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Surgical Complications in Heart Transplant Recipients - A Single Center Experience - (심장이식후에 발생한 외과적 합병증 - 단일 센터 경험 -)

  • Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu;Lee, Jae-Ik
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.719-724
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    • 2009
  • Background: As the patients who undergo heart transplantation have achieved better survival in recent years, growing number of recipients are at a risk for experiencing surgical complications in addition to rejection and infection. In this paper, we report on our experience with the surgical complications that occurred in heart transplant recipients. Material and Method: From April 1994 to September 2003, 37 heart transplantations were performed at our center by a single surgeon. The indications for transplantation were dilated cardiomyopathy, ischemic cardiomyopathy, valvular cardiomyopathy and familial hypertrophic cardiomyopathy. Result: Twenty postoperative complications required surgeries in 15 patients (41%). The types of operations required were; redo-sternotomy for bleeding (5), pericardiostomy for effusion (4), implantation of a permanent pacemaker (1), right lower lobe lobectomy for aspergilloma (1), removal of urinary stone (1), cholecystectomy for gall bladder stone (1), drainage of a perianal abscess (1), paranasal sinus drainage (1), total hip replacement (1), partial gingivectomy due to gingival hypertrophy (1), urethrostomy (1), herniated intervertebral disc operation (1) and total hysterectomy for myoma uteri (1). The locations of the complications were mediastinal in 10 (27%) cases and extramediastihalin 10 (27%) cases. Conclusion: The relatively high incidence of extrathoracic complications associated with heart transplantation emphasizes the importance of a multidisciplinary approach to the improve long-term survival when managing those complex patients.

The effects of Cudrania tricuspidata extract on bone metabolism in ovariectomized rats

  • Jo, You-Young;Seo, Sang Deog;Kim, Ji-Won;Cho, Hyun-Ji;Chon, Jeong-Woo;Lee, Kwang Gill;Lee, Heui-Sam;Park, Yoo-Kyoung;Kweon, HaeYong
    • International Journal of Industrial Entomology and Biomaterials
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    • v.32 no.2
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    • pp.80-89
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    • 2016
  • The effects of Cudrania tricuspidata (CT) extract on markers of osteoporosis were examined in ovariectomized rats. We classified 26 rats into five groups and provided a pellet chow diet and tap water throughout the 27-wk experimental period. During the last 15 wk, we added oral injections to each group as follows: sham-operated (SHAM, n=4) and ovariectomized-control (OVX, n=5) with distilled water, alendronate with 10 mg/kg/d of alendronate sodium (ALEN, n=5), CT (CT100, n=6) with 100 mg/kg/d of CT, and CT (CT300, n=6) with 300 mg/kg/d of CT. After the experimental period, blood, urine, and micro-CT images were assessed. The CT100 and OVX groups did not show any significant differences in urinary n-terminal telopeptide (NTx) (p<0.05 ), but with increases in CT concentration, the NTx level was slightly reduced. Serum osteocalcin was significantly higher in the CT groups than in all other groups (p<0.05 ). Notably, the serum calcium levels of all groups were within the normal range, but urinary calcium levels in the CT groups were significantly lower than the OVX group (p<0.05 ). In addition, the CT groups exhibited higher trabecular BMD than the OVX groups while showing similar BMD to the ALEN group (p<0.05 ). The Tb.Th of the ALEN group was lower than all other groups. Based on the overall analysis of results, CT prevented bone loss by inhibiting bone resorption and enhancing bone formation. Although alendronate showed a similar effect in preventing bone loss, it did so by solely inhibiting bone resorption, and its long-term use reportedly causes paradoxical effects such as hip fractures. Thus, for osteoporosis induced by ovariectomy, we conclude that CT extract is an effective natural treatment without severe side effects.

