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Correlation between Clinicomorphologic Findings and Clinical Outcome in Childhood $Henoch-Sch\"{o}nlein$ Purpura Nephritis (소아 $Henoch-Sch\"{o}nlein$ 자반병 신염의 임상양상 및 병리소견과 임상경과)

  • Huh Yun-Jung;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.30-37
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    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is usually a self-limited disease with a good eventual outcome. The prognosis of HSP is mainly determined by the renal involvement. In this study, We evaluated children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis about the clinical outcome correlated with renal manifestation and morphologic findings. Methods : The clinical features, initial laboratory and pathologic findings, and clinical out-come were evaluated in 60 children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis at Yonsei University Severance Hospital during the period from Jan. 1990 to Dec. 2002. Results : The ratio of male to female patients was 1.2:1. The interval between the onset of $Henoch-Sch\"{o}nlein$ purpura and renal manifestation was less than 3 months in 81% of the patients. Initial renal manifestation was microscopic hematuria in 100% of patients, isolated hematuria in 15%, acute nephritic syndrome in 7%, nephrotic syndrome In 22% of patients. Renal manifestation correlated with clinical outcome. Grade II and III were the most common in histologic grades of ISKDC. Renal pathologic finding correlated with clinical outcome. Conclusion : Renal manifestation and pathologic findings correlated with the clinical out-come. It is necessary to evaluate the correlation between pathologic findings and treatment.

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Acute Hyponatremia in Pneumonia and CNS Infections of Children (소아의 폐렴과 중추신경계 감염에서 급성 저나트륨혈증의 발생 양상)

  • Shin, Sung Hyun;Um, Tea Min;Lee, Yun Jin;Son, Seung Kook;Kim, Seong Heon;Kim, Su Yung
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.89-94
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    • 2012
  • Purpose: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. Methods: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. Results: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. Conclusion: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.

Binder Stiffness Effect on Permanent Deformation and Tensile Strength of Asphalt Concretes (바인더 강성이 아스팔트 콘크리트의 인장강도와 소성변형 특성에 미치는 영향 분석)

  • Kim, Hyun-Hwan;Yoo, Min-Yong;Kim, Jin-Chul;Kim, Kwang-Woo
    • International Journal of Highway Engineering
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    • v.12 no.2
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    • pp.17-23
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    • 2010
  • Since the relatively stiff binder shows a higher tensile strength as well as higher rutting resistance, it is believed that the binder stiffness is an important factor for rutting and tensile strength of asphalt mixtures. The typical tensile property is measured by indirect tensile strength (ITS) test at $25^{\circ}C$ and the rutting resistance is most widely measured by wheel tracking (WT) test at $60^{\circ}C$. The deformation strength ($S_D$) is newly developed property to estimate rut resistance of asphalt concretes at $60^{\circ}C$. The ITS and $S_D$ are very simple to measure by static test techniques, but the WT is measured by repeated loading procedure which requires relatively longer time and more efforts. Since these three properties are highly dependent upon the binder stiffness, it may be possible to estimate one property from another. Therefore, this study investigate the possibility of estimating the rutting characteristics (measured by WT test) by ITS or $S_D$ test, and the ITS by $S_D$. Because of binder stiffness effect, in the WT estimation by ITS, a tendency was observed for the higher ITS mixture to have the lower rut depth, giving $R^2{\fallingdotseq}$0.6, on the average. The ITS estimation by $S_D$ showed $R^2{\fallingdotseq}$0.64, and the WT estimation by SD showed $R^2{\fallingdotseq}$0.84, which is highest correlation among the three. Therefore, it was concluded that there is relatively good possibility of estimating WT result by $S_D$, and even though $R^2$ is somewhat low, there is some correlation between WT and ITS.

