• Tuberculosis and Respiratory Diseases
• /
• v.85 no.1
• /
• pp.18-24
• /
• 2022

Background: Neutrophilic asthma (NeuA) is usually resistant to corticosteroids. Tiotropium bromide (TIO) is a bronchodilator that is used as an add-on therapy to inhaled corticosteroid and long-acting β2 agonist in asthma treatment. However, the role of TIO in NeuA is not fully known. Thus, the aim of this study was to evaluate the effect of TIO on NeuA compared to that of corticosteroids. Methods: C57BL/6 female mice were sensitized with ovalbumin and lipopolysaccharide to induce neutrophilic inflammation. Dexamethasone (DEX) was administered on days 14, 17, 20, and 23. TIO was inhaled on days 21, 21, and 23. On day 24, mice were sacrificed. Airway hyper-responsiveness, levels of cytokines in bronchoalveolar lavage (BAL) and lung homogenates, and lung tissue histopathology were compared between the two groups. Results: Neutrophil counts, T helper 2 cells (T_H2)/T_H17 cytokines, and pro-inflammatory cytokine in BAL fluids were elevated in the NeuA group. TIO group showed lower total cells, neutrophil counts, and eosinophil counts in BAL fluids than the DEX group (p<0.001, p<0.05, and p<0.001, respectively). Airway resistance was attenuated in the TIO group but elevated in the NeuA group (p<0.001). Total protein, interleukin (IL)-5, and IL-17A levels in BAL fluids were lower in the TIO group than in the NeuA group (all p<0.05). Conclusion: TIO showed more potent effects than DEX in improving airway inflammation and attenuating airway resistance in NeuA.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.2
• /
• pp.175-184
• /
• 2022

Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls. Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated. Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), FEV₁/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV₁ were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z₅), total airway resistance (R₅), central airway resistance (R₂₀), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X₅, X₂₀) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups. Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.

• Kosin Medical Journal
• /
• v.33 no.2
• /
• pp.252-256
• /
• 2018

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a $Glidescope^{(R)}$ video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA $Supreme^{TM}$) rather than further intubation was successfully used to maintain the airway.

• The korean journal of orthodontics
• /
• v.21 no.1 s.33
• /
• pp.17-29
• /
• 1991

The purpose of this study was to provide quantitative data describing the effect of rapid palatal expansion (RPE) on nasal airway resistance (NAR). RPE is an orthopedic procedure which is commonly used to widen the maxilla in skeletal Class III patients. 18 subjects (9 males and 9 females, mean age: 10 years 7 months) were selected from the Orthodontics in Yongdong Severance Hospital. Recordings of NAR were taken by active anterior method prior to expansion, immediately after desired maximum expansion, and after approximately 3 months and 6 months, and 1 year. All data was recorded and statistically processed with the SPSS program of IBM PC system. The results are as followings . 1. The average initial NAR of the subjects was 3.84 cm $H_2O/LPS\;(SD{\pm}1.34)$. It was greater than the average NAR of the normal subjects. 2. Among 18 subjects, 9 subjects showed reduction of NAR and 9 subjects showed no specific change of NAR after expansion. 3 An average reduction in NAR after immediately expansion was statistically significant at the 0.05 level. 4. The reduction appeared stable throughout the post treatment observation period of 1 year after expansion. From these results, it was suggested that RPE is a useful method to reduce NAR.

• Parasites, Hosts and Diseases
• /
• v.60 no.4
• /
• pp.229-239
• /
• 2022

The high percentage of Vermamoeba was found in tap water in Korea. This study investigated whether Vermamoeba induced allergic airway inflammation in mice. We selected 2 free-living amoebas (FLAs) isolated from tap water, which included Korean FLA 5 (KFA5; Vermamoeba vermiformis) and 21 (an homolog of Acanthamoeba lugdunensis KA/E2). We axenically cultured KFA5 and KFA21. We applied approximately 1×10⁶ to mice's nasal passages 6 times and investigated their pathogenicity. The airway resistance value was significantly increased after KFA5 and KFA21 treatments. The eosinophil recruitment and goblet cell hyperplasia were concomitantly observed in bronchial alveolar lavage (BAL) fluid and lung tissue in mice infected with KFA5 and KFA21. These infections also activated the Th2-related interleukin 25, thymic stromal lymphopoietin, and thymus and activation-regulated chemokines gene expression in mouse lung epithelial cells. The CD4⁺ interleukin 4⁺ cell population was increased in the lung, and the secretion of Th2-, Th17-, and Th1-associated cytokines were upregulated during KFA5 and KFA21 infection in the spleen, lung-draining lymph nodes, and BAL fluid. The pathogenicity (allergenicity) of KFA5 and KFA21 might not have drastically changed during the long-term in vitro culture. Our results suggested that Vermamoeba could elicit allergic airway inflammation and may be an airway allergen.

