• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.3
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• pp.146-152
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• 2024

Objectives: This prospective observational study aimed to assess the clinical outcomes of perioperative airway and ventilatory management in patients undergoing surgery for oral cavity cancer. The study described the frequencies and types of procedures for securing the airway and the duration and types of postoperative ventilatory support. We compared the findings with those of the TRACHY study. Patients and Methods: One hundred patients undergoing oral cavity oncological surgeries were included. Airway assessment included inter-incisor gap, Mallampati class, neck movements, and radiological features. Surgical parameters, postoperative ventilatory support, and complications were documented. Results: The buccal mucosa was the most common cancer site (48.0%), and direct laryngoscopy was deemed difficult in 58.0% of patients. Awake fibreoptic intubation or elective tracheostomy was required in 43.0% of cases. Thirty-three patients were extubated on the table, and 34 patients were successfully managed with a delayed extubation strategy. In comparison with the TRACHY study, variations were observed in demographic parameters, tumour characteristics, and surgical interventions. Our mean TRACHY score was 1.38, and only five patients had a score ≥4. Prophylactic tracheostomy was performed in 2.0% of cases, in contrast to the TRACHY study in which 42.0% of patients underwent the procedure. Conclusion: The study emphasizes the challenges in airway management for oral cavity cancer surgery. While prophylactic tracheostomy may be necessary in specific cases, individualized approaches, including delayed extubation, are preferrable to maximize safety. Our findings contribute to better understanding and managing perioperative challenges in oral cancer patients and highlight the need for personalized strategies. Scoring systems like TRACHY should not be accepted as universally applicable.

• Sleep Medicine and Psychophysiology
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• v.7 no.1
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• pp.18-26
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• 2000

Objectives: To investigate the airway narrowing patterns by multi-level airway pressure(MAP) monitoring during sleep and to evaluate the value of CT scan taken during waking and sleep apneic periods to identify the level of airway narrowing(LAN) in patients with obstructive sleep apnea syndrome(OSAS). Methods: Eleven patients with OSAS underwent a night polysomnography with continuous MAP monitoring by 4-sensor(placed at nasopharynx, caudal-uvula, hypopharynx, esophagus) or 2-sensor(placed at caudal-uvula and esophagus) catheter. All patients had cine CT at five levels of high retro and alatal, low retropalatal, retroglossal, epiglottis and hypopharynx during awake and sleep periods. In each patient, LAN determined by CT scan($LAN_{CT}$) during sleep apnea was compared with LAN by MAP monitoring($LAN_{MAP}$). Results: MAP monitoring showed that four patients(36%) had a single pattern of LAN while the other seven patients(64%) showed two or more different LANs in different apneic episodes. Velopharynx was the most common level of frequently observed airway narrowing during sleep apnea(63.6%). However, a single pattern of airway narrowing was more frequent(72.7%) in airway CT during sleep apnea. Velopharynx was the most common narrowest level also in apneic CT(66%). In comparing $LAN_{CT}$ with $LAN_{MAP}$, the $LAN_{CT}$ of five patients(45.5%) were high-concordant, those of another five(45.5%) low-concordant, and that of one(9%) discordant with $LAN_{MAP}$. Conclusions: Cine CT scan during the awake state or sleep apnea may not reflect the LAN correctly in OSAS because most patients showed two or more different airway narrowing patterns during different episodes of sleep apnea in each patient.

• The Journal of the Korea Contents Association
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• v.8 no.12
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• pp.176-189
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• 2008

The purpose of this study was to analyze self-regulation about changing heart rate and perceived arousal variation when actors start their performance. Object of this study were 5 actors who belong to the theater selected using the purposive sampling method. This study used a measuring instrument of heart rate to measure arousal status, used behavior observation paper to observe and record self-regulation behavior and executed personal consultation after ending performance. There was graph mad by variation transition which calculated average and standard deviation about variation of heart rate each time of performance. The results of this study were as follows. First, there were high variation of awake level that actor's heart rates were rising before starting performance and the most high level of arousal was from 20minutes to 5minutes before starting performance. Second, there were self-regulation behaviors appeared such as deep breathing, breath controling, self talking, talking with other actors, concentrating an script, going to toilet, smoking, checking closes before starting performance. Third, when performance start, actors used psychological self-regulational method such as relaxation, self concentration, confidence reinforcement, coping with state or accommodation for controling raised arousal status.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1300-1307
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• 2001

