Background: All currently available mechanical and bioprosthetic valves are associated with various types of deterioration leading to dysfunction and/or valvular complications. Reoperation on prosthetic heart valves is increasingly under consideration for both clinical and prophylactic indications. This review was conducted to determine the factors affecting the risk of reoperation for prosthetic valve replacement. Material and method: From January 1985 to July 1996, 124 patients underwent reoperation on prosthetic heart valves, and 3 patients had a second valve reoperation. The causes of reoperation were prosthetic valve failure(96 cases, 77.4%), prosthetic valve thrombosis(16 cases, 12.9%), prosthetic valve endocarditis(7 cases, 5.6%) and paravalvular leak(5 cases, 4.1%). This article is based on the analysis of the experience with particular emphasis on the preoperative risks affecting the outcome of the reoperation. Result: Overall hospital mortality rate was 8.9%(11/124). Low cardiac output was the most common cause of death(70.6%). Left ventricular systolic dimension(p=0.001), New York Heart Association functional class IV(p=0.003) and serum creatinine level(p=0.007) were the independent risk factors, but age, sex and cardiothoracic ratio did not have any influence on the operative mortality. Follow-up period was ranged from 3 to 141 months (mean, 50.6 months). A late mortality rate was 1.8%. Conclusion: The surgical risk of reoperation on heart valve prostheses in the advanced NYHA class patients is higher, therefore reoperation is recommended before the hemodynamic impairment become severe.
Kim, Mi Sun;Lee, Soo Eon;Ahn, Hyo Jung;Park, Jae-Hong;Choi, Sung Chul
Journal of The Korean Dental Society of Anesthesiology
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v.13
no.1
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pp.13-18
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2013
CATCH 22 syndrome is a one of the most common chromosome microdeletion syndrome with multiple organ anomalies in humans, with an incidence of approximately 1:4,000 to 1:5,000 live births. It is caused by a microdeletion of 1.5 to 3.0 megabases on the long arm of chromosome 22. The phenotypic spectrum of this disorder is wide and various. A 19-year-old patient who showed delayed growth and development (Height; 110 cm, Weight; 18 kg) was referred to our department for the treatment of dental cavities. She was diagnosed as CATCH 22 syndrome in 2004. Physical examination revealed hypertelorism, a short philtrum, thick reflected lips and a small mouth. She underwent cleft palate surgery at 1 year of age and heart valve surgery due to the cardiovascular abnormality at 13 years of age. Convulsive seizures had persisted until 5 years ago but are well controlled at present. Oral examination showed poor oral hygiene, crowding, prolonged retention on #65, 75 and dental cavities on #16, 21, 65, 26, 36, and 46. Cavity treatment and prophylaxis were performed under general anesthesia. Also continuous follow-up checks have been carrying out with the periodic prophylaxis and dental home education. Problems with numerous cavities and gingivitis which can lead to specific risks are common for CATCH 22 syndrome patients. It is therefore of great importance that these patients are referred to foremost physician and dental specialist for the oral care. In addition, preventive treatment targeting the risk of dental cavities and gingivitis is especially important and, as the syndrome involves many different medical problems, the dental treatment should be carried out in collaboration with the patient's physician.
Background: The purpose of this study is to describe the characteristics of malpractice claims related to hemopneumothorax and to identify the causes and potential preventability of such claims. Material and Method: A retrospective study was performed by reviewing the records in the Lawnb website and Lx CD-rom: the records on closed malpractice claims involving hemopneumothorax were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the etiology of hemopneumothorax, patient age, results of lawsuit and indemnity payment, underlying diseases, cause of death or complications, and the factors associated with a successful defense. Result: Seven closed claim involving hemopneumothorax were founded in the data for malpractice. Three claims were supreme court decision, one was a high court decision and three claims were district court decision. The most common cause of death was tension pneumothorax. Four of which resulted in indemnity payments. Conclusion: While malpractice claims involving hemopneumothorax were uncommon, they resulted in a high rate and amount of indemnity payments. Claims are more common in pediatric patients. In case of iatrogenic hemopneumothorax, post-procedural X-ray can improve patient outcome and is also associated with decreased indemnity risks. Informed consent is also important.
Although exercise training has been utilized to improve vascular function in animals and humans, the impact of moderate intensity exercise training on fibrinolytic activities and nitric oxide (NO) bioavailability has not been well documented. Therefore, the purpose of the current study was to examine the impact of moderate intensity aerobic exercise training on fat mass, blood lipid profiles, fibrinolytic activity, and NO levels in high-fat-diet induced rats. The body weight, fat mass, blood lipid profiles, fibrinolytic activity, and nitrite/nitrate were measured pre- and postexercise (10 weeks) training. The body weight and fat mass reduced significantly in the exercise (EX) group compared to the control (CON) group. Blood lipid profiles and low-density lipoprotein were unchanged in the EX group compared to the CON group. However, triglyceride and free fatty acid were significantly lower in the EX group compared to the CON group, and high-density lipoprotein was significantly greater in the EX group compared to the CON group. In addition, fibrinolytic activity and nitrite/nitrate were significantly greater in the EX compared to the CON group. These results suggest that 10 weeks of the moderated intensity aerobic exercise training improves blood lipid profiles, fibrinolytic activity, and the nitrite/nitrate ratio, which may improve vascular health and reduce obesity-related cardiovascular disease risks in high-fat- diet induced rats.
