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Prenatal diagnosis and clinical course of restrictive foramen ovale in otherwise normal heart (단순 조기 난원공 협착의 산전 진단과 임상경과)

  • Lee, Ji Joung;Lee, Min A;Rhee, Yun ee;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.268-271
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    • 2007
  • Purpose : Premature narrowing of the foramen ovale is rare but serious clinical entity. Prenatal narrowing or obstruction of the foramen ovale shows symptoms such as right heart failure, fetal hydrops, triscupid regurgitation, left heart obstructive disease, and supraventricular tachycardia. This study aimed to assess the prenatal diagnosis and postnatal clinical course of restrictive foramen ovale in utero in otherwise normal heart. Methods : The subjects were five patients diagnosed with restrictive foramen ovale in utero from January 2001 to June 2005 at Chungnam National University Hospital. The diagnostic criteria was defined when the maximum diameter in a 4-chamber view is less than 2.5 mm and there is a continuous doppler velocity at the foramen ovale of more than 0.6m/s. Results : At the time of diagnosis of restrictive foramen ovale, gestation age was 34~37 wks, and chief complaints were fetal arrhythmia(2 cases), pericardial effusion, Ebstein anomaly and subaortic stenosis. Two cases which were diagnosed fetal hydrops and supraventricular tachycardia delivered by emergent cesarian section. Five cases were found to have right heart dilatation on echocardiogram after birth, but right heart dilatation became normalized at day 7 after birth and the clinical courses were not eventful. Conclusion : Identifying an obstructed foramen ovale in the fetus warrants the further search for additional cardiac and extracardiac anomalies, which may alter the prognosis. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.

A Study on Ensuring Biosafety of Biotechnology Product under Debate about Trade and the Environment (DDA 무역-환경 논의와 생명공학제품의 안전성 확보)

  • Sung, Bong-Suk;Yoon, Ki-Kwan
    • Environmental and Resource Economics Review
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    • v.13 no.3
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    • pp.519-547
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    • 2004
  • This paper analyze problems about scope of specific trade obligations(STOs), principle of dispute settlement procedure, and non-parties in context of the Cartagena Protocol on Biosafety(POB), which based on sub-paragraph 31(i) of DDA WTO Ministrial Declaration. The implications based on result of this study are as follows. First, to accept the wider scope of STOs under POB in Korea, importing country, won't be harmful to LMOs and Bioindustry. Instead, it will ensure a high level of biosafety concerning the import of LMOs. Exporters can take different kinds of trade measures to countervail adverse effect on the export of LMOs in this case. Therefore importer will endure the aftereffect. However, if korea were in exporter's place, to accept the wider scope STOs under POB will not have a good influence on the export of LMOs. Korea, therefore, should devise scheme for responding to debate about the STOs in MEAs, which have to be based on cost-benefit analysis and scenarios taking into account of speed and level in biotechology progress, status and trend of LMOs R&D and production, and condition of other industries. Second, it is not easy to agree with applying to what's rule between the POB and WTO for settlement dispute. Because there is the incompatibility between the POB characterized according to social rationality and WTO's rules for safety and environmental protection characterized according to scientific rationality. This issue have to be discussed for long period due to gap like that. Accordingly Korea, one of major LMOs importing countries, should suggest continuously that the effort is needed to ensure an adequate level of protection in transboundary movements of LMOs and scientific, environmental and socio-economic study. Third, in case of dispute between party and non-party of the POB, the duties under the WTO of non-party of the POB(if WTO member country) is valid. The country, therefore, will try to settle dispute based on WTO's rules. However, international society have to ensure for sound and safe use of LMOs in the field of transboundary movements. Accordingly Korea should devise scheme for preventing the possibility of dispute between party and non-party of the POB(if WTO member country), which is supported by policy options under the POB.

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Heart Transplantation: the Seiong General Hospital Experience (심장이식 환자의 임상적 고찰)

  • 박국양;박철현
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.606-613
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    • 1996
  • Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).

