• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.354-358
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• 2006

Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.

• Journal of Hospice and Palliative Care
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• v.11 no.4
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• pp.188-195
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• 2008

Purpose: The purpose of this study was to analyze the effects of aromatherapy on stress using meta-analysis. Methods: Meta-analysis was done with 21 published studies, and data were analyzed with the SAS 9.1 program. Results: Fifty eight effect size was estimated with data from 21 published studies. Overall mean effect size (ES), and mean effect size of dependence variables according to the type of intervention and subject and according to the total amount of time spent in aromatherapy were estimated. Overall mean effect size of the effects of aromatherapy was .593, and the subjective stress (.983) was most effective in the physiological faculty, followed by mean effect size of cortisol (.648) and pulse (.40). On the other hand, mean effect size of systolic blood pressure (.490) was moderate, and that of diastolic blood pressure (.401) was not large. Mean effect size of elderly (.706) cancer patients was considerable(.337). There were significant differences depending on the subjects. With regards to the types of aromatherapy, the effect size of aroma massage combined with inhalation therapy was .590, and there were no significant differences between the intervention methods. With regards to the time of intervention, $20{\sim}30$ minutes spent in aromatherapy was .730, and there were no significant differences between the times of intervention. The relationship between the effect size and intervention frequency was r=.349 and showed significant difference. Conclusion: This result suggests that aromatherapy is an effective intervention to reduce stress for subjects. Nursing intervention protocol by using aromatherapy should be developed and applied in clinical and community settings. Further studies on the effects of aromatherapy on stress should be done by using meta-analysis.

• Journal of Nutrition and Health
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• v.51 no.5
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• pp.386-399
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• 2018

Purpose: This study examined whether the supply of healthy Korean diets for 12 weeks is effective in improving the risk factors related to serum GGT and cardiovascular diseases in patients with hypertension and diabetes. Methods: This study selected 41 patients, who were treated with hypertension and diabetes. The Korean diet was composed of cooked-rice, soup, kimchi, and various banchan with one serving called bapsang, which emphasize proportionally high consumption of vegetables and fermented foods, moderate to high consumption of legumes and fish, and low consumption of animal foods. The control group was instead instructed to "eat and exercise as usual" while following the Korean Diabetes Association's dietary guidelines with an intake that can assist in glycemic control, maintain adequate weight, and meet the nutritional requirements. The Korean diet group (21 patients) were served three healthy Korean meals a day for 12 weeks, and the control group (20 patients, who trained in the diet guideline of diabetes) maintained their usual diabetic diet. The serum GGT, blood pressure, heart rate, glycemic control data, cardiovascular risk indicators, and changes in diet measured at the four visits (week 0, 4, 8, and 12) during the course of 12 weeks were compared and evaluated. Results: The serum GGT (p < 0.001), HbA1c (p = 0.004), heart rate (p = 0.007), weight (p = 0.002), Body Mass Index (p = 0.002), body fat mass (p < 0.001), body fat (%) (p < 0.001), and free fatty acid (p = 0.007) in the Korean diet group decreased significantly after the dietary intervention compared to the control group. The amount of intake of rice, whole grains, green vegetables, Kimchi, and soybean fermented food were increased significantly compared to the control group (p < 0.001). The Korean diet group showed significant decreases (p < 0.001) in the intake of animal protein, lipid, and cholesterol derived from animal foods compared to the control group but significant increases (p < 0.001) in the intake of total calories, folic acid, dietary fiber, sodium, potassium, and vitamins A, E, and C. Conclusion: In patients with hypertension and diabetes, it was confirmed that regular eating of a healthy Korean diet helps improve the risk factors for GGT and cardiovascular diseases.

• Journal of Nutrition and Health
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• v.35 no.3
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• pp.322-331
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• 2002

This study was carried out to evaluate the effect of vitamin $B_{6}$ intake by normal term delivery pregnant women on the concentration of vitamin $B_{6}$ in the material plasma, the umbilical cord plasma, and the placental tissue. Dietary intake data were obtained from a semi-quantitative frequency questionnaire. The daily mean energy and protein intakes were 2189.5 kcal (93.2% of RDA) and 79.3 g (113.3% of RDA), respectively. The average daily vitamin $B_{6}$ intake was 1.7 mg (91.4% of RDA) for the pregnant women. Their main sources of vitamin $B_{6}$ were cereal & starch (50%), and vegetables & fruits (33%). The pyridoxal phosphate (PLP) concentration of the maternal plasma, the umbilical cord plasma, and the placenta were 16.7 $\pm$ 4.1 nmol/1, 61.3 $\pm$ 19.8 nmol/l and 898.6 $\pm$ 159.2 ng/g, respectively. The PLP level was the highest in the placenta. The PLP level of the maternal plasma was significantly lower than the of the umbilical cord plasma (p < 0.001). The PLP level of maternal plasma correlated positively with that of the placenta (p < 0.0001) and the umbilical cord plasma (p < 0.05). Also the PLP level of the placenta correlated positively with that of the umbilical cord plasma (p < 0.05). These findings indicate that the vitamin $B_{6}$ nutritional status of the fetus is affected by placental vitamin $B_{6}$ levels, and that the placental vitamin B$_{6}$ levels reflect the maternal vitamin $B_{6}$ status. The umbilical cord plasma PLP level showed a positive correlation with the gestational length (p < 0.05). A negative association was observed between the PLP level showed of the umbilical cord plasma and the pregnancy weight gain (p < 0.03). The results suggest that the transfer of PLP from maternal plasma to the placental tissue could be an active transport, white the transfer of PLP from the placenta to the fetus is by means of simple diffusion. Thus, neonatal vitamin $B_{6}$ nutrition is influenced by the maternal nutritional status.

