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Background and Objectives：This study was designed to examine whether the multifractal Hurst exponents of heart rate can estimate activating and deactivating spontaneous baroreflex sensitivity (SBRS). Subjects and Methods： Age and sex matched 24 healthy volunteers were placed in the supine position and head-up tilt position for 30 minutes, and the systolic blood pressure and heart rate were measured in an noninvasive manner. When the RR interval (RRI) sequence and systolic pressure sequence simultaneously increased or decreased for more than three successive beats, the slope of the linear regression line of systolic blood pressure and RR interval sequence was defined as the value of spontaneous baroreflex sensitivity (SBRS). From the RR intervals, very short-term (α range, ≤12 heartbeats), short-term (β range, ≥12 heartbeats), and the multrifractal Hurst exponents were calculated to determine the linear correlation.coefficients for SBRS. Results：In the supine position, the linear correlation coefficients (p) of SBRS and H-5α, H-4α, H-3α, H-2α, H-1α, H1α, H2α, H3α, H4α, H5α were -0.195 (NS), -0.207 (NS), -0.232 (NS), -0.282 (NS), -0.355 (NS), -0.621 (0.003), -0.650 (0.001), -0.677 (0.001), -0.699 (0.0006) and -0.708 (0.0005), respectively. In the tilting position, the linear correlation coefficients of SBRS and H-5β, H-4β, H-3β, H-2β, H-1β, H1β, H2β, H3β, H4β, H5β were 0.024 (NS), 0.020 (NS), 0.010 (NS), -0.028 (NS), -0.193 (NS), -0.627 (0.0034), -0.607 (0.0045), -0.598 (0.0053), -0.572 (0.0084) and -0.539 (0.0141), respectively. Conclusion：Some of the very short-term and short-term generalized Hurst exponents, such as H5α and H1β, can be used for the estimation of spontaneous baroreflex sensitivity during patient placement in the supine and head-up tilt position, respectively. (Korean Circulation J 2007;37:443-448)

Background and Objectives:The prevalence of pediatric hypertension appears to be increasing, and secondary hypertension is more common in children than in adults. Essential hypertension is increasing in obese adolescents. An elevated blood pressure (BP) during childhood is associated with premature cardiovascular morbidity and mortality in adulthood. Oscillometric devices are convenient and minimize observer error. The purposes of this study were to measure the BP, using an oscillometric device, in relation to age, sex, weight, height and body mass index (BMI), in normal school aged children, and to identify the 95 and 99 percentile values for the diagnosis of hypertension by age group. Subjects and Methods:Between May and June 2005, the oscillometric blood pressure was measured, using a Dinamap monitor (Procare-200, GE, USA), in 9,499 Seoul school children (male 4,993, female 4,506), aged 7-18 years. The BP was measured on the right arm, in the sitting position, using a BP cuff having a width of 40-50% of the arm circumference. The mean and 5, 10, 25, 50, 75, 90, 95 and 99 percentile values and percentile curves of the systolic and diastolic BP were obtained in relation to age, sex, height, weight and BMI. Results:The systolic and diastolic BP levels were significantly increased in relation to age, height, weight and BMI. A correlation analysis showed that the BP levels were significantly correlated with weight (r=0.553), followed by height (r=0.491), BMI (r=0.470) and age (r=0.445) in males, and significantly correlated with weight (r=0.332), followed by height (r=0.317), BMI (r=0.286) and age (r=0.213) in females. Conclusion:Percentile values and percentile curves for the systolic and diastolic BP were obtained in normal children. These data will be useful in the diagnosis and treatment of pediatric hypertension. (Korean Circulation J 2006;36:744-752)

Purpose:Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods:The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results:There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion:The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

Background and Objectives:Laboratory research was carried out to investigate the teratogenic effect of X-ray on chick embryos, especially with regard to cardiovascular malformation. Materials and Methods:The chick embryos, 242, 242 and 215 eggs, were irradiated with X-ray at the dose of 500, 750 and 1000 cGy, respectively, during the incubation period between 0 and 9 days. A control group of 90 eggs received no irradiation. After 2 weeks of incubation, the embryos were sacrificed and examined. Results:The survival rate of irradiated group was significantly lower than that of control group (62.5 vs. 87.8%, p

The camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is characterized by congenital or early-onset camptodactyly, childhood-onset noninflammatory arthropathy associated with synovial hyperplasia. Some patients have pro-gressive coxa vara deformity and/or noninflammatory pericardial effusion. CACP is inherited as an autosomal recessive mode and the disease gene is assigned to a 1.9-cM interval on human chromosome 1q25-31. We describe a 10-yr-old boy who has typical features of CACP without familial association.

