• 제목/요약/키워드: Upper respiratory system

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Oscillometry-Defined Small Airway Dysfunction in Patients with Chronic Obstructive Pulmonary Disease

  • Amit K. Rath;Dibakar Sahu;Sajal De
    • Tuberculosis and Respiratory Diseases
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    • 제87권2호
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    • pp.165-175
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    • 2024
  • Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV1) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFLT) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV1% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFLT.

Evaluation on the Usefulness of Lung Tumor Stereotactic Radiosurgery Applying the CyberKnife $Synchrony^{TM}$ Respiratory Tracking System (사이버나이프 $Synchrony^{TM}$ 호흡 추적 장치를 이용한 폐종양 방사선수술의 유용성 평가)

  • Kim, Gha-Jung;Bae, Seok-Hwan;Choi, Jun-Gu;Chae, Hong-In
    • Journal of radiological science and technology
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    • 제33권4호
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    • pp.379-386
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    • 2010
  • This study evaluated the motion of tumors during the entire period of therapy and the accuracy of radiosurgery among forty eight lung tumor patients who were underwent radiosurgery using the CyberKnife Synchrony Respiratory Tracking System. The motion of lung tumor was measured by the coordinates of a gold acupuncture needle inserted into the tumor or the area around the tumor using the CyberKnife image guided system. Then the accuracy of radiosurgery was evaluated based on the error of correlation computed with the motion tracking system. The lung tumor motion is Cranio-Caudal direction by an average of $2.63{\pm}1.87\;mm$, moved left-right direction by $1.13{\pm}0.71\;mm$, and anterior-posterior direction by $1.74{\pm}1.16\;mm$. The degree of rotational movement was $1.66{\pm}1.66^{\circ}$ on X axis, $1.20{\pm}0.97^{\circ}$ on Y axis, and $1.18{\pm}0.73^{\circ}$ on Z axis. The vector of translation movement was measured to be $3.78{\pm}2.00\;mm$ on the average. The results show that directions of Cranio-Caudal(p < 0.001), anterior-posterior direction(p < 0.029), and three dimensional vector value(p < 0.002) showed statistical significance, because the lower side of tumor showed more intensive movement compared to the upper side of tumor. The radiosurgery was carried out by compensating the motion of tumor after accurate investigation of the correlation error with the average of $0.95{\pm}0.62\;mm$ during the lung tumor radiosurgery with the CyberKnife Synchrony Respiratory Tracking System.

A Case of Mucormycosis Obstructing the Trachea (기관폐쇄를 일으킨 모균병(Tracheal Mucormycosis) 1례)

  • Lee, Seong-Won;Ahn, Joong-Hyun;Son, Seong-Hyun;Kim, Min-Jeong;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • 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.

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The study for recent changes of disease-mix in health insurance data (의료보험 통계자료를 이용한 최근 우리나라 질병구조 변화관찰 - 의료보험관리공단 자료를 중심으로 -)

  • Yu, Seung-Hum;Jung, Sang-Hyuk
    • Journal of Preventive Medicine and Public Health
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    • 제23권3호
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    • pp.345-357
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    • 1990
  • Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

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Intravenous Target Controlled Infusion Sedation for Patients with Amyotrophic Lateral Sclerosis: Case Report (근위축성 측삭경화증 환자(ALS)의 치과 진료 시 목표농도 주입법을 이용한 정주 진정 마취: 증례 보고)

  • Doh, Re-Mee;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • 제12권3호
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    • pp.177-181
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    • 2012
  • Amyotrophic lateral sclerosis (ALS) is one of the major neurodegenerative diseases that involves degeneration at all levels of the motor system- from the cortex to the anterior horn of the spinal cord. Patients with ALS often have difficulty of ambulation for dental treatment though they have poor oral hygiene state. General anesthesia may cause respiratory problem due to its high sensitivity to muscle relaxant and weakened upper airway. In this case report, 38-year-old female patient with ALS required many dental treatments. Conscious sedation with intravenous target controlled infusion method was successfully employed and patient was discharged without any complications.

Pathological Studies on Urea Poisoning in Milk Goats (산양(山羊)의 요소중독(尿素中毒)에 관한 병리학적(病理學的) 연구(硏究))

  • Kim, Soon-Bok;Chung, Un-Ik
    • Korean Journal of Veterinary Research
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    • 제22권2호
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    • pp.233-237
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    • 1982
  • Pathological studies on 6 milk goats administrated with urea were carried out to determine the effects of acute and chronic poisonings on the animal. Clinical signs appeared about 10 minutes after ingestion of the urea and they consisted chiefly in dullness, staggering, uncontrolled urination, dyspnea, frothy salivation, bloating, muscular tremor, humping of back and tetanic spasms. Macroscopic lesions were failure of blood clot, frothy and bloody contents in the highly congested respiratory tract, pulmonary edema, rumenitis and abomatitis accompanying with petechiation of the upper small intestine. Microscopically, the liver showed vacuolar degeneration, fatty change and areas of necrosis and partial proliferation of the interlobular connective tissues in chronic crises. The renal epithelium displaced vacuolar degeneration, necrosis and hyaline casts in their lumens. In the lungs, there were hyperemia, edema, hemorrhages, and acute catarrhal bronchitis. Neuronal degeneration and necrosis in the central nervous system, catarrhal rumenitis, abomatitis, doudenitis and myocardial hemorrhage were also demonstrated.