Influence of Vetiver Grass (Vetiveria zizanioides) on Rhizosphere Chemistry in Long-term Contaminated Soils (중금속으로 오염된 토양에서 근권부의 화학적 특성에 미치는 vetiver grass (Vetiveria zizianioides)의 영향)

  • Kim, Kwon-Rae;Owens, Gary;Naidu, Ravi;Kim, Kye-Hoon
    • Korean Journal of Soil Science and Fertilizer
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    • v.41 no.1
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    • pp.55-64
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    • 2008
  • A detailed understanding and appreciation of the important mechanisms operating at the soil:root interface, commonly identified as the rhizosphere, is critical for evaluating the potential for particular plant species to be successfully used as part of a phytoremediation technique. For specific plants, mechanisms may exist to overcome the inherit limitation of the phytoremediation technique when poorly mobile soil metals are of interest. In the present study, the influence of root exudates on the rhizosphere chemistry of soil and consequential metal uptake were investigated following culture of vetiver grass (Vetiveria zizanioides), recognized as a promising plant for land stabilization, in three different long-term contaminated soils and one non-contaminated control soil. The soil solution pH increased (0.3-1.1 units) following vetiver grass culture and dissolved organic carbon (DOC) also significantly increased in all soils with the highest increase in PP02 (23 to $173mg\;L^{-1}$). Chemical changes are contributed to root exudation by vetiver grass when exposed to high concentration of heavy metals. Chemical changes, consequently, influenced metal (Cd, Cu, Pb, and Zn) solubility and speciation in the rhizosphere. The highest solubility was observed for soil Ko01 (eg. 2091 and $318{\mu}g\;L^{-1}$ for Cd and Pb, respectively). Initial heavy metal solubility in soils varied with soil and either increased or decreased following vetiver grass culture depending on the soil type. An increase in pH following plant culture generally resulted in a decrease in metal solubility, while elevated DOC due to root exudation resulted in an increase in metal solubility via the formation of metal-DOC complexes. Donnan speciation demonstrated a significant decrease in free Cd and Zn in the rhizosphere and the concentration of Cd, Pb, and Zn in vetiver grass shoot was highly correlated with soluble concentration rather than total soil metal concentration.

Evaluation of Indoor Air Quality in a Department of Radiation Oncology Located Underground (지하에 위치한 방사선종양학과에서의 실내공기 질 평가)

  • Kim, Won-Taek;Shin, Yong-Chul;Kang, Dong-Mug;Ki, Yong-Kan;Kim, Dong-Won;Kwon, Byung-Hyun
    • Radiation Oncology Journal
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    • v.23 no.4
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    • pp.243-252
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    • 2005
  • Purpose: Indoor air quality (IAQ) in the radiation treatment center which is generally located underground is important to the health of hospital workers and patients treated over a long period of time. this study was conducted to measure and analyze the factors related to IAQ and subjective symptoms of sick building syndrome, and to establish the causes influencing IAQ and find a solution to the problems. Methods and Materials : Self administrated questionnaire was conducted to check the workers' symptoms and understanding of the work environment. Based on a preliminary investigation, the factors related to IAQ such as temperature, humidity, fine particulate. carbon dioxide, carbon monoxide, formaldehyde, total volatile organic compounds (TVOC), and radon gas were selected and measured for a certain period of time in specific sites where hospital workers stay long in a day. And we also evaluated the surrounding environment and the efficiency of the ventilating system simultaneously, and measured the same factors at the first floor (outdoor) to compare with outdoor all quality, All collected data were assessed by the recommended standard for IAQ of the domestic and international environmental organizations. Results: Hospital workers were discontented with foul odors, humidity and particulate. They complained symptoms related to musculo-skeletal system, neurologic system, and mucosal-irritatation. Most of the factors were not greater than the recommended standard, but the level of TVOC was third or fourth times as much as the measuring level of some offices in the United States. The frequency and the amount of the ventilating system were adequate, however, the problem arising in the position of outdoor-air inlets and indoor-air outlets involved a risk of the indraft of contaminated air. A careful attention was a requirement in handling and keeping chemical substances including a developing solution which has a risk of TVOC emissions, and repositioning the ventilating system was needed to solve the contaminated-air circulation immediately Conclusion We verified that some IAQ-related factors and inadequate ventilating system could cause subjective symptoms in hospital workers. The evaluation of IAQ was surely needed to improve the underground working environments for hospital workers and patients. On the basis of these data, from now on, we should actively engage in designs of the department of radiation oncology or improvement in environments of the existing facilities.

