• 대한기관식도과학회지
• /
• 제3권1호
• /
• pp.148-153
• /
• 1997

Laryngotracheal stenosis is one of the most troublesome diseases in the Em field. Subglottic stenosis can be treated by a cricoid augmentation with rib cartilage. In case of tracheal stenosis, the treatment of choice is by tracheal end-to-end anastomosis after resection of the stenotic site. However, in case of subglottic stenosis combined with tracheal stenosis, it is hard to manage. Even though several methods(such as thyrotracheal anastomosis) have been tried, they have some limitations too much excision of normal trachea and too much pulling up of the trachea after resection of the stenotic lesion. The authors have managed two cases of laryngotracheal stenosis as an anterior and posterior subglottic augmentation with an autologous cartilage graft and laryngotracheal anastomosis. The first few weeks after the operation, we could do a decannulation successfully, but in one case the patient developed restenosis. Even though one case was unsuccessful, the authors believe that this method could be used in the treatment of laryngotracheal stenosis.

• Korean Journal of Radiology
• /
• 제25권3호
• /
• pp.277-288
• /
• 2024

Objective: We previously found that the incidence of sarcopenia increased with declining glucose metabolism of muscle in patients with treatment-naïve diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the relationship between sarcopenia and muscle glucometabolism using ¹⁸F-FDG PET/CT at baseline and end-of-treatment, analyze the changes in these parameters through treatment, and assess their prognostic values. Materials and Methods: The records of 103 patients with DLBCL (median 54 years [range, 21-76]; male:female, 50:53) were retrospectively reviewed. Skeletal muscle area at the third lumbar vertebral (L3) level was measured, and skeletal muscle index (SMI) was calculated to determine sarcopenia, defined as SMI < 44.77 cm²/m² and < 32.50 cm²/m² for male and female, respectively. Glucometabolic parameters of the psoas major muscle, including maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), were measured at L3 as well. Their changes across treatment were also calculated as ΔSMI, ΔSUVmax, and ΔSUVmean; Δbody mass index was also calculated. Associations between SMI and the metabolic parameters were analyzed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified. Results: The incidence of sarcopenia was 29.1% and 36.9% before and after treatment, respectively. SMI (P = 0.004) was lower, and sarcopenia was more frequent (P = 0.011) at end-of-treatment than at baseline. The SUVmax and SUVmean of muscle were lower (P < 0.001) in sarcopenia than in non-sarcopenia at both baseline and end-of-treatment. ΔSMI was positively correlated with ΔSUVmax of muscle (P = 0.022). Multivariable Cox regression analysis showed that sarcopenia at end-of-treatment was independently negatively associated with PFS (adjusted hazard ratio [95% confidence interval], 2.469 [1.022-5.965]), while sarcopenia at baseline was independently negatively associated with OS (5.051 [1.453-17.562]). Conclusion: Sarcopenic patients had lower muscle glucometabolism, and the muscular and metabolic changes across treatment were positively correlated. Sarcopenia at baseline and end-of-treatment was negatively associated with the prognosis of DLBCL.

• 환경위생공학
• /
• 제14권4호
• /
• pp.137-142
• /
• 1999

Current semiconductor industry factories are relying on the end-of-pipe treatment technology for waste water treatment and thus they mostly suffer from severe industrial water shortage. As a result in order to solve those waste and industrial water problems, there requires to be changed to the Clean Technology, that is Pollution Prevention Technology. Through above strategic actions with the Clean Technology, we shall strength more powerful and logical environmental pollution prevention system than those in the past. By changing the end-of-pipe treatment technology for waste water treatment and thus they mostly suffer from severe industrial water problems, there requires to be changed to the Clean Technology, that is Pollution Prevention Technology. Through above strategic actions with the Clean Technology, we shall strength more powerful and logical environmental pollution prevention system than those in the past. By changing the end-of-pipe treatment technology with physical, chemical and biological treatment methods as a mixed stream basis for treating of semiconductor waste stream into clean technology with pollution prevention technology as a waste segregation basis, we can bet 20 to 30% investment reduction as compared with end-of-pipe treatment technology.The results for water quality analysis were as follows : 1. Water quality analysis of the before treatment : pH : 9~10.5, Conductivity : $300~7,000{\mu}s/cm$, TDS : more then $3,000mg/{\ell}$, COD : $200~250mg/{\ell}$, SS : $500~600mg/{\ell}$, n-H : $8.3mg/{\ell}$ 2. Water quality analysis of the after treatment : pH : 6.5~7.5, Conductivity : 0.059, TDS : $40{\mu}s/cm$, COD : $20mg/{\ell}$, SS : $5mg/{\ell}$ n-H : $0.6mg/{\ell}$

