• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.127-129
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• 2015

Background and Objectives : The etiology of globus pharyngeus remains uncertain. It has been known there is a relationship between the presence of air bubbles in esophagus and GERD symptoms. The aim of this study is to identify relationship between the globus symptom and the presence of air column in esophagus. Subjects and Methods : The study population consisted of 46 patients who underwent CT scan as part of evaluation for globus. Controls were chosen from the population consisted of patients with lymphadenopathy who underwent CT scan. The correlation between the presence of globus symptom and diameter, volume, and position of the air column was assessed using t-test. Reproducibility of diameter and volume of the esophageal air column was analyzed using intraclass correlation coefficient. Results : In study group, the mean volume of the air column was $769.56{\pm}983.08mm^3$, the mean diameter was $8.24{\pm}4.90mm$, the mean distance from the inferior border of posterior lamina of cricoid cartilage was $88.86{\pm}28.01mm$. In control group, $682.18{\pm}767.28mm^3$, $8.37{\pm}5.50mm$, $88.34{\pm}21.06mm$, respectively. There were no differences of diameter, volume and distance of the air column between the two groups. We failed to obtain acceptable reliability when we compare the diameter and the volume of the esophageal air column. Conclusion : There was no relationship between air column of esophagus and presence of globus symptom. And the measurement of diameter and volume of the esophageal air column change over time and it should be considered in a further study.

• Transactions of the KSME C: Technology and Education
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• v.2 no.2
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• pp.73-80
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• 2014

Drug delivery in human upper airway was studied by the numerical simulation of oral airflow. We created an anatomically accurate upper airway model from CT scan data by using a medical image processing software (Mimics). The upper airway was composed of oral cavity, pharynx, larynx, trachea, and second generations of branches. Thin sliced CT data and meticulous refinement of model surface under the ENT doctor's advice provided more sophisticated nasal cavity models. With this 3D upper airway models, numerical simulation was conducted by ANSYS/FLUENT. The steady inspiratory airflows in that model was solved numerically for the case of flow rate of 250 mL/s with drug-laden spray(Q= 20, 40, 60 mL/s). Optimal parameters for mechanical drug aerosol targeting of predetermined areas was to be computed, for a given representative upper airways. From numerical flow visualization results, as flow-rate of drug-laden spray increases, the drag spray residue in oral cavity was increased and the distribution of drug spray in trachea and branches became more homogeneous.

• Korean Journal of Head & Neck Oncology
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• v.30 no.1
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• pp.10-14
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• 2014

목 적 CO2 가스 삽입 없이 내시경 보조 갑상선 절제술, 특히 액와 절개를 이용하는 경우의 대부분은 기구 사용을 용이하게 하기 위하여 흉부 또는 유륜에 절개를 넣어 시행하는 것이 대부분이다. 본 연구는 후이개 절개를 통하여 추가적 절개 없이 내시경을 이용한 갑상선 절제술 및 중심 임파선 절제술이 가능한지의 여부를 사체연구를 통하여 확인해 보고자 한다. 방 법 사체 이용 해부 및 수술 후이개 내시경 보조 갑상선 절제술이 가능한지의 확인은 수술 시야 및 접근성, 수술 완성도, 그리고 주요 구조물의 보존 여부인 3가지 항목으로 평가하였다. 결 과 수술 시야는 기구를 다루고 수술을 하기에 충분하였으며, 추가 절개 없이 수술을 완성할 수 있었다. 절제된 갑상선 조직의 피막은 손상되지 않았으며, 잔존 갑상선 조직이 없음을 수술 부위를 통하여 확인하여, 수술의 완성도 여부를 평가할 수 있었다. 모든 사체에서 되돌이 후두신경 및 상 또는 하부갑상선의 보존을 확인하였으며, 주변 구조물들의 손상이 없음을 확인하였다. 결 론 로봇이 아닌 후이개 절개를 이용한 내시경 보조 갑상선 절제술은 시행 가능한 접근법 및 수술방법이라 사료된다.

