• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.8 no.1
• /
• pp.69-74
• /
• 1997

The authors compared 20 cases of preoperative and postoperative results in patients with hypernasality who were treated at Yongdong Severance hospital from January 1994 to August 1996. According to the severity of the hypernasality, types of operations such as superior based pharyngeal flap surgery or posterior pharyngeal wall augmentation was selected. The preoperative and postoperative results wert analyzed by 2 otorhinolaryngologists and 1 speech therapist through an endoscopic examination and voice evaluation. follow up period was 1 month to 17 months and mean was 5.6 months. Types of the velopharyngeal closure according to the mobility of soft palate and pharyngeal wall could be divided into 3 types : coronal type(2 cases), sagittal type(4 cases), and circular types(14 cases), The results indicated that sagittal type showed the best result. In surgical treatment for hypernasality, the mobility of the pharyngeal lateral wall and making suitable size of lateral per during surgery were the most important factors affecting the patient's satisfaction.

• Proceedings of the KSLP Conference
• /
• 1996.11a
• /
• pp.84-84
• /
• 1996

1986년 10월부터 1996년 8월까지 연세대학교 의과대학 영동세브란스병원 이비인후과에 내원한 환자로서 문진, 이학적검사 및 방사선학적검사에 의하여 양측성대마비로 진단된 47례를 대상으로 성별, 연령, 주증상, 성대마비의 원인 및 치료경과에 대하여 후향적으로 분석하였다. 성별은 남자가 34례(72%), 여자가 13례(28%)였고 연령별로는 20대에서 60대에 걸쳐 비교적 고르게 분포하였으며 평균연령은 46세였다. 주증상이 호흡곤란이었던 경우가 22례(47%)로 가장 많았고 애성이 19례(40%)로 그 다음 순이었다. 성대마비의 원인별로 보면, 중추성이 4례(9%)였고, 나머지는 말초성으로 이중 비수술적 외상에 의한 경우가 15례(32%)로 가장 많았고 수술적 외상이 10례(21%), 특발성이 9례(19%), 기도내 삽관이 5례(11%)였으며, 이외에도 염증성요인에 의한 것이 2례, 갑상선종양에 의한 것이 1례, 그리고 중증근무력증에 의한 것이 1례이었다. 양측성대마비에 대한 치료로서 기관절개술이 13례(28%), 피열연골절제술이 13례(28%)에서 행해졌으며 이중 술후 완전탈관이 가능하였던 경우는 기관절개술을 시행하였던 경우에 6례(46%), 피열연골절제술을 시행하였던 경우에 9례(69%)였고 수술후 완전탈관까지의 기간은 기관절개술의 경우 평균 18개월, 피열연골절제술의 경우 평균 3개월이었다. 이외 보존적 치료가 20례(43%)에서 행해졌으며 이중 2례는 자연치유되었다.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.32 no.3
• /
• pp.118-123
• /
• 2021

The pulsed photoangiolytic 532-nm potassium-titanyl-phosphate (KTP) laser has emerged in recent years as an efficacious treatment modality for vocal fold lesions. It also has broadened the indications for other laryngeal laser surgery. Features of KTP laser that it is a fiber-based delivery system and its energy is selectively absorbed by oxyhemoglobin make it suitable for office-based laryngeal procedures. An office-based KTP laser surgery provides an alternative management option for benign laryngeal diseases and can be performed comfortably under flexible endoscopic guidance which is placed through the nose of a fully awake patient. Office-based laryngeal surgery with a KTP laser can alleviate the need for general anesthesia. However, there are some limitations to apply due to reduced visual precision and the fact that the vocal folds are moving during procedures. Clinicians should carefully weigh the advantages and disadvantages of office-based procedures before a treatment option is selected. Patient selection and standardized laser energy parameters may help in decreasing complications and improving the treatment results.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.18 no.1
• /
• pp.26-32
• /
• 2014

Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.13 no.2
• /
• pp.173-179
• /
• 2002

Background and Objectives : Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They nay occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. Recently, with the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Method : In the present study, 121 cases of the intracordal cyst were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 121 cases in the 2595 patients who underwent laryngeal micorosurgery(4.7%). Ductal cyst were 88 cases and epidermoid cyst were 33 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the indirect laryngoscopic examination, the ductal cysts are more frequently misdiagnosed as other diseases of the vocal cord such as vocal polyps or nodules. The degree of postoperative voice satisfaction is similar to that of vocal polyps. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without upture of the cystic wall or injury of the lamina propria.

