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Management of Laryngeal Contact Granuloma (후두 접촉성 육아종의 치료)

  • Ko, Moon-Hee;Son, Young-Ik;Jang, Jeon-Yeob;So, Yoon-Kyoung;Chung, Man-Ki
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.2
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    • pp.128-132
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    • 2008
  • Background: Laryngeal contact granuloma is an inflammatory hypertrophic granulation tissue arising at around the vocal process of arytenoid cartilage. Various approaches are currently used for the treatment, but a solid guideline has not been established. Objectives: We aimed to compare the each treatment modality in the hope of suggesting a guideline for the successful management of laryngeal contact granuloma. Method: Eighty-seven treatment cases of 56 patients were analyzed. Cases having recent intubation history were excluded from the study. All patients received vocal hygiene education. Proton pump inhibitors (PPI, N = 33) or H2 receptor antagonists ($H_{2}RA$, N =26) were used as a first-line treatment. Among the non-responders to $H_{2}RA$, 11 cases received PPI as a second-line therapy. Eight cases received botulinum toxin injection and 9 cases had laryngomicrosurgical removal. Results: As an initial therapy, response rate to PPI and $H_{2}RA$ was 60.6% and 38.5% respectively, which was not statistically different (p=0.091). Response rate of PPI as the second-line therapy was 36.3% (p=0.162 when compared to that of first-line PPI therapy). Response rate of Botulinum toxin injection was 75%. All cases of surgical removal recurred in a relatively short period (mean 1.9months). Conclusion: In patients having laryngeal contact granuloma, combined therapy with vocal hygiene education and PPI medication would provide more than 60% of therapeutic response. Botulinum toxin injection is highly effective even in non-responders to antireflux therapy. The only indications of surgery are to resolve diagnostic doubt or to treat acute airway compromise.

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Deep Sedation for Palate Alginate Impression Procedure in a Post-Fontan Procedure Patient with Mental Retardation (Fontan 수술을 받은 정신지체 소아에서 인상채득을 위해 시행한 깊은 진정)

  • Lee, Jung-Man;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Soon-Young;Shin, Teo-Jeon
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.1
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    • pp.45-50
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    • 2012
  • The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.

Effect of aeration on the physicochemical characteristics of livestock feces compost during composting period (퇴비화과정 중 공기공급 여부가 가축분뇨 퇴비의 물리화학적 특성에 미치는 영향)

  • Jeong, Kwang-Hwa;Kang, Ho;Kim, Tai-ll;Park, Chi-Ho;Yang, Chang-Buem
    • Journal of the Korea Organic Resources Recycling Association
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    • v.11 no.4
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    • pp.57-65
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    • 2003
  • Livestock farming is one of several industries that have faced criticism because of its impact on the water quality, soil contamination and air pollution. The livestock feces can cause some environmental problems. The best way to treat the feces is to recycle the manure as an organic fertilizer after fermentation or composting. This study was carried out to investigate the characteristics of composting of manure in several composting conditions. The variations of physicochemical characteristics of each compost piles containing different level of air volume were analyzed throughout the composting period. In this study, pigs manure compost piles mixed with saw dust were composted in 110L of laboratory scale plastic vessels and $1.5m^3$ of small cubic wooden composting vessels for 60days. The compost piles were ventilated continuously with air pump throughout the composting duration. The air volume ventilated into the piles was regulated by chock valve attached to the inlet pipe. The ventilation level was adjusted by 20, 50, 100, 150 and $200L/m^3/mim$, respectively. The highest temperature of the compost increased to $72^{\circ}C$ during composting period. After 20days from beginning of fermentation, concentrations of $H_2S$, $CH_3SH$, DMS and DMDS generated from compost piles were 29, 16, 6 and 5ppb in blow in state compost pile, conversely, in blow out state compost pile, the parameters were 32, 24, 15 and 14ppb, respectively.

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Revised Korean Cough Guidelines, 2020: Recommendations and Summary Statements

