Tonsillectomy as prevention and treatment of sleep-disordered breathing: a report of 23 cases

Woo, Jae-Man,Choi, Jin-Young Korean Association of Maxillofacial Plastic and Re 2016 Maxillofacial Plastic Reconstructive Surgery Vol.38 No.-

Background: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients. Methods: Total of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated. Results: Twenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep. Conclusions: When only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

MSE를 이용한 동영상의 장면전환검색에 관한 연구

최우진,김단환,정기봉,오무송 조선대학교 전자정보통신연구소 2002 電子情報通信硏究所論文誌 Vol.5 No.1

Multimedia information includes image information, sound information, character information and various informations. Difficulty follows to look for image which user wants by existent retrieval method. Therefore, introduce MSE(Mean Square Error) by index method for efficient practical use of video information in this research and propose scene change detection retrieval method of video. This image data for diagonal line direction color value of schedule pixel draw, (By j^(*)i matrix to Matrix A, i is frame number, j stored cost that express diagonal line Image height of frame to Matrix A). So that can grasp whole structure of video, do sampling in still image, Made user can grasp whole structure of video, do sampling in still image. Made user grasp scene change point of total video on one eye. If MSE of each frame exceeds critical value, search the frame by scene change.

직류 서보 전동기의 위치 제어를 위한 오차 적응 퍼지 PI 제어에 관한 연구

최우진,임영도,이준탁 東亞大學校 1994 東亞論叢 Vol.31 No.1

In this paper, the design technique of Error Adaptive Fuzzy PI controller with the aim to achieve the accuracy and the better robustness than the conventional PI controller and the Fuzzy controller presented. In the proposed Error Adaptive Fuzzy PI controller with fuzzy reasonings; a P controller mainly used to improve the transient response, and an I controller is mainly used to excute an acrate regulation action in steady state. Using this proposed alogorithm, the position controller of the DC servo system is implemented on 80486 micro processor with DT-2801 data acqusition board. Comparing to the conventional Fuzzy controller which is based on human being's inspection and intelligence or comparing to the convetional PI controller, the proposed Error Adaptive Fuzzy PI controller has the better robust dynamics against load disturbances.

2차원인 미지의 상태공간에서 손실정보의 비교

최우진 울산대학교 1978 연구논문집 Vol.9 No.2

2차원인 미지의 상태공간에 대하여 얻은 손실정보량 사이의 부등식관계를 밝히고 m차원과 m-1차원의 상태공간에서 표준판정의 경우에 대한 정보교란을 비교 검토 하였다. The relations between the amount of missing imformation and the errors of standard decisions are studied in a two-dimensional space of nature.

고등학생 및 대학생의 AIDS에 관한 지식 및 태도 비교조사

최길명,선우섭,이혁,조진우,이한 경희대학교 사회체육연구소 1996 體育科學論叢 Vol.- No.9

The present research is to provide basic data for establishing an effective educational program for preventing AIDS. The following are the results of data collected from 2,123 high-school third grade students (1,051 male and 1,072 female) and 2,109 college freshman students (1,483 male and 626 female) and analyzed in terms of their status, sex, and region: 1. As for the corrects answers to the questions concerning knowledge of AIDS, high-school and college male students tend to show higher grades, especially in theepidemic and non-epidemic aspects of AIDS. 2. As for the correct answers to the questions concerning attitudes to AIDS, high-school female students tend to show higher grades. 3. As for the corrects answers to the questions on knowledge of AIDS, college students received higher grades (p<.001), especially in the epidemic and non-epidemic aspects (16 questions) of AIDS. 4. As for the correct answers to the questions concerning attitudes to AIDS, college students received higher points (p<.05), especially in preventive attitudes (10 questions). 5. The regional order of correct answers to the questions concerning knowledge of AIDS in high-school students is Kyungsang, Choongchung, Kangwon, Chunla, Cheju, Seoul, and Kyunggee. But, the order of correct answers in college students is Chunla, Seoul, Kyungsang, Kangwon, Choongchung, Kyunggee, and Cheju. 6. The regional order of correct answers to the questions concerning attitudes to AIDS in high-school students is Choongchung, Cheju, Kyungsang, Seoul, Kangwon, Chunla, and Kyunggee. However, the order of correct answers in college students is Kangwon, Kyungsang, Choongchung, Chunla, Seoul, Kyunggee, and Cheju. The research result shows that the educational program for preventing AIDS must take into consideration knowledge on epidemic and non-epidemic aspects of AIDs and preventive attitudes toward AIDS. And, it also proves that it is necessary to devise an AIDS educational program for high-school and college students.

인슐린 주사제의 고충실 액체색층기 분석

우정택,팽정렬,김성운,양인명,김진우,김영설,김광원,최영길 최신의학사 1993 最新醫學 Vol.36 No.8