• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1987년도 제21차 학술대회 연제순서 및 초록
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• pp.20.1-20
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• 1987

후두 유두종은 후두에서 발생하는 가장 흔한 양성종양이나 임상적으로는 이비인후과영역에서 치유하기 어려운 질환중 하나이다. 1817년 Cheesmann이 성대에서 발생한 유두종을 처음 보고한 이래 많은 보고가 있었으나 아직도 결정적인 치료법이 없는 실정이다. 연자는 수술적 제거후 재발을 방지할 목적으로 Interferon을 술후 7일간은 300,000IU을 매일 피하주사하고 이후는 주 3회에 걸쳐 주사하였으며 동시에 5-FU l00mg을 주 5회 국소분무요법으로 3개월간 병합 실시하여 치료후 평균 3개월 이상 관찰 결과 대상환자 10명중 6명에서는 전혀 재발이 없었고 2명은 현저한 감소, 2명은 재발의 양상을 나타내었다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.89-89
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• 1993

후두의 상피세포에서 발생하는 질환중 전암성병변은 이형성(dysplasia)과 상피내암(carcinoma in situ)등이 있으며, 이들은 진행하게되면 침윤성 악성병변으로 전환하게 된다. 따라서 전암성 병변의 정도를 정확히 구분 및 파악함으로써 침윤성 암종으로의 전환여부를 미리 예견한다는 것은 악성 후두질환의 병태파악 및 예방에 중요한 역할을 차지한다. 이에 저자들은 최근 후두경하에 절제생검을 시행한 26례(침윤성 편평상피세포암 14례, 상피증식증 5례, 성대결절 7례)를 대상으로, 22례에서는 생검조직을 touch imprint법으로 도말하여 Feulgen염색한 후 CAS 200 화상분석기로 DNA함량분석을 시행하였고, 전례에 대하여 파라핀 포매조직에서 Ki-67 단크론성 항체(M1B1)를 이용하여 면역효소염색을 시행한 후 화상분석기로 양성표현율을 측정분석하여 다음과 같은 결과를 얻었다. 1) Ki-67 양성표현율은 침윤성 암종에서 31.65$\pm$11.59%, 상피증식증에서는 20.14$\pm$3.38%, 성대결절에서는 11.66$\pm$3.02%이었다. 2) 핵산지수(DNA index)는 침윤성 암종의 경우 비배수성이 10례 중 7례(70%), 상피증식증에서는 5례중 2례(40%), 성대결절에서는 7례 모두 이배수성을 보였다. 3) DNA함량분석에서 5기와 G2/M기를 합한 증식지수(PI)는 침윤성 암종에서 23.42$\pm$11.33%, 상피증식증에서는 13.09$\pm$10.90%, 성대결절에서는 4.50$\pm$1.19%로 침윤성 암종에서 가장 높았다. 이상의 성적에서 성대의 생검조직과 같은 미세조직으로부터도 DNA함량검사와 함께 Ki-67 양성표현율을 측정함으로써 전암성병변의 악성화 가능성 정도를 예견할 수 있었으며, 악성종양 환자의 예후판정에 도움을 얻을 수 있으리라 생각된다.

• 한국음향학회:학술대회논문집
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• 한국음향학회 1998년도 학술발표대회 논문집 제17권 2호
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• pp.399-402
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• 1998

본 논문에서는 환자의 음성을 정상, 양성종양, 악성종양으로 분류하는 실험을 켑스트럼 파라미터를 통한 음원분리와 신경회로망을 이용하여 수행하고 그 결과를 보고한다. 기존의 장애음성 데이터베이스에는 정상음성과 양성종양의 경우만 수록되어 있었고 외국의 환자들을 대상으로 한 경우만 있었기 때문에 국내의 환자들에게 직접 적용할 경우 어떠한 결과가 나올지 예측하기가 어려웠다. 최근 부산대학교 이비인후과팀에서 수집한 국내의 정상, 양성, 악성종양의 경우에 대한 데이터베이스를 분석하고 신경회로망에 의해 분류함으로써 사람의 음성신호만에 의한 후두질환이 식별이 가능하였다. 본 실험에서는 식별 파라미터로 음성신호의 선형예측오차신호에 관한 켑스트럼으로부터 음원비인 HNRR을 구하여 Jitter, Shimmer와 함께 사용하였다. 신경회로망은 입, 출력 층과 한 개의 은닉층을 갖는 다층신경망을 이용하였으며, 식별은 두단계로 나누어 정상과 비정상을 분류한 후 다시 비정상을 양성과 악성으로 분류하였다[1].