The Case-Control Study on the Risk Factors of Stroke in Korean Adults -Past Medical History, Life-Style Factors, Serum Lipid Level, Anthropometric Indices- (뇌졸중의 위험요인에 대한 환자-대조군연구 -과거병력, 생활습관, 혈청지질 및 비만요인을 중심으로-)

  • Ko, Soeng-Gyu;Jung, Yong-Soo;Park, Kyoung-Hoon;Bu, Song-Ah
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.423-430
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    • 2001
  • Objects: The purpose of this case-control study was done to examine the relationship between stroke prevalence and the anthropometric indices(body mass index(BMI), modified Broca's method(Broca's index), waist circumference(WC), waist-hip ratio(WHR)), dyslipidemia, past medical history(heart disease, hypertension, diabetes mellitus(DM)), life-style factors(smoking, drinking) in Korean adults. Methods : The study group consisted of neurologically confirmed 116 stroke patients as the case group and 116 non-stroke patients as control group. Obesity were defined as $BMI{\geq}25kg/m^2,\;Broca's\;index{\geq}30%$, WC >94cm in male and WC >80cm in female, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Oyslipidemia were defined as total $cholesterol{\geq}200mg/dl,\;triglyceride{\geq}200mg/dl,\;HDL-cholesterol {\leq}35mg/dl,\;LDL-cholesterol{\geq}160mg/dl$. Information on life-style factors and past medical history was obtained from personal interview. The analysis of the data was done by means of chi-square test(Pearson's chi-square test, Fisher's exact test) and student t-test. Results: The results were as follow. In the study group: Hypertension had a 4:05 odds ratio, Broca's $index{\geq}30%$ had a 1.98 odds ratio, WC >94cm in male had a 2.17 odds ratio, WC >80cm in female had a 2.80 odds ratio, $WHR{\geq}0.9$ in male had a 4.66 odds ratio, $WHR{\geq}0.8$ in female had a 5.35 odds ratio, but heart disease, DM, life-style factors, serum lipid and 8MI had no direct relationship with odds ratio(nonsignificant). By student t-test, risk factors for stroke were found to be total cholesterol(p=0,025), LDL-cholesterol(p=0.013), WC(p=0.000) and WHR(p=0.000). Conclusions: This study suggests that people should be advised to control hyperlitension, hyperlipidemia and obesity since these carry a risk of stroke.

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Association between the Pattern of Prophylactic Antibiotic Use and Surgical Site Infection Rate for Major Surgeries in Korea (예방적 항생제 사용 양상과 수술부위감염률의 관련성)

  • SaKong, Pil-Yong;Lee, Jin-Seok;Lee, Eun-Jung;Ko, Kwang-Pil;Kim, Cheol-Hwan;Kim, Yoon;Kim, Yong-Ik
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.1
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    • pp.12-20
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    • 2009
  • Objectives : The purpose of this study was to analyze the association between the pattern of prophylactic antibiotic use(PAU) and the surgical site infection(SSI) rate for major surgeries in Korea. Methods : We retrospectively reviewed the medical records of patients who underwent cardiac, colon and gastric surgery, hysterectomies and hip/knee replacements at 20 hospitals, and inclusive of over 500 beds. We randomly sampled 60 cases per surgery type for patients discharged between September and November, 2006. A total fo 2,924 cases were included in our analysis. Cox's proportional hazard analysis was conducted to evaluate the association between the pattern of PAU and SSI rate. Results : The proportion of patients who received their first prophylactic antibiotics(PA) 1 hour before incision was 65.5%, who received inappropriate PAs was 80.8%, and the proportion of patients whose PA was discontinued within 24 hours of surgery was 0.5%. The average duration of PAU after surgery was 9 days. The relative risk(RR) of SSI in patients who received their first PA more than 1 hour before incision was significantly higher than for those who received it within 1 hour prior to incision(RR=8.20, 95% CI=4.81-13.99). Inappropriate PA selection increased SSI rate, albeit with marginal significance(RR=1.97, 95% CI=0.96-4.03). Also, prolonged PAU following surgery had no effect on SSI rate. Conclusions : These results suggest that the pattern of PAU in the surgeries examined was not appropriate. Errors in the timing of PAU and of PA selection increase SSI rate. SSI rate remained unaltered following prolonged PAU after surgery.

