• Tuberculosis and Respiratory Diseases
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• v.77 no.4
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• pp.193-196
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• 2014

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.220-231
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• 1992

We have performed 28 single lung transplantation in mongrel dogs transplanting the left lung exclusively from November 1989 to September 1991, in the department of thoracic surgery of Seoul National University Hospital. In the donor dogs, the main pulmonary artery was divided proximal to its bifurcation, and the left atrium was incised freeing the left veins with a generous atrial cuff. We used cold saline in the first 7 transplantations and Euro-Collins or modified Euro-Collins solution in the remaining 17 transplantations as a lung preservatives. The bronchus was divided at two cartilage rings proximal to the upper lobe bronchus take off. In the recipient procedure, we used a Fogarty catheter as a bronchus block. Left atrial anastomosis was performed first using 5-O prolene and the pulmonary artery was anastomosed using 6-O prolene. The bronchus was anastomosed next with 4-O vicryl interruptedly and covered with a greater omentum which had been prepared previously. All dogs received cyclosporin A and azathioprine as immunosuppressants and were divided into two group. In the 10 Group I dogs, they survived within 6 days, mean survival time was 66.8$\pm$53.4 hours. In remainder 14 Group lI dogs, they survived above 6 days, mean survival time was 9. 5$\pm$5.6 days. The cause of death were as follows: 2 cases of sacrifice, 2 cases of respiratory insufficiency during operation, 2 cases of arrhythmia immediate postoperatively, 2 cases of bleeding, others in Group I, and 6 cases of sacrifice, 4 cases of sepsis, 3 cases of bleeding, others in Group lI. Results of bronchoscopic findings were obstruction above 50% in 12 cases of 16 performance cases within 5th day. Early chest radiologic haziness were showed, and total lung perfusion defect was frequently showed in both group within 7th day. Main autopsy findings were left atrial and pulmonary arterial thrombi and bronchial obstruction The major histologic findings of Group I were pleural exudate, hemorrhagic infarct, pulmonary congestion, and interesting histologic findings of Group II were 3 cases of perivascular or peribronchial lymphocyte infiltration, 3 cases of hemorrhage infarct, 2 cases of interstitial pneumonitis. The structual change of bronchioles, suggesting bronchiolitis obliterans was not observed due to improper preparation of proximal pulmonary tissue and short term survival times.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.240-243
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• 2006

Pulmonary hamartoma is a common benign tumor of the lung, but endobronchial hamartoma is a rare tumor. Although bronchoscopic rcemoval or removal by bronchotomy or sleeve resection with preservation of the lung may be possible, when irreversible lung damage has occurred because of chronic obstruction and pneumonitis, pulmonary resection may be indicated. We herein report a case of endobronchial hamartoma which was treated by left upper lobectomy. A 42-year-old female with 3-week history of cough and left chest pain visited our hospital. Bronchoscopy showed total occlusion of the orifice of the left upper lobe bronchus by a lobulated endobronchial tumor and bronchoscopic biopsy was failed due to bleeding. A left upper lobectomy was performed because of severe consolidation of the left upper lobe by chronic obstruction. The patient was discharged on postoperative 14th day.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.99-106
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• 1998

Background: Bronchial asthma is a complex disease, which is characterized by spontaneous exacerbations of airway obstruction and persistent bronchial hyperresponsiveness. Animal models have fallen short of reproducing the human disease, particularly in mimicking the spontaneous and persistent airflow obstruction that characterized in asthma. In animals, airflow obstruction is usually assessed by measuring airflow resistance during tidal breathing under such invasive technique as tracheostomy and anesthesia. A noninvasive technique for measuring pulmonary function in small animals is needed to evaluate long-term changes in lung function during the course of experimentally produced disease without sacrificing the animal. Purpose: The purpose of this study was to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness (AR) to inhaled methacholine in nonanethetized, unrestrained guinea pigs. Method: Guinea pig model of asthma was sensitized by subcutaneous injection with ovalbumin and challenged by inhalation of aerosolized ovalbumin(1% wt/vol ovlabumin). Airflow obstruction of conscious guinea pig was measured as specific airway resistance (airway resistance $\times$ thoracic gas volume). Airway resistance and thoracic gas volume of conscious guinea pig were assessed by body plethysmography before challenge and at regular intervals for as long as 30 minutes after challenge. AR to aerosolized methacholine of asthma group was compared with that of control group in body plethysmography. Result: Asthma model<> developed in 13 (65%) among 20 guinea pigs, in which early responses occurred in the airways after the exposure to inhalation with ovalbumin. Airway challenge with ovalbumin caused increase in specific airway resistance, which peaked at 6 minutes and amounted to a $231.5{\pm}30.4%$ increase from baseline. AR to aerosolized methacholine of asthma model increased significantly compared with control group. Conclusion: These results have showed a useful animal model to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness in nonanethetized, unrestrained guinea pigs.

