• Journal of Chest Surgery
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• v.28 no.4
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• pp.416-418
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• 1995

The microwave tissue coagulation therapy was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases.We experienced one case of the restenosis after the tracheal reconstruction. The patient, who was 42 year-old male, had severe dyspnea due to the tracheal stenosis for 4 years. The resection of tracheal stenosis and tracheal reconstruction was done. But the restenosis occurred at the tracheal anastomosis site because of the protrusive granulation at one month after operation. The patient was successfully treated by the microwave tissue coagulation therapy.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.128-139
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• 2001

The purpose of this study was to review the literatures of experimental tracheal reconstruction. Although there have been significant advancements in the surgical treatment of the long circumferential tracheal injuries, there still has been a difficult problem with high morbidity and mortality. The method for tracheal reconstruction after circumferential resection is preferred end-to-end anastomosis for defects up to 6 cm in length, but larger tracheal defects require the use of tracheal allograft, various artificial prosthesis or autogenous organs. The tracheal allotransplantation has been widely used as there was significantly improved the method of surgical technique, preservation and immunosuppression. But it has been limited by a number of factors such as few donor, limited use of immunosuppressant, delayed revascularization and re-epitheliazation. Experimental studies on the tracheal prosthesis have a long history and they tried to use silicone, polytetrafluoroethylene, polypropylene mesh, Dacron, Marlex mesh, external or internal stents. Other experimental studies were reported the use of autogenous tissues that were cartilage. jejunum, aorta, skin, muscle, periostium or esophagus. But a great variety of these protheses have been resulted unsatisfactory in a significant Proportion of cases. Alternatively, the tissue-engineering technique has showed a new approach to reconstruct trachea and much progress in tissue-engineering bas been made recently. In conclusion, although the tracheal allotransplantation and the use of prosthesis and allograft have been reported a lot of limitation to overcome, we could sooner expect good result of ideal tracheal prosthesis.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.174-177
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• 2001

Previously, we used a rigid bronchoscope in removal of endotracheal granulation tissue and foreign body. But these method has poor visual field and difficulty in handling of the instruments, therefore there were restriction in removing the endotracheal granulation tissue and foreign body. Recently we underwent one case each of endotracheal granulation tissue and foreign body causing dyspnea and removed them by right angled forceps under visualization via nasal rigid endoscope inserted through the tracheal stoma. We suggest this method for removal of tracheal foreign body, granulation tissue and excision of tumorous condition in patients with tracheocutaneous fistula.

• The Journal of Internal Korean Medicine
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• v.21 no.4
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• pp.591-595
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• 2000

Objective : This experiment was performed in order to study the effects of Scrophulariae Radix on the injured tracheal tissue induced So, in rats. Methods : Healthy adult male rats weighting about 250g were divided into 4 groups - the Normal group, the Control group, the group of Scrophulariae Radix administration for 5 days after $SO_2$, gas exposure(Sample I), and the group of Scrophulariae Radix administration for 10 days before and for 5 days after $SO_2$, gas exposure(Sample II). Results : In the trachea Control group, the lesion of the ciliated epithelium was severe and the mucus secretion of the respiratory tract was increased significantly. In the trachea of Sample I group, the lesion of the ciliated epithelium and the mucus secretion of the respiratory tract were decreased compared with Control group. In the trachea of Sample II group, the lesion of the ciliated epithelium and the mucus secretion of the respiratory tract were decreased compared with Control and Sample I group. conclusions : According to the above results, Scrophulariae Radix has significant effects on the injuried tracheal tissue caused by $SO_2$ in rats.

• Korean Journal of Oriental Medicine
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• v.2 no.1
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• pp.226-235
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• 1996

This experiment was performed in order to study the effects of Gyumsuyukgunjun on the injured tracheal tissue induced $SO_2$ in rats. Healthy adult male rats weighting about 250g were divided into 4 groups - the Normal group, the Control group, the group of Gyumsuyukgunjun administration for 5 days after $SO_2$ gas exposure (Sample I), and the group of Gyurnsuyukgunjun administration for 10 days before and for 5 days after $SO_2$ gas exposure (Sample II). The results were obtained as follows ; 1. In the trachea Control group, the lesion of the ciliated epithelium was severe and the mucus secretion of the respiratory tract was increased significantly. 2. In the trachea of Sample I group, the lesion of the ciliated epithelium and the mucus secretion of the respiratory tract were decreased compared with Control group. 3. In the trachea of Sample II group, the lesion of the ciliated epithelium and the mucus secretion of the respiratory tract were decreased compared with Control and Sample I group. According to the above results, Gyumsuyukgnjun has significant effects on the injuried tracheal tissue caused by $SO_2$ in rats.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.136-139
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• 1994

