응급실에 내원한 비출혈 환자에서 Rapidrhino 패킹의 효용성

이기일,권문오,양찬주,조인수,이기일 대한응급의학회 2017 대한응급의학회지 Vol.28 No.3

Purpose: Although there are many treatment options for managing epistaxis, little is known about their outcomes in the emergency department (ED). In this study, we evaluated the management of epistaxis, especially comparing the efficacy between Rapidrhino and Merocel . Methods: A retrospective review of patients with epistaxis visiting the ED between January 2010 and June 2016 was performed. Haemostatic properties of packs were initially measured in the ED, and after the removal of packs in the otorhinolaryngology clinic. Subgroup analyses were performed in a similar fashion for patients receiving and not receiving anticoagulants or the antiplatelet. Results: The initial success rates for Rapidrhino and Merocel were both high (90.3%, 86.3%, respectively). Rebleeding rates for Rapidrhino and Merocel were 41.4% and 56.3%, respectively. Overall, there was a significant difference between the two types of packs in recurrence (p=0.032). Particularly, in patients with anticoagulants, the initial success rates of Rapidrhino were higher than that of Merocel (88.6%, 76.2%, respectively, p=0.222). The rebleeding rate of Rapidrhino was much lower than that of Merocel (54.3%, 85.7%, respectively, p=0.016). In the Rapidrhino group, the rebleeding rate varied according to the packing removal date (p=0.001). Conclusion: Rapidrhino and Merocel are equally effective in the initial arrest of epistaxis in the ED. Rapidrhino may be more effective in controlling haemorrage on removal, particularly in patients with anticoagulants. Patients with epistaxis could be treated with Rapidrhino in the ED, which could be removed in the outpatient clinic one day later.

호흡기전담클리닉의 필요성과 추진 방향

이기일 대한의사협회 의료정책연구소 2020 의료정책포럼 Vol.18 No.3

이비인후과 의사를 위한 코로나바이러스감염증-19: 임상적 분석

이기일,김동규,모지훈 대한비과학회 2021 Journal of rhinology Vol.28 No.1

The novel SARS-CoV-2 virus that causes COVID-19 has emerged rapidly and the virus has caused a global pandemic since it was first diagnosed in December 2019. SARS-CoV-2 is the seventh virus associated with human transmission among corona viruses. Otorhinolaryngologists could be vulnerable to this viral transmission due to the high viral load in the nasal cavity and nasopharynx. Hence, it is essential to understand the novel COVID-19 from the perspective of otorhinolaryngologists. We provide literature reviews of previous human coronaviruses and the novel COVID-19 with clinical hallmarks, diagnostic approaches, and possible treatment options. Further study is necessary to elucidate viral features and standardize treatment protocols with curable anti-viral agents and vaccines.

Practical Review of Biologics in Chronic Rhinosinusitis With Nasal Polyps

이기일,류광희,유신혁,김용민,모지훈,신승헌 대한비과학회 2021 Journal of rhinology Vol.28 No.3

Well-characterized in chronic rhinosinusitis, type 2 inflammation is frequently associated with nasal polyps, comorbid asthma, and nonsteroidal anti-inflammatory drug hypersensitivity. Despite medical and surgical treatment, it recurs in a significant proportion of patients. Thus, severe uncontrolled type 2 chronic rhinosinusitis with nasal polyps is the most difficult-to-treat phenotype of chronic rhinosinusitis. Recently, dupilumab, a monoclonal antibody against IL-4 receptor α, and omalizumab, a monoclonal antibody against immunoglobulin E, were approved for patients with chronic rhinosinusitis with nasal polyps in the United States, Europe, and Korea. Therefore, rhinologists should understand novel biologics and their use. Here, we provide a literature review of several biologics with their indications, effectiveness, and safety.