• Physical Therapy Rehabilitation Science
• /
• v.7 no.1
• /
• pp.18-22
• /
• 2018

Objective: This study aimed to investigate the effect of different-sized airways of the inspiratory muscle trainer (IMT) on maximal inspiratory pressure (MIP) and the rating of perceived exertion, as measured by the modified Borg scale (m-Borg). Design: Cross-sectional study. Methods: Twenty healthy subjects (10 men, 10 women) volunteered for the study. The spirometry was used to measure MIP. The trial order of the three spirometry conditions was chosen randomly. After measuring the MIP and before taking the final break, each of the conditions were immediately measured using the m-Borg. All subjects used the IMT with an airway diameter of 5-, 6-, and 7-mm. Results: The MIP significantly decreased with the decreasing airway diameter of the IMT (p<0.001), and the differences in all three conditions (7- and 6-mm, 6- and 5-mm, and 7- and 5-mm airways) were significant (p<0.05). The RPE significantly increased with the decreasing airway diameter of the IMT (p<0.001), and the differences in all three conditions (7- and 6-mm, 6- and 5-mm, and 7- and 5-mm airways) were significant (p<0.05). Conclusions: Decreasing the airway diameter of the IMT decreased the MIP and increased the m-Borg. In regards to physical exercise within the clinical setting, the m-Borg could be a useful as a prior monitoring method to prevent dyspnea for patients with narrowed airways (blocked with secretion or sputum in pulmonary disease) and the different-sized airways of the IMT could be applied as a useful tool to improve MIP for prevention of pulmonary disease.

• Molecules and Cells
• /
• v.46 no.11
• /
• pp.700-709
• /
• 2023

Mucus hyperproduction and hypersecretion are observed often in respiratory diseases. MUC8 is a glycoprotein synthesized by epithelial cells and generally expressed in the respiratory track. However, the physiological mechanism by which extracellular nucleotides induce MUC8 gene expression in human airway epithelial cells is unclear. Here, we show that UTP could induce MUC8 gene expression through P2Y2-PLCβ3-Ca²⁺ activation. Because the full-length cDNA sequence of MUC8 has not been identified, a specific siRNA-MUC8 was designed based on the partial cDNA sequence of MUC8. siRNA-MUC8 significantly increased TNF-α production and decreased IL-1Ra production, suggesting that MUC8 may downregulate UTP/P2Y2-induced airway inflammation. Interestingly, the PDZ peptide of ZO-1 protein strongly abolished UTP-induced TNF-α production and increased IL-1Ra production and MUC8 gene expression. In addition, the PDZ peptide dramatically increased the levels of UTP-induced ZO proteins and TEER (trans-epithelial electrical resistance). These results show that the anti-inflammatory mucin MUC8 may contribute to homeostasis, and the PDZ peptide can be a novel therapeutic candidate for UTP-induced airway inflammation.

• The korean journal of orthodontics
• /
• v.40 no.2
• /
• pp.66-76
• /
• 2010

Objective: Obstructive sleep apnea (OSA) is a common disorder which is characterized by a recurrence of entire or partial collapse of the pharyngeal airway during sleep. A given tidal volume must traverse the soft tissue tube structure of the upper airway, so the tendency for airway obstruction is influenced by the geometries of the duct and characteristics of the airflow in respect to fluid dynamics. Methods: Individualized 3D FEA models were reconstructed from pretreatment computerized tomogram images of three patients with obstructive sleep apnea. 3D computational fluid dynamics analysis was used to observe the effect of airway geometry on the flow velocity, negative pressure and pressure drop in the upper airway at an inspiration flow rate of 170, 200, and 230 ml/s per nostril. Results: In all 3 models, large airflow velocity and negative pressure were observed around the section of minimum area (SMA), the region which narrows around the velopharynx and oropharynx. The bigger the Out-A (outlet area)/ SMA-A (SMA area) ratio, the greater was the change in airflow velocity and negative pressure. Conclusions: Pressure drop meaning the difference between highest pressure at nostril and lowest pressure at SMA, is a good indicator for upper airway resistance which increased more as the airflow volume was increased.

• Clinical and Experimental Pediatrics
• /
• v.63 no.1
• /
• pp.3-7
• /
• 2020

High-flow nasal cannula (HFNC) is a relatively safe and effective noninvasive ventilation method that was recently accepted as a treatment option for acute respiratory support before endotracheal intubation or invasive ventilation. The action mechanism of HFNC includes a decrease in nasopharyngeal resistance, washout of dead space, reduction in inflow of ambient air, and an increase in airway pressure. In preterm infants, HFNC can be used to prevent reintubation and initial noninvasive respiratory support after birth. In children, flow level adjustments are crucial considering their maximal efficacy and complications. Randomized controlled studies suggest that HFNC can be used in cases of moderate to severe bronchiolitis upon initial low-flow oxygen failure. HFNC can also reduce intubation and mechanical ventilation in children with respiratory failure. Several observational studies have shown that HFNC can be beneficial in acute asthma and other respiratory distress. Multicenter randomized studies are warranted to determine the feasibility and adherence of HFNC and continuous positive airway pressure in pediatric intensive care units. The development of clinical guidelines for HFNC, including flow settings, indications, and contraindications, device management, efficacy identification, and safety issues are needed, particularly in children.

• Korean Journal of Bronchoesophagology
• /
• v.3 no.2
• /
• pp.313-317
• /
• 1997

Airway mucus provides the protective functions such as lubrication, barrier, disposal of trapped materials, and humidification. In the normal state, the mucus do not interfere with Bas transport and the other vital functions of lung. In diseases such as asthma, bronchitis, and cystic fibrosis, the mucus hypersecretion was physiologically developed in the response of multiple neurohumoral mechanism system. And regardless of the mechanism, many clinical sequelae result from mucus hypersecretion: atelectasis, infection, increased airway resistance, increased work of breathing, increased cough with its resultant complication. And the condensation of mucus tv mucus hypersecretion can make the mucus plug by which bronchial obstruction is developed. We have experienced a 7 Pear-old male patient with recurrent pneumonic symtom, which the bronchial obstruction was developed by the impacted mucus plug on the bronchoscopic finding. We report this case with the review of literature.