No abstract available.
Diagnosis* ; Respiratory Distress Syndrome, Adult*

Fat embolism syndrome (FES) is a clinical manifestation that consists of multiple organ dysfunction due to fat emboli. FES occurs as a complication after trauma or procedures such as surgery. The diagnostic criteria of FES have not yet been established, so clinical criteria are used for its diagnosis. The clinical course of acute fulminant FES can be rapid. Liposuction surgery, in which adipocytes are mechanically disrupted, is one cause of FES. As the number of liposuction surgeries increases, clinicians should be aware of the possibility of FES. This was the first report of a case of acute fulminant FES with severe acute respiratory distress syndrome after liposuction surgery, in Korea.
Adipocytes ; Diagnosis ; Embolism, Fat* ; Korea ; Lipectomy* ; Respiratory Distress Syndrome, Adult

To evaluate the predictive values of oxygenation index (OI), arterial-alveolar oxygen tension ratio (a/APO)2, and alveolar-arterial oxygen gradient ((A-a)DO2) for early recognition of responsiveness to high frequency oscillatory ventilation (HFOV) in very low birth weight infants with respiratory distress syndrome (RDS), 23 infants who received HFOV treatment for severe RDS after failing to be improved with conventional mechanical ventilation from July 1995 to February 1998 were included. Twelve infants survived with HFOV (Responder group), while 11 infants could not maintain oxygenation with HFOV and died (Non-responder group). Clinical record (of each patient) were retrospectively reviewed and compared with the respiratory indices. Mean (A-a)DO2 was significantly lower in the responder group than in the non-responder group at 2 hr after HFOV (p=0.024), and the difference was more remarkable at 6 hr (p=0.005). Death in the patient with (A-a)DO2 over 350 at 2 hr after HFOV therapy was 100% in sensitivity and 80% in specificity. The earliest significant difference of mean a/APO2 between two groups was noted at 6 hr after HFOV treatment (p=0.019). OI showed no significant differences between two groups. In summary, (A-a)DO2 was the most effective and sensitive respiratory index for predicting the responsiveness to HFOV in infants with severe RDS providing due as early as 2 hr.
Comparative Study ; High-Frequency Ventilation* ; Human ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Oxygen/blood ; Predictive Value of Tests ; Prognosis ; Pulmonary Gas Exchange* ; Respiratory Distress Syndrome/therapy* ; Respiratory Distress Syndrome/mortality ; Respiratory Distress Syndrome/diagnosis* ; Retrospective Studies ; Sensitivity and Specificity ; Treatment Outcome

PURPOSE: To describe the high-resolution CT findings of varicella-zoster pneumonia. MATERIALS AND METHODS: Seven adult patients with clinically and serologically diagnosed varicella-zoster pneumonia underwent HRCT scanning. One had undergone a kidney transplant, and the others were immunocompetent. The HRCT findings were retrospectively analyzed by two radiologists in terms of the presence of a nodule, pneumonic consolidation, ground-glass attenuation and pleural effusion, and with regard to the number, size and distribution of nodules. RESULTS: HRCT findings of varicella pneumonia included nodule (n=7), consolidation (n=3), diffuse groundglass attenuation (n=1) and pleural effusion (n=1). Nodules were mostly 2-10 mm in size, and multiple (n=6), and zonal predominancy was not apparent. One case in which HRCT demonstrated diffuse groundglass opacity and slight bilateral pleural effusion involved a patient in whom complications of acute respiratory distress syndrome occured. CONCLUSION: When HRCT demonstrates the presence of nodules 2-10 mm in size multiple nodules, or nodule surrounded by ground-glass attenuation, or the coalescence of nodules and consolidation is observed in adults with chickenpox, the varicella-zoster pneumonia should be included in the differential diagnosis.
Adult ; Chickenpox ; Diagnosis, Differential ; Fluconazole ; Humans ; Kidney ; Pleural Effusion ; Pneumonia* ; Respiratory Distress Syndrome, Adult ; Retrospective Studies

Respiratory distress syndrome (RDS) in the newborn infants remains a major cause of mortality and morbidity in the newborn period despite much improvements in neonatal intensive care and artificial ventilatory techniques. Gastric fluid was obtained from 151 patients within 6 hours after delivery. The sensitivity, specificity, and predictive value of the simple shake test (133 cases) and stable microbubble rating (SMR) test (151 cases) were assessed in the diagnosis of RDS, as well as the relation between both tests and RDS. We carried out both tests of on gastric aspirates all newborn who admitted to NICU of Presbyterian Medical Center from June 1991 to August 1992. The results were summarized as follows: 1) Among the total 151 cases, RDS were found in 41 cases(27.2%). 2) RDS occurence rate of the simple shake test was 11/11 in 0 group, 17/26 in +1 group, 8/28 in +2 group, 2/41 in +3 group, and 2/27 in +4 group. RDS occurence rate was high the 0 and +1 group. 3) RDS occurence rate of the SMR test was 4/4 in very weak group, 32/36 in weak group, 1/33 in medium group, and 4/78 in strong group. RDS occurence rate was high in the very weak and weak group. 4) Among the positive group of the SMR test 95 cases, positive group of the shake test were found in 87 cases. Among negative group of the SMR test 38 cases, negative of the shake test were found in 29 cases (correlation coefficient=0.763). 5) Sensitivity of the shake test and SMR test were 70%, 87.8% respectively. Specificity of the shake test and SMR test were 93.3%, 96.4% respectively. Positive predictability were 75.7%, 90% respectively and negative predictability were 87.5%, 95.5% respectively. The shake test, as Well as SMR test, has significant value to diagnosis of the RDS. We predict RDS occurence rate of the SMR test was significantly higher than shake test.
Diagnosis ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Microbubbles* ; Mortality ; Protestantism ; Respiratory Distress Syndrome, Newborn* ; Sensitivity and Specificity

