• Title/Summary/Keyword: 관 삽입

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The clinical study for the postoperative tracheal stenosis (수술후성 기관협착증에 관한 임사적 고찰)

  • 김기령;홍원표;이정권
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.9.1-10
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    • 1977
  • Many etiological factors playa significant role in the development of tracheal stenosis; too high tracheostomy (Jackson, 1921), too small stoma (Greisen, 1966), the treatment with respirator using cuffed tube (Pearson et al., 1968; Lindholm, 1966; Bryce, 1972) and infection (Pearson, 1968). Although the incidence has been reduced due to development of surgical technique and antibiotics, the frequency of tracheal stenosis which produces symptoms after tracheostomy ranges from 1.5 per cent (Lindholm, 1967). In the management of the stenosis, mild cases are treated by mechanical dilatation with silicon tube or stent (Schmigelow, 1929; Montgomery, 1965) combined steroid (Birck, 1970), and in the cases of stenosis causes, these removed under the are bronchoscopy. But in severe stenosis, transverse resection with subsequent end-to-end anastomosis has been used in recent years (Pearson et al., 1968). During about 10 years, 1967 to 1977, a total of 23 patients with tracheal stenosis complicated among the 1, 514 tracheostomies have been treated in Severance Hospital. Now, we have obtained following conclusions by means of clinical analysis of 23 cases of tracheal stenosis. 1. The frequency of tracheal stenosis was 23 cases among 1, 514 cases of tracheostomy (1.5%). 2. Under the age of 5, these are 12 cases (52.2 %). 3. The sex incidence was comprised of 18 males and 5 females. 4. The duration of tracheostomy ranges from 4 days to 16 months. 5. The primary diseases requiring tracheostomy were following; central nerve system lesions 11 cases, upper air way obstruction 10 cases, extrinsic respiratory failure 2 cases. 6. Severe wound infections were only 2 cases. 7. The methods of treatment applied to tracheal stenosis were following; closed observation only 5 cases, nasotracheal intubation combined steroid 5 cases, T-tube stent combined steroid 3 cases, fenestration op. 4 cases, revision 4 cases and transverse resection and end-to-end anastomosis 2 cases.

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External Morphology of the American Leafminer, Liriomyza trifolii (Diptera: Agromyzidae), on Tomato with Scanning Electron Microscope (주사전자현미경을 이용한 토마토에 발생하는 아메리카잎굴파리(Liriomyza trifolii)의 외부형태적 특징)

  • Youn, Young-Nam;Kim, Ki-Duck;Park, Su-Jin;Kim, Nam-Sung;Seo, Mi-Ja;Chae, Soon-Yong
    • Korean Journal of Agricultural Science
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    • v.27 no.1
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    • pp.13-19
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    • 2000
  • The external morphology of male and female of Liriomyza trifolii (Burgess) was studied using the scanning electron microscopy (SEM). Three types of sensilla were identified on the funicle of antennae. The trichoid sensilla were most conspicious and distributed with a characteristic sharp structure at the apical end. Basiconic sensilla were showed distal curvature about $13{\mu}m$ long and $1.2{\mu}m$ to $1.4{\mu}m$ in diameter. Grooved sensilla were showed a finger-like projections at the peg apex. The function of these sensilla likely to be olfactory. The mouthparts were adapted for sucking food, and formed a elongate rostrum which was incorporated with labrum. The labrum was a small and flap-like shape. The slender and paired maxillary palp seemed to combine with each other lengthwise to long tube. The tarsus typically consisted of 5 segments, which might be variously modified, principally by thickening or flattening. The segment beared a pair of claws. Beneath the claws, there was a pair of pad-like pulvillia and a bristle-like median empodium. L. trifolii might secreted on the pulvillus and empodium an adhesive substance that enable them to cling to smooth surfaces. Male terminalia was complicated. The name 'aedeagus' seemed the best available general term for the copulatory organ, otherwise, female terminalia was usually relatively simple. This structure was reduced and formed a telescopic, eversible, and tubular ovipositor.

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Nasolacrimal Duct Obstruction after Radioactive Iodine Therapy for Thyroid Cancer (갑상선암에서 방사성 요오드 치료 후 발생한 코눈물길 폐쇄)

