• Title/Summary/Keyword: Obstruction Area

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Nasal Diseases and Its Impact on Sleep Apnea and Snoring (코질환과 수면무호흡증)

  • Kim, Chang-Hee;Rhee, Chae-Seo
    • Sleep Medicine and Psychophysiology
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    • v.11 no.1
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    • pp.17-21
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    • 2004
  • Nasal congestion is one of the most common symptoms of medical complaints. Snoring is caused by vibration of the uvula and the soft palate. Nasal obstruction may contribute not only to snoring and obstructive sleep apnea (OSA) but also impair application of continuous nasal positive airway pressure (CPAP), which is the most widely employed treatment for OSA. Total or near-total nasal obstruction leads to mouth breathing and has been shown to cause increased airway resistance. However, the exact role of the nasal airway in the pathogenesis of OSA is not clear and there is no consensus about the role of nasal obstruction in snoring and sleep apnea. Some reports have failed to demonstrate any correlation between snoring and nasal obstruction. On the other hand, opposing reports suggest that nasal disease may cause sleep disorders and that snoring can be improved after nasoseptal surgery. Reduced cross-sectional area causes increased nasal resistance and predisposes the patient to inspiratory collapse of the oropharynx, hypopharynx, or both. Discrete abnormalities of the nasal airway, such as septal deformities, nasal polyps, and choanal atresia and with certain mucosal conditions such as sinusitis, allergic rhinitis and inferior turbinate hypertrophy can cause snoring or OSA. Thus, these sources of nasal obstruction should be corrected medically or surgically for the effective management of OSA and adjunctive for CPAP.

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Delayed Parenchymal Transit During Tc-99m MAG3 Renography is a Valuable Sign in Diagnosing Urinary Obstruction in Patients with Early Hydronephrosis (초기의 수신증 환자의 요로폐쇄 진단에 있어 Tc-99m MAG3 신장 스캔시 실질통과지연 소견의 유용성)

  • Lee, Won-Woo;Moon, Dae-Hyuk;Kim, Jae-Seung;Ryu, Jin-Sook;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.5
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    • pp.306-313
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    • 2002
  • Purpose: Diuretic renography (DR) can be false negative in patients with upper urinary tract obstruction due to low compliance of the renal pelvis. Delayed parenchymal transit (DPT) may be a valuable sign in case of false negative DR. We compared the diagnostic values of DR and DPT during Tc-99m MAG3 diuretic scan in adults with suspected unilateral obstructive uropathy. Materials and Methods: Fifty-four patients(male:female=30:24, age: $40.7{\pm}15.5$ yrs) who underwent Tc-99m MAG3 diuretic scan due to suspicious unilateral obstructive uropathy were analyzed. DR with a $T_{1/2}\;of\;>\;15min$ was considered as positive for obstruction. DPT was considered to be present when there was delayed appearance of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal parenchyma. The renal area ratio was defined as the ratio of pixel number of hydronephrotic kidney over that of normal contralateral at $1{\sim}2min$ images. Definition of obstruction was improved hydronephrosis after intervention, or aggravated hydronephrosis without intervention. Non-obstruction was defined as unchanged hydronephrosis over 6 months. Results: Twenty-six renal units had obstruction and 28 no obstruction. The sensitivities of DR and DPT were 69% (18/26) and 50% (13/26) respectively. Two renal units with DPT but negative DR showed the renal area ratio of <1.1. Among the 20 obstructive renal units with DPT or positive DR, 13 with DPT had lower renal area ratio than 7 renal units without DPT ($0.97{\pm}0.20\;vs\;1.30{\pm}0.41,\;p<0.05$). Differential renal function was not significantly different between these groups. DPT correctly diagnosed all renal units with non-obstruction (specificity 100%), while the specificity of DR was 89% (25/28). Conclusion: DPT during Tc-99m MAG3 diuretic scan may be a valuable sign in diagnosing urinary obstruction especially in patients with false negative DR and early HN.

Anesthetic management for emergency tracheostomy in patients with head and neck cancer: a case series

  • Ci Young, Kim;Seongji, Cho;Seung-Hwa, Ryoo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.6
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    • pp.457-464
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    • 2022
  • Tracheostomy is a surgical procedure that is commonly used to treat upper airway obstruction. In particular, patients with head and neck cancer may require elective or emergency tracheostomy because of airway obstruction due to massive bleeding of the intraoral tumor mass and rapid growth of the tumor mass in the neck area. Here, we report four cases of tracheostomy in patients with head and neck cancer with narrowed airway space and difficulty in breathing. Based on these cases and a literature review, we recommend that oral and maxillofacial surgeons and dental anesthesiologists should cooperate closely and determine the appropriate timing to perform definitive airway management for such patients during palliative treatment, along with continuous evaluation of tumor location, risk of recurrence, and airway involvement.

