• Title/Summary/Keyword: Nasal Airway

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Expression of Bitter Taste Receptors in Human Nasal Respiratory Epithelium

  • An, Jeong-Mi;Wu, Hee-Won;Kim, Hyun-Jun;Kim, Chang-Hoon;Moon, Seok-Jun
    • International Journal of Oral Biology
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    • v.37 no.2
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    • pp.57-62
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    • 2012
  • The nasal cavity encounters various irritants during inhalation such as dust and pathogens. To detect and remove these irritants, it has been postulated that the nasal mucosa epithelium has a specialized sensing system. The oral cavity, on the other hand, is known to have bitter taste receptors (T2Rs) that can detect harmful substances to prevent ingestion. Recently, solitary chemosensory cells expressing T2R subtypes have been found in the respiratory epithelium of rodents. In addition, T2Rs have been identified in the human airway epithelia. However, it is not clear which T2Rs are expressed in the human nasal mucosa epithelium and whether they mediate the removal of foreign materials through increased cilia movement. In our current study, we show that human T2R receptors indeed function also in the nasal mucosa epithelium. Our RT-PCR data indicate that the T2R subtypes (T2R3, T2R4, T2R5, T2R10, T2R13, T2R14, T2R39, T2R43, T2R44, T2R 45, T2R46, T2R47, T2R48, T2R49, and T2R50) are expressed in human nasal mucosa. Furthermore, we have found that T2R receptor activators such as bitter chemicals augments the ciliary beating frequency. Our results thus demonstrate that T2Rs are likely to function in the cleanup of inhaled dust and pathogens by increasing ciliary movement. This would suggest that T2Rs are feasible molecular targets for the development of novel treatment strategies for nasal infection and inflammation.

Effect of Nasal Continuous Positive Airway Pressure after Early Surfactant Therapy in Moderate Respiratory Distress Syndrome (중등도 신생아 호흡 곤란 증후군에서 폐 표면 활성제 조기 투여 후 Nasal CPAP의 치료 효과)

  • Kim, Eun Ji;Kim, Hae Sook;Hur, Man Hoe;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1204-1212
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    • 2002
  • Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

High Flow Nasal Cannula versus Nasal CPAP in Preterm Infants (미숙아에서 경비지속기도양압과 가습고유량비강캐뉼라의 사용에 대한 비교 연구)

  • Yoon, Seong-Ho;Kwon,Young-Hee;Park, Hyun-Kyung;Kim, Chang-Ryul;Seol, In-Jun;Lee, Hyun-Ju
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.293-300
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    • 2011
  • Purpose: The aim of the study was to investigate the change in usage and clinical outcomes of using a humidified high flow nasal cannula (HHFNC) in preterm infants. Methods: A retrospective review of patients with gestational age <32 weeks born at our neonatal intensive care unit from January 2008 to March 2011 was performed. First, data were compared between Era 1 (January 2008 to February 2009) and Era 2 (March 2009 to March 2011) to describe the increased usage of HHFNC. Second, the patients (gestational age 25-30 weeks) were divided into two groups to compare clinical outcomes. nasal continuous positive airway pressure (NCPAP) and HHFNC groups who received either NCPAP or HHFNC as a respiratory support within 14 days of birth. Results: Compared to Era 1, HHFNC usage increased from 10 to 55% in Era 2, whereas NCPAP usage decreased from 40 to 5%. No difference in pulmonary or adverse outcomes including the incidence of reintubation and bronchopulmonary dysplasia (BPD), days on oxygen and a ventilator, and other outcomes was observed between the HHFNC and NCPAP groups. Days to reach full feed (32.2${\pm}$16.7 vs. 24.7${\pm}$10.2, P=0.05) and regain birth weight (20.9${\pm}$16.9 vs. 17.2${\pm}$4.3, P=0.04) decreased in the HHFNC group. Conclusion: HHFNC was feasible and did not differ in respiratory and other outcomes, but days to reach full feed and regain birth weight decreased in the HHFNC, when compared with the NCPAP. An additional prospective multicenter designed study is needed to better define safety and efficacy of HHFNC.