학생인권은 교권에 대립하는가?:교권 대 학생인권 프레임에 대한 비판적 담론분석

이기일,성열관 한국교육사회학회 2012 교육사회학연구 Vol.22 No.4

This study investigates the ideological construction of discourses on the Bill of Students' Human Rights (BSHR) through the selected editorial from the Chosun Daily and news report of JTBC. Discourses on students' human rights in print and broadcasting media are found to be imbricated within the structure of existing culture, yet, at the same time, challenge the traditional paradigm. Authors employ critical discourse analysis (CDA) as a methodological tool to deconstruct the common way of thinking in which frames the students' rights and the teachers' rights as binary opposition. Using Fairclough's CDA method, this paper tries to critically interpret and explain the way that the hidden and dominant power of control configures the discourses on BSHR. Firstly, the study analyzes the text of a news report and a newspaper editorial to reveal the linguistic discursive strategies embedded in their respective discourses. Secondly, authors examine at the analytical level of discursive practice, how related discourses are sutured together to create the oppositional framing of students' rights vs. teachers' rights. Lastly, the paper scrutinizes the factors behind ideological and social base of the texts such as parents' educational fever, patriarchism, totalitarianism, views of youth as immature, and differing interpretations of what infringes on student rights to learn. 이 논문은 인권조례를 둘러싼 논쟁에서 교권과 학생인권을 대립항으로 개념화하는 담론 프레임과 그 사회적 효과에 대해 분석하기 위한 것이다. 이에 조선일보 사설과 JTBC 뉴스 보도를 텍스트로 하여 학생인권조례 담론이 기존의 패러다임에 도전하는 동시에 기존의 문화에 속박되는 현실에 대해 비판적 담론 분석 방법을 통해 분석해 보았다. 이를 통해 학생인권반대 담론에서 교권 대 학생인권의 이항적 대립 관계로 규정되는 일상의 상식을 해체하고, 그 안에 은폐된 지배적인 권력과 통제 방식을 비판적으로 해석하고 설명하였다. 이 과정에서 첫째, 주어진 텍스트를 미시적으로 분석하여, 특정 담론에 내재된 언어적 담론 전략을 살펴보았다. 그런 다음, 담론적 실천 수준에서는 학생인권 반대 담론을 상호적으로 구성하는 여러 담론들이 재맥락화하면서 학생인권 대 교권의 대립 구도를 생산하는 과정을 분석하였다. 셋째, 담론의 사회적 실천 단계에서는 텍스트의 이데올로기적 조건과 사회적 효과에 대해 규명하고자 하였다. 학생인권은 교권을 유린할 수 있다는 불안 요소를 지닌 대립 프레임 안에 놓임으로써 기존의 상식 속에서 그 의미가 희석되었고 결국 학생인권조례 당초의 취지를 좌절시키는 사회적 실천 효과를 낳았다.

조종사비행(근무)시간기준에 대한 항공규정개선방안 연구 (FRMS를 중심으로)

이기일,Lee, Ki-Il 한국항공운항학회 2017 한국항공운항학회지 Vol.25 No.1

Approximately 70% of aviation accidents in the world are caused by human factors of pilots and 15-20% of these accidents are known to be caused by pilot fatigue. Recently ICAO established new standards of FRMS for aircrew. The US and the EU have introduced FRMS and established and operated new aviation regulation systems for pilot flight(duty) time limitations. On the other hand, Korea has not yet introduced FRMS. This study reviewed ICAO's standards of FRMS and analyzed the aviation regulations of the US and the EU. As a result of this study, it showed that Korea also needed to introduce FRMS. This study reasoned out plans to improve Korean aviation regulations about pilot flight time limitations based on international standards.

항공영어구술능력증명시험과 항공안전 연구

이기일 한국교통연구원 2014 交通硏究 Vol.21 No.2

The purpose of this research is to analyze and to improve the English Proficiency Test forAviation system. This research is an in-depth analysis of the fundamentals of the ICAO language proficiency requirements and how it relates to Korea's current implementation, implementation in other countries, pilot stress and aviation safety. ICAO Doc 9835 deals with ICAO language proficiency requirements. It recommends member states evaluate English proficiency of pilots and air traffic controllers in emergency situations or abnormal conditions using plain language. However, 57% of the general plain language (not related to aeronautical radiotelephony) in the Korean English Proficiency Test for Aviation speaking test differs from ICAO Doc 9835 guidelines. 320 Korean pilots and 47 foreign pilots from Korean Air and Asiana Airlinesparticipated in the survey. 93% of Korean pilots answered that the English Proficiency Test for Aviation did not enhance their aviation English proficiency skills and 45% answered that thestress caused from having to regularly re-take the test was an aviation safety hazard. The result of this research suggests the listening and speaking sections of the test should be significantly improved with content that has more direct relation to actual radiotelephony scenarios. In addition, the re-evaluation process for level 4 and above should be replaced with a qualitycomputer-based test system. 본 연구의 목적은 항공영어구술능력증명시험(EPTA) 제도를 개선하는 데 있다. 항공영어제도에 대한 ICAO의 기준을 살펴보고 한국의 운영현황, 외국의 운영사례, 스트레스와 항공안전과의 관계를 분석하였다. ICAO 항공영어제도의 기준이 되는 ICAO Doc 9835는 각 회원국에 항공기 운항 중 비정상 상황에서 발생할 수 있는 조종사와 관제사 간 항공무선통신과 관련한 Plain Language에 대하여 교육하고 평가하라고 권고하고 있다. 그러나 한국 EPTA는 말하기평가 57%가 일반회화방식의 Plain Language로 구성되어 있어 ICAO 기준과 다르게 나타나고 있다. EPTA 설문조사는 대한항공과 아시아나항공 소속 내국인조종사 320명과 외국인조종사 47명을 대상으로 벌였다. 설문결과는 내국인조종사의 경우 93%가 항공영어능력 향상에 도움이 안 된다고 답하고 있으며 45%는 재평가 스트레스가 비행안전 위협요인이 되고 있다고 밝히고 있다. 본 연구 결과를 통해서 현행 EPTA 듣기와 말하기 영역의 평가가 좀 더 실제 교신상황과 직접적으로 관련된 내용으로 개선되어야 할 것으로 보인다. 또한 4등급자 재평가는 교육과 연계한 컴퓨터 프로그램(CBT․Combuter Based Test)방안을 제시하였다.

