• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.661-667
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• 2003

Purpose : This study was performed to find the chief clinical problems associated with the ages of adult patients of tetralogy of Fallot(TOF) who had undergone total correction. Methods : Of the 30 patients who were registered at the Grown-Up Congenital Heart Disease (GUCH) Clinic of Samsung Medical Center for TOF, a retrospective investigation was carried out on 28 patients who underwent total correction. Results : Mean age at retrospective study was 30.8(range : 16-53) years old. Age at total correction was 15.8(range : 2-49) years old. Problems after corrective surgery were assessed. They were arrhythmia, pulmonary valve regurgitation, left pulmonary artery stenosis, residual ventricular septal defect, mitral valve regurgitation, tricuspid valve regurgitation, right ventricle outflow tract obstruction, aortic valve regurgitation, infective endocarditis and protein losing enteropathy. After repair of TOF, such arrhythmias as atrial arrhythmia and AV conduction disturbances were observed in some patients. Cardiomegaly was found significantly in the subjects with arrhythmia(P<0.05), and arrhythmia was less observed in patients who underwent surgery at a young age. Eight patients required a reoperation; the main indications were residual ventricular septal defect, right ventricle outflow tract obstruction and peripheral pulmonary artery stenosis. Conclusion : The majority of the patients seemed to live normal lives after Tetralogy of Fallot repair. However, as residual anatomic and functional abnormalities exist postoperatively, continued careful follow-up is needed to detect and correct structural and functional abnormalities.

• The Korean Journal of Nuclear Medicine
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• v.20 no.2
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• pp.73-78
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• 1986

Of 18 patients with Takayasu's arteritis who underwent $^{99m}Tc-MAA$ (macroaggregated albumin) perfusion luing scanning, 9 (50%) showed perfusion defects. Chest X-rays of them were nonspecific. One patient underwent $^{99m}Tc-DTPA$ radio aerosol inhalation lung scanning simultaneously, which revealed normal. So routine screening radioisotope perfusion lung scanning is helpful to evaluate pulmonary arterial involnmement in Takayasu's arteritis patients. And Takayasu's arteritis should be included in differential diagnosis of pulmonary embolism.

• Proceedings of the Korean Society of Community Living Science Conference
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• 2009.09a
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• pp.77-77
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• 2009

쇠비름(Portulaca oleracea L.)은 쇠비름과(Portulacaceae)에 속하는 일년생 초본으로 우리나라 각지에 5~9월에 걸쳐 자생하고 있다. 한국보다는 중국에서 식용으로 애용되고 있으며, 해열, 이뇨, 산혈 등의 효능이 있어 임질, 요도염, 유종, 대하증, 임파선염 등에 약용으로 사용하고 있다. 쇠비름의 성분으로는 vitamin $B_1$ 및 C, saponin, tannin, flavonoid, dopamine, noradrenalin 등이 보고되었다. 쇠비름에 관한 연구로는 항산화효과, 항균효과 및 해독효과가 발표되었으나, 고지혈증에 관한 연구는 미흡한 실정이다. 따라서 본 연구에서는 고콜레스테를 유발식이에서 쇠비름 에탄을 추출물이 혈청 중 지질에 미치는 영향에 대해 검토하고자 하였다. 실험동물은 6주령의 Sprague Dawley 흰쥐 수컷을 각 실험군당 10마리씩, AIN-93M을 기본으로 하여 대조군(고지방식이), 쇠비름 에탄올 추출물 투여군의 3군(고지방식이+25mg/kg, 75mg/kg, 125mg/kg)으로 나누어 4주간 실험 식이를 급여하고 사육기간 중 사료 섭취량, 체중증가율, 식이효율을 측정하였다. 실험 종료 후, 혈액을 채취하여 혈액에서의 total lipid, total cholesterol, triglyceride, HDL-cholesterol은 효소법을 이용한 kit(아산제약)을 사용하여 측정하였고, 심혈관계 질환의 위험도에 이용되는 동맥경화지수는(atherogenic index, AI) 계산식을 이용하여 산출하였다. 실험결과, 최종체중, 체중증가율, 식이효율 및 장기무게는 실험군 간의 차이를 나타내지 않았다. 그러나 고지방식이에 쇠비름 에탄올 추출물을 125mg/kg의 농도로 병합 투여했을 때 혈중의 total lipid, total cholesterol 및 triglyceride는 대조군에 비해 유의적으로 감소하였으며, 고지방식이에 의해 증가된 동맥경화지수도 대조군에 비하여 유의적으로 저하되었다. 그리고 고지방식이로 증가된 ALT 및 AST 활성이 쇠비름 에탄올 추출물 투여로 유의적으로 감소하였다. 따라서 쇠비름 에탄올 추출물은 혈청 중 지질 개선 효과와 간 기능 개선효과가 있는 것으로 사료되나, 어떤 성분이 콜레스테롤 저하 효과를 나타내는지 보다 자세한 연구가 요구되어 진다.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.40-44
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• 2015

