• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.996-1002
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• 2003

Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.532-537
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• 2010

Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.

• Journal of the Korean Society of Food Science and Nutrition
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• v.30 no.2
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• pp.350-356
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• 2001

The purpose of this study is to verify the relation among vegetarian diet, physical activity and the risk factors of cardiovascular disease. Two hundred and forty five buddhist nuns (age : 23~79 yrs) were selected as vegetarians. For control subjects, 235 healthy female adults (age : 23~79 yrs) were selected. Study period was from October 1996 to February 1997. The contents are consist of food consumption survey, anthropometric measurement, amount of energy expenditure, physical activity and clinical examination. Results were summarized as follows : The average ages of vegetarians were $44.2{\pm}17.3\;yrs$ and those of non-vegetarians were $40.5{\pm}18.4\;yrs$. Average body mass indices (BMI) of vegetarians and non-vegetarians were $22.5{\pm}2.7\;and\;21.1{\pm}2.5$, WHRs were $0.9{\pm}0.1\;and\;0.8{\pm}0.1$, and the average duration of vegetarian diet of the vegetarians was 13.1{\pm}12.9 years. All the nutrient intakes of both groups were over RDA's except calcium and vitamin A intakes of non-vegetarians that were below RDA's Fiber and vitamin C intakes of the vegetarians were significantly higher than those of non-vegetarians (p<0.01). Average energy intakes of vegetarians and non-vegetarians were $2177.1{\pm}420.6\;kcal/day\;and\;2103.2{\pm}534.9\;kcal/day$, total daily energy expenditure were $1789.9{\pm}325.8\;kcal/day\;and\;1703.8{\pm}344.8\;kcal/day$, those by physical activity were $507.8{\pm}360.9\;kcal/day\;and\;400.0{\pm}247.8\;kcal/day$. Serum lipid level, blood sugar, systolic blood pressure of vegetarians were significantly lower than those of non-vegetarians, but ratio of HDL-cholesterol/total-cholesterol was higher than those of non-vegetarians. Levels of total serum cholesterol of vegetarians and non-vegetarians were 161.4{\pm}33.3 mg/dL and 189.6{\pm}33.6mg/dL, HDL-cholesterol were $48.2{\pm}11.4\;mg/dL\;and\;50.8{\pm}12.2\;mg/dL$, LDL-cholesterol were $86.6{\pm}26.9\;mg/dL\;and\;111.1{\pm}17.0\;mg/dL$, atherogenic indice(AI) were $2.4{\pm}0.6\;and\;2.9{\pm}0.7$, fasting blood sugar were $90.8{\pm}14.3\;mg/dL\;and\;103.6{\pm}24.6\;mg/dL$, systolic blood pressure were $107.5{\pm}14.9\;mmHg\;and\;119.3{\pm}15.3\;mmHg$. Energy expenditure by physical activity was negatively correlated with levels of serum total-cholesterol and LDL-cholesterol and atherogenic indice(AI). Therefore, physical activity and vegetarian diet effectively helped reduce blood lipids related to cardiovascular disease.

• Journal of Nutrition and Health
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• v.41 no.3
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• pp.254-263
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• 2008

This study was conducted to analyze the effect of isoflavone intake on prevention of chronic disease in middle and old aged man. In this study we used FFQ (Food frequency questionnaire) and the isoflavone intake level of the subjects was 25.10 mg per day. We divided the subjects into three group -high, medium, low isoflavone intake level- and investigated the relation among isoflavone intake level and clinical/anthropometric characteristics. The intake of isoflavone was inversely related with the body fat in male subjects. And we also divided the subjects into 2 groups with normal and abnormal clinical/anthropometric risk factor. The isoflavone intake level of the abnormal group with high TG, high WHR and high body fat was lower than the normal group. The main food source of isoflavone was soybean curd, bean sprout, soybean paste, soybean and soy milk, and we also investigated the relation between frequency of soybean food and anthropometric and clinical variables. The frequencies of soybean curd, soybean paste, soybean broth, soy milk, bean sprouts, peanuts, soybean and dambuk as well as intake of isoflavone were inversely correlated with some anthropometric and clinical variables such as blood pressure, TG, BMI, % body fat, and waist-hip ratio, whereas positively correlated with HDL cholesterol, muscle mass and bone density. We suggest that high consumption of soy products and isoflavone is associated with decreased blood lipid and body fat in middle and old aged man and might be useful for prevention cardiovascular diseases. From this study, we obtained valuable basic information on recommended isoflavone intake level and guidelines for the prevention of some chronic diseases/health problems.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1217-1221
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• 2008

Purpose : An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. Results : Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. Conclusion : Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.

