• Title/Summary/Keyword: Cardiovascular disease

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Correlation between Semiquantitative Myocardial Perfusion Score and Absolute Myocardial Blood Flow in $^{13}N-Ammonia$ PET ($^{13}N$-암모니아 PET에서 반정량적 심근관류 점수와 절대적 심근혈류량의 상관관계)

  • Lee, Byeong-Il;Kim, Kye-Hun;Kim, Jung-Young;Kim, Su-Jin;Lee, Jae-Sung;Min, Jung-Joon;Song, Ho-Chun;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.194-200
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    • 2007
  • Purpose: $^{13}N$-ammonia is a well known radiopharmaceutical for the measurement of a myocardial blood flow (MBF) non-invasively using PET-CT. In this study, we investigated a correlation between MBF obtained from dynamic imaging and myocardial perfusion score (MPS) obtained from static imaging for usefulness of cardiac PET study. Methods: Twelve patients (11 males, 1 female, $57.9{\pm}8.6$ years old) with suspicious coronary artery disease underwent PET-CT scan. Dynamic scans (6 min: $5\;sec\;{\times}\;12,\;10\;sec\;{\times}\;6,\;20\;sec\;{\times}\;3,\;and\;30\;sec\;{\times}\;6$) were initiated simultaneously with bolus injection of 11 MBq/kg $^{13}N-ammonia$ to acquire rest and stress image. Gating image was acquired during 13 minutes continuously. Nine-segment model (4 basal walls, 4 mid walls, and apex) was used for a measurement of MBF. Time activity curve of input function and myocardium was extracted from ROI methods in 9 regions for quantification. The MPS were evaluated using quantitative analysis software. To compare between 20-segment model and 9-segment model, 6 basal segments were excluded and averaged segmental scores were used. Results: There are weak correlation between MBF (rest, 0.18-2.38 ml/min/g; stress, 0.40-4.95 ml/min/g) and MPS (rest 22-91%, stress, 14-90%), however the correlation coefficient between corrected MBF and MPS in rest state was higher than stress state (rest r=0.59; stress r=0.80). As a thickening increased, correlation between MBF and MPS also showed good correlation at each segments. Conclusions: Corrected and translated MPS as its characteristics using $^{13}N$-ammonia showed good correlation with absolute MBF measured by dynamic image in this study. Therefore, we showed MPS is one of good indices which reflect MBF. We anticipate PET-CT could be used as useful tool for evaluation of myocardial function in nuclear cardiac study.

Effects of Nattokinase fibrinol supplementation on Fibrinolysis and Atherogenesis (Nattokinase fibrinol의 섭취가 혈전 용해능 및 동맥경화에 미치는 영향)

  • Noh, Kyung-Hee;Park, Chong-Mu;Jang, Ji-Hyun;Shin, Jin-Hyuk;Cho, Mi-Kyung;Kim, Jeong-Ok;Song, Young-Sun
    • Journal of Life Science
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    • v.19 no.2
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    • pp.289-298
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    • 2009
  • Effects of Nattokinase fibrinol (NKF), defined as a fibrinolytic product, on fibrinolytic and atherogenetic markers were studied for healthy adults (20-31 years old), who is smoking more than 20 cigarettes per day. Subjects were divided into 29 for NKF group and 10 for placebo group in a short term study. They were given 2 tablets of NKF (4,000 unit) or placebo tablet and thereafter blood samples were collected at 0, 2, 4 hr prerid. For a 4-week long term study, 15 subjects for NFK group and 10 subjects for placebo group were supplemented one tablet of each NKF (2,000 unit) and placebo per day, respectively. Blood samples were collected at 0, 1, 2, 4 weeks later. The short-term experimental trial showed that NKF remarkably increased fibrinolytic activity at 2hr after consumption, which was maintained up to 4 hr, relative to that of placebo, while NKF reduced the euglobulin clot lysis time (ECLT) and retarded the activated partial thromboplastin time (aPTT), as compared to placebo group. NKF supplementation for 4 weeks elevated fibrinolytic activity, shortened ECLT and retarded aPTT. Furthermore, NKF supplementation increased anti-atherogenic index by decreasing triglyceride (TG) and elevating high-density lipiprotein (HDL)-cholesterol. These results indicate that NKF supplementation for short term or long term might have beneficial effects on preventing and treating cardiovascular disease by increasing fibrinolytic activity and improving atherogenic markers such as hyperlipidemia.

