• Journal of the korean veterinary medical association
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• v.23 no.9
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• pp.603-610
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• 1987

The pathological and microbiological studies were carried out to investigate an acute, febrile, highly fetal, infectious disease of rabbits that had occurred in the Winter and in the Spring and that had begun to be reported in Korea from November, 1985. The clinical signs of this disease were characterized by high fever, lethargy, piercing shriek, convulsion, and sudden death with epistaxis, but often they were not observed. The predominant pathogical findings were severe congestion and hamorrhage in trachea, dark brown discoloration of liver by diffuse necrosis or acute viral hepatitis, and hamorrhagic damages of lung, heart, spleen, kidney, etc. The etiological agent was a small round virus, in 25-35nm in diameter and without envelope, thus looking like a picorna virus. This disease resembled what was called the 'Viral Hamorrhagic Pneumonia in Rabbits'(tentative name) that had been reported for the first time in China in 1984. It will be desirable that the disease should be renamed as the 'Viral Hemorrhagic Fever in Rabbits', the 'Acute Viral Hepatitis in Rabbits', etc. because of its charateristics and the basis of pathological findings. An inactivated vaccine is now in the process of preparation for the prophylaxis of this viral disease.

• Applied Microscopy
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• v.28 no.1
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• pp.1-19
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• 1998

Ultrastructural study of the development of the atrioventricular (AV) node was studied by electron microscopy in human fetus ranging from 30 mm to 260 mm crown rump length, and compared with human adult. By 30 mm fetus, the right AV nodal primordium was located below the attachment of the right venous valve. The left AV nodal primordium was observed below the attachment of septum primum. The cytoplasm of the nodal primordia contained few mitochondria, and myofibrils. These cells were apposed to each other with occasional desmosomes. In 40 mm fetus, the AV node cells were poorly organized myofibrils, while working myocardial cells were well organized myofibrils with sarcomere. At 70 mm fetus, intercalated discs were developed in the working myocardial cells. At 100 mm fetus, the nodal cells contained a relatively clear cytoplasm with a few groups of myofibrils and mitochondria. By $140\sim200$ mm fetuses, the nodal cells were an increasing number of myofibrils and mitochondria and these were scattered throughout the cytoplasm. At 260 mm fetus, the nodal cells were small and contained a clear cytoplasm with sparse and poorly organized myofibrils and mitochondria. All major ultrastructural features which characterize the adult AV nodal cells were found in this stage. The working myocardial cells were larger and had a more compact cytoarchitecture than nodal cells. Zonula adherens or fasciae adherens type junction were not found between nodal cells, but they frequently observed between nodal and working myocardial cells.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.84-88
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• 2018

A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

• The Journal of Korean Medical History
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• v.34 no.2
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• pp.89-96
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• 2021

This research aims to find a way to utilize the literature to select the herbs to be added or subtracted according to the condition of the patient after determining the basic prescription to be used for the patient. The study is based on data concerning the herbal composition and application of prescriptions described in the Donguibogam. The composition herbs was expressed as a weight ratio, the standard deviation of the weight ratio was calculated for each prescription, and the case where the weight ratio was greater than the base value (highest weight ratio - standard deviation) was designated as a principal herb. The various expressions of applications were changed to representative terms by the researcher and used to calculate the frequency. Of the 4,373 prescriptions for Donguibogam, 3,307 were able to be expressed in terms of weight ratios with 640 prescriptions using Rehmannia glutinosa, Cnidium officinale, Angelica gigas and Paeonia lactiflora as the principle herb. Of the 640 prescriptions, 508 prescriptions included applied information. Rehmannia glutinosa can also be used for symptoms such as fetal leakage(胎漏), short ingestion(食少), fever(發熱), dazed expression(眼花). Cnidium officinale can also be used for symptoms such as migraine(偏頭痛), stroke(中風癱瘓), tetanus(破傷風). Angelica gigas can also be used for symptoms such as forgetfulness(健忘), incontinence of urination(小便不通), palpitations(驚悸). Paeonia lactiflora can also be used for symptoms such as heart pain and abdominal pain(心腹痛), cough(咳嗽).

