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Evaluation of the Potential of Retrograde Flow Competition in the Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting (우위대망동맥을 이용한 관상동맥우회술 후 역행성 혈류 발생가능성의 연구)

  • Chung, Bong-Kyu;Sun, Kyung;Kwon, Joon;Kim, Kwang-Ho;Jung, Jae-Seung;Son, Ho-Sung;Lee, Sung-Ho;Kim, Kwang-Taik;Kim, Hyung-Mook
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.20-26
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    • 2002
  • Background: Due to the concern of flow competition or retrograde steal, it has been generally suggested that the right gastroepiploic artery(RGEA) pedicled graft should be used in critical coronary stenosis lesion. The study was designed to evaluate the potential of retrograde flow competition in the RGEA pedicled graft by measuring the native pressure differences(PD) between the normal coronary artery and celiac arterial pressure, which would be compared with trans-stenosis pressure gradients(TSPG) in coronary artery occlusive disease. Material and Method: Between July, 1998 and February, 1999, pressures of the right coronary artery and the right gastroepiploic artery(or the celiac artery) were measured in patients with the patent right coronary artery(n=12). The PD between the arteries was compared with the TSPG in the occlusive coronary arteries(n=32). Result: The pressures of the normal right coronary artery and celiac artery were 143$\pm$23 vs. 134$\pm$17mmHg in systole(p<0.005), 74$\pm$13 vs. 73$\pm$14mmHg in diastole(p=NS), and 100$\pm$16 vs. 97$\pm$15mmHg in mean (p<0.05). The PD between the arteries were -8~25mmHg in systole, -4~7mmHg in diastole, and -1~10mmHg in mean. The TSPG measured in the occlusive coronary arteries were -4~19(7$\pm$5.8)mmHg in the lesion less than 75% stenosis vs. 7~74(27$\pm$18.3)mmHg in the 75% or over stenosis lesion(p<0.005). The normally existing pressure difference between the coronary arteries and RGEA(15~20mmHg) was significantlyless than the TSPG in .the occlusive coronary artery with 75% or over stenosis(p<0.001). Conclusion: If the pressure gradient between the RGEA and the coronary artery distal to the stenosis is the main determinant of development of retrograde flow competiton in the RGEA pedicled graft, the above data suggests that there will be little chance of competition when It is used in the coronary lesion with 75% or over stenosis.

Effects of Self Care Program on Hypertensive Control in Hypertensive Patient (고혈압환자에게 적용한 자가관리프로그램 중재 효과)

  • Kim, Ok-Ran
    • Research in Community and Public Health Nursing
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    • v.14 no.4
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    • pp.568-578
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    • 2003
  • This study was conducted to estimate the effects of self-care program on knowledge and symptoms related hypertension self-care and physiological index in essential hypertensive patients aged between 35-74 year. The subjects for the experiment group and the control group of this study were 70 men and women selected through random sampling from adults at Sangju Red Cross Hospital in Gyeongsanbuk-do, and the experiment was carried out during the period from the 15th of September to the 30th of April in 2002. This study measured systolic and diastolic blood pressure (SBP, DBP, the mean value of the two measures) and total cholesterol (TC) and surveyed the subjects' diet and life style in relation to hypertension using a self-report questionnaire. In order to study the significance of the effects of self-care program, the author carried out t-test, paired t-test, ANCOVA, chi-square analysis and effectiveness index (EI) analysis. Results of the study are as follows: The experiment group got higher mean scores than the control group in the degree of low sodium intake and the degree of high calcium and high potassium intake, and the difference was statistically significant(P<0.05). The effectiveness index of the self-care program in smoking was 0.797 at the 1st posttest and 0.601 at the 2nd posttest, and in physical activities 0.600 at the 1st posttest and 0.849 at the 2nd posttest. The rate of regular antihypertensive drugs intake of the experimental group was higher than that of the control group. and the effectiveness index of the self-care program was 0.715. The mean score of the systolic blood pressure of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). In conclusion, these findings support usefulness of self-care programs in reducing systolic blood pressure and in promoting self-care related to diet and life style for treating and preventing hypertension.

