• Title/Summary/Keyword: Head and Neck

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Changes in Blood Flow Velocity of Middle Cerebral Artery After Stellate Ganglion Block (성상신경절 차단후 중뇌동맥의 혈류 속도 변화)

  • Seo, Young-Sun;Kim, Sung-Hee;Hur, Chul-Ryung;Lee, Kyung-Jin;Lee, Sook-Yeoung;Kim, Chang-Ho;Kim, Chan;Lee, Young-Seok;Lee, Dong-Chul
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.57-62
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    • 1996
  • Stellate ganglion block(SGB) improves cutaneous blood flow of the head and neck region and upper extremity. For this reason, SGB has been performed in neural and circulatory disorders. But there is controversy on the cerebral blood flow regulation by sympathetic innervation. We investigated the hypothesis that cerebral blood flow could be affected by blocking ipsilateral sympathetic innervation of cerebral blood flow could be affected by blocking ipsilateral sympathetic innervation of cerebral vasculature. In 10 volunteers, the blood flow velocity and pulsatility index(PI) of middle cerebral artery(MCA) was measured using Transcranial Doppler Flowmeter, before and 15 minutes after SGB, at block side and opposite side. The blood flow velocity of MCA at block side was increased from $62.60{\pm}7.60$ cm/s to $72.80{\pm}8.01$ cm/s(P<0.01) and the PI at block side decreased from $0.75{\pm}0.12$ to $0.60{\pm}0.11$(P<0.05). But the blood flow velocity and PI at opposite side did not change. This study demonstrated that the cerebral blood flow could be increased by SGB, the preganglionic nerve fibers of which synapse with other cervical sympathetic ganglions.

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Pathophysiology of Functional Dysphonia (기능성 음성장애의 병태생리)

  • Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.75-78
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    • 2014
  • Functional dysphonia refers to a voice disturbance that occurs in the absence of structural or neurologic laryngeal pathological characteristics. Poorly regulated activity of the intrinsic and extrinsic laryngeal muscles is cited as the proximal cause of functional dysphonia (FD). Recently, the term functional dysphonia has been replaced in some clinical circles by diagnostic label muscle tension dysphonia (MTD), which serves to highlight excess, dysregulated, or imbalanced activity of the intrinsic and extrinsic laryngeal muscles as proximal cause of the observed dysphonia. And recent research evidence points to specific personality traits as important contributors to its development and maintenance. However, the origin of this dysregulated laryngeal muscle activity has not been fully elucidated. Further research is needed to better understand the pathogenesis of functional dysphonia, and factors contributing to its successful management.

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A Case of Bleomycin Induced Bronchiolitis Obliterans Organizing Pneumonia (Bleomycin에 의해 유발된 Bronchiolitis Obliterans Organizing Pneumonia 1예)

  • Oh, Hye-Lim;Kang, Hong-Mo;Choi, Cheon-Woong;Lee, Ho-Jong;Cho, Yong-Seun;Yoo, Jee-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.504-509
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    • 2001
  • There are numerous agents with potential toxic effects on the lung. In particular, cytotoxic drugs constitute the largest and most important group of agents associated with lung toxicity. Bleomycin is commonly used, either alone or in combination with other chemotherapeutic agents, in the treatment of squamous cell carcinoma(head and neck, esophagus, and genitourinary tract), lymphoma, and germ cell tumor. One of the therapeutic advantages of bleomycin is its minimal bone marrow toxicity. However, pulmonary toxicity is one of the most serious adverse side effects. Classically, pulmonary toxicity manifests as a diffuse interstitial process or less commonly as a hypersensitivity reaction. This pulmonary toxicity is generally considered to be dose related and can progress to a fatal fibrosis. It is also possible that bronchiolitis obliterans organizing pneumonia(BOOP) is another manifestation of bleomycin induced toxicity. Bleomycin induced BOOP is less common and has a favorable response to steroid therapy. Here we present a case that demonstrates a BOOP, secondary to a relatively small cumulative dose of bleomycin($225mg/m^2$), may be reversible.

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The Clinical Reaction Study on 64 Cases with Essential Bee Venom Treatment (분리정제봉약침(Essential Bee Venom) 시술환자 64례에 대한 임상적 반응 보고)

  • Jeon, Yong-Tae;Go, Ung;Kim, Sung-Moon;Jeong, Hae-Chan;Han, Kuk-In;Shin, Seon-Ho;Ko, Youn-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.165-170
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    • 2016
  • Objectives The purpose of this study was to observe clinical reactions (itching, pain, etc.) after Essential Bee Venom (EBV) treatment. Methods This study was conducted 64 patients who had been injected with EBV in Korean Medicine Hospital of Woosuk University and Haeundae Ja-Seng Hospital of Korean Medicine from October 5, 2015 to February 20, 2016. We checked clinical reactions of treatment region. Results 8 patients (12.5%) complained of localized itching and 4 patients (6.3%) complained of localized pain after EBV injection. In itching reaction of patients, 2 patients (15.4%) occurred itching in head and neck, 4 patients (12.9%) occurred in lumbar and back. In pain reaction of patients, 2 patients (6.5%) occurred pain in lumbar and back, 1 patient (11.1%) occurred pain in upper limb. All clinical reactions were happened within 7 treatment times. Conclusions This study suggested EBV treatment can cause clinical reaction like itching and pain. Clinical reactions were more common in inpatients than outpatient, and all reactions were happened within 7 treatment times. Doctors should recognize physical reaction caused by EBV and explain to patient. Further studies are needed to more improved treatment.

