• Tuberculosis and Respiratory Diseases
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• 제53권2호
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• pp.216-220
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• 2002

저자 등은 종양으로 오인되어 생검 시 대량 객혈을 동반한 기관지 강 내 비정상혈관 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제46권4호
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• pp.586-590
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• 1999

비관통성 흉부손상에 의한 기관-기관지 파열의 높은 사망률과 이환율은 조기 진단과 수술로 이를 낮출 수 있으므로 초기 임상증상과 단순흉부방사선상 기관-기관지 파열이 의심되는 소견이 있으면 바로 기관지경검사로 기관-기관지 파열을 진단하고 적절한 치료를 해야한다. 저자들은 교통사고후 비관통성 흉부손상을 받고 호흡곤란을 주소로 내원한 환자에서 기관지경검사로 기관 파열을 조기 진단하여 수술적 치료로 회복시킨 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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• pp.8.5-9
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• 1977

기도 및 식도이물은 이비후과영역에서 적지않게 경험하게 된다. 그중 특히 유소아에서 발생하는 기도이물은 응급을 요하게 되며 진단 및 치료를 지체함으로써 예기치 않은 불행한 사태를 초래하기도 한다. 유소아에서 주로 보이는 기도이물의 증상은 기침, 기침음, 호흡곤란 등이며 천식, 폐염, 후두염 등으로 혼동되기도 한다. 이물의 종류파 빈도를 환자의 연령, 생활방식, 환경, 문과수준에 따라 그 양상을 달리한다. 저자들은 1975년부터 1977년 4월까지 본원에 내원하여 기도이물의 진단하에 ventilating bronchoscopy, thoracotomy (이중 1례는 사망)을 시행하여 치유된 35례를 분석하였다. 1. 연령층은 1세부터 5세까지가 48%로 가장많고 다음이 0세에서 1세까지 였다. 또한 남과여의 비는 2.1 : 1로 남자가 많았다. 2. 주증상은 호흡곤란, 기침, 기침음의 순서였다. 3. Foreign body의 종류는 peanut, metal, vegetable의 순이였다. 4. 이물의 소재는 주로 우측 주기관지 였으며 우측과 좌측의 비는 2 : 1이었다. 5. 내원까지의 기간은 24시간 이내가 65%로 가장 많았다. 6. 치료는 ventilating bronchoscopy가 27례로 가장 많았으며, 4례는 자연적으로 치유되었다. 이에 과거의 여러 보고들과 비교하여 문헌적 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제44권6호
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• pp.1433-1439
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• 1997

소아에서 기관지내 이물은 드물지 않게 접하는 질환이 나 본 예의 환자의 경우와 같이 소아에서 후두 마스크를 사용하여 기관절개술(tracheostomy)을 회피하고 기관지 이물을 제거한 경험예는 현재까지 아직 발표된 바 없고, 아직까지도 마취과의사를 제외한 다른 진료분야의 의사들에게는 후두 마스크가 널리 알려져 있지 않기에 저자들은 후두 마스크를 사용하여 굴곡성 기관지경으로 기관지 이물을 성공적으로 제거한 1례를 문헌고찰과 함께 보고하는 바이다.

• 대한기관식도과학회지
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• 제3권1호
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• pp.109-114
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• 1997

Aspiration of foreign bodies into the airway is a common problem in spite of efforts to educate the public, and it can be sometimes fatal accidents. We clinically analyzed 101 cases of airway foreign bodies treated in the Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine for the past 10 years comparing data with the previous articles. There was male predominance in the occurrence rate, being 72% in the male patients. The peak age was 1 to 3 years of age, and 84.2% was below age of 10. The most common symptom after foreign body aspiration was intractable cough, and obstructive emphysema was most commonly found on the initial chest X-rays. Foreign bodies were mainly located at the right main bronchus and left main bronchus was the next. Peanuts were the most common airway foreign bodies. Ventilating bronchoscopy was performed in the 99 cases and foreign bodies were successfully removed in most cases. There was 2 deaths(2%) resulted from hypoxia after bronchoscopy. The fact that complication rates increase with the duration of the foreign bodies in situ is clear. Therefore, prompt bronchoscopy in patients with suspected airway foreign bodies is essential for lower complication rates.

