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本敎室에서 5年間 經驗한 耳鼻咽喉科領域 腫瘍의 統計的 觀察
姜東淑,李萬龍,宋華錫 中央醫學社 1968 中央醫學 Vol.15 No.1
Six-hundred-and-forty (640) cases of otolaryngologic tumors including 516 benign and 124 malignant tumors were subjected to a critical analysis. The cases were collected during the past 5 years at the department of otolaryngology of the Catholic Medical College. Following. results were obtained; 1. The sex ratio of malignant tumors is 2 males to 1 female, and of benign tumors is 1.2 males to 1 female. 2. Polyp consisted over one half of all the tumors. Squamous cell carcinoma predominated among the malignant tumors(75%). 3. The malignant tumor of the larynx was one fourth of all the malignant tumors with sex ratio being 3.5 males to 1 female. 4. The average age was 26.7 years in benign tumors and 49.6 years in malignant condition. 5. The most important and frequent complaint of the patients with malignant tumors was pain. 6. Twenty-five(25.2) per cent of benign tumors and 11.3 per cent of malignant tumors were surgically attacked.
朴海壽,姜東淑 中央醫學社 1964 中央醫學 Vol.7 No.3
Airway obstruction is one of the few real emergencies in medical practice. The history of tracheotomy is long and still it remains as one of the most important life saving procedure in case of asphyxia. This article report the result of clinical studies on 92 cases of tracheotomy performed at the E. N. T. Clinic, Inchon Methodist hospital, Inchon, Korea, covering-a three years period from January, 1960 to December, 1962. Among 719 E. N. T. operations, tracheotomy cases were 92 (12.6 per cent). This was surprisingly high number in frequency, 58 (63 per cent) of these cases were male and 34 (37 per cent) were female. Approximately two third of the cases were between one and five years of age (58.6 per cent), and youngest was 13 months and oldest was 58 year-old. Majority of the cases occurred in winter time while none case occurred in August and September. Analysis of the causative disease revealed more than two third of the cases were laryngeal or pharyngeal diphtheria, and none diphtheric acute laryngitis, laryngeal abscess, laryngeal edema, retropharyngeal abscess, intoxication, foreign body, Ludwig's angina, laryngeal cancer, laryngeal papilloma were next in order. Decannulation could be performed within one week in the most of diphtheria cases. The complication rate was 16.3 per cent (15 cases), and following postoperative complications were seen: cervical subcutaneous emphysema in four cases, mediastinal emphysema in one case, pneumothorax in one case, postoperative hemorrhage in two cases, pulmonary. atelectasis in three cases, and possible pneumonia in one case. As a permanent complication hoarseness developed in one case, caused by protracted perichondritis, which occurred following severe laryngeal abscess. The mortality rate was 8.6 per cent: 8 cases were died during or after operation. Three caes who died during operation visited the hospital with almost exhausted state because of imminent asphyxia. Among five cases, who died after operation, one death occurred due to extensive mediastinal emphysema with pneumothorax, one due to reobstruction of the airway, two due to cardiac failure(diphtheria cases), and one due to unknown cause. Following warnings summarized: 1) Tracheotomy should never be underestimated as a simple and easy surgical procedure, this is especially true in children and emrgency situation, 2) Unless temporary adequate airway is being provided general anesthesia. must be avoided even routine premedication such as administration of sedatives or narcotics. 3) Policy of watch and wait until last minutes should be condemned: tracheotomy should be done as elective rather than emergency. 4) In case of impending asphyxia emergency establishment of airway, such as introduction of bronchoscope, Mosher's life saving tube, or endotracheal tube, is considered to be very wise way to perform uneventful tracheotomy, it is, however, almost impossible to do so in some occasions. In such instances emergency tracheotomy is mandatory. 5) Surgeon should familiar with both orderly tracheotomy and emergency tracheotomy technic. 6) As Jackson recommended authors emphasize that tracheotomy should be done as low as possible, this is particularly so in younger age group to pervent decannulation difficulty. 7) Aftercare cf tracheotomized case is not easy. Doctor and nurses should always keep in mind that reobstruction of the airway can be happened by various causes, Regulation of the room temperature and humidity seems to be very important in keeping airway free from crust formation.