Tracheal stenosis is relatively common complication after tracheal intubation or tracheostomy for a long time. We experienced 10 cases of tracheal stenosis with various causes, prolonged intubation or tracheostomy caused the tracheal stenosis in seven, one after advanced cancer of the lung, one after inhalation burn, and the other was palliative management for tracheal stenosis by Gianturco type tracheal stent. We tried to correct this stenosis applying three tracheal stent and one Montgomery T-tube as a palliative approach, but failed in two, one restenosis due to regrowing of granulation tissue with scarring or another metastatic spread of cancer to systemic organs after 3 months of placing the stent. Tracheal circumferential resection and end to end anastomosis were done in seven, and obtained one postoperative complication as subglottic stenosis was followed by Montgomery T-tube and reoperation later. With the brief review of references, we report the cases.

• Journal of Chest Surgery
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• v.26 no.5
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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.

• Journal of Life Science
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• v.7 no.2
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• pp.88-94
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• 1997

This experiment was performed in order to study the effects of haepyoyijintang on the injured tracheal tissue induced $SO_{2}$ in rats. Healthy adult male rats weighting about 250g were divided into 4 groups-the Normal group, the Control group, the group of Haepyoyijintang administration for 5days after $SO_{2}$gas exposure (Sample I), and the group of Haepyoyijintang adiministration for 10 days before and for 5days after $SO_{2}$ gas exposure (Sample II). The results were obtained as follows; 1. In the trachea Control group, the lesion of the ciliated epithelium was and the mucus secretion of the respiratory tract was increased iginificantly. 2. In the trachea of SampleIgroup, the lesion of the ciliated epithelium and the mucus secretion of the respiratory tract were decreased compared with Control group. 3. In the trachea of SampleIIgroup, the lesion of the ciliated epithelium and the mucus secretion of the respiratory tract were decreased compared with Control and Sample Igroup. According to the above results, Haepyoyijintang has significant effects on the injuried tracheal tissu caused by $SO_{2}$ in rats.

• Journal of Chest Surgery
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• v.28 no.2
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• pp.156-161
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• 1995

Although there are many kinds of method in treatment of tracheal stenosis, tracheal resection and primary anastomosis can be performed for management of various kinds of tracheal stenosis because it is considered the most anatomical ideal therapeutic modality. During a 10-year period we performed 18 tracheal resection on 18 patients with no operative mortality and some morbidity. 13 patients had tracheal stenosis caused by endotracheal intubation [eight patients or tracheostomy [five patients ; and five patients caused by a variety of neoplastic lesions [four primary and one secondary . The length of tracheal stenosis were various from 1.5cm to 5.5cm and site of tracheal stenosis were cervical[17patients and thoracic [one patient . Operative techniques were tracheal resection and primary anastomosis[18 patients and additional procedures were cricoid cartilage reconstruction with costal cartilage [one patient , primary repair of esophagus[one patient and suprahyoid laryngeal release technique[eight patients without any complications. We have eight complications; tracheal restenosis were developed in five patients[growth of grannulation tissue at anastomotic site in three patients, delayed restenosis in two patients , anastomotic disruption in one patient, hoarseness and pneumonia in each of two patients. We managed tracheal complications with T-tube insertion in two patients, permanent tracheostomy in three patients and insertion of Gianturco tracheal stent in one patient, but tracheal stent did not reveal good result because it caused persistent production of sputum. We concluded that it is necessary to access full length of normal trachea including suprahyoid laryngeal release technique to avoid anastomotic tension in tracheal surgery and develope new ideal techniques to manage postoperative tracheal complications, because we suppose tracheal complications are developed due to anastomotic tension.

• Journal of Chest Surgery
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• v.24 no.5
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• pp.438-444
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• 1991

This study was designed to evaluate the viability of canine trachea after cryopreservation for two months. Eight cervical tracheal rings were resected in three dogs and both ends were anastomosed. The resected tracheal segments were cryopreserved and stored in liquid nitrogen at -196oC for two months. Two months later, the cryopreserved segments were thawed. Half of each segment was implanted into the abdomen of its donor animal and the other half was cultured in tissue media. Two weeks later, the animal was sacrificed. The native cervical trachea was removed to serve as a control and the abdominally implanted trachea was removed for study. At that time, both specimens were also cultured in tissue media. Tracheal epithelial viability was assessed histologically by using an inverted microscope. The epithelial cells were confirmed immunohistochemically using monoclonal antibodies against cytokeratin and epithelial membrane antigen. Control and cryopreserved segments showed good, viable epithelial cells, but the implanted segments showed slightly depressed viability. We conclude that canine tracheal epithelium can survive after cryopreservation for two months, but the implanted trachea will be slightly damaged by ischemia before revascularization, even if omental wrapping is used.