• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.165-173
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• 2005

Purpose : We performed the study to evaluate the value of the follow-up echocardiogram performed 6 months to 1 year after the onset of Kawasaki disease(KD), as recommended by American Heart Association(AHA) guidelines, when echocardiograms in the convalescent period were normal. Methods : Patients were selected from 147 cases diagnosed with KD at Pusan Paik hospital from January 2000 to October 2003. A total of 45 KD patients belonged to AHA risk level I and II were performed follow-up echocardiography. The patient's medical records and echocardiogram were reviewed. Additionally, we sought the opinion of pediatric cardiologists on the subject by means of a multiple-choice survey. Results : 37 children were belonged to AHA risk level I and the remaining 8 patients were belonged to risk level II. Of these 45 children, none were noted to have abnormalities on later follow-up echocardiogram. In the results of questionnaire, 37 percent of the participants advocate no follow-up after convalescent period for risk level I, and 33.3 percent favor periodic follow-up with echocardiography for risk level II up to one year. But there were no consensus about the diagnostic criteria of coronary abnormalities and how to follow-up these patients. Conclusion : All children with KD should have an echocardiogram at present and a follow-up study 6 to 8 weeks after the onset of fever. However, additional echocardiographies are not justified if the 6- to 8-week follow-up echocardiogram is normal. We would recommend that the more reasonable diagnostic criteria for coronary abnormalities and the Korean guidelines for long-term cardiovascular management and follow-up of KD need to be established.

• Pediatric Infection and Vaccine
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• v.8 no.1
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• pp.101-106
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• 2001

Purpose : The outbreaks of measles in infants and school children have been reported recently, but there are no specific treatment of these patients except symptomatic therapy. This study was performed to evaluate the effectiveness of intravenous gammaglobulin(IVGG) therapy in acute febrile phase of measles. Methods : The 68 cases in measles were treated with single dose of IVGG(400~500 mg/kg), and 44 cases were treated with only symptomatic treatment during the periods of 14 months from Jan. 2000 to Feb. 2001. They were compared to duration of fever, rash, the levels of CRP and days of admission on both groups after treatment. Results : The results obtained follows. The average of age was $7.9{\pm}3.6$ year old, and male to female was 1.0 : 1.6. The duration of fever after admission was $2.4{\pm}1.2$ days in treated group and $5.7{\pm}2.4$ days in control group. The period of disappearance of systemic erythematous maculopapular rash was $4.5{\pm}1.3$ days in treated group, and $6.9{\pm}2.4$ days in control group. The durations of admission day were also shown significantly shorter duration of period in treated group(P<0.05). The levels of CRP were no significant difference between two groups before treatment. However, treated group was significantly shown by improved within 5 days after IVGG therapy(P<0.05). Conclusions : The single dose of IVGG(400~500 mg/kg) therapy is one of rapid and effective therapy for clinical symptoms and signs in acute high febrile phase of measles.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.787-792
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• 2004

Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6％ and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.315-320
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• 2005

Objective : Toll like receptor(TLR) is known to be involved in innate immunity. Many microbial antigens stimulate TLR, and as a result of intracellular signal transduction, they activate nuclear factor-kB which produces diverse inflammtory cytokines. Until now, many research topics in Kawasaki disease focused on cytokine increasement. In this study, we aim to reveal TLR increasement which might be associated with initiation of inflammatory response. Methods : We obtained the peripheral blood of ten patients who were diagnosed with Kawasaki disease in Yonsei University College of Medicine from March 2003 to August 2003, as well as those of a febrile control group and the same number of a normal control group. Flow cytometry was done in all samples for quantification of TLR-2 expression in CD14 positive monocyte. And we also extracted total RNA of periphral monocyte and quantificated expression of TLR-2 mRNA by RT-PCR. Results : The expression of TLR-2 in Kawasaki disease increased significantly compared with the normal control group but not when compared with the febrile control group. And the expression decreased slightly in the subacute phase of Kawasaki disease compared with the acute phase, but this was statistically insignificant. mRNA expression of TLR-2 in peripheral blood monocyte also increased in the acute phase of Kawasaki disease. Conclusion : Expression of TLR-2 in Kawasaki disease increased when compared with the normal control group, which means that innate immunity is associated with the pathogenesis of Kawasaki disease.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.1
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• pp.274-282
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• 2014

