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Treatment Result of Proton Pump Inhibitor, Steroid Inhaler and Botulinum Tonxin Injection for Contact Granuloma (양성자펌프억제제, 스테로이드흡입제, 보툴리늄톡신 주사를 이용한 접촉성 육아종의 치료 결과)

  • Park, Hyoung Min;Oh, Na Rae;Baek, Min Kwan;Kim, Dong Young;Woo, Joo Hyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.1
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    • pp.32-37
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    • 2017
  • Background and Objectives : This study evaluated the efficacy of combination therapy of proton pump inhibitor (PPI) and steroid inhaler (SI), with or without botulinum toxin injection (BTX) for contact granuloma. Subjects and Methods : Fourteen contact granuloma patients were enrolled in this study. Combination therapy of PPI and SI were used for the first line treatment. When combination therapy was not effective, BTX was performed as the second method. Treatment results were recorded as responsible or non-responsible. Farwell grade, size, history of voice abuse, gender, and reflux finding score (RFS) were compared between responsible group and non-responsible group. Results : Initial response rate was 28.6% after treatment of PPI and SI. BTX was performed on three un-responsible patients. After BTX injection, three patients had complete remission of granuloma. Final response rate was 50.0%. Un-responsible group had significantly higher RFS than responsible group. Conclusion : The efficacy of PPI and SI was limited for contact granuloma in this study. Botulium toxin injection was recommended in early phase when PPI and SI did not effective for contact granuloma. Prospective studies evaluating the effects of PPI and SI are warranted.

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The Effect of SWH Application on Problem-Solving Type Inquiry Modules through Student-Student Verbal Interactions (학생-학생 언어적 상호작용 분석을 통한 문제 해결형 탐구 모듈에서의 SWH 활용 효과)

  • Lee, Eun-Kyeong;kang, Seong-Joo
    • Journal of The Korean Association For Science Education
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    • v.28 no.2
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    • pp.130-138
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    • 2008
  • The purpose of this study was to analyze the effects of Science Writing Heuristic(SWH) strategy on problem-solving type inquiry modules through student-student verbal interactions. The modules were applied to 23 students of the 3rd grade in middle school and the SWH strategy was applied to 3 experimental groups. The SWH is the strategy that each student, first of all, has a chance to think and propose ways of problem-solving by individual writing a blue card when problems were emerged, and then students discuss ways of problem-solving with group members by writing a green card. Verbal interactions during small group discussions were audio- and video-taped, transcribed and analyzed to compare the effect of the SWH strategy. As a results, experimental groups tended to force solely on questions and suggestions about problem-solving, but controlled groups executed experiment and discussed about problem-solving simultaneously. The analysis also showed that the experimental students dialogued more on the deep-leveled argumental interactions than the controlled students did; in particular, show more SS3 and SD1 verbal interaction regarding suggestions of problem solving. We argue, therefore, that the SWH strategy is effective to the problem-solving type inquiry modules.

PSYCHOPATHOLOGY IN ADOLESCENTS WITH PARENT ABUSE (부모학대 청소년의 정신병리)

  • Kwak, Young-Sook;Bang, Hyun-Soog
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.13-25
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    • 1998
  • Aim:We think that the most important etiology in parent abuse is the psychodynamic and psychopathology in the family. So, we investigated the adolescents being admitted in SNMH, whose chief complaints were parent abuse. We were trying to explore families psychodynamic and psychopathology, especially mother-child interaction and to differentiate them in according to developmental psychopathology. Method:Our objects were the adolescent patients admitted in SNMH from 1987 to 1997 because they attacked parents verbally and physically. We examined 21 adolescents except those with psychosis, organic mental disorder, autism and mental retardation by means of interview or chart review. Result and Conclusion:The number of male patients was 14 and the number of female patients was 7. The most common diagnosis was conduct disorder and borderline personality disorder. The mean age was in the mid-teens. We observed 4 subgroups that were divided developmentally in object relation. 1) Symbiotic group with mother:(1) They did not separate and remain in symbiotic relationships with their mothers based on insecure attachment. Fathers were abscent emotionally and physically, and their mothers were prominent in close relationships with the patients in their family , where as the patients were the only man in the family. Adolescents entered the second separation-individuation. They expressed anger and internal tension involved with the close attachment with their mothers and also attempted separation from their mothers through physically attacking them. (2) These patients had suffered from physical illness and developmental delay since birth. Therefore the parents overprotected their children. The children had persistent infantile omnipotence and fantasies of power, so they could not deal with unrealistic states, adapt to reality, and depended on their parents overtly. They easily acted out unless their demands were fulfilled. 2) Borderline personality disorder:We observed deficiencies in care taking. Their parents had personality problems and immaturity. They coulden’t help their children to be separated in the rapproachment phase. Their conflict about dependence-independence was revived in the second separation-individuation adolescent period. We understand parent abuse as an attempt to overcome the conflict. 3) Conduct disorder:They did not build up basic attachment with their parents. They think of their parents as only a means of fulfilling their needs. When patients’ need were not fulfilled and remained in a conflicted state, they attacked their parents, unable to control their aggressions and impulses.

