• Korean Journal of Bronchoesophagology
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• v.14 no.1
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• pp.5-7
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• 2008

Subcutaneous cervicofacial, mediastinal emphysemas are complications associated with head and neck surgery, trauma, infectious processes, tooth extraction. Drill cooling stream and dental syringe air ject are the sources of high pressure air that may enter exposed soft tissue. Since the introduction of the high-speed air turbine drill in the 1960s, The incidence of iatrogenic subcutaneous emphysema has increased. Most cases begin to resolve after 2 to 3 days and residual swelling is usually minimal at the end of 7 to 10 days. Surgical approach is not advised because it is likely to be ineffective. The differential diagnosis of neck swelling after dental procedure includes hematoma, cellulitis, angioedema, allergic reaction, subcutaneous emphysema. We report a rare case of patient with subcutaneous cervicofacial emphysema and mediastinal emphysema secondary to third molar extraction.

• Journal of Korean Dental Science
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• v.7 no.1
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• pp.25-30
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• 2014

Subcutaneous emphysema and pneumomediastinum is a relatively uncommon phenomenon. It may occur secondary to dental treatment using high-speed air turbine handpieces, especially after extraction of tooth. Subcutaneous emphysema is often limited only to the areas of head and neck, but also can involve deeper structures. Thorough examination and conservative treatment of these problems are essential in preventing life-threatening complications such as airway obstruction and mediastinitis. The subject of this report is a 57-year-old woman with subcutaneous emphysema and pneumomediastinum during the extraction of maxillary third molar using high-speed air turbine handpiece. If there isn't any appropriate measure, severe complications may occur. Therefore it is important to be well-informed of proper diagnosis and treatment. This article shall present a case report with literature review.

• Korean Journal of Bronchoesophagology
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• v.4 no.2
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• pp.240-243
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• 1998

Subcutaneous emphysema is an unusual and rarely reported complication of tonsillectomy. The more commen complications are hemorrhage, infection and following anesthesia, aspiration, cardiac arrhythmia, and laryngeal trauma can occur. Posttonsillectomy subcutaneous emphysema results directly from the introduction of air into the tonsillar bed either during the surgical procedure itself or in the postoperative period. This condition is generally benign and self limiting and usually requires treatment only for the primary respiratory disease. In this report, we describe a 40-year-old female patient in whom subcutaneous emphysema developed shortly after tonsillectomy. She was observed for 5 days, at which point subcutaneous emphysema was seen on the follow up soft tissue neck X-ray to disappeared.

• Tuberculosis and Respiratory Diseases
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• v.82 no.2
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• pp.158-165
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• 2019

Background: A recent study reported that mesenchymal stem cells possess potential cellular therapeutic properties for treating patients with chronic obstructive pulmonary disease, which is characterized by emphysema. We examined the potential therapeutic effect of Wharton's Jelly-derived mesenchymal stem cells (WJMSCs), following pretreatment with pioglitazone, in lung regeneration mouse emphysema models. Methods: We used two mouse emphysema models, an elastase-induced model and a cigarette smoke-induced model. We intravenously injected WJMSCs ($1{\times}10^4/mouse$) to mice, pretreated or not, with pioglitazone for 7 days. We measured the emphysema severity by mean linear intercepts (MLI) analysis using lung histology. Results: Pioglitazone pretreated WJMSCs (pioWJMSCs) were associated with greater lung regeneration than non-augmented WJMSCs in the two mouse emphysema models. In the elastase-induced emphysema model, the MLIs were $59.02{\pm}2.42{\mu}m$ (n=6), $72.80{\pm}2.87{\mu}m$ (n=6), for pioWJMSCs injected mice, and non-augmented WJMSCs injected mice, respectively (p<0.01). Both pioWJMSCs and non-augmented WJMSCs showed regenerative effects in the cigarette smoke emphysema model (MLIs were $41.25{\pm}0.98$ [n=6] for WJMSCs and $38.97{\pm}0.61{\mu}m$ [n=6] for pioWJMSCs) compared to smoking control mice ($51.65{\pm}1.36{\mu}m$, n=6). The mean improvement of MLI appeared numerically better in pioWJMSCs than in non-augmented WJMSCs injected mice, but the difference did not reach the level of statistical significance (p=0.071). Conclusion: PioWJMSCs may produce greater lung regeneration, compared to non-augmented WJMSCs, in a mouse emphysema model.

• Korean Journal of Bronchoesophagology
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• v.14 no.1
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• pp.50-53
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• 2008

Subcutaneous cervicofacial, mediastinal emphysemas are complications associated with head and neck surgery, trauma, infectious processes, tooth extraction. Drill cooling stream and dental syringe air ject are the sources of high pressure air that may enter exposed soft tissue. Since the introduction of the high-speed air turbine drill in the 1960s, The incidence of iatrogenic subcutaneous emphysema has increased. Most cases begin to resolve after 2 to 3 days and residual swelling is usually minimal at the end of 7 to 10 days. Surgical approach is not advised because it is likely to be ineffective. The differential diagnosis of neck swelling after dental procedure includes hematoma, cellulitis, angioedema, allergic reaction, subcutaneous emphysema. We report a rare case of patient with subcutaneous cervicofacial emphysema and mediastinal emphysema secondary to third molar extraction.