The Hot Spot in Superior Vena Caval Obstruction Using $^{99m}Technetium$ tin Colloid ($^{99m}Tc-tin$ colloid를 이용(利用)한 간(肝)스캔상(上) "Hot spot"로 나타난 상대정맥증후군(上大靜脈症候群) 1예(例))

  • Kim, Byung-Tae;Kwon, Kye-Ik;Shin, Young-Tae;Cho, Kyung-Sam;Lee, Myung-Chul;Cho, Bo-Yeon;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.15 no.1
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    • pp.45-49
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    • 1981
  • The hot spot on liver scan was demonstrated by many authors in various conditions such as SVC obstruction, Budd-Chiari syndrome, liver abscess, hemangioma of liver, hepatic venoocclusive diseases, IVC obstruction, and tricuspid insufficiency. And the appearance of hot spot in SVC obstruction is due to unsual collateral circulation. But there was no report of this hots pot on liver scan in our country. We have recently observed one patient with SVC obstruction who shows well-defined area of increased radioactivity between right and left lobe of liver on liver scan using $^{99m}Tc-tin$ colloid, and demonstrated collateral circulations with RI venography using $^{99m}Tc-O_4$. The injection site of radiocolloid was left antecubital vein. This hot spot did not appear when the radiocolloid was injected into right leg vein. We report here this hot spot on liver scan in SVC obstruction with review of some liter atures.

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Clinical Characteristics in Patients with Biliary Obstruction Diagnosed by $^{99m}Tc-DISIDA$ Scan -In 9 Cases with Normal Ultrasonographic Findings- ($^{99m}Tc-DISIDA$ 간담도 스캔상 담도폐쇄로 진단된 환자의 임상적 특성 -초음파 검사상 정상 소견을 보인 9예를 중심으로-)

  • Park, Bong-Chul;Yang, Soo-Hyun;Che, Dong-Ho;Park, Sung-Ki;Byun, Jong-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.82-85
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    • 1992
  • To evaluate the role of hepatobiliary (DISIDA) scan in the diagnosis of biliary obstruction, we studied the clinical characteristics of 9 cases with biliary obstructuon, whose hepatobiliary scans and ultrasonography were not concordant (normal ultrasonography and abnormal hepatobiliary scan). The results were as follows; 1) The main chief complaints (89%) were abdominal pain, especially in RUQ area. The levels of serum bilirubin were elevated in 67% of patients $(normal\sim5.9mg/dl)$ and those of alkaline phosphatase were elevated in 78% of patients $(normal\sim724U/L)$. 2) The final diagnoses were CBD stones (67%), tumor (22%) and 3 cases were associated with C. sinensis. 3) The major obstruction sites were in distal CBD (89%). From the above results we concluded that hepatobiliary scan is a useful diagnostic method of biliary obstruction, especially in distal CBD lesion and early stage, in spite of normal ultrasonography.

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Scintiangiographic Visualization of Systemic-Portal Venous Shunting as a Cause of "hot Spot" in Superior Vena Cava Obstruction (상대정맥폐쇄증에 의한 전신.문맥계 단락에 따른 국소성 간열소의 출현)

  • Park, Jeong-Mi;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.1
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    • pp.145-148
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    • 1985
  • A small number of pathologic entities such as Budd-Chiari Syndrome, cirrhosis, focal nodular hyperplasia, and superior and inferior vena cava obstruction has been reported to result in focal areas of increased uptake of radiocolloid on the hepatoscintigram. We recently studied a patient with focal accumulation of $^{99m}Tc-phytate$ at the inferior aspect of the liver, at the junction of the right and left lobe. The superior vena cava scintiangiogram was taken for the evaluation of the superior vena cava obstruction and collateral circulations. As a result of superior vena caval obstruction a considerable amount of blood flowed to the liver through the anterior parietal and periumblical venous channels. A certain fraction of radiocolloid delivered by the rete mirabile perfused to a localized area of the liver. This would explain the hot spot around the porta hepatis in this case.

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Evaluation of Thermal Utilization of Dousing System in PHWR Nuclear Power Plant

  • Nam, S.D.;Ryu, J.I.
    • Journal of ILASS-Korea
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    • v.4 no.3
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    • pp.42-52
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    • 1999
  • An effectiveness of thermal utilization of a dousing system in the 600 MW PHWR Nuclear Power Plant has been evaluated. The behavior and conditions of water droplet sprayed in a postulated accident conditions in containment configuration has been calculated. In this calculation, two pressure conditions with the consideration of obstruction area and containment wall effect has been established : one being the minimum containment pressure of 7 kPa(g) encountered for dousing shut off and the other being the containment design pressure 124 kPa(g). The results revealed that the effectiveness of the thermal utilization ranges from 93% to 97%. In the analysis on two cases without/with side wall effect in the containment building, the thermal utilization decreases with obstruction area from 89% to 85%, which satisfies the design criteria set for the containment pressure against the accident condition.

