• Journal of Korean Neurosurgical Society
• /
• v.52 no.3
• /
• pp.264-266
• /
• 2012

Injury to the bilateral internal branch of superior laryngeal nerve (ibSLN) brings on an impairment of the laryngeal cough reflex that could potentially result in aspiration pneumonia and other respiratory illnesses. We describe a patient with traumatic cervical injury who underwent bilateral ibSLN palsy after anterior cervical discectomy with fusion (ACDF). An 75-year-old man visited with cervical spine fracture and he underwent ACDF through a right side approach. During the post-operative days, he complained of high pitched tone defect, and occasional coughing during meals. With a suspicion of SLN injury and for the work up for the cause of aspiration, we performed several studies. According to the study results, he was diagnosed as right SLN and left ibSLN palsy. We managed him for protecting from silent aspiration. Swallowing study was repeated and no evidence of aspiration was found. The patient was discharged with incomplete recovery of a high pitched tone and improved state of neurologic status. The SLN is an important structure; therefore, spine surgeons need to be concerned and be cautious about SLN injury during high cervical neck dissection, especially around the level of C3-C4 and a suspicious condition of a contralateral nerve injury.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.27 no.2
• /
• pp.87-90
• /
• 2016

Cough, the most common symptom, encountered in the outpatient clinic can be caused by various underlying diseases. It defines as chronic cough that the duration of cough is more than 8 weeks with a normal chest X-ray findings. The cause of cough can be found out for more than 90% through the appropriate diagnostic approach and Upper airway cough syndrome, Asthma and Gastroesophageal reflex disease are the most common causes of disease to non-smokers. Chronic cough can be due to not one reason but various reasons and achieve good results by a systematic approach to diagnosis and a concrete treatment on the basis of the sufficient understanding of the underlying disease.

• Journal of Haehwa Medicine
• /
• v.19 no.2
• /
• pp.159-163
• /
• 2011

Cough is an important defensive reflex of the respiratory tract needed to clear and protect the upper airways, but it may become exaggerated and interfere quality of life. Gastroesophageal reflux disease (GERD) is one of the three most common causes of chronic unexplained cough. Diagnosing GERD related cough is challenging since many patients do not have esophagitis or an increased esophageal acid exposure during 24 h esophageal pH-metry. We treated two patients who had chronic cough, these subjects were diagnosed as Sikjeoksu (Shijisou, 食積嗽) and was administered Pyeongjingeonbi-tang (Pingchenjianpi-tang, 平陳健脾湯). First case had stuffiness below the heart and acid regurgitation with cough, but second case only had cough. After treatment, cough and other symptoms were improved. It showed that we must consider GERD on chronic cough patients.

• Allergy, Asthma & Immunology Research
• /
• v.10 no.6
• /
• pp.591-613
• /
• 2018

Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics. Meanwhile, in referral clinics, a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options for chronic wet cough in children and unexplained chronic cough in adults in Korea.

• Kosin Medical Journal
• /
• v.33 no.2
• /
• pp.257-262
• /
• 2018

Guillain-$Barr{\acute{e}}$ syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are demyelinating neurologic disorders with different target organs. Although they share similar pathogenetic mechanism, reports of simultaneous occurrence of the 2 disorders are rare. A 2 year 6 month old girl visited our hospital for fever, cough, and general weakness. Although the muscle power of extremities showed mild weakness and voiding difficulty, initial deep tendon reflex of both knees and ankles was normal. A nerve conduction study to evaluate the weakness revealed the absence of F waves. Cerebrospinal fluid analysis demonstrated pleocytosis with lymphocyte predominance and elevated protein levels. Magnetic resonance imaging showed abnormal T2 hyperintensity in pons, medulla and spinal cord. Serum anti-GD1b antibody was positive. Based on clinical findings, laboratory findings, nerve conduction study, and neuroimaging, the diagnosis of GBS and ADEM was made. This is the first case of GBS accompanied by ADEM in Korea.

• Korean Journal of Bronchoesophagology
• /
• v.3 no.1
• /
• pp.94-100
• /
• 1997

Background and Objectives : In children with tracheal stenosis, operative management remains a challenging problem due to difficulties of operative techniques and postoperative care. The purpose of this study was to determine the effectiveness of tracheal resection with end to end anastomosis as operative management for tracheal stenosis in children. Materials and Methods : 6 children with severe tracheal stenosis underwent tracheal resection with end to end anastomosis. Causes of stenosis were trauma in 1 case and prolonged intubation or tracheotomy in 5 cases. The diagnoses were made by radiologic evaluation (plain X-ray, CT, 3-Dimensional CT) and confirmed by direct laryngoscopy and ventilating bronchoscopy under general anesthesia. Thyroplasty and unilateral arytenoidectomy were performed in 1 case. Suprahyoid release was done in 1 case with severe adhesion. Decanulation was achieved following postoperative endoscopic examination and pulmonary function test. Postoperative physical and radiologic examinations were given at regular intervals. Results : Stenosis were improved from grade III grade I in 4 cases and from grade II to grade I in 2 cases. Decanulation was achieved on average postoperative 6 months in 5 cases, and 10 years in 1 case due to exertional dyspnea. There were 1 each case of immediate postoperative subcutaneous emphysema, pneumothorax and wound infection. Postoperative granulomas at anastomosis site were treated with laser vaporization under suspension laryngoscope and bronchoscope in 3 cases. There was 1 each case of delayed postoperative vocal cord palsy, aspiration pneumonia and loss of cough reflex. Conclusion In tracheal stenosis of children, tracheal resection with end to end anastomosis has good result with preservation of normal airway. Preoperative evaluation of local factors such as swallowing, vocal cord movement and cough reflex and general condition was important for successful treatment. As the cases in adults, authors considered this operation to be a curable operative management for tracheal stenosis.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.7 no.1
• /
• pp.17-21
• /
• 2009