• 대한후두음성언어의학회지
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• 제13권1호
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• pp.5-17
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• 2002

Objectives : Videostrobokymography(VSK) has been recently developed and reported by Sung et at. We aimed to analyze vibratory patterns and objective parameters in various benign vocal fold lesions using VSK, and examine the efficacy of VSK in clinical application. Materials and Methods : Using VSK, we analyzed the vibration pattern of normal vocal fold and various benign lesions, such as nodules, polyps, cysts, Reinke's edema and unilateral vocal fold paralysis. We also calculated objective parameters, open quotient and asymmetric index, and compared them with mean values of parameters in normal controls. Results : In nodules, polyps, and cysts, the open quotient on the site of the lesion was similar to the mean value in normal controls, however, on the other part of the vocal folds it was much larger than normal mean value. In Reinke's edema, irregular and asymmetric vibration was observed. The posterior portion of the vocal folds showed larger open quotients than the anterior portion. In the unilateral vocal fold paralysis, irregular vocal folds vibration and incomplete closure of the vocal folds were documented. Much larger asymmetric indices were calculated in the unilateral vocal fold paralysis than in normal controls and other lesions. The asymmetric index could be a good quantitative parameter of vibration from a patient with vocal fold paralysis. Conclusion : This study demonstrated that VSK could generate clear quantitative documentations of fine vibrations of vocal folds in many different benign lesions. VSK has a potential as an effective tool for quantitative analysis of vibratory patterns of the vocal folds iii clinical settings.

• 대한후두음성언어의학회지
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• 제12권1호
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• pp.22-27
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• 2001

Backgrounds and Objectives : There have been reported many studies which evaluate the effectiveness of combined laryngomicrosurgery(LMS) and voice therapy for the patients with benign vocal cord lesions. But the difference of voice improvement by onset time of voice therapy has not been reported. The purpose of this study is to analyze the differences of voice improvement by voice analysis test between the two groups with different onset time of voice therapy. Materials and Methods : Two groups, each of which comprises 15 patients, were analyzed. For the one group, the voice therapy was initiated 1 day after LMS. For the other, the therapy was initiated 1 week after LMS. Voice analytic parameters of the two groups were statistically analized to identify difference in voice improvement. Results : All measured parameters improved after voice therapy in two groups and showed no significant difference between two groups. Conclusions : The onset time of voice therapy after LMS has no significant impact on post-operative voice quality in the patients with benign vocal cord lesions. Early onset of post-operative voice therapy may serve as treatment modality for patients with benign vocal cord lesions.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1978년도 제12차 학술대회연제 순서 및 초록
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• pp.5.2-6
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• 1978

후두질환은 조기진단 및 치료에 의하여 그 예후가 크게 좌우되며 확진을 위하여는 조직생검이 필수적이다. 저자들은 후두질환의 조기진단에 도움이 되고자 1973년부터 1975년까지 3년간 서울의대부속병원 이비인후과외래에서 간접후두경, 또는 후두직달경하에 후두조직생검을 시행한 142례에 대하여 임상통계적 분석고찰을 시행하였으며, 결과는 다음과 같다. 1. 조직생검례는 총 124례이었으며, 남자 109례(76.8%), 여자 33례(23.2%)이었다. 남여비는 3.3 : 1이었다. 2. 연령별로는 50대, 60대가 각각 41례(28.8%)로 가장 많았으며, 40대(19.7%), 30대(11.2%)의 순이였다. 50대, 60대의 남여비는 각각 7 : 1, 6 : 1이었다. 3. 주소는 사성이 127례(89.4%)로 가장 많았으며, 연하곤란이 7례(4.9%)였고 기타 인후통, 호흡곤란 등이었다. 사성의 발생부터 내원까지의 기간은 평균 8.1개월이었으며 2∼6개월이 56례(44.0%)로 가장 많았고 6개월∼2년이 34례(24%), 2개월 이내가 17례(13.4%)였다. 3연이상은 15례(11.8%)였다. 4. 조직생검부위는 진성대가 76례(53.5%)였으며 가성대가 23례(16.2%), 후두개가 19례(13.3%)였고, 그 외에 발열연골부, 전연합, 성문하역의 순이었다. 5. 조직생검결과는 악성종양이 69례(48.6%), 후두결절 20례(14.0%), 후두유두종 15례(10.5%), 후두결핵 12례(8.4%)였으며, 기타의 양성종양이 15례(10.6%), 비특리성염증이 7례(5.0%)의 순이였다. 6. 악성종양을 의심하였으나 비특리성염증이나 후두결핵등으로 판명된 경우가 13.4%였다.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.47-53
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• 2008

Background and Objectives : Benign neoplasms of the larynx are rare, and papillomas account for approximately 90% of these neoplasms. Other benign neoplasms of the larynx are very rare and form a hetergenous group. We present clinical manifestations of unusual benign neoplasms based on our experiences and review of literatures. Materials and Method : We reviewed retrospectively the clinical records of 14 patients with benign neoplasms of the larynx, excluding papillomas, that were examined in our department during 11-year period from 1995 to 2006. Results : The presenting symptom was most commonly progressive dysphonia. Pathologic diagnosis revealed 5 cases of hemangioma, 3 granular cell tumor, 2 amyloidosis, 2 laryngocele, 1 schwannoma, 1 chondroma. Subsites of the neoplasms were 5 in true vocal cord, 3 in arytenoids, 2 in false vocal cord, 2 in supraglottis, and others were subglottis ; aryepiglottic fold. Treatment was surgical, by a external approach in 1 case of chondroma, and by laryngoscopic approach in other cases. In laryngoscopic approach, carbon dioxide laser was used in 10 cases. Postoperative course was satisfactory. Recurrence was encountered in I case of amyloidosis and revision operation was done 3 times. No recurrence was encountered in other cases. Conclusion : Uncommon benign neoplasms of the larynx require high index of suspicion and histological confirmation. Complete excision with an attempt to maintain normal structures generally results in cure.

