• 대한후두음성언어의학회지
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• 제9권1호
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• pp.22-26
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• 1998

Uvulopalatopharyngoplasty(UPPP) is one of the most popular surgical procedure for the treatment of obstructive sleep apnea syndrome(OSAS) occurring at the level of oropharynx. However, voice changes after UPPP have been a challenging issue for the professional voice users, because even minor changes in voice quality or articulation may be critical to professional singers, teachers, and so on. Several acoustic changes after UPPP have been proposed. However, based on the authors understanding, there is no report about voice changes after UPPP in Korean. We measured the first, second and third formant frequencies of /a/, /i/, /u/ phonations in 20 adult male patients who had undergone UPPP surgery, and the nasalances of Rabbit, Baby, and Mama passages. These parameters were measured preoperatively, at 1 month and 3 months after the operation. Any subjective voice changes were asked to be reported at the posto-perative visits. The third formant(F3) of /u/ phonation was significantly reduced at postoperative 1 month measurement. The nasalance of Mama passage was singnificantly increased at postoperative 3 months measurement. No one complained of subjective changes in voice quality, timbre, articulation or speech. Even though there are no complaints about postoperative voice changes subjectively, significant changes in the formant characteristics of certain vowel and changes in the nasality after UPPP require the clinicians to be mort cautious and careful in deciding UPPP for the professional voice users.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.428-431
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• 2015

Epithelial-myoepithelial carcinoma (EMC) of lung is a minor subset of salivary type carcinoma of lung of known low grade malignancy. Histologically, two-cell components forming duct-like structure with inner epithelial cell layer and outer myoepithelial cell layer are characteristics of EMC. In salivary gland, dedifferentiation of conventional low grade malignancy has been reported and is thought to be related with poor prognosis. However, precise histomorphology and prognostic factors of pulmonary EMC have not been clarified due to its rarity. Herein, we reported a rare case of EMC presented as endobronchial mass in a 53-year old woman, which showed predominant solid lobular growth pattern and lymph node metastases.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.491-499
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• 2000

Objective : In the cerebral aneurysm surgery, the goal is complete circulatory exclusion of the aneurysm without compromise of normal vessels. In an operating room, an operator should confirm the completeness and precision of the surgical result, before closing the wound. Object of this study was to determine which cases require intraoperative angiography. Methods : We reported our experience with 48 intraoperative angiographic studies performed during the surgical treatment of cerebral aneurysm of these 48 cases. There were 5 giant(10.4%), 15 globular(1.5-2.5cm)(31.25%) and 28 saccular(58.3%) aneurysm. We recorded the incidence of unexpected findings, such as residual aneurysms, major vessel occlusions. Using Fischer's exact test, we assessed whether unexpected angiographic findings showed any correlation with aneurysm site, size and clinical findings. Results : In 5 cases(10.4%), we detected unexpected angiographic findings which resulted in clip adjustment. By means of clip adjustment, an operator could restore the flow of two major arterial occlusion(4.2%) and also obliterate three persistent filling aneurysms(6.3%). Globular aneurysm was the only factor to predict unexpected angiographic findings(p<0.05). The subgroup of globular and giant aneurysm has a high risk of occlusion of the parent artery and its branches and/or residual aneurysm. There were two minor complications related to this procedure. Conclusion : Intraoperative assessment makes it possible to recognize and correct the technical defect. Particularly in globular aneurysm, we were able to prevent both the chance for another operation and the risk of postoperative complications.

• Advances in Computational Design
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• 제4권3호
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• pp.295-305
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• 2019

The sealing cement of total hip arthroplasty is the most widely used binder in orthopedic surgery for anchoring implants to their recipient bones. Nevertheless, this latter remains a fragile material with weak mechanical properties. Inside this material cracks initiate from cavities. These cracks propagate under the effect of fatigue and lead to the failure of this binder and consequently the loosening of the prosthesis. In this context, this work consists to predict the position of cracks initiation and their propagations path using the Extended Finite Element Method (XFEM). The results show that cracks can only be initiated from a sharp edges of an ellipsoidal cavity which the ratio of the minor axis over the major axis is equal to 0.1. A maximum crack length of 19 ?m found for a cavity situated in the proximal zone position under a static loading. All cracks propagate in same(almost) way regardless of the cavity(site of initiation) position and its inclination in the proximal zone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권1호
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• pp.3-14
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• 2021

