• 제목/요약/키워드: Nasal diseases

검색결과 194건 처리시간 0.027초

기류 제한에 영향을 미치는 허탈성 기도의 분석 (The detection of collapsible airways contributing to airflow limitation)

  • 김윤성;박병규;이경인;손석만;이효진;이민기;손춘희;박순규
    • Tuberculosis and Respiratory Diseases
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    • 제43권4호
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    • pp.558-570
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    • 1996
  • 연구배경 : 허탈성 기도의 분석은 만성 기도 질환 및 기관지 천식의 치료에 있어서 중요성을 가지고 있다. 순수한 허탈성 기도 질환과 기관지 천식에 의한 허탈성 기도 질환의 감별은, 전자는 pursed lip breathing이나 nasal positive pressure ventilation으로 치료하며, 후자는 약물요법이 사용된다는 점에서 중요하다. 기관지 천식이나 폐기종의 요인으로 고려되는 허탈성 기도는 비가역적인 기류 제한의 한 형태이며, 그것은 폐활량 측정법에 의해 측정되는 용적과 체적 기록법에 의해 측정되는 가스 압박에 의한 용적과의 차이를 비교함으로써 접근할 수 있다. 방법 : 폐활량 측정법을 이용하여 폐활량과 노력성 폐활량(SVC-FVC) 사이의 용적 차이를 측정함으로써, 기도 허탈의 지표로 유용한지를 조사하기 위해, 1995년 1월부터 7월까지, 본원 폐기능 검사실에 내원한 기류 폐쇄가 있는 환자 20명(만성폐쇄성폐질환 12명, 안정시의 기관지천식 7명, 만성폐쇄성폐질환과 기관지천식이 병합된 1명)과, 기류 폐쇄의 소견이 보이지 않는 정상인 20명을 대상으로 폐활량 측정법과 체적 기록법을 이용하여, 기관지 확장제 투여 전후의 폐활량 측정법 검사지표들의 변화를 측정하였다. 결과 : 1) 기류 폐쇄가 있는 환자의 평균 연령은 $58.3{\pm}7.24$(세), 신장은 $166{\pm}8.0$(cm), 체중은 $59.0{\pm}9.9$(kg)였으며, 정상인의 평균 연령은 $56.3{\pm}12.47$(세), 신장은 $165.9{\pm}6.9$(cm), 체중은 $64.4{\pm}0.4$(kg)으로 유의한 차이는 없었으며(p>0.05), 남녀비는 각각 14:6이었다. 2) 환자군의 SVC-FVC는 $395{\pm}317ml$, 정상군의 SVC-FVC는 $154{\pm}176ml$로 유의한 차이가 있었으며(p<0.05), 두 군의 분별치를 208ml로 했을때 민감도와 특이도가 가장 높았다. 3) 기관지 확장제 투여후, 폐활량 측정법이나 체적 기록법으로 가역성 기도 폐쇄를 보인 경우는 환자군에서 16명, 대조군에서는 7명이었으며(p<0.05), 기관지 확장제 반응군 및 비반응군의 SVC-FVC는 각각 $300.4{\pm}306ml$, $144.7{\pm}180ml$로 유의 한 차이가 있었다(p<0.05). 4) 기관지 확장제 투여전의 SVC-FVC는, 기도 저항(Raw)과 연관이 있었으며(r=0.307 p=0.05), 기관지 확장제 투여후의 SVC-FVC는, 기관지 확장제 투여전의 SVC-FVG(r=0.559 p=0.0002), TGV(r=0.488 p=0.002)및 기관지 확장제 투여후의 기도 저항(r=0.583 p=0.0001), TGV(r=0.375 p=0.0170)와 연관이 있었다. 5) 전체 실험군에서 흡연자(28명)와 비흡연자(12명)의 SVC-FVC는 각각 $267.5{\pm}303ml$, $277.5{\pm}276ml$이었으며, 통계적 유의성은 없었다(p>0.05). 결론 : 폐활량계에 의한 SVC-FVC측정이 허탈성 기도를 분석하고, 치료방침을 결절하는데 도움을 줄 수 있을 것으로 기대된다.

