• Title/Summary/Keyword: Diastolic blood pressures

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Effects of Preemptive Analgesia with Parecoxib Sodium on Haemodynamics and Plasma Stress Hormones in Surgical Patients with Thyroid Carcinoma

  • Wang, Lian-Dong;Gao, Xia;Li, Jun-Ying;Yu, Hong-Yan;Su, Hai-Wen;Liu, Lian-Zhong;Qi, Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3977-3980
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    • 2015
  • Background: To investigate the effects of preemptive analgesia with parecoxib sodium on haemodynamics and plasma stress hormones in surgical patients with thyroid carcinoma. Materials and Methods: Fifty-seven patients with thyroid carcinoma who underwent thyroidectomy selectively in Laiwu Hospital Affiliated to Taishan Medical University and Binzhou People's Hospital were selected and randomly divided into three groups, 19 cases in each group. The control group was intravenously injected 0.9% sodium chloride injection before anesthesia induction; trial group I was intravenously injected with parecoxib sodium 20 min before anesthesia induction; based on trial group I, trial group II was injected with parecoxib sodium again 12 h after surgery. The levels of plasma norepinephrine (NE), cortisol (Cor) and blood glucose before, 12 and 24 h after surgery and changes of haemodynamics before surgery, at the end of surgery and 12, 24 and 48 h after surgery were compared in the three groups. Besides, visual analogue scale (VAS) scores were recorded 4, 8, 12 and 24 h after surgery. Results: 12 and 24 h after surgery, the levels of plasma NE and Cor in three groups rose dramatically (P<0.05 or (P<0.01); The levels of plasma NE and Cor in trial groups I and II were evidently lower than in control group (P<0.05 or P<0.01), and those in trial group II slightly lower than in trial group I. 12 h after surgery, the heart rates (HR) and systolic pressures (SBP) in trial groups I and II increased obviously by comparison to surgery before (P<0.05 or P<0.01), but gradually returned to the preoperative level. HR, SBP and diastolic pressures (DBP) in trial groups I and II at the end of surgery and 12 h after surgery were all lower than in the control group, and significant differences were present (P<0.05 or (P<0.01). At 4, 8, 12 and 24 h after surgery, VAS scores in trial groups I and II were markedly lower than in the control group (P<0.05 or (P<0.01), the scores in trial group II being the lowest. Conclusions: Combined application of parecoxib sodium for preemptive analgesia before anesthesia and after surgery can effectively reduce the levels of plasma stress hormones and improve analgesic effects in surgical patients with thyroid carcinoma, and without conspicuous impact on haemodynamics.

Association of β3-Adrenergic Receptor Polymorphisms and High-Density Lipoprotein Cholesterol (고밀도 지단백 콜레스테롤과 베타 3-아드레날린성 수용체 유전자 변이와의 관련성)

  • Yu, Byeng-Chul;Jeon, Man-Joong;Lee, Yong-Hwan
    • Journal of Life Science
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    • v.19 no.5
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    • pp.664-670
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    • 2009
  • The ${\beta}$3-adrenergic receptor (ADRB3) is expressed mainly in visceral adipose tissue and is thought to contribute to lipolysis and the delivery of free fatty acids to the portal vein. This study was aimed at evaluating the association between high-density lipoprotein cholesterol (HDL-C) and ADRB3 genetic polymophisms. A total of 991 healthy examinees who were examined in a university hospital, located in Busan City, between May and December 2006 were enrolled in this study. Height, weight, body mass index, waist circumference, and systolic and diastolic blood pressures of the subjects were examined. Intravenous concentrations of fasting blood glucose, total cholesterol, HDL-C, low-density lipoprotein cholesterol, and triglyceride were also measured. After extracting DNA from the subjects, mutations of the +188T>C (Trp64Arg) of exon 1 and +3893T>C of intron 2 on the ADRB3 gene were genotyped using the single base extension method. We have identified a novel mutation of ADRB3 that is located in intron 2. The frequency of its minor allele was 0.164. Both the +188T>C mutation of exon 1 and +3893T>C mutation of intron 2 were significantly associated with HDL-C. The mean concentration of serum HDL-C was significantly lower in the presence of their minor allele 'C'. These results suggest that both mutations of +188T>C of exon 1 and +3895T>C of intron 2 have significant associations with HDL-C in the Korean population.

