• Annals of Clinical Neurophysiology
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• v.6 no.1
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• pp.43-47
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• 2004

We report a case of 36-year-old woman with myasthenia gravis (MG) combined with mediastinal leiomyosarcoma (LMS) and Stevens-Johnson syndrome (SJS). She was admitted to ICU with the symptoms of acute onset headache, diplopia, ptosis, dysphagia, general weakness, and respiratory difficulty for several days. Physical examination revealed tachypnea, decreased breath sounds and dullness to percussion in right lower chest. Neurologic examination showed ptosis, diplopia, decreased gag reflexes, and generalized proximal weakness. Laboratory studies revealed increased serum acetylcholine receptor antibodies and positive Tensilon test. Chest CT showed a huge mass in the right middle mediastium but no evidence of thymic enlargement. Mediastinal LMS was diagnosed by ultrasound-guided needle biopsy. The myasthenic symptoms were fluctuated in spite og intravenous immunoglobulin, plasmapheresis, and corticosteroid. During therapy, SJS developed. She died 4 months after the onset of the myasthenic symptoms despite the chemotherapy for LMS.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.170-174
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• 1978

A case of mediastinal seminoma is presented. A male driver, 27 years old Korean, has been suffered from substernal pain, cough and moderate swallowing difficulty since 5 months prior to this admission. At the time of onset, he visited at a local clinic to find some mass in his anterior mediastinum on chest P-A and lateral X-ray check. Recently, intermittent hiccups with much aggravated dysphagia forced him to visit our hospital, and admitted for radical resection under the impression of anterior superior mediastinal tumor of thymus origin. Median sternotomy was done and total resection of the tumor of 8.0X11.0X3.5cm was done without any specific complication and biopsy of the tumor revealed as primary mediastinal seminoma of the mediastinum. Supplementary prophylactic irradiation therapy was done with a tumor dose of 4,000 rad in 4 weeks after operation. Postoperative hospital course was uneventful and patient was joyful with his occupation for 3 months after discharge.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.19 no.2
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• pp.281-287
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• 2006

Objective : This study was designed to evaluate the effects of oriental medicine therapy on Vocal cord paralysis with Ramsay Hunt syn. Methods & Result : The clinical data was analyzed on a patient with Vocal cord paralysis with Ramsay Hunt syn. whose main symptoms were right facial palsy, auricle pain, dysphagia and hoarseness. The patient was treated by the acupucture and Herb-medicine.. As the result, symptoms are improved. Conclusion : This result suggest that the acupucture and Herb-medicine. was effective treatment of Vocal cord paralysis. So futher research is needed continuously.

• Therapeutic Science for Rehabilitation
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• v.10 no.1
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• pp.37-52
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• 2021

Introduction : Oral motor function is basic function of sensory exploration, feeding, and communication, that develops from the fetal stage to childhood. Problems with oral motor function result in difficulty within handling food in the oral cavity, decreased swallowing and feeding skills, difficulty with communication, and problems with oral hygiene. To treat these symptoms, oral motor therapy is provided for normalizing sensory adaptation in the oral cavity, and increasing postural control, oral movement and oral motor function. Discussion : The oral motor facilitation technique (OMFT) was developed for increasing general and integrated oral motor function based on the following: 1) understanding orofacial muscular physiology; 2) a comprehensive approach to sensory·adaptation·behavior·cognition; 3) sensorimotor stimulation by a manual approach; 4) motor control and motor learning theory. The OMFT is a new evidence-based treatment protocol, for children and adults with neuromuscular and oral motor problems. Conclusion : The goal of this article is to provide a theoretical background for OMFT development and the basic concept for the clinical application of OMFT. We hope that this article will help oral motor therapy experts to provide effective therapy in a more professional way.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.5
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• pp.2981-2988
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• 2014

The Purpose of the this study was to identify reliability and validity of the Korean version of the Swallowing Quality of Life questionnaire(KSWAL-QOL). The study was performed in 71 patients diagnosed dysphagia by videofluoroscopy and 80 healthy swallowers. The reliability was good with a Cronbach's ${\alpha}$ and intraclass correlation coefficient of .86~.96 and .80~.93, respectively. The Pearson product moment correlation coefficients between KSWAL-QOL scales ranged from .17~.74 which was showed significant correlation. Healty swallowers scored higher than dysphagic patients on all scales and statistically significant differences were observed across all the scales between healthy swallowers and dysphagic patients(p<.01). Tube feeders scored lower than non-tube feeders on all scales and statistically significant differences were observed in all the scales except sleep(p<.05). There are significant difference between diet steps in all scales except eating desire, communication, fear and people on diet fourth step feeding had the highest scores on the all scales(p<.05). Because KSWAL-QOL seems to be a reliable and valid tool, it is considered to be appropriate as a tool to measure quality of life of patient with swallowing disorder.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.69-83
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• 2022

Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

• Therapeutic Science for Rehabilitation
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• v.11 no.1
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• pp.69-85
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• 2022

