• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.78-83
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• 2016

Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.763-768
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• 2006

Purpose : We investigated the risk of aspiration using the lipid-laden macrophage index(LLMI) from laryngeal lavages in infants with bronchiolitis. Methods : Laryngeal lavages from 22 infants with acute bronchiolitis caused by respiratory syncytial virus(RSV) were evaluated during the acute stage. Repeat studies were performed at 3 to 4 weeks after the initial study(remission stage). Lavage cell counts and differentials were determined. The amount of lipid per single macrophage was evaluated and the LLMI was determined by evaluating 100 cells. Comparisons between acute stage and remission stage were made. Twenty-four hour pH monitoring(pHm) was performed in 12 patients. Results : The total cell number was significantly higher in the acute stage compared with the remission stage(P<0.05). The LLMIs in the acute stage were significantly higher than those in the remission stage(P<0.05). The neutrophils percentage of laryngeal lavage correlated with the LLMI(r=0.69, P<0.001). Four children had positive pHm recordings(pH-positive infants) and eight had negative pHm recordings(pH-negative infants). The pH-positive infants had higher LLMI and higher neutrophils percentage than those of the pH-negative infants(P<0.05). Conclusion : These findings suggest that there is a transient increased risk of aspiration during bronchiolitis. The LLMI from laryngeal lavage may be a useful marker for pulmonary aspiration in infants with bronchiolitis.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2009.05a
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• pp.141-144
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• 2009

본 연구는 사상관련전위를 이용하여 의식하에 제시된 미적자극이 대뇌활동에 미치는 영향을 밝혀내고자 이루어졌다. 이를 위해, 16명의 실험참가자에게 masking법를 이용해 미적자극을 의식하에 제시하였다(10msec). 제시된 자극은 선행연구를 통해 선정된 Beautiful Images(미자극), Ugly Images(추자극), Neutral Images(중성자극)이였다. 사상관련전위(event-related potentials; ERPs)는 64채널의 뇌파계를 이용하여 측정하였다. 그 결과, 후두엽 (Oz) 및 좌측두엽 (T5)에서 미자극에 의해 나타난 ERPs초기성분인 P1, N1, P2, N2의 진폭이 중성자극에 의해 나타난 진폭보다 컸다. 그리고, 후두염에서 추자극에 의해 보여진 P2, N2의 진폭 및 Late Slow Wave(LSW)의 평균전위가 중성자극에 의해 보여진 것보다 컸다. 이와 같은 ERPs성분은 자극의 탐지, 패턴인지, 기억탐색, 표적선택 등과 같은 자극의 정보처리와 관련되어 있다고 보고되고 있다. 따라서, 의식하에 제시된 미적자극은 서로 다른 대뇌 활동을 일으킴을 알 수 있다. 이는 인간은 의식하에서 미적자극에 대한 정보처리를 하는 기능을 가지고 있음을 뜻한다.

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.45-49
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• 2018

Group B streptococcus (GBS) is the leading cause of neonatal morbidity and mortality. Late-onset GBS disease commonly manifests as occult bacteremia or meningitis. Approximately 50% of survivors of late-onset meningitis have long-term neurologic sequelae. Cerebrovascular complications are often associated with unfavorable clinical outcomes of GBS meningitis. There have been a few reports of cerebral infarction accompanied by GBS meningitis. We report a 29-day-old girl with severe, widespread cerebral infarction due to late-onset GBS meningitis. Isolated GBS strain from this patient was serotype III, ST-19. Currently, she has cortical blindness and significant developmental delay.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.2
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• pp.149-153
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• 1999

Relapsing polychondritis is an uncommon disorder of unknown etiology. That involves multisystem characterized by recurrent inflammation, degenerative change of multiple cartilaginous structures. The most common clinical manifestation is an auricular chondritis. Other involving systems are joint, nose, eye, larynx, trachea, aorta, heart and kidney. A 26-year-old man who complained of hoarseness and sore throat was referred to the ENT department from internal medicine department. On initial video-laryngoscopic and radiologic examination, there was no abnormal finding. Treatment with high doses of corticosteroid and methotrexate was not effective. Symptoms were aggrevated with dyspnea. Three months later, on video-laryngoscopic examination, bilateral cord fixation with swelling was noted. The radiologic finding showed subglottic stenosis due to collapse of anterior wall of cricoid cartilage. The condition was managed with tracheotomy. We report a case of relapsing polychondritis involving larynx and trachea with bilateral vocal cord palsy which was managed with tracheotomy.

• Journal of Haehwa Medicine
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• v.14 no.1
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• pp.113-128
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• 2005

1. Acute laryngitis is a hoarse voice or the complete loss of the voice because of irritation to the vocal folds. 2. Acute laryngitis belongs with the GeupHuEum, HuBi, HuPung in oriental medicine. 3. GeupHuEum is caused by wind and cold, weak of lung and kidney, evil energy of liver, sore throat, etc. It is treated with the methods of cooling lung and wetting, removing heat and changing phlegm, etc. 4. Hubi is caused by fire and wind, dampness, large lung. It is treated with the methods of removing heat and antidote, reinforcing and descending fire, bleeding by acupuncture, vomiting. 5. Hupung is caused by phlegm and heat of lung and stomach, wind and heat. It is treated with the methods of dispersing wind and removing heat and changing phlegm by medicine, acupuncture, moxibustion, vomiting, fumigation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.98-103
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• 2003