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A Case of Mucopolysaccharidosis Type 2 Diagnosed Early through Brain MRI (뇌자기공명영상 검사를 통해 조기 발견된 제2형 뮤코다당증 1례)

  • Lee, Yoon kyoung;Cho, Sung Yoon;Kim, Jinsup;Huh, Rimm;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.2
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    • pp.87-92
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    • 2015
  • Mucopolysaccharidosis (MPS) is an inherited disease entity associated with lysosomal enzyme deficiencies. MPS type 2, also known as Hunter syndrome, has a characteristic morphology primarily involving x-l inked recessive defects and iduronate-2-sulfatase gene mutation. The purpose of this case report is to provide important clues to help pediatricians identify Hunter syndrome patients earlier (i.e., before the disease progresses). A 30-month-old boy showed developmental delay and decreased speech ability. Physical examinations revealed a flat nose and extensive Mongolian spots. Brain magnetic resonance images (MRIs) showed bilateral multiple patchy T2 hyperintense lesions in the periventricular and deep white matter, several cyst-like lesions in the body of the corpus callosum, and diffuse brain atrophy, which were in keeping with the diagnosis. Based on these findings, the patient was suspected of having MPS. In the laboratory findings, although the genetic analysis of IDS (Iduronate-2-sulfatase) did not show any pathogenic variant, the enzymatic activity of IDS was not detected. We could confirm the diagnosis of MPS, because other sulfatases, such as ${\alpha}$-L-iduronidase, were detected in the normal range. Early enzymatic replacement therapy is essential and has a relatively good prognosis. Therefore, early diagnosis should be made before organ damage becomes irreversible, and brain MRIs can provide additional diagnostic clues to help distinguish the disorder.

Measurement and Analysis of Low Flow in the Cheonggecheon Watershed (청계천 유역 갈수량 측정 및 분석)

  • Noh, Seong Jin;Kim, Hyeon Jun;Jang, Cheol Hee;Kim, Dong Pil;Hong, Il Pyo
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.1067-1071
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    • 2004
  • 도시 유역의 물순환 특성을 종합적으로 이해하기 위해서는 갈수량 자료의 구축이 필수적이다. 하지만 지금까지의 인구는 주로 치수분야에 한정되어 대부분의 자료 또한 홍수기에 대해서만 자료가 구축되어 있으며 상대적으로 갈수기에 내한 자료와 관련 연구는 부족한 편이다. 본 연구에서는 청계천 유역의 기존 수문자료를 이용하여 유역의 유출 특성을 분석하고 갈수량을 측정하여 청계천 유역의 물순환 특성을 파악하기 위한 기초자료를 구축하였다. 청계천은 서울의 서북쪽에 위치한 인왕산과 북한산의 남쪽 기슭, 남산의 북쪽 기슭에서 시작하여 서에서 동으로 종로, 세운상가, 동대문 등 서울의 도심부를 흐르는 유로연장 13.75 km, 유역 면적 $50.96 km^2$의 도시하천으로 중량천의 제1지류인 지방2급 하천이며, 정릉친, 성북천을 제1지류, 월곡천을 제2지류로 포함한다. 청계천은 도시화로 인해 1950년대부터 1970년대까지 점차 복개되었다가 2003년 7월부터 5.9 km의 본류구간에 대한 복원공사가 진행 중이다. 청계천은 홍수기 이후 유량이 급격히 줄어 11월 이후에는 다음 홍수기까지 강바닥이 완전히 들어나는 일종의 간헐천으로 홍수기를 제외한 시기의 자료는 전무한 실정이다. 본 연구에서는 유역내 8개의 모니터링 지점을 선정하여 2003년 9월 이후, 월 2회 이상 갈수량 자료를 현장 측정${\cdot}$분석하였다. 청계천 유역은 복원공사 완공 후에는 유역의 물순환 특성이 대폭 바뀔 것이 예상되는 지역으로 본 연구에서 구축된 갈수량 자료는 청계천 유역의 물순환계 변화를 분석하고 건전한 물순환 체계의 유지${\cdot}$관리를 위한 기본 자료가 될 것으로 판단된다., 바늘꽃과, 속새과, 십자화과, 장미과, 사초과, 삼과, 현삼과, 닭의장풀과가 각 1종씩 조사되었으며, 조사지점(II)인 1km지점에서는 15과 26종으로, 벼과가 4종, 마디풀과, 국화과가 3종, 버드나무과, 십자화과, 콩과가 2종씩, 바늘꽃과, 속새과, 자라풀과, 장미과, 사초과, 백합과, 현삼과, 골풀과, 닭의장풀과가 각 1종씩으로, 조사지점( I )보다 좀 더 많은 종이 분포하는 것으로 조사되었다. 또한 어류는 조사지점( I )에서 3회에 걸쳐 총 396개체가 채집되어 3목 8과 21종이었다. 이 중 한국 고유종은 11종이었고, 외래 어종은 검정우럭과 2종이 조사되었으며, Zacco platypus(피라미), Zacco temmincki(갈겨니), Acheilongnathus koreanus(칼납자루), Odontobutis platycephala(동사리), Coreoleuciscus splendidus(쉬리) 순으로 분포하고 있었고, Acheilognathus signifer(묵납자루)는 댐 건설 전에는 많이 분포하였으나 현장조사에서 서식을 확인 할 수 언어 개체수의 큰 감소내지 멸종된 것으로 추정되었다.에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다

