• Title/Summary/Keyword: tracheal tissues

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Review of Experimental Tracheal Reconstruction (실험적 기관 재건술에 대한 고찰)

  • 성숙환;김용희
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.128-139
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    • 2001
  • The purpose of this study was to review the literatures of experimental tracheal reconstruction. Although there have been significant advancements in the surgical treatment of the long circumferential tracheal injuries, there still has been a difficult problem with high morbidity and mortality. The method for tracheal reconstruction after circumferential resection is preferred end-to-end anastomosis for defects up to 6 cm in length, but larger tracheal defects require the use of tracheal allograft, various artificial prosthesis or autogenous organs. The tracheal allotransplantation has been widely used as there was significantly improved the method of surgical technique, preservation and immunosuppression. But it has been limited by a number of factors such as few donor, limited use of immunosuppressant, delayed revascularization and re-epitheliazation. Experimental studies on the tracheal prosthesis have a long history and they tried to use silicone, polytetrafluoroethylene, polypropylene mesh, Dacron, Marlex mesh, external or internal stents. Other experimental studies were reported the use of autogenous tissues that were cartilage. jejunum, aorta, skin, muscle, periostium or esophagus. But a great variety of these protheses have been resulted unsatisfactory in a significant Proportion of cases. Alternatively, the tissue-engineering technique has showed a new approach to reconstruct trachea and much progress in tissue-engineering bas been made recently. In conclusion, although the tracheal allotransplantation and the use of prosthesis and allograft have been reported a lot of limitation to overcome, we could sooner expect good result of ideal tracheal prosthesis.

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Resection and End-to-End Anastomosis in Pediatric Tracheal Stenosis (소아 환자에서의 단단문합술에 의한 기관협착 치험 9 례)

  • 김광현;성명훈;이재서;신진성;최승호
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.81-81
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    • 1993
  • Tracheal stenosis in children are often the result of prolonged intubation and its treatment depends on the severity and extent of the involved segment. Repeated surgical endoscopic procedures may be indicated in those with mild stenoses mainly consisting of granulation tissues, However, surgical reconstruction of the airway should be performed in patients with severe, extensive stenoses composed of mature scar tissue. The senior author has successfully managed such patients with cartilage graft augmentation and tracheal resection anastomosis. This is a presentation of 9 pediatric patients with tracheal stenosis who have been successfully treated by resection anastomosis. The details of the cases and indications for this type of surgery are discussed.

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The Effects of Kamihaepyoijin-tang on the Respiratory Patterns and Tracheal Tissues in Allergic Asthma (가미해표이진탕이 알레르기 천식 백서의 호흡 양상과 기관조직에 미치는 영향)

  • Kim Min Sue;Pack Dong Il
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.557-562
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    • 2002
  • 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.

The Morphologic Changes by Immunosuppression after Heterotopic Transplantation of the Murine Cryopreserved Trachea: An Animal Model for Obliterative Bronchiolitis (이소 이식된 쥐 기관의 면역억제 및 초냉동 보관에 의한 형태학적 변화: 폐색성 모세기관지염의 연구를 위한 동물 실험 모델)

  • 이창하;성숙환;오미혜
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.215-223
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    • 1999
  • Background: The replacement of the narrowed long-segment trachea with various prosthetic materials or tissue grafts remains a difficult and unsolved surgical problem. Homologous cryopreserved tracheal transplantation has been considered to treat the irreversibly-damaged organs, such as in the lung or heart transplantation and also to overcome the limited supply of donor organs. We examined the morphological changes and the immunosuppressive effects of the cryopreserved trachea after the heterotopic transplantation in the rats. Material and Method: Sixty tracheal segments harvested from 30 donor Wistar rats were heterotopically implanted into the peritoneal cavity of 20 recipient Wistar rats and 40 Sprague Dawley rats. The 60 recipient rats were divided into 6 groups(10 rats/ group). In groups I, II, and III, 30 tracheal segments were implanted immediately after the harvesting and in groups IV, V, and VI, the segments were implanted 28 days after the cryopreservation. Groups I and IV were Wistar syngeneic controls. Groups II and V were Sprague Dawley recipients receiving no immunosuppression and Groups III and VI, were Sprague Dawley recipients receiving immunosuppressive agents. At 28 days all rats were sacrificed and the tracheal segments were evaluated grossly and histologically. Result: Immunosuppression of the tracheal segments had a significant influence on the changes of the tracheal lumen and tracheal epithelial cells, irrespective of the cryopreservation of the trachea(p<0.001). In groups III and VI receiving immunosuppressive agents, the tracheal lumen was patent and the normal epithelial cells were observed, however in the other groups not receiving the immunosuppressive agents, there were almost luminal obliteration by the proliferation of the fibrous tissues and a loss of the epithelial cells, the findings were similar to those in the case of obliterative bronchiolitis after a lung and a heart-lung transplantation. Conclusion: With the appropriate immunosuppressive agents, the lumen and the respiratory epithelium of the transplanted tracheal segment were well preserved, even after the cryopreservation of the tracheal segment, which shows the possibility of the long-term preservation and homologous transplantation of the trachea. But fibroproliferative obliteration of the tracheal lumen and the loss of the normal respiratory epithelial cells, characteristic findings of obliterative bronchiolitis, were observed in the groups without the immunosuppression. This experiment using the rat trachea may be useful in studying the pathogenesis, treatment, and prevention of obliterative bronchiolitis after a lung and a heart-lung transplantation.

