• Clinical and Experimental Pediatrics
• /
• v.49 no.10
• /
• pp.1050-1055
• /
• 2006

Purpose : As a result of advances in neonatal intensive care and perinatal care, neurodevelopmental outcomes of very low birth weight infant(VLBWIS) is expected to lead to improvement. The aim of this study was to report neurodevelopmental outcomes and risk factors of neurologic impairment of very low birth weight infants during the past 10 years. Method : We performed a retrospective study of 447 newborn infants below 1,500 gm admitted to neonatal intensive care unit of Taegu Fatima Hospital between Janury 1996 and December 2004. Infants were subdivided into group 1(Jan. 1996 to Dec. 1998), group 2(Jan. 1999 to Dec. 2001), and group3(Jan. 2002 to Dec. 2004). We analyzed epidemiologic data to study changes of neurodevelopmental outcomes and risk factors of neurologic impairment. Result : The incidence of cerebral palsy and developmental delay decreased significantly in periods 2 and 3(vs period 1; cerebral palsy 10 percent, developmental delay; 18 percent, P<0.05). Periventricular leukomalacia incidence decreased in period 3(vs period 1; 14.5 percent, P<0.05). The overall survival rate of VLBWIS increased significantly in period 2 and 3(vs period 1; 90.0 percent, P<0.05). The risk factors of neurologic impairment are long-term ventilator care(above 1 wk), low Apgar score, low gestational age and low birth weight. Conclusion : In the most recent 10 years, neurologic impairments of VLBWIS significantly decreased, as a result of advances in neonatal intensive care and perinatal care.

• Clinical and Experimental Pediatrics
• /
• v.46 no.6
• /
• pp.548-553
• /
• 2003

Purpose : Matrix metalloproteinase(MMP)-9 is known to breakdown the blood-brain barrier by degrading the extracellular matrix of the subendothelial basement membrane in meningitis. Tissue inhibitor of metalloproteinase(TIMP)-1, a known inhibitor of MMP-9, has been postulated to inhibit the proteolytic activity of MMP-9 by bindng to MMP-9, but their interaction has not been fully understood yet. So far, there have been some reports on the relationship of MMP-9 and TIMP-1 in bacterial meningitis, but few reports in viral meningitis. Furthermore, there has been no report on this in Korea. We investigated the concentrations of MMP-9 and TIMP-1 in cerebrospinal fluid (CSF) and serum of patients with viral meningitis and control subjects, and evaluated their relationship with other clinical parameters of meningitis. Methods : CSF and blood were obtained from 25 subjects with viral meningitis and 14 control subjects. After centrifugation, supernatants were stored at $-20^{\circ}C$ and we assayed concentrations of MMP-9 and TIMP-1 by the sandwich ELISA method. Results : Concentrations of CSF MMP-9 and TIMP-1 were significantly elevated in patients with viral meningitis, when compared with those in control subjects. Their serum levels showed no differences between the two groups. MMP-9 levels were closely correlated with TIMP-1 levels in the CSF($r_s=0.42$, P<0.05). CSF MMP-9/TIMP-1 ratios were significantly higher in patients with viral meningitis than those in the control subjects(P<0.05). Both CSF MMP-9 and TIMP-1 levels positively correlated with CSF total leukocyte counts($r_s=0.43$, P<0.05, $r_s=0.48$, P<0.05). TIMP-1 levels positively correlated with total protein concentrations in the CSF($r_s=0.43$, P<0.05). Conclusion : MMP-9 and TIMP-1 may play an important role in the breakdown and maintenance of BBB in viral meningitis, respectively.

• Clinical and Experimental Pediatrics
• /
• v.46 no.4
• /
• pp.345-350
• /
• 2003

