• The Korea Journal of Herbology
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• v.27 no.1
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• pp.51-58
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• 2012

Objectives : This study was performed to investigate effect of evodiae fructus on acute reflux esophigitis rat induced by pylorus and forestomach ligation operation. Methods : Twenty-four laboratory rats were divided four groups and each group had six rats ; normal intact group, acute reflux esophagitis (RE) control group, two experiment RE group treated extract of evodiae fructus 600 mg/kg (EEF600) and 300 mg/kg (EEF300). All rats was fasted for 18 hr but free water, we induced RE by pylorus and forestomach ligation operation. Intact group and RE control group rats were orally administered a distilled water and two experiment groups were orally administed with EEF 600 mg/5ml/kg and 300 mg/5ml/kg. One hour after, rats were anesthetized, intact group was cut the abdomen open and sutured with 2.0 silk thread. RE control group and EEF group were cut the abdomen open, ligated pyloric canal and forestomach with 2.0 silk thread and sutured. Six hour after the operation, rats were sacrified, collected bloods in the abdominal vein, disectted a esophagus and stomach. The stomach was washed a 1 ml PBS and the esophagus was cut longitudinally and pictured a innter mucosa area to research damages in esophagus. Results : The esophagic tissue damage percentage of reflux esophagitis rat was increased compared to that of normal intact group. But esophagic damage percentage of EEF 600 were significantly decreased compared to that of RE control group. But there was no difference on gastric juice pH between control RE, alpha-tocopherol administration rat group and EEF administration rat group. In esophagus of RE control rat, gastric damage occurred severely and injury percentage of mucosa were increased, but EEF 600 mucous inflammatory damage percentage was significantly compared to that of RE control group. Proinflammatory cytokines such as TNF-alpha, IL-1beta and IL-6 in serum on RE control group were markedly grew than those of intact rat, those of vechicle group treated with EEF 600 and EEF 300 were remarkably decreased compared to production of proinflammatory cytokine of RE control group. In microscopic observation, intact group rat had no hyperemia, mucous injury and exclusion, ulcer and edema. But it could showed mucosa damages, submucosa edema and ulcer in RE control. However, administration of EEF 600 and EEF 300 made esophagus have less inflammation and injury by gastric acid. Conclusions : The results suggest that antiinflammatory Effect of EEF could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.528-531
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• 2009

Transesophageal echocardiography (TEE) is widely used to evaluate the heart function and the result of surgery during a cardiac operation. The incidence of complications associated with TEE is low, yet critical complications such as lower pharyngeal injury and esophageal perforation may happen. We report hereon a case of 77-year old male patient who suffered from injury to the pyriform sinus and concurrent deep neck infection after off pump coronary artery bypass surgery and intraoperative TEE.

• Journal of Sasang Constitutional Medicine
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• v.32 no.3
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• pp.64-71
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• 2020

Objectives To report an improved case with Taeeumin Mahwangjeongcheon-tang on the patient with chronic bronchitis caused by an inhalation injury. Methods The patient had been suffered from cough, sputum, dyspnea, and chest discomfort for 15 years. He was diagnosed as Taeeumin Esophageal Cold Pattern and was given Mahwangjeongcheon-tang according to Sasang constitutional medical theory. The clinical asthma measurement scale in oriental medicine(CAMSOM-V), quality of life questionnaire for adult Korean asthmatics(QLQAKA), and Spirometry were performed to evaluate the improvement of his symptoms. Results The clinical asthma measurement scale in oriental medicine(CAMSOM-V) improved from 16 to 14 points and the quality of life questionnaire for adult Korean asthmatics(QLQAKA) improved from 55 to 67 points. In spirometry, forced vital capacity improved from 3.07 to 3.59, and forced expiratory volume in 1sec improved from 2.59 to 2.84 after 4 weeks. Conclusion This report suggests that Mahwangjeongcheon-tang is effective for chronic bronchitis.

• The Korea Journal of Herbology
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• v.34 no.1
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• pp.117-124
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• 2019

