• 제목/요약/키워드: tracheal tissue

검색결과 100건 처리시간 0.035초

이상성 기류유량곡선(biphasic flow-volume loop)을 보인 결핵에 기인한 좌주기관지협착 1예 (A Case of Biphasic Flow-volume Loop in Left Mainstem Bronchial Stenosis)

  • 최수전;조문숙;이혁표;김주인;염호기
    • Tuberculosis and Respiratory Diseases
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    • 제45권2호
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    • pp.416-420
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    • 1998
  • 저자들은 기관지결핵의 후유증으로 좌주기관지 협착이 있었던 환자가 이상성 기류유량곡선을 보인 후 금속스텐트 삽입후 교정되었다가 스텐트 삽입 2개월 후부터 육아종형성에 따른 좌주기관지의 재협착이 나타나 다시 기류유량곡선상 이상성 기류유량곡선을 보인 증례를 경험하였기에 보고하는 바이다.

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Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

  • Escandon, Joseph M.;Mohammad, Arbab;Mathews, Saumya;Bustos, Valeria P.;Santamaria, Eric;Ciudad, Pedro;Chen, Hung-Chi;Langstein, Howard N.;Manrique, Oscar J.
    • Archives of Plastic Surgery
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    • 제49권5호
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    • pp.617-632
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    • 2022
  • Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

Cromakalim이 해명의 과민반응 매개체 유리에 미치는 영향 (Effects of Crormakalim on the Release of Mediators in Hypersensitivity of Guinea pig)

  • 노재열;김경환
    • 대한약리학회지
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    • 제29권2호
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    • pp.263-274
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    • 1993
  • $K^+$통로는 기도 평활근 세포에 존재하며 이들 통로가 활성화되면 평활근의 과분극의 결과 이완작용이 나타난다. $K^+$통로의 이런 효과는 과민반응과 천식 치료에 응용될 수 있으므로 우리는 $K^+$통로 개방제인 cromakalim (BRL34915, CK)이 $IgG_1$ 항체로 감작시킨 기도 및 폐조직으로 부터 유리되는 매개체 유리에 미치는 영향을 조사하였다. 피동적으로 감작된 두 조직은 $2{\times}10^{-6}\;M$의 CK로 30분동안 superfusion시킨 후 CK와 항원 (Ox-HSA) 0.1 mg/ml로 자극하였다. 또한 비만세포를 이용하여 CK의 효과를 조사하였다. 해명 폐조직 비만세포는 효소에 의한 digestion method (monodispersed; 미분리 정제), count current elutriation에 의한 방법(partially purified; 부분분리정제), 그리고 discontinuous Percoll방법(highly purified; 순수분리정제)에 의해 순수 분리되었다. CK로 전처치한후, 피동적으로 감작된 비만세포는 OA와 CaI의 여러 농도에 의해 자극되었다. 유리된 Hist은 spectrophotofluorometry에 의해, LT는 면역방사법에 의해 측정되었다. CK 전처치는 $IgG_1$ 감작후 항원에 의해 자극된 기도 조직에서 Hist 유리량을 35%까지, LT 유리량은 40%까지 감소시켰으나 기도 평활근 수축력에는 반응을 나타내지 못하였다. 항원 유도 폐조직에 있어서 CK전처치는 Hist유리량을 25%까지 감소시켰으나 LT 유리에는 미약한 감소를 나타내었다. 해명의 미분리정제, 부분분리정제, 그리고 순수 분리 정제된 비만세포로부터 Hist과 LT은 면역자극(OA)이나 비면역자극(CaI)에 의해 농도 의존적으로 유리되었다. 비만세포에서 유리된 LT는 5-lipoxygenase억제제인 A64077에 의해서 억제됨이 확인되었다. CK전처치는 OA유도 및 CaI유도 해명 폐조직 비만세포에서 Hist과 LT 유리량을 20%까지 감소시켰다. $IgG_1$ 감작후 Ox-HSA유도 기도 평활근 조직이나 혹은 OA유도 및 CaI유도 비만세포에서 Hist과 LT유리에 미치는 CK의 억제효과는 TEA와 GBC에 의해 완전히 봉쇄되었다. 이상의 결과에서 폐조직 비만세포는 LT를 유리할 수 있는 세포로 간주되며, 기도 평활근 이완제로 알려져 있는 CK은 특수 항원 유도 기도 평활근조직에서 매개체 유리를 부분적으로 억제하며, CK은 또한 OA유도 및 CaI로 유도된 순수분리 정제된 비만세포에서 매개체 유리를 부분적으로 억제하는 것으로 보아 비만세포가 활성화시 야기되는 여러 생화학적 현상중에서 미약하나마 $K{^+}$통로가 관여할 것으로 사료된다.

