1.CD5 mRNA Expression in Pepherial Blood Mononuclear Cell of Neonate.
Geun Wong NOH ; In Kul MOON ; Woo Gill LEE
Korean Journal of Perinatology 1997;8(2):163-171
PURPOSE: The CD5 molecules of mice (Ly-1) and humans (T1) are pan-T cell antigens and are also found on a minor subpopulation of B cells. Cl)5+ B cells constitute a large fraction of the B cells early in development and in neonate. There are many reports about the production and mRNA expression of CD5+ B cells and in this study CD5 mRNA expression by peripheral blood mononuclear cell (PBMC) was examined in neonate and compared with those in normal children and childrens of acute febrile diseases. METHODS: Ten normal neonate(mean age, 1.2 days), ten children of acute febrile disease (mean age, 8.5 months) and ten nomal children (mean age 9 months) were studied. One mililiter of venous blood was drawn and immunophenotypes were determined using FACS (fluorescent activated cell sortor) with FITC-conjugated anti-CD5 and PE-conjugated anti-CD 19. PBMC was separated and CD5 mRNA expression was examined in these groups. RESULTS: 1) From the analysis using FACS, there was no significant difference for the CD5+ 1' cell fractions in white blood cells among neonates(78.52+13.98 %), acute febrile infectious disease controls (l0.86 + 5.56 %) and normal controls (73.53 + 4.62 %) (p>0.05). 2) The fractions of CD5+ H cell in B cells were markedly high in neonate (65.18+ 13.67 %) as compared to that in children of acute febrile disease controls (27.14+5.96 %) and normal controls (20.04+5.92 %) (p<0.001). 3) CD5 mRNA expression was detected only in neonate and not in children of acute febrile disease controls or normal controls. CONCLUSIONS: Neonate has a large fraction of CD5+ B cells in total H cells as compared to that of children of acute febrile diseases or normal controls. PHMC of neonate normally expressed CD5 mRNA but that of acute febrile group or normal control group did not. Further study about the roles and meanings of CD5 mRNA expression may be needed.
Animals
;
Antigens, CD5
;
B-Lymphocytes
;
Child
;
Communicable Diseases
;
Humans
;
Infant, Newborn*
;
Leukocytes
;
Mice
;
RNA, Messenger*
2.Approximate Entropy: Analysis of Fetal Heart Rate Variability in Normal and Growth Retarded Fetuses.
Jung Hye HWANG ; Moon Il PARK ; Myung Kul YUM
Korean Journal of Obstetrics and Gynecology 1997;40(1):92-99
OBJECTIVES: This study is aimed to quantify the complex dynamics of beat-to-beat fetal heart rate(FHR) fluctuations by using approximate entropy(ApEn) which is a recently developed mathematical formula quantifying regularity and also to determine the differences between normal fetuses and growth retarded fetuses. BACKGROUND: Recently, some measures of heart rate variability and nonlinear "complexity" of heart rate dynamics have been used as indicators fetal well-being. Approximate entropy is a new mathematical approach and formula to quantify regularity in data. It has been shown to provide new information in fetal heart rate analysis. Because growth retarded fetus accounts for a significant increase in perinatal morbidity and mortality, than normal fetus, we postulated that there existed important differences between normal fetuses and growth retarded fetuses. METHODS: We analyzed FHR tracings for 40 minutes, and approximately 5,000 points in normal fetuses(n=315) and growth retarded fetuses(n=76). The overall "complexity" of each FHR time series was quantified by its approximate entropy, measure of regularity derived from nonlinear dynamics, "chaos theory". RESULTS: Mean baseline FHR increased in growth retarded fetuses than normal fetuses. And the FHR ApEn significantly decreased in growth retarded fetuses(ApEn=0.623) compared to that of the normal fetuses(ApEn=0.868) throughout all gestational ages(p < 0.001). CONCLUSIONS: The ApEn of FHR decreased in growth retarded fetuses throughout all gestational ages. These findings indicated that decreased ApEn values of FHR are associated with sickness and the greater perinatal morbidity risks. Therefore ApEn quantifies subtle changes in FHR regularity and promises for new information in FHR analysis.
