• The Korean Journal of Physiology
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• v.8 no.2
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• pp.49-53
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• 1974

A single dose of pilocarpine was subcutaneously injected into the rabbit in order to clarify the effects of cholinergic activities on the secretion of the pulmonary surfactant. The animal was sacrificed four hours after the injection, and the pressure-volume curve of the excised lung was obtained. The surfactant activities of the lung washings were also measured, and a comparison was made with the normal. The pressure-volume curve of the excised lung by the injection and ejection of air formed a loop (hysteresis) and the mean intra-alveolar pressure at 35 ml of air was 220 $mmH_20$ in the normal. The mean deflation curve of the pilocarpine treated rabbit lungs was shifted to the left compared with the normal. The surfactant activities were slightly increased than the normal. The above results suggest that pilocarpine stimulates the secretion of the pulmonary surfactant from the Type II alveolar epithelial cell.

• The Korean Journal of Physiology
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• v.5 no.2
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• pp.63-70
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• 1971

In an attempt to understand the possible effects of temperature and X-irradiation on the activities of surfactant in rabbits, the pulmonary surfactant from the rabbit was subjected to the incubation at $37^{\circ}C$ and X-irradiation with 900r in vitro, and activities of surfactant were measured at 10, 30, 60, and 90 minutes. Tension-area diagram of the lung extract was recorded automatically by the modified Langmuir-wilhelmy balance with a synchronized recording system designed in this Department. A comparison was made with the normal and the following results were obtained. 1) The maximal surface tension, minimal surface tension, width of the tension area diagram at the surface area of 40% and stability index of the normal rabbit lung extract were $31.6{\pm}3.11\;dynes/cm,\;8.2{\pm}0.56\;dynes/cm,\;21.4{\pm}4.40\;dynes/cm\;and\;1.12{\pm}0.22$,respectively. 2) In the $37^{\circ}C$ incubation group, maximal surface tension was similar to the normal value, while minimal surface tension was significantly lower and stability infer was markedly higher than the normal. 3) In the group where X-irradiation of 900r in vitro was applied, maximal surface tension did not differ greatly with the normal or the $37^{\circ}C$ incubation group. The minimal surface tension was significantly lower than the normal but comparing with the $37^{\circ}C$ incubation group, some decrease in minimal surface tension was noted. The width of the tension·area diagram at 40% and stability index in the irradiated group were significantly higher than the normal but a tendency of increase was noted comparing with the $37^{\circ}C$ incubation group.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.163-171
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• 2011

Recently published articles on interstitial lung disease (ILD) have focused on the accurate diagnosis of idiopathic pulmonary fibrosis (IPF), serum biomarkers, acute exacerbation of IPF, the prognostic factors of ILD and the trial of new treatment. In particular, reports on the serum biomarkers such as CC-chemokine ligand 18, surfactant protein, circulating fibrocytes, and acute exacerbation of IPF are sufficient to be mentioned here. Pirfenidone therapy is the most important trial for the treatment of IPF. Other newer treatment trials such as interferon-gamma, sildenafil and imatinib have been reported to be unsuccessful. On the other hand, the sirolimus trial for lymphangioleiomyomatosis is promising. Combined pulmonary fibrosis and emphysema and IgG4-related disease are established to be the new disease entities of ILD.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.374-380
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• 2021

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.925-935
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• 1996

