• Title/Summary/Keyword: 비강성

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Understanding Contemporary Interstate Rivalries: Consensus Rivalries and Rivalry Termination (숙적관계 국가들에 대한 연구 - 숙적관계 종식에 영향을 미치는 주요 요인들을 중심으로 -)

  • Oh, Soon-Kun
    • Strategy21
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    • s.32
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    • pp.222-270
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    • 2013
  • 서구 근대 국제관계학의 태동은 "전쟁의 원인"을 밝혀내려고 했던 유럽 지식인들의 학문적 도전에서부터 비롯되었다고 할 수 있다. 1, 2차 세계대전의 잔혹함을 겪으면서 이들은 전쟁(특히 전쟁의 원인)에 대한 좀 더 과학적인 연구를 통해 어떻게 하면 국가들 간의 전쟁을 예방할 수 있을까에 집중해 왔다. 이러한 학문적 경향을 반영한 것이 잘 알려진 미국 미시간 대학의 "전쟁 상관성 연구 프로젝트(Correlates of War Project)"이다. 이는 나폴레옹 전쟁이 끝나고 비엔나체제가 시작된 1815년 이후 국가들 간 발생한 모든 전쟁 관련 자료를 데이터베이스화하여,국제관계학자들이 전쟁(Interstate War)이나 군사분쟁(Militarized Interstate Disputes)을 정량 또는 정성적으로 연구할 수 있도록 다양한 정보들을 제공하고 있다. 최근 Paul F. Diehl, William R. Thompson과 같은 학자들은 전쟁을 분석단위로 하는 전쟁의 원인(Causes of War)을 연구하는 학풍에서 벗어나, 국가들 간의 분쟁과 전쟁을 연구하기 위해 숙적관계(Rivalry)라는 새로운 분석의 단위를 제시하였다. 숙적관계는 국제관계에 있어서 지속적으로 분쟁 또는 전쟁을 일으키는, 즉 무력분쟁의 긴 역사를 가지고 있는, 두 국가를 일컫는다. 국가들 간의 숙적관계는 학자들에 따라 Interstate Rivalry, Enduring Rivalry, Strategic Rivalry 등 다양한 정의와 성격을 갖고 있다. 이러한 국가들의 사례로는 2차대전 이전까지 프랑스-독일 관계, 2차대전 이후 중동지역 이스라엘과 아랍국가들 간의 관계, 냉전기 미소관계, 인도-파키스탄 및 남북한 관계 등을 예로 들 수 있다. 이렇게 널리 알려진 숙적관계 외에도 남미의 칠레-아르헨티나, 에콰도르-페루와 아프리카의 소말리아-에티오피아 등 학자들에 따라 1815년 이후 약 200개의 숙적관계를 제시하고 있다. 숙적관계에 대한 연구는 기존의 전쟁의 원인 중심이었던 정량적 국제분쟁 연구에 두 국가의 분쟁역사를 포함시키는 정성적 연구를 접합시키고 있다. 본 연구는 1945년 이후 숙적관계 국가들의 관계종식과 관련하여, 거시론적이고 전체론적 접근방법(Macro - level Holistic Approach)을 제시하고 있다. 먼저 1945년 이후 발생한 국가들 간의 숙적관계 종식(Rivalry Termination)을 이해하기 위해, 거시적 관점에서 숙적관계를 발생시키게 된 역사적 원인을 살펴보고 있다. 