• Environmental Mutagens and Carcinogens
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• v.25 no.1
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• pp.25-31
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• 2005

The objective was to use MR imaging to provide a template of posterior fossa development during the late stages in the chick embryos. The MR findings were then correlated with histological data. Fourteen normal formalin-fixed embryonic specimens with a gestational age of 14 to 20 days were examined with 1.5 Tesla unit MRl using a conventional clinical magnet and pulse sequences. The MR findings were correlated with the whole-mount histological specimens. Resolution of the morphological features of posterior fossa development in embryos greater than 14 days gestational age was possible. Development of cerebellum, brain stem, 4th ventricle and bony posterior fossa was documented. In the 14-day-old embryos, a premordial cerebellum was visualized in the enlarged bony posterior fossa, and it covered the the roof of the primitive fourth ventricle. The bony posterior fossa grows at the same rate along the supratentorial skull. The supratentorial skull and the rostral part of the brain grows at the same rate. The cerebellum begins to grow later than the rostral part of the brain. In the 19- to 20-day-old embryos, MRl revealed the rapid development of the cerebellar hemispheres, along with an increase in volume manifested by the more typical mushroom-shaped configuration observed in the newly hatched. At this stage, the cerebellum almost completely filled the posterior fossa and covered the entire fourth ventricle. The brain stem grew steadily, but the volume change was too subtle to evaluate. Features of cerebellar histogeneis were beyond the resolution of MRl. However, there were lots of artifacts in the features of the bony posterior fossa. An MR template of normal posterior fossa development would be useful to avoid confusion of normal development with abnormal development and to identify the expected developmental features when provided the estimated gestational age of a embryo.

• The korean journal of orthodontics
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• v.28 no.4 s.69
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• pp.547-561
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• 1998

Obstructive sleep apnea (OSA) is a disorder characterized by repetitive episode of upper airway collapse during sleep. Recent studies showed that not only the anatomic factors but the physiologic factors of the upper airway also have effcts on the occurrence of apnea and that the genioglossus muscle also plays an important role in the maintenance of the upper airway. A variety of therapies were performed to treat OSA, and among them the use of mandibular repositioning appliances showed reasonable results. But there is still a lack of research on the structural and physiological mechanism upon the use of mandibular repositioning appliances. The author selected 26(male 17, female 9) OSA patients that came to the Yonsei University Dental Hospital, Department of Orthodontics, and 20 normal adults (male 10, female 10) and took cephalometric radiographs of them in a supine position before and after the placement of the mandibular repositioning appliance to see the structural changes of the upper airway and compare the therapeutic effects between the two groups. We also studied the waking genioglossus muscle activity in OSA patients and investigated the difference in the electromyogram of the genioglosssus muscle upon the change in body posture and the use of mandibular repositioning appliance. Following results were obtained. 1. Among the cephalometric measurements of the upper airway structure, the length of the soft palate, maximum thickness of the soft Palate and SPAS, MAS, VAL, H-H1, MP-H showed statistically significant differences between the normal and OSA groups, but the IAS and EAS showed no statistically significant differences between the two groups. 2. In both the normal and OSA groups, as the epiglottis moved forward on wearing the mandibular repositioning appliance, the epiglottis level of the upper airway increased and the maximum thickness of the soft palate changed and the hyoid bone also moved forward, but the IAS in both groups showed various results and the effect of the mandibular repositioning appliance on the structure of the upper airway was different in the two groups. 3. Upon changing the position, the electromyogram of the genioglossus muscle showed a increasing tendency but there was no statistically significant differences, and when the mandibular repositioning appliance were worn there was a statistically significant increase in the electromyogram of the genioglossus muscle in both the upright and supine positions. The mandibular repositioning appliances not only have an effect on the anatomical structure of the upper airway but also on the physiology of the upper airway. There are different responses to the use of mandibular repositioning appliance between the normal and OSA groups therefore it could be considered to have the different physiology of the upper airway between the two groups.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.321-329
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• 1997

Purpose : It is well known that the risk of lymph nodes metastases to head and neck cancers are influenced by the location and size of the Primary tumor. as well as the degree and types of histological differentiation. However, data on the statistical analyses of lymph node metastases from the head and neck cancers among Korean Population are not available at present. In order to obtain current status of such data, we have analyzed cancer patients at the department of radiation oncology, korea universityhospital for radiation treatment. Materials and Methods : We have evaluated nine-hundred and ninetyseven (997) head and neck cancer Patients who visited to the Department of radiation oncology, between November 1981 to December 1995. After careful physical examinations and CAT scan, Patients were divided into two groups, those with positive lymph node metastases and with negative lymph node metastases. The nodal status were classified according to the TNM system of American Joint Committee on Cancer (AJCC) Besults : Four-hundred and sixteen Patients out of the 997 patients were lymph node positive $(42\%)$ and 581 patients were lymph node negative $(58\%)$ when they were first presented at the department of radiation oncelogy. According to the AJCC classification, the distribution of positive lymph node is as follow: Nl:106 $(25.5\%),\;N2a:100\;(24\%),\;N2b:68\;(16.4\%),\;N2c:69\;(16.6\%),\;3:73\;(15\%).$ respectively. The frequency of lymph node metastases according to the primary sites is as follow : larynx 283 $(28.5\%)$, paranasal sinuses: 182 $(18\%),\;oropharynx:144\;(14.5\%)\;nasopharynx:122(12\%),\;oral\;cavity\;92\;(9\%),\;hypopharynx:71\;(7\%),\;falivary\;gland:58\;(6\%)$ unknown primary:31 $(3\%),\;skin:\;14(2\%)$,. The most frequent Primary site for the positive Iymph node metastases was nasopharynx $(71\%)$ followed by hypopharynx $(69\%),\;oropharynx\;(64\%),\;oral\;cavity\;(39\%)$ The most common histologic type was squamous cell carcinoma (652/997: $65.4\%$). followed by malignant lymphoma $(109/997:11\%)$. Conclusion : Statistical results of lymph node metastases from head and neck cancer at our department were very similar to those obtained from other countries. It is concluded that the location of Primary cancer influences sites of metastases on head and neck, and stage of the primary cancer also influences the development of metastatic lesions. Since the present study is limited on the data collected from one institute. further statistical analyses on Korean cancer Patients are warrented.