Background : In order to elucidate one of the pathogenic mechanisms of ARDS associated with pulmonary surfactant and oxidant injury, acute lung injury was induced by N-nitroso N-methylurethane (NNNMU). In this model, the role of phospholipase $A_2$ ($PLA_2$), surfactant, gamma glutamyl transferase (GGT) and morphology were investigated to delineate one of the pathogenic mechanisms of ARDS by inhibition of $PLA_2$ with high dose of dexamethasone. Method: Acute lung injury was induced in Sprague-Dawley rats by NNNMU which is known to induce acute lung injury in experimental animals. To know the function of the alveolar type II cells, GGT activity in the lung and bronchoalveolar lavage was measured. Surfactant phospholipid was measured also. $PLA_2$ activity was measured to know the role of $PLA_2$ in ARDS. Morphological study was performed to know the effect of $PLA_2$ inhibition on the ultrastructure of the lung by high dose of dexamethasone. Results : Six days after NNNMU treatment (4 mg/kg), conspicuous pulmonary edema was induced and the secretion of pulmonary surfactant was decreased significantly. In the acutely injured rats' lung massive infiltration of leukocytes was observed. At the same time rats given NNNMU had increased $PLA_2$ and GGT activity tremendously. Morphological study revealed bizarre shaped alveolar type II cells and hypertrophied lamellar bodies in the cytoplasm of the alveolar type II cells. But after dexamethasone treatment (20 mg/kg, for six days) in NNNMU-treated rats, these changes were diminished i.e. there were decrease of pulmonary edema and increase of surfactant secretion from alveolar type D cells. Rats given dexamethasone and NNNMU had decreased $PLA_2$ and GGT activity in comparison to NNNMU induced ARDS rats. Conclusion : Inhibition of $PLA_2$ by high dose of dexamethasone decreased pathological findings caused by infiltration of leukocytes and respiratory burst. Based on these experimental results, it is suggested that an activation of $PLA_2$ is the one of the major factors to evoke the acute lung injury in NNNMU-induced ARDS rats.

• The Korean Journal of Physiology
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• v.6 no.1
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• pp.1-9
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• 1972

In order to observe a possible effect of CO intoxication on the activities of surfactant, the rabbit war exposed either to 0.1, 0.2 and 0.4% CO gas for two to six hours or 0. 1% CO gas for two hours daily for 1, 3 and 5 days, and the lung extract was prepared. The tension-area diagram of the lung extract was recorded automatically using the modified Langmuir-wilhelmy balance with a synchronized recording system, and the results were compared with control (i. e. : non-CO gas exposed normal rabbits). The results obtained are summarized as follows: 1. The maximal and minimal surface tensions, width of the tension-area diagram at the surface area of 40% in lung extract, and stability index of the normal rabbit lung extracts were $31.6{\pm}3.11\;dynes/cm,\;8.2{\pm}0.56\;dynes/cm,\;21.4{\pm}4.40dynes/cm\;and\;1.12{\pm}0.22$, respectively. 2. The activities of surfactant in the CO gas exposed group did not show any significant change from the control. 3. The above results suggest that CO gas produced no noticeable effect on the surfactant system of the lung.

• The Korean Journal of Physiology
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• v.25 no.1
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• pp.81-85
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• 1991

At the fifth day after right lung pneumonectomy in New-Zealand white rabbits $(0.8{\sim}1.1\;kg\;B.W.)$, phospholipid and protein concentration in the left lung lavage fluid were measured for clarification of the effect of unilateral pneumonectomy on the secretory function of the type II pneumocytes in growing rabbits. In an attempt to evaluate the effect of unilateral pneumonectomy on the compensatory growth of the residual lung, left lung weight and left lung weight-body weight ratio and DNA concentration, RNA/DNA and total DNA content in the left lung tissue were measured in pneumonectomized and in sham operated control rabbits. The lung weight of pneumonectomized rabbit was approximately two times heavier than that of the control rabbits. DNA concentration and RNA/DNA of the lung tissue were not changed but total DNA content was increased significantly. Phospholipid concentration in the lung lavage fluid of the pneumonectomized rabbits was over two times higher than that of control rabbits. from these experimental results, It is concluded that unilateral pneumonectomy in growing rabbits might cause to increase the secretion of pulmonary surfactant from type II pneumocyte of the residual lung. The cellular hyperplasia seems to be the primary response of the compensatory growing lung in unilateral pneumonectomized growing rabbits.

