• Title/Summary/Keyword: 경부

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하인두 및 경부식도의 재건술;인두위문합술, 전박유리피판술 및 유리공장이식술의 비교

  • 김영호;최은창;홍원표;김은서
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.92.2-92
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    • 1995
  • 후두암 및 하인두암의 광역절제후 결손된 하인두 및 경부식도의 재건방법에는 여러 근피판, 인두위 문합이나 유리공장이식술과 같은 소화장기의 이용 및 전박유리피판술 등이 있다. 저자들은 1985년부터 1994년까지 10년간 세브란스병원에서 후두 및 하인두암으로 수술적 치료를 받은 예중 인두위문합술로 재건한 7례, 유리공장이식술로 재건한 9례, 전박유리피판술로 재건한 7례의 치료성적을 후향적으로 고찰하여 하인두 및 경부식도의 재건에 사용할 수 있는 술식들의 치료결과 및 장단점을 알아보고자 하였다. 피판의 생존은 세가지 술식 모두에서 양호하였으며 구강을 통한 식이섭취가 전례에서 가능하였다. 발생한 합병증으로는 인두피부누공, 문합부위의 협착 등이 있었으며 보존적인 방법으로 치유가 가능하였다.

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A Novel Gate Drive Technique of MOSFET for Improving Light Load Efficiency (경부하 효율 향상을 위한 MOSFET의 부하별 게이트 구동 기법)

  • Kim, Jae-Hyun;Lee, Jae-Bum;Moon, Gun-Woo
    • Proceedings of the KIPE Conference
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    • 2014.07a
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    • pp.161-162
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    • 2014
  • 본 논문에서는 스탠바이 컨버터를 가지는 전력 변환 시스템에서 경부하 효율을 높일 수 있는 새로운 게이트 구동기법을 제안한다. 제안 방법은 스탠바이 컨버터의 보조 출력 전압을 조절하여 전력 MOSFET의 구동 전압 및 제어기 IC의 동작 전압을 경부하 조건에서 낮춘다. 따라서, MOSFET의 게이트 구동 손실과 제어기 IC의 손실을 크게 줄일 수 있다. 본 논문에서는 48V 입력전압 및 12V 출력전압/60A 출력전류의 주전원단 및 5V/3A의 출력의 스탠바이 전원단을 포함한 DC/DC 서버용 전원 장치를 실험하여 타당성을 검증하였다.

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Control strategy for improving light load efficiency of high-frequency driven high power density adapter (고주파수 구동 고전력밀도 아답터의 경부하 효율 개선을 위한 제어전략)

  • Joo, Hyung-Ik;Ji, Sang-keun;Ryu, Dong-Kyun;Han, Sang-Kyoo
    • Proceedings of the KIPE Conference
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    • 2019.07a
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    • pp.86-88
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    • 2019
  • 본 논문에서는 고주파수 구동 및 고전력밀도 아답터의 경부하 효율 개선을 위한 One Chip 디지털 통합제어 알고리즘을 제안한다. 제안 회로는 CRM PFC Boost 컨버터와 3-Level LLC 공진형 컨버터를 하나의 소형 MCU로 구성된 디지털 제어기를 사용함으로써 고주파수 구동을 가능케 하며, 주파수 제한 및 Burst mode로 구성된 알고리즘을 통해 높은 스위칭 주파수로 인해 발생하는 경부하 시 효율 개선을 통해 수동 소자와 제어단 부피 저감으로 고 전력밀도 달성이 가능하다. 최종적으로 제안 회로의 타당성 검증을 위하여 200W급 아답터의 전원회로를 위한 시작품을 제작하여 고찰된 실험결과를 제안한다.

