후두 수술 후의 음성 재활

소윤경,손영익,So, Yoon-Kyoung,Son, Young-Ik 대한기관식도과학회 2009 大韓氣管食道科學會誌 Vol.15 No.1

레이저 성문절제술 후의 음성수술

소윤경,손영익,So, Yoon-Kyung,Son, Young-Ik 대한후두음성언어의학회 2008 대한후두음성언어의학회지 Vol.19 No.1

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.

Initial Adherence to Autotitrating Positive Airway Pressure Therapy: Influence of Upper Airway Narrowing

소윤경,동헌종,김효열,정승규,장전엽 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.4

Objectives. There is still debate concerning the reason for the high initial failure rate of positive airway pressure (PAP) treatment. The objective of this study is to investigate the factors of the initial adherence to PAP, with an emphasis on the role of upper airway narrowing. Methods. The patients were divided into two groups according to the continuation of therapy within the first three months of treatment. The demographic and polysomnographic findings, the minimal nasal cross sectional area (MCA), the degree of palatine tonsilar hypertrophy (PTH) and the modified Mallampati grade of the oropharynx inlet (Orophx) were compared between the study groups. Results. Among 36 patients, 23 continued the auto-adjusting positive airway pressure (APAP) therapy (the adherent group) and 13 discontinued APAP within three months (the non-adherent group). The apnea-hypopnea index (AHI) was significantly higher in the adherent group than in the non-adherent group (P<0.001). The AHI distributions of the two groups are extremely different. Thirteen of the 23 patients in the adherent group had an AHI of more than 60/hr, while none of the patients in the non-adherent group had an AHI of more than 60/hr. In the patients with an AHI from 15 to 60/hr, the MCA at the wide side of the nasal cavity and the sum of the MCAs of both sides were significantly larger in the adherent group than those values in the non-adherent group (P=0.004). The PTH and the Orophx were not significantly different between the two groups. Conclusion. AHI is a definite significant factor of adherence to APAP therapy. The dimension of the nasal cavity has an influence on initial APAP adherence in the patients who have a not too high level of AHI. Objectives. There is still debate concerning the reason for the high initial failure rate of positive airway pressure (PAP) treatment. The objective of this study is to investigate the factors of the initial adherence to PAP, with an emphasis on the role of upper airway narrowing. Methods. The patients were divided into two groups according to the continuation of therapy within the first three months of treatment. The demographic and polysomnographic findings, the minimal nasal cross sectional area (MCA), the degree of palatine tonsilar hypertrophy (PTH) and the modified Mallampati grade of the oropharynx inlet (Orophx) were compared between the study groups. Results. Among 36 patients, 23 continued the auto-adjusting positive airway pressure (APAP) therapy (the adherent group) and 13 discontinued APAP within three months (the non-adherent group). The apnea-hypopnea index (AHI) was significantly higher in the adherent group than in the non-adherent group (P<0.001). The AHI distributions of the two groups are extremely different. Thirteen of the 23 patients in the adherent group had an AHI of more than 60/hr, while none of the patients in the non-adherent group had an AHI of more than 60/hr. In the patients with an AHI from 15 to 60/hr, the MCA at the wide side of the nasal cavity and the sum of the MCAs of both sides were significantly larger in the adherent group than those values in the non-adherent group (P=0.004). The PTH and the Orophx were not significantly different between the two groups. Conclusion. AHI is a definite significant factor of adherence to APAP therapy. The dimension of the nasal cavity has an influence on initial APAP adherence in the patients who have a not too high level of AHI.

Multifocality and Bilaterality of Papillary Thyroid Microcarcinoma

소윤경,김명우,손영익 대한이비인후과학회 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.2

Objectives. Papillary thyroid carcinomas frequently occur as two or more separate foci within the thyroid gland (18%–87%). However, those multifocal tumors are easy to be undetected by preoperative radiologic evaluations, which lead to remnant disease after initial surgery. We aimed to study the incidence of multifocal papillary thyroid microcarcinomas (PTMCs), diagnostic accuracy of preoperative radiologic evaluation, predictive factors, and the chance of bilateral tumors. Methods. Two hundred and seventy-seven patients with PTMC were included in this study. All patients underwent total thyroidectomy as an initial treatment. Medical records, pathologic reports, and radiological reports were reviewed for analysis. Results. Multifocal PTMCs were detected in 100 of 277 patients (36.1%). The mean number of tumors in each patient was 1.6±1.1, ranging from 1 to 10. The additional tumor foci were significantly smaller (0.32±0.18 cm) than the primary tumors (0.63±0.22 cm) (P<0.001). There was no significant relationship between primary tumor size and the presence of contralateral tumors. With more tumors detected in one lobe, there was greater chance of contralateral tumors; 18.8% with single tumor focus, 30.2% with 2 tumor foci, and 46.2% with 3 or more tumor foci in one lobe. Sensitivity of preoperative sonography was 42.7% for multifocal tumors and 49.0% for bilateral tumors. With multivariate analysis, nodular hyperplasia was the only significant factor for multifocal tumors. Conclusion. In cases of PTMCs, the incidence of multifocal tumors is high. However, additional tumor foci are too small to be diagnosed preoperatively, especially under the recent guidelines on radiologic screening tests for papillary thyroid carcinoma. Multifocal PTMCs have high risk of bilateral tumors, necessitating more extensive surgery or more thorough follow-up.