• Journal of Nutrition and Health
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• v.41 no.7
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• pp.634-664
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• 2008

This study investigated the effects of the nutrition education on body weight, visceral fat and diet quality in the postmenopausal women. The subjects (n = 101) were randomly divided into two groups: Nutrition education + Exercise (NEE) group (n = 51) and Exercise only (EO) group (n = 50). Nutrition education was consisted of counseling in portion control, food selection for low carbohydrate, high fiber food items and for the improvement in micronutrient intakes and diet quality. After 6 months, the reduction in the body weight and visceral fat area was significantly greater in the NEE than in the EO group. The NEE subjects were further divided into two groups according to the amount of visceral fat area reduction; high visceral fat area loss (HVL) group with a visceral fat area reduction 2.35% or greater and low visceral fat area loss (LVL) group with a reduction less than 2.35%. In the HVL group, the reduction in body weight, BMI, percent body fat, waist to hip ratio and visceral fat area was significantly greater than that in the LVL group. We observed a significant increase in the serum HDL-cholesterol level and a decrease in systolic blood pressure, fasting blood sucrose, total and LDL-cholesterol levels in the HVL group compared to the LVL group. The energyadjusted protein, fiber, calcium, vitamin $B_6$, vitamin C, vitamin E intakes were significantly increased in the HVL compared to LVL group. The index of nutritional quality (INQ) and mean adequacy ratio (MAR) were also increased in the HVL group compared to the LVL group. These results show that our nutrition education program was an effective intervention measure for the reduction of body weight and visceral fat, blood pressure, glucose and lipid levels in the blood and also for the improvement of nutrient intake and diet quality in postmenopausal women who are overweight.

• The Korean Journal of Pharmacology
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• v.26 no.2
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• pp.219-226
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• 1990

Enalapril maleate tablets of two different producers were tested for bioequivalence. Enalapril is rapidly metabolized to an active metabolite, enalaprilat which inhibits angiotensin-converting enzyme (ACE). The pharmacokinetics of enalapril maleate and the time course of inhibition of plasma ACE activity after administration of the drugs were studied. Two single doses of 10mg each of enalapril maleate were administered orally to twelve male volunteers in a balanced, randomized, two-way crossover investigation. Plasma enalaprilat concentrations were determined over a 23-hour after the dose by enzyme inhibition assay and enalapril by the same method following in vitro hydrolysis. Urinary recoveries of enalapril and enalaprilat were determined for the calculation of renal clearance. Plasma ACE activity was determined by an enzyme assay. Peak plasma levels of enalapril were observed about 1 hour after the doses, and practically all enalapril had disappeared from plasma within 6 hour. Peak enalapril concentrations of both formulations were almost identical ($Vasotec^{\circledR}$, 61.38 ng/ml; $Beartec^{\circledR}$, 64.27 ng/ml). The values of the pharmacokinetic parameters of enalaprilat computed for $Vasotec^{\circledR}$ and $Beartec^{\circledR}$ tablets are presented in that order; area under the curve=330.63:320.96 $ng{\cdot}hr/ml$; peak concentration=38.63:39.43 ng/ml; time to peak=3.83:4.08 hour; elimination half-life=3.95:3.92 hours. No statistically significant difference was detected when area under the curve and all other parameters were compared. Using criteria of 95% confidence interval for the comparison of these parameters, only the upper limits of area under the curve and time to peak of enalapril were over 120%. All the parameters of enalaprilat were acceptable. Percent inhibition of plasma ACE to plasma enalaprilat concentration showed the sigmoid concentration-inhibition relationship. Time courses of plasma ACE inhibition after the administration of both formulations were quite similar. The formulations were found to be equivalent when compared on the premise that no significant difference was detected when pharmacokientic parameters and inhibition of ACE activity were compared, based on the confidence limits analysis.

