• Title/Summary/Keyword: speech defects

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Development of A-ABR System Using a Microprocessor (마이크로프로세서를 이용한 자동청력검사 시스템 개발)

  • Noh, Hyung-Wook;Lee, Tak-Hyung;Kim, Nam-Hyun;Kim, Soo-Chan;Cha, Eun-Jong;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.46 no.2
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    • pp.15-21
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    • 2009
  • Hearing loss is one of the most common birth defects among infants. Most of hearing-impaired children are not diagnosed until 1 to 3 years of age - which is too late for the critical period (6 month) for normal speech and language development. If a hearing impairment is identified and treated in its early stage, child's speech and language skills could be comparable to his or her normal-hearing peers. For these reasons, hearing screening at birth and throughout childhood is extremely important. ABR (Auditory brain-stem response) is nowadays one of the most reliable diagnostic tools in the early detection of hearing impairment. In this study, we have developed the system that automatically detects if there is hearing impairment or not for infants or children. For future studies, it will be developed as a portable system to be able to take a measurement not only in sound proof room but also in nursery for neonates.

Patients' satisfaction on the obturators with different extension heights into defects after maxillectomy (높이가 다른 폐쇄장치에 대한 상악절제술 환자의 만족도)

  • Kwon, Ho-Beom;Lee, Jai-Bong;Yim, Soon-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.1
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    • pp.41-47
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    • 2010
  • Purpose: The purpose of this study was to compare the functional abilities of the low bulb obturators with those of high bulb obturators in terms of patients' evaluation. Material and methods: This study included 11 maxillectomy patients who underwent postoperative prosthodontic rehabilitations. Two obturators of the same design except for different bulb heights, were fabricated for each of the maxillectomy patient. After two months of alternate use, the functions of the obturators were measured by investigating the patients' subjective evaluations in terms of convenience, speech, nasality, leakage, and mastication and identifying their preferred prostheses. Wilcoxon signed rank test was used as a statistical method (P < .05). Results: There were no significant differences in patient evaluations of low and high bulb obturators (P >.05). And patients' preferences varied. Conclusion: In extreme situation such as in mouth opening limitation, the use of low bulb obturators can be recommended and result in comparable speech function to that of obturators with high lateral walls.

Reconstruction with Radial Forearm Free Flap after Ablative Surgery for Oral Cavity and Oropharyngeal Cancers (구강암과 구인두암의 절제술 후 전완유리피판술을 이용한 재건술)

  • Cho Kwang-Jae;Chun Byung-Jun;Sun Dong-Il;Cho Seung-Ho;Kim Mn-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.41-46
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    • 2003
  • Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.

Lateral Oropharyngeal Wall Coverage with Buccinator Myomucosal and Buccal Fat Pad Flaps

  • Jung, Bok Ki;Song, Seung Yong;Kim, Se-Heon;Kim, Young Seok;Lee, Won Jai;Hong, Jong Won;Roh, Tai Suk;Lew, Dae Hyun
    • Archives of Plastic Surgery
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    • v.42 no.4
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    • pp.453-460
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    • 2015
  • Background Reconstruction of oropharyngeal defects after resection of oropharyngeal cancer is a significant challenge. The purpose of this study is to introduce reconstruction using a combination of a buccinator myomucosal flap and a buccal fat pad flap after cancer excision and to discuss the associated anatomy, surgical procedure, and clinical applications. Methods In our study, a combination of a buccinator myomucosal flap with a buccal fat pad flap was utilized for reconstruction after resection of oropharyngeal cancer, performed between 2013 and 2015. After oropharyngectomy, the defect with exposed vital structures was noted. A buccinator myomucosal flap was designed and elevated after an assessment of the flap pedicle. Without requiring an additional procedure, a buccal fat pad flap was easily harvested in the same field and gently pulled to obtain sufficient volume. The flaps were rotated and covered the defect. In addition, using cadaver dissections, we investigated the feasibility of transposing the flaps into the lateral oropharyngeal defect. Results The reconstruction was performed in patients with squamous cell carcinoma. The largest tumor size was $5cm{\times}2cm(length{\times}width)$. All donor sites were closed primarily. The flaps were completely epithelialized after four weeks, and the patients were followed up for at least six months. There were no flap failures or postoperative wound complications. All patients were without dietary restrictions, and no patient had problems related to mouth opening, swallowing, or speech. Conclusions A buccinator myomucosal flap with a buccal fat pad flap is a reliable and valuable option in the reconstruction of oropharyngeal defects after cancer resection for maintaining functionality.

