• Title/Summary/Keyword: airway management

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Effects of Caffeic Acid, Myristicin and Rosemarinic Acid on the Gene Expression and Production of Airway MUC5AC Mucin

  • Lee, Hyun Jae;Lee, Kang Ro;Hong, Jang-Hee;Lee, Choong Jae
    • Natural Product Sciences
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    • v.22 no.4
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    • pp.275-281
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    • 2016
  • Perilla frutescens was empirically used for controlling airway inflammatory diseases in folk medicine. We investigated whether caffeic acid, myristicin and rosemarinic acid derived from Perilla frutescens significantly affect the gene expression and production of mucin from airway epithelial cells. Confluent NCI-H292 cells were pretreated with caffeic acid, myristicin or rosemarinic acid for 30 min and then stimulated with phorbol 12-myristate 13-acetate (PMA) for 24 h. The MUC5AC mucin gene expression and production were measured by reverse transcription - polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Additionally, we examined whether caffeic acid, myristicin or rosemarinic acid affects MUC5AC mucin production indued by epidermal growth factor (EGF) and tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), the other two stimulators of production of airway mucin. The results were as follows: (1) Caffeic acid, myristicin and rosemarinic acid inhibited the gene expression and production of MUC5AC mucin induced by PMA from NCI-H292 cells, respectively; (2) Among the three compounds derived from Perilla frutescens, only rosemarinic acid inhibited the production of MUC5AC mucin induced by EGF or $TNF-{\alpha}$, the other two stimulators of production of airway mucin. These results suggest that rosemarinic acid derived from Perilla frutescens can regulate the production and gene expression of mucin, by directly acting on airway epithelial cells and, at least in part, explains the traditional use of Perilla frutescens as remedies for diverse inflammatory pulmonary diseases.

Clinical Analysis for 120 Cases with Pediatric Airway Foreign Bodies (유소아 기도 이물의 임상 양상과 환기형 기관지 내시경술의 결과 : 서울대 병원의 경험 120례)

  • Cha, Won-Jae;Choi, Hyo-Geun;Moon, Sung-Joong;Hah, J.-Hun;Sung, Myung-Whun;Kim, Kwang-Hyun
    • Korean Journal of Bronchoesophagology
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    • v.12 no.2
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    • pp.26-30
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    • 2006
  • Backgroud and Objectives: Inhalation of foreign bodies in respiratory tract can be fatal to infants and child. After ventilating bronchoscopy technique was widelyused, most of the pediatric airway foreign bodies could be managed effectively. In this study, we aimed to analyze clinicalfeatures and outcomes of ventilating bronchoscopic removal of pediatric airway foreign bodies. Materials and Methods: One hundred twenty cases of ventilating bronchoscopy for pediatric airway foreign bodies at Seoul National University Hospital for the past 15 years were analyzed retrospectively. Results: In 120 cases, sex ratio (male: female) was 2.2:1 and mean age was 27.0 months. Most frequent type of airway foreign was peanut (60.2%). One hundred thirteen patients, in whom a foreign body was confirmed in the airway, were successfully managed by ventilating bronchoscopy. Delayed diagnosis and management made a significantly long postoperative hospital stay. Conclusion: Great care must be given when feeding young children, especially younger than 36 months, with nuts. Early intervention with ventilating bronchoscopy following a clinical suspicion is critical to successful treatment.

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Comparison of Three Supraglottic Airway Devices in Neutral and Cervical Neck Collar Position (융복합적 기술이 적용된 성문위기구들의 삽관용이성 비교)

  • Tak, Yang-Ju
    • Journal of Digital Convergence
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    • v.14 no.12
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    • pp.369-375
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    • 2016
  • Purpose of this study was to compare the easiness of insertion of three Supraglottic airway devices(SADs) in a neutral and cervical neck collar position in a manikin setting. Three different SADs-Laryngeal Mask Classic (LMA), I-gel and Streamlined Liner of the Pharynx Airway(SLIPA) were applied. Thirty nine emergency medical technicians (EMTs) who are working in Korea 119 rescue services were taught briefly about the use of the LMA, I-gel and SLIPA in a manikin setting. The time to effective ventilation was shorter in I-gel ($10.5{\pm}2.2$, $11.4{\pm}5.7$) and SLIPA ($12.3 {\pm}5.1$, $12.0{\pm}6.8$) than LMA ($17.2{\pm}3.2$, $18.5{\pm}5.5$) in a neutral and cervical neck collar position, respectively(p<0.05). There was no difference between head positions in each of the airways. In conclusion, in the speed of insertion, I-gel and SLIPA were superior to LMA in the neutral and cervical collar setting of a manikin.

