• 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 Bronchoesophagology
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• v.14 no.2
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• pp.57-63
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• 2008

Hypopharyngeal perforation secondary to tracheal intubation is rare, but may result in severe airway complications that include retropharyngeal abscess, pneumothorax, pneumonia, mediastinitis and death. The most common site of hypopharyngeal perforation is the pyriform sinus and the region of the cricopharyngeus muscle. We report a 62-year old man with intubation-induced hypopharyngeal injury presenting as deep neck infection. The patient presented with dyspnea and pain on the neck. Neck CT scan identified fluid and air collection on the neck from the hyoid bone to the thoracic inlet level. Despite of delayed diagnosis, we successfully operated him by using strap muscle myofascial transposition flap. The patient was followed up for 3 months without any complications.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.190-193
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• 2012

A 2-month-old, intact female Alaskan Malamute was presented for evaluation of dyspnea and subcutaneous emphysema of the neck following biting wound. Two small punctured skin lesions and crepitus on the neck were found during physical examination. Radiographs revealed pneumomediastinum and subcutaneous emphysema. Confirmative diagnosis of tracheal laceration was made by identifying the tracheal wall discontinuity on the computed tomography. CT is a valuable tool to diagnose an external traumatic tracheal injury, and more specifically, to assess the location and the extent of laceration, and it leads to early definitive treatment and reduction of the incidence of complications.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.588-593
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• 1990

The rupture of tracheobronchial tree caused by non penetrating blunt trauma is being increased in incidence though it is still rarely occurred on now Because this type of injury is uncommon, a high index of suspicion should be maintained in all crush injuries involving the chest. Early diagnosis and primary repair not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced a case of tracheobronchial rupture caused by non penetrating blunt chest trauma without rib fracture. The patient was a 16 year old male who was a high school student. He was compressed on anterior chest by hand ball goal post being failed down on the morning of admission day. After this accident, he was suffered from progressively developing dyspnea and subcutaneous emphysema on face, neck and anterior chest. The diagnosis, tracheal rupture, was made by chest CT and bronchoscopy. After right thoracotomy, the ruptured site was directly closed by using interrupted suture. Post-operative course was uneventful. Thus we report this case of traumatic tracheal rupture with review of literature.

• The Korean Journal of Emergency Medical Services
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• v.9 no.1
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• pp.95-99
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• 2005

Penetrating neck trauma by gunshot injury involving tracheobronchial tree is rare in Korea. Extensive tissue damage by cavitation, tissue fragmentation and shock wave transmission of high-velocity projectile along with associated organ injury renders high rate of mortality and morbidity. A 28 year old man in military service with gunshot wound in left cervical area presented initial symptoms of severe dyspnea and subcutaneous emphysema. Computed tomography of chest and cervical region as well as bronchoscopic evaluation was performed to confirm highly suspected injury to cervical trachea. Surgical exposure was established through a low collar incision; the damaged segment of 3.5 cm length including 2-4th tracheal rings was resected out and end-to-end anastomosis was performed. Bleeding from lacerated anterior jugular vein was controlled by ligation of both ends and a K2 bulllet was found upon inner border of body of first rib, medial to right carotid sheath and removed out. Cervical esophagus, carotid artery, internal jugular vein and recurrent laryngeal nerve were spared. Extubation was done on the first postoperative day and postoperative course until discharge on nineth postoperative day remained uneventful.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.303-305
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• 1991

The tracheobronchial rupture from blunt trauma is an uncommon injury with a variety of clinical presentations. Most of traumatic tracheobronchial tears occur within 2.5cm of the tracheal carina; lobar or segmental bronchi are rarely affected. Recently we experienced one case of traumatic rupture of right middle lobar bronchus in a patient who had fallen from a bicycle. Bronchoscopy showed linear disruption of the right middle lobe bronchus at its bifurcation site. Emergency right middle lobectomy was performed. The patient was recovered without any sequelae.

