• Title/Summary/Keyword: Airway area

Search Result 116, Processing Time 0.027 seconds

Penetrating Injuries by Foreign Body in the Head and Neck Region (두경부의 이물질 삽입에 의한 관통성 외상)

  • Hong, Soon-Xae;Baek, Ji-Young;Cha, In-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.22 no.3
    • /
    • pp.351-355
    • /
    • 2000
  • Penetrating injuries in the head and neck region are not common but can pose difficult situations to manage properly. In small cross-sectional area, the neck housed many vital structures, such as carotid artery, internal jugular vein, cervical spines, esophagus, laryngotracheal complex and nerves. Because each vital structure is located within the fascial compartments, bleeding into these closed spaces can give rise to compression of surrounding structures, which may result in compromised airway. Therefore, management of the penetrating injuries should be based on the fully understanding of anatomical relationships, accurate clinical examinations, a careful history taking and the proper treatment planning. We present two cases of penetrating injuries in the head and neck region and discuss on the clinical considerations for the proper management with the literature review.

  • PDF

Surgical Treatment for a Huge Maxillary Ameloblastoma via Le Fort I Osteotomy: A Case Report

  • Jung, Sang-pil;Jee, Yu-jin;Lee, Deok won;Kim, Hyung Kyung;Kang, Miju;Kim, Se-won;Yang, Sunin;Ryu, Dong-mok
    • Journal of Korean Dental Science
    • /
    • v.11 no.2
    • /
    • pp.86-91
    • /
    • 2018
  • Ameloblastomaa are odontogenic benign tumors with epithelial origin, which are characterized by slow, aggressive, and invasive growth. Most ameloblastomas occur in the mandible, and their prevalence in the maxilla is low. A 27-year-old male visited our clinic with a chief complaint of the left side nasal airway obstruction. Three-dimensional computed tomography showed left maxillary sinus filled with a mass. Except for the perforated maxillary left edentulous area, no invaded or destructed bone was noted. The tumor was excised via Le Fort I osteotomy. The main mass was then sent for biopsy and it revealed acanthomatous ameloblastoma. The lesion in the left maxillary sinus reached the ethmoidal sinus through the nasal cavity but did not invade the orbit and skull base. The tumor was accessed through a Le Fort I downfracture in consideration of the growth pattern and range of invasion. The operation site healed without aesthetic appearances and functional impairments. However, further long-term clinical observation is necessary in the future for the recurrence of ameloblastoma. Conservative surgical treatment could be the first choice considering fast recovery after surgery and the patient's life quality.

Fibrosing Mediastinits Causing Obstruction of Left Lower Lobar Bronchus: A Pediatric Case Report (좌하엽 기관지 폐쇄를 유발한 섬유성 종격동염: 소아 증례 보고)

  • Young Woo Sim;Young Seon Kim;Seung Eun Lee;Min Hye Jang
    • Journal of the Korean Society of Radiology
    • /
    • v.83 no.3
    • /
    • pp.744-749
    • /
    • 2022
  • Fibrosing mediastinitis is a rare benign disorder characterized by the proliferation of dense fibrous tissue within the mediastinum. It typically manifests as localized or infiltrative soft-tissue masses in the middle mediastinum or hilar area, which cause compression and encasement of adjacent mediastinal structures, such as the vessels or airway. Here, we report a rare case of fibrosing mediastinitis in a 13-year-old girl that presented as a middle mediastinal mass lesion on CT scan with obliterating left lower lobar bronchus. The patient's symptoms and follow-up chest CT showed significant improvement following systemic corticosteroid treatment. As fibrosing mediastinitis can improve with systemic steroid therapy, radiologists must be aware of its radiologic findings when discriminating between infiltrating soft tissue lesions in the mediastinum.

An Assessment of Environmental Characteristics Associated with the Level of Endotoxin Concentration in Hospital Lobbies (일부 종합 병원 로비의 공기 중 엔도톡신 농도에 미치는 환경 요인 평가)

