Background and Objectives : Laryngotracheal stenosis in bum patients with inhalation have features distinct from other stenosis after intubation or tracheostomy. However few studies have been reported and the incidence was reported variable. The purpose of this study is to evaluate the clinical manifestation and the incidence of laryngotracheal stenosis in bum patients with inhalation. Methods We retrospectively analyzed 138 bum Patients diagnosed inhalation injury who admitted to Hangang Sacred Heart Hospital from July 2002 to June 2004. Result : 5 patients were developed laryngotracheal stenosis. The incidence of Laryngotracheal stenosis in bum patients with inhalation was $3\%$. Symptom developed early in 2 patients, late in 3 patients.4 patients required trachostomy as initial airway support. The location of stenosis is subglottic region except 1 patient. Montgomery T-tube was inserted in 3 patients, and Single-stage laryngotracheal reconstruction was performed in 1 patient. Conclusion Incidence of laryngotracheal stenosis in our study is lower than other reports due to late presentation of symptom and early discharge after acute bum stage. Inhalation injury may lead to severe complication and sequelae, therefore physicians should be have a awareness for early diagnosis and all burn patients who have a history of inhalation injury should be followed closely.

Background : It is well-known that esophageal perforation (EP) is difficult in diagnosis and has high mortality rate despite proper management. There are disputes in regarding the reatment in cases of delayed diagnosis although in the early diagnosed cases, operation is recommended without arguments. Methods: From April, 2001 to December, 2004, nine patients who were diagnosed as EP in our hospital were analyzed retrospectively about the causes, the interval between the cause and the treatment, and operation methods. Results: There were 8 male and one female with men age of 49.3 years (range: 25-67 years). The causes of EP included perforations following operations of corvical spine in three cases, spontaneous perforation(Boehaave syndrome) in two cases, foreign bodies in two cases, operation of esophageal diverticulum in one case and blunt trauma bytraffic accident in one case. Mean interval between the first treatments and the causes was 11.6 days (range: 2-30 days). The sites of perforation were upper third of esophagus in three cases, middle third in three cases and lower third in three cases. All except two cervical cases presented as mediastinitis or empyema at the time of diagnosis. Primary repair and irrigation had been performed in 7 cases but five cases out of them required more than two procedures. Conclusions : More than one procedure wasrequired in the treatment of EP because of contaminations and infections which had been spread at the time of initial manifestatios, howeverprimary closure and massive irrigation is the best method in order to preserve esophagus unless the remaining esophagus is extensively damaged.

Acute lymphocytic leukemia(ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Currently, only $20-30\%$ of adults with ALL are cured with standard chemotherapy regimens. It is very important risk factor whether to failure to achieve complete remission within 4 weeks or not. The relapse of leukemia is usually classified as hematologic and extramedullary relapse, and extramedullary leukemic infiltration is rarely observed in patients with ALL. In October 2004, a 23-year-old man presented with painless enlargement of both parotid glands. He was diagnosed as ALL(L2 subtype) one month ago, and he gained complete remission with induction chemotherapy. Fine needle aspiration cytology and bone marrow biopsy revealed extramedullary and hemtologic remission. To our knowledge this is the first report of extramedullary relapse in the parotid in ALL.

Thymic cysts are uncommon tumors which usually occur in the neck and mediastinum. It is known to arise from embryonic remnants of the thymopharyngeal duct or from infammation of thymic tissues. Patients with thymic cyst are often asymptomatic and identified after surgical removal and histologic examination. We experienced a 73 year-old man with recently developed dyspnea. During the examination, chest CT showed a $5{\times}6cm$ sized cystic mass causing deviation of the trachea. It was located in between the right thyroid gland and anterior mediastinum. It also caused tracheal narrowing noted by bronchoscopy. Right anterior cervical incision and removal of the mass was performed and a histological diagnosis of thymic cyst was confirmed. The patient was discharged without complication.

Granular cell tumors are relatively uncommon benign laryngeal lesions thought to originate form Schwann cells. The granular cell tumor occurs everywhere in the body, especially in the head and neck. The larynx is relatively an uncommon location, accounting for approximately 3 to $10\%$ of all reported cases. Typically the most common presenting symptom is hoarseness, with some patients also presenting stridor, hemoptysis, dysphagia, and otlagia. But the tumor may be asymptomatic and discovered only incidentally during a routine examination. The diagnosis of granular cell honor can be confirmed by histopathologically and immunocytochemical staining fer S-100 antigen. Treatment of a granular cell tumor consists of a wide local excision by the endoscopic, transoral or laryngofissure methods. Recently, CO2 laser has been used to remove granular cell tumor with clear resection margin. This article describes one such case in a 62-year-old man, followed by a brief review of the literature on this subject.

This study aimed to report a case of infant who presented with a prenatal ultrasound diagnosis of agnathia, polyhydramnios followed by a review of previous studies. As widely acknowledge, agnathia is a complex lethal malformation characterized by absent mandible, microstomia, microglossia and ear anomaly which are secondary results to a defect of the first branchial auh. Newborn infants with agnathia often suffer from airway obstruction, causing fatal respiratory failure. The most difficult part of treating those newborns is to keep the airway patent. Therefore, as early airway management planning as possible is the most important part. Airway management was achieved with tracheotomy through an ex utero intrapartum treatment procedure(EXIT). The case of this infant, reporting here, was underwent tracheotomy with preservation of uteroplacental blood flow and gas exchange.

Deep neck infections mean infection in the potential spaces and facial planes of the neck, either abscess formation or cellulitis. Deep neck infections are caused by dental, salivary gland, pharyngeal and tonsillar infections. Sometimes, deep neck infection may be caused by tuberculosis in case of immunodefiecient patients. Acquired immunodeficiency syndrome(AIDS) is a disease associated with defective cell-mediated immunity after infected with human immunodeficiency virus(HIV). The chance of opportunistic infection in patients of AIDS increases as the level of immunodeficienty progresses. Human immunodeficiency virus infection is the most single significant risk factor for progression of pulmonary tuberculosis to extrapulmonary sites. In patients infected with HIV, the rate of extrapulomonary tuberculosis rises upto $60\%$. We report a case of a 47 year old male patient with AIDS associated with deep neck infection by tuberculosis.