• 대한후두음성언어의학회지
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• 제18권1호
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• pp.22-25
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• 2007

Background and Objectives: Biomedical signals have been usually used for the diagnosis of the laryngeal function such as speech, electroglottograph(EGG), airflow and other signals. But, in most cases these signals were analysed separately. Here, we propose a new interchannel parameter Glottal Closure Delay Ratio(GCDR) which is estimated from speech and EGG measured simultaneously. Materials and Method: Speech and EGG signal were recorded simultaneously from 13 normal subjects, 39 patients. The patients' data included 16 polyps and 23 vocal folds palsy. Time difference between glottal closing instance on EGG and the first maximum peak on speech in a pitch period was calculated. Glottal closing instance was defined as the maximum peak on the first derivative of EGG signal(dEGG). Results: The standard deviation and jitter were calculated using 20-30 GCDRs extracted from each data, and they are significant different between normal and vocal fold paralysis group. Conclusion: The GCDR may be the first index reflecting speech and EGG characteristics and the perturbation of this parameter was significant different between normal and vocal fold paralysis group.

• 대한두경부종양학회지
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• 제21권1호
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• pp.35-41
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• 2005

Wide vertical hemilaryngopharyngectomy with immediate glottic and pharyngeal reconstruction using a radial forearm free flap is reported in 1991 by Chantrain et al. This procedure was designed for the preservation of healthy hemilarynx and resection of pharynx with safe oncological margin in especially piriform sinus cancer or supraglottic cancer invading the hypopharynx. In the original paper, they used palmaris longus tendon for reconstruction of neoglottis. In other groups, they used rib cartilage instead of palmaris longus tendon. In this paper, we report two cases of piriform sinus cancer patients who treated with wide vertical hemilaryngectomy with radial forearm free flap reconstruction. In one case, the operation was performed as Chantrain et al described. But in another case, the ipsilateral forearm was impossible due to the positive Allen's test. So the contralateral forearm flap and rib cartilage graft was done. This reconstructive technique make large resection possible. As the dissection of thyroid cartilage and lateral displacement makes direct visualization and manipulation of piriform sinus lesions, sufficient resection margin in lateral and inferior pharyngeal wall cab be obtained.

• 대한두경부종양학회지
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• 제13권1호
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• pp.35-39
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• 1997

Background: Completion thyroidectomy is defined as the surgical removal of the remnant thyroid tissue following procedures less than total or near-total thyroidectomy. Although some authors advocate subtotal thyroidectomy with lower complication rates, total or completion thyroidectomy have been defended by others because of the improved survival and lower morbidity that is comparable with subtotal thyroidectomy. Objectives: The purpose of this paper is to review the necessity and safety of completion thyroidectomy for differentiated thyroid carcinoma(DTC). Materials & Methods: During the past 10 years(1986 to 1996) , authors have performed 211 total thyroidectomy. Ten of these patients were treated by completion thyroidectomy for DTC. Initial operation of 7 patients had been performed at St. Vincents Hospital and 3 patients at other hospital. The medical records of patients undergoing completion thyroidectomy were retrospectively reviewed. Results: The completion thyroidectomy specimen contained residual tumor cells in 8 of the 8 patients with papillary carcinoma and none of the two patients with follicular carcinoma. Complications of completion thyroidectomy were transient hypoparathyroidism in two patients and transient unilateral recurrent laryngeal nerve palsy in one patient. But permanent complications were not noticed. Conclusion: We recommend completion thyroidectomy as an efficient and safe method of surgical treatment with a low complication rate for DTC.

• 융합정보논문지
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• 제9권10호
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• pp.187-194
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• 2019

본 연구는 흡연 여부(흡연집단, 비흡연집단, 금연집단)에 따른 담뱃갑 경고그림 및 메시지 효과를 분석하기 위한 서술적 조사이다. 연구대상자는 G도에 거주하는 성인 대상으로 총 219명이 참여하였다. 자료수집은 2017년 6월 4일부터 6월 14일까지 실시하였다. 연구진행 방법은 보건복지부의 경고그림위원회에서 선정한 2016년 담뱃갑 경고그림과 경고메세지 10종(심장질환, 뇌졸중, 폐암, 후두암, 구강암 등)을 활용하여 설문조사를 실시하였다. 연구결과는 담뱃갑 경고그림과 경고메시지의 노출 후 흡연여부에 따른 금연의도는 흡연자, 비흡연자와 금연자 그룹 간에 통계적으로 유의한 차이를 보였다(F=36.08, p<.001). 따라서 국민건강증진법에 따라 흡연자의 금연 효과를 향상시키기 위하여 TV 금연공익광고를 포함한 담뱃갑 경고그림 및 경고메시지를 주기적으로 교체할 것을 제언한다.