• Tuberculosis and Respiratory Diseases
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• 제56권5호
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• pp.523-531
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• 2004

연구배경 : 최근 기계환기 중 기관지내시경술의 필요성이 증가하고 있으나, 시술 중 생리학적 변화나 안전성에 대한 연구가 부족한 상황이다. 이에 연구자들은 PEEP을 시술전과 동일하게 유지하면서 기관지내시경술을 시행하여 생리학적 변화 및 안전성에 대해 알아보고자 본 연구를 시행하였다. 방 법 : 2002년 6월부터 2002년 11월까지 삼성서울병원 내과계 중환자실에서 기계환기를 하면서 기관지내시경술을 시행했던 19명의 환자(남자 10명 여자 9명, 연령 중앙값 61.6세)를 대상으로 하였다. 기관지내시경술을 시행하기 전 100% 산소로 15분간 전산 소요법을 시켰으며 기관지내시경 시술 중 기계환기는 용적조절양식으로, 일회환기량 4 ml/kg, 호흡수 20회/분, 흡기 대 호기비 1:2로 환기하였으며 PEEP은 시술전과 동일하게 유지하였다. 시행 후 30분간 100% 산소를 유지하였다. 결 과 : 기관지내시경술 시행시간의 중앙값은 6분(범위 3-15분)이었다. 기관지내시경술을 시행하면서 호흡성 산증과 저환기, 최고기도압의 상승, 심박수의 증가, auto-PEEP의 발생을 보였다. 이들 변화는 기관지내시경 시술 후에 시술 이전의 상태로 되었다. 압력손상 및 혈압 감소 등의 심각한 합병증은 관찰되지 않았다 결 론 : 심각한 저산소증으로 높은 PEEP을 유지하고 있는 환자에게서 PEEP을 유지한 채로 기관지내시경술을 시행하여도 심각한 합병증은 관찰되지 않았다. 다만, 기관지내시경을 시행하는 동안 호흡성 산증 및 저환기를 보였고, 비록 가역적이지만 이러한 상태에서 환자의 노출을 최소화하기 위해서는 기관지내시경 시행시간을 최소화하여야 한다고 사료된다.

• Journal of Chest Surgery
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• 제13권3호
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• pp.206-211
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• 1980

One hundred and thirteen patients underwent diagnostic fiberoptic bronchoscopy to exclude the presence of the lung cancer at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital from January 1979, to July 1980. Sixty five cases of these patients were studied for passible lung cancer by bronchoscopic examination. Patients varied in age from 24 to 75 years, with the highest concentration lying in the sixth decade (49%). male was predominated with sex ratio of 6.3 : 1. Forth three (75.4%) of 57 cases impressed as definitive, and 8(14.5%) of 55 cases impressed as negatibe lung cancer were subsequently proved to have had lung cancer. Positive bronchoscopic biopsy was found in 10 of 14 lung cancers which were situated in the left main bronchus and in 11 of 13 neoplasms involving the right upper lobe bronchus. epidermoid cell carcinomas were most frequent(82.4%). Bronchial biopsy detected 34(79%) of 43 hilar cancers and 1.3(59%) 22 periphera neoplasms, in those patients who had fiberoptic bronchoscopic examinations. In the present series of 65 cases, the lesion was so far advanced when first seen that it was considered inoperable in 31 (47.7%) and operable 34(52.3%), 19(55.9%) of these refusing surgery. fifteen were explored of whom 12(80%) were resectable.

• 대한기관식도과학회지
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• 제17권1호
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• pp.9-13
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• 2011

Endobronchial ultrasound (EBUS), which enables visualization of lesions beyond the bronchus, broadens the fields of bronchoscopy. Two types of ultrasound, radial and linear, are used for bronchoscopy. Radial EBUS is performed by inserting an ultrasound mini-probe through the working channel of a flexible bronchoscope. Evaluation of the depth of invasion of early endobronchial lung cancers using radial EBUS is useful in deciding endobronchial treatment. A central tumor limited to within the cartilaginous layer is a good indication for endobronchial photodynamic therapy. EBUS-guide sheath (GS) technique is a sampling method assisted by localization of peripheral lesions using EBUS. The diagnostic yield of EBUS-GS method is higher than that of conventional transbronchial biopsy. High diagnostic values of EBSU-GS method are reported even in small (${\leq}2cm$) peripheral tumors. Linear EBUS is used for endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA has high diagnostic yields in mediastinal staging of lung cancer even in patients having radiologically early stage lung cancers with normal CT or PET findings in the mediastinum. EBUS is a valuable method in evaluating early endobronchial tumors and peripheral small lung cancers and as well as in mediastinal staging.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.161-174
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• 2022

Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

• Tuberculosis and Respiratory Diseases
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• 제72권6호
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• pp.486-492
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• 2012

Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders. Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine. Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication. Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.