특히 1945년 이후 숙적관계와 관련된 중요한 요인들 중에서 전쟁, 영토분쟁, 그리고 근대국가 형성에 대해 살펴보고 다음과 같은 두 가지 명제(proposition)를 제시한다. 첫째, 1945년 이후의 숙적관계 형성과 지속에는 2차대전 이후 독립국가 형성, 헌팅턴이 주장한 제3의 물결(민주화), 그리고 냉전기 미소경쟁 등의 역사적 배경이 영향을 주었다는 것이다. 둘째, 이러한 역사적 배경에 더하여 1945년 이후 숙적관계는 전쟁에 의해 시작된 숙적관계와 전쟁 없이 시작된 숙적관계 등 2가지로 나눌 수 있으며, 전쟁에 의해 시작되고 영토분쟁과 근대국가 형성 문제를 내포하고 있는 숙적관계가 그렇지 않은 숙적관계에 비해 오랫동안 지속되며 관계해결이 어렵다는 것이다. 앞서 제시된 2가지 명제들과 관련하여 본문에서는 다양한 학자들이 제시한 숙적관계 정의들에 일치하는 23개의 숙적관계(Consensus Rivalries)를 선정하여 이들에 대한 비교분석(Descriptive Analysis)을 실시하였다. 이들 사례들을 1945년 이전과 이후로 나누어, 숙적관계 형성과 종식에 있어 핵심요소인 국가들 간 힘의 차이(Power Relations), 분쟁의 주요 원인(Primary Conflict Issue), 숙적관계에 있어 다른 국가들과의 연계성(Rivalry Linkage), 전쟁의 횟수와 시기 등을 통해 비교하였다. 숙적관계의 종식과 관련하여 약소국 간의 숙적관계(Minor Dyad)가 오래 지속되고, 영토분쟁(Territorial Disputes)이 숙적관계를 지속시키는 주요인이며, 다른 숙적관계와의 연계성이 적은 숙적들이 오래 지속된다는 비교분석 결과가 나왔다. 또한 전쟁의 횟수는 숙적관계 종식에 큰 영향을 미치지 못하지만 전쟁으로 인해 시작된 숙적관계가 그렇지 않은 경우보다 더욱 오래 지속되는 것으로 확인되었다. 끝으로 2차대전 이전의 숙적관계는 대부분 전쟁을 통해 종식되었지만, 1945년 이후에는 전쟁 없이도 숙적관계가 종식된 경우가 많았음을 보여 주고 있다. 본 연구의 주목적은 "1945년 이후 형성된 숙적관계를 어떻게 종식시킬 수 있을 것인가?"라는 규범적 논제를 통해, 23개의 주요 숙적관계를 발굴하여 거시적, 역사적 관점에서 비교분석함에 있다. 이는 특히 우리나라가 처한 현실과 관련하여 중요한 시사점을 갖는다. 남북관계가 갖는 특수성보다는 1945년 이후 국제정치 역사속에서 발생한 숙적관계 현상이라는 일반성의 틀에서 남북관계를 이해하고자 했다. 남북관계를 베트남, 예멘, 독일 등 분단국가의 사례들과만 비교 연구하는 제한된 시각에서 벗어나, 인도-파키스탄, 그리스-터키, 에콰도르-페루 등 유사한 숙적들 간의 관계들과 비교하는 새로운 연구의 장을 제시하고자 한다. 따라서 앞으로 숙적관계 종식에 대한 더욱 다양화된 사례연구를 통해 한반도 분쟁해결에 필요한 새로운 교훈을 얻을 수 있을 것이다. 예를 들면 2차대전 이후 발생한 국경을 접하고 있는 비강대국들의 평화적인 숙적관계 종식에 대한 사례연구는 남북한이 앞으로 지향해야 할 방향을 제시해 줄 수 있을 것이다. 끝으로 본 연구는 특정한 정책적 함의를 도출하기 보다는 숙적관계와 관련된 하나의 거시적 이론를 제시하고, 주요 숙적관계 국가들에 대한 비교설명을 통해 현존하는 숙적관계 해결을 위한 하나의 분석의 틀을 제시하는 것으로 국제분쟁 연구에 기여하고자 하였다.

