Identifying the more suitable nostril for nasotracheal intubation using radiographs

Chi, Seong In,Park, Sookyung,Joo, Li-Ah,Shin, Teo Jeon,Kim, Hyun Jeong,Seo, Kwang-Suk The Korean Dental Society of Anesthsiology 2016 Journal of Dental Anesthesia and Pain Medicine Vol.16 No.2

Background: One nostril must be selected for nasotracheal intubation. In some cases, structural anomalies within the nasal cavity hinder the insertion of the tube or complications, such as epistaxis, develop. This study examined the possibility of using radiography to select the nostril that would induce fewer complications. Methods: Four hundred and five patients who underwent nasotracheal intubation under general anesthesia were studied. A 7.0-mm internal diameter nasal right angle endotracheal (RAE) tube and 6.5-mm internal diameter nasal RAE tube were inserted into men and women, respectively. Complications were considered to have developed in cases in which insertion of the tube into the nasal cavity failed or epistaxis occurred. The tube was inserted into the other nostril for insertion failures and hemostasis was performed in cases of epistaxis. The degree of nasal septal deviation was determined from posteroanterior skull radiographs or panoramic radiographs; the incidence of complications was compared depending on the direction of the septal deviation and the intubated nostril. Results: The radiographs of 390 patients were readable; 94 had nasal septum deviation. The incidence of complications for cases without nasal septum deviation was 16.9%, that for cases in which the tube was inserted into the nostril on the opposite side of the deviation was 18.5%, and that for cases in which the tube was inserted into the nostril with the deviation was 35.0%, showing a high incidence of complications when intubation is performed through the nostril with septum deviation (chi-square test, P < 0.05 ). Conclusions: Although there were no differences in the incidence rates of complications between intubation through the left nostril and that through the right nostril, radiological findings indicated that incidence of complications significantly increased when the tube was inserted into the nostril with the septum deviation.

악하선 암의 치료성적과 예후인자

임치영(Chi Young Lim),남기현(Kee Hyun Nam),이잔디(Jan Dee Lee),장항석(Hang Seok Chang),정웅윤(Woong Youn Chung),차인호(In Ho Cha),이창걸(Chang Geol Lee),최은창(Eun Chan Choi),박정수(Cheong Soo Park) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2

Purpose: Submandibular gland tumor is rare, less than 6% of head and neck tumor. The purpose of this article is to analysis the clinical experience and treatment outcomes of malignant submandibular gland tumor, suggesting a guideline of management. Methods: We retrospectively evaluated 26 patients who underwent operation for malignant submandibular gland tumor at Severence hospital between 1986 and 2004. Statistical analysis was performed by Kaplan-Meier method, log rank test, Chi-square test, Fisher's exact test using SPSS v12.0 for Windows. Results: They consisted of 18 males and 8 females whose median age was 47 years(range: 20-71). 10 cases of adenocystic carcinoma, 8 cases of carcinoma ex pleomorphic adenoma, 4 cases of mucoepidermoid carcinoma, 1 case each for acinic cell carcinoma, undifferentiated carcinoma, adeno carcinoma, epithelioid hemangioendothelioma. Sialoadenectomy only was performed in 10 cases(36.5%) and sialoadenectomy with neck node dissection was performed in 16 cases(63.5%). Adjuvant radiotherapy was done in 22 cases(84.6%). 10 year disease free survival rate for malignant submandibular gland tumor was 63.1 % and 10 year overall survival rate for malignant submandibular gland tumor was 70.1%. In univariate analysis, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. Conclusion: In this study, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. To prevent recurrence and to improve survival, early diagnosis and aggressive surgery must be considered.

발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

우리나라 시 · 군 · 구 지역보건의료계획의 비전(Vision) 문구 분석

안치영(Chi-Young Ahn),김현수(Hyun-Soo Kim),김원빈(Won-bin Kim),오창훈(Chang-hoon Oh),홍지영(Jee-Young Hong),김은영(Eun-Young Kim),이무식(Moo-Sik Lee) 한국농촌의학 지역보건학회 2017 농촌의학·지역보건 Vol.42 No.1