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.509-519
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• 2000

Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of individuals has been developed. The analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. This study was to clarify the Korean craniofacial skeletal pattern using Enlow's counterpart analysis considering the fact that the craniofacial skeletal pattern has racial and regional variations. This research will be helpful in the future for growth research and research of the orthognathic surgery. For this study, the samples were consisted of 100 Korean adult subjects(50 males and 50 females) who had normal occlusion and pleasing face. Measurement points and lines were established using Enlow's counterpart analysis and they were statistically evaluated. The results indicated that : 1. The average angle between PCF and PMV was $38.54^{\circ}$ in males and $38.43^{\circ}$ in females, and the average Wits' appraisal was -2.51 in males and -2.3 in females. The ramus alignment(R4) was 1.89 in males and 2.36 in females. 2. It shows that females have a longer ramus than the PCF compared to the males, because there was a significant difference in Ramus/PCF horizontal dimensions (Skeletal A3-B3) between female and male subjects 3. It shows that males have a longer mandibular corpus than the maxilla compared to the females, because there was a significant difference in Maxillary/Mandibular arches(Skeletal A4-B4) between male and female subjects 4. In cranial floor+maxilla/ramus+corpus at A and B points(Al-Bl), which represents difference in total horizontal length between the maxilla and mandible, there was no significant difference between males and females. In conclusions, compared to Caucasian, Korean have more depressed midface, prognathic mandible, and ramus that rotates inferioposterior. Also, we observe that Korean women have target ramus posterior cranial base, as compared with Korean men. Consequently, the total length of maxilla and mandible does not show any difference, because man's mandible is longer than maxilla in comparison with woman's one.

• The Korean Journal of Nuclear Medicine
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• v.36 no.3
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• pp.166-176
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• 2002

Purpose: The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of $^{99m}Tc-HMPAO$ (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. Materials and Methods: The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and $^{99m}Tc-HMPAO$ SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the legion of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). Results: The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was $32.50{\pm}5.67%$. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Conclusion: Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.267-272
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• 2003

Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

• Progress in Medical Physics
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• v.22 no.1
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• pp.18-27
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• 2011

The purpose of this study was to identify different cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla functional magnetic resonance imaging (fMRI) and further to investigate the human suitability for rural and urban environments. A total of 27 right-handed participants (mean age: $27.3{\pm}3.7$) underwent fMRI study on a 3.0T MR scanner. The brain activation patterns were induced by visual stimulation with each rural and urban sceneries. The participants were divided into two groups as 26 subjects favorable to rural scenery and 14 subjects unfavorable to urban scenery based on their filled-in questionnaire. The differences of the brain activation in response to two extreme types of pictures by the two sample t-test were characterized as follows: the activation areas observed in rural scenery over urban were the insula, middle frontal gyrus, precuneus, caudate nucleus, superior parietal gyrus, superior occipital gyrus, fusiform gyrus, and globus pallidus. In urban scenery over rural, the inferior frontal gyrus, parahippocampal gyrus, postcentral gyrus, superior temporal gyrus, amygdala, and posterior cingulate gyrus were activated. The fMRI patterns also clearly show that rural scenery elevated positive emotion such as happiness and comfort. On the contrary, urban scenery elevated negative emotion, resulting in activation of the amygdala which is the key region for the feelings of fear, anxiety and unpleasantness. This study evaluated differential cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla fMRI. These findings will be useful as an objective evaluation guide to human suitability for ecological environments that are related to brain activation with joy, anger, sorrow and pleasure.