Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration. This is the site of predilection for vocal cord nodules. The author performed laryngomicrosurgery for 70 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 5 years. The result obtained were as follows ; 1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy. 2) In children, surgery is rarely indicated because most nodules in children regress during adolescence. 3) For patients who use their voices professionally, voice therapy is indicated for three months. 4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered. 5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position. 6) Removal of the nodule shoule be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule. 7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch. 8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.
DNA variation of MYL2 intron 5 A345G and ADCYAP1R1 intron 2 A337G were investigated for carcass trait association in finished pigs. Three genotypes(two homozygotes and their heterozygote) were found at 10.6% AA, 45.6% AG and 43.8% GG in MYL2 and 60.5% AA, 34.6% AG, and 22.2% GG for ADCYAP1R1. In finished pig population, individuals containing genotype G- of MYL2 had significantly heavier carcass weight by more than 2.4 kg and thicker backfat thickness by more than 1.3 mm than those of AA homozygous pigs(p<0.05). No significant difference was found in other traits tested in this study such as marbling score, meat color, texture, moisture and separation score(p>0.05). The ADCYAP1R1 intron 2 377GG homozygotes showed coarse texture, i.e., meat quality was inferior than those of AG and AA genotypes, and the moisture level of homozygote AA was higher than those of AG and GG genotypes(p<0.05). The other carcass traits were not significantly associated with ADCYAP1R1 genotypes(p>0.05). The genetic polymorphism of MYL2 and ADCYAP1R1 genes affected the carcass traits in finished pig population. Further studies to explain the association between genetic variations and their phenotypic effects including economic traits in pigs are required including critical mutation in both genes through molecular approaches.
Park Han-Ki;Youn Young-Nam;Yang Hong-Seok;Yoo Byoung-Won;Choi Jae-Young;Park Young-Hwan
Journal of Chest Surgery
/
v.39
no.4
s.261
/
pp.281-288
/
2006
Background: Extracardiac pericardial-flap lateral tunnel Fontan operation has theoretical advantage of growth potentiality of the extracardiac tunnels. The mid-term results of this technique and morphologic change of the lateral tunnel were studied. Material and Method: Clinical data was reviewed in 42 patients who underwent extracardiac pericardial-flap lateral tunnel Fontan operation between November 1993 and December 2004. The age was $2.8{\pm}1.5$ years and the body weight was $12.3{\pm}3.2$ kg. Extracardiac tunnel was constructed using the pedicled pericardium with the base undetached. By reviewing the follow-up cardiac angiograms, the diameter and the cross-sectional area of the lateral tunnel was compared to those of inferior vena cava. Result: There were four operative mortality cases (9.8%) and the causes of death were low cardiac output for all four cases. Postoperatively, five patients had prolonged pleural effusion longer than two weeks and one patient required a permanent pacemaker due to complete heart block. Follow-up was possible in 37 patients and the follow up duration was $3.8{\pm}2.2$ years. During that period, one patient died, of upper gastrointestional bleeding combined with heart failure and one patient died a sudden death of unknown cause. Two patients required reoperation due to subaortic stenosis and anastomosis site stenosis between inferior vena cava and lateral tunnel. In one patient, bradyarrhythmia was anew but there was no thromboembolic complication. The lateral tunnel showed growth in proportion to the size of the inferior vena cava. Conclusion: Extracardiac pericardial-flap lateral tunnel Fontan operation is relatively simple and safe. The mid-term result was favorable and the extracardiac tunnel showed potential for growth.
Park Jae-Min;Jun Hee-Jae;Yoon Young-Chul;Lee Yang-Hang;Hwang Yoon-Ho;Cho Kwang Hyun;Han Il-Yong
Journal of Chest Surgery
/
v.38
no.2
s.247
/
pp.110-115
/
2005
Background: The aims of this paper were to review the mid term clinical results and to analyze the preoperative risk factors of isolated aortic valve replacement (AVR). Material and Method: Between January 1992 and February 2003, 80 patients underwent isolated AVR. 58 were male and 22 were female patients, raging from 12 to 75 years of age (mean :$46.8{\pm}13.0$ years). 74 patients except one early death and 5 follow-up loss were contacted by OPD or by telephone. The mean duration of follow-up was $44.2{\pm}29.7$ months and the total cumulative period was 272.8 patient-year. Result: The complications in hospital occurred in 35 cases : 12 wound problems (11 superficial, 1 deep), 11 arrhythmias (9 temporary, 2 persistent), 3 low cardiac output, and so forth. The late deaths were 4 cases : the heart-related deaths were 2 cases ($0.7\%$ patient-year). Conclusion: The risk factors that influenced the early mortality and morbidity were older age (> 60 years)(p=0.04), poor preoperative NYHA functional class (> 3) (p=0.048), high preoperative serum creatinin level (> 1.2 mg/100 ml)(p=0.031), long operation time (aortic clamping time>90 min)(p=0.042). The same factors influenced the late mortality and morbidity. Freedom from valve-related complication was $86.4{\pm}5.3\%,$ actuarial survival rate were $96.8{\pm}2.3\%$ at 3 years and $90.8{\pm}4.6\%$ at 10 years.
Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.
Cho, Jung Ik;Kim, Jong Geon;Kim, Jong Ho;Cho, Ji Hyun;Kim, Jong Duck
Pediatric Infection and Vaccine
/
v.9
no.1
/
pp.85-94
/
2002
Purpose: This study was performed for analysis of the results of polymerase chain reaction(PCR) and antibody test of Mycoplasma pneumoniae(M. pneumoniae) in children with symptoms of respiratory tract infection. In the cases of both positive antibody test and PCR for M. pneumoniae, the chest X-ray findings were assessed. Methods: The antibody test was done in 1,979 cases who have been admitted to Wonkwang university hospital department of pediatrics with symptoms of respiratory tract infection from January, 2000 to December, 2001. The positive antibody test was defined as titer of 1 : 80 and over 1 : 80. The PCR of M. pneumoniae were done in randomly selected 131 cases of respiratory tract infection. The chest X-ray findings were assessed in the cases of positive antibody test and PCR. Results: The numbers of cases of the positive antibody test for M. pneumoniae were 499 cases(25%). The PCR for M. pneumoniae were performed in 131 cases and the 45 cases(34%) were positive and 86 cases(66%) were negative. The 56 of 86 PCR negative cases were also negative antibody test, but 30 cases were positive antibody test. The 36 cases of 45 PCR positive cases were antibody positive, and 9 cases were antibody negative. The sputum Gram stain and culture for M. pneumoniae were negative in all the 499 cases of mycoplasma antibody positive respiratory infection. In these antibody positive 499 cases, the most common X-ray findings was interstitial pneumonic infiltration in 266 cases(53%), and pleural effusion were detected in 22 cases(4%), but nonspecific chest X-ray finding showed in 129 cases(26%). In PCR positive 45 cases, the most common chest X-ray finding was interstitial pneumonic infiltration in 32 cases(71%). Conclusion: The PCR for M. pneumoniae is more useful method for detection of mycoplasma infection in children with respiratory tract infection. The M. pneumoniae is a important etiologic agent for respiratory infection in children.
In the present study, to determine the effects of terminal sire strains, carcass characteristics, yields of retail cut, and meat quality of 425 pigs were examined. Terminal sires were divided into five strains (D1, D2, B1, B2, and BD) based on the countries of origin and breeds. The strains D1 and D2 showed high grade 1+ appearance ratios and strains B1, B2, and D1 showed high appearance ratios of carcass yield grade A. As for the real retail cut yields of meat, strain D1 showed large real retail cut yields of meat in shoulder, rib, fore leg, loin, belly, tenderloin and hind leg. Moisture contents were significantly higher in strain B1, and protein and fat contents were significantly higher for strain D1 than in the other strains (p<0.05). Shear force values were significantly higher for strain B1 than in the other strains (p<0.05). For meat color properties, the lightness were significantly higher in strains D1, D2, and BD, and the yellowness were significantly higher in strains D1, D2, and BD relative to the other strains (p<0.05). In sensory evaluation, drip of strains D1 and D2 were significantly lower while marbling and overall acceptability were significantly higher in the other four strains (p<0.05). Therefore, when considering the results of the present study comprehensively, using strains D1 and D2 that showed high grade 1+ appearance ratios, large real retail cut yields of belly, significantly higher lightness and sensory evaluation will be helpful to the incomes of producers and farm households.
Yi, Jin Woong;Oh, Byung Hak;Heo, Youn Moo;Jang, Min Gu;Min, Young Ki;Seo, Kyung Deok
Journal of the Korean Orthopaedic Association
/
v.56
no.4
/
pp.310-316
/
2021
Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm3 (32,400-203,904/mm3), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.
