• Journal of KSNVE
• /
• v.5 no.3
• /
• pp.373-383
• /
• 1995

From the viewpoint of the structural design, the principal problem of the heat exchanger is the potentiality of structural instabilities due to the fluid loading effect during operations. Excessive fluid loading may give rise to permanent deformation of tube and would enentually result in collapse of heat exchanger, which would cause an obstruction of the fluid flow in the narrow channels. In this study, a fluid-structural interaction model was developed to investigate analtically the vibration characteristics of thin rectangular tube used in the heat exchanger. The model consists of two flat plates separated by fluid. The effects of the fluid in the tube was stuided. For analyses, the natural frequency coefficients of the model were investigated for the plate aspect ratios, channel heights, and boundary conditions. As conclusions, the natural frequency coefficients of the tube is found to be affected largely by the fluid loading and the channel heights.

• Journal of Chest Surgery
• /
• v.3 no.1
• /
• pp.47-54
• /
• 1970

This is a report on two cases of aortic prostheses using Nylon tube. (Edwards-Tapp A-G Tube, Chemically treated braided Nylon arterial grafts). Especially, the complications after infection of synthetic graft are discussed with reviewing literature. First case was the patient who came to our hospital with rupture of the right femoral artery at the femoral fossa due to pyogenic necrotic process. After femoral arterial prostheses, good pulsation of dorsal artery of foot was obtained. However, the tube was obstructed after 8 weeks postoperatively due tll the complication of infection. In spite of the tube was removed because of obstruction and foreign body reaction of synthetic graft, an amputation of the leg was not necessary for formation of good collateral circulation. Second case was a case of aortic aneurysmal rupture in thoraco-abdominal junction which developed by the trauma of rib resection for osteomyelitis of the left 12th. rib An implantation of aortic graft was performed at the lowest tho13cic aorta by the way of thoraco-abdominal bypass without arterial pump. However, infection produced pyothorax in the left pleural cavity, exposing the tube within the pyothorax. The rupture of the anastomosed upper line occurred in 8 weeks postoperatively and the patient expired.

• Archives of Plastic Surgery
• /
• v.43 no.6
• /
• pp.506-511
• /
• 2016

Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.

• Korean Journal of Bronchoesophagology
• /
• v.5 no.2
• /
• pp.182-190
• /
• 1999

OBJECTIVES : To determine the results of posterior cricoid split with costal cartilage graft in the treatment of moderate and severe subglottic stenosis in adults, and to assess the effect of T-tube as a stent in this surgery. PATIENTS AND METHODS : Four adults with moderate and severe subglottic stenosis who underwent posterior cricoid split with costal cartilage graft from 1994 to 1995. Three patients were male and one was female. All of the patients had acquired subglottic stenosis, 2 of whom had a bilateral vocal folds paralysis. The surgical procedure we used included a cricoid lamina split with costal cartilage grafting and T-tube stenting. Arytenoidectomy was a added in 2 patients with bilateral vocal folds paralysis. RESULTS : Three of the 4 patients underwent decannulation, and 1 is still undergoing treatment. 3 patients who underwent decannulation demonstrated marked improvement in their symptoms of airway obstruction and good postoperative voice quality. CONCLUSIONS : The posterior cricoidotomy lumen augmentation with costal cartilage grafting is a safe and effective technique for the treatment of moderate and severe subglottic stenosis in adults and T-tube is a good alternative stenting material for this procedure.

• Journal of Gastric Cancer
• /
• v.13 no.4
• /
• pp.263-265
• /
• 2013

Intussusception is a rare cause of postoperative intestinal obstruction in adults. Many retrograde intussusceptions occur during the period following gastrectomy. A 77-year-old woman visited our hospital because of detected gastric adenocarcinoma. She received radical total gastrectomy with Roux-en-Y esophagojejunostomy. On the fifth postoperative day, she complained of abdominal pain, and we found leakage at the esophagojejunostomy site and dilatation of the Roux limb and the afferent limb of the jejunojejunostomy. Emergency surgery was performed. Retrograde jejunojejunal intussusception accompanied with a nasojejunal feeding tube was found at the efferent loop of the jejunojejunostomy. No ischemic change was found; therefore, manual reduction and primary repair of esophagojejunostomy was performed. She was discharged without complications on the 23rd re-postoperativeday. We suggest that the nasojejunal feeding tube acted as a trigger of intussusception because there was no definitive small bowel mass or postoperative adhesion. We present our findings here along with a brief review of the literature.

