• IMMUNE NETWORK
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• v.15 no.3
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• pp.142-149
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• 2015

Lung fibrosis is a life-threatening disease caused by overt or insidious inflammatory responses. However, the mechanism of tissue injury-induced inflammation and subsequent fibrogenesis remains unclear. Recently, we and other groups reported that Th17 responses play a role in amplification of the inflammatory phase in a murine model induced by bleomycin (BLM). Osteopontin (OPN) is a cytokine and extracellular-matrix-associated signaling molecule. However, whether tissue injury causes inflammation and consequent fibrosis through OPN should be determined. In this study, we observed that BLM-induced lung inflammation and subsequent fibrosis was ameliorated in OPNdeficient mice. OPN was expressed ubiquitously in the lung parenchymal and bone-marrow-derived components and OPN from both components contributed to pathogenesis following BLM intratracheal instillation. Th17 differentiation of $CD4^+$ ${\alpha}{\beta}$ T cells and IL-17-producing ${\gamma}{\delta}$ T cells was significantly reduced in OPN-deficient mice compared to WT mice. In addition, Th1 differentiation of $CD4^+$ ${\alpha}{\beta}$ T cells and the percentage of IFN-$\gamma$-producing ${\gamma}{\delta}$ T cells increased. T helper cell differentiation in vitro revealed that OPN was preferentially upregulated in $CD4^+$ T cells under Th17 differentiation conditions. OPN expressed in both parenchymal and bone marrow cell components and contributed to BLM-induced lung inflammation and fibrosis by affecting the ratio of pathogenic IL-17/protective IFN-$\gamma$ T cells.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.238-247
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• 1992

Immigration of Koreans to the United States has increased since the 1960's. Adjusting to life in the United States produces a great deal of stress for immigrants. Despite better economic opportunites, many see the U.S. culture as threatening to their family and cultural values. Differences in culture, language, expectations and social behavior can lead to misunderstandings between health care providers and clients. These misunderstanding can leaf to frustration on the part of each. The ultimate result of this is that often Korean-immigrants do not get their health care needs met and stress response symptoms can lead to disease if there is no appropriate care. To determine the health care needs and concerns of Korean-Americans, a health needs assessment is needed. Appropriate and adequate information about the health care needs of these individuals is important as it relates to American policy changes allowing greater numbers of immigrants to enter the U.S. The purpose of this prospective study was to describe Korean-American stress response. This study focused on the primary presenting problems for which subjects reported having sought care. These included a variety of stress-related symptoms, including peripheral manifestations, cardiopulmonary symptoms, central-neurological symptoms, gastrointestinal symptoms, muscle tension, habitual patterns, depression, anxiety, emotional irritability and cognitive disorganization. Of the 300 subjects who entered the study, 80% (N＝223) completed the questionnaire in full. Demographically, the percentage of females and males was 50% each and they ranged in age from 20 to 69 years. Ninety percent of the subjects were highly educated, 25% owners of business, 25% white collar professionals, 15% employed in sales or as skilled /unskilled labor, 30% had no occupation : and 5% were housewives or students. The SOS inventory is designed to quantify self-perception of behavioral, cognitive, and physiological components of the stress response. It consisted of 94 items divided into 10 subscales. The result of this study are as follows : The total mean 505 of all subjects (N＝223 was .8129 ; the mean 505 for male(N＝114) was .7665 and for females, (N＝108) .8594. The level of symptoms for central-neurologic and muscle tension was higher for than for males. The highest stress response of all subjects was emotional irritability symptoms(1.0644) : the lowest stress response of all subjects was peripheral manifestation symptoms.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1115-1119
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• 2001

Objective : Management strategies for pediatric chiasmatic-hypothalamic gliomas(CHG) include surgery, irradiation, chemotherapy and a combination of these modalities. This study was performed in order to compare the efficacy of various methods of treatment and to describe its optimal management. Material and Method : We have reviewed the results of management of 6 children with a diagnosis of CHG, who were observed closely during the last 8 years. The patients were aged 7 months to 15 years. Our patients presented with diencephalic syndrome, endocrine dysfunction, and progressive visual loss. None of these had evidence of neurofibromatosis-1. Treatment consisted of surgery alone(2), surgry and irradiation(2), surgery, irradiation and chemotherapy(1), and surgery and chemotherapy(1). Results : Four children had large exophytic suprasellar tumors and two showed diffuse midline lesions. Obstructive hydrocephalus was present in all patients. Pathologic examination revealed anaplastic astrocytoma in 1 and lowgrade astrocytoma in 5. Two patients, recently treated with radiation therapy following radical subtotal resection, showed significant tumor reductions and good clinical status. Four patients had partial tumor resection. Of these patients, two developed disease stabilization during follow-up period of 7 and 8 years, respectively. Life-threatening complications were noted in remaining two patients. Conclusion : CHG may follow an unpredicatable course and show a various reponse to each treatment modality. Further studies are indicated to define the optimal method of treatment of CHG in childhood.

• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.440-445
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• 2015

Purpose: Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases. Methods: Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong. Results: Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain. Conclusion: The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.319-324
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• 2007

Purpose: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. Methods: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. Results: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. Conclusion: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.

