• Proceedings of the KTCVS Conference
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• 1996.10a
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• pp.87-87
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• 1996

• 보건세계
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• v.43 no.12 s.484
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• pp.4-9
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• 1996

기도가 협착되어서 증상을 일으키는 질환으로 만성기관지염, 폐기종, 만성폐쇄성질환, 기관지천식 등이 있으며, 기침, 가래, 호흡곤란(숨참)등이 주요 증상인데 비의료인에게는 해소천식으로 더 잘 알려져 있다. 일반적으로 기침 가래가 나오고 숨이차면 해소천식이라고 하는데 실제로 이 만큼 오용되고 남용되는 단어는 드물 것이다. 동의보감에 의하면 해수(해소의 원명)는 기침을 말하는데 해는 가래가 없이 소리가 심한 경우이고 수는 가래를 주로하는 기침을 말하며 16가지 종류로 구분된다. 천식은 숨이 찬 증상을 말하는 것으로 8가지 종류로 구분되어 있다. 따라서 해소천식은 기침가래가 나오고 숨이 찬 증상을 말하는 것으로 특정질환을 말하는 병명이 아니다. 비의료인이 말하는 천식의 경우에는 숨이 찬 증상을 말하는 것이고 의료인이 천식이라고 할 경우에는 특정 기도질환인 기관지 천식을 말하는 것이므로 서로 오해하기가 쉽다. 실제로 일간지 건강상식란에 천식을 소개하였는데 의사는 병명으로서의 기관지천식을 설명하였고 동참한 한의사는 증상으로서의 천식을 설명하여 혼란을 일으켰던 예가 있었다. 한의학에서는 예전에 기관지천식은 효천(孝喘)이라고 부르고 천식의 증상이 심하고 위중한 상황일 때에는 천급(喘急)이라고 하여 한의학에서도 구별하였는데 도리어 현대에 와서 정확성이 없어지고 모호해진 이유는 무엇일지 궁금하다. 폐쇄성기도질환은 기도가 좁아지는 기전과 기도폐쇄의 가역성(기도가 정상으로 회복되는지)여부에 다라서 가역성폐쇄질환인 기관지천식과 비가역적인 만성폐쇄성기도질환으로 구분하고 있다.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1237-1241
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• 1997

Tracheal stenosis is a difficult disease entity to manage. Laser ablation is one effective treatment for treacheal stenosis and can be utilized if tracheal reconstructive surgery is impossible. Potassium titanyl phosphate laser, transmitted via flexible quartz fiber, can be precisely manipulated through flexible bronchoscope under local anesthesia. We treated 7 patients with trach al and broncheal lesion under local anesthesia with KTP laser from January 1995 to July 1996. The patients included three males and four females. The age of patients ranged from 22 to 66 years with a mean of 43.7 years The etiology of tracheal stenosis in patients was stenosis after tracheostomy(3 cases), prolong inturbation in cases of sepsis(1 cases), and the recurrence of lung cancer within endobronchial lesion(2 cases). In the cases of tracheal stenosis treated with laser ablation, there were 2 cases of recurrence of stenosis at the anastomosis site after the operation, 3 cases of stenosis at tracheostomy site, and 2 cases of local recurrence of lung cancer. The site of the tracheal stenosis was the balloon site of the tracheostomy tube(3-4cm inferior to the tracheostomy site, 2-3cm superior to the carina) and the anastomosis site that were narrowed to less than 5mm(4 cases). For the stenosis lesion in the endobronchial area, there were 2 patients with a lesion at the anterior wa l, 1 patient with a lesion at the posterior wall, 2 patients with circumferential stenosis. Laser ablation time was 25.4 $\pm$5.9min and used energy was 1768 $\pm$365J. We have used KTP laser via (lexible bronchoscope without major complications. Adjuvant radiation therapy may prevent fibroblast proliferation which leads to restenosis. In three patients of restenosis after laser ablation, adjuvant irradiation started within 4 hours after laser ablation, and the radiation doses were 1500cGy given in five fraction. In patients with adjuvant radiation therapy, stenosis has not recurred

• Journal of Chest Surgery
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• v.36 no.10
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• pp.789-793
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• 2003

Primary pulmonary angiosarcomas are extremely rare tumors. The diagnosis is often delayed due to nonspecific symptoms, mimicking pulmonary embolism and require careful clinical evaluation to exclude metastasis from the heart, pericardium, and distant extrathoracic sites. Most diagnosis are made postmortem. We report a case of primary pulmonary angiosarcoma histopathologically confirmed postoperatively, which was clinically suspected endobronchial carcinoma with endobronchial obstruction with relavant literature review.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.439-443
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• 2003

