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Treatment Result of Ovarian Dysgerminoma (난소 미분화배세포종에 대한 방사선치료 결과)

  • Shin Seong Soo;Park Suk Won;Shin Kyung Hwan;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.379-385
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    • 1997
  • Purpose : Ovarian dysgerminoma is a highly radiosensitive malignant tumor occurring in young age group. The conventional treatment was total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by radiotherapy. We retrospectively analyzed the treatment results of Patients who had received radiotherapy in the era before chemotherapy was widely used. Material and Method : Twenty two patients with ovarian dysgerminoma were treated at the Department of Therapeutic Radiology, Seoul National University Hospital between August, 1980 and May, 1991. Four patients were excluded from this study, because three patients received incomplete treatment and one received combined chemotherapy. Sixteen patients received postoperative radiotherapy and two patients had radical radiotherapy as tumor was unresectable. Median follow-up period was 99 months (range, 51-178) Median age was 22 years (range, 11-42). Among the postoperatively treated patients, three Patients were in stage IA, eight in stage IC, two in stage II, and three in stage III. One patient had Turner's syndrome. Radiotherapy was performed with high energy photon (telecobalt unit or linear accelerator, either 6MV or 10MV), The radiation dose to the whole abdomen was 1950-2100cGy (median, 2000) and 1050-2520cGy was added to the whole pelvis, the total dose to the whole pelvis was 3000-4500cGy (median, 3500). Prophylactic Paraaortic area irradiation was done in six Patients (dose range, 900-1500cGy). One patient who had positive Paraaortic node, received radiation dose of 1620cGy, followed by additional 900cGy to the gross mass with shrinking field. Total dose to the paraaortic node was 4470cGy. Six patients, including one who had paraaortic node metastasis, received Prophylactic irradiation to mediastinum and supraclavicular area (2520cGy). Of the two patients with unresectable tumors who received radical radiotherapy, one was in stage III and the other was in stage IV with left supraclavicular lymph node metastasis. The stage III patient received radiation to the whole abdomen (2000cGy), followed by boost to whole pelvis (2070cGy) and paraaortic area (2450cGy). Stage IV patient received radiation to the whole abdomen (2000cGy), followed by radiation to the whole pelvis and paraaortic area (2400cGy), mediastinum (2520cGy) , and left supraclavicular area (3550cGy) .Results : The 5 year local control rate was $100\%$ in patients who received postoperative adiuvant radiotherapy after total abdominal hysterectomy and bilateral salpingo-oophorectomy. Only one patient in stage III who did not receive prophylactic irradiation to mediastinum developed mediastinal metastasis. but was salvaged by chemotherapy. So. the 5 year overall survival rate uras also $100\%$. Two patients who received radiation only, are alive without disease at 112 and 155 months. Conclusion : Postoperntive adjuvant radiotherapy as well as radical radiotherapy in unresectable ovarian dysgerminoma was very effective. aut chemotherapy is also an effective treatment modality We now recomrneifd chemotherapy for Patients who need to save their ovarian functien and reserve radiotherapv fov chemo-resistant tumor or recurrence alter che motherapy.

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Effects of Crude Protein Levels in Total Mixed Rations on Dry Matter Intake, Digestibility and Nitrogen Balance in Early Pregnant Korean Black Goats (섬유질배합사료 내 조단백질 수준이 임신초기 흑염소의 건물섭취량, 소화율 및 질소출납에 미치는 영향)

