• Clinical Endoscopy
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• 제56권5호
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• pp.594-603
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• 2023

Background/Aims: The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimed to compare the observation ability with and without pharyngeal anesthesia under midazolam sedation. Methods: This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinal endoscopy under intravenous midazolam sedation. Patients were randomly allocated to pharyngeal anesthesia: PA+ or PA- groups (250 patients/group). The endoscopists obtained 10 images of the oropharynx and hypopharynx. The primary outcome was the non-inferiority of the PA- group in terms of the pharyngeal observation success rate. Results: The pharyngeal observation success rates in the pharyngeal anesthesia with and without (PA+ and PA-) groups were 84.0% and 72.0%, respectively. The PA- group was inferior (p=0.707, non-inferiority) to the PA+ group in terms of observable parts (8.33 vs. 8.86, p=0.006), time (67.2 vs. 58.2 seconds, p=0.001), and pain (1.21±2.37 vs. 0.68±1.78, p=0.004, 0-10 point visual analog scale). Suitable quality images of the posterior wall of the oropharynx, vocal fold, and pyriform sinus were inferior in the PA- group. Subgroup analysis showed a higher sedation level (Ramsay score ≥5) with almost no differences in the pharyngeal observation success rate between the groups. Conclusions: Non-pharyngeal anesthesia showed no non-inferiority in pharyngeal observation ability. Pharyngeal anesthesia may improve pharyngeal observation ability in the hypopharynx and reduce pain. However, deeper anesthesia may reduce this difference.

• 한국어류학회지
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• 제25권1호
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• pp.33-37
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• 2013

한국산 송사리속 2종에 대한 인두골과 인두치의 구조적 차이를 조사하였다. 그 결과 송사리 O. latipes와 대륙송사리 O. sinensis의 인두골은 모두 1쌍의 물방울 모양(stilliform)의 상인두골과 사각형 모양 (rectangular form)의 하인두골로 구성되었다. 특히 송사리와 대륙송사리의 인두치 열수에 있어서 상인두골은 각각 11~12열, 11~12열을 나타냈고 하인두골이 각각 6~7열, 5~6열을 나타냈다. 또한 인두치에서 송사리는 이빨의 끝이 옆으로 휘어지는 후크모양(top-hooked type)인 반면에, 대륙송사리는 이빨의 끝이 원뿔모양(conical type)을 나타났다. 이상과 같이 한국에 분포하는 2종의 송사리는 인두치에서 형태적 차이를 보여 주었다.

• 대한치과교정학회지
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• 제47권6호
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• pp.344-352
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• 2017

Objective: The purpose of this study was to compare the changes induced in the pharyngeal airway space by orthodontic treatment with bodily retraction of the mandibular incisors and mandibular setback surgery without extraction. Methods: This retrospective study included 63 adult patients (32 men and 31 women). Thirty-three patients who had been treated via four-bicuspid extraction and bodily retraction of the mandibular incisors (incisor retraction, IR group) were compared with 30 patients who had been treated via mandibular setback surgery (MS group) without extraction. Lateral cephalograms were acquired and analyzed before (T1) and after treatment (T2). Results: The superior pharyngeal airway space did not change significantly in either group during treatment. The middle pharyngeal airway space decreased by $1.15{\pm}1.17mm$ and $1.25{\pm}1.35mm$ after treatment in the IR and MS groups, respectively, and the decrease was comparable between the two groups. In the MS group, the inferior pharyngeal airway space (E-IPW) decreased by $0.88{\pm}1.67mm$ after treatment (p < 0.01). The E-IPW was larger in the MS group than in IR group at T1, but it did not differ significantly between the two groups at T2. No significant correlation was observed between changes in the pharyngeal airway space and the skeletal and dental variables in each group. Conclusions: The middle pharyngeal airway space decreased because of the posterior displacement of the mandibular incisors and/or the mandibular body. The E-IPW decreased only in the MS group because of the posterior displacement of only the mandibular body.

