• Tuberculosis and Respiratory Diseases
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• v.52 no.1
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• pp.54-61
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• 2002

Background: Tracheal stenosis is an urgent but uncommon disease. Therefore, primary care clinicians have limited clinical experience. Animal models of a tracheal stenosis can be used conveniently for the learning, teaching, and developing new diagnostic and therapeutic modalities for tracheal stenosis. Recently, a canine model of a tracheal stenosis was developed using a Nd-YAG laser. To describe the methods and results of developed animal model, we performed this study. Methods : Six Mongrel dogs were generally anesthetized and the anterior 180 degree of tracheal cartilage of the animal was photo-coagulated using a Nd-YAG laser. The animals were bronchoscopically evaluated every week for 4 weeks and a pathologic evaluation was also made. Results : Two weeks after the laser coagulation, the trachea began to stenose and the stenosis progressed through 4 weeks. All animals suffered from shortness of breath, wheezing, and weight loss in the 3 weeks after the laser treatment, and two died of respiratory failure just before the fourth week. The gross pathologic findings showed the loss of cartilage and a dense fibrosis, which resulted in a fibrous stricture of the trachea. Microscopy also showed that the fibrous granulation tissue replaced destroyed cartilage. Conclusion : The canine model can assist in the understanding and development of new diagnostic and therapeutic modalities for tracheal stenosis.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.775-779
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• 2008

Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a $CO_2$ laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with $CO_2$ laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

• Tuberculosis and Respiratory Diseases
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• v.64 no.3
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• pp.206-209
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• 2008

Tracheal tuberculosis is a relatively uncommon form of tuberculosis and can result in acute tracheal obstruction early in the disease course. This is a report of a case of tracheal tuberculosis with unusual clinical presentation.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.87.4-88
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• 1976

The statistcal study was done on 81 cases of the foreign bodies in the food passages (73 cases) and air passages (8 cases), who had visited the Dept. of Otolaryngology of Kyung Hee Medical Center and treated endoscopically, from Nov. 1971 to Mar 1976. The results were as follows, 1) The incidence of esophageal foreign bodies (73 cases) in order of frequency was coin (61 cases; 83.6%), bone (6 cases; 8.2%), food particles (3 cases; 4.1%), discs (2 cases), and other metals (l case). The incidence of foreign bodies in the air passages (8 cases) was food particles (3 cases; 37.5%), pointed metal (2 cases; 25%), plastic pencil cap (l case), plastic ring (1 case), and wood piece (1 case) in order. 2) In sex distribution, 51 cases (62.9%) were males and 30 cases (37.1%) were females, and the ratio between males and females was about 1.7 : 1.3. In the age incidence, 69 cases (82.5%) of all foreign bodies were under 5 years of age, and especially, coin cases were 59 cases (96.7%) and the highest was 8 years of age, lowest was 11 months of age. 7 cases (87.5%) of all airway foreign bodies were under 10 years of age. 4) The ratio between the food passages(73 cases) and the air passages (8 cases) was about 9 : 1. In the location of the foreign bodies of the food passages, 66 cases (90.4%) were in the first esophageal narrowing, 5 cases (6.9%) in the second narrowing, and 2 cases (2.7%) in the third narrowing. In the air passages, the frequent sites were trachea (5 cases; 62.5%), larynx (2 cases), and bronchus (1 case) in order. 5) In duration of lodgement, 63 cases (86. 3%) of esophageal foreign bodies were removed within 24 hours, and one case was removed within 16 days. The number of cases lodged within 24 hours were 4 cases (50%). in the air passages and one case was removed within 18 days. 6) In treatment, 37 cases (50.7%) of esophageal foreign bodies were extracted by modified upper esophagoscopy, 33 cases (42.5%) by esophagoscopy under the local anesthesia, 3 cases (4.1%) by esophagoscopy under the general anesthesia. 8 cases of the coin cases were passed into the stomach during the endoscopic examination. Laryngeal foreign bodies (2 cases; 25%) were extracted by laryngoscopy under the local anesthesia. 2 cases (40%) of tracheal foreign bodies by Bronchoscopy with tracheotomy under the local anesthesia, 3 cases (60%) by Bronchoscopy under the general anesthesia, and bronchial foreign body (1 case) by open thoracotomy under the general anesthesia, at the Dept. of Chest surgery.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.4.3-5
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• 1981

The Silicone tracheal T-tube was designed to maintain an adequate tracheal airway as well as to provide support in the stenotic reconstituted or reconstructed trachea. This report is our experiences with using silicone T-tube which were successfully used to two cases with extensive laryngotracheal trauma, and one case with decannulation difficulty for 9 months. Authors strongly believe that silicone T-tube is an excellent device out of consideration for our experienced cases, though many techniques have been applied for the treatments of tracheal problems.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.88.2-89
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• 1976

Clinical observation is made on the total 205 cases of foreign bodies in the air and food passages. The entire foreign body cases that had visited ENT Dept. of Han Gang Sacred Heart Hospital from January, 1972 to March, 1976 are included in this study. The results summarized are as follows: 1) The majority of the cases of foreign bodies are found in the food passage, 200 cases (97.6%) while in the air passage only 5 cases was present. 2) The most common foreign bodies in the esophagus was coin (90%) and in the air passage, the sorts of foreign bodies are bean, peanut, plastic bullet, corn and towel clip. 3) In the locality of foreign bodies, the first narrowing is the most frequent site in the esophagus. 4) The majority of the cases with esophageal foreign body is male (M:F 1.4 : 1), in the air passage (M:F 3:2). 5) The patients with esophageal foreign body visited within 3 days in 87%, and with trachiobronchial foreign body visited within a day in all cases.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.431-438
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• 2002