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Temperature and dose-size effects on infectivity and reproduction of entomopathogenic nematode, Steinernema longicaudum Gongju Strain (온도와 농도가 곤충병원성 선충 Steinernema longicaudum 공주계통의 병원성과 증식에 미치는 영향)

  • Choo, Ho-Yul;Lee, Dong-Woon;Ha, Pan-Jung;Kim, Hyeong-Hwan;Chung, Hye-Jin;Lee, Sang-Myeong
    • The Korean Journal of Pesticide Science
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    • v.3 no.2
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    • pp.60-68
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    • 1999
  • Effects of temperature and dose-size on infectivity and reproduction of Korean entomopathogenic nematode, Steinernema longicaudum Gongju strain were examined. The greater wax mea Galleria mellonella larvae were exposed to 5, 10, 20, 40, 80, and 160 infective juveniles/larva in $60{\times}15$ mm petri dishes and kept in $13^{\circ}C$, $18^{\circ}C$, $24^{\circ}C$, and $30^{\circ}C$ incubators. Each petri dish contained one larva weighed from 180 to 200 mg. Infectivity was observed everyday for 14 days and reproduction for 30 days. The infectivity of S. longicaudum was more influenced by temperature than by dose-size. Mortalities by S. longicaudum were lower at $13^{\circ}C$ at all concentrations but higher at $24^{\circ}C$ and $30^{\circ}C$ even at lower concentrations, 5 or 10 infective juveniles/larva. Lethal time was also shorter with increasing temperature and dosages. All host larvae died at $24^{\circ}C$ and $30^{\circ}C$ in 2 days at the rate of 160 infective juveniles per host while 83.3% of tested larvae died at $24^{\circ}C$ in 10 days and 90% at $30^{\circ}C$ in 6 days at the rate of 5 infective juveniles. Reproduction was also better with increasing temperature and dosages. The highest number of progenies was obtained at $30^{\circ}C$ in 6 days at the rate of 80 infective juveniles. However, progenies were not produced from cadavers at $13^{\circ}C$. Reproductive period was the shortest at $30^{\circ}C$ of all temperatures by 6 to 9 days. The results indicated that optimum temperatures for infectivity was $24^{\circ}C$ and $30^{\circ}C$ for reproduction.

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Effects of Silkworm Powder on Blood Glucose and Lipid Levels in NIDDM(Type II) Patients (인슐린 비의존형(Type II) 당뇨환자에서 누에분말 섭취가 혈당 및 혈중지질농도에 미치는 영향)

  • 조미란;조여원;정성현;류재환
    • Journal of Nutrition and Health
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    • v.31 no.7
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    • pp.1139-1150
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    • 1998
  • The purpose of this study is to investigate the effects of the silkworm powder on blood levels of glucose, Hb Alc, insulin, and lipids. Thirty-one NIDDM patients from Kyung Hee Medical Center were divided into two groups : patients with silkworm powder supplements and drug treatments(Drug diabetes) and patients with silkworm powder supplement only(Non-drug diabetes). For the control group, age-matched subjects were recruited. During the 4 weeks of the experimental period, silkworm powder(500mg/mea1) was given to the subjects right after each meal. Nutritional assessments and dietary education were carried out periodically, and body weight and blood pressure were measured when patients visited the hospital. Overnight fasting and 2-h postprandial blood glucose levels were measured at 2 week intervals. The blood levels of insulin, Hb Alc, and lipids were measured before and after the supplements. The mean ages of the three groups were 56.7-59.6 years old. The height, weight, and BMI did not differ among the groups. The fasting blood glucose levels were 138.1$\pm$22.0mg/dl for the Drug treated diabetes group, 175.0$\pm$32.0mg/dl for the Non-drug diabetes group, and 108. 3$\pm$16.gmg/dl for the control group at the begining of the supplement. After 4-wks of supplements, the blood levels of glucose tended to decrease in all three experimental groups. Before the supplements, the 2-h postprandial blood glucose levels of the Drug diabetes, Non drug diabetes, and control groups were 244.7$\pm$62.6mg/dl, 272.4$\pm$40.1mg/dl, and 147.7$\pm$28.0mg/dl, respectively. After the supplement, the levels were 197.2$\pm$30.gmg/dl, 208.6$\pm$ 56.6mg/dl, and 151.3$\pm$30.3mg/dl, respectively. This shows that silkworm powder tended to lower blood levels by 19.4% and 23.4% in NIDDM patient groups. However, the changes in the blood levels of insulin, Hb Alc, ind lipids were not observed after the supplement. In conclusion, the present study has demonstrated that silkworm powder has a tendency to decrease 2-h postprandial blood glucose levels, but it should be used with caution in controlling the diabetes. (Korean J Nutrition 31(7) 1139-1150, 1998)