• Journal of Chest Surgery
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• v.27 no.1
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• pp.68-71
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• 1994

A tracheo-esophageal fistula following from blunt chest trauma is one of less common lesion and few guidelines are available to direct its optimal management. Herein, we report a 24-year-old man injured in a motor vehicular accident sustained a nonpenetrating double blowout injury of the thorax and large tracheoesophageal fistula occurred. Tracheal defect required resection and reconstruction, of which the membranous portion underwent closure with borrowed adjacent esophageal wall primarily and substernal left colon interposition was performed 4 weeks later.

• The Journal of Korean Medicine
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• v.17 no.2 s.32
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• pp.178-190
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• 1996

This experiment was performed in order to study the effects of Haepyoyijintang on the pulmonary injury caused by $SO_2$. Healthy adult male rats weighting about 250g were divided into 4 groups- the Normal group, the Control group, the group of Haepyoyijintang administration for 5 days after $SO_2$ gas exposure (Sample I ), and the group of Haepyoyijintang administration for 10 days before and for 5 days after $SO_2$ gas exposure (SampleⅡ). The results were obtained as follows; 1. In the total number of leucocyte, Sample I and Sample II decreased significantly compared with Control group. 2. In the erythrocyte sedimentation rate, Sample I and Sample Ⅱ decreased significantly compared with Control group. 3. In the lung weight, Sample I and Sample II decreased significantly compared with Control group. 4. In the lung TBA level, only Sample II decreased significantly compared with Control group. 5. In the tracheal glycoprotein level, Sample I and Sample II decreased significantly compared with Control group. According to the above results, Haepyoyijintang has significant effects on the pulmonary injury caused by $SO_2$ in rats.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.344-356
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• 1997

This experiment was performed in order to study the clinical effect of Sojadodamgangkitang on the pulmonary injury caused by $SO_2$. Healthy adult male rats weighing about 250g were divided into 4 groups-the Normal group, the Control group, the group of Sojadodamgangkitang administration for 5 days after $SO_2$ gas exposure(Sample I), and the group of Sojadodamgangkitang administration for 10 days before and for 5days after $SO_2$ gas exposure(Sample II). The results were obtained as. follows; 1. In comparison with Control group, Sample I and Sample II were revealed significant effect on the total number of leucocyte. 2. In comparison with Control group, Sample I and Sample II were revealed significant effect on. the erythrocyte sedimentation rate. 3. In the effect on the lung weight, Sample I and Sample II were revealed significantly. 4. In the effect on the lung TBA level, only Sample II was revealed significantly. 5. In the effect on the tracheal glycoprotein level, Sample I and Sample II were revealed significantly. According to above results, Sojadodamgangkitang had significant effect on the pulmonary injury caused by $SO_2$ in rats.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.139-147
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• 1982

In case of segmental injury of trachea, the primary repair is very difficult, because the trachea is fixed in place without movability from the surrounding tissue. In addition to special anatomical situation of trachea, any ideal artificial prosthesis for tracheal replacement is not still appeared. Many authors proposed several procedures for the tracheal repair, but satisfactory results were few. Among the proposed procedures end to end anastomosis of trachea was noted superior when both ends of trachea could be approximated by mobilization of upper and lower injured trachea. The author's experiment was designed to determine the effect about decreased tension on trachea when the hyoid bone was released downward from the surrounding muscular structures. The experimental dogs were divided into two groups, suprahyoid releasing group (SH R) and control group of intact hyoid. SH R group was subdivided into two groups accord ing to he degree of tension. The experimental results were as follow; 1. SH R group: In view of X-ray, the distance between the angle of mandible and the displaced hyoid bone was lengthened downward. And it's range was from 1.3cm (38%) minimally to 2.7cm(108%) maximally. 2. Control group: The distance between the angle of mandible and hyoid was same in both pre and postoperation. As the result of this experiment study, the suprahyoid release technique seems to be the efficient method that enable of release the trachea maximally. And it should be expected that the SH R technique is applicable clinically.