• 제목/요약/키워드: Airway space

검색결과 118건 처리시간 0.024초

Airway Smooth Muscle Sensitivity to Methacholine in Precision-Cut Lung Slices (PCLS) from Ovalbumin-induced Asthmatic Mice

  • Kim, Hae Jin;Kim, Yeryung;Park, Su Jung;Bae, Boram;Kang, Hye-Ryun;Cho, Sang-Heon;Yoo, Hae Young;Nam, Joo Hyun;Kim, Woo Kyung;Kim, Sung Joon
    • The Korean Journal of Physiology and Pharmacology
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    • 제19권1호
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    • pp.65-71
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    • 2015
  • Asthma is a chronic inflammatory disease characterized by airway hyperresponsiveness (AHR) and reversible airway obstruction. Methacholine (MCh) is widely used in broncho-provocation test to evaluate airway resistance. For experimental investigation, ovalbumin-induced sensitization is frequently used in rodents (Ova-asthma). However, albeit the inflammatory histology and AHR in vivo, it remains unclear whether the MCh sensitivity of airway smooth muscle isolated from Ova-asthma is persistently changed. In this study, the contractions of airways in precision-cut lung slices (PCLS) from control, Ova-asthma, and IL-13 overexpressed transgenic mice (IL-13TG) were compared by analyzing the airway lumen space (AW). The airway resistance in vivo was measured using plethysmograph. AHR and increased inflammatory cells in BAL fluid were confirmed in Ova-asthma and IL-13TG mice. In the PCLS from all three groups, MCh concentration-dependent narrowing of airway lumen (${\Delta}AW$) was observed. In contrast to the AHR in vivo, the $EC_{50}$ of MCh for ${\Delta}AW$ from Ova-asthma and IL-13TG were not different from control, indicating unchanged sensitivity to MCh. Although the AW recovery upon MCh-washout showed sluggish tendency in Ova-asthma, the change was also statistically insignificant. Membrane depolarization-induced ${\Delta}AW$ by 60 mM $K^+$ (60K-contraction) was larger in IL-13TG than control, whereas 60K-contraction of Ova-asthma was unaffected. Furthermore, serotonin-induced ${\Delta}AW$ of Ova-asthma was smaller than control and IL-13TG. Taken together, the AHR in Ova-asthma and IL-13TG are not reflected in the contractility of isolated airways from PCLS. The AHR of the model animals seems to require intrinsic agonists or inflammatory microenvironment that is washable during tissue preparation.

관절경하 광범위 회전근 개 파열 수술 후 발생한 치명적인 기도 부종 - 증례 보고 - (Life-threatening Airway Edema after Arthroscopic Repair of Massive Rotator Cuff Tear - A Case Report -)

  • 문영래;유병식;소금영;임경준;강정훈
    • Clinics in Shoulder and Elbow
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    • 제10권1호
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    • pp.136-139
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    • 2007
  • 견관절경 수술로 많은 질환을 치료할 수 있으며 개방 술식에 비하여 많은 장점을 가지고 있다. 드물게 견관절 수술 후 세척액이 관절외 연부조직으로 유출되어 목과 인두에 부종을 유발하는 기도합병증이 보고되고 있다. 이 논문은 관절경하 회전근 개 봉합 수술 후 치명적으로 발생했던 기도 폐쇄를 보고하고자 한다. 결론적으로 이러한 위험한 합병증을 예방하기 위해서는 마취된 환자의 경우 불편감을 호소할 수 없으므로 술자들의 경부 부종 상태를 주기적으로 점검하여야 할 것이다.

Clinical assessment of the efficacy of supraglottic airway devices compared with endotracheal tubes in cats during volume-controlled ventilation

