Sabaeksan and Sabaeksangagaryureuk, a traditional prescription, has been used in Korea for many centuries as a treatment for chronic respiratory disease. The purpose of the present study was to determine the effect of Sabaeksan and Sabaeksangagaryureuk on acetylcholine-induced tracheal smooth muscle contraction in guinea pigs and norepinephrine-induced vascular smooth muscle contraction in pigs. Guinea pig (500g, female) were killed by CO2 exposure and a segment (8-10mm) of the thoracic trachea from each guinea pig and renal artery from each pig were 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 acetylcholine (Ach) and norepinephrine (NE) which evoked 50% of maximal response ($ED_{50}$) was obtained from cumulative dose response curves for acetylcholine (10-7-10-4M) and norepinephrine (10-7-10-4M). Contractions of tracheal smooth muscle evoked by Ach ($ED_{50}$) were inhibited significantly by Sabaeksan and Sabaeksangagaryureuk. Propranolol (10-7M) slightly but significantly attenuated the inhibitory effects of Sabaeksan and Sabaeksangagaryureuk. Indomethacin and methylene blue (10-7M) did not significantly alter the inhibitory effect of Sabaeksan and Sabaeksanga-garyureuk. Contractions of vascular smooth muscle evoked by NE (NE50) were inhibited significantly by Sabaeksan and Sabaeksangagaryureuk. Propranolol (10-7M) slightly but significantly attenuated the inhibitory effects of Sabaeksan and Sabaeksangagaryureuk. Indomethacin and methylene blue (10-7M) did not significantly alter the inhibitory effect of Sabaeksan and Sabaeksangagaryureuk. These results indicate that Sabaeksan and Sabaeksangagaryureuk can relax acetylcholine-induced contraction of guinea pig tracheal smooth muscle, and norepinephrine-induced contraction of pig vascular smooth muscle that this inhibition involves, in part, the relation of adrenergic receptor.
In chronic airway inflammatory diseases such as asthma and chronic bronchitis, it has been suggested that matrix metalloproteinases secreted from infiltrating neutrophil contribute the pathogenesis of the disease and have been a focus of intense investigation. We report here that hamster tracheal surface epithelial goblet cells (HTSE cells) produce matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2). Matrix metalloproteinase activities were investigated using [$^3H$]collagen-digestion assay and gelatin zymography. The subtype of matrix metalloproteinases expressed from HTSE cells was MMP-2 (gelatinase A), which was determined by Western blot with various subtype selective anti-matrix metalloproteinase antibodies. The MMP-2 and TIMP-2 cDNAs from HTSE cells were partially cloned by RT-PCR and they reveal more than 90% of sequence homology with those from human, rat and mouse. The collagenolytic activity was increased with the secretory differentiation of the HTSE cell and it was found that zymogen activation was responsible for the increased MMP-2 activity in HTSE cells. The results from the present study suggest that the metaplastic secretory differentiation of airway goblet cells may affect chronic airway inflammatory process by augmenting the zymogen activation of MMP-2.
The present study was made with the aim of finding out the Kamihaepyoijin-tang's effect on the allergic asthma using the Egg-White Implant(EWI) method model recommended by de Siqueira et al. Kamihaepyoijin-tang has widely been prescribed and used in Oriental Medicine for controlling and curing of cough, asthma, nasal obstruction. Previous studies have demonstrated that Kamihaepyoijin-tang had analgesic, anticonvulsive effects. But it is uncertain whether Kamihaepyoijin-tang could inhibit the allergic reaction of rats with experimentally induced allergic asthma using EWI method. With such aim. the respiratory patterns and eosinophil infiltration in the tracheal mucosa of the rats were mainly observed. The results were summerized as follows ; 1. The frequency of malformed respiratory patterns in Kamihaepyoijin-tang treated groups were decreased as compared with the control group. 2. The Ratio of malformed respiratory patterns in Kamihaepyoijin-tang treated groups were significantly decreased as compared with the control group(p<0.02). 3. The eosinophil infiltration in Kamihaepyoijin-tang treated groups were decreased as compared with the control group. 4. The eosinophil infiltration that inside of trachea tissue in Kamihaepyoijin-tang treated groups were significantly decreased as compared with the control group(p<0.05). Depending upon above results, it is considered that Kamihaepyoijin-tang has the inhibitory effects on the allergic asthma of rats and suggested that it could be used in relieving patients of the symptoms which are caused by allergic asthma.
