• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.881-887
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• 2009

Purpose : The survival rate of very low birth weight infant (VLBWI) had increased as a result of advances in neonatal intensive care. We evaluated the changes in outcomes of VLBWI who admitted to the neonatal care unit of Hallym University Kangnam Sacred Heart Hospital. Methods : Retrospective review of 339 VLBWI who were born from 1st January 1997 to 31th December 2008 were performed. Outcomes including survival rate, birth weight (BW), gestational age (GA), morbidities, and mortality between period I (1997- 2003) and period II (2004-2008) were compared. Results : Overall incidence of VLBWI was 2.3% and it was significantly higher in period II(3.3%). Mean BW and GA were significantly decreased in period II (P<0.001, P=0.01). The survival rate increased from period I (59.1%) to period II (74.2%). BW-specific survival rate increased in 1,000-1,249 gm and GA-specific survival rate significantly increased in 27-28 weeks and 29-30 weeks. The incidences of respiratory distress syndrome (RDS), retinopathy of prematurity (ROP), sepsis, bronchopulmonary dysplasia (BPD), intraventricular hemorrhage, periventricular leukomalacia, and necorotizing enterocolitis were same except patent ductus arteriosus. Conclusion : The survival rate of VLBWI was increased in period II, especially in less than 1,000 gm and below 27 weeks. This may be due to recent dramatic improvement of neonatal care. But more efforts are needed to improve outcome during initial phase and to reduce long term complication such as BPD and ROP.

• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.640-648
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• 2005

Purpose : Kawasaki disease(KD) is known as an acute multi-systemic vasculitis with various immunologic abnormalities. Adhesion of leukocyte to endothelial cells is a key event in the sequence of inflammatory response. This study was performed to investigate the clinical significance of serum soluble intercellular adhesion molecule-1(sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in acute and subacute stages of typical KD for diagnostic and prognostic value. Methods : A typical KD group was 32 patients who were hospitalized from Jan. 2002 to Jun. 2004 was enrolled. Control was 16 non-KD patients with febrile illness. sICAM-1 and sVCAM-1 were measured and compared by Echocardiographic and clinical findings and cardiac troponin T and I. Results : sICAM-1 and sVCAM-1 levels of acute KD were significantly elevated over control(P=0.019 vs. P=0.049, respectively) and sICAM-1 was significantly decreased in subacute stage(P=0.0015). sICAM-1 and sVCAM-1 had positive correlation with each other in both stages(P=0.0067, P=0.015, retrospectively). Neither sICAM-1 nor sVCAM-1 correctly reflected the coronary abnormalities and responsiveness to intravenous gammaglobulin(IVGG) in both stages. But sVCAM-1 was significantly increased in the carditis group in both stages(P=0.025, P=0.014, retrospectively) and had a positive correlation with troponin T(r=0.63, P=0.00063). Conclusion : The levels of sICAM-1 and sVCAM-1 were not very useful tools for detecting and predicting subsequent coronary abnormalities and responsiveness to IVGG in KD patients. However, sVCAM-1 appears to play a significant role in carditis of KD. Further studies are needed about various adhesion molecules and cytokines in the pathogenesis of KD.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.33 no.2
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• pp.124-128
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• 2000

This study was designed to investigate the effects of sea tangle(Laminaria japonica) extract (Dasi-Ex group: dry base $4.0{\%}$) and fucoidan-added (Fuco-I, II, III group: fucoidan of $1.0{\%}, 2.0{\%}, 3.0{\%}$ added to Dasi-EX) drinks on lipid metabolism of stressed mice. ICR male mice ($20 {\pm} 2 g$) were fed experimental diets and given free through water bottle filled with these beverages instead of water for 18 days including sociopsychological stress of 4 days. Dasi-Ex and Fuco-I, II, III groups resulted in slight decreases $3{\$}$ in body weight gain and $6{\~}12{\%}$ in feed and gross efficiencies compared with control groups. Serum protein contents were slightly increased $1{\~}5{\%}$ by administrations of these beverages compared with control group, reflecting inhibitory effect of sociopsychological stress by increase of protein levels. Significant differences in serum cholesterol contents of Dasi-Ex and Fuco-I groups could not be obtained, but Fuco-II and III groups resulted in marked decreases ($13{\~}17{\%}$) in serum cholesterol contents compared with control group. LDL-cholesterol contents resulted in marked decreases ($about 20 and 25{\%}$, respectively) in Fuco-II and III groups, whereas HDL-cholesterol content was significantly increases ($about 16{\%}$) in Fuco-III group compared with control group. Fuco-I, II and III groups resulted in a marked decreases ($15{\%}, 20{\%} and 40{\%}$, respectively) in atherogenic index (AI) compared with control group. Significant differences in serum lipid peroxide (LPO) contents of Dasi-Ex and Fuco-I groups could not be obtained, but Fuco-II and III groups resulted in a significant decrease about $10{\%}$ in serum LPO contents compared with control group. These results suggested that fucoidan drinks added sea tangle could significantly inhibited chronic degenerative diseases by improvement of effective lipid metabolism or fucoidan component.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.687-694
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• 2008

