• Korean Journal of Veterinary Service
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• v.27 no.1
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• pp.63-73
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• 2004

The present experiment was carried out to study the pathogenesis of Newcastle disease(ND), ND virus (NDV) antigens and genes in various organs from NDV inoculated chickens were detected by immunohistochemistry and RT-PCR. Immunohistochemically, NDV antigens were detected in the spleen, thymus, cecal tonsil, proventriculus, trachea and lungs at 12 hour post-inoculation (hpi). Viral antigens were localized mainly in the cytoplasm of lymphocytes and macrophages. After 48 hpi, clinical findings of the affected chickens were open-mouth breathing, conjunctivitis, watery diarrhea and edema around the eye and neck. After 72 hpi, chickens showed muscular tremor, paralysis of the legs and wings, and coma. Histopathological results consist of multi-focal necrosis with hemorrhages in lymphoid aggregates of the intestinal tracts, necrosis of the lymphoid tissues, neuronal degeneration and necrosis, and perivascular cuffing. Using RT-PCR, virus genes were detected in the spleen and proventriculus at 48 hpi, and in the brain at 60 hpi.

• Journal of Chest Surgery
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• v.54 no.3
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• pp.191-199
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• 2021

Background: Tracheal replacement is a challenge for thoracic surgeons due to stenosis in the trachea-prosthesis anastomosis. We propose that stenosis occurs due to fibrosis as a result of an abnormal healing process, characterized by an increased expression of wound healing growth factors (vascular endothelial growth factor [VEGF], survivin, and CD31), which promote angiogenesis and decrease apoptosis. We analyzed the immunoreactivity of VEGF, survivin, CD31, and caspase-3 in the development of fibrotic stenosis in prosthetic tracheal replacement. Methods: Fourteen dogs were operated on: group I (n=7) received a 6-ring cervical tracheal segment autograft, while in group II (n=7), a 6-ring segment of the cervical trachea was resected and tracheal continuity was restored with a Dacron prosthesis. The follow-up was 3 months. Immunoreactivity studies for VEGF, survivin, CD31, and caspase-3 were performed. A statistical analysis was done using the Wilcoxon signed rank test. Results: Four animals in group I were euthanized on the 10th postoperative day due to autograft necrosis. Three animals completed the study without anastomotic stenosis. Moderate expression of VEGF (p=0.038), survivin (p=0.038), and CD31 (p=0.038) was found. All group II animals developed stenosis in the trachea-prosthesis anastomotic sites. Microscopy showed abundant collagen and neovascularization vessels. Statistically significant immunoreactive expression of VEGF (p=0.015), survivin (p=0.017), and CD31 (p=0.011) was observed. No expression of caspase-3 was found. Conclusion: We found a strong correlation between fibrosis in trachea-prosthesis anastomoses and excessive angiogenesis, moderate to intense VEGF, CD31, and survivin expression, and null apoptotic activity. These factors led to uncontrolled collagen production.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.461-467
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• 2005

Pleura, diaphragm, pericardial fat pad, intercostal muscles and omentum can be used to protect and revascularize the bronchial suture line of tracheal transplantation, lung transplantation and pulmonary resection. The purpose of the present study is to compare the influence of the pleura, diaphragm and omentum in survival of isolated tracheal segments in the experimental animals. Material and Method: Sprague-Dawley rats weighing 250- 350g were used. The animals were divided in three groups; the pleura, omentum and diaphragm. Following intraperitoneal anesthesia, endotracheal intubation was performed. Then the trachea was exposed. A three-ring sec- tion of cervical trachea was excised. The resected trachea was implanted at each sites. After 2 weeks, rats were sacrificed. Histopathological examination of the tracheal segments was performed. For comparison of each groups, histopathological viability of resected tracheal segment was scored by three tissue layers; epithelium, submucosa, and cartilage. The results were presented as average score. Result: In histopathological examination, submucosa and cartilage using tracheal segment necrosis scoring system. The pleural group showed well preserved tissue. There was minimal necrosis and inflammation compared with other groups. In the pleural group, tracheal necrosis scores were $2.17\pm0.983$at epithelium, $1.67\pm0.516$ at submucosa and $2.17\pm0.753$ at cartilage. At the omental group, scores were $1.00\pm0.00,\;1.60\pm0.548\;and\;1.80\m0.447$. In the diaphragmatic group, scores were $1.40:\pm0.894,\;2.40\pm0.547\;and\;2.20\pm0.447$. Total necrosis score were $6.00\pm1.789$ in the pleural group, $4.40\pm0.894$ in the omental group and $6.00\pm1.414$ in the diaphragmatic group. Conclusion: There were no significant viability differences in terms of total necrosis score for the viability of resected tracheal segment. But the best result was achieved in the omental group. Therefore, omental wrapping on tracheal graft site will be beneficial for the prevention of graft necrosis.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.58-61
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• 2004