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.
The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique of tracheostomy to manage a wide variety of causes of upper airway obstruction. This technique has particular applicability in patients who require long term tracheostomy such as in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous advantages such as shortening of the gap between the skin and trachea : construction of a self-sustaining tract ; circumferential mucocutaneous junction to reduce infection, granulation tissue, bleeding, and stenosis of the tract : avoidance of the laryngotracheal damage : easy placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all, this technique can reduces the suprastomal buckling by the support of the superiorly based tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of SBFT is more time-consuming procedure than the conventional tracheostomy, A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995 in Dankook University Hospital was performed to present the surgical technique and com-plication rates. The average duration of follow up was 11 months. The complications were consisted of a wound infection and a sternal granulation. The other complications including wound dehiscence, tracheitis, pneumonia, tracheal granulation, sternal narrowing and subglottic stenosis were not experienced.
Insamjungchuntang has been used in Korea for many centuries as a treatment for respiratory disease. The effect of Insamjungchuntang on tracheal smooth muscle is not known. The purpose of the present study is to determine the effect of Insamjungchuntang on histamine and acetylcholine induced tracheal smooth muscle contraction in rats and guinea pigs. Guinea pig (500 g, male) and Sprague Dawley rats (200 g, male) were killed by $CO_2$ exposure and a segment (8-10 mm) 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 0.5 g loading tension. The dose of histamine (His) and acetylcholine (Ach) which evoked 50% of maximal response $(ED_{50})$ was obtained from cumulative dose response curves for histamine and acetylcholine$(10^{-7}{\sim}10^{-4}\;M)$. Contractions evoked by His ($ED_{50}$) and Ach $(ED_{50})$ were inhibited significantly by Insamjungchuntang. In guinea pig tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $38.58\(p<0.05)\;after\;10{\mu}l/ml$ Insamjungchuntang, $90.75\(p<0.01)\;after\;30{\mu}l/ml$. Insamjungchuntang and $133.17\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. In rat tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $10.0\(p<0.05)\;after\;10{\mu}l/ml$ Insamjungchuntang, $80.71\(p<0.01)\;after\;30{\mu}/ml$ Insamjungchuntang and $118.29\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. Also, in guinea pig tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $45.5\(p<0.01)\;after\;10{\mu}l/ml$ lnsamjungchuntang, and $93.17\(p<0.01)\;after\;30{\mu}l/ml$. lnsamjungchuntang $134.50\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. In rat tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $37.83\(p<0.01)\;after\;10{\mu}l/ml$ lnsamjungchuntang, $90.5\(p<0.01)\;after\;30{\mu}l/ml$ Insamjungchuntang and $135.17\(p<0.01)\;after\;100{\mu}l/ml$ Insamjungchuntang. Propranolol $(10^{-7}\;M)$ slightly but significantly attenuated the inhibitory effects of Insamjungchuntang. Following treatment with propranolol, the mean percent inhibition caused by $100{\mu}l/ml$. Insamjungchuntang fell to 46.42% in guinea pig induced by acetylcholine contraction and by $100{\mu}l/ml$ Insamjungchuntang fell to 5.43% (p<0.05) in rat induced by acetylcholine contraction and the mean percent inhibition caused by $100{\mu}l/ml$ Insamjungchuntang fell to 49.0% in guinea pig induced by histamine contraction and by $100{\mu}l/ml$ Insamjungchuntang fell to 48.6% (p<0.05) in rat induced by histamine contraction. Indomethacin and methylene blue $(10^{-7}\;M)$ did not significantly alter the inhibitory effect of lnsamjungchuntang. Also, I could find the effects of lnsamjungchuntang and Insamjungchuntanggamorphine on the tracheal smooth muscle in guinea pig and rat did not change significantly. These results indicate that Insamjungchuntang can relax histamine and acetylcholine-induced contraction of guinea pig and rat tracheal smooth muscle, and that this inhibition involves sympathetic effects.