  • Niyatiwatchanchai, Nutawan;Thengchaisri, Naris
    • Journal of Veterinary Science
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    • 제21권2호
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    • pp.27.1-27.10
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    • 2020
  • The efficacies of a supraglottic airway device (SGAD) and an endotracheal tube (ETT) in cats under general anesthesia with volume-controlled ventilation (VCV) were compared. Thirty healthy cats were randomly allocated for airway control using either an SGAD or an ETT. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly tested, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. The dose of propofol necessary to insert the SGAD or ETT, the static respiratory pressure, leakage during VCV, and end tidal CO2 (ETCO2) were recorded. Dosages of propofol and static respiratory measurements for the SGAD and ETT groups were compared using a t-test. The distribution of leakages and hypercapnia (ETCO2 > 45 mmHg) were compared using Fisher's exact test. A significance level of p < 0.05 was established. No significant difference in dose of propofol was observed between the SGAD and ETT groups (7.1 ± 1.0, 7.3 ± 1.7 mg/kg; p = 0.55). Static resistance pressure of the SGAD (22.0 ± 8.1 cmH2O/L/sec) was significantly lower than that of the ETT (36.6 ± 12.9 cmH2O/L/sec; p < 0.01). Of the 75 trials, leakage was more frequent when using an SGAD (8 events) than when using an ETT (1 event; p = 0.03). Hypercapnia occurred more frequently with SGAD (18 events) than with ETT (3 events; p < 0.01). Although intubation with an ETT is the gold standard in small animal anesthesia, the use of an SGAD can reduce airway resistance and the work of breathing. Nonetheless, SGAD had more dead space and the tidal volume for VCV needs adjustment.

Cone beam CT를 이용한 안면골격형태에 따른 상기도 공간 분석 (Pharyngeal airway analysis of different craniofacial morphology using cone-beam computed tomography (CBCT))

  • 김용일;김성식;손우성;박수병
    • 대한치과교정학회지
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    • 제39권3호
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    • pp.136-145
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    • 2009
  • 상기도 공간은 3차원 입체 구조물로서 두부규격방사선사진 등으로 분석하기에는 평가의 한계가 존재하였다. 본 연구는 최근 방사선 피폭량 등의 감소로 그 활용도가 높아진 cone beam CT (CBCT)를 이용하여 안면골격형태에 따른 상기도 공간의 면적, 전후방 폭경 및 측방 폭경을 측정하고 그 관련성을 알아보았다. 102명을 대상으로 CBCT (VCT, Vatech, Seoul, Korea)를 촬영하였으며, FH plane에 평행하면서 aa point (the most anterior point on the anterior arch of atlas), $CV_{2ia}$, $CV_{3ia}$ point (most infero-anterior point on the body of the second & third cervical vertebra)를 지나는 평면을 기준으로 설정하였다. 각 항목의 계측치는 one-way ANOVA를 이용하여 통계처리하고 Duncan test로 사후검정하였다. 연구 결과, 안면 골격형태에 따른 측방 폭경에는 유의한 차이가 없었다. Group 2 (Class II) 집단은 aa plane, $CV_2$ plane, $CV_3$ plane에 의해 형성된 상기도 공간의 단면적이 좁았으며, 전후방 폭경도 Group 3 (Class III)에 비해 유의성 있게 좁았다. 수직 안면골격형태와 정상 안면골격 형태간의 유의성 있는 차이는 없었으나, aa plane에서 형성된 상기도 공간의 전후방 폭경은 Group 1V (Class I vertical)가 Group 1N (Class I normal)에 비해 유의성 있게 좁은 것으로 나타났다 (p < 0.05).

Gender-specific cephalometric features related to obesity in sleep apnea patients: trilogy of soft palate-mandible-hyoid bone

  • Cho, Seok Hyun;Jeon, Jae-Yun;Jang, Kun-Soo;Kim, Sang Yoon;Kim, Kyung Rae;Ryu, Seungho;Hwang, Kyung-Gyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.58.1-58.8
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    • 2019
  • Background: The aim of this study is to investigate the relationship between gender-specific and obesity-related airway anatomy in patients with obstructive sleep apnea (OSA) by using cephalometric analyses. Methods: We retrospectively evaluated 206 patients with suspected OSA undergoing polysomnography and anthropometric measurements such as body mass index, neck circumference, and waist-hip ratio. We checked lateral cephalometry to measure tissue landmarks including angle from A point to nasion to B point (ANB), soft palate length (SPL), soft palate thickness (SPT), retropalatal space (RPS), retrolingual space (RLS), and mandibular plane to hyoid (MPH). Results: Male with OSA showed significantly increased SPL (P = .006) compared with controls. SPL and MPH had significant correlation with apnea-hypopnea index (AHI) and central obesity. Female with OSA showed significantly increased ANB (P = .013) and SPT (P = .004) compared with controls. The receiver operating characteristic curves revealed that SPT in male and ANB and SPT in female were significant in model 1 (AHI ≥ 5) and model 2 (AHI ≥ 15). MPH was also significant for male in model 2. Conclusion: Male and female with OSA had distinct anatomic features of the upper airway and different interactions among soft palate, mandible, and hyoid bone.