• Korean Security Journal
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• no.26
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• pp.29-58
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• 2011

Since 11 September 2001, warnings of risk in the nexus of terrorism and nuclear weapons and materials which poses one of the gravest threats to the international community have continued. The purpose of this study is to analyze the aim, principles, characteristics, activities, impediments to progress and developmental recommendation of the Global Initiative to Combat Nuclear Terrorism(GICNT). In addition, it suggests implications of the GICNT for the ROK policy. International community will need a comprehensive strategy with four key elements to accomplish the GICNT: (1) securing and reducing nuclear stockpiles around the world, (2) countering terrorist nuclear plots, (3) preventing and deterring state transfers of nuclear weapons or materials to terrorists, (4) interdicting nuclear smuggling. Moreover, other steps should be taken to build the needed sense of urgency, including: (1) analysis and assessment through joint threat briefing for real nuclear threat possibility, (2) nuclear terrorism exercises, (3) fast-paced nuclear security reviews, (4) realistic testing of nuclear security performance to defeat insider or outsider threats, (5) preparing shared database of threats and incidents. As for the ROK, main concerns are transfer of North Korea's nuclear weapons, materials and technology to international terror groups and attacks on nuclear facilities and uses of nuclear devices. As the 5th nuclear country, the ROK has strengthened systems of physical protection and nuclear counterterrorism based on the international conventions. In order to comprehensive and effective prevention of nuclear terrorism, the ROK has to strengthen nuclear detection instruments and mobile radiation monitoring system in airports, ports, road networks, and national critical infrastructures. Furthermore, it has to draw up effective crisis management manual and prepare nuclear counterterrorism exercises and operational postures. The fundamental key to the prevention, detection and response to nuclear terrorism which leads to catastrophic impacts is to establish not only domestic law, institution and systems, but also strengthen international cooperation.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.281-290
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• 1996

Purpose : Chest irradiation leads to a significant cardiac injury in a number of patients. To prevent, or to reduce the risk of radiation-induced cardiac injury, pentoxifylline(PTX), a haemorrheologic agent that improves the blood flow through small blood capillaries has been employed. Materials and Methods : One hundred and eighty ICR mice were divided into three study groups: control, radiation alone, and radiation-pentoxifylline. Each group was subdivided into 12 subgroups: 1 3, 6 and 10 days and 2, 3, 4, 6, 8, 12, 16 and 20 weeks by observation Period after irradiation. The total 15Gy of radiation was delivered in a single fraction through anterior mediastinal port. Pentoxifylline was injected subcutaneously daily 50mg/kg to the back of the mice from the first day of irradiation throughout the observation period. The mice of each group after a certain observation period were sacrificed and sectioned for histopathologic examination of the heart. Result : The findings of acute radiation-induced carditis i.e., heterophilic infiltration and vacuolization and ballooning of endothelial cells were observed upto 6 weeks and reduced sharply afterwards. The late radiation effects including pericarditis with mononuclear cell infiltration, pericardial fibrosis, endothelial cell changes, myocardial degeneration and fibrosis present from 4 weeks onwards after irradiation but with various degree of severity. The overall process of pathologic changes of radiation-pentoxifylline group was similar to those of radiation alone group but the duration of acute stage was relatively short and the severity of late cardiac toxicity was much lesser compared with those of radiation alone group. Conclusion : Pentoxifylline can effectively reduce the late radiation-induced cardiac injury and reslve the acute effects relatively rapidly.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.67-74
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• 2005

Purpose : The incidence of mortality associated with respiratory difficulties is decreasing nowadays contributed to the development of neonatology. However, complications associated with mechanical ventilator are increasing. This study is to determine clinical manifestations, diagnositc availability of the endotracheal tip culture in patients with Ventilator-Associated Pneumonia(VAP) in neonatal intensive care unit(NICU). Methods : A retrospective analysis of 50 neonates who were admitted to the NICU of Kangnam Sacred Heart Hospital and had given mechanical ventilator from 1 January 2000 to 30 June 2003. VAP group defined as neonates who had pneumonia with mechanical ventilation longer than 48 hours. They were classified into VAP group(n=13) and control group (n=37) and the prevalence, microorganisms cultured from the endotracheal tube tip and risk factors were investigated. Results : The prevalence of VAP was 26.0%(n=13) and the most dominant microorganism cultured in our NICU was methicillin-resistant coagulase negative staphylococcus(MR-CNS) in 4 cases. Other microorganisms were Pseudomonas, Enterobacter, methicillin-resistant Staphylococcus aureus(MRSA) and Klebsiella. Gestational age, birth weight, Apgar score, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, sepsis, renal failure, pulmonary hemorrhage, pneumothorax were not different significantly between two groups except intraventricular hemorrhage(P<0.001) and patent ductus arteriosus(P<0.05). Duration of hospital stay and mortality rate were also not different significantly. Conclusion : VAP occurred at a significant rate among mechanically ventilated NICU patients. Despite of limitation of encotracheal tip culture, the most common microorganism was MR-CNS. We should be aware of occurrence of VAP in NICU neonate who were with mechanical ventilator and should treat with great care.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.10-17
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• 2001