An Analytical Study on Student's Physical Examination of Elementing and Seconding School in Korea (우리나라 초(初)·중(中)·고(高) 학생(學生) 신체검사결과(身體檢査結果)에 대한 분석연구(分析硏究))

  • Youn, Chong Duk
    • Journal of the Korean Society of School Health
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    • v.1 no.1
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    • pp.114-132
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    • 1988
  • Aiming to appraise student's health status and recommend improvement and strengthening of the school health services, statistical analysis of the results of health examination were done with summarized data which were collected nation-wide through the Ministry of Education. After analysis of data obtained, the results of the study summarized as follows; 1) Requested Adequate care Requested Adequate care showed from 5 % to 3% in 1962 and 1984 respectively. In sexes, Requested Adequate in girls (2.8%) more apparent than in boys (2.5%) 2) Eyes i) Weak vision, abnormal refraction of eyes (myopia, hypermetropia and astigmatism), eye diseases (trachoma, others) were found as shown in the Table 2, Figure 3. Weak vision and abnormal refraction of eyes showed from 2 % (Elementary), 5 % ( Secondary) to 4 % (Elementary), 14 % (Secondary) in 1962 and 1984 respectively. In both sexes, the older the age of students the more weak vision and abnormal refraction of eyes had rapidly increased especially in over 15-year old. ii) Eye diseases (trachoma, others) showed from 2% to age of students the more diseases had students. 3) Ear, nose and pharynx Hearing disturbance, ear diseases (otitis mediae, others), nose (empyema, hypertrophy) and pharynx diseases were found as following 1) Hearing disturbance was found from 0.3%(Elementary), 1 %(Secondary) to 0.05 % (Elementary), 0.4 % (Secondary) in 1962 and 1984 respectively, however, recently the older the age of students the more had students. ii) Ear diseases showed from 1.7 % (Elementary) 1.0 % (Secondary) to 0.3 %(Elementary), 0.5%(Secondary) in 1962 and 1984 respectively. iii) In diseases of the nose and pharynx, tonsilitis showed from 2.5% (Elementary), 3.5 % (Secondary) to 1.8 % ( Elementary). 2.5% (Secondary) in 1962 and 1984 respectively. 4) Skin Infectious skin diseases and other skin diseases were found from 1.5% to 0.6% in 1962 am 1984 respectively. 5) Teeth Dental caries (in milk and permanent teeth) and otner oral diseases are shown from 12 % (Elementary), 8%(Secondary) to 75%( Elementary), 25% (Secondary) in 1962 and 1984 respectively. 6) Other defects and diseases A relatively higher morbidity was shown in the tubercular diseases, in anemia, and in heart diseases among the tuberculous diseases, nodular diseases, Pleurisy, heart diseases, anemia, beriberi, hernia, neurasthenia, speech difficulty, mental disorders, bone dysformity, motion difficulty of extremities. In both sexes, tuberculous diseases were found almost equally in both sexes and anemia in girls was more apparent than in boys. Trying to provide more effective health services in schools : i) A better and more effective physical examination should be carried out in each school and prior to the physical examination, the qualified daily observation of children by teacher should be keenly practiced. ii) According to the results of the required annual physical examination the leading cause of morbidity were dental caries, myopia, angina and otitis mediae and fore these diseases follow up should be carried out. iii) For prevention and treatment of diseases and defects health education for students in the classroom as well as to parents is urgently requested.

