급성 편도염 치료에 있어서 Loracarbef의 효과

나기상,성열웅,박찬일 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.1

The treatment of upper respiratory tract infection requires an agent with marked increased activity against broad sprectrum of pathogens, including β-lactamase producing bacteria. Loracarbef, a member of the carbacephem class of antibiotics resistant to β-lactamase producing pathogens, was evaluated for its efficacy and safety in the treatment of acute tonsillitis in adults. 30 patients with acute tonsillitis were given 200mg of loracarbef twice daily for 7 days. All patients were evaluated for the presence and severity of two subjective symptoms (sore throat and swallowing difficulty) and two objective signs (fever and throat injection) before and after the treatment. Overall clinical responses were assessed as : cure ; improvement ; relapse ; or failure. Of the 30 patients, 29 (97%) patients had a successful clinical responses (cure or improvement), 1 patient experienced a relapse, and there were no clinical failures. Loracarbef was well tolerated in all patients, although 1 patient complained of mild nausea. Our results indicate that loracarbef is a safe and effective alternative agent for the treatment of patients with acute tonsillitis.

만성 비부비동염 환자에서 부비동 내시경수술 후 비음도의 변화

나기상,XU JUN,박지수,박성제,강영애,김용민 대한이비인후과학회 2017 대한이비인후과학회지 두경부외과학 Vol.60 No.3

Background and Objectives The purpose of this study was to examine the effect of endoscopic sinus surgery (ESS) on nasalance in patients with chronic rhinosinusitis (CRS). Subjects and Method Eighty-one CRS patients were enrolled. The nasalance scores for oral, oro-nasal, and nasal passages were measured by nasometry and the nasal cavity volume was measured by acoustic rhinometry before and at 1 and 3 months after ESS. We divided the patients into four groups according to the following surgical interventions employed: unilateral anterior ethmoidectomy (group I), bilateral anterior ethmoidectomy (group II), bilateral total ethmoidectomy (group III), and bilateral pansinus surgery (group IV). We also divided the patients into three groups according to the CT scoring system and polyp grading system. Results In group III and IV, the nasalance scores for all passages and nasal cavity volume were significantly increased after ESS but did not return to its preoperative level at 3 months after surgery. However, there were no significant changes in nasalance scores or in the nasal cavity volume in group I. Similarly, there were no significant changes in nasalance scores in the mild group (CT scoring system) or no polyp group, whereas the nasalance scores were significantly increased postoperatively in the moderate to severe groups (CT scoring system), and in groups that have nasal polyp group. Conclusion The nasalance scores and nasal cavity volumes were increased after ESS and remained unchanged until postoperative 3 months. Postoperative changes in nasalance scores were more remarkable in patients who had more severe disease and who underwent more extensive surgery. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(3):112-9

아데노이드 및 구개편도 절제술이 비저항과 비강 내 Geometry에 미치는 영향

나기상,박찬희,구본석,김영덕,김관호,박용호 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

수술 전 최소단면적이나 비강 부피는 아데노이드나 구개편도의 비대 정도와 상관관계를 보이지 않았으나 비저항은 아데노이드 비대 정도와 유의한 상관관계를 보였다. 구개편도 및 아데노이드 절제술 후 코막힘과 구호흡 증상의 유의한 호전을 보였다. 수술 후 비강의 최소단면적과 부피 등 nasal geometry는 통계적으로 유의한 변화가 없었으나 비저항은 수술 후 유의한 감소를 보였으며 수술 후 비저항의 감소 정도는 아데노이드 비대 정도와 유의한 상관 관계를 보였다 . 이상의 결과로 아데노이드와 구개편도의 비대를 보이는 소아에서 코막힘 증상을 일으키는 데는 아데노이드 비대가 주요 원인이 되며 주로 비강의 후방에 위치한 아데노이드의 mass effect에 의할 것으로 생각한다. The aim of this study was to determine whether adenoid or tonsillar hypertrophy and subsequent adenoidectomy and tonsillectomy affect pediatric nasal airway resistance and nasal geometry and to evaluate the relationships between the degree of hypertrophy and nasal airway resistance or nasal geometry. Thirty-two children, aged 3 to 15 years, selected for adenoidectomy and tonsillectomy due to chronic nasal obstruction and mouth breathing were enrolled. The size of adenoid was evaluated by cephalometric radiograph. The degree of tonsillar hypertrophy was graded clinically. Nasal airway resistance and nasal geometry was evaluated by active anterior rhinomanometry and acoustic rhinometry respectively. These measurements were repeated one month and three months post-operatively. The size of adenoid was found well correlated to preoperative nasal airway resistance. However, there were no correlations between the degree of tonsillar hypertrophy and preoperative nasal airway resistance or nasal geometry. Nasal geometry was not changed after operation. However, nasal airway resistance was reduced significantly at 3 months after operation and the size of adenoid was found well correlated to postoperative changes of nasal airway resistance.

