• Tuberculosis and Respiratory Diseases
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• 제45권5호
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• pp.1087-1093
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• 1998

Mucormycosis is the common name given to several different diseases caused by fungi of the order Mucorales. The mucoraceae are ubiquitous fungi and are common inhabitants of decaying matter. In contrast to the widespread distribution of these fungi, disease in humans is limited, in most cases, to people with severe immunocompromised, diabetes mellitus, or trauma. 1be fungus gains entry to the body through the respiratory tract. The spores are presumably deposited in the nasal turbinates and may be inhaled into the pulmonary alveoli. The manifestations of mucormycosis are rhinocerebral, pulmonary, cutaneous, gastrointestinal, central nervous system, and miscellaneous. Sporadic reports can be found of mucormycosis involving other areas : heart, bones, kidney, bladder, mediastinum, and trachea. However, isolated tracheal mucormycosis is very rare. Therefore, we report a 57-year old, noninsulin dependent diabetic woman who presented with acute, severe degree of upper airway obstruction due to isolated mucormycosis of the trachea.

• 대한기관식도과학회지
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• 제3권2호
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• pp.287-292
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• 1997

We report 22 cases of well -differentiated thyroid carcinoma infiltrating the upper airway tract. This retrospective study was undertaken to evaluate the prognosis md to determine optimal therapy for thyroid carcinoma adhering to or invading the trachea or larynx from 1984.3 to 1996.12. The treatment was individualized depending on the extent of the cancer. There were 12 cases dissected free by an laryngotracheal shaving, 7 cases removed by an tracheal resection with end to end anastomosis, 3 cases removed by an total laryngectomy. In all of these cases, we performed a total thyroidectomy with an accompanying neck dissection. There were no major complications during the operation. Over the 5-years observation period, 11 patients are alive without a sign of recurrence, 4 Patients are alive with recurrence, 7 died of thyroid carcinoma; 2 of 12 in an laryngotracheal shaving cases, 2 of 7 in an tracheal resection with end to end anastomosis case, 3 of 3 in an total laryngectomy case. The result showed an radical operation for thyroid carcinoma invading the laryngotrachea improves the survival rate, but limits improving the cure rate, and the invasion of the thrchea or larynx must be treated whenever possible by an total resection followed by radioiodine and external beam radiation.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.114-120
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• 2018

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a $1.5{\times}1.3cm$ homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a $0.5{\times}0.4cm$ round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

• 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.

• Clinical and Experimental Pediatrics
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• 제61권12호
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• pp.392-396
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• 2018

Purpose: Adenotonsillar hypertrophy (ATH) that causes upper airway obstruction might lead to chronic hypoxemic pulmonary vasoconstriction and right ventricular (RV) dysfunction. We aimed to evaluate whether adenotonsillectomy (T&A) in children suffering from obstructive sleep apnea (OSA) due to severe ATH could improve RV function. Methods: Thirty-seven children (boy:girl=21:16; mean age, $9.52{\pm}2.20years$), who underwent T&A forsleep apnea due to ATH, were included. We analyzedthe mean pulmonary artery pressure (mPAP), the presence and the maximal velocity of tricuspid regurgitation (TR), the tricuspid annular plane systolic excursion (TAPSE), and the right ventricular myocardial performance index (RVMPI) with tissue Doppler echocardiography (TDE) by transthoracic echocardiography pre- and post-T&A. The follow-up period was $1.78{\pm}0.27years$. Results: Only the RVMPI using TDE improved after T&A ($42.18{\pm}2.03$ vs. $40{\pm}1.86$, P=0.001). The absolute value of TAPSE increased ($21.45{\pm}0.90mm$ vs. $22.30{\pm}1.10mm$, P=0.001) but there was no change in the z score of TAPSE pre- and post-T&A ($1.19{\pm}0.34$ vs. $1.24{\pm}0.30$, P=0.194). The mPAP was within normal range in children with ATH, and there was no significant difference between pre- and post-T&A ($19.6{\pm}3.40$ vs. $18.7{\pm}2.68$, P=0.052). There was no difference in the presence and the maximal velocity of TR (P=0.058). Conclusion: RVMPI using TDE could be an early parameter of RV function in children with OSA due to ATH.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.335-340
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• 2019

