• 대한두경부종양학회지
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• 제28권2호
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• pp.132-134
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• 2012

Ectopic thyroid is an uncommon embryologic aberration characterized by the presence of thyroid tissue in a site other than its usual pre-tracheal location. Dual ectopic thyroid is extremely rare, only few cases have been reported in the literature. Physical examination, laboratory test and radiologic examinations are usually performed for the diagnosis and therapeutic plan of dual ectopic thyroid. We report a 36-year old female with dual ectopic thyroid in lingual and hyoid regions but without thyroid tissue in its normal area. The diagnosis was made through pathologic examination after surgical resection.

• Journal of Chest Surgery
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• 제44권6호
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• pp.440-443
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• 2011

A glomus tumor is an uncommon soft tissue tumor that is most commonly found in the subungual area and a glomus originating in the trachea is extremely rare. Histologically and ultrastructurally, these tumors have been divided into three subtypes: classic glomus tumors, glomangiomas, and glomangiomyomas. Glomangiomyomas account for less than 10% of all glomus tumors and are the least common type. We report a case of a 54-year-old man with glomangiomyoma of the trachea who presented with stridor. We treated the tumor by segmental resection and primary repair via a transcervical approach.

• Clinical and Experimental Pediatrics
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• 제64권1호
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• pp.37-43
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• 2021

Background: Animal studies have shown that a leukocyte influx precedes the development of bronchopulmonary dysplasia (BPD) in premature sheep. The CXC chemokine receptor 2 (CXCR2) pathway has been implicated in the pathogenesis of BPD because of the predominance of CXCR2 ligands in tracheal aspirates of preterm infants who later developed BPD. Purpose: To test the effect of CXCR2 antagonist on postnatal systemic and pulmonary inflammation and alveolarization in a newborn Sprague-Dawley rat model of BPD. Methods: Lipopolysaccharide (LPS) was injected intraperitoneally (i.p.) into the newborn rats on postnatal day 1 (P1), P3, and P5 to induce systemic inflammation and inhibit alveolarization. In the same time with LPS administration, CXCR2 antagonist (SB-265610) or vehicle was injected i.p. to investigate whether CXCR2 antagonist can alleviate the detrimental effect of LPS on alveolarization by attenuating inflammation. On P7 and P14, bronchoalveolar lavage fluid (BALF) and peripheral blood (PB) were collected from the pups. To assess alveolarization, mean cord length and alveolar surface area were measured on 4 random nonoverlapping fields per animal in 2 distal lung sections at ×100 magnification. Results: Early postnatal LPS administration significantly increased neutrophil counts in BALF and PB and inhibited alveolarization, which was indicated by a greater mean cord length and lesser alveolar surface area. CXCR2 antagonist significantly attenuated the increase of neutrophil counts in BALF and PB and restored alveolarization as indicated by a decreased mean cord length and increased alveolar surface area in rat pups exposed to early postnatal systemic LPS. Conclusion: CXCR2 antagonist preserved alveolarization by alleviating pulmonary and systemic inflammation induced by early postnatal systemic LPS administration. These results suggest that CXCR2 antagonist can be considered a potential therapeutic agent for BPD that results from disrupted alveolarization induced by inflammation.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.301-308
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• 2018

Objectives. The age-based Cole formula has been employed for the estimation of endotracheal tube (ETT) size due to its ease of use, but may not appropriately consider growth rates among children. Child growth is assessed by calculating the body surface area (BSA). The association between the outer diameter of an appropriate uncuffed-endotracheal-tube (ETT-OD) and the BSA values of patients at 24-96 months of age was our primary outcome. Methods. Cole formula, BSA, age, height, weight and ultrasound measurement of subglottic-transverse-diameter were evaluated for correlations with correct uncuffed ETT-OD. The Cole formula, BSA, and ultrasound measurements were analyzed for estimation rates in all patients and age subgroups. The maximum allowed error for the estimation of ETT-OD was ${\leq}0.3mm$. Patients' tracheas were intubated with tubes chosen by Cole formula and correct ETT-OD values were determined using leak test. ETT exchange rates were recorded. Results. One-hundred twenty-seven patients were analyzed for the determination of estimation rates. Thirteen patients aged ${\geq}72months$ were intubated with cuffed ETT-OD of 8.4 mm and were accepted to need uncuffed ETT-OD >8.4 mm in order to be included in estimation rates, but excluded from correlations for size analysis. One-hundred fourteen patients were analyzed for correlations between correct ETT-OD (determined by the leak test) and outcome parameters. Cole formula, ultrasonography, and BSA had similar correct estimation rates. All three parameters had higher underestimation rates as age increased. Conclusion. The Cole formula, BSA, and ultrasonography had similar estimation rates in patients aged ${\geq}24$ to ${\leq}96months$. BSA had a correct estimation rate of 40.2% and may not be reliable in clinical practice to predict uncuffed-ETT-size.

