Background: Interrupted aortic arch is a rare congenital heart anomaly which still shows high surgical mortality. In this study, we investigated the causes of and the risk factors for mortality to improve the surgical outcomes for this difficult disease entity. Material and Method: From 1984 to 2004, 42 patients diagnosed as IAA were reviewed retrospectively. Age, body weight at operation, preoperative diagnosis, preoperative PGE1 requirement, type of interrupted aortic arch, degree of left ventricular outflow stenosis, CPB time, and ACC time were the possible risk factors for mortality. Result: There were .14 hospital deaths. Preoperative use of PGE1, need for circulartory assist and aortic cross clamp time proved to be positive risk factors for mortality on univariate analysis. Preoperative left ventricular outflow stenosis was considered a risk factor for mortality but it did not show statistical significance (p-value=0.61). Causes of death included hypoxia due to pulmonary banding, left ventricular outtract stenosis, infection, mitral valve regurgitation, long cardiopulmonary bypass time and failure of coronary transfer failure in TGA patients. Conclusion: In this study, we demonstrated that surgical mortality is still high due to the risk factors including preoperative status and long operative time. However preoperative subaortic dimension was not related statistically to operative death statistically. Adequate preoperative management and short operation time are mandatory for better survival outcome.
Kim Yon Tae;Chae Jong Koo;Kim Gil Whon;Shin Heung Mook
Journal of Physiology & Pathology in Korean Medicine
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v.16
no.1
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pp.62-66
/
2002
Hypertension is not only a well-established cardiovascular risk factor but also increase the risk of atherosclerosis. Most studies conducted to investigate the effectiveness of treatment for cardiovascular disease such as hypertension have focused primarily on conventional drug and physiotherapeutic treatments. BanhabackchulChunma-tang(半夏白朮天麻湯:BCT) is popular herbal medicine used in clinic for the treatment of various symptoms of drulatory disorders and weakness of digestive system, including anorexa and nausea with vertigo, severe headache, vomiting and so on. However, the mechanisms underlying its efficacy are unknown. This study investigated the effects of BCT as an alternative medication on the contraction induced by phenylephrine and KCI in rat thoratic aorta. BCT revealed siginificant relaxation on phenylephrine-induced arterial contraction, but revealed noncompetitive effect on concentration responses of phenylephrine-induced contraction. Treatment of N-L/sup ω/ -argine methyl ester(L-NAME) and methylene blue(MB)(10/sup -5/M) reduced the relaxation of BCT. BCT also increased in vitro NO production. It suggest that the relaxation effect of BBT is related with NO pathway, becausse the effect of L-NAME and MB are due to inhibition of NO synthesis from endothelial cells. These results indicate that BCT would be effective in hypertension treatment and its mechanism of relaxtion on arterial contraction is likely to be related with NO production, blocking of α-receptor and signal transduction after receptor activation.
Purpose: The risk of cardiovascular disease (CVD) has been shown to be associated with systemic inflammation in obese adults with metabolic syndrome (MetS). The aims of this study were to evaluate the prevalence of MetS and its relation to inflammatory markers in obese Thai children. Methods: A cross-sectional study was conducted. Children with history of endogenous obesity, chronic diseases, drug ingestion, and any acute illness within 2 weeks prior to enrollment were excluded. Their fasting blood glucose (FBG) levels, oral glucose tolerance tests, insulin, lipid profiles, and selected inflammatory markers, including interleukin-6, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein (hs-CRP) levels, were tested. Results: In this study, 58 obese Thai children (female, 20; male, 38) with a mean body mass index z score of $5.1{\pm}2.2$ were enrolled. The prevalence of MetS and prediabetes was 31% and 17.2%, respectively. None of the children had diabetes. FBG levels, 2-hour glucose levels, and lipid profiles were not statistically different between those with and without MetS. However, obese children with MetS had higher insulin levels and homeostasis model assessment of insulin resistance values. Elevated hs-CRP levels were found in 69% of the cases, although it was not statistically different between the 2 groups. Conclusion: We described a substantial prevalence of MetS in Thai obese children. Regardless of MetS status, two-thirds of the obese children had elevated hs-CRP level, indicating subtle ongoing inflammatory process. This chronic inflammation feasibly predisposes them to CVD in the future, even in children without MetS.
