• 제목/요약/키워드: Airway evaluation

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하인두 내에 발생한 유경성 섬유지방종 1예 (Pedunculated Fibrolipoma of the Hypopharynx: A Case Report)

  • 어태성;신향애;기정혜;김지훈
    • 대한후두음성언어의학회지
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    • 제33권2호
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    • pp.115-118
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    • 2022
  • Fibrolipomas are a rare microscopic variant of lipomas, characterized by mature adipose tissue interspersed with dense fibrous connective tissue. These lesions are rarely observed in the head and neck region and represent <0.6% of all benign tumors of the larynx and hypopharynx. Their clinical presentation depends on the location and size of lesions. Patients present with variable symptoms; however, fibrolipomas of the larynx and hypopharynx are clinically important because these tumors can cause unpredictable airway obstruction, particularly during general anesthesia induction. We present a case of a hypopharyngeal fibrolipoma in a 61-year-old patient with frequent dyspnea, dysphagia, and muffled voice. Laryngoscopy revealed a well-demarcated pedunculated ovoid mass involving the larynx. We performed laryngomicrosurgery using a carbon dioxide laser for surgical excision and subsequent evaluation confirmed the diagnosis of fibrolipoma. We report a case of hypopharyngeal fibrolipoma, together with a literature review.

미세먼지 유도 천식의 한약유효성 평가연구 동향 Pubmed를 중심으로 (Trends in research on the efficacy of herbal medicines for particular matter-induced asthma focused on Pubmed)

  • 권보인
    • 대한한의학회지
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    • 제44권3호
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    • pp.163-169
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    • 2023
  • Objectives: This study aimed to review the experimental research trends in asthma caused by particulate matter to conduct further researches, especially in clinical trials. Methods: We searched for the meaningful literature using medicinal herb for asthma through the Pubmed databases. Results: Finally, six studies were finally selected. These studies showed recent trends, from 2018 to 2021 and conducted mostly in South Korea. The type of fine dust and the method of inducing asthma are different for each paper, but the effective mechanism is relatively common. It was commonly confirmed that the ratio and number of eosinophils, th2 cells and related cytokines are decreased in BALF and lung tissue by administration of medicinal herb. Conclusions: Although the method of inducing asthma using fine dust has not yet been standardized, it is thought that more meaningful evaluation results can be derived if a standardized animal model is established in the future. Nevertheless, based on the results that herbal medicine is effective for particular matter induced asthma, it is expected that it will be the basis for expanding into future clinical studies.

소아수면과다증과 수면무호흡 (Childhood Hypersomnia and Sleep Apnea Syndrome)

  • 손창호;정도언
    • 수면정신생리
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    • 제3권2호
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    • pp.65-76
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    • 1996
  • 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.

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A New Approach to Objective Evaluation of the Success of Nasal Septum Perforation

  • Ozturk, Sinan;Zor, Fatih;Ozturk, Serdar;Kartal, Ozgur;Alhan, Dogan;Isik, Selcuk
    • Archives of Plastic Surgery
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    • 제41권4호
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    • pp.403-406
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    • 2014
  • Background Perforations in the nasal septum (NSP) give rise not only to disintegration of the septum anatomy but also impairment in normal nasal physiology. The successes of these surgical techniques are usually equated to anatomical closure of the perforation. The goal of this study is to evaluate the subjective and objective results of our surgical technique for septal perforation surgery. Methods All NSPs in the six patients were closed by inferior turbinate flap. The Nasal Obstruction Symptom Evaluation (NOSE) instrument was used to evaluate the preoperative and postoperative subjective sensation of nasal obstruction. Measurement of preoperative and postoperative nasal airway resistance was performed using active anterior rhinomanometry which is an objective test. Wilcoxson signed rank test and Spearman correlation test were used to analyze correlation between NOSE scores and rhinomanometric measurements. Results The full closure of the septal perforations was noted in 100% of patients. The total NOSE score was 14 preoperatively and one postoperatively. The improvement in NOSE scores was statistically significant ($P{\leq}0.002$). The mean preoperative total resistance (ResT150) value was $0.13Pa/cm^3s^{-1}$, which is below the normal range ($0.16-0.31Pa/cm^3s^{-1}$), while the mean postoperative ResT150 value was $0.27Pa/cm^3s^{-1}$. The correlation between the improvement in NOSE scores and improvements in ResT150 values was statistically significant. Conclusions Surgical approaches should aim to solve both the anatomical and physiological problems of NSP. The application of subjective and objective tests in the postoperative period will help surgeons assess the applied techniques.

