$. The result showed that the severity of voice complication depended on the extend of thyroidectomy which had a negative impact on $F_0$-related parameters. The deterioration of voice quality at 1 month after thyroidectomy may be affected by the loss of thyroid hormone in the blood. The descent of $F_0$-related parameters may be impacted by laryngeal fixation of surgical site adhesion.

갑상선 수술중 반회 후두 신경의 해부학적 고찰 (Anatomical Considerations of the Recurrent Laryngeal Nerve During Thyroidectomy)

  • 서광욱;박정수
    • 대한두경부종양학회지
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    • 제9권2호
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    • pp.183-192
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    • 1993
  • This study reports a prospective analysis of anatomical variations of recurrent laryngeal nerves during 300 thyroidectomies. During thyroidectomies for variable thyroid diseases. the course of recurrent laryngeal nerve was completely isolated from root of neck to the inferior comus of thyroid cartilage. In left side, nerve(53.7%) predominantly ran posterior to the inferior thyroidal artery(p<0.05) but in right side there was no predominant pattern. There were three nonrecurrent laryngeal nerves in the right side. About half of the cases in both sides(51.2% in right, 50.5% in left side) had one or more branches before terminating at cricothyroidal muscles. The average length of branches from inferior comus of thyroid cartilage to the origination of individual branch were l2.0mm in right side and 13.3mm in left side. In right side, majority(50.7%) of nerves ran though paratracheal space but difference did not reach the statistical but in left side, majority(88.3%) ran through tracheoesophageal groove and it was the dominant pattern(p<0.01), the overall status of passages of the nerve were relatively straight in left side(straight 87.8%, oblique 52.1%).

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갑상선 수술 중 반회후두신경의 손상 기전에 따른 신경 감시술의 효용성 (Effectiveness of Intraoperative Neuromonitoring According to the Mechanism of Recurrent Laryngeal Nerve Injury During Thyroid Surgery)

  • 신성찬;이병주
    • 대한두경부종양학회지
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    • 제36권1호
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    • pp.9-14
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    • 2020
  • Visual identification of recurrent laryngeal nerve (RLN) is considered as a gold standard of RLN preservation during thyroid surgery. Intraoperative neuromonitoring (IONM) is classified into the intermittent type and continuous type and helps surgeons identify the functional integrity of RLN and predict the postoperative vocal cord function. RLN injury during thyroid surgery is associated with tumor factors and surgeon factors. Tumor factors mean such as direct tumor invasion, adhesion of RLN to the tumor, and compression by a large thyroid tumor. Surgeon factors include nerve transection, stretching, thermal injury, and ligation injury. A recent meta-analysis reported that the IONM could reduce the RLN injury. Considering various nerve injury mechanism, we suggest that using both I-ONM and C-IONM together is more effective method in preventing nerve damage than using I-IONM alone.

유두상(乳頭像) 갑상선암(甲狀腺癌)에서 VEGF, HIF-$1{\alpha}$, E-cadherin, p53의 발현(發現)과 병기(病期)의 관련성(關聯性) 연구(硏究) (Relationship between the Expression of VEGF, HIF-$1{\alpha}$, E-cadherin, p53 and Stage in Papillary Thyroid Carcinoma)

  • 김종삼;나백주;이무식;김철웅;정계림
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2009년도 춘계학술발표논문집
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    • pp.335-338
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    • 2009
  • 본 연구에서는 HIF-$1{\alpha}$의 과발현은 VEGF의 발현과 유의한 상관 관계가 있음을 보여 주었다. 그리고, HIF-$1{\alpha}$의 과발현과 E-cadherin의 발현 사이에도 연관성은 있었지만 통계적인 유의성은 없었다. 종양의 병기와 VEGF, HIF-$1{\alpha}$, E-cadherin, p53의 상관성을 살펴본 결과 E-cadherin에서만 유의성이 관찰되었다. 갑상샘 유두암종에서 HIF-$1{\alpha}$의 발현이 종양의 증식과 관련된 단백, 특히 맥관형성과 관련된 단백인 VEGF의 발현, p53의 축적 및 E-cadherin의 발현소실과의 관계, 그리고 병리학적 표지자와의 관련성을 조사하고, 갑상샘 유두암종 환자의 수술후 예후와의 관계를 알고자 하였다.

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갑상선 수술 후 성대마비 환자의 기식 음성에 대한 공기역학적 및 음향적 분석 (An Aerodynamic and Acoustic Analysis of the Breathy Voice of Thyroidectomy Patients)

  • 강영애;윤규철;김재옥
    • 말소리와 음성과학
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    • 제4권2호
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    • pp.95-104
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    • 2012
  • Thyroidectomy patients may have vocal paralysis or paresis, resulting in a breathy voice. The aim of this study was to investigate the aerodynamic and acoustic characteristics of a breathy voice in thyroidectomy patients. Thirty-five subjects who have vocal paralysis after thyroidectomy participated in this study. According to perceptual judgements by three speech pathologists and one phonetic scholar, subjects were divided into two groups: breathy voice group (n = 21) and non-breathy voice group (n = 14). Aerodynamic analysis was conducted by three tasks (Voicing Efficiency, Maximum Sustained Phonation, Vital Capacity) and acoustic analysis was measured during Maximum Sustained Phonation task. The breathy voice group had significantly higher subglottal pressure and more pathological voice characteristics than the non breathy voice group. Showing 94.1% classification accuracy in result logistic regression of aerodynamic analysis, the predictor parameters for breathiness were maximum sound pressure level, sound pressure level range, phonation time of Maximum Sustained Phonation task and Pitch range, peak air pressure, and mean peak air pressure of Voicing Efficiency task. Classification accuracy of acoustic logistic regression was 88.6%, and five frequency perturbation parameters were shown as predictors. Vocal paralysis creates air turbulence at the glottis. It fluctuates frequency-related parameters and increases aspiration in high frequency areas. These changes determine perceptual breathiness.