Purpose : Bacterial meningitis is a serious infection of childhood associated with a significant morbidity and mortality. Repeated cerebrospinal fluid(CSF) examination is a useful prognostic indicator and a delayed sterilization is associated with a higher incidence of neurologic abnormalities. In this study we tried to determine the prognostic value of repeated CSF latex agglutination testing. Methods : We retrospectively evaluated 19 patients admitted to Ewha Womans University Mokdong Hospital for bacterial meningitis from January 1997 to June 2002. Bacterial meningitis was confirmed by a positive CSF culture and a positive CSF latex agglutination test. Repeated CSF examinations were done at three, seven, 14, 21 and 28 days after antibiotics therapy. Neuroradiologic studies were performed. Results : The mean age was $10.6{\pm}12.3months$(range; two to 33 months). The male to female ratio was 2.8 : 1. The causative organisms were Haemophilus influenzae type b 57.9%, Group B Streptococcus 21.1%, Streptococcus pneumoniae 15.7% and Escherichia coli 5.3%. Three days after the initiation of antibiotics therapy, repeated CSF latex agglutination tests persisted as positive in nine (47.4%) out of 19 cases, but all CSF cultures became negative. In those cases with negative latex agglutination tests three days after antibiotics therapy, neuroradiologic findings were completely normal. But, in cases with positive latex agglutination tests three days after antibiotics therapy, neuroradiologic abnormalities such as cerebral infarction, encephalomalasia occurred in 44.4%. Conclusion : Repeated CSF latex agglutination testing was valuable as a prognostic factor in bacterial meningitis. Neuroradiologic abnormalities may occur in cases with delayed clearance of CSF latex agglutination tests more often than in cases with negative latex agglutination tests three days after antibiotics therapy.

• The Korean Journal of Pharmacology
• /
• v.18 no.2
• /
• pp.15-25
• /
• 1982

It was undertake to investigate the factors involved in the micro thrombus formation in the plasma from the patients with cerebrovascular disease(CVD) and the in vitro actions of sodium nitroprusside on the platelet aggregate formation. 1) The microthrombus formation in the plasma from CVD was significantly enhanced, in comparison with that from the healthy volunteers. 2) Both lipid peroxide and cathepsin D in the plasma from CVD were higher than those levels from the healthy volunteers. 3) Whereas the platelets from healthy individuals showed less aggregation activity in response to ADP in the second phase those from CVD revealed the enhanced aggregating response to ADP. 4) When the bovine basilar artery, rabbit aorta and human umbilical artery were pretreated with $K^+-free$ PSS, ouabain, 13-hydroperoxylinoleic acid(13-HPLA) and cadmium they markedly enhanced the platelet aggregability respectively. 5) Platelet aggregation induced by $K^+-free$ PSS-treated bovine basilar artery was decreased by sodium nitroprusside in a dose-dependent manner, but not by either hydralazine. 6) Both dibutyryl cyclic AMP and 8-bromo cyclic GMP had the inhibitory action on the platelet aggregation. However, the latter had more prominent action than former. The antiaggregating effect by sodium nitroprusside was antagonized by pretreatment with methylene blue, but not by hemoglobin. These results provide the evidences for the therapeutic use of sodium nitroprusside in the emergency of cerebrovascular disease and in remains the further study of the clinical therapy with it.

• The Journal of Korean Society for Radiation Therapy
• /
• v.23 no.2
• /
• pp.103-108
• /
• 2011

Purpose: Opposing portal irradiation with helmet field shape that has been given to a patient with brain metastasis can cause excess dose in patient's scalp, resulting in hair loss. For this reason, this study is to quantitatively analyze scalp dose for effective prevention of hair loss by comparing opposing portal irradiation with scalp-shielding shape and tomotherapy designed to protect patient's scalp with conventional radiation therapy. Materials and Methods: Scalp dose was measured by using three therapies (HELMET, MLC, TOMO) after five thermo-luminescence dosimeters were positioned along center line of frontal lobe by using RANDO Phantom. Scalp dose and change in dose distribution were compared and analyzed with DVH after radiation therapy plan was made by using Radiation Treatment Planning System (Pinnacle3, Philips Medical System, USA) and 6 MV X-ray (Clinac 6EX, VARIAN, USA). Results: When surface dose of scalp by using thermo-luminescence dosimeters was measured, it was revealed that scalp dose decreased by average 87.44% at each point in MLC technique and that scalp dose decreased by average 88.03% at each point in TOMO compared with HELMET field therapy. In addition, when percentage of volume (V95%, V100%, V105% of prescribed dose) was calculated by using Dose Volume Histogram (DVH) in order to evaluate the existence or nonexistence of hotspot in scalp as to three therapies (HELMET, MLC, TOMO), it was revealed that MLC technique and TOMO plan had good dose coverage and did not have hot spot. Conclusion: Reducing hair loss of a patient who receives whole brain radiotherapy treatment can make a contribution to improve life quality of the patient. It is expected that making good use of opposing portal irradiation with scalp-shielding shape and tomotherapy to protect scalp of a patient based on this study will reduce hair loss of a patient.

