• Title/Summary/Keyword: 식도경

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A Clinical Study on Binaural Hearing Aid (양이 보청효과에 관한 연구)

  • 김기령;김영명;심윤주
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.9.2-9
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    • 1978
  • Monaural and binaural hearing aid performance under quiet and noisy conditions were compared in regard to (1) the degree of hearing impairment, (2) the symmetry of pure tone audiogram, (3) the automatic gain control of the hearing aid. (4) hearing impairement with recruitment and, word discrimination ability. Performance using binaural hearing aids was consistently superior to that using monaural hearing aids. The results were as follows. 1. Speech detection thresholds were enhanced by a mean of 4.25dB when tested with danavox 747 PP stereo type hearing aid and by a mean of 4.12 dB when tested hearing aids connected seperately to the right and left ears. 2. Binaurally tested speech reception thresholds were superior to monaurally tested thresholds by a mean of 3.56dB when tested in quiet and by a mean of 5.56dB when tested in noise. 3. Binaurally tested word discrimination scores were also superior by a mean of 17.09% in quiet and by a mean 19.63% in noise. 4. Both SRT and word discrimination scores were performed best by subjects with moderately-severe impairement. The performance by one mildly impaired subject was the poorest of all performances. The levels of performance order were; moderately-severe loss, severe loss. moderate loss and mild loss. 5. The data obtained using AGC aids when compaired with that of linear amplification show that when AGC aids were worn in both ears. the results were very poor but when one AGC aid was worn in one ear and linear amplification in the other. the results were good. 6. The advantages of binaural hearing aids were obvious even in cases 1) with great diferences in hearing thresholds between right and left ears, 2) when the subject was unable to discriminate words without vision and. 3) when the subject had extreme recruitme t phenomenon.

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The Phoniatric Evaluation of the Effect of the Laryngomicrosurgery for the Laryngeal Polyps and the Nodules (성대폴립및 결절의 치료 효과에 대한 음성의학적 고찰)

  • 김기령;홍원표;김광문;이경재;정태영;이명호
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.8.2-9
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    • 1983
  • Recently, the laryngomicrosurgery has been done for the removal of benign laryngeal mass and for the improvement of voice. For the evaluation of the effect of the treatment, there must be any objective method such as aerodynamic study, vocal fold vibration study, acoustic analysis, psycho-acoustic evaluation and the neuro-muscular study. The authors evaluated the phoniatric effect of the laryngomicrosurgery for the patients of 15 laryngeal polyps and 9 laryngeal nodules, who received pre-op. and post-op. vocal function study from Jun. 1981 to Mar. 1983. The results obtained were as follows ; 1) The post-op. mean value of the maximum phonation time was increased 40 % in the unilateral polyps, 62 % in the bilateral nodules and 18 % in the unilateral nodules. 2) The post-op. mean value of the phonation quotient was decreased 25 % in comparison with pre-op. value in the case of the bilateral polyps, 26 % in the unilateral polyps, 55 % in the bilateral nodules and 12 % in the unilateral nodules. 3) The post-op. mean value of the mean air flow rate was decreased 27 % in comparison with the pre-op. value in the case of the bilateral polyps, 25 % in the unilateral polyps, 65 % in the bilateral nodules, 25 % in the unilateral nodules. 4) The glottic chink of the 10 cases of polyps among the 11 cases were disappeared, and the glottic chink of the 5 cases of nodules among 7 cases were also disappeared after surgery. 5) The pre-op. hoarseness of the 10 cases of polyps among the pre-op. hoarseness of the 11 cases of polyps were changed to clear and the 3 cases of nodules were also changed to clear.

