• 제목/요약/키워드: Rhinosinusitis

검색결과 35건 처리시간 0.025초

외래 급성 비부비동염 환자의 잠재적으로 부적절한 항생제 사용 (Potentially Inappropriate Prescriptions of Antibiotics in Patients with Acute Rhinosinusitis in Ambulatory Settings in South Korea)

  • 정다이;제남경
    • 한국임상약학회지
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    • 제33권4호
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    • pp.261-269
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    • 2023
  • Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

부비동 내시경 수술 후 후각변화에 대한 예측 인자 (The Predictive Factors of Olfactory Changes after Endoscopic Sinus Surgery)

  • 예미경
    • Journal of Rhinology
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    • 제25권2호
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    • pp.63-68
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    • 2018
  • 본 종설에서는 부비동 수술 후 후각 회복에 영향을 미치는 인자들에 대해 서술 하였으며, 이들을 숙지함으로써 술 전에 후각 회복 여부를 예측할 수 있고, 술 후 후각 회복율을 높이는데 도움을 주고자 하였다. 부비동 내시경 수술 후 후각 기능은 다양한 치료 결과를 나타내고, 호전되었다고 하더라도 저후각증 상태로 남아있는 경우도 많은데, 이는 반복적인 감염과 상피조직의 손상이 후각신경세포들의 불가역적인 손상이나 편평상피화 및 섬유화를 초래함으로써 기인할 수 있다. 수술 후에도 지속되는 점막의 부종이나 후열 부위의 염증도 후각 회복을 저해할수 있다. 술 전 후각이 무후각증 일수록, 비용종이 있을수록, CT상 후열 혼탁이 경도일수록, 부비동 수술 과거력이 없을수록, 후각장애 기간이 짧을수록, 비호산구성 부비동염, 상처 회복이 순조로울수록 수술 후 후각 회복율이 높다고 할 수 있다. 만성부비동염에 동반되는 후각 장애는 환자나 의사 모두에게 해결이 힘든 문제이자 수술 후 결과를 정확하게 예측하기 어려운 문제로 남아있으며, 향후 더 많은 연구가 필요할 것으로 생각한다.

Differential Hrd1 Expression and B-Cell Accumulation in Eosinophilic and Non-eosinophilic Chronic Rhinosinusitis With Nasal Polyps

  • Chen, Kun;Han, Miaomiao;Tang, Mengyao;Xie, Yadong;Lai, Yuting;Hu, Xianting;Zhang, Jia;Yang, Jun;Li, Huabin
    • Allergy, Asthma & Immunology Research
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    • 제10권6호
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    • pp.698-715
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    • 2018
  • Purpose: Hrd1 has recently emerged as a critical regulator of B-cells in autoimmune diseases. However, its role in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains largely unexplored. This study aimed to examine Hrd1 expression and B-cell accumulation and their possible roles in CRSwNP. Methods: Quantitative real-time polymerase chain reaction, immunohistochemistry, enzyme-linked immunosorbent assay and Western blotting were used to assess gene and protein expression in nasal tissue extracts. Cells isolated from nasal tissues and peripheral blood mononuclear cells were characterized by flow cytometry. Local antibody production was measured in tissue extracts with a Bio-Plex assay. Additionally, changes in Hrd1 expression in response to specific inflammatory stimuli were measured in cultured dispersed polyp cells. Results: Nasal polyps (NPs) from patients with eosinophilic CRSwNP (ECRS) had increased levels of Hrd1, B-cells and plasma cells compared with NPs from patients with non-eosinophilic CRSwNP (non-ECRS) or other control subjects (P < 0.05). The average Hrd1 levels in B-cells in NPs from ECRS patients were significantly higher than those from non-ECRS patients and control subjects (P < 0.05). NPs also contained significantly increased levels of several antibody isotypes compared with normal controls (P < 0.05). Interestingly, Hrd1 expression in cultured polyp cells from ECRS patients, but not non-ECRS patients, was significantly increased by interleukin-$1{\beta}$, lipopolysaccharide and Poly(I:C) stimulation, and inhibited by dexamethasone treatment (P < 0.05). Conclusions: Differential Hrd1 expression and B-cell accumulation between the ECRS and non-ECRS subsets suggests that they can exhibit distinct pathogenic mechanisms and play important roles in NP.