• The Korean Journal of Physiology
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• v.2 no.2
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• pp.63-73
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• 1968

It is well known that mammalian alveolar membrane is covered with a very thin layer of surfactant film which characteristically reduces surface tension of alveolar membrane, and maintains alveolar stability. Since Clements in 1957 demonstrated that the surfactant is extractable by mincing the lung tissue in saline, various studies on the subject have been succeeded by many workers. However, the effect of radiation on the surfactant is not well clarified. Present study was attempted to observe the effect of x-irradiation on the activity of surfactant in rabbits. X-ray in dose of 300 r, 600 r or 900 r was irradiated to the chest of rabbits. The lung was removed from normal or irradiated rabbits sacrificed by arterial blood shedding, and lung-saline extract, adding 3 grams of lung tissue to 50 mili-liters of saline, was prepared by means of Vertis homogenizer. Tension-area diagram of lung extract was recorded automatically by a modified Langmuir-Wilhelmy balance with a synchronized recording system designed in this department. The surface tension of lung extract was measured at 1st, 2 nd, 3 rd, 7 th and 15 th post-radiation day in 300 r irradiated group, at 3 rd, 7 th and 15 th post-radiation day in 600 r irradiated group, 3 rd and 7 th post-radiation day in 900 r irradiated group respectively. For the histo-pathological study, lung tissue preparations were made in all irradiatiated groups on the day of experiment and in normal group. The results obtained are summarized as follows: 1. The minimal surface tension, maximal surface tension and stability index of normal rabbits lung extracts were 7.68 dynes/cm, 38.84 dynes/cm, and 1.39 respectively. 2. The activity of surfactant was depressed prominently by x-irradiation. However, increase in the dose of x-irradiation did not show any significant change in the degree of surfactant activity suppression. The most marked depression in surfactant was observed at the third post-radiation day in all irradiated groups. 3. Activity of surfactant depressed by x-irradiation showed a tendency of recovering to normal on 15 th post-radiation day. 4. The tendency of change in activity of surfactant following x-irradiation was somewhat correlative with histo-pathological changes. But the degree of depression of surfactant by x-irradiation did not correspond to the degree of histo-pathological changes, and recovery of lung tissue from radiation damage, tissue edema and congestion, seemed to be followed by restoration of surfactant activity. 5. The width of the tension-area diagram was measured at the surface area of 40% in lung extract of normal and x-irradiated rabbits. And it was found that the changes of the width corresponded well with that of minimum surface tension and of stability index in all normal and x-irradiated groups.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.179-187
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• 2011

Experimental tracheal ligation (TL) has been shown to reverse the pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH) and to normalize gas exchange. The purpose of this study was to determine whether the TL would correct the surfactant deficiency present in the fetal rabbit model of CDH by using lamellar body count. Lamellar bodies are synthesized and secreted by the type II pneumocytes of fetal lung. The phospholipids present in these bodies constitute the major component of pulmonary surfactant. Twenty-one pregnant New Zealand rabbits underwent hysterotomy and fetal surgery on gestational day 24. Two fetuses of each pregnant rabbit were operated. In the fetus of one end of bicornuate uterus, left DH was created by excision of fetal diaphragm through open thoracotomy (DH Group). In the fetus of the other end of bicornuate uterus, left DH and TL were created (TL Group). The fetuses were delivered by Cesarean section on gestational day 31. Fourteen in control group, 12 in the DH group and 13 in TL group were born alive. En bloc excision of lungs, bronchi and trachea was done in all newborn rabbits. A five Fr catheter was inserted through trachea and repeated irrigations with 10 cc normal saline were done. The irrigated fluid was centrifuged at $280{\times}g$ for 5 minutes and the lamellar bodies were counted with the upper level fluid in platelet channel of electronic cell counter. The average lamellar body counts were $37.1{\pm}14.2{\times}10^3/{\mu}L$ in control group, $11.5{\pm}4.4 {\times}10^3/{\mu}L$ in DH group, and $6.5{\pm}0.9{\times}10^3/{\mu}L$ in TL group. Lamellar body count in DH group was lower than in control group and did not increase after TL. This study shows TL has no therapeutic effect on decreased surfactant level of CDH and the pregnant rabbit is appropriate for the animal model of CDH.

• Neonatal Medicine
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• v.18 no.2
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• pp.409-411
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• 2011

In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.