• 한방안이비인후피부과학회지
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• 제20권1호통권32호
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• pp.218-227
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• 2007

Objective : The purpose of this study is to investigate outpatients of hypersensitive rhinitis including allergic rhinitis who had visited to Hospital of Oriental Medicine. Method : We analyzed statistics study in 580 patients, who had visited to the Dept. of dermatology, ophthalmology & otorhinolayngology Hospital of Oriental Medicine Dongeui University from March, 1998 to December, 2006. Results : The results were as follows. 1. There is more male(53.28%) than femal(46.72%). The age distributions of patients showed highest in 20-29 years, followed by 10-19 years, 30-39 years in order. 2. The yearly distributions of patients showed highest in 2004, followed by 2001, 2005 in order. The seasonal distributions of patients showed highest in fall, followed by winter, summer, spring in order. The monthly distributions of patients showed highest in September, followed by August, October in order. 3. The distributions of number of times in treatment showed highest in 1-5 times. The distributions of duration of treatment showed highest in 1 week. In the treatment method, a major portion of treatment methods was acupuncture, followed by herbal medicine treatment, aroma therapy in order. 4. The Frequency of use of Prescriptions showed highest in Bojungikgi-Tanggami. The Frequency of use of Extract showed highest in Sochungryong-Tang. 5. The distribution of past history showed highest in Atopic dermatitis. The distribution of Rhinologic Complication showed highest in Paranasal sinusitis.

• The Korean Journal of Pain
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• 제33권1호
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• pp.81-89
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• 2020

Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 ㎍/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children's hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 ㎍/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

• 한방안이비인후피부과학회지
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• 제32권4호
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• pp.41-61
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• 2019

Background : The current medical statistics used in clinical research are the results of Fisher's significance test and the Neyman-Pearson hypothesis test, which were combined by psychologists. Also, in the philosophical background, it is related to Popper's falsificationism based hypothesis-deductive method and reduction to absurdity. Objectives : This study was designed to find complementary and alternative methods of null hypothesis and alternative hypothesis used for the clinical research methodology of Korean medicine otolaryngology. Methods : The body of this paper was divided into seven part. These are historical background, hypothesis test, hypothesis test method used in the design of clinical study, falsificationism and reduction to absurdity, problem and alternative method of the Neyman-Pearson hypothesis test, diagnosis example of sinusitis differentiation syndromes by Bayesian statistics. Through this process, we found out problems of frequentist statistics and suggested alternative methods. Result & Conclusion : As a solution to the problems of the null hypothesis and the alternative hypothesis, there are effects size, confidence interval, Bayesian statistics and Lakatos methodology of scientific research programmes.

• 대한본초학회지
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• 제36권5호
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• pp.37-46
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• 2021

Objective : This study aims to examine the effectiveness and safety of herbal medicines in upper respiratory tract infection by conducting systematic review against amoxicillin. Methods : Relevant randomized controlled trials (RCTs) published by December 2020 were searched in PubMED database. Study selection was conducted according to the PRISMA guideline. The Risk of Bias of the RCTs were evaluated based on the Cochrane criteria. Study selection and bias assessment were conducted independently by two researchers, and the third party was involved if there is a disagreement. Results : Three RCTs were included. Meta-analysis was not performed due to different specific disease and outcome measurements among the included studies. Herbal medicine showed statistically significant improvement in symptoms and endoscopic findings compared to amoxicillin in acute rhinosinusitis. In addition, herbal medicine showed statistically significant improvement in symptoms and a smaller dose of additional antibiotics in acute tonsillitis. However, herbal medicine showed no significant effects compared to amoxicillin in chronic sinusitis patients after functional endoscopic sinus surgery. In terms of adverse events, no significant difference was observed between the herbal medicine group and the amoxicillin group in all studies. Conclusion : Herbal medicine might be more effective than amoxicillin in the treatment of upper respiratory tract infection. Nevertheless, it is hard to clear that conclusion due to the fact that the collected studies were conducted on different specific diseases and herbal medicine, and that the included studies had flaws in the research methodology.

