PURPOSE: Flow interruptor high frequency ventilator(HFV) on neonatal respiratory failure caused by various disorders has been applied in order to assess its therapeutic effect and safety. METHODS: Premature babies below 1.8kg with respiratory failure from 1991 to 1997 in the Fatima neonatal intensive care unit(NICU) for 6 year and 4 months are included. Flow interruptor HFV with low intermittent mandatory ventilation(IMV) has been applied in 74 cases. If clinical symptom and arterial blood gas analysis(ABGA) became stable for 6-12 hrs, we started weaning aggressively. RESULTS: Mean duration of HFV with low IMV was 5.4 4 days. Initial success rate of weaning was 63 cases(85.1%). Weaning failure rate was 11 cases(14.9%). Six cases was due to underlying sepsis. Four cases was caused by pneumothorax and one case resulted from patent ductus arteriosus(PDA) with congestive heart failure(CHF). Complication of HFV with combined low IMV was 5 cases of pneumothorax, 4 cases of grade III intraventricular hemorrhage and one case of bronchopulmonary dysplasia(BPD). Eleven cases of stage III or more retinopathy of prematurity(ROP) and 5 cases of periventricular leukomalasia(PVL) were confirmed. CONCLUSION: Flow interruptor HFV with low IMV can be used safely as conventional mechanical ventilators in the case of respiratory failure caused by various disorders. If MAP has been adjusted appropriately, incidence of pneumothorax and BPD are expected to diminish by aggressive weaning as clinical symptom become stable.
Estrogens, Conjugated (USP) ; Heart ; Hemorrhage ; High-Frequency Ventilation* ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Pneumothorax ; Respiratory Insufficiency* ; Sepsis ; Ventilators, Mechanical ; Weaning

No Abstract available.
Tracheal Stenosis*

The treatment of a brachymetacarpia using a distraction osteogenesis was mostly single, unilateral pattern. In case of multiple brachymetacarpia, single-stage lengthening or rapid distraction lengthening with a bone graft were usually used. Multiple brachymetacarpia treated by distraction osteogenesis is rarely reported. We report a case of a 15-year-old female presented with bilateral multiple brachymetacarpia treated by distraction osteogenesis simultaneously without complications. Also, we have evaluated the clinical results and factors which influence the clinical results.
Adolescent ; Brachydactyly ; Female ; Hand Deformities ; Humans ; Osteogenesis, Distraction* ; Transplants

Bilateral sagittal split ramus osteotomy (BSSRO) is generally indicated for mandibular setback, to improve occlusion, masticatory function, and aesthetics by altering the mandibular position. However, BSSRO narrows the pharyngeal airway and increases airway resistance, resulting in postoperative respiratory disturbances during emergence from anesthesia. Oxygen delivery system via high-flow nasal cannula (HFNC) has been known to improve airway patency and oxygenation via low-level positive pressure as well as reduce the respiratory load. We report a case of postoperative respiratory disturbance, following a large mandibular setback, despite nasotracheal extubation in the fully awake patient. Respiratory disturbance was successfully controlled after oxygen delivery via HFNC until self-respiration was completely restored. Therefore, the use of HFNC may facilitate the control of postoperative respiratory disturbances induced by anatomical changes in upper airway after BSSRO surgery.
Airway Resistance ; Anesthesia ; Catheters* ; Dyspnea ; Esthetics ; Humans ; Orthognathic Surgical Procedures ; Osteotomy, Sagittal Split Ramus* ; Oxygen ; Oxygen Inhalation Therapy ; Respiratory Distress Syndrome, Adult

We report the case of a newborn with a rare anatomic variation: a right aortic arch with a retroesophageal left subclavian artery and an anomalous origin of the pulmonary artery from the aorta. This variation was diagnosed using echocardiography and computed tomography, and we treated the condition surgically.
Anatomic Variation ; Aorta* ; Aorta, Thoracic* ; DiGeorge Syndrome ; Echocardiography ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Pulmonary Artery* ; Subclavian Artery*

Tracheal agenesis is an extremely rare and typically lethal congenital disorder. Approximately 150 cases have been described since 1900, and very few cases of survival have been reported. We describe tracheal reconstruction with external esophageal stenting in a patient with Floyd's type II tracheal agenesis. Neither long-term survival nor survival without mechanical ventilation for even a single day has previously been reported in patients with Floyd's type II tracheal agenesis. The infant in the present case survived for almost a year and breathed without a ventilator for approximately 50 days after airway reconstruction using external supportive stents.
Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Humans ; Infant ; Respiration, Artificial ; Stents* ; Trachea ; Ventilators, Mechanical