지역보건의료계획서에서 비전은 각 지역의 보건의료계획을 나타내는 핵심요소임에도 불구하고 작성방법에 대한 구체적인 지침이 부재하여 각 지역의 비전은 매우 다양하게 표현되어 있다. 이에 이 연구에서는 제6기 지역보건의료계획에서 제시한 비전 문구를 보건소 유형별, 권역별로 분석하였다. 전국 229개 지역의 제6기 지역보건의료계획서의 비전 문구와 이와 관련된 미션, 전략체계도, 중장기 추진과제 등을 대상으로 하였다. 지역을 권역별 4개, 읍·면·동 구성에 따른 보건소 유형을 4개로 분류하였고, 각 지역 비전의 글자 수, 문장 평가, 단어 빈도, 문구 평가를 빈도분석과 카이제곱검정, 일원배치분산분석을 이용하여 분석하였다. 비전의 글자 수가 17자 이하인 보건소가 172개소(75.1%)였고, 보건소 유형별로 유의한 차이가 있었다(p<0.05). 문구에 대한 수사표현에서 비유법(37.1%)이, 한글 외에 표현 언어 사용에서는 특수문자(43.2%)가 많았으며, 보건소 유형별로 유의한 차이가 있었다(p<0.01). 비전에 사용된 단어들은 ‘건강’, ‘행복’, ‘함께’, ‘군민’ 또는 ‘시민’, ‘도시’, ‘100세’ 등이었다. 문구평가 점수에서는 특·광역시 및 수도권에서 가장 높았으며, 보건소 유형 및 권역별로 유의한 차이를 보였다(p<0.05). 보건소 유형별로 과정 및 평가 영역, 공유가능성 등에서 유의한 차이가 있었다(p<0.01). 방향성은 충청권, 수도권 순으로 권역별로 유의한 차이가 있었으며(p<0.01), 미래지향성 및 공유가능성은 영남권이 가장 높아 권역별로 유의한 차이가 있었다(p<0.01). 비전은 지역보건의료계획에 가장 중요 요소 중 하나이다. 이 연구는 지역사회 특성별로 비전의 설정이 다름을 확인하였으며, 이러한 결과를 통하여 지역보건의료계획 등 보건소 비전 수립시 참고가 될 수 있는 기초적인 자료가 될 것으로 판단된다. Objectives: In this study, we analyzed vision statements of the 6th community health plan of local government in Korea. Methods: We examined vision statements letters, missions and strategy plans, and long-term missions of 6th community health plans of 229 local government in Korea. We also analyzed the numbers of vision letters, sentence examination, word frequency, each vision statement with frequency analysis, chi-square test, and one-way ANOVA. Results: Among 229 local government, 172(75.1%) of local government had the number of letters (Korean) less than 17 of vision statements, and there were a significant differences according to type of community health centers (p<0.05). Figuration (37.1%) were the most used in an expression of vision statement sentence, and special characters (43.2%) were the most used language except Korean. The most commonly used words of vision statement in order of frequency were ‘health’, ‘happiness’, ‘with’, ‘citizen’, ‘city’, ‘100 years old’ etc. Chungcheong provinces and Daejeon metropolitan city had a highest score in directionality on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Gyeongsang provinces, Ulsan, Daegu, and Busan metropolitan cities had a highest score in future orientation and sharing possibilities on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Conclusions: Vision is one of the most important component of community health plan. We need more detailed ‘vision statement guideline’ and the community health care centers of local government should effort to make more clear and complete their vision.

좌측 광범위 경부 림프절 청소술 후 발생한 양측 유미흉 2예

신종현(Jong-Hyun Shin),이잔디(Jandee Lee),윤지섭(Ji-Sup Yun),임치영(Chi-Young Lim),남기현(Kee-Hyun Nam),정웅윤(Woong Youn Chung),박정수(Cheong Soo Park) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.2

Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Early diagnosis of chy-lothorax is important due to the consequences on metabolic & cardiopulmonary conditions. This present report describes our recent experiences with two cases of bilateral chylothorax following left modified radical neck dissection that was treated successfully by conservative management.

항혈청 투여에 따른 돼지 전염성 설사병 예방효과 : Ⅰ.혈청학적 결과, RT-PCR 검사, 형광항체검사 Ⅱ.Serological Results, Rt-PCR for Fecal and Small Intestin, FA Test

지영철,한정희,권혁무,한태욱,정현규,박봉균 한국수의병리학회 2002 한국수의병리학회지 Vol.6 No.1

The purpose of this study was to investigate to potective effects against porcine epidemic diarrhea virus (REDV) infection in piglets by administration of the PEDV antiserum orally at 2 hrs, 24 hrs and 36 hrs after birth. six piglets adiminstered the antiserum were experimentally infected with PEDV at five-day-old. Control group were four piglets infected with PEDV only. Serum antibody titers aginst PEDV were examined by serum neutralization (SN) test, dectection for PEDV or PEDV antigen from feces and small intestines was tested by reverse transcrption-polymerase chain reaction (RT-PCR) and indirect immunoflurescence (IFA). The results obtained were as follows; 1. The piglets administered the PEDV antiserum showed higher antibody titers than those of control group and sustained during the experimental period. 2. The detection rate of PEDV in feces and small intestines by RT-PCR were 26.2% and 16.7% in PEDV antiserum treated group and 48.1% and 75.0% in control group, respectively. 3. The detection rate of PEDV antigen in the small intestine by IFA were 0% in PEDV antiserum treated group and 50.0% in control group, respectively. It was concluded that oral administration of antiserum against PEDV to piglets was effective in preventing PEDV infection.