This study aimed to investigate the general characteristics of patients with acute cerebral infarction, the characteristics of its treatment and its correlation with stroke rating scale and to analyze the factors that affect patient's quality of life. The subject of this study was 576 patients who survived more than a year after they were diagnosed with cerebral infarction that occurred within 7 days and discharged from a study center. Their quality of life was investigated through phone interview. The average age of subjects was $65.8{\pm}12.4$ years old and male subjects took up 62% among all subjects. The mean of quality of life showed $0.77{\pm}0.29$. There was statistically significant difference in factors such as gender, age, hypertension, atrial fibrillation, stroke history and smoking. The result of multiple regression analysis showed the quality of life was lower in females than in males and it was significantly low in older subjects or those with stroke history. Also high stroke scale was related to significantly low quality of life. As such, hospitalized patients due to stroke should receive appropriate intervention during the hospitalization and after their discharge and the development of program is required to prevent relapse.

• Journal of Animal Science and Technology
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• v.47 no.3
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• pp.379-390
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• 2005

Effects of dietary brown seaweed product levels on performance and metabolism of protein and energy were investigated in broiler chicks that were activated the acute phase response. One day old chicks were fed diets containing either 0.0(basal), 1.0, 2.0 or 4.0 % brown seaweed products for 3 weeks. The acute phase response was activated by injecting i.p. the Salmonella typhimurium lipopolysacharide(LPS) at $2^{nd}$ week of age. The acute phase response lowered nitrogen balance(NB)/ $kg^{0.75}$ (metabolic body size) and highered dietary ME values in birds fed diets containing brown seaweed product. Increase in dietary brown seaweed products levels lowered daily gain, and NB, uric acid nitrogen(UAN) excretion and ME utilization per $kg^{0.75}$ in chicks with the acute phase response. But the dietary brown seaweed product level did not affect the performance of 3 Week old broiler chicks that experienced the acute phase response. And the brown seaweed products 1.0 and 2.0 % diets lessened the feed intake reduction caused by the acute phase response in broiler chicks. The brown seaweed 2.0% diet increased NB / g diet or $kg^{0.75}$ and decreased the excretion of UAN/g diet or $kg^{0.75}$. This result indicated that the brown seaweed was able to interact with the acute phase response and increased protein retention via decreased breakdown of protein in birds fed brown seaweed 2.0% diet.

• Therapeutic Science for Rehabilitation
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• v.3 no.2
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• pp.71-81
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• 2014

Objective: The purpose of this study is to ob serve effects of CPM(Continuous Passive Motion) on hand functional and upper-extremity muscular strength rehabilitation for stroke patients. Method: Objects of this study, three patients have the symptoms of hemiplegia due to stroke. These are acute patients, within a 18 months after treatment and correspond in Brunnstrom stage 4~6. This study used single subject (A-B) design for three patients with a stroke and the effect of CPM was measured using Jebsen-Taylor hand function test, Purdue Pegboard test, hand muscular strength test. They received CPM for 3 weeks, 2 per day, 30 minutes for each, total 30 times. Results: Two patients' results of fingertip grip test in hand strength measurements did not change. Results of Jebsen-Taylor hand function test, Purdue Pegboard test and other hand muscular strength test were improved. To validate statistical results nonparametric statistical method, Wilcoxon signed ranks test was performed. P-Values are greater than 0.05 so difference between be fore and after treatment is not statistically significant result. Conclusion: Despite of limitation of short program period and fewer participants, CPM which has been conducted for stroke patients showed the effect on improvement of hand function and muscle strength. This study shows that CPM which is mainly used to treate lower-extremity rehabilitation can be use to improve performance of hand function and strength for patients with stroke.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.924-927
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• 1998