폴리에틸렌 미세플라스틱의 임신 마우스 위내 투여 및 기도 점적에 따른 신생자 간독성 평가 (Evaluation of Liver Toxicity of Neonates Following Intragastric Administration or Intratracheal Instillation of Polyethylene Microplatics to Pregnant Mice)

  • 김근우;김창열
    • 한국환경보건학회지
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    • 제48권2호
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    • pp.106-115
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    • 2022
  • Background: Current research suggests that humans are exposed to microplastics through consumption of foods and beverages, the airway route, and a variety of other means. Objectives: We evaluated oxidative stress and inflammation from polyethylene microplastics (PE-MPs) in the neonatal liver through intragastric administration or intratracheal instillation in pregnant mice. Methods: PE-MPs were administered from gestational day 9 to postnatal day 7. The intragastric administration group (0.01 mg/mouse/day or 0.1 mg/mouse/day) and intratracheal instillation group (6 ㎍/mouse/day or 60 ㎍/mouse/day) of PE-MPs were administered. After sacrifice, the oxidative stress and inflammation of the neonatal livers were measured. Results: As a result of the oxidative stress caused by PE-MPs in the neonatal livers, glutathione peroxidase decreased in a concentration-dependent manner in the intragastric administration group compared to the control group and intratracheal instillation decreased in high concentration PE-MPs. The catalase level increased at high concentrations of intragastric administration and intratracheal instillation. To confirm the level of inflammation caused by PE-MPs, monocyte chemoattractant protein-1 and tumor necrosis factoralpha were increased compared to the control group except for intratracheal intilation-high concentration PEMPs. The C-reactive protein level was decreased by intragastric administration compared to the control group and intratracheal instillation was increased compared to the control group. Conclusions: Despite the difficulty in comparing the toxic intensity between intragastric administration and intratracheal instillation of PE-MPs, our study revealed that oxidative stress and inflammation were induced in the neonatal liver. However, it is necessary to evaluate the toxic effects of microplastics on various organs as well. Overall, the present study indicates that the evaluation of toxic effects of long-term microplastic exposure, potential of microplastic toxicity on next-generation offspring and toxicity mechanism in human should be considered for further investigations.

Volumetric measurement of the tongue and oral cavity with cone-beam computed tomography: A systematic review

  • Kannitha Alina, Aflah;Winny, Yohana;Fahmi, Oscandar
    • Imaging Science in Dentistry
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    • 제52권4호
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    • pp.333-342
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    • 2022
  • Purpose: The goal of this systematic review was to compare the use of cone-beam computed tomography (CBCT) with that of computed tomography (CT) for volumetric evaluations of the tongue and oral cavity. Materials and Methods: A search for articles was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The PubMed, Scopus, ScienceDirect, and SAGE Journals databases were searched for articles published between 2011 and 2021. Articles were screened and assessed for eligibility. Screening involved checking for duplication, reading the title and abstract, and reading the full text. Results: The initial search retrieved 25,780 articles. Application of the eligibility criteria yielded 16 articles for qualitative analysis. Multiple uses of CBCT were identified. In several studies, researchers assessed the volumetric correlation between tongue and oral cavity volumes, as well as other parameters. Post-treatment volumetric evaluations of the oral cavity were also reported, and the reliability of CBCT was assessed. The use of CT resembled that of CBCT. Conclusion: CBCT has been used in the evaluation of tongue and oral cavity volumes to assess correlations between those volumes and with the upper airway. It has also been used for volumetric evaluation after surgical and nonsurgical procedures and to assess the relationships between tongue volume, tooth position, occlusion, and body mass index. Participants with obstructive sleep apnea and malocclusion have been evaluated, and the reliability of CBCT has been assessed. In the included studies, CT was utilized for similar purposes as CBCT, but its reliability was not assessed.

