• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.43-46
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• 2008

Hypophayngeal cancers are usually diagnosed in advanced stages and in many cases, they need total pharyngocervical esophagectomy and surgical reconstruction. Among many surgical reconstructive methods, jejunal free flap has anatomical and functional advantages such as tubed nature, peristaltic activity, excellent blood supply. In this study we analysed the surgical procedure and complications of jejunal free flap after total pharyngo-cervical esophagectomy. 20 cases performed jejunal free flap from 1995 to 2007 at Severance Hospital were reviewed. According to time of onset, early and late complications were reviewed. Surgical procedure was reviewed with operation record. Oral diet tolerance was reviewed on the basis of pharyngogram and subjective symptoms. The most common complication was stricture, and it occurred in 40% of cases and 63% of them were managed with conservative care. As early complication, fistula formation was all managed with conservative care. Oral feeding tolerance after jejunal free flap was 65% and 7 patients were tolerable to general diet. In our study, stricture was the most common complication and its management is important in post op oral diet tolerance.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.70-78
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• 1997

The development of preneoplastic and neoplastic squamous cell proliferations of body sites such as the skin, female lower genital tract, and larynx is strongly associated with specific types of human papillomaviruses (HPV). Antitumor $CD^{8+}$ cells recognize peptide antigens presented on the surface of tumor cells by major histocompatibility complex (MHC) class I molecules. The MHC class I molecule is a heterodimer composed of an integral membrane glycoprotein designated the alpha chain and a noncovalently associated, soluble protein called beta-2-microglobulin( $\beta$ -2-m). Loss of $\beta$-2-m generally eliminates antigen recognition by antitumor $CD^{8+}$ T cells. We evaluated the expression of $\beta$-2-m as a potential means of tumor escape from immune recognition and the presence of HPV DNA as a cause of laryngeal squamous cell carcinomas (SCCs). Laryngeal SCCs (n=39) were analyzed for MHC class I expression by immunohistochemistry and for presence of HPV by in situ hybridization technique. The results were as follows : 1) HPV DNA was detected in 10 (25.64%) out of 39 cases in laryngeal squamous cell carcinomas. 2) MHC class I down-regulation (heterogenous and negative expression) in HPV positive lesions was higher than HPV negative lesions. 3) The expression of MHC class I was related to cellular differentiation regardless of T-stage and nodal involvement. In conclusion, HPV was thought to be the etiological factor of SCC of larynx, and we found that the down-regulation of MHC class I was a common phenomenon In laryngeal SCC and may provide a way for tumor cells to escape from immune surveillance.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.11-15
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• 2018

Background/Objectives: The efficacy of radiotherapy alone versus chemoradiotherapy has been studied in patients with T2N0M0 laryngeal squamous cell carcinoma. Materials & Methods: Thirty nine patients with newly diagnosed T2N0M0 laryngeal squamous cell carcinoma were treated with either radiotherapy(RT group, 66-70Gy) or chemoradiotherapy(CRT group, cisplatin based concurrent chemoradiation with or without 2 cycles induction chemotherapy including cisplatin, $5-FU{\pm}$ docetaxel / radiation therapy same with above mentioned). The mean follow-up was 73.5 months. Results: The overall survival (OS), disease specific survival (DSS), disease free survival (DFS), and larynx preservation survival (LPS) at 5 years were 70%, 79%, 67%, and 71%. The complete response rate was 82.4% in RT group, and was 95.5% in CRT group. OS (57% vs 80%), DSS (69% vs 86%), DFS (52% vs 77%), and LPS (63% vs 77%) at 5 years were higher in CRT group than RT group, but it was not statistically significant. In subsite analysis, CRT group tends to improve DFS, compared to RT group, in glottic cancer (p=0.06). The toxicities were tolerable and no fatal case was observed in both groups. Conclusion: Chemoradiotherapy is effective as primary therapy for T2 laryngeal squamous cell carcinoma and showed manageable treatment induced toxicity.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.194-200
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• 2018

Objectives : The significance of leukoaraiosis on brain magnetic resonance imaging (MRI) is uncertain, but it is often seen with vascular risk factors or in the context of cognitive impairment. We aimed to investigate the effect of leukoaraiosis on the severity and course of delirium. Methods : Periventricular hyperintensity and deep white matter hyperintensity on brain MRI were rated in 42 patients with delirium by semiquantative visual rating scale. Correlations between their grades and the scores of Korean version of Delirium Rating Scale-Revised-98 (K-DRS-R-98) were analyzed, and the interaction effects between the groups according to the levels of leukoaraiosis and two evaluation points were also analyzed. Results : The grade of deep white matter hyperintensity in the occipital lobe was positively correlated with the scores on the total, severity items, cognitive items, and non-cognitive items of K-DRS-R-98. The cognitive items scores of K-DRS-R-98 in the low grade group of periventricular hyperintensity showed significantly steeper decrease than the high grade group. Conclusions : A difference in severity or recovery speed of delirium according to the level of leukoaraiosis may result from disruption in brain functional connectivity. Our results have a clinical implication in that the severity and course of delirium can be possibly predicted using the level of leukoaraiosis.