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Chloromethylisothiazolinone (CMIT)과 Methylisothiazolinone (MIT)의 건강영향에 대한 고찰 - 가습기 살균제 폐 손상을 중심으로 - (Review of Health Effects Caused by Chloromethylisothiazolinone (CMIT) and Methylisothiazolinone (MIT) - Focusing on Humidifier Disinfectant-associated Lung Injury (HDLI) -)

  • 박동욱;김지원;류승훈;박지훈;권정환;이소연;박소영
    • 한국환경보건학회지
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    • 제46권3호
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    • pp.312-323
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    • 2020
  • Objective: This study aimed to summarize the physiochemical properties, toxicity, and legal regulation of chloromethylisothiazolinone (CMIT) and/or methylisothiazolinone (MIT), review the health effects caused by exposure to CMIT/MIT, and evaluate the individual association of lung injury with the use of humidifier disinfectants (HD) containing a mixture of CMIT and MIT. Method: A literature review was conducted by searching keywords such as CMIT, MIT, health effect, dermatitis, asthma, and lung injury, either singly or combined. Results: Both CMIT and/or MIT were found to be associated with the development of several types of adverse health effects. In particular, respiratory diseases including asthma, nasal symptoms, cough, and rhinitis were caused by the use of products including CMIT or/and MIT. The mixture of CMIT/MIT has been banned in cosmetics. As of the end of 2017, nine patients who were confirmed to have HD associated lung injury (HDLI) were found to have used only an HD brand containing CMIT and MIT. Their responses regarding the name of the HD used could be trustworthy based on the short duration of HD use (less than six months) before the onset of HDLI and frequent use of HD per day. Conclusion: According to the toxicity and HDLI cases, the use of HD containing CMIT and /or MIT can cause fatal lung injury. Further study with manufacturers' assistance is necessary in order to obtain more clear evidence on the causal relationship since HDLI cases are being reported continuously.

Kirschner Wire Fixation for the Treatment of Comminuted Zygomatic Fractures

  • Kang, Dai-Hun;Jung, Dong-Woo;Kim, Yong-Ha;Kim, Tae-Gon;Lee, JunHo;Chung, Kyu Jin
    • 대한두개안면성형외과학회지
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    • 제16권3호
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    • pp.119-124
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    • 2015
  • Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

최근 5년간 응급실을 내원한 구강악안면외과 환자에 대한 임상적 연구 (A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY DURING RECENT 5 YEARS)

  • 김종렬;정인교;양동규;박봉욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권2호
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    • pp.155-162
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    • 2001
  • This is a clinical study on patients who had visitied the Emergency Room of Pusan National University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years, from 1992 to 1996. The results were as follow ; 1. The total number of patients was 2,680 and the ratio of male to female was 1.96:1, The highest monthly incidence was shown in September(12.1%) and October(10.5%) and the age distribution peaks was the third decade(24.3%), followed by the first(23.1%) and the fourth decade(17.2%). 2. Soft tissue injury group(29.1%) was the most prevalent, followed by tooth injury group(16.1%), facial bone injury group (16.0%), toothache group(11.2%), socket bleeding group(11.1%), infection group(9.8%) and TMJ dislocation group(5.9%). 3. The percentage of in-patients and out-patient were 21.6% and 78.4%, respectively. The frequent causes of admission were facial bone fracture(73.8%), infection(20.8%) and soft tissue injury(4.8%) in order. However, soft tissue injury was the most frequent cause in out-patient, followed by tooth injury(20.5%), toothache(14.3%), socket bleeding(14.2%) and TMJ dislocation(7.6%). 4. In the facial bone injury group, the mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%) and nasal bone fractures(4.0%). 5. In the mandibular bone fracture, the most common location was symphysis(36.7%), followed by the mandibular angles(33.1%) and the condyles(21.8%). 6. The common causes of facial bone fractures were violence, fall and traffic accident in order. 7. The common causes of soft tissue injury were fall down, fight and traffic accident in order and the highest incidence was observed in infants before the age of 10 years(44.0%). 8. In the group of tooth injury, tooth luxation(38.5%) showed the highest incidence followed by tooth fracture(33.2%) and tooth loss(17.1%). The common causes of tooth injury were fall, fight and traffic accident in order. 9. In infected patients group, the ratio of in-patients to out-patients was 1 : 1.28, Buccal(24,7%) and infraorbital space abscess(23.3%) showed the highest incidence. 10. The pain caused by dental caries(39.0%) and pericoronitis(26.6%) showed high incidence in the toothache group. 11. The high incidence was observed during third(34.0%) and fourth (24.5%) decades in TMJ dislocation group. 12. In the group of socket bleeding patients, 92% was post-operative hemorrhage and 8% was accompanied with other systemic hemorrhagic diseases.

