• Title/Summary/Keyword: otolaryngology

Search Result 3,114, Processing Time 0.038 seconds

Comparison of Clinical Efficacy Between Percutaneous Dilatational Tracheostomy and Surgical Tracheostomy (경피적 확장 기관절개술 (Percutaneous Dilatational Tracheostomy)의 시술 용이성 및 합병증)

  • Ahn, Jong-Joon;Koh, Youn-Suck;Chin, Jae-Yong;Lee, Ki-Man;Park, Wann;Hong, Sang-Bum;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lim, Chae-Man
    • Tuberculosis and Respiratory Diseases
    • /
    • v.45 no.6
    • /
    • pp.1277-1283
    • /
    • 1998
  • Background : Surgical tracheostomy(ST) is usually performed by surgeons in operating room. For a patient with mechanical ventilation, however, transportation to operating room for ST could be dangerous for patients. In addition, ST is often delayed due to unavailability of operating room or surgeon. Percutaneous dilatational tracheostomy(PDT), although novel in Korea, is gaining popularity as a bedside procedure in the hospitals of western countries. We evaluated the technical ease and safety of PDT in comparison with ST. Method : Thirty-eight patients in medical intensive care unit (ICU) who were either under mechanical ventilation for more than 7 days or required airway protection, were randomly assigned to ST(18 patients) or PDT(20 patients). Between two groups, there was no significant clinical difference except that female to male ratio was higher in the ST group. ST was performed by second year residents of the department of otolaryngology while PDT was performed by third grade medical resident and pulmonologist under bronchoscopic guide using Ciaglia Percutaneous Tracheostomy Set(Cook Critical Care, Bloomington, USA) in medical ICU. The following factors were compared between two groups : number of delayed cases after the decision for tracheostomy, procedural time, complications related to tracheostomy. Results : Delayed cases were 11 in ST group and 3 in PDT group (P<0.05). Procedural time was significantly shorter in PDT group ($15.6{\pm}7.1min$) than in ST group ($29.1{\pm}11.6min$, P<0.0001). Complications related to tracheostomy occurred in 5 cases in ST group : accidental decannulation (1), subcutaneous emphysema (2) and minor bleeding (2), and in 4 cases in PDT group : minor bleeding (2), subcutaneous emphysema (1) and premature extubation (1) (P>0.05). Conclusion : Since percutaneous dilatational tracheostomy was easy to practice and its complications were not different from surgical tracheostomy, PDT can be a useful bedside procedure for mechanically ventilated patients.

  • PDF

The Clinical Efficacy of Uvulopalatopharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡 증후군 치료에서 구개수구개인두성형술의 임상적 유용성)

  • Moon, Hwa-Sik;Choi, Young-Mee;Park, Young-Hak;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.6
    • /
    • pp.1366-1381
    • /
    • 1997
  • Background : Uvulopalatopharyngoplasty(UPPP) has become the most common surgical treatment for obstructive sleep apnea syndrome(OSAS). However, the results of this therapeutic modality have been quite variable with successful results by several authors and poor results by others. Until recently, in Korea, there is only a few reports about the clinical efficacy of UPPP. A prospective study was undertaken to evaluate the effectiveness and complications of UPPP. Method : Twenty-six OSAS patients who had undergone UPPP with preoperative and postoperative polysomnographic studies were included in this study. Two definitions of surgical success were used. The responder was defined, using a conventional criteria, as a 50% or more reduction in apnea index(AI) or apneahypopnea index(AHI) after UPPP, or a postoperative AI of <10 or AHI of <20. The initial cure was defined, using our own criteria, as a postoperative AI of <5 or AHI of <10. Complications were categorized in two groups : early(disorders during the first 10 postoperative days) and late. Results : Eighteen patients(69.2%) were responders, and ten patients(38.5%) were considered as initial cure. On the other hand, in five patients (19.2%), postoperative polysomnographic data demonstrated deterioration compared with preoperative data. Reduction rate of AI or AHI following UPPP was not significantly related to the preoperative body mass index, AI or AHI. There was no significant change of sleep architecture before and after UPPP in responder and initial cure groups. Early complications such as pain, dyspnea, bleeding, nasal reflux, dysphagia or wound disruption were observed in all patients. Late complications such as nasal reflux, voice change, dysphagia, loss of taste, pharyngeal dryness or foreign body sensation were discovered in 22 patients (84.6%). However, all early and late complications were of minor importance. Conclusion : The response to UPPP was favorable in approximately 70% of OSAS patient. However, the initial Cure rate of UPPP was relatively low. We suggest that selection of more appropriate surgical candidates and adequate surgical protocol is necessary to obtain a more successful result with UPPP.