• Phonetics and Speech Sciences
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• v.11 no.3
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• pp.49-55
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• 2019

This study sought to investigate whether mean speaking fundamental frequency (SFF) can be predicted by parameters of voice and speech range profile (VRP and SRP) in Korean normal adults. Moreover, it explored whether gender differences exist in the absolute differences between the SFF and estimated SFF (ESFF) predicted by the VRP and SRP. A total of 85 native Korean speakers with normal voice participated in the study. Each participant was asked to perform the VRP task using the vowel /a/ and the SRP task using the first sentence of a Korean standard passage "Ga-eul". In addition, the SFF was measured with electroglottography during a passage reading task. Predictive factors of the SFF were explored and the absolute difference between the SFF and the ESFF (DSFF) was compared between gender groups. Results indicated that predictive factors were age, gender, minimum pitch and pitch range for the VRP (adjusted $R^2=.931$), and pitch range (in semi-tones) and maximum pitch for the SRP (adjusted $R^2=.963$), respectively. The SFF and ESFF predicted by the VRP and SRP showed a strong positive correlation. The DSFF of the VRP and SRP, as well as their sum did not differ by gender. In conclusion, the SFF during a passage reading task could be successfully predicted by the parameters of the VRP and SRP tasks. In further studies, clinical implications need to be explored in patients who may exhibit deviations in SFF.

• Phonetics and Speech Sciences
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• v.11 no.3
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• pp.77-87
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• 2019

The study aimed to develop Speech Range Profile (SRP) and to examine and validate its clinical application. Forty-five participants without voice disorders aged 18-29 years were compared using SRP and Voice Range Profile (VRP). The authors developed the "Fire!" paragraph as a SRP task compromising 14 sentences including all Korean spoken phonemes and sentence types. To compare SRP and VRP results, the participants read the paragraph (reading) and counted from 21 to 30 (counting) as a part of SRP tasks, and produced a vowel /a/ from low to high frequencies (gliding) and a shortened form of the VRP as a part of VRP tasks. $F0_{max}$, $F0_{min}$, $F0_{range}$, $I_{max}$, $I_{min}$, and $I_{range}$ for each task were measured and compared, showing that $F0_{max}$, $F0_{min}$, $F0_{range}$, $I_{max}$, and $I_{range}$ were not different between reading and gliding. $I_{min}$, had the lowest value in counting. It is concluded that the newly developed SRP task, reading the "Fire" paragraph, can yield a maximum phonation range similar to that found by VRP. Therefore, it is expected that voice evaluation can be effectively performed in a relatively short time by applying SRP with the "Fire" paragraph, a functional utterance task, in place of VRP, which may be difficult to measure long term or in cases of severe voice disorders.

• Phonetics and Speech Sciences
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• v.13 no.4
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• pp.89-100
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• 2021

This study compared the voice range profiles (VRPs) with glissando and simplified VRP methods with 57 men who were in premutation (8-13 years), mutation (11-16 years), and postmutation (10-24 years) stages. The difference between modal and falsetto areas measured in two VRP methods was also compared. As the results, the average fundamental frequency (F0) was in the order of premuaton>mutation>postmutation. The maximum F0 (F0max), the range of F0 (F0range), the maximum intensity (Imax), and the range of intensity (Irange) were the lowest in the mutation stage, and these variables were higher in falsetto area than in modal area in both methods. In addition, most variables of VRP in glissando were higher than in simplified VRP, but the differences were not significant. This study showed that, in men in mutation stage, due to the temporary anatomical and physiological changes of the larynx, the mechanism of the vocal folds vibration changes and VRP shows a different pattern from that of other age groups. Both the VRPs of glissando and simplifed VRP are suitable for clinical practice by experienced examiners. And it is necessary to measure not only the falsetto area but also the modal area when measuring VRP.

