• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.543-548
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• 1999

Bronchopleural fistula(BPF) occurs as a postoperative complication in 2 to 5 percent of pulmonary resection. The detection of BPF is generally difficult and various diagnostic methods have been utilized to identify the site of the fistula in order to treat it adequately. Closure of these BPF can be surgical intervention or bronchoscopic application of various sealing agents. We report an experience with use of bronchoscopic instillation of n-butyl-2-cyanoacrylate($Histoacryl^{(R)}$) for closure of a postpneumonectomy BPF.

• Journal of Home Health Care Nursing
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• v.23 no.1
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• pp.25-33
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• 2016

Purpose: This study aimed to survey caregivers of patients with Neuromuscular Rare and Incurable Disease (NRID) using invasive home mechanical ventilator (HMV), in order to compare the incident rate of pneumonia by tracheal suction procedures used. Method: Participants were 99 family caregivers of NRID patients using HMV. Participants were given a questionnaire consisting of 12 demographic items, 10 items about disease and HMV related characteristics, 11 items about tracheal suction procedures, and 2 items about the incidence of pneumonia. Data were analyzed using chi-square tests and t-tests. Results: The items that predicted the incidence of pneumonia were "change of irrigation saline every suction" (p=.047), "use of aseptic catheter every suction" (p=.004), and "instillation of normal saline before suction" (p=.027). In addition, these items were 47.4%, 51.4%, and 38.8% respectively. Conclusion: Family members caring for NRID patients with invasive HMV should be educated about tracheal suction, especially the necessity of changing irrigation saline after every suction, using the aseptic catheter for every suction, and instillation of normal saline before suction. Medical personnel such as home care nurses should periodically check tracheal suction procedures, and re-educate family caregivers when necessary.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.3
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• pp.191-201
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• 2016

Purpose: In the present study, the effect of artificial tears with different ingredients on tear film stability and subjective symptoms of dry eyes in the early stage of soft contact lenses wear was investigated. Methods: The three kinds of artificial tears and saline solution were respectively applied onto 50 dry eyes which wore soft contact lenses made of etafilcon A. Then, non-invasive tear film break-up time (NIBUT) was measured at every five minutes for 30 minutes right after the instillation of artificial tears, and the changes in blink rate and subjective symptoms were estimated after 30 minutes from the instillations. Results: All three kinds of artificial tears increased NIBUT larger than saline. The effect of increasing NIBUT immediately after the instillation of artificial tears was the largest when the artificial tear containing viscosity enhancer was used. The duration time of the effect was the longest when the artificial tear having both surfactant and viscosity enhancer was applied. The blink rate was not significantly changed when both artificial tears and saline solution were instilled. Subjective symptoms were significantly improved by the instillation of both artificial tears and saline solution and dryness, irritation, tiredness, stiffness, dazzling were improved by the use of most solutions. However, the subjective symptoms were rebounded to the level before the instillation of artificial tears after 30 minute-instillation. Conclusions: It was revealed that both artificial tears and saline solution could improve the subjective symptoms of dry eye in the early stage of soft contac lenses however, the effect of these solutions on the tear film stability was different according to the components. From the results, it is suggested that the proper selection of artificial tears is necessary for the improvement of dry eye symptoms at the early stage of soft contact lenses wear in dry eye.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.621-628
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• 1997

Background : As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important to prevent pleural fibrosis, entrapment and depression of lung function. Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the predictors of effectiveness of intrapleural urokinase in the treatment of loculated pleural effusion. Method : Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleural cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. Result : Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in success group ($11.8{\pm}6.9day$) than in failure group ($26.62{\pm}16.5day$) (P<0.05). Amount of drained fluid during urokinase therapy was larger in success group ($917.1{\pm}392.7ml$) than in failure group ($613.8{\pm}259.7ml$) (P<0.05). Pleural fluid glucose was higher in success group ($89.7{\pm}35.9mg/dl$) than in failure group ($41.2{\pm}47.1mg/dl$) (P<0.05). Pleural fluid LDH was lower in success group ($878.4{\pm}654.3IU/L$) than in failure group ($2711.1{\pm}973.1IU/L$) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group (P<0.05). Conclusion : Longer duration of symptoms before admission, smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination, and honeycomb septation pattern on chest ultrasonograph were predictors for failure group of intrapleural urokinase instillation therapy.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1236-1251
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• 1998

