• Title/Summary/Keyword: Stenosis

Search Result 1,761, Processing Time 0.032 seconds

Clinically Correlated Anatomical Basis of Cricothyrotomy and Tracheostomy

  • Gulsen, Salih;Unal, Melih;Dinc, Ahmet Hakan;Altinors, Nur
    • Journal of Korean Neurosurgical Society
    • /
    • v.47 no.3
    • /
    • pp.174-179
    • /
    • 2010
  • Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. Methods : A total of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures. Results : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p < 0.0001). Conclusion : Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.

Research on the Effect and Satisfaction between Independenced and Parallelism Treatment of Acupuncture and Physical of Lumbago Patients (요통환자에 대한 침치료와 물리치료의 단독 및 병행치료의 효과와 만족도 조사)

  • Yoo, Sang-Min;Bae, Kyeong-Yeon;Lee, Yong-Hyun;Jung, Jae-Joong;Lim, Se-Young
    • Journal of Acupuncture Research
    • /
    • v.22 no.6
    • /
    • pp.75-84
    • /
    • 2005
  • Objectives : Research on the effect and satisfaction between Acupuncture Treatment, Physical Treatment and contemporary Treatments of Acupuncture and Physical of lumbago patients Methods : We separated lumbago patients into three groups. A group with only Acupuncture Treatment and a group with only Physical Treatment and a group with contemporary treatments of Acupuncture and Physical. Questionnaire survey and score of Visual Analog Scale(VAS) and Oswestry Disability Index(ODI) were examined for comparison. Results & Conclusion : 1. Of the 54 patients Acupuncture Teatment group had 17 patients with similar ratio of gender and the average age was 39.5 years old. For the Physical Treatment group the ratio of male was 75% of the 8 patients and had the youngest average age which was 29.1 years old and the group with contemporary Treatments the ratio of female was 62% of 29 patients and had the oldest average age which was 46.7 years old. 2. The Acupuncture Treatment group had the shortest treatment period because of many acute stage caused by lumber sprain and the improvement score was the best. The group of contemporary treatments had the longest history day and treatment period by serious disease like HIVD and spinal stenosis but the improvement score of VAS and ODI was good similar to the Acupuncture Treatment group. For the Physical Treatment group there was many patients with degenerative change but not severe pain. The VAS, ODI and the improvement score was the lowest before and after the treatment.

  • PDF

Color Doppler Ultrasonogram for the Peripheral Vascular disease in Diabetes Patients (당뇨병 환자의 하지 혈관 질환 검사에서 색도플러 초음파의 이용)

  • Lee, Kyung-Tai;Choi, Yun-Sun;Young, Ki-Won;Bae, Sang-Won;Lee, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
    • /
    • v.6 no.1
    • /
    • pp.80-85
    • /
    • 2002
  • Purpose: This study is to assess the involvement of vessels in lower extremity in diabetics, using color doppler ultrasonogram. Materials and Methods: Arteries of both lower extremities were divided into 3 groups-large vessel (above-knee arteries), popliteal vessel, and small vessel(below-knee arteries) -, and evaluated using color doppler ultrasonogram in 60 diabetics. In color doppler ultrasonogram, the wave forms of all vessels were divided into 5 grades; grade I was triphasic wave form, grade II was spectral broadening form, grade III was monophasic wave form, grade IV was pulsus tardus et parvus form, grade V was absence of wave. Grade III, IV, V were grouped into vessel obstruction. We reviewed the correlationships among the degree of the peripheral vascular involvement, duration of dibetes, existence of bilaterality, types of dibetes. Results: Bilateral involvement was high in both lower extremity. Luminal stenosis, vascular calcification and vessel obstruction were high incidence in the patients over ten years of diabetic duration. Prevalence of vascular calcification and vessel obstruction were high in the small vessel of ankle level. But, insulin injection was not related to the incidence of vascular abnormality. Conclusion: Color doppler ultrasonogram seems to be useful for evaluation of peripheral vascular status, decision making for necessity of additional test, periodic follow -up tool in diabetes patients.

  • PDF

A Case of Isolated Pulmonary Takayasu's Arteritis Combined with Pulmonary Thromboembolism and Hyperthyroidism (폐혈전증과 갑상선기능항진증이 동반된 타카야수 폐동맥염 1예)

  • Uhm, Jae Sun;Kwon, Jung Hyun;Kim, Tae Woo;Ji, Jeong Seon;Kim, Jin Woo;Kim, Seung Joon;Lee, Sook Young;Kim, Young Kyoon;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
    • /
    • v.57 no.2
    • /
    • pp.188-192
    • /
    • 2004
  • Takayasu's arteritis is a chronic inflammatory disease, involving mainly the aorta and its main branches, which can cause stenosis or occlusion. It involves the bracheocephalic, carotid, subclavian, vertebral, and renal, as well as the coronary and pulmonary arteries. The clinical manifestations range from asymptomatic to catastrophic, with dizziness, hypertension, claudication, cerebral infarction, chest pain and dyspnea. Takayasu's arteritis involving the pulmonary arteries, but not the aorta and its main branches, is very rare. Herein, a case of isolated pulmonary Takayasu's arteritis combined with pulmonary thromboembolism, and hyperthyroidism is reported, with a review of the literature.