Entropy*
;
Female
;
Fetal Heart*
;
Fetus*
;
Gestational Age
;
Heart Rate
;
Heart Rate, Fetal*
;
Mortality
;
Nonlinear Dynamics
;
Pregnancy
3.Development of Approximate Entropy of Fetal Heart Rate Varibility during Normal Pregnancy.
Myung Kul YUM ; Jung Hye HWANG ; Moon Il PARK
Journal of the Korean Pediatric Society 1997;40(4):464-472
Background : The approximate entropy of heart rate variability has recently been used as a tool in evaluating cardiovascular health and physiology and in diagnosing pertubated physiologic status, by quantifying the irregularity and the pattern of the heart rate variability. Therefore approximate entropy of the fetal heart rate variability will be used as an important tool in studying the fetal cardiovascular health and disease, but unfortunately there have been no previous systematic studies of the approximate entropy in normal fetuses. This study's aim has been to present the normal approximate entropy values of the fetal heart rate variability according to the gestational age, to demonstrate the developmental maturation of physiology of the control systems of the heart rate, and to quantify the evolution of the pattern of fetal heart rate variability. METHODS: Three hundred and thirty seven mothers with normal singleton pregnancies, who were 20 weeks or more of gestational age, were randomly chosen. For more than 40 minutes fetal heart rates and fetal movements were recorded and were downloaded to a computer. From each heart rate data, 5000 points ('total') of heart rate during which fetal movements occured and 1200 points ('rest') during which no fetal movement occured were selected and the approximate entropy was calculated, and then 2 weeks' average of the approximated entropy of the heart rate were calculated and compared to find the maturational differences of them. RESULTS: The approximate entropy of the rest period showed a tendency to increase with advancing gestation (p=0.0001). It was significantly higher between the 41st-42nd week (0.987 +/-0.017) than the period before the 24 th week (0.864+/-0.032) and between the 25th-26th week (0.868+/-0.022). (p<0.05). The approximate entropy of the total period showed another tendency (p<0.05): from a low level before the 24 th week (0.788+/-0.067) it increased to reach its peak at the 29th-30 th week (0.963+/-0.041) then it gradually decreased again to significantly (p<0.05) lower levels at the 37th-38th week (0.776+/-0.046) and the 39th-40th week (0.786+/-0.047). CONCLUSIONS: Normal value of approximate entropy, which is bound to be used as an index in evaluating the fetal well-being, has been presented from 20th to 42th week of gestation with an interval of two weeks. The systems that control the heart rate seem to mature consistently as gestation advances, but before the 26th week it is significantly more immature than at term. Fetal heart rate variability evolves from an immature oscillating pattern into a transitional patternless pattern during the second trimester and finally consolidates into a mature accelerational pattern during the third trimester.
Entropy*
;
Female
;
Fetal Heart*
;
Fetal Movement
;
Fetus
;
Gestational Age
;
Heart Rate
;
Heart Rate, Fetal*
;
Humans
;
Mothers
;
Physiology
;
Pregnancy
;
Pregnancy Trimester, Second
;
Pregnancy Trimester, Third
;
Pregnancy*
;
Reference Values
4.The Novel Low Frequency Oscillation in Pulmonary Artery Pressure.
Mung Kul YUM ; Dong Ju CHOI ; Moon Hong DOH ; Young Geun JUNG ; Seung Hwan KIM
Korean Circulation Journal 1993;23(5):714-722
BACKGROUND: It is well known that systemic blood pressure oscillates with low(0.04~0.1Hz), mid(0.1~0.15Hz), and high(respiratory) frequency range. But there has been no study about oscillation of pulmonary artery pressure(PAP). METHOD: We measured PAP for 5 minutes in 32 patients of ventricular septal defect and stored them to computer files. Power spectral density curve was obtained. Low, mid, respiratory frequency power were measured by integrating the area within each frequency range below the power density curve. RESULT: The incidence of significant low frequency power(more than 5% of total power) were higher in patients of high PAP and hign Rp/Rs than those of low PAP and Rp/Rs(p<0.01 and p<0.005 respectively). The low frequency power positively correlates with PAP and Rp/Rs(r=0.62, p<0.0005 and r=0.61, p=0.0005 respectively). CONCLUSION: It can be said conclusively that as PAP and pulmonary vascular resistance elevates, the PAP tends to definitively oscillate in low frequency range.
