BACKGROUND: Myocardial ischemia in human hypertension and in various animal models of hypertension may be due to abnormal maximal coronary vasodilator reserve and disturbaces of coronary vasomotion. The vascular reactivity defects in hypertension have been associated with the defective endothelium and sympathetic neural activation. However, such abnormalities in hypertension need to be elucidated. In the present study the effectsof cardiac ischemia reperfusion on coronary circulation, intramyocytic adenylates and purine nucleosides were examined in Langendorff-perfused Sprague Dawley rat (SD) and spontaneously hypertensive rat (SHR) hearts. Coronary venous and cardiac lactate and cardiac pyruvate were also measured. It should be noted that in the regulation of coronary flow the intrinsic flow autoregulation is highly variable due to coexisting metabolic flow control, and that natural coronary flow and cardiomyocytic energy state are normally reciprocally related in perfused heart. METHODS: For the Langendorff heart perfusion, bicarbonate perfusion buffer (pH 7.40+/-0.02,37degrees C) was equilibrated with 95% O2 : 5% CO2 and contained 5mM glucose (+5U/1 insulin) and 2mM pyruvate as energy-yielding substrates. Global hypoperfusion ischemia was induced by lowering coronary perfusion pressure of 100 to 40 cmH2O, followed by 20 min reperfusion. RESULTS: During the ischemia and reperfusion, metabolic acidosis and enhanced venous lactate output in SHR were observed with increases in coronary vascular resistance and myocardial oxygen consumption.In addition, coronary reactive hyperemia during reperfusion was depressed. Although ischemia-induced increase in combined adenosine plus inosine were abolished during prolonged reperfusion, SD still exhibited coronary vasodilation. The depressed reactive hyperemia in SHR was associated with decreases in cardiac adenosine triphosphate (ATP) pool and creatine phosphate/inorganic phosphate (CrP/Pi) ratio and an increase in cardiac lactate/pyruvate ratio. CONCLUSION: This abnormal vascular reactivity during ischemia and reperfusion in SHR may be in part due to an alteration in the cardiac energy state and hence to a mismatch between myocardial metabolic demand and supply.
Acidosis ; Adenosine ; Adenosine Triphosphate ; Animals ; Coronary Circulation ; Creatine ; Endothelium ; Glucose ; Heart* ; Homeostasis ; Humans ; Hyperemia ; Hypertension ; Inosine ; Ischemia ; Lactic Acid ; Models, Animal ; Myocardial Ischemia ; Oxygen ; Perfusion* ; Purine Nucleosides ; Pyruvic Acid ; Rats ; Rats, Inbred SHR* ; Reperfusion ; Vascular Resistance ; Vasodilation

No abstract available.
Coronary Circulation* ; Heart* ; Rats, Inbred SHR*

PURPOSE: The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). METHODS: A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. RESULTS: Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count (14,473+/-6,824/mm3 vs. 11,254+/-5,775/mm3, P=0.002) and the C-reactive protein (6.32+/-8.51 mg/L vs. 1.28+/-2.35 mg/L, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). CONCLUSION: This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.
Bacterial Infections ; C-Reactive Protein ; Enterovirus ; Escherichia coli ; Fever ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Neurologic Manifestations ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Sepsis ; Streptococcus agalactiae

This study was conducted to analyze the relations among nutritional knowledge, nutritional attitude eating practice and total nutritional diagnosis and also to find the influencing factors of them. The survey was done during the period from April 1990 to June 1990 and the target population were Ewha Woman's University students (freshmen and senior) of whom 1,354 peoples were surveyed. The summarized results are as follows ; 1. For the learning environment, the percentage of completion on nutritional knowledge course was 28.6% and among them the department of foods and nutrition had the highest score(100.0%) and the next was dept. of medicine(53.4%). 2. To find the relation which the nutritional knowledge, nutritional attitude, eating practice and the total nutritional diagnosis influence on one another, the multiple correlation analysis was done. The attitude the practice were highly correlated with total nutritional diagnosis, but the correlation between nutritional knowledge and total nutritional diagnosis was not significant. The correlation between the practice and nutritional knowledge which were positively and significantly correlated with attitude respectively was positive but not significant. 3. The difference which were analyzed by department, grade and completion on knowledge course on the nutritional knowledge, attitude, eating practice were significant (p<0.01) by ANOVA. 4. The significant variables on nutritional diagnosis are the eating practice points, the grade, the knowledge course, the breakfast and the attitude (r2=10.3%) by multiple regression analysis. This study has the limitation that it did not consider the environmental factors of dietary life such as dietary culture, family environment, cultural habit. Therefore important points of these dietary studies are to extend to the practical nutritional education and dietary improvement for the national health not restricted to the local area or local population.
Attitude ; Breakfast ; Diagnosis ; Eating* ; Education ; Female ; Health Services Needs and Demand ; Humans ; Learning

Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.
Appetite ; Aspirin ; Chickenpox ; Child ; Humans ; Hyperammonemia ; Immunoglobulins ; Infant ; Influenza, Human ; Jaundice ; Lethargy ; Liver Diseases ; Mucocutaneous Lymph Node Syndrome ; Precipitating Factors ; Reye Syndrome ; Salicylates ; Vomiting

No abstract available.
Purpura, Schoenlein-Henoch* ; Streptococcal Infections*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Purpose: This report describes a case of recurrent ophthalmoplegia associated with hyperhomocysteinemia due to methylenetetrahydrofolate reductase (MTHFR) gene polymorphism.Case summary: A 40‐year‐old healthy man presented with acute diplopia. He had a history of diplopia due to left sixth nerve palsy 2 years ago. Prism and alternate cover tests revealed left hypertropia in the primary position. Examination of ductions and versions showed mild elevation of the left eye on adduction. Brain and orbit magnetic resonance imaging were normal. Laboratory studies revealed an elevated level of erythrocyte sedimentation rate (ESR) and homocysteine. A diagnosis of left fourth nerve palsy associated with hyperhomocysteinemia was made. Symptoms were completely resolved within 2 weeks. Two years later, the patient again had diplopia associated with esotropia and limited abduction of the right eye. ESR and homocysteine level were normal. Analysis for MTHFR gene polymorphisms, which contribute to variable hyperhomocysteinemia, revealed 677TT homozygote variant. A diagnosis of recurrent paralytic strabismus associated with hyperhomocysteinemia, caused by MTHFR gene polymorphism, was made. Symptoms resolved within 1 month, and the patient did not have any further recurrence in 6 months. Conclusions Patients with hyperhomocysteinemia may present with ophthalmoplegia. An analysis for MTHFR gene polymorphisms is needed to diagnose hyperhomocysteinemia.

BACKGROUND: A rehabilitation hospital has the characteristics of longer hospital stay, a variety of medical and paramedical personnels involved in treatment, and more probability of the primary care giver being a nonmedical person. The purpose of this study is to describe the characteristics of nosocomial infection in a rehabilitation hospitals METHODS: Surveillance was done in a rehabilitation hospital affiliated university hospital from June to August 1996, May to June 1997, and July to September 1999. Nosocomial infection was investigated by an infection control practitioner (JCP) according to the Center for Disease Control and Prevention (CDC)'s definitions visiting the rehabilitation wards regularly. RESULTS: The overall NI rates were 3.83 in 1996, 4.42 in 1997 and 1.91 in 1999 per 1,000 patient days, and the urinary tract infection (UTI) rates were 2.82 in 1996, 2.87 in 1997 and 1.07 in 1999 per 1,000 patient days. Both of overall NI rate and UTI rate in 1999 decreased significantly compared with that in 1996 and 1997 (P<0.001). Comparing the ward specific NI rate, the average NI rate of the spinal cord injury ward was the highest (5.67 per 1,000 patient days) and that of the pediatric rehabilitation ward was the lowest (0.83 per 1,000 patient days). UTI constituted of the largest proportion of NIs. The distribution of UTI showed a decreasing tendency from 73.47% in 1996 to 56.00% in 1999, but the distribution of gastrointestinal infection showed an increasing tendency from 4.08% and 5.40% in 1997 and 1996 to 24.00% in 1999. The commonly isolated organisms were E. coli (33.63%), Enterococcus spp. (12.73%) and C. difficile (7.27%). It reflected that the main infection was UTI. CONCLUSION: The main NI in rehabilitation hospital was the UTI. It means that the infection control program of rehabilitation hospital should be focused on the control of UTI. Surveillance in the rehabilitation hospital enabled us to describe the characteristics of nosocomial infection in the rehabilitation hospital. NI rate was decreased through continuous communications and educations with factual datum and involvement of various medical and paramedical personnels. These results show that NI surveillance is crucial for an efficient infection control program.
Allied Health Personnel ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection* ; Enterococcus ; Humans ; Infection Control ; Infection Control Practitioners ; Length of Stay ; Primary Health Care ; Rehabilitation* ; Spinal Cord Injuries ; Urinary Tract Infections

OBJECTIVES: The aim of this study was to test the reliability and validity of the Korean version of Interpersonal Reactivity Index (K-IRI). METHODS: A total of 484 participants were included in this study. Internal consistency and test/retest reliability (n=35) were examined. Criterion validity of the K-IRI was assessed against Affective Dimension of the 3D-Wisdom Scale. Factor analyses were also performed using principal component analysis with varimax rotation. RESULTS: The internal consistency of the K-IRI was 0.80, and test-retest reliability was 0.76. Criterion validity was evaluated by correlating the K-IRI with the Affective Dimension of 3D-Wisdom Scale (r=0.31). Factor analyses revealed factor structures similar to the original IRI. CONCLUSION: The K-IRI appeared to be a reliable and valid instrument for assessing empathy in the Korean population. This suggests that this scale may be applicable in clinical trials, research, and clinical practice.
Empathy ; Principal Component Analysis ; Reproducibility of Results