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Metabolic syndrome in the overweight and obese adolescents and the impact of obesity on the cardiovascular system (과체중과 비만 청소년에서 대사증후군과 비만이 심혈관에 미치는 영향)

  • Hong, Young Mi;Song, Young Whan;Kim, Hae Soon;Park, Hae Sook;Min, Jung Hae;Jung, Jo Won;Kim, Nam Su;Noh, Chung Il
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1109-1118
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    • 2009
  • Purpose : Metabolic syndrome (MS), characterized by obesity and insulin resistance, elicits risk factors such as hyperlipidemia, hypertension, and glucose intolerance with additive effects on atherosclerosis, leading to cardiovascular diseases. The purposes of this study were to evaluate the prevalence of MS among overweight and obese adolescents and to investigate the impact of obesity on the cardiovascular system. Methods : In all, 684 adolescents were included in the study. Blood pressure, body mass index (BMI), fasting blood glucose, total cholesterol, triglyceride, low-density-lipoprotein (LDL)-cholesterol, high-density-lipoprotein (HDL)-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitive C-reactive protein (hs-CRP) were measured in the patients with a BMI of >85 percentile. Brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index were measured using Vascular Profiler (VP)-1000. Results : MS was confirmed in 19.5% of the overweight and obese adolescents and 50.8% of the obese adolescents. The systolic and diastolic blood pressure, height, weight, fat mass, %fat, BMI, obesity index, and waist circumference were higher in the overweight and obese adolescents with MS. Moreover, the triglyceride, AST, ALT, and hs-CRP levels were higher, whereas HDL-cholesterol level was significantly lower in this group. The overweight and obese adolescents with MS showed shorter diastolic and systolic times, higher heart rate and BaPWV, and longer E-wave deceleration time by echocardiography. Conclusion : Overweight and obese adolescents showed characteristic MS features such as hypertension and hyperlipidemia. Thus, obese adolescents predisposed to MS should be provided early treatment for obesity.

The Influence of Mixed NaCl-KCl Salt on Sodium Intake and Urinary Excretion of Sodium and Potassium (혼합식염 (NaCl-KCl) 이용 조리시 나트륨${\cdot}$칼륨 섭취와 소변 중 나트륨${\cdot}$칼륨 배설에 관한 연구)

  • Park, Su-Jeong;Lee, Sim-Yeol;Paik, Hee-Young
    • Journal of Nutrition and Health
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    • v.40 no.6
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    • pp.500-508
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    • 2007
  • The purpose of this study was to investigate the influence of mixed NaCl-KCl salt on sodium intake and urinary excretion of sodium and potassium. In this study, 3-day food records for pre-experimental diet and 24-hr urine collected for 2-days, 6-day experimental diet food and 24-hr urine were used to evaluate the relationship between Na metabolism. In the experimental diet food, mixed NaCl-KCl salt was added. During the pre-experimental diet period, intakes of Na and K were 178.2 mEq and 56.4 mEq, respectively. The urinary excretion of Na and K in 24-hr were 139.6 mEq, 27.7 mEq, respectively and urinary Na/K ratio was 6.6. During the experimental diet period, intakes of Na and K were 130.2 mEq and 120.4 mEq, respectively. The urinary excretion of Na and K in 24-hr were 100.2 mEq, 37.1 mEq, respectively and urinary Na/K ratio was 2.8. According to this study, it is concluded that mixed NaCl-KCl salt diet decreased the intake of Na, and increased the intake of K.

Salt-Related Dietary Behaviors and Sodium Intakes of University Students in Gyeonggi-do (경기지역 대학생의 소금 관련 식행동 및 나트륨 섭취량)

  • Chung, Eun-Jung;Shim, Eu-Gene
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.5
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    • pp.578-588
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    • 2008
  • The objective of this study was to evaluate associations of dietary sodium (Na) intake with salt-related dietary behaviors of 218 university students (95 men; 123 women) living in Gyeonggi area. Dish frequency questionnaire (DFQ) was used to identify salt-related dietary behaviors and to determine Na intakes. In men, systolic & diastolic blood pressures, Na intakes and DFQ-15 scores were significantly higher than in women. High-salt intake group (HS), classified by DFQ-15, had higher scores of high-salt dietary attitude and more Na intakes than low-salt intake group (LS). HS took protein foods and had balanced diets less frequently than LS (p<0.05). HS had fried dishes & fatty meats, and added salt to dishes more frequently (p<0.05). HS and LS had differences in preference of soy-boiled and Chinese or Japanese foods, in intake frequency of bean-paste soup, in use of soy sauce with fried food or raw fish, and in salt addition to dishes at the table (p<0.05). HS, classified by Na intakes, had high-salt dietary attitudes such as preference of seasoned rice & soy-boiled foods and habitual addition of soy sauce or salt to dishes at the table. The subjects using food labels when purchasing had better salt-related attitudes & behaviors, and lower DFQ-15 scores & Na intakes than the non-users (p<0.01). Self-assessed HS (SHS) had worse salt-related attitudes and behaviors (p<0.05). Male self-assessed LS (SLS) had higher Na intakes, which indicated that self-assessment of salt preference did not actually reflect Na intake. In summary, male university students belonged to a high-risk group of salt intakes, and HS preferred soy-boiled foods or fatty dishes, frequently added salt to dishes and rarely had balanced diets. These results suggest that nutrition education programs for university students should include fundamental dietetics and a balanced diet, in addition to a low-Na diet.

