• The Korean Journal of Physiology
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• 제8권2호
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• pp.49-53
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• 1974

제 II 형(第 II 型) 폐포세포(肺胞細胞)의 페포표면활성물질(肺胞表面活性物質) 분비기능(分泌機能)이 부교감신경성작용(副交感神經性作用)에 의(依)해서 영향(影響)을 받을 것인지를 구명(究明)하기 위해서 체중(體重) 매(每) kg 당(當) 0.5mg의 pilocarpine hydrochloride를 투여(投與)한 가토(家兎)에서 폐장(肺臟)의 압력(壓力)-용적곡선(容積曲線)및 폐세척액(肺洗滌液)의 표면활성도(表面活性度)를 측정(測定)한 결과(結果)는 다음과 같다. (1) 적출가토폐(摘出家兎肺)에 공기(空氣)를 주입(注入) 및 배출(排出)할 때의 압력(壓力)-용적곡선(容積曲線)은 정상(正常) 가토(家兎)의 그것보다 hysteresis현상(現象)이 더욱 심(甚)하였으며 특(特)히 배출곡선(排出曲線)이 좌측(左側)으로 편입(偏入)되어있었다. (2) 정상(正常) 가토폐세척액(家兎肺洗滌液)의 평균최대(平均最大) 및 최소표면장력(最小表面張力) 및 stability index는 각각(各各) 46.6 dyne/cm, 7.4 dyne/cm 및 1.5이었다. (3) Pilocarpine 투여가토폐세척액(投與家肺洗滌液)의 평균최대(平均最大) 및 최소표면장력(最小表面張力) 및 stability index는 각각(各各) 47.5 dyne/cm, 6.1 dyne/cm 및 1.5로서 최소표면장력(最小表面張力)은 감소(減少)하는 경향(傾向)을 보였다. (4) 이상의 실험결과(實驗結果)로 미루어 보아 pilocarpine 투여(投與)에 의(依)해서 제 II 형(第 II 型) 폐포세포(肺胞細胞)의 페포표면활성물질(肺胞表面活性物質)의 분비기능(分泌機能)이 증가(增加)되는 경향(傾向)을 보였다.

• The Korean Journal of Physiology
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• 제5권2호
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• pp.63-70
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• 1971

In an attempt to understand the possible effects of temperature and X-irradiation on the activities of surfactant in rabbits, the pulmonary surfactant from the rabbit was subjected to the incubation at $37^{\circ}C$ and X-irradiation with 900r in vitro, and activities of surfactant were measured at 10, 30, 60, and 90 minutes. Tension-area diagram of the lung extract was recorded automatically by the modified Langmuir-wilhelmy balance with a synchronized recording system designed in this Department. A comparison was made with the normal and the following results were obtained. 1) The maximal surface tension, minimal surface tension, width of the tension area diagram at the surface area of 40% and stability index of the normal rabbit lung extract were $31.6{\pm}3.11\;dynes/cm,\;8.2{\pm}0.56\;dynes/cm,\;21.4{\pm}4.40\;dynes/cm\;and\;1.12{\pm}0.22$,respectively. 2) In the $37^{\circ}C$ incubation group, maximal surface tension was similar to the normal value, while minimal surface tension was significantly lower and stability infer was markedly higher than the normal. 3) In the group where X-irradiation of 900r in vitro was applied, maximal surface tension did not differ greatly with the normal or the $37^{\circ}C$ incubation group. The minimal surface tension was significantly lower than the normal but comparing with the $37^{\circ}C$ incubation group, some decrease in minimal surface tension was noted. The width of the tension·area diagram at 40% and stability index in the irradiated group were significantly higher than the normal but a tendency of increase was noted comparing with the $37^{\circ}C$ incubation group.

• Tuberculosis and Respiratory Diseases
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• 제71권3호
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• pp.163-171
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• 2011

Recently published articles on interstitial lung disease (ILD) have focused on the accurate diagnosis of idiopathic pulmonary fibrosis (IPF), serum biomarkers, acute exacerbation of IPF, the prognostic factors of ILD and the trial of new treatment. In particular, reports on the serum biomarkers such as CC-chemokine ligand 18, surfactant protein, circulating fibrocytes, and acute exacerbation of IPF are sufficient to be mentioned here. Pirfenidone therapy is the most important trial for the treatment of IPF. Other newer treatment trials such as interferon-gamma, sildenafil and imatinib have been reported to be unsuccessful. On the other hand, the sirolimus trial for lymphangioleiomyomatosis is promising. Combined pulmonary fibrosis and emphysema and IgG4-related disease are established to be the new disease entities of ILD.