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Total Colonic Aganglionosis With Skip Area ("Skip Area"가 있는 선천성 거대결장)

  • Lee, Suk-Koo;Lee, Woo-Yong;Kim, Hyun-Hahk
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.74-78
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    • 1998
  • Early recognition and surgical treatment of Hirschsprung's disease prevents serious mortality and morbidity from enterocolitis and obstruction. Usually this disease is characterized by a single aganglionic segment of the colon extending distally to the anal margin. In surgical treatment, the surgeon performs a frozen section biopsy to confirm whether there are ganglion cells. If there are intervening ganglionic sites in aganglionic bowel, there may be confusion in diagnosis and treatment. The authors experienced one case of total colonic aganglionosis with skip area. A transverse loop colostomy was performed on a 7 day-old male baby with colon perforation due to Hirschsprung's disease. But intestinal obstruction persisted and required two more operations to find the true nature of the disease. There were aganglionic segments from the anal margin to the terminal ileum 3.7cm proximal to the ileocecal valve. The entire transverse colon and appendix were normally ganglionated.

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A Study about Factors Influencing on the Postoperative Prognosis of the Right Ventricular Outflow Trac Obstruction (우심실유출로협착증의 수술예후에 영향을 미치는 인자에 관한 연구)

  • 최강주
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.435-443
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    • 1994
  • Surgical procedures to relieve congenital right ventricular outflow tract[RVOT] obstruction of heart were performed on 125 patients from September 1985 to August 1992. There were 65 males and 60 females. Ages ranged from 7 months to 33 years with a mean age of 8 years. All the patients were divided into three main groups[I, II, III] depending on the presence or absence of cyanosis and combined anomalies. The patient were classified into two groups; A and B according to the outcome after surgical repair. Group A included the patients who had a good postoperative outcome with or without mild complications such as wound disruption, or hydrothorax. Group B included the patients who had a poor outcome including hospital death and significant postoperative complications such as heart failure, low output syndrome, respiratory failure, hepatic failure and others. And the results were summarized as follows. 1. There were no significant differences in age, body surface area and aortic dimension among the group I, II, and III, but there were significant differences among groups in pulmonary arterial dimension, ACT[aortic cross clamping time], TBT [total bypass time], preoperative and postoperative ratio of systolic pressure of right and left ventricles [pre PRV/RV and post PRV/LV], and the size of Hegar dilator which passed through the RVOT postoperatively [p<0.05]. 2. In the group A and B, there were significant differences in pulmonary arterial dimension [group A:1.6$\pm$0.5 cm, group B:1.9$\pm$0.6 cm], ACT [group A:102.3$\pm$ 46.0 minute, group B:76.1$\pm$46.1 minute], TBT [group A:133.9$\pm$56.6 minute, group B:94.9$\pm$51.9 minute], pre PRV/LV [group A:1.06$\pm$0.24, group B:0.8$\pm$0.32], post PRV/LV [group A:0.58$\pm$0.18, group B:0.43$\pm$0.16].It has been concluded that postoperative prognosis of RVOT obstruction was influenced by pulmonary arterial dimension, ACT, TBT, severity of RVOT obstruction [pre PRV/LV] and post PRV/LV.

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Flying Safety Area Model Creation and Obstruction Identification using 3D GIS Techniques (3차원 GIS 기법을 이용한 비행안전구역 모형 생성 및 장애 식별)

  • Park, Wan Yong;Heo, Joon;Sohn, Hong Gyoo;Lee, Yong Woong
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.26 no.3D
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    • pp.511-517
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    • 2006
  • In this paper, we studied the techniques to analyze the flying safety area focused on the air base rules for military that has been the criteria of the altitude restrictions around the airfield for both civilian and military purposes in Korea. We wanted to present the effective method to analyze the restricted area and to help solving problems that could result recently from the altitude restrictions around the airfield at the beginning of the development projects. To do this we proposed the methods to effectively generate the model of the flying safety area in accordance with the air base rules using 3D GIS techniques and to automatically identify the obstructions caused by the natural and man-made features in those areas. To apply the proposed methods actually to the airfield chosen for the study area, we presented the approaches to generate geospatial informations based on the commercial digital maps and satellite imagery and by generating the flying safety area model, identifying the obstructions, and visualizing the integrated model for the flying safety area analysis we showed the practical usability of the proposed techniques.