A Study on the In-Vitro Test of Thrombogenesis in Centrifugal Biopump (원심성 바이오 펌프를 이용한 혈전 생성의 생체 외 검사에 관한 연구)

  • Na, Myung-Hoon;Kim, Won-Gon;Kim, Joo-Hyun;Kim, Mee-Hyung;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.863-873
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    • 1999
  • 배경: 혈전 생성은 심혈관계 삽입물이나 순환 보조장치의 발전에 있어서 중요한 문제이므로 이러한 장치들의 혈전성에 대한 평가는 필수적이다. 따라서 이러한 장치들의 혈전성 연구를 시행하기 위한 효과적인 생체 외 실험 방식이 개발되어 원심성 순환 펌프의 발전에 큰 도움이 되고 있으며, 최근 엄밀하게 혈액과 공기의 접촉을 차단하는 방식이 믿을 수 있는 생체 외 실험 방식으로 강조되고 있다. 본 논문에서는 모의 순환 회로를 이용하여 기존에 행해진 연구 방법 상의 공기 접촉에 따른 핼액 응고 기전의 활성화 여부를 알아보기 위하여 공기 접촉 여부에 따른 혈액 인자의 변화를 관찰하여 확인하고, 또한 회로 내에서 생성된 혈전을 생체 내에서 형성된 혈전과 비교 분석하여 이 모의 순환 회로를 이용한 생체 외 검사가 새로 고안된 심혈관계 장치들의 혈전성을 평가하는데 있어서 동물실험을 대신할 수 있다는 기존의 주장을 검증하고자 하였다. 연구재료 및 방법: 바이오펌프를 이용한 같은 모의 순환 회로 한 쌍을 준비하고 동일 개체에서 얻은 헤파린을 첨가한(1u/$m\ell$) 신선한 혈액을 공기와 접촉시키지 않도록 한 A-회로와 공기와 접촉시킨 B-회로에 충전시켜 실험을 동시에 진행하여 결과를 얻었으며 총 12번 시행하였다. 회로에 충전한 혈액의 activated clotting time(ACT)은 정상의 3~5배였으며 ACT가 정상 범위의 1.5배가되면 실험을 끝냈고, Hematocrit(HCT), 혈소판, 동맥혈가스분석(ABGA), factor Ⅷ, factor \ulcorner, 섬유소원, thromboxane B2(TXB2), free hemoglobin(fHb) 등을 측정하였다. 실험이 끝난 후 A-회로와 B-회로에서 얻은 각 검사를 평가하고 분석하였으며 생성된 혈전을 생체 내에서 생성된 혈전과 조직 검사로 비교하였다. 본 연구의 자료분석은 SPSS 통계 프로그램을 이용하였고 유의수준 0.05를 기준으로 유의도를 판단하였다. 결과: 정상 ACT는 186.9$\pm$20.5초(평균$\pm$표준편차)이었고, 헤파린을 넣은 초기 ACT는 982.2$\pm$165.5초이었으며, 실험시간은 보통 60분에서 180분 사이였다. HCT, fHb, 혈소판, TXB2, factor Ⅷ, factor \ulcorner, 섬유원소의 초기값은 35.5$\pm$3.2%, 12.4$\pm$6.5 mg/dL, 354$\pm$56($\times$103)/$\mu$L, 72.6$\pm$15.1 mg/dL, 29.3$\pm$1.2%, 137.9$\pm$42.1 mg/dL, 그리고 17.7$\pm$9.7%이었다. 공기 접촉에 따른 차이를 보았을 때 ACT(p=0.398), HCT(p=0.988), fHb(p=0.898), 혈소판 (p=0.904), TXB2(p=0.985), factor Ⅷ(p=0.872), factor \ulcorner(p=0.489), 섬유원소(p=0.973)으로 전 예에서 통계적 유의성이 없었다. 실험 후 양 군에서 생성된 혈전의 현미경 소견은 B-회로의 혈전에 여러 군데 공기 방울이 관찰되는 것 이외에 A-회로에서 생성된 혈전과 차이가 없었고, 생체에서 생성된 혈전과 비교했을 때 그 양상이 같았다. A-회로와 B-회로에서 생성된 혈전의 총 량은 8.4$\pm$3.7 mL와 9.4$\pm$3.1 mL로 통계상 유의성은 없었다. (p=0.624). 결론: 모의 순환 회로를 이용한 혈전성 평가를 위한 생체 외 실험에 있어서 공기와의 접촉 여부는 혈액 응고 기전의 활성화나 혈전 생성에 별다른 영향을 미치지 않는다. 모의 순환 회로에서 형성된 혈전과 문헌에 있는 인체 내에서 형성된 혈전을 비교한 결과 그 형태가 일치하므로 이 모의 순환회로를 이용한 실험이 동물실험을 대신할 수 있다고 판단된다.