  • Hwang, Moon Won;Lee, Eung;Yang, Jae Wook
    • Journal of The Korean Ophthalmological Society
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    • v.55 no.1
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    • pp.1-6
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    • 2014
  • Purpose: To investigate the clinical manifestation of nasolacrimal duct obstruction after radioactive iodine therapy for thyroid cancer. Methods: The authors examined 622 patients who were treated with radioactive iodine therapy after the operation for thyroid cancer from January 2009 to December 2011. Fourteen patients (18 eyes) were diagnosed nasolacrimal duct obstruction based on the lacrimal irrigation test, lacrimal probing test and dacryocystography in our oculoplastic clinic. We analyzed the dose of radioactive iodine therapy, number of treatments, clinical manifestation and treatment type by retrospectively reviewing the patients' medical records. Results: The mean radioactive iodine dose ($215.7{\pm}23.1mCi$, p = 0.01) and the mean number of treatments ($1.36{\pm}0.50$, p < 0.001) were significantly greater in 14 patients who had nasolacrimal duct obstruction than in patients who did not. The average onset of tearing symptoms occurred 10.2 months after radioactive iodine therapy. The mean time between correct diagnosis and therapy was 18.4 months. Three patients (3 eyes) had occlusion at the common cannaliculus and 11 patients (15 eyes) had occlusion at the nasolacrimal duct. Ten patients (13 eyes) underwent endonasal dacryocystorhinostomy for complete obstruction and 4 patients (5 eyes) underwent silicone tube intubation for partial obstruction. Conclusions: Nasolacrimal duct obstruction is a rare complication associated with radioactive iodine therapy for thyroid cancer, thus, clinicians should be aware of this complication and refer patients with symptoms of epiphora to the oculoplastic department for specialized evaluation and treatment.

Unexpected Aggravation of COVID-19 After Recovery in Three Adolescents With Chronic Neurologic Conditions: A Case Series

  • Dayun Kang;Seung Ha Song;Bin Ahn;Bongjin Lee;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.147-154
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    • 2022
  • The clinical severity of coronavirus disease 2019 (COVID-19) in children is usually mild. Most of the affected patients completely recovered from COVID-19 before being released from approximately 7-day quarantine. However, children with comorbidities are at risk of more severe disease and adverse outcomes. We report three cases of COVID-19-affected adolescents with underlying chronic respiratory difficulty due to neurologic diseases who showed sudden clinical aggravations at the time of discharge, even after full clinical improvement. Patient 1 is a 17-year-old boy with Ullrich congenital muscular dystrophy who had cardiopulmonary arrest 9 days after the initial COVID-19 symptoms. Patient 2 is a 17-year-old girl with intracerebral hemorrhage with infarction in bed-ridden status who had cardiopulmonary arrest 11 days after the initial symptoms. Patient 3 is a 12-year-old boy with intraventricular hemorrhage with hydrocephalus in bed-ridden status who showed multiorgan failure 10 days after the initial symptoms. Remdesivir, dexamethasone, and empirical antibiotics were administered with mechanical ventilation and intensive unit care. Among the three patients, two (patients 1 and 3) were alive, and one (patient 2) expired. Clinicians caring for adolescents with chronic neurologic and/or pulmonary disease should keep in mind that these patients could have sudden deterioration after recovery from the acute phase of COVID-19 around or after the time of discharge.

Assessment and Improvement of the Horizontal In-Tube Condensation Heat Transfer Model in the MARS code (MARS 코드의 수평관내부 응축열전달 모델 평가 및 개선)

  • Lee, Hyun Jin;Ahn, Tae Hwan;Yun, Byong Jo;Jeong, Jae Jun
    • Journal of Energy Engineering
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    • v.25 no.1
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    • pp.56-68
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    • 2016
  • Extensive researches have been carried out for enhancing the safety of nuclear power plants and, especially, the development of passive cooling systems, such as passive containment cooling system (PCCS) and passive residual heat removal system, is increasingly important, where condensation is a crucial heat transfer mechanism. Recently, Ahn & Yun et al. developed a horizontal in-tube condensation heat transfer model as one of the activities for the PCCS development. In this work, we implemented the Ahn & Yun 's condensation heat transfer model into the MARS code and assessed it using the PASCAL experimental data. Based on the results of the assessment, we identified the limitations of the Ahn & Yun 's model and suggested a modified Ahn & Yun 's model, and assessed the model using various experimental data.

Effect of Observation Window at Peripheral Intravenous Catheter Site on Early Recognition of Infiltration among Hospitalized Children (아동의 말초정맥관 삽입 부위 관찰창 확보가 침윤조기감지에 미치는 효과)

  • Jeong, Ihn Sook;Park, Soon Mi;Park, Kyung Ju
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.534-541
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    • 2016
  • Purpose: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. Methods: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea. The 193 patients, who were hospitalized from January to May, 2014 formed the control group and did not have OW, and the 167 patients, who were hospitalized from January to May, 2015 formed the window group and had OW. Data were analyzed using ${\chi}^2$-test, independent samples t-test and multiple logistic regression. Results: First stage IV infiltration was 39.5% for the window group and 25.9% for the control group, which was significantly different (p=.007). The likelihood of $2^{nd}$ stage and above IV infiltration decreased by 44% in the window group, which was significantly different (p=.014). Conclusion: OW at the peripheral IV catheter site was found to be an effective measure in early recognition of IV infiltration. Considering the effect of OW, we recommend that nurses should make an OW with transparent dressing during stabilization of the IV catheter site in hospitalized children in clinical settings.