Lymph node metastasis of thyroid cancer occurs to anterior compartment (level VI) and superior mediastinal lymph node (Level VII). In lateral neck, it occurs commonly in middle and lower jugular lymph node (level III, IV). And it can also metastasis to posterior neck lymph node (level V). Superior mediastinal lymph node metastasis of thyroid cancer requires superior mediastinal dissection with massive removal of peritracheal and periesophageal soft tissue. After superior mediastinal dissection, severe complication may occurs such as innominate artery rupture and tracheal necrosis. We describe a case of tracheal necrosis as a complication of superior mediastinal dissection and total thyroidectomy in thyroid cancer patient.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.169-174
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• 2021

Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid-Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.328-339
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• 2013

Background: Ischemic injury and the rejection process are the main reasons for graft failure in tracheal transplantation models. To enhance the acceptance, we investigated the influence of mesenchymal stem cells (MSCs) on tracheal allografts. Methods: Extracted tracheal grafts from New Zealand white rabbits were cryopreserved for 4 weeks and orthotopically transplanted (control group A, n=8). In group B (n=8), cyclosporin A (CsA, 10 mg/kg) was injected daily into the peritoneal cavity. In group C (n=8), MSCs ($1.0{\times}10^7$ cells/kg) from the same donor of the tracheal allograft, which had been pre-cultured for 4 weeks, were infused intravenously after transplantation. In group D (n=8), MSCs were infused and CsA was injected daily. Four weeks after transplantation, gross and histomorphological assessments were conducted for graft necrosis, measuring the cross-sectional area of the allograft, determining the degree of epithelization, lymphocytic infiltration, and vascular regeneration. Results: The morphologic integrity of the trachea was retained completely in all cases. The cross-sectional areas were decreased significantly in group A (p=0.018) and B (p=0.045). The degree of epithelization was enhanced (p=0.012) and the lymphocytic infiltration was decreased (p=0.048) significantly in group D compared to group A. The degree of vascular regeneration did not differ significantly in any of the groups. There were no significant correlations among epithelization, lymphocytic infiltration, and vascular regeneration. Conclusion: The administration of MSCs with concurrent injections of CsA enhanced and promoted epithelization and prevented lymphocytic infiltration in tracheal allografts, allowing for better acceptance of the allograft.

• Korean Journal of Veterinary Research
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• v.22 no.2
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• pp.221-232
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• 1982