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Analysis of High-Resolution Manometry Results in LPRD Patients Who Do Not Response to PPI Medication (양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석)

  • Lee, Chang-Hee;Lee, Hyun-Sub;Jin, Sung-Min;Lee, Sang-Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.1
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    • pp.43-47
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    • 2012
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Materials and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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Problem Solver's Responses According to the Sentence Structures of Mathematical Word Problems (수학 문장제의 문장 구조에 따른 초등학생의 문제해결 반응 비교 분석)

  • Kang, Wha-Na;Paik, Suck-Yoon
    • Journal of Educational Research in Mathematics
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    • v.19 no.1
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    • pp.63-80
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    • 2009
  • This paper has a purpose to find out the important points about linguistic factors suited to the assessment purpose and mathematics teaching/learning that a word-problem sentence has to possess. We also examine the degree of understanding of sentence and the perceptive/emotional reactions of students toward two different kinds of word-problem sentences that have same mathematical contents, but different linguistic structures. The objects of this thesis are 124 students from the third to sixth grade in an elementary school. We execute assessment of simple-sentence-word-problem and complex-sentence-word-problem that have same mathematical contexts, but different linguistic structures. Then we have compared and examined their own process of solving the two types word-problems and we make up questionnaire and have an interview with them. The conclusions are as followings: First, simple-sentence-word-problem is more successful to suggest an information for solving a problem than complex one. Second, it is hard to find the strategy for solving a problem in complex-sentence-word-problem than simple one. Third, students think that suggested information and mathematical knowledge are different according to the linguistic structure in the process of perceiving the information after reading a word-problem. Fourth, in spite of same sentence type, the negative mental reaction is showed greatly to complex-sentence-word-problem even before solving a problem.

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Analysis of High-Resolution Manometry Results in LPRD Patients who do not Response to PPI Medication (양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석)

  • Lee, Chang-Hee;Lee, Hyun-Sub;Jin, Sung-Min;Lee, Sang-Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.151-155
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    • 2011
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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A Development Strategy of Busan New Port by a Comparative Analysis on Singapore and Hong Kong Ports (싱가포르 및 홍콩항과의 비교분석에 의한 부산 신항의 발전전략)

  • Kim, Jeong-Su
    • Journal of Korea Port Economic Association
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    • v.24 no.4
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    • pp.1-23
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    • 2008
  • In order for Busan New Port to secure more trading volumes than the competing ports at home and abroad, an alternative plan for the new port management policy needs to be sought. By the way, aiming to minimize trial and error while maximizing effect in establishing and driving the new port management policy, there is necessity of referring to the developmental strategies of the advanced ports such as Singapore and Hong Kong that are possessing the globally leading position as well as maximizing the substantial value added and the employment-creation effect even qualitatively. Accordingly, the purpose of this study is to propose for a reasonable development strategy for Busan New Port in line with conditions and characteristics of Busan New Port by comparing and analyzing conditions and characteristics of these two advanced ports and by comparative analysis on the developmental strategy according to this.

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The Effects of Teaching University Mathematics in English (대학 수학 교육에서 영어 강의의 효과 연구)

  • Lee, Hae-Moon;Kim, Young-Wook
    • Journal for History of Mathematics
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    • v.20 no.1
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    • pp.83-102
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    • 2007
  • A math class in Korean university was taught in English for one semester and the students' improvement was measured in math content and English proficiency. Pre and post test in 9 week intervals showed that math content loaming in the immersion class was superior to the non-immersed class. Especially, the immersion class showed remarkable improvement in difficult problems among math content test problems. The immersion class improved in math-related English, but not in general English. It is discussed that the particular English expressions for math are hardly separable from the math content knowledge in English because understanding and using those expressions correctly means the students' understanding of math concept in English and thus the math concept itself.

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