• 대한후두음성언어의학회지
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• 제7권1호
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• pp.32-38
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• 1996

The preservation of the voice-producing mechanism is an important feature in the management of laryngeal cancer by radiotherapy. But, radiation therapy has certain side effects such as mucositis, tissue edema, necrosis and fibrosis which could effect on normal voice production. Several subjective studies that used questionnaires and auditory perceptual judgements of voice have been interpreted to mean that radiation results in a normal or near-normal voice. Objective evidence of the status of vocal function after radiation treatment, however, is still lacking. We analyzed the changes that occur in voice parameters in a group of patients undergoing radiation therapy, in order to determine the effect of radiation on voice quality. In this study acoustic, aerodynamic measures of vocal function were used to determine the characteristics of voice production. We found that voice parameters in early glottic cancer changed meaningfully comparing to normal larynx with or without radiation and radiation therapy has an little effect on normal larynx.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.7-10
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• 2008

The early glottic cancers are traditionally treated by radiotherapy or endoscopic surgery. The excellent effectiveness of both treatment modalities for local control, larynx preservation, and disease specific death is similar. Therefore, functional voice outcome after treatment is one of the most important factors in the choice of treatment for early glottic cancer. To assess the functional outcomes and compare the voice quality in patients with early glottic cancer treated with curative intent with radiotherapy or laser cordectomy, we performed literature review. Most studies showed that the voice quality after radiation therapy is slightly better than that after laser cordectomy. Subanalysis according to types of laser cordectomy, however, indicates that voice quality depends on type of laser cordectomy. Especially, type I or type II laser cordectomy might be superior to other types of laser cordectomy and radiation therapy. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer including professional voice users.

• Radiation Oncology Journal
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• 제27권1호
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• pp.29-34
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• 2009

목적: 초기성문암에서 근치적 방사선치료는 성대를 보전하면서 완치할 수 있다. 저자들은 초기 성문암에서 방사선 치료 후 재발양상, 장기생존율 및 음성보존율을 알아보고자 하였다. 대상 및 방법: 1988년 2월부터 2003년 12월까지 계명대학교 방사선종양학과에서 초기(1, 2기) 성문부의 편평상피암으로 진단되어 방사선치료를 받은 환자 70명을 대상으로 하였다. 환자의 연령분포는 39세에서 79세로 중앙값 63세이며 병리학적으로 모두 편평상피암이었다. 병기로는 1기가 58명, 2기가 12명이었으며 남자가 67명으로 대부분을 차지하였다. 방사선치료선량은 하루 $1.8{\sim}2.2$ Gy 분할선량으로 총방사선량은 $54{\sim}70.2$ Gy로 병기 1기에는 중앙값 60 Gy, 2기에는 중앙값 66 Gy를 조사하였다. 추적관찰기간은 13개월에서 180개월로 중앙값이 77.5개월이었다. 생존율은 Kaplan Meier법을 사용하였으며 Log Rank법을 이용하여 분석하였다. 두 군 간의 비교는 Chi-square법을 이용하였다. 결과: 전체 환자에서 방사선치료 후 국소제어는 69명(98.5%)에서 되었으며 5년 생존율은 93.9%, 5년 무병생존율이 84.1%이었고 구제수술 후 5년 무병생존율은 92.8%로 1기는 93.1%, 2기는 91.7%이었다. 13명(18.5%)에서 국소재발을 하였으며 이 중 9명은 구제수술로 치료되었으며 4명은 재발을 진단받고 추적관찰이 되지 않았다. 방사선 치료 후 국소재발까지의 평균기간은 24개월($3{\sim}69$개월)이었다. 성문암으로 사망한 사람은 2명으로 폐, 뼈, 간의 전신전이로 각각 33, 71개월 후 사망하였고 9명은 성문암의 재발이나 전이 없이 다른 질환으로 평균 73개월 후 사망하였다. 방사선치료 후 심각한 만성 부작용은 없었다. 전체적으로 62명(88.5%)에서 음성을 보존할 수 있었다. 결론: 초기 성문암에서 방사선치료는 효과적인 치료법이며 우수한 장기생존율과 음성보존율을 얻을 수 있으므로 우선적으로 고려되어야 할 치료법이다.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2011년도 춘계학술발표대회
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• pp.986-989
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• 2011

Reversible data hiding is a technique that can embed information into cover media (image, video, voice signal) and can recover the original cover media after extracting the embedded information. In this papa, we propose a new reversible data hiding methods that based on block median preservation and the image local characteristic. By using the median value of a block, a high payload can be got and by considering the image local characteristic, a lot of distortion can be avoided and a high PSNR can be got. In the experiment, our methods can generate better result than the previous reversible data hiding methods.