• Journal of Korea Entertainment Industry Association
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• v.14 no.8
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• pp.91-102
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• 2020

The purpose of this study is to analyze musical songs from an academic perspective by applying vocal techniques that can express songs in depth in three dimensions. Singing a musical song cannot be completed with just the musical part, rather, it should be accompanied by the analysis of various aspects such as the emotional state of the scenes and the characters. To this end, this study performed a multi-dimensional analysis of fields such as theatrical structure, lyrics, musical structure, and dynamics. In addition, the study explored and applied Estill Voice Training(EVT) that actors can best express songs with the emotions of the theater and music. EVT categorizes voice into six tones: speech, sob/cry, falsetto, twang, opera, and belting. In this study, in addition to these six sounds, the positions of vocal cords and larynx were also applied to seek ways to effectively express songs using "Gar Nichts" from the musical "Elisabeth" as a case study. "Gar Nichts" is a song sung by the protagonist Elisabeth, which expresses the self and the conflict at the peak of pain. Musically, this song requires various sound and voice-changing techniques to cover the range of "G#3-Gb5." As a result, it was confirmed that in order to embody the emotions of the characters and the songs in depth, the analysis of scenes and characters as well as various singing techniques need to be applied in harmony.

• Clinical Pain
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• v.18 no.1
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• pp.24-30
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• 2019

Objective: Greater occipital nerve block (GONB) is a widely accepted treatment of primary headaches. Two ultrasound (US)-guided blockade techniques exist: 1) the classical distal nerve block technique performed medial to the occipital artery at the superior nuchal line, and 2) the new proximal nerve block technique performed at the obliquus capitis inferior muscle at the level of C2. Our study aim was to perform a head-to-head comparative study of these two US-guided techniques. Method: Forty-nine patients with primary headache treated in our university hospital were recruited. Patients were randomized into two groups of the classical nerve block and the new proximal nerve block techniques. The headache questionnaire was made to assess the intensity of the pain of headache attacks, number of days they experience headache, duration of headache, and amount of pain medication they consumed. Results: In both groups, a decrease in the severity and frequency of the headache was observed. There was no measurable difference in outcome between the two groups. Conclusion: Our study showed that the classic and new proximal techniques are equally effective in decreasing the headache severity and frequency.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2022.09a
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• pp.113-113
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• 2022

도라지(Platycodon grandiflorum)는 초롱꽃과 도라지속에 속하는 여러해살이풀로 7~8월에 보라색이나 흰색의 꽃을 피우고, 뿌리는 다육질로 원주형 또는 분지형이다. 잎은 거의 엽병이 없는 대생이며, 종자는 난형으로 3개의 모서리가 있다. 항염증 성분인 플라티코딘이 들어있어 편도염을 비롯한 후두염, 폐렴 등에 효과가 있어 우리나라 약용작물 재배면적의 상위를 차지하고 있는 주요 작물이다. 최근, 백수오, 감초 등 심근성 약용작물은 뿌리의 수확 비용 절감을 위해 용기재배가 도입되고 있다. 본 연구는 도라지 용기재배에 적합한 용기의 규격과 고온 경감을 위한 용기 재료 선발을 위해 수행하였다. 도라지 용기재배에 적합한 용기의 규격 선발은 기본 용기로 플라스틱 플륨관을 사용하였고, 높이는 40cm로 고정하여 직경을 10, 20, 30cm로 처리하였다. 2019년 4월 하순에 도라지 종자를 파종하여 용기 규격별로 각각 1주(10cm), 4주(20cm), 8주(30cm)를 남겨 두고 솎음 다음, 2020년 10월 하순에 수확하였다. 도라지의 생육 및 수량성을 조사한 결과, 용기의 직경이 증가함에 따라 근장, 근경, 근중 등 지하부 생육이 우수한 경향이었다. 또한, 10a당 수량은 노지재배 749kg에 비해 직경 10cm 778kg, 20cm 849kg, 30cm 1,156kg로 직경 30cm가 가장 우수하였다. 직경이 증가할수록 수량성이 증가하였으나 직경 30cm 이상의 용기는 수확 시 노동력이 증가하고, 배양토 비용이 증가하여 사용하지 않았다. 고온 경감을 위한 용기 재료 선발은 흰색과 검정색 플라스틱 플륨관을 높이 40cm × 직경 30cm 규격으로 절단하여 2020년 4월에 도라지 종자를 파종하였고, 2021년 10월 하순에 수확하였다. 이 중 검정색 용기는 무처리(대조), 유공, 반유공, 흰색부직포, 반사필름 처리를 하였다. 도라지의 수량성을 조사한 결과, 검정색 용기 중 유공처리가 무처리 대비 수량이 21%(1,080 → 1,304kg/10a) 증가하였다. 위의 결과로 도라지는 직경 30cm의 검정색 유공 용기가 용기재배에 적합한 것으로 판단되었다.