  • Lee, Kyeong-Min;Yeom, Jeongkwan;Lee, Wonjae;Ryu, Seung-Hun;Park, Dongjin;Park, Dong-Uk
    • Journal of Korean Society of Occupational and Environmental Hygiene
    • /
    • v.24 no.3
    • /
    • pp.310-320
    • /
    • 2014
  • Backgrounds: Endotoxin, which found in the outer membrane of the gram-negative bacteria cell wall, makes up almost all of the lipopolysaccharide(LPS). When people are exposed to endotoxin,it can result in diverse health effects such as an airway irritation and inflammation, fever, malaise, bronchitis, allergic asthma, toxic pneumonitis, hypersensitivity lung disease. Cases among the elderly, children or pregnant can occur more frequently than a healthy adult if they are repeatedly exposed to the existing endotoxin. Therefore, we investigated and assessed the environmental characteristics associated with the airborne endotoxin concentration level in six hospital lobbies. Method: Endotoxin from indoor air in six hospital lobbies was measured by an area sampling method and analyzed according to American Society for Testing and Materials International(ASTM international) E2144-01. Total suspended particulate(TSP), carbon dioxide($CO_2$), temperature and humidity were also measured by using direct reading measurements or airborne sampling equipment at the same time. Environmental characteristics were appropriately divided into two or three groups for a statistics analysis. One-way analysis variable(one-way ANOVA) was used to examine a difference of the endotoxin concentration, depending on the environmental characteristics. In addition, only variables with p-value(p<0.25) were eventually designed to the best model by using multiple regression analysis. Results: The correlation analysis result indicated that TSP(p=0.003) and $CO_2$(p<0.0001) levels were significantly associated with endotoxin concentration levels. In contrast, temperature(p<0.068) and humidity(p<0.365) were not associated with endotoxin concentration. Levels of endotoxin concentration were statistically different among the environmental characteristics of Service time(p=0.01), Establishment of hospital(p<0.001), Scale of hospital(p=0.01), Day average people using hospital(p=0.03), Cleaning time of lobby(p=0.05), Season(p<0.001), and Cleaning of ventilation system(p<0.001) according to ANOVA. Finally, the best model(Adjusted R-square=72%) that we designed through a multiple regression test included environmental characteristics related to Service time, Area of lobby, Season, Cleaning of ventilation system, and Temperature. Conclusions: According to this study, our result showed a normal level of endotoxin concentration in the hospital lobbies and found environmental management methods to reduce the level of endotoxin concentration to a minimum. Consequently, this study recognized to be requirement for the management of ventilation systems and an indoor temperature in order to reduce the level of endotoxin concentration in the hospital lobbies.

CYSTIC HYGROMA IN LEFT SUBMANDIBULAR AREA;REPORT OF A CASE (하악 우각부 및 악하부에 발생한 경부수활액낭종)

  • Lee, Hee-Cheul;Yoon, Kyu-Ho;Rho, Young-Seo;Park, Seong-Won;Shin, Myoung-Sang;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.16 no.2
    • /
    • pp.171-178
    • /
    • 1994
  • Cystic hygroma remains a complex entity in terms of its development and management. Most recently, cystic hygroma has been categorized as part of a larger spectrum that include lymphangioma. The majorities of lymhangioma occur in the head and neck as cystic hygromas with the posterior cervical region as the most common site. Cystic hygromas usually present in infancy or early childhood as compressible masses that may rapidly and intermittently enlarge. While they may arise in any anatomic location, hygromas of the head and neck are especially difficult and speech pathology. Since as airway obstruction, feeding difficulties, and speech pathology. Since its original description, there have been many attepmts at treatment modalities : surgical excision remains the treatment of choice. Complete extirpation of these lesions is often impossible, and recurrence rates are accordingly high. This is report of a case bout 5-year-old female patient with cystic hygroma, resulted in facial asymmetry and swallowing difficulty, in left submandibular area. We obtained the successful functional and esthetic results by simple surgical excision of tumor mass. Therefore, we represents the case with literatural reviews.

  • PDF

Task Analysis of Paramedics of Korea Based on DACUM Method (DACUM 기법에 의한 1급 응급구조사의 직무분석)

  • Bae, Ki-Sook;Koh, Bong-Yeun;Lee, Jung-Eun;Lee, In-Mo;Choi, Keun-Myoung;Kim, Soo-Tae
    • The Korean Journal of Emergency Medical Services
    • /
    • v.15 no.1
    • /
    • pp.5-23
    • /
    • 2011
  • Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.

Plans for Improvement of the Airspace Structure (공역체제 개선계획)

  • Kim, Chang-Seop
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.12
    • /
    • pp.144-177
    • /
    • 2000
  • Our nation have several procedures and law for national airspace management, however those procedures and law not enough to manage airspace. Therefore, I have studied this paper for improving flight safety and for providing economics flight of civcil aircraft and military aircraft, also, for increasing efficiency of airspace through systematic airspace management, additionally, for improving nation defense ability and for preventation our nation damage when occuring airspace problem. Nowaday. in using airspace. two theory which freely use theory and use theory under jurisdiction is opposed by every nation in worldwide. Consequently. we can realize every nation endeavour to increase their jurisdiction airspace. However. our nation is not still prepared to cope with other nation when occuring airspace trouble. because airspace definition is not prescribed on our aviation law. Therefore. several problems which are improved in our airspace management are presented on this paper. The presented matters are as follows. First, The airspace definition is not prescribed on aviation law and responsibility limit of airspace management is ambugious. Second. problem on structure of approach control area and special airspace, Third. problem on airway system. Fourth. civil agency and military agency apply respectively different regulation in establishment of aircraft flight route, To grasp these problems, considered the airspace conception, airspace classfication. legal character of airspace. our nation airspace state and management together with other nation airspace state and management. also compared our nation airspace management with other nation airspace management. And. improvement methods to solve problems which was appeared by comparing and analysis are presented on this paper.

