• 제목/요약/키워드: Cough reflex

검색결과 11건 처리시간 0.025초

Bilateral Internal Superior Laryngeal Nerve Palsy of Traumatic Cervical Injury Patient Who Presented as Loss of Cough Reflex after Anterior Cervical Discectomy with Fusion

  • Shin, Dong-Uk;Sung, Joo-Kyung;Nam, Kyung-Hun;Cho, Dae-Chul
    • Journal of Korean Neurosurgical Society
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    • 제52권3호
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    • pp.264-266
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    • 2012
  • Injury to the bilateral internal branch of superior laryngeal nerve (ibSLN) brings on an impairment of the laryngeal cough reflex that could potentially result in aspiration pneumonia and other respiratory illnesses. We describe a patient with traumatic cervical injury who underwent bilateral ibSLN palsy after anterior cervical discectomy with fusion (ACDF). An 75-year-old man visited with cervical spine fracture and he underwent ACDF through a right side approach. During the post-operative days, he complained of high pitched tone defect, and occasional coughing during meals. With a suspicion of SLN injury and for the work up for the cause of aspiration, we performed several studies. According to the study results, he was diagnosed as right SLN and left ibSLN palsy. We managed him for protecting from silent aspiration. Swallowing study was repeated and no evidence of aspiration was found. The patient was discharged with incomplete recovery of a high pitched tone and improved state of neurologic status. The SLN is an important structure; therefore, spine surgeons need to be concerned and be cautious about SLN injury during high cervical neck dissection, especially around the level of C3-C4 and a suspicious condition of a contralateral nerve injury.

만성 기침의 감별진단 (Differential Diagnosis of Chronic Coughing)

  • 도남용;박준희
    • 대한후두음성언어의학회지
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    • 제27권2호
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    • pp.87-90
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    • 2016
  • Cough, the most common symptom, encountered in the outpatient clinic can be caused by various underlying diseases. It defines as chronic cough that the duration of cough is more than 8 weeks with a normal chest X-ray findings. The cause of cough can be found out for more than 90% through the appropriate diagnostic approach and Upper airway cough syndrome, Asthma and Gastroesophageal reflex disease are the most common causes of disease to non-smokers. Chronic cough can be due to not one reason but various reasons and achieve good results by a systematic approach to diagnosis and a concrete treatment on the basis of the sufficient understanding of the underlying disease.

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평진건비탕(平陳健脾湯)으로 호전된 만성기침 2예(例) (Two cases of chronic cough treated with Pyeongjingeonbi-tang)

  • 이주관;양수영;이진우;오영선;이용구;박양춘
    • 혜화의학회지
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    • 제19권2호
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    • pp.159-163
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    • 2011
  • Cough is an important defensive reflex of the respiratory tract needed to clear and protect the upper airways, but it may become exaggerated and interfere quality of life. Gastroesophageal reflux disease (GERD) is one of the three most common causes of chronic unexplained cough. Diagnosing GERD related cough is challenging since many patients do not have esophagitis or an increased esophageal acid exposure during 24 h esophageal pH-metry. We treated two patients who had chronic cough, these subjects were diagnosed as Sikjeoksu (Shijisou, 食積嗽) and was administered Pyeongjingeonbi-tang (Pingchenjianpi-tang, 平陳健脾湯). First case had stuffiness below the heart and acid regurgitation with cough, but second case only had cough. After treatment, cough and other symptoms were improved. It showed that we must consider GERD on chronic cough patients.

KAAACI Evidence-Based Clinical Practice Guidelines for Chronic Cough in Adults and Children in Korea

  • Song, Dae Jin;Song, Woo-Jung;Kwon, Jae-Woo;Kim, Gun-Woo;Kim, Mi-Ae;Kim, Mi-Yeong;Kim, Min-Hye;Kim, Sang-Ha;Kim, Sang-Heon;Kim, Sang Hyuck;Kim, Sun-Tae;Kim, Sae-Hoon;Kim, Ja Kyoung;Kim, Joo-Hee;Kim, Hyun Jung;Kim, Hyo-Bin;Park, Kyung-Hee;Yoon, Jae Kyun;Lee, Byung-Jae;Lee, Seung-Eun;Lee, Young Mok;Lee, Yong Ju;Lim, Kyung-Hwan;Jeon, You Hoon;Jo, Eun-Jung;Jee, Young-Koo;Jin, Hyun Jung;Choi, Sun Hee;Hur, Gyu Young;Cho, Sang-Heon;Kim, Sang-Hoon;Lim, Dae Hyun
    • Allergy, Asthma & Immunology Research
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    • 제10권6호
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    • pp.591-613
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    • 2018
  • Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics. Meanwhile, in referral clinics, a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options for chronic wet cough in children and unexplained chronic cough in adults in Korea.

