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.
Park, Kyoung Soo;Shin, Myung Seok;Chang, Mea Young
Clinical and Experimental Pediatrics
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v.49
no.8
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pp.851-856
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2006
Purpose : The purpose of this study is to find out the diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants. Methods : Infants without cholestasis were classified into postnatal days and each change of serum bile acid was measured and analyzed. Also, the serum direct bilirubin, serum bile acid, ${\gamma}$-glutamic acid transferase, and alkaline phosphatase of premature infants with total parenteral nutrition induced cholestasis were measured for comparison and analysis of their correlation. Results : Changes of serum bile acid analysis after birth showed no significant difference between boys and girls, between premature infants and term infants without cholestasis. Serum bile acid levels are constant after two weeks after birth in neonates without cholestasis. In premature infants with total parenteral nutrition induced cholestasis, the increase of serum direct bilirubin over 2 mg/dL was $34.9{\pm}18.3$ days after birth, and the increase of serum bile acid was $28.1{\pm}18.3$ days. Its increase was about 1 week faster than serum direct bilirubin, however, there was no statistical significance(P=0.114). Comparing analysis of serum bile acid, ${\gamma}$-glutamic acid transferase, and alkaline phosphatase, serum bile acid showed the highest correlation to serum direct bilirubin(r=0.487, P=0.000). Conclusion : Serum bile acid is an important parameter of total parenteral nutrition induced cholestasis in premature infants and will be useful for early diagnosis and treatment.
It was reported that the novel compounds (LP9M80-H) of $Liriope$$platyphylla$ regulate glucose transporter (Glut) biosynthesis by activating the insulin-signaling pathway in the liver and brain of ICR mice. To investigate the therapeutic effects of LP9M80-H on the pathology of diabetes and obesity, alterations of key factors related to symptoms were analyzed in the Otsuka Long Evans Tokushima Fatty (OLETF) rats treated with LP9M80-H for 2 weeks. The abdominal fat masses in the LP9M80-H-treated group were lower than the vehicle-treated group, although there was no difference in body weight between the two groups. Additionally, when compared to the vehicle-treated group, LP9M80-H treatment induced a significant decrease in glucose levels and an increase in the insulin concentration in the blood of OLETF rats. A high level of insulin protein was also detected in pancreatic ${\beta}$ cells of LP9M80-H-treated OLETF rats. A significant reduction in the concentration of lipids and adiponectin was detected only in LP9M80-H-treated OLETF rats. Furthermore, the expression of insulin receptor ${\beta}$ and the insulin receptor substrate (IRS) was dramatically decreased in LP9M80-H-treated OLETF rats compared to the vehicle-treated group. Of the glucose transporters located downstream of the insulin-signaling pathway, glucose transporters (Glut) -2 and -3 were significantly decreased in LP9M80-H-treated OLETF rats, while the level of Glut-4 was maintained under all conditions. Therefore, these results suggest that LP9M80-H may contribute to relieving symptoms of diabetes and obesity through glucose homeostasis and regulation of lipid concentration.
Background: Atrioventricular valve regurgitation in pediatric patients with a functional single ventricles (FSV) - has been known as one of the important risk factors for death and unfavorable long-term results after a Fontan operation. We evaluated early and mid-term results of bivalvation valvuloplasty in FSV patients. Material and Method: We retrospectively evaluated 11 patients with a functional single ventricle who underwent bivalvationvalvuloplasty between 1999 and 2007. The degree of common atrioventricular valve regurgitation (CAVVR) was determined by color Doppler echocardiography (regurgitation grade scoring, trivial; 1, mild; 2, moderate; 3, severe; 4). Mean age at valve surgery was $6.9{\pm}7.0$ months (median 4 months, 24 days$\sim$21 months)and mean body weight was $6.2{\pm}2.8\;kg$ ($3.1{\sim}11.3\;kg$). Nine patients had isomerism heart and two of them had TAPVC. The concomitant procedures were performed in all but one patient. Additional commissural closure was performed in 3 patients and commissural annuloplasty in another 3 patients. Result: There was one hospital death after. surgery. A 32-day old patient who had been preoperatively dependent on a ventilator died of air way and lung problems 4.3 months after pulmonary artery banding and bivalvation valvuloplasty. Mean follow-up duration was 40 months ($4.3{\sim}114$ months). Mean preoperative CAVVR score was $3.3{\pm}0.6$, which decreased to $1.9{\pm}0.7$ postoperatively (p<0.0001). This residual regurgitation slightly increased to $2.2{\pm}0.4$ (no statistical significance) after a mean follow-up of 1.4.3 months. Six patients (60%) required re-operations for residual regurgitation at a subsequent bidirectionalcavopulmonary shunt or Fontan operation. One patient with Ebsteinoid malformation of the right sided atrioventricular valve required valve replacement due to stenoinsufficiency. Another patient required edge-to-edge repair at the right sided AV valve (between the right mural leaflet and the bridging leaflets). The remaining 4 patients required additional suture placements between bridging leaflets with or without commissural annuloplasty. All survivor had trivial or mild CAVVR at the latest follow-up. Conclusion: Bivalvation valvuloplasty for CAVVR in FSV patients is. an effective and safe procedure. However, significant numbers of the patients have small residual regurgitation and require additional valve procedures at subsequent operations. Long-term observations to monitor progression of the CAVVR is mandatory.