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제 I 형 알레르기 반응이 유도된 생쥐에서 식물추출 복합물(PEM381)의 효과 (Effects of Phyto-Extract Mixture (PEM381) in Type I Allergic Reaction-Induced Mice)

  • 김경범;박정수;정종문
    • 한국식품영양과학회지
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    • 제36권11호
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    • pp.1377-1384
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    • 2007
  • 본 연구에서는 녹차(Camellia sinensis)잎 추출물, 구아바(Psidium guajava)잎 추출물 그리고 장미 (Rosa hybrida)꽃잎 추출물로 이루어진 식물추출 복합물(PEM381)이 실험동물상에서 제 I 형 알레르기 반응에 미치는 영향을 알아보고자 제 I 형 알레르기 반응을 유발시킨 생쥐를 모델로 류코트리엔류, 프로스타글란딘류 그리고 히스타민 농도 및 호산구의 비강내 침윤 정도를 측정하였다. 그 결과 PEM381은 류코트리엔류의 생합성을 억제할 뿐만 아니라 호산구의 비강내침윤도 억제하는 것으로 나타났다. 그리고 비록 통계학적으로 유의적인 차이는 없었으나 PEM381은 히스타민 방출을 억제하는 것으로 나타났다. 그러나 PEM381에 의한 프로스타글란딘류의 생합성에 미치는 영향은 신뢰할만한 결과를 얻어내지 못했다. 이상의 결과로 미루어 PEM381은 알레르기성 비염, 아토피 피부염 및 기관지 천식 같은 제 I 형 알레르기 질환에 대하여 예방 및 개선에 유용하게 사용될 수 있을 것으로 생각된다.

단일병원 신생아 환자의 메티실린내성 황색포도알균 보균율 (Colonization Rate of Methicillin-resistant Staphylococcus aureus in Neonates: A Single Center Experience)

  • 최수영;한상우;윤혜선;기모란
    • Pediatric Infection and Vaccine
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    • 제19권3호
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    • pp.111-120
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    • 2012
  • 목 적 : 단일 병원 신생아입원실에 입원한 신생아를 대상으로 환자의 임상적 특징에 따른 MRSA 보균율을 알아보고, 그 기원을 추정해 보며, MRSA 보균에 영향을 미치는 요소들을 살펴보고자 하였다. 방 법 : 2008년 1월부터 2011년 12월까지 을지대학교 서울 을지병원 신생아 입원실에 입원하여 MRSA 감시배양검사를 시행받은 1,733명의 신생아를 대상으로 의무기록을 후향적으로 조사하였다. MRSA 감시배양검사는 비강, 서혜부, 직장에서 시행하였고, 퇴원 시까지 매주 반복 시행 하였다. MRSA 감시배양결과에 따라서 보균자와 비보균자로 나누었다. 결 과 : 대상환자 1,733명 중에 415명(23.9%)이 MRSA 보균자였다. 제태기간, 출생체중, 분만 방식, 분만전 산모에게 항생제 투여 여부, 출생장소, 입원전 체류 장소에 따라서 MRSA 보균율에 차이를 보였다(P<0.001). 다변량 검사에서 분만전 산모에게 예방적 항생제를 투여하지 않은 경우가 투여한 경우에 비해서 신생아가 MRSA 보균자가 될 위험도가 2.8배(OR=2.77; 95% CI, 1.88-4.07), 출생장소가 외부인 경우가 본원인 경우에 비해서 2.3배(OR=2.28; 95% CI, 1.17-4.42) 높음을 확인하였다. 결 론 : 신생아 입원환자를 대상으로 한 MRSA 보균율은 23.9%로 상대적으로 높은 보균율을 확인하였다. 환자특성을 고려하여 추정한 HA-MRSA 보균율은 51/511명(10%), CA-MRSA 보균율은 309/858명(36%) 이었다. 본병원 신생아에서 MRSA 보균과 연관된 요인은 산모의 예방적 항생제 사용여부와 출생장소임을 확인하였다.