This paper dealt with the pathological and clinical findings on the experimentally induced rodenticide (fluoroacetate, zinc phosphide, thallium sulfate, coumarin) and NaCN poisoning of ruminants (Holstein cattle and/or Korean native goat) for the purpose of the diagnosis in the accidental rodenticide poisoning of cattle. The results observed are summarized as follows: Fluoroacetate poisoning (cattle and goat): in the clinical signs, there were depression, convulsion, dyspnea, groan, grinding of the teeth, vomiting, opisthotonus and post-mortem tympany. In the macroscopical findings, the blood was more or less poor coagulative and dark red, bloody fluid with foam in the trachea, hyperemia and hemorrhage of tracheal mucosa and lung, cloudy swelling and hyperemia of kidney, epicardial hemorrhage(cattle), and hyperemia of abomasum, intestine and brain were observed. In the microscopical findings, there were pulmonary edema and hemorrhage, necrosis of convoluted tubular epithelium and interstitial hemorrhage of kidney, focal coagulative necrosis of myocardium, hemorrhage of pancreas and spleen, dilatation of Virchow-Robin space and hyperemia of brain, and necrosis with desquamation of mucosal epithelia of abomasum and upper small intestine. In the histological lesions of the liver, lobular peripheral hyperemia, centrilobular necrosis and cytoplasmic inclusion bodies of the hetatic cells were observed. The cytoplasmic inclusion body of the hepatic cells was not seen in the affected goat, but hydropic degeneration of the hepatic cells was marked. Zinc phosphide poisoning (cattle and goat): clinically, the affected animals died in recumbent position after ataxia, dyspnea and convulsion. In the macroscopical findings, hyperemia and hemorrhage of lung, cloudy swelling and hyperemia of liver and kidney, hemorrhage of spleen (cattle), and catarrh of abomasum and small intestine were observed. In the microscopical findings, necrosis of the convoluted tubular epithelium and hyperemia of kidney, hemorrhage of spleen, hyperemia of lung, hyperemia or hemorrhage of heart, cloudy. swelling and fatty changes of hepatic cells, dilatation of hepatic central vein, hyperemia of brain, and catarrh of abomasal and small intestinal mucosae were observed. Thallium sulfate poisoning (cattle): in the macroscopical findings dark red color of blood, hyperemia and hemorrhage of lung, bloody fluid with foam in the tracheal mucosa, petechiae of tracheal mucosa, cloudy swelling and hemorrhage of liver, necrotic lesions and hemorrhage of renal cortex and epicardial hemorrhage were observed. In the microscopical findings, severe hemorrhages of the lung, cloudy swelling and necrosis of hepatic cells, hyperemia and hemorrhage of liver, focal coagulative necrosis of mycordium, necrosis of the convoluted tubular epithelium and hyperemia of kidney, hyperemia and hemorrhage of spleen and dilatation of Virchow-Robin apace in brain were observed. Coumarin poisoning (goat): the poisoned animals died in the state of groan and depression. In the macroscopical findings, poor coagulation of blood, hemorrhage of lung, cloudy swelling and severe hemorrhages of liver, cloudy swelling and hemorrhage of kidney, abomasal hemorrhage, catarrh of small intestine, and hyperemia and hemorrhage of the other organs were observed, In the microscopical findings, hyperemia and hemorrhage of lung and kidney, cloudy swelling of the convoluted tubular epithelium of kidney, severe hepatic hyperemia, cloudy swelling and hydropic degeneration of heptatic cell, and hyperemia and hemorrhage of brain and spleen were observed. NaCN poisoning (cattle and goat): clinically, there were convulsion, severe dyspnea, paresis of hind limb, depression and then rigor of four limbs. In the macroscopical findings, bright red color of blood, hyperemia and bright and red tinge of lung cloudy swelling of kidney and liver, and hyperemia of abomasum were observed. In the microscopical findings, cloudy swelling and hydropic degeneration of hepatic cell, hyperemia and edema of lung, necrosis and degeneration of the convoluted tubular epithelium and hemorrhage in kidney, dilatation of Virchow-Robin space of brain and hemorrhage of spleen were observed.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.636-640
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• 1997

The common cause of tracheoesophageal fistula(T-I fistula) after tracheal intubation is ulceration and necrosis of the posterior wall of trachea by compression pressure generated by cuff. We experienced a young woman sustaining a T-I fistula which was found on the 12th day of intubation for cardiopulmonary resuscitation. Because spontaneous closure of the fistula is far uncommon, operative closure should be aimed for and should be done as soon as diagnosis is conformed. We delayed ope ative closure because of poor general condition of the patient. In spite of delayed reconstruction, the tracheal reconstruction itself was successful, but the patient died of peritonitis induced sepsis on the postoperative 41th day.

