• Journal of Trauma and Injury
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• v.34 no.2
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• pp.119-125
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• 2021

Purpose: The present study aimed to analyze the effect of trauma-related shock on myocardial function in the early stages of trauma through transthoracic echocardiography (TTE) findings. Methods: We performed a retrospective review and analysis of the medical records of patients aged ≥18 years who were evaluated by TTE within 2 days of admission for trauma-related shock (n=72). Patients were selected from a group of 739 patients admitted with trauma-related shock between January 2014 and December 2016. Results: The incidence rate of myocardial dysfunction in the left ventricle (LV) was 6.8% (5/72), with rates of 7.7% (4/52) in the thoracic injury group and 5.0% (1/20) in the non-thoracic injury group. In the diastolic function of LV, relaxation abnormality was present in 55.8% (29/52) of patients in the thoracic injury group and 50% (10/20) of patients in the non-thoracic injury group. Conclusions: This study may suggest that traumatic shock without thoracic injury may influence myocardial function in the early stages after trauma. Therefore, evaluation of myocardial function may be needed for patients experiencing shock after trauma, regardless of the presence of thoracic injury.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.785-791
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• 2000

Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. Material and Method: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period Result : Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42$\pm$8.0mm and 42$\pm$8.3mm left ventricular diastolic dimensions(LVIDd) were 64$\pm$10.0mm and 56$\pm$7.4mm left ventricular end systolic volumes(LVESV) were 62$\pm$19cc (z=1.87$\pm$0.06) and 59$\pm$24cc(z=1.78$\pm$0.08) left ventricular end diastolic volumes(LVEDL) were 169$\pm$40cc(z-1.17$\pm$0.1) and 112$\pm$29cc(z=0.85$\pm$0.1) and ejection fractions(EF) were 66$\pm$6.7% and 48$\pm$12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis ($\Delta$LVEF=-13.3-4.62$\times$LVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. Conclusion ; Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.

• Clinical and Experimental Pediatrics
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• v.54 no.8
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• pp.340-344
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• 2011

Purpose: Brain natriuretic peptide (BNP) has been considered a biochemical marker for myocarditis in Kawasaki disease. We performed this study to determine its quantitative significance. Methods: We attempted to correlate log-transformed BNP concentrations (log-BNP) and clinical, laboratory, and echocardiographic variables in 81 children with Kawasaki disease. Stepwise multiple linear regression analysis was used to determine the variables independently associated with log-BNP concentration. Results: Serum C-reactive protein level (P<0.0001), serum alanine aminotransferase concentration (P =0.0032), white blood cell count (P=0.0030), and left ventricular mass index (P=0.0024) were positively related with log-BNP, and hemoglobin level (P<0.0001), serum albumin level (P<0.0001), $Na^+$ concentrations (P<0.0001), left ventricular fractional shortening (P=0.0080), and peak early diastolic tissue velocity of the left ventricular basal lateral segment (P=0.0045) were negatively related to the log-BNP concentration. Multiple regression analysis showed that serum albumin concentration ($R_2$=0.31, P=0.0098) and left ventricular mass index ($R_2$=0.09, P=0.0004) were significantly associated with the log-BNP concentration. Conclusion: Elevated BNP levels during the acute phase of Kawasaki disease may be attributable to cardiac dysfunction associated with the increase in left ventricular mass, and log-BNP concentration may be a quantitative biochemical marker of myocarditis in Kawasaki disease.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2301-2305
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• 2016

Background: The early detection of anthracycline- induced cardiotoxicity is very important since it might be useful in prevention of cardiac decompensation. This study was designed with the intent of assessing the usefulness of cardiac troponin T (cTnT) and NT- Pro BNP estimation in early prediction of anthracycline induced cardiotoxicity. Materials and Methods: In this prospective study histologically proven breast cancer patients who were scheduled to receive anthracycline containing combination chemotherapy as a part of multimodality treatment were enrolled. Baseline cardiac evaluation was performed by echocardiography (ECHO) and biomarkers like cardiac troponin T (cTnT) and N terminal- pro brain natriuretic peptide (NT- Pro BNP). All patients underwent cTnT and NT- Pro BNP estimation within 24 hours of each cycle of chemotherapy and were followed up after 6 months of initiation of chemotherapy. Any changes in follow up ECHO were compared to ECHO at baseline and cTnT and NT- Pro BNP levels after each cycle of anthracycline-based chemotherapy. Results: Initial data were obtained for 33 patients. Mean change in left ventricular diastolic diameter (LVDD) within 6 months was $0.154{\pm}0.433cms$ (p value=0.049). Seven out of 33 patients had an increase in biomarker cTnT levels (p value=0.5). A significant change in baseline and follow up LVDD was observed in patients with raised cTnT levels (p value=0.026) whereas no change was seen in ejection fraction (EF) and left atrial diameters (LAD) within 6 months of chemotherapy. NT- Pro BNP levels increased in significant number of patients (p value ${\leq}0.0001$) but no statistically significant change was observed in the ECHO parameters within 6 months. Conclusions: Functional monitoring is a poorly effective method in early estimation of anthracycline induced cardiac dysfunction. Estimation of biomarkers after chemotherapy may allow stratification of patients in various risk groups, thereby opening window for interventional strategies in order to prevent permanent damage to the myocardium.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.436-444
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• 2002