Background: Myocardial cell death after myocardial infarction or reperfusion is classified into necrosis and apoptosis. Bcl-2 protein is a cytoplasmic protein, which inhibits apoptosis and is expressed in acute stage of myocardial infarction but not in normal heart. This study was performed to investigate whether Bcl-2 protein was expressed respectively to the reperfusion time. Materials and methods: Thirty nine New Zealand white rabbits weighing 1.5-4.8 kg (mean, 2.9kg) were alloted into 7 groups (n=5 in each group) which underwent left anterior descending coronary artery(LAD) occlusion for 30 minutes, followed by reperfusion. The animals were sacrificed at 1, 4, 8, 12, 24 hours, and 3, 7 days after occlusion. Ventricle was excised immediately after intervention. Tissues were fixed in 10% buffured formalin and embedded in paraffin. Bcl-2 protein was detected by immunohistochemical stain with using monoclonal antibody against Bcl-2 protein. Results: The positive immunohistochemical reactivity for Bcl-2 protein was observed in 12, 24 hours, and 3 days reperfusion groups. Bcl-2 protein was detected in salvaged myocytes surrounding the infarcted area. Conclusions: Bcl-2 protein is expressed at the late acute stage of infarct. Therefore, the expression of Bcl-2 protein may not protect acute cell death, but may play a role in the prevention of late cell death after myocardial is chemia-reperfusion.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.500-504
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• 2003

Purpose : To assess the clinical features and laboratory findings in Kawasaki patients with nonresponsibility to the acute antiinflammatory treatment, and identify the risk factors for the nonresponsibility, we reviewed the medical records of patients with Kawasaki disease. Methods : A retrospective study of 177 patients with Kawasaki disease at Wonkwang University Medical Center from June, 1997 to June, 2002, was performed. High dose intravenous immune globulin(IVIG) and aspirin were all used for the initial acute antiinflammatory treatment. Two groups, group A(n=19) of initial nonresponders and group B(n=158) of initial responders were compared clinically and laboratorically. Results : Nineteen(10.7%) of 177 patients hardly responded to the initial antiinflammatory treatment. Patients with failure to respond to initial treatment(group A) did not differ from the control group in terms of age, sex, WBC count, coronary abnormalities, and evidence of pyuria. Compared with initial responders(group B), the patients who were retreated(group A) had a significantly shorter feveradmission interval(P=0.041), and a higher level of both AST/ALT(P=0.011) and ASO titier(P=0.000). Conclusion : Among Kawasaki disease patients studied, retreatment group with initial nonresponders had significantly shorter fever-admission interval, and higher both AST/ALT level and ASO titer, than the initial response group.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.12 no.1
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• pp.10-19
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• 2018

The present study was to investigated the effects of motion-based virtual reality training on cognitive function and activities of daily living in patients with stroke. This study was participated in forty one patients with acute stroke. All subjects were randomly assigned into either the experimental group(n=20) or the control group(n=21). The both groups received the conventional occupational therapy during 30 min a day, 5 a week, 4 a weeks. Additionally, experimental group performed motion-based virtual reality training on each session during 30 min/day, and control group conducted conventional occupational therapy on each session during 30 min/day. The outcome measures were the LOTCA(Loewenstein Occupational Therapy Cognitive Assessment), TMT(Trail Making Test), VM(Visual Memory), K-MBI(Korean Modified Barthel Index). In comparison of change score of cognitive function, the experimental group showed a significantly greater improvements in attention and visual working memory than the control group(p<.05). As a result for change score of activities of daily living, the experimental group showed a significant greater improvement in self care than the control group(p<.05). Our findings suggest that motion-based virtual reality training may have a effects of the improvements of cognitive function and activities of daily living than conventional therapy in patients with acute stroke.