• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.12.2-13
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• 1983

Corrosive injuries of the esophagus by accident or suicidal attempt, though decreasing in number, still represent an important problem of our national pathology. One of the most difficult problems facing any physician is the diagnosis and management of caustic ingestion. In order to determine the extent of esophageal bums, to prevent the potential complication, to increase the therapeutic effect, the use of esophagoscopy is an essential step, and it has lessened an unnecessary admission and treatment. The authors have found the value of early esophagoscopy in selected 41 corrosive esophagitis patient who were admitted to Dept. of ENT, Wonju medical college, Yonsei university between 1980. 1-1982. 12

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.6.3-6
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• 1983

A total of 287 patients with foreign body in the air and food passage was treated in our unit between 1972 and 1982 and the following results were obtained : 1) The ratio between food and air passage was about 8 : 1. 2) The most common foreign bodies in the esophagus were coin (55.8%) and bone (28.5 %). Beans were the most common in the air passage (39.4%). 3) In sex distribution, there was no significant difference between male and females in the esophageal foreign bodies, but in the air passage male were prevalent (M : F = 57.9% : 42.1%). 4) In the age incidence, 61.8 % of the esophageal foreign bodies and 71 % of the foreign bodies in the air passage were under 5 Years of age. 5) The most prevalent site of Lodgement in the esophagus was the first narrowing (82.3 %). In the air passage, bronchial foreign bodies were more common and the right bronchus was the more frequent site (2 : 1). 6) In duration of lodgement, 62.2 % of esophageal foreign bodies and 55.2 % of foreign bodies in the air passage were removed within one day. 7) The most common complication of foreign bodies in the air passage was pneumonia (55.5%). 8) The removal of the foreign bodies in the air passage was performed by ventilation - bronchoscopy (84.3%). Two of 38 cases expired.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.94-100
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• 1997

Background and Objectives : In children with tracheal stenosis, operative management remains a challenging problem due to difficulties of operative techniques and postoperative care. The purpose of this study was to determine the effectiveness of tracheal resection with end to end anastomosis as operative management for tracheal stenosis in children. Materials and Methods : 6 children with severe tracheal stenosis underwent tracheal resection with end to end anastomosis. Causes of stenosis were trauma in 1 case and prolonged intubation or tracheotomy in 5 cases. The diagnoses were made by radiologic evaluation (plain X-ray, CT, 3-Dimensional CT) and confirmed by direct laryngoscopy and ventilating bronchoscopy under general anesthesia. Thyroplasty and unilateral arytenoidectomy were performed in 1 case. Suprahyoid release was done in 1 case with severe adhesion. Decanulation was achieved following postoperative endoscopic examination and pulmonary function test. Postoperative physical and radiologic examinations were given at regular intervals. Results : Stenosis were improved from grade III grade I in 4 cases and from grade II to grade I in 2 cases. Decanulation was achieved on average postoperative 6 months in 5 cases, and 10 years in 1 case due to exertional dyspnea. There were 1 each case of immediate postoperative subcutaneous emphysema, pneumothorax and wound infection. Postoperative granulomas at anastomosis site were treated with laser vaporization under suspension laryngoscope and bronchoscope in 3 cases. There was 1 each case of delayed postoperative vocal cord palsy, aspiration pneumonia and loss of cough reflex. Conclusion In tracheal stenosis of children, tracheal resection with end to end anastomosis has good result with preservation of normal airway. Preoperative evaluation of local factors such as swallowing, vocal cord movement and cough reflex and general condition was important for successful treatment. As the cases in adults, authors considered this operation to be a curable operative management for tracheal stenosis.

