• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.364-369
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• 2009

Purpose : Clinical and laboratory findings predict a severe outcome for mucocutaneous lymph node syndrome. This study aimed to define the clinical characteristics of Kawasaki disease (KD) patients with hyponatremia and to determine the factors associated with its development. Methods : Retrospective studies were performed on 114 KD patients who received an initial high-dose intravenous immunoglobulin (IVIG, single 2 g/kg/dose) within 10 days of fever onset from January 2006 to February 2008. These patients were divided into 2 groups. Group 1 consisted of 30 (26.3%) patients with hyponatremia, and group 2 consisted of 84 (73.6%) patients without hyponatremia. Clinical manifestations, laboratory results, and echocardiographic findings were compared between the groups. Results : Group 1 patients were more likely to have a coronary artery lesion (53.3% versus 20.2%, P=0.005) and suffered from diarrhea (41.3% versus 14.1%, P=0.007). There was a higher incidence of cardiovascular involvement in group 1 patients, including coronary dilatation (46.6%), valvular regurgitation (13.3%), pericardial effusion (6.7%) and medium-sized aneurysm (6.7%). There were no coronary aneurysms in group 2 patients. Serum C-reactive protein (CRP) was significantly higher in patients with hyponatremia ($12.2{\pm}7.79$ mg/dL versus $7.3{\pm}4.7$ mg/dL, P=0.003) and IVIG-resistant patients were more common in group 1 (13.3% versus 3.6%). Conclusion : These results indicate that hyponatremia in KD occurs in patients exhibiting severe inflammation and was significantly associated with the development of coronary disease. Further studies will be necessary to confirm the pathogenic mechanisms of hyponatremia in KD patients.

• 대한예방의학회:학술대회논문집
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• 1998.10b
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• pp.325-326
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• 1998

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.66-81
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• 2021

The coronavirus disease 2019 pandemic has been continuously spreading throughout the world. As of July 15, 2021, there have been more than 188 million confirmed cases and more than 4.06 million deaths. Although the incidence of severe infections is relatively low in children and adolescents compared to adults, a complication called multisystem inflammatory syndrome in children (MIS-C) may occur in some cases at approximately 2-6 weeks after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MIS-C can be seen in patients of various ages, from young infants to adolescents, and may present with diverse clinical manifestations. While fever present in a great majority of patients, symptoms suggesting the involvement of the digestive or nervous system and the skin and mucous membranes (Kawasaki disease-like symptoms) also appear in many cases. Cardiac involvement may also be observed, including left ventricular dysfunction, myocarditis, coronary artery dilatation, and coronary aneurysm. In some cases, hypotension or shock can occur, and mechanical ventilation or treatment in the intensive care unit may be necessary. Fortunately, recovery is generally reported after appropriate treatment. MIS-C is a rare but important complication of SARS-CoV-2 infection in children and adolescents. As such, it is important to recognize the clinical symptoms and provide appropriate treatment at an early stage. In this review, the epidemiology, clinical symptoms, suggested pathophysiology, diagnostic approach, and treatment of MIS-C will be discussed.

• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.1019-1023
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• 2003

Purpose : To determine the differences in clinical characteristics, blood chemistry and coronary artery complications between patients with Kawasaki disease who received intravenous immunoglobulin (IVIG) within the fourth day of illness and after the fifth day of illness. Methods : A retrospective chart review was conducted of all children with Kawasaki disease who were admitted to Ewha Mokdong Hospital between January 2001 and June 2002. The early treatment group received IVIG within the fourth day of illness(n=34) and the control group received IVIG after the fifth day of illness(n=53). Clinical manifestations, fever duration, hospitalization days, CBC, blood chemistry and coronary artery complications were compared between two groups. Results : No demographic differences were noted between the two groups(P>0.05). Total duration of fever was significantly shorter in the early treatment group than the control group($4.8{\pm}2.5days$ vs $7.4{\pm}3.0days$, P<0.05), but there were no differences in fever duration after IVIG treatment and hospitalization days between two groups(P>0.05). No significant differences were noted in the level of hemoglobin, WBC, ESR, CRP, AST, ALT and albumin between two groups(P>0.05). No significant differences in the incidence of IVIG retreatment were noted between the two groups(11.8% vs 5.7%, P>0.05). No significant differences in the incidence of coronary artery complications were noted between the two groups(11.7% vs 18.9%, P>0.05). No significant differences in the recurrence rate were noted between the two groups(3% vs 2%, P>0.05). Conclusion : Early IVIG treatment in patients with Kawasaki disease reduces the total fever duration. Coronary artery complications were not increased in patients with early IVIG treatment.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.489-495
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• 2005