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Immunization Effect on Naegleria fowleyi Infection in Splenectomized Mice (비장절제 마우스에서 Naegleria fowleri 감염에 대한 면역효과)

  • Han, Gwang-Hyeop;An, Myeong-Hui;Min, Deuk-Yeong
    • Parasites, Hosts and Diseases
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    • v.26 no.1
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    • pp.39-44
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    • 1988
  • A pathogenic free-living amoeba, Naegleria fowleri, is a causative protozoan parasite of primary amebic meningoencephalitis in human and experimental animals. It is known that humoral and cellular immunity contribute as the defence mechanism of host against this organism. Recently splenectomy has been argued on its effect on host defence mechanisms. The present study was aimed to observe the enact of immunization in splenectomized mice. For immunization, $5~10{\times}10^5$ trophozoites of Naegleria fewleri o 359 were intraperitoneally inoculated once a week for two weeks to BALB/c mice, and $5~10{\times}10^4$ of ameba trophozoites were intranasally inoculated for infection after splenectomy and/or immunization. ELISA technique was applied for the detection of seum IgG antibody levels. Experimental animals were divided into 4 groups; I. splenectomized and immuniEed; ll. splenectomized only; III. immunized only; IV. not splenectomized nor immunized. The results obtained were as follows: 1. Mortality rates of splenectomized and immunized mice in group I (38.1%) and immunized only in group III (25.0%) were lower than those of not immunized mice in group II (50%) and control group, IV (46.4%). 2. Survival times of mice in group I, II, III and IV were $20.1{\pm}3.6$, $17.3{\pm}4.5$, $20.4{\pm}7.0$ and $19.6{\pm}7.6$ days respectively, and there were no significant differences between them. 3. ELISA values (absorbance at 492nm) of group I (1, $10{\pm}0.29$) and group III ($1.31{\pm}0.28$) were significantly higher than that of group IV($0.24{\pm}0.37$) at day 31 of infection (p<0.05). Conclusively, it is presumed that humoral immunity against N. fowleri may operate as ever, after immunization, even though the mouse was splenectomized.

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Serotypes and Antimicrobial Susceptibility of Streptococcus pneumoniae (폐구균의 혈청형 분포와 항생제 감수성에 관한 연구)

  • Choi, Kyoung-Min;Kim, Jeong-Hyun;Shin, Kyoung-Mi;Yeon, Soo-In;Shin, Jeon-Soo;Yong, Dong-Eun;Lee, Kyoung-Won;Kim, Dong-Soo
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.159-166
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    • 2003
  • Purpose : Streptococcus pneumoniae is part of the normal flora but is also responsible for causing many invasive diseases such as pneumonia, meningitis, and sepsis in addition to noninvasive diseases such as otitis in children. Multi-drug resistant strains has raised a lot of concern worldwide and thus the importance of prevention has been emphasized. We have analyzed the current serotypes and antibiotic sensitivity of each serotype as a baseline study to estimate the efficacy of the pneumococcal vaccine in Korean children. Methods : One hundred sixteen cases of pneumococcus cultured at Yonsei Medical Center from September 2001 to January 2003 were analyzed. The serotyping was done with the Quellung reaction and penicillin resistance was tested using the oxacillin disc diffusion method. Results : Pneumococcus were cultured from the sputum in 76 cases(65.5%), from the blood in 13 cases(11.2%), from the ear discharge in 12 cases(10.3%), from the throat in 7 cases(6.0%), from the nasal cavity in 2 cases(1.7%), and one case(0.9%) each from the cerebrospinal fluid, eye discharge, peritoneal fluid, post-operational wound, brain abscess, and catheter tip. Serotyping was possible with 98 cases and the following serotypes were found; 15 cases of type 19F(15.3%), 11 cases of 19A(11.2%), 8 cases of 11A(8.2%), 7 cases each of 6A, 14 and 3(7.1%), 6 cases each of 35, 6B and 23F(6.1%). Eighty two cases(70.7%) out of 116 cases were penicillin resistant and serotypes 19F, 19A, 11A, 23F, 6A, 9V constituted the majority, 48 cases(59.8%). These serotypes showed resistance to cotrimoxazole (74.4%), tetracycline(69.5%), and erythromycin(90.3%) as well. In the 22 cases cultured from children, 19A and 19F were found in 25.0%, 6A, 6B, and 23F in 10.0%, 11A, 14, 19, and 29 in 5.0%. Fifty percent(10/20) of the clinical isolates were represented in the current 7-valent pneumococcal protein conjugate vaccine, and 85%(17/20) when the cross-reacting serotypes were included. Penicillin resistance was found in 86.4%(19/22). Conclusion : The percentage of serotypes included in the 7 valent pneumococcal protein conjugate vaccine found in our study was 40.8% which was less than other prior studies. In anticipation of a change of pneumococcal serotypes, a nationwide multicenter study is needed before the initiation of pneumococcal vaccines in Korea.