  • HwangBo, Soon;Choi, Sun-Ho;Lee, Sung-Hoon;Kim, Sang-Woo;Kim, Young-Keun;Sang, Byung-Don;Jo, Ik-Hwan
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.27 no.2
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    • pp.93-100
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    • 2007
  • This study was conducted to determine the effects of different levels (10, 12 and 15%) of crude protein (CP) in total mixed ration (TMR) on dry matter intake, digestibility and nitrogen balance of Korean black goats in the stage of early pregnancy and to obtain information on their optimal dietary levels of CP. In the present study, 12 Does of Korean black goats in the early pregnancy were allotted to four unreplicated groups by dietary level of CP and then they were housed in individual metabolism cages with completely randomized design throughout 30 days with 20 days adaptation and 10 days collection periods. Does in Control were fed a conventional diet and does in TMR10, TMR12 and TMR15 were fed a diet adjusted to about 10, 12 and 15% CP, respectively. Dry matter(DM) contents ranged from 89 to 91% in treatments. There were no differences fur fiber contents among three CP levels of TMR, showing that ADF and NDF had 18.57 to 19.85, and 53.41 to 54.80, respectively. Crude protein contents for three TMR treaements had 10.61, 12.15 and 14.97%, respectively. However, non-fibrous carbohydrate (NFC) contents decreased with increasing CP levels in treatments. Meanwhile, Intakes of DM, nutrients and digestible nutrients were significantly (p<0.05) higher in TMR15 and control than in TMR10 and TMR12. Moreover, DM intake per metabolic body weight and theit ratio per body weight was significantly (p<0.05) higher for control and TMR15 than other treatments. DM digestibility was not significantly different among treatments, but ether extract digestibility of treatments was significantly (p<0.05) higher than that of control, but there was no significant difference among treatments. Nitrogen retention significantly (p<0.05) increased with increasing CP levels in TMR, and TMR15 was highest among treatments. Our results showed that the increasing CP levels in TMR increased DM intake and nitrogen retention and suggested that the optimal dietary CP levels under TMR feeding system in early pregnant Korean black goats could be estimated for at least 15%.

THE EFFECT OF IRRADIATION MODES ON POLYMERIZATION AND MICROLEAKAGE OF COMPOSITE RESIN (광조사 방식이 복합레진의 중합과 누출에 미치는 영향)

  • Park, Jong-Jin;Park, Jeong-Won;Park, Sung-Ho;Park, Ju-Myong;Kwon, Tae-Kyung;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.27 no.2
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    • pp.158-174
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    • 2002
  • The aim of this study was to investigate the effect of light irradiation modes on polymerization shrinkage, degree of cure and microleakage of a composite resin. VIP$^{TM}$ (Bisco Dental Products, Schaumburg, IL, USA) and Optilux 501$^{TM}$ (Demetron/Kerr, Danbury, CT, USA) were used for curing Filtek$^{TM}$ Z-250 (3M Dental Products, St. Paul., MN, USA) composite resin using following irradiation modes: VIP$^{TM}$ (Bisco) 200mW/$\textrm{cm}^2$ (V2), 400mW/$\textrm{cm}^2$ (V4), 600mW/$\textrm{cm}^2$ (V6), Pulse-delay (200 mW/$\textrm{cm}^2$ 3 seconds, 5 minutes wait, 600mW/$\textrm{cm}^2$ 30seconds, VPD) and Optilux 501$^{TM}$ (Demetron/Kerr) C-mode (OC), R-mode (OR). Linear polymerization shrinkage of the composite specimens were measured using Linometer (R&B, Daejeon, Korea) for 90 seconds for V2, V4, V6, OC, OR groups and for up to 363 seconds for VPD group (n=10, each). Degree of conversion was measured using FTIR spectrometer (IFS 120 HR, Bruker Karlsruhe, Germany) at the bottom surface of 2 mm thick composite specimens V2, Y4, V6, OC groups were measured separately at five irradiation times (5, 10, 20, 40, 60 seconds) and OR, VPD groups were measured in the above mentioned irradiation modes (n=5 each). Microhardness was measured using Digital microhardness tester (FM7, Future-Tech Co., Tokyo, Japan) at the top and bottom surfaces of 2mm thick composite specimens after exposure to the same irradiation modes as the test of degree of conversion(n=3, each). For the microleakage test, class V cavities were prepared on the distal surface of the ninety extracted human third molars. The cavities were restored with one of the following irradiation modes : V2/60 seconds, V4/40 seconds, V6/30 seconds, VPD , OC and OR. Microleakage was assessed by dye penetration along enamel and dentin margins of cavities. Mean polymerization shrinkage, mean degree of conversion and mean microhardness values for all groups at each time were analyzed using one-way ANOVA and Duncan's multiple range test, and using chi-square test far microleakage values. The results were as follows : . Polymerization shrinkage was increased with higher light intensity in groups using VIP$^{TM}$ (Bisco) : the highest with 600mW/$\textrm{cm}^2$, followed by Pulse-delay, 400mW/$\textrm{cm}^2$ and 200mW/$\textrm{cm}^2$ groups, The degree of polymerization shrinkage was higher with Continuous mode than with Ramp mode in groups using Optilux 501$^{TM}$ (Demetron/Kerr). . Degree of conversion and microhardness values were higher with higher light intensity. The final degree of conversion was in the range of 44.7 to 54.98% and the final microhardness value in the range of 34.10 to 56.30. . Microleakage was greater in dentin margin than in enamel margin. Higher light intensity showed more microleakage in dentin margin in groups using VIP$^{TM}$ (Bisco). The microleakage was the lowest with Continuous mode in enamel margin and with Ramp mode in dentin margin when Optilux 501$^{TM}$ (Demetron/Kerr) was used.