Purpose : The purpose of this study was to analysis the effect of electrical stimulation for dysphagia caused by cerebral infarction. Methods : We recruited nineteen adults after cerebral infarction(14 male, 5 female; mean age, 69y) for our study. Electrical stimulation was used for participants with electrical stimulator connected to two pair of electrodes positioned on the neck for one hour a day and 5 times a week for 4 weeks. Maximum tolerated stimulation levels were applied at rest while participants held their mouth closed. Videofluoroscopic recordings, physical examination of swallowing, and swallow function score were used to evaluate swallowing state of participants. All evaluate items were evaluated before and after treatment. Results : There was no significance difference of swallowing stage. The swallow function score significantly increased from 1.8 to 5.3(p<0.001). Also, cough reflex(p<0.001), laryngeal excursion(p<0.01) were significantly reduced compared to before electrical stimulation. Conclusion : Therefore, electrical stimulation for dysphasia is proved effective as it activates the function of swallowing muscle.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.27 no.1
• /
• pp.5-10
• /
• 2016

Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

• Archives of design research
• /
• v.18 no.2 s.60
• /
• pp.219-232
• /
• 2005

Moderns are living within flood of web contents, animation, reflex data etc. as well as sight, product, environment design. There fore, modern consumer has much options. Designer must provide various result for consumer for this reason. And must invent new sensitivity and propose to consumer. As purpose of this MCC sensitivity palette research takes advantage of the most sensitive color, do. Because applying correct sensitivity more than when design with matter already settled, rid private prejudice, and is thing to convey design intention exactly to user. Excellent culture contents must be able to equip international color design sensitivity. MCC sensitivity palette research studies and carries on the head emotion and sensitivity language that is nationality first, and collect End arranged sensitivity adjective through data analysis and picture data analysis that is the next time research leader Munheonjeok. And distributed collected adjective equally, and arrange distributed adjective by field of each sensitivity and collect system. Do 3 colors, 4 colors color scheme in selected sensitivity adjective and completed Simheom version. Result of beta version research to color specialist and designer last digital palette through question and inquiry compose. Through this process, completed more real and correct digital color sensitivity palette. Completed color scheme is operated in www.mcdri.net on web, and also programs to windows base and developed to software. MCC color scheme palette that research result is made includes sensitivity data database. This database can use directly in industry and continuous development is available. Software can search color scheme in language and idea development through classification search that use 3 attributes of color is available there is cough data of each output device different color error.

• Journal of Korean Medical classics
• /
• v.3
• /
• pp.151-217
• /
• 1989

In this thesis, I intend to study the translational and clinical interpretation through the theory of Ja-Yeol, and reached the following conclusions. 1. Liver-Heat-Disease due to absess of the function of expelling and lifting off, that Liver-Yang cannot lift up to upper-warmer, and stagnate liver. I think the symptoms of yellowish urine, abdominal pain, somnolence, fever belong to the syndrome of 'Gi-Bun(氣分)', and the symptoms of ravings with surprising, distending pain of hypochondrium, restless involuntary movement of the limbs, unable to lie flat belong to the syndrome of 'Hyeol-Bun(血分)'. 2. Heart-Heat-Disease due that 'Eum-Gi(陰氣)' in heart cannot lay down and reach to stagnate at heart, inner part. I think the symptoms of unjoy, acute cardiac pain, fidgetiness, well-nausea, headeche, reddish face, anhidrosis, etc. reveal with Heart-Heat-Disease. 3. Spleen-Beat-Disease due that 'Eum-Gi' in spleen cannot lay down and Yin of spleen changs heat. I think the symptoms of heaviness of head, cheek pain, fidgetiness, cyanosis, well-nausea, fever, not to let flex and reflex with back pain, diarrhea with abdominal pain, left and right cheek pain reveal with Spleen-Heat-Disease. I think symptoms of fever, diarrhea with abdominal pain belong to the syndrome of Yin-exhausion. 4. Lung-Heat-Disease due to that 'Eum-Gi' in lung cannot lay down. When 'Wi-Gi(衛氣)' stagnates at external part, I think, the symptoms of intolerance to wind and cold, yellowish fur, fever reveal. When Wi-Gi stagnates at lung, inner part, I think, the symptoms of dispnea with cough, pain on chest and back, unable to breath deeply, hydrosis and chilling reveal. 5. Kidney-Heat-Disease, in that the symptoms of back pain, leg aching, extreme thirst and frequently drink, fever, pain and stiffness of nape, cooling and aching leg, heat on plantar pedis, not trying to speak reveal is regarded external heat disease of 'Tai-Yang-Gyeong's(太陽經)' disease that asthenic fever open 'Tai-Yang-Gyeong' and lift by not enough of 'Yang-Gi(陽氣)' lifeing up from Kidney space, the water space of five elements.