• 대한기관식도과학회지
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• 제8권1호
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• pp.22-28
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• 2002

Background and Objectives : The aim of the this study is to determine the efficacy of an external prosthesis made of ringed Polytetrafluoroethylene to prevent Postanastomotic stenosis after surgical correction of extensive tracheal defects in rabbits. Materials and Methods : Thirty rabbits were used, divided into two groups of 15 animals each. Group A rabbits underwent resection of six-ring segments of the cervical trachea and tracheal end-to-end anastomosis. The Procedure used in group B was similar to that used in group A. but the tracheal anastomosis was supported by an external ringed polytetrafluoroethylene prosthesis. After six months, rabbits were killed and tracheas were resected and then compared the postanastomotic tracheal stenosis using morphometry. Results : Anteroposterior diameter, transverse diameter, cross sectional area and intra luminal perimeter of trachea was greater in group B than group A. Also inflammatory changes of mucosa and submucosa were greater in group A than group B. Conclusion : A ringed PTFE as a external stent was effective to prevent tracheal stenosis resulting from the extensive tracheal resection and tracheal reconstruction in rabbits.

• Journal of Chest Surgery
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• 제32권5호
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• pp.442-447
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• 1999

서론: 성장기에서 기관의 성장양상에 관한 이해는 수많은 기관질병의 관리나 선천성 기관협착증에서 기관 성형술 등에서 매우 중요한 지표가 된다. 그러나 이에 관한 국내의 연구례가 거의없는 실정이다. 본 연구는 한국인 소아에서 기관의 내경과 단면적을 후향적으로 분석하여 기관질환의 치료에 기초자료를 제공하고자 한다. 대상 및 방법: 1996년 5월부터 1998년 8월까지 흉부전산화 단층촬영을 시행한 0세부터 20세까지 106명의 환자를 대상으로 하였는데 기관의 내경이나 단면적에 영향을 줄 수 있는 기관질환, 과거에 개흉술을 받은 경우, 종격동 종양, 폐쇄성 폐질환이 있는 경우는 본 연구에서 제외시켰다. 남자가 69명, 여자가 37명이었으며 기관의 종단내경과 횡단내경은 흉부유입부와 대동맥궁 부위에서 각각 측정하였다. 기관의 형태는 각 부위의 단면에서 원형, 타원형, 말발굽형으로 구분하였으며 단면적은 A = 1/4$\pi$ab (A: 단면적, $\pi$: 3.14, a: 종단내경, b: 횡단내경)의 공식으로 계산하여 각 부위의 내경과 연령 및 성별에 따른 단면적을 비교 분석하였다. 통계처리에서 p값이 0.05이하일 때 통계적 의미가 있는 것으로 간주하였다. 결과: 5세이하에서는 level I과 II 모두에서 기관의 형태가 원형을 이루고 있었으며 두 부위간의 단면적의 차이는 없었다. 성장함에 따라 level I의 형태는 타원형으로 변해가는 반면 level II에서는 그대로 원형을 유지하고 있었으며 level I의 단면적이 level II 보다 크다(p=0.020). 기관의 내경과 단면적은 성장함에 따라 직선관계로 증가한다는 것이 확인되었고(r>0.9), 5세이하의 소아에서는 여자가 남자보다 기관의 단면적이 크고 (p=0.020) 15세가 넘으면 반대로 남자가 더 크다 (p=0.002). 결론: 이상의 결과에서 흉부전산화 단층촬영은 기관의 내경과 단면적을 측정하는데 있어 안전하고 확실한 방법이며 성장기의 한국인에서 기관의 내경과 단면적에 대한 지표가 되고자 한다.

• Journal of Chest Surgery
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• 제26권5호
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• pp.343-348
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• 1993

Growth of suture line and anastomosis is required for long-term success after the tracheal and bronchial surgery in infant and pediatric patient. We used various suture materials in these cases, but the results were differ. To select the adequate suture material in tracheal surgery, we tried next. Tracheal anastomoses were performed in 150 Sprague Dawley rats, aged 4 to 8 [mean 5.8] weeks and weight 62 to 106[mean 83.6] gram, to compare polydioxanone[PDS] 7-0, polyglactin 910[Vicryl]7-0, and polypropylene [prolene] 8-0 suture materials. In 150 rats, only 29[20%] were lived over 300 days, and the weight was 250 to 320[mean 289.5]gram. Cross sectional area of the anastomoses and two or three tracheal rings below anastomosis site were measured under microscope, and calculated and compared as Hsieh`s equition. Cross-sectional area,anastomosis site/normal site 100, were 89.4 $\pm$ 5.34% in PDS group[n=9], 75.7 $\pm$ 6.06% in Vicrylgroup [n = 10], and 80.8$\pm$ 4.06% in Prolene group[n = 10]. Histopathologic studies were done for all autopsies or put in death around 300 days postoperatively. PDS absorblion was not seen 16 weeks after suture but disappeared over 24 weeks slide. Vicryl absorbtion was noted postoperative 8 to 16 weeks, with marked tissue reaction. Prolene showed least tissue reaction, but the suture material was persisted with regional fibrotic capsule.Causes of death were respiratory failure in 76 cases, tracheal rupture in 22 cases, hemorrhage, biting, starvation and etc. in 23 cases. With the brief review of literatures, we report the results.