만성 부비동염 환자에서의 부비동 전산화단층촬영 소견

나기상,정진욱 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

With the increasing use of endoscopic techniques for evaluation and surgical treatment of the paranasal sinuses, ostiomeatal unit computed tomographic (OMU CT) scanning for radiographic evaluation of sinuses is becoming more widely used. In this study, We reviewed OMU CT of 100 cases(200 sides) of chronic paranasal sinusitis patients in order to classify the pattern of sinusitis and to determine the prevalence of anatomic variations. The most frequently affected sinus in anterior ethmoid and ethmoid sinus disease is associated with mucosal abnormalties in secondary sinuses. Based on our staging system, type Ⅲ(30.0%) was most common, and followed by stage Ⅱ(27.5%) and stage Ⅰ(16.0%). The uncinate process is most frequently inserted into the lamina papyracea (50.0%) and the most frequent type of olfactory fossa was type Ⅱ(48.0%). The prevalence of agger nasi cell was 81.5%, and those of Haller's cell, Onodi cell, concha bullosa, and septal deviation were 33.0%, 28.0%, 30.5%, and 12.0% respectively. Maxillary sinus and frontal sinus were hypoplastic in 6.0% and 20.5% of patients and chonchal and presellar pneumatitization of sphenoid sinus was 5.0% and 11.0%.

Immunohistochemical Localization of Neuropeptides Using Whole Mount Preparations in the Nasal and Frontal Sinus Mucosa of Cats

나기상,이강오,남부현,박찬일 대한비과학회 1994 Journal of rhinology Vol.1 No.1

The airway mucosa is known to be densely supplied with several types of peptidergic nerve fibers. The distribution of these fibers has been studied by conventional thin sections. In the present study, the distribution of substance P-immunoreactive (SP-IR), vasoactive intestinal pep-tide-immunoreactive in the nasal mucosa and frontal sinus mucosa of cats, by using immunohistoche-mistry on whole mount preparations. Thick posterior nasal nerve divided into many small bundles of axons containing immunorea-ctive fibers and non-immunoreactive ones. A large number of VIP-IR and moderate number of SP-IR nerve fibers, most of which had no varicosities, were found in nerve bundles, whereas NPY-IR nerve fibers were hardly found in nerve bundles. The immunoreactive nerve bundles divided again to make a single varicose axon. SP-IR nerve fibers were present in highest density in the epithelium and along the arterioles. VIP-IR nerve fibers were abundant around submuco-sal glands and arterioles. Venous vessels were also innervated by VIP-IR nerve fibers. NPY-IR nerve fibers were found exclusively around arterioles. SP-IR, VIP-IR, and NPY-IR nerve fibers were also found in frontal sinus mucosa. Immunohistochemistry of whole mount preparations showed the detailed distribution of pep-tide-containing nerves, especially in the epithelium and different types of blood vessels. It may be useful to analyze changes of the neurons under various stimuli and in diseased conditions of airways.

