• 대한두경부종양학회지
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• 제24권2호
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• pp.200-202
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• 2008

Schwannoma is a benign soft tissue tumor arising from the schwann cells of the nerve sheath. Although 25 to 45% of schwannomas arise in the head and neck region, larynx is one of the rarest sites of involvement. Recently, we experienced a case of a laryngeal schwannoma causing voice change in a 53-years-old woman. Laryngeal schwannoma is located right false vocal fold with bulging, which was completely removed by microlaryngeal surgical excision. We report a rare case with a review of literature.

• 대한두경부종양학회지
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• 제31권1호
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• pp.22-26
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• 2015

Small cell carcinoma of larynx has been reported as a rare disease occurring in 0.5% of larynx cancer. This tumor is known as one of the most lethal of all malignancies and associated with early recurrence and distant metastasis, leading into death. We experienced a case of a 70-year old male patient, who had admitted for sore throat and dysphagia and diagnosed as small cell carcinoma of larynx. We present small cell carcinoma of larynx with a brief review of literature.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1997년도 제8회 학술대회 심포지움
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• pp.258-258
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• 1997

전체 성대 마비 환자의 약 10%에서 발생하는 것으로 알려진 양측 성대 마비는 안정 혹은 경미한 운동시에도 호흡 장애를 초래하는 경우라면 이에 대한 치료가 요구되는 질환이다. 이에 대한 치료 방법으로는 성문 기도를 넓히면서 흡인이 되지 않고 음성장애를 일으키지 않는데 목적을 두고 피열연골 고정술, 피열연골 절제술, CO2, 레저 피열연골 절제술, 성대 측방 고정술, 후성대 절제술, 점막하 성대 절제술, 근-신경식술 등 다양한 방법이 사용되어져 왔다. (중략)

• International journal of thyroidology
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• 제11권2호
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• pp.130-136
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• 2018

Background and Objectives: Intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) in thyroid surgery has been employed worldwide to identify and preserve the nerve as an adjunct to visual identification. The aims of this study was to evaluate the efficacy of IONM and difficulties in the learning curve. Materials and Methods: We studied 63 patients who underwent thyroidectomy with IONM during last 2 years. The standard IONM procedure was performed using NIM 3.0 or C2 Nerve Monitoring System. Patients were divided into two chronological groups based on the success rate of IONM (33 cases in the early period and 30 cases in the late period), and the outcomes were compared between the two groups. Results: Of 63 patients, 32 underwent total thyroidectomy and 31 thyroid lobectomy. Failure of IONM occurred in 9 cases: 8 cases in the early period and 1 case in the late period. Loss of signal occurred in 8 nerves of 82 nerves at risk. The positive predictive value increased from 16.7% in the early period to 50% in the late period. The mean amplitude of the late period was higher than that of the early period (p<0.001). Conclusion: IONM in thyroid surgery is effective to preserve the RLN and to predict postoperative nerve function. However, failure of IONM and high false positive rate can occur in the learning curve, and the learning curve was about 30 cases based on the results of this study.

• 대한중풍순환신경학회지
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• 제23권1호
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• pp.65-72
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• 2022

■Background Overall prevalence of visual field loss after stroke was estimated at 31%, ranged from 5.5- 57%. Among them, homonymous hemianopia is the most common symptom of post-stroke visual field loss and leads to a decrease in the quality of life and therapeutic effect. However, standard treatment has not been established. ■Case report A 48-year-old male with right side homonymous hemianopia by a left occipital-parietal lobe hemorrhage was treated with Qu-Ji-Du-Huang-Wan, acupuncture and electroacupuncture for 20 days. We used confrontation visual field exam, automated perimetry and visual analog scale for evaluating symptoms. Following treatment, confrontation visual field exam and the subjective discomfort was improved. ■Conclusions The present case report suggests that combined Korean medicine treatment might be an effective treatment of post-stroke homonymous hemianopia. A number of follow up studies should be conducted to clarify the effectiveness of treatment.