Clinical Analysis of Suspected Airway Foreign Bodies in Infants and Children (의증 유소아 기도이물의 임상적 고찰)

  • 안병훈;송달원;최용식;박기철;이근양;김중강
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.84-93
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    • 1997
  • The bronchoscopy is usually performed in the patients who present symptoms of wheezing, hemoptysis, signs of airway obstruction, unexplained long-term chronic cough with or without radiologic features of pneumonia, emphysema or atelectasis. The symptoms and signs of cases of suspected airway foreign body are of often cofused with those of asthma pneumonia and other respiratory tract disease. The ventilating bronchoscopy will be helpful for removal of certain foreign bodies as well as alleviating medically-unresponsive bronchopulmonary conditions via removing abnormal secretions or merely improving ventilation. The authors have performed clinical analysis of 59 patients who were suspected of airway foreign bodies and treated by ventilating bronchoscopy from September 1985 to February 1995. The results were as follows: 1) Among the 59 cases of bronchoscopy, 51 cases(97%) were under the age of 3. The ratio of male and female was 2.69:1 2) Most common presenting symptom was coughing(84.7%) followed by dyspnea, fever, wheezing and anterior chest pain. 3) Among 39 cases of identified foreign bodies, abnormal findings in the chest X-ray films were found in 33 cases(84.6%) and most common abnormal radiologic feature was pneumonia in 10 cases(25.6%) followed by combination of pneumonia and emphysema, or emphysema alone. All the 20 cases of absent foreign body presented abnormal radiologic features and common findings were pneumonia and atelectasis. 4) Vegetable foreign bodies were the most common form of removed airway foreign bodies(69.2%) followed by metallic foreign bodies(12.8%) and plastic foreign bodies(7.7%). 5) By distribution of the location of foreign bodies, 29 cases(74.4%) were located in the main bronchus( 16 cases of right side and 13 cases of left side), 8 cases were in the trachea and 2 cases were found at the cordal level. 6) By duration of foreign body lodgement in the airway, 9 cases(23.1%) were removed within 7 to 30 days, 10 cases(5.6%) within 3 days and 5 cases(12.8%) were enlodged over 30 days. 7) In the cases of absent foreign bodies, common bronchoscopic findings were mucopurulent or thick mucoid discharge in the main bronchi, erythema or edema of bronchial mucosa and all the cases were improved after ventilating bronchoscopy with concomitant medical management.

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Comparison of dexmedetomidine alone with dexmedetomidine and fentanyl during awake fiberoptic intubation in patients with difficult airway: a randomized clinical trial

  • Acharya, Ranjita;Sriramka, Bhavna;Koushik, Priyangshu
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.349-356
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    • 2022
  • Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

Clinical Analysis of Upper Aerodigestive Tract Foreign Body (기도 및 식도 이물에 대한 임상적 고찰)

  • Lee, Min-Young;Jung, Sung-Do;Kim, Young-Hoon;Chung, Phil-Sang;Lee, Sang-Joon
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.28-34
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    • 2009
  • Background and Objectives: Foreign bodies of upper aerodigestive tract are common problem for primary care physicians. Delayed diagnosis or failure of removal might cause fatal problemsand complications. Therefore proper diagnosis and management is imperative. In this study, we described clinical features of upper aerodigestive tract foreign body, and analyzed efficacy of different management modality. Materials and Methods: 250 cases of foreign bodies in the esophagus and trachea, between Jan. 1998 through Jan. 2009 has been retrospectively analyzed. A total of 24 cases and 226 cases had been found each as airway foreign bodies and esophageal foreign bodies. The clinical features are described and treatment outcomes, prognosis, and rate of complications of each management modality have been compared. Results: In airway foreign bodies, ventilating bronchoscopy yielded better results, 19 success out of 19 trials than fiberoptic bronchoscopy, 3 success out of 5 trials. Hospitalization days after removal of foreign body didn't show difference between two treatment modalities, although patients who had ventilating bronchoscopy had gone through general anesthesia. And there was no complication after removal of foreign body. In esophageal foreign bodies, rigid esophagoscope yielded better results, 99% of successful removal rate, compared to the EGD, only 78% of successful removal rate. There was no difference of hospitalization days between two modalities. And complication rate was even low in patients who had done rigid esophagoscopic foreign body removal. Conclusion: In upper aerodigestivetract foreign body. Rapid diagnosis and successful foreign body removal is important. Removal by rigid scope(ventilating bronchoscope, rigid esophagoscope) revealed less failure in both airway and esophageal foreign bodies.