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Association of Bone Mineral Density with Physiological Characteristics and Lifestyles in Premenopausal Working Women (폐경전 성인직장여성의 골밀도와 생리적 특성 및 생활습관과의 관련성)

  • 임화재
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.2
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    • pp.339-348
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    • 2004
  • This study was peformed to assess the relationships among bone mineral density (BMD), Physiological characteristics and lifestyle factors in 61 premenopausal working women aged 30∼49 y in Busan. The BMDs of the lumbar spines (Ll∼L4), femoral necks (FN), ward's triangles (WT) and trochanters (TC) were measured by dual energy X-ray absorptiometry. Data for physiological characteristics and physical activity was assessed by questionnaire and usual intakes of coffee, green tea, alcohol, Coca cola by food frequency questionnaire. The BMDs of L14, FN, WT and TC were 1.02 g/$\textrm{cm}^2$, 0.76 g/$\textrm{cm}^2$,0.69 g/$\textrm{cm}^2$ and 0.66 g/$\textrm{cm}^2$respectively The BMD of FN was assessed as osteopenia by T-score. The BMD of WT was positively correlated with age of monarch (p<0.05) and the BMD of Ll4 was positively correlated with delivery number (p<0.05). The BMD of Ll4 was positively correlated with hours of outdoor activity per weekend and week (p<0.05, p<0.05). The BMDs of FN and WT (p<0.05, p<0.05) were positively correlated with intake of green tea per month and the BMD of FN (p<0.05) was positively correlated with intake of wine per month. But the BMD of Ll (p<0.05) was negatively correlated with intake of Coca cola per month. So nutritional education for increasing hours of outdoor activity and decreasing intake frequency of beverage contributing to diminishment of bone mineral density is needed for premenopausal working women to prevent osteoporosis.

The Usefulness of Ultrasound-Guided Fine Needle Aspiration Cytology of Impalpable Neck Nodes in Patients with Lung Cancer (폐암 환자에서 촉진되지 않는 경부 림프절에 대한 초음파 유도 하 세침흡인 세포검사의 유용성)

  • Kim, Hee Kyoo;Ha, Seung In;Kim, Yu Ri;Park, Chan Bog;Oak, Chul Ho;Jang, Tae Won;Jung, Maan Hong;Oh, Kyung Seung;Chun, Bong Kwon;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.505-513
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    • 2004
  • Background : In lung cancer patients, the presence of metastatic neck nodes is a crucial indicator of inoperabilty. So thorough physical examination of neck is always mandatory, but sometimes those are hardly palpable even by the skillful hand. Ultrasonography is a useful diagnostic method in detection of small impalpable lymph nodes and in guidance of fine needle aspiration biopsy. In this study we evaluated the clinical usefulness of ultrasonography(USG) and ultrasound-guided fine needle aspiration cytology(US-FNA) in lung cancer patients without palpable neck nodes. Methods and Materials : From Sep 2002 to Sep 2003, 36 non-small cell lung cancer patients (20 adenocarcinoma, 16 squamous cell cancer) and 10 small cell lung cancer patients without palpable neck nodes on physical examiation were enrolled. patients who had contralateral mediastinal nodal enlargement(>1cm) on chest CT were excluded. After the routine check of USG on the neck, US-FNA was done in cases with enlarged neck nodes (${\geq}5mm$ in the short axis). The presence of enlarged lymph node on USG, and of malignant cells on cytology were evaluated by the histological type and the patients' clinical stage of lung cancer. Results : Among 36 non-small lung cell cancer patients, 14 (38.8%) had enlarged neck nodes on USG, and 5 of 10 small cell lung carcinoma patients. The mean diameter of the neck nodes was 9.8 mm (range, 7-12 mm). US-FNA of 14 non-small cell lung cancer patients revealed tumor cells in eight patients (57.1%). In 5 small cell lung cancer pateints, tumor cells were found in all cases. By the result of US-FNA, the clinical stage of 8 out of 36 (22.2%) non-small cell lung cancer patients had changed, including two cases of shift from the operable IIIa to the inoperable IIIb. In small cell lung cancer patients their clinical stage was not changed after US-FNA, but their pathological diagnosis was easily done in two cases, in whom endobronchial lesions were not found on bronchoscopy. Conclusions : USG and US-FNA of neck node seem to be safe, sensitive and cost-effective diagnostic tools in the evaluation of lung cancer patients without palpable neck nodes.

