• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.307-312
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• 1997

Reconstruction of the pharyngoesophagus is one of the most difficult challenges in head and neck surgery. The goals of pharyngoesophageal reconstruction include restoration of a person's ability to swallow and to speak with minimal morbidity, but no current reconstruction modality is clearly best. Following its first introduction as fasciocutaneous flap by Yang in 1981, the forearm flap based on radial artery has become recognized as a very reliable and relatively easy one to use. The forearm flap has thin, pliable and predominantly hairless skin and scant subcutaneous layer In addition, its vascular pedicle is long and of large caliber, which greatly increases the chance of successful revascularization. The forearm flap shows the potentiality for better functional rehabilitation in swallowing and speech as well as the possibility of three dimensional reconstruction. We experienced a case of radial forearm free flap for the reconstruction in a patient with the hypopharyngeal stricture. The early return of oral feeding was possible and successfully enough to return to the normal daily activity.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1995.04a
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• pp.89.1-89
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• 1995

근래에 장기간 보조 호흡이 많아지고 사고로 인한 기관손상이 증가함에 따라 기관 협착증의 빈도가 증가하고 있다. 기관 재건술에 사용하는 여러 조직 중에서 연골막은 유연하고 신생연골을 생성할 수 있으며 감염에 저항성이 있고 점막화가 빨라 이상적인 조직으로 알려져있다. 저자들은 실험동물로 각각 10마리의 가토를 사용하여 유리자가 이개연골막과 혈관경을 가진 자가이개 연골막을 이용한 기관재건술을 시행하고 8주후에 신생연골 형성능력을 정량적으로 비교 분석하여 다음과 같은 결과를 얻었다. 1) 기관 결손 부위는 두 실험군 모두에서 잘 재건되었다. 2) 이개연골막은 기관 결손을 재건하는데 유용한 조직임이 확인되었다. 3) 유리자가 이개연골막 이식군에서는 평균 0.15mm의 신생연골을 생성한 반면 혈관경을 가진 자가이개 연골막 이식군에서는 평균 0,45mm를 생성하여 더욱 효과적이었다.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.148-153
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• 1997

Laryngotracheal stenosis is one of the most troublesome diseases in the Em field. Subglottic stenosis can be treated by a cricoid augmentation with rib cartilage. In case of tracheal stenosis, the treatment of choice is by tracheal end-to-end anastomosis after resection of the stenotic site. However, in case of subglottic stenosis combined with tracheal stenosis, it is hard to manage. Even though several methods(such as thyrotracheal anastomosis) have been tried, they have some limitations too much excision of normal trachea and too much pulling up of the trachea after resection of the stenotic lesion. The authors have managed two cases of laryngotracheal stenosis as an anterior and posterior subglottic augmentation with an autologous cartilage graft and laryngotracheal anastomosis. The first few weeks after the operation, we could do a decannulation successfully, but in one case the patient developed restenosis. Even though one case was unsuccessful, the authors believe that this method could be used in the treatment of laryngotracheal stenosis.

• Proceedings of the Korean Society of Disaster Information Conference
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• 2022.10a
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• pp.155-157
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• 2022

기존의 안전교육 교수방법은 강의 방식으로 전달하고 있어 근로자의 참여를 이끌어내는데 한계점이 있으며, 불안전한 행동에 의한 안전사고를 예방하기 위해서는 스마트 체험식 안전교육으로 패러다임을 전환할 필요성이 있다. [연구배경/목적]:스마트 체험식 안전교육은 건설현장에서 근로자들이 보다 더 빠르게 위험을 인지하고 여기에 맞는 안전작업 이행과 위험발생 시 응급대처 능력 등을 향상시키므로 사전사후 학습전이의 효과성을 검정할 수 있다. 이러한 관점에서 안전사고를 예방하기 위한 본 연구는 안전교육의 체험학습방법과 참여방법, 교육콘텐츠 접근방법을 통하여 근로자의 안전행동 유도와 불안전행동 감소에 미치는 영향검증이 목적이다. [연구방향/범위]:실제 건설현장과 동일하게 작업환경을 구성해 놓은 스마트 체험식 안전교육시설에서 추락체험, 낙하물체험, 장비협착체험, 화재, 감전재해 등의 실제 사고를 체험해 볼 수 있도록 만들어진 체험학습 방법과 가상(VR, AR, 메타버스)공간에서 간접경험 할 수 있는 참여방법을 다룰 것이다. 그리고 안전체험교육 사전사후의 분석을 통하여 안전 학습전이 성과를 분석한다. [연구 분석방법]:연구의 주요 변인으로는 Human-Error, 안전행동요인, 불안전행동요인, 위험감수성, 조직특성, 조직의 안전문화, 조직의 역량, 안전교육특성, 교육콘텐츠 변화가 사전사후 분석을 통하여 현장 작업 시 안전 학습전이의 효과성을 검정하였다.