• Tuberculosis and Respiratory Diseases
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• v.48 no.3
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• pp.365-376
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• 2000

Background : Ever since Flexible Fiberoptic Bronchoscopy was introduced into clinical practice, it has played an important role in both diagnosis and therapy of respiratory diseases. Repeated bronchoscopic examinations is are not so uncommon. This study was designed prospectively to assess the clinical availability of the Repeated Flexible Bronchoscopy (RFB). Methods : Pre-established indications were as follows : 1) To confirm diagnosis or the cell type in proven malignancy 2) to diagnose or locate hemoptysis 3) to follow-up or confirm recurrence 4) to use in therapy. We performed RFB and analyzed the data in 156 patients during 28-month period. Results : The frequency of RFB was 23.0%. The indication for diagnosis or cell type of malignancy was 25 cases, of which 2 cases were confirmed by a third bronchoscopic examination and 3 cases by surgical procedures. Localization of the bleeding site was confirmed in 53.8%. RFB for small cell lung cancer yielded more information on residual or recurred lesion not apparent even with the CT scan in 30%. Previous cases of bronchostenosis due to endo-bronchial tuberculosis was shown to have worsened in 66.7%. Therapeutic manipulations were done in 126 cases, and bronchial suction was most common. Complications showed decreasing tendency with repeated examinations. Conclusion : The RFB for diagnosis or cell type of malignancy was useful in that comfirmation of diagnosis was possible in 85.7% of malignancy. More aggressive procedures should be employed including TBLB or TBNA. The RFB showed possible usefulness in the follow-up of patients with small cell lung cancer. For the patients with hemoptysis or endobronchial tuberculosis, the RFB did not the significance did not show significance because its results did not influence the diagnosis, therapy or clinical course.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.5.3-6
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• 1981

There are too many kinds of esophageal corrosive agents, such as sodium hydrochloride, acetic acid, hydrochloric acid, etc. Esophageal burn due to above chemical agents are decreasing recently, but still many patients visited to the hospital because of swallowing corrosive agents for the purpose of suicide or accidentally. Among the treatment of corrosive injury of the esophagus, prevention of esophageal stricture is the key point. Recently various methods are using as the treatment of corrosive esophagitis and prevention of esophageal stricture. 51 cases of corrosive injury of the esophagus who had been admitted and treated at the Dept. of Otolaryngology, Han Yang University Hospital during past 9 years (from May 1972 to Dec. 1980) were evaluated and report the result about age distribution, sex incidence, monthly distribution, cause of swallowing, swallowing agents, arriving time at hospital after swallowing, changes on oral and pharyngeal mucosa, laboratory findings, emergency treatment and treatment during admission, treatment follow up results and complications with review of liter ature. Following results were obtained; 1. Female patients 27 cases (52.9%) were more than male patients 24 cases (47.1%) and its ratio was 1.13 : 1. 2. Age distribution showed predilection for age of 21-30 with 20 cases(39.2%), and 11-20 with 11 cases (21.6%), 31-40 with 7 cases(13.7%), over 50 with 7 cases (13.7%) were following. 3. Monthly distribution showed predilection for March with 8 cases(15.7%), and April, July with 7 cases (13.7%), September with 6 cases(l1.8%), October 5 cases(9.8%) were following. 4. For the purpose of suicide was the most cause of swallowing with 40 cases(78.4%), and accidentally swallowing 11 cases(21.6%). 5. Acetic acid was the most swallowing agent with 24 cases (47.0%), and hydrochloric acid 11 cases (21.5%), lye 8 cases(15.7%), iodine 2 cases(3.9%) were following. 6. Arriving time at the hospital after swallowing showed predilection for within 12 hours with 42 cases (82.4%), and from 12 hours to 24 hours with 4 cases(7.8%) was next. 7. Moderate change with injection and swelling was the prevalent change on oral and pharyngeal mucosa with 20 cases(39.2%) and severe cases with ulceration 18 cases (35.3%), mild cases with injection 10 cases (19.6%) were following. 8. Leukocytosis was seen on 40 cases (78.4%), and increased Hct. was seen 31 cases (60.8%). On urine analysis, 14 cases(27.5%) showed over 1.030 S.G., and proteinuria was seen on 25 cases(49.0%), glycosuria was seen on 5 cases(9.8%) and hematuria was seen on 6 cases(11.8). 9. Gastric lavage was done on 30 cases (58.8%) as emergency treatment and on 3 cases(5.9%) tracheostomy was done for the airway keeping. 10. As methods of treatment during admission, L-tube insertion was done on 50 cases (98.0%), antibiotics was given to 49 cases (96.1%), steroid and antacid were given to 46 cases(90.2%). 11. 36 cases(70.6%) were in favorable condition after proper treatment, but 2 cases (3.9%) were expired during admission, 4 cases (7.8%) showed esophageal stricture in-spite of treatment, and 1 case(2.0%) showed pyloric stenosis. 12. Complications were observed in 8 cases (17.7%). Renal failure (4 cases), aspiration pneumonia (2 cases), upper G-I bleeding (1 cases), and diabetic coma (1 cases) were seen in order of frequency.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.532-539
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• 2006