Comparative Analysis of arterial Gases and Acid-base status in Patients with Congenital and Acquired Heart Disease at Preoperative Period, During Extracorporeal Circulation. and Postoperative Period (선천성 및 후천성 심질환 환자에서 체외순환 전, 중, 후의 동맥혈 가스의 비교 분석)

  • 이동석;이봉근;김송명
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.831-842
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    • 2001
  • Background: Patients with cardiac diseases who have structural defects in their heart bring about metabolic insult such as preoperative acid-base imbalance. Cardiac operation requires many nonphysiologic procedures such as extracorporeal circulation, hypothermia, and hemodilution. We studied the acid-base status of surgical heart diseases pre-operatively, during extracorporeal circulation, and post-operatively and researched the treatment indications of acid-base disturbances. Material and Method: From January 1997 to May 1999, fifty two cases of open heart surgery were carried out under extracorporeal circulation, which divided into a set of pediatric and adult groups, congenital and acquired groups, non-cyanotic and cyanotic groups, The $\alpha$ -stat arterial blood gas analysis was done in each group during the preoperative period, during the operation with extracorporeal circulation, and during the postoperative period. Result: Before surgery, all patients present metabolic acidosis, PaO2 was low in adult group and acquired group and compensatory respiratory alkalosis was noted in cyanotic group. During extracorporeal circulation, adult group revealed alkalosis and normal in acquired group. Pediatric group presents low Pa$CO_2$, metabolic acidosis and respiratory alkalosis. Congenital group and non-cyanotic group showed non-compensatory alkalosis trend and non-compensatory respiratory acidosis were observed in cyanotic group during extracorporeal circulation. Postoperative acid-base status of adult group was recovered to normal and the standard bicarbonate was increased in the acquired group. All of the pediatric, congenital non-cyanotic, and cyanotic groups revealed the lack of buffer base.

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Surgical Results of Selected Stage IIIB Non-small Cell Lung Cancer (병기 IIIB 비소세포암 환자에서의 수술 성적)

  • 민호기;김형수;유정우;최용수;김관민;김진국;장봉현;심영목
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.157-163
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    • 2003
  • Traditionally, patients with stage IIIB non small cell lung cancer (NSCLC) have been con-sidered Inoperable due to the short-term survival rate of this disease. However, some recent papers have reported good surgical treatment results for T4 lesions in stage IIIB NSCLC. This study reports the results of stage IIIB NSCLC patients who underwent surgical treatment at our institute. Material and Method: This study includes 109 patients who were diagnosed with pathological stage IIIA lung cancer and 59 patients who were diagnosed with pathological stage IIIB at our institute between 1994 to December 2001. Patients who underwent neo-adjuvant chemotherapy and radiation therapy were excluded from this study. According to the TNM classification, 13 patients from stage IIIA were classified into T3N1, 12 into T1N2, 73 into T2N2 and 11 into T3N2. Stage IIIB patients consisted of 26 patients with T4N0, 18 with T4Nl, 14 with T4N2, and 1 with T4N3. Result: The 30-day mortality for stage IIIA and IIIB were 4.58% and 5.08% respectively. The overall survival rate at the 1st, 2nd, 3rd, and 5th year were 69.1%, 53.7%, 41.6%, and 30.7% respectively in stage IIIA and 68.8%, 55.6%, 42.9%, and 35.9% respectively in stage IIIB. Patients with satellite nodules in the same lobe & no Iymph node involvement had a survival rate of 53.9% in 3 years compared with 15.2% in patients with satellite nodules in the same lobe with Iymph node involvement. Conclusion: Surgical treatment is recommended for selected stage IIIB NSCLC patients (pathological N0 stage & completely resectable patients), particularly for patients with satellite nodules in the same lobe & no lymph node involvement.