• 수면정신생리
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• 제12권2호
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• pp.105-110
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• 2005

The pathogenesis and mechanism of obstructive sleep apnea (OSA) has been under investigation for over 25 years, but its etiology and mechanism remains elusive. Skeletal (maxillary and/or mandibular hypoplasia or retrodisplacement, inferior displacement of hyoid) and soft tissue (increased volume of soft tissue, adenotonsillar hypertrophy, macroglossia, thickened lateral pharyngeal walls) factors, pharyngeal compliance (increased), pharyngeal muscle factors (impaired strength and endurance of pharyngeal dilators and fixators), sensory factors (impaired mechanoreceptor sensitivity, impaired pharyngeal dilator reflexes), respiratory control system factors (unstable respiratory control) and so on facilitate collapse upper airway. Therefore, OSA may be a heterogeneous disorder, rather than a single disease entity and various pathogenic factors contribute to the OSA varies person to person. As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.

• International Journal of Contents
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• 제7권4호
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• pp.98-102
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• 2011

In this study, we investigated the effects of neuromuscular electrical stimulation (NMES) on the treatment of 20 acute stroke patients with dysphagia. For both the treated and control groups, the basic facial stimulation training was conducted for 30 minutes, five times a week, for four weeks. NMES was performed on the treated group only, for 30 minutes each time. Both groups were evaluated according to the functional dysphagia scale (FDS) using a videofluoroscopic swallowing study (VFSS). After the treatment was performed for four weeks, the FDS results of the treated group showed a significance difference in oral transit time in the oral phase and in the triggering of pharyngeal swallow fluid, laryngeal elevation and epiglottic closure, nasal penetration, residue in valleculae, coating of pharyngeal wall after swallow fluid, and pharyngeal transit time in the pharyngeal phase. In addition, the treated group showed a significant difference in laryngeal elevation and epiglottic closure, nasal penetration, and pharyngeal transit time in the pharyngeal phase after the treatment compared to the control group. The results of this study showed that neuromuscular electrical stimulation may be an effective method of treating dysphagia in acute phase stroke patients.

• 대한후두음성언어의학회지
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• 제8권1호
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• pp.69-74
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• 1997

과대비성의 수술적 치료에 있어서 인두측벽의 운동성이 수술 후 어느 정도 남아있는가와 측두문의 크기를 어느 정도 유지하는 것이 적당한가를 결정하는 것이 환자의 만족도를 높이고 좋은 결과를 얻는데 중요한 부분을 차지함을 알 수 있었다.

• 한국발생생물학회지:발생과생식
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• 제27권3호
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• pp.137-147
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• 2023

Pharyngeal pouches are an important epithelial structure controlling facial skeletal development in vertebrates. A series of pouches arise sequentially in the pharyngeal endoderm through collective cell migration followed by rearrangement of pouch-forming cells. While crucial transcription factors and signaling molecules have been identified in pouch formation, a role for Neuropilins (Nrps) in pouch development has not yet been analyzed in any vertebrates. Nrps are cell surface receptors essential for angiogenesis and axon guidance. In all vertebrates, the two Nrp family members, Nrp1 and Nrp2, are conserved in the genome, with two paralogs for Nrp1 (Nrp1a and Nrp1b) and Nrp2 (Nrp2a and Nrp2b) being identified in zebrafish. Here, I report a potential requirement of Nrp signaling in pouch development in zebrafish. nrp1a and nrp2b were expressed in the developing pouches, with sema3d, a ligand for Nrps, being expressed in the pouches. Knocking down Nrps signaling in the pharyngeal endoderm led to severe defects in pouches and facial cartilages. In addition, blocking Mitogen-activated protein kinase (MAPK) activities, a downstream effector of Nrp signaling, in the pharyngeal endoderm caused similar defects in pouches and facial skeleton to those by knocking down Nrps signaling. My results suggest that Nrp signaling acts for pouch formation through MAPK.