Excessive gingival display is an esthetic issue that is commonly managed by different procedures. Lip repositioning is a modality to address concerns of affected patients. The aim of this review was to investigate the scientific evidence on outcomes and long-term stability of lip repositioning surgery with or without myotomy. The electronic search was conducted in three databases: MEDLINE, Embase, and the Cochrane Library up to October 2019. No publication status, language, or time restrictions were applied. The electronic search was complemented by a manual search of the reference lists. Three hundred thirty-eight studies were screened by title, and 16 articles remained for data extraction. The included studies assessed the lip repositioning procedure in 144 patients aged between 15-59 years (134 females and 10 males). Based on the available data, lip repositioning with myotomy/muscle containment can be a successful treatment for minor discrepancies in gingival display in selected cases. However, further well-organized controlled clinical trials are recommended to derive a conclusion about the long-term stability compared with other alternatives.

• The Journal of Korean Physical Therapy
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• 제34권3호
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• pp.104-109
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• 2022

Purpose: The purpose of this pilot study is to identify the problems and stability of a study to investigate "Effects of Squat Exercise according to Weight Support on Balance and Gait in Patients after Total Hip Replacement." before proceeding with the study. Methods: Twenty-two rehabilitation patients after THR surgery who met the selection criteria participated. The study subjects were randomly assigned to a squat group using a slider or a squat group using a reformer. The interventions were applied for two weeks. The patients were assessed using Berg balance scale (BBS), Timed up and go test (TUG), and 10-meter walking test (10MW). Results: Although twenty-two study subjects participated in this study, eight study subjects participated dropouts occurred during the study period. There was a significant difference within the group in BBS and TUG in two groups (p<0.05). The difference between the two groups was not significant in all outcome measures (p>0.05). The largest effect size was 1.21 and the smallest effect size was 0.39, all from the BBS. Conclusion: This pilot study suggest that it is feasible with minor adjustment to conduct a larger scale, powered RCT to examine the efficacy of squat exercise according to weight support with patients after THR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권1호
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• pp.13-20
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• 2022

The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.328-334
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• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• Korean Journal of Radiology
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• 제25권8호
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• pp.749-755
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• 2024

The recent surge in the incidence of small papillary thyroid cancers (PTCs) has been linked to the widespread use of ultrasonography, thereby prompting concerns regarding overdiagnosis. Active surveillance (AS) has emerged as a less invasive alternative management strategy for low-risk PTCs, especially for PTCs measuring ≤1 cm in maximal diameter. Recent studies report low disease progression rates of low-risk PTCs ≤1 cm under AS. Ongoing research is currently exploring the feasibility of AS for larger PTCs (<20 mm). AS protocols include meticulous ultrasound assessment, emphasis on standardized techniques, and a multidisciplinary approach; they involve monitoring the nodules for size, growth, potential extrathyroidal extension, proximity to the trachea and recurrent laryngeal nerve, and potential cervical nodal metastases. The criteria for progression, often defined as an increase in the maximum diameter of the PTC, warrant a review of precision and ongoing examinations. Challenges exist regarding the reliability of volume measurements for defining PTC disease progression. Although ultrasonography plays a pivotal role, challenges in assessing progression and minor extrathyroidal extension underscore the importance of a multidisciplinary approach in disease management. This comprehensive overview highlights the evolving landscape of AS for PTCs, emphasizing the need for standardized protocols, meticulous assessments, and ongoing research to inform decision-making.

• Anatomy and Cell Biology
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• 제55권2호
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• pp.118-123
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• 2022

This study aimed to clarify the anatomy of middle rectal artery and pelvic vasculature patterns, and to provide schematic information in a manner applicable to the total mesorectal excision. Forty sides of pelvis from 20 formalinembalmed cadavers (10 male, 10 female) were dissected, and all the pelvic vasculatures from the internal iliac artery were investigated, focusing on the middle rectal artery. Middle rectal arteries were classified into major types depending on their vascular origins. Each type was subdivided into minor types according to variability of the pelvic vasculature. A middle rectal artery was identified in 18 out of 20 cadavers, and in 25 out of 40 pelvic sides. In most cases, the middle rectal artery originated from the internal pudendal artery or inferior gluteal artery. These two arteries arose directly from the anterior trunk of the internal iliac artery or were bifurcated from the gluteal-pudendal trunk. In rare cases, these arteries arose from the posterior trunk of the internal iliac artery. The other origins of the middle rectal artery included the gluteal pudendal trunk, inferior vesical artery, internal iliac artery, obturator artery, and the prostatic artery, and the pelvic vasculatures in these cases also presented variability. The detailed anatomical findings related to the middle rectal artery and pelvic vasculatures are noteworthy for their improved clinical applicability.