Effects of Walking and Behavior Modification Program on Body Composition, Physical Fitness and Metabolic Syndrome Related Factors in Obese Girls (걷기운동과 행동수정 프로그램이 비만여중생의 체조성, 체력 및 대사증후군 관련인자에 미치는 영향)

  • Kim, Jong-Won;Jeon, Jae-Young;Kim, Tae-Un
    • Journal of Life Science
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    • v.17 no.12
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    • pp.1744-1753
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    • 2007
  • The purpose of this study was to provide obese middle school girls with walking and behavior modification program(WBMP) by investigating effects of the exercise on their body composition(BC), physical fitness(PF) and metabolic syndrome(MS). Analysis result of the difference between before and after the exercise(paired and independent t-test) was acquired by measuring BC, PF and MS for 12 weeks(60min/day, three a week). 24 Volunteers were 14 years over ${\geq}223.64kg/m^2$ and 15 years over ${\geq}24.00kg/m^2$. In the body composition, waist circumference(WC), body fat mass(BFM), %fat, arm muscle circumference(AMC), total body water(TBW), physical score(PS) were significant difference between the exercise group(EG) and the control group(CG), also including all factors in PF. The components of metabolic syndrome were significant difference between EG and CG, but HDL-C, systolic & diastolic blood pressure were no difference. The metabolic syndrome factors by separate of waist girth were no difference between EG and CG, but BMI, diastolic blood pressure were significant difference. The prevalence of metabolic syndrome was 4 of 24(16.7%) before intervention, but it dropped from 2 to 1 after intervention in WBMP. The components of metabolic syndrome was distributed a big WC>low HDL-C>high TG>hypertension. The changes of AMC, We, PS, BW, 50m run and BFM effect the factors on BMI(35%), WHR(waist-hip ratio, 69%), HDL-C(42%), fasting blood glucose(65%), HOMA-IR index(34%) and systolic blood pressure(39%) respectively. There were significantly increased in breakfast frequency, walking steps, and meal eating period, but decreased in snacks and eating out in exercise group.

Effect of Nutrition Education for Weight Control on the Dietary Behavior, Anthropometry, Body Composition, and the Serum Levels of Adipocytokines in the Elementary Obese Children (체중조절 영양교육 프로그램이 비만 아동의 식습관, 체중, 지방세포분비 호르몬의 농도에 미치는 영향)

  • Lee, Hyun-Sook;Choi, Jin-Sun;Kim, Wha-Young
    • Journal of the Korean Society of Food Culture
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    • v.20 no.3
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    • pp.323-330
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    • 2005
  • The purpose of this study was to evaluate the effects of the weight control programme through nutrition education on anthropometry, body composition, dietary behavior, and adipocyte-drived protein in obese elementary school children. The subjects were 17 obese children of OI over 120% from the fourth to sixth grades of elementary school. The subjects were given nutrition education for weight control along with physical and behavioral advices once a week, and the program was 12 weeks long. On the completion of 12 week weight control program, significant decreases in waist and hip circumferences were resulted, however, no changes in body mass index (BMI) and obesity index (OI) were found. Hemoglobin was significantly decreased and HDL-cholesterol was significantly increased. Energy intake was decreased significantly along with intakes of Ca, Fe, folic acid, vitamin B1, vitamin B6, and vitamin C. Meal distribution of energy was changed; % energy from snack significantly from 11.9% to 3.3%. Resistin, leptin, and adiponectin level were not changed; Resistin had a negative correlation with vitamin C intake. Leptin had positive correlations with weight and BMI. Adiponectin was negatively correlated with weight and BMI. In conclusion, nutrition education program for weight control for 12 weeks is effective in changing the dietary behavior, serum profile, and anthropometry in obese elementary children, however, no effect was seen in adipocytokine levels.

