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Thyroplasty for the Restoration of a Normal Voice (음성개선을 위한 갑상연골성형술)

  • 김기령;김광문;정명현;이원상;정승규
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.1-10
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    • 1982
  • The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

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Sandstone Diagenesis of the Lower Permian Jangseong Formation, Jangseong Area, Samcheog Coalfield (삼척탄전 장성일대에 분포하는 하부페름기 장성층 사암의 속성작용)

  • 박현미;유인창;김형식
    • The Journal of the Petrological Society of Korea
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    • v.7 no.2
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    • pp.132-145
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    • 1998
  • The coal-bearing siliciclastic rocks of the Lower Permian Jangseong Formation, Samcheog coalfield, represent a megacyclothem which shows cyclic repetitions of sandstone, shale, coaly shale, and coals. Petrographic, geochemical, and SEM studies for sandstone samples, and XRD analysis for clay minerals were carried out to understand diagenesis in the sandstones of the Jangseong Formation. The Jangseong sandstones are composed of 60% quartz (mainly monocrystalline quartz) and 36% clay matrix and cement with minor amounts of feldspar, lithic fragments and accessory minerals (less than 4%). Jangseong sandstones are classified mostly as quartzwackes and partly as lithic graywackes according to the scheme of Dott(1964). The textural relationships between authigenic minerals and cements in thin sections and SEM photomicrographs suggest the paragenetic sequence as follows; (1) mechanical compaction, (2) cementation by quartz overgrowth, (3) formation of authigenic clay minerals (illite, kaolinite), (4) dissolution of framework grains and development of secondary porosity, and (5) later-stage pore-filling by pyrophyllite. We propose that these diagenetic processes might be due to organic-inorganic interaction between the dominant framework grains and the formation water. The Al, Si ions and organic acid, derived from dewatering of interbedded organic-rich shale and coals, were transported into the Jangseong sandstones. This caused changes in the chemistry of the formation water of the sandstones, and resulted in overgrowth of quartz and precipitation of authigenic clay minerals of kaolinite and illite. The secondary pores, produced during dissolution of clay and framework grains by organic acid and $CO_2$ gas, were conduit for silica-rich solution into the Jangseong sandstones and the influx of silica-rich solution produced the late-stage pyrophyllite after the expanse of kaolinite. The origin of the solution that formed pyrophyllite is not likely to be the organic-rich formation water based on the observation of fracture-filling pyrophyllite in the Jangseong sandstones, but the process of pyrophyllite pore-filling was indirectly related to organic-inorganic interaction.

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Factors Affecting Problematic Drinking by University Students in Chuncheon Area (춘천지역 대학생의 문제음주에 영향을 미치는 요인)

  • Kim, Yoon-Sun;Kim, Bok-Ran
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.6
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    • pp.934-942
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    • 2014
  • The purpose of this study was to investigate factors affecting problematic drinking by university students in the Chuncheon area. Lifelong drinking rate of subjects was 98.1%. Problematic drinking rates according to AUDIT (alcohol use disorders identification test) were as follows: 21.3% 'no problem', 58.0% 'at-risk drinking', 10.0% 'alcohol abuse' and 10.7% 'alcohol dependence'. Research has shown that problematic drinking is more prevalent among freshmen, early drinkers, those with hypochondria, and students who are less satisfied with their campus life or whose own parents are frequent drinkers. It has been shown that more serious problematic drinking is associated with higher 'positive alcohol outcome expectancies' and 'coping motives for drinking', and 'recognition level of drinking cultures' is considered less desirable. Multiple regression analysis revealed that 'coping motives for drinking' was the most significant variable affecting the problematic drinking of university students. Developing and fostering various alcohol-reducing programs that largely focus on 'coping motives for drinking' will greatly contribute to solving problematic drinking.