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Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES (원격조정 고선량 근접 치료)

  • Park, Su-Gyeong;Chang, Hye-Sook;Choi, Eun-Kyong;Yi, Byong-Yong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.267-275
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    • 1992
  • Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

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Formation and elimination of pores in $YBa_2Cu_3O_{7-x}$ Oxides ($YBa_2Cu_3O_{7-x}$ 산화물에서 기공의 생성과 소멸)

  • 김찬중;홍계원
    • Proceedings of the Korean Powder Metallurgy Institute Conference
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    • 2001.04a
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    • pp.9-10
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    • 2001
  • 용융공정 $YBa_2Cu_3O_{7-x}$(123) 초전도체는 고자장 하에서도 통전특성이 우수하다 그러나 123 초전도체에는 미세균열이나 기공과 같이 초전도체의 통전특성에 유해 한 요인들도 다수 포함된다. 미세균열은 고온 정방정 상이 저온 사방정상으로 상변 태 시 발생하는 웅력에 의해 생성된다. 반면, 기공은 123 성형체를 녹이는 과정에서 123 상에 포함된 산소원자들이 격자로부터 이탈되고, 이 산소원자들이 모여 액상에서 기공을 형성한다. 제조공정에 따라 기공의 크기와 밀도가 다르지만 대략 수십 이크론 정도로 대단히 크다 생성된 기공 중 일부는 열처리 중에 소멸되나, 어떤 것들은 그대로 남아 초전도체의 치밀화를 방해한다. 본 연구에서는 123의 용융 및 $YBa_2Cu_3O_{7-x}$(211)과 액상으로의 분해 과정 및 포정반응과 관련된 미세조직을 조사하여 기공생성과 소멸과정을 조사하였고, 123의 최종 미세조직에 대한 기공의 영향에 대 하여 연구하였다. 열처리 스케쥴은 123-211-액상의 그림 l의 2원 상태도를 기초로 하여 결정하였다. 먼저 부분 용융상태에서의 기공의 분포를 알고자 시편을 105$0^{\circ}C$에서 0.5-1 시 간 유지한 후, 액체 질소통에 넣어 냉각하였다 (그림 2의 열처리 경로 CD)$\circled1$부분 용 융상태에서 급랭할 경우 211과 액상 상태가 그대로 유지되므로 액상에서의 기공분 포를 관찰할 수 있다. 또 다른 시편들은 그림 2의 @$\circled2$경로로 열처리하였다. 이 시편에서는 고온에서 생성된 211과 액상이 반웅하여 123 결정이 생성, 성장하므로 123 결정립 내의 기공분포를 알 수 있다. 그림 3은 시편에서의 기공과 액상포켓의 분포를 모식도와 각 부위의 미세조직 사진이다. 시편에는 산소가스 발생으로 인해 생성된 수형의 기공이 관찰된다. 기공은 시편의 중앙에 집중되며, 시편 바깥부분은 기공에 액상이 채워진 액상포켓이 관찰된다. 기공의 생성과 소멸과정은 다음과 같다. 출발물질인 123 분말이 211과 액상으로 분해될 때 산소가스가 배출되며, 이로 인해 액상에서 구형의 기공이 생성된다. 이들 중 일부는 액상으로 채워져 소멸되나, 나머지는 그대로 남는다. 특히, 시편 중앙에 서는 수십-수백 마이크론 크기의 커다란 기공이 다수 관찰된는데, 이는 기공의 합체로 만들어진 것이다. 포정반응 열처리 시 기공 소멸로 만들어진 액상포켓들은 주변 211 입자와 반응하여 123 영역으로 변한다. 이곳은 다른 지역과 비교하여 211 밀도 가 낮기 때문에, 미반응 액상이 남거나 211 밀도가 낮은 123 영역이 된다. 액상으로 채워지지 못한 구형의 기공들 중 다수가 123 결정 내로 포획되며, 그 형상은 액상/ 기공/고상 계면에너지에 의해 결정된다.

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Reconstruction of Pharyngoesophageal Defects Using free Flaps (유리 피판을 이용한 인두식도 결손의 재건)