Intermittent Airway Obstruction Caused by a Laryngeal Cyst Masquerading as Asthma Attacks

소윤경 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.1

Laryngeal cysts are uncommon and account for approximately 5% of all benign laryngeal lesions. Airway obstruction associated with laryngeal cysts has rarely been reported in adults. We report the first case of a laryngeal cyst causing sudden airway obstruction in an adult patient with asthma. A 70-year-old man who had been recently diagnosed with asthma presented to an emergency room (ER) with sudden dyspnea and a choking sensation. These symptoms disappeared soon after arrival to the ER but recurred several days later, again spontaneously resolving without medication or further treatment. Interestingly, a pedunculated laryngeal cyst was diagnosed incidentally by esophagoduodenogastroscopy and was completely removed by CO2 laser. Laryngeal cysts should be considered in the differential diagnosis of patients with asthma who show the unusual symptoms of airway obstruction. (J Clinical Otolaryngol 2015;26:117-120)

로버트 무진스키의 <소나타 제1번>에 관한 연구

소윤경 한국피아노교수법학회 2019 음악교수법연구 Vol.20 No.2

obert Muczynski(1929-2010) is a twentieth-century American composer and pianist who established a distinctive musical domain by integrating elements of classical music languages of Baroque through twentieth-century and American popular music. <Sonata No. 1, Op. 9>, composed in 1957, is the first of three sonatas by Muczynski. This study looks into Muczynski’s life before presenting the analysis of his work, and subsequently delves into exploring the characteristics of Muczynski’s music represented in <Sonata No. 1, Op. 9>. By doing so, it is observed that Muczynski was influenced by his only composition teacher Alexander Tcherepnin(1899-1977) in his simple use of musical ideas, along with utilization of various rhythms, irregular accents, and generating unique sound effects. Muczynski stayed within the traditional form, while in terms of rhythm, melody and harmony, his works can be distinguished by incorporating various dynamic rhythmic patterns, simple melody lines instead of long phrases, and added tones or harmonies based on interval of fourth. It is especially noted that he emphasizes the melody in unison and displays a distinct quality of combining contrasting chords at the end of the piece. He states his musical intentions clearly by specifying dynamics, articulation, directives, and tempo marks in great detail in the score. The analysis of <Sonata No. 1, Op. 9> displays reduced functionality of the first subject in the first movement, as the focus centers around the prelude, the variation and development of the prelude, and the second subject. Moreover, various types of bridging passages are utilized in putting the piece together. The second movement is in rondo-sonata form, and the use of compositional techniques that are typical of Muczynski, such as irregular time, hemiola, ostinato, and numerous energetic rhythmic patterns can be found. The integration of what is traditional and new in the works of Muczynski is what puts him apart from his peers who were more or less fixated in pursuing originality. It is my wish that this study will be of value for those who are interested in Muczynski’s Sonatas and seek to research them further in depth. 무진스키(Robert Muczynski, 1929-2010)는 바로크부터 20세기의 음악어법 및 미국 대중음악의 요소를 융합하여 독창적인 음악세계를 구축한 20세기 미국의 대표적인 작곡가이자 피아니스트이다. 1957년 작곡된 <소나타 제1번>(Sonata No. 1, Op. 9)은 그가 남긴 세 개의 소나타 중 첫 번째 작품이다. 본 논문은 작품을 분석하기 전에 무진스키의 생애를 알아보았고 <소나타 제1번>에 나타난 무진스키 음악의 특징에 대해 살펴보았다. 이를 통해 그는 유일한 작곡 스승인 체레프닌(A. Tcherepnin, 1899-1977)의 영향으로 음악적 아이디어를 간결하게 사용하여 작곡하였고 다양한 리듬의 사용, 불규칙한 악센트, 독특한 음향효과를 창출함을 알 수 있었다. 무진스키는 전통적인 형식으로 작곡하였으며 리듬과 선율, 화성적인 측면에서는 역동적이고 다양한 리듬, 긴 호흡의 선율 보다는 간단한 선율, 부가음 또는 4도 간격으로 구성된 화성을 사용 한 것이 특징이다. 특히 작품의 종결 부분에서는 선율을 유니즌으로 강조하고 서로 다른 화음을 결합하는 독특한 양상을 보였음을 알 수 있다. 그는 악보에 매우 자세하게 다이나믹, 아티큘레이션, 지시어, 템포를 명기하여 음악적 의도를 분명하게 표현하였다. <소나타 제1번>의 분석 결과 제1악장은 제1주제의 기능이 약화되고 서주와 서주의 변형 및 발전, 제2주제를 중심으로 전개된다. 또한 다양한 양상의 연결구를 사용하여 곡을 연결하였다. 제2악장은 소나타 론도 형식으로 구성되었고 무진스키 특유의 변박자, 헤미올라, 오스티나토, 에너지 넘치는 다양한 리듬 등이 주로 사용된다. 이처럼 무진스키가 자신의 작품에서 전통적인 것과 새로운 것을 결합한 것은 새로운 것만이 가치 있다고 여겼던 동시대의 작곡가들과 차별화 되는 점이다. 본 논문이 무진스키의 소나타에 관심을 가지고 심도 있게 살펴보고자 하는 연구자들에게 유용한 연구가 되길 기대한다.

