• 대한기관식도과학회지
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• 제5권2호
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• pp.164-173
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• 1999

Background : cis-Diamminedichloroplatinum(Ⅱ)(cis-platin) has been exhibited similar to bifunctional alkylating agents in the cell and known as an effective anticancer drug. Although this agent is very beneficial to the cancer patients, it may also damage to the normal cell. Many side effects were developed. Objectives : This experiments was undertaken to pursue the effect of cis-Platin on the mucous variation of the trachea. Materials and Methods : The male of Sprague-Dawley strain were used as and experimental animals. The experimental animals were killed at 1, 3 days and 1, 2 and 3 weeks after the third injection of cis-Platin was administered 1.5mg/kg to intraperitoneal injection at once a week for three weeks. The trachea was fixed to neutral formaline and stained with alcian blue(pH 1.0)-PAS, alcian blue(pH 2.5)-PAS double stains and these preparation observed with light microscope. Results : 1. In the trachea stained with alcian blue(pH 2.5)-PAS double stain, the epithelial cells were constricted in the 1 week, In the 1st day, 3rd day and 1st week, acidic mucopolysaccharide was increased but in the 2nd week, neutral mucopolysaccharide was increase. 2. In the trachea stained with alcian blue(pH 1.0)-PAS double stain, the 1st and 3rd day exhibited sulfa mucopolysaccharide with moderately or weakly positive reaction. In the 1st week the sulfa mucopolysaccharide with strongly positive reaction was increased. In the 2nd and 3rd week, the sulfa mucopolysaccharide with weakly positive and non-sulfa or neutral mucopolsaccharide with negative reaction were modified. Conclusion : It is consequently suggested that cis-Platin induces reversible toxic damage to tracheal cells including goblet cell.

• Journal of Chest Surgery
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• 제10권1호
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• pp.7-17
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• 1977

The increasing frequency of post-tracheostomy stenosis parallels the increase in the incidence of tracheostomy. The development of stenosis of trachea following the operation of tracheal tumor or tracheostomy is a very serious complication. The continuing need for an adequate tracheal substitute has not been answered, despite the necessities of excision and reconstruction of the trachea to keep for effective ventilation. Experimental tracheal reconstuction, with a prosthesis of heavy Marlex mesh and pericardium, _ vas performed in twelve dogs. Five to six tracheal ring circumferential defects were created and were bridged with heavy Marlex mesh fashioned into a tube of suitable diameter. Group A: A prepared cylinder of Marlex mesh was anastomosed outside the cut ends of the trachea. Group B: The external surface of the prepared cylinder of Marlex mesh was completely covered with suitably sized patch of pericardium and overlapped all margin of the Marlex mesh by 2 to 3 mm in each direction. Group C: The internal surface of the prepared cylinder of Marlex mesh was covered with suitably sized patch of pericardium and overlapped all margin of the Marlex mesh by 2 to 3 mm in each direction. The results of this exepriment were as follow: 1. In group A and B, the graft was well bridged with new granulation and fibrous tissue, and the lumen of trachea kept good patency for effective ventilation.. The interstices of Marlex became uniformly infiltrated with young well vasculated connective tissue. Epithelization has not yet occurred at 4 weeks in each group, but there were evidences of new growing mucosa at grafted site in 6 weeks. The remainder of the prosthesis was completely covered with glistening epithelium and the underlying fibrous tissue became more matured with little inflammation. These findings were more striking in group B than group A. 2. In group C, the covered pericardium was necrotized with stenosis of the lumen of grafted site due to poor blood supply.

• 대한한방내과학회지
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• 제12권2호
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• pp.74-88
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• 1991

In order to study the effects of Goosunsan known clinically for their effects of treatment for cough and asthmas the study was carried out to investigate the effect of Goosunsan extract on the contractile force of the isolated guinea pig's vaviovs kinds smooth muscles and elucidate its mechanism The result were obtained as follows: 1. The isolated trachea & ileum smooth muscles of guinea pig was suspended in the organ bath with oxygenated kreb's Henselsite bicarbonate buffer solution at $37^{\circ}C$, and the developed tension by the drug was recorded with Isometric transducer (nacro F-60). The resting tension was approximately 0.5g. 2. The isolated trachea & ileum smooth muscles of guinea pig was remakably relaxed by the administration of Goosunsan. 3. The contractile response of the trachea smooth muscle of the isolated guinea pig to histamine 10-4 M was remakably by Goosunsan extract. 4. The contractile response of the ileum smooth muscle of the isolated guinea pig to histamine 10-4 M was remakably by Goosunsan extract. 5. The contractile response of the trachea smooth muscle of the isolated guinea pig to acetylcholine 10-4 M was remakably by Goosunsan extract. 6. The contractile response of the ileum smooth muscle of the isolated guinea pig to acetylcholine 10-4 M was remakably by Goosunsan. 7. The contractile response of the trachea smooth muscle of the isolated guinea pig to 5-hydroxytryptamine 10-4 M was remakably by Goosunsan. 8. The contractile response of the ileum smooth muscle of the isolated guinea pig to 5-hydroxytryptamine 10-4 M was remakably by Goosunsan.

