• Title/Summary/Keyword: Cardiovascular disease

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관상동맥 협착을 동반한 심장에서 심근보호액 우심방 관류법의 심근 국소관류량 (The Local Myocardial Perfusion Rates of Right Atrial Cardioplegia in Hearts with Coronary Arterial Obstruction)

  • 이재원;서경필
    • Journal of Chest Surgery
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    • 제25권1호
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    • pp.1-16
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    • 1992
  • The quantitatively measured local myocardial perfusion rates with microspheres are used as an objective indicator of even distribution of cardioplegic solution, and the efficacy of the retrograde right atrial route of cardioplegia is evaluated in hearts with various levels of coronary arterial obstruction. After initial antegrade cardioplegia under the median sternotomy and aortic cannulation, 60 hearts from anesthetized New Zealand white rabbits are divided in random order as normal group [ligated left main coronary artery ; MA, MR] and diagonal group [ligated proximal diagonal artery ; LA, LR]. Half of each group [N=10] are perfused with antegrade cardioplegia[A] under the pressure of 100 cmH2O and the other half with retrograde right atrial route[R] under the pressure of 60 cmH2O[St. Thomas cardioplegic solution mixed with measured amount of microspheres]. The myocardium is subdivided into segments as A[atria], RV[right ventricle]. S[septum], LV[normally perfused left ventricular free wall], ROI[ischemic myocardium of left ventricular free wall]. LV and RQI are further divided into N[subendocardium] and P[subepicardium]. The resulting local myocardial perfusion rates and N /P of each group are compared with Wilcoxon rank sum test. The weight of the hearts is 5.94$\pm$0.66g, and there are no statistically significant dif-ferences[p>0.05, ANOVA] between six compared group. The mean flow rate[F: ml /g / min] of MR group is comparable with MA group[p>0.05], but in N and L group, there are significantly depressed F with right atrial route of cardioplegia, which means elevated perfusion resistance with this route. In spite of no significant differences in delivered doses of microsphere[DEL] between compared groups[p>0.05, ANOVA], there are significantly depressed REC and NF in hearts with right atrial cardioplegia which suggests increased requirement of cardioplegic solution with this route. The interventricular septum shows poor perfusion with right atrial route of cardioplegia without obstruction of supplying coronary arteries. But, with obstruction of coronary artery supplying septum as in M group, the flow rate is superior with right atrial route of infusion. The left ventricular free wall perfusion rates of every RQI with R route are superior to that of A route[p<0.05]. But, in LV segments, there are unfavorable effects of right atrial cardioplegia in L group, although the subendocardial perfusion is well maintained in N group. The LV free wall of left main group shows depressed perfusion rates with antegrade route as compared with RQI segments of diagonal group. But, by contraries, there are increased perfusion rates and superior N /P ratio with retrograde right atrial route. It implies more effective perfusion with right atrial route of cardioplegia in more proximal coronary arterial obstruction[i.e., M group as compared with L group]. As a conclusion, all region of ischemia have superior perfusion rates with right atrial car-dioplegia as compared with antegrade route, and especially excellent results can be obtained in hearts with more proximal obstruction of coronary arteries which would otherwise result in more severe ischemic damage. But, the depressed perfusion rates of the segments with normal coronary artery in hearts with coronary arterial obstruction may be a problem of concern with right atrial cardioplegia and needs solution.

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소아 후천성심장판막질환의 판막치환수술 (Cardiac valve replacement in children with acquired lesions)