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Establishment of Valve Replacement Registry and Risk Factor Analysis Based on Database Application Program (데이터베이스 프로그램에 기반한 심장판막 치환수술 환자의 레지스트리 확립 및 위험인자 분석)

  • Kim, Kyung-Hwan;Lee, Jae-Ik;Lim, Cheong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.209-216
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    • 2002
  • Background: Valvular heart disease is still the most common health problem in Korea. By the end of the year 1999, there has been 94,586 cases of open heart surgery since the first case in 1958. Among them, 36,247 cases were acquired heart diseases and 20,704 of those had valvular heart disease. But there was no database system and every surgeon and physician had great difficulties in analysing and utilizing those tremendous medical resources. Therefore, we developed a valve registry database program and utilize it for risk factor analysis and so on. Material and Method: Personal computer-based multiuser database program was created using Microsoft AccessTM. That consisted of relational database structure with fine-tuned compact field variables and server-client architecture. Simple graphic user interface showed easy-to-use accessability and comprehensibility. User-oriented modular structure enabled easier modification through native AccessTM functions. Infinite application of query function aided users to extract, summarize, analyse and report the study result promptly. Result: About three-thousand cases of valve replacement procedure were performed in our hospital from 1968 to 1999. Total number of prosthesis replaced was 3,700. The numbers of cases for mitral, aortic and tricuspid valve replacement were 1600, 584, 76, respectively. Among them, 700 patients received prosthesis in more than two positions. Bioprosthesis or mechanical prosthesis were used in 1,280 and 1,500 patients respectively Redo valve replacements were performed in 460 patients totally and 40 patients annually Conclusion: Database program for registry of valvular heart disease was successfully developed and used in personal computer-based multiuser environment. This revealed promising results and perspectives in database management and utilization system.

Association of Hypercapnia in the First Week of Life with Severe Intraventricular Hemorrhage in the Ventilated Preterm Infants (기계적 환기 요법을 시행 받은 미숙아에서 고탄산혈증과 뇌실내 출혈의 발생과의 관계)