Purpose: We measured anti-H. pylori IgG in Korean elementary school children living in Shinchon area of Seoul, Korea to evaluate the influence of environmental living standards on H. pylori infection. Methods: IgG antibodies to H. pylori were measured in plasma using a commercial ELISA kit (GAP IgG Helicobacter pylori, Bio-Rad Laboratories Inc., Hercules, CA, USA). Information on environmental status such as place of birth, parental income, type of housing, number of persons in the household, parents' occupation, family history of peptic ulcer disease and gastric cancer was obtained. Statistical analysis was done by Chi-square and logistic regression test using SPSS $7.0^{TM}$ for Windows. Results: Study subjects consisted of 571 children, and the age distribution ranged from 6.0 to 13.6 years with a mean of $9.6{\pm}1.8$ years. Male-to-female ratio was 1.1:1. The seropositive rates of H. pylori infection ranged from 10.4% in children aged 6 years to 30.9% in 12 year-old group, overall 16.8%. The prevalence of H. pylori infection progressively increased with age, but there was no significant difference in seropositive rates among children in different age groups (p=0.06). Seropositive rates of anti-H. pylori IgG on the basis of gender, place of birth, parental income, type of housing, parents' occupation, family history of peptic ulcer disease and gastric cancer showed no statistically significant difference. Interestingly, however, seropositive rate of anti-H. pylori IgG showed statistical significance in relation to number of persons in the household (p=0.003; Odds ratio 1.50 by logistic regression test). Conclusion: These results suggest that number of persons in the household is the most important factor among environmental living standards, and that risk of H. pylori infection increases by increment of 1.5 times as the number of persons in the household increases by one.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.47-55
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• 1984

To study the risk factors associated with maternal HBsAg carrier and the effects of maternal HBs antigenemia on the neonatal health, sera of 729 pergnant women admitted to the Keimyung University Hospital for delivery during the period of February 1-May 30. 1982 were tested for HBsAg by RPHA method and for anti-HBs by PHA method. Among them 43 women (5.9%) had HBsAg and 246 women (33.7%) had anti-HBs giving an infection rate of 39.6%. The interview data for 43 HBsAg positive mothers and randomly selected 210 HBsAg negative mothers showed a statistically significant association between acupuncture history and HBsAg positive rate (p<0.005) which suggest that acupuncture might have contributed significantly to the propagation of viral hepatitis in Korea. The living standard of HBsAg positive mothers was generally lower than that of HBsAg negative mothers which supports the hypothesis that environmental factors are associated with viral hepatitis B infection. None of the 43 neonates born to HBsAg positive mothers had HBsAg in their cord blood. Three months after birth, 35 out of 43 infants were retested and only one infant became HBsAg positive. At six months of age, 32 out of 35 infants were retested and none of them were HBsAg positive except the same infant who was positive at three months. Among 20 control infants of HBsAg negative mothers, all of them were HBsAg negative at three and six months follow-up. These findings are not consistent with the supposition that perinatal infection is a main route of viral hepatitis B transmission in south-east Asia including Korea. HBsAg positive mothers had significantly higher rate of premature delivery (27.9%) than HBsAg negative mothers (11.7%) (p<0.05). Also, the low birthweight incidence rate was higher among HBsAg positive mothers (23.3%) than negative mothers (14.1%) but this was not statistically significant (P=0.16). The premature rupture of membrane was more frequent among HBsAg positive mothers (25.5%) than negative mothers (11.1%) (p<0.05). There were no significant differences in the stillbirth rate and incidence of congenital anomalies between HBsAg positive and negative groups. It was not clarified in this study due to small sample size whether higher incidence of premature delivery and premature rupture of membranes among HBsAg positive mothers was due to HBs antigenemia per so or their lower living standard than HBsAg negative mothers.