새열낭종을 동반한 구순열 환아의 증례보고 (A Patient with Cleft Lip Combined with Branchial Cleft Cyst : A Rare Case Report)

  • 권명희;임대호;고승오;신효근
    • 대한구순구개열학회지
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    • 제13권1호
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    • pp.29-34
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    • 2010
  • 구순구개열은 두경부에서 가장 흔히 발생하는 선천적 기형 중 하나로 554명 중 1명의 빈도로 나타나며 인종에 따라 다양하다. 구순구개열 환아들은 다른 선천적 기형을 동반하여 나타나는 경우가 흔하며, 그 빈도는 문헌에 따라 다르지만 1.5~63.4%로 나타난다. 새열낭종은 두번째 인두강의 폐쇄부전으로 나타나는 선천적 결손으로, 주로 흉쇄유돌근 전방에 나타난다. 구순구개열 환자에 있어 새열낭종을 동반하는 경우는 매우 드물다. 전북대학교 구강악안면외과학 교실에서는 새열낭종을 동반한 구순열 환아 1례를 경험하였다. 환아는 우측 불완전 편측성 구순열로 내원하여, 구순성형술과 함께 우측 목에 존재하던 새열낭종에 대한 제거 수술을 시행하였다. 환아는 출생 당시부터 심실중격결손 및 동맥관개존증 등의 선천적 심장질환 및 갑상선 기능저하증을 가지고 있던 환아로 다양한 선천적인 결손을 동반한 본 환아의 증례를 문헌고찰과 함께 보고하는 바이다.

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백색광 간섭계를 이용한 안구돌출값 측정 (Exophthalmometric values using White-light Scanning Interferometer)

  • 장중수;김영길
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2017년도 춘계학술대회
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    • pp.175-178
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    • 2017
  • 안와 내에서 안구의 상대적 위치는 여러 병적인 상태를 짐작할 수 있는 하나의 기준이 될 수 있다. 특히 안와골절, 갑상선 안질환, 안와 종양 등의 진단과 이에 약물 및 수술적 치료의 결과를 판단하는데 유용하다. 현재 안구 돌출값을 측정하기 위해 주로 사용되는 대표적 측정 기기인 Hertel 안구돌출계와 Naugle 안구돌출계 등은 측정자에 의한 오차가 필연적이다. 본 논문에서는 안구 돌출값의 측정을 3차원 영상 측정기술인 백색광 간섭계를 이용하여 검사 정밀도 및 반복정도를 크게 올릴 수 있는 자동화 측정 방법에 대한 연구를 제안하고자 한다.

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분화된 갑상선암 수술후 T1-201 및 I-131 전신신티그라피 소견 (T1-201 and I-131 Whole Body Scintigraphy in Postoperative Well-differentiated Thyroid Cancer)

  • 현인영;차중직;이진오;강태웅;임상무;홍성운
    • 대한핵의학회지
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    • 제24권1호
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    • pp.87-92
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    • 1990
  • T1-201 and I-131 scintigraphy were performed to visualize malignant lesions postoperatively in 26 patients with well-differentiated thyroid cancer. Anyone of uptake index and retention index was higher in malignant lesions than that in benign lesions. T1-201 scintigraphy showed uptake ininflammatory tissues. T1-201 concentration was observed in fourteen patients and six of them had malignant lesions, while I-131 concentration was observed in six patients and all had malignant lesions. In sensitivity, combination of T1-201 and I-131 scintigraphy is higher than I-131 or T1-201 scintigraphy only. In postoperative patients with well-differentiated thyroid cancer, it may be useful that T1-201 scintigraphy will be performed simultaneously with I-131 scintigraphy for detecting recurrence.

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갑상선 수술 후 음성 변화에 대한 비대면 음성언어치료 증례 (A Case of Voice Therapy for Patient Who Voice Changed after Total Thyroidectomy Using Contactless Voice and Speech Therapy Service Platform)

  • 이길준;박수나
    • 대한후두음성언어의학회지
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    • 제32권1호
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    • pp.43-47
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    • 2021
  • Voice therapy is effective in many voice and speech disorders. However, patients have low accessibility to therapeutic facilities due to disease-unrelated reasons such as lack of time and pandemic of COVID-19. Contactless voice therapy could be an alternative and may helpful to all patients with voice and speech problems. We developed contactless voice and speech therapy program on the necessity of improving accessibility. Herein, we report the first case of voice therapy to 30 year-old female patient who complained voice change after total thyroidectomy using contactless voice and speech therapy service platform in Korea.