기도이물의 굴곡성 기관지경을 이용한 치료

강홍모 대한기관식도과학회 1996 大韓氣管食道科學會誌 Vol.2 No.2

기도내 이물제거에 경직성 기관지경이 많이 이용되었으나 성인에서는 굴곡성기관지경을 이용하여 용이하게 시행할 수 있으며 다양한 기구를 사용하면 성공률을 높일 수 있다. 따라서 성인의 기도이물제거에 굴곡성기관지경을 우선적으로 사용할 수 있을 것으로 생각된다.

위식도역류의 병태

최건,Choi, Geon 대한기관식도과학회 1996 大韓氣管食道科學會誌 Vol.2 No.1

이상에서 고찰한 위식도역류의 병태를 간략히 요약하면 다음과 같다. 위액에는 염산, 펩신, 담즙산과 췌효소등을 포함하고 있어 역류된 위액은 상부 기관식도관에 자극을 주거나 손상을 줄 수 있으며 개개인의 점막 상피의 저항도와 적절한 타액의 분비는 위액에 의한 손상의 정도를 결정하는 중요한 요소로 알려져 있다. 위식도역류로 인한 많은 증상이나 소견은 두가지의 기전으로 나타나서 첫째, 역류된 위액이 직접 조직에 영향을 주거나 둘째, 간접적으로 식도 하부에 분포된 미주신경에 의한 연관자극에 의해 일어나는데 위식도역류의 증상 중 두부, 경부, 심장 및 폐장의 증상은 이들 장기에 미주신경의 일부가 같이 분포하여 일어나는 간접적인 기전이다. 하부식도괄약근(lower esophageal sphincter)의 기능은 역류를 막는 가장 중요한 요소로 알려져 있어 간헐적으로 하부식도 괄약근의 압력이 떨어지면 역류가 일어나게 된다. 정상적인 식도의 연동운동은 식도에 역류된 위내용물을 위로 제거되는데 중요하며 위식도역류 환자에서 흔히 연동운동이 저하되거나 비정상적인 연동운동을 관찰할 수 있다. 또한 위내용물이 소장으로 비워지는 시간이 연장되어 위내용물이 위내에 축적되는 것도 위식도역류의 원인의 하나로 생각된다. 이러한 위식도역류의 병태를 연구하는 것은 이 질환의 이해에 도움을 줄 것으로 생각된다.

식도 천공의 치료와 예후에 영향을 미치는 인자의 분석

박경택,한일용,조광현,Park, Kyoung-Taek,Han, Il-Yong,Cho, Kwang-Hyun 대한기관식도과학회 2010 大韓氣管食道科學會誌 Vol.16 No.2

Background: The esophageal perforation is related to high morbidity and mortality rates if the diagnosis and treatment are delayed. The aim of this study is to evaluate the affecting factors on outcome and prognosis of the patients who suffer from esophageal perforation. Material and Methods: Twenty-six patients were treated with esophageal perforation in our institute from Jan. 1992 to Feb. 2010. We retrospectively reviewed the results of treatment for esophageal perforation to understand the risk factors affecting survival in patients. Results: The subjects are 26 patients suffered with esophageal perforation and the mean age is $52{\pm}17.8$ years old. 16 esophageal perforations were caused spontaneously, 25 cases were treated surgically. The mortality rate is higher in the cases o pre-operative mediastinitis. Conclusion: The shortness time interval until the beginning of treatment should be achieved to reduce the incidence of fatal post-treatment morbidity and mortality.

신생아에서 발생한 선천성 후두개 낭종 1례

서덕중,이준규,Seo, Deok-Jung,Lee, Joon-Kyoo 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.2

Congenital epiglottic cyst is rare cause of stridor in neonate and if managed inadequately, disaster such as death can occur. Diagnosis of congenital epiglottic cyst includes imaging studies and endoscopy. Fiberoptic or rigid endoscopic examination excludes other causes of stridor in neonate. Complete excision of cyst is treatment of choice under suspension laryngoscopic guidance. Here, we report a case of congenital epiglottic cyst and concomitant laryngomalacia presenting with seizure and respiratory difficulty in neonate with a review of literature.

기도를 침범한 분화성 갑상선암종

최종욱,김용환,박찬,고태옥,최건,Choi, Jong-Ouck,Kim, Yong-Whoan,Park, Chan,Ko, Tae-Ok,Choi, Geon 대한기관식도과학회 1997 大韓氣管食道科學會誌 Vol.3 No.2

We report 22 cases of well -differentiated thyroid carcinoma infiltrating the upper airway tract. This retrospective study was undertaken to evaluate the prognosis md to determine optimal therapy for thyroid carcinoma adhering to or invading the trachea or larynx from 1984.3 to 1996.12. The treatment was individualized depending on the extent of the cancer. There were 12 cases dissected free by an laryngotracheal shaving, 7 cases removed by an tracheal resection with end to end anastomosis, 3 cases removed by an total laryngectomy. In all of these cases, we performed a total thyroidectomy with an accompanying neck dissection. There were no major complications during the operation. Over the 5-years observation period, 11 patients are alive without a sign of recurrence, 4 Patients are alive with recurrence, 7 died of thyroid carcinoma; 2 of 12 in an laryngotracheal shaving cases, 2 of 7 in an tracheal resection with end to end anastomosis case, 3 of 3 in an total laryngectomy case. The result showed an radical operation for thyroid carcinoma invading the laryngotrachea improves the survival rate, but limits improving the cure rate, and the invasion of the thrchea or larynx must be treated whenever possible by an total resection followed by radioiodine and external beam radiation.