Tobacco Smoking Could Accentuate Epithelial-Mesenchymal Transition and Th2-Type Response in Patients With Chronic Rhinosinusitis With Nasal Polyps

  • Ki-Il Lee;Younghwan Han;Jae-Sung Ryu;Seung Min In;Jong-Yeup Kim;Joong Su Park;Jong-Seok Kim;Juhye Kim;Jubin Youn;Seok-Rae Park
    • IMMUNE NETWORK
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    • 제22권4호
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    • pp.35.1-35.16
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    • 2022
  • Tobacco smoking (TS) has been known as one of the most potent risk factors for airway inflammatory diseases. However, there has been a paucity of information regarding the immunologic alteration mediated by TS in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). To identify the effect of TS, we harvested human tissue samples (never smoker: n=41, current smoker: n=22, quitter: n=23) and analyzed the expression of epithelial-derived cytokines (EDCs) such as IL-25, IL-33, and thymic stromal lymphopoietin. The expressions of Th2 cytokines and total serum IgE showed a type-2 inflammatory alteration by TS. In addition, the epithelial marker E-cadherin and epithelial-mesenchymal transition (EMT)-associated markers (N-cadherin, α-SMA, and vimentin) were evaluated. Histological analysis showed that EDC expressions were upregulated in the current smoker group and downregulated in the quitter group. These expression patterns were consistent with mRNA and protein expression levels. We also found that the local Th2 cytokine expression and IgE class switching, as well as serum IgE levels, were elevated in the current smoker group and showed normal levels in the quitter group. Furthermore, the expressions of E-cadherin decreased while those of N-cadherin, α-SMA, and vimentin increased in the current smoker group compared those in the never smoker group. Taken together, these results indicate that TS contributes to the deterioration of pathogenesis by releasing local EDCs and Th2 cytokines, resulting in EMT in patients with CRSwNP. We verified that alterations of immunological response by TS in sinonasal epithelium can play a vital role in leading to CRSwNP.

세포교정영양요법(OCNT)을 이용한 부비동염 개선 사례 연구 (A Case Study on the Improvement of Sinusitis Using Ortho-Cellular Nutrition Therapy (OCNT))

  • 정혜정
    • 셀메드
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    • 제14권1호
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    • pp.63.1-63.3
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    • 2024
  • Objective: Report on the improvement of sinusitis through Ortho-Cellular Nutrition Therapy. Methods: A Korean male in his 60s suffering from sinusitis. Results: Improvement observed in sinusitis after the implementation of the nutrition therapy. Conclusion: Nutrition therapy can be beneficial for patients suffering from sinusitis.

경희의료원 한방소아.청소년과 외래 환자의 주소증에 대한 연구(2009년 3월~2010년 2월) (A Study of the Chief Complaint of Pediatric Outpatients in the Kyung Hee Oriental Medicine Hospital)

  • 최민형;김덕곤;이진용
    • 대한한방소아과학회지
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    • 제24권3호
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    • pp.121-137
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    • 2010
  • Objectives: The purpose of this study is investigate about chief complaints of pediatric outpatients in the oriental medicine hospital and search for a latest of patients and their symptom. Methods: The study was composed of 3024 new patients aged between 0 and 20 who had been visited pediatrics in Kyung Hee oriental medicine hospital from 2009 March to 2010 February. Results: In age distribution, 1 year old child have most visited, and the number of the patients have fallen sharply as age have increased. The most visited month is August, and the least is November. In systemic division of chief complaints, in order of respiratory part, growth part, restorative herb medicine part, digestive part, neurologic & psychologic part, dermatologic part visited in patients number, and in single chief complaints, in order of growth, restorative herb medicine, anorexia, rhinosinusitis, cold, atopic dermatitis, seizure & epilepsy have visited. As for age and systemic division, between 1 and 6 years old, the patients of respiratory division have most visited, more than 7 years old, growth division. As for age and single chief complaints, in 0 year old, seizure & epilepsy have most visited, between 4 and 6 years old, rhinosinusitis, more than 7 years old, growth. Growth and respiratory division have increased the most in August, restorative herb medicine and digestive division have increased the most in September. In single chief complaints, patients of growth have most visited in most of time, but in September and November patients of restorative herb medicine have visited the most. Conclusions: The most visited division was respiratory part, and the most visited chief complaints was growth. More data of patients should be accumulated for further study, and we expect more specific study would be done about many kinds of disease in basis of this study.

Ginsenoside F1 Attenuates Eosinophilic Inflammation in Chronic Rhinosinusitis by Promoting NK Cell Function