  • Kim, Jeong-Eun;Namgung, Ran;Park, Min-Soo;Park, Kook-In;Lee, Chul;Kim, Myung-Jun
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.34-43
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    • 2010
  • Purpose : The aim of this study was to examine whether hypercapnia during the first seven days of life was associated with severe intraventricular hemorrhage (IVH) in preterm infants requiring mechanical ventilation. Methods : A matched pair analysis was performed for 19 preterm infants with severe IVH(grade$\geq$3) and 38 infants with no severe IVH (normal or grade 1), who required mechanical ventilation for more than seven days. The univariate and multivariate analysis of severe IVH with maximal and minimal $PaCO_2$, averag $PaCO_2$, SD of $PaCO_2$, and difference in the $PaCO_2$ were assessed. The major perinatal factors and maximal ventilator index (VI) were also compared. Results : Infants with severe IVH had a higher maximal $PaCO_2$ (86.1$\pm$18.4 mmHg vs. 60.1$\pm$ 11.6 mmHg, P <0.001) and mean $PaCO_2$ (47.5$\pm$5.6 mmHg vs. 41.2$\pm$6.3 mmHg, P=0.004) and a larger SD or difference in $PaCO_2$ (14.0$\pm$4.4 mmHg vs. 9.0$\pm$2.4 mmHg; 60.3$\pm$20.9 mmHg vs. 35.5$\pm$11.8 mmHg, P <0.001). However the minimal $PaCO_2$ values did not differ between the groups. Disseminated intravascular coagulation, pulmonary hemorrhage, and the air leak syndrome were more frequent in the IVH group than in the controls. The maximal VI on each day was higher in the IVH group. The multivariate logistic regression analysis after controlling for bleeding tendency showed that the air leak syndrome, maximal VI, and maximal $PaCO_2$ were independently associated with severe IVH [OR, 1.324 (95% CI, 1.011-1.733; P=0.041)]. Conclusion : Extreme hypercapnia was significantly associated with severe IVH in preterm infants, after adjustment for major perinatal risk factors. Frequent monitoring of the $PaCO_2$ may be important for early detection of inadvertent hypercapnia and prompt correction of high PaCOS levels.

The Influence of Nutrients Addition on Phytoplankton Communities Between Spring and Summer Season in Gwangyang Bay, Korea (광양만에서 춘계와 하계 영양염류 첨가가 식물플랑크톤군집의 성장에 미치는 영향)

  • Bae, Si Woo;Kim, Dongseon;choi, Hyun-Woo;Kim, Young Ok;Moon, Chang Ho;Baek, Seung Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.19 no.1
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    • pp.53-65
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    • 2014
  • In order to estimate the effect of nutrients addition for phytoplankton growth and community compositons in spring and summer season, we investigated the abiotic and biotic factors of surface and bottom waters at 20 stations of inner and offshore areas in Gwangyang Bay, Korea. Nutrient additional experiments were also conducted to identify any additional nutrient effects on phytoplankton assemblage using the surface water for the assay. Bacillariophyceae occupied more than 90% of total phytoplankton assembleges. Of these, diatom Eucampia zodiacus and Skeletonema costatum-like species was mainly dominated in spring and summer, respectively. Here, we can offer the season why the two diatom population densities were maintained at high levels in both seasons. First, light transparency of spring season in the euphotic zone was greatly improved in the bay. This improvement is one of important factor as tigger of increase in E. zodiacus population. Second, low salinity and high nutrient sources supplied by Seomjin River discharge are a main cue for strong bottom-up effects on S. costatum-like species during the summer rainy season. Based on the algal bio-assays, although maximum growth rate of phytoplankton communities at inner bay (St.8) were similar to those of outer bay (St.20), half-saturation constant ($K_s$) for phosphate at outer bay was slightly lower than those of inner bay. This implied that adapted cells in low nutrient condition of outer bay may have enough grown even the low phosphate and they also have a competitive advantage against other algal species under low nutrient condition. In particular, efficiency of N (+) addition in summer season was higher compared to control and P added experiments. In the bay, silicon was not a major limiting factor for phytoplankton growth, whereas nitrogen (N) was considered as a limiting factor during spring and summer. Therefore, a sufficient silicate supply form water mixing Si recycled from diatom decomposition and river water is favorable form maintaining diatom ecosystems in Gwangyang Bay.

