Controlled Atrial Fibrillation after Pulmonary Vein Stenting

When there is no pulmonary vein reconnection after catheter ablation for atrial fibrillation, patients can experience recurrence of atrial fibrillation without clear evidence of non-pulmonary vein foci. We describe a patient with significant pulmonary vein stenosis and recurrent atrial fibrillation after four ablation procedures. After successful pulmonary vein stenting, the symptoms were resolved, and sinus rhythm was maintained for 2 years without treatment with antiarrhythmic medication. We believe pulmonary vein stenting potentially controlled atrial fibrillation by providing pulmonary vein pressure relief or by compressing the epicardial triggers occurring at the pulmonary vein ostium.ope

Etiology and clinical feature of oral allergy syndrome in children

Purpose: Oral allergy syndrome (OAS) is a unique allergic reaction to fresh fruits or vegetables, which is caused by cross-reactivity between foods and pollens. This study was conducted to investigate the clinical feature of OAS and relevant pollen allergens as well as the association between them in Korean children. Methods: This single-center study included 290 children who were sensitized to pollens at Severance Hospital, and the clinical characteristics of children with and without OAS were compared. A multicenter study included 97 children who were diagnosed with OAS at 3 hospitals between January 2008 and June 2014. The details of clinical features were collected by retrospective medical record reviews using a standardized case report form. The relevant pollen allergens were identified by skin prick tests and/or serum specific IgE levels. Results: The most commonly sensitized allergen was Japanese hop in pollen-sensitized children. Children with OAS were most commonly sensitized to birch and oak, and 12.4% of the pollen-sensitized children had OAS in the single center. The number of children who were newly diagnosed with OAS has increased over the past 7 years. The most common causative food of OAS was apple. More than 60% of patients with OAS had oral allergic reactions to multiple foods. Conclusion: OAS may be relatively common in pollen-sensitized children. OAS should be considered in children with allergic disease and sensitization to pollens.ope

A Case of Congenital Disseminated Malignant Rhabdoid Tumor of the Soft Tissue in Neonate

Malignant rhabdoid tumor (MRT) was first described as a “rhabdomyosarcomatoid” variant of Wilms tumor, but was later identified as a distinct entity. MRTs are extremely rare and highly aggressive neoplasm with poor outcome, occurring mostly in kidneys and central nervous system, less frequently in extrarenal sites. MRTs are referred to as “congenital” when it is diagnosed at or immediately after birth. There are few reports about congenital disseminated MRT at birth. We report a case of congenital malignant rhabdoid tumor presenting as a soft tissue mass in the right arm at birth although the autopsy revealed the systemic disseminated tumors through the whole body with typical microscopic findingsope

Utility of tools for the assessment of asthma control in childhood asthma

Purpose : The goal of asthma control is to maintain well-controlled state. In this study, we investigated whether childhood asthma control test (C-ACT) may reflect lung function and whether fractional exhaled nitric oxide (FeNO) can be used to improve the accuracy of C-ACT in reflecting the asthma control level. Methods : We reviewed the medical records of 155 patients with asthma underwent lung function tests and C-ACT upon visiting our outpatient clinic. We compared lung function test results according to the C-ACT score stratified by atopy and also examined FeNO according to C-ACT and the Global Initiative for Asthma (GINA) guidelines. The diagnostic accuracy of well-controlled asthma by C-ACT, FeNO, and C-ACT+FeNO was examined. We also calculated the cutoff value of FeNO and C-ACT for well-controlled asthma. Results : Peak expiratory flow (PEF) showed a significant correlation with the C-ACT score. Stratified by atopy, PEF, and forced expiration in one second (FEV1) showed significant correlations with the C-ACT score in the atopic asthma group. There was no difference in FeNO between subjects with C-ACT≥20 and <20, but FeNO was significantly higher in the uncontrolled asthma according to the GINA guidelines. The diagnostic accuracy of well-controlled asthma was higher when FeNO was combined with the C-ACT score than C-ACT or FeNO. Our study showed that the cutoff values of C-ACT and FeNO 19 and 18.3 ppb (parts per billion), respectively, for well-controlled asthma. Conclusion : C-ACT showed a significant correlation with PEF, and atopic asthma group showed significant correlations with PEF and FEV1. A combination of C-ACT with FeNO might reflect asthma control status more accurately.ope

Relationship Between Serum Interleukin-17F Level and Severity of Atopic Dermatitis in Children

