• Journal of Chest Surgery
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• 제34권6호
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• pp.465-471
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• 2001

Background: Hypothermia protects the brain by suppressing the cerebral metabolism and it is performed well enough before the total circulatory arrest(TCA) in the operation of aortic disease. Generally, TCA has been performed depending on the rectal or nasopharyngeal temperatures; however, there is no definite range of optimal temperature for TCA or an objective indicator determining the temperature for safe TCA. In this study, we tried to determine the optimal range of temperature for safe hypothermic circulatory arrest by using the intraoperative electroencephalogram(EEG), and studied the role of EEG as an indicator of optimal hypothermia. Material and Method: Between March, 1999 and August 31, 2000, 27 patients underwent graft replacement of the part of thoracic aorta using hypothermia and TCA with intraoperative EEG. The rectal and nasopharyngeal temperatures were monitored continuously from the time of anesthetic induction and the EEG was recorded with a ten-channel portable electroencephalography from the time of anesthetic induction to electrocerebral silence(ECS). Result: On ECS, the rectal and nasopharyngeal temperatures were not consistent but variable(rectal 11$^{\circ}C$ -$25^{\circ}C$, nasopharynx 7.7$^{\circ}C$ -23$^{\circ}C$). The correlation between two temperatures was not significant(p=0.171). The cooling time from the start of cardiopulmonary bypass to ECS was also variable(25-127min), but correlated with the body surface area(p=0.027). Conclusion: We have found that ECS appeared at various body temperatures, and thus, the use of rectal or nasopharyngeal temperature were not useful in identifying ECS. Conclusively, we can not fully assure cerebral protection during hypothermic circulatory arrest in regards to the body temperatures, and therefore, the intraoperative EEG is one of the necessary methods for determining the range of optimal hypothermia for safe circulatory arrest. :

• Journal of Chest Surgery
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• 제30권6호
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• pp.598-606
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• 1997

Among 136 patients having undergone mitral valve surgery from September of 1994 through August of 1995 in Sejong Heart Institute, forty four patients(18 males, 26 females) underwent mitral valve reconstruction using prosthetic rings and their clinical results were evaluated. Patients'ages ranged from 5 to 63 years(mean age 38.2 years). Mitral valvular diseases were due to rheumatic origin in 30 patients(68%), degenerative in 13(30%), and congenital in one patient(2%). Mitral regurgitation(MR) was in 33 patients(76%), mitral stenosis 2(5%), and mitral stenoinsufaciency 9 patients(19%). The patients were divided into Carpentier's functional groups : type I, 5 patients(11%) : type I, 24 patients(55%) ; type III, 4 patients (9%) i and mixed(II + III), 11 patients(25%). Average number of anatomic lesions of mitral valve per patient was 3.7. The techniques included prosthetic ring amluloplasty(44 patients, 32 Carpentier ring and 12 Duran ring), leaflet mobilization(24, 55%), chordae shortening(23, 52%), chordae transposition(23, 52%), commissurotomy(16, 35%), leaflet resection(9, 20%), papillary muscle splitting(8, 18%), and chordae reimplantation(1, 2%). Average 3.4 surgical procedures were applied on mitral valve per patient. There were two hospital mortality and one reoperation due to development of MR(grade III) after 2 weeks. During the mean follow up of 12 months, patients improved in terms of functional class of the New York Heart Association, which was mean 3.0 preoperatively and 1.3 postoperatively. Doppler echocardiographic studies showed adequate valve area(2.07$\pm$0.11 cm2 mean $\pm$standard error), improved ventricular contractiliy in 41 patients(93%), ab ence of MR in 23(53%), trace MR in 18(42%), and garde II MR in 2 patients(5%).

• The Journal of Internal Korean Medicine
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• 제22권3호
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• pp.285-290
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• 2001

Purpose : Impaired glucose tolerance (IGT) was standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes, replacing groups such as 'borderline' and 'chemical' diabetes. The main clinical significance of IGT is as a risk factor for type 2 diabetes and as a risk factor for cardiovascular disease and as a component of the metabolic syndrome. In 1997 the American Diabetes Association(ADA) was proposed the new classification and diagnostic criteria for diabetes, which is strict with the diagnostic baseline of Diabetes from 140mg/dl to 126mg/dl. And it's main purpose is to prevent chronic complications by early diagnosis and treatments. In the oriental medicine, Supungsunkihwan has been used in treatments of Diabetes including IGT & NIDDM, however there is not enough studies about the its objective hypoglycemic effect. so in order to investigate whether there is hypoglycemic effect of Supungsunkihwan, clinical studies were performed with IGT and mild NIDDM patients. Methods : Prior to the study, fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. In addition, ECG, cholesterol, TG, HbA1c levels were measured, and the dinical characteristics of patients that can be influence to the blood sugar level such as age, gender, rest type, diet type were surveyed. Supungsukihwan was administered for 7 days, and FBS & PP2hrs were measured again after the therapy. Result : PP2hrs glucose levels were decreased by the administration of Supungsunkihwan. And It's hypoglycemic effects has the correlation with age. That is, the more age increase, the more hypoglycemic effect decrease. Conclusion : Supungsukihwan has hypoglycmic effects on IGT & mild NIDDM patients and it is more effective when administrated to young patients relatively.

