스쿠버 다이빙으로 인한 인체의 압력손상

윤석근 ( Seok Keun Yoon ) 영남대학교 기초/임상의학연구소 2007 Yeungnam University Journal of Medicine Vol.24 No.2S

As economical and social status are getting better, many ordinary people are interested in well being and leisure sports, the populations enjoying SCUBA diving are increasing recently. The medical problems from SCUBA diving are also increasing. To provide diving knowledge to the medical Drs. for prevention of barotrauma from SCUBA diving and to provide medical knowledge to SCUBA divers for safer diving, author reviews barotrauma of the human body from SCUBA diving. Review includes diving physics, mechanism, clinical manifestations and prevention of barotrama. Pulmonary barotrauma manifests as pulmonary tissue damage, pneumothorax, mediastinal emphysema with or without arterial gas embolism. Arterial gas embolism is one of the most serious and urgent medical problem from SCUBA diving and it need immediate recompression treatment. Barotrauma in the middle ear is the most common medical problem from SCUBA diving, it manifests as Eustachian tube salpingitis, otitis media with effusion. Inner ear barotrauma may lead permanent sensorineural hearing loss. Barotruma also can be occurred in mask,1)teeth, dry suit, and gastrointestinal tract. Prevention of barotrauma is more important than treatment. Prevention of barotrauma is up to divers, diving instructors and medical Drs. Divers and diving instructors should follow guidelines in diving fitness test, keep physical state always to fit to dive, keep diving skills as sharp and keep physical ability to adjust changeable ocean environment. Medical Drs. are responsible to their decision of medical fitness test, so they should know about diving physic, diving physiology and recent guidelines about medical fitness to dive.

후두 유두종의 악성 변화

윤석근(Seok Keun Yoon),은선진(Sun Jin Eun),남혜주(Hae Ju Nam) 대한두경부종양학회 1990 대한두경부 종양학회지 Vol.6 No.1

It is well known that laryngeal papilloma has a tendency for malignant transformation, but the incidence was variable among many authors. The authors present a case of laryngeal cancer which was considered to be transformed from laryngeal papilloma after six years follow up, with serial pathological review of the specimen. Incidence of malignant transformation in our hospital is 2.5% of total laryngeal papilloma and it is the only case among 57 laryngeal cancer for 6 years duration. It must be stressed that long term follow up is recommanded in adult type laryngeal papilloma.

후두암에 동반펀 SIADH

윤석근(Seok Keun Yoon),최병흔(Byung Heun Choi),박헌웅(Hun Woong Park) 대한두경부종양학회 1987 대한두경부 종양학회지 Vol.3 No.1

The syndrome of inappropriate ADH secretion (SIADH) is a clinical disorder in which there is continual release of antidiuretic hormone (ADH) unrelated to plasma osmolality. ltmay occur usually in association with malignant tumors below the clavicle and other pulmonary disorders which are capable of synthesizing, storing and releasing ADH into the circulation but rarely with the head and neck tumors yet. We experienced a patient with unexplained hyponatremia associated with laryngeal carcinoma. The clinical and laboratory diagnostic studies suggested that patient's sodium deficiercy was secondary to the SIADH. Subsequent resection of the neoplasm, total laryngectomy led to resolution of hyponatremia, suggesting that a tumor associated humoral factor, such as vasopressin or vasopressin like substance, was responsible for the electrolyte disturbance.

