• Title/Summary/Keyword: airway

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Association of wheezing phenotypes with fractional exhaled nitric oxide in children

  • Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.57 no.5
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    • pp.211-216
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    • 2014
  • Asthma comprises a heterogeneous group of disorders characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR). Airway inflammation, which induces AHR and recurrence of asthma, is the main pathophysiology of asthma. The fractional exhaled nitric oxide (FeNO) level is a noninvasive, reproducible measurement of eosinophilic airway inflammation that is easy to perform in young children. As airway inflammation precedes asthma attacks and airway obstruction, elevated FeNO levels may be useful as predictive markers for risk of recurrence of asthma. This review discusses FeNO measurements among early-childhood wheezing phenotypes that have been identified in large-scale longitudinal studies. These wheezing phenotypes are classified into three to six categories based on the onset and persistence of wheezing from birth to later childhood. Each phenotype has characteristic findings for atopic sensitization, lung function, AHR, or FeNO. For example, in one birth cohort study, children with asthma and persistent wheezing at 7 years had higher FeNO levels at 4 years compared to children without wheezing, which suggested that FeNO could be a predictive marker for later development of asthma. Preschool-aged children with recurrent wheezing and stringent asthma predictive indices also had higher FeNO levels in the first 4 years of life compared to children with wheezing and loose indices or children with no wheeze, suggesting that FeNO measurements may provide an additional parameter for predicting persistent wheezing in preschool children. Additional large-scale longitudinal studies are required to establish cutoff levels for FeNO as a risk factor for persistent asthma.

AWAKE CEPHALOMETRIC ANALYSIS OF POSTERIOR AIRWAY SPACE AND CALCULATED RESISTANCE RELATED TO RESPIRATORY DISTURBANCE INDEX BEFORE AND AFTER MAXILLOMANDIBULAR ADVANCEMENT FOR OBSTRUCTIVE SLEEP APNEA (폐쇄성 수면 무호흡 환자의 상하악 전방이동술 전후의 두부계측방사선 사진에서 산출한 기도직경, 상기도 공간의 기류저항과 호흡방해지수 변화와의 연관성)

  • Park, Kwang-Ho;Waite, Peter D.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.157-161
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    • 2001
  • The purpose of this study cephalometrically evaluated changes in the posterior airway space for patients with obstructive sleep apnea syndrome(OSAS) before and after surgical advancement of the maxilla and mandible. The change in calculated airway resistance was correlated with the respiratory disturbance index(RDI). Twenty cephalometric radiographs were traced before and after surgery to determine the posterior airway area and calculate resistance. Polysomnograms of each patient were obtained before and after surgery. All patients had a decrease in calculated airflow resistance in the airway. The mean amount of resistance was 865.15 before surgery, decreasing to 192.65 after surgery (p<0.01). Eighty-five percent of the patients experienced improvement in their RDI. Reduction in the RDI appears to be due to an increase in the posterior airway space and decrease in flow resistance.

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Clinical Aanalysis of Airway Trauma (외상성 기도 손상의 임상적 고찰)

  • Cho, Hyun-Min;Kim, Young-Jin;Ryu, Han-Young;Hwang, Jung-Joo
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.7-11
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    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

A Study on Congestion Change of Dual Airways between Korea-China (한·중 항로 복선화 전후 혼잡도 변화 연구)

  • Cho, Jin Ho;Baik, Ho Jong;Chang, Jo Won
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.28 no.1
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    • pp.7-13
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    • 2020
  • A significant growth in local air traffic volume is leading to airway congestion and flight delays especially for Incheon-China and Incheon-Europe sectors. A key method to increase the airway capacity is to place a supplemental airway parallel to the existing one and in cooperation between the aviation authorities between China and Korea, a dual airway track was implemented on December 6, 2018. Here, we use airline A's flight data to analyze the congestion change effect of the new airway. Results show total delay time to Europe is reduced 51% (13.4 to 6.6 minutes) as the delay distribution for 16-30 minutes, 31 minutes and greater decreased from 23.2% to 8.2% and 8.7% to 1.0% respectively. The delay to China also decreased but the drop is not as significant as flights to Europe. This is caused by the difference in flight distance, traffic volume, and characteristics of flights landing and transiting China. Flights to Europe show a broad distribution in altitude allocation and reduction in aircraft separation demonstrating the effectiveness of a dual airway track.