• Molecules and Cells
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• 제42권4호
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• pp.345-355
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• 2019

Eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is one of the most challenging problems in clinical rhinology. FZD5 is a receptor for Wnt5A, and its complex with Wnt5A contributes to activating inflammation and tissue modification. Nasal polyps and eosinophil/non-eosinophil counts are reported to be directly correlated. This study investigated the expression and distribution of FZD5, and the role of eosinophil infiltration and FZD5 in eosinophilic CRSwNP pathogenesis. The prognostic role of eosinophil levels was evaluated in seven patients with CRSwNP. Fifteen patients with CRS were classified based on the percentage of eosinophils in nasal polyp tissue. Methylated genes were detected using methylCpG-binding domain sequencing, and qRT-PCR and immunohistochemistry were used to detect FZD5 expression in nasal polyp tissue samples. The results showed that mRNA expression of FZD5 was upregulated in nasal polyps. FZD5 expression was significantly higher in nasal polyp samples from patients with eosinophilic CRSwNP than in those from patients with non-eosinophilic CRSwNP, as indicated by immunohistochemistry. Furthermore, inflammatory cytokine levels were higher in eosinophilic CRSwNP-derived epithelial cells than in normal tissues. In conclusion, FZD5 expression in nasal mucosal epithelial cells is correlated with inflammatory cells and might play a role in the pathogenesis of eosinophilic CRSwNP.

• Imaging Science in Dentistry
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• 제50권4호
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• pp.299-307
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• 2020

Purpose: The diagnosis of chronic rhinosinusitis requires a comprehensive knowledge of the signs and symptoms of the disease and an accurate radiographic assessment. Computed tomography (CT) is the superior imaging modality for diagnosis of chronic rhinosinusitis. However, considering the lower dose and higher resolution of cone-beam computed tomography (CBCT) compared to CT, this study aimed to assess the agreement between the findings of CBCT and functional endoscopic sinus surgery (FESS). Materials and Methods: This descriptive prospective study evaluated 49 patients with treatment-resistant chronic rhinosinusitis who were candidates for FESS. Preoperative CBCT scans were obtained before patients underwent FESS. The agreement between the CBCT findings and those of FESS was determined using the kappa correlation coefficient. The frequency of anatomical variations of the paranasal sinuses was also evaluated on CBCT scans. Results: Significant agreement existed between pathological findings on CBCT scans and those of FESS, such that the kappa correlation coefficient was 1 for mucosal thickening, 0.644 for nasal deviation, 0.750 for concha bullosa, 0.918 for nasal polyp, 0.935 for ostiomeatal complex (OMC) obstruction, and 0.552 for infundibulum thickening. Furthermore, 95.9% of patients had 1 or more and 79.6% had 2 or more anatomical variations, of which nasal deviation was the most common (67.3%). Conclusion: Considering the significant agreement between the findings of CBCT and FESS for the detection of pathological changes in the paranasal sinuses, CBCT can be used prior to FESS to detect chronic rhinosinusitis and to assess anatomical variations of the OMC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.192-197
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• 2023

Objectives: Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. Materials and Methods: This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. Results: A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. Conclusion: Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권3호
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• pp.163-168
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• 2023

An oroantral fistula (OAF) or oroantral communication (OAC) is an opening between the oral cavity and the maxillary sinus. If left untreated, these openings may cause chronic maxillary sinusitis. Although small defects (diameter <5 mm) may close spontaneously, larger communications require surgical intervention. Various studies have been conducted on OAC closure using a platelet-rich fibrin (PRF) membrane; most of these prior studies have involved simple direct application of PRF clots. This study introduces a new "double-barrier technique" using PRF for closure of an OAF involving sinus mucosal lifting and closure. The PRF material is inserted into the prepared maxillary sinus space, and the buccal advancement flap covers the oral side. This technique was successfully used to treat two patients with chronic OAF in the posterior maxillary region after implant removal or tooth extraction. The use of a PRF membrane in a double-barrier technique may have advantages in soft-tissue healing and could enable easy closure of chronic OAF with minimal trauma.

• Pediatric Infection and Vaccine
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• 제12권2호
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• pp.178-185
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• 2005