Background : TNF-$\alpha$ appears to be a central mediator of the host response to sepsis. While TNF-$\alpha$ is mainly considered a proinflammatory cytokine, it can also act as a direct cytotoxic cytokine. However, there are not so many studies about the relationship bet ween TNF-$\alpha$ level and lung injury severity in ALI, particularly regarding the case of ALI caused by direct lung injury such as diffuse pulmonary infection. Recently, a natural defense mechanism, known as the stress response or the heat shock response, has been reported in cellular or tissue injury reaction. There are a number of reports examining the protective role of pre-induced heat stress proteins on subsequent LPS-induced TNF-$\alpha$ release from monocyte or macrophage and also on subsequent LPS-induced ALI in animals. However it is not well established whether the stress protein synthesis such as HSP can be induced from rat alveolar macrophages by in vitro or in vivo LPS stimulation. Methods : We measured the level of TNF-$\alpha$, the percentage of inflammatory cells in bronchoalveolar lavage fluid, protein synthesis in alveolar macrophages isolated from rats at 1, 2, 3, 4, 6, 12, and 24 hours after intratracheal LPS instillation. We performed histologic examination and also obtained histologic lung injury index score in lungs from other rats at 1, 2, 3, 4, 6, 12, 24 h after intratracheal LPS instillation. Isolated non-stimulated macrophages were incubated for 2 h with different concentration of LPS (0, 1, 10, 100 ng/ml, 1, or 10 ${\mu}g/ml$). Other non-stimulated macrophages were exposed at $43^{\circ}C$ for 15 min, then returned to at $37^{\circ}C$ in 5% CO2-95% for 1 hour, and then incubated for 2 h with LPS (0, 1, 10, 100ng/ml, 1, or 10 ${\mu}g/ml$). Results : TNF-$\alpha$ levels began to increase significantly at 1 h, reached a peak at 3 h (P<0.0001), began to decrease at 6 h, and returned to control level at 12 h after LPS instillation. The percentage of inflammatory cells (neutrophils and alveolar macrophages) began to change significantly at 2 h, reached a peak at 6 h, began to recover but still showed significant change at 12 h, and showed insignificant change at 24 h after LPS instillation compared with the normal control. After LPS instillation, the score of histologic lung injury index reached a maximum value at 6 h and remained steady for 24 hours. 35 kDa protein band was newly synthesized in alveolar macrophage from 1 hour on for 24 hours after LPS instillation. Inducible heat stress protein 72 was not found in any alveolar macrophages obtained from rats after LPS instillation. TNF-$\alpha$ levels in supernatants of LPS-stimulated macro phages were significantly higher than those of non-stimulated macrophages(p<0.05). Following LPS stimulation, TNF-$\alpha$ levels in supernatants were significantly lower after heat treatment than in those without heat treatment (p<0.05). The inducible heat stress protein 72 was not found at any concentrations of LPS stimulation. Whereas the 35 kDa protein band was exclusively found at dose of LPS of 10 ${\mu}g/ml$. Conclusion : TNF-$\alpha$ has a direct or indirect close relationship with lung injury severity in acute lung injury or acute respiratory distress syndrome. In vivo and in vitro LPS stimulation dose not induce heat stress protein 72 in alveolar macrophages. It is likely that 35 kDa protein, synthesized by alveolar macrophage after LPS instillation, does not have a defense role in acute lung injury.

