• Journal of Chest Surgery
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• v.24 no.3
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• pp.310-321
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• 1991

Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.

• Journal of fish pathology
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• v.28 no.1
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• pp.53-62
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• 2015

Here, we report the physiological changes and growth in disk abalone, Haliotis discus discus, in relation to dietary supplementation with citrus pomace (CP) 6%, Ecklonia cava residue (ECR) 6%, and CP + ECR (3% + 3%). The composition and nutrient content, survival rate and growth rate were measured 0, 4, 8 and 12 weeks after feeding the supplemented diets of CP and/or ECR. Moreover, the experiment of low salinity stress (25psu) for environmental resistance was examined for a period of 48 hours after feeding the supplemented diets for 12 weeks. The activities of superoxide dismutase (SOD), catalase (CAT), lysozymes, respiratory burst, and phenoloxidase were measured. The moisture content and crude protein condition of the body were increased with the addition of ECR only (P<0.05). We observed higher levels of survival in the experimental group compared with the control group. Moreover, the growth disk abalone that were fed a diet containing ECR was higher compared with the control group. However, the growth of abalone fed a diet containing CP was similar to the control group. With a rearing condition of low salinity stress, survival rate and lysozyme activity were increased in the ECR group compared with the control group. Dietary ECR reduced the level of CAT activity to approximately 30% of the control, however the level of CAT activity in the ECR group was similar to the start level of the previous stress. These results suggest that dietary ECR gives rise to an enhanced immunity in disk abalone, as a result of the decrease in CAT and lysozyme activity in particular. Accordingly, the growth and survival rate were increased by feeding an ECR-supplemented diet in the rearing of disk abalone, Haliotis discus discus.

• The Journal of the Korean dental association
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• v.55 no.6
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• pp.400-410
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• 2017

Approximately 30% of adult patients who want orthodontic treatment have transverse discrepancy with insufficient width of the maxilla. Particularly, in Class III patients requiring orthognathic surgery, the frequency of insufficient width of the maxillary arch related to respiratory problems is high. We report a case of non-surgical maxillary expansion using a Hyrax type expander with an orthognathic surgery, based on the reports that the ratio of non-fused midpalatal suture is not high in adults. A 30 years and 2 months old woman with a long face showed an Angle Class III with a vertical growth pattern. Class III molar and canine relation, anterior edge bite, and mandibular incisor compensatory lingual inclination were observed. The posterior buccal overjet seemed to be appropriate, but I diagnosed that there was a transverse discrepancy, for the following reasons. The inter-canine and inter-molar widths were sufficient but excessive lingual inclination of the mandibular molars was observed when assessing the bucco-lingual inclination based on the center of resistance of the maxillary and mandibular first molar. For this reason, it was expected that intercuspal interference would occur during orthodontic decompensation. Therefore, slow maxillary expansion using Hyrax type expander was performed and 2-jaw rotation surgery was performed to improve aesthetic and occlusion. Adults can also improve width discrepancy by non-surgical methods, which can avoid SARPE requiring additional surgery or segmental surgery lacking stability and predictability.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.8.2-8
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• 1979

Acute obstruction of the upper airway from trachea, a foreign body or Iaryngospasm may lead to death in a few minutes. The immediate restoration of an adequate airway in these patients may be lifesaving. Spontaneous respiration by means of a needle inserted into the trachea was studied in 21 rabbits using 16, 18, and 20 gauge extrcatheters. The results are as follows; 1) Airway resistance was markedly increased in all experimental animals. consequently tidal volume was also significantly decreased, but this seems to be compensatory by increased of respiratory frequency in l6G group. 2) Blood gas analysis revealed adequate pulmonary ventilation through the constricted airway (about 1/3 of normal sized trachea) during 60 minutes. In the other hand, hypercarbia, hypoxemia, and metabolic acidosis were developed in the group with severe constriction of the upper airway (about 1/4-1/6 of normal sized trachea). 3) The further study is postulated to confirm the the possibility of application of needle trcheostomy in man, but the rabbits were tolerable to the constricted airway with a small sized needle (l6G) into the trachea for 60 minutes.