Background: Although aortic valve sclerosis causes no significant hemodynamic alterations, it is associated with an increased risk of cardiovascular death and myocardial infarction. However, the role of ${\beta}_3$ integrin in aortic valve sclerosis remains unclear. Material and Method: Twenty male New Zealand rabbits were divided into two groups. Group 1 rabbits (n=10) received a normal chow diet, while group 2 (n=10) rabbits received a diet containing 1% cholesterol for 12 weeks. After the rabbits were euthanized, their aortic valves and ascending aortas were excised for analysis. Result: Total serum cholesterol ($2,148.3{\pm}1,012.5\;mg/dL$ versus $53.7{\pm}31.8\;mg/dL$, p<0.05), triglyceride ($240.4{\pm}218.3\;mg/dL$ versus $31.6{\pm}6.4\;mg/dL$, p<0.05), and low density lipoprotein (LDL)-cholesterol($2,065.3{\pm}960.9\;mg/dL$ versus $29.1{\pm}30.9\;mg/dL$, p<0.05) levels were significantly higher in the cholesterol diet group compared with the normal diet group. Myofibroblasts and macrophages were more highly expressed in the aortic valve leaflets of rabbits in the cholesterol diet group than of those in the normal diet group. A real-time polymerase chain reaction revealed decreased ${\beta}_3$ integrin mRNA levels in the hypercholesterolemic aortic valves and aortas. Conclusion: The present study shows that hypercholesterolemia induces aortic valve sclerosis. These findings suggest that alterations in ${\beta}_3$ integrin may playa role in the development of aortic valve sclerosis.

• Journal of the East Asian Society of Dietary Life
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• v.20 no.1
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• pp.37-45
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• 2010

The effects of an Acanthopanacis cortex water extract on lipid levels, lipid peroxide, total antioxidant status and antioxidant enzyme activities were evaluated in rats fed one of the following diets for six weeks: normal diet and deionized water (ND), normal diet and Acanthopanacis cortex water extract (NDC), high fat diet and deionized water (HFD), high fat diet and Acanthopanacis cortex water extract (HFDC). The food intakes were significantly lower, but the food efficiency ratios were significantly higher in the high fat diet groups. The level of HDL-cholesterol in the plasma was significantly increased and the levels of LDL-cholesterol and triglyceride in the plasma were significantly decreased by the Acanthopanacis cortex water extract in the high fat diet groups. As a a result, the AI (atherogenic index) and CRF (cardiac risk factor) were significantly lower in the high fat diet groups that were treated with Acanthopanacis cortex water extract. The triglyceride and the total cholesterol of the liver were also significantly upregulated in the high fat diet groups, while the total cholesterol of the liver decreased in response to treatment with Acanthopanacis cortex water extract (HFDC). The plasma and liver concentrations of thiobarbituric acid reactive substances (TBARS) were significantly reduced by the addition of Acanthopanacis cortex water extract to the normal diet groups. The total antioxidant status (TAS) in the plasma was significantly upregulated by adding Acanthopanacis cortex water extract to the high fat diet groups. The activities of SOD, catalase and GST were also significantly higher in the Acanthopanacis cortex water extract groups when compared to the ionized water groups. The activity of GSH-Px and the concentration of GSH in the liver were significantly higher following the addition of Acanthopanacis cortex water extract to the high fat diet groups. Taken together, these results suggest that a supplementation of the diet of rats fed a high fat diet with Acanthopanacis cortex water extract improves lipid metabolism, reduces lipid peroxide and improves the activities of antioxidant enzymes, which may have favorable effects on antioxidant systems by improving the total antioxidant status (TAS).