In the surgical treatment of aortic dissection, aortic arch replacement under total circulatory arrest is often performed after careful inspection to determine the severity of disease progression. Under circulatory arrest, antegrade or retrograde cerebral perfusion is required for brain protection. Recently, antegrade cerebral perfusion has been used more, because of the limitation of retrograde cerebral perfusion. This study is to compare these two methods especially in the respect to neurological complications. Material and Method: Forty patients with aortic dissection involving aortic arch from May 2000 to May 2004 were enrolled in this study, and the methods of operation, clinical recovery, and neurological complications were retrospectively reviewed. Result: In the ACP (antegrade cerebral perfusion) group, axillary artery cannulation was performed in 10 out of 15 cases. In the RCP (retrograde cerebral perfusion) group, femoral artery Cannulation was performed in 24 out of 25 cases. The average esophageal and rectal temperature under total circulatory arrest was $17.2^{\circ}C\;and\;22.8^{\circ}C$ in the group A, and $16.0^{\circ}C\;and\;19.7^{\circ}C$ in the group B, respectively. Higher temperature in the ACP group may have brought the shorter operation and cardiopulmonary bypass time. However, the length of period for postoperative clinical recovery and admission duration did not show any statistically significant differences. Eleven out of the total 15 cases in the ACP group and thirteen out of the total 25 cases in the RCP group showed neurological complication but did not show statistically significant difference. In each group, there were 5 cases with permanent neurological complications. All 5 cases in the ACP group showed some improvements that enabled routine exercise. However all 5 cases in RCP group did not show significant improvements. Conclusion: The Antegrade, cerebral perfusion, which maintains orthordromic circulation, brings moderate degree of hypothermia and, therefore, shortens the operation time and cardiopulmonary bypass time. We concluded that Antegrade cerebral perfusion is safe and can be used widely under total circulatory arrest.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.371-379
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• 2019

The purpose of this study was to investigate the effect of the change in the X-ray condition on the entrance surface dose (ESD) and dose area product (DAP) in the cine imaging of coronary angiography (CAG), and to analyze the usefulness of the condition change on the dose relation and image quality by measuring and analyzing the Signal to Noise Radio (SNR) and Contrast to Nois Ratio (CNR) of the angiographic images taken by the Image J program. Data were collected from 33 patients (24 males and 9 females) who underwent CAG at this hospital from November 2017 to March 2018. In terms of imaging condition and data acquisition, the ESD and DAP of group A with a high tube current of 397.2 mA and group B with a low tube current of 370.7 mA were retrospectively obtained for comparison and analysis. For the SNR and CNR measurement and analysis via Image J, the result values were derived by substituting the obtained data into the formula. The correlations among ESD and DAP according to the change in the imaging condition, SNR, and CNR were analyzed by using the SPSS statistical analysis software. The relationships of groups A and B, having a difference in the imaging condition, mA, with ESD ($A:483.5{\pm}60.1$; $B: 464.4{\pm}39.9$) and DAP ($A:84.3{\pm}10.7$; $B:81.5{\pm}7$) were not statistically significant (p>0.05). In the relationships with SNR and CNR based on Image J, the SNR ($5.451{\pm}0.529$) and CNR ($0.411{\pm}0.0432$) of the images obtained via the left coronary artery (LCA) imaging of group B showed differences of $0.475{\pm}0.096$ and $-0.048{\pm}0.0$, respectively, from the SNR ($4.976{\pm}0.433$) and CNR ($0.459{\pm}0.0431$) of the LCA of group A. However, the differences were not statistically significant (p<0.05). In the SNR and CNR obtained via the right coronary artery (RCA) imaging, the SNR ($4.731{\pm}0.773$) and CNR ($0.354{\pm}0.083$) of group A showed increased values of $1.491{\pm}0.405$ and $0.188{\pm}0.005$, respectively, from the SNR ($3.24{\pm}0.368$) and CNR ($0.166{\pm}0.033$) of group B. Among these, CNR was statistically significant (p<0.05). In the correlation analysis, statistically significant results were shown in SNR (LCA) and CNR (LCA); SNR (RCA) and CNR (RCA); ESD and DAP; ESD and sec; DAP and CNR (RCA); and DAP and sec (p<0.05). As a result of the analyses on the image quality evaluation and usefulness of the dose change, the SNR and CNR were increased in the RCA images of the CAG obtained by increasing the mA. Based on the result that CNR showed a statistically significant difference, it is believed that the contrast in the image quality can be further improved by increasing the mA in RCA imaging.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.544-548
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• 2006