• The Korean Journal of Physiology
• /
• v.2 no.1
• /
• pp.79-88
• /
• 1968

For the purpose of assessing the influence of the mamillary bodies on the general activity and stress response, mamillary body·damaged rats(mamillary body group), operated control rats, and normal control animals were prepared and 2 experiments were carried out. The mamillary bodies. were damaged electrolytically by passing 0.3 ma d.c. current through stereotaxically implanted electrodes. The operated control group received the same treatment except passage of current. In the 1st experiment, each subject belonging to the mamillary body group .(9 rats) or the operated control group (13 animals) was put individually into an activity cage across which an infrared beam traversed. The number of beam interruptions by the movement of the subject in the cage was. recorded hourly for 48 hours and was regarded as an index of general activity. In the 2nd experiment, each of the mamillary body group (52 animals), the operated control group (45 rats), and the normal control group (37 animals) was further divided into 4 subgroups and the adrenal ascorbic acid content of one of the 4 subgroups was measured before, another subgroup immediately after, a third subgroup 2 hours after, and the remaining subgroup 4 hours after termination of a cold stress ($-10^{\circ}C$ for 1 hour). Following results were obtained: 1. Though the total activities in 48 hours of the mamillary body group and the operated control group were not significantly different, the activities of the malnillary body group for a few hours. at the beginning of the measurement and also in the evenings of both the 1st and the 2nd experimental days were significantly greater than those of the operated control group. 2. Judged by the significant reduction in adrenal ascorbic acid content, the stress response of the mamillary body group was as marked as that of the operated control or the normal control group-immediately after termination of cold exposure. Recovery from the stress was accelerated significantly in the mamillary body group and insignificantly in the operated control group compared with that of the normal control group, the intergroup difference of the former two groups being insignificant. It was inferred from the above results that the mamillary bodies may exert an inconspicuous inhibitory influence upon the central mechanism of general activity, and that the mamillaryies bodies may not be the main seat of the stress mechanism, although more works are desirable to confirm the results.

• Journal of Chest Surgery
• /
• v.42 no.4
• /
• pp.441-446
• /
• 2009

Background: Side clamping of ascending aorta during proximal graft anastomosis in coronary bypassing surgery in-creases the risk of direct aortic injury as well as embolization of intimal atheroma. Heartstring proximal sealing system (Guidant Corporation, Santa Clara, Calif), developed to avoid aortic side clamping, may minimize risks of such complications. The aim of the current study is to compare the surgical outcomes of the two proximal anastomosis techniquesi.e., Heartstring system versus aortic side clamping in off pump coronary bypassing' surgery (OPCAB). Material and Method: From January 2003 to August 2008, 499 patients underwent OPCAB. Of them, proximal graft anastomosis was performed using Heartstring system in 182 patients (Group I) and conventional manual anastomosis in 317 patients (Group II). The two groups were compared for postoperative major complications and mortality. Result: Two groups showed similar characteristics in terms of preoperative demographic data, left ventricular ejection fraction, renal function and history of diabetes, hypertension and smoking. Although there was no inter-group difference in the history of cerebral ischemia (p=0.48), preoperative brain magnetic resonance angiography revealed greater incidence of severe carotid artery stenosis (>75% of lumen) in the Group I than in the. Group II (44.5% in the Group I and 30.0% in the Group II, p=0.003). There were no inter-group differences in postoperative mortality (p=0.40) and complications (p=0.47) including neurologic events (3 in the Group land 2 in the Group II, p=0.258). Whereas neurologic events all comprised transient ischemic attacks in the Group I, they comprised multiple embolic strokes in the Group II. One patient in the Group II experienced aortic dissection during proximal anastomosis which resulted in ascending aortic replacement. Conclusion: Although proximal anastomosis using Heartstring system did not show statistically significant benefit over aortic side clamping, the. absence of embolic stroke maybe a definite benefit which may be better defined through further studies over a larger cohort.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.38 no.12
• /
• pp.1699-1706
• /
• 2009