Acute combined central and peripheral nervous system demyelination: a case report

  • Roh, Young Eun;Kim, Young Mi
    • 고신대학교 의과대학 학술지
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    • 제33권2호
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    • pp.257-262
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    • 2018
  • Guillain-$Barr{\acute{e}}$ syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are demyelinating neurologic disorders with different target organs. Although they share similar pathogenetic mechanism, reports of simultaneous occurrence of the 2 disorders are rare. A 2 year 6 month old girl visited our hospital for fever, cough, and general weakness. Although the muscle power of extremities showed mild weakness and voiding difficulty, initial deep tendon reflex of both knees and ankles was normal. A nerve conduction study to evaluate the weakness revealed the absence of F waves. Cerebrospinal fluid analysis demonstrated pleocytosis with lymphocyte predominance and elevated protein levels. Magnetic resonance imaging showed abnormal T2 hyperintensity in pons, medulla and spinal cord. Serum anti-GD1b antibody was positive. Based on clinical findings, laboratory findings, nerve conduction study, and neuroimaging, the diagnosis of GBS and ADEM was made. This is the first case of GBS accompanied by ADEM in Korea.

기관절제 및 단단문합술에 의한 소아 기관협착증의 치료 (Tracheal Resection and End to End Anastomosis for Tracheal Stenosis in Children)

  • 최종욱;정근;김용환;김혜정;박찬;최건
    • 대한기관식도과학회지
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    • 제3권1호
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    • pp.94-100
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    • 1997
  • Background and Objectives : In children with tracheal stenosis, operative management remains a challenging problem due to difficulties of operative techniques and postoperative care. The purpose of this study was to determine the effectiveness of tracheal resection with end to end anastomosis as operative management for tracheal stenosis in children. Materials and Methods : 6 children with severe tracheal stenosis underwent tracheal resection with end to end anastomosis. Causes of stenosis were trauma in 1 case and prolonged intubation or tracheotomy in 5 cases. The diagnoses were made by radiologic evaluation (plain X-ray, CT, 3-Dimensional CT) and confirmed by direct laryngoscopy and ventilating bronchoscopy under general anesthesia. Thyroplasty and unilateral arytenoidectomy were performed in 1 case. Suprahyoid release was done in 1 case with severe adhesion. Decanulation was achieved following postoperative endoscopic examination and pulmonary function test. Postoperative physical and radiologic examinations were given at regular intervals. Results : Stenosis were improved from grade III grade I in 4 cases and from grade II to grade I in 2 cases. Decanulation was achieved on average postoperative 6 months in 5 cases, and 10 years in 1 case due to exertional dyspnea. There were 1 each case of immediate postoperative subcutaneous emphysema, pneumothorax and wound infection. Postoperative granulomas at anastomosis site were treated with laser vaporization under suspension laryngoscope and bronchoscope in 3 cases. There was 1 each case of delayed postoperative vocal cord palsy, aspiration pneumonia and loss of cough reflex. Conclusion In tracheal stenosis of children, tracheal resection with end to end anastomosis has good result with preservation of normal airway. Preoperative evaluation of local factors such as swallowing, vocal cord movement and cough reflex and general condition was important for successful treatment. As the cases in adults, authors considered this operation to be a curable operative management for tracheal stenosis.

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뇌경색환자의 연하곤란에 대한 전기자극 치료의 효과 (The Effect of Electrical Stimulation for Dysphagia Caused by Cerebral Infarction)

  • 권혜민;이정우;윤세원
    • 대한임상전기생리학회지
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    • 제7권1호
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    • pp.17-21
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    • 2009
  • Purpose : The purpose of this study was to analysis the effect of electrical stimulation for dysphagia caused by cerebral infarction. Methods : We recruited nineteen adults after cerebral infarction(14 male, 5 female; mean age, 69y) for our study. Electrical stimulation was used for participants with electrical stimulator connected to two pair of electrodes positioned on the neck for one hour a day and 5 times a week for 4 weeks. Maximum tolerated stimulation levels were applied at rest while participants held their mouth closed. Videofluoroscopic recordings, physical examination of swallowing, and swallow function score were used to evaluate swallowing state of participants. All evaluate items were evaluated before and after treatment. Results : There was no significance difference of swallowing stage. The swallow function score significantly increased from 1.8 to 5.3(p<0.001). Also, cough reflex(p<0.001), laryngeal excursion(p<0.01) were significantly reduced compared to before electrical stimulation. Conclusion : Therefore, electrical stimulation for dysphasia is proved effective as it activates the function of swallowing muscle.