• 대한기관식도과학회지
• /
• 제1권1호
• /
• pp.122-128
• /
• 1995

The experience with treatment of acquired subglottic stenosis in 20 adults is reviewed. Nine of the 20 patients (45%) had opeated by other institues before treatment. Causes of the disease were 10(50%) of blunt neck trauama and 10(50%) of prolonged intubation. The most common associated airway diseases were nine patients (45%) of bilateral vocal cord fixations. Twelve patients (60%) underwent anterior cartilage grafts, five patients (25%) had anterior and posterior cartilage grafts and three patients (15%) had end to end anastomosis according to the severity of cricoid deformities and mucosal defects. Associated procedures were 9 patients (45%) of arytenoidectomy. Thirteen of 20 patients (65%) have been decannulated. Fe-male group was significantly higher decannulation rate than male group (p=0.0074). Decannulation rates were decreased from anterior cartilage graft group to anterior and posterior cartilage grafts group and to end to end anastomosis group (p= 0.00247), this finding suggested the patients with severe cricoid deformitiy were higher likely hood of failure because we selected the method used in this study according to the severity of cricoid deformities and mucosal defects. Our results support the more aggressive treatment is indicated for subglottic stenosis in adults.

• 대한기관식도과학회지
• /
• 제8권1호
• /
• pp.61-65
• /
• 2002

Background : Acquired tracheoesophageal fistula(TEF) results mostly from Prolonged tracheal intubation and insertion of nasogastric tube. Although the incidence has decreased since the usage of low pressure, high volume cuff of endotracheal tube, it is seldom cured spontaneously and needs surgical treatment. Material and Methods : We have retrospectively reviewed five cases of TEF who underwent surgical treatment for cure from March, 1990 to September, 2001 and analyzed the cause, treatment, postoperative complications and prognostic factors. Results : Majority were men(80% : 4 of 5 patients) and the mean age was 29.4 years old(range, 11-58). The most predominant etiology was prolonged intubation or tracheostomy(80% : 4 of 5 patients) and 3 of 5 patients were treated by tracheal resection and end to end anastomosis with primary closure of esophagus. Postoperative complications occurred in 4 patients the most common complications were wound infection(4 cases) and esophageal leakage(2 cases). Extubation was done on postoperative day 11.5(range, 1-33) days, and factors causing delayed extubation were status esophagus. epilepticus, edema, and tracheal stenosis. Conclusion : Spontaneous closure of TEF is seldom possible and the surgical treatment of choice is tracheal resection and end to end anastomosis with primary repair of the esophagus. preoperative pulmonary rehabilitation and early extubation postoperatively are important factors for success.

• 중환자간호학회지
• /
• 제10권1호
• /
• pp.41-50
• /
• 2017

Purpose: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life. Methods: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital. Results: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members. Conclusions: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.

• 대한기관식도과학회지
• /
• 제10권1호
• /
• pp.41-45
• /
• 2004

Tracheostomy and endotracheal intubation are often performed in patients with acute and chronic respiratory failure. Recently, the incidence of iatrogenic tracheal stenosis has increased. Tracheal resection and end-to-end anastomosis would be one of the most physiologic treatment options for severe tracheal stenosis. Also, this treatment can be applied to the management of trachea invaded by thyroid cancer and tracheal neoplasm. The authors aimed to analyze the outcomes of end-to-end anastomosis of trachea following segmental resection in tracheal stenosis and tracheal invasion of cancer that we have recently experienced. Materials and methods Authors retrospectively studied 19 cases treated by tracheal resection with end-to-end anastomosis between Feburuary 1996 and January 2003. 12 patients had tracheal stenosis, 6 patients had tracheal invasion by thryroid cancer and 1 patient had tracheal cancer. We analyzed the direct causes of tracheal stenosis, preoperative vocal cord function, operation technique, early and delayed postoperative complications, and the outcome of end-to-end anastomois. Result Decannulation without significant aspiration was achieved in 16 cases($89.5\%$). A 27 year-old man could not be decannulated because of restenosis. A 62 year-old woman could not be decannulated because of bilateral vocal cord palsy. Conclusion End-to-end anastomosis is a safe and effective surgical method for tracheal stenosis. Case selection for end-to-end anastomosis and preservation of recurrent laryngeal nerve during operation is very important.