• The Journal of Internal Korean Medicine
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• v.27 no.2
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• pp.521-532
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• 2006

Backgrounds and Objectives: A major goat in asthma therapy isto reduce or prevent the inflammatory response associated with bronchial hyperresponsiveness, reversible airway obstruction and airway remodelling. Many studies have shown that eosinophilic infiltration is a prominent feathure in the pathophysiology of asthma. The importance of the Presence of eosinophils in the airways of asthmatics has long been recognized, but the mechanism by which these cells are recruited and retained in the lung are only now being elucidated Production of chemotactic cytokines by bronchial epithelial cells may contribute to the local accumulation of eosinophils in Patients with bronchial asthma. This study was designed to investigate the inhibitory effect of extraction of herbal dicoction, Gamichungsangbohatang(GMCSBHT) on eosinophil chemotactic cytokines. Material and Methods:We used water and 70% ethanol extracts of GMCSBHT and pulmonary epithelial cell lines A549(human type II -like epithelial cells). We estimated cytotoxic effects of GMCSBHT, and estimated the effects of water and 70% ethanol extracts of GMCSBHT on chemokines from prestimulated A549 cells by sandwich ELISA. Results: Chemokines of eotaxin, IL-8 were inhibited by GMCSBHT in dose-dependent manner. And ethanol extract of GMCSBHT has more inhibitory effects on eotaxin, IL-8 than hot water extract. Conculusions: These findings indicate that the supression of the expression of chemokines can be accomplished by GMCSBHT treatment, so GMCSBHT may inhibit the iuflammatory process by eosinophils in asthma.

• Tuberculosis and Respiratory Diseases
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• v.63 no.2
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• pp.145-153
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• 2007

Background: Asthma is a syndrome that is characterized by a variable degree of airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Colchicine is an inexpensive and safe medication with unique anti-inflammatory properties. IL-1Ra (Interleukin-1 receptor antagonist) mediates the anti-inflammatory effect in human inflammatory diseases, including asthma. This study examined whether IL-1Ra mediates the anti-inflammatory effect of colchicine in normal human bronchial epithelial cells (NHBE), RAW 264.7 cells (murine macrophage cell line), and a mouse lung. Methods: NHBE, RAW 264.7 cells and BALB/c mice were stimulated with colchicine, and the increase in the IL-1Ra level was estimated by ELISA, Western analysis and RT-PCR analysis. Results: Colchicine stimulated NHBE and RAW 264.7 cells to release IL-1Ra into the supernatant in a dose-and time-dependent manner. The major isoform of IL-1Ra in NHBE and RAW 264.7 cells is type I icIL-1Ra, and sIL-1Ra, respectively. IL-1Ra up-regulation was blocked by PD98059, a specific inhibitor in MAPK pathways. Colchicine also stimulated the secretion of IL-1Ra into the bronchoalveolar lavage (BAL) fluid of BALB/c mouse. Conclusion: Colchicine stimulates an increase in the IL-1Ra level both in vivo and in vitro, and might have an anti-inflammatory effect.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.72-75
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• 2005

A bronchopleural fistula after pulmonary resection is still showing high mortality and morbidity despite of advancing of treatment. Several treatment options have been developed including surgical treatment. In 1990, endobronchial closure using vascular occluding coils was introduced. These coils can occlude a bronchial air-leakage by mechani­cal obstruction as well as inducing fibrosis. We report, herein, the experience using a vascular occluding coils in treating postoperative bronchopleural fistula.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.161-166
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• 1983

The origin of hamartoma from the Greek words for "error" and "tumor" is credited to Albrecht who in 1904 described a disorganized arrangement of tissues normally present in an organ and applied also to tumors found in many organs other than the lung. The hamartoma is the most common benign tumor of the lung and revealed accidentally as asymptomatic coin lesion on routine chest X-ray, but the incidence is very low and especially endobronchial origin extremely low. We have been successful surgical experienced one case of a 36-year-old female having endobronchial hamartoma, 4x2.Sx2 cm in size and located at right main bronchial lumen near the carina, which consists of a hard, nodular surfaced mass and adhered to the cartilaginous portion of the right upper lobe bronchus by dense fibrous band and migrate to trachea on expiration or coughing. This case was not suspected by chest X-ray or bronchogram and confirmed bronchoscopy with biopsy. Right pneumonectomy was inevitable because of bronchiectatic change of right bronchus due to tumor obstruction. She was discharged with relatively good general condition on 21 days postoperatively.

• Korean Journal of Bronchoesophagology
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• v.8 no.2
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• pp.56-60
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• 2002

Actinomycosis is a chronic infectious disease, which is produced by Gram-positive anaerobic organisms, actinomycetes, normally inhabit in the mouth, bowel and female genital tract. Primary endobronchial actinomycosis is relatively rare infection and can be misdiagnosed as endobronchial tuberculosis or malignancies. We experienced a case of primary endobronchial actinomycosis in a 49-year-old man presented with fifteen-days history of hemoptysis and cough. He had a past history of extraction of teeth because of dental caries six months ago. Chest X-ray showed irregular consolidation ad bronchoscopic findings revealed nearly obstruction by tumor mass with active bleeding in RLL. Pathologic finding of the bronchial mass showed sulfur granule with granulation tissue formation. Intravenous administration of penicillin G followed by oral ampicillin therapy for 6 months resulted in marked improvement in symptoms and chest X-ray findings. We report this case with review of literature.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.238-243
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• 1996

Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.