• Title/Summary/Keyword: 폐쇄기

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Surgical Treatment of Esophageal Atresia with Tracheoesophageal Fistula -4 Cases Report- (기관식도루를 동반한 식도폐쇄의 외과적 치료 4례)

  • 김용성;이서원
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.466-471
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    • 1996
  • Esophageal atresia with tracheoesophageal fistula is a common form of congenital malformation of the esophagus, which was usually overlooked during the physical examination after delivery. The first report of esophageal atresia with tracheoesophageal fistula was done by Thomas-Gibson in 1696. We have performed primary repair by extrapleural approach through the right 4th intercostal space in 4 cases of congenital esophageal atresia with distal racheoesophageal fistula. End to end anastomosis was performed by Haight method in all cases. Postoperatively, two patients showed severe stenosis and one patient showed mild stenosis at the anastomotic site. Ballots dilatation was performed two cases with severe anastomotic stenosis.

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Overview of Biliary Atresia (담도폐쇄증의 개요)

  • Tae Yeon Jeon
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.979-990
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    • 2022
  • Biliary atresia is a progressive, idiopathic, obliterative disease of the extrahepatic biliary tree that presents with biliary obstruction in the neonatal period. It is the most common indication for liver transplantation in children. If untreated, progressive liver cirrhosis leads to death by two years of age. Nowadays, more than 90% of biliary atresia patients survive into adulthood with the development of Kasai portoenterostomy and liver transplantation technology. Early diagnosis is critical since the success rate of the Kasai portoenterostomy decreases with time. This study comprehensively reviews the recent advances in the etiology, classification, prevalence, clinical manifestations, treatment, and prognosis of biliary atresia.

Interpretation of Bronchodilator Response in Patients with Obstructive Airway Disease (폐쇄성 기도 질환자에서 기관지 확장제 반응에 대한 평가)

  • Choi, Hee-Jin;Kim, Ki-Bum;Cho, Young-Bock;Cho, Ihn-Ho;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.332-341
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    • 1995
  • Background: Measurement of bronchodilator response is necessary to establish reversibility of airflow obstruction that was helpful to estimate the diagnosis, treatment, and prognosis in obstructive airway disease. An useful index should be able to detect the bronchodilator response more sensitively not related with degree of airflow obstruction and also be independent of initial $FEV_1$. Method: Sensitivities of bronchodilator response in each group classified by degree of airflow obstruction in $FEV_1$, FVC, $FEF_{25\sim75%}$, Isovolume $FEF_{25\sim75%}$, sGaw were studied and correlation coefficients were calculated between initial $FEV_1$ and reversibilities expressed as absolute, %initial, % predicted, %possible in $FEV_1$. Result: Sensitivities of bronchodilator response were 61.5% in FVC, Isovolume $FEF_{25\sim75%}$ and sGaw, in severe group, and 56.3% in Isovolume $FEF_{25\sim75%}$ and sGaw, in moderate group, and 62.5% in $FEV_1$ and sGaw and 50.0% in FVC and Isovolume $FEF_{25\sim75%}$, in mild group, and 60.0% in sGaw and 58.0% in Isovolume $FEF_{25\sim75%}$ in total patients. Correlation coefficients between initial $FEV_1$(L) and absolute, % initial, % predicted, % possible were 0.15, -0.22(p<0.05), 0.02, 0.24(p<0.05) and correlation coefficients between initial $FEV_1$(% predicted) and absolute, % initial, % predicted, %possible were 0.06, -0.28(p<0.05), 0.08, 0.39(p<0.05). Conclusion: Volume related parameters were more sensitive index not related with degree of airway obstruction and the change in $FEV_1$ expressed as % predicted was the least dependent on initial $FEV_1$ and reversibilities, expressed as % initial or as % possible(predicted minus initial $FEV_1$)were correlated with initial $FEV_1$.

