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무증상의 후두개곡 낭종 환자에서 예기치 못한 어려운 기관내 삽관 1례
이상모,최준석,이철승,김원태,박천희 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1
Although vallecular cyst is often asymptomatic and harmless to the patient, discovery of large vallecular cyst after induction of anesthesia is a potentially life-threatening problem for thepatient and provides for the anesthesiologist a challenge in airway management. We describe a case of difficult intubation where the laryngeal inlet was obscured by a large vallecular cyst that was discovered during induction of general anesthesia. A 47-year-old man presented for elective laparoscopic colecystectomy due to GB polyp. He had normal mouth opening and neck extension; no mass or distortions of the tongue or neck were observed. Anesthesia and paralysis were induced with 80 ㎎ propofol, alfentanil 0.5 ㎎, midazolam 2.0 ㎎ and rocuromum 50 ㎎. It was noted that ventilation of the lungs via mask was difficult. Despite insertion of an oropharyngeal airway, ventilation proved to be more difficult. Intubation was attempted. Direct laryngoscopy (Macintosh 3 blade) revealed a 3-4 ㎝ tranlucent cyst arising from the left vallecula. The cyst completely obscured the view of epiglottis and vocal cords, preventing intubation despite multiple attempts by three anesthesiologists. StafF anesthesiologist was aspirated cyst using a 16-guage needle, syringe and 20 ㎖ of serous fluid were aspirated from cyst. The epiglottis and vocal cord were then exposed and tracheal intubation was performed easily with a size 7.0 cuffed oral tracheal tube. Anesthesia and the operation then proceeded uneventfully, following laparoscopic colecystectomy, an ENT surgeon removed the cyst.
편도선 절제술 중 Epinephrine 국소침윤에 의한 심정지와 급성 폐부종 1예
안익순,최준석,박천희,이철승,김원태,임경준 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3
Hemostasis and a clear surgical field are obtained by the local infiltration of a local anesthetic mixed with epinephrine during tonsillectomy. However, epinephrine may in itself, due to its cardiovascular effect, cause arrhythmia, heart failure, Pulmonary edema, and even cardiac arrest. We describe a 22-year-old patient who developed cardiac arrest due to epinephrine infiltration during tonsillectomy. The patient was resuscitated and recovered without any sequele after intensive treatment.
유남재,최영준,이철주 江原大學校 産業技術硏究所 2009 産業技術硏究 Vol.29 No.A
Most of debris flow occurred in Korea have been known to be caused by the heavy rainfall at the soil deposits on the mother rock, affected by conditions of rainfall, topography and geology, especially terrain deposits. A study on debris flow behavior should be carried out by investigating various types of debris flow systematically and analyzing their complicate characteristics in the engineering view points. Tremendous debris flows occurred at Duksan-ri in Inje-gun of Gangwon province during summer in 2006. These sites are selected to study the characteristics of debris flow by investigating the influencing factors on it and analyzing their correlations between them. Most of data about influencing factors were obtained by visiting sites in field..
N-아세틸시스테인 투여후 발생한 급성 무기폐 : 증례보고
이광범,안용미,이철승,최준석,박천희 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.34 No.1
Causes of atelectasis under general anesthesia are tracheal foreign body, blood clot, aspiration of bronchial secretion, one-lung ventilation and relative predominance of parasympathetic system. N-acetylcysteine is mucolytic agent which improves the capability of sputum drainage. After administration of N-acetylcysteine, an increased volume of liquified bronchial secretions may occur. When cough is inadequate, the airway must be maintained open by mechanical suction. In case that is a mechanical block due to local accumulation, the airway should be cleared by endotracheal aspiration. A 49-year-old female was admitted for bilateral laparoscopic oophorectomy due to ovarian tumors. There was not any problem during a general anesthesia induction. After instillation of N-acetylcysteine into endotracheal tube, acute atelectasis was developed in right lower lung.
Eisenmenger씨 증후군을 동반한 충수돌기염 천공에 의한 복막염 환자의 마취경험 : 증례보고
천경석,박천희,이철승,이철,안용미,최준석 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3
Eisenmenger's syndrome includes any condition in which communication between the pulmonary and systemic circulation gives rise to pulmonary vascular disease causing a right to left shunt with peripheral cyanosis, It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. We report a case of a 58-year-old woman with an emergency operation for peritonitis due to appendiceal perforation and Eisenmenger's syndrome secondary to large ventricular septal defect. We carefully performed balanced anesthesia with air-O₂-desflurane-remifentanil. She was transferred to the intensive care unit in intubated state postoperatively and discharged two weeks later without any complications.
Cheol June Choi,Jin Yong Lee,우라미,신태영,곽원석,우수동 한국응용곤충학회 2020 Journal of Asia-Pacific Entomology Vol.23 No.2
The purpose of this study was to select the most effective Metarhizium anisopliae isolates for the simultaneous control of Aedes albopictus and Culex pipiens mosquito adults. The selection was performed using 65 isolates of M. anisopliae, an entomopathogenic fungus isolated from Korean soils. The selection process was carried out through evaluations of conidial thermotolerance, UV-B tolerance, pathogenicity and virulence against adults of two mosquito species and conidial production on grain medium. The thermotolerance of 65 M. anisopliae isolates ranged from 0% to 99%, and their UV-B tolerance ranged from 7.1% to 94.8%. Among them, 30 isolates with high thermotolerance were selected for evaluation of their pathogenicity and virulence against adults of the two mosquito species. Metarhizium anisopliae isolates were more susceptible to Cx. pipiens adults than Ae. albopictus adults because 11 isolates were pathogenic to Ae. albopictus and 21 isolates were pathogenic to Cx. pipiens. Virulence and conidial production were evaluated using 6 isolates with similar pathogenicity against the two species of mosquito. As a result, the accumulated mortality was 74–100% for Ae. albopictus and 78–100% for Cx. pipiens. LT 50 values ranged from 2.3 to 5.2 days for Ae. albopictus and from 3.2 − 4.7 days for Cx. pipiens. Comparison of conidial production using three kinds of grain media showed various results according to isolate and medium. Based on the above results, M. anisopliae CN6S1W1 was finally selected as the most effective fungal isolate for the simultaneous control of Ae. albopictus and Cx. pipiens mosquito adults.
