• Journal of Chest Surgery
• /
• v.31 no.8
• /
• pp.792-798
• /
• 1998

Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.30.1-30.8
• /
• 2019

Background: Advancements in the field of microvascular surgery and the widespread adoption of microvascular surgical techniques have made the use of osteocutaneous fibula free flaps the standard of care in the surgical management of segmental mandibular defects. Although the literature possesses abundant evidence to support the effectiveness of fibula free flaps as a reconstructive method, there are relatively few studies reporting on outcomes as objectively measured by videofluoroscopic swallowing studies (VFSS). The purpose of this study is to explore the potential correlation between early postoperative VFSS and the long-term swallowing outcomes in patients who underwent mandibular reconstruction with fibula free flaps. Methods: We performed a retrospective chart review of 36 patients who underwent mandibular reconstruction with osteocutaneous fibular free flaps between 2009 and 2012. Demographics, clinical variables, VFSS data, and diet information were retrieved. Penetration and aspiration findings on VFSS, long-term oral feeding ability, and the need for gastrostomy tube were statistical endpoints correlated with postoperative clinical outcomes. Results: Thirty-six patients were reviewed (15 females and 21 males) with a mean age of 54 years (7-81). Seventeen cases were treated for malignancy. The size of the bony defect ranged from 3 to 15 cm (mean = 9 cm). The cutaneous paddle, a surrogate for soft tissue defect, ranged from 10 to 125 ㎠ (mean = 52 ㎠). A gastrostomy tube was present in patients preoperatively (n = 8), and postoperatively (n = 14). Seventeen patients had neoadjuvant exposure to radiation. Postoperative VFSS showed penetration in 13 cases (36%) and aspiration in seven (19%). Overall, 29 patients (80.6%) achieved unrestricted diet, and this was statistically correlated with age (p = 0.037), radiation therapy (p = 0.002), and preoperative gastrostomy tube (p = 0.03). The presence of penetration or aspiration on VFSS was a strong predictor for long-term unrestricted oral diet (p < 0.001). Conclusion: Early postoperative VFSS is an excellent predictor for long-term swallowing outcomes in patients undergoing mandibular reconstruction with osteocutaneous fibula free flaps.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.7 no.1
• /
• pp.1-13
• /
• 2012

Objectives: Although chuna medicine has progressed distinguishingly, yet chuna medical terminology hasn't been standardized. So there are a lot of difficulties in translating chuna related book and their meaning cannot be conveyed properly. For this reason, we could say standardization of chuna medical terminology is very essential. Purpose of our study was to develope a standard database of concept terms for chuna medicine, in addition, we considered establishing fundamental principles of chuna medical terminology. Methods: To select standard chuna medical terms, we sorted important chuna medical index words. Then we sorted those words into a group that has same meanings and united to one single term. In the meantime, we extracted index words from 26 domestic and foreign manual technique related books and sorted them out and based on these word, we translated chuna medical terms to Korean terms. In the case of chuna technique terms, we searched chuna text books for term those were wrongly used, and corrected them by suggesting fundamental principles of terminology. Results: 664 chuna words were selected as standard chuna terms and have been translated to English terms. In the process, adscititious words such as anatomical terms and title of books were exempted and selected only important words that could be used as index of chuna terms. In deciding essential elements of chuna technique terms, patient position, contact point, segmental contact point, malposition, procedure method were selected. Conclusions: Correcting chuna medical terms in a sort period could cause confusion, but in long term perspective, in the aspect of conveying the meaning clearly and education purpose, standardizing of chuna medical terminology must be done. From this study, standardization of chuna medical terms were chosen in large category, but further studies must be followed in order to standardize terms of subdivisional categories.

• Journal of Chest Surgery
• /
• v.24 no.1
• /
• pp.54-63
• /
• 1991

Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

• The Korean Journal of Nuclear Medicine
• /
• v.26 no.2
• /
• pp.312-317
• /
• 1992

To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of $^{99m}Tc-DTPA$ renal scan was peformed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyetonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

• Journal of the Korea Society of Computer and Information
• /
• v.17 no.9
• /
• pp.75-84
• /
• 2012

HMM-based Text-to-Speech systems generally utilize context dependent tri-phone units from a large corpus speech DB to enhance the synthetic speech. To downsize a large corpus speech DB, acoustically similar tri-phone units are clustered based on the decision tree using context dependent information. Context dependent information includes phoneme sequence as well as prosodic information because the naturalness of synthetic speech highly depends on the prosody such as pause, intonation pattern, and segmental duration. However, if the prosodic information was complicated, many context dependent phonemes would have no examples in the training data, and clustering would provide a smoothed feature which will generate unnatural synthetic speech. In this paper, instead of complicate prosodic information we propose a simple three prosodic boundary types and decision tree questions that use rising tone, falling tone, and monotonic tone to improve naturalness. Experimental results show that our proposed method can improve naturalness of a HMM-based Korean TTS and get high MOS in the perception test.

