Background/Aims: A catheter is inserted through the nasal cavity during high-resolution esophageal manometry (HRM), which may cause adverse events such as pain or epistaxis. Despite these possible safety considerations, studies on this subject are very limited. We aimed to investigate the usefulness of nasal cavity evaluation before HRM to reduce the risk of adverse events and test failure. Methods: Patients who underwent HRM after consultation with the ear-nose-throat department for nasal evaluation were retrospectively enrolled between December 2021 and May 2022. The included patients had a previous history of sinonasal disease or surgery or had subjective nasal discomfort. All patients answered the Sino-Nasal Outcome Test (SNOT-22) questionnaire, and subjective nasal discomfort was scored using a visual analog scale. Nasal endoscopy and acoustic rhinometry were performed for disease evaluation and volumetric assessment. Results: The analysis included 22 patients with a mean age of 58.9 years. The mean SNOT-22 score was 24.2, and 16 patients (72.7%) complained of subjective nasal obstruction. The HRM catheter was successfully inserted in 20 patients (90.9%), without any significant adverse events. The objective measurement outcomes of acoustic rhinometry and sinus endoscopy did not always correspond to subjective symptoms. Narrowed nasal airways unresponsive to decongestants were observed in two patients with failed catheter insertion. Conclusions: To reduce the risk of adverse events and test failure during HRM, a site-specific questionnaire to evaluate nasal obstruction might be helpful. When nasal obstruction is suspected, objective nasal cavity evaluation could be recommended for the safe and successful performance of HRM.
The study was based on a series of 252 patient with facial bone fractures who visited to Chun Cheon Sacred Heart Hospital, College of Medicine, Hallym University during the period of Dec., 1984 trough Nov., 1989. The results obtained are as follows; 1. The most frequent etiologic factor was traffic accident(45.2%). 2. The ratio of male to female was 5.5 : 1 and 2nd decade(44%) was the highest age group in incidence. 3. Monthly incidence was the highest in Aug(14.3%). 4. The most common site of fracture was mandible(55.3%) and zygoma complex(24.2%), nasal bone(11.6%), maxilla(8.9%) were next in order of frequeny. 5. In mandible fractures, the most frequent site was symphyseal area(36.9%) and 142 cases(85%) had fractures only in mandible. 6. In maxillary fractures, fracture with other facial bones(85.2%) was more frequent than fracture on maxilla only. The major fracture type on maxilla was Le Fort II type. 7. In fracture of zygoma complex, zygoma & zygomatic arch was the most frequent site(52.0%) and zygomatic arch(24.7%), zygoma(23.3%) were next in order. 8. Open reduction was major method of treatment in facial bone fractures except nasal bone ; mandible(62.9%), maxilla(77.8%), zygoma complex(65.8%). 9. Maxillofacial fractures were most frequently combined with head & neck injury(43.1%), and upp. & low. extremities(29.4%), chest and abdomen(11.9%) were in order of frequency.
Na, Ji Yeon;Kang, Joo Hyun;Choi, Seong-Ho;Jeong, Ho-Gul;Han, Sang-Sun
The Journal of the Korean dental association
/
v.55
no.4
/
pp.276-283
/
2017
Maxillary sinus squamous cell carcinoma is a relatively rare disease, comprising only 3% of malignant diseases of head and neck. As the growth rate is high and its prognosis is poor compared to others, the 5-year survival rate of maxillary sinus squamous cell carcinoma(MSSCC) is 23.4-49%. We introduce two rare clinical cases of squamous cell carcinoma originated from maxillary sinus of which symptoms include toothache and gingival swelling. On clinical examinations of both patients, deep periodontal pockets on upper right posterior teeth were detected. On panoramic images, the bony destruction of the maxillary sinus and its surrounding structures were not obvious and only alveolar bone loss was noted. It is difficult to diagnose MSSCC at an early stage due to symptoms of tooth pain and gingival swelling that are similar to that of periodontal diseases. However, if the symptoms do not improve after routine treatment of upper teeth, dentists should bear in mind of underlying malignant mass as differential diagnosis, thus early detection of the lethal disease. The aim of this study is to caution dental practitioners that malignancies have a potential to mimic periodontal diseases by introducing two cases of maxillary sinus squamous cell carcinoma presented as periodontitis.
Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Jun, Deuk-Soo;Hwang, Pil-Sung
Journal of Korean Foot and Ankle Society
/
v.4
no.2
/
pp.93-99
/
2000
Eleven patients with calcaneal fracture had 2 acute compartment syndrome of the feet and 9 late complication of the compartment syndrome of the feet. An interstitial pressure of more than 30 mmHg in either the central or interosseous compartment was considered pathologic and was treated by fasciotomy performed medially. Rigid claw toe deformity was treated by excision of the head and neck of the proximal phalanx, dorsal capsular release of the metatarsophalangeal joint, and lengthening of the extensor tendon. Patients were evaluated at a mean of 35 months(range, 21 - 44 months) after operation, and the examination was directed specifically toward symptoms and signs of myoneural ischemia, and walking pain. At follow-up, 2 patients with acute compartment syndrome of the foot had no evidence of myoneural ischemia, 9 patients with claw toe deformity had no pain with walking. Based on our clinical observations, we concluded that compartment syndrome of the foot may occur after the calcaneal fracture and fasciotomy is effective treatment for the prevention of the long term sequelae of this debilitating condition.
Torticollis is a deformity of the neck that shows tilting of the head toward the affected side and rotation of the chin toward the opposite side. In many cases with this condition, unilateral tightness of the sternocleidomastoid muscle is found frequently with fibrous tumor. The analysis of 43 cases of congenital muscular torticollis and result of their physical therapy are reported. The research was from Jan. 1, 1990 to Dec. 31, 1995 at Ulsan Dong Kang Hospital. The results obtained were as follows. 1. There were 30 males(69.8%) and 13 females(30.2%). Age distribution of patients showed below 2 month 20 cases(46.5%), above 1 year 7 cases(16.3%), $5{\sim}6/11{\sim}12$ months 4 cases(9.3%), and $7{\sim}8$ month 2 cases(4.6%). 2. 25 cases(58.1 %) were on the right and 18 cases(41.9%) on the left side. Torticollis was mild to moderately severe in mild 22 cases(51.1 %), moderate 18 cases (41.9 %) and severe 3 cases(7%). 3. There were normal spontaneous delivery in 36 cases(83.7%), Cesaean section in 4 cases (9.3%) and breech presentation in 3 cases(7%). Sequence of birth, the 1st born babys were 30 cases(69.8%) and the 2nd born babys were 13 cases(30.2%). 4. Above fair result of physiotherapy were 36 cases(83.7%). 5. Of the 43 cases with fellow up, above fair 32 cases(74.4%) and poor 11 cases(25.6%) showed. As conclusion, passive stretch exercise of sternocleidomastoid muscle with early torticollis diagnosis seems more successful in recovery than no exercise.
Background: Vascular occlusive event is one of the etiologies of sudden sensorineural hearing loss (SNHL). Stellate ganglion block (SGB) induces dramatic and intense vasodilatation in head and neck. Based on this principle, SGB has used as one of the treatment modalities in SNHL. This study was performed to evaluate immediate response of SGB on pure tone audiogram (PTA) in SNHL. Methods: Forty patients were studied. Each patient received daily ipsilateral SGB in paratracheal approach using 0.2% bupivacaine for 2 weeks. On first, third, and fifth day of treatment, we checked their PTA twice 1 hour before (Pre-PTA) and after (Post-PTA) SGB. Pre- and Post-PTA were compared. Several factors were analyzed as a prognostic factor of therapeutic results. Results: Eleven of 40 patients revealed decreased PTA after SGB. Degree of decreased PTA were insignificant ($2.5{\pm}1.6$ dB). Initial and final PTA results was $76.2{\pm}22.5$ and $49.8{\pm}28.3$ dB, respectively. Thirty-one of 40 patients were improved their PTA over 10 dB. The recovery was mainly influenced by the severity of initial hearing loss (P<0.001) and slightly by age (P<0.05). However, the change of PTA after SGB, time interval to receive SGB, sex, site, and number of SGB were not correlated to therapeutic outcome. Conclusions: These results suggest that vasodilatation by SGB has no immediate improvement in SNHL. Therefore, we question whether SGB is beneficial to all patients with SNHL as a therapeutic modality.
Kim Jong Sik;Cho Hyun Sang;Kim Young Kon;Cho Jung Keun;Ju Sang Kyu;Park Young Hwan
The Journal of Korean Society for Radiation Therapy
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v.9
no.1
/
pp.87-93
/
1997
The using of compensator is required to adjust the irregular dose distribution due to irregular thickness of the body in Total Body Irradiation. Aluminuim, copper or lead is generally used as compensator. In our study, we would like to introduce a result of the attenuation and compensation effect of radiation use compensator made by duralumin and its clinical use. The thickness of compensator was calculated by the attenustion of radiation, which was measured by polystyrene phantom and ionization chamber(farmer). The compensation effect of radiation was measured by diode detector. All of conditions were set as in real treatment, and the distanc from source to detector was 446 cm. We also made fixation of device to easily attach the compensator to LINAC. Beam spoiler was menufactured and placed on the patient to irradiate sufficient dose to the skin. diode detector were placed on head, neck, chest, umbilicus. pelvis and knee with each their entranced exit points, and datas of dose distribution were evaluated and compared in each points for eleven patients(Feb. 96-Feb. 97). The attenuation rate of irradiation by duralumin compensator was measured as $1.4\%$ in 2mm thickness. The mean attenuation rate was $1.3\%$ per 2mm as increasing the thickness gradually to 50 mm. By using duralunim compensator, dose distribution in each points of body was measured with ${\pm}2.8\%$ by diode detectior. We could easily calculate the thickness of compensator by measuring the attenuation rate of radiation, remarkably reduce the irragularity of dose distribution duo to the thickness of body and magnify the effect of radiation therapy.