• 대한기관식도과학회지
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• 제4권1호
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• pp.52-58
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• 1998

BACKGROUND： Aspiration is defined as the laryngeal penetration of secretions below the level of the true vocal cords. Aspiration can result in life-threatening complications, such as bronchospasm, airway obstruction, pneumonia, pulmonary abscess, sepsis, and death. The patient with high vagal palsy had significant aspiration and dysphagia OBJECTIVE： To formulate a step-by-step management paradign for the patients with high vagal palsy MATERIALS AND METHODS : The medical records of 23 patients who were diagnosed as high vagal palsy from September, 1995 to April, 1998 in Seoul National University Hospital were reviewed retrospectively. Eleven patients were managed conservatively and 12 patients were operated to treat chronic aspiration. RESULTS : The main etiologies of high vagal palsy were mass lesions of the skull base such as neurogenic tumor, pseudotumor, meningioma or nasopharyngeal carcinoma. Aspiration and dysphagia improved in 7 out of 11 patients who were managed conservatively after 2.2 months on the average. The patients who were refractory to the conservative management underwent surgery and showed improvement in 10 out of 12 patients. The employed surgical modalities were vocal cord medialization combined with cricopharyngeal myotomy in 7 patients, laryngotracheal separation in 3 patients and arytenoid adduction only in 2 patients. Two patients still had gastrostomy tube due to the persistent symptoms. Two patients had improved after surgery, but died of underlying disease. CONCLUSION : The patients with high vagal palsy are recommended to be managed conservatively for the first 2 months. If aspiration and dysphagia are persisting after conservative management, vocal cord medialization combined with or without cricopharyngeal myotomy should be considered. If failed, laryngotracheal separation or gastrostomy will be the next option based on the control of the oropharyngeal secretion.

• Journal of Microbiology and Biotechnology
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• 제31권4호
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• pp.610-620
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• 2021

There has been increasing interest in the head and neck squamous cell carcinoma (HNSCC) that is caused by high-risk human papillomavirus (HR-HPV) and has posed a significant challenge to Otolaryngologists. A rapid, sensitive, and reliable method is required for the detection of HR-HPV in clinical specimens to prevent and treat HPV-induced diseases. In this study, a multiple cross-linking spiral amplification (MCLSA) assay was developed for the visual detection of HPV-16. In the MCLSA assay, samples were incubated under optimized conditions at 62℃ for 45 min, and after mixing with the SYBR Green I (SGI) dye, the positive amplicons showed bright green fluorescence while the negative amplicons exhibited no obvious change. The specificity test revealed that the developed MCLSA technique had high specificity and could effectively distinguish all five HPV-16 strains from other pathogenic microorganisms. In terms of analytical sensitivity, the limit of detection (LoD) of MCLSA assay was approximately 5.4 × 101 copies/tube, which was 10-fold more sensitive than loop-mediated isothermal amplification (LAMP) and RT-PCR. The detection results of laryngeal cancer specimens collected from 46 patients with suspected HPV infection in the Liaoning region demonstrated that the positive detection rates of MCLSA and hybridized capture 2 kit were 32.61% (15/46). The true positive rate of the MCLSA assay was higher than that of RT-PCR (100% vs. 93.33%) and LAMP (100% vs. 86.67%). Therefore, the MCLSA assay developed in the present study could be a potentially useful tool for the point-of-care (PoC) diagnosis of HR-HPV, especially in resource-limited countries.

• Anatomy and Cell Biology
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• 제51권4호
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• pp.266-273
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• 2018

The ganglion cardiacum or juxtaductal body is situated along the left recurrent laryngeal nerve in the aortic window and is an extremely large component of the cardiac nerve plexus. This study was performed to describe the morphologies of the ganglion cardiacum or juxtaductal body in human fetuses and to compare characteristics with intracardiac ganglion. Ganglia were immunostained in specimens from five fetuses of gestational age 12-16 weeks and seven fetuses of gestational age 28-34 weeks. Many ganglion cells in the ganglia were positive for tyrosine hydroxylase (TH; sympathetic nerve marker) and chromogranin A, while a few neurons were positive for neuronal nitric oxide synthase (NOS; parasympathetic nerve marker) or calretinin. Another ganglion at the base of the ascending aorta carried almost the same neuronal populations, whereas a ganglion along the left common cardinal vein contained neurons positive for chromogranin A and NOS but no or few TH-positive neurons, suggesting a site-dependent difference in composite neurons. Mixtures of sympathetic and parasympathetic neurons within a single ganglion are consistent with the morphology of the cranial base and pelvic ganglia. Most of the intracardiac neurons are likely to have a non-adrenergic non-cholinergic phenotype, whereas fewer neurons have a dual cholinergic/noradrenergic phenotype. However, there was no evidence showing that chromogranin A- and/or calretinin-positive cardiac neurons corresponded to these specific phenotypes. The present study suggested that the ganglion cardiacum was composed of a mixture of sympathetic and parasympathetic neurons, which were characterized the site-dependent differences in and near the heart.