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.383-394
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• 1999

Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

• Journal of Preventive Medicine and Public Health
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• v.13 no.1
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• pp.77-86
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• 1980

The present study was conducted to investigate smoking status and the relationship of smoking to hypertension and diseases on 1,504 subjects who were over 30-year-old age in Kyungsan Gun, Kyungpook province, during the period of 12 months from March 1978 to February 1979. The results obtained are summarized as follows: Of 1,504 subjects, 52.2 percent smoked. The percentage of males smoking showed 84.8 and the percentage of females was 30.7. There were no statistically significant differences between the rate of smoking and educational levels. Protestants demonstrated lower rates of smoking compared with other groups. Regarding the age started to smoke, 66.4 precent of male smokers and 16.9 percent of female smokers commenced smoking before the age of 19. In the regard to the average number of cigarettes smoked daily, 45.8 percent of male smokers consumed some 20 cigarettes and 24.1 percent of female smokers consumed some 10 cigarettes. 3.2 percent of male smellers smoked 40 or more cigarettes a day. Alcohol consumption was closely associated with smoking. 90.7 percent of male alcohol drinkers and 60.1 percent of female drinkers smoked. Cigarette smokers have higher rates of ailments than nonsmokers as a whole. The complaints of cough with sputum and shortness of breath revealed higher rates among smokers than among nonsmokers. Frequency of illnesses showed higher for smokers than for nonsmokers. Smokers were more likely than nonsmokers to suffer from chronic obstructive lung diseases such as chronic bronchitis, asthma, and emphysema. Abnormal systolic blood pressure (>160mmHg) and diastolic (>100) revealed significantly higher among smokers than among nonsmokers.

• Journal of Life Science
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• v.16 no.2 s.75
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• pp.199-205
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• 2006

Peroxisome proliferator activated receptor (PPAR)-$\alpha$ of three PPAR subtypes ($-\alpha,\;-\beta/-\gamma,\;-\delta$), which are members of the nuclear hormone receptor superfamily of ligand-activated transcription factors, plays a key role in lipoprotein and glucose homeostasis. A variation in the PPAR-a gene expression has been suggested to influence the development of metabolic syndrome through alterations in lipid concentrations. The aim of our study was to investigate the association between the PPAR-a and metabolic syndrome among South Korean. A total of 542 health screen examinees were enrolled in this study who were examined in Kosin University Gospel Hospital from December, 2004 to July, 2005. The height, weight, waist circumference, and systolic and diastolic blood pressure of the subjects were examined and fasting blood glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride were measured by-sampling in venous blood. The metabolic syndrome was defined as the presence of three or more of the following : waist circumference men ${\geq}90cm$, women ${\geq}80cm$, blood pressure ${\geq}130/85mmHg$, fasting glucose ${\geq}110mg/dL$, HDL cholesterol men <40 mg/dL, women <50 mg/dL, triglyceride ${\geq}150mg/dL$. The blood pressure, fasting glucose, HDL cholesterol, triglyceride were evaluated by using the criteria of NECP ATP III and waist circumference was assessed by using the criteria of WHO Asia-Western Pacific. And the author compared the frequency of the PPAR-$\alpha$ mutation of L162V ($C{\rightarrow}G$ variant in exon 5) in a sample of 542 subjects with and without the metabolic syndrome by polymerase chain reaction allele-specific oligonucleotide (PCR-ASO) method. One (0.2%) hetero-isotype among high risk of metabolic syndrome was identified. The values of waist circumference, body mass index and low density lipoprotein cholesterol of the mutant were 100 cm, 28.6 $kg/m^2$ and 120 mg/dL, respectively. Although the author failed to see significant association between the presence of the PPAR-$\alpha$ L162V polymorphism and metabolic syndrome, one PPAR-$\alpha$ L162V polymorphism in metabolic syndrome patients was found.

• Journal of Biomedical Engineering Research
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• v.19 no.1
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• pp.69-80
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• 1998

This research was designed to investigate how the exercise program affects paraplegic standing and walking employing functional electrical stimulation(FES). Emphasis was also given to fatigue of major lower extremity muscles induced by different types of electrical stimulation. We applied continuous and intermittent rectangular pulse trains to quadriceps of 10 normal subjects and 4 complete paraplegic patients. The frequencies were 20Hz and 80Hz, and the knee angle was fixed at 90$^{\circ}$and 150$^{\circ}$to investigate how muscle fatigue is related to muscle length. The knee extensor torque was measured and monitored. We have been training quadriceps and gastrocnemius of a male paraplegic patient by means of electrical stimulation for the past two year. FES standing was initiated when the knee extensors became strong enough to support the body weight, and then the patient started FES walking utilizing parallel bars and a walker. We used an 8-channel constant-voltage stimulator and surface electrodes. The experimental results indicated that paralyzed muscles fatigued rapidly around the optimal length contrary to normal muscles and confirmed that low frequency and intermittent stimulation delayed fatigue. Our exercise program increased muscle force by approximately 10 folds and decreased the fatigue index to half of the initial value. In addition, the exercise enabled the patient to voluntarily lift each leg up to 10cm, which was of great help to the swing phase of FES walking. Both muscle force and resistance to fatigue were significantly enhanced right after the exercise was applied every day instead of 6 days a week. Up to date, the patient can walk for more than two and half minutes at 10m/min while controlling the on/off time of the stimulator by pushing the toggle switch attached to the walker handle.