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어려운 기도 관리: 후두 상부의 기도 폐쇄

  • 성명훈
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.112-112
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    • 2003
  • 호흡곤란에 대한 적절한 대처는 의사로서 숙지하여야 할 가장 중요하고도 기본적인 개념 중의 하나이다. 상부 기도에 발생하는 여러 가지 임상적 상황은 흔히 흡기성 천명을 동반하는 호흡 곤란으로 나타나고, 이에 대해 흔히 기도 삽관이나, 기관절개술 등이 행해 지지만, 그 발생 원인에 대해서 감별점들을 숙지하지 않으면, 원발 질환에 대한 합리적인 치료 뿐만 아니라 응급상황에서 적절하게 기도를 확보하는 데에도 문제가 생길 수 있다. 후두 상부에 일어나는 기도폐쇄의 상황은 비강에서부터 인두와 성문 상부, 식도 입구부에 이르는 해부학적 위치에 발생하는 다양한 질환들에 의한다. 비강과 비인두에는 pyriform aperture stenosis, choanal atresia, lacrymal duct cyst, 또는 teratoma나 encephalocele과 같은 질환이 발생할 수 있다. 구강, 인두부에서는 다양한 종류의 안면골격의 이상이나 설거대증, 또는 설갑상선, 갑상설관낭종, 또는 유피종등이 설기저부에 발생하기도 하고, 흔한 이유로 심한 편도-아데노이드 비대가 심각한 호흡곤란을 일으키기도 한다. 특히 소아에서는 이물의 가능성도 항상 염두에 두어야한다 이와 같이 기도 협착의 위치에 따라서 임상적 표현 양상이 구별될 수 있고, 또 부위에 따라 다양한 질환이 감별되어야 하므로 발생 위치에 따른 각 질환의 이해가 적절한 기도의 관리를 위해서 필수적이다.

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Coexistence of Bronchial Atresia and Bronchogenic Cyst -A Case of Report- (동반된 기관지 폐쇄와 기관지성 낭종 - 1례 보고 -)

  • 이장훈;이정철;한승세;이동협;정태은
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.73-76
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    • 1998
  • We report very rare case of concurrent bronchial atresia and bronchogenic cyst. Morphologic apical segment of right upper lobe directly stemmed from right main bronchus. Bronchogenic cyst was communicating with atretic segmental bronchus and both were filled with mucus. The etiology is not well known, however it is likely that a single insult arround the 5th∼6th week causes both malformations.

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Lip Closing Force and the Related Factors in Elementary School Children (초등학교 어린이의 평균 구순폐쇄력과 이에 영향을 미치는 요소)

  • Lee, Haney;Baek, Kyounghee;Kim, Jaegon;Lee, Daewoo;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.4
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    • pp.343-352
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    • 2019
  • Abnormal orofacial functions such as lip incompetency in the period of growth and development can cause morphological anomalies of the craniofacial complex. Therefore, it is crucial to make an early diagnosis based on the evaluation of the myofunctional conditions, and to make appropriate treatment plans. The objectives of this study were to quantitatively evaluate the standard lip closing force (LCF) of each age in the elementary school children, and to evaluate the relationships between LCF and affecting factors. The sample consisted of 765 children who were 7 - 12 years old in Jeonju city. Clinical examination about occlusal conditions and lip competency, and LCF measurement were performed by a single examiner. LCF was measured three times for each children with the LCF measuring device. The LCF was correlated positively with age in both sexes. The distribution of LCF groups was correlated significantly with Angle's classes and lip competency (p = 0.016, 0.004). The proportion of children with high LCFs was greater in the "competent lip" group, whereas the proportion of those with low LCFs was greater in the "incompetent lip" group.

Role of Dacryoscintigraphy in the Diagnosis and Treatment of Pediatric Patients with Epiphora (유루를 호소하는 소아 환자의 진단 및 치료에서 누비공신티그라피의 역할)