A Case of Tracheal Carcinoma Diagnosed by Rigid Bronchoscopy in Lidocaine Anaphylaxis Patient (리도카인 아나필락시스 환자에서 경직 기관지내시경술을 통해 기도 암종을 진단한 1예)

  • Yoon, Byeong Kab;Ban, Hee Jung;Kwon, Yong Soo;Oh, In Jae;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul;Song, Sang Yoon
    • Tuberculosis and Respiratory Diseases
    • /
    • v.67 no.2
    • /
    • pp.140-144
    • /
    • 2009
  • The majority of flexible bronchoscopies are performed under topical anesthesia with lidocaine being the most commonly used agent. Anaphylaxis rarely occurs after local administration of lidocaine, but can be a fatal complication. We experienced a case of unexpected anaphylaxis. A 66-year-old woman was scheduled for flexible bronchoscopy to evaluate a tracheal mass and stenosis. The oral and nasal mucosa were pretreated with lidocaine. About 2~3 minutes later, the patient developed hypotension and we treated for anaphylaxis in the emergency room. Then, we decided to perform rigid bronchoscopy in this patient, under conditions of general anesthesia. A rigid bronchoscopy was performed in this patient, safely and successfully. The tracheal mass was determined to be squamous cell carcinoma.

Effect of Combined Traditional Acupuncture and Applied Kinesiology on Lumbar Diseases

  • Ahn, Chang Beohm;Lee, Sang-Ju;Park, Yeo Bin;Park, Yun Leong
    • Journal of Acupuncture Research
    • /
    • v.37 no.2
    • /
    • pp.94-101
    • /
    • 2020
  • Background: Several Korean medical doctors have been practicing applied kinesiology (AK), invented in 1964 by Dr. George J Goodheart, USA. Although the efficacy of traditional acupuncture (TA) and pharmacopucture treatment for lumbar conditions/diseases has been examined, the possible benefits of combining TA and AK have not been reported. Therefore, the aim of this study was to report the effects of combining TA and AK treatment for lumbar disorders using the Japanese Orthopedic Association lumbar score (JOALS) assessment. Methods: There were 21 outpatients treated at Samse Korean Traditional Hospital between March 2018 and September 2018, who presented with L4/L5 or L5/S1 root radiculopathy associated with lumbar spinal stenosis (LSS) and lumbar herniation of intervertebral disk (LHID). They were treated 10×(2 sessions per week, for 5 weeks) with TA and AK approaches that included a category block, manipulation or strain/counterstrain treatments. The primary outcome was mainly assessed using the JOALS score which was used before (0 ×), during (5 ×), and after treatment (10 ×). Results: There were 19 patients diagnosed with LSS and 2 were diagnosed with LHID. Using the JOALS assessment, TA and AK combined approaches improved the lumbar conditions of all 21 patients after 5 × treatmentsand continued to improve after 10 × treatments (p < 0.001). Conclusion: Combined TA and AK treatment was effective in treating spinal conditions/diseases. Prospective, relevant, well-controlled protocols for TA and AK therapies for various conditions are needed.

A Case of Combined Korean Medicine Treatment of Hip Pain Caused by Obturator Nerve Entrapment: Case Report (폐쇄신경 포착으로 인한 고관절 통증 환자의 복합한방치료: 증례보고)

  • Chu, Hui-Yeong;Lee, Sang-Woon;Bae, In-Su;Yoon, Kyung-Young;Youn, Jun-Heum;Hwang, Dong-Wook;Cho, Hyun-Woo
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.30 no.3
    • /
    • pp.163-169
    • /
    • 2020
  • This study reports on the effectiveness of Korean traditional medicine treatment on a patient with right hip pain caused by obturator nerve entrapment due to ganglion cyst. The patient had been misdiagnosed for a stenosis at the other hospital, but he got a different diagnosis this time with the examination. The patient was treated with Korean traditonal medicine, which includes pharmacopuncture, acupuncture, manual treatment (Chuna), and herbal medicine. Numerical rating scale (NRS), Oswestry Disability Index (ODI) and Euroqol five dimension (EQ-5D) index were used as a objective tool for evaluating the patient's symptoms. After treatment, NRS and ODI were decreased, while EQ-5D index was increased. This study suggests that a combined Korean traditional medicine may be effective in reducing symptoms related to obturator nerve entrapment.