Seasonal Nutrient Intakes of Elderly Women Living Alone as Compared to Those Living with Family in the Gyeongpuk Rural Area (경북 농촌지역 여성 독거노인과 가족동거노인의 계절별 영양소섭취 비교)

  • Lim, Young-Jee;Choi, Young-Sun
    • Korean Journal of Community Nutrition
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    • v.12 no.1
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    • pp.58-67
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    • 2007
  • For the rapidly growing elderly population, the achievement and maintenance of good nutritional status is critical to health, functioning and quality of life. Elderly women living alone have been identified as a group associated with poor nutrition. The purpose of this study was to assess dietary intakes of elderly women living alone as compared to those of elderly women living with family in a rural area and to examine seasonal variation. The subjects are 49 elderly women living alone and 41 elderly women living with family who reside in Goryeong-gun, Gyeongbuk, and their food intakes were assessed once each time in summer 2005, winter 2005-2006, and spring 2006. The average ages were 74.7 years for living alone and 72.8 years for living with family. Education level was not different between the two groups. Height, weight, body mass index, systolic and diastolic blood pressures, and fasting blood glucose were not significantly different between the two groups. Average intakes of major nutrients, nutrient adequacy ratio, mean adequacy ratio and index of nutritional quality were lower in the elderly women living alone compared with the elderly women living with family in summer, but the differences in intakes of most nutrients became insignificant both in winter and in spring. High carbohydrate and low fat diet was prevalent and intakes of carbohydrate and fat in summer deviated from macronutrient acceptable distribution ranges. Percentages of the subjects who consumed energy less than 75% of the estimated energy requirement and nutrients less than the estimated average requirement were higher than those reported by the Third National Health and Nutrition Examination Survey. In summer, the percentage of the subjects who consumed energy less than both 75% of the estimated energy requirement and 4 nutrients less than estimated average requirements was 58.5% of the elderly women living alone, which was higher than 26.5% of the elderly women living with family and that of National Nutrition Survey. Therefore, nutrition policies including nutrition education and support are necessary to improve nutritional status of elderly, especially elderly women living alone and should reflect regional and seasonal characteristics.

Clustering of Metabolic Risk Factors and Its Related Risk Factors in Young Schoolchildren (초등학교 저학년 어린이에서의 대사위험요인 군집의 분포와 관련 위험요인)

  • Kong, Kyoung-Ae;Park, Bo-Hyun;Min, Jung-Won;Hong, Ju-Hee;Hong, Young-Sun;Lee, Bo-Eun;Chang, Nam-Soo;Lee, Sun-Hwa;Ha, Eun-Hee;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.3
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    • pp.235-242
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    • 2006
  • Objectives: We wanted to determine the distribution of the clustering of the metabolic risk factors and we wanted to evaluate the related factors in young schoolchildren. Methods: A cross-sectional study of metabolic syndrome was conducted in an elementary school in Seoul, Korea. We evaluated fasting glucose, triglyceride, HDL cholesterol, blood pressures and the body mass index, and we used parent-reported questionnaires to assess the potential risk factors in 261 children (136 boys, 125 girls). We defined the metabolic risk factors as obesity or at risk for obesity ($\geqq$ 85th percentile for age and gender), a systolic or diastolic blood pressure at $\geqq90th$ percentile for age and gender, fasting glucose at $\geqq110mg/dl$, triglyceride at $\geqq110mg/dl$ and HDL cholesterol at $\leqq40mg/dl$. Results: There were 15.7% of the subjects who showed clustering of two or more metabolic risk factors, 2.3% of the subjects who showed clustering for three or more risk factors, and 0.8% of the subjects who showed clustering for four or more risk factors. A multivariate analysis revealed that a father smoking more than 20 cigarettes per day, a mother with a body mass index of = $25kg/m^2$, and the child eating precooked or frozen food more than once per day were associated with clustering of two or more components, with the odds ratios of 3.61 (95% CI=1.24-10.48), 5.50 (95% CI=1.39-21.73) and 8.04 (95% CI=1.67-38.81), respectively. Conclusions: This study shows that clustering of the metabolic risk factors is present in young schoolchildren in Korea, with the clustering being associated with parental smoking and obesity as well as the child's eating behavior. These results suggest that evaluation of metabolic risk factors and intervention for lifestyle factors may be needed in both young Korean children and their parents.