A lower laryngeal and upper tracheal stenosis that is of idiopathic origin is occasionally seen. It is called an idiopathic tracheal stenosis. These circumferential fibrous stenosis is rare and they are most often located in the subglottic larynx and extend to varying distances predominantly in young women. Because of the unknown nature of the disease process and uncertainty about its future progression, patients were approached conservatively. Recently, surgical resection and reconstruction have been increasingly performed, as favorable results were obtained. Three female patients with dyspnea were admitted. For two patients, they were diagnosed this conditions as bronchial asthma by mistake. All patients were performed computed tomography and bronchoscopy. For two patients with subglottic stenosis, subglottic resection was performed by cervical collar incision, and for the other one patient with distal tracheal stenosis, tracheal resection was performed by right posterolateral thoracotomy. A diagnosis of idipathic tracheal stenosis was confirmed by postoperatively pathologic finding. For one case, because of anastomosis site infection and restenosis, a whole tracheal exposure was performed by cervical collar incision and median sternotomy. And reoperation was peformed successfully.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.248-250
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• 1996

Congenital esophageal stenosis due to tracheobronchial remnant is very rare disease entity and usually occurs in mid and lower esophagus. The cause is esophageal sequestration of a tracheobronchial anlage before embryologic separation. A 4 years old girl was admitted with swallowing difficulty, food regurgitation which progressively got worse in recent 2 years. She was operated under the dagnosis of achalasia. During the myoto y procedure we found the bean sized hard nodular mass, which was 4cm above the esophagogastric junction, and after the resection of mass, esophagoplasty was carried out. The histologic finding of the mass revealed traheal cartilages and respiratory glands.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1090-1096
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• 2002

Purpose : We evaluated the clinical manifestations, bronchoscopic findings and therapeutic effects of flexible fiberoptic bronchoscopy in atelectasis of children. Methods : Sixty six children who received bronchoscopy due to persistent atelectasis, acute severe atelectasis and incidental atelectasis on plain chest radiography were studied retrospectively. Results : The most common causative underlying disease was pneumonia(60.4%). Other underlying conditions were pulmonary tuberculosis, chronic lung disease, postoperative state, bronchial asthma and chest trauma. The most common abnormal findings were inflammatory changes such as bronchial stenosis(n=15), mucosal edema and large amount of secretion(n=14), granulation tissue( n=3) and mucus plug(n=3) although 39.4% showed normal airways. Other findings were congenital airway anomalies, endobronchial tuberculosis, extrinsic compression and obstruction by blood clot. In 32 children with pneumonia-associated atelectasis, 43.7% revealed normal airways, and the most common abnormal findings were also inflammatory changes. Eighteen out of 39 patients who received therapeutic intervention such as suctioning of secretion, bronchial washing and intrabronchial administration of N-acetylcysteine($Mucomyst^{(R)}$) had complete or partial resolution of their atelectasis. In 32 patients with pneumonia-associated atelectasis, 56.5% showed improvement by therapeutic intervention. Conclusion : In this study, atelectasis was mainly associated with inflammatory airway diseases such as pneumonia. The most common abnormal bronchoscopic findings were inflammatory changes such as mucosal edema and large amounts of secretion and bronchial stenosis, although about 40% revealed normal airway. Flexible bronchoscopy is helpful for either diagnosis or treatment, especially in pneumonia-associated atelectasis.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2005.09a
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• pp.32-32
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• 2005

• Proceedings of the KTCVS Conference
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• 1993.06a
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• pp.111-111
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• 1993

• Journal of Chest Surgery
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• v.36 no.11
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• pp.874-877
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• 2003

Necrotizing bronchial aspergillosis usually occurs in the immumocompromised host. Aspergillus invades bronchial epithelium and forms endobronchial mass or endobronchial stenosis. A 78-year-old male patient with diabetus mellitus complaining of dyspnea and cough was admitted to our hospital. Plain chest X-ray and chest computed tomogram showed a large endobronchial mass and total collapse of left upper lobe of the lung. Bronchoscopic biopsy of the endobronchial mass revealed chronic inflammation. To confirm the endobronchial mass, we performed sleeve lobectomy of left upper lobe of the lung. Histologically the mass was diagnosed as necrotizing bronchial aspergillosis. We report a case of necrotizing bronchial aspergillosis in an elderly man who has diabetus mellitus with review of the literature.