• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.297-305
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• 2017

Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation. If the general method of intubation was expected to be difficult, awake intubation was performed. The degree of nasal bleeding during intubation was also evaluated. Results: The mean age of the operators (11 men, 7 women) was 27.8 years. FNI was performed in a total of 716 patients. The success rate was 88.3% for the first attempt and 94.6% for the second attempt. The failure rate of intubation in anesthetized patients was 4.9%, and 13.6% in awake patients. When intubation was performed in anesthetized patients, the failure rate from the first to fifth trial was 9.6%, which decreased to 0.7% when the number of trials increased to > 30 times. In terms of awake intubation, there was no failed attempt when the resident had performed the FNI > 30 times. The number of FNIs performed and nasal bleeding were important factors influencing the failure rate. Conclusion: The success rate of FNI increased as the number of FNI performed by residents increased despite the nasal bleeding.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.53-67
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• 2005

It is known that Korean stop consonants in syllable-initial position are of three types : lax, aspirated and forced (or unaspirated). In syllable-final position, however, these three different types are merged to a single type with the same place of articulation, although the original three-way distinction is preserved in Korean orthographic (Hangul) system. Thus the syllable-final stops are phonetically realized as voiceless "applosives" which are characterized by the absence of oral release. The aim of the present study is to investigate the laryngeal adjustments for these syllable-final stops in various phonological conditions by using fiberscope, and, is to further investigate electromyographically the laryngeal adjustments for Korean stops both in the syllable-initial and final positions in various phonological conditions. The results can be summarized as follows : 1. In the case of syllable-initial stops, the glottal widths in each three types of the Korean stops during the articulatory closure are clearly different. And the pattern of thyroarytenoid(VOC) activity appeared to characterize the three different types of Korean stops. 2. The basic laryngeal feature of the Korean syllable-final applosives is characterized by a small degree of glottal opening which begins at or slightly after the oral closure. 3. In the case, syllable-final stop followed by the copula "ita", the syllable- final stop is pronounced as the stop consonant at the initial position of the following syllable containing the vowel[i], the underlying features of three-way distinction for the stops in the Korean orthographic(Hangul) system being manifested at the laryngeal adjustment. 4. In the case of the final applosives followed by the initial stops and fricatives, the laryngeal feature of the final applosives appears to be assimilated by that of the following consonant irrespective of the difference in the place of articulation, as far as the glottal abduction/adduction is concerned. It is clearly demonstrated in the case of syllable-initial stop that thyoarytenoid(VOC) activity is suppressed for the production of the stop consonants in question, the degree of which is slightest for the forced type and most marked for the aspirated type, while it is moderate for the lax type.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.71-76
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• 2001

Purpose: Many diagnostic modalities for neonatal cholestasis have shown features that are helpful, however until recently none of them are not pathognomonic of biliary atresia (BA). We carried out a prospective study of infants with cholestatic jaundice with the aim of establishing an efficient method of diagnosing BA. Methods: Twenty-seven consecutive infants with cholestatic jaundice were enrolled in this study and ranged from 7 to 152 days in age (mean; $51.2{\pm}34.2$ days). Gastroduodenoscopy was carried out using a fiberscope (Olympus N30). All the babies were fasted for at least 4 hours before the procedure and 20 ml of 10% dextrose solution was given at the time of endoscopy. The endoscopic examination focused on the 5 minutes observation of the evidence of biliary secretion. If there was lack of the evidence of the biliary secretion, endoscopy was removed and repeated the examination with some pause. Results: There are lack of the evidence of biliary secretion in all infants with BA. In non-BA group, 8 out of the 10 infants showed biliary secretion on the first trial, however one (Alagille syndrome) of the two infants without evidence of biliary secretion, finally exhibited biliary secretion on the second trial. The above observations resulted in the diagnostic accuracy of 96.3% with 100.0% sensitivity and 90.0% specificity. Conclusion: In light of the results from our relatively small study, endoscopy is a convenient, and relative inexpensive procedure. we strongly support the use of endoscopy for the diagnosis of BA in the screening and evaluation of infantile cholestasis.