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Research of Strangles Antibody Titer of Horses in Jeju (제주에서 사육되는 말의 선역항체가 조사)

  • Lee, Young-woo;Jeong, Hyeon-woo;Lee, Kyoung-kap
    • Journal of Veterinary Clinics
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    • 제34권2호
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    • pp.132-134
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    • 2017
  • Streptococcus equi subsp. equi which is a Gram-positive bacteria causes strangles a highly contagious disease that affects the respiratory system of the horse. The disease is characterized by fever, nasal discharges and enlargement of the lymph nodes in the head and upper neck region. This study was performed to monitor the level of serum strangles antibody titers of horses in Jeju. A total of clinically healthy 122 horses (41 horses less than 5 months, 81 horses more than 1 years old) were included in this study. Serum antibody titers against strangles were measured by means of Passive haemagglutination (PHA) titers. As the results, the level of foals was definitely low. The results of this study have shown that there is a need to consider the vaccination against strangles infection at foals.

A Case Report: Limitation of Mouth Opening in Dermatomyositis (개구장애를 동반한 피부근염 환자 증례)

  • Kim, Hye-Kyung;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • 제35권2호
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    • pp.155-163
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    • 2010
  • Dermatomyositis (DM) is an idiopathic inflammatory connective tissue disorder and a systemic autonomic immune disease which shows a progressive muscle weakness and characteristic rash. It is identified by a characteristic rash accompanying, or more often preceding muscle weakness. Pathognomonic skin lesions are a blue-purple discoloration on the upper eyelids with edema (heliotropic rash), a flat red rash on the face and upper trunk, and erythema of the knuckles with a raised violaceous scaly eruption (Gottron's papule). The myopathy represents inflammatory and degenerative changes primarily affecting proximal muscles. DM often involves GI tract and respiratory system with as risk of 15-25% internal malignancy. It's managed with sun protection since muscle weakness as well as a rash could be aggravated by sun exposure. Systemic corticosteroid is an initial therapy and other immunosuppressive agent has been used as alternatives. Facial muscles are unaffected and masticatory muscles are rarely affected in DM. We present trismus close to muscle contracture in a patient with DM. Therefore, it needs continuous mouth-opening exercise to prevent progressive muscle contracture and to ensure normal mouth opening.

Ultrastructure of nasal cilia in children with recurrent or persistent respiratory diseases (반복 지속성 호흡기 질환 소아에서 비강 섬모의 미세구조 검사의 의의)

  • Shin, Su-A;Yang, Seung;Oh, Jae-Won;Lee, Ha-Baik;Park, Cheol-Eon;Kwan, Jung-Kyun
    • Clinical and Experimental Pediatrics
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    • 제49권4호
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    • pp.410-416
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    • 2006
  • Purpose : Ciliary abnormalities of the respiratory system usually accompany recurrent or persistent respiratory diseases such as paranasal sinusitis, bronchiectasis, rhinitis, and/or otitis media, since they cause certain derangements in ciliary cleaning activities. This disease is usually inherited by autosomal recessive trait, but may also be found to be acquired or transient in rare cases after heavy exposure to pollutants, cigarette smoking or severe infection. We performed this study in children with frequently recurrent or persistent respiratory diseases to clarify if the ciliary abnormalities are preceding factors. Methods : We enrolled 17 children with suspected respiratory ciliary abnormalities. The indications for evaluation of ciliary ultrastructure were recurrent or persistent respiratory infections. Children with immunologic abnormalities were excluded. From August 2000 to July 2003, we performed a biopsy on nasal mucosa and examined the structure of ciliary status by using an electron microscope. Results : Of the subjects, there were seven males and 10 females, aged 2 to 10 years. Out of the 17 subjects, 12 cases of chronic paranasal sinusitis, nine chronic coughs, nine frequent upper respiratory infections, seven cases of recurrent otitis media, four cases of recurrent pneumonia, and four cases of bronchial asthma were found. Out of the 17 cases on which histologic examinations were conducted, four cases showed pathologic findings, including one case of inner dynein arm defect, one of microtubular transposition, one of supernumerous tubules, and one singlet, respectively. Conclusion : It is essential for differential diagnosis and effective treatment to identify the abnormalities of ultrastructure of nasal cilia in children with symptoms of frequently recurrent or persistent respiratory diseases, if immunodeficiency or respiratory allergy could be excluded.

The Clinical Study of Bell's palsy of Children (소아(小兒)에서 발생(發生)하는 구안와사(口眼喎斜)의 임상적(臨床的) 고찰(考察))

  • Seo, Won-hee;Moon, Ik-ryoul;Park, Jong-tae;Kim, Jin-young
    • Journal of Acupuncture Research
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    • 제19권5호
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    • pp.73-91
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    • 2002
  • Objective : The purpose of this study is to assess treatment of children's bell's palsy based on physiological and pathological character. Methods : At the age of 0 to 15, 30 bell's palsy out-patients who visited and treated more than 3weeks at the Department of Acupuncture & Moxibustion, Dong-indang Oriental Medicine Hospital, from 07-01-2001 to 06-30-2002. They were treated with Acupuncture, Herb, Aqua-acupuncture, Physical therapy and measured by HBGS(House-Brackmann Grading System) and DEFS(Detailed of Facial Symmetry of Phillsbury and Fisch) at visit and 3 weeks after. Result and Conclusion : Children's bell's palsy is mostly caused by recent upper respiratory infection and developed most frequently on March, September, seasonally in Spring, Autumn. A group of children's bell's palsy was marked much higher than a group of adult's bell's palsy conducted by Kim's report with oriental medicine in treatment outcome. But we discovered that there was not the signifcant difference between two groups.

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