• The Journal of Internal Korean Medicine
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• 제22권2호
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• pp.199-205
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• 2001

Background and Purpose : Transcranial doppler ultrasonography(TCD) is a noninvasive and nonradioactive technique for evaluation of the hemodynamics in large cerebral vessels. Sahyangsohap-won(SS) has been considered to be effective for the treatment of various disease, especially cerebrovascular, cardiovascular, and psychosomatoform disorders. But, there is no study about the effect of SS on the cerebral hemodynamics in humans. The aim of this study was to assess the effect of SS on the changes in cerebral hemodynamics and the dose-dependant effect by using TCD. Subjects and Methods : 30 healthy subjects were randomly divided into three group: group 1 took no drug, group 2 took SS one pill, and group 3 took SS 2 pills. Changes in the mean blood flow velocity(MBFV) and pulsatility index(PI) in the middle cerebral artery were evaluated by means of TCD. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with the breath-holding index(BHI). Systolic blood pressure(SBP), diastolic blood pressure(DBP), and heart rate(HR) were measured by means of ambulatory blood pressure monitoring. In group 2 and group 3, the evaluations were performed during the baseline and were repeated at 20, 40, and 60 minutes after SS administration. In group 1, the evaluation was performed at corresponding time intervals. Results : In mean values of MSFV, PI, SSP, DBP, and HR, no stastically significant differences were found between the 3 groups. However, BHI values were significantly lower in groups 2 and 3 than in group 1 at 40 minutes after SS administration(P<0.05, group 1 vs group 2, group 1 vs group 3 by post-hoc analysis: Scheffe's test) but in dose-dependant effect, there was no difference between group 2 and group 3. Conclusion : These results suggest that SS can decrease vascular resistance in cerebral small arteries or arterioles and enhance their distensibility. Further studies on larger numbers of subjects are needed to confirm these effects and the dose-dependant effects.

• Journal of Life Science
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• 제17권5호
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• pp.606-612
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• 2007

Fibrin clots remained in blood vessels can be one of the serious factor caused cardiovascular disease, such as ischemia, infarction and necrosis The development of an antithrombotic and thrombolysis solvent is necessary to prevent and treat these diseases. In this study, the fibirinolytic protease was prepared from the maggots of Protaetia brevitarsis using ammonium sulfate fractionation and desalting column. The optimum pH and temperature for the enzyme activity were pH 9.0 and $50^{\circ}C$, respectively. The enzyme activity was relatively stable at pH 7.0-9.0 and temperature below $60^{\circ}C$. The activity of the enzyme was strongly inhibited by phenylmethanesulfonyl fluoride. And the activity of the enzyme was inhibited by $Ca^{2+}\;and\;Zn^{2+}$, but it was not by $Mg^{2+}\;and\;Fe^{2+}$ ions. In these experimental results, we have speculated that the enzyme derived from maggots of Protaetia hrevitarsis is a serine protease with a strong fibrinolytic activity.

• Journal of Nutrition and Health
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• 제36권10호
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• pp.1052-1060
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• 2003

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly, even it is worse in rural areas. In the present study, we conducted the anthropometric measurement and the dietary intakes including macronutrients, minerals and vitamins to assess the nutrient intakes and nutritional risk in elderly people in rural kyungpook province in South Korea. Subjects (n = 168, mean age, 67.3 yrs) were interviewed using d general questionnaire and 3 days of 24-hours recall for dietary intake. Nutrient intakes were analyzed using CAN-pro soft program and compared to Korean RDA and nutrition reference values (NRV). The anthropometric measurement showed that the weight and the height of the subjects in the rural area were below the average of the same age of Korean elderly people. The energy and protein intakes were 85％ and 90％ of Korean RDA, respectively. The intakes of lipid, cholesterol and dietary fiber were 62％, 40％ and 22％ of NRV for Korean adults. Main sources for protein and lipid intakes came from the vegetable sources and this pattern was more prominent in female elderly people. Ca intake was half of Korean RDA (56％), while P intake was 132％ of Korean RDA. For the antioxidant trace mineral (Fe, Cu, Mn, Zn, and Se) intakes, Fe and Zn intakes were 78％ and > 103％ of Korean RDA. Cu, Mn and Se intakes were > 113％, > 275％, and > 185％ of Korean NRV. Thiamin, niacin and vitamin C intakes were above Korean RDA, but the intakes of vitamin A and riboflavin were 88％ and 63％ of Korean RDA, respectively. On summarizing the results of the present study, the elderly people in rural area consume less lipid, cholesterol, Ca, and dietary fiber. Ca intake is lower, while P intake is higher, and this would be the potential risk for bone health. Also, Na intake was high, which can be the potential risk for the cardiovascular disease prevailance. Vitamin intakes were fairly good status, excepting riboflavin. Antioxidant mineral intakes were much higher than Korean NRV, unexpectedly. The results suggest that the elderly people in rural area have inadequate intakes of protein, lipid, dietary fiber and Ca, which mainly should be supplied from animal products. Recommendations to increase diet variety would be emphasized for this nutritionally poor-conditioned subjects, specially including animal food products and high dietary fiber food.

