• Tuberculosis and Respiratory Diseases
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• v.64 no.5
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• pp.356-361
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• 2008

Background: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. Methods: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. Results: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. Conclusion: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.518-523
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• 1989

A 42-year old male was seen with symptoms of dysphagia, chest pain and dyspnea of 9 months duration. A benign tumor of the posterior mediastinum was diagnosed from x-ray studies and a transthoracic needle aspiration biopsy which was inconclusive. A left thoracotomy revealed a huge mass occupying the retrocardiac space and the contra-lateral mediastinum. It was resected by blunt dissection and, during this process, a 3.0 cm laceration was created in the esophageal wall. This was repaired with Tevdec sutures and staplers and was reinforced with an intercostal muscle flap to prevent leakage. The postoperative course was entirely uneventful.

• The Korean Journal of Cytopathology
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• v.10 no.2
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• pp.163-167
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• 1999

Primary small cell carcinoma of the salivary gland is a rare neoplasm that accounts for approximately 1.8% of all primary major salivary gland malignancies. Because of its rarify, it is difficult to diagnose small cell carcinoma of the parotid gland by fine needle aspiration cytology(FNAC). We experienced a case of primary small cell carcinoma of the parotid gland in a 72-year-old woman who presented with two palpable masses of the left infraauricular and ocular legions of two to three month's duration, respectively. Aspirate smears from the left infraauricular area were highly cellular on necrotic and lymphocytic background and showed individually dispersed cells or three-dimensional clusters of small cells. The tumor cells were round to oval with a very high nucleocytoplasmic ratio. Nuclei were about two times the size of lymphocytes and had uniformly dispersed but hyperchromatic to pyknotic chromatin. Nucleoli were occasionally visible but were generally inconspicuous. Numerous mitotic figures were detected. The clusters of these small tumor cells exhibited angular nuclear molding, irregular nuclear outlines, and occasionally rosette like arrangement. The tumor was confirmed by histology and immunohistochemistry.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.713-721
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• 2008

Purpose : This study aims to describe the clinical characteristics of severe meconium aspiration syndrome (MAS) which required mechanical ventilation over 48 h and to delineate the progress of respiratory failure and radiographic findings in severe MAS. Methods : Twelve infants admitted to the Neonatal Intensive Care Unit (NICU) of the Seoul National University Bundang Hospital diagnosed with severe MAS from January 2004 to July 2007 were analyzed retrospectively. Results : The presence of persistent pulmonary hypertension of the newborn (PPHN) is the only independently significant risk factor for a longer hospital stay and longer duration of mechanical ventilation. Surfactant replacement therapy (SRT) was not randomized but only performed in infants with radiographic findings for respiratory distress syndrome (RDS). In the presence of radiographic findings for RDS, the duration of high-frequency oscillatory ventilation was significantly longer. PPHN developed in 8 infants (75%). The PPHN group had a significantly longer duration of mechanical ventilation. All infants who received SRT showed radiographic improvement within 12 h, but there was no significant change in the severity score during the same period. Infants without the PPHN complications showed significant decrease in the severity score within 12 h after SRT, whereas infants with PPHN complications did not. Conclusion : The clinical course of severe MAS differed significantly depending on the development of PPHN. SRT conferred radiographic improvement in infants who showed radiographic findings for RDS, but did not influence the clinical course of MAS significantly.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.51-55
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• 2007

Objectives: The aim of this study is to compare the efficacy of fresh versus frozen reconstituted botulinum toxin type A (BTX-A) for the treatment of adductor type spasmodic dysphonia. Materials and Methods: After reconstitution with normal saline, BTX-A was used within 4 hours or it was kept frozen in a consumer grade freezer at about $-25^{\circ}C$ for up to 4 months. Thirty patients with spasmodic dysphonia were randomly assigned and treated with the either fresh or frozen BTX-A. About 83% of injections resulted in a satisfactory outcome with 5.3 months of mean action duration. Treatment outcomes and side effects of total 161 injections were compared along the duration of keeping BTX-A frozen. Results: There were no statistical differences in the duration of action, self-rated satisfaction score, and the duration of hoarseness and/or aspiration between fresh and frozen BTX-A treated groups. No significant side effects were observed and the frozen BTX-A were proved to be free of bacterial contamination. Conclusion: After being reconstituted and kept frozen, BTX-A may be safely used for more than 4 months without significant loss of its effectiveness or additional side effects.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.82-82
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• 1993