  • Moon, Ji-Hyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.154-162
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    • 1999
  • The laryngopharyngectomy for tumor ablation is the most common indication for pharyngoesophageal reconstruction in our country. Most of these cases are advanced laryngeal cancer that has spread beyond the larynx, pharynx and cervical esophagus. Such patients are obviously unable to breathe, swallow, or speak in the normal manner. The ideal reconstruction would restore normal anatomy, permitting patients to breathe and swallow without aspiration, and would not require a permanent tracheostomy. Reconstruction of the pharyngoesophageal defect traditionally been carried out with tubed local random flap, deltopectoral or musculocutaneous flap. Another approach is the pedicled enteric flap. But microsurgical reconstruction of the pharyngoesophagus, using either the free jejunal or the tubed radial forearm flap, have now become the preferred technique. Among them, we used jejunal free flap in 39 cases, tubed radial forearm free flap in 5 cases, patched radial forearm free flap in 2 cases and pectoralis major myocutaneous island flap in 2 cases from December 1990 to Febrary 1999. In this paper we illustrated that both forearm and jejunal free flap is a usful alternative in reconstruction of hypopharynx and cervical esophagus.

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Descending Necrotizing Mediastinitis : The Retrospective Review of Surgical Management (하행 괴사성 종격동염 : 외과적 치료의 후향적 조사)

  • 이재진;신호승;신윤철;지현근;이원진;홍기우
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.769-774
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    • 2001
  • Background: Descending necrotizing mediastinitis(DNM) is a serious complication originating in odontogenic or oropharyngeal infection with previously reported mortality rates of 25% to 40%. We retrospectively reviewed the 4 years of our surgical drainage and debridement in DNM. Material and Method: We studied 7 cases diagnosed as DNM from 1997 through 2000. Primary oropharyngeal infection lead to DNM in four cases(57%) and odontogenic abscess in three cases(43%). All patients were received emergent cervicotomy and thoracotomy or sternotomy for debridement of necrotic tissue and mediastinal or pleural drainage. Result: Five cases were evolved well and were discharged after a mean of 42 days. Two patients(28.6%) died. Three patients required reoperation due to local surgical complication; empyema(two) and impending cardiac tamponade. One of these patients died on 12 post-reoperative day due to great vessel erosion, renal and respiratory insufficiency. The other patient died of broncho- esophageal fistula and asphyxia on 10 postoperative day without reoperation. Conclusion: On the basis of experience accrued in treating these patients, early diagnosis by cervicothoracic computed tomographic scan of neck and thorax aids in rapid indication of a surgical approach of DNM. We emphasize that performing early surgical drainage and debridement of necrotic tissues with intensive postoperative care can significantly reduce the mortality rate.

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A Study on the Comparison of Learning Performance in Capsule Endoscopy by Generating of PSR-Weigted Image (폴립 가중치 영상 생성을 통한 캡슐내시경 영상의 학습 성능 비교 연구)

  • Lim, Changnam;Park, Ye-Seul;Lee, Jung-Won
    • KIPS Transactions on Software and Data Engineering
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    • v.8 no.6
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    • pp.251-256
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    • 2019
  • A capsule endoscopy is a medical device that can capture an entire digestive organ from the esophagus to the anus at one time. It produces a vast amount of images consisted of about 8~12 hours in length and more than 50,000 frames on a single examination. However, since the analysis of endoscopic images is performed manually by a medical imaging specialist, the automation requirements of the analysis are increasing to assist diagnosis of the disease in the image. Among them, this study focused on automatic detection of polyp images. A polyp is a protruding lesion that can be found in the gastrointestinal tract. In this paper, we propose a weighted-image generation method to enhance the polyp image learning by multi-scale analysis. It is a way to extract the suspicious region of the polyp through the multi-scale analysis and combine it with the original image to generate a weighted image, that can enhance the polyp image learning. We experimented with SVM and RF which is one of the machine learning methods for 452 pieces of collected data. The F1-score of detecting the polyp with only original images was 89.3%, but when combined with the weighted images generated by the proposed method, the F1-score was improved to about 93.1%.