Purposes : This study reports the possible causes of seizure recurrence in patients underwent previous epilepsy surgery, and surgical strategy for resection of the additional epileptogenic zone locating at the distant area to the site of first resection. Methods : A total of 10 patients with previous surgery due to intractable epilepsy were studied. Five of these underwent standard temporal lobectomy, four extratemporal resection, and one corticoamygdalectomy. Seizure outcome of these were class III-IV. Evaluation methods for reoperation included MRI, 3D-surface rendering of MRI, PET, prologned video-EEG recording with surface electrodes and subdural grid electrodes. Additional resection was done in the frontal lobe in two, in the temporal lobe in three, in the parietal lobe in two, and in the supplementary sensori-motor area in two. Tumor in the superior frontal gyrus in the left hemisphere was removed in one patient. Extent of resection was decided based on the results of ictal subdural grid EEGs and MRI findings. Awake anesthesia and electrocortical stimulation were performed in the two patients for defining the eloquent area. Results : Histopathologic findings revealed extratemporal cortical dysplasia in six, hippocampal sclerosis and cortical dysplasia of the temporal neocortex in one, neuronal gliosis in two, and meningioma in one. Previous pathology of the five patients with cortical dysplasia in the second operation was hippocampal sclerosis plus cortical dysplasia of the temporal neocortex. After reoperation, seizure outcomes were class I in six, class II in three, class III in one at the mean follow-up period of 17.5 months. Characteristically, patients in class II-III after reoperation showed histopathologic findings of hippocampal sclerosis plus temporal neocortical cortical dysplasia plus extratemporal cortical dysplasia. Conclusions : Seizure recurrence after epilepsy surgery was related with the presence of an additional epileptogenic zone distant to the site of first operation, and the majority of the histopathology of the surgical specimens was cortical dysplasia. In particular, hippocampal sclerosis plus temporal neocortical cortical dysplasia was highly related with seizure recurrence in patients with previous operation. In these patients, multimodal evaluation methods were necessary in defining the additional epileptogenic zone.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.3
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• pp.513-519
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• 1999

Chloral hydrate is one of the most widely used sedative agents to control the difficult to treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with Enflurane (1-1.5vol%) for 60 seconds to 37 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The average age and weight of the patients was 34.3 months(22-43mo.) and 14.9kg(11-21kg) respectively. It is suggested that sleep induction with low dose Eflurane produced a stable state during dental treatment with respect to vital sign and behavior. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of Acupuncture Research
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• v.18 no.3
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• pp.56-68
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• 2001

Objective : Functional brain mapping study on acupuncture stimulation using the [14C]2-deoxyglucose([14C]2-DG) autoradiography provides quantitative data and visualized pathway in central nervous system(CNS). We aimed to investigate the neural pathway and spatial distribution of metabolic activity elicited in CNS on electroacupuncture stimulation using [14C]2-DG autoradiography. Methods : The study were divided into three groups by stimulation times. 45-mins stimulation group according to Sokoloffs method, 5-mins stimulation group according to Duncun's method, and 15-mins stimulation group. ;A venous catheter was equipped into right jugular vein. The rats (Sprague-Dawley rats, 230-260g) were kept fastened loosely on a holding platform without anesthesia. Electroacupuncture stimulation (5 ms, 2 Hz, 1~3 mA) were applied on the left Zusanli (ST36) acupoint and [14C]2-DG ($25{\mu}Ci/rat$) injection was performed through the catheter. After sacrifice, the brain and the spinal cord were made to sections for film image. The film images were digitalized as the isotope concentration based upon comparison of optical densities with that of the standards and normalized by the optical density of corpus callosum. Results : 1. 15-mins stimulation group was most effective among 3 experiments. 2. On 15-mins stimulation group, medial geniculate nucleus, intetpeduncular nucleus intermedius, ventral periolivary nucleus, caudal periolivary nucleus, medial superior olive, lateral paragigantocellular nucleus, including hypothalamic arcuate nucleus were increased by more than 25% (at least, p<0.05) by electroacupuncture stimulation. 3. Especially, the metabolism in hypothalamic arcuate nucleus was increased by 90% (p<0.05). 4. The fact that arcuate nucleus of hypothalamus might play a role of interconnection area between ascending and descending pathway of acupuncture stimulation was demonstrated visually. Conclusions : Advanced study on electroacupuncture stimulation elicited significant increase of metabolic activity in various nuclei of hypothalamus will provide the important experimental basis in research of the relationship between electroacupuncture stimulation and internal visceral functions.

• Journal of Nutrition and Health
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• v.32 no.6
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• pp.644-653
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• 1999

Background : Excessive intakes of $\omega$6 polyunsaturated fatty acid (PUFA) can increase oxidative stress, which may increase insulin resistance and could be the cause of metabolic syndrome X such as diabetes mellitus. One of the ways to reduce oxidative stress is the consumption of antioxidants such as vitamin E. It is controversial that vitamin E intakes may alleviate insulin resistance. The purpose of the study was whether high vitamin E intake may influence whole body glucose disposal rate(GDR), glycogen deposites, triglyceride content, lipid peroxide levels and antioxidant enzyme activities in Sprague Dawley rats fed high $\omega$6 PUFA diest. Methods : Sprague Dawley rats were divided into three groups. The control group consumed chow diet. High and low vitamin E groups consumed 40% PUFA of total energy intakes. One kilogram of diet mixture contained 300IU of $\alpha$-tocopherol in high vitamin E group, while it had 30 IU in low vitamin E group. Diets were given for 8 weeks. After 7 were of diet consumption, indwelling catheters were inserted in carotid artery and jugular vein of all rats so that GDR could be measured in awake and unstressed state. Results : Daily PUFA intakes were lower in the control group than others. Daily vitamin E intake of high vitamin E group was about ten times higher than those of low vitamin E group and the control group(p<0.0001). $\alpha$-tocopherol content in lier was highest in the high vitamin E group. GDR of the control group was 24% higher than others, and vitamin E intakes did not affect GDR. Glycogen deposit of liver in the control group was significantly higher than others, and it was not altered by vitamin E supplementation. Muscle glycogne content showed a similar tendency as liver glycogen in different diet groups. Triglyceride deposit in muscle was not different among groups. Lipid peroxide content of liver in the high vitamin E group was lower than the low of glutathione peroxidase were lowered in low vitamin E group than others, however, those of superoxide dismutase and catalase were not different. Conclusions : High vitamin E intakes can decrease oxidative stress in rats fed high (())-6 PUFA diet, but they cannot alleviate insulin resistance. Thus, increased oxidative stress through high (())-6 PUFA diet may be minimal for influencing insulin resistance.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.82-89
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• 2017