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한국의 소아 청소년에서 인플루엔자 백신의 효능평가 (Protective Field Efficacy Study of Influenza Vaccines for Korean Children and Adolescent in 2010-2011 Season)

  • 김승연;김남희;은병욱;김소희;박기원;장현오;강은경;김동호
    • Pediatric Infection and Vaccine
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    • 제19권3호
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    • pp.149-156
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    • 2012
  • 목 적 : 소아청소년을 대상으로 2010-2011 인플루엔자 백신의 야외 효능을 확인하고자 하였다. 방 법 : 2010년 9월에서 2011년 2월까지 소아 청소년을 대상으로 서울 경기지역의 7개 병원과 1개 초등학교에서 인플루엔자 백신을 접종한 시험군과 접종하지 않은 대조군을 모집하였다. 급성 발열성 호흡기 질환 증상이 있을시 임상시험기관에 방문하도록 하여 검체를 채취하여 감염여부를 확인하였다. 결 과 : 시험 군 407명 중 3명(0.74%)에서 3건의 신종 H1N1 인플루엔자 바이러스가 검출되었고, 대조군 230명 중 10명(4.35%)에서 12건을 검출하여 9명(3.91%)에서 9건의 신종 H1N1, 3명(1.30%)에서 3건의 H3N2 인플루엔자 바이러스를 검출하였다. 시험군에서의 인플루엔자 발생률은 0.74%, 대조군에서 4.35%였다. 백신의 야외 효능은 83.2%였다. 결 론 : 소아청소년을 대상으로 2010-2011년 인플루엔자 백신의 야외효능은 우수하였음을 확인하였다.

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Pulmonary Function and Its Influence Factors of Residents in Yeosu Industrial Complex

  • Hong, Eun-Ju;Ahn, Gi-Sub;Chung, Eun-Kyung;Guo, Xinbiao;Son, Bu-Soon
    • 한국환경과학회지
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    • 제20권7호
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    • pp.799-809
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    • 2011
  • Objectives: This study is aimed at identifying the influential factors on the pulmonary function of ordinary residents in the surrounding areas of Yeosu Industrial Complex. Methods: The PFT (Pulmonary Function Test) was conducted on the target residents numbering 989 people (male 361, female 628). The exposed group (813 people) resided within the radius of 5km from Yeosu Industrial Complex and the control group (176 people) resided in the radius of more than 15 km from May 2007 to November 2007. The survey also took into account other factors including personal characteristics, life habits, respiratory diseases and allergic symptoms, medical histories, and the living environments of the residents in order to further identify influential factors on pulmonary function. Result: When comparing the PFT values of the exposure groups to the control group of the same city, values of the exposure groups were meaningfully lower with an %$FEV_1$ of 107.05% and %FVC of 100.28%. Conversely, the control group reported an %$FEV_1$ and %FVC of 107.26% and 102.85% respectively, indicating that ambient air pollutants reduce lung function. The odds ratio of asthma diagnosis history increased when a subjects residence was close to a heavily trafficked road, traffic amount was huge, a bed was used, and the family had less than four members. However the results were not statistically meaningful. The odds ratios of abnormal pulmonary function were statistically higher among those with asthma(OR=4.29, CI=1.75-10.56), wheezing (OR=2.59, CI=1.24-5.41), and nasal congestion (OR=2.87, CI=1.36-6.08) (p<0.01). The factors affecting $FEV_1$ were symptoms including asthma, passive smoking and allergic eye disease ($R^2$=0.049, p<0.001). For the FVC symptoms including asthma ($R^2$=0.014, p<0.001) were measured. The analysis showed that FVC decreased with increases in $O_3$ and CO(p<0.01). Furthermore, $FEV_1$ decreased with increases in $O_3$(p<0.01). Conclusions: These results will provide preliminary data for establishing responsive measures to protect the health of residents in industrial complexes from air pollution, and to develop lasting environmental health policies.