  • 김종환
    • Journal of Chest Surgery
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    • 제16권2호
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    • pp.139-146
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    • 1983
  • Between 1974 and 1982, 31 patients from 7 to 15 years of age have undergone valve replacement for their acuqired cardiac valvular diseases at Seoul National University Hospital. Furteen patients (45.2%) had a definite history of rheumatic fever and only 4 patients (12.9%) had atrial fibrillation on their preoperative electrocardiograms. Characteristically, the valvular lesions were ones of insufficiency with or without associated stenosis in all patients except only one whose mitral valve was tightly stenotic. Thrity-seven valves were replaced in 31 patietns including a case of successful replacement of his failed xenogragt mitral valve : 4 mechanical valves were used in 3 patients and 33 xenograft valves were used in the remaining 28 patients. The size of the valves were not the major problem at the time of opertion because most of the patients had a dilated heart from disease. There were 3 diaths within 30 days of surgery (9.7% operative mortality rate) and 3 late deaths (9.7% late mortality rate) with an overall mortality rate of 19.4%. Twenty-eight early survivors were followed up for a total of 488 patient-months. Thromboembolic complications occurred in 5 patients with 2 deaths: cmbolic rate of 17.9% or the actuarial embolic incidence of 12.29%/patients-year. four xenograft tissue valves in 4 patients had failed during the period from 19 to 41 months of surgery with an overall valve failure rate of xenograft of 14.3% or the actuarial incidence of 9.84% failure/patient-year. One of these 4 patients had required replacement of his failed mitral xenograft valve which had severe calcification and tissue disruption with primary tissue failure rate of 3.6% or the actuarial incidence of 3.13% failure/patient-year. The actuarial survial including the operative morality was 50.0% at 5 years of surgery. /the actuarial incidence free from thromboembolism in bioprosthetic group was 85.4% at 42 months, while it was 33.4% in mechanicial group at 60 months after operation. The actuarial incidence free from overall valve failur of 100.0% until 18 months after surgery was followed by a rapid decrease during the next 2-year period, and it was only 17.8% at the follow-up end of 42 months after surgery. It was suggested that the major advantage of low thrombogenecity with xenograft valve should be balanced against the high incidence of accelerated valve failure when it is used in children whose age is younger than 15 years old. The possible role of recurrent rheumatic attacks to the early failure of xenograft tissue valve was also discussed.

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기계판막을 판륜상연에 위치시킨 대동맥판 치환술 (Alternative Technique of Aortic Valve Replacement -Implantation of Mechanical Aortic Valve at a Supra-Annular Level-)

  • 최종범;이삼윤
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.504-509
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    • 1996
  • 대동맥 판 치환술시 봉합법으로써 단순봉합(simple interrupted suture), 8자형 봉합(figure of eight su- ture), 수평 석상봉합법 (horizontal mattress suture method) 등이 이용되고 있다. 그러나 심내막염에 의 해 판륜이 손상되거나 퇴행성 변성으로 판륜이 약화된 환자들에서는 본봉합법으로대동맥판 치환이 어려 울 수 있고,치환후 판막주위 누출등의 합병증이 발생할수 있다. 저자들은 1993년 6월부터 1995년 6월 까지 심내막염에 의한 대동맥판 환자 4례,퇴행성 판막환자 3례,류마티스성 판막병변 환자 1례에서 수직 석상봉합법 (vertical mattress suture method)으로 기계판막(mechanical valve)을 판륜 상연에 위치시 키는 술식을 시행하였다. . 2례에서 농양으로 판륜이 결손되어 자가심막편을 이용하여 결손부위를 봉합하였다. 판막 치환을 위 해 2-0 polyester 봉합사를 이용했고, 봉합사를 지지하는 테프론 조각을 심실쪽에 위치시키고 침사가 심 실쪽에서 발살바동쪽으로 통과하도록 하는 수직 석상봉합법을 이용하였다. 본 수술방법으로 최소한 19mm기계판막의 사용은 완전히 배제할 수 있었다. 술후 평균 13.3개월에 심에코 검사로 추적 관찰한 \ulcorner과, 판막운동의 이상은 발생하지 않았으며, 판막자체에서 발생하는 압력 경사는 3례에서 6mmHg이 하였고 5례에서 20내지 40mmHg였다 이와같은 결과에서 판륜이 손상되거나 약화된 대동맥판 환자에 서 판막치환술시 수직 석상 봉합법을 이용하여 기계판막을 판륜상연에 위치시키므로써 수술이 용이하 고 술후 합병증을 감소시킬 수 있을 것으로 사료된다.

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한국 여성에서 비만과 우울증의 연관성 (The Relationship between Obesity and Depression in Korean Women)