Airway hyperresponsiveness and etiology in patients with chronic cough (만성기침 환자의 원인적 고찰 및 기관지 과민성)

  • Kim, Kyung Ho;Lee, Gyu Taeg;Park, Sung Woo;Oh, Je Ho;Ki, Shin Young;Moon, Seung Hyug;Jeong, Sung Hwan;Kim, Hyun Tae;Uh, Soo Taek;Kim, Yong Hoon;Park, Choon Sik;Jin, Byung Won
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.146-153
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    • 1997
  • Background : Chronic cough is commomly defined as a persistent or recurrent cough exceeding 3 week's duration. The prevalence of chroinc cough is reported to range from 14% to 23 % for nonsmoking adults. The post nasal drip syndrome has been determined to be the most common cause of chronic cough, followed by asthma, chronic bronchitis, gastroesophageal reflux and bronchiectasis. Cough can be the only manifestation of asthma. Bronchial provocation tests are useful in diagnosing cough variant asthma. We investigated the clinical or laboratory findings and the incidence of airway hyperresponsiveness and evaluated the etiology in patients with chronic cough. Method : We evaluated 46 patients with chronic cough. Methacholine challenge test were done. Results : The results were as follows : 1) Thirty - five percent(16/46) of the chronic cough patients and 44% of the post nasal drip syndrom(7/16) showed the positive responses to methacholine challenge test 2) The underlying causes of chronic cough were post nasal drip syndrome in 35%, bronchitis in 21.7%, cough-variant asthma in 17.4%, and unknown condition in 25.9%. 3) Airway hyperresponsiveness in chronic cough was not related to respiratory symptom, nasal symptom, post nasal drip, smoking, derangement of ventilatory function, atopy, or sinusitis. Conclusion : Airway hyperresponsivenss in patients with chronic cough increased in frequency when compaired with normal control, allergic rhinitis. Cough-variant asthma account for 17.4% of patients with chronic cough.

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Classification of Sleep/Wakefulness using Nasal Pressure for Patients with Sleep-disordered Breathing (비강압력신호를 이용한 수면호흡장애 환자의 수면/각성 분류)

  • Park, Jong-Uk;Jeoung, Pil-Soo;Kang, Kyu-Min;Lee, Kyoung-Joung
    • Journal of Biomedical Engineering Research
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    • v.37 no.4
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    • pp.127-133
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    • 2016
  • This study proposes the feasibility for automatic classification of sleep/wakefulness using nasal pressure in patients with sleep-disordered breathing (SDB). First, SDB events were detected using the methods developed in our previous studies. In epochs for normal breathing, we extracted the features for classifying sleep/wakefulness based on time-domain, frequency-domain and non-linear analysis. And then, we conducted the independent two-sample t-test and calculated Mahalanobis distance (MD) between the two categories. As a results, $SD_{LEN}$ (MD = 0.84, p < 0.01), $P_{HF}$ (MD = 0.81, p < 0.01), $SD_{AMP}$ (MD = 0.76, p = 0.031) and $MEAN_{AMP}$ (MD = 0.75, p = 0.027) were selected as optimal feature. We classified sleep/wakefulness based on support vector machine (SVM). The classification results showed mean of sensitivity (Sen.), specificity (Spc.) and accuracy (Acc.) of 60.5%, 89.0% and 84.8% respectively. This method showed the possibilities to automatically classify sleep/wakefulness only using nasal pressure.

Treatment of skeletal Class II adult patient with vertical and transverse problems caused by nasal airway obstruction using microimplant anchorage (비강기도 협소에 의한 수직 및 횡적 문제를 가진 골격성 II급 성인환자에서의 마이크로임플란트를 이용한 증례보고)

  • Chae, Jong-Moon;Chang, Na-Young;Cho, Jin-Hyoung;Kang, Kyung-Hwa;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.39 no.4
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    • pp.257-272
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    • 2009
  • This case report describes the treatment of an adult patient with a Class I canine and molar relationship but a convex profile with a retrognathic mandible and marked lip protrusion, as well as an excessive lower anterior facial height and reduced transverse width on both arches due to a nasal airway obstruction. The constricted arches were expanded by surgically-assisted rapid palatal expansion and the application of a Schwarz appliance to the maxilla and mandible. Acceptable facial balance was obtained using contemporary directional force technology with microimplant anchorage (MIA), which provided horizontal and vertical anchorage in the maxillary and mandibular posterior teeth, as well as intrusion and torque control in the maxillary anterior teeth, resulting in a favorable counterclockwise mandibular response. The total treatment period was 29 months and the results were acceptable for 13 months after debonding.

