PURPOSE: Congenital pulmonary airway malformation (CPAM)—a rare developmental anomaly—affects the lower respiratory tract in newborns. By comparing the reliability of diagnostic tools and identifying predictive factors for symptoms, we provide comprehensive clinical data for the proper management of CPAM. METHODS: We reviewed the medical records of 66 patients with prenatally diagnosed CPAM delivered at Severance Children's Hospital between January 2005 and July 2017. RESULTS: We enrolled 33 boys and 33 girls. Their mean gestational age and birth weight were 38.8 weeks and 3,050 g, respectively. Prenatal ultrasonography and postnatal radiography, lung ultrasonography, and chest computed tomography (CT) showed inconsistent findings. Chest CT showed superior sensitivity (100%) and positive predictive value (90%). Among the 66 patients, 59 had postnatally confirmed CPAM, three had pulmonary sequestration, one had cystic teratoma, and one had a normal lung. Of the 59 patients with CPAM, 21 (35%; mean age, 23.4 months) underwent surgery, including 15 who underwent video-assisted thoracoscopy. Twenty-five and 12 patients exhibited respiratory symptoms at birth and during infancy, respectively. Apgar scores and mediastinal shift on radiography were significantly associated with respiratory symptoms at birth. However, none of the factors could predict respiratory symptoms during infancy. CONCLUSION: Radiography or ultrasonography combined with chest CT can confirm an unclear or inconsistent lesion. Apgar scores and mediastinal shift on radiography can predict respiratory symptoms at birth. However, symptoms during infancy are not associated with prenatal and postnatal factors. Chest CT combined with periodic symptom monitoring is important for diagnosing and managing patients with prenatally diagnosed CPAM and to guide appropriate timing of surgery.
Birth Weight ; Bronchopulmonary Sequestration ; Cystic Adenomatoid Malformation of Lung, Congenital ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Lung ; Medical Records ; Parturition ; Radiography ; Respiratory System ; Teratoma ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Prenatal

OBJECTIVE: To explore the clinical characteristics and treatment skills of children with respiratory special foreign body. METHOD: To retrospectively analyze the clinical characteristics of 49 cases of special airway foreign bodies in children during 2013. 5.1-2014. 5.1 in our hospital, and the treatment methods were summarized. RESULT: Fourty-seven cases with rigid bronchoscopy foreign body cured, 1 case turned Department of thoracic sur- gery chest to remove foreign body, 1 case of death. CONCLUSION The clinical characteristics of special airway foreign bodies in children is different from ordinary foreign body, treatment of preoperative, intraoperative and postoperative is not fully equivalent to the ordinary foreign body.
Bronchoscopy ; Child ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Respiratory System ; pathology ; Retrospective Studies

This review focus on the progress of the treatment of obstructive sleep apnea-hypopnea syndrome by using positive airway pressure and upper airway multilevel surgeries. OSAHS is a disease caused by multiple etiologies. We should consider upper airway anatomical abnormalities and the severity of OSAHS before reasonable treatment plans were formulated. "PAP-surgery-PAP" is the classic procedure for treating moderate OSAHS and severe OSAHS. Preoperative use of PAP could reduce the hypoxic condition of patients and decrease surgical risk. Surgery can effectively reduce the optimal PAP pressure value, and increase the tolerance of patient. Postoperative use of PAP can improve surgical efficacy, shorten patient recovery time. However, the influence of different surgical methods on optimal PAP pressure value is lacking in large samples. More related studies need to be per formed in the future.
Continuous Positive Airway Pressure ; Humans ; Respiratory System ; surgery ; Sleep Apnea, Obstructive ; surgery ; therapy ; Treatment Outcome

BACKGROUNDJuvenile onset recurrent respiratory papillomatosis (JORRP) is a relatively rare disease. It affects the larynx in most cases. Because reports on JORRP to the lower respiratory tract (LRT) are few, we investigated clinical features of patients with a history of JORRP to analyze the risk factors of this disease.

METHODSData from 208 JORRP patients admitted to Beijing Tongren Hospital from January 2008 to December 2010 were reviewed. Gender, age at onset of symptoms, age at first surgery, duration of symptoms before the first surgical procedure, the number of surgical procedures, mean interval between surgical interventions, and the number of tracheotomies in patients with and without LRT spread of JORRP were analyzed. The data from patients with and without tracheotomy were recorded and compared. Two cases of primary tracheal papillomatosis were reviewed.

RESULTSPapillomas extension down to the LRT was observed in 46 children (22.1%). Patients with LRT papillomatosis had a shorter time from the onset of the symptoms until the first surgery, required significantly more surgical procedures, and had a shorter mean surgical interval. Tracheotomy was performed in 13/162 (8.0%) children with laryngeal papillomatosis vs. 36/46 (78.3%) children with LRT papillomatosis. After tracheotomy, 36/49 (73.5%) children developed LRT papillomatosis and 10/157 (6.4%) children who did not have a tracheotomy developed LRT papillomatosis. Patients with tracheotomy required a significantly higher number of surgical procedures. The younger the patient had a tracheotomy, the longer the duration of cannulation was.

CONCLUSIONSJORRP patients with LRT spread are prone to develop more aggressive disease. Tracheotomy resulted in a significant increase of LRT involvement.