• 대한기관식도과학회지
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• 제7권1호
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• pp.9-13
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• 2001

Background： Tracheal resection and end-to-end anastomosis are the preferred treatment for tracheal tumor or tracheal stenosis. Absorbable suture material has been commonly used in case of tracheal anastomosis. But anastomosis technique is controversial. This experimental study compared between interrupted suture and continuous suture using Polydioxanone (PDS) absorbable suture material after tracheal resection and end-to-end anastomosis in rabbits. Methods : Twenty-four rabbits were used, divided into two groups of 12 animals each. The trachea was resected and then anastomosed with continuous 6-0 polydioxanone (PDS) (group 1), and intermittent 6-0 polydioxanone (PDS) (group 2). The animals were followed up for 6 months. Stenosis of the trachea was assessed at the time of death. Results : In two groups, anteroposterior diameter, transverse diameter, cross sectional area, and perimeter were greater in group 2 than in group 1 but, not significantly different. In addition, histologic findings were not different in two groups. Conclusions : This study suggest that stenosis after tracheal resection and end-to-end anastomosis using absorbable polydioxanone (PDS) suture material be not significantly different in both groups.

• 한국임상수의학회지
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• 제15권1호
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• pp.188-192
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• 1998

A 3-month old female Holstein calf was presented with about a month history of intermittent dyspnea, exercise intolerance and cough despite antibiotic therapy. Auscultation revealed prominent inspiratory and exploratory crackles and wheezes over the causal cervical trachea which were heard equally over both side of the chest.4 modest amount of forced exercise caused severe respiratory distress with stertorous noise and occasional honkinglike cough. Pasteurella spp. was isolated on the nasal swabs and a hemogram showed mild leucocytosis with a mature neutrophilia and mild monocytosis. Lateral radiographs of the neck and thorax revealed a marked narrowing of the tracheal lumen extending from the level of the fifth cervical to the second thoracic vertebra, and the lung field was judged to be within normal limitsi except very mild peribronchial thickening. The hypertrophic non-union fractures of the first pair of ribs were noted with a well delineatedr redundant callus formations and also the completely healed fractures were found on the next seven pairs of ribs. A diagnosis of tracheal collapse was made, which is thought to be a traumatic origin.4 poor prognosis was given. The calf was euthanatized and necropsied. The tracheal rings from 19th to 41s1 were collapsed dorsoventrally. Histologically, there was no difference between the collapsed and normal areas of the tracheae except the folding mucosal layer in the collapsed area. This report details a case of tracheal collapse in a calli and the literature is reviewed.

• Journal of Yeungnam Medical Science
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• 제22권1호
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• pp.104-112
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• 2005

Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation.

• 대한한의학회지
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• 제15권2호
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• pp.173-183
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• 1994

The results about effects of Maecmoondongtang on the pulmonary function of $SO_2$ exposed rats were summerized as follows: 1. Maecmoondongtang reavealed significant effect on decrease of the lung weight in pulmomary edema of rats. 2. Maecmoondongtang reavealed very significant effect on decrease of the TBA value of lung. 3. It was recognized Maecmoondongtang had signiftcant effect on decrease of glycoprotein contents in trachea. 4. It was recognized maecmoondongtang had significant effect on decrease of mucos area in tracheal epithelium. 5. Maecmoondongtang had effects on recovery of the cillia cells of tracheal epithelium and inhibition of mucous secretion. According to the above result. it was recognized Gamimaecdongtang had significant effect on decrease of lung weight in pulmonary edema. the TBA value. glycoprotein contents in trachea. and mucous area in tracheal epithelium. and recovery of the cillia cells of tracheal epithelium. and inhibition of mucous secretion. So I think we can take advantage of this medicine very usefully for treatment of pulmonary edema. pheumonia. acute and chronic bronchitis etc.

• 대한수의학회지
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• 제37권1호
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• pp.87-101
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• 1997