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Molecular Epidemiologic Study of a Methicillin-resistant Staphylococcus aureus Outbreak at a Newborn Nursery and Neonatal Intensive Care Unit

  • Kang, Hyun Mi;Park, Ki Cheol;Lee, Kyung-Yil;Park, Joonhong;Park, Sun Hee;Lee, Dong-Gun;Kim, Jong-Hyun
    • Pediatric Infection and Vaccine
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    • v.26 no.3
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    • pp.148-160
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    • 2019
  • Purpose: This study aimed to investigate the molecular epidemiology of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak at a newborn nursery and neonatal intensive care unit (NICU). Methods: During the outbreak, from August to September 2017, MRSA isolates collected from neonates and medical staff underwent genotyping and screened for virulence factors. Antibiotic susceptibilities were tested. Results: During the study period, 41 neonates were admitted at the nursery (n=27) and NICU (n=14). Of these, 7 had MRSA infections (skin infection [n=6] and sepsis [n=1]) and 4 were colonized with MRSA. Associated medical staff (n=32) were screened; three were nasal MRSA carriers. Staphylococcal chromosomal cassette mec (SCCmec) type II, sequence type (ST) 89, spa type t375 was found to be the skin infection outbreak causing strain, with multi-drug resistance including low-level mupirocin resistance. SCCmec type IVa, ST 72, and a novel spa type designated t17879, was the cause of MRSA sepsis. Many different types of MRSA were colonized on the neonates; however, SCCmec type IVa, ST 72, spa type t664 was colonized in both neonates and a NICU nurse. All MRSA isolates from colonized infants were positive for the Panton-Valentine leukocidin (PVL) toxin gene. Conclusions: The strain causing an outbreak of skin infections had multi-drug resistance. Also, MRSA colonized in the neonates were found to carry the PVL toxin gene. Because different strains are present during an outbreak, molecular epidemiologic studies are important to identify the outbreak strain and colonized strains which aid in effective control and prevention of future MRSA outbreaks.

Radiotherapy Results of Midline Malignant Reticulosis (MMR) (중심선 악성 세망증의 방사선 치료 결과)

  • Yun, Sang-Mo;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.291-297
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    • 1996
  • Purpose : This study was performed to evaluate survival, failure patterns, and prognostic factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. Materials and Methods : A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy from June 1985 to November 1992. There were 19 male and 4 female patients, The patients' age ranged from 17 to 71 years (median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in $30\%$ of the patients. The nasal cavity was most frequently involved No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total $45\~54$ Gy (median 50.4 Gy) using 6 MV X-ray No patients received chemotherapy as initial treatment. Results : Overall 5-year and 10-year survival rates were $52.4\%$ and $44.1\%$, respectively. Seventy Percent(12/17) of the patients achieved complete response to radiotherapy, and $29.4\%$ (5/17) achieved partial response. The Patients with complete response showed a better 5-year survival rate than those with partial response ($66.9\%$ vs. $20\%$. p=0.004). Symptom duration before diagnosis, the presence of systemic symptom, and the number of primary sites had no influence on survival. The patterns of failure were as follows: local failure(1), failure in adjacent site(1), local and distant failure(1) distant metastasis(2). and conversion to malignant lymphoma(1). We could not find factors associated with the patterns of failure. Conclusion : The most important facto associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However. about $50\%$ of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.