This study surveyed 146 obese elementary school children(94 male and 52 female) in Seoul, and measured height, body weight, degree of obesity, blood pressure, fasting blood sugar, serum lipid profiles and liver function. The hypertension was above 95 percentile depending on age and sex. and the hyperglycemia was defined as above 110mg/dl. The hypercholesterolemia and hypertriglyceridemia were defined as above 200mg/dl, 160mg/dl, repectively. The abnormal liver function was considered as elevated alanine aminotransferase(ALT>35IU/L)or aspartate aminotransferase(AST>35IU/L). The results were as follows: 1. The mean degree of obesity was $29.56\pm12.56\%$, and the percentage of overweight was $18.5\%$, mild obesity $41.1\%$, moderate obesity $35.6\%$, severe obesity $4.8\%$ respectively in surveyed children. 2. The systolic blood pressure was $108.34\pm13.73mmHg$, diastolic blood pressure was $67.46\pm8.27mmHg$. 3. FBS was $93.79\pm6.51mg/dl$. 4. Total cholesterol, triglyceride, ALT and AST were $183.34\pm31.38mg/dl$. $115.55\pm56.43mg/dl,\;24.08\pm18.42IU/L,\; 28.73\pm10.45IU/L,$ respectively. 5. The prevalence of complications was $47.2\%$ : hypertension$(13\%)$, hyperglycemia$(0.7\%)$, hypercholesterolemia$(23.3\%)$, hypertriglyceridemia$(17.1\%)$, and liver dysfunction$(21.9\%)$. In conclusion. childhood obesity is associated with various risk factors. Therefore, the aggressive approaches to successful prevention, early detection, and effective treatment of obesity in children are urgently required.

• Korean Journal of Occupational Health Nursing
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• v.18 no.1
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• pp.44-54
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• 2009

Purpose: The aim of this study was to examine the effects of obesity on the physiological levels of adiponectin, leptin and components of metabolic syndrome (MS) in male workers, aged 30-40 years. Methods: Body mass index (BMI) was measured with Anthropometric equipment. Blood pressure and serum parameters were measured with an automatic digital sphygmomanometer and autochemical analyzer, respectively. Adiponectin and leptin were analysed by ELISA kits and MS was defined based on the NCEP-ATP III. Results: Body fat mass of waist and hip, systolic and diastolic blood pressure were significantly higher, as expected, in the BMI>25kg/$m^2$ in comparison with the $BMI{\leq}25kg/m^2$. While fasting glucose, insulin, HOMA-IR and leptin in the BMI>25kg/$m^2$ were also significantly higher compared with $BMI{\leq}25kg/m^2$, HDL-cholesterol and adiponectin were significantly higher in $BMI{\leq}25kg/m^2$. On multiple logistic regression analysis for the components of MS, exercise, adiponectin and leptin were an only independent factor for MS in non-obese male workers($BMI{\leq}25kg/m^2$) after adjustment for age, cigarette smoking and drinking habits. Conclusion: These results suggested that the obesity in men was associated with physiological levels of adiponectin and leptin contributing to feedback control of MS and that dysfunction and/or declination in feedback control system associated with changes in physiological levels of neurptrophics: adiponectin and leptin might ultimately induce MS.

• Journal of Sasang Constitutional Medicine
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• v.31 no.2
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• pp.22-30
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• 2019