Background: Snoring is the cardinal symptom of obstructive sleep apnea (OSA). Snoring and upper airway obstruction associated with major oxygen desaturation may occur in populations undergoing flexible bronchoscopy. Methods: To evaluate the prevalence of patients at a high risk of having OSA among patients undergoing bronchoscopy with sedation and to investigate whether snoring during the procedure predicts patients who are at risk of OSA, we prospectively enrolled 517 consecutive patients who underwent the procedure with moderate sedation. Patients exhibiting audible snoring for any duration during the procedure were considered snorers. The STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire was used to identify patients at high (score ${\geq}3$ out of 8) or low risk (score <3) of OSA. Results: Of the 517 patients, 165 (31.9%) snored during bronchoscopy under sedation. The prevalence of a STOP-Bang score ${\geq}3$ was 61.9% (320/517), whereas 200 of the 352 nonsnorers (56.8%) and 120 of the 165 snorers (72.7%) had a STOP-Bang score ${\geq}3$ (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ${\geq}3$ after adjustment for the presence of diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and stroke (adjusted odds ratio, 1.91; 95% confidence interval, 1.26-2.89; p=0.002). Conclusion: Two-thirds of patients undergoing bronchoscopy with moderate sedation were at risk of OSA based on the screening questionnaire. Snoring during bronchoscopy was highly predictive of patients at high risk of OSA.

• Imaging Science in Dentistry
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• 제52권4호
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• pp.333-342
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• 2022

Purpose: The goal of this systematic review was to compare the use of cone-beam computed tomography (CBCT) with that of computed tomography (CT) for volumetric evaluations of the tongue and oral cavity. Materials and Methods: A search for articles was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The PubMed, Scopus, ScienceDirect, and SAGE Journals databases were searched for articles published between 2011 and 2021. Articles were screened and assessed for eligibility. Screening involved checking for duplication, reading the title and abstract, and reading the full text. Results: The initial search retrieved 25,780 articles. Application of the eligibility criteria yielded 16 articles for qualitative analysis. Multiple uses of CBCT were identified. In several studies, researchers assessed the volumetric correlation between tongue and oral cavity volumes, as well as other parameters. Post-treatment volumetric evaluations of the oral cavity were also reported, and the reliability of CBCT was assessed. The use of CT resembled that of CBCT. Conclusion: CBCT has been used in the evaluation of tongue and oral cavity volumes to assess correlations between those volumes and with the upper airway. It has also been used for volumetric evaluation after surgical and nonsurgical procedures and to assess the relationships between tongue volume, tooth position, occlusion, and body mass index. Participants with obstructive sleep apnea and malocclusion have been evaluated, and the reliability of CBCT has been assessed. In the included studies, CT was utilized for similar purposes as CBCT, but its reliability was not assessed.

• 한국임상수의학회지
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• 제41권2호
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• pp.117-122
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• 2024

A 3-year-old spayed female Russian blue cat was presented for dyspnea, nasal discharge, and stertorous breathing. Plain thoracic radiography revealed no specific findings. Computed tomography (CT) was performed to differentiate upper airway tract disorders. It revealed the presence of an iso-attenuating mass measuring 10.0 × 7.9 × 15.6 mm, with mild homogeneous contrast enhancement occupying the rostral nasopharynx. The mass was surgically debulked via a longitudinal incision in the soft palate. Histopathological and immunohistochemistry analysis of the surgically excised mass revealed CD3-/CD79a+ B cell lymphoma with an incomplete margin. The patient underwent hypofractionated radiation therapy, receiving a total of 36 Gray (Gy) in 6 Gy fractions over a six-week period. A follow-up CT examination was performed after 27 months of irradiation and the patient was confirmed to have achieved a complete response. There were no complications related to irradiation. The patient was alive for 40 months without recurrence. This study suggests that hypofractionated radiation therapy combined with surgical debulking could be considered as a treatment option for feline nasopharyngeal lymphoma.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.181-187
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• 2008