  • PDF

A Clinical Study of Hoarseness (애성을 주소로 한 후두질환의 임상 통계적 고찰)

  • 윤완규;조규모;송기준;김홍수
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1983.05a
    • /
    • pp.6.4-7
    • /
    • 1983
  • Hoarseness is the most common and early symptom in laryngeal diseases. A clinico - statistical analysis was performed on 228 cases with chief complaint of hoarseness at the department of otolaryngology, Jeonbug National University during the past 3 years from January 1980 to December 1980. 1) The number of the patient with hoarseness were 228 cases (2.3 %) among total outpatient of 10110 cases. 2) Among the 228 cases with hoarseness, male were 115 cases and female were 113 cases, so sex ratio was nearly same. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 43 cases (18.9 %), chronic laryngitis 36 cases (15.8 %), vocal nodule 30 cases(13.2 %), vocal polyp 30 cases (13.2 %), vocal cord paralysis 26 cases (11.4 %), laryngeal carcinoma 18 cases (7.9 %) and laryngeal tuberculosis 15 cases (6.6 %). There were other diseases of larynx in 30 cases (13.2 %). 4) The incidence of age distribution in order of frequency were 4th decade (26.8 % ), 3rd decade (18.9%), 5th decade (17.1 %), 2nd decade (15.8 %) and 6th decade (9.6 %). 5) The duration from onset to consultation in order of frequency were 11 days-1 month (22.8 %), 1 month-3 months(19.7%), 3 months -6 months (18.9 %), within 10 days (13.6 %), 6 months-l year (13.2 % ), 1 year -3 years(7. 9 %) and 3 years over. 6) The duration from onset to consultation for underlying diseases were as follows ; acute laryngitis was within 10 days, chronic laryngitis was 3 months - 6 months, vocal nodule was 1 month-3 months, vocal polyp was 3 months -1 year, vocal cord paralysis was 11 days -1 month. 7) Associated symptoms with hoarseness in order of frequency were sore throat (25 %), sputum (8.8 %), swallowing difficulty (7.9 %) and dyspnea (6.1 %). But 84 cases (36.8 %), there were no other symptoms except hoarseness.

  • PDF

Efficacy and Safety of Miniscalpel Acupuncture in Knee Degenerative Osteoarthritis Patients: A Study Protocol for a Randomized Controlled Pilot Trial (퇴행성 슬관절염 환자에 대한 도침요법의 효능 및 안전성 연구: 임상예비연구)

  • Jun, Seungah;Park, Mu Seob;Oh, Se Jung;Lee, Jung Hee;Gong, Han Mi;Choi, Seong Hun;Hwangbo, Min;Lee, Hyun-Jong;Kim, Jae Soo
    • Korean Journal of Acupuncture
    • /
    • v.33 no.2
    • /
    • pp.67-74
    • /
    • 2016
  • Objectives : The Knee degenerative osteoarthritis patients are not satisfied with the conventional therapies of KDOA, which results in the use of alternative therapies. The miniscalpel acupuncture is effective in treating chronic soft tissue, releasing contractures. However, there is little scientific evidence supporting the use of miniscalpel acupuncture in knee degenerative osteoarthritis. This study was designed to obtain basic data for a further large-scale trial as well as provide information about the feasibility of miniscalpel acupuncture in knee degenerative osteoarthritis patients. Methods : We describe the protocol for a randomized controlled pilot clinical trial of 5 weeks duration. Twenty patients will be recruited and randomly allocated to two treatment groups: miniscalpel acupuncture treatment(experimental group); and acupuncture and electro-acupuncture treatment(control group). Miniscalpel acupuncture will be performed once with a 1-week interval for 3 weeks. Electro-acupuncture will be administered twice per week for a period of 3 weeks. The primary outcomes will be measured by visual analogue scale and range of motion. The secondary outcomes will be short-form McGill Pain Questionnaire and Western Ontario and McMaster Universities Osteoarthritis Index. Both primary and secondary outcomes will be measured at baseline and at 1, 2, 3 and 5 weeks(i.e. 2 weeks after treatment completion). Conclusions : This pilot study will provide a basic foundation for a future large-scale trial as well as information about the feasibility of miniscalpel acupuncture in knee degenerative osteoarthritis.