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Maxillofacial rehabilitation of hemi-maxillectomy patient using a closed hollow bulb obturator fabricated by one-step polymerization technique: a clinical report (상악골 부분절제술 시행 환자에서 one-step 중합 기술로 만든 hollow bulb 폐색장치를 이용한 악안면 수복 증례)

  • Sim, Jae-Hyuk;Kim, Min-Kyoo;Han, Jung-Suk;Lee, Jai-Bong;Kim, Sung-Hun;Yeo, In-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.35-40
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    • 2016
  • The maxillary defects lead to anatomical and functional deformity of the maxillofacial region. As far as functions are concerned, such defects can produce difficulty in speech, mastication, and deglutition. Obturator prostheses play a very important role in functional recovery for post-maxillectomy patients. To achieve rigidity of the obturator, appropriate retention should be given, and the weight of the prosthesis be reduced. There are two types of hollow bulb obturator: open and closed. A closed type has many advantages. Nevertheless, some problems, including complexity of fabrication and water leakage into the bulb, have the closed hollow obturator not be widely used. The one-step polymerization technique described in this case overcomes the shortcomings by easily constructing a small hollow bulb with two thermoplastic resin sheets.

THE CERVICAL ISLAND FLAP FOR INTRAORAL RECONSTRUCTION FOLLOWING EXCISION OF ORAL CANCER -REPORT OF 3 CASES- (구강암 적출후 경부 도상 피판을 이용한 구강내 결손부의 재건 -3 치험례-)

  • LEE, Seong-Geun;LIM, Jong-Soo;KIM, Kyung-Hyun;JEON, So-Yeun;CHO, Young-Sung;SHIN, Sang-Hun;CHO, Young-Cheol;SUNG, Iel-Yong;KIM, Uk-Kyu;KIM, Jong-Ryoul;CHUNG, In-Kyo;YANG, Dong-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.263-268
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    • 1998
  • Many myocutaneous flaps have been used for the reconstruction of intraoral defects caused by the excision of oral cancer. Among these myocutaneous flaps, cervical island flap has been introduced by Farr et al. Although different in detail, this flap was designed as the platysma myocutaneous flap by Futrell et al in the supraclavicular site. Since many authors applied this flap to cover intraoral defect, they discussed deeply the blood supply of this flap. To improve further flap survival, it was modified by Tashiro et al. This flap makes its vascularity highly reliable. The amount of tissue needed for reconstruction can be accurately planned. The surgical and reconstruction procedure can be performed simply, rapidly, and effectively. Oral functions including deglutition, speech, and denture fitting are not compromised. With it's minimal deformity, new donor fields is not necessory. Of course, we keep in mind that this flap has limitations in patients where much bulk of tissue defects is needed and more than 3000 rad radiation due to the metastasis of neck lymph node is exposed. In three patients with intraoral squamous cell carcinoma($T_{1-3}N_0M_0$), we performed induction chemotherapy with FP regimen including pepleomycin. Thereafter, we ablated oral cancer and peformed reconstruction of intraoral defects with cervical island flap designed by Tashiro et al. Due to these significant benefits and minimal limitations, we have found that this flap is adequate for reconstruction of most intraoral defects following cancer ablation.

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Removable prosthetic rehabilitation in patient with maxillofacial defects caused by gunshot: A case report (총상으로 인한 악안면 결손을 가진 환자에 대한 가철성 보철물 수복증례)

  • Lee, Donggyu;Kang, Jeongkyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.198-204
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    • 2017
  • Maxillofacial defect comes from congenital defect, trauma and surgical resection. Patients with intraoral defect are commonly related to maxillary defect and they need prosthetic rehabilitation. Functional reconstruction of partially edentulous mandible has many limitations. However, if both condyles are intact, maxillofacial prosthesis using partial denture give competent results. In this case, a patient of 58 year-old male has a defect on palate and left mandibular posterior teeth from gunshot. The maxillary defect of this patient is Class IV according to Aramany classification and the mandibular one is Type V according to Cantor and Curtis classification. For retention of the obturator, remaining teeth are fully utilized and artificial teeth are arranged harmoniously to provide stable occlusion. Mandibular RPD covered limited range of deformed soft tissue derived from mandibular resection surgery. With these treatments, the patient in this case showed improvements in mastication, swallowing and speech.

