Kim, Kyu Yeun;Hur, Ji Ae;Kim, Ki Hwan;Cha, Yoon Jin;Lee, Mi Jung;Kim, Dong Soo
Clinical and Experimental Pediatrics
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v.58
no.3
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pp.108-111
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2015
DiGeorge syndrome is an immunodeficient disease associated with abnormal development of 3rd and 4th pharyngeal pouches. As a hemizygous deletion of chromosome 22q11.2 occurs, various clinical phenotypes are shown with a broad spectrum. Conotruncal cardiac anomalies, hypoplastic thymus, and hypocalcemia are the classic triad of DiGeorge syndrome. As this syndrome is characterized by hypoplastic or aplastic thymus, there are missing thymic shadow on their plain chest x-ray. Immunodeficient patients are traditionally known to be at an increased risk for malignancy, especially lymphoma. We experienced a 7-year-old DiGeorge syndrome patient with mediastinal mass shadow on her plain chest x-ray. She visited Severance Children's Hospital hospital with recurrent pneumonia, and throughout her repeated chest x-ray, there was a mass like shadow on anterior mediastinal area. We did full evaluation including chest computed tomography, chest ultrasonography, and chest magnetic resonance imaging. To rule out malignancy, video assisted thoracoscopic surgery was done. Final diagnosis of the mass which was thought to be malignancy, was lymphoproliferative lesion.
OBJECTIVES: This study was designed to measure the minimal cross-sectional areas and volumes of the pharynx in snoring patients and normal subjects and to see if there is an increase in the minimal cross-sectional areas and volumes of the pharynx with advancement of the mandible. METHODS: The pharyngeal computed tomography and 3-dimensional reconstruction were used to measure the cross-sectional areas and volumes of the nasopharynx, oropharynx, and hypopharynx with the jaw in normal position and in protrusive position in 7 patients with snoring and 7 control subjects while they were awake. RESULTS: The oropharynx was revealed to have the most narrow site in the pharynx and there was a tendency for the snorers to have a smaller nasopharyngeal and oropharyngeal cross-sectional area than normal subjects but not statistically significant. There were no significant differences in the volumes of the nasopharynx and oropharynx between the two groups. With advancement of the jaw the minimal cross-sectional area of oropharynx was significantly increased, and the volume was also increased but not significantly. The minimal cross-sectional areas and volumes of nasopharynx as well as hypopharynx were not significantly influenced by the advancement of the mandible. CONCLUSIONS: There was a tendency for snorers to have a smaller oropharynx than normal subjects and the oropharyngeal lumen was increased with the advancement of the mandible in both snorers and normal subjects.
Kim, Sang Hyun;Im, Jun Sang;Kim, Bong Seok;Lim, Hyun Ju;Oh, Jong Woo;Park, Jin Suck;Yoon, Young Jin;Lee, Ha Na;Cha, Dong Seok;Jeon, Hoon
Korean Journal of Pharmacognosy
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v.46
no.1
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pp.38-43
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2015
Ligularia stenocephala has a wide range of types of constituents with various pharmacological properties. Here in this study, we examined the effect of methanolic extract of L. stenocephala (MLS) on the lifespan and stress tolerance using Caenorhabditis elegans model system. We found that lifespan of wild-type worms was significantly lengthened in the presence of MLS in a dose dependent manner. MLS also elevated the tolerance of worms against osmotic, heat shock, and oxidative stress. We also demonstrated in vivo antioxidant capacity of MLS by checking intracellular reactive oxygen species levels as well as antioxidant enzyme activities such as catalase and superoxide dismutase. We further investigated several aging-related factors, including pharyngeal pumping rate and body length. Here, we showed that MLS exerts longevity effect independent of both factors. In addition, body movement of aged worms was significantly elevated, suggesting MLS could enhance healthspan as well as lifespan.