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미세먼지 유발 폐기능 손상 동물모델에서 RML의 호흡기 보호 효과 (Respiratory Protective Effect of a RML on PM10D-induced Lung Injury Mouse Model)

  • 김수현;김민주;신미래;노성수;김승형;박해진
    • 대한본초학회지
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    • 제37권3호
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    • pp.29-39
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    • 2022
  • Objective : This study is aimed to evaluate the protective effects of Rehmanniae Radix, Mori Folium, and Liriopie Tuber mixture (RML) on lung injury of Particulate matter less than 10 um in diameter and diesel exhaust particles (PM10D) mice model. Methods : To investigate the anti-inflammatory activity of RML, PM10D was diluted in aluminum hydroxide (Alum) in 7-week-old male mice and induced by Intra-Nazal-Tracheal (INT) injection method. Animal experiments were divided into 5 groups. Nor (normal mice), CTL (PM10D-induced mice with the administration of distilled water), DEXA (PM10D-induced mice with the administration of 3 mg/kg Dexamethasone), RML 100 (PM10D-induced mice treated with RML 100 mg/kg weight), and RML 200 (PM10D-induced mice treated with RML 200 mg/kg body weight). After 11 days administration, mice were sacrificed and inflammation-related immune cells in broncho-alveolar lavage fluid (BALF) were analyzed. Inflammation-related biomarkers were also analyzed in blood and lungs. Lung tissue was observed through histological examination. Results : In the PM10D induced model, the PML showed decreases in CXCL-1 and IL-17A in BALF. Expression of inflammatory cytokines and cough-related mRNA genes was significantly decreased in serum and lung tissue. The mixture treatment of RML significantly improved the immune related cells in the serum. In addition, histological observations showed a tendency to decrease the severity of lung injury. Conclusions : Overall, these results confirmed the respiratory protective effect of the RML mixture in a model of lung injury induced by air pollution (PM10+DEP), suggesting that it is a potential treatment for respiratory damage.

선천성 낭포성 선종양기형 -1례 보고- (Congenital cystic adenomatoid malformation)

  • 선경;백광제;이철세;채성수;김학제;김형묵
    • Journal of Chest Surgery
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    • 제17권1호
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    • pp.118-124
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    • 1984
  • Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

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해표이진탕이 기도 뮤신의 분비, 생성 및 유전자 발현에 미치는 영향 (Effect of Haepyoijin-tang on Airway Mucin Secretion, Production, Gene Expression and Hypersecretion of Mucus)

  • 석연희;민상연;김장현
    • 대한한방소아과학회지
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    • 제29권3호
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    • pp.65-79
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    • 2015
  • Objectives : In this study, effects of haepyoijintang (HIJ) on the increase in airway epithelial mucosubstances of rats and ATP-, PMA-, EGF- or TNF-${\alpha}$-induced MUC5AC mucin production and gene expression from human airway epithelial cells were investigated. Methods : Hypersecretion of airway mucus was induced by exposure of rats to $SO_2$ during 3 weeks. Effect of orally-administered HIJ during 2 weeks on increase in airway epithelial mucosubstances from tracheal goblet cells of rats was evaluated using histopathological analysis after staining the epithelial tissue with PAS-alcian blue. Possible cytotoxicity of HIJ was evaluated by examining the potential damage of kidney and liver functions by measuring serum GOT/GPT activities and serum BUN and creatinine concentrations of rats and the body weight gain during experiment, after administering HIJ orally. At the same time, the effect of HIJ on ATP-, PMA-, EGF- or TNF-${\alpha}$-induced MUC5AC mucin production and gene expression from human airway epithelial cells (NCI-H292) were investigated. Confluent NCI-H292 cells were pretreated for 30 min in the presence of HIJ and treated with ATP ($200{\mu}M$), PMA (10 ng/ml), EGF (25 ng/ml) or TNF-${\alpha}$ (0.2 nM) for 24 hrs, to evaluate the effect of HIJ both on ATP-, PMA-, EGF- or TNF-${\alpha}$-induced MUC5AC mucin production using enzyme-linked immunosorbent assay (ELISA) and on gene expression by the same inducers using reverse transcription-polymerase chain reaction (RT-PCR). Results : (1) HIJ decreased the amount of intraepithelial mucosubstances of trachea of rats. (2) HIJ did not show renal and hepatic toxicities and did not affect body weight gain of rats during experiment. (3) HIJ significantly inhibited ATP-, PMA-, EGF-, and TNF-${\alpha}$-induced MUC5AC mucin productions from NCI-H292 cells. (4) HIJ significantly inhibited ATP-, PMA-, EGF-, and TNF-${\alpha}$-induced MUC5AC mucin gene expression from NCI-H292 cells. Conclusions : The result from the present study suggests that HIJ might control the production and gene expression of airway mucin observed in various respiratory diseases accompanied by mucus hypersecretion and do not show in vivo toxicity to liver and kidney functions after oral administration. Effect of HIJ with their diverse components should be further investigated using animal experimental models that can reflect the pathophysiology of airway diseases through future studies.