• 대한중풍순환신경학회지
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• 제24권1호
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• pp.25-40
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• 2023

Background: Although not clarified, the overall prevalence of visual field loss after stroke was estimated at 52% of stroke survivors and for visual acuity loss, at 70% of them. Among visual field loss patients after stroke, homonymous hemianopia is the most common symptom. Visual defect degrades the quality of life by disrupting independent life and affecting the survival of the patients, but highly-evidenced treatment has not been found until now. ■Case report A 51-year-old female with left-side homonymous hemianopia and central vision loss by a right occipital-temporal hemorrhage was treated with Hyeolbuchukeo-tang, Ikgibohyeol-tang, acupuncture, electroacupuncture, and moxibustion. We used a confrontation visual field exam, automated perimetry and visual analog scale, and visual acuity test to observe changes in the patient's symptoms and evaluate the efficacy of the treatment. After 61 days of such interventions, the patient's subjective discomfort lessened, followed by positive changes in the scales of tests mentioned above. ■Conclusion This case suggests that combined Korean medicine treatment might be an effective tool for treating post-stroke homonymous hemianopia and central vision loss. More studies should be conducted to support the effectiveness of the treatment.

• 대한두경부종양학회지
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• 제22권1호
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• pp.3-7
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• 2006

Purpose: The nonrecurrent laryngeal nerve(NRLN) is a rare anomaly that is associated with the developmentally aberrant subclavian artery. Although rare on the right side and exceptional on the left, an aberrant nonrecurrent pathway for RLN represents a major surgical risk. Three course variations of right NRLN can be distinguished: descending(type I) , horizontal(type II), ascending(type III). This study is performed to characterize the variations of NRLN, associated vascular anomaly, and proper surgical methods for preventing nerve damage. Materials and Methods: Between January 1998 and March 2006 3,381 thyroidectomy were performed at our institution, and during these operations a nonrecurrent laryngeal nerve was observed in 13 cases (0.38%). There were 1 men and 12 women with a median age of 48 years(range 28-57). All of them are identified on the right side. Results: In all cases, there were no clinical symptoms observed preoperatively. The nerve anomaly was diagnosed preoperatively in only one case. There were type I variations of right RLN in 2 cases and type II variations in 11 cases. The retroesophageal aberrant right subcalvian artery; no innominate(brachiocephalic) artery was found and the right common carotic artery was arising directly from the aortic arch, was seen in 12 cases. A vocal cord palaysis caused by NRLN damage during operation was observed in one patient(7.6%) , where the nerve was close to the superior thyroid artery. No other complications were noted. Conclusion: It can be possible to predict NRLN from signs associated with the vascular anomaly; clinical symptoms or imaging studies. When an vascular anomaly is not detected preoperatively, overlooking possibility of NRLN may lead to severe operative morbidity. Hence, It is most important to identify all the thyroid structures carefully during thyroid surgery and to be aware of the possibility of anatomic variations of RLN.

• 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.

• 대한두경부종양학회지
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• 제14권2호
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• pp.236-243
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• 1998