Transfer and Expression of a Tomato Inhibitor II and $\beta$-Glucuronidae Fusion Gene in Flowering Cabbage, Brassica oleracea var. acephala DC. (꽃양배추로의 프로타제 저해제 II와 $\beta$-Glucuronidase 융합 유전자의 도입 및 발현)

  • 김창길;정재동;안진흥;김경민
    • Korean Journal of Plant Tissue Culture
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    • v.25 no.1
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    • pp.37-43
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    • 1998
  • The highest transformation frequency was observed when cotyledonary and hypocotyl explants of flowering cabbage (Brassica oleracea var. acephala DC) 'Eunbae' were cultured on shoot induction medium without kanamycin for 1 day, then cocultured with Agrobacterium tumefaciens LBA4404;;pGA1036 harboring tomato inhibitor II promoter and $\beta$-glucuronidae (GUS) fusion gene for 3 days. These explants were transferred to MS medium containing 20 mg/L kanamycin, 500 mg/L carbenicillin, and 1 mg/L BA. The explants were subsequently subcultured every 2 weeks. Incorporation of the GUS gene into flowering cabbage was confirmed by PCR analysis of DNA. Southern blot analysis showed that ECL-labeled GUS gene was hybridized to the expected amplified genomic DNA fragment of about 366 bp from transgenic flowering cabbage. Histochemical analysis based on the enzymatic activity of the GUS protein indicated that PI-II promoter activity was sysmatically associated with vascular tissue in wonded as well as in non-wounded leaves, petioles and stems, but not in roots. Partial wounding with razor blade showed not systemic induction but partial induction.

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Nonocclusive Mesenteric Ischemia That Developed during Redo-double Valve Replacement Surgery, and This Was Caused by Acute Aortic Dissection (이중판막 재치환술 시 발생한 급성 대동맥 박리증으로 인한 비폐쇄성 장간막 허혈)

  • Lee, Sak;Song, Suk-Won;Cho, Sang-Ho;Song, Seung-Jun;Kim, Kwan-Wook;Chang, Byung-Chul
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.248-251
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    • 2009
  • Nonocclusive mesenteric ischemia (NOMI) is a rare complication that occurs in about 0.05% of patients after openheart surgery, and NOMI refers to the mesenteric ischemia that's caused by splanchnic vasospasm without occlusion of the great intestinal vessels. In the presently reported case, NOMI developed to maintain the blood flow to the heart and brain after several minutes of a hypotensive status and the latter was caused by acute aortic dissection that complicated an aortic cannulation procedure. Unfortunately, the patient died even though the problems were diagnosed early and proper treatment was administered. Early diagnosis of NOMI by angiography and the selective infusion of vasodilators are thought to be the only way to improve survival for patients with clinically suspected NOMI.

The Study about influence of immersiveness on PPL advertising in on-line game (몰입 정도가 온라인 게임 내 PPL 인지에 미치는 영향에 대한 연구)

  • Park, Seong-Min;Ryu, Seoung-Ho
    • Journal of Korea Game Society
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    • v.6 no.3
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    • pp.67-76
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    • 2006
  • This study is to examine relationship between immersiveness aspect and the recognition of garners who are exposed to PPL (Product Placement Advertisement) in online game. The frequency of exposure, the placement type of PPL, the perception under the threshold of consciousness and the interest at the product and knowledge about PPL have been widely known as the factors of effectiveness in PPL advertising. In this study, 'immersiveness' is newly introduced to investigate the effectiveness of PPL advertising due to the unique characteristics of game which easily leads to immersion. Control group is exposed to movie clip and experimental group to lacing online game. In conclusion, the deep immersion has reduced the perception level of user on PPL except the variable of PPL placement. This study suggests that how to design the PPL placement in game for enhancing marketing effect is all the more vital, in spite of the result that the player in high immersion cannot distinguish different images.

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Cross-Pin and Interference Screw Femoral Fixation in Anterior Cruciate Ligament Reconstruction using Hamstring Tendon -Technical Note- (슬괵건을 이용한 전방십자인대 재건술시 횡고정 핀과 간섭나사를 이용한 대퇴터널 고정술 -수술 수기-)

  • In Yong;Bahk Won-Jong;Park Jong-Beom;Hong Seung-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.60-63
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    • 2002
  • Purpose : The purpose of this study was to introduce new femoral fixation technique using a cross-pin and a bioabsorbable interference screw in hamstring ACL reconstruction. Method : Semitendinosus and gracilis were harvested for quadrapled graft. After tibial tunnel had been made, femoral tunnel was made 35 mm in depth. Then the graft passed through the tunnels. Cross-pin was fixed through the drill hole which had been made through upper sleeve of the Rigidfix system. While pulling the graft, bioabsorbable interference screw was fixed through the anteromedial portal. Conclusion : We introduced the new femoral fixation technique using a cross-pin and a bioabsorbable interference screw as a good method with high fixation strength and tight graft-bone contact.

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