전신질환과 관련된 음성장애의 치료 (The Management of Systemic Voice Disorders)

  • 우주현
    • 대한후두음성언어의학회지
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    • 제27권1호
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    • pp.5-10
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    • 2016
  • Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

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색체디자인을 위한 MCC 개발에 관한 연구 (A Study on MCC Development for Color Design)

  • 문은배
    • 디자인학연구
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    • 제18권2호
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    • pp.219-232
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    • 2005
  • 현대인은 시각, 제품, 환경 디자인뿐 아니라 웹 콘텐츠, 애니메이션, 영상자료 등의 홍수 속에서 생활하고 있다. 그러므로 현대의 소비자는 그 어느 때 보다도 많은 선택권을 가지고 있으며 모든 디자인 결과물은 소비자에게 다양성을 제공할 수 있어야 한다. 우리는 디자인의 발전과 더불어 색채를 통한 새로운 감성을 개발함으로써 소비자에게 한 발 더 가까이 접근해야 한다. 그리고 새로운 감성을 창출하여 소비자에게 제안해야 한다. 본 MCC 팔레트는 디자인 할 떠 보다 정확한 감성을 적용하여 개인적인 편견을 없애고, 사용자에게 디자인 의도를 정확하게 호소하기 위한 것이다. MCC 팔레트는 한국적인 정거와 감성언어를 연구하고, 문헌적인 자료와 사진자료를 통해 감성 형용사를 수집하였다. 그리고 수집된 형용사를 균등하게 배분하였으며, 배분된 형용사를 각각 감성의 분야별로 정리하여 체계를 수집하였다. 그리고 각각 형용사별로 3색, 4색 배색을 하고 이들의 결과를 색채 전문가와 디자이너에게 설문 및 자문을 통하여 팔레트를 구성하였다. 그 결과 보다 실용성이 높은 색채 팔레트를 완성하였다. 완성된 배색은 웹상의 www.mcdri.net에서 운영되고 있으며, 또한 winders로 프로그램 되어 CD-ROM형 소프트웨어로 개발하였다. 인구결과로 만들어진 MCC 팔레트는 감성 자료 검색 데이터베이스를 구축함으로써 개발 후 실질적으로 적용이 가능하며, 각 매체별 색채오차 해소, 색채 배색의 검색을 통한 아이디어 개발, 사용층 및 사용대상에 대한 체계적인 접근을 용이하게 한다. 즉 산업체 활성화, 실무 사용자의 편의 도모, 디자인 교육 활성화를 위한 정보제공 등 산업계 및 교육계에 많은 도움이 될 것이다.

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황제내경(黃帝內經) 소문(素問) 자열론(刺熱論)에 대한 연구(硏究) (A study on the Theory of 'Ja-Yeol(刺熱)' in 32nd Chapter of 'So Moon(素問) Yellow Emperior's Nei-Ching(黃帝內經)')

  • 권건혁;홍원식
    • 대한한의학원전학회지
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    • 제3권
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    • pp.151-217
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    • 1989
  • In this thesis, I intend to study the translational and clinical interpretation through the theory of Ja-Yeol, and reached the following conclusions. 1. Liver-Heat-Disease due to absess of the function of expelling and lifting off, that Liver-Yang cannot lift up to upper-warmer, and stagnate liver. I think the symptoms of yellowish urine, abdominal pain, somnolence, fever belong to the syndrome of 'Gi-Bun(氣分)', and the symptoms of ravings with surprising, distending pain of hypochondrium, restless involuntary movement of the limbs, unable to lie flat belong to the syndrome of 'Hyeol-Bun(血分)'. 2. Heart-Heat-Disease due that 'Eum-Gi(陰氣)' in heart cannot lay down and reach to stagnate at heart, inner part. I think the symptoms of unjoy, acute cardiac pain, fidgetiness, well-nausea, headeche, reddish face, anhidrosis, etc. reveal with Heart-Heat-Disease. 3. Spleen-Beat-Disease due that 'Eum-Gi' in spleen cannot lay down and Yin of spleen changs heat. I think the symptoms of heaviness of head, cheek pain, fidgetiness, cyanosis, well-nausea, fever, not to let flex and reflex with back pain, diarrhea with abdominal pain, left and right cheek pain reveal with Spleen-Heat-Disease. I think symptoms of fever, diarrhea with abdominal pain belong to the syndrome of Yin-exhausion. 4. Lung-Heat-Disease due to that 'Eum-Gi' in lung cannot lay down. When 'Wi-Gi(衛氣)' stagnates at external part, I think, the symptoms of intolerance to wind and cold, yellowish fur, fever reveal. When Wi-Gi stagnates at lung, inner part, I think, the symptoms of dispnea with cough, pain on chest and back, unable to breath deeply, hydrosis and chilling reveal. 5. Kidney-Heat-Disease, in that the symptoms of back pain, leg aching, extreme thirst and frequently drink, fever, pain and stiffness of nape, cooling and aching leg, heat on plantar pedis, not trying to speak reveal is regarded external heat disease of 'Tai-Yang-Gyeong's(太陽經)' disease that asthenic fever open 'Tai-Yang-Gyeong' and lift by not enough of 'Yang-Gi(陽氣)' lifeing up from Kidney space, the water space of five elements.

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