Background : The incidence of pulmonary tuberculosis has been reducing, but endobronchial tuberculosis continues to be a signigicant heath problem. We performed prospectively bronchoscopy in patients diagnosed with pulmonary tuberculosis in order to evaluate the frequency of endobronchial tuberculosis and its related findings. Follow-up bronchoscopy was also performed after treatment to evaluate the incidence of endobronchial complications such as stenosis and remaining lesions. Methods : From January, 1999 to December, 2003, bronchoscopy was performed on patients newly diagnosed with pulmonary tuberculosis. Results : 458 patients were enrolled in this study, out of 699 patients with pulmonary tuberculosis from 1999 to 2003. 234(51%) had endobronchial tuberculosis. The frequency was 40.3% in males and 66.3% in females, The most common symptom was nonspecific cough and sputum, and the main radiologiy finding was patchy infiltration. The most common subtype of endobronchial tuberculosis was the edema-hyperemic form. The right lung was involved more frequently than the left, and the left upper lobe was the most commonly involved site. 58 patients underwent follow-up bronchoscopy and most of been cured without major sequels. However, 8 patients had a stenosis of trachea and main bronchus, and 6 patients had still had endobronchial lesions. Therefore the treatment was prolonged for 3 months. Conclusion : Endobronchial tuberculosis of pulmonary tuberculosis has been remained of high incidence. bronchoscopic and follow-up bronchoscopy examination needs to evaluate the incidence of endobronchial tuberculosis and its related findings and major complication despite of treatment.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.9.2-9
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• 1983

We have observed 74 cases of radiolucent foreign bodies in food and air passage in E. N. T. department of Hang Gang Sacred Hospital, from Jan. 1972 to Mar. 1983. The following results were obtained. 1) Distribution of location was 56 cases(75.6 %) in food passage and 18 cases (24.4 %) in air passage. 2) In age distribution, 46 cases (82.1 %) of F. B. in food passage were found in patient over 21 years old and 12 cases (66.7 %) of F. B. in air passage were found in patient under 5 years old. 3) Female seems to be more frequently involved than male in cases of F. B. of food passage and in cases of air passage, male is more frequent. Food passage male: female - - - 25 : 31 Air passage male: female - - - 10 : 8 4) Meats was the most frequent foreign body in food passage (19 cases-33.9%), and the bony pieces was next (17 cases-30.4 %). Plastic material was the most frequent foreign body in air passage (9 cases-49.9 %), and the vegetable seed was the second (4cases-22.0 %). 5) In the location of F. B. in food passage, the first narrowing of the esophagus was the most frequent site and in air passage, the bronchus-especially right bronchus-was the most frequent site. 6) In the duration of lodgement, 44 cases(78.6 %) of F.B. in food passage were visited with - in 24 hours, and 11 cases (61 %) of F. B. in air passage were visited with - in 24 hours. 7) Simple chest PA was checked in all patient and then, esophagogram was checked in 34 cases of F.B. in food passage, among them positive finding was noticed in 23 cases. 8) Removal of F. B. in food passage by esophagoscopy was performed in 54 cases (96.4 %), but in the cases of air passage, removal of F. B. by bronchoscopy was performed in 14 cases (77.8 %). 9) Complications of food passage by the F. B. itself or esophagoscopy were esophageal mucosal laceration (1 cases-1.8 %) and esophageal perforation (1 case -1. 8 %) and complication of air passage by F. B. itself or bronchoscopy were atelectasis (2 cases -11.1 %) and pneumonia (3 cases-16.7 %).

