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.

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.

양측 성대마비 환자에 대한 $CO_2$레이저 피열연골 내측부분절제술

최홍식,최영준,이용훈,박헌이 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.2

Bilateral vocal cord paralysis can result in severe airway compromise. Over the years a variety of arytenoidectomy procedures have bee described, and one or more of these have been the gold standard for many years. A widely accepted treatment is endoscopic laser total arytenoidectomy. However, vocal results are usually poor. Objective : To evaluate the effect of treatment of endoscopic laser medial partial arytenoidectorny for bilateral vocal cord paralysis Material and Methods : We performed endoscopic medial partial arytenoidceomy with $CO_2$laser for 3 patients with bilateral vocal cord paralysis. The $CO_2$laser is operated with a continuous 7-watt beam in superpulse mode. We compared degree of dyspnea and glottic area of pre-operation with those of post-operation for 3 patients. We analysed aerodynamic study pre-operatively and post-operatively for 1 patient. Results The symptom of dyspnea was improved markedly and the glottic area was widened from 34% to 50% compared with that of pre-operation. The voice quality was slightly decreased. Tracheotomy was not necessary for not-tracheotomized patient and decanulation was possible for tracheotomized patient post-operatively. Cunclusion: The endoscopic laser medial partial arytenoidectomy is a convient and effective method for opening the posterior glottic airway.

역류성 후두염의 증상을 가진 환자에서의 24시간 이중 탐침 식도 산도 측정

남순열,박선태,정훈용 대한기관식도과학회 1997 大韓氣管食道科學會誌 Vol.3 No.1

The term laryngopharyngeal reflux (LPR) refers to the backflow of food or stomach acid back up into the larynx (the voice box) or the pharynx (the throat). Esophagopharyngeal reflux is suggested as an etiologic factor in laryngeal disease. To examine a possible esophageal basis for laryngopharyngeal symptoms, we studied 48 patients with persistent laryngopharyngeal symptoms, and 12 relative control subjects. Patients were evaluated for cervical symptoms by questionnaire and underwent gastrofiberoscopy, fiberoptic laryngoscopy, esophageal manometry and 24-hour ambulatory double-probe pH monitoring. We found LPR in fourteen out of 48 patients with cervical symptoms (29%). The LPR group consisted of nine men and five women. The symptoms that LPR patients complained were throat lump sensation, hoareness, sore throat, throat clearing, chronic coughing and dysphagia in order of frequency, and they were not different significantly from non-LPR patients. The laryngoscopic findings in LPR patients were posterior erythema, laryngeal edema and diffuse erythema, and there was also no significant difference between LPR group and non-LPR group. There was statistically significant correlation between LPR and gastroesophageal reflux (GER). We concluded that there is no pathognomonic symptoms or laryngoscopic findings in diagnosis of LPR, and 24-hour ambulatory double-probe pH monitoring is an essential diagnostic tool in LPR.

원발성 악성 기관 종양 3례

고중화,전영명,신상준,주희재 대한기관식도과학회 1997 大韓氣管食道科學會誌 Vol.3 No.1

The rarity of primary tumor of the trachea, which was recently estimated in a circumscribed population to be 2.7 new cases per million per year, explains the relatively limited experience that has been acquired even by major institutions. Although there may already by a high degree of airway obstruction, tracheal tumors are usually misdiagnosed as bronchial asthma or chronic bronchitis because of its nonspecific symptoms. Surgery is the treatment of choice. Recently, the authors experienced three cases of primary tracheal malignant tumors ; one case of mucoepidermoid carcinoma and two cases of adenoid cystic carcinoma. The authors report on these cases with a review of the literature for give help in differential diagnosis and treatment planing of tracheal tumor.

경구개에 발생한 거대 다형성 선종 1례

김용우,정용재,김희규 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.1

Pleomonhic adenoma, the most common of the benign salivary gland tumor, is called benign mixed tumor. The tumor was first described by Kaltschmied in 1725 and clinically systematized by Bilroth in 1859. Most pleomorphic adenoma arise in major salivary glands. However, their development in minor salivay glands of the oral cavity, pharynx, paranasal sinuses, and in skin and lacrimal glands is well known. The palate is the most common site of origin of pleomorphic adenoma in minor salivary gland. Recently the authors have experienced a case of the huge pleomorphic adenoma of the hard palate in a 70 years old woman. This is the report of a case with review of literature.

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.

경부에 발생한 Castleman씨 질환 2례

김광문,김명상,박국진,전희선 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.1

Castleman's disease was originally described as a localized mediastinal lymph node enlargement characterized by angiofollicular hyperplasia and intrafollicular capillary proliferation, with surgical removal of mass the only treatment required. It has been divided into two distict histologic types. The hyaline-vascular type is more common and characterized by small hyaline-vascular follicles and interfollicular proliferation. The plasma-cell type is occurred less frequent and more likely to present with constituitional symptoms. It commonly involves the mediastinal and pulmonary lymph nodes, with neck involvement in only 15% to 20% of cases. We report two cases of hyaline-vascular type of Castleman's disease located in the neck area with references to recent literature.

공기음영으로 오인될 수 있는 두경부 영역의 관통성 나무이물에 대한 컴퓨터 전산화 단층촬영의 의의

오승철,김찬우,박병훈,강인봉,김선태,장일환,차흥억,이선규 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.1

Retained wooden foreign bodies following penetrating trauma are a difficult diagnostic problem. However, penetrating wooden foreign bodies of head and neck have the potential for misinterpretation or failure to detect such foreign bodies on CT. Given the likelihood that such a miss will result in an abscess or neurovascular injury, we present the method with higher window settings, they had a higher attenuation with a unique striated internal architecture and different Hounsfield numbers readily differentiate air and non-air hypodense material such as fat, or possibly wood. Being aware of the potential appearance of wood, we may also find CT useful in excluding small retained fragments in postoperative patients with persistent symptoms. This article presents two cases in which wooden foreign bodies of head and neck were present with CT evaluation.

Neurasthenic Laryngomalacia에서 의 Laser Aryepiglottoplasty의 적용 1례

김영모,조정일,최종철,한창준 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.1

Laryngomalacia is the most common cause of inspiratory stridor and varying degrees of airway obstruction in infants but rarely occurs in children or adults. However, acquired airway obstruction would be developed due to the presence of redundant mucosa in the aryepjglottic folds similar to that seen in congenital laryngomalacia after central nervous system damage. To this condition, the term“Neurasthenic Laryngomalacia”is applied. We have recently experienced a case of neurasthenic larygomalacia, which has been managed by laser aryepiglottoplasty with good result. We report management and outcome of this patient with a review of the literatures.