• Journal of Chest Surgery
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• v.24 no.6
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• pp.570-578
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• 1991

The spontaneous pneumothorax is the sudden collapse of the lung usually by air leakage from the ruptured sub-pleural bleb and has high recurrence rate. For prevention against recurrence, many drugs such as tetracycline, talcum powder, quinacrine, etc. have been used but the effects are not satisfactory. We reduced the recurrence rate successfully by the fibrin glue instillation through the chest tube. From the January 1989 to September 1990, we have managed 65 patients of spontaneous pneumothorax with closed thoracostomy and fibrin glue[fibrinogen 1gm/50ml with approtinin 3, 000kIU /ml, thrombin 5, 000IU /ml in 3% each 10ml] instillation through the chest tube. And we compared the results with those of 106 patients of spontaneous pneumothorax who were managed only by the closed thoracostomy from January 1985 to December 1988. Only the patients who visited our hospital with recurrence were considered as the recurred cases but the others were considered as not recurred. And the removal of chest tubes usually done 3 days after cessation of air leakage or 2 days after fibrin glue instillation Statistical analysis was done by X2-test. The results were as followings: 1. The recurrence rate of fibrin glue instillation group was lower than that of non-instillation group[1st attack: 15.1% versus 27.6% p<0, 05, the 2nd attack: 33.3% versus 73.7% p<0.01, the total 18.5% versus 35.8% p<0.01]. 2. The mean duration of chest tube drainage in the fibrin glue instillation group was shorter than non-instillation group[4.24$\pm$1.36 days versus 4.48$\pm$1.73 days p<0.05]. 3. The mean duration of hospitalization was shorter in the instillation group [8.12$\pm$3.5 days versus 10.8$\pm$3.8 days p<0.05] The complications were transient mild fever, chest pain, pleural effusion in 46 cases of 65 patients, but those didn`t make any problem. We concluded that the fibrin glue is effective in the reduction of recurrence rate, obliteration of air leakage and duration of hospitalization.

• Journal of Environmental Health Sciences
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• v.48 no.2
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• pp.106-115
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• 2022

Background: Current research suggests that humans are exposed to microplastics through consumption of foods and beverages, the airway route, and a variety of other means. Objectives: We evaluated oxidative stress and inflammation from polyethylene microplastics (PE-MPs) in the neonatal liver through intragastric administration or intratracheal instillation in pregnant mice. Methods: PE-MPs were administered from gestational day 9 to postnatal day 7. The intragastric administration group (0.01 mg/mouse/day or 0.1 mg/mouse/day) and intratracheal instillation group (6 ㎍/mouse/day or 60 ㎍/mouse/day) of PE-MPs were administered. After sacrifice, the oxidative stress and inflammation of the neonatal livers were measured. Results: As a result of the oxidative stress caused by PE-MPs in the neonatal livers, glutathione peroxidase decreased in a concentration-dependent manner in the intragastric administration group compared to the control group and intratracheal instillation decreased in high concentration PE-MPs. The catalase level increased at high concentrations of intragastric administration and intratracheal instillation. To confirm the level of inflammation caused by PE-MPs, monocyte chemoattractant protein-1 and tumor necrosis factoralpha were increased compared to the control group except for intratracheal intilation-high concentration PEMPs. The C-reactive protein level was decreased by intragastric administration compared to the control group and intratracheal instillation was increased compared to the control group. Conclusions: Despite the difficulty in comparing the toxic intensity between intragastric administration and intratracheal instillation of PE-MPs, our study revealed that oxidative stress and inflammation were induced in the neonatal liver. However, it is necessary to evaluate the toxic effects of microplastics on various organs as well. Overall, the present study indicates that the evaluation of toxic effects of long-term microplastic exposure, potential of microplastic toxicity on next-generation offspring and toxicity mechanism in human should be considered for further investigations.

