• 대한기관식도과학회지
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• 제13권1호
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• pp.43-46
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• 2007

Nasopharyngeal stenosis is an obliteration of the normal communication between the nasopharynx and the oropharynx resulting from the fusion of the tonsillar pillars and soft palate to the posterior pharyngeal wall. It is a rare but serious problem. The most common etiology is currently the surgical trauma associated with uvulopalatopharyngoplasty or adenotonsillectomy. It can range in severity from a thin band to a complete obstructing cicatrix, Symptoms vary from mild hyponasal speech to almost complete nasal obstruction with oral breathing, We present a case of a 16 year-old male with nasopharyngeal stenosis after radiofrequency-assisted adenoidectomy in this paper. This patient was managed by synechiolysis, obturator and buccal mucosal graft.

• 대한수의학회지
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• 제45권1호
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• pp.93-97
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• 2005

Systemic aspergillosis were outbroken of 17 Korean native calves at livestock farm in Kyunggi province. Two 3 months old calves were died after having diarrhea, coughing, dyspnea, nasal discharge, and abdominal breathing. These calves were diagnosed of aspergillosis as multifocal to coalescing pyogranulomatous inflammation with intralesional aspergillus infiltration at liver, kidney, spleen, heart, lymph nodes, lungs, intestine and cerebrum. Aspergillus fumigatus was cultured from the affected tissues. And the small intestine was positive against bovine viral diarrhea (BVD) virus on FA test. We considered that the secondary fungal infections killed the calves after BVD virus infection primarily.

• Journal of Rhinology
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• 제25권2호
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• pp.108-113
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• 2018

Cholesterol granuloma is a disease in which cholesterol crystals act as a foreign substance in the surrounding tissues and cause granulomatous reaction and fibrosis within the chamber. It is found in various locations of the body, but the most common location is the temporal bone associated with middle ear disease. Because the disease is associated with breathing disturbance, it may also occur in the paranasal sinus. However, it has been rarely reported since its first report by Graham and Michaels in 1978. Recently, we experienced a case of cholesterol granuloma of the right maxillary sinus of a 63-year-old female patient without any nasal symptoms. We successfully managed this case with Caldwell-Luc operation. Also, we summarized the cases of cholesterol granuloma of the sinonasal region reported in Korea.

• 수면정신생리
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• 제4권2호
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• pp.164-171
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• 1997

Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.

• Tuberculosis and Respiratory Diseases
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• 제42권1호
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• pp.84-92
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• 1995

연구배경: 수면무호흡증후군은 호흡정지로 인한 저산소혈증때문에 심 폐부전, 말초혈관 기능장애 혹은 중추신경질환을 유발할 수 있을 뿐만 아니라 갑작스런 사망을 일으킬 수 있는 질환으로 조기진단 및 적절한 치료가 요구된다. 현재까지는 지속적 기도양압 치료가 가장 효과적인 치료법으로 알려져 있으나, 최적양압을 구하기 위하여는 검사자나 환자의 시간과 노력 그리고 경제적 손실이 많은 실정이다. 저자들은 지속적 기도 양압 치료시의 최적양압에 도달하는 시간을 파악하여 전통적 수면다원화검사 및 양압처방에 소요되는 시간과 노력 그리고 경제적 손실을 줄여 보고자한다. 방법: 수면무호흡증후군 환자에서 진단 및 치료적 수면다원화검사를 실시하며 최적 지속적 기도양압은 2Cm $H_2O$부터 시작하여 무호흡이 정상화되고 최저산소포화도가 향상될 때까지 증가시켜 최적압 도달까지 걸린 시간을 측정 분석하였다. 결과: 1) 지속적 기도양압 치료시 치료전보다 총수면시간, 효과적인 수면시간은 유의한 차이가 없었으나, REM 수면, REM 수면에 도달하는 시간, 무호흡지수, 무호흡 저호흡지수, 최저산소포화도는 의의있게 호전되었다. 2) 평균 최적 지속적 기도양압은 $7.7{\pm}2.9Cm\;H_2O$였고, 이 최적압에 도달하는데 걸리는 시간은 $151.5{\pm}91.3$분이었다. 3) 대상환자들의 33%에서 최적압에 도달하는데 4시간 이상이 소요되었으며, 최적압 도달후 다시 압조정이 필요하였던 경우는 60(47%)예 였고, 나머지 67(53%)예에서는 더 이상의 압조정이 필요없이 처음의 최적압으로 효과가 있었다. 결론: 최적 지속적 기도양압치에 도달하는데 환자의 약 1/3에서 4시간 이상 걸리는 것으로 보아 split night CPAP titration 방법은 수정되어져야 할 것으로 생각되며, nap study시의 2~3시간은 적절한 CPAP titration을 하기에는 불충분할 것으로 생각된다.