Angiotensinogen gene M235T polymorphism as a predictor of cardiovascular risk in hypertensive adolescents (고혈압 청소년의 심혈관계 위험요소로서 Angiotensinogen M235T 유전자 다형)

  • Gil, Joo Hyun;Lee, Jung Ah;Park, Eun Young;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.36-43
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    • 2009
  • urpose : The renin-angiotensin system (RAS) has been demonstrated to play a major role in regulating blood pressure. Therefore, components of the RAS are likely candidate genes that may predispose an individual to essential hypertension and cardiovascular complications. Among them, the M235T polymorphism of the angiotensinogen gene has been speculated to be associated with elevated circulating angiotensinogen concentrations and essential hypertension. This study aimed to analyze the angiotensinogen M235T polymorphism in hypertensive adolescents and investigate its relationship with cardiovascular risks. Methods : Forty Korean hypertensive adolescents (aged 16-17, systolic $BP{\geq}140 mmHg$ and/or diastolic $BP{\geq}90 mmHg$) and fifty seven normal adolescents were included. Obesity index (OI), body mass index (BMI) were calculated. BP was measured by oscillometric methods in resting state. Polymerase chain reaction (PCR) technique was performed on DNA from the hypertensives subjects to analyze the M235T polymorphism. Serum homocysteine, insulin, renin, aldosterone and angiotensin converting enzyme (ACE) were tested according to each genotype. The carotid intima-media thickness (IMT) and carotid artery diameter, Pulse wave velocity (PWV) and ankle-brachial index (ABI) were measured according to each genotype. Results : Genotype frequencies of T/T, M/T and M/M were 62.5%, 35.0%, 2.5%, respectively in hypertensive adolescents. The results were not significantly different compared to control group. Serum insulin, renin levels, BMI and OI were significantly higher in thoses with the M/M genotype as compared to those with the T/T of M/T genotype. Conclusion : This study showed that the M235T polymorphism was not associated with essential hypertension or any cardiovascular risks. Further clinical research is required to ascertain the relationship between this polymorphism and cardiovascular complications in Korean hypertensive adolescents.

Clinical Usefulness of Ambulatory Blood Pressure Monitoring in Children and Adolescents (소아 및 청소년에서 24시간 활동 혈압 측정의 임상적 유용성)

  • Hwang, Young-Ju;Park, Hyo-Jung;Yang, Eun-Ae;Cho, Min-Hyun;Ko, Cheol-Woo;Yang, Dong-Heon;Hwang, Hyun-Hee
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.154-162
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    • 2011
  • Purpose: With increasing prevalence of hypertension (HTN) in children and adolescent, pediatricians have become more interested in blood pressure (BP) measurements. The ambulatory blood pressure monitoring (ABPM) is known to be useful to differentiate true HTN and white coat HTN. The object of this study is to assess the clinical usefulness of ABPM in Korean children and adolescents. Methods: A retrospective review of 51 patients in Kyungpook National University Hospital from January 2002 to February 2010 was done. All patients were 6-18 years old and underwent ABPM. We calculated the mean value of ABP, BP load, nocturnal dip and compared the results with the patients' diagnosis and characteristics. Results: The mean age of the 51 patients was $17.8{\pm}1.8$ years and 19 children were obese. 37 patients (72.5%) were truly hypertensive and 1 patient was diagnosed as masked HTN and 7 children (14%) as white coat HTN. The rest of the patients were normotensive. Among patients with white coat HTN, 5 were in a prehypertensive state. Mean systolic and diastolic BP load of patients with true HTN were significantly higher than non-hypertensive children (P<0.001). Although the nocturnal dip of all patients were below 10%, there was no statistical significance. The obese patients showed higher systolic and diastolic BP. Their systolic and diastolic BP load were significantly higher than non-obese patients (P<0.001). Conclusion: ABPM in children and adolescents seems to be a valuable tool in the assessment of white coat HTN and in the confirmation of true HTN. A considerable number of white coat HTN patients are revealed to be in a prehypertensive state and need close follow-up.

