Pressure damage to respiratory mucosa from overinflation of bronchial cuffs has been implicated as a cause of bronchial rupture, a rare but devastating complication of double-lumen endobronchial tubes (DLTs). In vivo, we evaluated the pressure/volume characteristics of the bronchial cuffs by left main bronchus diameter and DLT size. Thirty patients were divided into three groups : in group 1, 35 Fr DLT was used and left main broncus diameter (LMBD) was less than 12 mm; in group 2, 37 Fr DLT and LMBD less than 12 mm ; in group 3, 37 Fr DLT and LMBD larger than 12 mm. The bronchial cuff volume needed to seal left main bronchus(cuff sealing volume) and bronchial cuff pressure to 2.5 ml of cuff volume at 0.5 ml increments were measured . The results were as follows. 1) The mean+SE cuff sealing volume were 0.3+/-0.1 ml, 0.4+/-0.1 ml and 1.0+/-0.2 ml in group 1, 2 and 3 respectively. 2) The mean+ SE bronchial cuff pressure at 0.5, 1, 1.5 and 2 ml of cuff volume were 27.5+/-5.0, 64.0+/-10.2, 105.4+/-15.5, 124.1+/-16.7 mmHg in group 1, 31.5+/-3.7, 74.1+/-6.2, 126.0+/-11.8, 175.3+/-14.6 mmHg in group 2 and 10.9+/-2.4, 23.8+/-3.4, 50.5+/-5.4, 89.2+/-7.5 mmHg in group 3 respectively. We concluded that initial cuff inflation volume of 0.5 ml in group 1 and 2, 1ml in group 3 is appropriate.
Bronchi* ; Humans ; Inflation, Economic ; Respiratory Mucosa ; Rupture

The mucociliary system has primary defence mechanism in the respiratory tract. The effects of various drugs used clinically in the treatment of disease of the nasal cavity have not been fully elucidated. The aim of this study was to investigate the effects of alpha1 receptor agonist, phenylephrine hydrochloride on ciliary beat frequency in vitro using a video computerized analysis technique. The ciliated epithelial cells from the nasal mucosa in four volunteers were collected in a culture medium and exposed to 0.125%, 0.25%, 0.5%, 1.0%, and 2.5% phenylephrine hydrochloride solution according to 0.5 hour, 1 hour, 2 hours, 4 hours, 8 hours, 12 hours, 1 day, 2 days, 3 days, 4 days, 5 days, and 6 days. There was a significant decrease in ciliary beat frequency with exposure to 0.125% phenylephrine hydrochloride solution for 12 hours, and 0.25% phenylephrine hydrochloride solution for 8 hours(p<0.05). There were cilioinhibitory effects with concentration dependent response by phenylephrine hydrochloride solution. After substitution of the culture medium with phenylephrine hydrochloride free one showed no ciliary recovery in all groups. The results of this study suggest that phenylephrine hydrochloride may have phamacologically a cilioinhibitory effect in vitro on ciliated epithelium.
Epithelial Cells ; Epithelium ; Nasal Cavity ; Nasal Mucosa ; Phenylephrine* ; Respiratory Mucosa* ; Respiratory System ; Volunteers

Congenital lingual cyst is rare and there has been no prior case report about prenatally detected lingual cyst in Korea. When a huge oral cyst is observed at prenatal period and can cause life-threatening airway obstruction at birth, ex utero intrapartum treatment (EXIT) procedure is needed to secure the airway. Herein we present a baby with a prenatally detected huge oral cyst. He was delivered safely assisting EXIT procedure and underwent an operation for resection of the cyst from his tongue. The oral cyst was diagnosed as a lingual cyst with rare histologic type consisting mixed gastrointestinal and respiratory epithelium.
Airway Obstruction ; Korea ; Mouth ; Parturition ; Respiratory Mucosa ; Tongue

