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A case of diffuse alveolar hemorrhage after tonsillectomy -A case report-
김진평,박정제,김남주,우승훈 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.63 No.2
Diffuse alveolar hemorrhage (DAH) is an acute, life-threatening event. The blood-gas barrier must be very thin to allow gas exchange and is therefore subjected to high mechanical stresses when the capillary pressure rises. In general anesthesia, inhaled gases cause high mechanical stresses, and thus DAH occurs under certain conditions. We describe a case of inferred postoperative DAH. A 25-year-old man had an acute episode after undergoing a tonsillectomy for snoring. During surgery, no problems occurred and no marked bleeding was observed. After removal of the endotracheal tube, however, the patient had severe cough and hemoptysis. The patient was treated with an antihemorrhagic agent and antibiotics. He recovered after 1 week. Chronic snoring likely caused the alveolar damage in this patient and intubation led to DAH. The patient presented with a benign course that regressed spontaneously with medical intervention.
Multi-Sensor Signal based Situation Recognition with Bayesian Networks
김진평,장규진,정재영,김문현 대한전기학회 2014 Journal of Electrical Engineering & Technology Vol.9 No.3
In this paper, we propose an intelligent situation recognition model by collecting andanalyzing multiple sensor signals. Multiple sensor signals are collected for fixed time window. Atraining set of collected sensor data for each situation is provided to K2-learning algorithm to generateBayesian networks representing causal relationship between sensors for the situation. Statisticalcharacteristics of sensor values and topological characteristics of generated graphs are learned for eachsituation. A neural network is designed to classify the current situation based on the extracted featuresfrom collected multiple sensor values. The proposed method is implemented and tested with UCImachine learning repository data.
김진평,박정제,손희영,김록범,김호엽,우승훈 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.3
Purpose: Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. Materials and Methods: We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. Results: 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin,Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. Conclusion: We found that i-PTH was a predictor of hypocalcemia,and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy.
Carcinoma Showing Thymus-Like Differentiation (CASTLE)치험 1예
김진평,성병기,안성기,이정희 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.5
Carcinoma showing tymus-like diferentiation (CASTLE)and surounding soft tisue, or soft tissue of the neck. It originates from ectopic thymus or branchial pouch remnants. The histolo-gic finding shows that the tumor is divided into lobules of variable size and shape, cord with thin and thick fibrous septa, which are infiltrated by lymphocytes and plasma cells. Tumor cells consist of large vesicular nuclei, prominent nucleoli, and abundant cyto-lymphoepithelioma of thymus. We report a case of CASTLE that we treated by surgery and radiation therapy.
김진평,Roza Khalmuratova,전시영,박정제,허동구,안성기,우승훈,강기문,채규영 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.1
Purpose: Radiotherapy for head and neck cancer does not impair the voice quality as much as laser treatment or surgery, but it can induce muscle wasting and fibrosis and symptoms of dry mouth. We investigated the effect of irradiation on the myosin heavy chain (MyHC) expression in laryngeal muscles. Materials and Methods: Rats were irradiated with one dose of 10, 15, 20, 25, 30, or 35 Gy and other rats were irradiated with 20 Gy. The thyroarytenoid (TA), posterior cricoarytenoid (PCA), and cricothyroid (CT) muscles were subjected to reverse transcription-polymerase chain reaction (RT-PCR). Results: Two weeks after irradiation with 10, 15, or 20 Gy, all the MyHC type expressions had decreased in a dose-dependent manner in the TA, PCA, and CT muscles, and especially the expression of MyHC IIa decreased much more than the expressions of the other MyHC isoforms in all muscles. In the 20 Gy-irradiated rats, almost all the MyHC isoform expressions declined over 12 weeks in the TA, PCA, and CT muscles, except for the MyHC I expression in the PCA and CT muscle. The MyHC IIa expression was markedly decreased in all the muscles. Conclusion: The laryngeal muscles responded differently to radiation, but they showed a time-dependent and long-lasting decrease in the expressions of all the MyHC isoforms in the TA, PCA, and CT muscles. In particular,the expression of the MyHC IIa isoform in all the muscles may be more sensitive to irradiation than the expressions of the other MyHC isoforms.