The Effect of Mixing Beverage with Aralia continentalis Kitagawa Root on Blood Pressure and Blood Constituents of the Diabetic and Hypertensive Elderly (땅두릅뿌리를 이용한 혼합음료가 당뇨 및 고혈압 환자의 혈압과 혈액 성상에 미치는 영향)

  • 최미숙;도대홍;최도점
    • The Korean Journal of Food And Nutrition
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    • v.15 no.2
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    • pp.165-172
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    • 2002
  • Studies were carried out to observe the influence of the Aralia continentalis Kitagawa root on blood pressure and blood constituents of the 24 hypertensive elderly(10 men and 14 women aged over 60). Total subjects were divided into three groups according to taking antihypertensive medications(A), antihypertensive medications and mixing beverages with the Aralia continentalis Kitagawa root(B) or mixing beverages with Aralia continentalis Kitagawa root(C). The systolic blood pressure of C group was significantly lower than that of A and B groups. The diastolic blood pressure of C group was lower than A and B groups. The blood glucose level of C group was a little lower than that of A and B groups. The level of TG increased more in A group than C group and decreased in B group. The levels of T-cholesterol and LDL-cholesterol lowered in B and C groups and HDL-cholesterol level was higher in C group. The GOT, GPT and T-bilirubin levels of C group were significantly higher than others. Mixing beverages with Aralia continentalis Kitagawa root did not affect on blood protein and non-protein nitrogens. In conclusion, mixing beverages with Aralia continentalis Kitagawa root had an effect on lowering blood pressure, blood glucose, T-cholesterol and LDL-cholesterol concentrations.

Relationship Between Carotid Intima-Media Thickness Using Ultrasonography and Diagnostic Indices of Metabolic Syndrome (초음파를 이용한 경동맥 내-중막 두께와 대사증후군 진단지표의 연관성)

  • Ko, Kyung-Sun;Heo, Kyung-Hwa;Won, Yong-Lim;Lee, Sung-Kook;Kim, Ki-Woong
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.285-291
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    • 2009
  • The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipments and the NCEP-ATP III criteria were used to define MetS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was $0.739{\pm}0.137\;mm$ and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=-0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.

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Effects of Hemorrhage on the Electroencephalograms in Dogs Anesthetized with Ketamine, Propofol and Isoflurane (출혈이 Ketamine, Propofol, Isoflurane 마취견의 뇌파에 미치는 영향)

  • Yoon, In-Sub;Jang, Hwan-Soo;Lim, Jae-Hyun;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.539-546
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    • 2009
  • The effect of hemorrhage on the electroencephalogram(EEG) was investigated in fifteen mixed-breed dogs anesthetized with ketamine, propofol and isoflurane. Animals were randomly allocated to three groups (n = 5) by anesthetic agents; group 1 (ketamine 5 mg/kg, IV), group 2 (propofol $156\;{\mu}g$/kg/min, IV) and group 3 (isoflurane 2.0% end-tidal concentration). Medetomidine ($40\;{\mu}g$/kg, IM) was used in all dogs as a preanesthetic agent. Recording electrode for EEG was positioned at CZ. EEG, heart rate, systolic/diastolic blood pressure, $pCO_2$, $pO_2$ and blood pH were measured before anesthesia, after anesthesia and after every bleedings. Three bleedings were accomplished by drawing blood through the femoral artery catheter at a rate of 7 ml/kg (10% of total blood volume) for 10 minutes. In the course of hemorrhage, a systolic/diastolic pressure continuously decreased in all groups. The $pCO_2$ values and heart rates were increased in all groups. The $pO_2$ values were most significantly increased in group 1 compared with those in other groups. The pH values were not significantly changed. On statistical analysis of EEG, there was no significant changes in group 1 and 3. But in group 2, band 3, 4 and 7 were significantly altered after 2nd and 3rd bleeding. Power alterations of band 3, 4 and 7 were thought to be related with hemorrhage over 20% of total blood volume in group 2. In conclusion, the regulation of infusion rate would be considered when a dog, anesthetized with propofol, bleed over 20% of total blood volume.