  • 윤대현;박진호;이철민;신찬수;조상헌;오병희
    • 정신신체의학
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    • 제15권1호
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    • pp.51-55
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    • 2007
  • 연구목적 : 비만과 우울증은 모두 심각한 공공 의료 문제이고 특히 주된 심혈관계 질환 위험인자이다. 비만과 우울증 상에 관한 해외 연구는, 일정한 결론은 아니나, 여러 연구에서 연관성 존재를 보고하고 있고 특히 일부 연구는 여성에서 그 연관 정도가 큼을 보고 한 바 있다. 본 연구는 한국 여성에서 있어 비만, 특히 복부비만과 우울증상의 연관성을 분석하고자 한다. 방법: 여성 연구 대상자 4,609명을 대상으로 Beck 우울 척도 및 체계측을 시행한 결과를 이용 우울증상과 비만과의 연관성을 분석하였다. 비만도는 체질량지수로 정하였으며 체질량지수 $25kg/m^2$ 이상을 비만으로 하였고 복부비만은 허리둘레 85cm 이상으로 정의하였다. 임상적으로 우울증을 의심할 수 있는 Beck 우울척도 분할점은 16점으로 하였다. 결과: 정상 체중군에 비해 비만 여성군에서 우울 여성의 비율이 유의미하게 높았고(27.6% VS. 23.2%, p<0.01), 복부 비만 여성에서도 우울 여성군의 비율이 통계적으로 유의하게 높았고(26.9% VS. 22.7%, p<0.01), 비만 여성군 중 우울 여성에서 복부 비만 가진 비율이 통계적으로 유의미하게 높았다(93.2% VS. 86.9%, p<0.01). 결론 : 본 연구의 결과는 한국 여성에서 비만, 특히 복부비만과 우울증간 연관성이 존재함을 보였고 향후 전향적 연구를 통한 비만과 우울증간 상호 역할에 대한 적극적 이해가 필요함을 시사한다.

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직장인 남성을 대상으로 한 12주간의 영양교육이 대사증후군 관련 인자에 미치는 영향 (Effects of Worksite Nutrition Counseling for Health Promotion; Twelve-Weeks of Nutrition Counseling Has Positive Effect on Metabolic Syndrome Risk Factors in Male Workers)

  • 이미선;강해진;오혜선;백윤미;조여원;박유경;최태인
    • 대한지역사회영양학회지
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    • 제13권1호
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    • pp.46-61
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    • 2008
  • The purpose of this study was to investigate the effect of nutrition counseling on improving metabolic syndrome (MS) risk factors. Sixty-eight subjects were grouped according to their numbers of MS risk factors. Subjects who have three or more risk factors of MS were defined as "High risk", subjects who have two risk factors of MS were defined as "low risk", and subjects who have below two risk factors of MS were defined as "no risk" group. All groups finished nutrition counseling every three weeks for 12 weeks. Anthropometric, dietary assessments (24 hr-recall) and blood samples were measured at 0 and 12 weeks nutrition counseling. After 12 weeks of intervention, anthropometric data (weight, BMl, body fat (%), and waist/hip ratio) were significantly decreased (p < 0.05) in all groups. Daily consumption of calorie was decreased significantly (p < 0.05) in the group of low risk and high risk. Blood level of fasting plasma glucose was significantly decreased (p < 0.001) in all groups after 12 weeks of intervention. Significantly, the fasting plasma glucose level was returned to normal range in the high risk group. The number of people who have three or more risk factors of MS (high risk group) was decreased from 25 to 12. Sum of MS Criteria decreased from 85 to 52 in the group of MS and decreased from 143 to 99 in all groups. These results indicate that nutrition counseling for male workers at the worksite proved to be helpful by reducing the risk factors of MS and thereby reducing the risk of cardiovascular disease. Continuing and systematic nutritional management programs should be developed and implemented for male workers at the worksites.