Hypothyroidism Following Surgery and Radiation Therapy for Head and Neck Cancer (두경부암 환자에서 수술 및 방사선치료 후 갑상선 기능 저하)

  • Park, In-Kyu;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.225-231
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    • 1997
  • Purpose : Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. Materials and Methods : From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy The follow-up duration was 3 to 80 months. Results :The overall incidence of hypothyroidism was 56.3\%$);7 out of 71 patients $(9.9\%)$ developed clinical hypothyroidism and 33 patients $(46.4\%)$ developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000), Four of 26 patients $(15.4\%)$ with neck dissection alone developed hypothyroidism while 36 of 45 patients $(80\%)$ with laryngectomy and neck dissection developed hypothyroidism. Conclusion : The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced theincidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.

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Percutaneous Mini-open Reduction for Mason II or III Radial Head and Neck Fracture (요골 두 및 경부 골절의 경피적 도수 정복술)

  • Lee, Jeong-Gil;Koh, Il-Hyun;Kim, Hyung-Sik;Choi, Yun-Rak;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.230-236
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    • 2010
  • Purpose: We wanted to evaluate the result of percutaneous, mini-open reduction for the treatment of Mason II or III radial head and neck fractures. Materials and Methods: 13 patients (8 male, 5 female) with Mason II or III radial head and neck fractures were treated by 1 cm percutaneous mini-open reduction under fluoroscopy. The average age of our subjects was 29 years. Follow up duration was 18 months. Results: Union was noted in all cases. Mean radial neck angulation was decreased from 33.2 degrees to 7.8 degrees. The mean change in angulation between the immediate post-operative and last follow-up was 0.7 degrees. The mean range of motion at the elbow joint was at last follow up, 133.1 degrees in flexion, 7.3 degrees in extension, 80 degrees in pronation and 84.3 degrees in supination. Postoperatively, mean Mayo Elbow Performance Index, American Shoulder and Elbow Surgeons elbow score, and Disabilities of the Arm, Shoulder and Hand score were 96.2, 97 and 1.2. Temporary posterior interosseous nerve palsy (1 case) and minimal cubitus valgus deformity (1 case) were noted. Conclusion: Selected Mason II or III radial head and neck fractures can be treated satisfactorily with percutaneous mini-open reduction.

A Study on Anastomotic Complications after Esophagectomy for Cancer of the Esophagus : A Comparison of Neck and Chest Anastomosis (식도암 수술후 문합부 합병증에 관한 연구 - 경부문합과 흉부문합 간의 비교-)

  • 이형렬;김진희
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.799-805
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    • 1999
  • Background: Leakage, stricture formation, and tumor recurrence at the anastomotic site are serious problems after esophagectomy for cancer of the esophagus or cardia. The prevalence of these postoperative complications may be affected by whether an anastomosis is made in the neck or in the chest, therefore a comparison was made between anastomoses made at these two sites. Material and Method: Between 1987 and 1998, 36 patients with cancer of the esophagus underwent transthoracic esophagectomy with cervical(NA, n=20) or thoracic anastomosis(CA, n=16). The tumors were staged postoperatively(stage IIA, n=13; s tage IIB, n=7; stage III, n=16) and were located in the middle thoracic(n=22) or lower thoracic esophagus and cardia(n=14). Result: The overall operative mortality was 8.3%(5% for NA group, 12.5% for CA group). The anastomotic leak rate for the NA group was 15.0% and 12.5% for the CA group. The anastomotic leak rate differed according to the manual(27.3%) or stapled(8.0%) techniques(p < 0.05). The median proximal resection margins in the NA and CA groups were 9.6 cm and 5.8 cm, and the corresponding rates of anastomotic tumor recurrence were 5.3% and 28.6%(p < 0.05). The prevalence of benign stricture formation (defined as moderate/severe dysphagia) was higher in the NA group(36.8%) than in the CA group(21.4%). When an anastomosis was made by the stapled technique, smaller size of the staple increased the prevalence of stricture formation - 41.7% with 25-mm staple and 9.1% with 28-mm staple(p < 0.05). Conclusion: Wider resection margin could decrease the anastomotic tumor recurrence, and the stapled technique could decrease the anastomotic leak. The prevalence of benign stricture was higher in the cervical anastomosis but the anastomotic leak and smaller size(25-mm) of the staple should be considered as risk factors.

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