• Advances in pediatric surgery
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• v.1 no.2
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• pp.140-148
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• 1995

To study the clinical profiles and outcome of surgery in infants with esophageal atresia, we reviewed 96 esophageal atresia cases who were treated from April, 1978 to June, 1995. There were 51 male and 45 female infants, a ratio of 1.1:1. The low birth weight(<2500g) patients were 32%. Clinical findings at the time of diagnosis included drooling in 57%, choking in 50%, cyanosis in 38%, respiratory distress in 27% and swallowing difficulty in 20%. Gross classification included 6 cases of type A esophageal atresia(6%), 79 cases of type C(82%), 3 cases of type E (3%) and 8 cases of type F(8%). Associated anomalies occurred in 34 infants(35%). Among them, cardiac anomalies were most common(60%). A primary repair of the defect was carried out in 76 patients with type A or C. A staged operation comprising a repair or gastric tube interposition after gastrostomy was performed in 8 patients. In all 3 infants with H-type, a division of fistula was performed. Esophageal resection and anastomosis was done in 8 infants with esophageal stenosis. In one infant, a gastrostomy was performed and he expired before staged operation. Anastomotic complications included leakage in 16 cases(17%), stricture in 37 cases(39%) and recurrent tracheoesopohageal fistula in 3 cases(3%). The mortality rate was 14% and the leading cause of death was pneumonia. The overall survival rate was 86%, and according to Waterston criteria, the survival rates were 93%, 85% and 58% in class A, Band C, respectively. 75 patients were followed up with median follow up 6.4 years. Among them, 93% were uneventful and 7% had frequent pneumonia.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.175-183
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• 2009

Background: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement or pediatric mitral lesions can cause problems such as a lack of growth potential. There re only limited experiences with mitral valve repair at any institution, so the purpose of his study is to evaluate the outcomes of mitral valve repair n pediatric patients. Material and Method: Sixty-four consecutive children (28 males and 36 females) with a mean age of $5.5{\pm}4.7$ years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups: group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without trial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). Result: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there as no significant difference among the groups. The median follow-up was 4.6 years range: $0.5{\sim}12.2$ years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of $2.1{\pm}1.1$ procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there ere significant differences according to the repair strategies. Conclusion: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.261-266
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• 2002

Vascular ring, originating from abnormal regression of the aortic arch during fetal life, can cause prolonged and recurrent respiratory symptoms and dysphagia when the diagnosis is delayed. We report a 4 month old girl with vascular ring, who had been treated for persistent respiratory symptoms including stridor, wheezing, and dyspnea soon after birth. Initially her respiratory symptoms were thought to be due to bronchiolitis, for which respiratory syncytial virus was confirmed by immunofluorescent staining. Her clinical course was again complicated with tracheitis and pneumonia due to Haemophilus influenzae type b. The possibility of anatomical anomaly was investigated when it was felt to be difficult to insert a suction catheter deep down through a endotracheal tube which was placed for adequate ventilatory management. A three-dimensional chest CT revealed a vascular ring consisting of a double aortic arch. For 5 months following surgery, her respiratory symptoms have slowly been improving. She developed another episode of pneumonia which was milder than the one which occurred before the surgery.