양성 기도협착질환에서 실리콘 기도스텐트의 임상경험 - Dumon 스텐트와 Natural 스텐트의 비교 - (Clinical Experience of Silicone Airway Stent in the Management of Benign Tracheobronchial Stenosis)

  • 류연주;유창민;최재철;권용수;김호중;김진국;서수원
    • Tuberculosis and Respiratory Diseases
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    • 제59권1호
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    • pp.62-68
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    • 2005
  • 연구배경 : 양성 기도협착질환 환자에서 새로 개발된 Natural 기도스텐트의 임상결과를 Dumon 스텐트와 비교하였다. 방 법 : 양성 기도협착으로 스텐트를 삽입한 94명의 환자 (39 Dumon, 55 Natural)를 대상으로 임상증상, 시술 전 검사결과, 시술방법, 그리고 추적관찰시의 임상경과를 후향적으로 조사하였다. 결 과: 원인질환으로 기관지결핵 후 기도협착 (74%)이 가장 많았고, 기관삽관 후 기관협착 (20명), 기관절개술 후 기관협착 (2명)등이 있었다. 스텐트를 삽입한 후, 전체 94명의 환자 중 82명 (87%)에서 주관적으로 호흡곤란이개선되었고, Dumon 스텐트군(35/39, 90%)과 Natural 스텐트군 (47/55, 86%) 사이의 차이는 없었다. 모두 48명 (51%)에서 중앙값 14개월(범위6-37개월)후에 스텐트를 성공적으로 제거할 수 있었고, Dumon 스텐트군 (54%, 16개월 후) 과 Natural 스텐트군 (49%, 12개월 후)간의 차이는 없었다. 스텐트 삽입 후 부작용은 스텐트의 위치 변동이 45명 (48%)에서, 육아종 과형성이 41명 (44%)에서, 점액저류에 의한 스텐트 내경 50% 이상의 감소가 17명 (18%)에서, 그리고 스텐트 삽입 전후부위의 협착이 40명 (43%)에서 발생하였다. Dumon 과 Natural 스텐트를 삽입한 환자들 사이에서 부작용의 분포의 차이는 없었다. 결 론 : 새로 개발한 Natural 기도스텐트는 양성기도협착 환자에서 기존의 Dumon 스텐트와 대등한 임상 결과를 보여주고 있어, 기도 협착이 있는 환자의 치료에 유용하게 사용할 수 있을 것으로 사료된다.

맥문동탕이 호흡기 점액의 생성 및 분비에 미치는 영향 (Effect of Macmundongtang on Production and Secretion of Respiratory Mucus)