IMPROVEMENT OF DOSE CALCULATION ACCURACY ON kV CBCT IMAGES WITH CORRECTED ELECTRON DENSITY TO CT NUMBER CURVE

  • Ahn, Beom Seok;Wu, Hong-Gyun;Yoo, Sook Hyun;Park, Jong Min
    • Journal of Radiation Protection and Research
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    • v.40 no.1
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    • pp.17-24
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    • 2015
  • To improve accuracy of dose calculation on kilovoltage cone beam computed tomography (kV CBCT) images, a custom-made phantom was fabricated to acquire an accurate CT number to electron density curve by full scatter of cone beam x-ray. To evaluate the dosimetric accuracy, 9 volumetric modulated arc therapy (VMAT) plans for head and neck (HN) cancer and 9 VMAT plans for lung cancer were generated with an anthropomorphic phantom. Both CT and CBCT images of the anthropomorphic phantom were acquired and dose-volumetric parameters on the CT images with CT density curve (CTCT), CBCT images with CT density curve ($CBCT_{CT}$) and CBCT images with CBCT density curve ($CBCT_{CBCT}$) were calculated for each VMAT plan. The differences between $CT_{CT}$ vs. $CBCT_{CT}$ were similar to those between $CT_{CT}$ vs. $CBCT_{CBCT}$ for HN VMAT plans. However, the differences between $CT_{CT}$ vs. $CBCT_{CT}$ were larger than those between $CT_{CT}$ vs. $CBCT_{CBCT}$ for lung VMAT plans. Especially, the differences in $D_{98%}$ and $D_{95%}$ of lung target volume were statistically significant (4.7% vs. 0.8% with p = 0.033 for $D_{98%}$ and 4.8% vs. 0.5% with p = 0.030 for $D_{95%}$). In order to calculate dose distributions accurately on the CBCT images, CBCT density curve generated with full scatter condition should be used especially for dose calculations in the region of large inhomogeneity.

Research of 6MeV electron dose distribution (Electron therapy에서의 dose distribution에 관한 연구)

  • Je Jae Yong;Park Chul Woo;Jin Sung Jin;Park Eun Tae
    • 대한방사선치료학회:학술대회논문집
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    • 2005.06a
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    • pp.27-32
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    • 2005
  • Electron is used for the treatment of skin cancer, breast cancer, and head and neck cancer in clinic. Our study is performed to check the isodose distribut ion in source surface distance(SSD) and source bolus distance(SBD) setup, nipple influence to isodose distribution of electron, junctional area isodose variation of photon and electron field. Dosimetry is carried out with phantom, acryl, and film as the same condition of treatment setup. $8\%$ of isodose difference is noted with the surface distance(SSD) and source bolus distance(SBD) setup. To reduce the influence of nipple. corresponding volume of bolus should be removed. And bolus covering all the electron field reduced hot and cold spot of junctional area of photon.

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A 10-year overview of chronic orofacial pain in patients at an oral medicine center in Iran

  • Taheri, Jamile Bigom;Anbari, Fahimeh;Sani, Sahba Khosousi;Mirmoezi, Seyed Mohammad;Khalighi, Hamid Reza
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.4
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    • pp.289-294
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    • 2022
  • Background: Orofacial pain is defined as pain felt in the soft or hard tissues of the head, face, mouth, and neck. Chronic orofacial pain is often challenging to diagnose and difficult to treat. Due to the lack of available information about the prevalence and clinical form of orofacial pain, this study aimed to evaluate the characteristics of chronic orofacial pain in patients presenting at the Department of Oral Medicine of Shahid Beheshti Dental School between 2012 and 2022. Methods: In this retrospective study, we evaluated the files of 121 patients at the Department of Oral and Maxillofacial Diseases of Shahid Beheshti Dental School, which were completed during 2012-2022. We extracted the required information from these files. Results: In total, 121 files were included in the study (30 male, 91 female). The mean age of the patients was 43.68 ± 16.79 years. The most common diagnosis in patients with chronic orofacial pain was temporomandibular disorders (TMD) (55.3%). Among pain-related factors, psychological factors showed the highest frequency (30.5%). Opening and closing (43.8%) had the highest frequency among factors that increased pain, and the rest (6.6%) had the highest frequency among the factors that reduced pain. Most patients experienced unilateral pain over the masseter area. Most patients reported their pain intensity to be greater than 7 in the verbal analog scale (VAS). The most common symptom associated with pain was joint noise (37.1%). Conclusion: A ten-year retrospective evaluation of patient files showed that more than half of the patients with chronic orofacial pain had TMD.