SURFACE ROUGHNESS OF COMPOSITE RESIN ACCORDING TO FINISHING METHODS (복합레진 표면의 연마방법에 따른 표면조도)

  • Min, Jeong-Bum;Cho, Kong-Chul;Cho, Young-Gon
    • Restorative Dentistry and Endodontics
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    • v.32 no.2
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    • pp.138-150
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    • 2007
  • The purpose of this study was to evaluate the difference of surface roughness of composite resin according to composite resin type, polishing methods, and use of resin sealant. Two hundred rectangular specimens, sized $8{\times}3{\times}2mm$, were made of Micro-new (Bisco, Inc., Schaumburg, IL, U.S.A) and Filtek Supreme (3M ESPE Dental Products, St. Paul, MN, U.S.A.), and divided into two groups; Micronew-M group, Filtek Supreme-S group. Specimens for each composite group were subdivided into five groups by finishing and polishing instruments used; M1 & S1(polyester strip), M2 & S2 (Sof-Lex disc), M3 & S3 (Enhance disc and polishing paste), M4 & S4(Astropol) and M5 & S5 (finishing bur), Polished groups were added letter B after the application of resin surface sealant (Biscover), eg, M1B and S1B. After specimens were stored with distilled water for 24hr, average surface roughness (Ra) was taken using a surface roughness tester. Representative specimens of each group were examined by FE-SEM (S-4700: Hitachi High Technologies Co., Tokyo, Japan). The data were analysed using paired t-test, ANOVA and Duncan's tests at the 0.05 probability level. The results of this study were as follows ; 1. The lowest Ra was achieved in all groups using polyester strip and the highest Ra was achieved in M5, S5 and M5B groups using finishing bur. On FE-SEM, M1 and S1 groups provided the smoothest surfaces, M5 and S5 groups were presented the roughest surfaces and voids by debonding of filler on the polished specimens. 2. There was no significant difference in Ra between Micronew and Filtek Supreme before the application of resin sealant, but Micronew was smoother than Filek Supreme after the application of resin sealant. 3. There was significant corelation between Ra of type of composite resin and polishing methods before the application of resin sealant (p=0.000), but no significant interaction between them after the application of resin sealant. On FE-SEM, most of composite resin surfaces were smooth after the application of resin sealant on the polished specimens. 4. Compared with before and after the application of resin sealant in group treated in the same composite and polishing methods, Ra of M4B and M5B was statistically lower than that of M4 and M5, and S5B was lower than that of S5, respectively (p<0.05). In conclusion, surface roughness by polishing instruments was different according to type of composite resin. Overall, polyester strip produced the smoothest surface, but finishing bur produced the roughest surface. Application of resin sealant provided the smooth surfaces in specimens polished with Enhance, Astropol and finishing bur, but not provided them in specimens polished with Sof-Lex disc.