• Journal of the Korean Wood Science and Technology
• /
• 제30권4호
• /
• pp.58-65
• /
• 2002

본 연구는 수액치환법을 이용한 침엽수 간벌소경재나 미(저)이용 활엽수재의 산지 보존처리 기술을 개발하기 위하여 수행되었다. 본 논문에서는 증산법과 원구법을 이용한 3종 침엽수와 3종 활엽수의 방부제, 난연제, 치수 안정제 처리 가능성을 조사하여 보고한다. 수종과 처리약제의 조합에 관계없이 원구법이 증산법에 비하여 약제의 목재내 침투가 양호할 뿐만 아니라 약제의 침투가 균일한 관계로 수분 이동경로를 이용한 처리재 생산은 원구법의 사용이 바람직하였다. 원구법 처리는 수관부를 절단한 후 실시하기 때문에 증산법에 비하여 처리가 용이할 뿐만 아니라 벌채 및 조재 후 산지의 일정 장소로 운재 후 처리를 실시하기 때문에 증산법과 비교할 때 집약적 처리로 단위시간당 처리재 생산량이 높고 산지 환경오염 문제도 예방할 수 있는 장점이 있다.

• 로봇학회논문지
• /
• 제5권4호
• /
• pp.359-366
• /
• 2010

This study proposes the design method for the robot rotation arm which the end effector that is connected in end of the arm keeps parallel motion even though the robot arm rotates. So far, most robot arm rotates together the end effector when the arm rotates. For this, this study proposes the mechanism that the arm is linked to each 4 parallel link so that rotation is possible by 4 pins, and the rotation arm connects 2 joints of diagonal line direction to a link in each 4 joint for rotation, and designs so that can change length of the link. For verification of design, this study targeted that develop the rotation arm for medical examination that use in ophthalmology. It is important that a medical robot offers comport to patient and design compactly so that medical examination and treatment space may can be defined enough. It is designed so that all drive elements may be positioned on interior of the arm and optimization of design for main parts was carried out in this study for this. The robot arm which is developed in this study manufactured to use by medical phoropter arm, and got good result by an experiment. The robot rotation arm which is proposed in this study is judged to contribute very effectively in case use of a medical robot arm for medical examination and treatment, also the robot arm which the end effector that is connected in the end of the arm needs to keep parallel motion. And, the robot arm which is developed in this study made an application as license.

• Clinical Psychopharmacology and Neuroscience
• /
• 제16권4호
• /
• pp.469-480
• /
• 2018

Objective: Pharmacogenomic-based antidepressant treatment (PGATx) may result in more precise pharmacotherapy of major depressive disorder (MDD) with better drug therapy guidance. Methods: An 8-week, randomized, single-blind clinical trial was conducted to evaluate the effectiveness and tolerability of PGATx in 100 patients with MDD. All recruited patients were randomly allocated either to PGATx (n=52) or treatment as usual (TAU, n=48) groups. The primary endpoint was a change of total score of the Hamilton Depression Rating Scale-17 (HAMD-17) from baseline to end of treatment. Response rate (at least 50% reduction in HAMD-17 score from baseline), remission rate (HAMD-17 score ${\leq}7$ at the end of treatment) as well as the change of total score of Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER) from baseline to end of treatment were also investigated. Results: The mean change of HAMD-17 score was significantly different between two groups favoring PGATx by -4.1 point of difference (p=0.010) at the end of treatment. The mean change in the FIBSER score from baseline was significantly different between two treatment groups favoring PGATx by -2.5 point of difference (p=0.028). The response rate (71.7 % vs. 43.6%, p=0.014) were also significantly higher in PGATx than in TAU at the end of treatment, while the remission rate was numerically higher in PGATx than in TAU groups without statistical difference (45.5% vs. 25.6%, p=0.071). The reason for early drop-out associated with adverse events was also numerically higher in TAU (n=9, 50.0%) than in PGATx (n=4, 30.8%). Conclusion: The present study clearly demonstrate that PGATx may be a better treatment option in the treatment of MDD in terms of effectiveness and tolerability; however, study shortcomings may limit a generalization. Adequately-powered, well-designed, subsequent studies should be mandatory to prove its practicability and clinical utility for routine practice.