• 대한후두음성언어의학회지
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• 제19권2호
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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.

• 대한치과마취과학회지
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• 제12권1호
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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.

• 유기물자원화
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• 제11권4호
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• pp.57-65
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• 2003

축산업은 수질이나 토양오염 그리고 대기오염에 미칠 수 있는 영향으로 인해 관심의 대상이 되는 산업에 포함되어 있다. 가축분뇨가 환경오염원이 될 수 있는 것은 사실이다. 이러한 가축분뇨를 처리할 수 있는 최상의 방법은 가축분뇨를 적절한 방법으로 퇴비화 하여 유기성 비료로서 재활용하는 것이다. 따라서 본 연구는 몇가지 방법의 퇴비화 조건에서 가축분뇨의 퇴비화 특성을 조사하기 위하여 실시되었다. 각기 다른 정도의 공기를 함유하는 퇴비단들의 물리화학적 특성을 퇴비화 전기간에 걸쳐 조사하였다. 본 실험에서는 돼지분뇨를 톱밥과 혼합하여 110L 크기를 가진 실험실 규모의 플라스틱 재질의 용기들과 목재로 된 $1.5m^3$ 크기의 소형 사각용기에 충진한 후 60일 동안의 퇴비화를 수행하였다. 시험 전 기간 동안 공기펌프로 퇴비단에 공기를 공급하였고 주입 공기량은 유입부에 설치된 밸브로 조절하였다. 공기주입량은 각 용기들에 따라 20, 50, 100, 150, $200L/m^3/mim$ 수준으로 하였다. 퇴비화 기간 동안 발효 최고 온도는 $72^{\circ}C$까지 상승하였다. 퇴비화 20일째에 송풍 처리구의 퇴비단 표면에서 포집된 가스에서의 $H_2S$, $CH_3SH$, DMS 그리고 DMDS 농도는 29, 16, 6, 5ppb 이었고 무송풍구에서의 농도는 각각 32, 24, 15, 14ppb의 수준을 나타냈다.

• Tuberculosis and Respiratory Diseases
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• 제84권4호
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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.

• Tuberculosis and Respiratory Diseases
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• 제79권1호
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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.

• 한국축산시설환경학회지
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• 제18권3호
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• pp.207-220
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• 2012

본 연구에서 고형침전물이 누적되어 쌓이는 것을 효과적으로 부유시키고 혼합하여 미세한 공기방울이 액비에 접촉함으로서 발효촉진을 도모하고자 폭기식 2류체 제트노즐 설계조건 구명시험을 실시하여 1차 노즐과 2차 노즐 구경비 설정 및 1차 노즐에서의 액체의 적정 유속을 설정하고, CFD 이용 유동해석에 의한 노즐 분사구 위치를 설정하였다. 이 결과를 토대로 가축분뇨 액비저장조 침전물 교반장치를 제작하여 농가에 많이 보급되고 있는 200 ton 규모의 액비저장조에 설치하여 침전물 교반 성능을 평가한 결과는 다음과 같다. 1. 침전물 교반기의 설계조건 구명을 위해 2류체 노즐을 공시하여 시험한 결과 1차 노즐과 2차 노즐의 구경비를 1:2로 한 상태에서 1차 노즐의 유속을 12.3 m/s 이상으로 하여야 기체 기포의 미세화가 가능한 것으로 판단되었다. 2. 컴퓨터유동해석을 한 결과 노즐의 설치간격을 같게 하는 것이 노즐당 담당부피를 같게 설치하는 것보다 효율적인 것으로 분석되었다. 3. 설계요인 시험과 유동해석을 토대로 4개의 노즐이 일자형 관에 설치된 침전물교반 장치를 제작 200톤 저장조에 설치 가동시험을 실시하였다. 먼저, 전체 평균 TS와 VS가 각각 23.4 g/L, 15.5 g/L인데 반하여, 교반 전 40 cm 이상 높이의 TS 및 VS가 평균 21.1 g/L, 13.3 g/L으로 교반기를 가동하지 않는 경우는 많은 고형물이 바닥에 가라앉아 있음을 알 수 있다. 또한, 가동 후 45분이 경과한 후에는 TS와 VS 모두 전체 평균과 동일한 값을 나타내고 있어 침전물들이 충분히 부유되어 혼합됨을 확인할 수 있다. 액체제트 분사교반 45 분후에 평균 23.5 g/L, 15.5 g/L로, 액체-기체 2류체 노즐 사용시 23.6 g/L, 14.9 g/L로 증가한 것은 교반 전에 바닥에 침전되어 있던 고형물들을 부유시켜 교반 혼합하는 것이 가능한 것으로 판단되었으며, 호기발효를 고려하지 않은 균일도 측면에서는 액체제트를 사용한 것이 보다 균일한 것으로 나타났다. 4. 침전물 교반기의 가동주기를 알아보기 위해 가축분뇨의 교반을 중지하였을 때 2시간 후에도 0.4 m 높이에서 TS 및 VS가 증가하고 있어 교반정지 간격을 2시간으로 주어도 교반기 운영에는 큰 지장이 없을 것으로 판단된다.