Purpose: A Tessier classification number 7 cleft is an uncommon malformation that results from a failure of mesenchymal fusion within the maxillary and mandibular prominences of the 1st pharyngeal arch. Many operative techniques of the number 7 cleft repair have been proposed to restore function and improve aesthetics. Fifteen patients underwent repair of a number 7 cleft over 13 years by a modification of the surgical Technique, and an appraisal of the operative outcome is reported herein. Methods: A retrospective review was conducted involving 15 patients with number 7 clefts who underwent surgery from 1996 to 2009. The changes in surgical technique included skin closure, attachment of the orbicularis oris muscle, and position of the repaired commissure; the changes were analysed with a review of the medical records and the outcomes of surgery were analysed via photographs. Specifically, the technique of skin closure was changed from the a Z-plasty to a linear closure, the orbicularis oris muscle overlapped attachment was replaced by a side-to-side approximation with horizontal mattress sutures, and the position of the repaired commissure was changed from 1 mm laterally to 1 mm medially in reference to the non-cleft side. Results: A Z-plasty caused additional cutaneous scarring, an overlapped attachment of the orbicularis oris muscle caused a thick oral commissure, and the repaired commissure migrated to the lateral side, so a 1 mm, laterally-positioned commissure caused asymmetry. The altered procedure included a linear skin closure, a side-to-side orbicularis oris muscle approximation, and a 1 mm, medially-positioned commissure, which together resulted in a good outcome. Conclusion: The altered procedure for repair of a number 7 cleft as described herein, yields a short scar, no functional problems with the orbicularis oris muscle, a thin oral commissure, and symmetry of the repaired commissure.
Do, Su Bin;Chung, Chul Hoon;Chang, Yong Joon;Kim, Byeong Jun;Rho, Young Soo
Archives of Plastic Surgery
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v.44
no.6
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pp.530-538
/
2017
Background A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula. Methods Squamous cell carcinoma cases that underwent flap reconstruction after cancer resection from 1995 to 2013 were analyzed retrospectively. We investigated several significant clinical risk factors. The treatment modality was selected according to the size of the fistula and the state of the surrounding tissue, with options including conservative management, direct closure, flap surgery, and pharyngostoma formation. Results A total of 127 cases (18 with fistulae) were analyzed. A higher T stage (P=0.048) and tube-type reconstruction (P=0.007) increased fistula incidence; other factors did not show statistical significance (P>0.05). Two cases were treated with conservative management, 1 case with direct closure, 4 cases with immediate reconstruction using a pectoralis major musculocutaneous flap, and 11 cases with direct closure (4 cases) or additional flap surgery (7 cases) after pharyngostoma formation. Conclusions Pharyngocutaneous fistula requires global management from prevention to treatment. In cases of advanced-stage cancer and tube-type reconstruction, a more cautious approach should be employed. Once it occurs, an accurate diagnosis of the fistula and a thorough assessment of the surrounding tissue are necessary, and aggressive treatment should be implemented in order to ensure satisfactory long-term results.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.16
no.2
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pp.118-122
/
2005
Background and Objectives The compensatory articulation not only influences general speech intelligibility, but also prevents precise assessment of the velopharyngeal function. This study was performed to investigate frequently affected phonemes, prevalence and the characteristics of compensatory articulation in the patients with cleft palate having velopharyngeal insufficiency. Material and Method An archival review was taken on 103 cleft palate subjects. Their age ranged from 2.6 to 63 years (mean age of 9.8 years). They were grouped into two : preschool group (n=71) and older patient group (n=32). The prevalence and patterns of compensatory articulation were examined on oral high pressure consonants such as plosives, fricatives and affricates. Results : Compensatory errors were observed in $49.5\%$ of the subjects and were mostly glottal stops with the exception of 4cases who had pharyngeal fricatives in addition to glottal stops. The most frequently substituted phonemes were velar plosives and tense sound. There was no significant difference of prevalence in both groups. However, errors for bilabial and alveolar plosives were more frequently observed in preschool group. Conclusion High prevalence of compensatory articulation observed in both preschool and older age group indicates that their articulation errors tend to remain unless appropriate speech therapy is provided. To improve speech intelligibility of the patients with cleft palate having velopharyngeal insufficiency, it is advisable to address and correct the compensatory articulation errors in their earlier ages.
