• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.114-118
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• 2009

Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.232-240
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• 1997

Background : Postprimary pulmonary tuberculosis is located mainly in upper lobes. The tuberculous lesion involving the lower lobes usually arises from the upper lobe cavity through endobronchial spread. When tuberculosis is confined to the lower lung field, it often masquerades as pneumonia, lung cancer, bronchiectasis, or lung abscess. Thus the correct diagnosis may be sometimes delayed for a long time. Methods : We carried out, retrospectively, a clinical study on 50 patients confirmed with lower lung field tuberculosis who visited the Department of Pulmonary Medicine at Hanyang University Hospital from January 1992 to December 1994. The following results were obtained. Results : Lower lung field tuberculosis without concomitant upper lobe disease occurred in fifty patients representing 6.9% of the total admission with active pulmonary tuberculosis over a period of 3 years. It occurred most frequently in the third decade but age distribution was relatively even. The mean age was 43 years old. Female was more frequently affected than male (male to female ratio 1 : 1.9). The most common symptom was cough(68%), followed by sputum(52%), fever(38%), and chest discomfort(30%). On chest X-ray of the 50patients, consolidation was the most common finding in 52%, followed by solitary nodule(22%) collapse(16%), cavitary lesion(10%), in decreasing order. The disease confined to the right side in 25 cases, left side 20 cases, and both sides 5 cases. Endobronchial tuberculosis (1) Endobronchial involvement was proved by bronchoscopic examination in 20 of 50patients. (2) Mean age was 44years old and female was more affected than man (male to female ratio 1 : 3). Sputum AFB stain and Mycobacterium tuberculosis culture were positive only in 50% of cases unlikely upper lobe tuberculosis, additional diagnostic methods were needed. In our study, bronchoscopic examination and percutaneous fine needle aspiration biopsy increased diagnostic yield by 18% and 32%, respectively. The most common associated condition was diabetes mellitus(18%) and others were anemia, anorexia nervosa, stomach cancer, and systemic steroid usage. Conclusion : When we find a lower lung field lesion, we should suspect tuberculosis if the patient has diabetes mellitus, anemia, systemic steroid usage, malignancy or other immune suppressed states. Because diagnostic yield of sputum AFB smear & Mycobacterium tuberculosis culture was low, additional diagnostic methods such as bronchoscopy and fine needle aspiration biopsy were needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.678-685
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• 2016

Deglutition inspection has been the gold standard for inspection of dysphagia using a penetration device of the division of radiology to date. However, inspection using an endoscope has facilitated diagnosis of dysphagia in recent days. In this study, we compared the results of VFSS alone with those of VFSS combined with FEES to determine if the detection rate of penetration, aspiration, and pharyngeal residue increased. This study evaluated at 130 persons who underwent both VFSS and FEES from December 2013 through March 2014, and used VFSS (FELAVISION, SHIMADZU) and FESS (EVIU LUCERA CV-260SL, OLYMPUS) as devices. After preparing barium diluted solution, yogurt that diluted barium and rice that diluted barium in 2.5 ml, 5 ml, 10 ml by modifying Logemann's protocol in part, and having subjects take the solution, this study confirmed pharyngeal residue, penetration, aspiration etc. VFFS and FEES using full HD video revealed aspiration in 36 of the 130 patients in both inspections. Additionally, aspiration was discovered in 36 patients upon VFFS, but in 41 upon FESS. Although FEES was more sensitive at diagnosing dysphagia, the two inspection methods are complementary, so diagnostic value will be greatly improved when the endoscope operating method and accurate fluoroscopic inspection are combined.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.630-636
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• 1996

Bronchiolitis obliterans organizing pneumonia(BOOP) is a pathologic entity characterized by the formation of plugs of fibrous tissue in bronchioles and alveolar ducts. It clad been described in association with several connective tissue diseases, i.e. systemic lupus erythematosus, Behcet's disease, polymyositis-dermatomyositis, polymyalgia rheumatica and Sjogren's syndrome. Recently, there were few additional reports on BOOP, anteceded by rheumatoid arthritis. We clad experienced a case of 60 years old female patient who clad been admitted for acute respiratory difficulty and abnormal chest roentgenographic findings. She was diagnosed as having rhematoid arthritis 20 years ago. On the course of our treatment, she did not respond to antibiotics. Moreover, no microorganism grew in the sputum and blood. Thus, the bronchoscopic biopsy was done. The patient showed a dramatic response to steroid therapy, and the pathologic bindings of the bronchoscopic biopsy confirmed as BOOP. To our knowledge, this is the first reported case of BOOP anteceded by rheumatoid arthritis in Korea.