목 적 : 안와 연조직염은 성인에 비해 소아에서 흔한 질환으로 안와 중격을 경계로 안와의 침범여부에 따라 안와주위 연조직염과 안와 연조직염으로 구분된다. 이 구분은 치료와 예후에 많은 차이를 보인다. 저자들은 안와 연조직염의 원인균, 임상증상, 검사 소견, 치료 및 합병증의 발생 등의 차이를 알아보고자 하였다. 방 법 : 1995년 5월부터 2004년 4월까지 안와 연 조직염으로 연세의료원에 입원 치료한 환아 50명을 대상으로 후향적으로 의무기록 고찰을 시행하였다. 결 과 : 총 50명 중 남아 32명, 여아 18명이었으며, 평균 연령 $3.2{\pm}3.5$년이었다. 안와 컴퓨터 단층 촬영상에서 안와주위 연조직염으로 진단받은 환아는 36명이었고, 안와 연조직염으로 진단받은 환아 10명, 확진되지 않은 환아 4명이었다. 안와주위 연조직염은 안구주위 부종 이외에 발열 7례(19%), 안구 동통 2례(6%), 결막 부종 8례(22%)의 증상이 있었으며, 안와 연조직염은 안구주위 부종 이외에 발열 8례(80%), 안구 동통 6례(60%), 안구 돌출 2례(20%), 결막 부종 7례(70%), 안구 운동 장애 2례(20%)의 증상이 있었다. 안와주위 연조직염의 선행질환으로 부비동염 5례(14%), 상기도감염 3례(8%), 결막염 7례(19%), 피부 상처 5례(14%), 원인 불명 16례(44%)였으며, 안와 연조직염의 선행질환은 부비동염 5례(50%), 상기도감염 2례(20%), 원인 불명 3례(30%)였다. 안와주위 연조직염 환아에서 C반응성단백, 적혈구침강속도는 각각 10례(50%), 15례(65%)에서 상승하였으며, 안와 연조직염에서는 4례(80%), 3례(100%)에서 상승하였다. 안와 연조직염 10례 중 9례에서, 안와주위 연조직염 36례 중 34례에서 1차 선택 항생제로 cefoxitin+aminoglycoside, penicillinase resistant penicillin+3세대 cephalosporin이 선택되었다. 안와주위 연조직염에서는 1차 선택 항생제로 모두 호전되었으나, 안와 연조직염 환아에서는 cefoxitin+aminoglycoside를 투여했던 7례 중 5례에서 호전 소견을 보이지 않아, 2차 항생제로 vancomycin 또는 clindamycin이 추가되었다. 수술적 처치는 총 3례에서 시행되었으며, 안와 연조직염 1례에서 세균성 뇌수막염이 동반되었다. 결 론 : 안와 연조직염은 안와의 침범여부에 따라 임상양상, 치료 및 예후가 달라지며, 임상 양상이 모호한 경우가 있으므로 초기단계에 반드시 안와 컴퓨터 단층촬영을 시행한 후에 치료에 임하는 것이 필요할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제49권4호
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• pp.410-416
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• 2006

목 적 : 호흡기계 섬모 이상은 점막 섬모의 청소 기능에 장애를 초래하므로 반복적 혹은 지속적인 호흡기 계통의 질환 즉, 부비동염, 기관지염, 기관지확장증, 비염 또는 중이염 등을 동반한다. 이 질환은 주로 선천적으로 발생하지만, 드물게는 후천성 혹은 일과성으로 발생되기도 한다. 본 연구에서는 자주 재발하거나 지속되는 호흡기 질환의 증상을 가진 환아들을 대상으로 호흡기계 섬모 이상이 선행하는지를 알아보고자 하였다. 방 법 : 2000년 8월부터 2003년 7월까지 한양대학교병원 소아과에 입원하였거나 외래에 내원한 3개월 이상 지속되는 만성 또는 재발하는 호흡기 질환 환아들 중 17례에서 비강 내 점막 조직생검을 시행한 후 전자현미경을 이용하여 섬모의 상태를 검사하였다. 결 과 : 대상 환아 중 남아가 7례였고 여아가 10례였으며, 연령분포는 2세에서 10세 사이였다. 대상 환아 17례 중 만성 부비동염이 12례, 만성 기침이 9례, 잦은 상기도 감염이 9례에서 관찰되었으며 그 다음으로는 재발성 중이염(7례), 재발성 폐렴(4례), 기관지 천식(4례) 순으로 관찰되었다. 조직검사를 시행한 17례 중 4례가 병적인 소견을 나타냈는데 1례에서는 inner dynein arm 결손이 있었고 1례는 microtubular transposition, 1례는 supernumerous tubules, 1례는 singlet을 가지고 있었다. 결 론 : 자주 재발하거나 지속되는 호흡기 질환의 증상을 가진 환아에서 면역 결핍증 등이 배제된 경우 기도 섬모의 상태를 반영하는 것으로 사료되는 비강 내 점막 생검 실시를 통한 섬모의 미세구조 이상을 확인함으로써 선천적 또는 후천적 원인의 감별 및 효과적인 치료 방법을 결정하는데 도움이 될 것으로 사료된다.