A Comparision of Radiotherapy Alone with Induction Chemotherapy-Radiotherapy in Inoperable Head and Neck Cancer (수술 불가능한 두경부 종양에서 방사선 단독요법과 유도 화학요법 및 방사선 병용요법의 비교)

  • Park, In-Kyu;Yun, Sang-Ho;Kim, Sang-Bo;Ryu, Sam-Uel;Park, Jun-Sik
    • Radiation Oncology Journal
    • /
    • v.9 no.2
    • /
    • pp.205-213
    • /
    • 1991
  • In order to determine the value of induction chemotherapy (CT) for inoperable head and neck cancer, the authors conducted a retrospective study. Fifty-five patients were treated with CT and radiotherapy (R-T)(CT+RT group). This group was compared with a group of 54 patients treated RT alone (RT alone group). The CT regimen used were CF (cis-platine+5-FU), CVB (cyclophos-phamide+vincristine+bleomycin), CAP (cyclophosphamide+adriamycin+prednisolone) or PVBM(cis-platine+vincristine+bleomycin+methotrexate). Toxicity from induction chemo-therapy was minimal, and toxicity was limited primarily to nausea and vomiting, mucositis and myelosuppression. The complete response (CR) rate to CT was $14.5\%$ and the partial response (PR) rate was $47.3\%$ for an overall major response rate of $61.8\%$. The major response rate at the completion of loco-regional therapy was $87.3\%$(48/55) with 32 CR ($58.2\%$) and 16 PR ($29.1\%$) for CT-RT group and $81.5\%$(44/55) with 27 CR ($50.0\%$) and 17 PR ($31.5\%$) for RT alone group (p=0.57). Median follow-up of CT-RT group was 17 months and 11 months for RT alone group. Median survival was 30 months for CT-RT group and 24 months for RT alone group (p=0.3). The overall survival rate at 2 years, 3 years and 5 years, respectively was $60.9\%,\;48.6\%\;and\;42.5\%$, for CT-RT group, and $54.9\%,\;49.9\%\;and\;49.9\%$ for RT alone group (p=0.33). Comparision between patients in both groups, stratified by overall stage, T and N stage, site, and pathology, all failed to show any significant difference in survival rates. We conclude that this retrospective study failed to demonstrate an advantage for induction chemotherapy in inoperable head and neck cancer.

  • PDF

Induction Chemotherapy Followed by Radiotherapy for Stage IV Hypopharyngeal Cancer (4기 병기 하인두암에서 선행 항암화학요법후 방사선치료)

  • Kang Ki Mun;Chai Gyu Young;Kim Jin Pyeong;Lee Won Seop
    • Radiation Oncology Journal
    • /
    • v.22 no.4
    • /
    • pp.247-253
    • /
    • 2004
  • Purpose: Hypopharyngeal cancer is diagnosed at the advanced stage in most cases, which the prognosis known to be poor. Thus, the efficacy of induction chemotherapy followed by radiotherapy, with regards to the response and survival rate for stage IV hypopharyngeal cancer patients, was examined. Materials and Methods: From July 1998 to February 2000, 18 cases were diagnosedas AJCC stage IV hypopharyngeal cancer without distant metastasis. These patients were treated with induction chemotherapy followed by radiotherapy, and the results retrospectively analyzed. The regimen of the induction chemotherapy was the 5-FU and cisplatincombination, at 3-week intervals for, 2 cycles. The total radiation dose for the primary lesion and metastatic lymph nodes was $68.4\~72.0$Gy (median: 70.2 Gy). Results: The: The median follow up period was 28 months, ranging from 7 to 99 months. The 3-year overall survival and disease-free survival rate were 41.7 and $31.1\%$, respectively. In 6 cases ($33.3\%$), conservation of the larynx for over 3 years was possible. After the induction chemotherapy there were 16 partial responses ($88.8\%$), 1 complete response and 1 with no response ($5.6\%$ each), therefore, 17 of the 18 cases ($94.6\%$) showed responses. After the completion of the induction chemotherapy and radiotherapy, a complete response was noted in 13 cases ($72.2\%$), a partial response in 5 ($27.8\%$), with an overall response rate of $100\%$. In the analysis of the prognostic factors influencing the survival rate, the 3-year and disease-free survival rates for the complete and partial response groups were 43.1, and $20.0\%$, and 39.6, and $20.0\%$, respectively (p=0.0003, p=0.002). Only the final response after treatment completion was statistically significant. Conclusion: For stage IV hypopharyngeal cancer, induction chemotherapy followed by radiotherapy was an effective treatment, with no severe side effects.