• 대한후두음성언어의학회지
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• 제20권2호
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• pp.131-135
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• 2009

Background and Objectives: Benign vocal fold lesions have shown various voice onset types on phonation, however, they have not been documented yet. We studied to know the relationships between benign vocal fold lesions and voice onset types. Materials and Method: 114 subjects were evaluated by using videokymographic examinations. The subjects were classified into three types: normal, contact, and open types according to the patterns of voice onset types on phonation. Benign vocal fold lesions were investigated and voice onset types were compared between normal and disease groups. Voice parameters were obtained from and compared in all subjects to assess acoustic and aerodynamic factors. Results: The normal type among onset types were more than contact type or open type in both normal and disease groups. Disease group showed many contact and open types when. compared with normal group. Vocal nodule and vocal polyp were showed many normal and contact types, however, sulcus vocalis was almost showed open type among voice onset groups. The values of mean flow rate (MFR) of contact type were significantly higher compared to normal type in disease group (p<0.05). Shimmer of contact type was higher than normal type in diseasegroup, but the difference was not significant (p=0.057). Conclusion: Benign vocal fold lesions were related to the various types of voice onset. The various types of voice onset should be considered when benign vocal fold lesions were examined.

• 대한후두음성언어의학회지
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• 제24권1호
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• pp.47-50
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• 2013

Background and Objectives:The purpose of this study is to find features in acoustics and to learn useful features of parameters in order to distinguish laryngeal diseases through many acoustic variables. Materials and Methods:The subjects of this study were 125-male patients who had been diagnosed with vocal nodule, vocal polyp, vocal cyst, Reinke's edema, leukoplakia. To research the features of each disease in acoustics, they are measured 34 parameters by using MDVP. Results:It is clear that in order to see a meaning result when distinguishing laryngeal diseases, $F_0$, $MF_0$, $T_0$, Fhi, Flo, PER variables are significant (p<.05). It means that variables related to fundamental frequency are important to anticipate which group will be diagnosed with Reinke's edema and leukoplakia. vAm had an effect on getting a significant result in terms of amplitude perturbation parameters, which is useful to distinguish between laryngeal polyp/cyst and other laryngeal disease (p<.05). ATRI made a significant result in related to tremor parameters, which is useful to distinguish between laryngeal polyp and other laryngeal disease (p<.05). Conclusion:$F_0$, $MF_0$, $T_0$, Fhi, Flo, PER, vAm, ATRI might be meaningful parameters distinguishing pathologic from benign laryngeal diseases. Especially, the vAm and ATRI are an important factor when forecasting which group would be diagnosed with vocal polyp.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.98-102
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• 2006

Background and Objectives : Voice onset time(VOT) is defined as the time interval from oral release of a stop consonant to the onset of glottal pulsing in the following vowel. VOT is a temporal characteristics of stop consonants that reflects the complex timing of glottal articulation relative to supraglottal articulation. Stop consonants are characterized by creation of a pressure difference across a complete occlusion in the vocal tract, followed by a sudden release 'burst' due to opening that occlusion. The objects of this study is to evaluate a usefulness of voice onset time in the assessment of voice disorderd patients. Subjects : Subjects were 20 adults with normal voice and with benign laryngeal disorders. Subjects with voice disorders represented the following vocal pathologies : vocal polyp, vocal nodule, Reinke's edema and unilateral vocal fold paralysis(UVFP). Control subjects were matched for age (21-40 yews old) and sex(male) with the voice disorders subjects and had normal vocal qualities with no history of voice disorders. Methods : Each voice-disordered and matched control subject read the test passages containing three types of Korean bilabial consonants. VOT measures were made for the initial $/p/p^h/\;and\;/p'/$. VOT was measured using acoustic waveform or wide band spectrogram. Results : For each voiceless stop consonants, there was a significant difference in VOT between the voice disordered and normal subjects. The mean VOTs of the lax stops in UVFP was significantly shorter than those of control subjects in the UVFP. The mean VOTs of the aspirated stops in the vocal polyp and nodule were longer than those of control subjects, but not significant. The mean VOTs of the glottalized in voice disordered groups were longer than those of control subjects, and significant statistically in the UVFP. Conclusions : VOT may be a clinically useful acoustic parameter in the assessment of voice disordered patients, especially in the unilateral vocal fold paralysis.