Purpose: Pulmonary underdevelopment is one of the pulmonary causes of neonatal mortality, which is categorized into pulmonary agenesis, pulmonary aplasia, and pulmonary hypoplasia. Congenital diaphragmatic hernia is a well-known cause of pulmonary hypoplasia; however, further studies are needed for other etiologies. Patients with pulmonary underdevelopment show varying degrees of clinical severity. Most patients with pulmonary underdevelopment have respiratory distress at birth, while a few have only mild symptoms. Our study investigated the natural course and prognosis of pulmonary underdevelopment by analyzing multiple cases from a single tertiary medical center. Methods: A retrospective review was conducted on patients diagnosed with pulmonary hypoplasia and agenesis from January 2000 to August 2019. Cases were extracted from the clinical database of Seoul National University Children's Hospital by searching for keywords related to pulmonary underdevelopment. Results: A total of 28 patients were identified. Four patients had pulmonary agenesis, and all were idiopathic. Twenty-four patients had evidence of pulmonary hypoplasia with diverse causes. The median age at diagnosis was 11.5 days (range, 1-240 days) and the mean gestational age was 35 weeks 2 days± 3 weeks 6 days. Twenty patients received ventilator care and 11 had various degrees of pulmonary hypertension. The long-term survival rate was 50%. The median age of death among pulmonary hypoplasia patients were 11 days (range, 1-730 days). All patients without ventilator care survived. The incidence of ventilator care, pneumothorax, and pulmonary hypertension were significantly higher among patients who died. Conclusion:The prognosis of pulmonary underdevelopment depends on the severity of respiratory distress and pulmonary hypertension in earlier life. Patients with severe distress appear to have severe degree of pulmonary hypoplasia. Patients without ventilator support in the neonatal period survived without significant morbidities.

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The production of highly concentrated PM10 is in the spotlight as a social issue, and it increases the attack rate of Asthma. This study aimed to analyze the characteristics of concentration and distribution for PM10 from 2000 to 2011, and investigate its correlation with the death from Asthma. Furthermore, this study was designed to analyze it by dividing into two cases like including Asian dust and excluding Asian dust because it presented the high concentration when Asian dust was occurred in the spring. This study has found that the annual average concentration distribution of PM10 in Seoul was higher in the central area than the peripheral area. The annual average concentration of PM10 and death from asthma displayed the tendency to gradually decrease. The correlation coefficient for all period was 0.92(p=0.000), and the correlation was 0.84(p=0.001) in case of remove Asian dust. The monthly average concentration of PM10 has increased in the winter and decreased in the summer. The death from Asthma and correlation coefficient for all period was 0.588(p=0.044) and 0.640(p=0.025) in case of removing Asian dust. Although the causes of Asthma had a great diversity, the similar tendency by a factor of PM10 meant that the correlation was high.

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