Effects of Lime and NPK Application Rates on the Soil Characteristics after a 10-year Experiment in Oversown Hilly Pasture of Mixed Grass-Clover Sward I. Changes in the pH, contents of T-N, organic matter and available $P_{2}O_{5}$, coefficient of $P_{2}O_{5}$ absorption, and lime requirement by the soil depth (겉뿌림 산지초지에서 석회 및 3요소 시용수준이 10연후 토양특성에 미치는 영향 I. 토심별 pH, T-N, 유기물 및 유효인산 함량, 인기흡수계수와 석회소요량)

  • Jeong, Yeon-Gyu;Lee, Hyeok-Ho
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.13 no.1
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    • pp.49-57
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    • 1993
  • The main experiment related to this report was undertaken to assess the effects of two rates of $Ca(OH)_2$ (0, 250 kg/10a only at establishment) and five rates of N-$P_{2}O_{5}$-$K_2O$ (0-0-0, 0-10-10, 6-15-15, 12-20-20, 24-25-20 kg/10a/year) on the pasture establishment, on forage yield and quality, vegetation etc. After this 10-year main experiment, this pasture had been used to assess the effects of the above treatments on the soil characteristics in oversown hilly pasture of a grass-clover sward. This 1st part is concerned with the soil properties of pH-value. OM, T-N, avail. $P_{2}O_{5}$ and $P_{2}O_{5}$ absorption coefficient, and lime requirement by the soil depth. 1. The pH of the topsoil(0~l5 cm) was lowered from pH 5.12 of before the experiment to 4.90 of when $Ca(OH)_2$ was applied and to 4.68 of when $Ca(OH)_2$ was not applied. The pH decrease was more evident with the increase of NPK application rate and in the upper part of the top soil(0.0~7.5 cm). The additional application of lime was necessary in all the experiment blocks due to the strong acidity of the soil, and the amounts of lime requirement were increased with increased application rates of NPK and soil depth. 2. The contents of organic matter and T-N were increased in all the blocks by the establishment of the hilly pasture, and were higher in $Ca(OH)_2$ applied blocks than non-applied blocks. The contents were inversely correlated with the soil depth. No correlation was observed between the contents and the application rates of NPK. 3. The content of available $P_{2}O_{5}$-$K_2O$, was increased with the increased application of P, especially in the upper part of top soil. The content in the upper part(0.0~7.5 cm) was about twice of that in the lower part(7.5~15.0 cm). Since the contents of available $P_{2}O_{5}$$P_{2}O_{5}$/10a/year were applied, respectively), it is necessary to decrease the application rate of $P_{2}O_{5}$, gradually. The $P_{2}O_{5}$ absorption coefficient in topsoil (0.0~15.0 cm) was more or less higher when no lime and less $P_{2}O_{5}$, was applied. No correlation was observed in subsoil. 4. Further studies on the methods, rates, time of additional application of lime, and on the methods of decreased apllication of $P_{2}O_{5}$ should be performed for better management of oversown hilly pasture.

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Characteristics of Spatio-temporal Variation of the Water Quality in the Lower Keum River (금강 하류역에서 수질의 시공간적 변화특성)

  • YANG Han-Soeb;KIM Seong-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.23 no.3
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    • pp.225-237
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    • 1990
  • Various chemical constituents were measured from April to August 1988 at the down-ward 20 stations of Keum River, which is located in the Midwest of Korea, to understand the characteristics of water quality with respect to spatio-temporal variations of each constituent. The 24-hrs continuous measurements with 2-hrs interval were made simultaneously at station 2 near the estuary weir and station 9(Ganggyeong) of 35 km upstream from the weir in April. By the results observed for one day in April at station 2, salinity has a range of $7.88\~22.14\%_{\circ}$ and its temporal variability is identical to the pattern of tidal cycle in the neigh-bouring Kunsan Harbor. However, turbidity shows relatively high values only at an interval of 4~5 hours after the lowest salinity time, though hourly fluctuation of pH is very small. Silicate and dissolved inorganic nitrogen have inversively linear correlationships with salinity, implying the concentration of the two nutrients strongly regulated by estuarine mixing of sea and river waters. In contrast, phosphate sustains roughly a constant level over a wide salinity range and distinctly lower values than those corresponding to nitrate in the oceans. Such distributions of phosphate have been observed in some estuaries, and interpreted as driven by removal of dissolved phosphate into bottom sediments and the bufforing of phosphate by particulate matter. COD values at station 2 are relatively high in day-time(particularly afternoon) and in high-salinity periods. At station 9, saltwater intrusion was never found but water level changed to the extent of 2.5 m for one day. Although each parameter at this station exhibits very slight variations in their abundance for 24 hours compared with station 2, the contents of COD, silicate and ammonia are significantly higher than at station 2. Concentration of suspended matter is relatively high in the brackish water region up to $\~20$ km above the river mouth, probably due to strong tidal stirring of the bottom de-posits. Also, relatively high pH, COD and $O_2$ saturation at the upward stations of $40\~50$ km from the weir are presumably attributable to active photosynthesis of plants in the region. In general, COD and nutrients except phosphate are higher values at the upper stations than in the estuary zone, and show the highest abundances in July nearly at all stations. Finally, in the estuarine region tidal mixing of sea-river waters seems to be an important factor controlling the distributions of turbidity, COD, silicate and nitrate as well as salinity. However, water quality in the upward fresh-water zone is remarkably variable according to months or seasons.

