• Title/Summary/Keyword: Aspiration Level

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A Case Report of Injection Laryngoplasty Who have Difficulty in Neck Extension Using, an I-Gel Laryngeal Mask Airway (경부 신전이 불가한 성대 마비 환자에서 I-Gel$^{TM}$ 후두마스크를 이용한 전신 마취하 성대주입술 증례)

  • Jo, Kwang-Hee;Jung, Chan-Min;Jang, Chul-Ho;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.96-98
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    • 2014
  • Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

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General Anesthesia and Endoscopic Upper Gastrointestinal Tumor Resection (전신 마취와 내시경적 상부위장관 종양절제술)

  • Seung Hyun Kim
    • Journal of Digestive Cancer Research
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    • v.11 no.3
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    • pp.125-129
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    • 2023
  • Appropriate sedation and analgesia are crucial for successful endoscopic procedures, patient safety, and satisfaction. Endoscopic resection for upper gastrointestinal tumors requires a deep sedation level because the procedure is lengthy and induces moderate to severe pain. Continuous patient consciousness assessment and vigilant vital signs monitoring are required for deep sedation. General anesthesia may unintentionally occur even during deep sedation for endoscopic tumor resection, which may cause unexpected complications, especially in high-risk patients. Previous studies have revealed that general anesthesia increases the en bloc resection rate and decreases the procedure time. Complications, such as perforation, aspiration pneumonia, and cardiopulmonary instability, including hypoxemia, hypotension, and arrhythmia, occurred more frequently in patients with sedation compared to those with general anesthesia. Therefore, general anesthesia demonstrated potential benefits in endoscopic treatment results and patient safety. General anesthesia should be considered a useful alternative for sedation in patients undergoing endoscopic gastrointestinal tumor resection. However, more high-quality prospective studies are required to determine the safety and effectiveness of general anesthesia in endoscopic upper gastrointestinal tumor resection because most studies comparing general anesthesia and sedation in these procedures have been retrospectively conducted and the results were inconsistent.

Risk Factors Associated with Poor Outcomes in Patients with Brain Abscesses

  • Ko, Seok-Jin;Park, Kyung-Jae;Park, Dong-Hyuk;Kang, Shin-Hyuk;Park, Jung-Yul;Chung, Yong-Gu
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.34-41
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    • 2014
  • Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

How Different are Learner Speech and Loanword Phonology?

  • Kim, Jong-Mi
    • Phonetics and Speech Sciences
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    • v.1 no.3
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    • pp.3-18
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    • 2009
  • Do loanword properties emerge in the acquisition of a foreign language and if so, how? Classic studies in adult language learning assumed loanword properties that range from near-ceiling to near-chance level of appearance depending on speech proficiency. The present research argues that such variations reflect different phonological types, rather than speech proficiency. To investigate the difference between learner speech and loanword phonology, the current research analyzes the speech data from five different proficiency levels of 92 Korean speakers who read 19 pairs of English words and sentences that contained loanwords. The experimental method is primarily an acoustical one, by which the phonological cause in the loanwords (e.g., the insertion of [$\Box$] at the end of the word stamp) would be attested to appear in learner speech, in comparison with native speech from 11 English speakers and 11 Korean speakers. The data investigated for the research are of segment deletion, insertion, substitution, and alternation in both learner speech and the native speech. The results indicate that learner speech does not present the loanword properties in many cases, but depends on the types of phonological causes. The relatively easy acquisition of target pronunciation is evidenced in the cases of segment deletion, insertion, substitution, and alternation, except when the loanword property involves the successful command of the target phonology such as the de-aspiration of [p] in apple. Such a case of difficult learning draws a sharp distinction from the cases of easy learning in the development of learner speech, particularly beyond the intermediate level of proficiency. Overall, learner speech departs from loanword phonology and develops toward the native speech value, depending on phonological contrasts in the native and foreign languages.

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Massive Hemorrhage after Pleuropneumonectomy in a Patient of Tuberculous Empyema and Bronchopleural Fistula with Hemoptysis - Report of One Case - (각혈을 동반한 결핵성 농흉 및 기관지늑막루의 환자에서 늑막 및 전폐절제술후 다량의 출혈환자의 치험 1례)