Youn, Cha Kyung;Cho, Sung Il;Lee, Min Young;Jeon, Young Jin;Lee, Seog Ki
The Korean Journal of Physiology and Pharmacology
/
v.21
no.1
/
pp.117-124
/
2017
The present study aimed to show that pro-inflammatory cytokines [tumor necrosis factor (TNF)-${\alpha}$, interferon (IFN)-${\gamma}$, and interleukin (IL)-$1{\beta}$] synergistically induce the production of nitric oxide (NO) production in mouse mesangial cells, which play an important role in inflammatory glomerular injury. We also found that co-treatment with cytokines at low doses (TNF-${\alpha}$; 5 ng/ml, IFN-${\gamma}$; 5 ng/ml, and IL-$1{\beta}$; 1.25 U/ml) synergistically induced NO production, whereas treatment with each cytokine alone did not increase NO production at doses up to 100 ng/ml or 50 U/ml. Silymarin, a polyphenolic flavonoid isolated from milk thistle (Silybum marianum), attenuates cytokine mixture (TNF-${\alpha}$, IFN-${\gamma}$, and IL-$1{\beta}$)-induced NO production. Western blot and RT-PCR analyses showed that silymarin inhibits inducible nitric oxide synthase (iNOS) expression in a dose-dependent manner. Silymarin also inhibited extracellular signal-regulated protein kinase-1 and -2 (ERK1/2) phosphorylation. Collectively, we have demonstrated that silymarin inhibits NO production in mouse mesangial cells, and may act as a useful anti-inflammatory agent.
Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Jun, Deuk-Soo;Whang, Pil-Sung
Journal of Korean Foot and Ankle Society
/
v.3
no.1
/
pp.12-18
/
1999
Eleven patients with calcaneal fracture had 2 acute compartment syndrome of the feet and 9 late complication of the compartment syndrome of the feet. An interstitial pressure of more than 30 mmHg in either the central or interosseous compartment was considered pathologic and was treated by fasciotomy performed medially. Rigid claw toe deformity was treated by excision of the head and neck of the proximal phalanx, dorsal capsular release of the metatarsophalangeal joint, and lengthening of the extensor tendon. Patients were evaluated at a mean of 35 months(range, 21 - 44 months) after operation, and the examination was directed specifically toward symptoms and signs of myoneural ischemia, and walking pain. At follow -up, 2 patients with acute compartment syndrome of the foot had no evidence of myoneural ischemla, 9 patients with claw toe deformity had no pain with walking. Based on our clinical observations, we concluded that compartment syndrome of the foot may occur after the calcaneal fracture and fasciotomy is effective treatment for the prevention of the long term sequelae of this debilitating condition.
Fine needle aspiration cytology has become a frequently used technique for the diagnosis of lesions in the head and neck. Fine needle aspiration cytology of the salivary glands were performed on 66 patients. In 59 patients with satisfactory samples, cytologic diagnoses were as follows; there were 47 benign lesions, including pleomorphic adenoma(20), Warthin's tumor(3), benign cystic lesion(4), Inflammatory lesion(4), lymphoid lesion(3), myoepithelioma(1), unspecified benign neoplasm (5), and unclassified benign lesion(7). There were 6 cases of undetermined malignancy and 6 malignant lesions including mucoepidermoid carcinoma(3), adenoid cystic carcinoma(1), carcinoma ex pleomorphic adenoma(1), and metastatic carcinoma(1) in cytologic diagnosis. In 25 patients, the cytologic diagnosis was correlated with histologic findings. The sensitivity of the benign lesion was 96% and the specificity was 82%. There was no false-positive diagnosis. The sensitivity and the specificity of pleomorphic adenoma were 75% and 95%, respectively. Some of Warthin's tumors were confused with benign cystic lesion due to frequent cystic change of the tumor. The sensitivity and specificity of the malignant lesions were 56% and 88%, respectively. There were three false negative diagnoses. Two mucoepidermoid carcinomas were correctly diagnosed by cytology. Two of three adenoid cystic carcinomas were misdiagnosed as benign tumors.
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