Blood Pressure
;
Heart Septal Defects, Ventricular
;
Humans
;
Incidence
;
Pulmonary Artery*
;
Vascular Resistance
5.The Effectiveness for Vagal Stimulation by Ice Water Application to Face during Controlled Respiration and Mechanism of Individual Variability of Responsiveness to Vagal Stimulation (Power Spectral Analysis of Heart Rate Variability).
Myung Kul YUM ; Seung Hwan KIM ; Dong Ju CHOI ; Moon Hong DOH ; Young Kyun CHUNG
Korean Circulation Journal 1993;23(4):571-579
BACKGROUND: The effectiveness for vagal stimulation by ice water aplication to face during metronome-controlled respiration of 15 breaths/minute was examed. The importance of basal vagal tone and sympathovagal interaction in the individual variability of responsiveness to the vagal stimulation was investigated. METHOD: Fifty three 12~13 year old healthy volunteers were included. Vagal tone and sympathovagal interaction before and after application of ice water to the face were assessed by power spectral analysis of RR interval(heart rate) variability. RESULT: Basal heart rate, high frequency power, and low to high frequency power ratio were 81+/-13(58~110 beats/min), 791+/-1061(56~4161 msec2) and 1.08+/-1.22(0.04~4.85) during controlled respiration. After ice water application twenty three children developed 5 more nodal escape beats due to severe bradycardia. Minimum heart rate, high frequency power and low to high power ratio changed to 42+/-12(19~72/min), 1890+/-1882(221~7258msec2) and 0.64+/-0.43(0.12~1.46). The increased ratio of high frequency power, maximum heart rate decrement and its percent after stimulation were 5.44+/-5.62(0.63~24.26), 39+/-14(10~81/min) and 47+/-15(16~81%) respectively. The increased ratio of high frequency power was correlated with basal logarithmic high frequency power(r=-0.60, p=0.0004). Maximum heart rate decrement was correlated with basal logarithmic high frequency power(r=-0.41, p=0.0018) and low to high frequency power ratio(r=0.27, p=0.04). CONCLUSION: Application of ice water to the face during controlled respiration produces powerful vagal stimulation and bradycardia, however, there is a wide individual variability of responsiveness to it. The absolute basal vagal tone contribute to this individual variability.
Bradycardia
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Child
;
Healthy Volunteers
;
Heart Rate*
;
Heart*
;
Humans
;
Ice*
;
Respiration*
;
United Nations
;
Water*
6.Risk Factors for Neonatal Sepsis in Premature Infants Admitted to Neonatal Intensive Care Unit.
Chang Ryul KIM ; Jae Won OH ; Myung Kul YUM ; Soo Jee MOON
Journal of the Korean Pediatric Society 2000;43(9):1174-1179
PURPOSE: The purpose of this study is to find out the risk factors of sepsis except the prematurity itself. METHODS: Seventy-seven premature infants less than 37 weeks of gestation, who were admitted to the neonatal intensive care unit of Hanyang University Kuri Hospital between July 1995 and December 1996, were enrolled in this study. All 77 premature infants, 14 patients proven to have sepsis by blood culture. They were matched with 24 controls by gestational age and date of birth. The risk factors for neonatal sepsis between the groups were compared. RESULTS: Fourteen of 77 subjects(18.2%) had culture-proven sepsis. Among them, all but one, who had confirmed sepsis on the first day of life, were late-onset >72 hours of age(16+/-6 days of life). Gestational age and birth weight of sepsis group(mean+/-SD) were similar to those of controls: 31.6+/-3.6 week vs 31.5+/-3.3 weeks; 1673+/-832g vs 1651+/-513g, and survival rate was also similar between the two groups(n=ll, 79% for sepsis group vs n=20, 77% for the control). In the analyses of risk factors of sepsis only parenteral nutrition and duration of parenteral nutrition were significantly more frequent and longer in the sepsis group compared to the control(n=8, 73% vs n=6, 30%, P=0.022; 20+/-15 days vs 7+/-4 days, P=0.0364). CONCLUSION: Incidence of neonatal sepsis in premature infants <37 weeks of gestaton admitted to neonatal intensive care unit was 18.2%. Ninty-three pevcent of the infants was late-onset sepsis. Sepsis group had more frequent use and longer duration of parenteral nutrition. In order to reduce neonatal sepsis in premature infants, use and duration of paventeral nutrition should be restricted.