Adult respiratory distress syndrome(ARDS) is a descriptive term that has been applied to many acute, diffuse infiltrating lung lesions of various etiology when they are accompanied by severe arterial hypoxemis. Despite the various eiology, clinical symptom and nonspecific pathophsiologic derangement, ARDS has a high mortality rate. But early diagnosis and prompt good management including PEEP therapy will decrease the mortality rate. This report described a case of ARDS following anesthesia and also discussed with literature.
Adult* ; Anesthesia* ; Early Diagnosis ; Humans ; Lung ; Mortality ; Respiratory Distress Syndrome, Adult*

OBJECTIVETo study the association between serum level of high-mobility group box 1(HMGB1) and neonatal respiratory distress syndrome (NRDS).

METHODSA total of 35 infants with NRDS and 35 normal neonates (control group) were enrolled. Peripheral venous blood samples were collected with 12-24 hours after birth. ELISA was used to measure the serum level of HMGB1.

RESULTSThe infants with mild and severe NRDS had a significantly higher serum level of HMGB1 than the control group (P<0.05). The infants with severe NRDS had a significantly higher serum level of HMGB1 than those with mild NRDS (P<0.05). The infants with NRDS who died had a significantly higher serum level of HMGB1 than those who survived (P<0.05). The receiver operating characteristic (ROC) curve showed that the optimal cut-off value for serum level of HMGB1 to predict NRDS was 625.3 pg/mL with an area under the ROC curve (AUC) of 0.846 (95%CI: 0.755-0.936), and the optimal cut-off value for serum level of HMGB1 to predict the death of infants with NRDS was 772.2 pg/mL with an AUC of 0.916 (95%CI: 0.813-1.000).

CONCLUSIONSInfants with NRDS have a significant increase in the serum level of HMGB1, and the serum level of HMGB1 can well predict the development and prognosis of NRDS.

Female ; HMGB1 Protein ; blood ; Humans ; Infant, Newborn ; Male ; Prognosis ; Respiratory Distress Syndrome, Newborn ; blood ; diagnosis

Acute Disease ; Fatal Outcome ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Respiratory Distress Syndrome, Newborn ; diagnosis ; therapy

ObjectiveAcute respiratory distress syndrome (ARDS) is a devastating clinical syndrome whose diagnosis and therapy are still in question. The aim of this review was to discuss the current challenge for the diagnosis and treatment of ARDS.

Data SourcesData sources were the published articles in English through December 2017 in PubMed using the following key words: "acute respiratory distress syndrome," "definition", "diagnosis," "therapy," "lung protective strategy," "right ventricular dysfunction," and "molecular mechanism."

Study SelectionThe selection of studies focused on both preclinical studies and clinical studies of therapy of ARDS.

ResultsThe incidence of ARDS is still high, and ARDS causes high intensive care units admissions and high mortality. The Berlin Definition proposed in 2012 is still controversial owing to lack of sensitivity and specificity. ARDS is still under recognition and it is associated with high mortality. Lung protective strategies with low tidal volume (VT) and lung recruitment should consider the physiology of ARDS because ARDS presents lung inhomogeneity; the same low VT might increase local stress and strain in some patients with low compliance, and lung recruitment could injure lungs in ARDS patients with low recruitability and hemodynamic instability. Acute cor pulmonale is common in severe ARDS. ARDS itself and some treatments could worsen acute cor pulmonale. Molecular understanding of the pathogenic contributors to ARDS has improved, but the molecular-associated treatments are still under development.

ConclusionsARDS is a devastating clinical syndrome whose incidence and mortality has remained high over the past 50 years. Its definition and treatments are still confronted with challenges, and early recognition and intervention are crucial for improving the outcomes of ARDS. More clinical studies are needed to improve early diagnosis and appropriate therapy.

Animals ; Humans ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; diagnosis ; therapy ; Tidal Volume ; physiology

H-type tracheoesophageal fistula (TEF) is extremely rare in infants and children, and clinical manifestations of this condition are diverse based on its severity. Some cases of congenital TEF diagnosed in adulthood have been reported, which indicate the difficulty of early diagnosis of this disease. Gastroesophageal reflux (GER) may induce chronic aspiration, pulmonary aspiration, apparent life-threatening events, and failure to thrive. We report a 5-month- old boy whose recurrent pneumonia and wheezing did not improve under usual treatment and led to acute respiratory distress syndrome. He was found to have severe GER on the second-trial of the esophagogram and was eventually revealed to have congenital H-type TEF upon repeated evaluation.
Child ; Early Diagnosis ; Failure to Thrive ; Gastroesophageal Reflux ; Humans ; Infant ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory Sounds ; Tracheoesophageal Fistula