• The Journal of the Korea Contents Association
• /
• v.16 no.10
• /
• pp.522-532
• /
• 2016

Purpose: This study was conducted to develop case-based self-learning multimedia contents for preventing malpractice that frequently occurred among nurses working in the operating room. Methods: Based on the learning needs of operating room nurses, real case reports, and literature reviews, the case-based multimedia learning contents were developed according to the instructional design procedure. The assessment of learning needs was performed by the combination of surveys using structured questionnaire and of interviews for 40 operating room nurses. Results: The learning contents included four learning modules with real malpractice cases from the areas of operating preparation, nursing skills during operation, environmental management of operating room, and patient safety and observation-related. The 80 minute long case-based multimedia learning contents were finally developed after content validity tests from clinical experts. Each module contained photos, sounds and flash animation with voice recording on the contents of nursing error cases and standardized protocols. Conclusion: The developed multimedia learning contents based on real error cases in this study can be utilized as an educational hands-on training materials for nurses to prevent malpractice in the operating room.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1979.05a
• /
• pp.7.2-8
• /
• 1979

The tests related to air usage are valuable for evaluating phonatory function of clinical cases having glottic incompetence. Measurement of mean air flow rate, maximum phonation time and phonation quotient are important test for voice disorder. Stroboscopy is very useful for clinical evaluation of abnormality in the mode of vocal cord vibration. Author obtained following clinical result from 56 cases of laryngeal disorders in Kurume medical school in Japan. 1) Unilateral laryngeal lesions, are 35 cases (62.5%) and bilateral laryngeal lesions are 21 cases (37.5%). 2) Sex ratio is 39 cases (69.8%) of male and 17 cases (30.2%) of female. 3) In maximum phonation time below 10 seconds are 26 cases (46.4%) and above 10 seconds are 30 cases (53.6%). 4) In phonation quotient below 300 ml/sec are 33cases (58.9%). and above 300ml/sec are 23 cases (41.0%). 5) In mean air flow rate below 300ml/sec are 37 cases (66.1%) and above 300ml/sec are 19 cases (33.9%). 6) Symmetry of vibratory movement of the vocal cord, regularity of vibration, amplitude of vibration, wave on the mucosa and glottic closures are observed by stroboscopic examination. 7) Postoperative voice test and stroboscopic examination revealed good result in compare pre-operation with post-operation.

• Journal of Chest Surgery
• /
• v.35 no.6
• /
• pp.475-478
• /
• 2002

A 45 year old man was admitted for aggravated dyspnea, abdominal distension and poor oral intake. On Echocardiogram, mitral stenosis(severe), tricuspid regurgitaion(IV), and LA thrombus were diagnosed. We used heparin with continuous infusion for prevention of systemic thrombo embolism. On the 11th day of admission, the patient showed thrombocytopenia and we suspected Heparin-induced thrombocytopenia. Hirudin was used in this case as alternative anticoagulant during cardiopulmonary bypass to prevent serious complication of heparin. The patient was recovered without any complication as postoperative bleeding or systemic thromboembolism.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.6
• /
• pp.497-508
• /
• 1998

Purpose: Using rest T1-201/dipyridamole stress gated Tc-99m-MIBI/ 24 hour delay T1-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), T1-201 rest perfusion (Rest), T1-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. Materials and Methods: In 39 patients (M;F= 34:5, age $58{\pm}8$), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0: normal to 3: defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. Results: After bypass surgery, ejection fraction increased from $37.8{\pm}9.0%$ to $45.5{\pm}12.3%$ in 22 patients who had decreased ejection fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Though univariate logistic regression analysis revealed Rev (p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). Conclusion: Among independent predictors obtained by rest T1-201/ stress gated Tc-99m-MIBI/ delayed T1-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor.

• 대한미세수술학회:학술대회논문집
• /
• 1996.10a
• /
• pp.181.2-182
• /
• 1996