The comparative analysis on the distribution of cancers (암환자 분포의 비교 분석)

  • Kim, Seung-Kook
    • The Journal of Korean Society for Radiation Therapy
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    • v.12 no.1
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    • pp.155-165
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    • 2000
  • This paper is based on the records of researching the patients with cancer in the Chunnam National University Hospital from January 1990 to December 1999 and referred to the Korea Cancer Center Hospital's annual report. The results are as the following : 1. Along the total O.P.D 5,680,284, the patients of therapeutic radiology are 201,367 in $3.55\%$ 2. Among the 12,404 cancer patients, stomach cancer patients are $2,048(16.51\%),\;liver\;cancer\;patients\;are\;1,490(12.01\%),\;lung\;cancer\;patients\;are\;1,418(11.43\%)\;cervix\;and\;uterus\;cancer\;patients\;are\;1,102(8.88\%)$ and sexual ratio of male to female appeared 1.38 : 1 Therefore, male cancer patients are more than female patients. 3. The age distribution of cancer was $2,791(22.50\%)\;by\;55{\sim}64\;age,\;2,582(20.82\%)\;by\;45{\sim}54\;age,\;and\;2,530(20.40\%)\;by\;65{\sim}74\;age.\;Therefore,\;the\;60\%\;of\;all\;cancer\;patients\;were\;45{\sim}75$ ages. 4. Among the 9,815 therapeutic radiology patients, $1,755(17.89\%)\;are\;in\;the\;uterus\;system,\;1,534(15.63\%)\;are\;in\;the\;head\;and\;neck,\;1,519(15.48\%)$ are in the lung. Therefore, the proportion of three kinds of therapeutic radiology patients is about $50\%$. 5. The occupational distributions of 12,404 cancer patients$(90{\sim}99\;year)\;are\;2,795(22.53\%)\;by\;orderly\;farmers,\;2,763(22.28\%)\;by\;house\;wives,\;586(4.71\%)\;by\;businessmen,\;and\;391(3.15\%)$ by public service personnel. Industrial, miners, forest men, soldiers didn't nearly appear. 6. The number of patients of cancer diagnosis was $9,431(76.03\%)\;by\;the\;biopsy\;of\;primary\;region,\;and\;2,201(17.74\%)$ by clinical examination Therefore, those two kinds of methods took a propertion of about $94\%.\;The\;number\;of\;deceases\;on\;departments\;was\;153(32.42\%)\;in\;PD,\;133(28.18\%)\;in\;GI,\;63(13.35\%)$ in GS. Therefore, those three kinds of deceases took a proportion of about $74\%$.

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Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer

  • Kim, Wan Wook;Lee, Jeeyeon;Jung, Jin Hyang;Park, Ho Yong;Kim, Won Hwa;Kim, Hye Jung;Park, Ji-Young;Tufano, Ralph P.
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.302-307
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    • 2020
  • Background: This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon's palpation in papillary thyroid cancer. Methods: This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness. Results: Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively. Conclusion: Determination of central LN metastasis by a surgeon's palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

Yeungnam University type drive-through (YU-Thru) coronavirus disease 2019 (COVID-19) screening system: a rapid and safe screening system

  • Seo, Wan Seok;Kim, Seong Ho;Song, Si Youn;Hur, Jian;Lee, Jun;Choi, Sunho;Lee, Yoojung;Bai, Dai Seg
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.349-355
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    • 2020
  • Active and prompt scale-up screening tests are essential to efficiently control the coronavirus disease 2019 (COVID-19) outbreak. The goal of this work was to identify shortcomings in the conventional screening system (CSS) implemented in the beginning of the outbreak. To overcome these shortcomings, we then introduced a novel, independently developed system called the Yeungnam University type drive-through (YU-Thru), and distributed it nationwide in Korea. This system is similar to the drive-throughs utilized by fast food restaurants. YU-Thru system has shortened the time taken to test a single person to 2-4 minutes, by completely eliminating the time required to clean and ventilate the specimen collection room. This time requirement was a major drawback of the CSS. YU-Thru system also reduced the risk of subjects and medical staff infecting one another by using a separate and closed examination system. On average, 50 to 60 tests were conducted per day when using the CSS, while now up to 350 tests per day are conducted with the YU-Thru system. We believe that the YU-Thru system has made an important contribution to the rapid detection of COVID-19 in Daegu, South Korea. Here, we will describe the YU-Thru system in detail so that other countries experiencing COVID-19 outbreaks can take advantage of this system.