Objective : Chronic acid reflux esophagitis (CARE), one of gastroesophageal reflux disease (GERD) is increasing worldwide. Coptidis rhizoma extract (CRE) is a traditional herb that cures a variety of diseases. This study was conducted to evaluate the protective effect of CR on rats with chronic acid reflux esophagitis. Methods : The antioxidant activities were evaluated through radical scavenging assays using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzothiazolin-6-sulfonic acid) (ABTS) radical scavenging assays. CARE was surgically induced in 5-week-old male SD rats by ligating the border between forestomach and glandular portion with a 2-0 silk tie and covering the duodenum using 18-Fr $N{\acute{e}}laton$ catheter. To evaluate the esophageal protective effect of CRE, rats were divided into 3 groups: Nor (normal rats), Veh (chronic acid reflux esophagitis induced rats), CR (chronic acid reflux esophagitis induced rats treated with CRE 200 mg/kg body weight). Results : The administration of CRE significantly prevented the mucosal injury of the esophagus tissue and histological findings improved the esophageal lesion. It has been shown that inflammation is prevented by the increase of antioxidant-related factors (Nrf-2, HO-1, SOD, catalase, and GPx-1/2) through the antioxidant pathway of esophageal tissue. The administration of CRE reduced the increase of serum peroxynitrite ($ONOO^-$) and markedly reduced the protein expression of inflammatory mediator such as $NF-{\kappa}Bp65$, $p-I{\kappa}B{\alpha}$, iNOS, and IL-6. Conclusions : Overall, these results suggest that CRE administration confirmed the protective effect of esophageal mucosa, suggesting that it is a potential treatment for chronic acid reflux esophagitis.

• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.174-179
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• 2010

Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. Methods : A total of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures. Results : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p < 0.0001). Conclusion : Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.195-198
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• 1987

We experienced a case of esophageal leiomyoma recently in department of Thoracic and Cardiovascular Surg., Pusan Baik Hospital, Inje Medical College. Patient had suffered from dysphagia and chest discomfort for 2 years. The esophagogram showed an ovoid smooth filling defect in lower portion of the esophagus, mucosal fold of esophagus was not destroyed. A benign intramural tumor of the esophagus such as leiomyoma was suspected with X-ray finding and clinical features. Open thoracotomy was performed through the left 8th intercostal space. A firm egg sized mass in the well of lower esophagus was enucleated by blunt dissection with caution to avoid injury of the mucosa of the esophagus. The diagnosis of leiomyoma was confirmed with histopathological finding. Postoperative course was uneventful.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.765-767
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• 1999

Tracheobronchial rupture following tracheal intubation is a rare complication. We experienced a case of tracheal rupture following double-lumen endotracheal tube intubation. A 76 year old female was admitted due to coughing and chest discomfort. The operation was performed with the diagnosis of congenital broncho esophageal fistula. During the operation, accidently the main trachea was ruptured longitudinally. There was no history of surgical trauma. The ruptured trachea was repaired with prolene and monofilament absorbable sutures. The cause of tracheal rupture was suspected overinflation of the cuff. The patient was discharged from the hospital without any significant complications.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.785-790
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• 1990

A 30-year-old male with a symptomatic aberrant right subclavian artery underwent surgical intervention on January 17, 1990. An aberrant right subclavian artery is a rare congenital anomaly, but it is the most common one of the aortic arch anomalies. This anomalous vessel usually does not produce symptoms, but occasionally symptomatic patients require surgical intervention. Although ligation and division of the aberrant right subclavian artery through left thoracotomy has been advocated by many surgeons, the ischemic symptoms of the upper extremity or the brain can occur. In the procedure described here, ligation and division of the aberrant artery and its anastomosis to the ascending aorta with Gore \ulcornerTex vascular graft was performed simultaneously through midsternotomy. With this procedure, we relieved the esophageal obstruction and established normal blood flow to the right arm. Hoarseness developed postoperatively. We consider that above symptom has been attributed to the injury of the left recurrent laryngeal nerve during dissection.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.581-587
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• 1992

Tracheoesophageal fistula[TEF] is a rare but life-threatening lesion that may occur from ventilation with a cuffed tube. It occurs most frequently when an inlying esophageal tube is also being used-usually for feeding purposes. The mechanism of injury appears to be pressure experted on the tracheal wall by the cuff, which then compresses the "party wall" of the trachea and esophagus against the foreign body that lies in the esophagus. The patient was 32 years old female who had been receiving a treatment of respiratory failure induced by postoperative sepsis with assist ventilator and nasogastric tubal feeding. Sudden attack of abdominal gas distention and massive drainage of gas through N-G tube were developed during assist ventilation in that patient, so we diagnosed as tracheal stenosis with a tracheoesophageal fistula induced by prolonged endotracheal intubation We performed tracheal reconstruction and primary closure of perforated esophagus after weaning ventilator. The postoperative course was uneventiful.eventiful.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.272-274
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• 2012

Killian-Jamieson diverticulum is a rare diverticular disease. This disease differs from Zenker's diverticulum in its location and mechanism. Various treatment modality have been attempted, but traditional surgical treatment has been recommended for a symptomatic Killian-Jamieson diverticulum due to the concern of possible nerve injury. We performed surgical treatment by cervical incision. We report here on a case of Killian-Jamieson diverticulum and we briefly review the relevant literature.