Birth Weight
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Gestational Age
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Humans
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Incidence
;
Infant
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Infant, Newborn
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Infant, Premature*
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Intensive Care, Neonatal*
;
Parenteral Nutrition
;
Parturition
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Pregnancy
;
Risk Factors*
;
Sepsis*
;
Survival Rate
7.Linear and Non-linear Analysis of Cardiovascular System in Preterm Infants.
Eun Young PARK ; Myung Kul YUM ; Soo Jee MOON
Journal of the Korean Society of Neonatology 2002;9(1):57-64
PURPOSE: We investigated the autonomic and complex modulation in heart rate and blood pressure in preterm infants. METHODS: In 20 healthy preterm infants and 20 full-term infants (gestational age of 32.5+/-2.3 and 39.2+/-1.0 weeks each, P<0.0001), we recorded electrocardio gram and non-invasive blood pressure simultaneously and continuously during their sleep in the supine position. To evaluate the autonomic and complex modulation in heart rate and blood pressure, we performed power spectral analysis and analysis of the determinism. RESULTS: When compared to full-term infants and in the analysis of R-R interval, the preterm infants had significantly lower high-frequency power (30.7+/-15.1% vs 20.3+/-7.7%, P<0.05), higher low- to high-frequency power ratio (1.9+/-1.6 vs 3.0+/-2.1, P<0.05), and significantly lower prediction error (4.1+/-2.8% vs 2.9+/-1.3%, P<0.05). In the analysis of blood pressure, they showed no significant difference. CONCLUSION: Compared to heart rates of full-term infants, the heart rates of preterm infants are less modulated by cardiac parasympathetic activity and more deterministic.
Blood Pressure
;
Cardiovascular System*
;
Heart Rate
;
Humans
;
Infant
;
Infant, Newborn
;
Infant, Premature*
;
Supine Position
8.Abnormal Chaotic and Periodic Heart Rate Dynamics In Uncomplicated Intrauterine Growth Retarded Fetuses.
Myung Kul YUM ; Nam Soo KIM ; Jae Won OH ; Chang Ryul KIM ; Soo Ji MOON ; Jung Hye HWANG ; Moon Il PARK
Korean Journal of Perinatology 1997;8(4):401-407
No abstract available.
Fetus*
;
Heart Rate*
;
Heart*
9.Serum Fluoride Level in Normal Adult Women and Changes in Serum Fluoride Level after Disodium Monofluorophosphate Administration.
