• Title/Summary/Keyword: Bronchial Diseases

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Change of Bronchial Permeability in Patients with Bronchial Asthma (기관지 천식환자에서 기도 투과성에 관한 연구)

  • Hwang, Jeong-Sil;Kim, Sin-Ae;Kwack, Jun-Gu;Park, Myung-Jae;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hun;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.164-171
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    • 1991
  • To evaluate the effect of damaged bronchial epithelium on epithelial permeability and physiologic changes of the airway in patients with bronchial asthma, we measured the concentration of protein and albumin in bronchoalveolar lavage fluid (BALF), the width of intercellular junction and bronchial hyperreactivity in 22 patients with bronchial asthma and 21 healthy subjects. The results were as follows: 1) The concentration of protein in BALF from patients with bronchial asthma was higher when compared with that of normal subjects ($237{\pm}182$ vs $113{\pm}78\;{\mu}g/mL$, p<0.05), and the concentration of albumin was also higher than that of normal subjects ($116{\pm}126$ vs $32{\pm}88\;{\mu}g/mL$, p<0.05). The ratio of the concentration of protein in BALF to that in serum was increased in patients with bronchial asthma when compared with that of normal subjects ($0.35{\pm}0.30$ vs $0.16{\pm}0.11%$, p<0.05). 2) The intercellular junction of bronchial epithelium was widened in 14 of 20 patients with bronchial asthma, in contrast, 5 of 14 normal subjects (p<0.05). The mean width of intercellular junction was greater when compared with that of normal subjects ($1.71{\pm}1.81$ vs $0.56{\pm}0.85\;{\mu}m$, p<0.05). The width was well correlated with the ratio of protein in BALF to that of serum (r=0.3226, p=0.047) when observed in 18 patients with bronchial asthma and 10 patients with normal subjects. 3) The bronchial hyperreactivity, expressed as $PC_{20}$, was inversely correlated with the concentration of protein in BALF (r=-0.3030, p=0.038) in when observed in 18 patients with bronchial asthma and 19 normal subjects. 4) The width of intercellular junction was well inversely correlated with $PC_{20}$ (r=-0.5006, p=0.002) when observed in 19 patients with bronchial asthma and 11 patients with normal subjects. In conclusion, increased permeability and the damage of bronchial epithelium may lead to change of bronchial hyperreactivity.

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A Case of Chest Traumatic Bronchial Rupture, Manifested by Bronchial Web in Bronchoscopy (Web 양상으로 발현한 외상성 기관지 파열 1예)

  • Shim, Jae-Jeong;Han, Seung-Hwan;Lee, Jin-Goo;Cho, Jae-Yeun;In, Kwang-Ho;Kim, Kwang-Taek;Yoo, Sae-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.574-578
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    • 1994
  • The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.

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A Case of Bronchial Artery Aneurysm Demonstrating Hilar Mass (폐문부 종괴로 관찰된 기관지 동맥류 1예)

  • Hong, Seong-Ah;Ha, Tae-Hoon;Lyu, Ji-Won;Kim, Yang-Ki;Lee, Young-Mok;Kim, Ki-Up;Uh, Soo-taek;Noh, Hyung-Jun;Kim, Yong-Jae;Goo, Dong-Erk
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.62-66
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    • 2007
  • A bronchial artery aneurysm is a rare condition, which needs optimal treatment due to the possibility of a life-threatening hemorrhage by rupture. The surgical removal of the aneurysm is the standard treatment. However, there are a few reports of coil embolization with a transcatheter. A 69 year-old man was referred for a further evaluation of a mass in the right hilum on chest radiography. He denied any respiratory symptoms. A chest CT scan showed a $3{\times}3{\times}4.5cm$ sized vascular mass with strong contrast enhancement on the right hilar area that originated from the bronchial artery. On the angiogram, the bronchial artery originated from the descending thoracic aorta at the T8 level. A bronchial artery aneurysm was catheterized selectively. and embolized successfully with a coil. After coil embolization, the selective bronchial arteriography confirmed complete occlusion. We report this case of bronchial aneurysm that was treated successfully with coil embolization.

Neural Mechanism in Bronchial Asthma (기관지천식에서의 신경적 기전)

  • Choi, Byoung-Whui
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.73-86
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    • 1994
  • In addition to classic cholinergic and adrenergic pathways, the existence of a third division of autonomic control in the human airways has been proved. It is called a nonadrenergic noncholinergic(NANC) nervous system, and difficult to study in the absence of specific blockers. Neuropeptides are certainly suggested to be transmitters of this NANC nervous system. It is very frustrating to understand the pathophysiologic role of these peptides in the absence of any specific antagonists. However, further studies of neuropeptides might eventually lead to novel forms of treatment for bronchial asthma. Another study of the interaction between different components of the autonomic nervous system, either in ganglionic neurotransmission or by presynaptic modulation of neurotransmitters at the end-organ will elute neural control in airway disease, particularly in asthma. Studies of how autonomic control may be disordered in airway disease should lead to improvements in clinical management. Epithelial damage due to airway inflammation in asthma may induce bronchial hyperresponsiveness. Axon reflex mechanism is one of possible mechanisms in bronchial hyperresponsiveness. Epithelial damage may expose sensory nerve terminals and C-fiber nrve endings are stimulated by inflammatory mediators. Bi-directional communication between the nerves and mast cells may have important roles in allergic process. The psychological factors and conditioning of allergic reactions is suggested that mast cell activation might be partly regulated by the central nervous system via the peripheral nerves. Studies in animal models, in huamn airways in vitro and in patients with airway disease will uncover the interaction between allergic disease processes and psychologic factors or neural mechainsms.

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A Case of Bronchial Stump Aspergillosis (기관지 단단 국균증 1예)

  • Lee, Hee-Seung;Ryu, Jung-Cheol;Park, Tae-Koon;Park, Tae-Joon;Yang, Eun-Soo;Choi, Soo-Jeon;Kwak, Young-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.3
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    • pp.299-301
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    • 1994
  • Bronchial stump aspergillosis(BSA) is an infrequent disease developing on the bronchial stump after lobectomy with the silk as a suture material. The silk induces inflammatory reaction, granuloma formation, secondary infection of the bronchial stump and leads to BSA. If a patient complains of cough, hemoptysis, expectoration of suture material several months or years after lobectomy with the silk, BSA should be considered as one of causative mechanisms. Bronchoscopic identification of silk thread with aspergillosis and its removal is necessary. We report a case of BSA in a 59-year-old man with review of the literature.

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