The Comparison of Clinical Outcomes of Off-Pump versus On-Pump Coronary Artery Bypass Grafting in High Risk Patients (고위험군 환자에서 시행한 On-Pump CABG와 Off-Pump CABG의 비교연구)

  • 윤영남;이교준;김치영;안지영;오영준;유경종
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.749-754
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    • 2004
  • Off-pump coronary artery bypass grafting (Off-Pump CABG) has been proven to have less morbidity and to facilitate early recovery. High-risk surgical patients may have benefitted by avoiding the adverse effects of the cardiopulmonary bypass. We compared the effectiveness of Off-Pump CABG with that of coronary artery bypass using cardiopulmonary bypass (On-Pump CABG) in high-risk patients. Material and Method: 682 patients (424 Off-Pump CABG and 258 On-Pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Patients who were considered high risk were selected High risk is defined as the presence of one or more of nine adverse prognostic factors. Data were collected from 492 patients in Off-Pump CABG and 100 in On-Pump CABG for risk factors, extent of coronary disease, and in-hospital outcomes. Result: Off-Pump CABG group and On-Pump CABG group did not show differences in their preoperative risk factors. We used more arterial grafts in Off-Pump CABG group (p < 0.05). Postoperative results showed that operative mortality (0.5% in Off-Pump CABG versus 2.0% in On-Pump CABG), renal failure (2.6% in Off-Pump CABG versus 7.0% in On-Pump CABG), and perioperative myocardial infarction (1.5% in Off-Pump CABG versus 1.0% in On-Pump CABG) did not differ significantly. However, Off-Pump CABG had shorter mean operation time (p<0.05), lower mean CK-MB level (p <0.05), lower rate of usage of inotropics (p < 0.05), shorter mean ventilation time (p <0.05), lower perioperative stroke (0% versus 2.0%), and shorter length of stay (p < 0.05) than On-Pump CABG. On-Pump CABG had more distal grafts (p<0.05) than Off-Pump CABG. Although Off-Pump CABG and On-Pump CABG did not show statistical differences in mortality and morbidity was more frequent in CABG. Conclusion: Off-Pump CABG reduces morbidity and favors hospital outcomes. Therefore, Off-Pump CABG is safe, reasonable and may be a preferable operative strategy for high-risk patients.

The In-hospital Analysis of Outcome of Off-pump CABG and On-pump CABG (비체외순환 및 체외순환하에서의 관상동맥우회로술의 임상 고찰)

  • 안재범;김인섭;정성철;배윤숙;유환국;김병열;김우식
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.762-767
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    • 2004
  • With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with these having on-pump CABG. Material and Method: From January 2001 to June 2003, 87 patients underwent CABG. Thirty-sin patients underwent on-pump CABG, fifty-one patients under-went off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups, Result: The were no differences in their sex ratios, ages, preoperative risk factors, preoperative Ml, Canadian classes, extent of coronary artery diseases and, echocardio-graphic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270$\pm$79.3 min vs 372$\pm$142.2 min, p<0.001), mean ventilation time (17.1$\pm$13.4 hr vs 24.3$\pm$17.8 hr) and CK-MB level (8,9$\pm$18.7 IU/L vs 25.7$\pm$8.4 IU/L) than on-pump CABG groups, On-pump CABG group had more distal grafts (2.2$\pm$0.5 vs 1.7$\pm$0.71 than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

Surgical Result of the Modified Blalock-Taussig Shunt in Early Infancy (조기 영아기에서의 변형 블라록-타우시히 단락술의 수술 결과)

  • 이정렬;곽재건;최재성
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.573-579
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    • 2002
  • Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.

Antimutagenic Effects of Korean Bamboo Trees and Inhibitory Effect of Hepatic Toxicity of Bamboo Extracts Coated Rice (한국산 대나무의 항돌연변이 효과 및 대나무 코팅쌀의 간 독성 억제효과)

  • Lee, Min-Ja;Kim, Eun-Young;Jeong, Keun-Ok;Park, Kun-Young;Moon, Gap-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1279-1285
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    • 2004
  • To evaluate the antimutagenic effect and hepato protective of bamboo trees and bamboo byproduct, hot-water extracts from four kinds of bamboo [wang-dae (Phyllostachys bambusoides S. et Z.), som-dae (Phyllostachys nigra var. henonis), maengjong-juk (Phyllostachys pubescens) and o-juk (Phyllostachys nigra Munro)] and maengjong-juk extract coated rice were evaluated for antimutagenicity by Ames test using Salmonella typhimurium TA100. Bamboo extracts showed strong antimutagenic activity in the Ames test which MNNG was used as mutagen in the absence and presence of S9 mix. Maengjong-juk extract coated rice diet suppressed the loss of body weight significantly. Food intake was increased in maengjong-juk extract coated rice supplemented group but showed no significant differences between control and maengjong-juk extract coated rice diet groups. Food efficiency of maengjong-juk extract coated rice supplemented group was significantly higher than that of the control group. Liver weight was significantly increased by maengjong-juk extract coated rice diet administration. Plasma GOT & GPT activities of rabbit were significantly suppressed in maengjong-juk extract coated rice supplemented group. These results suggest that bamboo trees extracts and maengjong-juk extract coated rice are bioavailable resource on treatment of cardiovascular disease, such as atherosclerosis and hypercholesterolemia.