경부종물의 진단

최병훈,송계원,윤석근 영남대학교 의과대학 1986 Yeungnam University Journal of Medicine Vol.3 No.1

. As public awareness of the various warning signs of malignancy increases, so does the concern evoked by the self identified finding of mass in the head and neck area. Not all the palpable masses are always significantly abnormal, but any nontender mass especially to the adult is significant enough to warrent further full investigation and follow up, the object of which should be to derermine the possibility of malignancy and urgency of treatment. Approach to the diagnosis of the neck mass is so important in that it affects decision regarding further evaluation would lead to the determination of the most efficacious mode of therapy, eventually to the good prognosis. So, it should be emphasized that approach to the diagnosis of neck mass should be planned, systematic and thorough, this begins with the taking careful history following prtformance of comprete examination of the head and neck especially to the nasopharynx,tongue base, pyriform sinus,palathne tonsil and larynx. Then a number of laboratory and radiologic studies are available,following triple endoscopy under general anesthsia and blind biopsy if needed. The most important rule to keep is that any biopsy procedures should be delayed to the last modality of effort to the diagnosis and if it should be done, under the plan of radical neck dissection.

자가면역성 갑상선질환에서의 혈청 thyroglobulin치의 동태

윤석근,이재태,이규보 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3

1991년 3월부터 1992년 2월까지 경북대학교병원 핵의학과에서 진료한 갑상선질환중에서 그레이브스병 234예와 하시모도갑상선염 45예를 대상으로 혈청 thyroglobulin치를 immunoradiometric assay법으로 측정하고 동시에 시행한 갑상서기능검사 소견과 더불어 antithyroglobulin antibodies, antimicrosomal antibodies, thyrotropin-binding inhibiting immunoglobulin 스캔상에서의 선종 크기 등을 비교 검토하였던 바 다음과 같은 결과를 얻었다. 혈청 thyroglobulin치는 그레이브스병에서 평균 149.65±17.55ng/㎖(M±SE), 하시모도갑상선염에서는 평균 51.09±0.08ng/㎖(M±SE), 정상대조군에서는 평균 8.25±1.36ng/㎖(M±SE) 였다. 그레이브스병에서 혈청 thyroglobulin치는 갑상선기능항진증의 정도를 반영하는 갑상선 동위원소 옥소의 섭취율과 혈청 T_3 그리고 선종의 크기와 유의한 상관성이 있었다. 그레이브스환자 중에서도 antithyroglobulin antibodies가 음성인 군에서는 그 상관관계의 유의성이 더욱 높았으며 혈청 T4와 TF4와도 상관성의 유의성이 인정되었다. 하시모도갑상선염에서는 혈청 thyroglobulin치가 갑상선기능검사의 결과치와 상관성이 없었다. 3년이상 장기간 치료한 그레이브스병에서는 초진예에 비하여 혈청 thyroglobulin치가 기능항진소견들과 정의 상관성이 있었으며, 자가면역항체들의 출현빈도가 높았다. 이상의 결과로 보아 그레이브스병에서 혈청 thyroglobulin치의 상승빈도는 정상인에 비하여 높았으며 그 농도는 갑상선기능항진증의 정도를 반영하는 소견이 된다. 항 thyroglobulin항체가 음성인 갑상선기능항진증 환자에서 혈청 thyroglobulin치의 농도는 기능항진증의 정도를 반영하면서 항갑상선제의 치료효과의 난치도와 갑상선자극상태가 크다는 것을 시사한다. 항 thyroglobulin항체가 양성인 갑상선기능항진증 환자에서 혈청 thyroglobulin치의 농도는 비록 그 농도가 높지는 않더라도 치료효과의 난치도와 갑상선자극 상태가 크다는 것을 나타낸다. The thyroid prohormone thyroglobulin is a large soluble glycoprotein with a molecular weight of 660,000 daltons and a sedimentation coefficient of 19S. Thyroglobulin contains thyroxin rich iodopeptides of small molecular size(15,000 to 30,000). Thyroglobulin is released from the thyroid under physiologic as well as pathologic conditions. Serum thyroglobulin may show in creased levels in hyperthyroidism, thyroiditis, nontoxic goiter and thyroid carcinoma. Some investigators have reported the usefulness of serum thyroglobulin as a predictor of the long-term outcome of therapy after cessation of antithyroid drugs. Measurement of throglobulin and thyroid-stimulating immunoglobulin may become the ideal clinical index of the effect of antithyroid drugs in Graves' disease on the immunological basis. The author investigated serum thyroglobulin levels in patients with Graves' disease of 234 cases and Hashimoto's thyroiditis of 95 cases. Serum thyroglobulin were 149.65±17.55ng/㎖(M±SE) in Graves' diease, 51.09±13.66ng/㎖(M±SE) in Hashimoto's thyroiditis and 8.25±1.36ng/㎖ in normal controls. In Graves's disease, serum thyroglobulin levels were well correlated with radioactive iodine (Ⅰ-131) thyroid uptake, serum T3 and goiter grades. Furthermore, the positive correlation between serum thyroglobulin levels and the parameters of hyperthyroidism became to be more escalated in the cases with a negative antithroglobulin antibody. In Hashmoto's thyroiditis, serum levels of thyroglobulin had no significant correlations with thyroid function parameters, autoantibodies or goiter grades. Therefore, serum thyroglobulin levels can be a useful mean of assessing the degree of thyroidal stimulation and correlated well with thyroidal stimulation especially in patients with a negative antithyroglobulin antibody.

