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김안호(Ahn-Ho Kim),차용우(Yong-Woo Cha) 한국항만경제학회 2005 韓國港灣經濟學會誌 Vol.21 No.2
The trends of efficiency change for 10 years by using Malmquist model show that all periods except 1998/1999, 2001/2002, and 2002/2003 which were decreasing in efficiency exhibit an upward tendency in terms of averaged Malmquist index. The averaged Malmquist efficiency of the ports of Pyeongtaek, Daesan, and Sokcho has rapidly upwarded, and those of the ports of Wando, Samcheonpo, Tongyoung, Woolsan, Pohang, Samcheok, and Okgae were declined to the below 1.0 of efficiency scores. The averaged technical efficiency change has shown the upward trends except the periods of 1996/1997, 2000/2001, 2001/2002, and 2002/2003 which have been declined. However, overall efficiency was decreasing. The seaports which have improved their technical efficiency are the ports of Pyeongtaek, Daesan, and Sokcho, but those of Seoguipo, and Okpo have downed to the level of below 1.0.
한영진 ( Young Jin Han ),이강대 ( Kang Dae Lee ),김성원 ( Sung Won Kim ),김우성 ( Woo Sung Kim ),차용우 ( Yong Woo Cha ),이재훈 ( Jae Hoon Lee ),강대형 ( Dae Hyoung Kang ),박효상 ( Hyo Sang Park ) 대한갑상선학회 2009 International Journal of Thyroidology Vol.2 No.2
Background and Objectives: Iatrogenic injury of recurrent laryngeal nerve (RLN) remains as one of the most serious concerns in thyroid surgery. This study was aimed to analyze the mechanisms and potential risk factors of iatrogenic injury of RLN during thyroid surgery. Materials and Methods: Retrospective study of 7 patients with permanent vocal cord palsy and 15 patients with temporary vocal cord palsy among the 1,010 cases of thyroidectomy performed at our institution by a single surgeon from April 1998 through July 2008 was conducted. Medical records of these patients were reviewed to identify the mechanisms and potential risk factors of iatrogenic injury of RLN. Results: The causes of permanent RLN injury were 3 transections, 3 ligations, 1 unrecognized injury. The causes of temporary RLN injury were 1 transection, 1 forcipressure and 13 unrecognized injuries. Anatomic risk factors were bifurcated RLN (4 cases), thin diameter of the nerve (4 cases) and reoperation (1 case). Tumor factors were malignant (14 cases) and large-sized tumor (5 cases). Surgeon factors were poor surgeon's experience (1 case) and excessive blunt dissection at Berry's ligament (1 case) and incomplete hemostasis (1 case). Conclusion: Risk factors of iatrogenic RLN injury include anatomic, tumor and surgeon factors, the risk may rise when these factors are accompanied with each other. Thorough evaluation of the risk factors and surgical technique considering the factors may be helpful to prevent injury of the RLN.
정상 성대 기능을 가진 갑상선유두암종 환자에서 암 침윤이 있는 반회후두신경 보존의 기능적, 종양학적 결과
김영록 ( Young Rok Kim ),김주연 ( Joo Yeun Kim ),김성원 ( Sung Won Kim ),이봉주 ( Bong Ju Lee ),차용우 ( Yong Woo Cha ),이강대 ( Kang Dae Lee ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.2
Background and Objectives: Complete excision with resection of the recurrent laryngeal nerve (RLN) in differentiated papillary thyroid carcinoma (PTC) with invasion of RLN, reportedly did not improve the survival over incomplete excision. However some investigators have provided definitive oncologic and functional outcomes concerning the preservation of recurrent laryngeal nerve involved in thyroid cancer. Materials and Methods: The RLN involved by locally invasive papillary thyroid carcinoma was preserved in 15 patients with functioning vocal cord, between April 1998 and April 2004. Retrospective study was performed with medical records of 11 patients who were followed-up more than 48 months. All patients were treated by the shaving technique for RLN preservation. Postoperative radioiodine and thyroid stimulating hormone suppression therapy were combined for ablation of microscopic residual PTC. Results: Postoperative survival rate of the patients with RLN preservation was 100%, and local recurrence was not observed. There were 13 nerves showing infiltration by PTC during the operation. Permanent vocal cord paralysis was not observed and transient vocal cord paralysis occurred in 1 nerve (7.7%) of 1 patient. Conclusion: Although the number of patients and follow-up duration of the study may be limited, preservation of RLN infiltrated by PTC maintained the functioning vocal cord without any clinical recurrence.