• Clinical and Experimental Pediatrics
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• v.48 no.12
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• pp.1362-1369
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• 2005

Purpose : This study aimed to investigate the correlation between the plasma level of N-terminal pro-B-type natriuretic peptide(pro-BNP) and several known risk factors influencing outcomes after Fontan operations, and to assess whether pro-BNP levels can be used as predictive risk factors in Fontan operations. Methods : Plasma pro-BNP concentrations were measured in 35 patients with complex cardiac anomalies before catheterization. Cardiac catheterization was performed in all subjects. Mean right atrium pressure, mean pulmonary artery pressure(PAP), and ventricular end-diastolic pressure(EDP) were obtained. Cardiac output and pulmonary vascular resistance were calculated by Fick method. Results : Plasma pro-BNP levels exhibited statistically significant positive correlations with mean PAP(r=0.70, P<0.001), pulmonary vascular resistance(r=0.57, P<0.001), RVEDP(r=0.63, P<0.001), LVEDP(r=0.74, P<0.001), and cardiothoracic ratio(r=0.71, P<0.001). The area under the ROC curve using pro-BNP level to differentiate risk groups in Fontan operations was high : 0.868(95 percent CI, 0.712-1.023, P<0.01). The cutoff value of pro-BNP concentrations for the detection of risk groups in Fontan operations was determined to be 332.4 pg/mL(sensitivity 83.3 percent, specificity 82.7 percent). Conclusion : These data suggest that plasma pro-BNP levels may be used as a predictive risk factor in Fontan operations, and as a guide to determine the mode of therapy during follow-up after Fontan operations.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.870-872
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• 2005

Bronchogenic cysts are anomalous cystic lesions of foregut and usually located in the lung or mediastinum. Generally intramuscular cysts of the esophagus are considered as enterogenous foregut malformations. We report a young adult with an intramural bronchogenic cyst causing dysphagia and heartburn. It was located in the muscular layer of the esophagus and was removed without any damage to the mucosa. Histopathologic findings revealed that it was a bronchogenic cyst.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.707-710
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• 2004

Bridging bronchus (BB) is an extremely rare tracheobronchial anomaly. This anomaly is often associated with a sling left pulmonary artery (SLPA) and is diagnosed in infancy or at autopsy. A 29-year-old female patient with previous history of pulmonary tuberculosis was admitted because of persistent fever, cough and sputum. Fiberoptic bronchoscope and chest computed tomography revealed a bridging bronchus and associated atelectasis. The right middle and lower lobe was supplied by a bronchus which originates from the left main bronchus and bridges the mediastinum. There was no anomaly of a left pulmonary artery. Right middle and lower bilobectomy was performed.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.339-345
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• 2002

Purpose : The purpose of this study was to evaluate the clinical usefulness of chest high-resolution computed tomography(HRCT) in patients with chronic coughs or persistent wheezing with normal chest X-ray finding. Methods : We reviewed the charts, chest X-rays, and HRCT findings of patients with chronic coughs or persistent wheezing of less than 2 years of age. The records were sourced from the Department of Pediatrics, Inha University Hospital covering the period from July, 1999 to June, 2000. Chronic cough was defined as a cough which was prolonged for more than 3 weeks. Results : The sample consisted of 24 patients(male 15 and female 9, mean age $4.7{\pm}3.8$ months old). Among them, 16 patients showed normal findings(66.7%) and 8 patients showed abnormal (33.3%) in simple chest X-rays. Among 16 patients who had the normal chest X-rays, 13 patients showed abnormal chest HRCT findings(81.3%) such as air space consolidation of the dependent portion(62.5%), bronchiolitis obliterans(12.5%), and bronchopulmonary dysplasia(6.3%). Conclusion : We suggest that the chest HRCT is a useful diagnostic tool in the evaluation of patients with chronic cough or persistent wheezing with normal chest X-ray, especially below 2 years of age.

• Korean Journal of Animal Reproduction
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• v.23 no.1
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• pp.63-68
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• 1999

A 4-year old Korean-native cow of third parturition delivered an deformed calf with congenital anasarca and hypoplasia of the extremity at Muan County in Chonnam Province. At parturition, the dam showed amniotic fluid approximately two times more than that at the normal and also occurred severe dystocia. The anomaly died before parturition was 82 cm long and weighed 25 kg. It was difficult to recognize the neck and face of the anomaly due to severe edema and the stretched tongue through mouth was found. The shape of the extremity was recognizable and the systemic hypoplasia of the body with marked edema was found. At necropsy, there was a large amount of serous fluid both in pleural and peritoneal cavity. Also the fluid was contained some of yellowish granular materials and diffusely was fulfilled in all subcutaneous tissue. There was a partial opening in diaphragm which was resulted in the protrusion of approximately half of liver toward peritoneal cavity. There were two kidneys (15${\times}$21 and 13${\times}$18 cm) on the left which were enlarged and relatively larger than the right one (13${\times}$9 cm). In addition, there were found slight to moderate hepatomegaly and splenomegaly with slight congestion, and diffuse edema of intestinal serosa. Lung (32${\times}$49 mm) with marked hypoplasia was smaller than the size of heart (56${\times}$45mm). Serological test to the dam showed relatively high antibody titer (＞64) to Akabane virus which might be involved in the outbreak of the deformed Korean-native calf as one of many causative agents.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.804-808
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• 2002