Pottery filled with organic materials was excavated from the G-2 building site of Yongjangseong Fortress, Jingo, a relic of the Goryeo Dynasty. In this study, the characteristics of organic material were confirmed by a scientific analysis of organic material in pottery found at the palace in Yongjangseong, Jindo. In addition, it was intended to review the analysis method to identify the natural resin and to secure characteristic components(biomarkers) for each natural resin and use them as basic data in the future. The organic materials in the pottery were analyzed using attenuated total reflectance Fourier-transformed infrared spectroscopy(ATR-FTIR) and gas chromatography mass spectrometry(GC-MS). The infrared spectral characteristics were estimated to be natural resin, and biomarkers of organic materials were identified as sesquiterpene-based compounds(C15H24, MW 204) and derivatives. The lacquer(T.vemicifluum) is composed mainly of alkenes, alkanes, and catechol. Pine resin(P.densiflora), on the other hand, is primarily composed of diterpenoid(abietic acid, pimaric acid) and Whangchil(yellow lacquer) is identified to have sesquiterpenes(such as selinene, muurolene, calamenene) as its main components. So, the organic material in the pottery can be identified as Whangchil by comparing their compounds with modern resin materials from Dendropanax. morbifera that correspond with the results. Whangchil, which is exuded from the Dendropanax. morbifera, has been used as a natural coating materials since ancient times, and it has been confirmed that the characteristic components are well preserved even 700 years later. It can be assumed that the interior Whangchil was stored not for use as a coating, but rather for ritual purposes when the building was constructed, because the pottery was found near the cornerstone. Furthermore, based on simplified sample preparation using pyrolysis-gas chromatography mass spectrometry(Py-GC-MS), the thermal decomposition products were found to be similar to the characteristic components, suggesting that this method can be applied to the identification of natural resins used in historic artifacts.
Han Byeol Kang;Youngmin Ahn;Byung Wook Eun;Seungman Park
Pediatric Infection and Vaccine
/
v.31
no.1
/
pp.37-45
/
2024
Purpose: This study aimed to examine the clinical features and determinants of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMP) and to assess the differences in the time to fever resolution between doxycycline (DXC), tosufloxacin (TFX) and corticosteroid (CST) as second-line treatment. Methods: We retrospectively analyzed the medical records of patients under the age of 18 who were admitted to Nowon Eulji University Hospital between July 2018 and February 2020, diagnosed with mycoplasma pneumonia. Macrolide resistance was confirmed by detecting point mutations in the 23S rRNA gene. MUMP was clinically defined by persistent fever (≥38.0℃) lasting for 72 hours or more after the initiation of macrolide treatment. In cases of MUMP, patients were treated with an addition of CST, or the initial macrolide was replaced either DXC or TFX. Results: Out of 157 cases of mycoplasma pneumonia, 83 cases (52.9%) did not respond to macrolides. Patients with MUMP exhibited significantly higher C-reactive protein (CRP) levels (3.2±3.0 vs. 2.4±2.2 mg/dL, P=0.047), more frequent lobar/segmental infiltrations or pleural effusions (56.6% vs. 27.0%, P<0.001; 6.0% vs. 0.0%, P=0.032), and a higher prevalence of 23S rRNA gene mutations (96.4% vs. 64.6%, P<0.001) when compared to those with macrolide-susceptible M. pneumoniae pneumonia. In terms of second-line treatment, 15 patients (18.1%) responded to CST, 30 (36.1%) to DXC, and 38 (45.8%) to TFX. The time to defervescence (TTD) after initiation second-line treatment was significantly shorter in the CST group compared to the DXC (10.3±12.7 vs. 19.4±17.2 hours, P=0.003) and TFX groups (10.3±12.7 vs. 25.0±20.1 hours, P=0.043), with no significant difference observed between the DXC and TFX groups (19.4±17.2 vs. 25.0±20.1 hours, P=0.262). Conclusions: High CRP levels, the presence of positive 23S rRNA gene mutation, lobar or segmental lung infiltration, and pleural effusion observed in chest X-ray findings were significant factors associated with macrolide unresponsiveness. In this study, CST demonstrated a shorter TTD compared to DXC or TFX. Further, larger-scale prospective studies are needed to determine the optimal second-line treatment for MUMP.
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