Kim, Hak Geon;Kim, A Young;Cha, Eunjoo;Lee, GilJoon
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.28
no.1
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pp.38-42
/
2017
Background and Objectives : Globus pharyngeus is a sensation of foreign body in the throat. There are many studies evaluate relationships between globus pharyngeus and organic diseases such as laryngopharyngeal reflux, esophageal motility disorders as well as psychotic causes. But, Also many patients without etiologic causes complain of globus sensation. The authors performed a study that evaluate association between oral water intake and symptoms of globus sensation on the basis of a belief that pharyngeal dehydration due to lack of oral water intake causes globus sensation. Materials and Methods : A survey using visual analogue scale to evaluate symptoms was performed with 73 patients with globus pharyngeus. Results : Patients who drink water less than 500 mL per day (p=0.04) and less than five times per day (p=0.02) were improved after 6 months due to education and doctor's recommendation. Conclusion : Frequent and enough water intake should be recommended to resolve symptoms of globus sensation.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.40
no.1
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pp.43-47
/
2014
Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.
PURPOSE. To assess removable prosthetic restoration tolerance according to the patient section of the short form of the Gagging Problem Assessment Questionnaire (GPA-pa SF) and the influence of gender, education level and prosthesis type and denture-related mucosal irritation on the GPA-pa SF scores before treatment and over a period of two months after prosthesis insertion. MATERIALS AND METHODS. 130 participants who required removable prosthesis were surveyed with a standard form that included questions regarding age, gender, education level, dental attendance, and prosthetic restoration type. Participants answered the GPA-pa SF before restoration (T0) and 1 day (T1), 2 days (T2), 15 days (T3), 1 month (T4), and 2 months (T5) after prosthesis insertion. RESULTS. Of the 130 participants, 110 participants completed the prosthetic restoration procedure, but only 93 of these were able to use the prosthesis over the two-month period. The mean GPA-pa SF score obtained at T0 was higher than the scores obtained at the other periods in the total of the sample. Significant difference was present between mean scores obtained at T0-T1 and T2-T3 than scores obtained at other periods (P<.05). Female participants and participants with denture-related mucosal irritation had higher GPA-pa SF scores at all time points analysed. Significant difference was present between mean GPA-pa SF scores obtained at T2-T3 than scores obtained at other periods for females and participants with denture-related mucosal irritation (P<.05). Education level and prosthesis type did not significantly influence the GPA-pa SF score at any time point analysed (P>.05). CONCLUSION. GPA-pa SF scores were higher before the restoration procedure began, and decreased over time with the use of prosthesis. Gender and denture-related mucosal irritation affected the GPA-pa SF scores.
Kim, Dae-Sung;Kim, Myung-Rae;Choi, Jang-Woo;Kim, Choong
Maxillofacial Plastic and Reconstructive Surgery
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v.21
no.4
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pp.395-400
/
1999
Elongation of the styloid process (styloid syndrome, Eagle's Syndrome) is named after Eagle who insisted the styloid process as a cause of pain but distinguishable from the glossopharyngeal neuralgia. Eagle's syndrome is characterized by a dull nagging pharyngeal pain, a palpable hardness in the tonsillar fossa, radiopaque elongation and enlargement of the syloid process. This is to report two cases of Eagle's Syndrome. The clinical and radiological features, development and pathogenesis of the Eagle's Syndrome and pathologic findings of the calcified styloid ligaments were described with review of literatures. The external cervical approach to resect the enlarged calcified processes can be an option due to better visualization and accessbility, less infection at risk than intra-oral approach. The findings and results were as follows ; 1. The calcified styloid ligaments accompanied with throat pain were reseded in size of $5.5{\times}48mm(#1,\;Rt)$, $3.6{\times}5mm(#1,\;Lt)$, $5.2{\times}51mm(#2,\;Rt)$ and $3.1{\times}38mm(#2,\;Lt)$. 2. The submandibular approach to resect the calcified styloid process is of help to get better visibility and accessiblilty avoiding the injury to the deep cervial vital structures. 3. The resected styloid processes were examined histopathologically as the matured cortical bones with marrow structures or cartilagenous cells without any findings of neoplasmic changes. 4. The remained process did not show any noticeable regrowth in 3 years after surgical amputation.
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