• Journal of Chest Surgery
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• 제21권5호
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• pp.941-947
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• 1988

The mucoepidermoid carcinoma of the bronchus is very rare neoplasm. The histological appearance is an intimate mixture of mucous-producing cell and epidermoid cell. The malignant potency of the tumor was determined by histologic pattern. Bronchoplasty techniques represent the ideal form of excisional therapy for benign endobronchial tumor as well as tumors of low-grade malignant potential, such as bronchial adenoma, and for repair of traumatic airway injuries and benign stricture and selected group of patients with carcinoma of the lung. We experienced a case of-low-grade mucoepidermoid carcinoma in a patient of 21-year old male who has been suffered from hemoptysis episodes for several years. The sleeve resection of left main bronchus and left lower lobectomy due to bronchiectatic change were carried out. The patient are being followed up without specific problem.

• 대한기관식도과학회지
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• 제2권2호
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• pp.213-221
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• 1996

To evaluate the clinical effectiveness of expandable metallic stents, the stents were implanted under endoscopic guidance with local anesthesia or general anesthesia for maintenance of the constructed subglottic space of trachea. The nine patients with respiration difficulty were subjected for expandable stents. The stenosis of upper airway were due to the framework problem of subglottic trachea and tracheostoma after total laryngectomy. Stents were constructed of 0.4 m stainless steel win in a zigzag configuration of 8 bends. A single stent was 20 m in diameter when fully expanded and 20 mm long. The stents were placed accurately to the stenotic site and followed to the 5 month after stent placement. The stenotic area became narrowed with overgrowing of granuloma in all patients and the metallic stents were removed and the stenotic area reconstructed surgically. As conclusion, this technique for the treatment of the subglottic trachea showed simple and safe, but highly recurred due to overgrowing of granuloma. We suggest that the expandable metallic stent is not encouraging in this study.

• 대한기관식도과학회지
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• 제9권1호
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• pp.101-104
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• 2003

One of major problem in endotracheal intubation for general anesthesia is intrathoracic tracheal obstruction induced by tumor such as, intrathoracic goiter and malignant lymphoma etc. Small amount of secretion or hemorrhage and mild tracheal edema may cause aggravation of tracheal obstruction during endotracheal intubation. Also, it is too difficult to perform the emergency tracheostomy in middle tracheal obstruction. We tried to perform femorofemoral cardiopulmonary bypass without endotracheal intubation for induction of general anesthesia in case of middle tracheal obstruction and We reported with review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권4호
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• pp.399-405
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• 1997

Mediastinum is the space located between the right & left lung lobes in the center of the thorax, and contains many vital organs such as heart, aorta, trachea, esophagus, vagus nerve, lymphatics. So the infection of mediastinal space causes a serious and potentially fatal process. Like other infections, surgical drainage, aggressive antibiotic therapy and supportive care are recommended for optimal outcome. Airway management in the presence of the neck, glottic edema, elevation of the tongue is a formidible problem especially in the case from odontogenic origin. We have recently encountered such a case resulting in a number of local and systemic complications.

• 수면정신생리
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• 제12권2호
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• pp.98-104
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• 2005

Approximately 1% to 3% of all children have obstructive sleep apnea syndrome (OSAS). OSAS in children can lead to a variety of symptoms and sequalae; impairment of development and quality of life, behavioral and personality disturbance, learning problem, cor pulmonale and hypertension. Diagnosis and treatment of OASA for children are different from those for adults in many respects. Adenotonsillar hypertrophy is major cause of childhood OSAS. Overnight polysomnography in a sleep laboratory is the gold standard for diagnosing childhood OSAS. However, because full polysomnography in children may be difficult to obtain, expensive, and inconvenient, other methods to diagnose OSAS have been investigated. Adenotonsillectomy is the most common surgical treatment of childhood OSAS. But if residual symptoms remained after adenotonsillectomy, it should be considered to additional treatment such as weight control, sleep positional change, and continuous positive airway pressure (CPAP).

• 대한후두음성언어의학회지
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• 제22권1호
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• pp.30-33
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• 2011

Laser is a relatively recent addition to laryngeal surgery. Since their invention, laser use and applications have expanded rapidly. The use of lasers in surgery has offered a time- and cost-efficient alternative to cold surgical techniques and has been used in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke's edema). Despite the notable benefits, laser surgery is not without disadvantages. Laser heat can increase scarring and cause damage to adjacent tissue. With laser laryngeal microsurgery, there is potential for airway fire, endolaryngeal bleeding, perichondritis, chondritis, granuloma, surgical emphysema, laryngeal stenosis and web formation, postoperative edema and swallowing problem. Surgeons should be known about these complications and could manage properly.

• 대한기관식도과학회지
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• 제1권1호
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• pp.94-100
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• 1995

Despite improvement in respiratory care, including widespread use of low pressure and high volume cuffed tubes, tracheal stenosis remains a feared complication of prolonged intubation and tracheostomy. In such patients, other coexisting problems such as vocal cord paralysis, tracheoesophageal fistula, noncontiguous stenotic segments and laryngeal stenosis may occasionly be encountered. Therefore tracheal stenosis still presents a significant management problem, despite recent endoscopic advances and surgical techniques. Between 1991 and 1994, authors preformed tracheal resection with end-to-end anastomosis on 11 patients with tracheal stenosis. The total success rate (asymptomatic patients with patent airway) was 72.7% and there were no serious complication. This report reviews our experience about this procedure and surgical results. And it investigates associated factors for successful results.

• 대한기관식도과학회지
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• 제1권1호
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• pp.50-54
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• 1995

Despite improvement in respiratory care, including widespread use of low pressure and high volume cuffed tubes, tracheal stenosis remains a feared complication of prolonged intubation and tracheostomy. In such patients, other coexisting problems such as vocal cord paralysis, tracheoesophageal fistula, noncontiguous stenotic segments and laryngeal stenosis may occasionly be encountered. Therefore tracheal stenosis still presents a significant management problem, despite recent endoscopic advances and surgical techniques. Between 1991 and 1994, authors preformed tracheal resection with end-to-end anastomosis on 11 patients with tracheal stenosis. The total success rate (asymptomatic patients with patent airway) was 72.7% and there were no serious complication. This report reviews our experience about this procedure and surgical results. And it investigates associated factors for successful results.

• 말소리와 음성과학
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• 제2권2호
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• pp.79-83
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• 2010

As bolus enters the pharynx during the swallow, laryngeal closure takes place by approximating the epiglottis to the arytenoid Laryngeal Closure Duration(LCD) is the duration of contact between the arytenoids and the epiglottis from the first contact to the last(Logemann et al, 2000). Epiglottic inversion continues pharyngeal swallow stage is completed in order to protect the airway. The purpose of this study is to measure layrngeal closure duration (LCD) in three groups of subjects: a) 10 stroke patients who aspirate before and during the swallow(aspirators), b) 10 stroke patients who do not aspirate during the swallow c)10 normal control subjects. Means and standard deviation of LCD was analyzed in both 5ml and 10 ml thin liquids using 100msec timer in videoflouroscopic swallowing examination. The mean for each group was 0.15 seconds shorter from aspirators to control group. There was a significant difference between aspirators and normal subjects for laryngeal closure duration during the swallow. Laryngeal closure duration after a stroke lead to aspiration. However, only one of this temporal problem may not be enough to aspiration.

• Clinical and Experimental Pediatrics
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• 제60권9호
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• pp.273-281
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• 2017

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.