• 대한의생명과학회지
• /
• 제6권2호
• /
• pp.109-118
• /
• 2000

본 연구는 전자현미경적인 방법을 이용하여 흰쥐 기관지와 폐조직에 미치는 간접흡연의 영향을 조사하였다. 실험동물은 1일 3회씩 매회 15분간, 4주 동안 비주류 담배연기를 흡입하도록 하였다. 간접흡연 그룹의 폐조직에서는 세포질내에 다수의 용해소체을 함유하고 있는 중성구, 그리고 다양한 크기의 용해소체와 잔사체를 함유하는 대식 세포가 관찰되었다. 또한 폐포격벽은 팽대되었으며 섬유화현상이 나타났다. 기관지상피는 섬모상피세포가 점차 소실되었고, 분비세포 또는 배상세포들은 그 수가 증가하였으며, 섬모가 소실되고 표면적이 확장된 배상세포도 관찰되었다. 본 연구결과 이러한 미세구조의 변화는 간접흡연에 의한 세포상해의 전형적인 결과로 파악된다.

• Imaging Science in Dentistry
• /
• 제41권4호
• /
• pp.189-193
• /
• 2011

The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

• Journal of Chest Surgery
• /
• 제33권8호
• /
• pp.688-692
• /
• 2000

Descending Necrotizing Mediastinitis(DNM) is a complication of oropharyngeal infections that can spread to the mediastinum. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. late diagnosis is the principal reason for the high mortality in DNM. An 18-year-old female admitted with Ludwig's angina from dental caries. Despite of combined antibiotics, dental extraction and drainge of submental abscess, infection spread to the cervical area. Chest computed tomogram revealed extension of the abscess to the pretracheal and periaortic space and development of bilateral pleural empyema. We performed bilateral cervical mediastinotomy and thoracotomy for drainage and debridement. Tracheostomy to secure the airway and postoperative pleural irrigation were performed. Postoperative course was uneventful and patient was discharged on the 40th postoperative day. It is important to perform chest CT scanning for early diagnosis of DNM when oropharyngeal infection spreads to the cervical area. Improved survival of patients with DNM implies early and radical surgical drainage and debridement via a cervical mediastinomy and thoracotomy.

• 대한치과교정학회지
• /
• 제18권1호
• /
• pp.253-265
• /
• 1988

This study was designed to compare the normal head posture group with the extended head posture group in order to investigate the relatinship between head posture and craniofacial morphology. The subjects were devided into two groups; one included 80 children with normal head posture and occlusion, and the other 60 malocclusion patients with extended head posture. Their lateral cephalograms were traced and analysed based on 38 selected items. The following conclusion were reached. 1. The craniocervical angulations in normal group; OPT to SN, CVT to SN, OPT to FH and CVT to FH angles were $101.7^{\circ},\;104.8^{\circ},\;91.7^{\circ}\;and\;100.7^{\circ}$, respectively. 2. Compared with normal group, experimental group showed increase in mandibular plane angle, decrease in facial plane angle, airway space and posterior facial height but, there were insignificant differences in anterior facial height and tongue level between two groups. 3. Of the craniocervical angulations, OPT to FH angle was most highly correlated to the variables of the craniofacial morphology. 4. The effect of craniocervical angulation on craniofacial morphology in experimental group was different from that in comparison of normal group and experimental group.

• Archives of Plastic Surgery
• /
• 제32권5호
• /
• pp.660-662
• /
• 2005

It is well documented that adenoidectomy is attributed to hypernasality in certain cases, but not clear that the enlarged tonsils affect the quality of speech. Hypertrophied tonsils may cause and complicate the problem of velopharyngeal incompetency. The huge tonsils prevent lateral pharyngeal walls from a medial movement and interfere velar elevation, being hypernasality. Hyponasality developes as the tonsils encroach in nasopharyngeal space. Voluminous tonsils also interfere airflow in the oropharyneal passage and produce the phenomenon of cul-de-sac resonance or muffled sound. The authors and et al. present a case of velopharyngeal insufficiency accompanied with hypertrophic tonsils. Improving the lateral constricting pharyngeal wall and velar elevation after tonsillectomy minimized the velopharyngeal gap. Accordingly, the procedures of sphincter pharyngoplasty and palatal lengthening resolved the problem of hypernasality instead of pharyngeal flap. Tonsillectomy prior to pharyngeal flap surgery tends to reduce the postoperative airway problems. Sometimes, however, only tonsillectomy does without pharyngeal flap. Surgical approach by stages and intermittent evaluation are recommended at intervals of at least six weeks.