Cases of incomplete Kawasaki disease (KD), wherein the patient does not fulfill the full diagnostic criteria for KD, are often detected in infants younger than 6 months of age. The clinical manifestations in infants with incomplete KD may resemble other infectious diseases, including meningitis. For this reason, clinicians may have difficulty differentiating incomplete KD from other infectious diseases in this population. Various neurological features are associated with KD, including aseptic meningitis, subdural effusion, facial nerve palsy, cerebral infarction, encephalopathy, and reversible corpus callosum splenial lesions on magnetic resonance imaging. We report a case of a 5-month-old girl with incomplete KD, associated with cerebrospinal fluid pleocytosis and an epidural fluid collection. Echocardiography indicated dilatation of the main coronary arteries. The girl made a complete recovery, with resolution of both the epidural fluid collection and coronary artery aneurysms. In this case, the child is well, and showed normal developmental milestones at the 7-month follow-up.

• Journal of Acupuncture Research
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• v.29 no.3
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• pp.129-137
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• 2012

Objectives : Polyarteritis nodosa is a progressive disease of connective tissue that is characterized by nodules along arteries; nodules may block the artery and result in inadequate circulation to the particular area. This report is intended to estimate the efficacy using oriental complex treatment on a patient with Polyarteritis nodosa. Materials and Methods : From 19th March, 2012 to 12th May, 2012, One male inpatient diagnosed with polyarteritis nodosa was treated with general oriental medicine therapy : needle-embedding therapy ; acupuncture ; pharmacopuncture ; acupotomy therapy and herbal medication. VAS(visual analogue scale) was used for evaluation of both leg pain. Other subjective symptoms including night sweat, tinnitus, upper heat were evaluated by percentage comparing the symtoms before and after treatment. Results : The patient showed a certain degree of improvement in both leg pain and other subjective symtoms. Conclusions : Oriental treatments such as needle-Embedding therapy, acupuncture and moxibustion therapy, pharmacopuncture therapy, acupotomy therapy and herbal medication can be effective for controlling pain and other accompanied symtoms due to polyarteritis nodosa.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.255-257
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• 2007

Giant cell arteritis, which is also referred to as temporal arteritis, is defined as a systemic vasculitis in individuals over 50 years of age. Here, we report a case of giant cell arteritis combined with oculomotor nerve palsy. An 81-year old female patient experienced a headache for 10 days in her left temporoparietal area, that was characterized by a continuous dull ache and heaviness with intermittent shooting and lancinating pain. Her symptoms persisted in spite of receiving strong analgesics in another hospital. Upon physical examination, she was found to have marked tenderness over the left temporal area, especially along the path of the temporal artery as well as limitation of adduction, supraduction and infraduction of the left eyeball. At the time of admission, her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were 52 mm/hr and 3.94 mg/dl. In addition her brain MRI revealed no specific findings. Giant cell arteritis was suspected based on the clinical symptoms and signs as well as the elevated ESR and CRP. Oral steroid therapy started was started with an initial dose of 40 mg of prednisolone per day that was gradually tapered to 5 mg a day for 2 weeks. Her headache subsided one day after the steroid therapy and oculomotor nerve palsy was markedly improved after 2 weeks of the therapy. After 2 months she had recovered completely from her symptoms.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.178-184
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• 2017

This study was performed on 16 patients diagnosed with tsutsugamushi disease and cerebral infarction from January 2007 to December 2015. An acute cerebral infarction was diagnosed by brain MRI and MRA. Tsutsugamushi disease was diagnosed using a polymerase chain reaction. To distinguish the difference between the generalized cerebral infarction and infarction with tsutsugamushi disease, the blood pressure and body temperature were measured uponadmission. In general, the blood pressure increases during an acute cerebral infarction. Interestingly, in this study, 12 patients showed a systolic blood pressure less than 130 mmHg uponadmission. The location of the cerebral infarction and whether single or multiple cerebral infarction were examined. Thirteen patients had a cerebral infarction in anterior circulation and 3 patients developed in posterior circulation. To evaluate the coagulation disorders, prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, fibrin degradation product (FDP). D-dimer, which is generally known to increase in an acute cerebral infarction, showed a significant increase in the 13 patients. Fibrin degradation products (FDP) showed a significant increase in 15 patients. The pathophysiological mechanism of tsutsugamushi disease is known as vasculitis, which may result in an endothelial cell injury and proliferation of the endothelial wall, which may lead to a cerebral infarction accompanied by coagulopathy. Without endothelial cell damage and proliferation, a vasospasm caused by vasculitis may cause vasoconstriction and cerebral infarction.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.510-518
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• 2010