  • Jeong, Hwan-Jeong;Bom, Hee-Seung;Song, Ho-Cheon;Min, Jung-Jun;Kim, Ji-Yeul;Jeong, Sang-Ki;Park, Yeoung-Geol
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.362-367
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    • 1999
  • Purpose: We conducted this study to evaluate the role of dacryoscintigraphy in the diagnosis and treatment of pediatric patients with epiphora. Materials and Methods: In 58 patients aged from 2 months to 15 years (mean age $2.8{\pm}2.3$ years), dacryoscintigraphy was performed using a gamma camera with 4 mm pinhole collimator. We correlated symptoms with dacryosicntigraphic findings in all patients. In 37 patients who underwent ophthalmologic procedures, we analyzed the agreements of dacryoscintigraphic findings with the operation. Results: High rates of agreements between epiphora and obstruction on dacryoscintigraphy (69/72, 95.8%), and between scintigraphic obstructive findings and operation sites (44/47, 93.6%) were noted. Nine of foully-four (20.5%) asymptomatic eyes showed obstructive findings on dacroscintigraphy. Conclusion: In pediatric patients with epiphora, dacryoscintigraphy is a useful tool not only in diagnosing nasolacrimal duct obstruction but also in making a decision for therapeutic procedures.

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Analysis of Vegetation Structure with The Types of Abandoned Channels in The Mangyeong River (만경강 폐천 유형별 식생구조 분석)

  • Kim, Eun-Jin;Hong, Il;Yeo, Hong-Koo;Cho, Kang-Hyun
    • Proceedings of the Korea Water Resources Association Conference
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    • 2009.05a
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    • pp.2023-2027
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    • 2009
  • 본 연구는 현재와 과거의 하도 지형자료 분석을 통하여 만경강에서 나타나는 폐천(Abandoned channel)을 파악하고, 유형을 폐쇄형, 개방형, 육화형 폐천으로 구분하여 각각의 본류구간과 함께 식물상 및 식생분포 특성을 비교하였다. 만경강의 경우 1918년 하도 형태가 경지정리 및 치수사업에 따른 제방축조 등 인위적인 절단(Engineered cutoff)으로 8개소 이상의 구간에서 하도 선형이 크게 변경됨으로써 폐천이 형성되는 것으로 나타났다. 현재 폐천부지는 육화형태의 농지 이용 및 개방형 또는 폐쇄형의 습지로 유지되는 것으로 조사되었다. 폐천 유형에 따라 나타난 식물상은 폐쇄형 56종류, 개방형 31종류로 조사되었다. 육화형의 본류의 경우 보에 의한 영향으로 달뿌리풀 (Phragmites japonica)과 저수로 검정말(Hydrilla verticillata) 등의 수생식물이 우점하는 정체수역이 나타났다. 개방형 폐천은 갈수기에도 수심이 깊은 수역이 확보되어 본류에 비하여 출현종수가 높았다. 폐쇄형 폐천은 연꽃(Nelumbo nucifera), 애기부들(Typha angustifolia) 등의 다양한 수생식물이 출현하여 본류에 비해 안정된 습지 생태계를 유지하였다. 만경강의 개방형과 폐쇄형 폐천은 수생식물의 증가와 전형적인 습지생태계를 유지하고 있었으며 본류의 정체수역이 관찰되었다. 본래 하천의 연속성을 향상하기 위한 유수생태계의 복원은 하천의 건강성을 향상하기 위한 방안이 될 것이다.

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A Case of Localized Subaortic Stenosis Associated with Aortic Regurgitation (대동맥판폐쇄부전을 동반한 국소성)

  • 김삼현;서필원
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.780-784
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    • 1996
  • The localized form of subaortic stenosis shows a spectrum of pathological lesions varing from dis- crete membrane to a thickened flbromuscular collar. Aortic valve is commonly involved late in the pro- cess resulting in regurgitation. Because of the likelihood o the progressive obstruction and aortic regurgitation, early elective oper- ation should be considered for the patient with subaortic stenosis. We experienced a case of localized fibromuscular subaortic stenosis associated with aortic regurgi- tation. Excision of the fibromuscular ridge and septal myectomy-myotomy relieved the subaortic seen- osis. Regurgitant aortic valve was repaired by peeling away the Hbrotic tissue on the cusps and subcommissural annuloplasty at the each commissural area. On postoperative echocardiographic examination, the systolic pressure gradient between left ventricle and aorta decreased markedly and the aortic regurgitation was not detected at all.

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