A Comparative Consideration of Dementia in Oriental and Occidental Medicine (치매(痴呆)에 관(關)한 동서의학적(東西醫學的) 비교(比較) 고찰(考察))

  • Lee, Dong-Weon;Shin, Gil-Jo;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.16 no.1
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    • pp.1-16
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    • 1995
  • This study was done in order to investigate the etiology and pathology of dementia in the variety literature. Dementia in elderly persons(above the age of 60) mainly classfied Alzheimer disease and Cerebral vascular dementia. The results were as follows: 1. Dementia patients have abnormal mental function, who have no mental weakness but defects of memory, verbal disturbance, behavior disturbance and loss of intellectual function. 2. Dementia regard as 'me-beng(?病)', 'jeon-gwang(癲狂)', and 'heo-ro(虛勞)' in oriental medicine and the symptom is a silence with no response, mixing, a crying or a laugh, a stranger behavior and a amnesia; disturbances of speech, emotion, behavior. 3. Dementia caused by Alzheimer disease, Multi infarct dementia, Parkinson's disease, sequelae of acute CO poisoning, head injury and alcoholism(occidental medically) and the 'Dam(痰) and Damhwa(痰火), weakness of heart and spleen(心脾虛) caused by pent up anger of seven emotions(七情鬱結), the weakness of liver and kidney(肝腎不足)(oriental medically). 4. The causes of Alzheimer disease are various; a heredity factor, a morphological factor of brain tissues, a psychological factor and a biochemical factor (occidental medically) ; the 'Dam(痰) and Damhwa(痰火) caused by weakness of the internal organs and disturbance of the emotions(oriental medically). 5. Cerebral vascular dementia caused by loss of the certain cerebral neurons and oriental medically caused by obstruction of 'dam(痰)' or 'eo heul(瘀血)'. It is recommended that further study of many sided investigations, specially against a weakness of spiritual functions and a certain neurotoxin in the future.

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Long Term Follow Up of Maxilla Reconstruction Following the Ablative Cancer Surgery (악성종양 절제술 후 상악 재건의 장기 추적관찰)

  • Lee, Han Earl;Ahn, Hee Chang;Choi, M.Seung Suk;Jo, Dong In
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.448-454
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    • 2007
  • Purpose: The objective of this study was to evaluate the outcomes of using the free flap in the reconstruction of maxillary defects. Methods: 27 consecutive cases of maxillary reconstruction with free flap were reviewed. All clinical data were analyzed, including ideal selection of flap, time of reconstruction, recurrence of cancer, postoperative complications, flap design, and follow-up results. The main operative functional items, including speech, oral diet, mastication, eye globe position and function, respiration, and aesthetic results were evaluated. Results: Among the 24 patients who underwent maxillary reconstruction with the free flap, 14 patients underwent immediate reconstruction after maxillary cancer ablation, and 10 patients underwent delayed reconstruction. There occurred 1 flap loss. Recurrences of the cancer after the reconstruction happened in 2 cases. Postoperative complications were 3 cases of gravitational ptosis of the flap, 2 cases of the nasal obstruction, and 1 case of fistula formation. Out of 27 free flaps, there were 15 latissimus dorsi myocutaneous flaps, 5 radial forearm, 4 rectus abdominis myocutaneous flaps, 1 scapular flap, 2 fibula osteocutaneous flap, respectively. Flaps were designed such as 1 lobe in 9 cases, 2 lobes in 9 cases, and 3 lobes in 5 cases. Among the 14 patients who had intraoral defect or who had palatal resection surgery, 2 patients complained the inaccuracy of the pronunciation due to the ptosis of the flap. It was corrected by the reconstruction of the maxillary buttress and hung the sling to the upper direction. All of the 14 patients were able to take unrestricted diets. In 6 patients who had reconstruction of inferior orbital wall with rib bone graft, they preserved normal vision. Aesthetically, most of the patients were satisfied with the result. Conclusion: LD free flap is suggested in uni-maxilla defect as the 1st choice, and fibular osteocutaneous flap and calvarial bone graft to cover the larger defect in bi-maxilla defect.