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Thymic Cyst Causing Tracheal Stenosis : one case report (기도협착을 유발한 흉선낭종)

  • Hwang, Jung-Joo;Yang, Hong-Seok;Paik, Hyo-Chae;Hong, Soon-Won;Lee, Doo-Yun
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.68-71
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    • 2004
  • Thymic cysts are uncommon tumors which usually occur in the neck and mediastinum. It is known to arise from embryonic remnants of the thymopharyngeal duct or from inflammation of thymic tissues. Patients with thymic cyst are often asymptomatic and identified after surgical removal and histologic examination. We experienced a 73 year-old man with recently developed dyspnea. During the examination, chest CT showed a $5\times6cm$ sized cystic mass causing deviation of the trachea. It was located in between the right thyroid gland and anterior mediastinum. It also caused tracheal narrowing noted by bronchoscopy. Right anterior cervical incision and removal of the mass was performed and a histological diagnosis of thymic cyst was confirmed. The patient was discharged without complication.

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Thymic Cyst Causing Tracheal Stenosis : one case report (기도협착을 유발한 흉선낭종)

  • Hwang, Jung-Joo;Yang, Hong-Seok;Paik, Hyo-Chae;Hong, Soon-Won;Lee, Doo-Yun
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.25-27
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    • 2005
  • Thymic cysts are uncommon tumors which usually occur in the neck and mediastinum. It is known to arise from embryonic remnants of the thymopharyngeal duct or from infammation of thymic tissues. Patients with thymic cyst are often asymptomatic and identified after surgical removal and histologic examination. We experienced a 73 year-old man with recently developed dyspnea. During the examination, chest CT showed a $5{\times}6cm$ sized cystic mass causing deviation of the trachea. It was located in between the right thyroid gland and anterior mediastinum. It also caused tracheal narrowing noted by bronchoscopy. Right anterior cervical incision and removal of the mass was performed and a histological diagnosis of thymic cyst was confirmed. The patient was discharged without complication.

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Studies on the Experimental Heart and Heart-Lung Transplantation in the Mongrel Dogs for the Purpose of Clinical Application (임상적용을 위한 한국산 잡견에서의 실험적 심장및 심폐 이식술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.458-468
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    • 1992
  • With the aid of extracorporeal circulation, nine dogs underwent orthotopic cardiopulmonary transplantation after preservation of the donor heart in a hypothermic amino acid[glutamate, aspartate] enriched high potassium extracellular solution, and preservation of the donor lung with hypothermic low potassium dextran solution from June 1990 to May 1991. The mean body weights of dogs were 20kg and the recipients` preoperative hematologic and hemodynamic pictures were within normal range except slightly decreased level of albumin and total protein, which was supposed to be due to malnutrition. The following modifications of the original Stanford technique were emphasized: [1] the posterior mediastinum is dissected as little as possible with meticulous hemostasis; [2] the surgical procedure is kept away from the phrenic and vagus nerves; [3] the tracheal anastomosis may be wrapped with recipient`s pulmonary artery flap or surrouding soft tissues. A combination of Cyclosporine, Azathioprine, corticosteroid was used as perioperative immunosuppressive therapy. Postoperatively all recipients could be weaned from extracorporeal circulation, showing favorable vital signs, but within 24 hours, irreversible congetive heart failure, ascites, arrhythmias developed with a mean survival time 13.6$\pm$6.6[n=9, range=6~26] hours. Hemoglobin and platelet counts were significantly[p<0.05] decreased postoperatively, which is thought to be attributed to blood damage by cardiopulmonary bypass and hemodilution. Postmortem finding included multiple subendocardial patch hemorrhage in both atrial and ventricular cavities, pulmonary and liver congestion, and all tracheal anastomoses were intact. Further consideration about quality control of the animal, infection, rejection, the effect of cardiopulmonary bypass on the experimental animal is required to improve the results.