• The Korean Journal of Blood Transfusion
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• 제23권2호
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• pp.136-144
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• 2012

Background: Fresh frozen plasma (FFP) transfusion is administered primarily for management of acquired bleeding disorders. However, in practice, FFP transfusion is increasing without a solid rationale. Methods: We conducted an audit to evaluate the appropriateness of the indications for FFP transfusion during the period from July 2010 through June 2011. Assessment of the appropriateness of the indications was based on the national transfusion guidelines and the transfusion criteria promulgated by the Severance Hospital. Results: In total, 17,733 units of plasma were transfused to 1,949 patients over 4,982 events. We found that administration of FFP was not in compliance with the recommended guidelines in 1,990 events. The number of total FFP transfusions was higher in medical departments (Gastroenterology) than in surgical departments (Thoracic and cardiovascular surgery, General surgery). However, the proportion of cases of inappropriate transfusion was higher in surgical departments than in medical departments. Both the total number of FFP transfusion and the proportion of inappropriate transfusion were high in patient with neoplasm, disease of the digestive system, and diseases of the circulatory system. Conclusion: Continuous monitoring on appropriateness for FFP transfusion and feedback to the physician are critical in securing the transfusion safety as well as maintaining the quality of FFP transfusion. New-found indication for FFP transfusion should be investigated and applied in timely manner.

• Korean Journal of Plant Resources
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• 제31권4호
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• pp.312-321
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• 2018

Angelica tenuissima, also known as Ligusticum tenuissimum, is classified as a food-related plant and has been used as traditional medicines treating headache and anemia in Asia. However, its anti-melanogenic effect has not been reported in detail. When the extract of Angelica tenuissima (ATE) was prepared by the extraction with 70% EtOH at $80^{\circ}C$ (final yield = 22%), the contents of decursin and Z-ligustilide in ATE were determined 0.06% and 8.43%, respectively. Total flavonoid and phenolic content in mg ATE were $5.52{\pm}0.07{\mu}g$ quercetin equivalents and $237.27{\pm}13.24{\mu}g$ gallic acid equivalents, respectively. Antioxidant capacity of ATE determined by DPPH and ABTS assay was increased with a dose dependent manner up to $1000{\mu}g/m{\ell}$. The amount of melanin synthesis followed by ${\alpha}-melanocyte$ stimulating hormone on B16F10 cells were significantly reduced in the presence of ATE (250 to $1000{\mu}g/m{\ell}$, p<0.05). ATE (125 to $1000{\mu}g/m{\ell}$, p<0.05) suppressed the tyrosinase activity but did not show any significant effect on ${\alpha}-glucosidase$ activity at the same condition. Taken together, ATE possesses tyrosinase inhibitory potential with significant antioxidant capacities. These effects of ATE might be involved in suppression of melanin synthesis, at least, in B16F10 cells. The anti-melanogenic potential of ATE will provide an insight into developing a new skin whitening product.

• Journal of Ginseng Research
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• 제45권5호
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• pp.546-554
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• 2021

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

• Korean Journal of Psychosomatic Medicine
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• 제29권2호
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• pp.207-212
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• 2021

Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is a neuroinflammatory disease mediated by autoantibodies to NMDAR. In the initial clinical stages of anti-NMDAR encephalitis, psychiatric symptoms like delusions, perceptual disturbances, and disorganized speech or behaviors are pronounced even without obvious neurological symptoms. Early treatments like immunotherapy and/or tumor removal are central to good clinical outcomes. Hence, it is important to diagnose early anti-NMDAR encephalitis, distinguishing it from mental disorder. In the present case study, the authors described psychiatric symptoms assessed with Positive and Negative Syndrome Scale (PANSS) of Ms. A, a 26-year-old woman, in the early phase of anti-NMDAR encephalitis. We will discuss the characteristic psychopathology of anti-NMDAR encephalitis toward prompt diagnosis and treatment. Ms. A showed a higher negative subscale score than positive one on the PANSS. Compared with mental disorder, negative symptoms and cognitive impairment would be more prominent in the early stage of anti-NMDAR encephalitis. Rituximab and teratoma removal were effective, and quetiapine showed good tolerability. It is recommended to evaluate anti-NMDAR encephalitis when negative symptoms, cognitive impairment, catatonia, changes in consciousness level, and neurological symptoms are observed, especially in young women.