Objectives The aim of this study is to investigate the related factors of nonalcoholic fatty liver disease (NAFLD). Methods The subjects were 187 persons diagnosed as fatty liver by abdominal ultrasonography. They were divided into three groups according to the severity of fatty liver: control, mild, moderate or severe. The three groups' general characteristics, laboratory results, liver function indexes, metabolic syndrome indexes, tumor markers, heart rate variability values and Sasang constitution distribution were compared and analyzed. Results Male ratio, height, weight, body mass index, red blood cell count, hemoglobin level and creatinine level were higher in NAFLD groups than in control group. The levels of sodium and amylase were higher in control than in NAFLD. In liver function, the levels of aspartate transaminase, alanine transaminase and gamma-glutamyl transpepsidase of NAFLD were higher. In metabolic syndrome index, systolic blood pressure, diastolic blood pressure, waist circumference, total cholesterol, triglyceride and low density lipoprotein cholesterol levels were higher in NAFLD, while high density lipoprotein cholesterol level was higher in control. The alpha-feto protein level was higher in NAFLD, and the heart rate variability was not different between NAFLD and control groups. In Sasang constitution, Taeeumin ratio of NAFLD was higher than of control. Conclusions The results suggest that nonalcoholic fatty liver is clinically related to liver dysfunction, metabolic syndrome, tumor markers, and Sasang constitution. Further studies are needed to control nonalcoholic fatty liver disease and prevent severe disease such as cirrhosis and cancer caused by fatty liver.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.720-737
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• 2022

Objectives: To compare the effectiveness and safety of East Asian traditional medicine treatments (EATMT) versus conventional management in patients following heart valve replacement surgery. Methods: We searched several databases, including the Korean Studies Information Service System, PubMed, China National Knowledge Infrastructure, and Citation Information by NII. The search range included randomized controlled trials from each first issue until June 27, 2021. Two review authors independently extracted the data. We assessed the risk of systematic errors by evaluating risk domains using the "Risk of bias" tool. Results: We included 5 trials in the review. In the EATMT, the investigators reported significant improvements in reshaping of the heart structure: left ventricular end diastolic diameter (MD -4.43, 95% CI -6.06 to -2.79; 130 participants; 2 studies; high evidence). Comparisons with usual care revealed a significant decrease in gastrointestinal complications rate (OR 0.30, 95% CI 0.20 to 0.47; 503 participants; 2 studies; high evidence). We assessed 4 studies as having a low risk of bias and 1 study as having a high risk of bias. Conclusion: This systematic review suggests that East Asian traditional medicine interventions may be effective in preventing and alleviating complications, but we found evidence of important trade-offs between known benefits and known adverse effects in cardiac dysfunction and inflammation following heart valve replacement. Consequently, additional high-quality studies should be conducted.

• Journal of the Korean Society of Radiology
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• v.16 no.4
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• pp.443-451
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• 2022

In this case, non-rheumatic GLA was observed and it was intended to report a case of ultrasound examination. The case patient, a 60-year-old male, visited the emergency room for dyspnea and palpitations. For radiology examination, chest X-ray examination and CT examination were performed, and a giant left atrium was confirmed. Echocardiography was performed to find the cause of the giant left atrium. Echocardiography The size and volume of the left atrium were evaluated by Simpson's method, and the giant left atrium with LVEDVI 6 times larger than that of the general giant left atrium could be evaluated. Also, a giant left atrium in a patient without rheumatic heart disease is evaluated as a very rare case. Since non-rheumatic giant left atrium could be caused by functional mitral regurgitation, diastolic dysfunction. It was confirmed that ultrasonography, which allowed both morphological and hemodynamic examinations, could be a useful case.

• The Korean Journal of Physiology and Pharmacology
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• v.26 no.2
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• pp.87-94
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• 2022

Myocardial infarction promotes cardiac remodeling and myocardial fibrosis, thus leading to cardiac dysfunction or heart failure. Peiminine has been regarded as a traditional anti-fibrotic Chinese medicine in pulmonary fibrosis. However, the role of peiminine in myocardial infarction-induced myocardial injury and fibrosis remained elusive. Firstly, rat model of myocardial infarction was established using ligation of the left coronary artery, which were then intraperitoneally injected with 2 or 5 mg/kg peiminine once a day for 4 weeks. Echocardiography and haemodynamic evaluation results showed that peiminine treatment reduced left ventricular end-diastolic pressure, and enhanced maximum rate of increase/decrease of left ventricle pressure (± dP/dt max) and left ventricular systolic pressure, which ameliorate the cardiac function. Secondly, myocardial infarction-induced myocardial injury and infarct size were also attenuated by peiminine. Moreover, peiminine inhibited myocardial infarction-induced increase of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α production, as well as the myocardial cell apoptosis, in the rats. Thirdly, peiminine also decreased the myocardial fibrosis related protein expression including collagen I and collagen III. Lastly, peiminine reduced the expression of p38 and phosphorylation of extracellular signal-regulated kinase 1/2 in rat model of myocardial infarction. In conclusion, peiminine has a cardioprotective effect against myocardial infarction-induced myocardial injury and fibrosis, which can be attributed to the inactivation of mitogen-activated protein kinase pathway.