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Management of subclinical thyroid dysfunction and cardiovascular events in patients with ESRD on HD
( Sang Jo Han ),( Joo Lee ),( Jeong Mi Shin ),( Eun Lee ),( Young Mo Kang ),( Bum Jin Jeong ),( Young Jun Cho ),( Ji Suk Seong ),( Yong Mun Woo ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background: Normal thyroid function influences basal metabolic rate and general body metabolism and thyroid dysfunction is often associated with dyslipidemia and increased cardiovascular risk in general polulation. It is known that about 25% of patients with end-stage renal disease(ESRD) on hemodialysis had subclinical thyroid dysfunction. We investigated that subclinical hypothyroid dysfunction associate with dyslipidemia and cardiovascular event in hemodialysis patients. Hence, we conducted our study to elucidate whether subclinical thyroid dysfunction treated or not in ESRD patients. Methods: All hemodialysis patients in Red Cross Hospital within a period of one year were included in the study. Thyroxine-3 (T3), free thyroxine- 4 fT4, Thyroid Stimulating Hormone (TSH) and lipid profiles in the serum were estimated and death from all causes and CV events served as outcome variables over a median follow-up period of 12 months. Participants were divided into groups based on the thyroid function. Statistical analysis was carried out by using SPSS. Results: Among the 92 cases, 28.2% of the patients were having thyroid disorder. In which 2.1% were of hypothyroid, 13.7% were of subclinical hypothyroid, and 0.8% were of hyperthyroid, 11.6% were of subclinical hyperthyroid. We observed negative correlation between TC & fT3. Total cholesterol was raised in hypothyroidism in comparison to euthyroid ESRD patients. However, thyoroid function didn’t have significant association with lipid profiles. Cardiovascular disease significantly often occurred in subclinical thyroidism patients than other group Conclusions: Our results show that the blood thyroid hormone level isn’t affected by dyslipidemia but affected by occurrence of CVD. Therefore, the management of subclinical hypothyroidism in hemodialysis patients should be considered. Keywords: Thyroid function; Dyslipidemia; Cardiovascular events; End stage renal disease (ESRD)
P081 : A clinical study of malignant skin tumors excised simply before definite diagnosis
( Sung Min Park ),( Gun Wook Kim ),( Hyun Ho Cho ),( Won Jeong Kim ),( Je Ho Mun ),( Margaret Song ),( Hyun Chang Ko ),( Byung Soo Kim ),( Moon Bum Kim ),( Hoon Soo Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Background: Although some skin tumor have distinct clinical feature, biopsy is essential for confirming the diagnosis in most cases of skin tumor. Furthermore, appropriate treatment method is determined according to the diagnosis. Encountering patients who visit after simple excision for skin tumor before definite diagnosis, clinicians experience difficulties in further evaluation and management. Objectives: To evaluate the characteristics of simply excised malignant skin tumor before confirming the diagnosis. Methods: Retrospective study was conducted by reviewing the record of patients visited after excision of malignant skin tumor without confirming diagnosis in other hospital. We investigated the previous and final diagnosis, completeness of excision, recurrence, and management. Results: Twenty-four patients were enrolled in this study. Most patients had undergone an operation at surgical hospital. Although basal cell carcinoma and squamous cell carcinoma were common, there were various tumors including myxofibrosarcoma, mucinous eccrine carcinoma, sebaceous carcinoma, porocarcinoma, and so on. Re-operation was required in most cases. Conclusion: Our study showed that excision of malignant skin tumor before definite diagnosis leads to many problems such as delay of accurate diagnosis, possibility of incomplete excision, difficulty to localize remaining tumor and to decide resection margin.
Variable Structure Control with Optimized Sliding Surface for Spacecraft Slewing Maneuver
Cho, Sang-Bum,Moon, Gwan-Young,Kim, You-Dan 한국항공우주학회 2006 International Journal of Aeronautical and Space Sc Vol.7 No.1
A variable structure controller with an optimized sliding surface is proposed for slew maneuver of a rigid spacecraft. Rodrigues parameters are chosen to represent the spacecraft attitude. The quadratic type of performance index is used to design the sling surface. For optimization of the sliding surface, a Hamilton- Jacobi-Bellman equation is formulated and it is solved through the numerical algorithm using Galerkin approximation. The solution denotes a nonlinear sliding surface, on which the trajectory of the system satisfies the optimality condition approximately. Simulation result demonstrates that the proposed controller is effectively applied to the slew maneuver of a rigid spacecraft.
Attitude Control of a Tethered Spacecraft
Sang-Bum Cho,N. Harris McClamroch 한국항공우주학회 2007 International Journal of Aeronautical and Space Sc Vol.8 No.2
An attitude control problem for a tethered spacecraft is studied. The tethered spacecraft is viewed as a multi-body spacecraft consisting of a base body, a massless tether that connects the base body and an end mass, and tether actuator dynamics. Moments about the pitch and roll axes of the base spacecraft arise by control of the point of attachment of the tether to the base spacecraft. The control objective is to stabilize the attitude of the base spacecraft while keeping the perturbations of the tether small. Analysis shows that linear equations of motion for the tethered spacecraft are not completely controllable. We study two different control design approaches: (1) we decouple the attitude dynamics from the tether dynamics and we design a linear feedback to achieve stabilization of the attitude dynamics, and (2) we decouple the controllable modes from the uncontrollable mode using Kalman decomposition and we design a linear feedback to achieve stabilization of the controllable modes. Simulation results show that, although it is difficult to control the tether, the tether motion can be maintained within an acceptable range while stabilizing the attitude dynamics of the base spacecraft.