[논문]해석방법에 따른 사각 RC 라멘교의 거동

진치섭,이승훈,엄장섭,배상현 釜山大學校生産技術硏究所 2006 生産技術硏究所論文集 Vol.65 No.-

본 연구에서는 사각(900°~450°) RC 라벤교를 2차원 보해석과 3차원 판해석으로 해석하였다. 연구 결과로부터 다음과 같은 결론을 얻었다. 슬래브 지점부의 단면력 집중에 따라,3차원 판해석에 의한 단면력은 2차원 보해석의 단면력보다 1.015~1.830배 크게 나타났다. 따라서 슬래브 지점부의 철근 보강 영역은 경사폭의 0.11~0.30배로 나타났다. 슬래브 최대 정모멘트 발생각과 라멘교 사각과의 상관관계를 살펴보면, 라벤교 사각 900° ~45°에 대하여 최대 정모벤트 발생각은 93° ~ 51°로 나타났다. 따라서 라벤교의 주인장 철근 이음장 위치는 최대 정모맨트 발생 구역 밖에들도록 해야한다.

큰양송이 Portobella 균주의 배양조건 및 형태적 특성

지정현 외 한국버섯학회 2003 한국버섯학회지 Vol.1 No.1

국내외에서 수집된 큰양송이(포토벨라)의 균주와 양송이 ASI707을 공시하여 균사체 배양조건과 균주별 자실체의 형태적 특성을 조사한 결과는 다음과 같다. 퇴비추출배지에서 균사생장이 우수하였고, 최적배양온도는 25℃, pH는 7.0 이었다. 균사생장에 가장 적합한 탄소원으로 Sucrose와 Starch, 질소원으로는 Malt extract가 선발되었고, 최적 C/N율은 10이었다. 인공재배한 자실체는 공시균주간에 갓크기, 갓두께 등에서 큰 차이가 없었으나 개체중은 25.8~33.8g 내외로 균주간에 다소 차이를 보였다. 공시균주 중 KME59007은 다발성으며 평당 수량도 44.6kg으로 가장 많았다. The compost dextrose(CD) medium was selected as an optimum liquid culture media for Portobella(Agaricus brunescens). The optimal conditions for the mycelial growth of Agaricus brunescens were 25 and pH 7.0. Sucrose and soluble starch were favorable to mycelial growth. Malt extract and ammonium nitrate appeared to be more favorable than the other kinds of nitrogen sources. The optimum C/N ratio was about 10.When the collected Portobella strains were compared with growth characteristics, KME 59007 appeared the highest of 44.6kg/3.3m².

임상병리과 의료영역과 임상병리사의 업무

池賢淑 대한의사협회 1996 대한의사협회지 Vol.39 No.2

항혈청 투여에 따른 돼지 전염성 위장염 예방효과 : Ⅰ. 혈청학적 결과, RT-PCR 검사, 형광항체검사 Ⅰ. Serological Results, Rt-PCR for Fecal and Small Intestin, FA Test

지영철,한정희,권혁무,한태욱,정현규,박봉균 한국수의병리학회 2002 한국수의병리학회지 Vol.6 No.1

The purpose of this study was to investigate to potective effects against transmissible gastroenteritis virus (TGEV) infection in piglets by administration of the TGEV antiserum orally at 5 hrs, 24 hrs and 36 hrs after birth. five piglets adiminstered the antiserum were experimentally infected with TGEV at four-day-old. Control group were four piglets infected with TGEV only. Serum antibody titers against TGEV were examined by serum neutralization (SN) test, dectection for TGEV or TGEV antigen from feces and small intestines was tested by reverse transcrption-polymerase chain reaction (RT-PCR) and indirect immunoflurescence (IFA). The results obtained were as follows; 1. The piglets administered the TGEV antiserum showed higher antibody titers than those of control group and sustained during the experimental period. 2. The detection rate of TGEV in feces and small intestines by RT-PCR were 24.5% and 20.0% in TGEV antiserum treated group and 44.0% and 75.0% in control group, respectively. 3. The detection rate of TGEV antigen in the small intestine by IFA were 26.7% in TGEV antiserum treated group and 75.0% in control group, respectively. It was concluded that oral administration of antiserum against TGEV to piglets was effective in preventing TGEV infection.