• KIEAE Journal
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• 제12권5호
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• pp.63-70
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• 2012

In order to set the direction of providing facility for the utilization of castle heritage, as well as to establish the method for securing access and determine installation criteria in consideration of preservation environment, an analysis was carried out on the cases of having secured access for people with disabilities in England for the advanced utilization of castle heritage. As the result of the analysis, the planning factors of the facility for people with disabilities in England for the utilization of castle heritage were deduced as follows: 1) The plan for facility was focused on the disabled using wheelchairs and visually impaired persons, rather than on services for hearing-impaired persons and people with learning disability. 2) As for audience movement line plan, regular route was used for audience movement line to lead them in a single direction. 3) As for the provision of prior access information, 3 stepwise access grades were established for the facility information plan of heritage. 4) As for information service by disability type, models were provided; and complementary explanation was provided by using text, drawing, picture, video and voice. 5) Rest spaces were secured where audience could look out upon castle heritage. For the utilization of castle heritage, it is necessary to develop planning factors of the facility design for people with disabilities according to its characteristics.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.11-15
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• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

• 대한기관식도과학회지
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• 제9권1호
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• pp.30-38
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• 2003

Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50％ to 70％ of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20％ to 30％ range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.30-34
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• 2016

Background and Objectives : Microsurgical resection of intracordal cysts is technically difficult and challenging because the wall of cysts may be tightly attached to underlying vocal ligament and/or overlying epithelium, and therefore their thin wall will easily rupture during surgical dissection. We aimed to evaluate the voice outcomes of standard microflap subepithelial resection and the recurrence rate depending on the intraoperative rupturing of the cyst. Materials and Methods : Medical records of Samsung Medical Center, Seoul, Korea, were reviewed for sixty-four consecutive patients who received surgical resection of vocal cyst using microflap subepithelial dissection technique between the year 2004 and 2013. Meticulous dissection was performed to completely remove the cyst wall while preserving the mucosa and the lamina propria as much as possible. Voice outcomes and recurrence rates were compared according to the type, size and the intraoperative rupture of cyst. Results : Presence or absence of cyst rupture was clearly described in the operation records of 41 patients. Intraoperative rupture of the cyst occurred in 32 of 41 (78%) patients. The recurrence was detected in 5 of 64 (7.8%) total cases and 4 of 32 (12.5%) cases of ruptured cyst, but not in 9 cases of intact extirpation. Rupture was more common in case of mucous retention cyst compared with epidermoid cyst (p=0.036). Subjective and objective voice parameters were measured at before and 3 months after surgery, which improved regardless of the cyst rupture. Conclusion : Although complete microsurgical extirpation of intracordal cyst while keeping the cyst wall intact is technically difficult, meticulous dissection with maximal preservation of surrounding tissue may warrant the improvement of voice outcomes.

• 대한두경부종양학회지
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• 제1권1호
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• pp.81-86
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• 1985

A case of primary laryngeal non-Hodgkin's lymphoma is detailed with a review of the literature, on this rare site of presentation. Histologic findings and radio-therapeutic technique are included with longterm follow-up data. Local radiotherapy is a curative treatment of choice due to longterm NED survival with preservation of voice.

• 대한두경부종양학회지
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• 제1권1호
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• pp.87-94
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• 1985

A total of eighty five cases with supraglottic carcinoma treated by radical radiotherapy in Yonsei Cancer Center between Jan. 1974 and Dec. 1980, was observed through retrospective analysis. This study is concerned wi th patients selection for irradiation alone or combined treatment with surgery. Emphasis is directed to the analysis of effectiveness of radical radiotherapy instead of partial laryngectomy in T-1, T-2 and early T-3 lesion. A satisfactory control of laryngeal disease and preservation of a normal voice ranging from 100% for $T_1N_0$ lesions, 61.1% for $T_2N_0$ to 50% for $T_3N_0$. But 47.1% of cases with node metastasis on admission had poor results to irradiation suggesting of necessicity of combined treatment. 5 year recurrence-free survivals was 43.3% in all cases with supraglottic carcinoma treated by irradiation alone, although it was 87.5% in T-1 and 51.8% in T-2.