The development of trachea in fetuses on 60, 90 and 120 days of gestation and neonates of Korean native goats was investigated by microscopy and scanning and transmission electron microscopy. The results were summarized as follows; Light microscopic studies: 1. In the 60-day-old fetuses, the tracheal walls were differentiated and divided into four layers of the mucosa, submucosa, muscle and cartilage, and adventitia. The tracheal epithelium is composed of stratified ciliated columnar epithelium at 60- and 90-day-old fetuses while the epithelium observed at 120-day-old fetuses was pseudostraified ciliated colummar epithelium. 2. In the 90-day-old fetuses, tracheal glands extended into the submucosa and peripheral area of the tracheal cartilage. The blood vessels were observed in the submucosa and adventitia. The elastic and collagenous fibers were observed in the tracheal walls. 3. In the neonates, the tracheal walls consisted of mucosa with well-developed folds, submucosa, tracheal glands, muscle and cartilage, collagenous and elastic fibers, and adventitia, which were more developed than those of 120-day-old fetuses. The tracheal epithelium was developed as that in adults. Scanning electron microscopic studies: 4. In the 60-day-old fetuses, most of tracheal epithelial cells were nonciliated but short microvilli were sporadically observed on the luminal surface. On rare occasions, a few cells have solitary cilium. 5. In the 90-day-old fetuses, the ciliated cells appeared increasingly and cilia elongated longer than those of 60-day-old fetuses. 6. In the 120-day-old fetuses, the nonciliated cells covered with microvilli in dome-shape were barriered by thick carpet of cilia. The nonciliated cells also have many papillary projectons on the apical surface. 7. In the neonates, the nonciliated cells in tracheal epithelium were covered compactly with numerous cilia, and many secretory droplets were found on the cilia. Transmission electron microscopic studies: 8. In the 60-day-old fetuses, nonciliated cells of the tracheal epithelium contain large amounts of glycogen granules in the supernuclear and subnuclear areas meanwhile a few cell organelles were formed. Cilia were well formed along the apical cell membranes of the ciliated cells. Also found in the ciliated cells were basal corpuscles, mitochondria and short chains in granular endoplasmic reticulum(GER). Between the epithelial cells presented were well-defined junctional complex with zonula occludens and desmosomes. The nuclei were variable in size and shape. The more developed nucleoli were observed conspicuosly. 9. In the 90-day-old fetuses, nonciliated cells contained large glycogen granules. Accumulated glycogen granules were observed in the subnuclear and supranuclear portion of the cytoplasm. A few short microvilli were covered with glycocalyx. Ciliated cells contained numerous mitochondria and short chains of GER. 10. In the 120-day-old fetuses, the ciliated cells contained numerous mitochondria, abundant short chains of GER and nucleoli. Nonciliated cells contained some Golgi complex and mitochondria. The cell borders were well-defined and distinct junctional complex with zonula occludens, desmosomes, and interdigitorum. 11. In the neonates, well-developed goblet cells were observed in the tracheal epithelium. Ultrastructures of ciliated and nonciliated cells on the tracheal epithelia were similar in pattern as those in adults.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 2003년도 제3차 추계학술대회
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• pp.107-107
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• 2003

Purpose; Tracheal transplantation is necessary in patients with extensive tracheal stenosis, congenital lesions and many oncologic conditions but bears many critical problems compared with other organ transplantations. The purpose of this study was to make an intestine-cartilage composite graft for potential application for tracheal reconstruction by free intestinal graft. Methods; Hyaline cartilage was harvested from trachea of 2 weeks old New Zealand White Rabbits. Chondrocytes were isolated and cultured for 8 weeks. Cultured chodrocytes were seeded in the PLGA scaffolds and mixed in pluronic gel. Chondrocyte bearing scaffolds and gel mixture were embedded in submucosal area of stomach and colon of 3kg weighted New Zealand White Rabbits under general anesthesia. 10 weeks after implantation, bowels were harvested for evaluation. Results; We could identify implantation site by gross examination and palpation. Developed cartilage made a good frame for shape memory Microscopic examinations include special stain showed absorption of scaffold and cartilage formation even though not fully matured Conclusion; Intestine-cartilage composite graft could be applicable to future tracheal substitute and needs further Investigations.

• Journal of Chest Surgery
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• 제28권8호
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• pp.766-771
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• 1995

The trachea is defined as the airway from the inferior border of the cricoid cartilage to the top of the carinal spur. This paper would confirm the normal tracheal length of Korean adults through the actual measurement using the fiberoptic bronchoscopy. The subjects of this study were 25 patients, 13 males and 12 females between the age of 20 to 69 without abnormality on the neck, trachea, mediastinum and lung pharenchyme on the preoperative chest X-ray, who received the operations from the period of July to September, 1994. For those patients who had heart diseases, the cardiothoracic ratio was below 50%. The measurement was performed on the patients with endotracheal intubation under the general anesthesia in supine and neutral position. The tracheal length was calculated by the difference between the length from the tip of the endotracheal tube [E-tube to carina and to the needle which was inserted into the E-tube at the lower border of the palpated cricoid cartilage, by inserting the broncoscopy through the E-tube. The result was as follow : 1 The measured tracheal length for men was 11.8 0.2 cm[mean standard deviation and women was 10.5 0.3 cm, and that was longer than this [p<0.01 . The average was 11.2 1.0 cm and the standard error was 0.20 cm. 2 According to the correlation between the tracheal length to weight, height[Ht , age, and body surface area[BSA respectively, the Ht [p=0.003 , age [p=0.055 , and the BSA[p=0.017 were significant, while weight was not [p=0.314 . 3 From the regression analysis of the tracheal length[T.L. to the Ht, Age, and the BSA which were significant, the following equation was derived.i Ht : T.L.= -1.29 + 0.076 x Ht [P=0.003 ii Age: T.L.= 10.04 + 0.028 x Age [P=0.055 iii BSA : T.L.= 5.60 + 3.48 x BSA [P=0.017 iv In multi-regression : T.L. = -4.15 + 0.034 x Age + 0.085 x Ht [P=0.0002]