Purpose:The purposes of this study were to compare the magnitude and phase between the RR interval and QT interval variability in the frequency domain. Methods:Twenty four, 12-13 year old healthy males were randomly selected. At resting state and for 5 minutes, ECGs were obtained, and they were digitized to 1000Hz. After measurement of RR interval, QT interval variability was measured using template matching strategy. After normalization of the RR and QT interval time series, power spectral and cross spectral analysis were performed. From each of the time series, low(0.04-0.15 hertz) and high(0.15-0.4 hertz) frequency power were measured. From the phase spectrum, the phases and time lags between the two time series at each of the two frequency range were calculated. Results:The average of RR interval and QT interval was 616.0±71.0, 364.0±47.0 msec, respectively. Their normalized lowand highfrequency power was 4.4±7.9 NU (normalized unit), 0.1±0.1 NU (p

Background: The estimation of ADA activity in pleural fluid has been proved useful tool in the diagnosis of tuberculous pleural effusions. However, there is controversy about its usefulness when estimated in bronchial washing fluid in the patients with pulmonary tuberculosis. This study aims at evaluating the usefulness of measuring ADA activity in bronchial washing fluid of tuberculous patients as biochemical marker in the early diagnosis of the disease. Methods: We examined the difference of ADA activity in bronchial washing fluid among the group I(tuberculosis group), group II(lung cancer group) and group III(control group). Results: There was significantly higher bronchial washing fluid ADA level in tuberculosis group compared to the lung cancer and control groups(p

Chronic hepatitis associated with hypereosinophilia has been very rarely reported worldwide. A 7-month-old male infant presented with a high fever, cough, non-projectile vomiting and hepatomegaly. The eosinophil count of the peripheral blood increased up to 21,500/mm3 (49% of WBC). The infant had a history of frequent contact with a neighbor keeping a pigsty. The pathologic examinations of the liver showed severe porto-periportal necroinflammation with marked eosinophilic infiltration, giant cell transformation and ballooning degeneration of hepatocytes, and degranulation of the eosinophils. Bone marrow showed increased eosinophils and decreased myeloid series. Pericardial effusion and bilateral pulmonary consolidation were noted. Corticosteroid aggravated the clinical symptoms of the infant. Anthelmintic treatment significantly normalized the eosinophil count and liver function tests, but cardiopulmonary manifestations continued.

연구배경:폐동맥 압력의 변화와 주기성과 복잡성을 가진 심박동수 동력성과의 상관관계를 알아보 고, 이러한 심박동수 동력의 변이성으로 평균 폐동맥 압력을 비침습적인 방법으로 예견이 가능한지 알 아보고자 본 연구를 시행하였다. 방 법:심실중격결손을 가진 32명의 영유아를 대상으로 심도자술을 시행하는 동안 평균 폐동맥 압 력을 계속 측정하면서 동시에 5분 이상 심전도를 감시하고 자료를 수집하였다. 또한, 고주파수(>0.15Hz) 와 저주파수(0.03-0.15Hz)를 보이는 심박동수 변이성을 스펙트럴 분석(spectral analysis)을 이용해 계 산하고 전체 심박동 시간의 일련의 복잡성을 근사 엔트로피(approximate entropy)에 의해 정량화하였다. 결 과:평균 폐동맥압이 20mmHg 이상인 폐동맥 고혈압 영유아가 평균 폐동맥압이 20mmHg 이 하인 정상 폐동맥압 영유아보다 저주파수와 고주파수의 심박동수 변이성이 의미있게 낮게 나왔으며, 심박 동수 동력성의 복잡성을 나타내는 근사 엔트로피도 의미있게 낮았다. 평균 폐동맥 압력은 심박동수 변 이성의 크기인 스펙트럴 파워(spectral powers)보다는 심박동수 변이성의 근사 엔트로피와 의미있는 상관관계를 보였다. 결 론:좌우 단락으로 인한 폐동맥 고혈압증을 가진 영유아에서는 주기적이고 복잡성을 가진 심박 동수의 진동이 억제되고 있음을 알 수 있고, 심박동수 변이성의 근사 엔트로피를 이용하여 비침습적인 방법으로 평균 폐동맥 압력을 예측할 수 있음을 알 수 있었다.