  • PDF

Reference values for respiratory system impedance using impulse oscillometry in school-aged children in Korea (학동기 소아에서 impulse oscillometry system로 측정한 폐기능 정상치)

  • Wee, Young Sun;Kim, Hyoung Yun;Jung, Da Wun;Park, Hye Won;Shin, Yoon Ho;Han, Man Yong
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.9
    • /
    • pp.862-867
    • /
    • 2007
  • Purpose : The impulse oscillometry (IOS) is applicable to young children because it requires minimal cooperation and a non-invasive method to measure the mechanics of respiratory system. This study aimed to develop the reference values in school-aged children in Korea, using IOS which is a modification of forced oscillation technique (FOT). Methods : Measurements were performed in 92 previously untrained healthy children, aged 7 to 12 years old, using IOS. We analyzed the relationships between the data about their age, height, weight, body surface area (BSA), body mass index (BMI) and the result of IOS using the linear regression test. Results : The success rate of IOS was 92.4%. Stepwise multiple regression of resistance of respiratory system (Rrs) and reactance of respiratory system (Xrs) in natural form for age, height, weight, BSA, BMI showed that height was the most significant predictor and altogether of 5 variables explained the Rrs and Xrs most. Our regression equations at multiple frequencys were comparable to published reference values, especially about the Rrs obtained at 5 Hz. Conclusion : IOS is a feasible method to measure the respiratory resistance in untrained children. We got the reference values using IOS and it seems to be useful to diagnose a variety of respiratory diseases.

A case of postoperative nasopharyngeal reflux associated with retropharyngeal lymphangioma in newborn infant (수술 후 비인두 역류가 동반된 신생아의 후인두림프관종 1례)

  • Koo, Kyo Yeon;Lee, Jun Seok;Lee, Soon Min;Park, Min Soo;Namgung, Ran;Park, Kook In;Lee, Chul;Yoon, Choon Sik;Jung, Woo Hee;Choi,, Hong Shik
    • Clinical and Experimental Pediatrics
    • /
    • v.53 no.2
    • /
    • pp.258-261
    • /
    • 2010
  • Lymphangioma is a rare benign congenital tumor of the lymphatic system, which is commonly diagnosed before 2 years of age. In the natronal report, cystic lymphangioma was usually reported as a huge translucent mass located in the head and neck area. It's occurrence in retropharyngeal space with respiratory obstruction and swallowing difficulty in neonate is extremely rare and postoperative nasopharyngeal reflux has rarely been reported. Complete resection is the standard therapy. However, involvement of the upper airway may be determining prognosis in the extensive lymphangiomas because of the difficulty of complete excision. We present a case of cystic lymphangioma in neonate which was initially asymptomatic but gradually progressed to cause respiratory obstruction due to enlargement. After resection, nasopharyngeal reflux developed with dysfunction of the soft palate and gradually improved with conservative care over 5 months.

Risk factors affecting the difficulty of fiberoptic nasotracheal intubation

  • Rhee, Seung-Hyun;Yun, Hye Joo;Kim, Jieun;Karm, Myong-Hwan;Ryoo, Seung-Hwa;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.20 no.5
    • /
    • pp.293-301
    • /
    • 2020
  • Background: The success rate of intubation under direct laryngoscopy is greatly influenced by laryngoscopic grade using the Cormack-Lehane classification. However, it is not known whether grade under direct laryngoscopy can also affects the success rate of nasotracheal intubation using a fiberoptic bronchoscpe, so this study investigated the same. In addition, we investigated other factors that influence the success rate of fiberoptic nasotracheal intubation (FNI). Methods: FNI was performed by 18 anesthesiology residents under general anesthesia in patients over 15 years of age who underwent elective oral and maxillofacial operations. In all patients, the Mallampati grade was measured. Laryngeal view grade under direct laryngoscopy, and the degree of secretion and bleeding in the oral cavity was measured and divided into 3 grades. The time required for successful FNI was measured. If the intubation time was > 5 minutes, it was evaluated as a failure and the airway was managed by another method. The failure rate was evaluated using appropriate statistical method. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were also measured. Results: A total of 650 patients were included in the study, and the failure rate of FNI was 4.5%. The patient's sex, age, height, weight, Mallampati, and laryngoscopic view grade did not affect the success rate of FNI (P > 0.05). BMI, the number of FNI performed by residents (P = 0.03), secretion (P < 0.001), and bleeding (P < 0.001) grades influenced the success rate. The AUCs of bleeding and secretion were 0.864 and 0.798, respectively, but the AUC of BMI, the number of FNI performed by residents, Mallampati, and laryngoscopic view grade were 0.527, 0.616, 0.614, and 0.544, respectively. Conclusion: Unlike in intubation under direct laryngoscopy, in the case of FNI, oral secretion and nasal bleeding had a significant effect on FNI difficulty than Mallampati grade or Laryngeal view grade.