• Title/Summary/Keyword: Cardiovascular dysfunction

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A Comparative Study of Motor Recovery from Stroke between High and Low Frequency Electrical Acupoint Stimulation (뇌경색 환자의 운동장애에 대한 주파수별 전침치료효과의 비교)

  • Kim, Young-Suk;Jung, Woo-Sang;Na, Byung-Jo;Park, Seong-Uk;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup;Hong, Jin-Woo
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.289-298
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    • 2007
  • Objectives : Electrical acupoint stimulation (EAS) has been used to treat motor dysfunction of stroke patients with reportedly effective results. The purpose of this study was to evaluate the efficacy of EAS with different frequencies in treating motor dysfunction of ischemic stroke patients. Methods : The subjects of this study were sixty-two ischemic stroke patients with motor dysfunction at Kyunghee Oriental Medicine Hospital who were hospitalized for one week to one month from onset. They were treated with 2Hz or 120Hz EAS for two weeks, and motor evoked potentials (MEP) were measured before and after EAS treatment. To compare the effect of 2Hz EAS with 120Hz, we measured latency, central motor conduction time (CMCT) and amplitude of MEP before and after EAS treatment. Results : After two weeks of treatment, we compared MEP data of the affected side between the 2Hz group and the 120Hz group. The 2Hz group showed more significant improvement than the 120Hz group in latency, CMCT and amplitude (P=0.008, 0.002, 0.002). In case of the affected side MEP data divided by normal side MEP data, the 2Hz group also showed improvement on latency, CMCT and amplitude with significant differences (P=0.003, 0.000, 0.008). Conclusions : These results suggest that low frequency EAS activates the central motor conduction system better than high frequency EAS, and it means that EAS with low frequency is more helpful for motor recovery after ischemic stroke than that with high frequency.

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Effects of exercise on obesity-induced mitochondrial dysfunction in skeletal muscle

  • Heo, Jun-Won;No, Mi-Hyun;Park, Dong-Ho;Kang, Ju-Hee;Seo, Dae Yun;Han, Jin;Neufer, P. Darrell;Kwak, Hyo-Bum
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.6
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    • pp.567-577
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    • 2017
  • Obesity is known to induce inhibition of glucose uptake, reduction of lipid metabolism, and progressive loss of skeletal muscle function, which are all associated with mitochondrial dysfunction in skeletal muscle. Mitochondria are dynamic organelles that regulate cellular metabolism and bioenergetics, including ATP production via oxidative phosphorylation. Due to these critical roles of mitochondria, mitochondrial dysfunction results in various diseases such as obesity and type 2 diabetes. Obesity is associated with impairment of mitochondrial function (e.g., decrease in $O_2$ respiration and increase in oxidative stress) in skeletal muscle. The balance between mitochondrial fusion and fission is critical to maintain mitochondrial homeostasis in skeletal muscle. Obesity impairs mitochondrial dynamics, leading to an unbalance between fusion and fission by favorably shifting fission or reducing fusion proteins. Mitophagy is the catabolic process of damaged or unnecessary mitochondria. Obesity reduces mitochondrial biogenesis in skeletal muscle and increases accumulation of dysfunctional cellular organelles, suggesting that mitophagy does not work properly in obesity. Mitochondrial dysfunction and oxidative stress are reported to trigger apoptosis, and mitochondrial apoptosis is induced by obesity in skeletal muscle. It is well known that exercise is the most effective intervention to protect against obesity. Although the cellular and molecular mechanisms by which exercise protects against obesity-induced mitochondrial dysfunction in skeletal muscle are not clearly elucidated, exercise training attenuates mitochondrial dysfunction, allows mitochondria to maintain the balance between mitochondrial dynamics and mitophagy, and reduces apoptotic signaling in obese skeletal muscle.

Surgery for Partial Anomalous Pulmonary Venous Connections: Modification of the Warden Procedure with a Right Atrial Appendage Flap

  • Kim, Chilsung;Cho, Yang Hyun;Lee, Mina;Yang, Ji-Hyuk;Jun, Tae-Gook;Song, Jin Young;Huh, June;Kang, I-seok
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.94-99
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    • 2014
  • Background: Surgical repair of a partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) may be complicated by sinus node dysfunction or SVC obstruction. We modified the Warden procedure by using a right atrial auricular flap to decrease the occurrence of these complications. Methods: Between February 2005 and July 2012, 10 consecutive patients underwent a modified Warden procedure to correct PAPVC. The median patient age was 5.7 years. Eight patients (80%) had an atrial septal defect. To surgically correct the PAPVC, we made a U-shaped incision on the right atrial appendage and sutured the flap to the posterior wall of the SVC. The anterior wall was reconstructed with various patch materials. Results: No early or late deaths occurred, nor did any patient require early or late reoperation for SVC or pulmonary venous obstruction. No new arrhythmias appeared during follow-up, which was complete in all patients (mean, 29.5 months). Conclusion: Our modification of the Warden procedure seems to be effective and safe. This technique may lower the risk of SVC obstruction, pulmonary venous obstruction, and sinus dysfunction.