• Journal of Environmental Health Sciences
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• v.39 no.1
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• pp.48-55
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• 2013

Objective: The use of nanoparticle products is expected to present a potential harmful effect on consumers. Also, the lack of information regarding inhaled nanoparticles may pose a serious problem. In this study, we addressed this issue by studying pulmonary toxicity after nasal instillation of Al-NPs in SD rats. Methods: The animals were exposed to Al-NPs at 1 mg/kg body weight (low dose), 20 mg/kg body weight (medium dose) and 40 mg/kg body weight (high dose). To determine pulmonary toxicity, bronchoalveolar lavage (ts.AnBAL) fluid analysis and histopathological examination were conducted in rats. In addition, cell viability was investigated at 24 hours after the treatment with Al-NPs. Results: BAL fluid analysis showed that total cells (TC) count and total protein (TP) concentrations increased significantly in all treatment groups, approximately two to three times. Also, lactate dehydrogenase (LDH) and cytokines such as TNF-alpha and IL-6 dose-dependently increased following nasal instillation of Al-NPs. However, polymorphonuclear leukocytes (PMNs) levels showed no significant changes in a dose dependant manner in BAL fluid. In the cytotoxicity analysis, the treatment of Al-NPs significantly and dose-dependently induced cell viability loss (20 to 30%) and damage of cell membrane (5 to 10%) in rat normal lung epithelial cells (L2). Conclusions: Our results suggest that inhaled Al-NPs in the lungs may be removed quickly by alveolar macrophages with minimal inflammatory reaction, but Al-NPs have the potential to affect lung permeability. Therefore, extensive toxicity evaluations of Al-NPs are required prior to their practical application as consumer products.

• The Korean Journal of Urological Oncology
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• 제15권3호
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• pp.178-186
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• 2017

Purpose: Poloxamer 407 (P407) thermo-sensitive hydrogel formulations were developed to enhance the retention time in the urinary bladder after intravesical instillation. Materials and Methods: P407 hydrogels (P407Gels) containing 0.2 w/w% fluorescein isothiocyanate dextran (FD, MW 4 kDa) as a fluorescent probe were prepared by the cold method with different concentrations of the polymer (20, 25, and 30 w/w%). The gel-forming capacities were characterized in terms of gelation temperature (G-Temp), gelation time (G-Time), and gel duration (G-Dur). Homogenous dispersion of the probe throughout the hydrogel was observed by using fluorescence microscopy. The in vitro bladder simulation model was established to evaluate the retention and drug release properties. P407Gels in the solution state were administered to nude mice via urinary instillation, and the in vivo retention behavior of P407Gels was visualized by using an in vivo imaging system (IVIS). Results: P407Gels showed a thermo-reversible phase transition at $4^{\circ}C$ (refrigerated; sol) and $37^{\circ}C$ (body temperature; gel). The G-Temp, G-Time, and G-Dur of FD-free P407Gels were approximately $10^{\circ}C-20^{\circ}C$, 12-30 seconds, and 12-35 hours, respectively, and were not altered by the addition of FD. Fluorescence imaging showed that FD was spread homogenously in the gelled P407 solution. In a bladder simulation model, even after repeated periodic filling-emptying cycles, the hydrogel formulation displayed excellent retention with continuous release of the probe over 8 hours. The FD release from P407Gels and the erosion of the gel, both of which followed zero-order kinetics, had a linear relationship ($r^2=0.988$). IVIS demonstrated that the intravesical retention time of P407Gels was over 4 hours, which was longer than that of the FD solution (<1 hour), even though periodic urination occurred in the mice. Conclusions: FD release from P407Gels was erosion-controlled. P407Gels represent a promising system to enhance intravesical retention with extended drug delivery.

