• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.46-56
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• 1996

Perichondrium is generally used for reconstruction of airway and successful regeneration of cartilage framework using perichondrium are reported by several authors. It has many advantages for airway reconstruction. It can maintain the stable framework and it has higher flexibility so it's easy to design according to the shape of defects. It resist strongly against infection process. Its airtightness and rapid mucosalization enables to predict good postoperative recovery and results. To investigate the differences in cartilage regeneration between avascular and vascularized perichondrial flap, this study was designed with vascularized flaps composed of vascularized perichondrium and central auricular artery and vein. Morphologic study was performed to determine the fate of the grafted perichondrium at regular intervals using light microscopy with H & E stain. Chondrogenic potential and formation of cartilaginous plate of experimental group was superior than in the control group. Grafted perichondrium was fed by consistent feeding vessel. At 6 weeks, the regenerated cartilage could hardly be distinguished form the normal cartilage framework but in control group, regenerated cartilaginous tissue was generally immature in same period. In conclusion, this study indicated that consistent vasculature to grafed tissue is the essential factor for successful reconstruction of cartilaginous framework.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.58-61
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• 2004

Lymph node metastasis of thyroid cancer occurs to anterior compartment (level VI) and superior mediastinal lymph node (Level VII). In lateral neck, it occurs commonly in middle and lower jugular lymph node (level III, IV). And it can also metastasis to posterior neck lymph node (level V). Superior mediastinal lymph node metastasis of thyroid cancer requires superior mediastinal dissection with massive removal of peritracheal and periesophageal soft tissue. After superior mediastinal dissection, severe complication may occurs such as innominate artery rupture and tracheal necrosis. We describe a case of tracheal necrosis as a complication of superior mediastinal dissection and total thyroidectomy in thyroid cancer patient.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.474-481
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• 2004

Background: Tracheal transplantation is necessary in patients with extensive tracheal stenosis, congenital lesions and other oncologic conditions but bears. many critical problems compared to other organ transplantations. The purpose of this study was to develop intestine-cartilage composite grafts for potential application in tracheal reconstruction by free intestinal graft. Material and Method: Hyaline cartilage was harvested from trachea of 2 weeks old New Zealand White Rabbits. Chondrocytes were isolated and cultured for 8 weeks. Cultured chondrocytes 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 3 kg weighted New Zealand White Rabbits under general anesthesia. 10 weeks after implantation, bowels were harvested for evaluation. Result: We identified implantation site by gross examination and palpation. Developed cartilage made a good frame for shape memory. Microscopic examinations included special stain s howed absorption of scaffold and cartilage formation even though it was not fully matured. Conclusion: Intestine-cartilage composite graft could be applicable in the future as tracheal substitute and should be further investigated.

• Tuberculosis and Respiratory Diseases
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• v.52 no.1
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• pp.54-61
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• 2002

Background: Tracheal stenosis is an urgent but uncommon disease. Therefore, primary care clinicians have limited clinical experience. Animal models of a tracheal stenosis can be used conveniently for the learning, teaching, and developing new diagnostic and therapeutic modalities for tracheal stenosis. Recently, a canine model of a tracheal stenosis was developed using a Nd-YAG laser. To describe the methods and results of developed animal model, we performed this study. Methods : Six Mongrel dogs were generally anesthetized and the anterior 180 degree of tracheal cartilage of the animal was photo-coagulated using a Nd-YAG laser. The animals were bronchoscopically evaluated every week for 4 weeks and a pathologic evaluation was also made. Results : Two weeks after the laser coagulation, the trachea began to stenose and the stenosis progressed through 4 weeks. All animals suffered from shortness of breath, wheezing, and weight loss in the 3 weeks after the laser treatment, and two died of respiratory failure just before the fourth week. The gross pathologic findings showed the loss of cartilage and a dense fibrosis, which resulted in a fibrous stricture of the trachea. Microscopy also showed that the fibrous granulation tissue replaced destroyed cartilage. Conclusion : The canine model can assist in the understanding and development of new diagnostic and therapeutic modalities for tracheal stenosis.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.231-234
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• 1996

In the bronchial stenosis due to benign causes, bronchoplastic procedure has been considered as one of the best surgical treatment, because of preserving normal lung tissue below the affected bronchi. We have treated 2 patients (tracheal leiomyoma, bronchial stenosis due to chronic inflammatory cicatrization) that suffered from benign tracheal and bronchial stenosis by bronchoplastic procedure using autologous costal cartilage covered with pericardium. Patients showed good patency of bronchoplastic bronchi in bronchoscopic examination that was performed at 6 months afte the operation.

• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.253-260
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• 1997

Successful regeneration of a cartilage framework using perichondrium has been reported by several authors but there are some arguments surrounding mucosal regeneration. Some authors report that regeneration of mucosa is completed by ingrowth from neighboring tissue but others insist that it occurs via metaplasia from the squamous epithelium. This study was designed to investigate the differences, especially in mucosal regeneration between nonvascularized and vascularized flaps via immunohistochemical study. A morphologic study was carried out to elucidate the characteristics o( the regenerated mucosa which was sutured on the vascularized perichondrium and fabricated in a rabbit ear. A nonvascularized perichondrial-mucosal composite flap with the same dimension was transferred in the control group. BrdU was labelled on both normal mucosa and grafted mucosa in the experimental group without my statistically significant differences. In cytokeratin stain, it was regarded that mucosal coverage of the control group occurred by ingrowth from the neighboring mucosa. It can be conceived that metaplasia of the grafted mucosa occurs in a vascularized composite flap transferred group.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.117-121
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• 1998

Relapsing polychondritis is a rare disesase involving any cartilaginous structure of entire body and is characterized by recurrent episode of inflammation and degeneration of cartilage and most commonly involve ear, nose, larynx, trachea, ribs, Eustachian tube, etc. Its signs and symptoms are recurrent swelling of auricle, saddle nose deformity, polyarthralgia, hoarseness and dyspnea, audiovestibular disturbance and cardiovascular abnormality, etc. Characteristic histologic findings are loss of normal basophilic staining of cartilage, perichondrial inflammatory infiltration with plamsa cells, lymphocytes and neutrophils, and finality, destruction of cartilage and replacement with scar tissue. Our case had saddle nose deformity, arthralgia, tracheal collapse, hearig loss and positive histologic finding but no auricular perichnodritis. Her major problem was airway. obstruction due to tracheal collapse. This case was diagnosed with relapsing polychondritis according to the Damiani's criteria. This case indicates that any patients complaining of airway obstruction have to be examined systemically.

• Herbal Formula Science
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• v.10 no.2
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• pp.143-158
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• 2002

The purpose of the present study is to determine the effect of Jakyakgamchotang on histamine or acetylcholine induced tracheal smooth muscle contraction in rats and guinea pigs. Guinea pig(500g, male) and Sprague Dawley rats(250g, male) were killed by $CO_2$ exposure and a segment (4-5mm) of the thoracic trachea from each rat and guinea pig was cut into equal segments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force displacement transducers under 0.5g loading tension. The dose of histamine(His) which evoked 50% of maximal response($ED_{50}$) was obtained from cumulative dose response curves for histamine($10^{-7}{\sim}10^{-4}M$). Contractions evoked by His($ED_{50}$) were inhibited significantly by Jakyakgamchotang. In guinea pig tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was 90.8% (p〈0.001) after $100{\mu}l/ml$ Jakyakgamchotang. In rat tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was 22.1% (p〈0.05) after $100{\mu}l/ml$ Jakyakgamchotang. Propranolol indomethacin and methylene blue($10^{-7}M$) slightly but significantly attenuated the inhibitory effects of Jakyakgamchotang. These results indicate that Jakyakgamchotang can relax histamine or acetylcholine induced contraction of guinea pig and rat tracheal smooth muscle.

• Korean Journal of Acupuncture
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• v.17 no.1
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• pp.67-73
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• 2000

The purpose of the present study is to determine the effect of Radix Stemonae on histamine induced tracheal smooth muscle contraction in guinea pigs. Guinea pig(500g, male) were killed by $CO_2$ exposure and a segment (8-10mm) of the thoracic trachea from guinea pig was cut into equal segments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force displacement transducers under 0.5g loading tension. The dose of histamine (His) which evoked 50% of maximal response ($ED_{50}$) was obtained from cumulative dose response curves for histamine ($10^{-7}∼10^{-4}M$). Contractions evoked by His ($ED_{50}$) were inhibited significantly by Radix Stemonae. In guinea pig tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was 87.4% (p<0.01) after $100{\mu}l/ml$ Radix Stemonae. Following treatment with propranolol, the mean percent inhibition caused by $100{\mu}l/ml$ Radix Stemonae fell to 16.2% in guinea pig induced by histamine contraction. Indomethacin and methylene blue($10^{-7}M$) did not significantly alter the inhibitory effect of Radix Stemonae. These results indicate that Radix Stemonae can relax histamine induced contraction of guinea pig tracheal smooth muscle, and that this inhibition involves sympathetic effects.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.739-746
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• 1997

A variety of experiments concerning the development of ideal prosthetic grafts for correcting circumferential tracheal defects have been performed. The requirements for an ideal tracheal prosthesis are impermeability to air, consistency to prevent collapse, and acceptance by the host tissue causing a minimum inflammatory reaction, allowing fibroblastic infiltration and epithelialization. The synthetic material, polyurethane(PU), is known as a biocompatible polymer with an inert component. In this study, the tracheal prosthesis was made from microporous PU(30 micrometer in diameter) coated with gelatin and reinforced with isoplastic rings. This procedure provides the prosthesis with a compression strength. The out side diame er of the prosthesis was 20 mm with a length of 30 mm. The gelatin used in the study was obtained from pig skin and immobilized and cross-linked by irradiation(60 Co gamma ray) to promote host tissue incorporation and render the prosthesis epithelization after implantation. Animal experiments using 10 mongrel dogs were performed to compare three kinds of prosthesis; gelatin coated polyurethane graft, uncoated polyurethane graft, and prosthesisf pericadium complex graft. After 6 weeks of implantation, the epithelialization of implants was seen on the gelatin-coated and prosthesisfpericadium complex grafts. Implanted prosthesis were complicated by airway obstruction due to anastomosis granuloma. Early tracheal stenosis was found in the uncoated graft group. Two kind of anastomosis techniques were tested on the gelatin-coated prosthesis. Everted anastomosis resulted severe granuloma than the inverted anastomosis. In the prosthesislpericadium complex graft, bacteria and inflammation at a anastomotic site was found. Based on these results, gelatin coated porous polyurethane trachea prosthesis is biocompatible and may be useful in clinical application with further investigation.