• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1096-1101
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• 2005

Purpose : Recently, early surfactant replacement and tidal volume based gentle ventilation has been a fundamental treatment of respiratory distress syndrome(RDS). The aims of this study were to survey the changes in ventilator care duration and rate of complication in RDS groups. Methods : We performed a retrospective study of 255 newborn infants less than 1,500 g admitted to the neonatal intensive care unit(NICU) and discharged from January 1999 to December 2003. 141 of 255 newborn infants were RDS groups that required invasive management, such as endotracheal intubation, surfactant replacement and assisted ventilation. We analyzed epidemiologic data to study the changes in ventilator care duration and outcome of RDS groups. Results : Of 141 RDS groups, 135 were mild to moderate RDS groups and only 6 were severe RDS groups. 24(17.8%) of 135 mild to moderate RDS groups and 3(50%) of 6 severe RDS groups were antenatal no use of maternal dexamethasone. 127(90.1%) of 141 RDS groups underwent replacement of surfactant during 3 hours after birth. 121(85.9%) weaned within 48 hours. Conclusion : Our study shows a decreased frequency of severe RDS by a antenatal use of maternal dexamethasone and decreased duration of ventilator care by early surfactant replacement and gentle ventilation.

• Proceedings of the Korea Information Processing Society Conference
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• 2022.05a
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• pp.539-542
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• 2022

신생아 호흡곤란 증후군은 주로 미숙아에게 발생하는 호흡기 질환으로, 특징적 영상 소견 및 다른 검사 소견을 바탕으로 진단된다. 본 논문은 기계 장치 등 외부 요소의 영향을 최소화하고자 폐 영역을 분할하여 신생아 호흡곤란 증후군을 진단하는 기법을 제안한다. 분할에는 UNet 구조를 사용하고 진단에는 EfficientNet-B5를 사용하여 최종적으로 신생아 호흡곤란 증후군의 진단 정확도 0.852를 달성하였다.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.52-59
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• 1999

This study was conducted to evaluate the effect of the antenatal ambroxol administration to mothers who were in danger of imminent preterm delivery in preventing the neonatal respiratory distress syndrome(RDS). Forty-two preterm newborn infants who were delivered at Yeungnam University Hospital from January 1996 to December 1997 were divided into two groups, 21 in ambroxol-treated group and 21 in control group. Six cases of the respiratory distress syndrome were developed from 21 ambroxol-treated infants, but 13 cases of RDS, from 21 control infants. This result indicated a significant reduction of the occurrence of RDS by antenatal administration o[ ambroxol (p<0.05). There were no differences in the occurrence of adverse effects of ambroxol in mothers between the two groups. There was also no difference between pre- and post-treatment hematologic and biochemical parameters in ambroxol-treated group. In conclusion, when premature delivery is expected, the administration of ambroxol before delivery enhances lung maturation in premature newborn infants and prevents the occurrence of respiratory distress syndrome without significant adverse effects.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.376-384
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• 2002

Background : The mortality from acute respiratory distress syndrome(ARDS) in the late stage, which is characterized by progressive pulmonary fibroproliferation, is ${\geq}80%$. Although previous prospective trials failed to show a survival benefit of steroid therapy in early ARDS, recently, a few of reports have described the survival benefit of the long-term use of steroid in patients with late ARDS. In this study, we analyzed the effect of steroid therapy on patients with late ARDS retrospectively in a single. Medral intensive care unit (MICU). Methods : Over a 3-year period, the medical records of 48 ARDS patients who had been on mechanical ventilation more than 8 days were reviewed. 14 patients were treated by the long-term use of methylprednisolone and another 34 patients served as a control. Both groups were comparable regarding clinical and physiologic data lung injury score(LIS), multiple organ failure score, APACHE III and SAPS II score. Because steroid was instituted after 8 days of advanced mechanical ventilatory support in average, we arbitrarily defined the $8^{th}$ day of ARDS as first day of the study. Results : Initially, the groups had similar PF($PaO_2/FiO_2$) ratio, LIS, APACHE III and SAPS II score. By 7th day after the start of steroid therapy, there were significant improvements in PF ratio, LIS, APACHE III and SAPS II score. The mortality in the steroid treated group was significantly lower(42.9% vs 73.5%, p<0.05). Conclusion : Although the data of this study was retrospective and was not randomized, in order to improve the patient's outcomes, steroid therapy should be considered in late ARDS patients. However, prospective trials are needed to define the indication and the effect of steroid therapy in late ARDS.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.367-375
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• 2002

Background : Murine typhus is a flea-borne, worldwide Rickettsial disease caused by Rickettsia typhi. Its symptoms are typically mild but sometimes can be fatal. The major clinical features include fever, rash, and headache. Recently, we experienced 6 cases of ARDS associated with a Rickettsia typhi infection. This study was aimed to analyze the attributing factors for fatal murine typhus and to review the characteristics of the patients who showed acute respiratory distress syndrome as the initial presentation. Methods : The medical records of 15 patients diagnosed as murine typhus were reviewed. The diagnosis was made by single titers of 1:512 or higher, or a 4-fold rise with compatible clinical features. Acute Respiratory Distress Syndrome (ARDS) was defined according to the American-European Consensus Conference. The Characteristics between the ARDS group and the non-ARDS group of murine typhus were compared. Results : Six patients developed ARDS as their initial presentation. Two of them were women and three of them had lived urban area. None of Them a showed skin rash. One of them expired during treatment. The time lapse until the commencement of the specific treatment, the lower serum albumin level, the higher serum total bilirubin level, the higher APACHE III score and the higher MOD score were significantly associated with the ARDS group compared to the non-ARDS group. Conclusion : Murine typhus should be considered as one of the etiologies for the ARDS of unknown cause, particularly in an endemic regions. ARDS caused by Murine typhus generally has a good prognosis.