Clinical Study of Inguinal Hernia in Pediatric Patients (소아 서혜부 탈장에 대한 임상적 고찰; 단일병원 10년간 1244예 후향적 고찰)

  • Yoon, Won-Hwa;Heo, Chan-Young;Chun, Yong-Soon
    • Advances in pediatric surgery
    • /
    • v.15 no.1
    • /
    • pp.44-51
    • /
    • 2009
  • This study is a retrospective analysis of 1244 cases of the inguinal hernia in children under the age of fifteen years who were operated at the department of pediatric surgery, Inje University Busan Paik Hospital from March, 1997 to February, 2007. The ratio of male to female was 3.6:1. The type of hernia was indirect in all of the cases. The hernia was on the right side in 656 cases (53.9 %), left side in 467 cases (37.5 %), and bilateral in 121 cases (9.7 %). The hernia presented most frequently in infants under age 12 months; 364 cases (29.2 %). Fifty-nine cases (21.7 %) were in female and 305 cases (31.3 %) in male. There were 428 cases (33.6 %) in 1-3 years age group, 295 cases (23.7 %) in 4-6 years, 112 cases (9.0 %) in 7-9 years, 39 cases (3.1 %) in 10-12 years and 16 (1.2 %) in 13-15 years. The content of hernia sac was small bowel (59 %), omentum (31 %) in males and the ovary and tube (54 %) and small bowel (26 %) in female. The incidence of combined operation at the time was 3.2 %, and consisting of orchiopexy (67.5 %), frenulotomy (12.5 %), appendectomy (10 %), circumcision (5 %), and fistulotomy (5%). The incidence of combined disease was 2.8 % and consisting of undescended testis, Hirschsprung's disease, idiopathic hypertrophic pyloric stenosis, imperforate anus, and congenital heart disease. After unilateral inguinal hernia repairs, contralateral hernias developed in 34 patients. The laterality of the primary site of hernias were left in 19 cases (55.8 %), and right 15 cases (44.1 %). The 936 cases (75.2 %) were operated under general anesthesia; Mask bagging 663 cases (53.2 %), endotrachea intubation 257 cases (20.6 %), and laryngeal mask 16 cases (1.2 %). The remainder 308 cases (24.7 %) were operated under regional caudal anesthesia.

  • PDF

Treatment of Diffuse Tracheobronchial Amyloidosis by Repeated Electrocautry Under Fiberoptic Bronchoscopy (굴곡성 기관지경하 전기소각술로 치료한 미만성 기관기관지형 유전분증 1예)

  • Kim, Ho-Joong;Koh, Jong-Hoon;Chang, Myeong-Jun;Hong, Sung-Hun;Kim, Kyung-Hwan;Hyun, In-Kyu;Lee, Myoung-Koo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
    • /
    • v.42 no.2
    • /
    • pp.250-255
    • /
    • 1995
  • Diffuse tracheobronchial amyloidosis is an uncommon form of pulmonary involvement, and causes prolonged cough, dyspnea, wheezing and repeated development of pneumonia. We report a case of diffuse tracheobronchial amyloidosis in 58-year-old woman that was traeted by repeated electrocautry under flexible fiberoptic bronchoscopy. The patient had a long-standing history of dyspnea and was admitted due to resting dyspnea, which was aggravated to impending respiratory failure after diagnostic procedures. We applied repeated electrocautry to the endobronchial amyloid tumors and successfully reduced bronchial stenosis and the pateint didn't feel dyspnea. We suppose that, in certain cases of tracheobronchial amyloidosis patients, endobronchial electrocautry would be a helpful procedure.

  • PDF

Clinical characteristics of hypertensive encephalopathy in pediatric patients

  • Ahn, Chang Hoon;Han, Seung-A;Kong, Young Hwa;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
    • /
    • v.60 no.8
    • /
    • pp.266-271
    • /
    • 2017
  • Purpose: The aim of this study was to assess the clinical characteristics of hypertensive encephalopathy according to the underlying etiologies in children. Methods: We retrospectively evaluated 33 pediatric patients who were diagnosed as having hypertensive encephalopathy in Chonbuk National University Children's Hospital. Among the patients, 18 were excluded because of incomplete data or because brain magnetic resonance imaging (MRI) was not performed. Finally, 17 patients were enrolled and divided into a renal-origin hypertension group and a non-renal-origin hypertension group according to the underlying cause. We compared the clinical features and brain MRI findings between the 2 groups. Results: The renal group included renal artery stenosis (4), acute poststreptococcal glomerulonephritis (2), lupus nephritis (2), and acute renal failure (1); the nonrenal group included essential hypertension (4), pheochromocytoma (2), thyrotoxicosis (1), and acute promyelocytic leukemia (1). The mean systolic blood pressure of the renal group ($172.5{\pm}36.9mmHg$) was higher than that of the nonrenal group ($137.1{\pm}11.1mmHg$, P<0.05). Seizure was the most common neurologic symptom, especially in the renal group (P<0.05). Posterior reversible encephalopathy syndrome (PRES), which is the most typical finding of hypertensive encephalopathy, was found predominantly in the renal group as compared with the nonrenal group (66.6% vs. 12.5%, P<0.05). Conclusion: We conclude that the patients with renal-origin hypertension had a more severe clinical course than those with non-renal-origin hypertension. Furthermore, the renal-origin group was highly associated with PRES on brain MRI.