• Journal of Navigation and Port Research
• /
• v.40 no.1
• /
• pp.7-14
• /
• 2016

Although the life jacket can provide the buoyance with the drowner, heat loss can make the drowned individual be subject to the hypothermia. In this study, The thermal insulation of two types life jacket including inflatable and foam type were evaluate by both experiments and numerical analysis. To estimate the thermal resistance of the jackets, experiments on the heat flux were conducted by the thermal manikin exposed to cold water. Heat flux loss on the surface of thermal manikin were measured for both foam and inflatable type life jacket. Also, finite element method is applied to a body section in order to understand the level of hypothermia of each life jacket. The segmental of human thigh is represented by a multi-layered section which considers the heat conduction within tissue, bone and fat. As a result, the thermal resistance and hypothermia time of each jackets have been compared based on the finite element analysis. It was found that the insulation ability of suggested life jackets is better than that of conventional type.

• Journal of Navigation and Port Research
• /
• v.39 no.4
• /
• pp.285-291
• /
• 2015

Exposure to cold sea water can be life-threatening to the drowned individual. Although appropriate life jacket can be usually be provided for the buoyance at the drowning accident, heat loss can make the drowned individual experience the hypothermia. Inflatable life jackets filled with inflatable air pocket can increase the thermal protection as well as the buoyancy force. Because it is important to know how the human body behaves unde the different life jacket, present study compares the thermal insulation capacity of solid type life jacket with that of inflatable life jacket. In order to represent the insulation capacity of life jacket, thermal resistance is estimated based on the assumption of steady-state. Also, a transient three-dimensional thermal distribution of the thigh is analyzed by using finite element method implementing the Pennes bioheat equation. The finite element model is a segmental, multi-layered representation of the body section which considers the heat conduction within tissue, bone, fat and local blood flow rate.

• Phonetics and Speech Sciences
• /
• v.10 no.4
• /
• pp.77-89
• /
• 2018

Speech articulators are coordinated for the purpose of segmental constriction in terms of a task. In particular, vertical jaw movements repeatedly contribute to consonantal as well as vocalic constriction. The current study explores vertical jaw movements in conjunction with bilabial constriction in bilabial stop /p/ in the context /a/-to-/a/. Revisiting kinematic data of /p/ collected using the electromagenetic midsagittal articulometer (EMMA) method from seven (four female and three male) speakers of Seoul Korean, we examined maximum vertical jaw position, its relative timing with respect to the upper and lower lips, and lip aperture minima. The results of those dependent variables are recapitulated in terms of linguistic (different word boundaries) and paralinguistic (different speech rates) factors as follows. Firstly, maximum jaw height was lower in the across-word boundary condition (across-word < within-word), but it did not differ as a function of different speech rates (comfortable = fast). Secondly, more reduction in the lip aperture (LA) gesture occurred in fast rate, while word-boundary effects were absent. Thirdly, jaw raising was still in progress after the lips' positional extrema were achieved in the within-word condition, while the former was completed before the latter in the across-word condition. Lastly, relative temporal lags between the jaw and the lips (UL and LL) were more synchronous in fast rate, compared to comfortable rate. When these results are considered together, it is possible to posit that speakers are not tolerant of lenition to the extent that it is potentially realized as a labial approximant in either word-boundary condition while jaw height still manifested lower jaw position in the across-word boundary condition. Early termination of vertical jaw maxima before vertical lower lip maxima across-word condition may be partly responsible for the spatial reduction of jaw raising movements. This may come about as a consequence of an excessive number of factors (e.g., upper lip height (UH), lower lip height (LH), jaw angle (JA)) for the representation of a vector with two degrees of freedom (x, y) engaged in a gesture-based task (e.g., lip aperture (LA)). In the task-dynamic application toolkit, the jaw angle parameter can be assigned numerical values for greater weight in the across-word boundary condition, which in turn gives rise to lower jaw position. Speech rate-dependent spatial reduction in lip aperture may be able to be resolved by means of manipulating activation time of an active tract variable in the gestural score level.

• Journal of the Computational Structural Engineering Institute of Korea
• /
• v.35 no.2
• /
• pp.73-82
• /
• 2022

The study presents a three-dimensional approach to simulate the nonlinear behavior of a 72 m long Ultra High Performance Fiber Reinforced Concrete (UHPFRC) pre-stressed box girder for a pedestrian bridge in Busan, South Korea. The concrete damage plasticity (CDP) model is adopted to model the non-linear behavior of the UHPFRC material, in which the material properties are obtained from uniaxial compressive and tensile tests. The simulation model based on the proposed stress-strain curve is validated by the results of four-point bending model tests of a 50 m UHPFRC pre-stressed box girder. The results from the simulation models agree with the experimental observations and predict the flexural behavior of the 50 m UHPFRC pre-stressed box girder accurately. Afterward, the validated model is utilized to investigate the flexural behavior of the 72 m UHPFRC pre-stressed box girder. Here, the load-deflection curve, stress status of the girder at various load levels, and connection details is analyzed. The load-deflection curve is also compared with design load to demonstrate the great benefit of the slender UHPFRC box girder. The obtained results demonstrate the applicability of the nonlinear finite element method as an appropriate option to analyze the flexural behavior of pre-stressed long-span girders.