• Title/Summary/Keyword: Nasal Airway

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Clinical Application of Nasal Intermittent Positive Pressure Ventilation with Bi-level Positive Airway Pressure(BiPAP) (기도 이중 양압(BiPAP)을 이용한 비강 간헐 양압환기의 임상적 적용)

  • Cho, Jae-Youn;Lee, Sang-Youb;Lee, Sang-Hwa;Park, Sang-Myun;Suh, Jung-Kyung;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.723-730
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    • 1995
  • Background: Noninvasive ventilation has been used extensively for the treatment of patients with neuromuscular weakness or restrictive chest wall disorders complicated by hypoventilatory respiratory failure. Recently, noninvasive positive pressure ventilation has been used in patients with alveolar hypoventilation, chronic obstructive pulmonary disease(COPD), and adult respiratory distress syndrome. Sanders and Kern reported treatment of obstructive sleep apnea with a modification of the standard nasal CPAP device to deliver seperate inspiratory positive airway pressure(IPAP) and expiratory positive airway pressure(EPAP). Bi-level positive airway pressure(BiPAP) unlike nasal CPAP, the unit delivers a different pressure during inspiration from that during expiration. The device is similar to the positive pressure ventilator or pressure support ventilation. Method and purpose: Bi-level positive airway pressure(BiPAP) system(Respironics, USA) was applied to seven patients with acute respiratory failure and three patients on conventional mechanical ventilation. Results: 1) Two of three patients after extubation were successfully achieved weaning from conventional mechanical ventilation by the use of BiPAP ventilation with nasal mask. Five of seven patients with acute respiratory failure successfully recovered without use of conventional mechanical ventilation. 2) $PaO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients significantly improved more than baseline values(p<0.01). $PaCO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients did not change significantly more than baseline values. Conclusion: Nasal mask BiPAP ventilation can be one of the possible alternatives of conventional mechanical ventilation in acute respiratory failure and supportive method for weaning from mechanical ventilation.

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A Moonlighting Protein Secreted by a Nasal Microbiome Fortifies the Innate Host Defense Against Bacterial and Viral Infections

  • Gwanghee Kim;Yoojin Lee;Jin Sun You;Wontae Hwang;Jeewon Hwang;Hwa Young Kim;Jieun Kim;Ara Jo;In ho Park;Mohammed Ali;Jongsun Kim;Jeon-Soo Shin;Ho-Keun Kwon;Hyun Jik Kim;Sang Sun Yoon
    • IMMUNE NETWORK
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    • v.23 no.4
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    • pp.31.1-31.18
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    • 2023
  • Evidence suggests that the human respiratory tract, as with the gastrointestinal tract, has evolved to its current state in association with commensal microbes. However, little is known about how the airway microbiome affects the development of airway immune system. Here, we uncover a previously unidentified mode of interaction between host airway immunity and a unique strain (AIT01) of Staphylococcus epidermidis, a predominant species of the nasal microbiome. Intranasal administration of AIT01 increased the population of neutrophils and monocytes in mouse lungs. The recruitment of these immune cells resulted in the protection of the murine host against infection by Pseudomonas aeruginosa, a pathogenic bacterium. Interestingly, an AIT01-secreted protein identified as GAPDH, a well-known bacterial moonlighting protein, mediated this protective effect. Intranasal delivery of the purified GAPDH conferred significant resistance against other Gram-negative pathogens (Klebsiella pneumoniae and Acinetobacter baumannii) and influenza A virus. Our findings demonstrate the potential of a native nasal microbe and its secretory protein to enhance innate immune defense against airway infections. These results offer a promising preventive measure, particularly relevant in the context of global pandemics.

High-flow nasal cannula oxygen therapy in children: a clinical review

  • Kwon, Ji-Won
    • Clinical and Experimental Pediatrics
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    • v.63 no.1
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    • pp.3-7
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    • 2020
  • High-flow nasal cannula (HFNC) is a relatively safe and effective noninvasive ventilation method that was recently accepted as a treatment option for acute respiratory support before endotracheal intubation or invasive ventilation. The action mechanism of HFNC includes a decrease in nasopharyngeal resistance, washout of dead space, reduction in inflow of ambient air, and an increase in airway pressure. In preterm infants, HFNC can be used to prevent reintubation and initial noninvasive respiratory support after birth. In children, flow level adjustments are crucial considering their maximal efficacy and complications. Randomized controlled studies suggest that HFNC can be used in cases of moderate to severe bronchiolitis upon initial low-flow oxygen failure. HFNC can also reduce intubation and mechanical ventilation in children with respiratory failure. Several observational studies have shown that HFNC can be beneficial in acute asthma and other respiratory distress. Multicenter randomized studies are warranted to determine the feasibility and adherence of HFNC and continuous positive airway pressure in pediatric intensive care units. The development of clinical guidelines for HFNC, including flow settings, indications, and contraindications, device management, efficacy identification, and safety issues are needed, particularly in children.