Allyl sulfur compounds play a major role in the chemoprevention against carcinogenesis. The present study compared the antiproliferative effects of diallyl sulfide (DAS), diallyl disulfide (DADS) and garlic extract on p53-wild type H460 and p53-null type H1299 non small cell lung cancer cells (NSCLC). The DAS and DADS treatment of both H460 and H1299 cells resulted in the highest numbers of cells in apoptotic state as measured by acridine orange staining, however, garlic extract treatment did not induce any significant apoptotic cells by MTT assay. DADS was found to be more effective in inducing apoptosis on NSCLC. The level of p53 protein in H460 cell was increased following DADS treatment. DAS and garlic extract treatment of H460 cells induced a rise in the level of Bax and a fall of Bcl-2 level. These results demonstrate that DAS, DADS and garlic extract are effective in reduction of anti-proliferative gene in NSCLC and suggest that modulation of apoptosis-associated cellular proteins by DAS, DADS and garlic extract may be the mechanism for apoptosis which merit further investigation as potential chemoprevention agents.
Allyl Compounds/pharmacology* ; Anticarcinogenic Agents/pharmacology ; Apoptosis ; Carcinoma, Non-Small-Cell Lung/metabolism ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Disulfides/pharmacology* ; Garlic* ; Human ; Lung Neoplasms/metabolism ; Lung Neoplasms/drug therapy* ; Plant Extracts/pharmacology ; Protein p53/biosynthesis ; Proto-Oncogene Proteins/biosynthesis ; Proto-Oncogene Proteins c-bcl-2/biosynthesis ; Sulfides/pharmacology* ; Toxicity Tests ; Tumor Cells, Cultured

Rounded atelectasis is a focal, pleural-based lesion that is the result of pleural and subpleural scarring and atelectasis of the adjacent lung tissue. We experienced a case of asbestosassociated rounded atelectasis that had developed in a 50-year-old male. When examined with routine chest radiography, the patient was shown to have an asymptomatic chest mass.Computed tomography showed a pleural-based mass with a curvilinear shape about 4.2 cmin greatest diameter in the medial basal segment of the right lower lobe. To exclude the possibilityof malignancy the mass was excised by video-assisted thoracotomy. The mass wasround and firm, and was gray and yellow in color. Microscopically, marked pleural fibrosisextended into the underlying lung parenchyme and then resulted in atelectasis. There areferruginous bodies in dense fibrous pleura.
Asbestos ; Cicatrix ; Humans ; Lung ; Lung Diseases ; Male ; Middle Aged ; Pleura ; Pulmonary Atelectasis* ; Radiography ; Thoracotomy ; Thorax

We developed a high-performance liquid chromatographic procedure for the determination of 4-(4-chlorophenyl)-4-hydroxypiperidine (CPHP), a toxic metabolite of haloperidol, in human. Chromatographic analysis was performed on a reverse-phase C₁₈ column with a mobile phase containing 50 mM potassium phosphate buffer/acetonitrile (75:25, vol/vol) using UV detection with a wavelength of 220 nm. The limits of detection for CPHP were 1 ng/ml in urine and the assay was linear over the concentration range of 2-500 ng/ml for urine. This analytical method was applied to measure CPHP in human. Nineteen healthy subjects were enrolled and all subjects received a single oral dose of 5 mg haloperidol following a treatment of placebo or itraconazole at 200 mg/day for 10 days in a randomized crossover manner. CPHP was detected in urine samples and average recovered amount of CPHP was 81.31 µg/24 hr in the placebo phase and it was significantly reduced to 30.34 µg/24 hr after itraconazole treatment. The finding provides in vivo evidence that CPHP is an in vivo metabolite of haloperidol in human and its formation is mediated by CYP3A4.
Chromatography, High Pressure Liquid ; Cytochrome P-450 CYP3A ; Haloperidol* ; Healthy Volunteers ; Humans* ; Itraconazole ; Limit of Detection ; Methods* ; Potassium

The number of cases of extracorporeal membrane oxygenation (ECMO) has rapidly increased all over Korea since the introduction of peripheral cannulation catheters. However, the application of ECMO to children has been limited due to the shortage of pediatric equipment and difficulty in maintaining an ECMO system with peripheral cannulation. For this reason, there have been only few reports of pediatric ECMO in Korea, and most of them pertained to the veno-arterial type ECMO for supporting the cardiac system in postcardiotomy patients. We report here on the successfully performing veno-venous ECMO, with using a double lumen percutaneous catheter, in a child with acute respiratory distress syndrome.
Catheterization ; Catheters ; Child ; Extracorporeal Membrane Oxygenation ; Humans ; Korea ; Respiratory Distress Syndrome, Adult