• Title/Summary/Keyword: airway

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Difficult airway management in a patient with a parapharyngeal tumor

  • Ji, Sung-Mi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.153-156
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    • 2015
  • A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a $6{\times}4{\times}8.6cm$ heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.

Perioperative airway management of a patient with Beckwith-Wiedemann syndrome

  • Tsukamoto, Masanori;Hitosugi, Takashi;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.313-316
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    • 2016
  • Airway obstruction in pediatric patients always poses a challenge for anesthesiologists. Beckwith-Wiedemann syndrome causes various abnormalities such as macroglossia and omphalocele. Patients with these abnormalities often need corrective surgeries. Management of difficult airway caused by conditions such as macroglossia in patients with this syndrome could be challenging. We encountered a case of difficult airway in an infant with Beckwith-Wiedemann syndrome. It was predicted that macroglossia might cause difficult ventilation, intubation, and extubation. Preoperative assessment and preparations for difficult airway should be considered.

Sleep Disordered Breathing and Nasal Obstruction (수면호흡장애와 코막힘)

  • Chung, Yoo-Sam
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.93-97
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    • 2005
  • Nasal obstruction may cause or aggravate sleep disordered breathing but exact pathogenesis is not clear. The possible mechanism could be combination of alteration in upper airway aerodynaimcs, loss of nasal reflex or sensation, effect of mouth opening, and a genetic predisposition. Anatomical narrowing of nasal airway cause more rapid airflow and induce more negative inspiratory air pressure. So, it increases collapsibility of pharyngeal airway. Loss of nasal sensation to airflow block nasal reflex. Mouth opening decreases the activity of pharyngeal airway dilator muscles and narrowing the pharyngeal airway may occur. The treatment of nasal obstruction should be done according to the cause. The causes of nasal obstruction are various from problems of external nasal opening to nasopharynx. Relief of nasal obstruction may not cure sleep disordered breathing always. In some mild obstructive sleep apnea patients, treatment of nasal obstruction only may cure sleep disordered breathing. In some severe sleep apnea patients, treatment of nasal obstruction may increase compliance of continous nasal positive airway pressure.

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Diagnostic Value of Pulmonary Perfusion Scan in Patients of Airway Foreign Body (기관지 이물 환자에서 폐장관류주사(pulmonary perfusion scan)의 적용 의의)

  • 최종욱;정광윤;민헌기;황찬승;김혜정
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.75-81
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    • 1995
  • To evaluate the diagnostic value of pulmonary perfusion scan, we obtained 99mTc MAA per-fusion lung scan from 25 cases of airway foreign bodies. The results were as follows. 1) Significant changes in blood gases were not observed after the establishment of regional hypoperfusion caused by airway foreign body. 2) Near total or total defect was noted on perfusion scan from most of the airway foreign body. 3) There was correspondance of findings of perfusion lung scan and duration of airway foreign body. 4) After the removal of airway foreign bodies, perfusion scan abnormalities were reversed in parallel with the recovery of pulmonary blood flow. We concluded that pulmonary perfusion scan may be valuable for detection of foreign body and reversible hypoperfusion.

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Study on Clinical Utility of the Laryngeal Mask Airway in Dogs (개에서 Laryngeal Mask Airway의 임상적 효용성에 관한 연구)

  • Kim Yong-hoon;Lee Joo-myoung;Cheong Jongtae
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.214-219
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    • 2005
  • This experiment was conducted in order to identify the effect of the laryngeal mask airway and it's clinical utility on cardiovascular system, intraocular pressure and stress reaction at the time of anesthesia care. The heart rate, systolic arterial pressure, diastolic arterial pressure and intraocular pressure were significantly reduced in the experimental group to be compared with the control group. But, there were no significant differences in mean arterial pressure, central venous pressure and blood cortisol concentration between both groups. In view of the above results, it is thought that the airway management using the laryngeal mask airway will be useful to reduce the stress condition in the induction of anesthesia.

Suppression of Induced Mucin Production from Human Airway Epithelial Cells by Coumarin and Indomethacin (쿠마린과 인도메타신의 억제작용 쿠마린과 인도메타신의 억제작용)

  • Lee, Jae-Woo;Kim, Kil-Dong;Jeon, Byeong-Kyou;Lee, Choong-Jae
    • YAKHAK HOEJI
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    • v.54 no.5
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    • pp.416-421
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    • 2010
  • We examined whether indomethacin, noscapine, coumarin, uridine and betaine affect airway mucin production induced by EGF or TNF-${\alpha}$ from NCI-H292 cells. Cells were pretreated with each agent for 30 min and then stimulated with EGF or TNF-${\alpha}$ for 24 h. Of the five compounds, coumarin suppressed airway mucin production induced by EGF or TNF-${\alpha}$. However, indomethacin suppressed airway mucin production induced by EGF. This result suggests that coumarin and indomethacin can regulate the production of mucin induced by EGF, by directly acting on airway epithelial cells.