Objective : This study aimed to develop a Comprehensive Oro-Facial Function Scale (COFFS) that can evaluate oro-facial function in patients with dysphagia. Methods : To verify the item composition and reliability of the COFFS, preliminary items were collected by selecting and analyzing four previous studies, and the Content Validity Ratio (CVR) was derived through a second survey of experts. Cronbach's 𝛼 was calculated for the internal validity of the evaluation items, and the test-retest reliability and inter-rater reliability were calculated using the internal classification coefficients (ICC). Results : The content validity ratio of all items was 0.67; in the case of Cronbach's 𝛼 value for each domain, 0.849 for communication domain, -0.224 for the oro-facial structure and shape, 0.831 for the ability to perform orofacial movements, and 0.946 for mastication and swallowing function. The test-retest reliability was 0.974 and the inter-rater reliability was 0.937, showing high reliability. Conclusion : In this study, the evaluation tool of COFFS was finally selected from 34 items in four areas and developed on a 3-5 point scale according to the evaluation items. In future studies, additional research is needed to prove its validity through correlation with other evaluation tools that measure oro-facial function.

• Therapeutic Science for Rehabilitation
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• v.10 no.1
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• pp.53-61
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• 2021

Introduction : OMFT is a therapeutic technique based on sensorimotor, motor control and motor learning, and its major goal is to improve oral motor function. The oral motor conceptual hierarchical development is divided into 5 steps: 1) sensorimotor, 2) movement integration, 3) structural movement, 4) functional oral motor, and 5) comprehensive oral motor. Discussion : The OMFT consists of 3 techniques, 10 categories, and 50 sub-item. 1) Warming up technique: 2 categories, 12 sub-item, warming up by sensory awareness and adaptation, therapy situation adaptation, neck movement; 2) Key point technique: 7 categories, 30 sub-item, oral motor facilitation and increasing chewing skill by direct stroke of oral structures such as the face, lips, cheeks, gum, jaws, and tongue; 3) Application technique: 1 category, 8 sub-item, facilitate food intake and swallowing. Conclusion : The goal of this article is to introduce 3 techniques, 50 sub-item of OMFT, as a comprehensive oral motor therapy method, for application to clients. This article provides information that will help oral motor specialists in treating clients with oral motor problems more effectively and professionally.

• Radiation Oncology Journal
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• v.26 no.1
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• pp.17-23
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• 2008

Purpose: The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Materials and Methods: Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy(median dose, 57.2 Gy) over $36{\sim}115$ days(median time, 45 days). Thirteen patients(43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus(56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. Results: The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate $1{\sim}3$ months after radiotherapy was 20%(6/30) and the partial response rate was 70%(21/30). Sixteen patients(53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients(10%), and radiation pneumonitis occurred in two patients(6.7%). Conclusion: The prognosis of esophageal cancer remains poor, in spite of advances in radiotherapy techniques. Radiotherapy is one of the main treatment modalities for the relief of dysphagia and treatment related complications are minimal. It is expected that the addition of chemotherapy or another systemic modality to radiotherapy will improve tumor control and increase the survival rate in advanced esophageal cancer.

• Korean Journal of Bronchoesophagology
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• v.15 no.2
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• pp.49-56
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• 2009

Purpose : To evaluate the treatment outcome for patients with locally advanced, unresectable esophageal cancer treated with relatively high dose radiation therapy(RT). Materials and Methods : From January 2000 to December 2008, 32 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated with radiation therapy(RT) with or without concurrent chemotherapy. Ten patients were excluded from analysis because of distant metastasis and drop off. Patient distributions according to AJCC stages II, III IVa were 7(31.8%), 12(54.6%), 3(13.6%) respectively. The locations of tumor were cervical/upper thorax 3 (13.6%), mid thorax 13(59.1%), and lower thorax/abdominal 6(27.3%), respectively. Eleven patients received RT only, and 11 patients received cisplatin based concurrent chemoradiotherapy(CCRT). Median radiation dose was 65 Gy(range 57.6~72 Gy). Results : The median follow-up was 9.1 months(range 1.9~43.8 months). The response rates for complete response, Partial response, stable disease and Persistent disease were 6(27.3%), 11(50.0%), 4(18.2%) and 1(4.5%), respectively. Two patients(9.1%) suffered from esophageal stenosis and stents were inserted. Two patients(9.1%) had Grade 3 radiation pneumonitis and one of them expired due to acute respiratory distress syndrome(ARDS) at 36 days after completion of radiation therapy. The recurrence rate was 11(50.0%). The patterns of recurrence were persistent disease and local progression in 5(22.7%), local recurrence 3(13.7%) and concomitant local and distant recurrence in 3(13.7%). The overall survival(OS) rate was 32.1% at 2 years and 21.4% at 3 years(median 12.0 months). Disease free survival(DFS) rate was 17.3% at 2 and 3 years. All patients who had no dysphagia at diagnosis showed complete response after treatment and 100% OS at 3 years(p=0.0041). The OS for above 64.8 Gy group and 64.8 Gy or below group at 3 years were 60.6% and 9.1%(p=0.1341). The response to treatment was the only significant factor affecting OS(p=0.004). Conclusion : Relatively high dose radiation therapy in unresectable esophageal cancer tended to have a better outcome without increased complication rate. Further study with more patients is warranted to justify improved result.