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The Evaluation and Development of Head and Neck Radiation Protective Device for Chest Radiography in 10 Years Children (소아(10세) 흉부 방사선촬영에서의 두경부 방사선 방어기구 개발 및 평가)

  • Lee, Jun Ho;Lim, Hyun Soo;Lee, Seung Yeol
    • Journal of Radiation Protection and Research
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    • v.40 no.2
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    • pp.118-123
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    • 2015
  • The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

Mammalian Reproduction and Pheromones (포유동물의 생식과 페로몬)

  • Lee, Sung-Ho
    • Development and Reproduction
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    • v.10 no.3
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    • pp.159-168
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    • 2006
  • Rodents and many other mammals have two chemosensory systems that mediate responses to pheromones, the main and accessory olfactory system, MOS and AOS, respectively. The chemosensory neurons associated with the MOS are located in the main olfactory epithelium, while those associated with the AOS are located in the vomeronasal organ(VNO). Pheromonal odorants access the lumen of the VNO via canals in the roof of the mouth, and are largely thought to be nonvolatile. The main pheromone receptor proteins consist of two superfamilies, V1Rs and V2Rs, that are structurally distinct and unrelated to the olfactory receptors expressed in the main olfactory epithelium. These two type of receptors are seven transmembrane domain G-protein coupled proteins(V1R with $G_{{\alpha}i2}$, V2R with $G_{0\;{\alpha}}$). V2Rs are co-expressed with nonclassical MHC Ib genes(M10 and other 8 M1 family proteins). Other important molecular component of VNO neuron is a TrpC2, a cation channel protein of transient receptor potential(TRP) family and thought to have a crucial role in signal transduction. There are four types of pheromones in mammalian chemical communication - primers, signalers, modulators and releasers. Responses to these chemosignals can vary substantially within and between individuals. This variability can stem from the modulating effects of steroid hormones and/or non-steroid factors such as neurotransmitters on olfactory processing. Such modulation frequently augments or facilitates the effects that prevailing social and environmental conditions have on the reproductive axis. The best example is the pregnancy block effect(Bruce effect), caused by testosterone-dependent major urinary proteins(MUPs) in male mouse urine. Intriguingly, mouse GnRH neurons receive pheromone signals from both odor and pheromone relays in the brain and may also receive common odor signals. Though it is quite controversial, recent studies reveal a complex interplay between reproduction and other functions in which GnRH neurons appear to integrate information from multiple sources and modulate a variety of brain functions.

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Unit Loadings of Heavy Metals by Non-point Sources - Case Study in a Valley Watershed - (비점원에 의한 중금속 원단위 부하량 - 곡간지 유역을 중심으로 -)

  • Kim, Jin-Ho;Han, Kuk-Heon;Lee, Jong-Sik
    • Korean Journal of Environmental Agriculture
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    • v.27 no.1
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    • pp.35-43
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    • 2008
  • The study was carried out to estimate runoff loads of heavy metals in the valley watershed at the middle of South Korea, during farming season. There were no other pollution sources except agricultural activity. From 27 April 2006 to 31 October 2007, water samples were collected using two methods. The first method was regular sampling wherein water samples were taken every two weeks; and the other method was through regular sampling when water were collected during each rainfall event. Results showed that heavy metals were found in the water from the regular samples, and were highest during May and June. It was presumed that this might have been contributed by farming activities. Heavy metal concentration of the irregular samples was lower than regular samples. The correlation coefficient between each heavy metal of the regular samples were as follows: Fe-Al>Cr-Al>Fe-Cr>Mn-Fe. The correlation coefficient of the irregular samples were the following: Fe-Al>Fe-Cu is positive; and Pb-Cu>Ni-Al is negative. Measured pollutant loads of heavy metals in the valley watershed were : 2.047 kg $day^{-1}$ of Al, 0.008 kg $day^{-1}$ of Cd, 0.034 kg $day^{-1}$ of Cr, 0.311 kg $day^{-1}$ of Cu, 0.601 kg $day^{-1}$ of Fe, and 0.282 kg $day^{-1}$ of Zn in 2006; while in 2007, the following were observed: 2.535 kg $day^{-1}$ of Al, 0.026 kg $day^{-1}$ of Cd, 0.055 kg $day^{-1}$ of Cu, 0.727 kg $day^{-1}$ of Fe, and 0.317 kg $day^{-1}$ of Zn. In the analysis of data gathered, the loading rates of effluents from the valley watershed during the rainy season were : 79.8% of Al, 69.1% of Cu, 82.5% of Fe, and 69.1% of Zn in 2006; while 69.9% of Al, 67.5% of Cu, 70.4% of Fe, and 67.5% of Zn in 2007.

