• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.484-489
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• 2003

Purpose : To understand morphologic and hemodynamic variations in patients with pulmonary atresia with intact ventricular septum(PA/IVS), and to decide the best treatment modalities, we measured right ventricular volume, inflow, and outflow valvular annulus size in these patients and compared them with those of normal newborns. Methods : Eight patients with PA/IVS diagnosed by echocardiography from January to December 2001 were enrolled in this study. Among the total eight patients, five were male and three were female. The mean age of patients was 6.9 days(1-34 days), and the mean body weight was 3,343 gm (2,970-4,000 gm). Ten fullterm newborn infants with sepsis or hyperbilirubinemia without heart disease were enrolled as a control group. Echocardiographic and Doppler studies using Acuson Aspen (7Mh probe) were recorded on super-VHS videotape and later on, with review mode. We measured volumes of right and left ventricles, aortic, pulmonic, mitral and tricuspid valvular annulus sizes using an installed program, and then these parameters were compared with those of the control group. Results : Mean Z-value of tricuspid valvular annulus in PA/IVS was $-3.69{\pm}2.80$(-8.4--0.45), and tricuspid/mitral valvular annulus size ratio $0.68{\pm}0.15$(0.43--0.84). The more the tricuspid/mitral valvular annulus size ratio, the more Z-value of tricuspid valvular annulus(P=0.003, r=0.885). Those patients who underwent pulmonary valvuloplasty(balloon or surgical) had a tendency toward larger volume of the right ventricle, more Z-value of pulmonic and tricuspid valvular annulus, and more tricuspid/mitral valvular annulus size ratio than those patients who underwent a shunt operation. Conclusion : Compared to a measurement of the volume of the right ventricle, measurements of tricuspid/mitral valvular annulus size ratio and Z-value of tricuspid valvular annulus may be easier and better parameters to decide the treatment method and to predict prognosis in PA/IVS patients.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.50-56
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• 1999

Background : Pleural effusion is a common clinical problem and many clinical and laboratory evaluations, such as tumor marks, have been studied to discriminate malignant pleural fluid from benign pleural fluid. However their usefulness in the diagnosis of pleural effusion is still not established fully. We studied the diagnostic value of cyfra 21-1 in diagnosis of malignant pleural effusion. Methods: Pleural fluid was obtained from 45 patients with malignant diseases(32 lung cancer patients, 13 metastatic malignant diseases) and 47 patients with benign diseases. The level of cyfra 21-1 in the pleural fluid and serum were determined using a CYFRA 21-1 enzyme immunoassay kit(Cis-Bio International Co.). The t-test was used for comparison between two diseases groups and receiver operating characteristic(ROC) curves were constructed by calculating the sensitivities and specificities of the cyfra 21-1 at several points to determine the diagnostic accuracy of the cyfra 21-1. Results: In patients with primary lung cancer, the level of cyfra 21-1 in the pleural fluid was significantly higher than those of patients with benign diseases and had positive correlations between the level of cyfra 21-1 in the pleural fluid and serum levels. In the ROC curve analysis of the pleural fluid, the curve for primary lung cancer group was located closer to the left upper comer and the cut off value, sensitivity and specificity of the cyfra 21-1 of the primary lung cancer group was determined as 22.25ng/ml, 81.8% and 78.7% respectively. Conclusions: Our data indicates that the measurement of cyfra 21-1 level in pleural effusion has useful diagnostic value to discriminate malignant pleural effusion in primary lung cancer from benign pleural effusion.

• Clinical and Experimental Pediatrics
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• v.52 no.12
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• pp.1364-1369
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• 2009

Purpose : To analyze abnormal ventricular activation in childhood congenital heart disease induced by postoperative changes in ventricular volume and pressure and ventricular scar formation using signal-averaged electrocardiography (SAECG). Methods : Fifty-two patients who had undergone open heart surgery (OHS) were enrolled. Patients were divided into the following 3 groups: right ventricular volume overload (atrial septal defect, group1), left ventricular volume overload (ventricular septal defect, group2), and right ventricular pressure overload (tetralogy of Fallot, group 3). The patients were monitored by standard 12-lead ECG and SAECG before and 2 months after the operation. QRS duration, QT and QTc intervals, filtered QRS (f-QRS), high frequency low amplitude potential (HFLA), and root mean square (RMS) voltage in the terminal 40 ms of SAECG were determined. Results : In the preoperative period, group1 showed significant increase in QRS (P=0.011) compared to those of the other 2 groups. In the postoperative period, group3 showed significant increase in the QTc interval (P=0.004) compared to those in the other 2 groups. SAECG parameters showed no significant differences among the groups in the pre- or postoperative period. Of the 52 patients, 12 (23%) in the preoperative period and 21 (40%) in the postoperative period had at least 1 SAECG abnormality. The prevalence of SAECG abnormalities was significantly higher in the postoperative group 2 and group 3 (preoperative: 20% versus postoperative: 28%, P<0.001, preoperative: 14% versus postoperative: 64%, P<0.001, respectively). Conclusion : Abnormal SAECG patterns may be attributed to postoperative scars, OHS itself, and/or ventricular overload.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.194-198
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• 2009