Background : In order to investigate the usefulness and safety of Natural Stent, we performed this study in a canine model of tracheal stenosis induced using Nd-YAG laser. Materials and Methods : After tracheal stenosis was induced in 12 Mongrel dogs using Nd-YAG laser, either Dumon (n=6) or Natural (n=6) stent was inserted into the trachea. To assess the degree of stent migration and mucostasis, bronchoscopy was performed every week for 4 weeks, after which all stents were removed. One week after stent removal, tracheal stenosis was evaluated by bronchoscopy. Results : The degree of stent migration was not different between the dogs with Dumon stent ($3.0{\pm}0.8$) and those with Natural ($2.0{\pm}1.0$), nor was the degree of mucostasis, at Dumon ($1.7{\pm}0.5$) and Natural Stent ($1.5{\pm}0.6$), respectively. One week after stent removal, the degree of tracheal stenosis was not different between the Dumon ($1.5{\pm}0.5$) and the Natural group ($1.0{\pm}0.4$). In addition, there was no death and the degree of tracheal stenosis remained always within the safe limit (less than 2.0) in all animals. Conclusion : In a canine model of tracheal stenosis induced using Nd-YAG laser, the usefulness and safety of Natural Stent were similar to those of Dumon Stent. A clinical trial is necessary to document the usefulness and safety of Natural Stent in patients with tracheal stenosis.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.3.3-4
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• 1981

We have observed foreign body in food and air passage in 138 cases during the period from Jan. 1972 to Dec. 1980 in E.N.T. department of Kyung Hee university hospital. The following results were obtained. 1) Age distribution was predominent in under 5 years old showing 102 cases (73.9%). 2) Distribution of location was 132 cases in food passage and 6 cases in air passage. 3) In food passage, malewas 81 cases (61.4%). In air passage, male was 4 cases(66.7%). 4) Coin was the most frequent foreign body in food passage. Others were metals, meats, bony pieces, and shell. 5) Distribution of lodgement was frequent in first narrowing of esophagus. 6) Duration of lodgement was 112 cases (84.8%) within 24 hours in food passage and 4 cases (66.7%) within 24 hours in air passage.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1090-1096
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• 2002

Purpose : We evaluated the clinical manifestations, bronchoscopic findings and therapeutic effects of flexible fiberoptic bronchoscopy in atelectasis of children. Methods : Sixty six children who received bronchoscopy due to persistent atelectasis, acute severe atelectasis and incidental atelectasis on plain chest radiography were studied retrospectively. Results : The most common causative underlying disease was pneumonia(60.4%). Other underlying conditions were pulmonary tuberculosis, chronic lung disease, postoperative state, bronchial asthma and chest trauma. The most common abnormal findings were inflammatory changes such as bronchial stenosis(n=15), mucosal edema and large amount of secretion(n=14), granulation tissue( n=3) and mucus plug(n=3) although 39.4% showed normal airways. Other findings were congenital airway anomalies, endobronchial tuberculosis, extrinsic compression and obstruction by blood clot. In 32 children with pneumonia-associated atelectasis, 43.7% revealed normal airways, and the most common abnormal findings were also inflammatory changes. Eighteen out of 39 patients who received therapeutic intervention such as suctioning of secretion, bronchial washing and intrabronchial administration of N-acetylcysteine($Mucomyst^{(R)}$) had complete or partial resolution of their atelectasis. In 32 patients with pneumonia-associated atelectasis, 56.5% showed improvement by therapeutic intervention. Conclusion : In this study, atelectasis was mainly associated with inflammatory airway diseases such as pneumonia. The most common abnormal bronchoscopic findings were inflammatory changes such as mucosal edema and large amounts of secretion and bronchial stenosis, although about 40% revealed normal airway. Flexible bronchoscopy is helpful for either diagnosis or treatment, especially in pneumonia-associated atelectasis.

• Tuberculosis and Respiratory Diseases
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• v.59 no.4
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• pp.368-373
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• 2005

Background : Bronchial anthracofibrosis usually manifest as a form of obstructive airway disease, and can be accompanied by parenchymal diseases such as pneumonia, and pulmonary tuberculosis. This study investigated the ventilatory dynamics according to the severity of bronchial stenosis in patients with bronchial anthracofibrosis. Method : One hundred and thirteen patients with bronchial anthracofibrosis that was confirmed by bronchoscopy and who had undergone a pulmonary function test were enrolled in this study group. The correlation coefficients between the pulmonary functional parameters and the number of lobes with bronchial stenosis were investigated. Results : The incidence of ventilatory dysfunction was 56(49.6%) for obstructive, 8(7.1%) for restrictive, 2(1.8%) for mixed, and 47(41.6%) for a normal pattern. The $FEV_1/FVC$, $FEF_{25{\sim}75%}$, $FEF_{25%}$, $FEF_{50%}$, $FEF_{75%}$, and PEF showed a significant negative correlation (p<0.05) and the Raw had a significant positive correlation with the number of lobes with bronchial stenosis(p<0.001). Conclusion : These findings suggest that the most common abnormality of the ventilatory function in bronchial anthracofibrosis is an obstructive pattern with a small airway dysfunction according to the severity of bronchial stenosis.