We report a case of trisomy 22 in a liveborn male infant which was confirmed by fluorescence in situ hybridization(FISH), macrocultures and GTG-banding, and RHA-banding procedures of peripheral white blood cells. The infant showed lung hypoplasia, which is a unique presentation, with other clinical manifestations of previously reported cases of trisomy 22, such as intrauterine growth retardation, cleft palate, micrognathia, large atrial septal defect, limb anomalies, imperforate anus, and hypospadias. Our report gives weight to the previously reported observation that pulmonary hypoplasia may be associated in trisomy 22.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1090-1096
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• 2002

Purpose : We evaluated the clinical manifestations, bronchoscopic findings and therapeutic effects of flexible fiberoptic bronchoscopy in atelectasis of children. Methods : Sixty six children who received bronchoscopy due to persistent atelectasis, acute severe atelectasis and incidental atelectasis on plain chest radiography were studied retrospectively. Results : The most common causative underlying disease was pneumonia(60.4%). Other underlying conditions were pulmonary tuberculosis, chronic lung disease, postoperative state, bronchial asthma and chest trauma. The most common abnormal findings were inflammatory changes such as bronchial stenosis(n=15), mucosal edema and large amount of secretion(n=14), granulation tissue( n=3) and mucus plug(n=3) although 39.4% showed normal airways. Other findings were congenital airway anomalies, endobronchial tuberculosis, extrinsic compression and obstruction by blood clot. In 32 children with pneumonia-associated atelectasis, 43.7% revealed normal airways, and the most common abnormal findings were also inflammatory changes. Eighteen out of 39 patients who received therapeutic intervention such as suctioning of secretion, bronchial washing and intrabronchial administration of N-acetylcysteine($Mucomyst^{(R)}$) had complete or partial resolution of their atelectasis. In 32 patients with pneumonia-associated atelectasis, 56.5% showed improvement by therapeutic intervention. Conclusion : In this study, atelectasis was mainly associated with inflammatory airway diseases such as pneumonia. The most common abnormal bronchoscopic findings were inflammatory changes such as mucosal edema and large amounts of secretion and bronchial stenosis, although about 40% revealed normal airway. Flexible bronchoscopy is helpful for either diagnosis or treatment, especially in pneumonia-associated atelectasis.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1212-1218
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• 2005

Purpose : Forward pulmonary blood flow may be absent in some neonates with Ebstein's anomaly by anatomical or functional pulmonary atresia in association with the elevated pulmonary vascular resistance, patent ductus arteriosus and tricuspid regurgitation. We reviewed the presentation and outcomes of symptomatic neonates with Ebstein's anomaly focusing on the pulmonary atresia. Methods : Clinical presentation and outcome of 15 symptomatic neonates with Ebstein's anomaly seen at Asan medical center from 1998 to 2004 were reviewed. Results : Ten(67%) of 15 patients showed no forward pulmonary blood flow and 6 of them had functional pulmonary atresia. $O_2$ saturation and pH were lower and cardiothoracic(CT) ratio in chest radiography was more increased in the patients with pulmonary atresia than in the patients without pulmonary atresia(P<0.05). pH and CT ratio were not different between the anatomical and functional pulmonary atresia group, but $O_2$ saturation was lower in functional atresia group(P<0.05). 13 patients(87%) were managed with $PGE_1$. 4 of 6 patients with functional pulmonary atresia were treated with inhaled nitric oxide. Surgery was performed in 1 of 5 patients without pulmonary atresia and in 8 of 10 patients with pulmonary atresia during follow-up period(mean 37 months). 3 patients(20%) died and none of patients without pulmonary atresia died. Conclusion : We found that most symptomatic neonates with Ebstein's anomaly had functional or anatomical pulmonary atresia. The neonates with Ebstein's anomaly who had no forward pulmonary blood flow were more symptomatic and needed surgery earlier. Further studies will be needed to distinguish effectively functional and anatomical pulmonary atresia and to manage appropriately neonates with functional atresia.

• Journal of Mushroom
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• v.12 no.1
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• pp.17-23
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• 2014

pH of oriental medicine sludge was 5.3, which was similar to 5.2 of the main ingredient, corncob. Its sugar content, however, was 4.8 mg/g, which was 2.5 times higher than concorb's 1.9 mg/g. According to the addition content analysis of oriental medicine sludge by using blood agar plate, the experimental group showed much more robust growth than the control group. 10% of oriental medicine sludge was added to corncob and pine tree sawdust for test-tube culture. Then they were cultivated at $25^{\circ}C$ for 6 days after inoculating Flammulina velutipes liquid spawn. The control group and experimental group showed 2.2~3.4 and 5.8~6.4 cm hypae growths respectively. At the field test for 10% herbal medicine refuse, mushroom yield dropped by 5% compared to the control group. However, it had distinctively lower number of deformity and the 2nd grade products. An economic analysis was conducted based on the cultivation facility that produces 160,000 mushrooms per day. The analysis demonstrated that the facility can save 50,000,000 won in the starting year and 130,000,000 won in the following years from the unit cost of production excluding labour and operation cost.

• Tuberculosis and Respiratory Diseases
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• v.50 no.6
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• pp.710-717
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• 2001

Two cases of an anomalous systemic arterial supply to the basal segments of the left lower lobe without pulmonary sequestration are presented. In the first case, a preoperative diagnosis was made by chest CT, and confirmed by angiography, in a 22-year old man who had a recurrent hemoptysis. There was systemic arterial supply that originated from the thoracic descending aorta and no pulmonary arterial supply to the basilar segments of the left lower lobe. However, the pulmonary parenchyma was normal without sequestration. Ligation of the abnormal artery and a left lower lobectomy were performed without complications. In the second case, there were characteristic features of this anomaly on chest CT and the angiogram in a 31-year-old man with symptoms of hemoptysis. The patient refused surgery.