Analysis of Domestic Water Consuming Pattern and Metered Water Use (생활용수 소비패턴 및 실사용량 분석)

  • Kim, Ju Hwan;Cho, Im Young;Park, Noh Heuk;Woo, Hyoung Min;Ahn, Hyo Won
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.1310-1315
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    • 2004
  • 용수수요 추정의 기본은 수도계획에 사용할 수 있는 실사용량에 대한 조사로 이에 대한 자료가 거의 없기 때문에 각 수도사업별로 제시되는 추정방법이 조금씩 상이하며, 추정방법의 진위를 가릴 수 없이 수요추정의 악순환을 초래하고 있는 실정이다. 기존 물사용량 예측은 급수량 기준의 도시 전체에 내한 평균 LPCD를 이용함에 따라 물사용 특성을 충분히 고려찬 수 없어 지역별 실제 물사용량과 큰 오차가 유발되었다. 그러므로 수도계획 및 설계에 사용할 수 있는 신뢰성 있는 설계인자를 도출하기가 불가능하여 물수요 관리정책 수립, 수도요금체계 조정 및 누수방지계획 수립 등 경제적인 수도시설의 건설에 애로를 겪고 있다. 본 연구에서는 생활용수 중 가정용수에 대하여 세탁기, 변기, 싱크대 등 수도전에 유량계를 설치 실제 가정에서 사용하고 있는 용도별 사용량을 실측, 파악하였으며, 이로부터 얻은 용도별 사용량에 대한 기간별 소비특성을 분석하였다. 이로부터 생활용수 사용량의 소비패턴 및 시간대별 부하율 산정이 가능하며, 각종 용도별 사용수량의 소비형태를 찾아낼 수 있었다. 또한 가정용수 중 용도별 물 사용비율은 세탁용수, 변기, 주방, 목욕용수의 순으로 나타났으며 주택유형별로는 아파트 연립주택, 다세대 주택, 단독주택의 순으로 단독주택에서의 물사용량이 가장 적게 나타났다. 생활용수 공급량에 내해서는 시간별, 주별, 월별 그리고 계절변동 총량을 파악하였으며 시간대별로는 오후 3시경이 최대 소비량을 보였고, 주별로는 월요일 그리고 월별로는 7월의 용수사용량이 가장 큰 것으로 조사 되었다. 본 연구로부터 도출된 용도별 실측 물사용량 자료 및 분석결과로부터, 지금까지 공급량 기준의 계획수립이 이루어져왔던 파종 수도시설 규모결정시 합리적인 용수수요예측 및 수요관리가 이루어질 수 있을 것으로 판단되며, 용수수요의 과다예측 오해 해소 등 경제적, 과학적 물관리 정책수립을 위한 기초자료를 제공할 수 있을 것으로 기대된다.는 경제적인 방법이 될 수 있다. 하천수 등의 상호 관계 분석을 통해 장기간의 유역 물순환체계 변화를 분석할 수 있었다.골풀과, 닭의장풀과가 각 1종씩으로, 조사지점( I )보다 좀 더 많은 종이 분포하는 것으로 조사되었다. 또한 어류는 조사지점( I )에서 3회에 걸쳐 총 396개체가 채집되어 3목 8과 21종이었다. 이 중 한국 고유종은 11종이었고, 외래 어종은 검정우럭과 2종이 조사되었으며, Zacco platypus(피라미), Zacco temmincki(갈겨니), Acheilongnathus koreanus(칼납자루), Odontobutis platycephala(동사리), Coreoleuciscus splendidus(쉬리) 순으로 분포하고 있었고, Acheilognathus signifer(묵납자루)는 댐 건설 전에는 많이 분포하였으나 현장조사에서 서식을 확인 할 수 언어 개체수의 큰 감소내지 멸종된 것으로 추정되었다.에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히 교사들이 중요하게 인식하는 해방적 행동에 대한 목표를 강조하여 적용할 필요가 있음을 시사하고 있다.교하여 유의한 차이가 관찰되지 않았다. 또한 HSP 환자군에서도 $IL1RN^{*}2$ allele 빈도와 carriage rat

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