• Journal of Environmental Health Sciences
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• v.46 no.6
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• pp.667-675
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• 2020

Objectives: Exposure to fine dust (PM10) could contribute to the occurrence of cardiovascular disease or respiratory abnormalities. Since garlic is known to possess an anti-oxidative stress effect, the present study was performed to evaluate the effect of garlic intake on fine dust-mediated pulmonary toxicity. Methods: Rats were intratracheally instilled with fine dust at 15 mg/kg body weight (BW)/day for five days following five-day intragastric intubation of garlic at 0.7 or 1.4 g/kgBW/day, or 13.1 mg/kgBW/day S-allyl-cysteine (SAC) as a reference component in garlic. Blood and bronchoalveolar lavage fluid (BALF) were collected. Results: Deposit of fine dust was visually and histopathologically observed in the lungs. Body weight gain during the instillation period was significantly lowered in all the groups instilled with fine dust. Neutrophil numbers in blood were significantly elevated in the fine dust alone group, but this alteration was diminished in the groups administered with garlic. Levels of serum glutathione were lower in the rats instilled with fine dust alone, and this decrease in the glutathione level seems dose-dependently compensated among the groups administered with garlic. Similar findings were observed in the BALF with statistical significance. Typical pulmonary histopathological observation related with inflammation was demonstrated in the lungs of the rats exposed to fine dust alone, whereas such histopathologic findings were not improved in the groups administered with garlic. Conclusion: The present study suggests that garlic intake could alleviate fine dust-mediated pulmonary or systemic toxicities. Further investigation is necessary to delineate the mechanism of garlic-mediated effects on pulmonary function.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.2
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• pp.183-189
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• 2015

Foeniculum vulgare Mill. (fennel) is used to flavor food, in cosmetics, as an antioxidant, and to treat microbial, diabetic and common inflammation. No study to date, however, has assessed the anti-inflammatory effects of fennel in experimental models of inflammation. The aims of this study were to investigate the anti-inflammatory effects of fennel in model of lipopolysaccharide (LPS)-induced acute lung injury. Mice were randomly assigned to seven groups (n=7~10). In five groups, the mice were intraperitoneally injected with 1% Tween 80-saline (vehicle), fennel (125, 250, $500{\mu}l/kg$), or dexamethasone (1 mg/kg), followed 1 h later by intratracheal instillation of LPS (1.5 mg/kg). In two groups, the mice were intraperitoneally injected with vehicle or fennel ($250{\mu}l/kg$), followed 1 h later by intratracheal instillation of sterile saline. Mice were sacrificed 4 h later, and bronchoalveolar lavage fluid (BALF) and lung tissues were obtained. Fennel significantly and dose-dependently reduced LDH activity and immune cell numbers in LPS treated mice. In addition fennel effectively suppressed the LPS-induced increases in the production of the inflammatory cytokines interleukin-6 and tumor necrosis factor-alpha, with $500{\mu}l/kg$ fennel showing maximal reduction. Fennel also significantly and dose-dependently reduced the activity of the proinflammatory mediator matrix metalloproteinase 9 and the immune modulator nitric oxide (NO). Assessments of the involvement of the MAPK signaling pathway showed that fennel significantly decreased the LPS-induced phosphorylation of ERK. Fennel effectively blocked the inflammatory processes induced by LPS, by regulating pro-inflammatory cytokine production, transcription factors, and NO.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.18-23
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• 1995

We analyzed the results of ethanol sclerotherapy in 47 patients with cystic thyroid lesion. Cytologic study showed all of the lesions to be benign. The patients were followed clinically and ultrasonically I month and 3 or more months after ethanol sclerotherapy. If the cystic lesions recurred, repeated treatment was offered. In 4 patients with pure cystic lesion, all of the patents had almost total resolution of the cystic lesions. In 43 patients with mixed cystic lesion, 16(37.2%) patients had almost total resolution of the cystic lesions, 10(23.3%) patients showed a decrease' in the cystic lesion of <50%, but 11(25.6%) patients it did not change in size. Overall, in 30(63.8%) patients the cystic lesion decreased in size. Eleven patients who were not effective by sclerotherapy or follicular proliferation by cytology were converted to surgery. Although no severe complication were observed, there were complication of severe pain in I patient and a drunken feeling in I patient. If the malignancy must be excluded by repeated cytologic examination of aspirated fluid, we consider instillation of ethanol into the cystic lesions of the thyroid to be a simple, safe, economical and effective treatment.