Acute airway obstruction resulting in Pneumonia after palatoplasty: A Case Report (구개성형술후 폐렴을 동반한 급성 기도 폐색: 증례보고)

  • Ra, Ju-Il;Koo, Hyun-Mo;Jeong, Jong-Sun;Park, Chul-Hui;Kim, Hyeon-Min;Song, Min-Seok
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.2
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    • pp.81-86
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    • 2005
  • Cleft palate patients with congenital anomalies have an increased risk of airway problems following palatoplasty. Factors that were related included presence of associated congenital anomalies, duration of surgery, age at time of surgery, history of previous airway problem, and excessive pressure exerted on the base of the tongue by Dingman retractor. This report described a complication of post-operative Pneumonia after palatoplasty (Furlow technique), which resulted in a life-threatening acute airway obstruction in an infant with cleft palate. Patient has a history of previous mild airway problems. In addition to this problem, we speculate that Furlow technique involves more extensive surgical dissection than other techniques may increase risk for upper airway obstruction. Awareness of this risk permits identifying those patients prior to surgery so that they can be monitored and managed properly, minimizing the likelihood of major complications or possibility of death.

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Differentiation of tidal volume & mean airway pressure with different Bag-Valve-Mask compression depth and compression rate (Bag-Valve-Mask의 사용방법에 따른 일회호흡량과 평균기도압의 변화 연구)

  • Jo, Seung-Mook;Jung, Hyung-Keon
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.2
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    • pp.67-74
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    • 2012
  • Purpose : The purpose of this study is to get basal user guidelines of safer bag-valve-mask application on patient with normal pulmonary patho-physiologic condition. Methods : This study was accomplished by pre-qualified 25 EMS junior grade students. Participants were instructed randomly compress bag to one-third, half and total and also with differesnt compression speed. Resultant tidal volumes and mean airway pressures obtained in RespiTrainer were analysed in relation to the each compression depth and rate. Results : Demographic difference does not affect tidal volume with any compression depth and rate change. Increasing compression depth is correlated with tidal volume increasement at any compression rate and also with mean airway pressure. If the compression depth is same, compression rate change did not affect significantly the resultant tidal volume or mean airway pressure. Conclusion : Hand size, Experience, BMI dose not affect tidal volume. Compress the 1600 ml bag half to total amount is safe way to offer sufficient tidal volume without risky high airway pressure delivery to patient airway who with normal lung patho-physiologic condition.

Development and Effects a Simulation-based Emergency Airway Management Education Program for Nurses in a Neonatal Intensive Care Unit (신생아집중치료실 간호사를 위한 시뮬레이션 기반 응급기도 관리 교육 프로그램 개발 및 효과)

  • Kim, Minjung;Kim, Sunghee
    • Child Health Nursing Research
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    • v.25 no.4
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    • pp.518-527
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    • 2019
  • Purpose: The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit. Methods: The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0. Results: The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem-solving ability, and confidence in clinical performance. Conclusion: The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses' practices.

The current status and legal review of advanced airway management implemented by 119 EMTs (소방 119구급대원에 의해 시행된 전문기도관리 현황 및 법적 고찰)

  • Park, Si-Eun
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.2
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    • pp.169-186
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    • 2021
  • Purpose: This study aimed to analyze the data from public information disclosure about pre-hospital advanced airway management and identify the problem by considering domestic laws and guidelines. Methods: Data were collected between 2017 and 2018 and analyzed using SPSS 25.0. Then, the problems of the analysis results based on the relevant laws and practical guidelines were reviewed. Results: The review of domestic laws and practice guidelines revealed that ambulance nurses can implement supraglottic airway device only under the following three conditions: ① smart advanced life support pilot project area, ② trained to insert I-Gel, and ③ member of a special ambulance. In total, 21,574 cases of advanced airway management (endotracheal intubation: 2,428, I-Gel: 18,502, LMA : 499, KING AIRWAY: 144) were reported. In many cases, advanced airway management was performed by ambulance nurses who did not meet the above conditions, which was in violation of laws and guidelines. In addition, the prognosis of intubated patients was not followed up. Conclusion: The Korea National Fire Agency must stop all unlicensed medical practice by untrained, uneducated, and uncertified nurses and demand quality control programs for intubated patients.