• Journal of Chest Surgery
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• v.32 no.4
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• pp.341-346
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• 1999

Background: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. Material and Method: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. Result: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. Conclusion: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.662-671
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• 2001

Background: This study was aimed to assess improvement in myocardial perfusion after TMR by measuring regional myocardial blood flow(RMBF) in porcine model of chronic myocardial ischemia. Material and Method: Ameroid ring was placed around the proximal left circumflex coronary artery in fourteen pigs. After 4 weeks, the control group(7 pigs) underwent rethoracotomy only, and the TMR group(7 pigs) underwent Ho:YAG laser TMR at the circumflex territory. After another 4 weeks, the animals were sacrificed for the measurement of RMBF using colored microspheres. The ratio of RMBF between the circumflex territory and the interventricular septum was calculated and compared. Result: At 4 weeks after ameroid constriction, RMBF of the circumflex territory decreased to 46∼89% of RMBF of the interventricular septum. In five of six animals in the TMR group, RMBF of the circumflex territory at 8 weeks after ameroid constriction was higher compared with RMBF at 4 weeks after ameroid constriction. However, the improvement was statistically significant only in two animals. In three of the four animals in the control group, RMBF of the circumflex territory also increased at 8 weeks compared with RMBF at 4 weeks. The degree of increase in RMBF was not different between the control and the TMR groups. Conclusion: In porcine model of chronic myocardial ischemia, the degree of increase in RMBF of the ischemic area after Ho:YAG TMR was not different from the increase by development of native collateral circulation. Perfusion of ischemic myocardium after TMR is not thought to improve to the degree that can be demonstrated by currently available method of assessment such as radioisotope myocardial scintigraphy.

• Progress in Medical Physics
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• v.16 no.4
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• pp.214-219
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• 2005

As part of Korean retinal prosthesis project, we have provided preliminary experimental results regarding voltage parameters for the stimulation of chemically degenerated rabbit retina. Since our APB-treated chemically degenerated retina is only ON-pathway blocked, now we switch our experiments to more appropriate retinal degeneration model, genetically degenerated retina model (RD mouse: rd/rd (C3H/HeJ)). Before studying with RD mouse, we started control experiments with normal SD rat to understand characteristics of retinal ganglion ceil activity with postnatal maturation in rodents. Ganglion cell activities were recorded with 8${\times}$8 multi-electrode array. Moving spontaneous bursts appeared until postnatal day of 15. During pre-eye opening period, no light evoked response appeared. After postnatal day of 2 weeks (post-eye opening period), ON-, OFF- and ON/OFF response appeared. The fractional distributions of ON, OFF, and ON/OFF ganglion cell is about $40\%,\;50\%$, and $5\%$. The percentage ($\%$) of light evoked response in each dorso-temporal, ventral, and dorso-nasal area of eye is about $50\%,\;37.5\%$ and $12.5\%$, respectively. We concluded that the optimal period for experiment in rodent is about postnatal day of 2${\~}$3 weeks.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.206-215
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• 2007

Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.195-202
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• 2010

Purpose : Despite recent advances in pulmonary hypertension management and surgery, appropriate guidelines remain to be developed for operability in congenital heart disease with pulmonary artery hypertension (PAH). Our aim was to evaluate clinical outcomes of patients with severe PAH who underwent surgical closure of left-to-right shunt lesions (LRSL) on the basis of pulmonary reactivity. Methods : We retrospectively reviewed 21 patients who underwent surgical closure of LRSL with severe PAH (${\geq}8$ Wood unit) from January 1995 to April 2009. The median age at operation was 26 years. Atrial septal defect, ventricular septal defect (VSD), VSD and patent ductus arteriosus (PDA), and PDA was present in 11, 4, 4, and 2 patients, respectively. Results : Operability was based on vasoreactivity of PAH. Of the 21 patients, 5 showed response to pulmonary vasodilator therapy and 8 showed vasoreactivity after balloon occlusion of defects. The remaining 8 patients were considered operable because of significant left-to-right shunt (Qp/Qs ${\geq}1.5$). Five patients underwent total closure of defects and 16 were left with small residual shunts. The median follow-up duration was 32 months. There was no significant postoperative mortality or morbidity. Systolic pulmonary artery pressure (PAP) decreased in all but 2 patients. All patients except 1 showed improvement of New York Heart Association functional class. Conclusion : Closure of LRSL in patients with severe PAH on the basis of pulmonary vasoreactivity seems reasonable. PAP and clinical symptoms improved in most patients. Further research is needed for the evaluation of long-term results.