Genome-wide hepatic DNA methylation changes in high-fat diet-induced obese mice

  • Yoon, AhRam;Tammen, Stephanie A.;Park, Soyoung;Han, Sung Nim;Choi, Sang-Woon
    • Nutrition Research and Practice
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    • 제11권2호
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    • pp.105-113
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    • 2017
  • BACKGROUND/OBJECTIVES: A high-fat diet (HFD) induces obesity, which is a major risk factor for cardiovascular disease and cancer, while a calorie-restricted diet can extend life span by reducing the risk of these diseases. It is known that health effects of diet are partially conveyed through epigenetic mechanism including DNA methylation. In this study, we investigated the genome-wide hepatic DNA methylation to identify the epigenetic effects of HFD-induced obesity. MATERIALS AND METHODS: Seven-week-old male C57BL/6 mice were fed control diet (CD), calorie-restricted control diet (CRCD), or HFD for 16 weeks (after one week of acclimation to the control diet). Food intake, body weight, and liver weight were measured. Hepatic triacylglycerol and cholesterol levels were determined using enzymatic colorimetric methods. Changes in genome-wide DNA methylation were determined by a DNA methylation microarray method combined with methylated DNA immunoprecipitation. The level of transcription of individual genes was measured by real-time PCR. RESULTS: The DNA methylation statuses of genes in biological networks related to lipid metabolism and hepatic steatosis were influenced by HFD-induced obesity. In HFD group, a proinflammatory Casp1 (Caspase 1) gene had hypomethylated CpG sites at the 1.5-kb upstream region of its transcription start site (TSS), and its mRNA level was higher compared with that in CD group. Additionally, an energy metabolism-associated gene Ndufb9 (NADH dehydrogenase 1 beta subcomplex 9) in HFD group had hypermethylated CpG sites at the 2.6-kb downstream region of its TSS, and its mRNA level was lower compared with that in CRCD group. CONCLUSIONS: HFD alters DNA methylation profiles in genes associated with liver lipid metabolism and hepatic steatosis. The methylation statuses of Casp1 and Ndufb9 were particularly influenced by the HFD. The expression of these genes in HFD differed significantly compared with CD and CRCD, respectively, suggesting that the expressions of Casp1 and Ndufb9 in liver were regulated by their methylation statuses.

Effects of Controlled Photoperiod on Body Development in Growing Juvenile Rats

  • Lee, Seung-Hoon;Lee, Han-Ki;Shin, Jin-Hee;Hong, Yun-Kyung;Lee, Sang-Kil;Lee, Sang-Un;Suzuki, Takao;Kang, Tae-Young;Hong, Yong-Geun
    • Reproductive and Developmental Biology
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    • 제34권2호
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    • pp.89-94
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    • 2010
  • Melatonin is induced by light information through the retina and leads to growth factor activation. Thus, we investigated the effects of melatonin by controlling the photoperiod of growing young rats. Male Sprague-Dawley rats (n=6; 4 weeks old) were divided into two experimental groups: the L/D group (normal photoperiod; light/dark: 12/12 h; lights on at 9:00 a.m.) and the L/L group (light/light: 24 h). Rat body weight and food consumption were measured daily for 8 weeks. After 8 weeks, the rats were anesthetized with a mixture of ketamine (50 mg/kg) and xylazine (10 mg/kg) and sacrificed. Tissue was then collected for RNA isolation (from brain, heart, liver, kidney, adrenal gland, testis, tibia, hind limb muscles). Also, serum was isolated from blood using a centrifugal separation. The L/L group had significantly lower body weight than the L/D group from 4 to 6 weeks (p<0.05). The L/D group had increased tissue mass, compared with the L/L group, but the difference was not statistically significant. The L/D group had a significantly higher melatonin concentration than the L/L group between the hours of midnight and 2:00 a.m (p<0.01). These results indicate that photoperiod length may affect the secretion of melatonin from the pineal gland. Also, the reduction of nocturnal melatonin secretion may retard the development of growing young rats. In future studies, we plan to compare exogenous melatonin administration with endogenous melatonin concentration induced by photoperiod control. Moreover, we will confirm whether the effects seen in pathological animal models can be reversed by controlling the photoperiod.

채소류의 항산화 효과 비교 연구 (Study on the Antioxidant Activity in the Various Vegetables)

  • 서정혁;백옥진;강영운;안지은;윤지숙;오금순;안영순;박선희;이상재
    • 한국식품위생안전성학회지
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    • 제28권4호
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    • pp.337-341
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    • 2013
  • 항산화 기능은 암이나 심혈관질환 발생을 억제하는 것으로 보고되고 있어서 다양한 식물들에 대해서 항산화 효과가 연구되고 있다. 그러나, 채소류에 대해서는 항산화 효과에 대한 광범위한 조사는 이루어지지 않아 단지 몇몇 천연 항산화제만이 식품 산업에서 이용되고 있다. 따라서, 본 연구에서는 식품 산업에서 다양한 천연 항산화제를 이용할 수 있도록, 여러 가지 채소류에 대해 항산화 활성을 조사하여 채소류 중 항산화 효과에 대한 과학적 자료를 제공하기 위해 수행되었다. 24 품목의 채소류를 대상으로 총 275개의 시료를 구입하여 항산화 효과를 측정하였다. 총 페놀 함량(TPCs)은 gallic acid를 대조 표준용액으로 Folin-Ciocalteu 시약을 사용하여 비색법으로 측정하였으며 DPPH 라디컬 소거능은 $IC_{50}$(DPPH 라디칼을 50% 저해하는데 필요한 추출물의 농도) 농도로 측정하였다. 조사 결과 여러가지 채소류에 대한 총 페놀 함량은 $0.32{\sim}49.26{\mu}g/kg$였으며 DPPH 라디컬 소거 활성은 0.0~2.43 mg/mL로 조사되었다. 본 연구에서 조사된 채소류 중 항산화 효과가 가장 좋은 채소는 2가지 항산화 측정 방법에서 모두 마늘이였다.