Purpose : To evaluate the geometry of carotid artery by assessing the images of contrast-enhanced MR angiography (CE-MRA) and interrelationships between the geometry of carotid artery and clinical factors. Materials and Methods : 216 consecutive patients who performed supraaortic CE-MRA with fast spoiled gradient-echo imaging were included. Their medical records were reviewed for variable information including risk factors predictive of generalized atherosclerotic disease (age, hypertension (HTN), diabetes mellitus, hyperlipidema, and smoking), sex, body weight, height, and body mass index (BMI). We reviewed the CE-MRA with carotid origin (3 types), carotid artery tortuosity, angle of internal carotid artery bifurcation, the type of aortic arch branching, and the presence of the coiling of carotid artery. Results : Multinomial logistic regression analysis showed that significantly contributed clinical backgrounds for carotid origin were the age and the BMI. With an increase of age at 1, the probability that the type of carotid origin become from type 1 to type 2 was 0.9 times (p=0.004) in right carotid artery (RCA), 0.9 times (p = 0.031) in left carotid artery (LCA), 0.9 times that are likely to be type3 from type 2 (p<0.001) in RCA and 0.9 times in LCA (p=0.009). Increase in BMI at 1 increased odds of becoming type 2 as 1.1 times (p = 0.067) in RCA, 1.1 times (p=0.009) in LCA and increased chance of becoming type 3 as 1.2 times (p = 0.001) in RCA, 1.2 times (p=0.003) in LCA. Mean value of right and left carotid tortuosity were $240.9{\pm}69.0^{\circ}$and $154.4{\pm}55.0^{\circ}$, respectively. Conclusion : The BMI, age, sex and presence of HTN affects the geometry of carotid arteries, the site of origin and tortuosity of carotid artery specifically.
Background: The aim of this study is to confirm that peripheral blood sampling for measuring of serum immunoglobulin can predict immunological changes after xenograft implantation. Material and Method: Between March 2006 and January 2007, 19 patients were enrolled (10 xenograft implantation group, 9 control group). Through 3 peripheral blood samples, we measured changes in serum immunoglobulin G and M levels preoperatively, and 2 and 10 days postoperatively. Result: In both groups, serum immunoglobulin levels showed similar changes-they decreased 2 days postoperatively, then increased up to the baseline levels 10 days postoperatively. However, this postoperative change of immunoglobulin G and M was not significantly different in absolute value or pattern between the 2 groups (Ig G; p-value=0.393, Ig M; p-value=0.193). Conclusion: We could not predict immunological changes after xenograft implantation by measuring serum immunoglobulin levels by simple blood sampling. Direct checking of ${\alpha}$-Galactose antibody may confirm an immunological reaction after xenograft implantation.
This study was performed to investigate the effects of Sineui-Dae (Sasa coreana Nakai, a kind of bamboo) extracts on the improvement of serum lipid composition by using rats fed a hypercholesterol diet for 4 weeks. The experiment animals were administered with the following diets; high cholesterol diet group (HC diet) as a control and three supplemented groups with high cholesterol diets (HCW, HCM or HCH diet). Three kinds of extracts were prepared by orderly extraction with hexane, methanol, and water. We measured free cholesterol, cholesteryl ester, total cholesterol LDL- and HDL-cholesterol triglyceride and phospholipid in the serum of rats in three experimental and control groups. There were no significant differences in body weights and feed intakes between the HC control group and the extract supplemented groups. The levels of total cholesterol and LDL-cholesterol in the serum of extract supplemented groups were lower than that of the group fed with HC diet only. Serum HDL-cholesterol levet which is known as an antiatherosclerosis factor, was higher in all groups supplemented with bamboo extract by 17.2-21.9% compared to the HC control group. All groups supplemented with bamboo extracts showed the lowering effect of atherogenic index compared to the HC control group (HC group: 2.96${\pm}$0.08, HCM group: 1.48${\pm}$0.02, HCW group: 1.69${\pm}$0.04, HCH group: 1.84${\pm}$0.01). Furthermore, serum triglyceride and phospholipid decreased significantly in the HCM diet compared to the HC control diet. These results suggest that Sineui-Dae bamboo extract, especially methanol extract, has improving effects on hyperlipidemia of rats fed a high cholesterol diet.
