Do We Know the Normal Blood Pressure Level in Korean Children and Adolescents?

Lucy Youngmin Eun 대한심장학회 2019 Korean Circulation Journal Vol.49 No.12

Is multisystem inflammatory syndrome related with coronavirus disease 2019, Kawasaki disease, and angiotensin-converting enzyme 2 in children?

Eun, Lucy Youngmin The Korean Pediatric Society 2021 Clinical and Experimental Pediatrics (CEP) Vol.64 No.5

Infliximab, Is It Really a New Horizon for the Treatment of Kawasaki Disease?

Lucy Youngmin Eun 대한심장학회 2019 Korean Circulation Journal Vol.49 No.2

Aortic Dissection and Rupture in a Child

조윤주,Eun Jeong Lee,Jin Won Oh,Chang Min Moon,Deok Kyu Cho,Yun Hyeong Cho,Ki Hyun Byun,Lucy Youngmin Eun 대한심장학회 2012 Korean Circulation Journal Vol.42 No.7

Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease

Sohyun Kim,Lucy Youngmin Eun 대한소아청소년과학회 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.8

Purpose: Coronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA. Methods: This retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence (group 2) of CAA. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to collinearity between indicators of IDA, each indicator was paired with anemia in 3 models. Results: Serum iron, iron saturation, and ferritin concentration, the 3 indicators of IDA, were significantly higher in group 1 than in group 2. Three sets of models including anemia with iron indicators produced the OR of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The areas under the curve (AUCs) of ferritin concentration, iron saturation, serum iron, anemia, and Kobayashi score were 0.907 (95% CI, 0.851– 0.963), 0.729 (95% CI, 0.648–0.810), 0.711 (95% CI, 0.629–0.793), 0.638 (95% CI, 0.545–0.731), and 0.563 (95% CI, 0.489–0.636), respectively. Conclusion: Indicators of IDA, especially ferritin, were highly associated with CAA; therefore, they were stronger predictors of CAA than Kobayashi scores. IDA indicators can be used to predict CAA development and to suggest requirements for early interventions.

Assessment of cardiac function in syncopal children without organic causes

Kim, Heoungjin,Eun, Lucy Youngmin The Korean Pediatric Society 2021 Clinical and Experimental Pediatrics (CEP) Vol.64 No.11

Background: Syncope is a common problem in children and adolescents. However, a large proportion of syncope cases have no underlying cause. Purpose: This study aimed to identify the factors affecting the severity of syncope using tissue Doppler imaging (TDI). Methods: This retrospective study included 61 children and adolescents with syncope who underwent echocardiography. The head-up-tilt test (HUT) was performed when there was a more severe syncopal event. We compared the echocardiographic findings between the execute HUT and nonexecute HUT, negative HUT result and positive HUT result, and normal electrocardiogram (ECG) and abnormal ECG groups. Data were analyzed using an unpaired t test post hoc analysis. Results: In the execute and nonexecute HUT groups, the odds ratios were 0.55 for medial E/E' (P=0.040) and 0.64 for lateral E/E' (P=0.049). Comparison of the results of the decreased, normal, and increased groups for lateral E/E' revealed a significant difference in the execution HUT and nonexecute HUT groups (overall, P=0.004; decreased vs. increased, P=0.003; normal vs. increased, P=0.050). Conclusion: Medial E/E' and lateral E/E' were decreased in patients with severe syncopal events. These findings suggest that the presence of left ventricular diastolic deterioration may cause hypoperfusion even in the absence of organic causes and, consequently, increase syncope severity and frequency. The TDI measured by echocardiography can be used as an index to predict syncope recurrence and/or severity.

Relationship between serum sodium level and coronary artery abnormality in Kawasaki disease

Park, Sora,Eun, Lucy Youngmin,Kim, Ji Hong The Korean Pediatric Society 2017 Clinical and Experimental Pediatrics (CEP) Vol.60 No.2