A study on the correlation between airway space and facial morphology in Class III malocclusion children with nasal obstruction (비폐쇄를 보이는 III급 부정교합아동의 기도 공간 형태와 안모 골격 형태와의 상관관계 연구)

  • Jung, Ho-Lim;Chung, Dong-Hwa;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.37 no.3 s.122
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    • pp.192-203
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    • 2007
  • Objective: The aim of this study was assessment of the relationship between airway space and facial morphology in Class III children with nasal obstruction. Methods: For this study, 100 Class III children (50 boys and 50 girls) were chosen. All subjects were refered to ENT, due to nasal obstruction. Airway space measurements and facial morphology measurements were measured on lateral cephalometric radiograph. Pearson correlation analysis was used to assess the relationship between airway space and facial morphology Results: Ramal height, SNA, SNB, PFH, FHR and facial plane angle were positively related to upper PAS, and sum of saddle angle, articular angle, and genial angle, SN-GoGn, Y-axis to SN and FMA negatively related to upper PAS. Genial angle, FMA were positively related to lower PAS, and articular angle, facial depth, PFH and FHR negatively related to lower PAS. PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH and AFH were positively related to tonsil size. Sum of saddle angle, articular angle, genial angle, facial length, AFH, FMA and LFH were positively related to tongue gap, and IMPA and overbite was negatively related to tongue gap. Upper PAS, related to size of adenoid tissue, was mainly related to posterior facial dimension following a vertical growth pattern of face and mandibular rotation. Lower PAS and tonsil size, related to anterior-posterior tongue base position, were significantly related to each other. Lower PAS was related to growth pattern of mandible, and tonsil size was related to size of mandible and horizontal growth pattern of face. Tongue gap was related to anterior facial dimension following a vertical growth pattern of face. Conclusion: Significant relationship exists between airway space and facial morphology.

Effect of Smoking on Nasal Resistance (흡연이 비저항에 미치는 영향)

  • Oh, Cheon-Hwan;Kim, Jang-Wook
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.113-118
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    • 1999
  • Background & Objectives : Nasal resistance which is halfly responsible for airway resistance is known to be influenced by hypoxia, hypercapnia, exercise, pregnancy, alcohol, ammonia and smoking. Smoking is a common part of our sociocultural environment and we have many a times been introduced to its various adverse effects, which have usually been more focused on lung problems. The purpose of this study is to determine any relationship between smoking and nasal resistance and to evaluate it's effective sites. Materials and Methods : Acoustic rhinometry was performed in 25 smokers and 25 nonsmokers who had no nasal symptoms nor abnormal rhinoscopic findings, and used an acoustic rhinometry to measure the distance from nose-piece to the C-notch, cross sectional area at the C-notch, and volume of the nasal cavity from nose-piece to 7cm. The authors compared the data between the two groups. Results : The cross sectional area at the C-notch was significantly decreased(p<0.05) in smoking group. The distance to the C-notch and the volume of nasal cavity were decreased likely in smoking group but there were no significant difference(p>0.05). Conclusion : Smoking reduced the cross sectional area at the C-notch, so increased the nasal resistance. The underlying mechanisms seems to be decreased nasal mucosal reactivity and congestion of the nasal mucosa. The authors believe there should follow more studies on pathophysiologic mechanisms and the histopathologic changes which involve the effect of smoking on nasal structures.

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Fixation of Nasal Bone Fracture with Carved Merocel® (Carved Merocel®을 이용한 비골골절의 고정)

  • Kong, Jung Sik;Jung, Jae A;Kang, So Ra;Kim, Yang Woo;Jeon, Young Woo
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.93-96
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    • 2011
  • Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.

