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Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.
Diagnosis of a patient with dysphonia begins with a thorough history and physical examination. Larynx can be visualized either indirectly or directly with a rigid or flexible laryngoscope. One notable limitation of simple indirect laryngoscopy is that the examination dose not yields a recordable and reproducible image of the larynx and vocal tract. And unaided human eye is unable to visualize the vibratory patterns of the true vocal cord during phonantion. When available, stroboscopy provides useful information regarding vocal told closure, vibration, and mucosal wave which is useful to decide between microsurgery, vocal reeducation or a combined treatment Even there are some limitations, recognition of the advantages and disadvantages of stroboscopy allows for optimal appreciation and stroboscopy remains an essential diagnostic tool in the assessment of dysphonia.
Objective : A working group of psychiatrists from the Korean Academy of Anxiety Disorders was established to determine the appropriate medication algorithm for treating patients with panic disorder. In this article, we discussed the consensus among psychiatrists regarding the use of cognitive behavior therapy (CBT) in the development of a treatment algorithm for panic disorder in Korea. Methods : Based on the guidelines or algorithms published by the American Psychiatric Association, National Institute for Clinical Excellence, and Canadian Psychiatric Association, we constructed questionnaires regarding the core components and contents of CBT for patients with panic disorder. Fifty-four experts in panic disorder completed the questionnaires. Results : There was statistically significant consensus among the experts in the belief that cognitive reconstruction and psychological education are the core components of CBT for the treatment of patients with panic disorder. However, there was some inconsistency between the opinions of some experts regarding the content and frequency of CBT and the results of studies published outside of Korea. Conclusions : CBT, especially the psychological education and cognitive reconstruction components, should be considered when treating patients with panic disorder. However, further consideration needs to be put into the design of a more detailed treatment guideline for the use of CBT in the treatment of patients with panic disorder.
The object of this paper is in viewing the aspects of the final sound symbols of Hunminjungeum in the late Chosun period focusing on character consciousness from the aspect of Korean linguistic history. We deal with the many aspects of the consciousness on the final sound symbols of Hunminjungeum by late Chosun scholars differing from early Chosun when the characters were created. It discusses aspects of late Chosun consciousness of the final sound symbols divided into consciousness of the final sound symbols succeeded from the system of Hunminjungeumyeui(訓民正音例義), consciousness of the final sound symbols succeeded from the system of Hunminjungeumhaerye(訓民正音解例), independent consciousness of the final sound symbols, etc.
Splashing and spreading of a liquid by drop impact on liquid film depends on the impact velocity, drop size, drop properties and liquid film thickness. These parameters can be summarized by three main dimensionless parameters: Weber number, Ohnesorge number and non-dimensional film thickness. Upon impact of a drop on liquid film, these parameters influence the shape of the splash and the formation and propagation of the crown. In the present study, the splashing and spreading resulting from drop impact on liquid film has been numerically investigated by using a Level Set method for the interface tracking of the two-phase flow simulation. For various dimensionless parameters, characteristics of the crown formation and spreading were predicted, and the results were found to show good agreement with available experimental data in the earlier stage of crown formation and show some discrepancies in the later stage of crown spreading due to the present 2D axi-symmetric computation, which cannot predict the secondary drops.