• 대한임상검사과학회지
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• 제40권2호
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• pp.129-134
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• 2008

Obstructive sleep apnea syndrome (OSAS) is occurred by apnea by the obstruction of upper trachea while sleeping, followed by repetitive drop on arterial oxygen saturation ($SpO_2$). Therefore, the present study was focused on relation between $SpO_2$ of while having difficulty in breathing and clinical characteristics of OSAS while sleeping. The study took place at Ewha women university Mokdong hospital with 149 subjects (male 121, female 28) who were examined for polysomnography (PSG) from May 2007 to February 2008. All subjects were adhered to electrodes and sensors to measure electroencephalogram (EEG), electrooculogram (EOG), chin & leg electromyogram (EMG), airflow at nasal and oral cavities, breathing movement of chest and abdominal snoring sound and $SpO_2$. Lowest $SpO_2$ in male was meaningfully low with higher body mass index (BMI), louder snoring sound and thick neck circumference (p<0.01). While mean $SpO_2$ based on the degree of AHI did not show significant difference, lowest $SpO_2$ was significantly low with high AHI (p<0.001). Also, lowest $SpO_2$ was closely correlated with BMI (r=-00.343, p<0.001), snoring sound (r=0.177, p<0.05), apnea index (r=-0.589, p<0.001), hypopnea index (r=-0.336, p<0.001) and apnea-hypopnea index (r=-0.664, p<0.001). $SpO_2$ was closely related to clinical characteristics of OSAS, like male, BMI, snoring sound and neck circumference. Also, polysomnography accompanied by recent development of sleep study is considered as critical test to diagnose OSAS, decide the severity of illness, and evaluate the treatment plan.

• 대한한의진단학회지
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• 제20권2호
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• pp.67-75
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• 2016

Objectives There was a correlation between respiratory index and Profile of Mood States (POMS). However, no study has examined the relationship between hyperventilation and POMS. Therefore, this study showed differences in POMS subscales and respiratory patterns between hyperventilation group and normal group. Methods 20 healthy men and women were to complete Nijmegen and Korean-Profile of Mood States(K-POMS) questionnaire aimed at subjects (13 men, 12 women). By attaching a capnometer to the nasal cavity portion, end-tidal $PCO_2$ was measured. Also, marker was attached at Zhangmen, Juque, Shuifen. The movement of the marker was taken as a web cam. Statistical analysis Mann Whitney U test was used for the nonparametric methods. Results In the subscale of K-POMS were significant differences(Tension-0.001, Anger-0.007, Fatigue-0.002, Depression -0.004) between the normal group and the group with the hyperventilation. In addition, between the two groups were obtained a significant result(0.046) in the movement of the Shuifen acupoint. Conclusions Nijmegen questionnaire score is higher, the higher negative subscale scores of K-POMS. Also, differences in Nijmegen questionnaire score may help to determine the presence or absence of the abdominal breathing.

• 대한치과의사협회지
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• 제49권4호
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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.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.64-68
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• 2020

The coexistence of craniofacial cleft and bilateral choanal atresia has only been reported in three cases in the literature, and only one of those cases involved a Tessier number 3 facial cleft. It is also rare for bilateral choanal atresia to be found in adulthood, with 10 previous cases reported in the literature. This report presents the case of a 19-year-old woman with a Tessier number 3 facial cleft who was diagnosed with bilateral choanal atresia in adulthood. At first, the diagnosis of bilateral choanal atresia was missed and septoplasty was performed. After septoplasty, the patient's symptoms did not improve, and an endoscopic examination revealed previously unnoticed bilateral choanal atresia. Computed tomography showed left membranous atresia and right bony atresia. The patient underwent an operation for opening and widening of the left choana with an image-guided navigation system (IGNS), which enabled accurate localization of the lesion while ensuring patient safety. Postoperatively, the patient became able to engage in nasal breathing and reported that it was easier for her to breathe, and there were no signs of restenosis at a 26-month follow-up. The patient was successfully treated with an IGNS.

• 수면정신생리
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• 제7권1호
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• pp.27-33
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• 2000

수면 중 나타나는 호흡장애를 좀 더 정확하게 측정하기 위해 고안된 비강 공기압 측정기의 민감도를 온도감지 센서와 비교하기 위해 30명의 수면무호흡 증후군 환자와 6명의 상기도 저항증후군 환자에서 저호흡-무호흡 지수와 각성지수를 비교하였다. 그리고 상기도 저항 증후군에서 각성을 일으키는 상기도 압력변화에 대해 알아보기 위하여 온도감지 센서에서 발견되지 않은 저호흡-무호흡과 관련된 각성에서 상기도의 압력을 측정하였다. 비강 공기압 측정기가 기존의 온도감지 센서보다 훨씬 더 민감한 방법임을 알 수 있었다(p<0.05). 비강 공기압 측정기로 검사하여 저호흡-무호흡지수가 평균 41%가 증가되었고 호흡장애가 심하지 않은 경증의 수면무호흡 증후군이나 상기도 저항 증후군에서 더 많이 증가하였다. 비강 공기압 측정기로 검사한 저호흡-무호흡지수를 비교하면 상기도 저항 증후군이 수면무호흡 증후군의 가장 경미한 형태라는 것을 알 수 있었다. 상기도 저항 증후군에서 나타나는 각성에서 상기도의 압력 변화는 일정한 범위에서 나타나지 않았고 다양한 압력 분포를 보였으며 수면 중 호흡장애의 정도가 심해질수록 압력변화의 폭이 더 커지는 양상을 보였다. 비강 공기압 측정기가 기존의 온도감지 센서보다 더 민감하지만 아직까지 해결해야 할 문제가 일부 남아 있어서 온도 감지 센서를 완전히 대체하기는 어려울 것으로 보인다. 그러나 경증의 수면무호흡 증후군이나 상기도 저항 증후군을 진단하는 데에는 많은 도움이 될 것이다. 특히 상기도 저항 증후군의 진단에 기존에는 상기도 압력 측정이 필요하다고 하였으나 비강 공기압 측정기를 이용하면 불편한 상기도 압력 측정은 필요 없을 것으로 생각된다.