• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.345-346
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• 2002

• Nutrition Research and Practice
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• v.8 no.4
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• pp.391-397
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• 2014

BACKGROUND/OBJECTIVE: Myocardial cell death due to occlusion of the coronary arteries leads to myocardial infarction, a subset of coronary heart disease (CHD). Dietary fiber is known to be associated with a reduced risk of CHD, the underlying mechanisms of which were suggested to delay the onset of occlusion by ameliorating risk factors. In this study, we tested a hypothesis that a beneficial role of dietary fiber could arise from protection of myocardial cells against ischemic injury, manifested after occlusion of the arteries. MATERIALS/METHODS: Three days after rats were fed apple pectin (AP) (with 10, 40, 100, and 400 mg/kg/day), myocardial ischemic injury was induced by 30 min-ligation of the left anterior descending coronary artery, followed by 3 hr-reperfusion. The area at risk and infarct area were evaluated using Evans blue dye and 2,3,5-triphenyltetrazolium chloride (TTC) staining, respectively. DNA nicks reflecting the extent of myocardial apoptosis were assessed by TUNEL assay. Levels of cleaved caspase-3, Bcl-2, and Bax were assessed by immunohistochemistry. RESULTS: Supplementation of AP (with 100 and 400 mg/kg/day) resulted in significantly attenuated infarct size (IS) (ratio of infarct area to area at risk) by 21.9 and 22.4%, respectively, in the AP-treated group, compared with that in the control group. This attenuation in IS showed correlation with improvement in biomarkers involved in the apoptotic cascades: reduction of apoptotic cells, inhibition of conversion of procaspase-3 to caspase-3, and increase of Bcl-2/Bax ratio, a determinant of cell fate. CONCLUSIONS: The findings indicate that supplementation of AP results in amelioration of myocardial infarction by inhibition of apoptosis. Thus, the current study suggests that intake of dietary fiber reduces the risk of CHD, not only by blocking steps leading to occlusion, but also by protecting against ischemic injury caused by occlusion of the arteries.

• Journal of Nutrition and Health
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• v.32 no.6
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• pp.713-725
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• 1999

Women have a greater incidence of coronary heart disease(CHD) after menopause. It relates to hormone imbalance-induced changes in known CHD risk factors, especially hyperlipidemia. Accordingly, once women are diagnosed, the rate of morbidity and mortality is greater than for men. Thus, preventive strategies are critical to improve the quality oflife in the later years for women. The purpose of ths study was to explore the difference of anthropometric, environmental factors and food behaviors between normocholesterolemia and hypercholesterolemia within postmenopausal women. The subjects were classified as normocholesterolemia and hypercholesterolemia based on the Guideline for Korean Hyperlipidemia. The results obtained are summarized as follows. The distributions of general characteristics such as age, family income, occupation status, age at menarche, and menopausal period were not significantly different between the normocholesterolemia group and hypercholesterolemia group. The anthropometric factors such as body mass index(BMI) and waist hip ratio(WHR) were not significantly different between the normocholesteroemia group and the hypercholesterolemia group but odds ratio of hypercholesterolemia group was higher than that of normocholesterolemia but not significant. Aerobic activity more than 1hours/day was significantly related to low serum cholesterol concentration. Eating behaviors related to regular meal time, regular breakfast habit, and slow meal speed were related to low serum cholesterol concentration. Eating the chicken without skin was significantly related to low serum cholesterol concentration. Our data indicate that desirable eating habit, aerobic activity more than 1hr/day are important factors of serum cholesterol concentrations in postmenopausal women. The result of this study provide information that is important in designing appropriate dietary guidelines for hypercholesterolemia in postmenopausal women.

• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.491-498
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• 1999

Objectives : To determine the relations between seven blood lipids such as total cholesterol(TC), triglyceride(TG), HDL-cholesterol(HDL), LDL-cholesterol(LDL), apolipoprotein A-1(Apo A1), apolipoprotein B(Apo B) and lipoprotein(a)(Lp(A)) and the coronary heart diseases(CHD), the quantitative techniques of meta-analysis were applied to studios of blood lipids and CHD in Koreans. Methods : We searched the Korean and the English literature published from 1980 to August, 1997 by manual search and bibliography review. Information on sample size, study design, participant characteristics(gender, age) and blood lipid levels were abstracted by reviewers using inclusion criteria. Estimates of the effect sizes of blood lipid levels on CHD in Koreans and corresponding 95% confidence intervals were calculated using random-effect models. Results : We identified 16 case-control studies to apply meta-analysis. The overall effect sizes for CHD were 20.3(95% CI: 14.23-20.22) in TC, 24.8(95% CI: 12.6-36.86) in TG, 15.16(95% CI: 3.99-26.33) in LDL, -3.48(95% CI: -5.79 - -1.17) in HDL, -9.78(95% CI: -16.98 - -2.58) in Apo-a1, 17.88(95% CI: 9.72-26.05) in Apo B and 18.95(95% CI: 17.88-20.02) in Lp(a). Conclusions : Our results suggested that seven blood lipids were significantly associated with CHD in Koreans. Well-designed and prospective studies between blood lipids and CMD in Koreans should be peformed.

• Journal of Nutrition and Health
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• v.30 no.3
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• pp.307-317
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• 1997

To determine the effects of endogenous and exogenous strogen on serum lipid levels, twenty nonsmoking healthy Korean women were participated in this experiment for 12 weeks. They were assigned to three groups : (1) eight women aged 22 to 30(yr) for the premenopausal(Pre) group, (2) eight, aged 49 to 60(yr) for the postmenoparusal(Pst) group, (3) four, aged 23 to 30(yr) for the oral contraceptive(OC) group which used triphasic OC formulation. Fasting blood samples representing every phase of the hormonal levels were obtained from the subjects of the Pre and the OC group. From the subjects of the Pst group, fasting blood samples were obtained once per three weeks for 12 weeks. All the serum data were adjusted for dietary effects, exercise, personality type and body mass index(BMI) by using analysis of covariation(ANCOVA). Serum lipid levels of the three groups were significantly different. While serum levels of triglycerides(TG)(p<0.0001), low density lipoprotein-chloesterol(LDL-C)/high density liporotein-cholesterol(HDL-C) ratio (LDC-C/HDL-C)(P<0.01) and total cholesterol (TC)/HDL-C ratio (TC/HDL-C)(P<0.001) were significatnly high in the Pst group, serum HDL-C(P0.001) level was significantly high in the Pre group. The OC group showed significantly low serum TC(P<0.0001) and LDL-C(P<0.0001) levels. There was no signidicant difference in the fluictuation of serum lipid levels during the menstrual cycle of the Pre group. However, in the OC group, serum TG level was significantly increased at phase 2(P<0.05) where exogenous estrogen administration was highest. Even though other serum lipid levels of the OC group were not significantly fluctuated according to the exogenous estrogen administration, there was a trend of increased levels of serum TC, LDL-C, LDL-C/HDL-C and TC/HDL-C and decreased level of HDL-C during the menstruation period. Also, serum TC level was high(P<0.005) and serum TG level was low (P<0.005) at the baseline of the OC group compared with the periods of OC administration. When screening and counseling the female population at risk for coronary heart disease(CHD), the result of this study suggest that in may be desirable to divide the population into several groups according to their personal physiological characteristics, such as age, OC administration, menstrual cycle and menopause, as well as general risk factors for CHD.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.1
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• pp.22-29
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• 2016

Serum gamma-glutamyltransferase (GGT) has been widely used as a marker of alcohol intake and liver failure. Recently, the relativity between GGT and various diseases has been identified with growing interest. In this study, we examined relativity between GGT value and risk factors of coronary heart diseases among those with normal GGT value, excluding heavy drinkers. Specifically, we compared the differences based on age and gender. Data from the 2011 KNHNES were used (N=3,619). When the subjects were categorized according to quartile based on the serum GGT levels, there was 10~20, 21~27, 28~38, 39~71 IU/L in men, and 6~12, 13~16, 17~22, 23~42 IU/L in women. The mean of most variables was the highest in the $4^{th}$ quartile (Q4), however age and LDL Cholesterol were the highest in the $2^{nd}$ quartile (Q2) in men. The FRS and 10-year CHD risk was the highest in the $2^{nd}$ quartile in men, and the highest in the $4^{th}$ quartile in women. Increased GGT was correspondingly linked with age in women but age was the highest in GGT in the $2^{nd}$ quartile in men. In the 70's, the highest Q1 and Q2 was in men and the highest Q3 and Q4 in women. Although GGT value was within the normal range, increased GGT showed correlation with various risk factors. The FRS and 10-year CHD risk showed different patterns according to age and gender along with increased GGT value.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.158-167
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• 2022

