• 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.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.799-803
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• 1998

Background: Tumors of the trachea are rare despite their histologic similarity to tumors of the main stem bronchus and lung. Materials and methods: Fourteen patients with tracheal tumor underwent surgical, radiational, or laser photocoagulation therapy from March 1981 to July 1996. Nine patients were malignant and five patients were benign. The most common malignant tumor was adenoid cystic carcinoma. Results: Age ranged from 10 to 65 years with mean age of 45.9 years. Most tumors were located middle and lower one-third of trachea. Surgery was done through collar incision, or collar incision with vertical partial sternal division, or left posterolateral thoracotomy, or sternal division with laryngeal release. Two patients died after operation, because of the disruption of anastomosis and airway obstruction,and laryngeal edema after suprahyoid release. Only one patient died after 8 month of diagnosis. The other patients were doing well during the follow-up period.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.238-243
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• 1995

Sleep Apnea Syndrome is characterized by hypersomnolence, snoring, and sleep apnea. The symptoms of hypothyroidism include apathy, somnolence, lethargy, personality change, and intellectual deterioration and may be related to hypothyroid-related sleep disorders. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A 60-yr-old man was admitted due to hypersomnolence, snoring and generalized edema. Polysomnogram showed obstructive pattern of sleep apnea syndrome. Neck CT scan revealed narrowing of upper airway which is consistent with obstructive sleep apnea syndrome. Physical examination and hormonal study also disclosed the evidence of hypothyroidism. We report a case of sleep apnea syndrome due to primary hypothyroidism with review of literatures.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.384-387
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• 2007

The finding of a tracheal penetrating injury that's caused by a foreign body is rare in adulthood. A 42-year-old man had experienced penetrating trauma due to a glass fragment 10 years ago. He presented with blood tinged sputum and dyspnea on exertion, and this had developed 1 year previously. Chest CT scan and bronchoscopy revealed a foreign body crossing the tracheal lumen and the object arose from outside of the trachea; this was all associated with airway edema. We removed the foreign body, which was a 5cm length of glass fragment, and we repaired the tracheal defect using a simple primary suture. The postoperative course of the patient was uneventful and he is now being followed up at the outpatient department; he has had no additional symptoms.

• The Korea Journal of Herbology
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• v.29 no.4
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• pp.1-8
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• 2014

Objectives : The root bark of Morus alba L. (Mori Cortex Radidus; MCR) has been traditionally used to reduce heat from the lungs, soothe asthma, and edema and to promote urination. In this study, we investigated the effect of MCR ethanol extract on ovalbumin (OVA)-induced allergic asthma in mice. Methods : Mice were sensitized at day 0, 7 and 14 with 0.2% OVA and then airway challenged at day 21, 23, 25, 27 and 29 to induce allergic asthma. MCR extracts at doses of 50 and 100 mg/kg body weight (bw) were orally administered during OVA challenge once per a day. The levels of allergic mediators such as histamine, OVA-specific IgE, IFN-${\gamma}$ and IL-4 were measured in the sera of mice by ELISA. The histopathological change of lung tissues was observed with hematoxylin and eosin (H&E) staining. Results : MCR extract significantly decreased not only the serum levels of histamine, OVA-specific IgE, and IL-4 compared with those of OVA control group, but significantly increased the serum level of IFN-${\gamma}$. In H&E staining, MCR extract inhibited the infiltration of inflammatory cells and bronchiolar damage with epithelial thickening in lung tissues of OVA-induced asthma mice. Conclusions : These results indicate that MCR extract inhibits lung damage by asthma through regulating the allergic immune response, suggesting that MCR may be used as a useful agent for the treatment of allergic asthma.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.253.1-262
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• 1997

Hypothermia during lung preservation decreases metabolic processes. After the rabbit lung was flushed with modified Euro-Collins solution, heart-lung block was harvested and the left lung was assessed after ligation of the right pulmonary artery and right main-stem bronchus. Heart-lung block was immersed in the same solution for 6 hours. The modified Euro-Collins solution and storage temperature of group 1(10 cases) was 4t, roup 2(10 cases) was l$0^{\circ}C$. On completion of the storage period, the left lung was ventilated and reperfused with blood u:high used a cross-circulating paracorporeal rabbit as a "biologic deoxygenator" for 60 minutes. Pulmonary artery pressure, airway pressure, difference in oxygen tension between mow and outflow perfusate and degree of pulmonary edema were assessed at 10-minute intervals while the left lung was ventilated at 0.8 of the inspired oxygen fraction. The mean pulmonary venous oxygen tensions at 10 and 60 minutes after reperfusion were 209.52$\pm$42.46 and 103.48$\pm$ 15.96 mmHg in group I versus 247.78$\pm$36.19 and 147.91 $\pm$ 11.07 mmHg in group II(p=0.049, (0.0001). The mean alveolar-arterial oxygen differences at 20 and 60 minutes after reperfusion were 357. 95$\pm$ 12.84 and 437.31 14.26 mmHg in group I versus 310.88$\pm$3).47 and )90.93$\pm$ 15.86 mmHg in group II (p=0.0092, (0.0001). The mean pulmonary arterial pressures at 10 and 60 minutes after reperfusion were 40.56$\pm$ 18.66 and 87. 2$\pm$ 17.22 mmHg in group I versus 31.22$\pm$6.84 and 65.78$\pm$ 11.02 mmHg in group rl (p : 0.048, 0.0062). The mean pulmonary vascular resistances at 10 and 60 minutes after reperfusion were 2.69$\pm$0.85 and 4.36$\pm$0.86 mmHg/ml/min in group I versus 1.99$\pm$0.39 and 3.29$\pm$0.55 mmHg/ml/min in group II(p : 0.0323, 0.0062). There were no difference between groups in peak airway pressure, lung compliance and degree of pulmonary edema. In conclusion that preservation of lung at l$0^{\circ}C$ was superior to preservation at 4$^{\circ}C$.}C$.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.815-821
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• 2006

Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.931-939
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• 1996

An experimental comparative study was done to determine the protective effects of three preservation solutions on isolated rabbit heart-lung bloc during acute ischemia and reperfusion of the lung during lung transplantation. Thirty Isolated rabbit heart-lung blocs were divided into 3 groups , group I(n:9) was preserved with Hartmann's solution, group II(n: 10) with modified University of Wisconsin solution, and group III(n: 1 1) with Kosin solution. The isolated heart-lung blocs were washed with Hartmann's so ution. Aftar infusion of each preservation solution into pulmonary artery, the heart-lung bloc was stored at 4'c cold preservation solution for each group for 4 hours and .then the heart-lung blocs were reventilated and reperfused. The changes of weight of heart-lung blocs, airway pressure, percent change of PCO2, level of lactate and adenosine deaminase(ADA) and microscopic structure of the lung parenchyme were evaluated. Results were as follows 1. A change of weight of the heart lung bloc after reperfusion was lowest in group 111(p< .05) 2. The airway pressure increased after reperfusion in group I but decreased in group II, and II. Especially in group II, post-reperfusion airway pressure returned to level lower than that of en-bloc resection. 3. Pulmonary artery pressure during reperfusion after 4 hour preservation was lowest in group III, and pulmonary artery pressure in group II was higher than in group I(P> 0.1). 4. The level of lactate and ADA in the lung tissue were higher in group III than in group I and II(P< .05) 5. The percent change of PCO2 in perfusate was slightly higher in group III than group I and II. 6. Microscopic changes in lung tissue after reperfusion were diffuse pulmonary edema, expansion of inter- stitial tissue, focal aggregation of erythrocytes, and basement membrane abnormalities, but no differences were found among the three groups. In conclusion, the protective effects of modified University of Wisconsin solution and Kosin solution were slightly superior to Hartmann's solution.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.328-338
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• 1994

Background: Effect of sulfur dioxide($SO_2$) exposure on airway is well known but little about the effect of $SO_2$ exposure on lung parenchyme. This study is to determine if short tenn exposure to $SO_2$ in concentration commonly found in industrialized environment cause potentially harmful effect on the lung parenchyme, and to evaluate the exposure time-response relationship between short tenn exposure to $SO_2$ and the inflammatory response in mouse lung. Method: 5ppm $SO_2$ gas was used and 48 mice were grouped into control(10), 30(9), 60(11), and 120 minute exposure(18) group. In each group, bronchoalveolar lavage(BAL) was done immediately after and at 1,2,3 days after exposure. Histological examination was performed in control and 120 minute exposure group. Results: 1) Cell response in bronchoalveolar lavage fluid. In 30 and 60 minute exposure group, compared to the control group, lymphocyte count has significantly increased(p<0.05) at 1 day after exposure but did not differ at 2 days after exposure. In 120 minute exposure group, also compared to the control group, there was significant increase in total cell, macrophage, and lymphocyte count at 1 day after exposure, (p<0.05) which lasted for 2 days but did not significantly differ at 3 days after exposure. 2) Histological findings in 120 minute exposure group. In the airway, mild epithelial cell damage and ciliary loss were noted but there was no evidence of inflammatory cell infiltration. Interstitial inflammatory infiltration was noted at 1 day after exposure, which lasted for 3 days after exposure and there was no evidence of edema or fibrosis in the interstitium Conclusions: These data indicate potentially noxious effect of $SO_2$ on the lung parenchyme as well as the airway at exposure level that are regarded as relatively safe, and the duration of injury depends on the exposure time.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.2
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• pp.123-127
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• 2003

Chemical burns onto oral mucosa which are infrequent, may result from contact with a wide variety of chemical agents. The degree of injury depends on the chemical, its concentration, duration of contact, and the natural penetrability and resistance of the tissues involved. Chemicals do not usually "burn" in that they do not cause destruction by hyperthermic activity. Rather, they damage tissue by causing coagulation of protein by one of several processes, reduction, oxidation, desiccation, corrosion, or vesication. Paraquat(Gramoxon) is the most frequently agricultural chemicals that induce the severe toxic reactions onto the organs of human body in Korea. The toxic reaction are composed of pulmonary edema and fibrosis, formation of hyaline membrane, inflammatory reaction and bleeding tendency, owing to the cell damage by the production of superoxide radicals. The contents of essential treatment in paraquat intoxication are commonly airway and breathing maintenance, gastric lavage, much hydration and diuresis, hemoperfusion and medications for the removal of the chemicals and the prevention of various complications. The sedative oral dressings, such as, orabase ointment application, warm saline gargling, lidocaine viscous gargling and oral gargling by the mixed solutions(tetracycline, prednisolone and 10% dextrose water) are important for the improvement of chemical oral mucositis and the comfortable feeding of diet. The authors managed properly two cases of oral chemical mucositis that were occurred by the incorrect use of agricultural chemicals(paraquat) and report the cases with the review of literatures about care of the chemical intoxication and oral mucositis.