The Impact of Health Behaviors of Male Workers without Diabetes on HbA1c (당뇨병이 없는 남성 근로자의 건강행태 특성이 당화혈색소에 미치는 영향)

  • Park, Ji-Yun;Kim, Keon-Yeop;Lee, Su-Jin
    • Journal of health informatics and statistics
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    • v.43 no.4
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    • pp.344-351
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    • 2018
  • Objectives: The purpose of this study is to investigate the impact of health behaviors of male workers without diabetes such as smoking, drinking and physical activities on HbA1c using 2015 and 2016 data from Korea National Health and Nutrition Examination Survey (KNHANES). Methods: The final study subjects of KNHANES were a total of 1,703 male workers in their 30s-50s who had normal levels of fasting blood sugar level, HbA1c, and hemoglobin. For the study variables, age, household income, educational level and occupation were included as socio-demographic characteristics; smoking behavior, drinking behavior, and physical activity behavior as characteristics of health behavior; and waist circumference, body mass index, systolic and diastolic blood pressures, total cholesterol, triglyceride and HDL cholesterol as medical examination characteristics were included. The analysis was conducted using independent variables t-test, one-way ANOVA, Pearson's correlation analysis and multiple regression analysis. Results: Socio-demographic factors that affect HbA1c were age, educational level, and occupation. As for HbA1c according to the status of current smoking, it was higher in order of the present, past and nonsmoking and HbA1c according to smoking amount pack-year increased linearly in between less than 1 pack-year and over 30 pack-year (p<0.001). Muscular exercises affected the reduction of HbA1c (p<0.05). In the multiple regression analysis with independent variables of the socio-demographic characteristics and health behavior, factors affecting HbA1c were age, occupation and smoking amount pack-year (p<0.05). In the multiple regression analysis where the characteristics of physical examination were added, factors affecting HbA1c were age, occupation, smoking amount pack-year, waist circumference and total cholesterol (p<0.001). Conclusions: As a result, the health behavior that had the most effect on HbA1c management for male workers without diabetes was the total lifetime smoking amount. Therefore, it is essential to prevent smoking as well as control, cholesterol to prevent diabetes for male workers.

Clinical observation for the Geriatric C.V.A. (노인(老人) 뇌졸중(腦卒中)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Seo, Un-Kyo;Jeong, Ji-Cheon;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.14 no.2
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    • pp.50-70
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    • 1993
  • Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

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Recovery Trajectory in Tachycardia Induced Heart Failure Model (빈맥을 이용한 심부전 모델에서 회복궤도)

  • 오중환;박승일;원준호;김은기;이종국
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.422-427
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    • 1999
  • Background: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. Material and Method: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean${\pm}$standard deviation. Result: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8${\pm}$7.4, 82.1${\pm}$21.1, 59.9${\pm}$7.7 and 46.5${\pm}$6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6${\pm}$4.1, 17.5${\pm}$5.8, 36.3${\pm}$7.3, and 41.5${\pm}$2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5${\pm}$8.2, 12.3${\pm}$3.5, 17.9${\pm}$4.6, and 15.5${\pm}$3.4ml. Blood norepinephrine level was 133.3${\pm}$60.0pg/dL at the baseline and 479.4${\pm}$327.3pg/dL at the heart failure stage(p=0.008). Conclusion: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

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Homocysteine, insulin, vitamin B12 and folic acid levels in obese children (비만아에서 혈청 호모시스테인, 인슐린, 비타민 B12, 엽산 농도에 대한 연구)

  • Park, Jee Yoon;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.475-481
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    • 2006
  • Purpose : As the prevalence of childhood obesity is increasing, hypertension, hyperlipidemia, insulin resistance and diabetes mellitus have become problems. High homocysteine levels and low vitamin $B_{12}$ supplementation are acknowledged to have a role in coronary artery disease, but there are few studies on homocysteine, insulin and vitamin $B_{12}$ levels in obese children. We aimed to study whether homocysteine, insulin, vitamin $B_{12}$, folic acid levels could have any difference and relation in obese children. Methods : The disease group consisted of 27 children from 8 to 11 years old, whose obesity index was over 130. The control group consisted of 30 healthy children of the same age group. Obesity index and body mass index were calculated by height and body weight of the children, and their systolic and diastolic blood pressures at resting state were checked. Total cholesterol, triglyceride, homocysteine, insulin, vitamin $B_{12}$, folic acid levels were studied after 10 hours of fasting. Intracellular fluid, extracellular fluid, protein, mineral, muscle mass, lean body fat, fat mass and fat percentages were checked by bioelectrical impedance. Results : Homocysteine levels were higher in obese children($8.1{\pm}2.1{\mu}mol/mL$ vs. $4.9{\pm}1.0{\mu}mol/mL$). Insulin levels were also higher in obese children($26.8{\pm}11.2{\mu}IU/mL$ vs. $12.5{\pm}5.24{\mu}IUl/mL$). Vitamin $B_{12}$ was lower in obese children($798.6{\pm}174.3pg/mL$ vs. $967.8{\pm}405.0pg/mL$). But there was not a difference in the folic acid levels between the two groups. In obese children, systolic blood pressure (r=0.535), triglyceride(r=0.517), total cholesterol(r=0.408), folic acid(r=0.408), vitamin $B_{12}$(r=0.338) and abdomoanl fat %(r=0.306) had a positive correlation. Conclusion : We found definite differences of insulin, homocysteine, and vitamin $B_{12}$ plasma levels in obese children, but we need more study to use those parameters as risk factors of metabolic syndrome in pediatric obese patients.