소아 성대 결절에 대한 음성 치료의 효과

소윤경 대한이비인후과학회 부산,울산,경남 지부회 2018 임상이비인후과 Vol.29 No.2

Background and Objectives:Vocal nodules occur with a 12-22% prevalence in pediatric populations. Most otolaryngologists recommend voice therapy as the primary treatment. The aim of this study is to evaluate patient compliance with voice therapy and its effect on vocal nodules in children. Materials and Methods:We retrospectively reviewed 44 pediatric patients between 3 and 11 years old diagnosed with vocal nodules between March 2015 and December 2017. We evaluated the treatment adoption rate, dropout rate during voice therapy, and reasons for dropout. For patients who completed voice therapy, we measured the changes in nodule size, perceptual parameters, and acoustic parameters. We evaluated patient satisfaction using the pediatric voice handicap index (P-VHI). Results:Of the 44 pediatric patients diagnosed with vocal nodules, 22 (50%) agreed to voice therapy. Of the 22 patients who started voice therapy, 5 (22.7%) dropped out during therapy because they were unsatisfied with their treatment. Another 4 patients discontinued therapy for reasons unrelated to treatment effectiveness. Vocal nodule disappeared or decreased in all 13 patients who completed voice therapy. All voice parameters were improved and statistically significant changes were observed in perceptual, acoustic, and P-VHI parameters. Conclusions:Although compliance to voice therapy among the pediatric patients with vocal nodules was low, there were significant improvements in voice parameters for those who completed voice therapy. A change toward a positive perception of voice therapy is necessary and a multidisciplinary approach is needed to improve the effect of voice therapy on pediatric patients with vocal nodules.

21세기 공동 주택 단위 평면 계획

소윤경 연세대학교 생활과학대학 1997 생활과학 Vol.- No.30

초고층 주상복합 아파트 단위평면의 공간구성에 관한 조사연구

소윤경,하미경 한국주거학회 2002 한국주거학회 논문집 Vol.13 No.3

The purpose of this study is to examine the characteristics of unit plans in the high-rise mixed-use condominium and to provide the data fur architectural planning and design. The tools of statistical analysis are frequency, percentage, mean, cross-tab, and correlation. The results of this study are as fellows; The most frequently found shape of unit is a deformed polygon. The common rooms in housing units are dressing room, powder room, offset-kitchen, family room, passage, hallway, and foyer. The specially prepared spaces are wash room, home bar, independent porch, and garden. As to room size and area ratio in a dwelling unit, those of living room are biggest and highest irrespective of unit size. As the floor area of unit increases, does the size of each room and space but the area ratio of each room decreases. This research is made to develop an Apartment Information System. This integrated information system is to be designed to provide residents of high-rise mixed-use condominiums with convenient, economical, and safe life.

농가의 신재생에너지 도입 의향 분석

소윤경,한재환,김원빈,엄지범 한국농식품정책학회 2023 농업경영정책연구 Vol.50 No.1

The purpose of this study is to examine farmers’ perceptions of renewable energy and analyze the factors of farmers’ intention to adoption of renewable energy. In addition, there is an additional purpose of research to derive a plan to expand the adoption of renewable energy. 347 farms participated in the survey, and the analysis method used an ordered probit model and marginal effect analysis. From the analysis results, it was confirmed that in order to expand the adoption of renewable energy by farmers, it is necessary to expand the subsidy support project for facility costs. In addition, if the government provides priority support to low-income farmers who grow food crops, it can be expected to expand the inflow of farmers. Finally, it is important to provide farmers with various information related to renewable energy. Therefore, it is necessary to prepare a “Farm Renew-able Energy Management Model” that includes related to the income increase effect of farmers.