Evaluating the usefulness of BinkieRTTM (oral positioning stent) for Head and Neck Radiotherapy (두경부암 환자 방사선 치료 시 BinkieRTTM(구강용 고정장치)에 대한 유용성 평가)

  • GyeongJin Lee;SangJun Son;GyeongDal Lim;ChanYong Kim;JeHee Lee
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.21-30
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    • 2022
  • Purpose: The purpose of this study is to evaluate the effectiveness of oral positioning stent, the BinkieRTTM in radiation treatment for head and neck cancer patients in terms of tongue positions reproducibility, tongue doses and material properties. Materials and Methods: 24 cases using BinkieRTTM during radiation treatments were enrolled. The tongue was contoured on planning CT and CBCT images taken every 3 days during treatment, and then the DSC and center of tongue shift values were analyzed to evaluate the reproducibility of the tongue. The tongue dose was compared in terms of dose distribution when using BinkieRTTM and different type of oral stents (mouthpiece, paraffin wax). Randomly selected respective 10 patients were measured tongue doses of initial treatment plan for nasal cavity and unilateral parotid cancer. Finally, In terms of material evaluation, HU and relative electron density were identified in RTPS. Results: As a result of DSC analysis, it was 0.8 ± 0.07, skewness -0.8, kurtosis 0.61, and 95% CI was 0.79~0.82. To analyze the deviation of the central tongue shift during the treatment period, a 95% confidence interval for shift in the LR, SI, and AP directions were indicated, and a one-sample t-test for 0, which is an ideal value in the deviation(n=144). As a result of the t-test, the mean and SD in the LR and SI directions were 0.01 ± 0.14 cm (p→.05), 0.03 ± 0.25 cm (p→.05), and -0.08 ± 0.25 cm (p ←.05) in the AP direction. In the case of unilateral parotid cancer patients, the Dmean to the tongue of patients using BinkieRTTM was 16.92% ± 3.58% compared to the prescribed dose, and 23.99% ± 10.86% of patients with Paraffin Wax, indicating that the tongue dose was relatively lower when using BinkieRTTM (p←.05). On the other hand, among nasal cavity cancer patients, the Dmean of tongue dose for patients who used BinkieRTTM was 4.4% ± 5.6%, and for those who used mouthpiece, 5.9% ± 6.8%, but it was not statistically significant (p→.05). The relative electron density of Paraffin Wax, BinkieRTTM and Putty is 0.94, 0.99, 1.26 and the mass density is 0.95, 0.99 and 1.32 (g/cc), Transmission Factor is 0.99, 0.98, 0.96 respectively. Conclusion: The result of the tongue DSC analysis over the treatment period was about 0.8 and Deviation of the center of tongue shifts were within 0.2 cm, the reproducibility was more likely excellent. In the case of unilateral head and neck cancer patients, it was found that the use of BinkieRTTM rather than Paraffin Wax or Putty can reduce the unnecessary dose irradiated to the tongue. This study might be useful to understand of BinkieRTTM's properties and advantages. And also it could be another considered option as oral stent to keep the reproducibility of tongue and reducing dose during head and neck radiation treatments.

The Effect of Nasal BiPAP Ventilation in Acute Exacerbation of Chronic Obstructive Airway Disease (만성 기도폐쇄환자에서 급성 호흡 부전시 BiPAP 환기법의 치료 효과)

  • Cho, Young-Bok;Kim, Ki-Beom;Lee, Hak-Jun;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.190-200
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    • 1996
  • Background : Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. Method : We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure $6-8cmH_2O$ and an expiratory positive airway pressure $3-4cmH_2O$. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. Results : Pretreatment and after 3 days of treatment, mean $PaO_2$ was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and $PaCO_2$ was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in cr group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean $PaO_2$, $PaCO_2$ and pH respectively. Conclusion: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPD, is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.

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