만성 부비동염 환자에서 비기류에 대한 민감도의 변화

나기상,이석호,임동우,김병국,박찬일 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

Nasal patency may be considered to have two aspects: the resistance to airflow and the sensation of airflow. Although the sensation of nasal airflow has received little attention from clinicians, it is likely that it is of great importance in clinical practice. However, there are no study that assess the sensation of nasal airflow in patients complaining of nasal obstruction. The aim of this study is to assess the airflow sensitivity of the nose in patients with chronic paranasal sinusitis. To assess the airflow sensitivity, we designed an apparatus delivering a pulsing jet of air at varying velocities. We measured threshold velocities at six different sites of each nasal cavity in fifteen patients and compared with the values in normal subjects. All patients had bilateral chronic sinusitis with polyp. The threshold velocities at all but site 5 were higher in sinusitis patients than in normal subjects. The difference at site 1, 3, 4 and 6 was statistically significant. Since a high threshold velocity indicates low sensitivity, our results suggest that airflow sensitivity is lowered in patients with chronic sinusitis. Disturbance of airflow sensation may contribute to the sensation of nasal obstruction in patients with chronic paranasal sinusitis.

만성 부비동염 환자에서 부비동 내시경수술 후 후각기능의 호전

나기상,신광철,김용민 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

Few studies on the outcome of endoscopic sinus surgery have assessed the effect of this treatment on the sense of smell. We have collected data prospectively on 30 patients with bilateral chronic sinusitis, before and 8 weeks after surgery. Patients were asked after surgery whether their sense of smell was normal, better, a little better, the same, or worse. Olfactory detection thresholds were obtained using butanol sniff bottles. Subjective sensation of olfaction was improved in 70%, the same in 30% of patients. However, olfactory threshold score was improved in 50%, the same in 32%, and worse in 18% postoperatively. Normosmic nose was found in 10% before surgery. 26.7% showed hyposmic, and 63.3% were anosmic before surgery. The postoperative butanol test showed that 11.7% was normosmic, 50% hyposmic and 38.3% anosmic. Preoperative butanol threshold scores were lower as the severity of sinusitis increased while the degree of postoperative improvement showed no correlation with the severity of sinusitis. Cases of primary surgery showed higher preoperative butanol threshold scores and more pronounced postoperative improvement than cases of revision surgery. The results of this study suggest that impairment of olfaction in chronic sinusitis may be significantly improved following endoscopic sinus surgery.

타액선종양에 대한 임상적 고찰

나기상 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

A clinical analysis was performed on 46 cases of salivary gland tumor who treated at the Department of Otolaryngology, Chungnam National University Hospital. The parotid gland was the most common site, followed by the palate and the submandibular gland. The most frequent histologic type was pleomorphic adenoma(58.7%), followed by adenoid cystic carcinoma(15.2%) and mucoepidermoid carcinoma(13.0%). Plemorphic adenoma and mucoepidermoid carcinoma were more common in female than in male, but adenoid cysitic carcinoma was more common in male. Painless, slowly growing mass was the most common chief complaint of patients with salivary gland tumor. The surgery was the main method of treatment. Although the duration of follow-up check-up in not long, recurrence is not observed.

오존노출시간 및 희생시기에 따른 백서 비점막의 형태학적 변화

나기상,김병국,김용민,박찬일 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Ozone causes epithelial injury in the upper and lower respiratory tract of laboratory animals. Although there has been good characterization of the ozone induced lesions in the nasal mucosa, it's not clear that morphologic changes depend on the concentration of ozone and time of exposure. And also it's not clear that there is a change between time of sacrifice after last exposure, too. This study was designed to compare the morphological changes in the nasal mucosa in rats exposed to 0.6 and 1.2ppm with different time of exposure and sacrifice after last exposure. We observed infiltration of neutrophils, increased goblet cells, epithelial hyperplasia and ciliary loss in the groups that exposed for 3 and 7days. The degree of changes increased in the groups exposed for 7days than 3days. But there was no difference between the groups sacrificed in immediately and 18hours after last exposure except infiltration of neutrophils. These findings were similar to the groups exposed to 0.6 and 1.2ppm.

외상성 시신경손상 환자에서 치료방법에 따른 치료결과 비교

나기상,전우진,이석호,정봉진,박근성 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.10