개심술후 폐기능 -수술직후 및 장기간의 추이에 대하여- (Pulmonary Function Following Open Heart Surgery -early and late postoperative changes-)

  • 이성행
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.364-374
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    • 1980
  • Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

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Identification of Alternative Splicing and Fusion Transcripts in Non-Small Cell Lung Cancer by RNA Sequencing

  • Hong, Yoonki;Kim, Woo Jin;Bang, Chi Young;Lee, Jae Cheol;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • 제79권2호
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    • pp.85-90
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    • 2016
  • Background: Lung cancer is the most common cause of cancer related death. Alterations in gene sequence, structure, and expression have an important role in the pathogenesis of lung cancer. Fusion genes and alternative splicing of cancer-related genes have the potential to be oncogenic. In the current study, we performed RNA-sequencing (RNA-seq) to investigate potential fusion genes and alternative splicing in non-small cell lung cancer. Methods: RNA was isolated from lung tissues obtained from 86 subjects with lung cancer. The RNA samples from lung cancer and normal tissues were processed with RNA-seq using the HiSeq 2000 system. Fusion genes were evaluated using Defuse and ChimeraScan. Candidate fusion transcripts were validated by Sanger sequencing. Alternative splicing was analyzed using multivariate analysis of transcript sequencing and validated using quantitative real time polymerase chain reaction. Results: RNA-seq data identified oncogenic fusion genes EML4-ALK and SLC34A2-ROS1 in three of 86 normal-cancer paired samples. Nine distinct fusion transcripts were selected using DeFuse and ChimeraScan; of which, four fusion transcripts were validated by Sanger sequencing. In 33 squamous cell carcinoma, 29 tumor specific skipped exon events and six mutually exclusive exon events were identified. ITGB4 and PYCR1 were top genes that showed significant tumor specific splice variants. Conclusion: In conclusion, RNA-seq data identified novel potential fusion transcripts and splice variants. Further evaluation of their functional significance in the pathogenesis of lung cancer is required.

소아 폐쇄성 수면무호흡증후군 1례 (A Case of Childhood Obstructive Sleep Apnea Syndrome)

  • 신홍범;이유진;정도언
    • 수면정신생리
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    • 제11권2호
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    • pp.106-109
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    • 2004
  • 소아의 폐쇄성 수면 무호흡증은 흔히 편도 아데노이드 비대증으로 인해 발생하는 것으로 알려져 있으나 비만, 두개 악안면 기형 등 다양한 원인에 의해서도 발생할 수 있다. 소아의 폐쇄성 수면 무호흡증은 야뇨증, 사건 수면, 행동 장애 등과 같은 다양한 합병증을 동반할 수 있다. 그 원인이 편도 아데노이드 비대증이면 수술적인 제거를 통해 증상 호전을 기대할 수 있으나 비만 등 다른 원인에 의한 것이라면 지속성 상기도양압술과 체중 감량 및 생활습관 변화를 통한 치료가 필요하다. 저자들은 편도 아데노이드 절제술 시행 후에도 심한 폐쇄성 수면 무호흡증이 지속되고 다양한 합병증이 나타난 환아에서 상기도양압술로 무호흡 관련 증상 및 동반된 합병증의 호전을 보인 1례를 경험하였기에 보고한다.

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소방 1급응급구조사의 병원임상수련 술기 실태 조사 (The Actual State of Hospital-based Skill Training in Level 1 Emergency Medical Technician)

  • 노상균;이재국;방성환
    • 한국화재소방학회논문지
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    • 제26권5호
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    • pp.54-60
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    • 2012
  • 이 연구는 소방 119구급대에서 근무하는 1급 응급구조사의 병원임상수련 실태를 조사한 연구이다. 조사대상은 소방에 근무하는 1급 응급구조사 42명으로 하였으며, 2012년 5월 11일부터 2012년 5월 12일까지 구조화된 무기명 자기기입식 설문지를 이용한 설문조사에 의하였다. 연구결과 1급 응급구조사의 업무범위를 한 번 이상 직접 경험한 경우는 56.5 %였고, 이들 중 기관내삽관 66.9 %, 후두마스크 8.4 %, 정맥로확보 76.6 %, 니트로글리세린 설하투여 61.2 %, 기관지확장제 흡입 50.0 %, 수액투여 73.8 %, 인공호흡기 사용 57.6 %, 포도당 주입 57.6 %를 경험하였으며, 1급 응급구조사 업무범위를 16개 의료기관별로 살펴본 결과 58.0 %가 한 번 이상 직접 경험하였다. 향후 1급 응급구조사의 교육 요구도에 대한 지속적 연구가 필요하며, 병원임상수련의 문제점 분석, 임상실습지침서의 보완과 실무중심의 교육프로그램 운영 및 관리에 대한 규정과 지속적인 평가가 필요하다.