• Journal of Chest Surgery
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• 제34권7호
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• pp.534-538
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• 2001

배경: 기관의 크기와 기관주위의 정상형태에 대한 지식은 임상에서 기도나 호흡관리, 그리고 기관재건술을 시행하는데 중요한 정보가 된다. 흉부 단순촬영은 기관의 직경을 재는 간단한 방법이지만 그 상이 확대되는 경향과 측면촬영에서 어깨와 상이 겹쳐서 나타나는 단점이 있다. 이에 저자들은 한국인 정상 성인의 기관의 정상치를 알기 위해 흥부 전산화 단층촬영을 이용하여 기관의 내경과 단면적을 측정하였다. 대상 및 방법: 남자 43명과 여자34명을 대상으로 하여 각각 나이에 따라 20~39세는 제 1군, 40~59세는 제2군, 60세 이상은 제 3군으로 구분하였다. 흉부 유입구와(Level 1) 대동맥궁에서(Level 2) 흉부 전산화 단층촬영을 이용하여 각각 전후경과 횡경을 재고 그 단면적을 구하였다. 결과: level 1에서 한국인 성인 남자의 기관의 전후경은 15.95$\pm$2.99 m, 횡경은 17.72$\pm$2.13 m이었고, 여자의 경우 전후경은 15.56$\pm$2.12 m, 횡경은 14.18$\pm$2.07mm로 남녀간에 유의한 차이가 있었다(p 0.05). Level 2에서 남자의 전후경은 19.77$\pm$2.57 m, 횡경은 18.02$\pm$2.19 mm이었고 여자의 전후경은 15.35$\pm$1.82 m, 횡경은 15.00$\pm$1.60 mm로 남녀간에 유의한 차이가 있었다 (p 0.05). 기관단면적은 남자가 각 Level에서 279.14$\pm$61.37 $\textrm{mm}^2$(Level 1), 281.93$\pm$63.97 $\textrm{mm}^2$(level 2)였고, 여자가 173.29$\pm$35.81 $\textrm{mm}^2$(Level 1), 181.88$\pm$34.74 $\textrm{mm}^2$(Level 2)로 두 위치에서 단면적은 남녀간에 유의한 차이가 있었다(p 0.05). 기관의 각각의 위치에서 내경과 단면적은 연령군에 따라 고연령층에서 증가하는 추세를 나타내었으나 통계적인 의미는 없었다. 결론: 한국 정상 성인의 기관내경과 단면적의 크기는 성별에 따라 통계적으로 유의한 차이가 있었으나 연령에 따른 차이는 없었고, 전산화 단층촬영은 기관의 내경과 단면적의 크기를 얻는데 비교적 정확하고 안전한 방법이라 생각된다.

• Journal of Chest Surgery
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• 제8권2호
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• pp.119-124
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• 1975

This is a case report of the rupture of the trachea and the esophagus following external blunt trauma without any associated injury. A 7 year old male patient was brought to the emergency room. Hanyang University Hospital, on 23 Jul, 1974 while he played under the pile of pingpong table A table was fall down over the patient accidentally. The patient was injured by the table and found lying in unconsciousness on the ground.There was subcutaneous emphysema on his anterior chest and neck. A contusion on the upper part of the sternum was noted. The breathing sound were diminished over the left side of the chest. Ronchi were heard over the right lung field. This patient was suffered from vomiting, dypsnea, and irritable mental state after this accident. On the chest roentgenogram in A-P view, hyperlucency at the mediastinum and parapericardiac area suggested the pneumomediastinum. On the next day, a diagnosis of the tracheal and esophageal rupture was confirmed by the esophagogram with Lipiodol swallowing. A right thoracotomy was performed and ruptured orifice of the trachea and the esophagus were closed with interrupted sutures. Postoperative course was uneventful and primary closure of the rupture of the trachea and the esophagus were succeeded.

• 대한두경부종양학회지
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• 제32권1호
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• pp.49-52
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• 2016

The lobular capillary hemangioma (LCH) was previously known to pyogenic granuloma and is benign vascular lesion which grows rapidly on skin and mucosa. It arises from whole body, but oral and nasal cavities are most predilection sites in the head and neck area. The laryngeal LCH looks like a granulomatous lesion of posterior glottis and its common etiology are tracheal intubation and laryngopharyngeal reflux disease etc. The LCH in larynx can cause blood tinged sputum and lump sense. The lesions refractory to medical therapy or causing dyspnea may require surgical excision. A 74-year-old man who presented gradually aggravated dyspnea, lump sensation and hoarseness of one month came to our hospital. The stroboscopic examination revealed large well-margined glottic mass. It was excised with $CO_2$ laser and finally diagnosed as LCH. We present a rare unique case of glottic LCH with a review of literatures.