  • 지행옥
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.839-844
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    • 1989
  • There appears to be significant problems remained in the treatment of tuberculous empyema with BPF in spite of several surgical methods: decortication, thoracoplasty, and pleuropneumonectomy. We presented one case of tuberculous empyema with BPF. The patient was 42-year-old male and his chief complaint was hemoptysis. In past history, he was treated with left closed thoracostomy and antituberculous medication for two months, 16 years ago. Chest X-ray, tomogram and C. T, revealed a huge mass with central necrosis in the lower 2/3 of left thoracic cavity and shifting of the mediastinal structure to the right. Needle aspiration cytology was undifferentiated large cell carcinoma. Left thoracotomy was made under the impression of lung cancer and pleuropneumonectomy was done. Operative findings; thick walled empyema sac filled with hematoma and BPF, the mediastinum was fixated due to fibrosis and calcification of the pleura and the mediastinum. Postoperative biopsy was consistent with tuberculosis. In the postoperative course, there was massive hemorrhage and so reoperation was done. But there was no active bleeding focuses in the thoracic cavity at the time of reoperation. Massive transfusion, coagulant therapy and intermittent clamping and declamping of the chest tube were carried out. Especially, serum calcium level was chronically decreased and so large amount of calcium gluconate was infused for the calcium level to be normal. Total transfused blood; whole blood was 33 pints, packed cell was 63 pints and fresh frozen plasma was 70 pints. At the postoperative[reop] 45th day, intrathoracic hemorrhage was stopped and the chest tube was removed. In conclusion, this suggest that uncontrollable bleeding after pleuropneumonectomy of the tuberculous empyema with BPF could be treated without reoperation in case of the mediastinal fixation due to fibrosis and calcification of the pleura and the mediastinum.

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Study on the Development of Test for Indicators of Positive Experiences about Science (과학긍정경험 지표 검사를 위한 도구 개발 연구)

  • Shin, Youngjoon;Kwak, Youngsun;Kim, Heekyong;Lee, Soo-Young;Lee, Sunghee;Kang, Hunsik
    • Journal of The Korean Association For Science Education
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    • v.37 no.2
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    • pp.335-346
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    • 2017
  • In this study, we developed and examined the validity and reliability of the Test for Indicators of Positive Experiences about Science (TIPES) that measures students' positive experiences about science. We have developed TIPES through literature reviews, development of the preliminary version of TIPES, a pilot test and revisions of the preliminary version, and the test of the final version. Through literature reviews and Delpi methods, we developed the preliminary version of TIPES, which consists of five categories such as science academic emotion, science-related self-concept, science learning motivation, science-related career aspiration, and science-related attitude. Using the preliminary version, we conducted a pilot test with 198 students consisting of 4th, 6th, 8th, and 10th graders, and modified the first version based on the results from the pilot test and expert meetings. We then conducted a main test with the revised version of TIPES with 1,841 students consisting of 4th, 6th, 8th, and 10th graders. According to a confirmatory factor analysis, a reliability test and descriptive statistics analyses, TIPES found to have a good validity as well as reliability. In addition, there are statistically significant differences in the norm distribution and scores of TIPES by student's grade, gender, school location, and level of participation in science-related activities. Discussed in the conclusion are the implications of this research for science education research and science teaching and learning practices in the school.

The Significance of Gonadotropin Ratio in In Vitro Fertilization of Human Oocytes (성선 자극호르몬의 비율이 인간난자의 체외수정에 미치는 영향에 관한 연구)

  • Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.2
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    • pp.135-147
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    • 1988
  • To compare the stimulation effect of the ratio in follicle stimulating hormone and luteinizing hormone in induction of multiple follicular growth, the serum $E_2$ level, the diameter of follicle, number of aspirated follicles and cleavage rate of in vitro fertilized preovulatory oocytes as well as the pregnancy rate were evaluated. Forty one patients with irreparable tubal disease were stimulated by hMG(n=24) or FSH/hMG(n=17) for the purpose of in vitro fertilization and embryo transfer. The following results were obtained. 1. Serum estradiol($E_2$) levels on the day of hCG administration were $921.0{\pm}353.3\;pg/ml$ in hMG group and $1272.9{\pm}1060.6\;pg/ml$ in FSH/hMG group. The serum $E_2$ value of hMG group was significantly lower than that of FSH/hMG group. 2. The diameter of leading follicle by ultrasonogram on the day of hCG administration were $16.2{\pm}2.0\;mm$ in hMG group and $16.2{\pm}2.6\;mm$ in FSH/hMG group. No significant difference of follicle diameter between two groups was demonstrated. 3. The number of follicles with diameter above 10 mm by sonogram on the day of hCG injection were $3.91{\pm}2.32$ in hMG group and $6.52{\pm}3.86$ in FSH/hMG group. There was significant difference of number of follicles between two groups, (p< 0.01). 4. The number of oocytes found per patient at aspiration were $2.59{\pm}1.00$ in hMG group and 3. $76{\pm}2.31$ in FSH/hMG group. There was significant difference of number of aspirated oocytes between two groups. (p< 0.05). 5. The detection rate of preovulatory oocyte at aspiration were 68.4%(39/57) in hMG group (n=22) and 77.6%(38/49) in FSH/hMG group (n=13). 6. The cleavage rate of preovulatory oocyte at 44 hours after insemination were 74.4%(29/39) in hMG group(n=22) and 81.6%(31/38) in FSH/hMG group (n=13). When only hMG was used, one pregnancy was established in 15 patients to whom 29 zygotes were transferred. And a full term normal female baby was delivered by elective cesarean section. In the FSH/hMG group, five pregnancies out of 9 transferred patients were confirmed by serum ${\beta}-hCG$. Two pregnancies were spontaneously aborted before the 6th week of pregnancy. One patient aborted her baby at the 18th week of pregnancy because of incompetent internal os of the cervix. Two patients delivered two full term babies by elective cesarean section. From the above findings, paralell with the increase in the ratio of exogenous follicle stimulating hormone to luteinizing hormone, an increase in oocyte recovery was observed as well as an improvements in pregnancy rate. It was concluded that FSH enrichment early in the follicular phase had a beneficial effect in the controlled ovarian hyperstimulation.