부서진 기관튜브로 발생한 소아 기관지 이물

한민석,권성근,Han, Min-Seck,Kwon, Seong-Keun 대한기관식도과학회 2010 大韓氣管食道科學會誌 Vol.16 No.1

Fracture of tracheostomy tube with subsequent migration into the tracheobronchial tree is rare, but tracheobronchial foreign body in child carries the potentially fatal risk of respiratory obstruction, We report a case of a 5-year-old girl who had aspirated a fractured tracheostomy tube which was removed under rigid bronchoscope.

경비 식도 내시경

박영학,김현수,Park, Young-Hak,Kim, Hyun-Soo 대한기관식도과학회 2010 大韓氣管食道科學會誌 Vol.16 No.2

Transnasal esophagoscopy allows. the upper aerodigestive tract, from the nasal cavity to the gastric cardia to be examined in the outpatients department. It is well tolerated by patient with topical anesthesia alone and no sedation or patient preparation is required. The technique is easily learned and performed in the otolaryngologist and highly cost efficient. It is a useful tool for accurate diagnosis and can be used in a variety of office-based procedures.

거대 경부 낭성수종 환자에서의 OK-432 치료 1 예

이인효,김정은,김용재,김동욱,Lee, In-Hyo,Kim, Jung-Eun,Kim, Young-Jae,Kim, Dong-Wook 대한기관식도과학회 2010 大韓氣管食道科學會誌 Vol.16 No.1

Cystic hygroma is a rarc congenital malformation of the lymphatic system and seen rarely in adults. It represents an error in communication between the large draining lymphatic channels and the venous system, Conventional surgical excision remains the most popular method of treatment in many developing countries despite the dangers associated with treatment modality. We present a case of huge cervical cystic hygroma in a 26-year old female who was treated with OK-432 sclerotherapy.

백서 기관 점막의$SO_2$ 노출 후 회복과정의 조직학적 관찰 및 laminin의 발현에 관한 연구

이형석,태경,조석현,한장희,정진석,Lee, Hyung-Seok,Tae, Kyung,Cho, Seok-Hyun,Han, Jang-Hee,Jeong, Jin-Suck 대한기관식도과학회 2002 大韓氣管食道科學會誌 Vol.8 No.1

Background and Objectives : Sulfur dioxide gas is one of the major airborne Pollutants noxious to human in industrialized countries. The most vulnerable areas in the human respiratory system were the trachea and main bronchi and a gradient of decreasing damage was observed in the peripheral tracheobronchial tree. Induced functional alteration was increased mucosal permeability, and morphological changes were epithelial sloughing, intracellular edema, mitochondrial swelling, widened intercellular spaces, and ciliary cytoplamic extrusions. The laminins are a family of extracellular matrix glycoproteins localized in the basement membrane. Their primary role is cell-matrix attachment, but many additional biologic activities, including Promoting cell growth and migration, tumor growth and metastasis, wound repair, and graft survival, have been demonstrated. Materials and Methods : Histologic changes and expression of laminin in tracheal mucosa sacrificed at 1 day, 2 day, 3 day, 1 week, 2 weeks, and 3 weeks after continued SO2 exposure of 250 ppm for 30 minutes a day(to 7week) were studied in rats. In this study, mild immune reaction for laminin was noted at the apical cytoplasm of epithelial cells and basement membrane one day after a 7 week $SO_2$ exposure. The cilia and nucleoi of epithelial cells were normal and no immune reaction was noted in Goblet cells. The lamina propria of the tracheal tissue was infiltrated by monocytes and lymphocytes. Results : At 24 hours after exposure, all tracheal cells except Goblet cells revealed a mild immune reaction for laminin. No immune reactions were noted in the basement membrane. At 72 hours after exposure, mild or moderate immune reactions for laminin was seen in the tracheal cell cytoplasm. Irregular faint immune reaction for laminin was noted in the basement membrane. At 1 week after exposure, strong immune reaction for laminin was detected over all tracheal cells, and the basement membrane was seen clearly. At 2~3 weeks after exposure, strong immune reaction for laminin was seen in all tracheal epithelial cells except Goblet cells and a mild immune reaction was partly revealed in the basement membrane. Conclusion : Our study suggests that 502 produces histologic damage on the tracheal mucosa. Longer duration after exposure of $SO_2$ makes more progressive healing on the tracheal mucosa and increased immunoreactivity for laminin.

Tracheal Foreign Body by Accidental Fracture of Tracheostomy Tube

유재철,장문영,정영호,진홍률,Yoo, Jae-Chul,Chang, Mun-Young,Jung, Young-Ho,Jin, Hong-Ryul 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.2

Fractured tracheostomy tube presenting as foreign body in the tracheobronchial tree is very rare. Authors experienced a case of broken tracheostomy tube presenting as a foreign body in the trachea, which was removed with the help of flexible bronchoscope. A few causes could be suggested for the tube break: aging and deterioration of the tube with repeated use, a flaw of the tube in the manufacturing process, and a wrong sterilization.method causing weakness of the tube. We report this case with brief literature review.