A Study of Serum Lipid Levels, Blood Sugar, Blood Pressure of Vegetarians and Non-Vegetarians (IV) - Based on age, abnormal serum lipid level, blood pressure, blood sugar - (채식인과 비채식인의 혈중 지질수준, 혈당, 혈압에 관한 연구(IV)-연령대별 비정상자수를 중심으로-)

  • Cha, Bok-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1320-1326
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    • 2004
  • The purpose of this study is to verify the relation between vegetarian diet and the risk factors of cardiovascular disease. Results were summarized as follows: Levels of total cholesterol, LDL-cholesterol, atherogenic index (AI), diastolic blood pressure, blood sugar and HDL-cholesterol were significantly higher (p<0.01) in non-vegetarians than those of vegetarians, but ratio of HDL cholesterol/total-cholesterol was lower in non-vegetarians. The number of subjects with abnormal serum total-cholesterol, LDL-cholesterol, atherogenic index (AI) and systotic blood pressure were much more in non-vegetarians than those in vegetarians, it were confirmed clearly as the increment of ages. In the multiple regression analysis, we acknowledged that the main factors affecting on total-cholesterol in vegetarians were age, BMI and the systolic blood pressure (R-square: 0.21), while important factors were age, BMI, the systolic blood pressure and physical activity (R-square: 0.81) in the non-vegetarians. In the vegetarians, age and BMI were the main factors having influence on LDL-cholesterol (R-square: 0.18), while age, BMI, systolic blood pressure and the physical activity (R-square: 0.82) were main factors in the non-vegetarian. In conclusion, vegetable diet may improve blood lipid level, blood pressure, blood sugar.

A Study of Serum Lipid, Blood Sugar, Blood Pressure of Buddhist Nuns in Vegetarians and Non-Vegetarians (III) - Based on Age - (채식인과 비채식 일반인의 혈중 지질, 혈당, 혈압에 관한 연구(III) -연령을 중심으로-)

  • Cha, Bok-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1311-1319
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    • 2004
  • The purpose of this study was to compare the serum lipid level, blood sugar and blood pressure in vegetarians and non-vegetarians. The subjects of the study were 127 Buddhist nuns (age: 23∼79 y) from Oonmoon Temple in Choungdo district Gyeongsang Bookdo province and 118 Buddhist nuns practicing Zen meditation at Soodeok Temple in Yeosan district Chongcheong Namdo province. For control subjects, 235 healthy female adults (age: 23∼79 y) were selected. They were the nurses in the Gyeongsang National University Hospital, teachers and housekeepers living in Jinju, Gyeongsang Namdo province. The period of this study was from October 1996 to February 1997. The contents were consisted of food consumption survey, anthropometric measurement, estimated amount of energy expenditure, physical activity and clinical examination. The mean ages of the subjects were 44.2 y for vegetarians and 40.5 y for non-vegetarians, respectively. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, WHR 0.85 and 0.84, percentage of body fat 28.79 and 26.55 respectively. The average duration of vegetarian diet of the vegetarians was 13.16 y. Levels of total cholesterol, LDL-cholesterol, atherogenic index (AI), diastolic blood pressure, blood sugar and HDL-cholesterol were significantly higher (p<0.01) in non-vegetarians than those of vegetarians. In both of subjects, levels of TG, total cholesterol, LDL-cholesterol, atherogenic index (AI) and systolic blood pressure were significantly higher (p<0.01) with an increment of age and the vegetarians showed a lower ratio of rise than the non-vegetarians. Levels of serum TG, LDL-cholesterol and AI were utmost in the 60 s and declined in the 70 s. Consequently, vegetarian diet can be considerably effective in reducing the level of the risk factors causing cardiovascular disease.