1991년부터 1997년월까지 7년간 한림대학교 이비인후과학교실에서 국소침범한 갑상선암으로 치료를 받은 10명의 환자들을 후향적으로 검토하여 다음과 같은 결과를 얻었다. 1) 성별 분포는 남녀비는 1:2.3이었으며 연령별 분포는 60대 이상이 7명으로 노인에 호발함을 알 수 있었다. 2) 임상승상은 애성이 5례(50%)로 가장 많았으며 무증상이면서 경부종괴로 온 경우가 3례 그외에 연하곤란, 호흡곤란 객혈 등이었다. 3) 침범된 구조는 기관 7례, 반회후두신경과 종격동임파절이 각각 5례, 경부식도 3례, 경동맥 3례, 기관주위임파절 3례, 하인두 1례, 미주신경 1례 순이었다. 4) 침범된 구조물들에 대한 수술로는 기관 수상절제술 및 단단문합술이 1례. 기관 수상절제와 윤상기관성형술 1례, 기관 창절제술 및 일차봉합술 1례. 기관 창절제술 및 흉쇄유돌근-근막피판재건술 1례, 기관 면도식절제술 1례, 식도 부분절제술 2례, 식도 면도식절제술 1례, 편측 윤상후두절제술 1례, 윤상연골 부분절제술 및 흉쇄유돌근-근골막피판재건술 1례, 갑상연골 면도식절제술 1례, 반회후두신경절제술이 2례, 미주신경절제술 1례, 경동맥절제술 및 $Gortex^{\circledR}$를 이용한 재건술 2례, 경동맥 면도식절제술 1례 등이었다. 이상에서 국소침범한 갑상선암은 대부분의 경우 가능한 완전절제를 시도하였으나 광범위 절제 후 재건술의 어려움이 있었으며 또한 대부분이 노인 환자로서 전신상태에 따른 예후가 불량한 경우가 있었다. 따라서 각 환자의 나이와 침범 정도에 따른 개별적인 술식으로 치료방법을 선택하는 것이 중요할 것으로 사료된다.하다고 생각된다. 6) 횡문근육종과 골육종의 경우 3례중 2례에서 광범위한 수술적 제거후 방사선치료를 병행하였으며, 현재 무병생존 중이고, 1례는 화학요법과 방사선치료의 병합요법을 시행하였으나 실패하였다. 육종의 경우 광범위한 수술적 절제가 가장 좋은 치료로 사료되며, 미세잔존암이 남아있는 경우는 방사선 치료의 병합이 필요하리라 생각된다.\beta$4-tyrosine phosphorylation site (Clone M)을 얻었다. 암 세포의 부착 및 침투 능력의 기능적 연구로 모노 클로날 항체와 fibronectin, laminin, Matrigel을 단백질 기질로 사용하였으며 결과 비교를 위하여 pRc/CMV 벡터만 주입시켰던 클로운과 방광암 세포주를 $\beta$4 integrin 음성 대조군으로 또한 이 Integrin의 높은 발현을 보이는 두경부 편평상피암 세포주를 양성 대조군으로 이용하였다. 결과 : 세포부착능력에 있어서 온전한 $\beta$4 cytoplasmic domain이 존재하는 클로운이 laminin에 강한 부착능력을 보였으나 fibronectin의 부착정도는 $\beta$4 integrin의 표현정도와 관계없이 모든 클로운에서 비슷하였다. Matrigel을 투과하는 암세포 침윤 능력에서는 $\beta$4 integrin의 표현이 존재하는 클로운들이 투과 능력이 높았으나 세포외 리간드가 없는 control membrane을 사용하였을 때와 비교하여 투과능력의 차이를 보이지 않았다. 결론 : 유전자 주입(transfection) 방법으로

• 한국어류학회지
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• 제10권2호
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• pp.231-240
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• 1998

납자루아과(亞科)에 속하는 가시납지리(Acanthorhodeus gracilis)의 두골(頭骨), 척주(脊柱), 지느러미 골격을 조사하였다. 두개부(頭蓋部)에 천문이 없으며, 상사골(上篩骨)의 전단에 돌기가 없고, 안와설골(眼窩楔骨)은 2개로 되어 있다. 기저후두골(基底後頭骨) 돌기(突起)는 전반부에서부터 발달하였고, 상후두골(上後頭骨)은 높은 삼각형 형태의 돌기를 갖고 있으며, 미설골(尾舌骨)은 선단(先端)이 2분기(分技)되고 수평판(水平板)과 수직판(垂直板)의 후방(後方)이 넓어지며 후연(後緣)이 돌출되어 있다. 인두치(咽頭齒)는 1열로 인두치식(咽頭齒式)은 5 - 5이며 4개의 유리치(遊離齒)를 갖고 있다. 편대(扁帶)에는 오훼골(烏喙骨) 구멍이 없으며, 미골추체(尾骨推體)에는 미신경골(尾神經骨)이 나타나지 않고, 길고 가느다란 후요대돌기(後腰帶突起)를 갖는다. 유리신경간련(遊離神經間練)은 넓은 판상(板狀)이고, 신경간극(神經間棘)은 14~15개이며 제1~제4신경간극(神經間棘)은 하나의 기기골을 나머지는 두 개의 기기골을 기부(基部)에 갖고 있고, 혈관간극(血管間棘)은 11~12개이며 제1~제 4혈관간극(血管間棘)은 하나의 기기골을 나머지는 두 개의 기기골을 갖고있다.