Purpose: Kawasaki disease (KD) is an immune-related multisystemic vasculitis that occurs in children, especially ensuing from a coronary artery abnormality. Sodium level is known to be related to vascular injury, which could affect the progress of KD. The purpose of this study was to determine the serum sodium levels that could predict the occurrence of cardiac and coronary artery events in KD. Methods: We conducted a retrospective review of medical records for 104 patients with KD from January 2015 to December 2015. Patients with serum Na levels of <135 mEq/L at the time of initial diagnosis were assigned to the hyponatremia group. Laboratory findings and echocardiographic data were analyzed for various aspects. Results: Among the 104 patients with KD, 91 were included in the study, of whom 48 (52.7%) had hyponatremia. The degree of fever, white blood cell count, percentage of neutrophils, percentage of lymphocytes, total bilirubin level, brain natriuretic peptide level, erythrocyte sedimentation rate, and C-reactive protein level were higher in the patients with hyponatremia. They also demonstrated a trend of larger coronary artery diameters based on Z scores. Conclusion: The severity of vascular inflammation in acute KD with hyponatremia might worsen the prognosis of coronary vasculature. Although no statistically significant correlation was found between the initial serum sodium levels and coronary arteriopathy in the patients with KD in this study, a long-term follow-up study with a larger number of enrolled patients should be designed in the future to elucidate the relationship between serum sodium level and coronary arteriopathy in patients with KD.

Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease

Kim, Sohyun,Eun, Lucy Youngmin The Korean Pediatric Society 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.8

Purpose: Coronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA. Methods: This retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence (group 2) of CAA. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to collinearity between indicators of IDA, each indicator was paired with anemia in 3 models. Results: Serum iron, iron saturation, and ferritin concentration, the 3 indicators of IDA, were significantly higher in group 1 than in group 2. Three sets of models including anemia with iron indicators produced the OR of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The areas under the curve (AUCs) of ferritin concentration, iron saturation, serum iron, anemia, and Kobayashi score were 0.907 (95% CI, 0.851-0.963), 0.729 (95% CI, 0.648-0.810), 0.711 (95% CI, 0.629-0.793), 0.638 (95% CI, 0.545-0.731), and 0.563 (95% CI, 0.489-0.636), respectively. Conclusion: Indicators of IDA, especially ferritin, were highly associated with CAA; therefore, they were stronger predictors of CAA than Kobayashi scores. IDA indicators can be used to predict CAA development and to suggest requirements for early interventions.

심장조직 정밀분석을 위한 고주파 초음파 횡파 탄성 영상 시스템

이승엽(Seungyeop Lee),은영민(Lucy Youngmin Eun),황재윤(Jae Youn Hwang),은용순(Yongsoon Eun) 한국비파괴검사학회 2021 한국비파괴검사학회지 Vol.41 No.4

심장질환 진단을 위한 다양한 영상 장치가 있지만 작은 병변 또는 경미한 단계의 질환을 발견하는 것은 어렵다. 본 연구에서는 심장질환에 의한 미세한 심장 조직 변화를 분석할 수 있는 고주파 초음파 횡파영상 시스템을 제안한다. 제안된 시스템은 작은 병변을 감지할 수 있도록 높은 해상도의 영상을 얻기 위하여 38 MHz 초음파 변환자를 제작 이용하였고, 조직 내의 충분한 횡파의 발생을 위해 기계적 진동기를 사용하였다. 시스템의 성능 확인을 위해 팬텀을 이용하여 심장의 횡 방향 / 축 방향 분해능을 측정하였고, 해상도는 각각 144 μm와 168 μm가 측정되었다. 시스템의 유효성 확인을 위해 돼지 심장을 이용한 체외 실험을 수행하였다. 돼지 심장 실험은 정상 심장 조직을 국소적으로 냉각 및 가열시킨 후 실험하였고, 본 시스템으로 심장조직의 국소적 변화를 관찰할 수 있었다. 따라서 향후 본 연구에서 제안하는 영상 시스템을 적용한 임상연구를 거쳐 심장질환 조기진단이 가능하게 될 것이다. Several imaging devices have been used to diagnose heart disease. However, these imaging devices have limitations with regard to the observation of small lesions, which makes early detection of heart disease difficult. This study proposes a shear wave imaging system with a high-frequency ultrasound transducer to measure the mechanical properties of heart tissue to diagnose heart disease. A 38-MHz ultrasound transducer is used to achieve a high-resolution image, and a mechanical vibrator is used to generate shear waves in the heart tissue. In the phantom experiments, spatial resolutions are experimentally determined. The lateral and axial resolutions are 144 and 168 μm, respectively. The feasibility of the proposed system is demonstrated in the experiments pertaining to induced disease-like deformations. The obtained images exhibit local variations in the mechanical properties. Thus, the proposed imaging system can detect small lesions in heart tissue, which is important for early detection of heart disease.

Cardiac function associated with home ventilator care in Duchenne muscular dystrophy

Lee, Sangheun,Lee, Heeyoung,Eun, Lucy Youngmin,Gang, Seung Woong The Korean Pediatric Society 2018 Clinical and Experimental Pediatrics (CEP) Vol.61 No.2

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.