• YAKHAK HOEJI
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• v.57 no.2
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• pp.139-149
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• 2013

Glaucoma is a potentially blinding chronic disease requiring life-long commitment to medical therapy. Failure to adhere to anti-glaucoma treatment may lead to disease progression and visual loss. This study surveyed the adherence to glaucoma eye drop and eye drop instillation technique of glaucoma patients and analyzed the improvement of the adherence and installation technique after patient education for eye drop instillation instructions. Collected responses were statistically analyzed using Kruskal-Wallis test, Mann-Whitney test, Chi-square test, Fisher's exact test, Spearman's correlation coefficient, or one sample proportion test. The survey after patient education for proper eye drop instillation revealed that, even if the patients experienced the adverse effect of their eyes getting dry, they used the eye drop more regularly. They were better at instillation techniques like putting the eye drop inside the eye, and also avoiding applying too much medication or touching their eye with the eye drop bottle. Also, when the patients were divided into groups based on etiologic division, there was difference among groups regarding which category they answered has improved. The result showed improvement in adherence to glaucoma eye drop and eye drop instillation technique after patient education, implicating that patient education is an important aspect of eye care for glaucoma patient and helps them participate in the proper management.

• Journal of Environmental Health Sciences
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• v.43 no.4
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• pp.273-279
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• 2017

Objectives: Carbon nanotubes (CNTs) are next-generation industrial nanoparticles which possess excellent mechanical strength along with good thermal conductivity and electric properties. Given these characteristics, carbon nanotubes are being widely applied in various fields, including research and development. However, concerns have been raised over hazardous properties due to their similar fiber shape to asbestos. Recent studies have shown that CNTs pose potential hazards which may cause fibrosis and/or lung inflammation similarly to asbestos. Methods: After intratracheal instillation of SWCNTs and MWCNTs to rats, pulmonary surfactant (PS) of the SWCNTs and MWCNTs was measured and analyzed using bronchoalveolar lavage fluid collected from the lung. After a single intratracheal instillation of SWCNTs and MWCNTs, phospholipid predominantly showed a significant increase compared to the control group, while proteins exhibited a significant increase both three days and one week after instillation. Results: As a result of surface tension, MWCNTs showed a significant decrease three days after treatment compared to the control group. In the case of the total cell number three days after instillation, MWCNTs revealed a temporarily significant increase when compared to the control group. For PMN number, when compared to the control group, SWCNTs displayed a significant increase throughout the observation period, while MWCNTs showed a significant increase three days and three months after treatment. Conclusions: After exposure to CNTs, the total cell number and PNT number, which indicate inflammatory response, were significantly increased. Therefore, this study suggests fiber-shaped CNTs may have a harmful effect on the lungs.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.143-154
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• 1991

Pneumconiosis is a sort of pulmonary fibrosis consequent to the inhalation of the respirable dusts. Thus, the pathogenesis of silicosis have concentrated largely on the early response of alveolar macrophage and the later fibroblastic stimulation. But the role of the other cells and continuing cell injury in the pathogenesis has not been fully studied. And the chemical factors such as prostaglandin, fibroblast stimulating factor and inhibiting factor and chemotaxin are also participated in the mechanism of pulmonary fibrosis in silicosis. In order to clarify the role of alveolar cells and prostaglandin, we investigated the changes of the cellularities in bronchoalveolar lavage fluid and tissue pathology in the experimental silicosis with the time sequence. The experimental animals were divided into 3 groups; control group received only intratracheal injection of 0.5 ml saline, silica group received the intratracheal instillation of 40 mg silica with the same amount saline, and aspirin group received 450 mg/kg of aspirin after silica instillation. The results were as follows: 1) The total cells of bronchoalveolar lavage fluid in the silica group markedly increased in comparison with the control group, but there was no significant difference between the silica and aspirin groups. 2) The percentages of alveolar macrophages to the total number of cells in the silica group tended to be lower than those in the control group and also lower than those in the aspirin group at the 1st week after silica instillation. 3) The percentages of neutrophils to the total number of cells in the silica group were significantly higher than those in the control group during the entire period and also higher than those in the aspirin group at the 3rd day after silica instillation. 4) In the silica group, the percentages of lymphocytes to the total number of cells were increased 143 progressively with the time course and those were significantly higher than those in the control group from the 3rd week after silica administration. There were marked differences of lymphocyte percentages between the silica and aspirin groups at the 1st week after silica instillation. 5) The inflammatory change was observed in the rat lung at the 1st day after silica instillation. Also the silicotic nodule appeared in the silica group at the 1st week but we could not find out that nodule in the aspirin group at that time. The fibrotic changes in the rat lung tended to be increased progressively with the time course, therefore, the diffuse fibrotic pattern appeared in the whole field at the 20th week after silica instillation. 6) By the electron microscopy, there were gradual increases of phagosomes and vacuoles in the alveolar macrophage in the silica group as compared with the control group. These results suggest that the neutrophils and the lymphocytes have also participated in the pulmonary fibrosis even though the alveolar macrophage has a major role, and prostaglandin mediate the inflammation and pulmanary fibrosis in the experimental silicosis.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.447-453
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• 1988