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Oxidative Inactivation of Peroxiredoxin Isoforms by H2O2 in Pulmonary Epithelial, Macrophage, and other Cell Lines with their Subsequent Regeneration (폐포상피세포, 대식세포를 비롯한 각종 세포주에서 H2O2에 의한 Peroxiredoxin 동위효소들의 산화에 따른 불활성화와 재생)

  • Oh, Yoon Jung;Kim, Young Sun;Choi, Young In;Shin, Seung Soo;Park, Joo Hun;Choi, Young Hwa;Park, Kwang Joo;Park, Rae Woong;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.31-42
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    • 2005
  • Background : Peroxiredoxins (Prxs) are a relatively newly recognized, novel family of peroxidases that reduce $H_2O_2$ and alkylhydroperoxide into water and alcohol, respectively. There are 6 known isoforms of Prxs present in human cells. Normally, Prxs exist in a head-to-tail homodimeric state in a reduced form. However, in the presence of excess $H_2O_2$, it can be oxidized on its catalytically active cysteine site into inactive oxidized forms. This study surveyed the types of the Prx isoforms present in the pulmonary epithelial, macrophage, endothelial, and other cell lines and observed their response to oxidative stress. Methods : This study examined the effect of exogenous, excess $H_2O_2$ on the Prxs of established cell lines originating from the pulmonary epithelium, macrophages, and other cell lines, which are known to be exposed to high oxygen partial pressures or are believed to be subject to frequent oxidative stress, using non-reducing SDS polyacrylamide electrophoresis (PAGE) and 2 dimensional electrophoresis. Result : The addition of excess $H_2O_2$ to the culture media of the various cell-lines caused the immediate inactivation of Prxs, as evidenced by their inability to form dimers by a disulfide cross linkage. This was detected as a subsequent shift to its monomeric forms on the non-reducing SDS PAGE. These findings were further confirmed by 2 dimensional electrophoresis and immunoblot analysis by a shift toward a more acidic isoelectric point (pI). However, the subsequent reappearance of the dimeric Prxs with a comparable, corresponding decrease in the monomeric bands was noted on the non-reducing SDS PAGE as early as 30 minutes after the $H_2O_2$ treatment suggesting regeneration after oxidation. The regenerated dimers can again be converted to the inactivated form by a repeated $H_2O_2$ treatment, indicating that the protein is still catalytically active. The recovery of Prxs to the original dimeric state was not inhibited by a pre-treatment with cycloheximide, nor by a pretreatment with inhibitors of protein synthesis, which suggests that the reappearance of dimers occurs via a regeneration process rather than via the de novo synthesis of the active protein. Conclusion : The cells, in general, appeared to be equipped with an established system for regenerating inactivated Prxs, and this system may function as a molecular "on-off switch" in various oxidative signal transduction processes. The same mechanisms might applicable other proteins associated with signal transduction where the active catalytic site cysteines exist.

Awareness Activation of Dance Copyrights and Research of Effectiveness Plans (무용의 저작권 인식 활성화와 실효성 방안 연구)