An Aerodynamic study used aerophone II for snoring patients (코콜이 환자의 sleep splint 착용 전후의 음향학적 및 공기역학적 연구)

  • Jung, Se-Jin;Kim, Hyun-Gi;Shin, Hyo-Keun
    • The Journal of the Korean dental association
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    • v.49 no.4
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    • pp.219-226
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    • 2011
  • Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.

Extranodal NK/T cell Lymphoma, nasal type: clinical, radiological, histological features for early diagnosis (원발성 비성 NK/T 세포 림프종: 조기 진단을 위한 임상적, 방사선학적, 조직학적 특징)

  • Park, Kyung-Ran;Han, Seon-Hee;Kim, Hyun-Sil;Lee, Seung-Jun;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.497-501
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    • 2010
  • Primary nasal type natural killer (NK)/T cell (NKTC) lymphoma, a specific form of malignant lymphoma, has a higher geographic incidence in Oriental, Mexican, and South American populations than the Western population. In Koreans, it comprises 9-12% of all cases of non-Hodgkin's lymphoma. This type of lymphoma has also been named as angiocentic lymphoma and lethal midline granuloma because the most common site is the upper airway area and its clinical aggressiveness presents with a necrotic and destructive pattern. NKTC lymphoma can also be detected in different organs (testis, spleen, parotid gland, skin, gastroinstinal tract, central nervous system, lungs, bone marrow, etc.) other than the upper airway including the oral cavity. The lymphoma detected in the oral cavity shows various destructive and inflammatory changes, similar to the signs of inflammation and infection from periodontitis and pulpal disease, making a diagnosis difficult with just the clinical signs. For early detection, clinical, radiological, and pathological examinations are required. This report describes the clinical, radiological and histological characteristics with a case report for the early detection of NKTC lymphoma in the oral cavity.

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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    • v.41 no.4
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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.

Corrective Rhinoplasty for Deviated Nose a New Osteotomy Technique (굽은 코 교정을 위한 새로운 뼈자름술)

  • Park, Dae Kyun;Kim, Sang Beom;Han, Seung-Kyu;Kang, Eun Taek;Kim, Woo Kyung
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.243-249
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    • 2007
  • Purpose: Posttraumatic nasal deformities might not be corrected adequately by conventional osteotomy techniques when the configuration of the nasal bone has been changed due to malunion. To consistently obtain good aesthetic and functional results, the anatomic reduction of malunion sites of the nasal bone is important. The purpose of this study is to present an osteotomy technique, including refracture along malunion sites and anatomical reduction of a malformed nasal bone, for the correction of a posttraumatic deviated nose. Methods: From March of 2003 to May of 2004, 27 patients, who underwent corrective rhinoplasty for the correction of bony pyramid deviation, were included in this study. Postoperative results of the technique were evaluated objectively at 1 year after surgery regarding nasal midline location, nose symmetry, and nasal contour. Results were rated as excellent, good, fair, or poor. All patients were also evaluated subjectively for cosmetic improvement, changes in breathing, and overall satisfaction. Results: Objective analysis of the outcomes revealed an excellent result in 17 patients(63%), good in 9(33%), and fair in 1 patient(4%). No case evaluated had a poor result. Regarding subjective analysis, 19 patients(70%) evaluated the cosmetic outcome as perfect. Among the 21 patients with preoperative airway problems, 19 patients(90%) reported improved breathing post-operatively. Patients' overall satisfaction levels were also very positive. No postoperative complications occurred during the 14 month mean follow-up period. Conclusion: The osteotomy technique presented in this study is simple, effective, and safe for correcting posttraumatic nasal deviation, and also produces consistent results.