Purpose : Active perioperative intervention and improvement on surgical technique has decreased the mortality rate of total anomalous pulmonary venous connection (TAPVC); however, when complicated with pulmonary venous obstruction, operative mortality is still high. The purpose of this study was to investigate the clinical course of TAPVC. Methods : Twenty-seven patients who were diagnosed with TAPVC (without other complex heart anomalies) by echocardiogram at Kyungpook National University Hospital from January 1994 to February 2008 were included. Results : Mean age at diagnosis was $28.1{\pm}33.4$ days (1-126 days). Sites of drainage were supracardiac type (15), cardiac (6), infracardiac (5), and mixed (1). Seven patients had pulmonary venous obstruction: 5 with supracardiac type, 1 with cardiac, and 1 with infracardiac. Intraoperative trans-esophageal echocardiograms were performed in 14 patients (58.3%). The operative mortality was 16.7% (4 of 24) and overall hospital mortality (including deaths without operation) was 22.2% (6 of 27). There were 5 postoperative pulmonary venous obstructions. The sites of obstruction were anastomotic in 3 of 5 (60%) patients, and ostial pulmonary vein in the other 2 (40%) patients. Three patients who presented with anastomotic pulmonary venous obstruction underwent reoperation, but all the patients were found to have pulmonary venous anastomotic obstruction. The other 2 patients with ostial pulmonary vein obstruction who had no significant symptoms were diagnosed by routine echocardiographic examination during follow-up. Conclusion : In TAPVC patients, early diagnosis and aggressive surgical management will improve prognosis, and we must pay attention to early and late pulmonary vein restenosis through intraoperative trans-esophageal echocardiogram and peri- and post-operative echocardiographic follow-up examinations.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.519-524
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• 2010

Purpose : To determine the efficacy of the N-terminal fragment of B-type natriuretic peptide (NT-proBNP) as a useful diagnostic method in children with incomplete Kawasaki disease (KD). Methods : Ninety-six patients who were diagnosed as having KD between January 2008 and June 2009 were enrolled in the study. American Heart Association recommendations for diagnosis were used, and patients were divided into the complete KD and incomplete KD groups. Blood tests including NT-proBNP were performed on admission day. Nineteen patients who had other febrile diseases other than KD were enrolled as control. Results : Thirty-three patients (34%) had incomplete KD. Change in the lips and oral cavity and conjunctivitis were the most common clinical features, but their frequency was lower than complete KD (76% vs 98%, 76% vs 90%). Patients with incomplete KD exhibited significantly higher NT-proBNP level than that of control ($1,407.7{\pm}1633.5pg/mL$ vs $126.2{\pm}135.5pg/mL$, $P$<0.001). An NT-proBNP cutoff value of 158 pg/mL provided a sensitivity of 81% and a specificity of 74% for diagnosis of incomplete KD. Conclusion : NT-proBNP assay can be clinically useful for the diagnosis of incomplete KD, if the patient has persistent fever, change in the lips and oral cavity, and conjunctivitis, and if the patient with those symptoms is suspected to have incomplete KD.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.154-165
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• 1991