June-soo Park,Ha-cheol Song,Ki-seok Yoon,Taek-sang Choi,Jai-hak Park 대한기계학회 2005 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.19 No.11
This study is concerned with structural integrity evaluations for the interference-fit flywheels in reactor coolant pumps (RCPs) of nuclear power plants. Stresses in the flywheel due to the shrinkage loads and centrifugal loads at the RCP normal operation speed, design overspeed and joint-release speed are obtained using the finite element method (FEM), where release of the deformation-controlled stresses as a result of structural interactions during rotation is considered. Fracture mechanics evaluations for a series of cracks assumed to exist in the flywheel are conducted, considering ductile (fatigue) and non-ductile fracture, and stress intensity factors are obtained for the cracks using the finite element alternating method (FEAM). From analysis results, it is found that fatigue crack growth rates calculated are negligible for smaller cracks. Meanwhile, the material resistance to non-ductile fracture in terms of the critical stress intensity factor (K_(IC)) and the nil-ductility transition reference temperature (RT_(NDT)) are governing factors for larger cracks.
( June Hong Ahn ),( Kwan Ho Lee ),( Jin Hong Chung ),( Kyeong-cheol Shin ),( Eun Young Choi ),( Hyun Jung Jin ),( Jong Geol Jang ),( Kyung Soo Hong ),( Young Seok Lee ),( Euna Lee ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Background: Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in chronic obstructive pulmonary disease (COPD) and is independently associated with cardiometabolic comorbidities and systemic inflammation. Although several factors are associated with NAFLD, influence of sarcopenia on NAFLD has not been fully determined in COPD. We explored whether sarcopenia is associated with NAFLD in COPD population. Methods: Data from the Korean National Health and Nutrition Examination Surveys 2008-2011 were analyzed. The subjects were defined as having NAFLD when they had scores higher than 36 in a hepatic steatosis index (HSI) value, which was a previously validated NAFLD prediction score. The sarcopenia index [=total appendicular skeletal muscle mass (kg)/body mass index (kg/m2) x100] measured by dual-energy X-ray absorptiometry was used to diagnose sarcopenia with cut points of 0.789 for men and 0.512 in women. Results: Using the HSI, NAFLD was identified in 124 (14.6%) of 850 COPD subjects. Among the entire of 850 subjects, the prevalence of sarcopenia in subjects without NAFLD, with NAFLD were 18.0% and 34.7%, respectively (p<0.001). In univariate analysis, NAFLD was significantly associated with young age, male, high body mass index (BMI), sarcopenia, metabolic syndrome, hypertension, diabetes mellitus (DM) and decreased forced vital capacity (FVC) in COPD population. Multivariate logistic analysis adjusted for the age, sex, metabolic syndrome, hypertension, DM, and FVC demonstrated that sarcopenia (odds ratio =1.95; 95% confidence interval, 1.11-3.46, p value=0.0219) was associated with NAFLD in COPD subjects. Conclusions: Sarcopenia is associated with increased risk of NAFLD, independent of age, sex, lung function and metabolic factors. Pulmonologist should be aware of possible liver comorbidities in sarcopenic COPD patients.
( June Hong Ahn ),( Kwan Ho Lee ),( Jin Hong Chung ),( Kyeong-cheol Shin ),( Eun Young Choi ),( Hyun Jung Jin ),( Jong Geol Jang ),( Kyung Soo Hong ),( Young Seok Lee ),( Euna Lee ),( Mi Jeong Nam ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.0
Objectives: The effects of inhaler education in chronic obstructive pulmonary disease (COPD) patients remain unclear. The objective of this study was to evaluate techniques and adherence in using inhaler devices and to investigate the effects of repeated education using inhaler device handling in COPD patients. Methods: We prospectively enrolled COPD patients who used their particular inhaler device for more than 1 month and evaluated the efficacy of repeated education for COPD. The educational intervention was 6-month education program of three visits, during which subjects were tested their inhaler technique and adherence, taught about inhaler technique face-to-face by advanced practice nurse. Inhaler technique, adherence, mMRC, COPD assessment tests (CAT), EuroQol-5D (EQ-5D), patient health questionnaire (PHQ-9), and feeling of satisfaction with inhaler questionnaire (FSI-10) were compared before and after education. Results: A total of 261 COPD patients performing a total of 308 inhaler devices were included in the study. 244 (93.5%) were men and the mean age was 69.8 ± 7.7. At least one errors were observed in 267 (86.7%) and at least one critical inhaler errors were observed in 43.2% (133/308). Education significantly decreased in percentage of incorrect techniques, incorrect critical techniques and poor adherence (86.7% vs 39.3%, p<0.001; 43.2% vs 8.8%, p<0.001; 2.3% vs 0.4%, p=0.009, respectively). FSI-10 for inhaler was significantly improved after education (44.4 ± 4.7 vs 47.7 ± 4.1, p<0.001). mMRC, CAT, EQ-5D and PHQ-9 were not significantly improved after education. Conclusions: Repeated face-to-face inhaler device handling education by advanced practice nurse significantly improved the inhaler technique, adherence and feeling of satisfaction with inhaler.