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18-year Follow-up of Extended Newborn Screening for Metabolic and Endocrine Disorders (대사 및 내분비 질환에 대한 광범위 신생아 선별 검사의 18년 추적 관찰)

  • Song, Wung Joo;Lee, Sunho;Jeon, Young Mi;Kim, Sook Za;Jang, Mea Young
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.2
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    • pp.35-42
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    • 2018
  • Purpose: To follow up Korean patients with metabolic and endocrine disorders ascertained by Korea Genetics Research Center, and assess the long-term effectiveness of extended newborn screening program in Korea. Methods: From January 2000 to December 2017, tandem mass spectrometry and fluoroimmunoassay were employed in extended newborn screening (NBS). The NBS program obtained dried blood spots from 283,626 babies, 48 hours after birth, and screened for galactosemia, congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), and 50 preventable inborn errors of amino acid, fatty acid, and organic acid metabolism. Results: 28 cases of amino acid disorders, 75 cases of organic acid disorders, 27 cases of fatty acid disorders, 51 cases of urea cycle disorders, 127 cases of CH, 14 cases of CAH, and 15 cases of galactosemia were ascertained through NBS and subsequent confirmatory laboratory tests. Patients with amino acid metabolic disorders, galactosemia, CH, or CAH were more likely to have a better long-term outcome if detected early. Early management of MSUD led to much better outcome in over 90%. Despite early intervention, 32% of other organic acidemia cases still resulted in developmental delay and neurological problems. Fatty acid disorders showed varied results; those with EMA and MCAD had a good outcome, but those with VLCAD had serious neurological problems and considerably higher mortality. 75% with UCD experienced serious neurological complications and higher mortality. Conclusion: The nation-wide NBS program must be accompanied by comprehensive long-term management and physician and family education of inborn errors of metabolism for a better outcome.

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Somatic Cell Analysis and Cobalamin Responsiveness Study in Ten Korean Patients with Methylmalonic Aciduria (한국 메틸말로닌산혈증 환아 10례에서 Somatic Cell 분석과 cobalamin 반응성 연구)

  • Lim, Han Hyuk;Song, Wung Joo;Kim, Gu-Hwan;Watkins, David;Rosenblatt, David S.;Kim, Yoo-Mi;Chang, Mea Young;Kil, Hong Ryang;Kim, Sook Za
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.12-19
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    • 2019
  • Purpose: Isolated methylmalonic acidemia (MMA) is an autosomal recessive inherited disorder of propionate metabolism. There are two subtypes of MMUT gene defects. $Mut^0$ represents complete loss of methylmalonyl-CoA mutase (MCM) activity while mut- is associated with residual MCM activity, which can be stimulated by hydroxocobalamin (OHCbl) supplementation. The objective of this study is to investigate cobalamin responsiveness and mutations present in Korean MMA population. Methods: We evaluated 10 MMA patients using somatic cell complementation analysis on their fibroblasts to measure MCM activity and vitamin B12 responsiveness for the optimal treatment. MMUT gene was sequenced to identify the MMA mutations. Results: For all patients, the incorporation of $[^{14}C]-propionate$ was low, and there was no response to OHCbl. The incorporation of $[^{14}C]-methyltetrahydrofolate$ and $[^{57}Co]-CNCbl$ fell within the normal range. There was adequate synthesis of methylcobalamin while the synthesis of adenosylcobalamin was low. The complementation analysis showed all patients were $mut^0$. The sequence analysis identified 12 different MMUT mutations, including 2 novel mutations, p.Gln267Ter and p.Ile697Phe, were identified. All the patients in this study had neonatal onset of symptoms, belonged to $mut^0$ complementation class, and as a result, showed no cobalamin responsiveness. Conclusion: No Korean MMA patient showed cobalamin responsiveness.