To establish the hematological reference values in the healthy adults visited our hospitals, following examination were done on 2823 persons by Coulter Counter Model S-plus II ; white blood cell count: (WBC), red blood cell count(RBC), hemoglobin(Hb), hematocrit(Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), red cell distribution width(RDW), platelet, plateletcrit, mean platelet volume(MPV) and platelet distribution width(PDW). The following results are obtained. 1) Male, mean value of WBC ; $6,800{\pm}2,680(2SD)/{\mu}l$ Female, mean value of WBC ; $5,950{\pm}2,380(2SD)/{\mu}l$ 2) Male, mean value of RBC ; $428{\pm}60(2SD){\times}10^4/{\mu}l$ Female, mean value of WBC ; $415{\pm}56(2SD){\times}10^4/{\mu}l$ 3) Male, mean value of Hb ; $15.4{\pm}1.8(2SD)g/dL$ Female, mean value of Hb ; $13.0{\pm}1.6(2SD)g/dL$ 4) Male, mean value of Hct ; $45.3{\pm}5.0(2SD)%$ Female, mean value of Hct ; $38.2{\pm}4.6(2SD)%$ 5) Male, mean value of MCV ; $93.8{\pm}5.8(2SD)fL$ Female, mean value of MCV ; $92.2{\pm}7.4(2SD)fL$ 6) Male, mean value of MCH ; $31.8{\pm}2.2(250)pg$ Female, mean value of MCH ; $31.4{\pm}2.8(2SD)pg$ 7) Male, mean value of MCHC ; $34.0{\pm}1.2(2SD)%$ Female, mean value of MCHC ; $33.9{\pm}1.2(2SD)%$ 8) Male, mean value of RDW ; $12.7{\pm}1.0(2SD)%$ Female, mean value of RDW ; $12.6{\pm}1.4(2SD)%$ 9) Male, mean value of Platelet ; $242.9{\pm}87.8(2SD){\times}10^3/{\mu}l$ Female, mean value of Platelet ; $242.2{\pm}89.0(2SD){\times}10^3/{\mu}l$ 10) Male, mean value of Plateletcrit ; $0.201{\pm}0.076(2SD)%$ Female, mean value of Plateletcrit ; $0.204{\pm}0.076(2SD)%$ 11) Male, mean value of MPV ; $8.20{\pm}1.70(2SD)fl$ Female, mean value of MPV ; $8.36{\pm}1.82(2SD)fl$ 12) Male, mean value of PDW ; $16.1{\pm}0.8(2SD)%$ Female, mean value of PDW ; $16.0{\pm}0.8(2SD)%$.

• The Journal of Natural Sciences
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• v.10 no.1
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• pp.209-216
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• 1998

The results of the study of diving the 21st century's Korea fashion market into consumer market, fashion market, and a new marketing strategy are as follows. The 21st consumer market is First, a fashion democracy phenomenon. As many people try to leave unconditional fashion following, consumer show a phenomenon to choose and create their own fashion by subjective judgements. Second, a phenomenon of total fashion pursuit. Consumer in the future are likely to put their goals not in differentiating small item products, but considering various fashion elements based on their individuality and sense of value. Third, world quality-oriented. With the improvement of life level, it accomplishes to emphasize consumers' fashion mind on the world wide popular use of materials, quality, design and brand image. Fourth, with the entrance of neo-rationalism, consumers show increasing trends to emphasize wisdom, solidity in goods strategy pursuing high quality fashion and to demand resonable prices. Fifth, concept-oriented. Consumers are changing into pursuing concept appropriate to individual life scene. Prospecting the composition of the 21st century's fashion market, First, sportive casual zone will draw attention more than any other zone. This is because interest in sports will grow according to the increase of leisure time and the expasion of time and space in the 21st century, and also ecology will become the important issue of sports sense because of human beings's natural habit toward nature. Second, the down aging phenomenon will accelerate its speed as a big trend. Third, a retro phenomenon, a concept contrary to digital and high-tech, will become another big trend for its remake, antique, and classic concept in fashion market with ecology trend. New marketing strategy to cope with changing fashion market is as follows. First, with the trend of borderless concept, borders between apparels are becoming vague, for example, they offer custom-made products to consumers. Second, as more enterprises take the way of gorilla and guerrilla where guerrillas who aim at niche market show up will develop. Basically, they think highly of individual creative study, and pursue the scene adherence with high sensitiveness. However this polarization becomes mutually-supplementing relationship showing gorilla's guerilla movement, and guerilla's gorilla high-tech. Third with the development of value retailing, enterprises pursuing mass merchandising of groups called category killers are expanded and amplified to new product fields, and expand business' share. Fourth, using outsourcing, the trend to use exterior function leaving each enterprise's strength by inspecting its own work is gradually strong. Fifth, with the expansion of none store sale, the entrance of the internet and the CD-ROM sales added to communication sales such as catalogues are specified. An eminent American think tank expect that 5-5% of the total sale of clothes and home goods in 2010 will be done by none store sale. Accordingly, to overcome the problems, First international, global level marketing, Second, the improvement of technology, Third, knowledge-creating marketing are needed.

• Journal of Preventive Medicine and Public Health
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• v.25 no.2 s.38
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• pp.127-140
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• 1992

This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at $-20^{\circ}C$ in polypropylene tubes further copper and zinc analysis. Mean of serum coppper levels was $91.97{\pm}4.76{\mu}g/dl$ in control, $106.21{\pm}2.73{\mu}g/dl$ in cirrhosis and $127.05{\pm}0.77{\mu}g/dl$ in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were $110.82{\pm}7.24{\mu}g/dl$ in control, $68.10{\pm}5.43{\mu}g/dl$ in cirrhosis and $63.78{\pm}2.20{\mu}g/dl$ in HCC. The values of cirrhosis and HCC were statistically significantly lower than that of control(p<0.05). The Cu/Zn ratio was statiatically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistical significance on the cirrhosis and the HCC, but that of serum sinc was statistically significant as 0.951 and 0.952(p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. H\Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of 'grouped' cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.