• 한국응급구조학회지
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• 제9권1호
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• pp.95-99
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• 2005

Penetrating neck trauma by gunshot injury involving tracheobronchial tree is rare in Korea. Extensive tissue damage by cavitation, tissue fragmentation and shock wave transmission of high-velocity projectile along with associated organ injury renders high rate of mortality and morbidity. A 28 year old man in military service with gunshot wound in left cervical area presented initial symptoms of severe dyspnea and subcutaneous emphysema. Computed tomography of chest and cervical region as well as bronchoscopic evaluation was performed to confirm highly suspected injury to cervical trachea. Surgical exposure was established through a low collar incision; the damaged segment of 3.5 cm length including 2-4th tracheal rings was resected out and end-to-end anastomosis was performed. Bleeding from lacerated anterior jugular vein was controlled by ligation of both ends and a K2 bulllet was found upon inner border of body of first rib, medial to right carotid sheath and removed out. Cervical esophagus, carotid artery, internal jugular vein and recurrent laryngeal nerve were spared. Extubation was done on the first postoperative day and postoperative course until discharge on nineth postoperative day remained uneventful.

• 대한두경부종양학회지
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• 제25권2호
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• pp.174-177
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• 2009

Parathyroid cyst are rare lesion of the neck and superior mediastinum. They are classified as either functional or nonfunctional based on the presence or absence of hyperparathyroidism. They typically present as a palpable neck mass, or as an incidental finding during neck surgery. So, it must be included within the differential diagnosis of a neck lump. A 48-year old woman was admitted to our hospital for evaluation of left anterior neck mass. Physical finding showed soft, movable, non-tender mass on the lower left third of the neck. Laboratory findings revealed normal thyroid function and normal serum calcium level. On previous history, patient underwent two times sono-guided fine needle aspiration at local clinic, and about 10cc clear watery aspirate was noted. Computerized tomography findings showed non-enhancing hypodense cystic lesion on left thyroid area with tracheal deviation to right side. Preoperative diagnosis was thyroid cyst, and thyroidectomy was planed. Intra-operative finding showed huge cystic mass occupying the left thyroid area and smooth, shiny, semitransparent thin cyst wall was noted, which was loosely attached to the thyroid. The cyst was easily dissected free from the thyroid and surrounding tissues. After cyst removal, pathological study confirmed as a parathyroid cyst.

• Tuberculosis and Respiratory Diseases
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• 제46권5호
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• pp.628-635
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• 1999

연구배경 : 만성 폐쇄성 폐질환을 대변하는 폐기종에서 주요 기능적 장애는 호기의 장애이며, 최대 호기류량은 기도의 크기, 폐의 탄력반동압 그리고 기도의 함몰성에 의해 결정된다. 기도의 항몰성은 폐기종에서 기류를 제한하는 하나의 기전으로 작용하지만, 폐용적과 폐의 과팽창을 유지하는 기전으로 작용하여 가스교환을 증진시킨다는 주장도 있다. 따라서 폐기종에서 기관이 호흡에 미치는 생리학적 역할이 무엇인지를 알아보고자 본 연구를 수행하였다. 방 법 : 1997년 1월 1일부터 8월 31일까지 보라매병원 호흡기내과를 방문하여 단순 흉부방사선검사, 체간용적기록계(body plethysmography)를 포함하는 폐기능검사 및 HRCT를 통해 폐기종으로 진단된 20명을 대상으로 하였다. HRCT에서 대동맥궁의 정상부위에서 기관의 단면적을 호흡주기에 따라 측정하고 이를 체표면적으로 보정한 값과 동맥혈의 이산화탄소분압 및 산소분압, 기도저항, 폐유순도 등 폐기능지표와의 상관 관계를 분석하였다. 결 과 : 폐기종에서 기관의 단면적은 호기시 동맥혈의 이산화탄소분압(r=-0.61, p<0.05) 및 산소분압(r=0.6, p<0.05) 그리고 매분환기량(r=0.73, p<0.05)과 유의한 상관관계가 있었지만, 흡기시에는 상관관계가 없었다(이산화탄소분압과는 r=-0.22, p>0.05, 산소분압과는 r=0.26, p>0.05, 매분환기량과는 r=0.44, p>0.05). 매분환기량은 상시호흡량(tidal volume)과는 r=0.45(p<0.05)로 유의한 상관관계가 있었지만, 호흡수와는 r=-0.31(p>0.05)로 상관관계가 없었다. 폐기종에서 기관의 단면적은 호흡주기와 상관없이 $FEV_1$ FVC, $FEV_1$/FEC, 최대 호기류량, 잔기용적, 폐확산능, 기도저항, 폐유순도 등의 다른 폐기능지표와는 상관관계가 없었다. 결 론 : 폐기종에서 호기시 기관의 단면적은 주로 가스 교환(gas exchange)의 지표들과 유의한 상관관계가 있었지만, 폐용적이나 폐의 과팽창을 시사하는 지표와는 상관관계가 없었다. 따라서 폐기종에서는 호기시 동일 압력점의 개념에 의해 발생하는 기도압박으로 기관의 단면적이 감소하고 이러한 현상이 기류를 제한하는 하나의 기전으로 작용하는 것이지 폐용적이나 폐의 과팽창을 유지시켜 가스교환을 증진시키는 것은 아니라고 생각된다.