• Journal of Hospice and Palliative Care
• /
• v.12 no.4
• /
• pp.194-198
• /
• 2009

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

• Applied Microscopy
• /
• v.12 no.1
• /
• pp.1-10
• /
• 1982

Serous otitis media is closely related with auditory tube function, but its etiology and pathogenesis are not clearly defined yet. So we tried to prove the theory of hydrops ex vacuo via the experimental study with cats by means of obstructing the pharyngeal orfice of the auditory tube and observe the serial changes in tympanic mucosa through light and electron microscopy. The results are as follows; 1. We confirmed the production of serous otitis media with auditory tube obstruction and have a new understanding of auditory tube function in middle ear aeration. 2. The effusion in serous otitis media was produced from the next day of experiment and increased till the fourteenth day, but decreased after the spontaneous perforation of ear drum. 3. Through the light microscopy, we observed the increasement of the sercretory cells including goblet cells, epithelial hyperplasia, capillary proliferation and invasion of inflammatory cells. 4. Through the elctron microscopy, we observed the protrusion of secretory cells, blobs in cilia, loss of cilia, increasement of vesicles, vacuoles and dense bodies in ciliated cells and Invasion of inflammatory cells. With above results, we concluded that aeration through auditory tube is the most important factor in serous otitis media and presumed the effusion was secreted by secretory cells.

• Korean Journal of Head & Neck Oncology
• /
• v.34 no.2
• /
• pp.77-80
• /
• 2018

Subglottic cysts have been reported as a relatively rare problem of pediatrics who have a history of premature birth and period of intubation. They may cause significant upper airway obstruction and many cases require tracheostomy to airway management. Endoscopic marsupialization by microinstruments or laser has been standard primary treatment but a high recurrence rate has been reported. A 19-month-old child presented with stridor who has history of ventilation via an endotracheal intubation in the newborn period for 7 days. Radiologic examinations were performed for aggravated dyspnea symptom and subglottic cystic mass was found, then it was marsupialized at operation room and tracheostomy was done at the same time. After decannulation of tracheostomy tube, there is no recurrence of cyst nor upper airway obstruction for 29 months. We report this case with a review of literature.

• Korean Journal of Bronchoesophagology
• /
• v.4 no.1
• /
• pp.117-121
• /
• 1998

Relapsing polychondritis is a rare disesase involving any cartilaginous structure of entire body and is characterized by recurrent episode of inflammation and degeneration of cartilage and most commonly involve ear, nose, larynx, trachea, ribs, Eustachian tube, etc. Its signs and symptoms are recurrent swelling of auricle, saddle nose deformity, polyarthralgia, hoarseness and dyspnea, audiovestibular disturbance and cardiovascular abnormality, etc. Characteristic histologic findings are loss of normal basophilic staining of cartilage, perichondrial inflammatory infiltration with plamsa cells, lymphocytes and neutrophils, and finality, destruction of cartilage and replacement with scar tissue. Our case had saddle nose deformity, arthralgia, tracheal collapse, hearig loss and positive histologic finding but no auricular perichnodritis. Her major problem was airway. obstruction due to tracheal collapse. This case was diagnosed with relapsing polychondritis according to the Damiani's criteria. This case indicates that any patients complaining of airway obstruction have to be examined systemically.

• Journal of Nutrition and Health
• /
• v.25 no.7
• /
• pp.668-683
• /
• 1992

To evaluate the current practices of the tube feeding and the status of tube feeding patient 76 adult in-patients at 6 hospitals located in Seoul and Chung-buk province were examined through reviewing patient charts observing patients and interviewing patients nurses dietitians patients' family or care-givers. The results were as follows : 1) An average age of the patients was 54.5 years with 41% over 60 years old. Patients with decreased mental status dysphagia esophageal obstruction and respiratory problem were fed by tubes. 2) The range of duration of tube feeding is between 4 days and 6 years. Most patients were received formula through nasogastric tube(89.5%) while 7.9% of gastrostomy and 2.6% of jejunostomy. Administration method for formula were bolus feeding regardless of the route of formula delivery. 3) Mean total calories received for men were 1590 kcal and 1450 kcal for female. Mean volume per meal was 282m, l and mean frequency of feeding was 5.68 while mean feeding interval 3$\frac{1}{4}$ hours and mean rate of infusion 68.4ml/min. All patients received hospital-blenderi-zed formula as the major source of nutrition. Home-blenderized formula and commercial formula as a supplement were used 35%, 13.2% respectively. 4) Thirty-eight percent of patients was hypoalbuminemia and 61% was at the moderate level of deficiency in hemoglobin. 5) Complications associated with tube feeding were diarrhea (22.4%) constipation(21.1%) vomiting(11.8%) and so on. 6) Serum albumin levels of patients who have complications associated with tube feeding were significantly lower than those of patients without complications In planning a tube feeding regimen the type of a formula must be integrated with both a delivery system and a protocol for administering the tube feeding. the multidisciplinary effort required to deliver enteral therapy is essential to improve current practices used at hospitals.