This paper intends to examine how North Korea has incited and persuaded its people by figuring out the structure regarding the meaning creation of its documentary film "Kim Jong-un, the Respected Comrade Supreme Commander, Giving On-site Guidance on the Grand Project of the People's Army" produced in 2015, which was North Korea's politically important year. The analysis results show that its narrative structure of the film took the form of an introduction, body, and conclusion to substantiate it obviously given theme. Its imaging techniques are geared towards uplifting the public's combat mentality and its sound contributes to achieving their adherence. In this regard, its film literature has the following meaning structure: first, the film takes the form of both film annals and the structure for the public to easily comprehend; second, the film clearly demonstrates its deep-rooted theme asking for the public to follow in the footsteps of the party's late father for its leadership; and third, the film also aims to establish the images of an always awake working leader by implanting and arranging the leader's diligence about his revolutionary activities in the documentary film. North Korea's documentary films serve as a weapon used for instigating revolution and construction. Given this, the producers of all documentary films have made sure to turn film literatures into the film literatures of the great leader. It was identified that under the social vision that the Kim Jong-un regime is a "socialist civilized country", he has tightened his grip on power in North Korea through the propaganda tool of film literatures.

• Sleep Medicine and Psychophysiology
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• v.1 no.1
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• pp.47-59
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• 1994

Objectives: The main purpose of this study was to investigate the possible differences in sleepiness, performance, and body temperature during the night between morning(M) and evening(E) type subjects. Methods: After a survey study, to verify the validity and reliability of the Korean translation of the Home' and $\ddot{O}stberg's$ Morningness-Eveningness Questionnaire(1976), 8 extreme M-type subjects(3males, 5 females) and 8 extreme E-type subjects(3 males, 5 females) were selected from the university student population who had participated in the survey study. All subjects underwent sleep latency test and a battery of performance tests at intervals of 2 hours through the night, from 23:00 to 07:00. Oral temperature of each subject was taken every hour from 21 : 00 to 8 : 00. Between the testing times, the experimenters ensured that subjects remained awake. Results: More profound sleepiness was found in the M-type compared to the E-type throughout the night, with significant differences in sleepiness occuring at 23:00 and 01:00 hours. Overall performance efficiency tended to be lower through, the night in the M-type than in the E-type on all tests. A difference in time of temperature minimum between the two types was not noteworthy. Rather, there appeared to be a substantial difference in temperature level during the declining phase, with the temperature of the M-type being lower than that of the E-type. Conclusions: These results indicate the existance of a temporal relationship between sleepiness, perfonnance and body temperature during night work. Since the M-type exhibited greater sleepiness and lower performance efficiency overnight than the E-type, it may be assumed that the E-type is more suitable for and tolerable to night work. There was some discussion of the limitations in generalizing these results together with some suggestions for future studies.

• Anxiety and mood
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• v.9 no.2
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• pp.128-134
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• 2013

Objective : As treatments for breast cancer require long period of time, the patients need continuous monitoring and management of their health related quality of life. The purpose of this preliminary study is to explore the utility of monitoring quality of life using a mobile phone based application, which was developed to enable the patients to report daily quality of life more efficiently. Methods : Department of psychiatry, breast cancer center and U-health team of Asan Medical Center collaborated in developing a mobile application titled 'DugunDugun'. Through the application, patients with breast cancer receiving neo-adjuvant chemotherapy could report on various questions about their daily quality of life. We extracted and explored the daily basis of the data of sleep duration, number of awake, sleep satisfaction, mood and anxiety from nine patients who reported on the questionnaire for more than a month. Results : The longitudinal data collected using our mobile application well represented the characteristics of individual sleep patterns and daily emotional changes. Most of the patients showed high daily variations in the scores of their quality of life while their averaged scores were similar among patients. The patient with highest daily variations in the subjective sleep quality and daily emotional change had highest score corresponding to moderate depression in Beck Depression Inventory (BDI). Conclusion : The results suggest that mobile application could be a useful tool for monitoring and collecting the daily quality of life in the patients with breast cancer. We expect that mobile application could facilitate early detection and proper intervention for the cancer patients at psychological crisis.