• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.164-173
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• 1999

Background : cis-Diamminedichloroplatinum(Ⅱ)(cis-platin) has been exhibited similar to bifunctional alkylating agents in the cell and known as an effective anticancer drug. Although this agent is very beneficial to the cancer patients, it may also damage to the normal cell. Many side effects were developed. Objectives : This experiments was undertaken to pursue the effect of cis-Platin on the mucous variation of the trachea. Materials and Methods : The male of Sprague-Dawley strain were used as and experimental animals. The experimental animals were killed at 1, 3 days and 1, 2 and 3 weeks after the third injection of cis-Platin was administered 1.5mg/kg to intraperitoneal injection at once a week for three weeks. The trachea was fixed to neutral formaline and stained with alcian blue(pH 1.0)-PAS, alcian blue(pH 2.5)-PAS double stains and these preparation observed with light microscope. Results : 1. In the trachea stained with alcian blue(pH 2.5)-PAS double stain, the epithelial cells were constricted in the 1 week, In the 1st day, 3rd day and 1st week, acidic mucopolysaccharide was increased but in the 2nd week, neutral mucopolysaccharide was increase. 2. In the trachea stained with alcian blue(pH 1.0)-PAS double stain, the 1st and 3rd day exhibited sulfa mucopolysaccharide with moderately or weakly positive reaction. In the 1st week the sulfa mucopolysaccharide with strongly positive reaction was increased. In the 2nd and 3rd week, the sulfa mucopolysaccharide with weakly positive and non-sulfa or neutral mucopolsaccharide with negative reaction were modified. Conclusion : It is consequently suggested that cis-Platin induces reversible toxic damage to tracheal cells including goblet cell.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.649-652
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• 2009

A 75-year-old man presented with worsening dyspnea and intermittent dysphagia of one month's duration. A plain chest X-ray showed severe tracheal indentation by the right superior mediastinal mass. A chest CT established the diagnosis of a saccular aneurysm arising from the right proximal subclavian artery. Resection of the aneurysm and arterial revascularization was done through a median sternotomy with supraclavicular extension. Aneurysm wall and thrombus culture results were negative and pathology showed an atherosclerotic aneurysm. After the operation, dyspnea and dysphagia were reduced, but he died of advanced stomach cancer 8 months later.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.133-136
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• 2011

Background and Objectives : Previous jet ventilation is not becoming more common because of high price, making loud noise, and causing a movement of the vocal cords due to the jet stream. So we designed a new type of manually controlled jet ventilation using previous laryngoscope and introduced it's clinical application. Materials and Method : A prospective study involved 20 patients all having undergone surgical intervention under new type of manually controlled jet ventilation from June 2009 to January 2011. The prospective study was to assess the vital sign and operative and postoperative complications. Results : The Manually Controlled Jet Ventilation were performed in 20 patients. 50% of the patients have Post-located laryngeal lesion, 20% with tracheal stenosis, 20% with glottic cancer biopsy and laser cordectomy, 10% with postglottic stenosis. Conclusion : Manually Controlled Jet Ventilation (Manujet) can be used for airway surgery.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.3
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• pp.445-462
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• 1999

The purpose of this study is to provide some basic data for the direction of nursing education and practice to prevent nursing malpractice as investgating perception of the nurse on the nursing malpractice and its case. Data were collected from 450 nurse working in four general hospitals which were located in Chonbuk province from November 9 to 21, 1998 through questionnare. The structured instruments developed by the reseacher were used for collecting data. The Results were as follows: 1) As for the cognition of the nursing malpractice case, the transfusion accident was 37.3%, the side-effects of KCL injection(19.3%), hymen rupture by uterus cancer test, the side-effects of aminophyllin injections on dyspnea patient and the others were 10% below. 2) With regard to the channel of the perception of the nursing malpractice case, mass-communication was taken first and followed through by neighbors, In-service education, school education, continuing education 3) As for the direct${\cdot}$indirect experience of the nursing malpractice case, transfusion accident was 51.3%, the fall of NPO patient after an operation 40.1%, the side-effect of KCL injection 32.5%, suicide of the psychiatric patient 32.5%, and the others were 30% below. 4) The possibility of nursing malpractice case was an average 2.57(${\pm}$0.91) and the highest was the fall of the NPO patient after an operation. 5) The perception on the responsibility of the nursing malpractice in its case was indicated as a joint-fault in ten nursing malpractice instances. As compared to the real decision, nurse's perception of the responsibility in the fall of the NPO patient after an operation, the side-effect of KCL injection, the tracheal edema of the patient who had a thyroid operation, the suicide of psychiatric patient, the hymen rupture by uterus cancer test accorded real decisions. But the other cases were different from the real decisions. These cases were perceived as ones of joint fault even in cases determined as Dr's single fault cases or those in which both doctor and nurse were declared free of fault. 6) Knowledge levels of the nursing malpractice, school education and In-service education were perceived as low but anxiety levels of the malpractice were high. 7) With regard to the countmeasure of the hospital after nursing malpractice, the rate answered as "the practice settled the accident temporarily and forced the person in charge to be punished" was highest. In conclusion, the level of the cognition of the clinical nurse on nursing malpractice cases was low. As nurses' perception on the responsibility of the nursing malpractice case was compared to the real decision, there was a difference in five cases out of the ten cases.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.299-306
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• 1996

Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.