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A Study on the Prevention of Nosocomial Respiratory Infection in Critical Care Nurses (중환자실 간호사의 호흡기병원감염 예방에 관한 연구)

  • Choi Ji-Youn;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.397-413
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    • 1999
  • The purpose of study is to prevent Nosocomial Respiratory Infection after understand the Correlation about Recognition and Performance of Critical Nurses. Data were collected from Critical Nurses 300 persons who has worked in 14 Subsidary Hospitals of University in Seoul and the collection periode is from Nov. 1st, 1997 to Jul. 14th. 1998. There are 40 questions and constructed by 6 Domains which Hand Washing, Suction Management, Airway Management, Respiratory Instrument. Ventilation and Respiratory Intervention. Also, the Data were analized with SPSS program. The obtained results are as follows : (1) The Mean of Recognition for Prevention of Nosocomial Respiratory Infection is 4.649 and by Domains, Respiratory Intervention(4.758), Suction Management (4.669), Airway Management(4.660), Hand Washing(4.651), Ventilation(4.605) and Respiratory Instrument(4.561) according to the Mean. (2) The Mean of Performance for Prevention of Nosocomial Respiratory Infection is 3.991 and by Domains, Respiratory Intervention(4.498), Airway Management (4.107), Hand Washing(4.084), Suction Management(3.898), Respiratory Instrument(3.860) and Ventilation(3.690) according to the Mean. (3) In the Correlation of Recognition and Performance for the Prevention of Nosocomial Respiratory Infection, Hand Washing(r=0.755, p=0.000), Airway Management(r=0.724, p=0.000), Respiratory Intervention(r=0.693, p=0.000) are mentioned significant correlation level. The Performance is good whenever the Recognition is high for Respiratory Instrument(r=0.143, p=0.054) but it's not significant level and Suction Management and Ventilation has no Correlation. (4) In Normal Properties, The Recognition is good(p<.05) when Nurses has plenty Clinical Career, Attendance of the Education and Exclusive Nurse for the Respiratory Infection is in Hospital. The Age is not significant correlation level statistically but represent a little correlation. The Performance is good(p<.05) when Elder Age, Attendance of the Education and the plenty Clinical Career is not significant correlation level statistically but represent a little correlation. Another properties has no menas. According to the results, Suggestion is as follows ; (1) Required Education to advance Recognition and Performance about Prevention of Nosocomial Respiratory Infection for a little clinical career of Nursing and younger Nurses. (2) It needs to analyze Performance about Prevention of Nosocomial Respiratory Infection by observation of research worker.

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Anesthetic Management of a Patient with Kimura's Disease (Kimura병 환자의 전신마취 사례)

  • Choi, Eun-Ji;Park, Sang-Jin
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.38-43
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    • 2009
  • Kimura's disease is an idiopathic chronic condition, associated with a high-titer of IgE and peripheral eosinophilia. It frequently presents as a solitary or multiple lesions in the head and neck area. During the perioperative period, anesthesiologists should understand the anatomical structures of the patient who has Kimura's disease involvement of the head and neck, especially the airway. It is important to pay attention to the occurrence of signs and symptoms of acute allergic reactions related to a high-titer of IgE and eosinophilia. We report our experience with anesthetic management in an 18-year-old patient with multiple neck masses due to Kimura's disease.

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Laser Aryepiglottoplasty in Neurasthenic Laryngomalacia (Neurasthenic Laryngomalacia에서 의 Laser Aryepiglottoplasty의 적용 1례)

  • 김영모;조정일;최종철;한창준
    • Korean Journal of Bronchoesophagology
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    • v.4 no.1
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    • pp.122-126
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    • 1998
  • Laryngomalacia is the most common cause of inspiratory stridor and varying degrees of airway obstruction in infants but rarely occurs in children or adults. However, acquired airway obstruction would be developed due to the presence of redundant mucosa in the aryepjglottic folds similar to that seen in congenital laryngomalacia after central nervous system damage. To this condition, the term“Neurasthenic Laryngomalacia”is applied. We have recently experienced a case of neurasthenic larygomalacia, which has been managed by laser aryepiglottoplasty with good result. We report management and outcome of this patient with a review of the literatures.

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