• Korean Journal of Bronchoesophagology
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• v.13 no.2
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• pp.50-56
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• 2007

Background and Objectives: Laryngotracheal stenosis and its reconstruction in children is a highly challenging field to airway surgeons, and the way of stenting after a reconstructive surgery is still controversial. The aims of this study were to analyze the single institutional experiences of laryngotracheal reconstruction (LTR) in the pediatric patients with laryngotracheal stenosis and to compare the outcomes of single-stage LTR (SSLTR) with conventional two-stage LTR (TSLTR) in these patients. Materials and Methods: Medical records of 14 children (mean age 4.1 years) were reviewed, who received 20 LTR including 6 revisions for their moderate to severe subglottic stenosis and/or combined posterior glottic stenosis. Of these 20 LTR, tracheostoma was temporarily maintained after LTR in 12 cases (TSLTR) or not in the other 8 cases (SSLTR). Results: Overall decannulation rate of LTR that were performed before and after the year of 2003 was 40% (4/10) and 70% (7/10) respectively. Decannulation rate was 42% (5/12) in TSLTR group and 75% (6/8) in SSLTR group (P = 0.197). Mean interval to decannulation after LTR was 9.8 months and 7.2 days in TSLTR and SSLTR groups respectively (P = 0.004). A number of additional touch-up procedures that were required after LTR was 4 in TSLTR and 2.7 in SSLTR group (P = 0.238). Major complication rate was similar in both groups (33% in TSLTR and 38% in SSLTR, P = 0.910). Conclusion: A laryngotracheal reconstruction in children is a technically demanding procedure and its outcome is largely dependent on the surgeon's experience. Albeit there was a tendency that SSLTR ofters a higher decannulation rate, less additional touch-up procedures and similar complication rates, a shorter interval to decannulation after LTR was the only advantage that was confirmed as statistically significant in this study.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.9.2-9
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• 1982

The incidence of decannulation difficulty included tracheal stenosis has markedly increased in recent years because of translaryngeal intubation and tracheostomy although advancing antibiotics and new treatment for these problems. Treatment has always been difficult but in mild cases, a new soft, flexible tracheal T-tube that designed to maintain an adequate tracheal airway as well as to provide support in the reconstructed trachea and in severe cases, transverse resection with subsquent end to end anastomosis has been used in recent years. Authors experienced 2 cases of tracheal stenosis and decannulation difficulty which developed after tracheostomy that was performed due to automobile accident and fall down respectively and using a silicone tracheal T-tube for 3 months good results were obtained. So authors reported with brief review of literatures.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.43-46
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• 2008

Hypophayngeal cancers are usually diagnosed in advanced stages and in many cases, they need total pharyngocervical esophagectomy and surgical reconstruction. Among many surgical reconstructive methods, jejunal free flap has anatomical and functional advantages such as tubed nature, peristaltic activity, excellent blood supply. In this study we analysed the surgical procedure and complications of jejunal free flap after total pharyngo-cervical esophagectomy. 20 cases performed jejunal free flap from 1995 to 2007 at Severance Hospital were reviewed. According to time of onset, early and late complications were reviewed. Surgical procedure was reviewed with operation record. Oral diet tolerance was reviewed on the basis of pharyngogram and subjective symptoms. The most common complication was stricture, and it occurred in 40% of cases and 63% of them were managed with conservative care. As early complication, fistula formation was all managed with conservative care. Oral feeding tolerance after jejunal free flap was 65% and 7 patients were tolerable to general diet. In our study, stricture was the most common complication and its management is important in post op oral diet tolerance.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.3.3-4
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• 1981

We have observed foreign body in food and air passage in 138 cases during the period from Jan. 1972 to Dec. 1980 in E.N.T. department of Kyung Hee university hospital. The following results were obtained. 1) Age distribution was predominent in under 5 years old showing 102 cases (73.9%). 2) Distribution of location was 132 cases in food passage and 6 cases in air passage. 3) In food passage, malewas 81 cases (61.4%). In air passage, male was 4 cases(66.7%). 4) Coin was the most frequent foreign body in food passage. Others were metals, meats, bony pieces, and shell. 5) Distribution of lodgement was frequent in first narrowing of esophagus. 6) Duration of lodgement was 112 cases (84.8%) within 24 hours in food passage and 4 cases (66.7%) within 24 hours in air passage.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1117-1120
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• 1997

Ten cases with esophageal foreign body were treated surgically from July 1980 to October 1995 at the Departme t of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The mean age was 45.3 years, with a range from 25 to 71. Out of ten cases, 6 were female and four were male. Common symptoms were dysphagia, fever, foreign body sensation and neck pain. Three cases of foreign bodies were of fish bones, two of bubble paclcage of drugs, one case of a Eeer bottle cap, one of a piece glass, one of a bathtub plug, one of chicken and one of a bean. The diagnosis was established by esophagography using a water soluble contrast material and esophagoscopy. Among of ten cases, two had esophageal stricture due to the ingestion of Aye at a young age. One case had experienced psychological problems. All foreign bodies were removed by surgical procedures. Five cases were treated by cervical esophagostomy, one case by right thoracotomy, one case by retrograde bougienation through gastrostomy and two cases by cervical incision and drainage for cervical abscess. Three cases developed pos operative esophageal leaks which healed spontaneously and transient hoarseness developed in one case. One case developed traumatic pneumothorax and subcutaneous emphysema which was treated by closed thoracostomy. There were no operative deaths. C(ocean J Thorac Cardiovasc Surg 1997;30:1117-20)

• Journal of the Korea institute for structural maintenance and inspection
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• v.28 no.2
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• pp.1-8
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• 2024

The expansion joint is installed to offset the expansion of the superstructure and must ensure sufficient gap during its service life. In detailed guideline of safety inspection and precise safety diagnosis for bridge, damage due to lack or excessive gap is specified, but there are insufficient standards for determining the abnormal behavior of superstructures. In this study, a data-based maintenance was proposed by continuously monitoring the expansion-gap data of the same expansion joint. A total of 2,756 data were collected from 689 expansion joint, taking into account the effects of season. We have developed a method to evaluate changes in the expansion joint-gap that can analyze the thermal movement through four or more data at the same location, and classified the factors that affect the superstructure behavior and analyze the influence of each factor through deep learning and explainable artificial intelligence(AI). Abnormal behavior of the superstructure was classified into narrowing and functional failure through the expansion joint-gap evaluation graph. The influence factor analysis using deep learning and explainable AI is considered to be reliable because the results can be explained by the existing expansion gap calculation formula and bridge design.