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Analysis of Clinical Feature and Management of Laryngeal Fracture: Recent 22 Case Review
김진평,우승훈,조상재,손희영,박정제 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.5
Purpose: Laryngeal fracture is rare, but complications are frequent and severe. Controversy still exists in regards to its proper management. The aim of this study was to present the clinical findings and management of laryngeal fracture in Korea. Materials and Methods: We analyzed the medical records of 22 patients with laryngeal fracture at a tertiary care trauma center from 2000 to 2010 retrospectively. Results: In total, 22 patients (19 men and 3 woman) presented with laryngeal fractures caused by blunt (n=13) or penetrating (n=9) injury. Pain (68.1%), odynophagia (68.1%), hoarseness (18.1%), hemoptysis (13.6%), and subcutaneous emphysema (9%) were the common presenting symptoms and noncomminuted fracture was common. High velocity blunt trauma (mostly traffic accidents) patients had more extensive injury and poor voice outcomes. Penetrating trauma patients due to physical assault or suicide attempt demonstrated more frequently injuries on the left side. Conclusion: In driver-caused traffic accidents, where injuries in a wide area within the larynx occurred, poor voice results were seen, and these injuries required aggressive treatment. When endotracheal intubation was performed at experienced emergency centers with fiberoptic laryngoscopes, airway management was safely achieved. In addition, if the fractured laryngeal framework was corrected at appropriate times, voice results were good.
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.
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.
IoT 기반 스마트 스테이션을 위한 철도 역사 내 위치추정 방법
김진평,안치형 한국철도학회 2020 한국철도학회논문집 Vol.23 No.10
본 논문에서는 향후 스마트스테이션 역사내 IoT (Internet of Things) 센서를 이용하여 특정 서비스 지역을 감지하는 위치 추정 방법을 제시하였다. IoT 센서로 사용된 BLE (Bluetooth Low Energy) 비콘의 수신신호강도 값으로부터 IoT 서비스의 시설에 따른 가상 영역을 분할하였다. 실제 지하철 역사 내에 구성된 여러 IoT 센서에서 수신 된 수신 신호강도 값들은 다층 퍼셉트론 알고리즘을 이용하여 할당 된 영역을 인식하게 된다. 제안 된 방법의 검증을 위해 실제 지하철 역사 환경에서 실험을 수행 하였다. 실제 지하철 역사 내 2 개의 분할 구역을 인식하기 위하여 10 개의 센서가 서로 다른 전송 전력 레벨로 사용되었다. 결과적으로 약 78.1%의 영역 인식 정확도를 확인 하였다. 제안된 서비스 영역 (Zone) 기반의 이용객 위치측위 방법이 향후 스마트스테이션에서 이용객 중심의 실시간 IoT 서비스 활성화에 기여할 것으로 기대된다.
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.