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The Effects of Oyo-Tang(五拗湯) on the Respiratory Patterns and Tracheal Tissues in Allergic Asthma (오요탕(五拗湯)이 알레르기 천식(喘息)의 호흡(呼吸) 양상(樣相)과 기관(氣管) 조직(組織)에 미치는 영향(影響))

  • Kwon, Soon-Ho;Jung, Hee-Jae;Jung, Sung-Ki;Rhee, Hyung-Koo
    • The Journal of Korean Medicine
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    • v.20 no.2
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    • pp.98-107
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    • 1999
  • This study aimed to find out Oyo-Tang's effects on allergic asthma using the Egg-White Implant(EWI) method model recommended by Siqueira et al. Oyo-Tang has widely been prescribed and used in Oriental Medicine for controlling and curing of cough, nasal obstruction, pharyngeal pain and hoarseness. Previous studies have demonstrated that Oyo-Tang has analgesic, sedative, anticonvulsive, antitussive and antihistamine effects. But it was uncertain whether Oyo-Tang could inhibit the allergic reactions, to alleviate the symptoms of allergic asthma. With such aim. the respiratory patterns and eosinophil infiltration in the tracheal mucosa of rats with experimentally induced allergic asthma (using EWI method) were mainly observed. The results are as follows: 1. Oyo-Tang decreased the number of poor respiration with respect to control group (P<0.05) 2. Oyo-Tang decreased the number of eosinophils infiltrated in tracheal mucosa with respect control group (P<0.05). The above results demonstrate that Oyo-Tang has the inhibitory effects on the process allergic asthma and suggest that it could be used in relieving patients of the symptoms caused allergic asthma.

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The Effects of Kamichungsangboha-tang on the Respiratory Patterns and Tracheal Tissues in Allergic Asthma (가미청상보하탕이 Allergy성 기관지천식에 미치는 실험적 연구)

  • Woo Young Sik;Kim Jin Il;Kang Pil Koo;Park Dong Il
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.6
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    • pp.1217-1222
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    • 2002
  • This study was aimed to find out Kami-Chungsangboha-tang's effects on allergic asthma using Egg-White Implant(EWI) method model recommended by Siqueira et al. Kami-Chungsangboha-tang has widely been prescribed and used in Oriental Medicine for controlling and curing of the symptoms of Asthma(dyspnea, wheezing, cough, sputum, chest discomfort). The Previous studies have demonstrated that Kami-Chungsangboha-tang had analgesic, sedative, anticonvulsive and antihistamine effects. But it was uncertain whether Kami-Chungsangboha-tang could inhibit the allergic reaction, so alleviate the symptoms of allergic asthma. With such aim, the respiratory patterns and eosinophil infiltration in the tracheal mucosa of rats with experimentally induced allergic asthma (using EWI method) were mainly observed. The results are as follows ; 1. Kami-Chungsangboha-tang decreased the number of malformed respiration with respect to control group (p<0.02). 2. Kami-Chungsangboha-tang decreased the number of eosinophils infiltrated in tracheal mucosa with respect to control group (p<0.05). Depending upon above results, it is considered that Kami-Chungsangboha-tang has the inhibitory effects on the process of allergic asthma and suggested that it could be used in relieving patients of the symptoms caused by allergic asthma.

EFFECTS OF PANAX GINSENG SAPONINS ON CHEMICAL MEDIATOR RELEASE FROM AIRWAY SMOOTH MUSCLE IN ACTIVELY SENSITIZED GUINEA PIG

  • Ro Jai Youl;Yoon Suk Jong;Lee Jong Wha;Kim Kyung Hwan
    • Proceedings of the Ginseng society Conference
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    • 1993.09a
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    • pp.84-93
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    • 1993
  • It has been reported that ginseng is effective in the central nervous system, immune system, and the strong inflammatory responses. However, there has been no research report yet about the effect of ginseng on allergic hypersensitivity reactivity. To confirm the ginseng effects on the release of mediators(histamine. leukotrienes etc.) which cause the hypersensitivity reactivity and inflammatory response, we used actively sensitized guinea pig airway tissues by utilizing the superfusion technique. In this procedure. the contractile response and mediators released after antigen stimulation of sensitized tissues, and IgG and IgE antibody products were measured in sera of immunized animals. Then the results of the controll group were compared to those of ginseng pretreatment groups. In the total saponin(TS) and panaxatriol(PT) pretreatment, histamine release decreased by $20\%$ in the tracheal tissues after active sensitization by ovalbumin(OVA, 10mg/kg), but in the lung parenchyma, histamine release decreased by $40\%.$ Panaxadiol(PD) significantly decreased histamine release by $40\%$ in the both tissues after active sensitization. TS, PT and PD of ginseng poorly blocked leukotrienes (LTs) and prostagrandin $D_2(PGD_2)$ release(less than $10\%$). Ginseng TS and PT had no effect on the serum IgG antibody production by ovalbumin, whereas PD significantly increased serum IgG antibody contents(approximately by 2 times). However, $IgG_1$ antibody products in the serum of guinea pig actively sensitized with ovalbumin after PD pretreatment were decreased, compared to that with ovalbumin alone. IgE antibody production by passive cutaneous anaphylaxis(PCA) titer in the TS pretreatment increased 3 times more than in the absence of TS(PCA titer by PT was not detected). These studies show that some ginseng saponins can in part act to inhibit mediator release in antigen - induced airway smooth muscle by inducing the IgG antibody production which has been changed in the specificity.

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