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최선명,임길채,한광우,남순열 대한기관식도과학회 2003 大韓氣管食道科學會誌 Vol.9 No.1
Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.
편도 및 아데노이드 수술 후 주관적 음성 변화의 양상과 인자
김종양,최선명,최세준,남순열,김상윤,최승호,Kim, Jong-Yang,Choi, Sun-Myung,Choi, Se-Jun,Nam, Soon-Yuhl,Kim, Sang-Yoon,Choi, Seung-Ho 대한후두음성언어의학회 2004 대한후두음성언어의학회지 Vol.15 No.1
Some patients who have undergone adenotonsillectomy (AT) or tonsillectomy(T) complain of voice change. Research was designed to determine the relationship between subjective voice change and change of parameters in boice analysis and to find the degree of voice change according to age and excised tissue volume. In 34 patients who underwent AT and 17 patients who underwent T, we measured the masalance, the fundamental frequency of /a/phonation and the formants and bandwidths of /a/, /i/, /u/ phonations. These parameters were measured preoperatively and also 7 days after the operation. Excised tissue volume was measured on operation. Postoperative changes were statistically analyzed. Any subjective voice change was asked to be reported at the visit 7 days after the operation. There was analysis for the difference of above parameters between some who answered "voice change" (A group) and the others who answered "no voice change" (B group). 24 patients(71%) who underwent AT and 4 voice change. Nasals nasalance change is an important factor in subjective voice change after AT.
구본조,최선명,윤상원,주종은 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.9
A Lithiasis within the nasal cavity (rhinolith) can be formed by either endogenous or exogenous material. It occurs as a result ofthe solidification of mucus and nasal debris by mineral salts, calcium, magnesium phosphate and carbonate. Rhinolithiasis leadsto unilateral obstruction of the nasal airway followed by inflammation of the nasal mucus membrane and the paranasal cavities.It can be seen by the endoscopic examination as a hard intranasal mass, but diagnosis of rhinolithiasis can be difficult due to thevarying clinical presentations. Surgery is obligatory for the removal of rhinoliths and in most cases it can be done by nasal endoscopicremoval. Giant rhinolith, which is penetrated into the surrounding anatomical structures, needs more extended surgicalapproaches such as Caldwell-Luc operation or lateral rhinotomy. Here, we report one case of rhinolithiasis, which was removedsurgically for the purpose of diagnosis and treatment, and present a literature review of this condition. (Korean J Otolaryngol2006;49:936-8)
최두영,최선명,임길채,남순열 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.7
Background and Objectives:The Voice Handicap Index (VHI) was developed to asses patients' perception on the severity of their voice disorders. The purpose of this study was to determine the severity of handicap expresed by patients with various voice disorders, and to help clinicians in making future treatment plan. VHI may also be used as a guideline in making diag-nosis according to diferent factors of voice quality. :The people who had visited the Asan Medical Center with hoarsenes from August 2000 to August 201 were studied. They filled out the questionnaire composed of 30 questions about their voice disorders. The subjects were consisted of 6 groups;50 patients with vocal cord nodule, 43 pati-ents with laryngitis, 42 patients with vocal cord polyp, 25 patients with glottic cancer and 14 patients with unilateral vocal cord paralysis. Descriptive statistics were used to analyze the data and mean value of VHI scores. Results:The mean score of VHI was found to be statistically higher in the subjects with the history of voice abuse (p<0.002). Overall, the group with unilateral vocal cord paralysis showed the highest VHI score that was statisticaly significant (p<0.001). When the functional factor is considered, groups with unilateral vocal cord paralysis and glottic cancer had shown higher scores compared to the other groups. When the physical factor is considered, groups with unilateral vocal cord paralysis and vocal cord polyp had shown higher scores. When the emotional factor is considered, groups with unilateral vocal cord paralysis had shown higher scores. Conclusion:verity of the problems that cannot be asesed through visual perception or objective acoustic and aerodynamic measures. In addition, the measurement of VHI score was easy to perform, non-invasive, and inexpensive. In using this method, we expect to reveal the efficacy of the treatment for voice disorders. (Korean J Otolaryngol 2002;45:706-10)
후두에 발생한 혈관근육지방종(Angiomyolipoma) 1예
박정준,최선명,윤상원,김은경 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.3
Angiomyolipoma is a benign tumor that is co nd smooth muscle. The kidney is the most commonly affected organ. In the general population, the incidence of angiomyolipoma is about 0.3%. It is sometimes associated with tuberous sclerosis. However, extrarenal angiomyolipoma is uncommon, although it has been observed in other organs such as liver, heart, mediastinum, spermatic cord, vaginal wall, oral cavity, etc. In the larynx, angiomyolipoma has been rarely reported in the literature. We present a case of angiomyolipoma in the larynx, which was completely removed by laryngomicrosurgery. Thus, we report this case with a review of the literature. (Korean J Otolaryngol 2007 ;50 :278-80)
이진희,최선명 한국유아교육학회 2017 INTERNATIONAL JOURNAL OF EARLY CHILDHOOD EDUCATION Vol.23 No.2
This study aimed at illuminating how practitioners in a child-care center experienced an evaluation approach based on Appreciative-Inquiry (AI) and engaged themselves in autonomous changes over a span of one year. Their journey started with sharing a peak experience in the child care center, values, and three wishes to make more of the most energized and proud experiences through paired interviews. The inquiry stage was followed by imagining a better future of the child care center with a shared vision, and innovating practices with strategic plans and collaborative wisdom, and implementing changes, along with monitoring and evaluating the whole 4-I process of AI-based evaluation approach. The participants focused on their professional competencies to work as “happy teachers in a positive organizational culture,” who would be willing to take new challenges, sharing their talents, knowledge and skills, and growing up with open-ended communication. They created 3 learning communities to join in on a voluntary basis and took their time to learn from other practitioners’ experiences, talents, and wisdom. The shared activities for professional development also influenced their classroom environment, interactions with the children, and curricular changes to encourage children’s choices and active participation. The results indicated positive possibilities of an AI-based evaluation approach to encouraging bottom-up changes with teachers’ increased autonomy, a collegial climate of a learning organization, and utilization of evaluation results.