The present study was carried out to investigate the glycoconjugate properties of the nasal mucosa in the rat after inhalation of formaldehyde. Sprague-Dawley male rats were inhalated 30 ppm formaldehyde for 3 times with 3 hours exposure. The olfactory and respiratory mucosa in the nasal mucosa were taken from the animals on 3, 6,9 days and 2, 3, 4, 5 weeks after inhalation of formaldehyde. The properties of glycoconjugate of the olfactory and respiratory mucosa were investigated using nine biotinylated lectins (PSA, UEA I, PHA-L, BSL I, PNA, MAL I, DBA, BSL II or sWGA). In experimental groups, the degenerative changes of the olfactory epithelium were observed until 3 weeks after inhalation of formaldehyde, but the respiratory epithelium was no change. In control group, the olfactory cells in the olfactory epithelium reacted with PSA, UEA I, PNA, DBA, BSL II, sWGA, and the supporting cells reacted with PSA, PHA-L, PNA, MAL I, DBA, BSL II, sWGA, and Bowman's glands reacted with all the lectins. In experimental groups, the olfactory cells reacted with UEA I, DBA, and the supporting cells reacted with PHA-L, MAL I, DBA, UEA I, and the positive reaction of Bowman's glands was increased. In control group, the goblet cells in the respiratory epithelium reacted with UEA I, MAL I, and the ciliated columnar cells reacted with PSA, UEA I, PHA-L, BSL I, DBA, BSL II, sWGA, and the septal nasal glands reacted with all the lectins except UEA I. In experimental groups, the goblet cells reacted with UEA I, MAL I and PNA. Conclusively, the olfactory mucosa was shown a lot of changes in the properties of glycoconjugates following inhalation of formaldehyde, but respiratory mucosa was shown feeble change. These results suggest that there were different sugar residues of glycoconjugate in the olfactory and respiratory mucosa following inhalation of formaldehyde, respectively.
Animals ; Formaldehyde ; Glycoconjugates ; Goblet Cells ; Humans ; Inhalation ; Lectins ; Male ; Nasal Mucosa ; Olfactory Mucosa ; Phytohemagglutinins ; Rats ; Respiratory Mucosa ; Wheat Germ Agglutinins

BACKGROUND AND OBJECTIVES: We determined the localization of leukocyte-type 12-lipoxygenase (L-12-LO) in murine nasal mucosa and to investigate the expression of L-12-LO according to the development of murine nasal mucosa. MATERIALS AND METHOD: Immunohistochemical staining was done on the nasal mucosa of mice at gestational days 16, 17, 18, and mice at postnatal days 1, 3, 7, 14, and adult mice. Alcian blue (pH 2.5)-periodic acid Schiff staining on murine nasal mucosa was performed. RESULTS: In murine nasal respiratory mucosa, the expression of L-12-LO was noted in ciliated epithelial cells, basal cells, serous acini, and secretory ducts, but it was not found in the mucous acini and goblet cells. In olfactory mucosa, the expression of L-12-LO was noted in the olfactory receptor cells, supporting cells, and basal cells. The expression in respiratory mucosa according to the development was strongly noticed from the gestational day 16 through postnatal day 7. The expression in postnatal day 14 and adult mice was weaker than in the previous time point. The expression in olfactory mucosa showed no difference throughout the developmental stage. CONCLUSION: As a result of this study, we found the exact localization of L-12-LO in murine nasal mucosa, and we also found the different expression of L-12-LO between the respiratory and olfactory mucosa. This fact suggests the possible involvement of L-12-LO in the development of murine respiratory mucosa.
Adult ; Alcian Blue ; Animals ; Arachidonate 12-Lipoxygenase* ; Epithelial Cells ; Goblet Cells ; Humans ; Immunohistochemistry ; Mice ; Nasal Mucosa* ; Olfactory Mucosa ; Respiratory Mucosa

BACKGROUND AND OBJECTIVES: The olfactory mucosa in patients with persistent anosmia after endoscopic sinus surgery were immunohistochemically examined by using antimicrotubule associated protein 5 (MAP 5) and further compared with normosmic patients after surgery. PATIENTS AND METHODS: Sixty-three biopsy specimens were obtained from the olfactory region of 15 patients with persistent anosmia and 6 patients with normosmia following sinus surgery. RESULTS: Immuno-histochemical examination of all specimens with microtubule-associated protein 5 (MAP5) antisera demonstrated olfactory epithelium in 11 of 18 specimens from normosmic patients and in 12 of 45 samples from anosmic patients. There was a significant difference in the proportion of specimens containing olfactory epithelium between both patients. In normosmic pateints, most of the biopsy samples contained normal-appearing olfactory tissue. However, two main patterns of histological findings were found in the olfactory mucosa of anosmic patients: First, the olfactory receptor cells were remarkably decreased in their number. Second, the orderly arrangement of cells characteristic of normal olfactory epithelia was lost, demonstrating degenerative appearance. CONCLUSION: These data suggest that olfactory epithelium can be degenerated even in chronic sinusitis and thereafter extensively replaced with respiratory epithelium, resulting in increased sampling error. Moreover, unimproved olfactory deficit following sinus surgery may be due to the abnormalities observed at the olfactory epithelium level.
Biopsy ; Humans ; Immune Sera ; Olfaction Disorders* ; Olfactory Mucosa ; Respiratory Mucosa ; Selection Bias ; Sinusitis

Upper respiratory tract infection is one of the most common illnesses affecting children. On average, children experience around six to eight upper respiratory tract infections (URTIs) each year. Although these infections usually are mild and self limiting, they occasionally lead to complications that can be life threatening. Most URTIs can be placed within four main categories of infection: nasopharyngitis, pharyngitis, sinusitis and otitis media. Within each category of illness, there is a range of related conditions that may have similar or overlapping clinical presentations. A sound judgment is required to determine the most affected part of the respiratory mucosa. The clinical features, diagnosis and treatment of URTIs in children will be reviewed here.
Child ; Humans ; Judgment ; Nasopharyngitis ; Otitis Media ; Pharyngitis ; Respiratory Mucosa ; Respiratory Tract Infections ; Sinusitis