• Journal of Yeungnam Medical Science
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• 제38권4호
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• pp.374-380
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• 2021

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

• Tuberculosis and Respiratory Diseases
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• 제43권6호
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• pp.925-935
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• 1996

연구목적: ARDS 발병기전의 일단을 알아보기 위하여 실험동물에서 ARDS와 같은 병변을 유도하는 N-nitroso-N-methylurethane(NNNMU)로 흰쥐에서 급성 폐손상을 유도하였다. ARDS에서의 제 II형 폐포세포의 기능 및 형태학적인 변화가 폐포강 내로의 단백질 이동과 관계 있다고 생각되므로 surfactant를 정량하고 동시에 gamma glutamyl transpeptidase(GGT)의 활성도를 측정하였다. 그리고 백혈구와 연관된 free radical의 역할을 알아보고자 phospholipase $A_2$ ($PLA_2$)의 활성도도 측정하였다. 이때 $PLA_2$의 inhibitor인 dexamethasone을 이용하여 $PLA_2$가 ARDS 발병에 미치는 영향을 알아보고자하였다. 방법: NNNMU에 의해 나타나는 폐부종의 확인을 위해 체중에 대한 폐장의 무게의 비를 계산하였고, 제 II형 폐포세포의 기능을 알아보기 위하여 surfactant의 양 및 GGT의 활성도를 측정하였다. 또한 염증세포의 침윤 및 제 II형 폐포세포의 형태학적인 변화를 광학 및 전자현미경을 이용하여 확인 하였으며 $PLA_2$의 활성도도 측정 하였다. 또한 이 모든 실험을 dexamethasone을 투여한 군에서도 시행하여 $PLA_2$의 억제로 나타나는 효과를 관찰하였다. 결과: NNNMU로 유도된 ARDS와 유사한 급성폐손상시 dexarnethasone은 폐부종을 감소시키고 GGT 및 $PLA_2$의 활성도를 감소시켰다. 형태학적으로는 염증세포 침윤의 감소가 관찰되었으며 병리학적인 소견도 호전시켰다. 결론: ARDS의 병인 중 $PLA_2$의 활성화가 염증세포의 침윤을 증가시키고 동시에 resprratory burst에 의한 free radical의 생성과 그 작용이 급성 폐손상의 중요한 기전으로 생각된다. 특히 $PLA_2$는 백혈구 세포막의 NADPH oxidase의 활성화에 따른 free radical의 생성뿐만 아니라 lipid medialor의 생성에도 관여하여 폐부종을 야기하는 중요한 요소가 되는데, 과량의 dexamethasone 은 $PLA_2$를 억제함으로써 이러한 변화를 감소시키는 것으로 생각된다.

• The Korean Journal of Physiology
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• 제6권1호
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• pp.1-9
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• 1972

In order to observe a possible effect of CO intoxication on the activities of surfactant, the rabbit war exposed either to 0.1, 0.2 and 0.4% CO gas for two to six hours or 0. 1% CO gas for two hours daily for 1, 3 and 5 days, and the lung extract was prepared. The tension-area diagram of the lung extract was recorded automatically using the modified Langmuir-wilhelmy balance with a synchronized recording system, and the results were compared with control (i. e. : non-CO gas exposed normal rabbits). The results obtained are summarized as follows: 1. The maximal and minimal surface tensions, width of the tension-area diagram at the surface area of 40% in lung extract, and stability index of the normal rabbit lung extracts were $31.6{\pm}3.11\;dynes/cm,\;8.2{\pm}0.56\;dynes/cm,\;21.4{\pm}4.40dynes/cm\;and\;1.12{\pm}0.22$, respectively. 2. The activities of surfactant in the CO gas exposed group did not show any significant change from the control. 3. The above results suggest that CO gas produced no noticeable effect on the surfactant system of the lung.

• The Korean Journal of Physiology
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• 제25권1호
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• pp.81-85
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• 1991

At the fifth day after right lung pneumonectomy in New-Zealand white rabbits $(0.8{\sim}1.1\;kg\;B.W.)$, phospholipid and protein concentration in the left lung lavage fluid were measured for clarification of the effect of unilateral pneumonectomy on the secretory function of the type II pneumocytes in growing rabbits. In an attempt to evaluate the effect of unilateral pneumonectomy on the compensatory growth of the residual lung, left lung weight and left lung weight-body weight ratio and DNA concentration, RNA/DNA and total DNA content in the left lung tissue were measured in pneumonectomized and in sham operated control rabbits. The lung weight of pneumonectomized rabbit was approximately two times heavier than that of the control rabbits. DNA concentration and RNA/DNA of the lung tissue were not changed but total DNA content was increased significantly. Phospholipid concentration in the lung lavage fluid of the pneumonectomized rabbits was over two times higher than that of control rabbits. from these experimental results, It is concluded that unilateral pneumonectomy in growing rabbits might cause to increase the secretion of pulmonary surfactant from type II pneumocyte of the residual lung. The cellular hyperplasia seems to be the primary response of the compensatory growing lung in unilateral pneumonectomized growing rabbits.