Preliminary Research on the Effect of Cosmetic Containing Ginseng Extract on Quality of Life of Healthy Women Based on Skindex-16 (인삼 추출물 함유 한방화장품이 건강한 성인 여성의 삶의 질에 미치는 영향에 관한 예비 연구; Skindex-16을 중심으로)

  • Cho, Ga Young;Park, Hyo Min;Kwon, Lee Kyung;Cho, Sung A;Kang, Byung Young;Kim, Yoon Bum
    • Journal of the Society of Cosmetic Scientists of Korea
    • /
    • v.41 no.4
    • /
    • pp.333-340
    • /
    • 2015
  • This study is designed to analyze the effect of skincare using cosmetic containing ginseng extract, on improving quality of life (QOL) of healthy women, with blind testing. QOL is a concept that represents how one's disease or health condition can physically, psychologically, and socially influence his or her daily life. The study was conducted to assess the effect of a ginseng cosmetic preparation on quality of life (QOL) using the Skindex-16 score, stratified by blind versus non-blinded option. 45 healthy women aged between 30 and 49 years with no skin disease were recruited for this study. Volunteers were divided into two groups. Group A (n = 22) received anti-aging cream with ginseng extract in the original packaging, which included the brand name and logo. Group B (n = 23) received the same cream in a plain white jar without any package decoration or logo. Both groups used the cream for 8 weeks. For the skin-related QOL assessment, Skindex-16 was used at baseline, forth, and eighth week. All volunteers except two dropouts in Group A completed the dermatology-specific QOL measure, Skindex-16, at baseline, after 4 weeks, and after 8 weeks of treatment with the provided samples. As a result, the mean score of 43 participants at baseline was $22.70{\pm}4.82$. There was a significant difference between the baseline score and the score after 8 weeks in both groups: The scores changed from $23.30{\pm}5.14$ to $20.20{\pm}4.83$ in Group A, from $22.17{\pm}4.58$ to $20.52{\pm}3.60$ in Group B. The "Symptom" subscale of Skindex-16 improved after 4 weeks and the "Emotion" subscale improved after 8 weeks in Group A. The "Function" subscale did not show improvement in either groups. Both groups showed no interaction effect between follow up time and groups in Skindex-16 and subscale. This research opens up the possibility of skincare using ginseng cream having a positive effect on QOL in healthy women. Moreover, one can predict that skincare ritual itself may have greater impact on the improvement of QOL, compared to the product packaging.

A Statistical Study of the Foreign Bodies in the Food and Air Passages for past 4 years and 5 months (과거 4년 5개월간 본교실에서 취급한 식도 및 기도이물의 통계적 고찰)

  • 전지일;김성일;조현상;김정원;최태규;김진구;최병익;임현준;김영학
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1976.06a
    • /
    • pp.87.4-88
    • /
    • 1976
  • The statistcal study was done on 81 cases of the foreign bodies in the food passages (73 cases) and air passages (8 cases), who had visited the Dept. of Otolaryngology of Kyung Hee Medical Center and treated endoscopically, from Nov. 1971 to Mar 1976. The results were as follows, 1) The incidence of esophageal foreign bodies (73 cases) in order of frequency was coin (61 cases; 83.6%), bone (6 cases; 8.2%), food particles (3 cases; 4.1%), discs (2 cases), and other metals (l case). The incidence of foreign bodies in the air passages (8 cases) was food particles (3 cases; 37.5%), pointed metal (2 cases; 25%), plastic pencil cap (l case), plastic ring (1 case), and wood piece (1 case) in order. 2) In sex distribution, 51 cases (62.9%) were males and 30 cases (37.1%) were females, and the ratio between males and females was about 1.7 : 1.3. In the age incidence, 69 cases (82.5%) of all foreign bodies were under 5 years of age, and especially, coin cases were 59 cases (96.7%) and the highest was 8 years of age, lowest was 11 months of age. 7 cases (87.5%) of all airway foreign bodies were under 10 years of age. 4) The ratio between the food passages(73 cases) and the air passages (8 cases) was about 9 : 1. In the location of the foreign bodies of the food passages, 66 cases (90.4%) were in the first esophageal narrowing, 5 cases (6.9%) in the second narrowing, and 2 cases (2.7%) in the third narrowing. In the air passages, the frequent sites were trachea (5 cases; 62.5%), larynx (2 cases), and bronchus (1 case) in order. 5) In duration of lodgement, 63 cases (86. 3%) of esophageal foreign bodies were removed within 24 hours, and one case was removed within 16 days. The number of cases lodged within 24 hours were 4 cases (50%). in the air passages and one case was removed within 18 days. 6) In treatment, 37 cases (50.7%) of esophageal foreign bodies were extracted by modified upper esophagoscopy, 33 cases (42.5%) by esophagoscopy under the local anesthesia, 3 cases (4.1%) by esophagoscopy under the general anesthesia. 8 cases of the coin cases were passed into the stomach during the endoscopic examination. Laryngeal foreign bodies (2 cases; 25%) were extracted by laryngoscopy under the local anesthesia. 2 cases (40%) of tracheal foreign bodies by Bronchoscopy with tracheotomy under the local anesthesia, 3 cases (60%) by Bronchoscopy under the general anesthesia, and bronchial foreign body (1 case) by open thoracotomy under the general anesthesia, at the Dept. of Chest surgery.