Intrapleural instillation of tetracycline as a preventive measure against recurrence in spontaneous pneumothorax was performed at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for 3 years from Jul. 1984 to Aug. 1987. In this period, 124[70.0%] out of 177 patients of spontaneous pneumothorax who received closed thoracostomy were followed up. Tetracycline pleurodesis was applied to 32 cases. The recurrence rate of the tetracycline instillation group was lower than that of noninstillation group. In patients with first attack, the recurrence rate was 12.5% in the instillation group and 35.3% in the noninstillation group. In the second episodes, 25.6% and 83.3%[p< 0.01], in the third episodes 25.0%, 100.0%[p< 0.05]. In total cases, 18.8% and 39.8%[p< 0.05] of recurrence rates were observed. Systemic or local reactions such as fever, chest pain, and pleural effusion were observed in 23 patients[71.9%] after instillation, but all were transient and benign without sequelae. In cases of systemic or local reactions the recurrence rate was lower than that with no reactions but with no statistical significance. In the four patients primarily treated with tetracycline pleurodesis who then underwent thoracotomy, mild alterations were shown in the pleurae except dense adhesions at the previous thoracotomy sites. There was no significant difference between the two groups in terms of durations of hospitalization and post-treatment recurrences.

• Tuberculosis and Respiratory Diseases
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• v.50 no.3
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• pp.367-372
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• 2001

Bacillus Calmette-Guerin(BCG) has been widely used for the prophylaxis of superficial bladder tumor recurrence and for the treatment of bladder carcinoma in situ. More than 95% of patients who receive BCG instillation tolerate the treatment well and side reactions have been reported in less than 5% of patients. Most side effects are minor and self-limiting. However, a rare occurrence of severe systemic reactions have been reported. Among the severe systemic reactions, hypersensitivity pneumonitis should be considered in patients with pneumonic complications after BCG instillation in cases where the culture for mycobacteria is negative in the sputwn, brochoalveolar lavage and blood specimen. In addition, a fiberoptic bronchoscopy with transbronchial lung biopsy demonstrates a fibrosis of the alveolar septums, where there is and an increased lymphocyte count with out tuberculous inflammatory changes, the and CD4 : CD8 ratio is increased and no symptomatic response to antituberculosis chemotherapy is observed. Here we report a 68 years old man with interstitial pneumonitis following intravesical BCG instillation.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.3
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• pp.336-344
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• 2014