Purpose : Kawasaki disease (KD) is a systemic vasculitis, a leading cause of pediatric acquired heart disease. Histopathological findings of coronary artery lesion (CAL) in KD indicate destruction of the coronary artery wall with diffuse vasculitis. Matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) might play central roles in this process. Special attention to MMP-9 has recently been emerging. This study was performed to investigate the clinical significance of MMP-9 and its inhibitors, TIMP-1 and TIMP-2, in KD. Methods : We compared 47 KD patients with 14 febrile controls. Serum MMP-9 and TIMP-1, TIMP-2 were measured by ELISA and compared according to clinical stages and coronary involvement. Results : In acute stage, MMP-9 and TIMP-1 were significantly higher, whereas TIMP-2 was lower, in KD than those in febrile controls ($P$<0.05). The elevated MMP-9 levels in acute phase significantly decreased during the subacute and convalescent phases ($P$<0.05). During acute phase, the MMP-9, TIMP-1, and MMP-9/TIMP-2 levels in the CAL group were lower than those in the non-CAL group, but they increased significantly in the subacute phase ($P$<0.05). MMP-9 has a positive correlation with TIMP-1 in the acute and subacute phases, and negative correlation with TIMP-2 in the subacute and convalescent phases ($P$<0.05). Conclusion : These results suggest that MMP-9, TIMP-1, and the imbalance in MMP-9 and TIMP-2 might play important roles on the pathophysiology of KD and especially on the development of CAL. However, further larger studies are needed.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.101-108
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• 1997

Purpose : The clinical characteristics of renovascular hypertension (RVHT) in children were analyzed. Methods : Medical records of 16 children diagnosed as RVHT on the basis of angiography during Jan. '86 to Jun. 94 in our hospital were reviewed retrospectively. Results : The mean age at the onset was 8.5 yrs and the sex ratio(M:F) was 7:9. The causes of RVHT were Takayasu arteritis in 6, Moyamoya disease in 5, and fibromuscular dysplasia in 3 patients. Abdominal bruit was noted in 6 patients (38%). Peripheral renin activity was raised in all tested patients. Bilateral renal arterial involvemnent was found in 9 patients (56%). Captopril renal scans showed good correlation with angiographic findings. Five patients were treated with antihypertensives only, and blood pressure was controlled completely in 2 and incompletely in 3. Percutaneous transluminal angioplasty was performed in 10 patients with 50% of success rate. However, hypertension was recurred due to restenosis or accompaning aortic stenosis in 3 patients. Surgical treatment was performed in 4 patients, and the blood pressure was controlled partially in 1 and poorly in the remaining 3. Conclusions : Takayasu arteritis, Moyamoya disease and fibromuscular dysplasia are the major causes of childhood RVHT in our country. The diagnosis of RVHT in children should be based on a set of tests individually selected for case by case. For the low curability of the current treatment modalities available, RVHT in children should not be regarded as 'curable' so far. We expect, however, that the outcome will be improved by more extensive application of the newly developed surgical technique.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.28-34
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• 1992

Background: Diffuse panbronchiolitis (DPB) is a chronic obstructive pulmonary disease distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. It is prevalent in Japan, but is known to be rare outside of Japan. Only a few cases in Chinese, Italian, Noirth American and Korean have been reported. During recent two years we have found 16 cases of DPB in Seoul National University Hospital and analyzed the clinical characteristics. Method: We reviewed the patients' age, sex, duration of illness, smoking history, occupational history and past medical history. And we analyzed patients' symptoms, physical signs, laboratory findings and responses to treatment. Results: 1) Male: female ratio was 2.2:1, the ages ranged from 27 to 72 years old, and the duration of disease varied from 1 to 20 years. 2) Most of the patients were being treated as bronchiectasis, miliary tuberculosis, chronic bronchitis or bronchial asthma before they were diagnosed as DPB. 3) Only one patient was a smoker, and 25% of patients had the occupational history of exposure to particles or gas. And all patients had paranasal sinusitis. 4) High resolution computed tomography (HRCT) was very useful in diagnosing the disease in most of the patients. 5) PFT showed obstructive and restrictive abnormalities, and blood gas revealed hypoxemia in most of the patients. 6) Pseudomonas aeruginosa was isolated in the sputum of four patients (25%). 7) The titers of cold hemaglutinin, RA factor and CRP were elevated in most of the patients. 8) Most of the patients improved after treatment with erythromycin. Conclusion: DPB might not be a rare disease in Korea. So DPB should be suspected in a patient who has chronic cough, sputum, dyspnea and diffuse fine nodular chest X-ray abnormality. HRCT and open lung biopsy should be considered in a patient suspected of DPB.