  • 성현경;민상연;김장현
    • 대한한방소아과학회지
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    • 제27권1호
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    • pp.69-81
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    • 2013
  • Objectives In this study, effects of Macmundongtang (MMT) on ATP or TNF-${\alpha}$ or PMA or EGF induced MUC5AC mucin production and gene expression from human airway epithelial cells and the increase in airway epithelial mucosubstances of rats were investigated. Materials and Methods Confluent NCI-H292 cells were pretreated for 30min in the presence of MMT and treated with ATP ($200{\mu}M$) or PMA (10 ng/ml) or EGF (25 ng/ml) or TNF-${\alpha}$ (0.2 nM) for 24hrs, to assess the effect of MMT both on ATP- or PMA- or EGF- or TNF-${\alpha}$-induced MUC5AC mucin production using enzyme-linked immunosorbent assay (ELISA) and on gene expression by the same inducers using reverse transcription-polymerase chain reaction (RT-PCR). At the same time, hypersecretion of airway mucus was induced by exposure of rats to SO2 during 3 weeks. Effect of orally-administered MMT during 2 weeks on increase in airway epithelial mucosubstances from tracheal goblet cells of rats was assesed using histopathological analysis after staining the epithelial tissue with PAS-alcian blue. Possible cytotoxicity of MMT was assessed by investigating the potential damage of kidney and liver functions by measuring serum GOT/GPT activities and serum BUN concentration of rats and the body weight gain during experiment, after administering MMT orally. Results (1) MMT did not only inhibit but also increased MUC5AC mucin productions and expression levels of MUC5AC gene from NCI-H292 cells. (2) MMT did not decrease the amount of intraepithelial mucosubstances of trachea of rats. (3) MMT did not show renal and hepatic toxicities and did not affect body weight gain of rats during experiment. Conclusions The result from the present study suggests that MMT might normalize the production and gene expression of airway mucin observed in various respiratory diseases accompanied by yin-deficiency, without in vivo toxicity to liver and kidney functions after oral administration.

자음강화탕(滋陰降火湯)이 호흡기 점액의 생성 및 분비에 미치는 영향 (Effect of Jaeumganghwa-tang on Production and Secretion of Respiratory Mucus)

  • 천진홍;민상연;김장현
    • 대한한방소아과학회지
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    • 제30권2호
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    • pp.31-46
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    • 2016
  • Objectives In this study, the effects of Ja-eum-gang-hwa-tang (JGT) on the increase in airway epithelial mucosubstances of rats and ATP- or PMA- or EGF- or TNF-${\alpha}$-induced MUC5AC mucin production and gene expression from human airway epithelial cells were investigated. Materials and Methods Hypersecretion of airway mucus was produced by exposure of $SO_2$ to rats for 3 weeks. The effect of orally-administered JGT for 2 weeks on increased epithelial mucosubstances from tracheal goblet cells of rats was assessed by using histopathological analysis after staining the epithelial tissue with Hematoxylin-eosin and PAS-alcian blue. Possible cytotoxicity of JGT was assessed by investigating the potential damage on kidneys and liver functions by measuring serum GOT/GPT activities and serum BUN concentration of rats and the body weight gain during experiment. Also, the effect of JGT on ATP- or PMA- or EGF- or TNF-${\alpha}$-induced MUC5AC mucin production and gene expression from human airway epithelial cells (NCI-H292) were investigated. Confluent NCI-H292 cells were pretreated for 30 min in the presence of JGT and treated with ATP ($200{\mu}M$) or PMA ($10ng/ml$) or EGF ($25ng/ml$) or TNF-${\alpha}$ (0.2 nM) for 24 hrs to assess the effect of JGT both on ATP- or PMA- or EGF- or TNF-${\alpha}$-induced MUC5AC mucin production by using enzyme-linked immunosorbent assay (ELISA) and on gene expression by the same inducers using reverse transcription-polymerase chain reaction (RT-PCR). Results (1) JGT decreased the amount of intraepithelial mucosubstances of trachea of rats. (2) JGT did not show any renal and hepatic toxicities, and did not affect body weights either. (3) JGT significantly inhibited ATP-, PMA-, EGF-, and TNF-${\alpha}$-induced MUC5AC mucin productions from NCI-H292 cells. (4) JGT inhibited EGF-, and PMA-induced expression levels of MUC5AC gene in NCI-H292 cells. However, ATP- and TNF-${\alpha}$-induced MUC5AC gene expression levels were not affected in NCI-H292 cells. Conclusions The result from the present study suggests that JGT might control the production and gene expression of airway mucin observed in various respiratory diseases which accompanied by mucus hypersecretion. Also, JGT did not show liver toxicity or impact on kidney functions. The effect of JGT should be further studied by using animal experimental models which can show proper pathophysiology of airway diseases.

앙고라 토끼의 급성폐사성질병(急性斃死性疾病)의 병인학적(病因學的) 연구(硏究) : 소위(所謂) 토끼의 바이러스성(性) 급사병(急死病) (Etiological Studies on the Acute Fatal Disease of Angora Rabbits : The So-Called Rabbit Viral Sudden Death)

  • 이차수;박청규
    • 대한수의학회지
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    • 제27권2호
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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.

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