잠양자음약물(潛陽滋陰藥物)이 뇌출혈(腦出血) 환자(患者)의 고혈압(高血壓)에 미치는 영향(影響)에 대한 임상적(臨床的) 고찰(考察) (The clinical study of the effect of Jamyang.Jaum prescriptions on the hypertension evolution in cerebral hemorrhage patients)

  • 최철원;김동웅;신선호;전희준;황보연;정대영
    • 대한한의학회지
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    • 제18권1호
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    • pp.72-81
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    • 1997
  • The causes of stroke are presumed hypertension, atherosclerosis,. cardiac disease, diabetes mellitus and old age and risk factors of stroke are suggested hypertension, hyperlipidemia. obesity, smoking and drinking etc. Especilly, hypertension is one of the most important cause and risk factor of stroke, therfore without therapy hypertension leads to stroke. The frequence of hypertension is significantly higher in hemorrhage patients of intracranial hemorrhage and subarachnoid hemorrhage. Antihypertensive therapy has an impact not only on the primary prevention of stroke but also on stroke recurrence and the declining of stroke motality has been attributed to the widespread availability and use of antihypertensive therapy. The goals of antihypertensive therapy decrease the complications and motalitv of cardiovascular system and prevent the promoting arteriosclerosis. In this study, we observed the blood pressure change of cb-hemorrhagic patients with hypertension who were hospitalized from 1996. 3. 1 to 1997. 2 .26 in Wonkwang Oriental Hospital. These patients had no antihypertensive therapy and were supplied herb med(Jaum sikpoongtang, Chungrijagamtang, Gojinumja) in medication. Our results suggested as follows. 1. Systolic and diastolic average BP at admission is $150.71{\pm}15.61mmHg$ and $95.00{\pm}8.8mmHg$ and this is hypertension state defining WHO 2. During one week in admission, the blood pressure demostrated a marked declination by SBP 8.97mmHg and DBP 6.22mmHg. 3. During two week in admission, the declination of SBP was significant in paired t-test(p<0.05) but, the declination of DBP was non-significant in paired t-test. 4. The blood pressure during third and fourth weeks gradually declined but, non-significant in test. According to the above results, we suggested that the BP declination Was affected by $Jamyang{\cdot}Jaum$ prescriptions in acute stage of cerebral hemorrhage.

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HPLC와 NMR를 이용한 염미성 펩타이드 분석방법 검증 (An Analytical Method for the Validation of a Salt-enhancing Peptide Using a Liquid Chromatography and a Nuclear Magnetic Resonance (NMR) Spectroscopy)

  • 박선유;정용진;김미연;황지홍;권택규;서영호
    • 생명과학회지
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    • 제27권11호
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    • pp.1324-1330
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    • 2017
  • 최근 염분의 섭취와 관련하여 건강에 대한 우려가 늘어남에 따라, 염미대체제에 대한 소비자들의 관심이 급증하고 있으며, 세계적으로 경쟁력 있는 천연 저염제품의 개발이 필요한 실정이다. 최근 연구를 통해 식물성 및 동물성 원료 배합을 통해 가수분해물을 조제하여 최적 화합물을 얻는 것에 성공하였다. 본 연구에서는 염미성 펩타이드 분말내 arginine을 함유한 염미성 펩타이드를 규명하고 정량 하고자 하였다. L-arginine 또는 arginine을 포함한 펩타이드를 표준물질로 하여 $^{13}C$-NMR로 분석한 결과 유사한 위치에 구아니딘기 탄소가 시그널(L-arginine: 156.8 ppm, Arg-Ala: 156.4 ppm, Arg-Ser: 156.4 ppm)이 나타남을 확인하였고, 이를 통해 간편하고 신속하게 arginine 함유 펩타이드 정량분석이 가능할 것으로 기대된다.