• Tuberculosis and Respiratory Diseases
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• 제40권5호
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• pp.616-621
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• 1993

저자들은 최근 기관지 천식의 진단하에 치료를 받았으나 호전이 없던 40세 여자 환자에서 흉부 전산화 단층촬영 및 굴곡성 기관지경 검사로 기관내의 종양을 확인하고 수술적 제거로 확진, 완치된 기관에 발생한 평활근종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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• pp.8.2-8
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• 1979

상부기도가 갑자기 폐쇄증을 일으켜 심한 호흡곤란증을 호소하는 환자에 대하여 응급으로. 기도 및 호흡을 재확보하여야하며 이와같은 예를 임상에서 가끔 직면하게 된다. 이러한 환자에게 적절한 기도확보는 생명을 유지시킬 수 있다. 저자는 토끼를 대상으로 기존 기관의 직경을(약 3.4mm) 약 1/3(1.2mm), 1/4(0.8mm) 및 1/6(0.6mm)로 협소시켜 생리적 변화를 추적하였다. 결과는 다음과 같았다. 1) 혈액가스의 분석결과 직경을 약 1/3로 감소시켰던 군에서 생리적 변동이 별로 없었다. 2) 직경을 약 1/4, 1/6로 감소시켰던 군에서는 $PaO_2,$ $PaCO_2$ 및 pHa에 뚜렷한 변화를 나타내어 저산소혈증, 과탄산혈증 및 대사성산증을 나타내었다. 3) 호흡저항은 모든 군에서 뚜렷하게 증가하여 1회 호흡량도 현저하게 감소하였는데 16G(직경 1.2mm 호흡로)에서는 호흡수의 증가로 폐포환기가 적당하게 영위됨에 따라서 혈액가스 및 vital signs의 변동이 별로 없던 것으로 보아 토끼에서는 이 정도의 호흡로 폐쇄에는 1시간까지 견딜 수 있음을 알았다.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.91-95
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• 2000

성인의 기관에서 발생한 점액선 선종은 매우 드문 종양으로 대부분 양성이다. 저자 등은 객혈을 주소로 내원한 환지에서 발견된 기관의 점액선 선종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제54권3호
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• pp.191-199
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• 2021

Background: Tracheal replacement is a challenge for thoracic surgeons due to stenosis in the trachea-prosthesis anastomosis. We propose that stenosis occurs due to fibrosis as a result of an abnormal healing process, characterized by an increased expression of wound healing growth factors (vascular endothelial growth factor [VEGF], survivin, and CD31), which promote angiogenesis and decrease apoptosis. We analyzed the immunoreactivity of VEGF, survivin, CD31, and caspase-3 in the development of fibrotic stenosis in prosthetic tracheal replacement. Methods: Fourteen dogs were operated on: group I (n=7) received a 6-ring cervical tracheal segment autograft, while in group II (n=7), a 6-ring segment of the cervical trachea was resected and tracheal continuity was restored with a Dacron prosthesis. The follow-up was 3 months. Immunoreactivity studies for VEGF, survivin, CD31, and caspase-3 were performed. A statistical analysis was done using the Wilcoxon signed rank test. Results: Four animals in group I were euthanized on the 10th postoperative day due to autograft necrosis. Three animals completed the study without anastomotic stenosis. Moderate expression of VEGF (p=0.038), survivin (p=0.038), and CD31 (p=0.038) was found. All group II animals developed stenosis in the trachea-prosthesis anastomotic sites. Microscopy showed abundant collagen and neovascularization vessels. Statistically significant immunoreactive expression of VEGF (p=0.015), survivin (p=0.017), and CD31 (p=0.011) was observed. No expression of caspase-3 was found. Conclusion: We found a strong correlation between fibrosis in trachea-prosthesis anastomoses and excessive angiogenesis, moderate to intense VEGF, CD31, and survivin expression, and null apoptotic activity. These factors led to uncontrolled collagen production.

• Journal of Chest Surgery
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• 제13권4호
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• pp.503-506
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

• Journal of Chest Surgery
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• 제28권8호
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• pp.801-806
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• 1995

Tracheal rupture by a blunt trauma is an uncommon injury, and its clinical presentations are variable. It is a kind of the modern hazard. Herewith, we report a successful management of the tracheal rupture. A 22 year-old female was transferred from other hospital 4 hours after a car crash. Physical examination, simple chest X-ray, Chest CT and fiberoptic bronchoscopy revealed rupture of the membranous portion of the trachea about 5cm in length extending to the right main bronchus. Ruptured membraous portion of the trachea was sutured directly with absorbable suture. Her postoperative course was uneventful, and follow-up fiberoptic bronchoscopy revealed intact membranous portion of the trachea.

• 대한기관식도과학회지
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• 제2권2호
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• pp.213-221
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• 1996

To evaluate the clinical effectiveness of expandable metallic stents, the stents were implanted under endoscopic guidance with local anesthesia or general anesthesia for maintenance of the constructed subglottic space of trachea. The nine patients with respiration difficulty were subjected for expandable stents. The stenosis of upper airway were due to the framework problem of subglottic trachea and tracheostoma after total laryngectomy. Stents were constructed of 0.4 m stainless steel win in a zigzag configuration of 8 bends. A single stent was 20 m in diameter when fully expanded and 20 mm long. The stents were placed accurately to the stenotic site and followed to the 5 month after stent placement. The stenotic area became narrowed with overgrowing of granuloma in all patients and the metallic stents were removed and the stenotic area reconstructed surgically. As conclusion, this technique for the treatment of the subglottic trachea showed simple and safe, but highly recurred due to overgrowing of granuloma. We suggest that the expandable metallic stent is not encouraging in this study.