Female ; Humans ; Infant ; Infant, Newborn ; Larynx ; pathology ; surgery ; virology ; Male ; Papillomavirus Infections ; epidemiology ; Respiratory System ; pathology ; surgery ; virology ; Respiratory Tract Infections ; epidemiology ; Risk Factors ; Software ; Tracheotomy

PURPOSE: The purpose of this study was to analyze the effectiveness of saline solution vs. heparinized-saline for maintenance of arterial lines and to detect changes in platelet and aPTT as physiological indexes. METHODS: In this nonequivalent control group, non-synchronized, double-blind study the effects of heparinized and saline solution on the maintenance of arterial lines were compared. Fifty five patients received the heparinized solution and fifty nine patients received the saline solution. All patients who had surgery in K-university hospital between September and December 2011 were eligible for participation in the study. RESULTS: There was no statistically significant difference between the saline and the heparin group in the maintenance time of the arterial lines or the number of irrigations. There was no statistically significant difference between the groups in changes in the number of platelets and aPTT for interaction between the groups and time intervals. CONCLUSION: The results indicate that saline solution can be used as an irrigation solution for the maintenance of arterial lines of adult surgical patients, rather than heparinized-saline, in view of potential risk factors in the use of heparin.
Adult ; Aged ; Anticoagulants/*therapeutic use ; Central Nervous System Diseases/surgery ; Digestive System Diseases/surgery ; Double-Blind Method ; Female ; Heparin/*therapeutic use ; Humans ; Male ; Middle Aged ; Musculoskeletal Diseases/surgery ; Partial Thromboplastin Time ; Platelet Count ; Respiratory Tract Diseases/surgery ; Risk Factors ; Sodium Chloride/*therapeutic use ; Vascular Access Devices

Female ; Humans ; Infant ; Infant, Newborn ; Larynx ; abnormalities ; surgery ; Male ; Respiratory System Abnormalities ; surgery ; Vocal Cords ; abnormalities ; surgery

respiratory tracts or both, disseminated vasculitis involving both small arteries and veins, and necrotizing glomerulonephritis. The most common oral lesions associated with WG are ulceration and strawberry gingivitis. A 47-years old man in medical care associated WG was consulted our Division of Oral and Maxillofacial Surgery for the chief complaint of toothaches. Pre-operative panorama showed the alveolar radiolucency and the loss of lamina dura regarding the left upper teeth. An oropharyngeal magnetic resonance imaging also revealed the increased bone marrow signal intensity on the left maxilla. Under the impression of maxillary osteonecrosis due to WG, maxillary saucerization with removal of involved teeth was performed. We obtained good results and report the first case of WG in Korea, with the review of literatures regarding oral and general systemic features.]]>
Arteries ; Autoimmune Diseases ; Bone Marrow ; Fragaria ; Gingivitis ; Glomerulonephritis ; Korea ; Magnetic Resonance Imaging ; Maxilla ; Osteonecrosis ; Respiratory System ; Surgery, Oral ; Tooth ; Toothache ; Ulcer ; Vasculitis ; Veins ; Wegener Granulomatosis

OBJECTIVE: To investigate the clinical treatment effect of refractory hypertension accompanied with OSAHS by surgery on upper airway. METHOD: Thirty-two patients were enrolled in our research. PSG and blood pressure were examined on preoperation and 6th month, 1 year, 2 year of postoperation. RESULT: The AHI and the time of SaO2 < 90% were lower significantly, and LSaO2 was improved (P < 0.01). The blood pressures of 32 patients were decreased. CONCLUSION The operation on upper airway could improve the hypertension of patient with OSAHS effectively.
Adult ; Blood Pressure ; Female ; Humans ; Hypertension ; surgery ; Male ; Respiratory System ; surgery ; Sleep Apnea, Obstructive ; surgery

The Streptococcus milleri group, which also includes S. anginosus, S. intermedius and S. constellatus, is found in the oropharynx, upper respiratory tract, gastrointestinal tract, and urogenital tract mucosa. Bacteria in the Streptococcus milleri group are associated with bacteremia and abscess formation. Most of the reports of of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions. Predisposing factors that have been associated with S. milleri group empyema include mucosal disturbances (sinusitis, periodontal disease, enteric disease), preceding to pneumonia, thoracic surgery, malignancy, neurological disease, alcohol abuse, and also diabetes mellitus. We report on a 42-year-old man with mental retardation. He who suffered from dyspnea and a fever that he had developed for over 14 days. S. constellatus and anaerobic bacterias (Prevotella buccae and Micromonas micros) were cultured. The patient was treated with the drainage of pleural effusion and clindamycin and levofloxacin.
Abscess ; Adult ; Alcoholism ; Bacteremia ; Bacteria ; Bacteria, Anaerobic ; Cheek ; Clindamycin ; Diabetes Mellitus ; Drainage ; Dyspnea ; Empyema ; Fever ; Gastrointestinal Tract ; Humans ; Intellectual Disability ; Mucous Membrane ; Ofloxacin ; Oropharynx ; Periodontal Diseases ; Pleural Effusion ; Pneumonia ; Respiratory System ; Streptococcus ; Streptococcus constellatus ; Streptococcus milleri Group ; Thoracic Surgery

Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.
Abscess ; Bronchopulmonary Sequestration ; Compliance ; Humans ; Iliac Artery ; Lost to Follow-Up ; Medical Records ; Renal Artery ; Respiratory System ; Retrospective Studies ; Sepsis ; Thoracic Surgery ; Thoracotomy