Association of instant noodle intake with metabolic factors in Korea: Based on 2013~2014 Korean National Health and Nutrition Examination Survey (성인 남녀에서 라면 섭취에 따른 대사적 지표 평가 : 2013~2014 국민건강영양조사 자료를 이용하여)

  • Yeon, Jee-Young;Bae, Yun-Jung
    • Journal of Nutrition and Health
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    • v.49 no.4
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    • pp.247-257
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    • 2016
  • Purpose: The aim of this study was to investigate the relationship between instant noodle intake and metabolic factors in Korean adults. Methods: Study subjects were 5,894 (male 2,293, female 3,601) aged 19~64 years who participated in the 2013~2014 KNHANES. Information on frequency and consumption of instant noodles was obtained by the food frequency questionnaires method in KNHANES (Korean National Health and Nutrition Examination Survey), and subjects were classified according to age, sex, and instant noodle consumption (INC). Results: The frequency and consumption of instant noodles was 1.2 times/week and 1.2 servings in subjects. High INC group (${\geq}1$ serving/week) was significantly younger in age compared with the low INC group (< 1 serving/week). However, the high INC group had significantly higher waist circumference, metabolic factors (triglyceride, cholesterol, and HDL-cholesterol), and dietary intake (energy intake, fat, and sodium density) compared with the low INC group. Hyperglycemia showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors, including age, gender, household income, education, smoking, and alcohol compared with the lowest quartile (OR: 1.4, 95% CI: 1.1-1.8). In female, abdominal obesity showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors compared with the lowest quartile (OR: 1.6, 95% CI: 1.2-2.2). Conclusion: Consumption of instant noodles was associated with increased prevalence of abdominal obesity and hyperglycemia in women. These findings suggest an association of instant noodle consumption status with metabolic risk.

Nutritional and health consequences are associated with food insecurity among Korean elderly: Based on the fifth (2010) Korea National Health and Nutrition Examination Survey (KNHANES V-1) (한국 노인에서 식품불안정 (food insecurity)이 건강상태 및 식이섭취상태에 미치는 영향 연구: 국민건강영양조사 제 5기 1차년도 (2010) 자료를 이용하여)

  • Lee, Seungjae;Lee, Kyung Won;Oh, Ji Eun;Cho, Mi Sook
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.519-529
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    • 2015
  • Purpose: The purpose of this study was to examine the prevalence of food insecurity in Korean elderly and to analyze the health status as well as food and nutrient intakes according to food insecurity status. Methods: A total of 939 elderly subjects (over 65 years old) were used in our analysis from the fifth 2010 Korean National Health and Nutrition Examination Survey (KNHANES V-1). The variables consisted of general characteristics, physical and mental health, nutrient intake, rate of deficient intake of energy and nutrients compared with Dietary Reference Intakes for Koreans (KDRIs) and food quality and diversity according to the status of food insecurity. Food insecurity status was measured using a self-reported food security questionnaire on the dietary situation in the previous year, and participants were classified according to three groups: food secure group, mildly food insecure group, and moderately/severely food insecure group. Results: The proportion of the food insecure group was approximately 67% and the food insecure group had lower income and educational status than the food secure group. Food insecurity was associated with worse physical and mental health status after adjusting potentially confounding variables. The results showed that food insecurity in Korean elderly significantly affected mental health (including stress cognition, depression experience, and suicide thoughts) which exceeded stages of physical health. In addition, food insecurity showed significant association with low nutrient intake and high rate of deficient intakes of energy and nutrients compared with KDRIs, and a reduction of dietary quality and diversity was indicated in the food insecure group. Conclusion: This study concludes that the prevalence of food insecurity may affect the physical and mental health as well as dietary intake of the elderly Korean population. Therefore, food insecurity should be considered as an important public health issue in Korea.

Assessment of Carotid Geometry by Using the Contrast-enhanced MR Angiography (조영증강 MR 혈관 조영술을 이용한 경동맥 기하학의 평가)