Plummer-Vinson Syndrome 2례 : Report of Two Cases

윤석근,서장수,최병흔,한태희,이형철 대한이비인후과학회 1986 대한이비인후과학회지 두경부외과학 Vol.29 No.6

嗅神經芽細胞腫 一例

尹錫根 최신의학사 1984 最新醫學 Vol.27 No.4

Cu 촉매하에서 유기주석 화합물과 고분자에 결합된 Iodide의 Cross-Coupling 반응에 관한 연구

강석구,임권호,김재선,윤석근,윤승수 성균관대학교 기초과학연구소 1996 論文集 Vol.47 No.2

The copper iodide-catalyzed cross-coupling of polymer bound aryl iodide with organostannanesin N-methyl-2-pyrrolidone (NMP) was accomplishied smoothly in the presence of NaCl.

비중격 만곡증 및 만성 비후성 비염 환자에서 비중격 성형술과 하비갑개 수술의 치료효과

김용대,서보수,조길성,송시연,윤석근,송계원 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.2

Septoplasty with turbinate surgery is common surgical treatment In patients with septal deviation and chronic hypertrophic rhinitis. The aim of this study was to evaluation objective outcomes of septoplasty with turbinate surgery by analysis of subjective symptom score with objective acoustic rhinometric test before and after surgery, prospectively. Materials and Methods: We reviewed 45 adult patients which were done septoplasty with bilateral turbinectomy or turbinoplasty and followed up at least 3 months by one rhinologist from November 1999 to April 2000, prospectively. We analyzed subjective symptom score. minimal cross-sectional area (MCA) , C-notch cross-sectional area, and total volume of both nasal cavity before and after surgery. Correlation test was studied between symptom improvement and acoustic rhinometric results. Results: Twenty nine cases were male and sixteen cases female. The average age was 26.9 year-old (range: 17 to 57 years). There was significantly improvement of symptom score in postoperative 3 months (p<0.05). There was significantly increased C-notch cross-sectional area and total volume in postoperative 3 months. Symptoms improvement were associated with acoustic rhinometric profiles, but, there was not significantly correlation. Conclusion: Septoplasty with turbinate surgery is considered to be effective for nasal obstruction in patients with septal deviation and turbinate hypertrophy. Acoustic rhinometric test is favorable objective test for evaluation of symptom improvement after septal surgery.

성인 만성 부비동염에서 내시경적 부비동 수술 전·후의 증상 호전도와 음향비강통기도 검사 결과

김용대,김재열,장근영,이형중,송시연,윤석근 영남대학교 의과대학 2002 Yeungnam University Journal of Medicine Vol.19 No.1

Background: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paransal sinusitis with or without polyp. Materials and Methods: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. Results: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. Conclusion: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.