• 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.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.492-496
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• 1984

For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. We experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 4.0 cm segmental narrowing below the tracheostoma. Before reconstruction, we tried to T-tube cannulation, but the result was not satisfactory. So we resected the narrowed segment and tracheal reconstruction was performed with uneventful result.

• Journal of the Korean Solar Energy Society
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• v.22 no.4
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• pp.1-9
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• 2002

This study is on the design and evaluation of Zero Energy Solar House(ZeSH) including active solar heating system. Various innovative technologies such as super insulation, passive solar systems, super window, ventilation heat recovery system...etc were analyzed by individual and combination for the success of ZeSH. The ESP-r simulation program was used for this. Simulation results shows that almost 77% of heating load can be reduced with the following configuration of 200mm super insulation, super windows, passive solar system and 0.3 ventilation rate per hour. Active solar heating system (ASHS) was designed for the rest of the heating load including hot water heating load. The solar assisted heat pump is used for the auxiliary heating device in order to use air conditioner but not included in this study. The yearly solar fraction is 87% with a solar collector area of $28m^2$. The parametric studies as the influence of storage volume and collector area on the solar fraction was analyzed.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.260-265
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• 1993

Twelve patients underwent surgical correction of total anomalous pulmonary venous connection[TAPVC] between Sep. 1989 and May 1993. There were 9 boys and 3 girls whose ages ranged from 10 days to 17 month [median 1.2 month]. Six patients were less than 1 month of age at operation. The anomalous drainage was supracardiac in 6, cardiac in 2, infracardiac in 2, and mixed in 2. There were 3 early death, and its mortality rate was 25%. There were no operative mortality after Sep. 1991. Age at operation, presence of preoperative pulmonary venous obstruction, preoperative assisted ventilation and type of anomaly did not affect early mortality. Late pulmonary venous obstruction was developed in 4 patients between 1 month to 4 month after operation. Among these patients, 2 were died and one was reoperated and well, and the other one was not operated because of patient`s refusal. We conclude that late pulmonary venous obstruction is fatal and its early detection and correction is important for improving late survival.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.345-351
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• 1985

Tracheal stenosis is due to tracheostomy or prolonged intubation. Development of tracheal stenosis following tracheostomy is very serious complication. In recent practice, tracheostomy has became more popular because of increased occasions of major and minor traumas. At the Dept. of thoracic surgery, Chonbuk national university hospital, we have experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Chest X-ray revealed the narrowing of trachea at cervicothoracic junction due to previous tracheostomy. We resected the narrow segment & tracheal reconstruction was performed with an excellent result in postoperative periods. Postoperative air tracheogram did not reveal demonstrable narrowing of air filled trachea.

• The Korean Journal of Emergency Medical Services
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• v.17 no.3
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• pp.21-28
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• 2013

Purpose: The purpose of this study is to get basic user guidelines of safe and efficient bag-valve-mask application on patients having abnormal pathophysiological pulmonary conditions. Methods: This study was performed by pre-qualified 35 EMS junior and senior students. Participants were instructed to compress ambulatory bag randomly about half, one-third, one-fourth within different airway resistance and pulmonary compliance. Resultant tidal volume and pulmonary wedge pressures on RespiTranier monitor were analysed in relation to pulmonary physiologic index. Results: At least over half compression of bag guaranteed minimal tidal volume regardless of pulmonary conditions. There was no increase of pulmonary wedge pressure above the level of barotrauma on half compression at any pulmonary conditions. Conclusion: Assisted ventilation with ambulatory bag on patients with pathological pulmonary conditions should be over half compressed regardless of respiratory disease entity.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.73-76
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• 1982

For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, among the variable complications following tracheostomy, the tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. At the Dept. of thoracic surgery, CAFGH, we have experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 2.5 cm segmental narrowing 5 cm below the tracheostoma. Before recon-struction, we tried to dilate the stenotic segment for about 2 months, but the result was not satisfactory to relieve dyspnea. So, we resected the narrowed segment and tracheal reconstruction was performed with an excellent result in postoperative periods till now.

• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.261-269
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• 1997

When performing an endotracheal intubation or tracheotomy to an unconscious patient in emergent situations, one should consider the possibility of later complication of laryngo-tracheal stenosis which can result in difficulties in decannulation. Laryngo-tracheal stenosis is a bothersome problem developing as a complication of treatment by tracheotomy with a cuffed tube and long-term endotracheal intubation with assisted ventilation. One hundred twenty-three cases of laryngo-tracheal stenosis patients during the four yew period from May 1992 to April 1996 were restrospectively reviewed according to several parameters such as the duration of intubation, site of stenosis, treatment modality and, site of tracheostoma. The present report is an analysis of these materials to search for the possible etiologic factors and its proper preventive methods. It was desirable that the endotracheal intubation should be limited within 20 days at most. Tracheotomy performed by non-otolaryngologists has a tendency to be on a higher level of trachea. Technical precautions should be taken into consideration when doing a tracheotomy. The success rate of decannulation of tracheal T-tube was 78.8% and it required average 11 months.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.364-374
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• 1980

Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.456-460
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• 2016

Background: Surgical correction needs to be considered when diaphragm eventration leads to impaired ventilation and respiratory muscle fatigue. Plication to sufficiently tense the diaphragm by VATS is not as easy to achieve as plication by open surgery. We used pneumatic compression with carbon dioxide ($CO_2$) gas in thoracoscopic diaphragmatic plication and evaluated feasibility and efficacy. Methods: Eleven patients underwent thoracoscopic diaphragmatic plication between January 2008 and December 2013 in Pusan National University Hospital. Medical records were retrospectively reviewed, and compared between the group using $CO_2$ gas and group without using $CO_2$ gas, for operative time, plication technique, duration of hospital stay, postoperative chest tube drainage, pulmonary spirometry, dyspnea score pre- and postoperation, and postoperative recurrence. Results: The improvement of forced expiratory volume at 1 second in the group using $CO_2$ gas and the group not using $CO_2$ gas was $22.46{\pm}11.27$ and $21.08{\pm}5.39$ (p=0.84). The improvement of forced vital capacity 3 months after surgery was $16.74{\pm}10.18$ (with $CO_2$) and $15.6{\pm}0.89$ (without $CO_2$) (p=0.03). During follow-up ($17{\pm}17$ months), there was no dehiscence in plication site and relapse. No complications or hospital mortalities occurred. Conclusion: Thoracoscopic plication under single lung ventilation using $CO_2$ insufflation could be an effective, safe option to flatten the diaphragm.