• Parasites, Hosts and Diseases
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• v.51 no.3
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• pp.335-341
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• 2013

Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.1
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• pp.85-92
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• 1999

Cryptosporidiosis is an intestinal disease caused by the protozoan Cryptosporidium parvum. The most common manifestation in human is enteric symptoms, which in immunocompetent hosts are self-limiting but can be life threatening in immunocompromised hosts, characterized by profuse watery diarrhea, abdominal pain, severe weight loss. It's prevalence rate in immunocompetent host is variable by geographic locations (3~11%) but up to 15~40% in AIDS patients. Now it is considered as one of the important enteropathogens causing diarrhea not only in immunocompromised but also in immunocompetent hosts, especially in children. We experienced two cases of cryptosporidiosis in a 15 year old boy who was admitted due to diarrhea, abdominal pain and fever and in a 8 year old boy who was admitted due to watery diarrhea and vomiting. These are the first clinical cases of cryptosporidiosis confirmed by electron microscopy of the colonic mucosa among immunocompetent children in Korea.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.1
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• pp.96-99
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• 2008

Toxoplasma gondiiis a widespread apicomplexan parasite which is able to infect virtually all warm-blooded vertebrates. Twenty-two percent of the U.S. population is infected, but severe disease in adults is mainly limited to immunosuppressed patients. In patients with acquired immunodeficiency syndrome(AIDS), T. gondii causes a life-threatening opportunistic infection, with Toxoplasma encephalitis as its most severe manifestations. T. gondii is also known to cause congenital infection and is among the pathogens with the highest incidence of complications in pregnancies. Despite its clinical importance, only very few therapeutic drugs against T. gondii are available, all of which target the rapidly dividing tachyzoites, leaving the dormant encysted bradyzoite stage unaffected. We searched 15 traditional medicines that have anti-inflammatory effect from dongyibogam and Traditional Chinese medicine. In vitro studies were performed with HeLa cell cultures, with quantification of Toxoplasma growth by a cell proliferation assay. The result of experiment shows the selectivity of Citrus unshiu Markovich is 6.0. This is higher than sulfadiazine (selectivity was 1.63). For in vivo studies, mice were acutely infected intraperitoneally with $10^5$ tachyzoites of the virulent RH strain and then treated per orally for 4 days from 6 hours postinfection. Efficacy was assessed by sequential determination of parasite burdens in peritoneal cavity. In vivo, Citrus unshiu Markoviche inhibited Toxoplasma growth at a concentration of 10㎎/㎏ of body weight per day, the inhibition ratio was estimated to be 64.01%.

• Journal of Chest Surgery
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• v.53 no.2
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• pp.58-63
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• 2020

Background: Despite progress in treatment, Stanford type A aortic dissection is still a life-threatening disease. In this study, we analyzed surgical outcomes in patients with Stanford type A aortic dissection according to the extent of surgery at Daegu Catholic University Medical Center. Methods: We retrospectively analyzed 98 patients with Stanford type A aortic dissection who underwent surgery at our institution between January 2008 and June 2018. Of these patients, 82 underwent limited replacement (hemi-arch or ascending aortic replacement), while 16 patients underwent total arch replacement (TAR). We analyzed in-hospital mortality, postoperative complications, the overall 5-year survival rate, and the 5-year aortic event-free survival rate. Results: The median follow-up time was 48 months (range, 1-128 months), with a completion rate of 85.7% (n=84). The overall in-hospital mortality rate was 8.2%: 6.1% in the limited replacement group and 18.8% in the TAR group (p=0.120). The overall 5-year survival rate was 78.8% in the limited replacement group and 81.3% in the TAR group (p=0.78). The overall 5-year aortic event-free survival rate was 85.3% in the limited replacement group and 88.9% in the TAR group (p=0.46). Conclusion: The extent of surgery was not related to the rates of in-hospital mortality, complications, aortic events, or survival. Although this study was conducted at a small-volume center, the in-hospital mortality and 5-year survival rates were satisfactory.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.162-168
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• 2007

Oral and maxillofacial infection is the oldest and most common disease in human history. The infection ranges from the low-grade infection that only requires minimal treatment to the high-grade and life-threatening fascial space infection. In this study, the data on oral and maxillofacial infections were analyzed to aid in the diagnosis and treatment, and to predict the prognosis. This report was based on data from 831 patients with oral and maxillofacial infection (394 males and 437 females) who were hospitalized in the Department of Oral and Maxillofacial surgery of Chosun University Dental Hospital from January 1998 to May 2005. The ratio of males to females was 0.9:1. By age, patients between 60 and 70 years old were the greatest in number (17.1%), while only 5.9% of the patients were between 10 and 20 years old. The most common cause of infection was odontogenic origin (84.4%), followed by post-extraction infection (6.2%), unknown (5.9%), and trauma (3.5%). The most common fascial space involved was the buccal space (39.4%), followed by the canine (20.6%), submandibular (15.9%), pterygomandibular (9.5%), submental (7.6%) and sublingual (2.8%) space. The number of the involved fascial space was one (75.2%), two (19.8%), or more than three (5.0%). In terms of the treatment duration, the hospitalization period of 6 to 10 days was the greatest in number (49.9%). All patients had uneventful recovery without major complication. There are statistically significant correlations between age and treatment period, and the involved space and treatment period, but no correlations between the variables of sex and treatment.