Background: This study investigated mortality and morbidity in patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) support after operations for congenital heart disease (CHD). Methods: CHD patients requiring postoperative ECMO support between May 2011 and May 2021 were retrospectively reviewed. Patients were divided into non-survivors and survivors to hospital discharge. Survival outcomes and associations of various factors with in-hospital death were analyzed. Results: Fifty patients required postoperative ECMO support. Patients' median age and weight at the time of ECMO insertion were 1.85 months (interquartile range [IQR], 0.23-14.5 months) and 3.84 kg (IQR, 3.08-7.88 kg), respectively. Twenty-nine patients (58%) were male. The median duration of ECMO support was 6 days (IQR, 3-12 days). Twenty-nine patients (58%) died on ECMO support or after ECMO weaning, and 21 (42%) survived to hospital discharge. Postoperative complications included renal failure (n=33, 66%), bleeding (n=11, 22%), and sepsis (n=15, 30%). Prolonged ECMO support (p=0.017), renal failure (p=0.005), continuous renal replacement therapy (CRRT) application (p=0.001), sepsis (p=0.012), bleeding (p=0.032), and high serum lactate (p=0.002) and total bilirubin (p=0.017) levels during ECMO support were associated with higher mortality risk in a univariate analysis. A multivariable analysis identified CRRT application (p=0.013) and a high serum total bilirubin level (p=0.001) as independent risk factors for death. Conclusion: Postcardiotomy ECMO should be considered as an important therapeutic modality for patients unresponsive to conventional management. ECMO implementation strategies and management in appropriate patients without severe complications, particularly renal failure and/or liver failure, are crucial for achieving positive outcomes.

• Journal of the Korean Society of Food Science and Nutrition
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• v.15 no.2
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• pp.191-200
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• 1986

It is now generally accepted that individuals at increased risk for cardiovascular disease may be identified by certain traits or habbits. The factors such as high blood pressure, elevated blood cholestrol, age, sex and obesity are associated with increseaed frequency of disease. The blood cholesterol level lowering will decrease cardiovascular disease risk. The regression of atherosclerosis can be achieved by lowering the level of circulating cholesterol. Those things are connected with the quantity and quality of protein, fats, carbohydrates, especially soluble and non-soluble fiber, magnesium and calcium. The lipoprotein and lipid metabolism are connected with the lipid transport. The factors on lipid absorption and blood serum lipid pattern of human are exist. The factors have a variety of materials with different chemical and physical properties. The soluble fiber diet make a low blood and liver lipids. Many kind of soluble fiber results in a lowering of blood cholesterol and triglyceride levels. The cholesterol lowering effects of dietery fiber may be a results of alterations of in intestinal handling of fats, hepatic metabolism of fatty acid or triglyceride acid metabolism of lipoprotein. It is investigated that the high density lipoprotein (HDL) is inversely related to coronary artery disease. It has been postulated that HDL may be an important factor in cholesterol efflux from the tissues, therby reducing the amount of cholesterol deposited there. Alternatively, the HDL may pick up cholestyl ester and phospholipid during normal VLDL lipolysis in the plasma. The HDL levels are relatively insensitive to diet. At present time, the cause-and -diet effect of HDL's inverse relation to CHD remains unclear.

• Korean Circulation Journal
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• v.48 no.12
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• pp.1148-1156
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• 2018

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.539-542
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• 2004

Not only morphology of pulmonary artery or pulmonary artery resistance, but major aortopulmonary collateral arteries are risk factors of Fontan procedure. We report a successful Fontan procedure after rehabilitation of pulmonary arteries by unifocalization and systemic to pulmonary shunt in a high risk Fontan candidate with functional single ventricle combined with hypoplastic pulmonary arteries and major aortopulmonary collateral arteries supplying most of the bilateral lung field.