Kinetic analysis of the lower limb in visual handicap children (시각장애 아동의 보행 시 하지의 운동역학적 분석)

  • Yi, Jae-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.3952-3958
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    • 2011
  • This study was to investigate the difference in gait pattern between the visual handicap children and non handicap children in by analyze the biomechanical variation and pattern of lower limb. Therefore, we have made a choice of four visually handicapped children and two subjects, who had no medical disorder for the last six months. In order to collect the gait pattern data of each group, we have used six infrared cameras and one forceplate Also, we have used QTM program to collect the raw data and Visual3D program to calculate kinetic variable. The results were as follows, An/Posterior GRF of breaking phase and propulsion phase in stance phase was lower in visual handicapped children than that of non handicapped children and breaking phase was longer than propulsion phase. extension moment at the ankle was quite lower than general gait pattern and there was little variation at the knee joint which makes the results differ from the general gait pattern. However, hip joint moment was relatively higher than that of other joints. Mechanical variation of lower limb, in case of foot and shank, showed similar results. but generated very low mechanical energy. In thigh, the form of mechanical energy generation was slightly different in each group but generated more mechanical energy than other segments.

A Study on the Status of Antioxidant Nutrients and Lipid in the Middle-aged Korean Men Living in Taegu (대구지역 중년 남성의 혈중 항산화성 영양소와 지질상태에 관한 연구)

  • 조성희;이옥주;임정교;최영선;유리나;박의현
    • Journal of Nutrition and Health
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    • v.28 no.1
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    • pp.33-45
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    • 1995
  • Serum levels of antioxidant vitamins and lipids were determined along with anthropometric measurements in 174 healthy male subjects with mean age of 50.3$\pm$6.8 years from Taegu area in Korea. Body mass index (BMI) and waist/hip(W/H) ratio of the subjects were 23.18$\pm$2.46 and 0.88$\pm$0.04, respectively and their systolic and distolic blood pressures were 127.8$\pm$15.5 and 83.9$\pm$10.8mmHg. Twenty one percent of the subject had BMI over 25. Average seum levels of total cholesterol, LDL- and HDL-cholesterol and triglyceride were 187.7$\pm$34.9, 117.6$\pm$33.5, 41.1$\pm$9.0 and 140.7$\pm$83.6mg/dl, respectively. Sixteen percent of the subject had LDL-chole-sterol over 130mg/dl. Serum level of lipid peroxide measured as thiobarbituric acid reactive substances(TBARS) of the subject was 2.01$\pm$0.77 MDA nmoles/ml and those of $\alpha$-tocopherol, retinol. ascorbic acid and sum of $\alpha$- and $\beta$-carotene were 9.59$\pm$3.11$\mu\textrm{g}$/ml, 1.15$\pm$ 0.38$\mu\textrm{g}$/ml, 10.5$\pm$3.8$\mu\textrm{g}$/ml and 64.6$\pm$43.$\mu\textrm{g}$/dl, respectively. About 14% of the sujects had low vitamin E status of less than 7.0$\mu\textrm{g}$/ml,. while 6% had low vitamin C status of less than 4.0$\mu\textrm{g}$/ml, Serum vitamin E showed positive correlations with total cholesterol and LDL-cholesterol and triglyceride, but no correlation with TBARS. Fatty acids of serum total lipid were composed of 42.9% as saturnted. 19.3% as monounsaturated and 36.7% polyunsaturated fatty acids(PUFA). N-6 and n-3 PUFA were 27.7% and 8.3% of total fatty acids. N-6/n-3 PUFA ratios were negatively correlated both with serum total cholesterol and TBARS.