Tracheostomy was done to form temporary opening in the trachea, to remove secretion, to maintain ventilation and to protect against aspiration. In recent times, with the development of care methods such as low pressure cuff, endotracheal intubation is being combined with tracheostomy in the treatment of patients who are treated long period in the intensive care units and the duration from endotracheal intabation to tracheostomy is like to prolong. To determine the proper time of tracheostomy in the patient in the intensive care units, authors reviewed retrospectively the 96 patients who received the tracheostomy procedure among the 8776 patients who were admitted in the intensive care units of Asan medical center form March 1990 to March 1993, and analyzed the complications of tracheostomy, decannulation and the cause of decannulation failure according to disease, age indication of endotracheal intubation and duration of endotracheal intubation.

• Journal of Pharmaceutical Investigation
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• v.23 no.4
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• pp.217-223
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• 1993

The combined products of antacid and anti-ulcer agent were prepared with antacid composed of aluminium hydroxide dried gel, magnesium hydroxide and simethicone with a ratio of 1:1:0.1 (M) and anti-ulcer agent, aceglutamide aluminium (AGA). The efficacy of antacid was evaluated in vitro with Fuchs, Johnson-Duncan and Rosset-Rice methods and in vivo using an aspiration method in rat. The addition of anti-ulcer agent did not affect the neutralizing capacity of M significantly. The combined products with the M/AGA ratios of 2.3:1 and 3.4:1 produced the maximum pH of $4.0{\sim}5.8$ and the duration time of $64{\sim}137$ min in vitro test. The in vivo neutralizing test in rats showed the rapid increase of gastric pH up to 3.5 within 30 min and the gastric pH of $4{\sim}6$ was kept for 5 hr.

• The Korean Journal of Cytopathology
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• v.1 no.2
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• pp.152-157
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• 1990

A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was blulsh opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined ceil borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.

• Journal of Nutrition and Health
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• v.26 no.5
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• pp.593-602
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• 1993

As part of the Nutrition CRSP Mexico project conducted in rural villages in highland Mexico, this study examined whether nutritional factors, family characteristics, and the duration of schooling were associated with cognitive performances in 107 schoolers(53 boys and 54 girls) aged 8~10. Food intake was measured by recall, direct observation and weighment twice monthly over the course of a year. Families were characterized in terms of socioeconomic status and parental cognitive performance, education and aspiration. Dietary quality, but not energy intake, and anthropometry (wt-for-age, ht-for-age, head circumference) were significantly associated with cognitive test results for both verbal and performance measures. When the effect of SES is controlled using partial correlation, the relationships were substantially weakened. Sex differences were also found in response to nutritional deprivation. Among boys, dietary quality was the most important indicator of cognitive performance, while household economic conditions were more importantly associated with cognitive performance among girls. Participation in schooling was important for cognitive skille as it related to nutritional status.

• Journal of Korean Neurosurgical Society
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• v.38 no.4
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• pp.273-280
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• 2005

Objective : There is no acceptable indication and treatment of choice for infantile and child subdural hygroma and there are only a few reports about that in Korea. So the authors studied the clinical findings of infantile and child patients with subdural hygroma to improve the understanding and to suggest a standard treatment method. Methods : The authors retrospectively evaluated the causes, preoperative symptoms, radiological thicknesses, and postoperative results of 25patients with subdural hygroma who received surgical therapy. Results : There were 16boys and 9girls whose median age was 6months[range $2{\sim}120months$]. The main clinical manifestations were seizures, increased intracranial pressure, macrocrania and alteration of consciousness. Radiological thicknesses of the subdural hygroma varied from 7mm to 42mm and postoperative changes of thickness[y] could be expressed with the factor of month[x]: $y\;=\;-1.32\;{\times}\;+11.8$ in subdural drainage, and $y\;=\;-1.52\;{\times}\;+14.9$ in subduroperitoneal shunts. Of the 25patients, 2 [50%] were successfully treated by aspiration, 13 [59%] by subdural drainage, and 9 [69%] by subduroperitoneal shunt. Conclusion : It is suggested that the diagnosis and treatment of subdural hygroma in infants and children should be carefully addressed because of its high prevalence in children, and especially in infants. It is also suggested that the subdural drainage could be primary initial treatment method because it is simpler than a shunt, and since our data show that there is no statistical difference in postoperative recovery duration between the two operative methods.