BACKGROUNDS: The pathophysiology of chronic airflow obstruction, such as bronchial asthma, is characterized by mucus hypersecretion, goblet cell hyperplasia(GCH), smooth muscle hypertrophy, cells infiltration. In fatal asthma patients, one findings is mucus hypersecretion due to GCH. However, the mechanisms of GCH in these hypersecretory diseases remain still unknown. In this study, a rat model was rapidly induced with GCH by instillation of TiO2 intratracheally. We intend to confirm GCH and association of concomitant inflammatory cells infiltration and to observe the effect of potent antiinflammatory agent, that is dexamethasone, on GCH with inflammatroy cells. METHODS: Twenty-one-8-weeks-old male Sprague-Dawley rats were divided into three groups. Endotoxin-free water was instilled intratracheally in group 1(control) ; TiO2 was instilled in the group 2 ; and dexamethasone was injected intraperitoneally to group 3 before TiO2 instillation. After 120 hours, all rats were sacrificed, and trachea, bronchi, and lungs were resected respectively. These tissues were made as paraffin blocks and stained as PAS for goblet cells and Luna stain for eosinophils. We calculated the ratio of goblet cell to respiratory epithelium and number of infiltrated eosinophils from each tissue. RESULTS: (1) Fraction of goblet cells was significantly increased in group 2 than in group 1 in the trachea and in the main bronchus. (10.19±11.33% vs 4.09±8.28%, p<0.01 and 34.09±23.91% vs 3.61±4.84%, p<0.01, respectively). (2) Eosinophils were significantly increased in the airway of group 2 than that of group 1. (5.43±3.84% vs 0.17±0.47 in trachea and 47.71±16.91 vs 2.71±1.96 in main bronchi). (3) There was significant difference in the decrease of goblet cells and eosinophils(r=0.719, p=0.001). (4) There was significant difference in the decrease of goblet cells after dexamethasone infection between group 2 and group 3 (p<0.01). Also, infiltration of eosinophils was suppressed by dexamethasone. CONCLUSION: We made an animal model of TiO2-induced goblet cell hyperplasia. GCH was observed mainly in the main bronchi with concomitant eosinophilic infiltration. Both goblet cell hyperplasia and eosinophilic infiltration were suppressed by dexamethasone. This animal model may serve as a useful tool in understanding of the mechanism of GCH in chronic airway diseases.
Animals ; Asthma ; Bronchi ; Dexamethasone* ; Eosinophils ; Goblet Cells* ; Humans ; Hyperplasia* ; Hypertrophy ; Inflammation* ; Lung ; Male ; Models, Animal ; Mucus ; Muscle, Smooth ; Paraffin ; Pulmonary Disease, Chronic Obstructive ; Rats ; Rats, Sprague-Dawley* ; Respiratory Mucosa ; Trachea ; Water

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.
Adult ; Drainage ; Dyspnea ; Hemoptysis ; Humans ; Korea ; Lung ; Mycobacterium tuberculosis ; Oxygen ; Posture ; Prevalence ; Quadriplegia ; Spine ; Thoracic Wall ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.
Adult ; Drainage ; Dyspnea ; Hemoptysis ; Humans ; Korea ; Lung ; Mycobacterium tuberculosis ; Oxygen ; Posture ; Prevalence ; Quadriplegia ; Spine ; Thoracic Wall ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

OBJECTIVES: This study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients. METHODS: We analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment. RESULTS: Immediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%). CONCLUSIONS: The 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.
Chemical Hazard Release ; Chlorine* ; Cough ; Dizziness ; Dyspnea ; Headache ; Humans ; Korea ; Medical Records ; Mucous Membrane ; Nausea ; Outpatients ; Peak Expiratory Flow Rate ; Pharyngitis ; Respiratory Function Tests

Achalasia is a primary esophageal motility disorder characterized by functional obstruction of the distal esophagus and subsequent dilation of the proximal esophagus. The most common symptoms in children and adolescents are vomiting, progressive dysphagia, weight loss, recurrent pneumonia, nocturnal cough, and chest pain. A girl who had been diagnosed with asthma poorly responsive to inhaled steroids until age 17, presented at the hospital with cough, sputum, and fever. Finally, she was diagnosed with achalasia and underwent esophageal balloon dilatation, which relieved her GI and pulmonary symptoms. We report this case with a literature review.
Adolescent ; Asthma ; Chest Pain ; Child ; Cough ; Deglutition Disorders ; Dilatation ; Esophageal Achalasia ; Esophageal Motility Disorders ; Esophagus ; Fever ; Humans ; Pneumonia ; Sputum ; Steroids ; Vomiting ; Weight Loss