• Journal of Chest Surgery
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• v.34 no.5
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• pp.418-421
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• 2001

53세 남자 환자가 객혈을 주소로 입워하여 우축 상엽 편평상피세로 폐암으로 진단 받았다. 캄퓨터 단층촬영상 하부 기관에 종양의 침윤이 의심되었다. 우측 하엽과 중엽을 보존하기 위해서 우측상엽과 하부 기관외측을 포함하여 절제하는 기관기관지 성형술 시행하였고, 수술후 우측 폐의 팽창은 완전하였다. 수술 후 1주일째 시행한 기관지 내시경 검사상 우측 중엽과 하엽의 기관지는 뒤틀림 없이 잘 유지되어 있었다. 수술 후 항암치료와 방사선 치료를 받고 현재 환자는 수술 후 1년 7개월 동안 외래 추적관찰 중이다. 저자들은 우측 상엽의 폐암이 기관 하부를 침범한 경우에 우측 기관 소매 전폐절제술의 합병증을 피하고 환자의 폐기능을 보조하면서 침윤된 우측상엽을 포함하여 절제하는 기관기관지 성형술을 시행하여 이에 보고하는 바이다.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.256-259
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• 2001

식도 결핵은 아주 드문 질환으로 연하곤란과 흉통이 가장 흔한 증상이면 다량의 토형은 드문 것으로 되어 있다. 본원에서는 다량의 토형을 동반한 식도 결핵에 의한 식도 대동맥루를 가진 환자를 지험했다. 4세 남자 환자는 다량의 토혈로 응습실을 통해 입원했다. 내원 당시 응급으로 시행한 내시경 검사상 incisor로부터 25cm 하방에 0.7 cm의 풍부한 혈관성의 육아종성 병변을 발견하고, 응급개흉술로 식도의 종양성 병변에 대해 쐐기 절제술을 시행하였다. 식도의 종양성 병변부위는 대동맥과 심게 유착되어 있었고 식도에서 대동맥쪽으로의 식도루를 이중 결찰했다. 환자는 술후 8일째 갑작스런 흉관을 통한 다량의 출혈과 구토 후 토형이 있어 응급 재 개흉술을 시행하여 대동맥파열과 식도 문합부 파열을 확인하였으나 더 이상의 교정이 불가능하여 사망하였다. 이에 문헌고찰과 함께 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.66-69
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• 2010

An antral web is an extremely rare gastric anomaly that disturbs the gastric outlet. The onset of symptoms will depend on the diameter of the aperture. Obstructive symptoms may not occur when the aperture is >1 centimeter in diameter. If the aperture is larger than 1 cm without significant symptoms, conservative treatment is sufficient. A case of an antral web with an ulcer and vomiting in a 7-year-old boy who received ibuprofen for 2 days is presented. The patient became symptom-free after medical treatment.

• Proceedings of the KSLP Conference
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• 2003.11a
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• pp.151-152
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• 2003

말소리가 만들어지는 과정 중에서 성대에서 성대음이 만들어지는 과정이 가장 핵심적인 과정이라고 할 수 있다. 이때의 성대의 진동을 관찰할 수 있는 방법은 1) 초고속 영화 촬영(Ultra-speed cinematography), 2) 스트로보스코피(Stroboscopy), 3) 성문파형검사(Glottography) 등이 사용되어 왔다. 1)은 고가의 장비이며 분석도 어려워서 아주 극소수의 연구기관에서만 부분적으로 사용되어 왔고, 2)와 3)은 임상에서 그리고 연구실에서 널리 사용되어 왔다. 스트로보스코피의 영상을 비디오로 녹화하는 장비는 이제는 이비인후과 영역에서 웬만한 종합병원급 의료기관 이라면 거의 필수적인 장비로 자리잡고 있다 그만큼 성대의 미세한 병변에 대한 진단적 가치가 높다고 할 수 있겠다. 스트로보스코피는 끊어져서 발생되는 제논 광선이 내시경을 통하여 성대에 전해지고, 성대의 실제의 진동 보다. 아주 느리게 움직이는 것 같은 일종의 허상이 화면에 나타나고 이를 비디오시스템으로 저장하여 관찰하는 것이다(Fig. 1, 2). (중략)

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.9.2-9
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• 1979

Frequently, we have been noted foreign bodies in air way, which can produce different signs and symptoms needed for differential diagnosis with other diseases. Occasionally, it can be followed by some pulmonary complications and removal difficulty. Therefore it can be serious and fatal in few cases, especially in children. Three cases were evaluated with clinical and roentgenographic features of air way obstruction due to foreign bodies and discussed with previous many literatures.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1996.04a
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• pp.81-81
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• 1996

선천성 후두열은 매우 드문 선천성 기형으로 신생아에게 심각한 호흡곤란 및 수유장애를 초래할 수 있다. 해부학적 결손정도와 관련된 기형에 따라 다양한 증상이 나타난다. 가장 흔한 특징적 증상으로는 흡기시 천명, 간헐적으로 나타나는 수유시 호홉곤란을 들 수 있다. 이 증상들은 후두연화증, 성대마비, 후비공폐색 둥과 같은 다른 선천성 기형에서도 나타나기 때문에 미리 의심하지 못하면 진단이 어렵다. 따라서 진단을 위해서는 세심한 주의와 정확한 내시경 검사가 필요하다. 저자들은 선천성 후두열 2례를 경험하였다. 첫 증례는 제 II형이었고 두번째는 III형이었으며, 두 증례 모두 전방 후두열 접근법으로 치료하였다. 제 III형 환아는 술전 흡기시 천명을 동반한 호흡곤란과 여러번의 흡인성 폐렴을 겪었으며 술후 캐놀라발거는 가능하였으나 경구를 통한 수유시 흡인을 동반하여 현재까지 위루술을 통해 음식을 섭취하고 있는 상태이다. 저자들은 최근 경험한 선천성 후두열 2례를 video presentation과 함께 보고하는 바이다.