Background and Objectives : Although many studies have examined the effect of drinking on voice change, its cause and degree remain unclear. Since voice change occurs more frequently the day following drinking, rather than immediately afterwards, we examined whether the voice change was correlated with reflux laryngitis due to gastroesophageal motor disturbances. Subjects and Methods : For this study, 10 patients were selected who had neither voice change nor symptoms of reflux laryngitis at baseline (male : female=5 : 5, mean age=28 years old) They were subjected to psychoacoustic, acoustic, and aerodynamic tests and video stroboscopy at 4:00 P.M. the day before drinking (test 1), at 8:00 A.M. (test 2) and 4:00 P.M. (test 3) on the following day. On the day of drinking, the subjects had to drink more than their usual amount of Soju(Korean liquor) and were not allowed to talk much. The stroboscopy findings were quantified using the PC Belafsky score. Results : The laryngeal response to gastric reflux after drinking was compared between tests 1 and 2. In both tests, laryngeal edema and injection were observed on video stroboscopy. The psychoacoustic test detected more severe hoarseness in test 2 than in test 1. In addition, the acoustic test detected a mild increase in both jitter and shimmer. However, the differences between tests 2 and 3, which were performed when there was reduced or no gastric reflux, were not significant. Conclusions : Drinking may cause gastric reflux, which produces reversible voice change by irritating the vocal cords and larynx. Therefore, reflux laryngitis should be suspected in a patient whose voice changes markedly after drinking.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.2
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• pp.141-147
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• 2009

Background and Objectives: Although laryngopharyngeal reflux disease (LPRD) is a widely recognized disease in the field of otolaryngology, controversies still exist regarding the diagnosis and treatment for it. The purpose of this survey was to find out current trends in diagnosis and management of LPRD among Korean otolaryngologists. Materials and Method: Questionnaires were obtained from 26 Korean otolaryngology specialists by electronic balloting, and 46 members of the Korean Society of Head and Neck Surgery (KSHNS) bye-mail. Survey participants were asked about their preferences in diagnostic policy, duration/dosage of antireflux treatment, and their familiarity to the reflux symptom index (RST) and the reflux finding scores (RFS). Results: The majority of the survey participants (64%) preferred empiric therapy trial with proton pump inhibitors (PPIs) based on patients' symptoms and their laryngeal findings. PPIs alone (27%) or PPIs with prokinetics (32%) were usually prescribed as a first line treatment mostly with once daily schedule in the morning before meal and for less than 4 months of duration (86%). More than 90% of participants were aware of the RSI and RFS, but less than 50% of them were actually using those items in the clinics. Conclusion: Most of Korean otolaryngologists who participated in this survey answered that they prefer starting empirical treatments with proton pump inhibitors mainly based on the patient's symptoms and their laryngeal findings.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.161-166
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• 2000

Background and Objectives : Vocal fold hemorrhage occur by blood accumulation in Reinke's space by vocal trauma. It is mostly asymptomatic, but in some cases it may cause severe dysphonia. It is often seen in patients who use their voice professionally. However, recent changes of life style affected the phonation in general population. We studied to know what are the causes and what are the major factors to affect the vocal fold hemorrhages. Materials and Methods : 19 subjects were evaluated by using of questionaire and laryngoscopic examinations. We evaluated the factors to lead the change in voice directly, underlying causes, occupations and laryngeal findings. Results : The direct causes of the vocal fold hemorrhages were clearing throat, talking, coughing and singing. Reflux laryngitis and upper respiratory infection were the underlying diseases. Vocal fold hemorrhages were developed during the menstruation in 5 patients. Accompanying functional voice disorders were seen in 13 patients, such as, vocal fold nodule, nodule with varix, vocal polyp, Reinke's edema. Patients with reflux laryngitis had the habits of clearing throat as the direct cause of the vocal fold hemorrhages and had hyperkinetic functional voice disorders. Voice abuse was the direct cause of the vocal fold hemorrhages in patients who was in the period of the menstruation. The most common site of the hemorrhage was at the membranous portion of the vocal folds. Conclusions : Authors thought the forceful laryngeal activity was the cause of the vocal fold hemorrhages. And reflux laryngitis and menstruation was the risk factors of the vocal fold hemorrhages.

• Journal of Korean Society of Transportation
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• v.20 no.2
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• pp.17-26
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• 2002

Driver's psychophysiological load is one of the key measures for evaluating the safety of the highway. The purpose of this study is to propose and to test the methodology of evaluating the length limit of tangent section using driver's psychophysiological load. Driver's psychophysiological data is represented by the data acquire by frontal and occipital lobe. In order to compare the differences between tangent segments and the orders, real road driving experiments were performed. We collected psychophysiological data during the operation of vehicles. The experimental data were analyzed using FFT (Fast Fourier Transform) and relative power spectrum tools. These routine produces the beta value which is a major factor in consideration of driver's condition. The results in this study are summarized as follows: (1) A new methodology of evaluating the length limit in tangent section of highway using driver's psychophysiological load was proposed. (2) It was observed that driver's work load at tangent section was three times lower than that at the other section types. The beta value at tangent section is 2.219, while that at general section is 0.821. (3) It was observed that the driver's work load was significantly dropped to 0.428 after the continuous driving of 4.2km tangent section. (4) Based on the experimental subjects(from 27 Years to 31). we suggest that 30 times of design speed(3.0 km) could be acceptable as the length limit of tangent section in highway rather than the Previous limit which is 20 times of design speed(2.0km).