Chemical pneumonitis is defined as lung irritation caused by inhalation of substances toxic to the lungs. Acute chemical pneumonitis causes swelling of the lung tissue, movement of fluid into the air spaces in the lung, and a decreased ability to absorb oxygen and eliminate carbon dioxide. Teflon (polytetrafluoroethylene) is a commonly used synthetic fiber or insulator. To our knowledge, chemical pneumonitis and acute respiratory failure induced by Teflon inhalation has not been previously reported in Korea. We experienced a 44-year-old patient who had a cough and dyspnea that were aggravated 10 h after smoking tobacco wet by Teflon for 5 min at his workplace. Upon arrival at the emergency room, his blood pressure was low and his arterial blood gas analysis revealed hypoxemia. A chest radiograph showed diffuse haziness on both mid- to-lower lung fields. Following treatment by conservative therapy, including oxygen supply and steroid use, his condition was relatively good and his chest radiograph normalized.
Adult ; Anoxia ; Blood Gas Analysis ; Blood Pressure ; Carbon Dioxide ; Cough ; Dyspnea ; Emergencies ; Humans ; Inhalation ; Korea ; Lung ; Oxygen ; Pneumonia ; Polytetrafluoroethylene ; Respiratory Insufficiency ; Smoke ; Smoking ; Thorax ; Tobacco

OBJECTIVES: To provide reference data for the study and treatment of thoracic scoliosis.SUMMARY OF LITERATURE REVIEW: There have been no reports on the prevalence of thoracic scoliosis in Korea. MATERIALS AND METHODS: From August 2011 to October 2012, radiographs of patients under 80 years of age who underwent routine chest radiographs were retrospectively reviewed. Based on their age when the chest radiographs were obtained, the patients were divided into 8 groups. The prevalence and angle of the curve of thoracic scoliosis were investigated in each age group, and the prevalence of thoracic scoliosis according to sex, the direction of the curve, number of vertebrae in the major curve, the location and rotation of the apical vertebrae, and osteophyte location were examined. RESULTS: The prevalence of thoracic scoliosis was 2.4% (621 patients), and female patients (3.0%, 375 of 12471) showed a higher prevalence than male patients (1.8%, 246 of 13654) (p<0.001). Right curvature was present in 445 patients and left curvature in 176 patients. In each age group, the prevalence and degree of thoracic scoliosis were 1.1% (14.2°±3.2°), 2.3% (17.4°±7.7°), 2.5% (17.0°±8.9°), 1.9% (15.8°±5.9°), 1.3% (15.5°±6.6°), 2.1% (18.0°±13.6°), 2.9% (14.3°±3.6°), and 6.1% (16.2°±4.8°), respectively. The mean curvature in all scoliosis patients was 16.0°±7.0°. The angle of the curve was significantly different by sex (15.4°±7.1° for males, 16.8°±7.6° for females). The average curve angle of patients with thoracic scoliosis was 16.0°±7.0°, among whom it was 10°–20° in 533 patients, 20°–30° in 64, 30°–40° in 11, and over 40° in 13. CONCLUSIONS This study could be used as a reference point for the study and treatment of thoracic scoliosis.

STUDY DESIGN: A cross-sectional study. OBJECTIVES: To provide reference data for the study and treatment of thoracic scoliosis. SUMMARY OF LITERATURE REVIEW: There have been no reports on the prevalence of thoracic scoliosis in Korea. MATERIALS AND METHODS: From August 2011 to October 2012, radiographs of patients under 80 years of age who underwent routine chest radiographs were retrospectively reviewed. Based on their age when the chest radiographs were obtained, the patients were divided into 8 groups. The prevalence and angle of the curve of thoracic scoliosis were investigated in each age group, and the prevalence of thoracic scoliosis according to sex, the direction of the curve, number of vertebrae in the major curve, the location and rotation of the apical vertebrae, and osteophyte location were examined. RESULTS: The prevalence of thoracic scoliosis was 2.4% (621 patients), and female patients (3.0%, 375 of 12471) showed a higher prevalence than male patients (1.8%, 246 of 13654) (p<0.001). Right curvature was present in 445 patients and left curvature in 176 patients. In each age group, the prevalence and degree of thoracic scoliosis were 1.1% (14.2°±3.2°), 2.3% (17.4°±7.7°), 2.5% (17.0°±8.9°), 1.9% (15.8°±5.9°), 1.3% (15.5°±6.6°), 2.1% (18.0°±13.6°), 2.9% (14.3°±3.6°), and 6.1% (16.2°±4.8°), respectively. The mean curvature in all scoliosis patients was 16.0°±7.0°. The angle of the curve was significantly different by sex (15.4°±7.1° for males, 16.8°±7.6° for females). The average curve angle of patients with thoracic scoliosis was 16.0°±7.0°, among whom it was 10°–20° in 533 patients, 20°–30° in 64, 30°–40° in 11, and over 40° in 13. CONCLUSIONS: This study could be used as a reference point for the study and treatment of thoracic scoliosis.
Cross-Sectional Studies ; Female ; Humans ; Korea ; Male ; Osteophyte ; Prevalence ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Scoliosis ; Spine ; Thoracic Vertebrae ; Thorax

OBJECTIVE: The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss.METHODS: A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed.RESULTS: The average age of 50 males and 29 females was 57.6±13.5 years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring.CONCLUSION: Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.
Arteries ; Female ; Hemorrhage ; Humans ; Incidence ; Lung ; Male ; Neoplasm Metastasis ; Postoperative Hemorrhage ; Spinal Cord ; Spine ; Thyroid Neoplasms