A Longitudinal Study of the Growth Changes on Nasopharynx and Adenoid of the Korean with Normal Occlusion (정상 교합자의 비인두와 Adenoid 성장에 관한 누년적 연구)

  • JI, Myung-Ju;Park, Kyung-Duk;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.26 no.4
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    • pp.373-387
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    • 1996
  • The purpose of this study was to evaluate the growth pattern of nasopharyx and adenoid and to obtain useful measurements for evaluating the fuction of the nasal breathing. The biennial serial cephalometric radiographs of 33 samples(19 male, 14 female) with normal occlusion from 8.5 years to 18.5 years of age were used in this study. The distances, areas and ratios on nasopharynx and adenoid were measured and analyzed in each age and sex. The results of this study might be summarized as follows ; 1. The mean value and standard deviation of each measurement was obtained in each age and sex. 2. The nasopharyngeal height and the nasopharyngeal depth increased significantly by 14.5 years of age in male and 12.5 years of age in female(p<0,05), 3. The relative nasal airway area showed the minimal value at 8.5 years of age and showed significant increase from 10.5 years to 12.5 years of age in male and from 12.5 years to 14,5 years of age in female(p<0.05). 4. In the correlation analysis between the measurements on the nasal airway and the measurement of relative nasal airway area, the measurements of Ad2-PNS, Ad2-PNS/Ho'-PNS and Upper pharynx appeared singnificant correlation with the measurement of relative nasal airway area(p<0.01).

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The Usefulness of a Bronchodilator after the Closed Reduction of Nasal Bone Fracture (비골 골절 정복술 후 기관지 확장제 투여의 유용성)

  • Kim, Jin Yong;Kim, Young Hwan
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.22-27
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    • 2011
  • Purpose: Packing the nose is a common procedure after the closed reduction of a nasal bone fracture to prevent postoperative complications, such as bleeding and adhesion formation as well as to stabilize the framework of the nasal bone. On the other hand, it is difficult for a patient to endure nasal packing because of breathing difficulties, headaches, chest discomfort, insomnia, general weakness and hypoxia. This study examined the availability of a bronchodilator to improve the decreased oxygen saturation and postoperative symptoms on nasal packing. Methods: From February, 2010 to July, 2010, a prospective randomized comparison of the incidence of a range of postoperative signs and symptoms was conducted on 60 patients, who did (n=30) and did not (n=30) undergo bronchodilator infusion (aminophylline 250 mg/10 mL + normal saline 100 mL IV qd) following nasal packing. The postoperative symptoms and oxygen saturation in the two groups were compared. Results: Patients who had infused the bronchodilator showed improved oxygen saturation. Nevertheless, there were no significant differences in the postoperative uncomfortable symptoms (dyspnea, headache, chest discomfort, insomnia, general weakness) between the two groups. Conclusion: A bronchodilator after nasal packing improves oxygen saturation by dilating the airway tract but it cannot reduce the uncomfortable symptoms caused by nasal obstruction. Overall, the bronchodilator is a useful medication for improving the level of oxygen saturation.

Relationships between Respiratory Diseases and Safety of Pediatric Dental Sedation (소아의 호흡기 질환과 안전한 치과진정법의 연관성)

  • Chung, Woojin;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.327-330
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    • 2015
  • The safety and success of dental sedation for children depend mainly on respiratory status of patients. A special condition, that is, nasal breathing in supine position with their oral airway blocked by rubber dam, should be considered. Therefore, irrespective of medical consultation, pediatric dentists themselves should do respiratory assessment especially adenotonsillar hypertrophy, nasal obstruction, posterior nasal drainage and airway hypersensitivity. Patients with sinusitis, allergic rhinitis, asthma, snoring and OSAS(obstructive sleep apnea syndrome) can induce the sedation failure and complete management of these can improve the safety of dental sedation.

The PIV measurements on the respiratory gas flow in human airway (호흡기 내 주기적 공기유동에 대한 PIV 계측)

  • Kim, Sung-Kyun;Chung, Seong-Kyu
    • 한국가시화정보학회:학술대회논문집
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    • 2005.12a
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    • pp.93-98
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    • 2005
  • The mean and RMS velocity field of the respiratory gas flow in tile human airway was studied experimentally by particle image velocimetry(PIV). Some researchers investigated the airflow for the mouth breathing case both experimentally and numerically. But it is very rare to investigate the airflow of nose breathing in a whole airway due to its geometric complexity. We established the procedure to create a transparent rectangular box containing a model of the human airway for PIV measurement by combination of the RP and the curing of clear silicone. We extend this to make a whole airway including nasal cavities, larynx, trachea, and 2 generations of bronchi. The CBC algorithm with window offset (64*64 to 32*32) is used for vector searching in PIV analysis. The phase averaged mean and RMS velocity distributions in Sagittal and coronal planes are obtained for 7 phases in a respiratory period. Some physiologic conjectures are obtained. The main stream went through the backside of larynx and trachea in inspiration and the frontal side in expiration. There exist vortical motions in inspiration, but no prominent one in expiration.

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