Comparison of endotracheal intubation speed and ease by using the supraglottic airway laryngopharyngeal tube: A manikin study (성문위기도기 인후두튜브(SALT)를 이용한 기관내삽관 신속성과 용이성 비교: 마네킨을 이용한 연구)

  • Yun, Seong-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.2
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    • pp.29-38
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    • 2015
  • Purpose: The purpose of this study was to improve airway management ability by comparing the speed, angle of the neck, and confidence and ease of supraglottic airway laryngopharyngeal tube (SALT) and endotracheal intubation via direct laryngoscopy. Methods: The subjects of this experimental research study with a randomized crossover design were 44 emergency medicine technician - paramedics working in the fire department of 'J' - do. SPSS version 19.0 was used in the statistical analysis. Results: Speed and angle of the neck (p<.001), as well as confidence and ease (p<.001), showed significant differences between endotracheal intubation with a SALT and endotracheal intubation via direct laryngoscopy. Conclusion: If endotracheal intubation via direct laryngoscopy is difficult to use or in trauma patients, using a SALT is safe and enables fast intubation. Moreover, in order to improve the efficiency of advanced airway management, the application of SALT should be introduced in the domestic scene.

Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome

  • Park, Sang-Jin;Choi, Eun Kyung;Park, Suyong;Bae, Kunjin;Lee, Deokhee
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.219-221
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    • 2018
  • Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

The Role of Proprotein Convertases in Upper Airway Remodeling

  • Lee, Sang-Nam;Yoon, Joo-Heon
    • Molecules and Cells
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    • v.45 no.6
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    • pp.353-361
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    • 2022
  • Chronic rhinosinusitis (CRS) is a multifactorial, heterogeneous disease characterized by persistent inflammation of the sinonasal mucosa and tissue remodeling, which can include basal/progenitor cell hyperplasia, goblet cell hyperplasia, squamous cell metaplasia, loss or dysfunction of ciliated cells, and increased matrix deposition. Repeated injuries can stimulate airway epithelial cells to produce inflammatory mediators that activate epithelial cells, immune cells, or the epithelial-mesenchymal trophic unit. This persistent inflammation can consequently induce aberrant tissue remodeling. However, the molecular mechanisms driving disease within the different molecular CRS subtypes remain inadequately characterized. Numerous secreted and cell surface proteins relevant to airway inflammation and remodeling are initially synthesized as inactive precursor proteins, including growth/differentiation factors and their associated receptors, enzymes, adhesion molecules, neuropeptides, and peptide hormones. Therefore, these precursor proteins require post-translational cleavage by proprotein convertases (PCs) to become fully functional. In this review, we summarize the roles of PCs in CRS-associated tissue remodeling and discuss the therapeutic potential of targeting PCs for CRS treatment.

Relations between Airway Narrowing and Prevertebral Soft Tissue Swelling after Anterior Cervical Spine Surgery : The Value of Lateral Neck Radiographs

  • Kim, Hee-Seop;Youm, Jin-Young;Kwon, Hyon-Jo;Choi, Seung-Won;Kim, Seon-Hwan;Koh, Hyeon-Song
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.97-102
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    • 2007
  • Objective : The authors attempted to evaluate the pattern of the airway narrowing due to prevertebral soft tissue swelling after surgery of the anterior cervical spine and their clinical significances using plain cervical X-ray images. Methods : Twenty-four patients undergoing anterior cervical spine surgery were reviewed from January 2004 to December 2005. Postoperatively, in daily basis, lateral radiograph of the neck was obtained in neutral position. We measured the upper airway diameter above and below the epiglottis level and prevertebral soft tissue diameter every day for a week and finally 2 weeks after surgery using their simple lateral cervical X-ray films. Results : Both airway narrowing and prevertebral soft tissue swelling were maximum in postoperative 2 days, and decreased rapidly in postoperative 7 days. Airway narrowing was aggravated postoperatively but slowly decreased as prevertebral soft tissue swelling diminished. But, the severity of airway narrowing showed no clinical correlations with clinical symptom and radiologic severity. Conclusion : Not all patients who show severe airway narrowing and prevertebral soft tissue swelling on their plain cervical X-ray film complain respiratory insufficiency. But, the patients with undergoing anterior cervical spine surgery should be monitored carefully for respiratory insufficiency, especially during several days following operation because both airway narrowing and prevertebral soft tissue swelling become peak at postoperative 2-3 days.