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Effects of Medical Nutrition Therapy on Changes of Anthropometric Measurements, Dietary Pattern and Blood Parameters in Over Weight or Obese Women (과체중 및 비만 여성에서 의학영양치료에 의한 체격지수의 변화 양상 및 식사 섭취와 혈액학적 지표의 변화)

  • Lee Jeong-Sook;Lee Hye-Ok;Yim Jung-Eun;Kim Young-Seol;Choue Ryo-Won
    • Journal of Nutrition and Health
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    • v.38 no.6
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    • pp.432-444
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    • 2005
  • The purpose of this study was to investigate the effect of medical nutrition therapy (MNT) on anthropometric measurements, quality of diets, and blood parameters through the weight loss program in over weight or obese women. The subjects (n=76, $age\;31.1{\pm}8.4y,\;weight\;70.3{\pm}7.9kg,\;BMI\;27.2{\pm}2.4kg/m^2$) without medical disease were treated with MNT 5 times for 12 weeks by dietitian. Anthropometric measurements included height, weight, fat mass, lean body mass, triceps and thigh skin-fold thickness, mid-arm, waist, hip and thigh circumference. Dietary assessments were accomplished using 3-days food records, diet quality index (DQI), and dietary pattern. The dietary pattern was assessed by daily energy intakes from breakfast, lunch, dinner, and snacks of calorie density, and numbers of eating. Blood levels of leptin, lipid profiles (total lipids, total cholesterol, LDL-cholesterol, HDL-cholesterol), and insulin were analyzed. Anthropometric measurements decreased significantly after MNT (p<0.001). Waist circumference was reduced most rapidly and tricep skin-fold thickness was reduced most effectively after 12 weeks of MNT. Daily energy intake, calorie density and numbers of eating incidence decreased significantly $0796.4{\pm}395.5\;vs\;1402.9{\pm}217.8\;kcal/day,\;162.3{\pm}56.5\;vs\;113.4{\pm}30.1,\;5.0{\pm}1.4\;vs\;3.8{\pm}0.4$, respectively, p<0.05). The daily energy intake from breakfast and snacks significantly decreased (p<0.001). Calories from snack, calorie density of snack and numbers of snacking also decreased (p<0.05). The mean scores of DQI significantly increased ($7.6{\pm}2.1\;vs\;6.5{\pm}1.6$, p<0.05). The plasma levels of total lipid, triglyceride (TG), total cholesterol, LDL-cholesterol and leptin decreased significantly after MNT ($489.8{\pm}100.4\;vs\;447.0{\pm}87.3mg/dL,\;187.7{\pm}34.0\;vs\;175.9{\pm}31.5mg/dL,\;115.2{\pm}29.2\;vs\;109.2{\pm}26.7mg/dL,\;15.7{\pm}7.6\;vs\;12.4{\pm}5.9ng/mL$, respectively, p<0.05). These results indicate that MNT efficiently reduced the body weight through the changes in dietary intake, dietary patterns and dietary quality. MNT also changed body composition and reduced the levels of plasma lipid, cholesterol and leptin.

The effect of community based participatory obesity management program in obese school children (학령기 비만아동을 위한 지역사회 참여형 비만관리 프로그램의 효과)

  • Cho, In-Sook;Ryu, Hyun-Sook
    • Journal of the Korean Applied Science and Technology
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    • v.34 no.4
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    • pp.737-745
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    • 2017
  • The aim of this study was to develop a community based participatory obesity control program and measure the effects of the program on obesity, exercise habit, eating habit and life habits among obese elementary school children. The community based participatory obesity control program was provided for the experimental group of $4^{th}$ grade elementary school students for 10 weeks. The program included obesity related health educations and counseling once a week, jump rope classes twice a week and folk game classes held once a week. Method: There were 24 students with obesity in the experimental and 27 in the control groups. The collected data were analyzed by the Kolmogorov-Smirnov test, ${\chi}^2$-test, independent t-test and repeated measure ANOVA. Results: After 10weeks of participation in the program, the experimental group showed significantly lower Body Mass Index (p<.001) and waist hip ratio (p=.036), significantly higher exercise habit (p=.004), eating habit (p=.003) and life habit (p=.001) than those in the control group. Conclusion: This study provides evidence that community based participatory obesity management program is effective nursing intervention for managing child obesity.