Our nation have several procedures and law for national airspace management, however those procedures and law not enough to manage airspace. Therefore, I have studied this paper for improving flight safety and for providing economics flight of civcil aircraft and military aircraft, also, for increasing efficiency of airspace through systematic airspace management, additionally, for improving nation defense ability and for preventation our nation damage when occuring airspace problem. Nowaday. in using airspace. two theory which freely use theory and use theory under jurisdiction is opposed by every nation in worldwide. Consequently. we can realize every nation endeavour to increase their jurisdiction airspace. However. our nation is not still prepared to cope with other nation when occuring airspace trouble. because airspace definition is not prescribed on our aviation law. Therefore. several problems which are improved in our airspace management are presented on this paper. The presented matters are as follows. First, The airspace definition is not prescribed on aviation law and responsibility limit of airspace management is ambugious. Second. problem on structure of approach control area and special airspace, Third. problem on airway system. Fourth. civil agency and military agency apply respectively different regulation in establishment of aircraft flight route, To grasp these problems, considered the airspace conception, airspace classfication. legal character of airspace. our nation airspace state and management together with other nation airspace state and management. also compared our nation airspace management with other nation airspace management. And. improvement methods to solve problems which was appeared by comparing and analysis are presented on this paper.
Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. But occasionally, severe morbidity and death may result. Reexpansion pulmonary edema occurs when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. In the treatment of the chronically collapsed lung, physicians must remember the possible events and prevent the complications. When the difference in airway resistance or lung compliance between the two lungs is exaggerated, conventional mechanical ventilation might lead to preferential ventilation with hyperexpansion of one lung and gradual collapse of the other. Differential ventilation has been advocated to avert this problem. By differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in two patients. Therefore we suggest that differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.
Jang, Hwan Hee;Kim, Mi Ju;Cho, Su Yeon;Kim, Jung Bong;Lee, Sung Hyeon;Lee, Young Min
Journal of the East Asian Society of Dietary Life
/
v.25
no.5
/
pp.813-821
/
2015
Asthma is an increasing global health problem, and novel strategies to prevent or ameliorate the condition are needed. The purpose of the present study was to evaluate the anti-inflammatory and anti-asthma effects of Adenophora triphylla var. japonica extracts. We investigated the molecular mechanism underlying the effects of 80% ethanol extracts (AE) of A. triphylla on lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. AE treatment inhibited pro-inflammatory cytokines such as TNF-${\alpha}$ and IL-6 as well as nitric oxide (NO) production in LPS-stimulated RAW 264.7 cells. In particular, NO and pro-inflammatory cytokine production was suppressed more effectively by aerial parts (AE-A) than roots (AE-R) of A. triphylla. Quantitative RT-PCR assay showed that AE reduced mRNA levels of iNOS and COX-2. We also evaluated the anti-asthmatic effects of AE-A in an ovalbumin (OVA)-induced BALB/c mouse model. AE-A supplementation significantly reduced the amounts of airway eosinophils, IL-4 and IL-13 levels in BALF, and IgE levels in serum as compared with untreated, OVA-induced mice. These results suggest that AE-A can be considered as a therapeutic agent to potentially relieve asthma.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.6
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pp.431-436
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2009
There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.
Background and Objectives : The treatment of supraglottic stenosis remains a challenging problem in the field of otolaryngology due to its association with dyspnea, dysphagia, and frequent recurrence. Any satisfactory treatment is not yet known. The author experienced six cases of supraglottic stenosis and report the successful treatment of five cases by repeated endoscopic laryngeal excision with KTP-532 laser under suspension layngoscopy. Materials and Methods : Six adults who were treated for supraglottic stenosis between March 1994 and December 1998 at the Department of Otoloaryngology-Head and Neck Surgery, Korea University Medical Center were studied retrospectively. The patients were placed under general anesthesia followed by endoscopic laryngeal excision with KTP-532 laser under supension laryngoscopy. The scar tissue and granulation tissue were visualized with an operating microscope, and then removed using KTP-532 laser (15watts, continuous mode). Intraoperative local steroid(Triamcinolone ) was injected in all cases after the stenotic portions were removed. Results : Endoscopic excision was performed in five cases ; among the five cases, cricoid cartilage was concomitantly removed in two cases, and epiglottis was removed in one case. Satisfactory swallowing and airway respiration were possible in all five patients who underwent endoscopic widening. Conclusion : The treatment of supraglottic stenosis is different from that of tracheal or glottic stenosis in that supraglottic stenosis is mainly developed in membraneous form. Repeated laser excision and local steroid injection under suspension laryngoscopy is an effective and recommend able method for the treatment of supraglottic stenosis.