  • Kim, So Jeong;Lee, Jinju;Choi, Woo Sun;Kim, Hyo Jeong;Kim, Mi-Yeon;Kim, Sun Chang;Kim, Hun Sik
    • Journal of Ginseng Research
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    • 제45권6호
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    • pp.695-705
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    • 2021
  • Background: Ginsenosides have beneficial effects on several airway inflammatory disorders primarily through glucocorticosteroid-like anti-inflammatory activity. Among inflammatory cells, eosinophils play a major pathogenic role in conferring a risk of severe refractory diseases including chronic rhinosinusitis (CRS). However, the role of ginsenosides in reducing eosinophilic inflammation and CRS pathogenesis is unexplored. Methods: We investigated the therapeutic efficacy and underlying mechanism of ginsenoside F1 (G-F1) in comparison with those of dexamethasone, a representative glucocorticosteroid, in a murine model of CRS. The effects of G-F1 or dexamethasone on sinonasal abnormalities and infiltration of eosinophils and mast cells were evaluated by histological analyses. The changes in inflammatory cytokine levels in sinonasal tissues, macrophages, and NK cells were assessed by qPCR, ELISA, and immunohistochemistry. Results: We found that G-F1 significantly attenuated eosinophilic inflammation, mast cell infiltration, epithelial hyperplasia, and mucosal thickening in the sinonasal mucosa of CRS mice. Moreover, G-F1 reduced the expression of IL-4 and IL-13, as well as hematopoietic prostaglandin D synthase required for prostaglandin D2 production. This therapeutic efficacy was associated with increased NK cell function, without suppression of macrophage inflammatory responses. In comparison, dexamethasone potently suppressed macrophage activation. NK cell depletion nullified the therapeutic effects of G-F1, but not dexamethasone, in CRS mice, supporting a causal link between G-F1 and NK cell activity. Conclusion: Our results suggest that potentiating NK cell activity, for example with G-F1, is a promising strategy for resolving eosinophilic inflammation in CRS.

비부비동염과 혈압의 상관관계 (Relationship between Chronic Rhinosinusitis and Blood Pressure)

  • 서윤태;김덕수;길부관;신승헌;예미경
    • 임상이비인후과
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    • 제29권2호
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    • pp.182-189
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    • 2018
  • Background and Objectives : There were few literatures about the relationship between upper airway disorders and cardiovascular risk factors such as hypertension, although an association between impaired lower respiratory function and cardiovascular alterations was often reported. Our purpose was to assess the relationships between chronic sinusitis and hypertension. Materials and Methods : Three hundred subjects with bilateral chronic sinusitis who underwent functional endoscopic sinus surgery between 2015and 2017 were evaluated. Six hundred forty subjects without any nasal diseases were enrolled as a control group. Blood pressure and body mass index (BMI) were measured using a standardized method, and subjects were asked about current use of any antihypertensive medication, history of diabetes, smoking and alcohol drinking habits.Sinusitis group was assessed by nasal endoscopic examination, paranasal sinus CT scan and allergy test. Results : Average systolic and diastolic blood pressures were statistically significantly higher in subjects with sinusitis than control group. Chronic rhinosinusitis was associated with a 1.415-fold (95% confidence interval 1.053-1.930) increased hazard of hypertension after multivariate adjustment. Conclusions : These results suggest that sinusitis is associated with high blood pressure. Therefore patients with sinusitis may need special attention for blood pressure control. Further studies need to be performed to elucidate the pathogenesis behind such associations.

가공유제의 환경피해와 대책 (A Counterplan and Environmental damage of Cutting fluids)

  • 김남경;김해지;정종달
    • 한국공작기계학회:학술대회논문집
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    • 한국공작기계학회 2002년도 춘계학술대회 논문집
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    • pp.223-238
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    • 2002
  • This paper presented on an environment estimation of cutting fluid which is a mouse model of acute bacterial rhinosinusitis using cutting fluid in grinding and cutting. Above results will be remarked the necessity of friendly environmental cutting skill when it had used in workshop. The results of a mouse experimental using cutting fluid showed that it are occurred to the respiratory organs sickness. Also cutting fluid are occurred to hurtfulness a person when it used to grinding and cutting in workshop. Also, the results of grinding experiments in avitation materials showed that surface roughness are superior to more emulsion type oil than vegetable type oil according to increase of the depth of cut. Grinding force are similar to both emulsion type oil and vegetable type oil.

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Nomogram plot for predicting chronic otitis media in Korean adults

  • Kang, Eun Jin;Lee, Jea Young
    • Journal of the Korean Data and Information Science Society
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    • 제28권4호
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    • pp.899-910
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    • 2017
  • Nomogram is useful for predicting the prevalence of each patient through the scoring system without a complex formula. Because there are few studies on chronic otitis media (COM) in adults, this study aims to identify the relevant risk factors for COM in Korean adults and to build a nomogram for the risk factors. The Health Interview Survey data subset, derived from the Sixth Korean National Health and Nutrition Examination Survey (KNHANES VI), was used to evaluate the participants. Of the participants, the weighted prevalence of COM was 5.3%. Residence, earphone use, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, and subjective hearing status were identified as risk factors for COM. Using 6 risk factors, we propose a nomogram for COM, and use AUC to verify the discrimination of the nomogram.