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A Study on Historicity of 《Three Purities Album (三淸帖)》 in the Kansong Art Museum (간송미술관 소장 《삼청첩(三淸帖)》의 역사성에 대한 고찰)

  • Baik, In-san
    • Korean Journal of Heritage: History & Science
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    • v.46 no.2
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    • pp.186-205
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    • 2013
  • ${\ll}$Three Purities Album${\gg}$ in the Kansong Art Museum is an album of poems and pictures of apricot tree, orchids and bamboos drawn by Lee Jeong. Given that the poems and pictures in the album were drawn by Lee Jeong who has been recognized as a person who established the standards of ink bamboo drawings in the Joseon Dynasty, the album is highly valuable. Nevertheless, there are more values and meanings that Three Purities Album has. The production circumstances and transmission processes of Three Purities Album include the historical characteristics and meanings of the time so that it is also worthwhile as a historical material. During the Japanese Invasion of Korea in 1592, Lee Jeong was stabbed with a sword by Japanese invaders and got injured. After he suffered, he tried to make his masterpiece in his lifework and finally created Three Purities Album. For the work, Lee Jeong received memorial writings from Choi Rip, Cha Cheon-ro and Han Ho, and asked them writings. They were the best literary men in the poem and calligraphy fields at that time. Yu Geun, Lee An-nul, and Yu Mong-in made writings and poems to praise his work. Likewise, ${\ll}$Three Purities Album${\gg}$ is the 'treasure of the time' created through the participation of the best literary men at that time. Given the aspects, it is fair to say that ${\ll}$Three Purities Album${\gg}$ is not simply a personal artwork of Lee Jeong, but is a comprehensive artwork and also a cultural monument created through the skills and capabilities of the literary artists in the middle of the Joseon Dynasty. After the death of Lee Jeong, Three Purities Album was handed over to Hong Ju-won. But, during the second Manchu Invasion into Korea in 1636, the album was in danger of disappearance by fire. As of now, there are still signs of fire in it, which vividly shows the urgent situation at that time. After the second Manchu Invasion into Korea in 1636, Hong Ju-won recovered some damaged writings with the help of Yoon Shin-ji. Since then, the album had been handed down as a family treasure over the next 7 generations. It can be found in the writings by Song Si-yeol and Uh Yu-bong. Unlike the literary men who praised Three Purities Album in terms of its work when Lee Joeng was alive, they focused on the transmission courses of the album and involved persons. That seems to be because the stories and characters appearing in Three Purities Album impressed the later literary men and were meaningful to them rather than the album itself. It strongly reflected the positions of Hong Jung-gi and Hung Sang-han who asked for writings as the descendants of Hong Ju-won. That is because the traces of the persons involved in Three Purities Album are the causes for admiring their ancestors and enhancing their political legitimacy and family dignity. Therefore, in this aspect, it is possible to witness the fundamental causes of the unique artistic awareness by East Asian people who consider their historical meanings as well as the aesthetic value of artworks significant. Unfortunately, during the Japanese invasion at the end of the Joseon Dynasty, Three Purities Album was handed over to Japanese Tzuboikouso. But, fortunately, Jeon Hyeong-pil who made an effort to regain our cultural assets by investing his entire property during the Japanese Imperialism regained the album, which is now preserved in the Kansong Art Museum. ${\ll}$Three Purities Album${\gg}$ truly includes the whole processes to overcome national crises that Korean people experienced during the Japanese Invasion in 1592, the second Manchu Invasion of Korea in 1636, and the Japanese Imperialism, and it shows the sufferings of our cultural assets and the history of preservation. Also, the album shows that one artwork is able to accumulate its historical meanings in the process of transmission and thus enhances its meanings and values. ${\ll}$Three Purities Album${\gg}$ features accumulative and constant historical meanings and it is a typical case showing that an artwork is plenty of aesthetic and historical values. It is expected that this work will contribute to promoting more studies on finding historical meanings and hysteresis of artworks.