  • LEE, Seoeun
    • Trans-
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    • v.2
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    • pp.1-38
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    • 2017
  • Dance, as an art which expresses thoughts and emotions by movement human, is included in work that its copyright has to be protected, choreographers who are creators and dancers who are performing can exercise their rights included in copyright laws. However, artists who work in the dancing scene have lack of awareness about copyrights and the application level is low. The purpose of this thesis is to look into the current status and issues about dance copyright and to discuss activation plans and effectiveness plans for dance copyrights. The main point is to check into the level of awareness for dance copyrights with choreographers, dancers and students majoring in dance who are in charge of the art of dancing, to present issues about the necessity of the dance copyrights protection plans by analyzing interviews-in-depth and to prepare the dance copyrights protection plans which are concretely realistic. For the research methods, first, I looked into ideas and contents about copyrights through a document research and then, wanted to prepare theoretical background by reviewing actual cases of performing art copyrights related to dance. Next, I carried out surveys about awareness of copyrights with students majoring in dance, choreographers and dancers then carried out analysis of actual proof. Also, I chose three famous dancers who are actively performing in the current dancing scene and did interviews-in-depth about dance copyrights then carried out a recording analysis. I tried to complement the analysis by discussing deeper which I couldn't deal with in the previous surveys and to contemplate awareness activation of dance copyrights and plans. As a result of the research, the level of the awareness about dance copyrights through age, major, education and career was very low. The level of awareness was almost same compared to the previous research 10 years ago. 'Music', which can be an element of copyright issue in dance, was the highest in rate, and dance was recognized as an art which is combined with various elements as a combination work. The way of protection for works of choreography and performance only used data preservation and contracts and didn't register copyrights or record in dace notation. Majority of responders answered that they couldn't have any education about copyrights while they were recognizing the necessity of education and management for copyrights. The analysis of interviews-in-depth was also matched to the result of the previous surveys and a deeper discussion about the status of dance copyrights and issues was carried out. The plans of effectiveness for dance copyrights through the result of previous research are as followings. First, an advanced education is necessary above all to increase the awareness and application of copyrights in dancing scene. Long-term education like study curriculums and short-term education like special courses and seminars should be combined, and education about copyrights for dance groups, choreographers, dancers and students majoring in dance should keep on going. Second, revision of performing art works is necessary for the activation of dance copyrights, and establishing a dance copyright association to manage copyrights systematically and training dance copyright experts are necessary as well. Third, as the way of copyright protection for choreographers and dancers, an establishment for relation gain and loss about copyrights is necessary when creating dance works and performing, and registration of dance works should be activated. Also, the dancing scene should sign contracts for choreography and performance and this contract culture should be activated, and it should systematically preserve and manage choreography and performance records through basic ways. Hereby, it is considered to prepare a foundation to foster the awareness of dance copyrights and activate dance copyrights.

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Environmental Pollution in Korea and Its Control (우리나라의 환경오염 현황과 그 대책)

  • 윤명조
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.5-6
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    • 1972
  • Noise and air pollution, which accompany the development of industry and the increase of population, contribute to the deterioration of urban environment. The air pollution level of Seoul has gradually increased and the city residents are suffering from a high pollution of noise. If no measures were taken against pollution, the amount of emission of pollutant into air would be 36.7 thousand tons per year per square kilometer in 1975, three times more than that of 1970, and it would be the same level as that of United States in 1968. The main sources of air pollution in Seoul are the exhaust has from vehicles and the combustion of bunker-C oil for heating purpose. Thus, it is urgent that an exhaust gas cleaner should be instaled to every car and the fuel substituted by less sulfur-contained-oil to prevent the pollution. Transportation noise (vehicular noise and train noise) is the main component of urban noise problem. The average noise level in downtown area is about 75㏈ with maximum of 85㏈ and the vehicular homing was checked 100㏈ up and down. Therefore, the reduction of the number of bus-stop the strict regulation of homing in downtown area and a better maintenance of car should be an effective measures against noise pollution in urban areas. Within the distance of 200 metres from railroad, the train noise exceeds the limit specified by the pollution control law in Korea. Especially, the level of noise and steam-whistle of train as measured by the ISO evaluation can adversely affect the community activities of residents. To prevent environmental destruction, many developed countries have taken more positive action against worsening pollution and such an action is now urgently required in this country.

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Effect of Nasal Continuous Positive Airway Pressure after Early Surfactant Therapy in Moderate Respiratory Distress Syndrome (중등도 신생아 호흡 곤란 증후군에서 폐 표면 활성제 조기 투여 후 Nasal CPAP의 치료 효과)

  • Kim, Eun Ji;Kim, Hae Sook;Hur, Man Hoe;Lee, Sang Geel
    • 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.