Leukocyte count and hypertension in the health screening data of some rural and urban residents (일부 농촌과 도시의 건강선별조사 자료로 본 백혈구수와 고혈압과의 관계)

  • Lee, Choong-Won;Yoon, Nung-Ki;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.363-372
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    • 1991
  • We used the health screening data of some rural and urban residents to examine the cross-sectional association between leukocyte count and hypertension. The 206 male and 203 female rural residents were selected by multi-stage cluster sampling method in Kyungsan-Kun area of Kyungbuk province in 1985 and 600 urban residents were selected by the same sampling method as the rural residents in Daegu city of the same province in 1986 compatible with age-sex distribution of Daegu city of 1985 census, but of whom 384 actually responded. The rest of 600 were replaced by age and sex with those who were members of the medical insurance plan visiting the health management department of the university hospital to get the biannual preventive medical checkups. Excluded in the analysis were those having hypertensive history, diseases and extreme outlying values of the screening tests, leaving 373 rural and 571 urban residents. Leukocyte count was measured with ELT-8 Laser shadow method and the unit $cells/mm^3$, Blood pressures were determined with an aneroid sphygmomanometer with pre-standardized method and hypertensives were defined as those showing systolic blood pressure more than 140mmHg and/or diastolic blood pressure more than 90mmHg. Total residents pooled (N=944) showed a significant difference between hypertensives and normotensives ($6965.93{\pm}1997.01\;vs\;6490.61{\pm}1941.32,\;P=0.00$) and in rural residents was noted the similar significant difference (P=0.03). None of significant differences were noted in any stratum stratified by residency and sex. Compared to the lowest quintile of WBC, 2/5 quintile showed odds ratio 0.99 (95% Confidence interval, Ci 0.62-1.59), 3/5 quintile 1.41 (95% CI 0.90-2.21), 4/5 quintile 1.76 (95% CI. 1.14-2.72), and highest quintile 1.80 (1.15-2.82) in the total residents. Likelihood ratio test for linear trend for it indicated a significant trend ($X^2_{trend}=5.53,\;df=1,\;P<0.05$). There were no other significant odds ratios compared to the lowest quintile of WBC in strata stratified by residency and sex. The odds ratios in total residents which had showed significant odds ratios became nonsignificant and of reduced magnitude after controlling age, frequency of smoking and drinking with multiple logistic. regression. In each stratum, it changed magnitudes of odds ratios slightly and unstably. None of the trend tests showed any significant trend. These results suggest that the Friedman et al's finding of association between leukocyte count and hypertension may be due to an statistical type I error resulting from the data dredging in an exploratory study, in which more than 800 variables were screened as possible predictors of hypertension.

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Effect of Pyruvate and Aspartate Enriched University of Wisconsin Solution on Myocardial Protection (피루브산염과 아스파라진산염을 첨가한 위스콘신대학 용액의 심근보호 효과)

  • 이정렬;김준석;한재진;강문철
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.11-19
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    • 2002
  • Background: Ischemia-reperfusion myocardial injury is an important factor to determine the early and the late mortality of transplanted patients. Recently, modulation of the cytosolic NADH/NAD+ ratio by Pyruvate and aspartate was tested to Protect the heart from ischemia-reperfusion injury. Material and Method: We added pyruvate and aspartate to the University of Wisconsin solution, and evaluated their effect on myocardial protection. We used 16 piglet(age 1 to 3 days) hearts. Eight hearts were arrested with and stored in the University of Wisconsin solution(UW solution) for 24 hours(control group), and the other eight hearts were arrested with and stored in the modified UW solution added pyruvate(3mmol/L) and aspartate(2 mmol/L)(test group). All hearts underwent modified reperfusion with blood cardioplegic solution followed by conversion to a left-sided working model with perfusion from a support pig. And then, we measured stroke work index(SWI), high-energy phosphate stores, and myocardial water content of the hearts. SWI was calculated at left ventricular end-diastolic pressures of 3, 6, 9, and 12 mmHg after 60 and 120 minutes reperfusion, respectively, Result: At 60 minutes and 120 minutes after reperfusion, SWI was higher in the test group than in the control group significantly. The levels of AMP, ADP, ATP of the test group were also higher. But, the creatine phosphate level and myocardial water content were similar in the two groups. Conclusion: From these results, we could Prove that pyruvate and aspartate enhance cardiac contractility and high-energy phosphate stores after ischemia.