Hyun Koo YOON ; Mi Sun JUNG ; In Kul MOON ; Sang Woo KIM ; Ho Yeon CHUNG ; Ki Ok HAN ; Hak Chul JANG ; In Kwon HAN ; Hun Ki MIN
Journal of Korean Society of Endocrinology 1997;12(4):565-570
BACKGROUND: Since the morning fluoride level of 10 uM is recommended for adults patients being treated for osteoporosis so far, measurement of serum fluoride level is important to detect abnormally high levels or to detect levels below the therapeutic windows. Aims of this study are to determine the normal range of serum ionic fluoride levels in Korean female adults (from 5th to 7th decade), and to evaluate the in vivo fluoride pharmacokinetics of monofluorophosphate in Korean adults. METHODS: Serum level of fluoride was measured from blood samples of 72 female subjects (age 43-69years) using an ion selective electrode. For pharrnacokinetics of monofluorophosphate-calcium (MFP-Ca), 6 subjects (age 27~45 years) were included to be withdrawn the blood hourly for the first S hours and the blood was withdrawn at 24 hours after a single dose of MFP-Ca. RESULTS: Mean level of serum fluoride was 1.64+-0.12uM in 5th, 6th, 7th decades adults, and there was no difference of serum fluoride levels among age groups. Peak serum fluoride level exhibited 5.02+-0.67pM, and returned to basal level on 24 hours after a single dose of MFP-Ca. CONCLUSION: This study shows that mean serutn fluoride of Korean female adults (from 5th to 7th decade) is not different from that of other reports, and a single dose of MFP-Ca does not cause serum fluoride levels above the recommended therapeutic windows of 5-10uM for 24 hours.
Adult*
;
Electrodes
;
Female
;
Fluorides*
;
Humans
;
Osteoporosis
;
Pharmacokinetics
;
Reference Values
10.(99m)Tc-MIBI SPECT Findings in Diabetics with Coronary Artery Disease.
Won Ju LEE ; Moon Hong DOH ; Keun Woo LEE ; Dong Ju CHOI ; Mung Kul YUM ; Sun Il JUNG ; Jin Hak CHOI
Korean Circulation Journal 1993;23(6):867-873
BACKGROUND: Evaluation of coronary artery disease(CAD) by radionuclide myocardial perfusion scintigraphy is safe, convenient and informative for diagnosis of CAD & assessment of functional significance of stenotic lesions. We tried to evaluate the characteristics of CAD in dibetics by intravenous dipyridamloe (99m)Tc-MIBI(methoxy isobutyl isonitrile) SPECT(Single Photon Emission Computed Tomography). METHOD: (99m)Tc-MIBI SPECT and coronary arteriography(CAG) were performed simultaneously in less than 2 week interval in 41 diabetics(diabetic group) and 103 non-diabetics(non-diabetic group) with clinical suspicion of CAD. The sensitivity and specificity of (99m)Tc-MIBI SPECT for detection of CAD were compared between two groups. The site and number of involved vessels, the extent of perfusion defect and redistribution pattern were compared between two groups. RESULT: 1) The sensitivity and specificity of (99m)Tc-MIBI SPECT for detection of CAD were 97% and 80% in diabetics, these were comparable to those in non-diabetics(97% and 78%). 2) Three vessel disease were common(p<0.01)in diabetics(SPECT 28.1%, CAG 32.3%) than in non-diabetics(SPECT 11.4%, CAG 7.5%). Distal lesions were also more common(p<0.005) in diabetics(CAG 40.3%) than in non-diabetics(CAG 15.7%). 3) On stress SPECT, the extent of perfusion defect was not different in individual vessel areas between diabetics and non-diabetics. However the perfusion defect of left ventricle as a whole was significantly higher(p<0.05) in diabetics(35.2+/-16.2%) than in non-diabetics(26.4+/-15.5%). 4) On rest SPECT, the percent redistribution was significantly lower in diabetics than in non-diabetics(left anterior descending artery area ; diabetic group 31.1+/-22.5% vs non-diabetic group ; 49+/-28.5%, p<0.05, left ventricle as a whole ; diabetic group 30.6+/-21.2% vs non-diabetic group 48.2+/-27.6%, p<0.02). CONCLUSION: Quantitative (99m)Tc-MIBI SPECT provided high sensitivity and specificity for detection of CAD in diabetics. Multiple vessel disease, distal lesion and fixed lesions were more common in diabetics than in non-diabetics, (99m)Tc-MIBI SPECT is useful noninvasive test for diagnosis of CAD & important prognostic implications.
Arteries
;
Coronary Artery Disease*
;
Coronary Vessels*
;
Diagnosis
;
Heart Ventricles
;
Perfusion
;
Perfusion Imaging
;
Sensitivity and Specificity
;
Tomography, Emission-Computed, Single-Photon*