Background: The purpose of this study is to evaluate the validity of a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein. Material and Method: Between August 2004 and October 2005, 70 limbs in 50 patients were treated by a combined high saphenous vein division and sclero-therapy. The operative indication is valvular incompetence of femoral-saphenous or popliteal-saphenous junction. Patients received local anesthesia and were treated by a combined high saphenous vein division, ligation of incompetent perforating vein and $1{\sim}3%$ sclerosant. Patients received 1 day hospitalization and applied in com-pression stocking for 6 weeks. Patients followed after 1 week, 1 and 3 months. Result: Mean age of patients was $50{\pm}11$. The female was more common. 8 patients was no symptom, another 42 patients complained of pain, heaviness and fatigue of limbs. The symptoms of varicose vein disappeared 1 month after the procedure in all symptomatic patients. 8 patients needed a adjuvant sclerotherapy for residual varicose vein on 1 week after the procedure. There were only minor complications such as hematoma (1), wound infection (1), thrombophlebitis (20), skin blister (10), hyper-pigmentation (1), and skin ulcer (1). Conclusion: We concluded that a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein is simple, less invasive, economical, and effective treatment for primary varicose vein, and it has a special advantage that saphenous vein can be used as a bypass conduit later. The method was selective in old aged patients.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.220-227
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• 2004

The number of patients with coronary artery disease and peripheral vascular disease are increasing, and the need of small diameter vessel is also increasing. We developed small diameter artificial vessel and experimented in vivo. We got allogenic valve from mongrel dogs, and removed all cells from the allogenic valve. Then, we seeded autologous bone marrow cells onto the decellularized scaffold. After implantation of artificial vessel into the canine carotid artery, we performed angiography regularly. In case of vessel occlusion or at 8 weeks after operation, we euthanized dogs, and retrieved the implanted artificial vessels. Control vessels were all occluded except one (which developed aneurysmal dilatation). But autologous cell seeded vascular graft were patent by 4 weeks in one, by 6 in one and by 8 weeks in two. Histologic examination of patent vessel revealed similar structure to native artery. Tissue-engineered vascular graft manufactured with decellularized allogenic matrix and autologous bone marrow cells showed that tissue engineered graft had similar structure to native artery.

• Korean Journal of Ichthyology
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• v.27 no.3
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• pp.228-232
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• 2015

The structure of the ventricle in the heart of Hypomesus nipponensis was investigated by light and scanning electron microscope. The heart consisted of four consecutive chambers, the sinus venosus, atrium, ventricle and bulbus arteriosus. The wall of the ventricle was divided into endocardium, myocardium, subepicardium and epicardium. The valves were observed in the artrioventricular and bulboventricular junctions. The ventricular myocardium was an entirely spongy without coronary vessels. The trabecular network was formed with lumina included a central lumen and the trabecula was cylindrical shape. Collagen distribution was apparent in the subepicardium, artrioventricular valve and bulboventricular valve. But in the trabeculae, collagen distribution was observed partly in the base of the ventricle. Especially, the endocardial bridges were observed between trabeculae. These results might be considered that the structure of the ventricle in the heart of pond smelt is adapted to sedentary habit associated with its habitat and lifestyle.

• Science of Emotion and Sensibility
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• v.10 no.2
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• pp.147-154
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• 2007

Electrocardiogram(ECG) being the recording of the heart's electrical activity provides valuable clinical information about heart's status. Many researches have been pursued for heart disease diagnosis using ECG so far. However, electrocardio-graph uses foreign diagnosis algorithm in the con due to inaccuracy of domestic diagnosis results for a heart disease. This paper proposes ST-segment extraction technique diagnosing heart disease parameter from raw ECG data. As the ST-segment is used for prediction of Coronary Artery Disease, we can predict heart disease using classification approach in data mining technique. We can also predict patient's clinical characterization from patient clinical data.