  • Lee, Chung-Min;Ryu, Chang-Woo;Kim, Keun-Woo
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.1
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    • pp.47-55
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    • 2010
  • Purpose : To evaluate the geometry of carotid artery by assessing the images of contrast-enhanced MR angiography (CE-MRA) and interrelationships between the geometry of carotid artery and clinical factors. Materials and Methods : 216 consecutive patients who performed supraaortic CE-MRA with fast spoiled gradient-echo imaging were included. Their medical records were reviewed for variable information including risk factors predictive of generalized atherosclerotic disease (age, hypertension (HTN), diabetes mellitus, hyperlipidema, and smoking), sex, body weight, height, and body mass index (BMI). We reviewed the CE-MRA with carotid origin (3 types), carotid artery tortuosity, angle of internal carotid artery bifurcation, the type of aortic arch branching, and the presence of the coiling of carotid artery. Results : Multinomial logistic regression analysis showed that significantly contributed clinical backgrounds for carotid origin were the age and the BMI. With an increase of age at 1, the probability that the type of carotid origin become from type 1 to type 2 was 0.9 times (p=0.004) in right carotid artery (RCA), 0.9 times (p = 0.031) in left carotid artery (LCA), 0.9 times that are likely to be type3 from type 2 (p<0.001) in RCA and 0.9 times in LCA (p=0.009). Increase in BMI at 1 increased odds of becoming type 2 as 1.1 times (p = 0.067) in RCA, 1.1 times (p=0.009) in LCA and increased chance of becoming type 3 as 1.2 times (p = 0.001) in RCA, 1.2 times (p=0.003) in LCA. Mean value of right and left carotid tortuosity were $240.9{\pm}69.0^{\circ}$and $154.4{\pm}55.0^{\circ}$, respectively. Conclusion : The BMI, age, sex and presence of HTN affects the geometry of carotid arteries, the site of origin and tortuosity of carotid artery specifically.

Cognitive and Psychological Characteristics of Psychiatric Patients with Military Service Eligibility Issues (군 복무 적합성 판정을 위해 내원한 환자들의 인지적 및 심리적 특성)

  • Nam, Jisoo;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.119-129
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    • 2019
  • Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients who visited psychiatric outpatient clinic with military service suitability issues. Methods : Since January, 2017 to September, 2018, patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. And each of participants tested with K-WAIS-IV, K-SCL-95 by clinical psychologist. The data were analyzed using SPSS 18.0. Results : The results indicated 24.6% of the patients have significantly low level of intellectual functioning. and 10.8% of the patients have borderline level of intellectual functioning, and 26.3% of them were below average. The results of psychological characteristics showed patients have cautious and potentially dangerous level of depression, anxiety, agoraphobia, and suicidal idea. And PTSD subscale's mean score was above problematic level. Next, we divided patients into two groups based on question of whether the patient is eligible to serve in the military service or not arises from recruitment process or army training center. But two group didn't differ significantly. And for further analyses, we also divided patients into two groups based on if they got single psychiatric diagnosis or more than one psychiatric diagnosis. Conclusions : The results indicated that group which has coexisting psychiatric disorders were more depressed, had higher level of anger and aggression, and had more serious levels of suicidal ideas than single psychiatric diagnosis group. The implications and limitations were discussed along with some suggestions for the future studies.

Study on verification of various national standards regarding phthalate testing in industrial products (공산품 중 프탈레이트류 함유량 분석법에 관한 국내외 표준의 검증 연구)

  • Song, Moon-Hwan;Cho, Young-Dal;Choe, Eun-Kyung;Myoung, Young-Chan
    • Analytical Science and Technology
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    • v.25 no.3
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    • pp.178-189
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    • 2012
  • As phthalates classified as toxic to reproduction category 2 and endocrine disrupting chemicals were more strictly regulated as Substances of Very High Concern (SVHC) for authorization in under EU REACH and considered as priority substances in RoHS II, standardization of phthalate testing method is now being proposed in IEC 62321 of IEC TC 111 and the 2nd revision of KS M 1991 is also finished. In order to assist standardization activities related to phthalating testing, solvent extraction part of existing national standards were compared and verified. Recovery of DEHP (diethylhexyl phthalate) from PVC (polyvinyl chloride) by Soxhlet extraction increased in the order of methanol, toluene, dichloromethane and hexane from 46.9% to 95.3% as measured by GC-MS. Optimum extraction time was verified to be 6 hours using hexane. Recovery of DBP (dibutyl phthalate), BBP (butylbenzyl phthalate), and DEHP from different matrixes such as PVC, nitro cellulose, ABS (acrylonitrile butadiene styrene). and EPDM(ethylene propylene diene monomer) rubber were evaluated to be more than 90% up to 99%. The detection limits of phthalates in solvent extraction followed by GC-MS analysis were 0.08~0.3 ${\mu}g/mL$ in solution and 8~30 mg/Kg in polymeric samples. GC-MS analyses of phthalates were carried out using different solvent extraction based on the EN 14372, ASTM D 7083, Japanese test method (MHLW 0906-4) and KS M 1991, proving that equivalent recoveries ranging from 98%~99% were obtained. DBP and DEHP were detected in three consumer products such as a child toy, a power cable and manicure with the amount of 22~1,910 mg/kg.

