• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1073-1079
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• 2003

Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

• Clinical and Experimental Pediatrics
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• v.48 no.12
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• pp.1330-1336
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• 2005

Purpose : It has been suggested that changes in cerebral blood flow by ventilator care could be a risk factor in periventricular leukomalacia(PVL) and severe periventricular-intraventricular hemorrhage(PV-IVH). The study aims to assess the relationship between perinatal clinical events, including ventilator care, and the development of PVL and severe PV-IVH; especially, whether ventilator care could be causers of PVL and severe PV-IVH as an individual risk factor. Methods : Among 255 very low birth weight infants who survived in the Fatima neonatal intensive care unit from January 1999 to December 2003, 15 infants with PVL and eight infants with severe PV-IVH were classified as a study group, while 231 infants were enrolled as a control group. The analysis was performed retrospectively with medical records. Results : Twenty four infants were diagnosed with PVL or severe PV-IVH. Asphyxia, recurrent apnea, sepsis, acidosis and ventilator care were significantly increased in the PVL goup. Asphyxia, recurrent apnea, RDS, acidosis and ventilator care were significantly increased in the severe PV-IVH group. Conclusion : Infants with PVL or severe PV-IVH may have multiple perinatal risk factors including asphyxia, recurrent apnea, sepsis, acidosis, RDS and ventilator care. Because most patients with ventilator care have multiple perinatal risk factors, ventilator care does not cause PVL and severe PV-IVH independently. Therefore, incidences of PVL and severe PV-IVH can be decreased by not only gentle ventilation, but also more professional antenatal care.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.2
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• pp.45-51
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• 2009

Pulmonary diseases distress millions of people worldwide. Numerous studies have shown an association between pulmonary disease and psychiatric disorders. Despite this, little is known about the treatment of psychiatric disorder in patients with pulmonary disease. The three main goals of this article are 1) to discuss the major disorders such as asthma, chronic obstructive pulmonary disease, hyperventilation, tuberculosis, lung cancer that most clinicians see in practice, 2) to provide an information about psychiatric treatment such as anxiety, depression, psychosis in pulmonary disease, and 3) to provide some clinically relevant suggestions about pharmacologic interactions between pulmonary and psychotropic drugs.

• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.1-16
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• 2006

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1204-1212
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• 2002

Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1179-1184
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• 2008

Purpose : Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development. Methods : PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2000 and February 2007. The characteristics of each patient were analyzed through retrospective examination of their medical histories. Results : Among 183 patients, 17 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P<0.05). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 72 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax. Conclusion : Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 72 h after birth.

• Journal of Veterinary Clinics
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• v.9 no.2
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• pp.401-406
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• 1992

For the purpose of effective treatment and prevention of porcine respiratory diseases, Enrofloxacin(Baytril premix) was administered in the feed to trial herd occurred sporadically the respiratory diseases and then a serious investigation was carried out on the therapeutic effect, weight gain, feed conversion rate and lung lesion scoring. The results obtained were as follows, 1. The grower pigs which were administered with Baytril premix for 10 days gained the average body weight of 31kg for 33 days compared to 20.5kg of control group(p<0.05). Also drastical improvement of feed conversion rate(p<0.05) and disappearance of clinical signs were approved. 2. Average scorings of lung lesions were 7.92% in the medication group and 15.8% in the control group respectively. 3. Respiratory diseases outbreaked in the trial farm were pleuropneumonia caused by Actinobacillus (Haemophilus)pleuropneumoniae, Mycoplasmal pneumonia and Pasteurellosis.

• Tuberculosis and Respiratory Diseases
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• v.63 no.1
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• pp.13-16
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• 2007

현 상태에서 패혈증에서 최선의 치료는 조기, 목표지향치료, 저일호흡량을 포함한 폐 보호 기계환기, 그리고 activated protein C 등을 들 수 있으며, 코티코스테로이드 치료나 적극적인 인슐린 치료법에 대해서는 아직 치료효과가 검증되지 않은 상태이다. 전통적으로 시행되고 있는 조기에 광범위한 항생제 투여, 창상의 치료 등은 한상 강조되어야 할 치료 방법이다.

• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.587-596
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• 1994

COPD의 치료에 대해 약술하였다. 예방을 위해서는 개인적으로는 금연, 국가사회적으로는 공해의 해결이 필요하며 진행된 질병에서는 진행을 막기 위한 감염의 예방 및 감염시 즉각적인 항균제 치료, 필요에 따라서 항염증제, 그리고 생활의 질을 높이기 위해서 각종 재활요법이 필요하다. 원활한 재활요법을 위해서는 필요한 기구 장비의 구입이 쉬워야 하고 치료진에서는 호흡기 전문의사, 호흡치료사, 의료기사, 병원 및 가정간호사, 사회사업가(social worker), 정신과의사, 영양사 등의 팀으로의 접근이 필요하고 제도적으로 보험적용이 되도록 해야 하겠다. 불구가 심한 예에서는 폐이식이 시도되며 기술적인 문제는 다소 해결된듯하나 장기공여자 등의 문제로 보편화되지는 않고 있다.

• Journal of Veterinary Clinics
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• v.14 no.1
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• pp.42-47
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• 1997

돼지의 호흡기감염은 양돈산업에서 과밀한 사육으로 인하여 발생되는 주요한 질환중의 하나이다. 호흡기감염을 일으키는 병원체들은 주로 기관분비물과 점액에 상주하는 것으로 알려져 있다. 그러므로 호흡기감염의 치료를 위하여 기관분비물내에 항균약제의 농도는 적절하게 유지되어져야 한다. sulfadiazine(SDZ)과 trimethoprim(TMP)의 혼합제제는 전세계적으로 돼지의 호흡기감염의 치료에 널리 사용되어지고 있으나, 기관분비물에서 약물의 동태학적 특성에 관한 연구는 거의 찾아 볼 수가 없었다. 본 연구는 돼지의 좌측전대정맥으로 SDZ/TMP혼합제제를 일회 투여한 후 형성되는 약물동태학적 매개변수를 알아보기 위하여 실시되었다. 혈장과 기관분비물에서 SDZ/TMP농도는 HPLC (High Performance Liquid Chromatography)로 측정하여 약물동태학적 매개변수를 산출하였다. 혈장에서 SDZ와 TMP의 약물동태학적 매개변수는 2-compartment 와 1-compartment모델에 적합하였다. 혈장내 TMP의 반감기(0.90$\pm $0.06시간)가 SDZ(7.25$\pm $1.09시간)에 비하여 매우 짧은 점이 주요한 차이점으로 볼 수 있었으며, 더욱이 투여후 8시간이후에서는 측정이 되지 않았다. 기관분비물에서 SDZ의 농도는 전체 실험기간(0.5∼32시간)동안 거의 일정하게 유지되었고, 16시간후에서는 혈장농도보다 높은 수준을 나타내었다. TMP농도는 투여후 2∼3시간에서 혈장농도보다 높게 유지되었다. 이러한 결과를 토대로 호흡기감염의 처치와 예방에 있어서 약물의 용량 및 투여빈도를 결정하는데 응용되어 질 수 있을 것이다.