알레르기비염의 삶의 질 평가를 통한 최신 한방치료의 효과 (The Effectiveness of Recent Traditional Korean Medical Therapy on Treating Allergic Rhinitis Examined by Quality of Life Questionnaires)

  • 염승철;이건목;조남근;이건휘
    • Journal of Acupuncture Research
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    • 제24권1호
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    • pp.79-98
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    • 2007
  • Objectives : The study of Traditional Korean medical therapy has recently become a popular academic field as proven to be an great alternative to the limitation of Western medical treatment. However, there has been little study examining the Quality of life to investigate the Effectiveness of Recent Traditional Korean Medical Therapy on Treating Allergic Rhinitis. Thus, this study aims to reveal the characteristics of Allergic Rhinitis patients, their clinical symptoms, and other accompanying diseases. Moreover, it attempts to investigate the sense of improvement and satisfaction from the Allergic Rhinitis patients treated with Traditional Korean Medical therapy by examining Quality of Life Questionnaires. Subject and Method : A total of 380 subjects that consists of allergic rhinitis patients and non patients were participated in this study. 330 allergic rhinitis patients were divided into two groups; the experimental group (230 subjects) was treated with Traditional Korean Medical therapy, and the control group (100 subjects) was not treated with any other therapy. Also, the normal control group (50 subjects) who had no symptoms of the allergic rhinitis was participated in this study as well. All the subjects were asked to answer to the questionaries that consist of two parts such as recalling the symptoms that they had 3 month ago, and describing the current symptoms that they had the present. The experimental group also was asked to answer the quality of life questionnaire before and after the therapy. Results: The results of investigating recent Traditional Korean therapy are as follows: 1. The reservoir rate of other disease was 39.0% in the control group and 34.8% in the experimental group. These were higher than the rate of the normal control (10.0%), which reveals the clinical characteristics of allergic rhinitis patients. 2. The symptoms of Allergic Rhinitis showed improvement after Traditional Korean medical therapy, which can be shown by its statistical significance. (p=.000<.001). 3. 97.0% of the Allergic Rhinitis patients treated with the Korean Therapy answered the improvement of symptom within 4 weeks, and 88.3% of the patients were satisfied with the Traditional Korean medical therapy. 4. The Nasal symptoms had prominently positive effect at the most as the symptoms significantly affect sleep disturbances, ocular symptoms, activity limitation, and emotional problems.

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대학병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구 (A clinical study on the dental emergency patients visiting an University Hospital emergency room)

  • 장창수;이창연;김주원;임진혁;김좌영;김영희;양병은
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권6호
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    • pp.439-447
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    • 2011
  • Introduction: In today's society, the rapid and appropriate care of the dental emergency patients is much more important. So, a retrospective study on the characteristics of emergency dental injuries and diseases will be very meaningful. Materials and Methods: This retrospective clinical study was carried by reviewing the radiographic films and emergency chart of 11,493 patients who had visited the emergency room of Hallym Sacred heart Hospital and were treated in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2010. Results: The male to female ratio was 1.9:1. The highest monthly incidence was observed in May (10.4%) and June (8.9%) and the peak age distribution was the first decade (56.0%), followed by the second decade (16.0%). Trauma was the most common cause in dental emergency patients, followed in order by toothache, odontogenic infection, temporomandibular joint (TMJ) disorder and oral hemorrhage. Soft tissue injury was most prevalent in the trauma group, followed by tooth injury and facial bone fractures. In the tooth injury group, tooth fracture (56.7%) showed the highest incidence followed in order by tooth subluxation (18.2%), tooth concussion (16.9%), tooth avulsion (11.5%) and alveolar bone fractures (3.7%). In the facial bone fracture group, mandibular fractures (81.8%) showed the highest incidence followed in order by maxilla fractures (15.7%), nasal bone fractures (9.0%), zygomaticomaxillary complex fractures (5.4%), orbital bone fractures (2.5%). In mandibular bone fractures, the most common location was the symphysis (70.1%), followed in order by the mandibular angle (33.0%), mandibular condyle (22.8%) and mandibular body (13.6%). In the infection group, a submandibular space abscess (46.2%) was most common followed in order by a buccal space abscess (17.4%), canine space abscess (16.9%) and submental space abscess (12.3%). TMJ dislocation (89.3%) showed the highest incidence in the TMJ disorder group, followed by TMJ derangement (10.7%). In the other group, a range of specific symptoms due to post operation complications, trigeminal neuralgia, chemical burns and foreign body aspiration were reported. Conclusion: For the rapid and appropriate care of the dental emergency patients, well-organized system should be presented in oral and maxillofacial surgery. And it is possible under analysis of pattern and the variation of the dental emergency patients.