• 대한치과교정학회지
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• 제44권1호
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• pp.13-19
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• 2014

Objective: The aim of this study was to evaluate long-term changes in the pharyngeal airway dimensions after functional appliance treatment in adolescents with skeletal Class II malocclusions. Methods: Pharyngeal airway dimensions were compared between subjects with skeletal Class II malocclusions (n = 24; mean age: $11.6{\pm}1.29$ years) treated with a Class II bionator and age-matched control subjects with skeletal Class I occlusions (n = 24; mean age: $11.0{\pm}1.21$ years) using a series of lateral cephalograms obtained at the initial visit (T0), after treatment (T1), and at the completion of growth (T2). Results: The length of the nasopharyngeal region was similar between adolescents with skeletal Class I and Class II malocclusions at all time points, while the lengths of the upper and lower oropharyngeal regions and the pharyngeal airway areas were significantly smaller in the skeletal Class II adolescents before treatment when compared to the control adolescents (p < 0.05). However, following treatment with a functional appliance, the skeletal Class II adolescents had increased pharyngeal airway dimensions, which became similar to those of the control subjects. Conclusions: Functional appliance therapy can increase the pharyngeal airway dimensions in growing adolescents with skeletal Class II malocclusions, and this effect is maintained until the completion of growth.

• 대한치과교정학회지
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• 제39권3호
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• pp.136-145
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• 2009

상기도 공간은 3차원 입체 구조물로서 두부규격방사선사진 등으로 분석하기에는 평가의 한계가 존재하였다. 본 연구는 최근 방사선 피폭량 등의 감소로 그 활용도가 높아진 cone beam CT (CBCT)를 이용하여 안면골격형태에 따른 상기도 공간의 면적, 전후방 폭경 및 측방 폭경을 측정하고 그 관련성을 알아보았다. 102명을 대상으로 CBCT (VCT, Vatech, Seoul, Korea)를 촬영하였으며, FH plane에 평행하면서 aa point (the most anterior point on the anterior arch of atlas), $CV_{2ia}$, $CV_{3ia}$ point (most infero-anterior point on the body of the second & third cervical vertebra)를 지나는 평면을 기준으로 설정하였다. 각 항목의 계측치는 one-way ANOVA를 이용하여 통계처리하고 Duncan test로 사후검정하였다. 연구 결과, 안면 골격형태에 따른 측방 폭경에는 유의한 차이가 없었다. Group 2 (Class II) 집단은 aa plane, $CV_2$ plane, $CV_3$ plane에 의해 형성된 상기도 공간의 단면적이 좁았으며, 전후방 폭경도 Group 3 (Class III)에 비해 유의성 있게 좁았다. 수직 안면골격형태와 정상 안면골격 형태간의 유의성 있는 차이는 없었으나, aa plane에서 형성된 상기도 공간의 전후방 폭경은 Group 1V (Class I vertical)가 Group 1N (Class I normal)에 비해 유의성 있게 좁은 것으로 나타났다 (p < 0.05).

• 대한의용생체공학회:의공학회지
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• 제24권6호
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• pp.515-522
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• 2003

인두는 구강과 식도, 비강과 폐의 중간에서 능동적으로 구강을 통해 섭취되는 음식물과 비강을 통해 흡입되는 공기의 통로역할을 하는 주요한 기관이다. 본 연구는 유한요소기법을 이용한 인두의 3차원 구조의 재구성 과정을 거쳐 인두의 생체역학모델을 구현하였으며, 연하곤란환자의 인두근육의 주요부분에 대한 구조적 변형특성을 3가지로 분류하여 유한요소기법을 이용하여 인두내의 압력에 대한 형상의 변형을 관찰 후 최적화 과정을 거쳐 각 부분에서의 추정 압력 구배를 측정하여 연하과정에서 내부에 생성되는 압력의 연속적인 압력분포를 추정하였다. CT에 의한 인두의 변형 형상을 추정하여 임의 압력에 의한 인두구조의 변형 형상을 유한요소 해석에 의해 계산한 후 비교하여 실제 인두강 내에 형성되는 압력을 추정하였다. 재료적 특성은 인두의 기능이상 시 근조직경화가 발생, 즉 stiffness 가 증가하는 것으로 가정하여 응력-변형률 관계에 있어서 각각 $25\%,\;50\%,\;75\%$씩 증가시켜 분석하였다. 이러한 인두의 생체역학모델은 인두기능장애를 가진 환자의 치료 계획 수립에 도움이 되는 유용한 자료를 제공 할 것으로 생각된다.