Background: Recent discovery of the Th17 pathway is providing new opportunities for understanding chronic immune-mediated diseases. The Th17 pathway has been historically associated with chronic inflammatory diseases such as psoriasis, multiple sclerosis, and rheumatoid arthritis. Among Th17 cytokines, pathogenic roles of IL-17A and IL-17F in asthma have been well described. Recently, the number of peripheral blood Th17 cells was found to correlate with disease severity in patients with atopic dermatitis (AD). This study aimed to investigate serum IL-17F levels in children with AD and to correlate this with severity of the disease. Methods: Enzyme-linked immunosorbent assay was used to measure IL-17F levels in the sera of 228 patients with AD and 62 control children. The SCORing Atopic Dermatitis (SCORAD) tool was used to determine the severity of disease. Results: The mean serum level of IL-17F in children with AD was significantly higher than that in the control group (p<0.05) Serum IL-17F levels were also higher in patients with severe AD than in those with mild AD (p<0.001), and IL-17F levels and SCORAD scores were positively correlated (p<0.05). Conclusions: Serum IL-17F level might be a useful marker in children with AD.ope

Heterogeneity of asthma according to systemic inflammatory pattern in children

Purpose: Asthma is a chronic airway inflammation. We evaluated whether systemic inflammatory patterns could reflect the nature of airway inflammation. We assessed characteristics of asthma according to systemic inflammatory patterns. Methods: A total of 413 children with asthma were enrolled in the study. Four systemic inflammatory patterns were classified according to eosinophil and neutrophil counts in peripheral blood. Children with neutrophil count≥5,000/μL were defined as the NEUhi group, those with neutrophil count <2,720/μL as the NEUlo group. The intermediate group with neutrophil count between 2,720/μL and 5,000/uL was excluded from the study. Children with eosinophil≥650/μL were defined as the EOShi group, those with eosinophil count<240/μL as the EOSlo group. The remaining patients were excluded from the study. The characteristics of asthma include pulmonary function test results, bronchodilator response, airway hyperresponsiveness, and atopy. Results: The EOShi group had a lower PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second [FEV1]), a lower FEV1, and a higher immunoglobulin E level rather than the EOSlo groups, although there were no significant differences between the NEUhi and NEUlo groups. The eosinophil percentages of the induced sputum samples were higher in the EOShi group than the EOSlo group and correlated with blood eosinophil counts. Conclusion: Eosinophilic inflammation was related to characteristics of asthma and sputum eosinophils. However, neutrophilic inflammation reflected neither asthma features, sputum neutrophils, nor eosinophilic inflammation. Further studies on blood neutrophils involving asthma phenotypes in terms of more specific characteristics of asthma should be needed in children.ope

Long-Term Prognosis of Patients with an Implantable Cardioverter-Defibrillator in Korea

PURPOSE: The objective of this study was to elucidate the long-term prognosis of patients with implantable cardioverter-defibrillators (ICDs) in Korea. MATERIALS AND METHODS: We enrolled 405 patients (age, 57.7±16.7 years; 311 men) who had undergone ICD implantation. The patients were divided into three groups: heart failure (HF) and ICD for primary (group 1, n=118) and secondary prevention (group 2, n=93) and non-HF (group 3, n=194). We compared appropriate and inappropriate ICD therapy delivery among the groups and between high- (heart rate ≥200 /min) and low-rate (<200 /min) ICD therapy zones. RESULTS: During the follow-up period (58.9±49.8 months), the annual appropriate ICD therapy rate was higher in group 2 (10.4%) than in groups 1 and 3 (6.1% and 5.9%, respectively, p<0.001). There were no significant differences in annual inappropriate ICD therapy rate among the three groups. In group 1, the annual appropriate ICD therapy rate was significantly lower in patients with a high-rate versus a low-rate therapy zone (4.5% and 9.6%, respectively, p=0.026). In group 3, the annual inappropriate ICD therapy rate was significantly lower in patients with a high-rate versus a low-rate therapy zone (3.1% and 4.0%, respectively, p=0.048). CONCLUSION: Appropriate ICD therapy rates are not low in Korean patients with ICD, relative to prior large-scale studies in Western countries. Appropriate and inappropriate ICD therapy could be reduced by a high-rate therapy zone in patients with HF and ICD for primary prevention, as well as non-HF patients, respectively.ope