Pierre Robin sequence (PRS) describes the clinical triad of micro- and/or retrognathia, glossoptosis and cleft soft palate. Glossopexy has been demonstrated to be an effective treatment in selected cases of obstruction caused by glossoptosis (generally 6 to 10 months of glossopexy period). If radiofrequency therapy (RF) can reduce tongue volume in PRS, it will be helpful in early releasing of the glossopexy. Two-dayold patient showed a PRS triad. Intermittent cyanosis, respiratory difficulty and feeding problems were also observed. The respiration was not improved and prolonged intubation increased the possibility of respiratory complications like pneumonia. The surgical intervention- glossopexy and RF was done 20 days after birth. We applied RF combined with conventional glossopexy and could get successful results while reducing the overall treatment time to 6 weeks. The follow-up until 12 months after birth was uneventful. Considering that early recovery is highly beneficial to PRS patients by reducing risks associated with glossopexy and low energy RF application is very simple and low risk to patient, our combination therapy should be considered for the treatment of airway problem related to PRS.
Journal of The Korean Dental Society of Anesthesiology
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v.2
no.2
s.3
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pp.101-106
/
2002
Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.
Allergic asthma is a worldwide public health problem and a major socioeconomic burden disease. It is a chronic inflammatory disease marked by airway eosinophilia and goblet cell hyperplasia with mucus hypersecretion. Mouse models have proven as a valuable tool for studying human asthma. In the present report we describe a comparison of mouse asthma models. The experiments were designed as follows: Group I was injected with ovalbumin (OVA, i.p.) on day 1 and challenged with 1% OVA (aerosol exposure) on days $14{\sim}21$. Group II was injected on day 1, 14 and aerosol-immunized on days $14{\sim}21$. Group III was injected on day 1, 14 and immunized by 1% OVA aerosol on days $18{\sim}21$. We assessed asthma induction by determining the total number of white blood cells (WBC) and eosinophils as well as by measuring cytokine levels in bronchoalveolar lavage fluid (BALF). In addition, we evaluated the histopathological changes of the lungs and determined the concentration of immunoglobulin E (IgE) in serum. Total WBC, eosinophils, Th2 cytokines (IL-4, IL-13) and IgE were significantly increased in group I relative to the other groups. Moreover, histopathological studies show that group I mice show an increase in the infiltration of inflammatory cell-in peribronchial and perivascular areas as well as an overall increase in the number of mucus-containing goblet cells relative to other groups. These data suggest that group I can be a useful model for the study of human asthma pathobiology and the evaluation of existing and novel therapeutic agents.
Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.
Backgrounds & Methods : Asthma is considered to be chronic inflammatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia. Recently, there has been many researches about asthma. IBS(Irritable Bowel Syndrome), PUD(peptic Ulcer disease) and GERD(gastroesophageal reflux disease) are the most common diseases of the gastrointestinal tract. Recent studies suggest that IBS, PUD and GERD are associated with bronchial hyper-responsiveness and bronchial asthma might be more prevalent in IBS and GERD patients than in control subjects. In addition, there are many comments about the interrelationship between the gastrointestinal problem and asthma in the oriental medical books. Actually, many oriental medical doctors don$^{\circ}$Øt consider the gastrointestinal condition when they deal with the asthmatic patients these days. So, we assessed the prevalence of gastrointestinal symptoms and histories in a cohort of patients with asthmatic symptoms. We evaluated 128 outpatients with asthmatic symptoms(60 males and 68 females, aged 13-75). All subjects enrolled completed the GSRS(Gastrointestinal Symptom Rating Scale). GSRS is an interview based rating scale consisting of 15 items for assessment of gastrointestinal symptoms in IBS and PUD developed by Jan Svedlund. Results : The limit of total score of GSRS in asthmatic patients is zero to 30. The number of patients with no GI symptoms is 66(51.5%). The number of patients with GSRS>5 is 62(48.4%), GSRS>10 is 24(18.8%), GSRS>15 is 8(6.25%). The number of patients with history of gastritis is 54(42.2%), gastric ulcer is 13(10.2%), gastroptosis is 8(6.25%), IBS is 6(4.68%), others is 6(4.68%). Conclusions : This study suggests that patients with bronchial asthma have an significant prevalence of gastrointestinal symptoms. Additional studies are needed to find the mechanism of the association between gastrointestinal symptoms and asthma.
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