• Journal of Chest Surgery
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• v.54 no.3
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• pp.206-213
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• 2021

Background: Tracheoesophageal fistula (TEFs) is a rare condition that requires complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the literature and at Pusan National University Yangsan Hospital using standardized techniques. Methods: This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. The surgical method was determined based on the size of the fistula observed within the endoscope. Results: TEF occurred in 7 patients (87.5%) after intubation or tracheostomy and in 1 patient (12.5%) after esophageal surgery due to conduit necrosis. For tracheal management, 5 and 2 patients underwent tracheal resection and end-to-end anastomosis and primary repair, respectively. The median length of resection was 2.5 cm (range, 1.3-3.4 cm). For esophageal management, 6 patients underwent primary repair and 1 patient underwent esophageal diversion. One patient underwent TEF division with a stapler. Interposition of a muscle flap was performed in 2 patients. TEF recurrence, esophageal stenosis, and dehiscence or granulation occurred in 1, 1, and 2 patients, respectively. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. Conclusion: Although TEF surgery is complex and challenging, good results can be achieved if surgical standards are established and experience is accumulated.

• Korean Journal of Veterinary Research
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• v.27 no.2
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• pp.277-290
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• 1987

This paper dealt with etiological studies on the acute fatal disease of Angora rabbits occurring as a group in Korea. The disease was confirmed as an acute infectious disease caused by virus. The results obtained were summarized as follows: The disease produced a high morbidity in the rearing Angora rabbits and a high mortality in the infected rabbits, and was acute. The infected rabbits died soon without premonitory signs after inappetence. The body temperature of the affected rabbits rose to $40^{\circ}C$ and nearly all deaths occurred within 48 hours after inoculation. In many cases a bloody foam was visible from the nostrils after death. According to the progress of the disease the nervous signs, such as ataxia, paralysis of the legs, and torticollis could be recognized in the some cases. Rabbits that had recovered from the disease were severe emaciation, and bristly and sparse hairs. In macroscopical findings, there were hemorrhage and edema of the lung, hemorrhage or hyperemia of the tracheal and broncheal mucosae, appearance of blood-tinged effusion in the respiratory tract. The principal lesions were found in the liver. Usually the lobular necrosis of the liver cells was progressed, and focal necrosis and hemorrhagic spots of various sizes were often observed in the liver. Liver was as a whole pale. In chronic cases, however, there was a slight liver cirrhosis with the atrophy of the parenchymal cells. The other lesions encountered grossly consisted of swelling and petechiae of the kidney, hyperemia and hemorrhage of the spleen, catarrh of the small intestine, and hyperemia of the brain. The urinary bladder contained a lot of turbid urine or bloody urine and urinary cast, and was distended with the urine. In microscopical findings, the most striking lesions occurred in the liver and may be classified as viral hepatitis. The hepatic lesions were initially characterized by progression from periportal to peripheral necrosis of the lobules with the infiltration of mononuclear cells. Focal necrosis of various sizes, hemorrhage and hyperemia were often observed in the hepatic lobules. In chronic cases, there were intensive infiltration of lymphocytes, proliferation of fibroblasts, appearance of plasmal cells, and atrophy of parenchymal cells in the hepatic tissue. Perivascular lymphocytic infiltration and meningitis were seen in the brain and spinal cord. In the kidney, there were acute glomerulonephritis, hemorrhage, necrosis of the uriniferous tubules, and retention of eosinophilic substance within the renal tubules. Proliferation of fibroblasts and infiltration of mono-nuclear cells were found in the interstitial stroma of the kidney in chronic case. There were also hemorrhage and edema in the lung, hyperemia and hemorrhage in the trachea and bronchus, perivascular lymphocytic infiltration and focal myocardial necrosis in the heart, hyperemia and hemorrhage in the spleen, vacuolization and desquamation of mucous epithelia in the urinary bladder, catarrhal inflammation of the small intestine, hemorrhage in the adrenal cortex and hyperemia in the other organs. In the electron microscopical findings of the hepatic tissue, crystals of viral particles appeared in the cytoplasm of the hepatocytes and the sinusoidal endothelial cells, and the viral particles, were small in size and polygonal. The authors suppose the virus may belong to picornaviridae family of RNA viruses. Also immature virus-like particles, dilated rough endoplasmic reticulum and destruction of nuclear membrane were seen in the hepatocytes. From these results, it is concluded that the sudden death is an acute viral disease characterized by hepatitis and the affected rabbits may be died of viremia.