Mapping properties on certain classes of regular univalent functions

Bernadi는 Libera에서 기인된 convex 함수족, starlike 함수족 close-to-convex 함수족에 대한 성질들을 확장시켰다. 이 논문에서 우리는 Livingston의 정리를 확장하고 일반화 시켰다. 또한 Bernadi의 정리와 유사한 정리가 univalent인 함수들의 부분함수족인 위수가 β인 starlike 함수족, 위수가 β인 convex 함수족, 위수가 α이고 형태가 β인 close-to-convex 함수족에 대해서도 성립한다는 것을 증명하였다. 그리고 S*(β),K(β),C(α, β)에 대한 각각의 starlikeness, convexity, close-to-convexity의 반경을 조사하였다.;Bernadi extended0 the mapping properties of Liberals results for the classes of convex, starlike and close-to-convex. In this thesis, we are to extend and qeneralize the theorems of Livingston and obtain analogue theorems of Bernadi for the subclasses of univalent functions, namely, starlike functions of order β, convex functions of order β and close-to-convex functions of order α and type β. Further, we study on the radius of convexity, starlikeness and close-to-convexity for the classes K(β), S*(β) and C(α, β), respectivelyABSTRACT 목차 = ⅱ Ⅰ. INTRODUCTION = 1 Ⅱ. GENERALIZATION OF LIVINGSTON&amp;apos;S RESULT ON THE RADIUS OF STARLIKENESS, CONVEXITY AND CLOSE-TO-CONVEXITY = 4 Ⅲ. ANALOGUE THEOREMS OF BERNARDI&amp;apos;S FOR STARLIKE FUNCTIONS OF ORDER β, CONVEX FUNCTIONS OF ORDER β, CLOSE-TO-CONVEX FUNCTIONS OF ORDER α AND TYPE β = 10 Ⅳ. ON THE RADIUS OF CONVEXITY, STARLIKENESS = 13 REFERENCE = 18 논문초

Feasibility and safety of transcatheter closure of patent ductus arteriosus in small children weighing 10kg or less

의학과/석사목 적: 경피적 심도자술을 통한 중재적 폐쇄술은 현재 동맥관 개존의 표준적 치료로 시행되고 있다. 지속적인 기술의 발전과 시술 경험의 축적으로 성공률이 향상되었으나, 시술과 연관된 합병증은 여전히 보고되고 있으며, 특히 체중이 작은 영아에서 합병증 발생 비율이 높다. 이에 본 연구는 이전의 연구들보다 많은 환자를 대상으로 한 시술 결과를 분석하여, 체중이 10kg 이하인 소아에서 적절한 치료에 도움이 되고자 하였다.방 법: 2003년 1월부터 2009년 12월까지 연세대학교 세브란스병원 소아심장과에서 동맥관 개존을 진단받고 경피적 심도자술을 통한 중재적 폐쇄술을 받은 환아 115명을 대상으로 하였다.결 과: 대상 환자의 평균 나이는 9.1 ± 5.9개월이고, 평균 체중은 7.6 ± 1.8kg 이며, 동맥관의 평균 최소직경은 3.6 ± 1.8mm 이었다. 전체 115명의 대상 환자 중 114명의 환자에서 시술이 성공적으로 시행되었다. (성공률 99%) 실패한 1명의 환자는 시술 직후 기구의 위치가 불안정하여, 색전의 가능성이 높아 제거한 경우였다. 시술이 성공한 114명의 환자 중 1명은 시술 3년 후까지 미세한 단락이 관찰되었다. 경도의 하행 대동맥 협착이 관찰된 환자는 2명이었고, 그 중 1명은 진행하는 소견을 보여 시술 후 3개월에 경피적 혈관 성형술을 시행하였다. 3명의 환자에서 경도의 폐동맥 협착이 보였다. 그 외 시술과 연관된 혈관 손상 및 용혈 현상, 그리고 다량 출혈과 같은 합병증은 관찰 되지 않았다.결 론: 10kg 이하 소아에서 경피적 심도자술을 통한 동맥관 개존의 중재적 폐쇄술은 성공률이 99% 로, 높은 성공률 및 안전성을 보여 주었다. 따라서 체중이 10kg 이하인 소아 환자의 동맥관 개존에 대한 경피적 심도자술을 통한 중재적 폐쇄술은 향후 안전한 선택적 치료 방법으로 적용될 수 있을 것이다.ope

생산직 미혼 여성노동자의 주변적 지위에 관한 연구

학위논문(석사)--서울대학교 대학원 :인류학과 인류학전공,1995.Maste