• Advances in pediatric surgery
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• v.13 no.1
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• pp.87-92
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• 2007

An 1-month old female newborn was admitted to our hospital because of jaundice which occurred at 2 days after birth. Plain chest X-ray and chest CT revealed a collapsed right middle lobe and lobar emphysema was suspected. Right upper lobectomy of the lung was done and pathologic findings showed an infantile lobar emphysema. After the operation, the newborn was discharged without complication and was followed up through the out patient clinic. Infantile lobar emphysema is rare and male dominant. Left upper lobe of the lung is the most prevalent site. Patients with infantile lobar emphysema complain of respiratory symptoms. We report one case of infantile lobar emphysema on right upper lobe of lung, in a female with no respiratory symptoms.

• BMB Reports
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• v.56 no.8
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• pp.439-444
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• 2023

Emphysema is a chronic obstructive lung disease characterized by inflammation and enlargement of the air spaces. Regorafenib, a potential senomorphic drug, exhibited a therapeutic effect in porcine pancreatic elastase (PPE)-induced emphysema in mice. In the current study we examined the preventive role of regorafenib in development of emphysema. Lung function tests and morphometry showed that oral administration of regorafenib (5 mg/kg/day) for seven days after instillation of PPE resulted in attenuation of emphysema. Mechanistically, regorafenib reduced the recruitment of inflammatory cells, particularly macrophages and neutrophils, in bronchoalveolar lavage fluid. In agreement with these findings, measurements using a cytokine array and ELISA showed that expression of inflammatory mediators including interleukin (IL)-1β, IL-6, and CXCL1/KC, and tissue inhibitor of matrix metalloprotease-1 (TIMP-1), was downregulated. The results of immunohistochemical analysis confirmed that expression of IL-6, CXCL1/KC, and TIMP-1 was reduced in the lung parenchyma. Collectively, the results support the preventive role of regorafenib in development of emphysema in mice and provide mechanistic insights into prevention strategies.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.882-884
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• 1994

Congenital lobar emphysema is one of the abnormal development of pulmonary parenchyme which may cause respiratory distress in infant. This disease is an unusual condition barely mentioned before 1949, and only 166 cases were reported till 1967 in English literature. This report describes a 13 months old girl who had a congenital left upper lobar emphysema. The left upper lobectomy was the operation for this case and the postoperative course was not eventful, and have been in good condition upto now.

• Tuberculosis and Respiratory Diseases
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• v.51 no.2
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• pp.97-107
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• 2001

Background : Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. Method: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both $FEV-1$ and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. Results : There was no significant difference in the demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the $PaCO_2$ was higher ($42.9{\pm}4.7$ vs $38.8{\pm}3.1\;mmHg$ at rest; $47.9{\pm}7.0$ vs $41.1{\pm}5.9\;mmHg$ after exercise; p<0.01) and the right ventricular ejection fraction was lower ($57.6{\pm}6.5$ vs $61.4{\pm}4.7%$ at rest; $51.1{\pm}10.8$ vs $59.8{\pm}6.6%$ after exercise; p<0.01) both at rest and after exercise. The $PaCO_2$ after exercise was also lower ($65.7{\pm}12.6$ vs $80.2{\pm}14.4\;mmHg$, p<0.01), while the Pa02 at rest tended to be lower($82.9{\pm}12.0$ vs $87.8{\pm}7.5$, p>0.05). In both groups, right ventricular ejection fraction correlated with the $PaCO_2$ after exercise(PTE r=0.536, PE r=0.557), and the $PaCO_2$ at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). Conclusion : Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.

• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.310-317
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• 2012

Background: Airway obstruction and the extent of emphysema are reported to be responsible for reduced bone mineral density (BMD). Corresponding to different phenotypes of a pulmonary disease, different severity in extra pulmonary features may exist. We compared BMDs of subjects with or without airway obstruction and/or emphysema and investigated the relationships among BMD, the severity of airway obstruction, and the extent of emphysema. Methods: Using a university hospital database, we reviewed patients over 40 years old who performed spirometry, computed tomography of chest, and measurement of BMD of the lumbar (L) spine. According to the presence or absence of airway obstruction and/or emphysema, four groups were classified. Results: Among a total of 59 subjects, 33 (56%) had osteoporosis. The prevalence of osteoporosis in subjects with no airway obstruction and no emphysema, those with only emphysema, those with only airway obstruction, and those with both airway obstruction and emphysema were 42%, 57%, 64%, and 73%, respectively (p=0.047 by linear-by-linear association). The mean T-scores of BMD of L1 (p=0.032) and L1-4 spines were different among the four groups (p=0.034). Although the T-score of L1 BMD negatively correlated with the extent of emphysema (r=-0.275, p=0.035) and positively with each of body mass index (BMI) (r=0.520, p<0.001), forced expiratory volume in one second ($FEV_1$) (r=0.330, p=0.011), $FEV_1$/forced vital capacity (r=0.409, p=0.001), and forced expiratory flow at 25~75% of FVC ($FEF_{25-75%}$) (r=0.438, p=0.0001), respectively, multiple linear regression analysis indicated that BMI (p<0.001) and $FEF_{25-75%}$ were predictive of BMD (p=0.012). Conclusion: Low BMI and airway obstruction were strongly associated with reduced bone density rather than the extent of emphysema.