OBJECTIVES: The aim of this study was to investigate whether the ciliary activity of respiratory epithelium is affected in allergic rhinitis. METHODS: Twenty Wistar rats were divided into an unsensitized control group and sensitized allergic group. The sensitized group was immunized intraperitoneally with ovalbumin, followed by intranasal administration of ovalbumin. Allergy was determined by an increase in nasal symptoms, the number of tissue eosinophils and a positive result to a passive cutaneous anaphylaxis (PCA) test. Nasal, nasopharyneal, tracheal, and bronchial epithelial cells were obtained from both the control and allergic groups. Ciliary beat frequency (CBF) was measured using a video-computerized analysis technique in vitro. We compared the CBF of two groups in each site. We also evaluated the findings of the nasal mucosa of both groups with an scanning electron microscope. RESULTS: In vitro CBF measurement demonstrated that the CBF of the control and allergic groups did not differ significantly (p>0.05). CONCLUSION: CBF is not affected by respiratory allergy.
Administration, Intranasal ; Animals ; Eosinophils ; Epithelial Cells* ; Hypersensitivity ; Nasal Mucosa ; Ovalbumin ; Passive Cutaneous Anaphylaxis ; Rats* ; Rats, Wistar ; Respiratory Mucosa ; Rhinitis*

OBJECTIVE: To describe five rare cases of bilateral olfactory clefts respiratory epithelial adenomatoid hamartoma (REAH), and investigate the clinicopathologic features in REAH. METHOD: Five cases with REAH were reported and the relevant literatures were reviewed. All the cases were confirmed by pathology. RESULT: The chief complaint in 4 cases when visited was nasal obstruction and rhinorrhea, with or without hyposmia and headache. Another was discomfortable of head-facial region, sometimes with pus discharge and blood in nasal discharge. Polypoid neoplasms can be seen in nasal meatus of the 5 cases. Endoscopic sinus surgery was utilized to eliminate foci in 5 cases. All REAH foci located in bilateral olfactory clefts areas, four of which appeared polypoid changes,one appeared obvious inflammatory edema. All of them presented as wide-based lesion with tenacious quality compared to polyps. Histologically, these lesions were characterized by a glandular proliferation lined by ciliated respiratory epithelium originated from the surface epithelium, and the glands surround into round or oval, with various sizes and separated by stromal tissue. CONCLUSION It is possible to continue developing after operation, if REAH is not completely resected. Complete resection of lesions is the key to treatment success for this entity in endoscopic sinus surgery. Although REAH arising from the rhino sinusal region is very rare, rhinolaryngologists must know this entity in order to differentiate it from inverted papilloma and adenocarcinoma.
Adult ; Female ; Hamartoma ; pathology ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Nose Diseases ; pathology ; Olfactory Mucosa ; pathology ; Respiratory Mucosa ; pathology

The upper respiratory system is lined with epithelium (mucosa) of the pseudostratified ciliated columnar type that produces mucus as a secretion. The major constituent of mucus is mucin, a glycoprotein of distinct physical and biochemical properties that exists in various organs. The aim of this study was to analyze the biochemical and molecular biological conditions affecting mucin secretion in cultured secretory cells of the upper respiratory mucosa. Rat nasal epithelial cells were cultured in four conditions differing in culture matrix : 1) plastic surface (PL), 2) thick collagen gel (TG), 3) thin collagen gel (GC), and 4) collagen gel coated membrane (CO). In each group, cell proliferation patterns, gel lysis and ciliary regeneration were observed, and attachment efficiency and confluence day were recorded. After confluence, mucin in the culture media was tagged with [3H]-glucosamine and analyzed by elution through Sepharose CL-4B column. The expression of MUC1 in cultured cells was analyzed by RT-PCR. In PL and GC, attachment efficiency was less than 2.2%. The shape and size of each cell in active proliferation was not regular. Confluence was observed on culture day 21 (range : 15-24). In TG and CO, attachment efficiency was more than 10.0% and the shape and size of each cell in active proliferation was regular in a compact fashion. Eight days (range : 7-11) were needed for confluence. After elution through column, mucin was detected in TG and CO but not in GC and PL. MUC1 was expressed in TG and CO but not in GC and PL. In conclusion, a thick collagen gel matrix was essential in mucin secretion and MUC1 expression in cultured secretory cells of the rat nasal mucosa.
Animals ; Cell Proliferation ; Cells, Cultured ; Collagen ; Culture Media ; Epithelial Cells ; Epithelium ; Glycoproteins ; Membranes ; Mucins* ; Mucus ; Nasal Mucosa* ; Plastics ; Rats* ; Regeneration ; Respiratory Mucosa ; Respiratory System ; RNA, Messenger* ; Sepharose