Split orthodontic airway plate: An innovation to the utilization method of conventional orthodontic airway plate for neonates with Robin sequence

  • Choo, HyeRan;Kim, Seong-Hun;Ahn, Hyo-Won;Poets, Christian F.;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.52 no.4
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    • pp.308-312
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    • 2022
  • Since the emergence of neonatal infant orthodontics for treatments of cleft lip and palate with or without Robin sequence (RS) in Europe in the 1950s, advancements in design and scope of its application have been remarkable. As the first institution to adopt orthodontic airway plate (OAP) treatment in the United States in 2019, we saw a need for innovation of the original design to streamline the most labor-intensive and time-consuming aspects of OAP utilization. A solution is introduced using a systematic split expansion mechanism to re-size the OAP periodically to accommodate the neonate's maxillary growth. To date, seven RS patients have received this modified treatment protocol at our institution. Each patient completed full treatment using only one OAP. This innovative utilization method is aptly named the split orthodontic airway plate (S-OAP). Details of the S-OAP and its modifications from conventional OAP are reported.

A STUDY ON THE CHANGE OF AIRWAY SPACE AND CRANIAL, CERVICAL ANGULATION AFTER MANDIBULAR SETBACK OPERATION (하악골 후방이동 수술후 기도 공간과 두개 및 경추 각도의 변화에 관한 연구)

  • Chang, Hyun-Ho;Kim, Jae-Seung;Yi, Choong-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.115-131
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    • 2000
  • In the study of craniofacial deformity, it is very important that identifying the factor which can affect the morphology and which is closely related to the morphology, because it can not only improve the comprehension of growth and developmental process but also be applied in growth prediction and treatment modality. Several investigators have already mentioned the characterstics of head posture and airway space in relations to morphologic difference. But it is very meaningful work in clarifying the correlation between morphology, head posture and airway space that observing the change of head posture after morplologic change caused by operation and the change of airway space after same procedure. To investigate above correlation, I selected normal group which is consisted of 43 adults and mandibular prognathism group which is consisted of 47 adults who had been operated by sagittal split ramus osteotomy and were followed up more than 1 year. With their lateral skull radiograghs, reference lines which can evaluate each measuring points and areas without effect of postural change were first determined. And using above reference lines, change of airway space, positional change of tongue and hyoid, change of cranial and cervical angulations were measured. The results obtained from the study were as follows 1. In the change of head posture, the position of tongue and hyoid neighboring to pharynx is more closely related to the reference line of cervical column than to reference line of cranium. 2. After mandibular setback operation, the airway dimension was decreased to 81.6% of preoperative state at 1 month postoperatively and was slightly increased to 89.7% at 1 year postoperatively. 3. Posterior movement of tongue plays important role in decrease of airway dimension and inferior movement of hyoid was closely correlated with posterior movement of tongue. 4. Postoperative anterior movement of mandible, namely, morphologic relapse had correlation with relapse phenomenon of airway dimension. 5. Craniocervical angulation increased postoperatively. Especially in the postoperative early state, there was increased foreward inclination of cervical angulation rather than increase of cranial angulation. But at postoperative 1 year it was observed that cervical inclination was returned to preoperative state and cranial angulation was increased gradually. 6. Increase rate of airway dimension was correlated with the increase of cranial angulation from postoperative 1 month to 1 year. In conclusion, relapse tendency of airway dimension following increase of cranial angulation was found after mandibular setback operation and it is considered that increase of cranial angulation is one of compensatory mechanism in airway maintenance.

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