• Tuberculosis and Respiratory Diseases
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• v.53 no.1
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• pp.17-26
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• 2002

Background : The detection and early elimination of the causes for acute respiratory distress syndrome(ARDS) at the initial stage can result in a more favorable prognosis. Miliary tuberculosis as a cause of the ARDS is quite rare. A diagnosis of miliary tuberculosis is difficult due to the diversity of radiological patterns and non-specific clinical finfings, and low sensitivity of sputum examinations for acid-fast bacilli(AFBs). An analysis of the clinical data is the first step in diagnosing these unusual, rare cases. Materials and Methods : In this study the clinical features, laboratory data, radiological findings and diagnostic methods were analyzed in 9 cases with an initial presentation of ARDS due to miliary tuberculosis. The ARDS was defined by the definition of the American-Europian consensus conference 1992. Results : The mean age of the patients was $67{\pm}18$ years (F:M=7:2). The chief complaints were dyspnea(5/9), coughing (3/9) and fever(5/9). On a physical examination, fine or coarse crackles were noted(6/9). The ARDS developed on average 6.7 days after the initial respiratory symptoms. The mean $PaO_2/FiO_2$ of the patients was $133.5{\pm}53.4$, the number of cases with a WBC<5000/$mm^3$ was 4 out of 9 cases. A platelet count<70,000/$mm^3$ was observed in 2 out of 9 cases, and the serum albumin level was $2.6{\pm}0.6$ g/dL. The initial simple chest PA showed ground glass appearances and consolidation in all cases, However, the miliary nodular densities were observed in only 4 out of the 9 cases. HRCT revealed alveolar densities and a consolidation in 5 out of 6 cases, and miliary nodules in 5 out of 6 cases, The diagnosis of tuberculosis was made by a liver biopsy (4/4, 100% sensitivity), a bone marrow biopsy (1/2, 50% sensitivity), and an open lung biopsy (1/1), the sputum AFB was positive in only 2 out of 9 cases. The patient was treated with INH, RFP, EMB, PZA, and steroids. The survival rate was 55.5%. Conclusion : Miliary tuberculosis should be considered as one of the causes for ARDS in areas where there is a high prevalence of tuberculosis. The chief complaints of the patients on admission are dyspnea, fever and coughing without any specific riskfactors. A liver biopsy is particularly useful in ARDS patients with mechanical ventilation to determine the causes of the ARDS if miliary tuberculosis is suspected as being the underlying disease.

• Journal of Veterinary Clinics
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• v.32 no.1
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• pp.94-97
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• 2015

An 11-year-old intact male Yorkshire terrier had intermittent vomiting, anorexia and depression for a month. Clinical laboratory works showed azotemia and anemia. Chronic kidney disease with developing anemia was diagnosed clinically. Clinical signs were resolved but anemia was deteriorated and blood transfusion was performed. On 10 hours after transfusion, the dog showed acute respiratory distress. Transfusion related acute respiratory distress syndrome (ARDS) was diagnosed based on acute clinical signs, risk factors of transfusion, bilateral alveolar infiltration on thoracic radiographs, and $PO_2:FiO_2$ ratio less than 200 on arterial blood analysis. The dog died within 2 hours after ARDS diagnosis.

• The Korean Chronic Disease News
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• no.183
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• pp.8-8
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• 1996

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1252-1264
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• 1998

Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.

• Clinical and Experimental Pediatrics
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• v.45 no.7
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• pp.855-861
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• 2002

Purpose : Thymus size can be affected by several factors and perinatal diseases can be estimated by its size. The purpose of this study was to search for a relationship between cardiothymic/thoracic(CT/T) ratio and perinatal diseases such as neonatal respiratory distress syndrome(RDS) and intrauterine growth retardation(IUGR) by measuring the width of the cardiothymic shadow at the level of the carina and dividing it by the width of the thorax at the costophrenic angles. Methods : A clinical study was conducted on newborn infants with RDS(n=51), IUGR(n=27), and premature rupture of membranes(PROM, n=48), who were admitted at NICU of Catholic University of Daegu from June 2000 to Oct. 2001. CT/T ratio was measured within six hrs of age, at 2-3 days of age, and at 5-7 days of age. Results : CT/T ratios of RDS group, IUGR group, and PROM group were $0.46{\pm}0.07$, $0.32{\pm}0.04$. $0.36{\pm}0.06$, respectively. CT/T ratios of RDS group within 6hrs of age, at 2-3 days of age, and at 5-7 days of age were $0.43{\pm}0.07$, $0.34{\pm}0.06$, $0.25{\pm}0.04$, respectively. There were statistically significances among the RDS group, the IUGR group, and the PROM group and in the RDS group at different times. Regression for gestational age among three groups was not statistically significant but correlation for gestational age in the entire groups was statistically significant. CT/T ratio between normal spontaneous vaginal delivery and c-section among three groups was not statistically significant. CT/T ratios with dexamethasone-treated group and untreated group was not statistically significant. Conclusion : We concluded that thymus size differed significantly in the perinatal diseases such as RDS and IUGR, and so can be used as an early diagnostic tool for perinatal diseases.