Analysis of the Relationship between Fatty Pancreas and Cardiovascular Disease in Abdominal Ultrasonography (복부초음파검사에서 지방췌장증과 심혈관계질환과의 연관성 분석)

  • Cho, Jin-young;Ye, Soo-young
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.729-737
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    • 2019
  • Fatty pancreas is an abnormal process of lipid deposition in cells, resulting in increased fat tissue and obesity. The result is a risk factor for cardiovascular and metabolic diseases. The aim of this study was to evaluate the usefulness of pancreatic fat as a predictor of cardiovascular disease and metabolic syndrome in pancreatic ultrasonography. In 407 patients who underwent a comprehensive screening at the W Health Care Center in Busan from September 2. 2018 to December 31, 2018, the degree of fat deposition in the pancreas was evaluated as the degree of mild, moderate. Data on non-obstructive atherosclerosis, BMI, hyperlipidemia, hypertension, and diabetes were collected to assess the association of pancreatic fat deposition with cardiovascular disease and metabolic syndrome. In addition, we tried to analyze the correlation between liver dysfunction and thyroid dysfunction as the degree of fat pancreas increased. We examined the relationship between six parameters including atherosclerosis, BMI, hyperlipidemia, hypertension, diabetes, liver dysfunction, and thyroid dysfunction among patients with fatty pancreas. We concluded that the carotid intima-media thickness of atherosclerosis, which is a risk factor of cardiovascular disease, is most closely related to fatty pancreas.

Mitral Valve Reconstruction in Patients with Moderate to Severe Left Ventricular Dysfunction (중등도 이상의 좌심기능부전 환자에서 승모판성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.812-819
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    • 2003
  • Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

Right Heart Failure during Veno-Venous Extracorporeal Membrane Oxygenation for H1N1 Induced Acute Respiratory Distress Syndrome: Case Report and Literature Review

  • Lee, Seung-Hun;Jung, Jae-Seung;Chung, Jae-Ho;Lee, Kwang-Hyung;Kim, Hee-Jung;Son, Ho-Sung;Sun, Kyung
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.289-293
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    • 2015
  • A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

Clinical Study about Warning Signs of Patients with Acute Stroke (급성기(急性期) 중풍환자(中風患者)에 대한 중풍전조증(中風前兆症) 조묘(調杳) 연구(硏究))

  • Jung, Jae-Han;Sun, Jong-Joo;Choi, Chang-Min;Kim, Seok-Min;Kim, Chang-Hyun;Min, In-Gyu;Jeong, Dong-Won;Park, Sung-Uk;Jung, Woo-sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Kim, Young-Suk;Bae, Hyung-Sup;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.28 no.1
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    • pp.47-67
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    • 2007
  • Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.

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A case of a patient with ocular motor dysfunction treated with Traditional Korean Medicine (안구운동장애를 주소로 하는 환자 치험 1례)

  • Woo, Ji Myung;Yei, Young-chul;Jin, Chul;Kim, Young-seok;Cho, Ki-ho;Mun, Sang-Kwan;Jung, Woo-sang
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.15 no.1
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    • pp.85-89
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    • 2014
  • ■ Objectives The purpose of this clinical study is to evaluate the effect of Traditional Korean Medicine(TKM) on a patient with abnormal eye movement. ■ Methods A patient with abnormal eye movement of limbs diagnosed with midbrain infarction was treated with herbal medication, acupuncture, moxa, and herbal medical injection. Then we evaluated the improvement by measuring range of eye movement. ■ Results Increase of range of eye movement and improvement of symptom of diplopia were observed after the TKM treatment. ■ Conclusion This study proved the effect of TKM treatment on abnormal eye movement due to midbrain infarction.

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Effect of Panax notoginseng on Hepatic Microvascular Dysfunction in Rats

  • Lee, Soo-Kyoung;Kim, Jun-Gi;Choi, Dall-Young;Park, Won-Hwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.6
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    • pp.1658-1663
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    • 2006
  • Panax notoginseng (Buck) F.H chen. root (PNS) is used as a therapeutic agent to stop haemorrhages and a tonic to promote health in Korean and Chinses medicine. The pharmacokinetic profiles of the main PNS are still not accurately investigated. Our preliminary aim is to elucidate the pharmacokinetics features of the PNS in rats. Objective of this study is to determine whether PNS affects hepatic microvascular dysfunction elicited by gut ischemia and reperfusion (I/R), since gut I/R causes hepatic microvascular dysfunction, and to investigate the role of nitric oxide (NO). No has been found to be a modulator of the adhesive interactions between platelet and endothelial cells. Male Wistar rats were exposed to 30 min of gut ischemia followed by 60 min of reperfusion. Intravital microscopy was used to monitor the number of non-perfused sinusoids (NPS). In another set of experiments, PNS (1 g/kg pre day intragastrically) was administered to rats for 7 days. In some experiments, dexamethasone (ST) (2 mg/kg per day intravenously) was administered. In control rats, gut I/R elicited increases in the number of NPS, and plasma TNF-${\alpha}$ and ALT activities, and these changes were mitigated by the pretreatment with PNS. Pretreatment with an No synthase inhibitor diminished the protective effects of PNS on the increase in NPS and plasma TNF-${\alpha}$ levels, but not its effect on the increase in plasma ALT activities. Pretreatment with PNS increased plasma nitrite/nitrate levels. The responses caused by gut I/R were attenuated by the pretreatment with ST. Pretreatment with an NO synthase inhibitor did not affect the effect of ST. These results suggest that PNS attenuates the gut I/R-induced hepatic microvascular dysfunction and inflammatory responses such as TNF-${\alpha}$ production in the early phase via enhancement of NO production, and sequential hepatocellular damage via its anti-inflammatory effect like corticosteroid effect.