• 대한두경부종양학회지
• /
• 제11권2호
• /
• pp.119-124
• /
• 1995

Traditionally, wound drainage after thyroid or parathyroid surgery has been widely used to prevent airway obstruction due to accumulation of hematoma or seroma within the paratracheal dead space. Recently, however, the routine use of drains after thyroid or parathyroid surgery has become a matter of controversy. To determine whether the rouine use of drains after thyroid or parathyroid surgery is warranted, a prospective study on the complications after various types of thyroid or parathyroid surgery without wound drains was conducted. Three hunded sixty-six consecutive patients underwent thyroid or parathyorid surgeries by one surgeon from January through December 1994 were included in this study. Of these, only 38 patients (10.4%) required the wound drains. Indications for drainage included the patients with a large dead space(n=9) or wet operative field at the conclusion of surgery(n=11), and patients with radical neck disection(n=18). In the remaining 328 patients(89.6%), the wounds were closed without drains after thyroid lobectomy and isthmusectomy(n=226), bilateral subtotal thyroidectomy(n=21), total or near-total thyroidectomy(n=62), isthmusectomy(n=9) and parathyroid surgery(n=l0). Histologic findings revealed benign tumors in 214(65.2%), carcinoma in 89(27.1%), Graves' disease in 15(4.7%), hyperparathyroidism in 7(2.1%) and parathyroid cyst in 3(0.9%). Among the 328 patients without drain used, wound related complications were seen in only 15 patients(4.6%); 12 patients with seroma and 3 patients with hematoma. All but one complications could be controlled by two or three aspirations, and the remaining one patient required re-exploration. There were no instances of laryngeal nerve palsy or wound infection. The mean length of hospital stay after surgery was 2.8 days with a range of 1 to 11 days. These results support the routine use of drains is not warranted in most thyroid or parathyroid surgeries.

• Journal of Oral Medicine and Pain
• /
• 제34권3호
• /
• pp.247-256
• /
• 2009

코골이와 수면무호흡증은 대부분 상기도의 인두부위의 폐쇄에 의해 발생되므로, 이 부위의 폐쇄를 방지하기 위해 혀나 하악을 전방으로 이동시키는 다양한 구강내 장치가 코골이 및 수면무호흡증의 치료에 사용되고 있다. 본 연구는 세 종류의 코골이장치 즉, 하악전방이동장치(mandibular advancement appliance, MAA), 혀견인장치(tongue retaining appliance, TRA), 하악-혀전방이동장치(mandibular advancement-tongue retaining appliance, MATRA )가 구인두와 하인두 공간을 어떻게 변화시키는지를 비교하고자 하였다. Class I 교합을 갖고 코골이 및 수면무호흡증의 증상이 없으며 체질량지수 (BMI)가 정상인 남성 9명을 대상으로 상기 세종류의 코골이장치를 제작하였으며, 이때 MAA, MATRA의 하악전방이동량은 5mm로 TRA, MATRA의 혀전방이동량은 10-20mm로 설정하였다. 그리고, 코골이장치를 장착하지 않은 CO상태와 MAA, TRA, MATRA를 장착한 상태에서 측모두부 규격방사선사진을 촬영한 후, 구인두와 하인두 공간, 두경부 자세, 연구개와 설골의 위치와 관련된 20가지 측정항목에 대해 통계분석을 시행하였다. 분석결과 MAA, TRA, MATRA 모두 상부 구인두 공간을 유의성 있게 증가시켰으나, MATRA 만이 하부 구인두 공간을 유의성 있게 증가시켰다. 이러한 결과는 코골이와 수면무호흡증을 개선시키는데 있어 MATRA가 MAA와 TRA에 비해 효과적일 수 있음을 시사한다.

• 융합신호처리학회논문지
• /
• 제12권3호
• /
• pp.157-162
• /
• 2011

본 연구는 심폐소생술 (CPR) 중 인공호흡의 무선 전송 시스템 구현에 관한 것으로, 병원 전 단계에서의 CPR 성과를 높임으로써 응급환자의 생존율을 높이기 위한 환자-병원간 무선 통신 시스템이다. 기도삽관 기반 호흡기류센서를 적용하여 호흡량을 측정하였는데, 기도삽관을 통한 인공호흡은 기류량의 손실을 최소화하여 보다 정확한 흡기-호기량 계측이 가능하고, 기도-식도 구분을 통해 식도팽창을 방지하여 다른 인공호흡 방법에 비해 장점을 입증하였다. 또, 인공호흡 주요지표인 분당 평균호흡량 (V), 호기말 이산화탄소 농도 ($EtCO_2$), 기도압력 (Ptr)을 디지털화하여 정의하였으며 정의된 데이터를 무선 통신 시스템을 이용하여 전송망의 대역폭 및 지연시간을 확인하였다. 호흡신호를 전송하기 위해 필요한 최대대역폭 (815 Kbps) 에 비해 Wireless LAN의 대역폭 (54 Mbps) 이 충분하여 네트워크 부하는 1.5 % 미만이었으며, 전송지연시간은 0.3 초 이내로 측정되었다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권1호
• /
• pp.7-14
• /
• 2001

Purpose : The lateral cephalometric Korean norms of the skeletal and pharyngeal dimension were analyzed for the diagnosis of obstructive sleep apnea syndrome(OSAS). Materials and Methods : The lateral cephalometric radiographies were taken in male(n=53) and female(n=50), who had a normal profile, class I occlusion, normal ANB $(0{\sim}4^{\circ})$ and normal Wits $Appraisal(-4{\sim}0mm)$. The X-rays were traced by two oral and maxillofacial surgeons twice. The significant differences between male-female and examiners were tested. Results : The angle of mandibular line to Nasion-Sella line was $31.12^{\circ}/33.79^{\circ}$ (in male/in female, p=0.0018). The lower Gonion angle was $73.74^{\circ}/73.74^{\circ}(p=0.9978)$. The length of the soft palate was 36.93mm/34.35mm(p=0.0002). The pharyngeal airway space was 13.42mm/11.55mm at mandibular plane level(PAS(ML))(p=0.0025). The hyoid was placed inferiorly to mandibular plane 10.18mm/7.72mm(p=0.0051). The results from this study are to be used for the diagnosis of OSAS.

• 대한치과교정학회지
• /
• 제46권6호
• /
• pp.395-408
• /
• 2016

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.