  • Joo, Hyonsoo;Moon, Ji-Yong;An, Tai Joon;Choi, Hayoung;Park, So Young;Yoo, Hongseok;Kim, Chi Young;Jeong, Ina;Kim, Joo-Hee;Koo, Hyeon-Kyoung;Rhee, Chin Kook;Lee, Sei Won;Kim, Sung Kyoung;Min, Kyung Hoon;Kim, Yee Hyung;Jang, Seung Hun;Kim, Deog Kyeom;Shin, Jong Wook;Yoon, Hyoung Kyu;Kim, Dong-Gyu;Kim, Hui Jung;Kim, Jin Woo
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.263-273
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    • 2021
  • Cough is the most common respiratory symptom that can have various causes. It is a major clinical problem that can reduce a patient's quality of life. Thus, clinical guidelines for the treatment of cough were established in 2014 by the cough guideline committee under the Korean Academy of Tuberculosis and Respiratory Diseases. From October 2018 to July 2020, cough guidelines were revised by members of the committee based on the first guidelines. The purpose of these guidelines is to help clinicians efficiently diagnose and treat patients with cough. This article highlights the recommendations and summary of the revised Korean cough guidelines. It includes a revised algorithm for the evaluation of acute, subacute, and chronic cough. For a chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered in differential diagnoses. If UACS is suspected, first-generation antihistamines and nasal decongestants can be used empirically. In cases with CVA, inhaled corticosteroids are recommended to improve cough. In patients with suspected chronic cough due to symptomatic GERD, proton pump inhibitors are recommended. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, intake of angiotensin-converting enzyme inhibitor, intake of dipeptidyl peptidase-4 inhibitor, habitual cough, psychogenic cough, interstitial lung disease, environmental and occupational factors, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and unexplained cough can also be considered as causes of a chronic cough. Chronic cough due to laryngeal dysfunction syndrome has been newly added to the guidelines.

The Korean Cough Guideline: Recommendation and Summary Statement

  • Rhee, Chin Kook;Jung, Ji Ye;Lee, Sei Won;Kim, Joo-Hee;Park, So Young;Yoo, Kwang Ha;Park, Dong Ah;Koo, Hyeon-Kyoung;Kim, Yee Hyung;Jeong, Ina;Kim, Je Hyeong;Kim, Deog Kyeom;Kim, Sung-Kyoung;Kim, Yong Hyun;Park, Jinkyeong;Choi, Eun Young;Jung, Ki-Suck;Kim, Hui Jung
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.14-21
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    • 2016
  • Cough is one of the most common symptom of many respiratory diseases. The Korean Academy of Tuberculosis and Respiratory Diseases organized cough guideline committee and cough guideline was developed by this committee. The purpose of this guideline is to help clinicians to diagnose correctly and treat efficiently patients with cough. In this article, we have stated recommendation and summary of Korean cough guideline. We also provided algorithm for acute, subacute, and chronic cough. For chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered. If UACS is suspicious, first generation anti-histamine and nasal decongestant can be used empirically. In CVA, inhaled corticosteroid is recommended in order to improve cough. In GERD, proton pump inhibitor is recommended in order to improve cough. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, angiotensin converting enzyme inhibitor, habit, psychogenic cough, interstitial lung disease, environmental and occupational factor, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and idiopathic cough can be also considered as cause of chronic cough. Level of evidence for treatment is mostly low. Thus, in this guideline, many recommendations are based on expert opinion. Further study regarding treatment for cough is mandatory.

Development of a 2-fluid Jet Mixer for Preventing the Sedimentation in Livestock Liquid Manure Storage Tank (가축분뇨액비저장조 침전물 퇴적 방지를 위한 2류체 제트노즐식 교반장치 개발에 관한 연구)

  • Yu, B.K.;Hong, J.T.;Kim, H.J.;Kweon, J.K.;Oh, K.Y.;Park, B.K.
    • Journal of Animal Environmental Science
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    • v.18 no.3
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    • pp.207-220
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    • 2012
  • There are around 7,500 manure tanks to treat the manures from pigs in Korea. In the tank, there are too much sediments deposited on the base and wall, which causes low efficiency of stock capacity and manure fermentation. In order to minimize sediments and to ferment manure effectively, we developed a 2-fluid jet mixer for mixing sediments in liquid livestock manure tank. For developing the prototype, we tested a factorial experimental system with various nozzles, and simulated CFD models with two kinds of nozzle arrangement. From the results of factorial experiment and CFD simulation, we concluded the dia. ratio of primary : secondary nozzle should be 1:2 and the nozzles should be arranged at the same distances toward to the circumferential direction. With this results, we manufactured a 2-fluid jet mixer which is consists of four 2-phase nozzles, centrifugal slurry pump and root's type air blower. And, we carried out the performance test of the prototype in the round shaped liquid manure tank in the farm. The performance test results showed that the uniformity of TS (Total Solid) and VS (Volatile Solid) was raised from 21.3 g/L, 13.3 g/L In steady state to TS and VS to 23.0 g/L, 14.1 g/L in the mixing operation. Therefore, we could conclude that the prototype of 2-fluid mixer could make the solid material which could be sediments in the tank not to be deposited in the tank and to be contacted to air bubbles which could enhance the efficiency of the fermentation of livestock manure.