Chunggeumtang has been used in Korea for many centuries as a treatment for respiratory disease. The effect of Chunggeumtang on tracheal smooth muscle is not konwn. The purpose of the present study is to determine the effect of Chunggeumtang on histamine and 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 (8-10mm) of the thoracic trachea from each rat and guinea pig was cut into equal swegments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force diplacement transducers under 0.5g loading tension. The dose of histamine (His) and acetylcholine (Ach) which evoked 50% of maximal response ($ED_{50}$) was obtained from cumulative dose response curves for histamine and acetylcholine($10^{-7}{\sim}10^{-4}M$). Contractions evoked by His ($ED_{50}$) and Ach ($ED_{50}$) were inhibited significantly by Chunggeumtang. In guinea pig tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $6.1%after\;30{\mu}l/ml$ Chunggeumtang, and 49.4% (p<0.01) after $100{\mu}l/ml$ Chunggeumtang. In rat tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $6.7%\;after\;30{\mu}l/ml$ Chunggeumtang, and $54.2%\;(p<0.01)\;after\;100{\mu}l/ml$ Chunggeumtang. Also, in guinea pig tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $30.6%\;(p<0.05)\;after\;30{\mu}l/ml$ Chunggeumtang, and $53.0%\;(p<0.01)\;after\;100{\mu}l/ml$ Chunggeumtang. In rat tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $24.1%\;(p<0.05)\;after\;30{\mu}l/ml$ Chunggeumtang, and $55.3%\;(p<0.01)\;after\;100{\mu}l/ml$ Chunggeumtang. Propranolol and indomethacin($10^{-7}M$) slightly but significantly attenuated the inhibitory effects of Chunggeumtang. Following treatment with propranolol, the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 27.6% in guinea pig induced by acetylcholine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 28.7% (p<0.05) in rat induced by acetylcholine contraction and the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 16.2% in guinea pig induced by histamine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 28.7% (p<0.05) in rat induced by histamine contraction. Indomethacin, the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 20.0% in guinea pig induced by acetylcholine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 16.9% (p<0.05) in rat induced by acetylcholine contraction and the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 16.4% in guinea pig induced by histamine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 23.1% (p<0.05) in rat induced by histamine contraction. Methylene blue($10^{-7}M$) did not significantly alter the inhibitory effect of Chunggeumtang. Also, I could find the effects of Chunggeumtang and Chunggeumtanggamorphine on the tracheal smooth muscle in guinea pig and rat did not change significantly. These results indicate that Chunggeumtang can relax histamine and acetylcholine-induced contraction of guinea pig and rat tracheal smooth muscle, and that this inhibition involves sympathetic effects and the release of cyclooxygenase products.
Developmental pulmonary abnormalities are known as rare condition. diagnosis was made at autopsy in the early cases reported, however, as diagnostic aids such as X-ray, bronchography, bronchoscopy and exploratory thoracotomy have come into use, the condition is being discovered more often recently in living persons, and it appears to occur with sufficient frequency to merit consideration in the differential diagnosis of certain chest conditions. According to Schneider and Boyden there are three main types of this abnormality: [1] Agenesis, in which there is complete absence of one or both lungs; there is no trace of bronchial or vascular supply or of parenchymal tissue. [2] Aplasia, in which there is suppression of all but a rudimentary bronchus which ends in a blind pouch; there are no vessels or parenchyma. [3] Hypoplasia, in which the bronchus is fully formed but is reduced in size and ends in a _ flesh structure which usually lies within the mediastinum. Rudimentary pulmonary parenchyma may be present around the bronchial stump and often is the site of cystic malformation. We experienced one case of hypoplastic lung with cystic malformation which was originated from a small aberrant rudimentary bronchus, and the rudimentary bronchus was branched from the right side of tracheal end. The diagnosis was finally confirmed by the histopathological finding. Now, we report this case with a brief review of literatures.
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.
A glomus tumor is an uncommon soft tissue tumor that is most commonly found in the subungual area and a glomus originating in the trachea is extremely rare. Histologically and ultrastructurally, these tumors have been divided into three subtypes: classic glomus tumors, glomangiomas, and glomangiomyomas. Glomangiomyomas account for less than 10% of all glomus tumors and are the least common type. We report a case of a 54-year-old man with glomangiomyoma of the trachea who presented with stridor. We treated the tumor by segmental resection and primary repair via a transcervical approach.
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