Homologous blood transfusion entails substantial risks, including allergic reactions, transmission diseases such as hepatitis, acquired immunodeficiency syndrome. Autotransfusion system is a common method of reducing the need for homologous blood transfusion during cardiac operation. Between July 1993 and July 1995, a series of 40 patients undergoing open heart surgery was selected to an autotransfusion group(n=20) or a control group(n=20). The cell saver system(AT1000, Electromedics, Englewood, CO, USA) was employed for autotransfusion. With this system, shed blood in operative field during cardiopulmonary bypass(CPB) and remained blood in cardiotomy reservior after CPB was aspirated by means of a locally heparinized collecting system. After centrifuge salvaged blood, the resulting red cell concentrate reinfused subsequently. The amounts of blood loss were 766.5$\pm$121.3 ml in cell saver group, 770.1$\pm$113.6 ml in control group, and there were no significant differences between two groups(P=NS). The amounts of blood transfused were 2.91$\pm$1.72 units in cell saver group, 4.82$\pm$1.72 units in control group. Composition of processed blood by cell saver was hemoglobin 17.4 gm%, hematocrit 56.4%, RBC 5,780,000/ul, WBC 9,900/ul, and platelet 33,000/ul. There was no complication related to cell saver. Conclusively, cell saver autotransfusion system is safe, effective method for reducing the homologous blood trasfusion in cardiac surgery.
Park, Sun You;Jeong, Yong Jin;Kim, Mi-Yeon;Hwang, Ji Hong;Kwon, Taeg Kyu;Seo, Young Ho
Journal of Life Science
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v.27
no.11
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pp.1324-1330
/
2017
Salt, or sodium chloride (NaCl), is a critical ingredient in many foods. It has roles in the flavor profiles of food products, textures of foods and preservation of foods against microbes. However, it increases risks of hypertension and is closely related to the development of cardiovascular disease. In recent years, health concerns related to sodium intake caused an increased demand for salt-reduced products in worldwide; it became necessary to develop natural salt-alternative products that are globally competitive. In a recent study, researchers succeeded in obtaining a natural salt enhancer through the hydrolysis of vegetable- and animal-matter mixtures. This study used various methods to identify and quantify peptide-containing arginine as a salt-alternative peptide (SAP) in an optimum combination. Arginine, or dipeptide-containing arginine, was analyzed as a standard substance using an NMR spectroscopy. The NMR carbon signal of the guanidine group of the standard substance was verified in a similar location (the L-arginine (Arg) was 156.8 ppm, the Arg-Alanine was 156.4 ppm and the Arg-Serine was 156.4 ppm). The results suggested that it is possible to analyze peptide-containing arginine quantitatively through the hydrolysis of vegetable- and animal-matter mixtures.
Korean red ginseng has broad efficacious effects against hypertension, diabetes, nociception, and cancer, and it counteracts weakness. It has been reported that Korean red ginseng is able to normalize blood pressure, improve cholesterol and lower blood glucose levels. We have recently reported that Korean red ginseng extract (KRGE) significantly prevented rat carotid arterial thrombosis in vivo, and inhibited platelet aggregation ex vivo and in vitro in a dose-dependent manner. The purpose of this study was to examine the effects of KRGE on blood circulation in human by measuring ex vivo platelet aggregation, plasma coagulation and serum lipid profiles in healthy volunteers. Subjects were randomly divided into three groups (placebo-group, KRGE-low dose group, KRGE-high dose group). Administration of KRGE to subjects significantly inhibited ADP-induced platelet aggregations both in KRGE-low dose group from $72.79{\pm}20.53$ to $62.00{\pm}23.06%$ (p=0.0009), and in KRGE-high dose group from $75.14{\pm}21.86$ to $64.52{\pm}24.72%$ (p=0.0039), respectively. Administration of KRGE to subjects also significantly inhibited collagen-induced platelet aggregations both in KRGE-low dose group from $85.52{\pm}12.57$ to $79.62{\pm}20.47%$ (p=0.0916), and in KRGE-high dose group from $80.24{\pm}18.11$ to $70.31{\pm}25.93%$ (p=0.0565), respectively. Whereas, KRGE has no significant effects on coagulation system, such as prothrombin time (PT) and activated partial thromboplastin time (APTT), and serum lipid profiles, such as total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride. KRGE also has no significant effects on hematological and serum biochemical profiles. These results suggest that KRGE has a potential to improve blood circulation through antiplatelet activity in human, and KRGE intake may be beneficial for the individuals with high risks of thrombotic and cardiovascular diseases.