• Physical Therapy Rehabilitation Science
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• v.7 no.1
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• pp.18-22
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• 2018

Objective: This study aimed to investigate the effect of different-sized airways of the inspiratory muscle trainer (IMT) on maximal inspiratory pressure (MIP) and the rating of perceived exertion, as measured by the modified Borg scale (m-Borg). Design: Cross-sectional study. Methods: Twenty healthy subjects (10 men, 10 women) volunteered for the study. The spirometry was used to measure MIP. The trial order of the three spirometry conditions was chosen randomly. After measuring the MIP and before taking the final break, each of the conditions were immediately measured using the m-Borg. All subjects used the IMT with an airway diameter of 5-, 6-, and 7-mm. Results: The MIP significantly decreased with the decreasing airway diameter of the IMT (p<0.001), and the differences in all three conditions (7- and 6-mm, 6- and 5-mm, and 7- and 5-mm airways) were significant (p<0.05). The RPE significantly increased with the decreasing airway diameter of the IMT (p<0.001), and the differences in all three conditions (7- and 6-mm, 6- and 5-mm, and 7- and 5-mm airways) were significant (p<0.05). Conclusions: Decreasing the airway diameter of the IMT decreased the MIP and increased the m-Borg. In regards to physical exercise within the clinical setting, the m-Borg could be a useful as a prior monitoring method to prevent dyspnea for patients with narrowed airways (blocked with secretion or sputum in pulmonary disease) and the different-sized airways of the IMT could be applied as a useful tool to improve MIP for prevention of pulmonary disease.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.50-52
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• 2013

Povidone-iodine (PVP-I, Betadine) has many advantages as a disinfectant solution for preoperative preparations, especially for oral surgery. It is widely used because of its low toxicity and excellent bactericidal effect. The authors report a case of pneumonia secondary due to the aspiration of PVP-I, which was used as an oral disinfectant. We present a case of aspiration pneumonia that resulted from the careless use of PVP-I during preoperative preparation. The patient was a 10-month-old female scheduled for elective surgery to correct a complete cleft of secondary palate. During the preparation of the oral cavity for that cleft palate patient, PVP-I was incidentally aspirated to the airway. The lung resistance was noted with positive pressure and pneumonic infiltration on chest radiograph was seen. The operation was postponed and the patient underwent respiratory care. Three months later, elective palatoplasty under general anesthesia was performed without complication. Based on the experiences of this case, the authors advise that throat-packing should be placed before oral preparation to prevent serious pulmonary complications.

• IMMUNE NETWORK
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• v.23 no.4
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• pp.31.1-31.18
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• 2023

Evidence suggests that the human respiratory tract, as with the gastrointestinal tract, has evolved to its current state in association with commensal microbes. However, little is known about how the airway microbiome affects the development of airway immune system. Here, we uncover a previously unidentified mode of interaction between host airway immunity and a unique strain (AIT01) of Staphylococcus epidermidis, a predominant species of the nasal microbiome. Intranasal administration of AIT01 increased the population of neutrophils and monocytes in mouse lungs. The recruitment of these immune cells resulted in the protection of the murine host against infection by Pseudomonas aeruginosa, a pathogenic bacterium. Interestingly, an AIT01-secreted protein identified as GAPDH, a well-known bacterial moonlighting protein, mediated this protective effect. Intranasal delivery of the purified GAPDH conferred significant resistance against other Gram-negative pathogens (Klebsiella pneumoniae and Acinetobacter baumannii) and influenza A virus. Our findings demonstrate the potential of a native nasal microbe and its secretory protein to enhance innate immune defense against airway infections. These results offer a promising preventive measure, particularly relevant in the context of global pandemics.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.191-202
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• 2000

Background: Bronchial asthma is characterized by airway hyperresponsiveness(BHR) and inflammation. The cyclooxygenase(COX) is believed to be one of the important enzymes in these inflammatory reactions. Recently, the COX was divided into two isoforms, COX1 and COX2. COX2 is induced by lipopolysaccharide and some cytokines at the inflammation site. Prostaglandin E2(PGE2), produced from COX2, may affect airway inflammation. The purpose of this study is to evaluate the effect of COX2 inhibitor on COX2 expression, plasma PGE2, airway resistance and histologic finding in an animal asthma model. Methods : Sprague-Dawley rats were divided into 3 groups. The normal control group did not receive any treatment, but the asthma control group was sensitized by ovalbumin but not treated with the COX2 inhibitor(nimesulide, Mesulid$^{(R)}$). The treatment group was sensitized and treated with nimesulide. Specific airway resistance(sRaw) before and after nimesulide ingestion was investigated. The PGE2 level in the plasma was examined and COX2 immunogold-silver stain on lung tissue was performed. Results: sRaw and eosionophilic infiltration on airway, which increased in the asthma control group, was compared to normal control(p=0.014). However, there was no difference in eosinophilic infiltration between asthma control and treatment groups(p=0.408) and no difference in COX2 expression on bronchiolar epithelium among the three groups. Plasma PGE2 levels were not statically different among the three groups. Conclusion: The role of COX2 in the allergen-induced BHR was not significant The effect of nimesulide was not observed on BHR, COX2 expression, and plasma PGE2 level. Therefore, COX2 may not be a major substance of allergic asthma.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.42-54
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• 1992