  • PDF

A statistical survey of the foreign bodies in the food and air passages (식도 및 기도이물의 통계적고찰)

  • 류항희;강병길;추연수;박재훈;김춘길;주양자
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1976.06a
    • /
    • pp.88.1-88
    • /
    • 1976
  • The authors have been performed a statistical survey for 228 cases with foreign bodies in the food and air passages who had visited the department of Otolaryngology, National Medical Center and removed endoscopically during the period of last 10 years from 1966 to 1975. The following results were obtained: 1. The total numbers of foreign bodies in the food and the air passages were 228 cases, and among of them 181 cases were foreign bodies in the food passage and 47 cases were foreign bodies in the air passage. The ratio between the food and the air passages was about 3.7 : 1. 2. The prevalent foreign bodies in the esophagus were coin, meat and food particles and bone in order of frequency. In air passage, bean and peanut were most prevalent foreign bodies and the next were metalic substances, fish bone in order of frequency. 3. In the age incidence, 65.4% of the esophageal foreign bodies and 67.6% of foreign bodies in the air passage were under 5 years of age especially coin, 92.9%. 4. In sex distribution, 99 cases were female, and the ratio between male and female was 1.3:1. There was no significant difference between male and female in the foreign bodies of the esophagus but the foreign bodies in the air passage were more prevalent in male as the ratio of 2.1:1. 5. The most prevalent site of lodgement in esophagus was first physiologic narrowing of the esophagus as the count of 83.8%. In foreign bodies of the air passage, bronchial foreign bodies were most frequent. And bronchial foreign bodies were more frequent in the right side as the ratio of 3.7:1. 6. In duration of lodgement, 56.0% of foreign bodies of the food passage were removed within 24 hours and almost of them were removed within 5 days. In foreign bodies in the air passage, only 32.4% were removed within 24 hours but 29.7% were removed within more than 1 week in the air passage. 7. Under the esophagoscope, granulation tissue were noted in the 5 cases of the foreign bodies in the esophagus due to foreign bodies. In foreign bodies of the air passage, complication were encountered in the 4 cases and also removed surgically and among of them, 2 patients were expired due to complications during post operative course.

  • PDF

Polarization-sensitive Optical Coherence Tomography Imaging of Pleural Reaction Caused by Talc in an ex vivo Rabbit Model (생체 외 토끼 모델에서의 탈크에 의해 유발되는 흉막 반응의 편광 민감 광 결맞음 단층촬영 이미징)

  • Park, Jung-Eun;Xin, Zhou;Oak, Chulho;Kim, Sungwon;Lee, Haeyoung;Park, Eun-Kee;Jung, Minjung;Kwon, Daa Young;Tang, Shuo;Ahn, Yeh-Chan
    • Korean Journal of Optics and Photonics
    • /
    • v.31 no.1
    • /
    • pp.1-6
    • /
    • 2020
  • The chest wall, an organ directly affected by environmental particles through respiration, consists of ribs, a pleural layer and intercostal muscles. To diagnose early and treat disease in this body part, it is important to visualize the details of the chest wall, but the structure of the pleural layer cannot be seen by chest computed tomography or ultrasound. On the other hand, optical coherence tomography (OCT), with a high spatial resolution, is suited to observe pleural-layer response to talc, one of the fine materials. However, intensity-based OCT is weak in providing information to distinguish the detailed structure of the chest wall, and cannot distinguish the reaction of the pleural layer from the change in the muscle by the talc. Polarization-sensitive OCT (PS-OCT) takes advantage of the fact that specific tissues like muscle, which have optical birefringence, change the backscattered light's polarization state. Moreover, the birefringence of muscle associated with the arrangement of myofilaments indicates the muscle's condition, by measuring retardation change. The PS-OCT image is interpreted from three major perspectives for talc-exposure chest-wall imaging: a thickened pleural layer, a separation between pleural layer and muscle, and a phase-retardation measurement around lesions. In this paper, a rabbit chest wall after talc pleurodesis is investigated by PS-OCT. The PS-OCT images visualize the pleural layer and muscle, respectively, and this system shows different birefringence of normal and damaged lesions. Also, an analyisis based on phase-retardation slope supports results from the PS-OCT image and histology.