This study reviewed the changes of hemodynamlcs and centrAl pulmonary artery dimension in 54 patients who underwent bidirectional cavopulmonary shunt(BCPS) between February 1992 and December 1995 at Seoul National University Childrell's Hospital. Ag and body weight of patients averaged 36.8 $\pm$ 37.7 months and 8.0$\pm$3.0 kg, respectively Eightynine percent of patients had more than 2 violations of the risk factors for Fontan operation, resulting overall hospital mortality of 16.6%(9154). Serial hemodynamic and anglographic examinations before and mean 16.3 $\pm$ 14.3 months iirter BCPS were compared. The arterial oxygen saturation improved from a preoperative value of 71 9: 10.1 % to 79.H $\pm$ 8. 5% (n:4), p<0.05). The values of arterial oxygen saturation were lower as the age of the patients with BCPS in place was older(n=22, R'=0.341, p=0.004). A mean pulmonary artery pressure and pulmonary vascular resistance reduced from 31 $\pm$17 to 1).5$\pm$3.SmmHg(n=22, p<0.05) and from ).2$\pm$2.1 to 2.3$\pm$2.7 unit (n=7. p>0.05), respectively. Follow-up study showed a significant Increase of absolute values of ipsilateral pulmoanry artery (n: 14, p<0.05), but no change of contralateral pulmonary artreries (n: 14. p=not significant(HSI). However, there w re significant decreases in diameters of both ipsilateral and contralateral pulmonary arteries standardized by patients' body surface areas(16.8% decrease, n: 14, p< 0. 05 for ipsilatreal, 25.1%, n=14, p<0.05 for contralateral). Pulmonary artery indices for cross sectional areas of both pulmonary arterises decreased 9.3 $\pm$ 13.8% with showing a trend of more decrease as the follow-up duration was longer, We conclude that the bidirectional cavopulmonary shunt provide an excellent.
Two experiments were conducted to determine whether water extracts from Artemisia capillaries (A. capillaries) and Camellia sinensis (C. sinensis) could be used as alternatives to antibiotic growth promoters in broiler feed. The experiment 1 was verified their chemical composition, extracts yields, total phenolic compounds concentration, antioxidant activity, antimicrobial activity, and chicken splenocytes proliferation through in vitro test. The extract yields of A. capillaries and C. sinensis were 26.5 and 16.8%, respectively. Total phenolic compounds concentrations of them expressed as gallic acid equivalent were 15.28 and 26.74 mg/mL, respectively. Electron donating abilities of them expressed as $SC_{50}$ showing 50% DPPH radical scavenging were 0.30 and 0.06 mg, respectively. Bacterial inhibitory rates of them against Escherichia coli, Staphylococcus aureus, and Salmonella Typhimurium were ranged from 42.1 to 52.3% and from 21.6 to 33.7%, respectively. And, these extracts increased proliferation of chicken splenocytes. Especially, A. capillaris was more excellent than Echinacea and Concanavalin A known as T-cell stimulator. The experiment 2 was investigated their effects on growth performance, relative organ weight, cecal microflora, blood biochemical parameters, and splenic cytokines mRNA expression in broiler chicks. Four hundred eighty 1-day-old male broiler chicks (Ross 308) were divided in to 4 treatment groups with 4 replicates of 30 birds in each group: NC (control, no antibiotics), PC (avilamycin, 10 ppm; salinomycin, 60 ppm), AC (A. capillaries, 100 ppm), and CS (C. sinensis, 100 ppm); treatments were administered through water supplementation. Final body weight was significantly higher in all treated groups than in NC (p<0.05). Cecal Salmonella numbers were significantly or somewhat decreased in all treated groups than in NC (p<0.05). The relative weights and lengths of the small intestine were more significantly decreased in the PC and AC groups than in the other groups. Cecal Salmonella numbers were significantly or somewhat decreased in all treated groups than in the NC group (p<0.05). The contents of total cholesterol, aspatate aminotransferase, and alanine aminotransferase in blood serum were more significantly decreased in all treated groups than in NC (p<0.05). In conclusion, these results suggested the possibility that these extracts could serve as alternatives for antibiotic growth promoters.
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