Background:It has been suggested that the cyclooxygenase metabolites play an important role in changes of early hemodynamic parameters in the endotoxin-induced acute lung injury. But there have been many debates about their role in the late increase of alveolar-capillary permeability, and it is not known whether they act directly or indirectly through oxygen free radicals which have been known to be produced during the metabolic process of cyclooxygenase pathway. So we performed this study to identify the pathogenetic role of cyclooxygenase metabolites in the endotoxin-induced acute lung injury in domestic pigs. Method: We infused endotoxin into 8 domestic pigs; endotoxin only (n=3), and pretreatment with indomethacin (n=5). We observed the sequential changes in hemodynamic parameters, the concentration of plasma oxidized glutathione (GSSG) in pulmonary arterial and venous blood, and albumin content in bronchoalveolar lavage fluid (BALF). Results: 1) While cardiac output decreased, mean pulmonary arterial pressure, pulmonary vascular resistance, and alveolar-arterial oxygen difference increased over phase 1 (0-2hr) and phase 2 (2-4.5hr) by endotoxin, indomethacin attenuated the decrease in cardiac output during phase 1 and increase in mean pulmonary arterial pressure, pulmonary vascular resistance, and alveolar-arterial oxygen difference during both phases. 2) The increase in plasma GSSG content during phase 2 was not attenuated by indomethacin. 3) The content of BALF albumin was significantly lower in indomethacin groups than that of endotoxin group. Conclusion: These results suggest that it is likely that cyclooxygenase metabolites have an effect on endotoxin-induced acute lung injury during both phases probably through direct action.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.618-627
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• 1999

Background : Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy. Usually the RFP resistant M.tuberculosis is also resistant to isoniazid (INH), so the RFP resistance is the marker of multi-drug resistant (MDR) tuberculosis. But unusual cases of mono-RFP-resistant tuberculosis have been recently reported with increasing frequency, especially associated with HIV infection in western countries. Therefore, we conducted a retrospective study to investigate the frequency, causes, and the clinical characteristics of mono-RFP-resistant tuberculosis in Korea. Methods : Of the bacteriologically confirmed and susceptibility-proven 699 pulmonary tuberculosis patients (921 isolates) who visited Asan Medical Center from January 1990 to August 1997, eighteen patients with INH-susceptible and RFP-resistant tuberculosis were evaluated. Previous history of tuberculosis, antituberculous drug compliances, associated systemic illness, drug susceptibility patterns, and clinical outcomes were analysed. And rpoB gene sequencing was done in 6 clinical isolates of M. tuberculosis. Results : The mean age of 18 patients was $43{\pm}14$ years, and the sex ratio is 12:6 (M : F). Sixteen (89%) patients had previous history of tuberculosis. None had diagnosed gastrointestinal disorders, and 2 HIV tests that were performed came out negative. Susceptibility tests were done repeatedly in eleven patients, and six (55%) were mono-RFP resistant repeatedly while five (45%) evolved to MDR tuberculosis. Eight (44%) patients were cured, six (33%) failed, three (17%) were lost to follow-up, and the other one is now on treatment. rpoB gene sequencing showed 5 mutations, codon 531 TCG to TIG mutation in 4 isolates and 526 CAC to TAC in 1 isolate. Conclusion : The clinical characteristics of mono-RFP resistant tuberculosis were similar to that of MDR tuberculosis in Korea where the HIV infection rate is lower than western countries. But some patients with mono-RFP-resistant tuberculous could be cured by primary drug regimens including RFP, suggesting that mono-RFP-resistant tuberculous is a different entity from MDR tuberculosis.