This study was conducted to investigate the antioxidative effects of chungkukjang fermented using Bacillus subtilis DJI (DJI CJ) in rats fed high cholesterol diet. Sprague-Dawley male rats weighing 185-195 g were divided into 6 groups: normal group (N), high cholesterol group (C), high cholesterol and DJI CJ with no salt group (C-CJN), high cholesterol and DJI CJ added with solar salt group (C-CJS), high cholesterol and DJI CJ added with refined salt group (C-CJR), and high cholesterol and commercial CJ group (C-CCJ). The body weight gain and food intake in all four CJ groups were lower than C group. The serum activities of AST and ALT that were elevated by high cholesterol diet were significantly decreased by CJ supplemented. The hepatic activities of catalase and SOD in C group were increased to 20.59% and 18.72%, respectively, compared with N group, but those of C-CJN, C-CJS, C-CJR, and C-CCJ groups were similar to those of N group. Liver TBARS contents were significantly decreased in all CJ groups, compared with C group. The contents of brain lipofuscin in C-CJN, C-CJS, C-CJR, and C-CCJ groups were remarkably inhibited about 20.86%, 22.06%, 14.73%, and 12.88%, respectively, compared with C group. There were no significant differences among DJI CJ groups in antioxidative effects. According to this study, DJI chungkukjang or commercial chungkukjang seems to protect tissues from oxidative stress by stimulating antioxidative systems in rats fed a high cholesterol diet.

• The Journal of Korean Medicine
• /
• v.27 no.3 s.67
• /
• pp.187-200
• /
• 2006

Objectives: Acupuncture has been applied in Asia for thousands of years, especially to rehabilitation after stroke. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells shown by using brain imaging techniques. This study was to evaluate the effect of GB 34-GB 39 electro-acupuncture (EA) on regional cerebral blood flow (rCBF) in stroke patients and normal volunteers using single photon emission computed tomography (SPECT). Methods: The study procedure was divided into two parts: patients and volunteers studies. For the patients study, ten ischemic stroke patients (3 males, 7 females, mean age $68.5{\pm}8.9$ years old) were selected. Baseline brain SPECT was done with triple head gamma camera (MultiSPECT3, Siemens, USA) after intravenous administration of 1,110 MBq of $^{99m}Tc-ECD$. Fifteen-minute EA at GB 34 and GB 39 were applied on the affected limb. The same dose of $^{99m}Tc-ECD$ was injected during the EA, and the second set of SPECT images wasobtained. Using the computer software (ICON 7.1, Siemens, USA), 3 SPECT slices (upper, middle, lower) surrounding the brain lesion were selected and each slice was divided into 10-16 brain regions. Asymmetry indexes (AI) were analyzed in each brain region. We regarded over 10% changes of AI between before and after EA as significance. For the volunteers study, 10 healthy human volunteers (5 males, 5 females, mean age $28.1{\pm}6$ years old) were selected. In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed. On the 7th day after the resting examination, 15 minute EA was applied at GB 34 and GB 39 on the right side of the subjects. Immediately after EA, the second SPECT images were obtained inthe same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: In stroke patients, six of the eight (75%) had significantly increased perfusion in post-acupuncture scans compared to their baseline state. In normal volunteers, GB 34-GB GB EA increased rCBF in both hemispheres including right ventral posterior cingulate (Brodmann area (BA) 23), left superior temporal, anterior transverse temporal (BA 22, 41), left parastriate, peristriate (BA 18, 19), right occipitotemporal, angular (BA 37, 39), left rostral postcentral, caudal postcentral and preparietal (BA 2, 3, 5). However GB 34-GB 39 EA decreased rCBF in the right hemisphere including triangular and middle frontal lobes. Conclusions: The results demonstrated that OB 34-GB 39 EA increased cerebral perfusion in ischemic stroke patients and increased rCBF grossly in temporal lobes of normal volunteers. It is also suggested that there may be a correlation between the GB meridian and the territory of the middle cerebral artery.

• Clinical and Experimental Pediatrics
• /
• v.45 no.9
• /
• pp.1134-1140
• /
• 2002

Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.