A Study of the Reliability and Validity of Standard Tools for the Pattern Identification of Gastroesophageal Reflux Disease (위식도역류질환 변증도구의 신뢰도 및 타당도 평가)

  • Cho, Yun-jae;Ha, Na-Yeon;Ko, Seok-Jae;Park, Jae-Woo;Kim, Jinsung
    • The Journal of Internal Korean Medicine
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    • v.43 no.1
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    • pp.1-21
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    • 2022
  • Purpose: The standard tool for the pattern identification is used for identifying patterns in patients using a questionnaire. The purpose of this study is to reorganize the standard tool for the pattern identification of gastroesophageal reflux disease (GERD) developed in 2017 and to analyze the reliability and validity of the standard tool for pattern identification by applying it to GERD patients. Methods: To reorganize the standard tool for the pattern identification of GERD developed in the previous study, we searched the literature in the main databases, OASIS (Oriental Medicine Advanced Searching Integrated System) and CNKI (China National Knowledge Infrastructure). We added the search results to the data used in the previous study and went through the reorganizing courses, such as evaluating the validity of the translation, the Delphi technique, and a small survey. After reorganization, the patients who visited the Kyunghee University Korean Medicine Center for GERD symptoms were provided the questionnaire, including the reorganized standard tool for pattern identification. We analyzed the survey results to evaluate their reliability and validity. Results: Fifty patients completed the questionnaire. Reliability analysis results showed a pattern identification match rate of 86%, Cronbach's α coefficient of 0.834, and intraclass correlation coefficient of 0.907. The Mann - Whitney U test and logistic regression were implemented to check the relations between the survey questions and pattern identification results; the Pearson correlation, compared with other scales, showed a moderate score. Conclusion: We reorganized the standard tool for the pattern identification of GERD to be updated on current issues and so that it is easily used. The analysis results of the questionnaire showed that the reorganized standard tool had high reliability and moderate validity.

Comparison of Reconstructive Techniques after Total Gastrectomy as Determined by Patient Quality of Life and Nutritional Status (위전절제술 후 재건술식에 따른 환자의 영양상태와 삶의 질 비교)

  • Seo, Kyeong-Soo;Lee, Jong-Myeong;Kim, Woo-Yeong
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.219-227
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    • 2007
  • Purpose: Many reconstruction procedures have been developed in order to resolve patient complaints after a total gastrectomy. However, until now, there has been no general agreement with regard to the ideal reconstruction to perform after a total gastrectomy. Moreover, there have been few reports of the long-term effects of different reconstruction procedures. In this study, we compared the long-term nutritional status and quality of life for patients that received either a Roux-en-Y esophagojejunostomy (R-Y), jejunal interposition (JI), jejunal pouch interposition (JPI), or double tract reconstruction (DT), to determine the optimum reconstruction procedure after a total gastrectomy. Materials and Methods: The study consisted of 41 patients younger than 80 years who had undergone a total gastrectomy with curative resection and who had no evidence of recurrence at our hospital between August 2000 and January 2004. The patients were classified into the following four groups, according to the type of reconstruction; simple Roux-en-Y (R-Y group, n=15), jejunal interposition (JI; group, n=8), j Jejunal pouch interposition (JPI group, n=8), double tract interposition (DT group, n=10). The nutritional status was assessed by measuring body weight, serum albumin level, serum hemoglobin level, and the level of serum total protein, and the PNI (Prognostic nutritional index). Quality of life was assessed by GSRS. In addition, endoscopy was performed to confirm the presence of reflux esophagitis. Results: The laboratory findings showed no significant differences between the four groups except for a lower total protein and album level in the DT group after 3 years postoperatively (P=0.006, P=0.033). The percentage of body weight at 1 year, and 3 years postoperatively in the JI group (P=0.013, P=0.011) were significantly less than other groups (P=0.011, P=0.000). The frequency of postoperative symptoms and reflux esophagitis and eating capacity showed no significant differences between the four groups. The GSRS score in the JIP group was significantly better than for the other groups at 1 year, and 3 years postoperatively (P=0.028, P=0.003). Conclusion: We believe that the jejunal pouch interposition is the most useful of the four procedures for improving postoperative quality of life.

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Short-term Results of Endobronchial Brachytherapy for Malignant Airway Obstructions (악성 기도 폐쇄에 대한 기관내 근접 조사 방사선치료의 단기 임상 경험)

  • Ahn Yong Chan;Lim Do Hoon;Choi Dong Rak;Kim Moon Kyung;Kim Dae Yong;Huh Seung Jae;Kim Ho Joong;Chung Man Pyo;Kwon O Jung;Rhee Chong Heon
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.299-306
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    • 1996
  • Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

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