Objectives: This study was performed to assay the effect of neodymium oxide on the generation of reactive oxygen species and DNA oxidative damage by intratracheal instillation. Methods: Two groups of rats were exposed to neodymium oxide($Nd_2O_3$) via intratracheal instillation with doses of 0.5 mg and 2.0 mg, respectively. At two days and at 12 weeks after exposure, the contents of neodymium oxide in the lung, liver, kidney, heart and brain, leukocyte, olive tail moment, ROS, RNS, lactate dehydrogenase, albumin, cytokine and MDA from BALF were measured. Results: Neodymium oxide contents in the liver, kidney, heart, and brain were detected at less than $1{\mu}g/g$ tissue concentration. However, in the lungs at four weeks the highest amount were detected and then found to be drastically reduced at 12 weeks. ROS and RNS in bronchoalveolar lavage increased in concentration dependently at two days, four weeks and 12 weeks after neodymium oxide instillation. However, ROS and RNS decreased with the passage of time. At two days the total number of WBC in BALF in the high concentration group was significantly increased, and at four weeks the total number of WBC were significantly increased in the low and high concentration groups(p<0.01). At two days after exposure, the LDH of the low and high concentration groups was significantly increased. At 12 weeks, only the LDH of the high concentration group was significantly increased compared to in the control group(p<0.01). As a result of Comet assay, after two days, damage to the DNA of the low and high concentration groups was observed. Conclusions: Intratracheal instillation of neodymium oxide induces the generation of ROS and DNA damage in rats.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.508-516
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• 2019

Objectives: The present study was performed to obtain acute toxicity information on glyoxal in male rats after intratracheal instillation. Methods: In order to calculate the LD₅₀ of glyoxal using Probit analysis with SAS, the test article was one intratracheal instillation to male Sprague-Dawley rats at dose levels of 0, 225, 451 or 902 mg/kg. During the test period, mortality, clinical signs, and body and organ weights were examined. At the end of the 14-day observation period, all animals were sacrificed and complete gross postmortem and histopathological examinations were performed. Results: Four animals of the 902 mg/kg group died within one week after the administration of glyoxal. All treatment group in a dose dependent manner, decreased body weight was found during the study period. The absolute and relative lung weight, and histopathological changes (bronchiolar-alveolar hyperplasia, chronic inflammation) of lung exhibited an increased in glyoxal treated groups in a dose dependent manner. However, there were no changes on the organ weights and histopathological changes of any other organ except lung. Conclusions: The results obtained in the present study suggest that the LD₅₀ in male Sprague-Dawley rats after a single intratracheal instillation of glyoxal was considered to be 866.9 mg/kg and the lung was found to be the target organ for glyoxal.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.4
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• pp.240-246
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• 2016

Objective: The study aimed to investigate the efficacy of intrauterine instillation of granulocyte colony-stimulating factor (G-CSF) on the day of ovulation triggering or oocyte retrieval in infertile women with a thin endometrium. Methods: Fifty women whose endometrial thickness (EMT) was ${\leq}8mm$ at the time of triggering during at least one previous in vitro fertilization (IVF) cycle and an index IVF cycle were selected. On the day of triggering (n = 12) or oocyte retrieval (n = 38), $300{\mu}g$ of G-CSF was instilled into the uterine cavity. Results: In the 50 index IVF cycles, the mean EMT was $7.2{\pm}0.6mm$ on the triggering day and increased to $8.5{\pm}1.5mm$ on the embryo transfer day (p< 0.001). The overall clinical pregnancy rate was 22.0%, the implantation rate was 15.9%, and the ongoing pregnancy rate was 20%. The clinical pregnancy rate (41.7% vs. 15.8%), the implantation rate (26.7% vs. 11.7%), and the ongoing pregnancy rate (41.7% vs. 13.2%) were higher when G-CSF was instilled on the triggering day than when it was instilled on the retrieval day, although this tendency was likewise not statistically significant. Aspects of the stimulation process and mean changes in EMT were similar in women who became pregnant and women who did not. Conclusion: Intrauterine instillation of G-CSF enhanced endometrial development and resulted in an acceptable pregnancy rate. Instillation of G-CSF on the triggering day showed better outcomes. G-CSF instillation should be considered as a strategy for inducing endometrial growth and good pregnancy results in infertile women with a thin endometrium.