• Journal of Embryo Transfer
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• v.26 no.2
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• pp.129-133
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• 2011

Drinking of excessive ethanol during pregnancy induces a fetal alcohol syndrome. Genistein is one of naturally occurring isoflavones at relatively high levels in soybeans. In this study, we investigated the effects of genistein ($1{\times}10^{-8}$ and $1{\times}10^{-7}\;{\mu}g$/ml) on the ethanol (1 ${\mu}l$/ml)-induced teratogenesis of developing mouse embryos during the critical period (embryonic days 8.5~10.5) of organogenesis using a whole embryo culture system and then morphological scoring analysis. Ethanol-treated embryos exhibited a variety of developmental abnormalities. However, the total morphological scores for ethanol plus genistein groups were significantly higher than those of ethanol alone group (p<0.05). In particular, there were significant increases in the ethanol plus $1{\times}10^{-8}\;{\mu}g$/ml of genistein group on the scores for heart, optic system, branchial bar, mandibular process, and caudal neural tube and further in the ethanol plus $1{\times}10^{-7}\;{\mu}g$/ml of genistein group on the scores for heart, hind-, mid-, and forebrains, optic system, branchial bars, maxillary and mandibular processes, caudal neural tube, forelimb, hindlimb, and somites as compared with those of ethanol alone group (p<0.05). These results indicate that genistein has a preventive effect against ethanol-induced teratogenesis.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1236-1240
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• 2008

Smith-Lemli-Opitz syndrome (SLOS) is a rare, autosomal recessive disease caused by an inborn error in cholesterol synthesis. Patients with this disease suffer from multiple malformations due to reduced activity of 7-dehydrocholesterol reductase (DHCR7), which increases 7-dehydrocholesterol (7DHC) and 8-dehydrocholesterol (8DHC) concentrations and decreases cholesterol concentration in body fluids and tissue. The SLOS phenotypic spectrum ranges from a mild disorder with behavioral and learning problems to a lethal disease characterized by multiple malformations. Here, we describe a newborn male with ambiguous genitalia who was diagnosed to have type II SLOS during the neonatal period. A clinical examination revealed low levels of unconjugated estriol in the maternal serum, and a variety of fetal ultrasound anomalies, including prenatal growth retardation. After birth, the infant was diagnosed to have congenital heart disease (Tetralogy of Fallot with severe pulmonary artery stenosis), cleft lip and palate, micrognathia, postaxial polydactyly, ambiguous genitalia, and cataracts. Clinical investigation revealed extremely low plasma cholesterol levels and the presence of mutation (homozygote of p.Arg352Gln) in the DHCR7 gene. The patient underwent palliative heart surgery (to widen the pulmonary artery) and received intravenous lipid supplementation. Cholesterol levels increased slightly, but not to normal values. The patient died from cardiopulmonary failure and sepsis 72 days after birth. This report provides the first description of a Korean patient with SLOS confirmed by verification of DHCR7 gene mutation and illustrates the need for early recognition and appropriate diagnosis of this disease.

• Archives of Pharmacal Research
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• v.28 no.4
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• pp.421-432
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• 2005

In order to understand the renal reabsorption mechanism of neutral amino acids via amino acid transporters, we have isolated human L-type amino acid transporter 2 (hLAT2) and human T-type amino acid transporter 1 (hTAT1) in human, then, we have examined and compared the gene structures, the functional characterizations and the localization in human kidney. Northern blot analysis showed that hLAT2 mRNA was expressed at high levels in the heart, brain, placenta, kidney, spleen, prostate, testis, ovary, lymph node and the fetal liver. The hTAT1 mRNA was detected at high levels in the heart, placenta, liver, skeletal muscle, kidney, pancreas, spleen, thymus and prostate. Immunohistochemical analysis on the human kidney revealed that the hLAT2 and hTAT1 proteins coexist in the basolateral membrane of the renal proximal tubules. The hLAT2 transports all neutral amino acids and hTAT1 transports aromatic amino acids. The basolateral location of the hLAT2 and hTAT1 proteins in the renal proximal tubule as well as the amino acid transport activity of hLAT2 and hTAT1 suggests that these transporters contribute to the renal reabsorption of neutral and aromatic amino acids in the basolateral domain of epithelial proximal tubule cells, respectively. Therefore, LAT2 and TAT1 play essential roles in the reabsorption of neutral amino acids from the epithelial cells to the blood stream in the kidney. Because LAT2 and TAT1 are essential to the efficient absorption of neutral amino acids from the kidney, their defects might be involved in the pathogenesis of disorders caused by a disruption in amino acid absorption such as blue diaper syndrome.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.11-18
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• 2004

Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.381-387
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• 2006

Purpose : Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods : The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results : There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion : The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

• Journal of Korean Academy of Nursing
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• v.13 no.1
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• pp.7-21
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• 1983

For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5％ 10％ 20％ 30％ 40％ 50％ 60％ Diagnosability : 12% 23% 40% 53% 64% 75% 80%.