Immediate effects of mandibular posterior displacement on the pharyngeal airway space: A preliminary study

  • Choi, Yeonju;Kim, Yong-Il;Kim, Seong-Sik;Park, Soo-Byung;Son, Woo-Sung;Kim, Sung-Hun
    • 대한치과교정학회지
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    • 제50권2호
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    • pp.129-135
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    • 2020
  • Objective: This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved. Methods: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired t-test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables. Results: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length (p < 0.001) and increased in height (p < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced (p < 0.001). The hyoid bone was also posteriorly displaced (p < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables. Conclusions: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.

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

  • 조광희;정찬민;장철호;최홍식
    • 대한후두음성언어의학회지
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    • 제25권2호
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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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3D-CT를 이용한 골격성 III급 개방교합자의 악교정 수술 전, 후 설골 및 상기도의 변화 (The structural change in the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients using 3-dimensional computed tomography)

  • 이윤섭;백형선;이기준;유형석
    • 대한치과교정학회지
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    • 제39권2호
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    • pp.72-82
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    • 2009
  • 본 연구는 골격성 III급 개방교합자의 악교정 수술 전, 후 설골과 상기도의 변화를 3D-CT를 이용하여 관찰하고 이를 정상교합자와 비교하기 위하여 시행하였다. 전치부 개방교합을 동반한 골격성 III급 부정교합으로 진단되어 악교정 수술을 받은 환자 중 12명을 선정 후, 3D-CT를 통해 설골과 상기도의 3차원 입체영상을 분석하여, 악교정 수술 전, 후의 설골의 위치 변화 및 상기도의 부피 변화를 살펴보고, 이의 결과를 정상교합자 10명과 비교하였다. 설골은 골격성 III급 개방교합군에서 악교정 수술 전에 정상교합군의 설골에 비해 전방에 위치하고 있었고 악교정 수술 후 설골은 후, 상방으로 변화하였으나 유의성은 관찰되지 않았다. Hyoid plane과 mandibular plane이 이루는 각은 악교정 수술전의 골격성 III급 개방교합군이 정상교합군보다 큰 값을 나타내었고, 악교정 수술 후에는 그 차이가 더욱 증가하였다. 골격성 III급 개방교합군의 상기도 부피는 정상교합자보다 작으며 이는, 악교정수술 후에 더욱 감소하였다. 3차원 영상 분석 결과, 골격성 III급 개방교합자의 상기도는 정상교합자에 비해 좁으며, 하악골 후퇴술 이후 더욱 감소하기 때문에 이는 수술적 개선의 안정성에 영향을 줄 수 있음을 알 수 있었다.

기관절개술과 후두절개술로 치료한 거대 성문하 용종 1예 (Huge Subglottic Polyp Treated with Tracheotomy and Laryngofissure)

  • 홍용태;여차동;홍기환
    • 대한후두음성언어의학회지
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    • 제28권1호
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    • pp.52-54
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    • 2017
  • Vocal polyps are benign laryngeal lesions which arise from the Reinke's space abd hoarseness is the most common symptom. However, airway compromised is rarely presented in the vocal polyp. A rare case of large subglottic polyp causing dyspnea is reported. Tracheostomy was performed under local anesthesia and then the mass was resected under general anesthesia using a laryngofissure approach. The dyspnea and hoarseness disappeared after surgery immediately. The histopathological findings indicated a diagnosis of vocal cord polyp with chronic inflammatiuon. We consider that tracheostomy is the safest and most useful procedure to guarantee the upper airway in cases of large vocal polyp showing dyspnea. We hereby report a case of huge subglottic polyp in which a tracheostomy and laryngofissure was required for removing the subglottic mass successfully.

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