Strain-Specific Differences in House Dust Mite (Dermatophagoides farinae)-Induced Mouse Models of Allergic Rhinitis

이기일,배준상,김은희,김지혜,Lele Lyu,정영준,모지훈 대한이비인후과학회 2020 Clinical and Experimental Otorhinolaryngology Vol.13 No.4

Objectives. Limited information is available regarding strain-related differences in mouse models of allergic rhinitis induced by Dermatophagoides farinae (Der f1). In this study, we compared differences between two mouse strains and determined the optimal dose of Der f1 for allergic rhinitis mouse models. Methods. Forty-eight mice were assigned to the following six groups (n=8 per group): group A (control, BALB/c), group B (Der f1-sensitized BALB/c, 25 μg), group C (Der f1-sensitized BALB/c, 100 μg), group D (control, C57BL/6), group E (Der f1-sensitized C57BL/6, 25 μg), and group F (Der f1-sensitized C57BL/6, 100 μg). Allergic inflammation was induced with Der f1 and alum sensitization, followed by an intranasal challenge with Der f1. Rubbing and sneezing scores, eosinophil and neutrophil infiltration, and immunoglobulin, cytokine, and chemokine levels in the nasal mucosa and from splenocyte cultures were assessed. Results. Rubbing and sneezing scores were higher in groups B, C, E, and F than in groups A and D, with a similar pattern in both strains (i.e., group B vs. E and group C vs. F). Serum immunoglobulin levels were significantly elevated compared to the control in groups B and C, but not in groups E and F. Eosinophil and neutrophil infiltration increased (all P<0.05) after the Der f1 challenge (groups B, C, E, and F) compared to the control (groups A and D) in both the BALB/c and C57BL/6 strains, without any significant difference between the two strains (group A vs. D, group B vs. E, and group C vs. F) (P>0.05). BALB/c mice (group B) showed a greater elevation of splenic interleukin (IL)-4 (P<0.01), IL-5 (P<0.01), and IL-6 levels (P<0.05) and nasal IL-4 mRNA levels (P<0.001) than the C57BL/6 mice (group E). Interestingly, mice treated with 100 μg Der f1 showed a weaker allergic response than those treated with 25 μg. Conclusion. We found 25 μg to be a more appropriate dose for Der f1 sensitization. BALB/c mice are more biased toward a Th2 response and are a more suitable model for allergic rhinitis than C57BL/6 mice. This study provides information on the appropriate choice of a mouse model for allergic rhinitis.

레클레르시아 아데카르복시라타에 의한 각막궤양 1예

이기일,정성근,황형빈 대한안과학회 2014 대한안과학회지 Vol.55 No.6

Purpose: To report a case of corneal ulcer caused by Leclercia adecarboxylata in an immunocompetent patient. Case summary: A previously healthy 43-year-old female presented with right ocular pain and was referred to our clinic under the impression of corneal abrasion and secondary infection. The patient was treated at a local clinic for 3 days using artificial tears, therapeutic contact lens, topical antibiotics, and anti-inflammatory eye drops but showed no improvement. Gram staining, bacterial and fungal cultures and antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of Leclercia adecarboxylata. The patient was treated with moxifloxacin and ofloxacin eye drops. After 2 weeks of treatment, the infection resolved without remaining scars. Conclusions: Reportedly, Leclercia adecarboxylata affects humans only as an opportunistic pathogen or part of polymicrobial infections. However, in the present case, Leclercia adecarboxylata was isolated as a single pathogen in an immunocompetent patient which is the first clinical report of this microorganism found in an ocular sample. Therefore, if antibiotic-susceptible gram-negative bacilli are found in opthalmologic samples, the above bacteria should be considerd in the diagnosis. J Korean Ophthalmol Soc 2014;55(6):918-922

Effectiveness of the TnR Nasal Mesh® for the Correction of Caudal Septal Deviation

이기일,안홍근,김종엽,인승민 대한이비인후과학회 부산,울산,경남 지부회 2020 임상이비인후과 Vol.31 No.2

The correction of caudal septal deviation is difficult, simply because of the intrinsic memory of the septal cartilage. We conducted a case series analysis of the effectiveness of the TnR Nasal Mesh® . This case study enrolled 3 male patients with severe caudal septal deviation. All surgical procedures were performed using endonasal septoplasty via bilateral flap elevation. Pre- and post-operative analyses of subjective symptoms were performed using the Visual Analog Scale (VAS). Nasal patency was evaluated using the objective findings of semi-quantitative endoscopy and acoustic rhinometry before and after surgery. The patients exhibited subjective and objective improvement in VAS scores, endoscopic, and acoustic rhinometry results. No significant complications were observed. We verified the clinical effectiveness of TnR Nasal Mesh® for caudal septal correction without the external open approach. We suggest that septal batten grafting with the alloplastic TnR Nasal Mesh® can be an alternative method for caudal septal correction.