• 대한후두음성언어의학회지
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• 제29권2호
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• pp.98-102
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• 2018

Background and Objectives : Detection of vascular abnormalities in vocal cord (VC) leukoplakia is important for the diagnosis of neoplastic change of the mucosa. The aim of this study was to investigate the value of i-scan in the differential diagnosis of VC leukoplakia based on visualization of abnormal vascular features. Material and Methods : Fifty-two patients with leukoplakia were enrolled in the study. Images of their larynx obtained using conventional white light endoscopy and an i-scan-enhanced endoscopy (Pentax DEFINA EPK-3000 Video Processors, with Pentax VNLJ10) were reviewed. The microvascular features of the lesions and vascular changes were analyzed and the results were compared with the histopathologic diagnosis. Results : Among the 52 leukoplakia patients, 7 (13.5%) patients had squamous hyperplasia, 10 (19.3%) mild dysplasia, 2 (3.8%) moderate dysplasia, 14 (26.9%) severe dysplasia, 4 (7.7%) carcinoma in situ, and 15 (28.8%) invasive squamous cell carcinoma on histopathologic examination. Using i-scan-enhanced endoscopy, abnormal vascular change with neoplastic neoangiogenesis was detected in most cases of malignant VC lesion [severe dysplasia : 9/14 (64.3%), carcinoma in situ: 2/4 (50.0%), and invasive squamous cell carcinoma : 11/15 (73.4%)]. Conclusion : i-scan-enhanced endoscopy is a useful optical technique for the diagnosis of VC leukoplakia. Our results suggest that i-scan may be a promising diagnostic tool in the early detection of laryngeal cancer.

• 말소리와 음성과학
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• 제10권4호
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• pp.147-154
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• 2018

Wet voice quality (WVQ) is a characteristic that appears after swallowing. Although the concept is accepted by many clinicians worldwide, it is nevertheless ambiguous. In this study, we investigated WVQ in patients with swallowing disorders using acoustic analysis. A total of 106 patients diagnosed with penetration-aspiration by the videofluoroscopic swallowing study (VFSS) were recruited. A voice recording of vowel /a/ was conducted before and after the VFSS, and an acoustic analysis was then performed using PRAAT. Voice after VFSS was used for a perceptual judgment and divided into two groups: the Wet group (48 patients) and the Non-wet group (58 patients). At the post-VFSS stage, the two groups displayed significant differences in many acoustic parameters including F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP. The parameter affecting judging wetness resulted into Jitter and NHR by the logistic regression test. At the pre-VFSS stage, the two groups differed significantly in many acoustic parameters including Intensity, Jitter, RAP, Shimmer, NHR, FUF, DVB, and CPP. Both pre-and post-VFSS, the mean values of all significant parameters, except Intensity, HNR, and CPP, were higher in the Wet group. According to pre-and post-VFSS, the two groups displayed interactions in many parameters (Intensity, F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP). In particular, Intensity increased in both groups after the VFSS, although the increase in the Non-wet group was greater. Based on these results, it was conjectured that the WVQ after swallowing resulted from the secretion effect of the mucous membrane due to the dry laryngeal characteristic of elderly patients, rather than aspiration resulting in food on the vocal cords.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2019년도 춘계학술대회
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• pp.104-107
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• 2019

현대인들은 과거에 비해 풍부한 먹거리와 다양한 삶의 형태를 가지게 되었으나 바쁜 생활 속에 아침을 거르게 되고, 제 시간에 식사를 하지 못하는 등의 올바르지 못한 식습관을 형성하게 되었다. 이러한 식습관은 장기간 유지되면서 소화기관 장애로 이어지게 된다. 그에 가장 쉽게 발생하는 증상이 역류성 식도염과 삼킴 장애라고 불리는 연하 곤란이 있으며, 그 중 연하 곤란은 다양한 합병증의 형태로 발전하거나 위암, 후두암등의 전조증상으로 확인되기도 하여 빠르고 정확한 진단이 요구된다. 이에 따른 진단 결과는 현재도 의사가 수동적으로 판단하며 그 결과가 제각각이다. 여기서 말하는 진단 결과는 중증 정도를 말하는 것이며, 그에 따른 치료법이나 합병증을 파악할 때의 잘못된 진단으로 과한 치료나 부족한 대처로 이어지게 될 수도 있다. 본 논문에서는 연하 곤란의 심각 정도를 파악하기 위해 연하 곤란 진단 과정에서 식도로 이어지는 구간에 후두개곡과 이상와 부에 남는 잔여 음식물을 확인하기 위한 X-ray 이미지 처리에 K-means 알고리즘을 사용하는 프로그램을 개발하는 것을 연구하였다.