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Attenuation of Renal Ischemia-Reperfusion Injury by Antioxidant Vitamins in Pigs (돼지의 신장에서 Antioxidant Vitamins에 의한 허혈 및 재관류 손상의 감소에 관한 연구)

  • Kim, Myung-Jin;Lee, Soo-Jin;Park, Chang-Sik;Son, Hwa-Young;Jun, Moo-Hyung;Jeong, Seong-Mok;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.94-98
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    • 2007
  • This study was to investigate the effects of ascorbic acid and alpha-tocopherol on the attenuation of renal ischemia-reperfusion (IR) injury in pigs. Ten pigs were subjected to 60 minutes of warm unilateral renal ischemia followed by removal of contralateral kidney and then divided into two groups. Treatment group was performed ascorbic acid and alpha-tocopherol pretreatment 2 days before operation and ascorbic acid with heparin-saline solution irrigation-aspiration. Otherwise, control group used only irrigation-aspiration of heparin-saline solution. Blood samples were collected from these pigs for measurement of serum blood urea nitrogen (BUN) and creatinine values, antioxidant superoxide dismutase (SOD) at pre, day 1, day 3, day 7 and day 14. The kidneys were taken for histopathologic evaluation after euthanasia on postoperative day 14. The levels of BUN were significantly increased in the control group on day 1, day 3 and day 7 (P<0.05). And the level of creatinine was significantly increased in the control group on day 3 (p<0.05). Activity of antioxidant enzymes in plasma revealed significant difference (p<0.05) between control and treatment group at day 14. In histopathologic findings, treatment group was showed less damage than that of control group on the basis of renal tubular damage. It was concluded that ascorbic acid and alpha-tocopherol attenuated renal I/R injury in the pigs.

Effects of Swallowing Training with Biofeedback on Swallowing Function and Satisfaction in Acute Stroke Patients with Dysphagia (생체되먹임을 통한 삼킴훈련이 삼킴장애가 있는 급성기 뇌졸중 환자의 삼킴기능과 만족감에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Gyu-Yong;Won, Young-Sik
    • The Journal of the Korea Contents Association
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    • v.17 no.4
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    • pp.63-71
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    • 2017
  • The purpose of current investigation was identified to the effects of swallowing training with surface electromyography biofeedback on swallowing function and dietary level, satisfaction in acute stroke patients with dysphagia. Sixteen acute stroke patients with dysphagia was participated in our study. All stroke paitents were allocated in randomly to experiemental group(n=8) and control group(n=8). Both group received traditional dysphagia therapy during 30min/day, five per week, for four weeks. experimental group was perfomed swallowing training with surface electromyography biofeedback, additionally 30 min/day, and control group received only swallowing training, additionally 30 min/day. Assessments evaluated Functional Dysphagia Scale(FDS) and Penetration-Aspiration Scale(PAS) for measure of swallowing function, and Functional Oral Intake Scale(FOIS) assessed for measure of dietary level. satisfaction assessed by using Visual Analog Satisfaction Scale(VASS). In results, after intervention both group improved significant on swallowing function, and dietary level, compared to before intervention(p<0.05). After intervention, satisfaction of both group was not significant difference(p>0.05). In comparison of change score between two group, experimental group improved significantly than control group in dietary level(p<0.05). Swallowing training with surface electromyography biofeedback may be a effective dysphagia therapy to improve on dietary level in acute stroke patients with dysphagia.

Indication of Bone Marrow Aspiration in Acute Idiopathic Thrombocytopenic Purpura in Children (소아 급성 특발성 혈소판 감소성 자반증에서 골수흡인 검사의 적응)

  • Kim, Won-Duck;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.239-245
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    • 2001
  • Background: Acute idiopathic thrombocytopenic purpura(ITF) is one of the common hematologic disorders in children. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITF. Materials and Methods: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WEC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of $50{\times}l0^9/L$ or lower was the cutoff level. Results: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. Conclusion: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.

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