The antiplatelet and antithrombotic activities of Korean Red Ginseng (KRG) were examined on rat carotid artery thrombosis in vivo, and platelet aggregation in vitro and ex vivo. Administration of KRG to rats not only prevented carotid artery thrombosis in vivo in a dose-dependent manner, but also significantly inhibited ADP- and collagen-induced platelet aggregation ex vivo, while failed to prolong coagulation times such as activated partial thromboplastin time (APTT) and prothrombin time (PT), indicating the antithrombotic effect of KRG might be due to its anti platelet aggregation rather than anticoagulation effect. In line with the above observations, KRG inhibited U46619-, arachidonic acid-, collagen- and thrombin-induced rabbit platelet aggregation in vitro in a concentration-dependent manner, with $IC_{50}$ values of $620{\pm}12$, $823{\pm}22$, $722{\pm}21$ and $650{\pm}14\;{\mu}g/mL$, respectively. Accordingly, KRG also inhibited various agonists-induced platelet serotonin secretions as it suppressed platelet aggregation. These results suggest that KRG has a potent antithrombotic effect in vivo, which may be due to antiplatelet rather than anticoagulation activity, and KRG intake may be beneficial to the individuals with high risks of thrombotic and cardiovascular diseases.
Objectives: Korean elderly people are known to consume diets high in carbohydrates low in vegetables compared to other age groups. This study evaluated the chronic disease risks and nutritional status in this group based on the percentage of energy from carbohydrates and the frequency of vegetable intake. Methods: Using the 2007~2009 Korean National Health Nutrition Examination Survey data, except those who were undergoing treatment for chronic disease, final 1,487 subjects aged 65 and older were divided into 4 groups: moderate carbohydrate energy ratio of 55~70% and low frequency of vegetable intake defined as less than 5 times per day (MCLV), moderate carbohydrate ratio and high frequency of vegetable intake more than 5 times (MCHV), high carbohydrate energy ratio above 70% and low frequency of vegetable intake less than 5 times (HCLV), and high carbohydrate ratio and high frequency of vegetable intake more than 5 times (HCHV). All data were analyzed after the application of weighted value, using a general linear model or logistic regression. Results: More than half of Korean elderly consumed diets with HCLV, and this group showed poor nutritional status and lower frequency of intake of most food items, but with no risk of chronic disease such as diabetes, obesity, hypertension, cardiovascular disease or anemia probably due to low intake of energy. On the contrary, MCHV group with a high percentage of energy from fat and protein showed the highest intake of energy and most nutrients, the highest frequency of intake of most of food items and a tendency of high risk of abdominal obesity, being followed by the MCLV group. Meanwhile, HCHV group showed a tendency of high risk of hypertension, followed by HCLV group with low frequency of intake of vegetables compared with the two moderate carbohydrate groups. Conclusions: The results suggested that the percentage of energy from carbohydrate and the frequency of vegetable intake affected the nutritional status, but not significantly affected the risk of chronic disease in Korean elderly. Further studies using more detailed category of % energy from carbohydrates and of type and amount of vegetables with consideration of individual energy intake level, excessive or deficient, are needed to confirm the results.
Kim, Margarette C. Nogoy;Sun, Bin;Shin, Sangeun;Lee, Yeonwoo;Li, Xiang Zi;Choi, Seong Ho;Park, Sungkwon
Food Science of Animal Resources
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v.42
no.1
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pp.18-33
/
2022
Beef contains functional fatty acids such as conjugated linoleic acid and longchain fatty acids. This review summarizes results from studies comparing the fatty acid composition of beef from cattle fed either grass or grain-based feed. Since functional lipid components are contributed through dietary consumption of beef, the fatty acid composition is reported on mg/100 g of meat basis rather than on a percentage of total fat basis. Beef from grass-fed contains lesser total fat than that from grain-fed in all breeds of cattle. Reduced total fat content also influences the fatty acid composition of beef. A 100 g beef meat from grass-fed cattle contained 2,773 mg less total saturated fatty acids (SFA) than that from the same amount of grain-fed. Grass-fed also showed a more favorable SFA lipid profile containing less cholesterol-raising fatty acids (C12:0 to C16:0) but contained a lesser amount of cholesterol-lowering C18:0 than grain-fed beef. In terms of essential fatty acids, grass-fed beef showed greater levels of trans-vaccenic acid and long-chain n-3 polyunsaturated fatty acids (PUFA; EPA, DPA, DHA) than grain-fed beef. Grass-fed beef also contains an increased level of total n-3 PUFA which reduced the n-6 to n-3 ratio thus can offer more health benefits than grain-fed. The findings signify that grass-fed beef could exert protective effects against a number of diseases ranging from cancer to cardiovascular disease (CVD) as evidenced by the increased functional omega-3 PUFA and decreased undesirable SFA. Although grain-fed beef showed lesser EPA, DPA, and DHA, consumers should be aware that greater portions of grain-fed beef could also achieve a similar dietary intake of long-chain omega-3 fatty acids. Noteworthy, grain-fed beef contained higher total monounsaturated fatty acid that have beneficial roles in the amelioration of CVD risks than grass-fed beef. In Hanwoo beef, grain-fed showed higher EPA and DHA than grass-fed beef.
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