• The Korean Journal of Physiology
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• 제2권2호
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• pp.63-73
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• 1968

It is well known that mammalian alveolar membrane is covered with a very thin layer of surfactant film which characteristically reduces surface tension of alveolar membrane, and maintains alveolar stability. Since Clements in 1957 demonstrated that the surfactant is extractable by mincing the lung tissue in saline, various studies on the subject have been succeeded by many workers. However, the effect of radiation on the surfactant is not well clarified. Present study was attempted to observe the effect of x-irradiation on the activity of surfactant in rabbits. X-ray in dose of 300 r, 600 r or 900 r was irradiated to the chest of rabbits. The lung was removed from normal or irradiated rabbits sacrificed by arterial blood shedding, and lung-saline extract, adding 3 grams of lung tissue to 50 mili-liters of saline, was prepared by means of Vertis homogenizer. Tension-area diagram of lung extract was recorded automatically by a modified Langmuir-Wilhelmy balance with a synchronized recording system designed in this department. The surface tension of lung extract was measured at 1st, 2 nd, 3 rd, 7 th and 15 th post-radiation day in 300 r irradiated group, at 3 rd, 7 th and 15 th post-radiation day in 600 r irradiated group, 3 rd and 7 th post-radiation day in 900 r irradiated group respectively. For the histo-pathological study, lung tissue preparations were made in all irradiatiated groups on the day of experiment and in normal group. The results obtained are summarized as follows: 1. The minimal surface tension, maximal surface tension and stability index of normal rabbits lung extracts were 7.68 dynes/cm, 38.84 dynes/cm, and 1.39 respectively. 2. The activity of surfactant was depressed prominently by x-irradiation. However, increase in the dose of x-irradiation did not show any significant change in the degree of surfactant activity suppression. The most marked depression in surfactant was observed at the third post-radiation day in all irradiated groups. 3. Activity of surfactant depressed by x-irradiation showed a tendency of recovering to normal on 15 th post-radiation day. 4. The tendency of change in activity of surfactant following x-irradiation was somewhat correlative with histo-pathological changes. But the degree of depression of surfactant by x-irradiation did not correspond to the degree of histo-pathological changes, and recovery of lung tissue from radiation damage, tissue edema and congestion, seemed to be followed by restoration of surfactant activity. 5. The width of the tension-area diagram was measured at the surface area of 40% in lung extract of normal and x-irradiated rabbits. And it was found that the changes of the width corresponded well with that of minimum surface tension and of stability index in all normal and x-irradiated groups.

• Advances in pediatric surgery
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• 제17권2호
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• pp.179-187
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• 2011

Experimental tracheal ligation (TL) has been shown to reverse the pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH) and to normalize gas exchange. The purpose of this study was to determine whether the TL would correct the surfactant deficiency present in the fetal rabbit model of CDH by using lamellar body count. Lamellar bodies are synthesized and secreted by the type II pneumocytes of fetal lung. The phospholipids present in these bodies constitute the major component of pulmonary surfactant. Twenty-one pregnant New Zealand rabbits underwent hysterotomy and fetal surgery on gestational day 24. Two fetuses of each pregnant rabbit were operated. In the fetus of one end of bicornuate uterus, left DH was created by excision of fetal diaphragm through open thoracotomy (DH Group). In the fetus of the other end of bicornuate uterus, left DH and TL were created (TL Group). The fetuses were delivered by Cesarean section on gestational day 31. Fourteen in control group, 12 in the DH group and 13 in TL group were born alive. En bloc excision of lungs, bronchi and trachea was done in all newborn rabbits. A five Fr catheter was inserted through trachea and repeated irrigations with 10 cc normal saline were done. The irrigated fluid was centrifuged at $280{\times}g$ for 5 minutes and the lamellar bodies were counted with the upper level fluid in platelet channel of electronic cell counter. The average lamellar body counts were $37.1{\pm}14.2{\times}10^3/{\mu}L$ in control group, $11.5{\pm}4.4 {\times}10^3/{\mu}L$ in DH group, and $6.5{\pm}0.9{\times}10^3/{\mu}L$ in TL group. Lamellar body count in DH group was lower than in control group and did not increase after TL. This study shows TL has no therapeutic effect on decreased surfactant level of CDH and the pregnant rabbit is appropriate for the animal model of CDH.

• Neonatal Medicine
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• 제18권2호
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• pp.409-411
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• 2011

In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.