Clinical observation of meconium aspiration syndrome and effect of suctioning through endotracheal intubation on prognosis of meconium aspiration syndrome (태변 흡인 증후군의 임상적 고찰과 기관 내 삽관 후 조기 태변 흡인이 예후에 미치는 영향)

  • Yoon, Yong Ho;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.959-964
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    • 2007
  • Purpose : The purpose was to investigate the clinical considerations of patients affected by meconium aspiration syndrome (MAS) and the effect of suctioning through endotracheal intubation immediately after delivery on the prognosis of MAS. Methods : A total of 44 inpatients diagnosed as MAS in the Neonatal Intensive Care Unit (NICU) at Cheil Hospital were selected from January 2004 to June 2006. They were divided into two groups. In the early aspiration group (12 patients), suctioning through endotracheal intubation was performed according to the neonatal resuscitation program of the American Academy of Pediatrics and the American Heart Association because infants born through meconium-stained amniotic fluid (MSAF) were not vigorous after birth. In the early non-aspiration group (32 patients), endotracheal intubation was not performed because the infants born through MSAF were vigorous after birth. These two groups were analyzed retrospectively by medical records in the fields of clinical features, obstetric risk factors, complications, treatment, and duration of hospitalization. Results : There was no significant difference in mean gestational age, mean birth weight, sex, and delivery mode between the early aspiration group and the early non-aspiration group. Mean Apgar score of the early aspiration group both in 1 and 5 minute score was significantly lower than in the early non-aspiration group. Lengths of hospitalization and duration of mechanical ventilator care were longer in the early non-aspiration group, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group than in the early aspiration group. Conclusion : In this study, the early non-aspiration group used surfactant more and had a longer duration of mechanical ventilator and hospitalization, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group. Therefore, more detailed guidelines for vigorous infants born through MSAF are needed and we should study and follow up the long term prognosis of neurological complications of MAS.

Ventilator-Associated Pneumonia in Neonatal Intensive Care Unit : Clinical Manifestations, Ddiagnostic Availability of Endotracheal Tip Culture (신생아 집중치료실에서 인공 환기요법 관련 폐렴의 임상양상과 기관내 삽관의 유용성에 관한 연구)

  • Kim, Nam Young;Sung, Tae Jung;Shin, Seon Hee;Kim, Sung Koo;Lee, Kon Hee;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.67-74
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    • 2005
  • Purpose : The incidence of mortality associated with respiratory difficulties is decreasing nowadays contributed to the development of neonatology. However, complications associated with mechanical ventilator are increasing. This study is to determine clinical manifestations, diagnositc availability of the endotracheal tip culture in patients with Ventilator-Associated Pneumonia(VAP) in neonatal intensive care unit(NICU). Methods : A retrospective analysis of 50 neonates who were admitted to the NICU of Kangnam Sacred Heart Hospital and had given mechanical ventilator from 1 January 2000 to 30 June 2003. VAP group defined as neonates who had pneumonia with mechanical ventilation longer than 48 hours. They were classified into VAP group(n=13) and control group (n=37) and the prevalence, microorganisms cultured from the endotracheal tube tip and risk factors were investigated. Results : The prevalence of VAP was 26.0%(n=13) and the most dominant microorganism cultured in our NICU was methicillin-resistant coagulase negative staphylococcus(MR-CNS) in 4 cases. Other microorganisms were Pseudomonas, Enterobacter, methicillin-resistant Staphylococcus aureus(MRSA) and Klebsiella. Gestational age, birth weight, Apgar score, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, sepsis, renal failure, pulmonary hemorrhage, pneumothorax were not different significantly between two groups except intraventricular hemorrhage(P<0.001) and patent ductus arteriosus(P<0.05). Duration of hospital stay and mortality rate were also not different significantly. Conclusion : VAP occurred at a significant rate among mechanically ventilated NICU patients. Despite of limitation of encotracheal tip culture, the most common microorganism was MR-CNS. We should be aware of occurrence of VAP in NICU neonate who were with mechanical ventilator and should treat with great care.

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