목 적 : 천식의 특징은 기도염증의 결과인 가역적인 기류제한과 기관지과반응성이다. 최근에 호기산화질소(exhaled nitric oxide; FeNO)이 비침습적으로 기도염증을 알 수 있는 지표로서 이에 대한 많은 연구가 있었다. 또한 FeNO는 천식의 중증도를 나타내는 데 이용되는 객담내 호산구수나 메타콜린 기도유발시험과 관련이 있다고 보고되었다. 이에 저자들은 간헐성 천식환자에서 폐기능검사와 호기산화질소와의 관계를 알아보고자 본 연구를 시행하였다. 방 법 : 2005년 4월부터 8월까지 경희의대부속병원 소아과에서 천식으로 진단되어 폐기능검사와 호기산화질소 측정이 가능하였던 5세부터 15세의 80명의 환자를 대상으로 하였다. 최근 4주내에 상기도 감염이 없었고, 부신피질스테로이드를 포함한 조절약물을 사용하지 않은 경우에 연구 대상에 포함하였다. 폐기능검사는 Microspirometer를 사용하였다. Eco Medics사의 Chemiluminescence NO-analyzer(CLD 88 sp, Duernten, Switzerland)를 사용하여 FeNO를 측정하였으며 폐기능 검사와 FeNO와의 상관관계 분석은 Spearman correlation coefficient를 사용 하였다. 결 과 : 1초간 강제호기량(forced expiratory volume in 1 second, $FEV_1$)의 평균은 $0.890{\pm}0.455L$이었으며 강제폐활량 (forced vital capacity; FVC)의 평균은 $1.071{\pm}0.630L$이었다. $FEV_1%pred$의 평균은 $98.39{\pm}34.27%$였으며 $FEV_1/FVC$의 평균은 $88.53{\pm}19.49$이었다. FeNO의 평균치는 16.88 parts per billion(ppb)이었다. FeNO 측정치는 $FEV_1$(r=0.345, P<0.01), FVC(r=0.244, P<0.05)와 유의한 상관관계를 보였으나 $FEV_1%pred$와 $FEV_1/FVC$는 FeNO와 유의한 상관관계를 나타내지 않았다. 결 론 : FeNO의 측정은 폐기능 검사와 함께 소아천식 환자의 관리에 유용하게 사용될 수 있는 신빙성있는 검사로 생각되며 측정 방법이나 측정치의 참고치 설정에 앞으로 많은 연구가 필요할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제47권2호
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• pp.218-230
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• 1999

연구배경: 두개안면 및 상기도의 해부학적 이상은 폐쇄성 수면 무호흡 발생과 밀접한 관련이 있는 것으로 알려져 있다. 저자들은 한국인 폐쇄성 수면 무호흡 증후군 환자가 지니고 있는 두개안면 및 상기도의 해부학적 특성을 평가하고, 폐쇄성 수면 무호흡의 발생을 예측함에 있어서 두개골계측분석의 임상적 유용성을 조사하고자 하였다. 방법: 폐쇄성 수면 무호흡 증후군 환자 39명(OSAS), 단순코골이 39명(simple snorers) 및 정상인 20명(control)을 대상으로 Riley 등의 방법을 이용한 두개골계측분석의 각 계측치와 수면다원검사의 각 지표와의 상호 관련성을 분석하였다. 결과: Pm-UPW길이와 V-LPW길이는 OSAS 및 simple snorers 에서 control에 비해 각각 유의하게 짧았으며 (p<0.01), PAS 깊이는 simple snorers가 control에 비해 짧았다 (p<0.05). ANS-Gn길이는 OSAS가 control에 비해 유의하게 길었고 (p<0.01), PNS-P길이는 OSAS 및 simple snorers가 control에 비해 각각 유의하게 길었다(p<0.01). MP-H길이는 OSAS가 control 및 simple snorers 에 비해 각각 유의하게 길었고 (p<0.01), simple snorers는 control에 비해 길었다(p<0.05). NL/Pm-P각도는 OSAS가 control 에 비해 작았다(p<0.05). MP-H길이는 OSAS에서 무호흡-저호흡지수와 유의한 상관관계가 있었으며 (r=0.561, p<0.01), OSAS와 simple snorers를 합한 대상에서도 MP-H 길이와 무호흡-저호흡지수는 유의한 상관관계가 있었다(r=0.511, p<0.01. PNS-P길이는 OSAS와 simple snorers를 합한 대상에서 무호흡-저호흡지수와 관련성이 있었다(r=0.286, p<0.05). 전체 대상에서 남자의 비만도가 PNS-P길이(r=0.355, p<0.01) 및 MP-H길이(r=0.460, p<0.01)와 유의한 상관관계가 있었다. 결론: 두개골계측분석은 폐쇄성 수면 무호흡 증후군의 원인이 될 수 있는 두개안면 및 상기도약 해부학적 특성을 평가할 수 있는 유용한 검사이다. 여러 가지 두개골계 측치중에서 설골의 위치를 나타내는 MP-H길이는 수면중에 발생 가능한 상기도의 협착 혹은 폐쇄 정도를 예측하는 자료로서 임상적 유용성이 높을 것으로 생각된다.