This study was performed to investigate the relationship between obesity, health-related lifestyle, and dietary intake and serum lipid level in 96 male university students. Health-related lifestyle factors were obtained from questionnaires. Dietary intakes were evaluated with one-day 24-hr recall and two-day dietary record. Anthoropometric data were recorded and serum cholesterol and triacylglycerol concentrations were measured. 21.9%, 36.5%, 36.5%, and 6.2% of the subjects had levels beyond the normal range in serum total cholesterol(TC), HDL-cholesterol(HDL-C), LDL-cholesterol(LDL-C), and triacyglycerol respectively, and 57.3% of the subjects had more than one hyperlipidemic factor. TC was correlated positively with BMI(p〈0.01), waist length(p〈0.05), hip length(p〈0.05), and the amount of smoking(p〈0.05). HDL-C was correlated negatively with BMI(p〈0.05) and hip lenghth(p〈0.05). LTD-C was correlated positively with BMI(p〈0.01), water length(p〈0.05), hip length(p〈0.01), and coffee consumption(p〈0.05). TG was correlated positively with waist length(p〈0.01), waist-to-hip ratio(p〈0.05), and amount of smoking(p〈0.01) and negatively correlated with frequence of exercise(p〈0.05). Among nutrient intakes, only the ratio of protein to energy was correlated negatively with TC(p〈0.05). Logistic regression analysis revealed that BMI, waist length, hip length, waist-to-hip ratio, and amount of cigarette smoking were associated with an increased risk of hyper-TC. BMI, waist length, and hip length were associated with an increased risk of hypo-HDL-C. BMI and coffee consumption were associated with an increased risk of hyper-LDL-C. Amount of cigarette smoking was associated with an increased risk of hyper-TG. In conclusion, a high prevalence of hyperlipidemia in subjects was observed. Also obesity, smoking, and coffee consumption were observed to be highly with the risk of hyperlipidemia in subjects. These findings imply that these factors should be primarily considered in planing the nutrition education program for the prevention of cardiovascular disease in male university students.
Background and Objectives: Comprehensive epidemiological data are lacking on the incident atrial fibrillation (AF) in patients with cardiac implantable electronic devices (CIEDs). This study aimed to examine the incidence, risk factors, and AF-related adverse outcomes of patients with CIEDs. Methods: This was an observational cohort study that analyzed patients without prevalent AF who underwent CIED implantation in 2009-2018 using a Korean nationwide claims database. The subjects were divided into three groups by CIED type and indication: pacemaker (n=21,438), implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) with heart failure (HF) (n=3,450), and ICD for secondary prevention without HF (n=2,146). The incidence of AF, AF-associated predictors, and adverse outcomes were evaluated. Results: During follow-up, the incidence of AF was 4.3, 7.3, and 5.1 per 100 person-years in the pacemaker, ICD/CRT with HF, and ICD without HF cohorts, respectively. Across the three cohorts, older age and valvular heart disease were commonly associated with incident AF. Incident AF was consistently associated with an increased risk of ischemic stroke (3.8-11.4-fold), admission for HF (2.6-10.5-fold), hospitalization for any cause (2.4-2.7-fold), all-cause death (4.1-5.0-fold), and composite outcomes (3.4-5.7-fold). Oral anticoagulation rates were suboptimal in patients with incident AF (pacemaker, 51.3%; ICD/CRT with HF, 51.7%; and ICD without HF, 33.8%, respectively). Conclusions: A substantial proportion of patients implanted CIED developed newly diagnosed AF. Incident AF was associated with a higher risk of adverse events. The importance of awareness, early detection, and appropriate management of AF in patients with CIED should be emphasized.
This study was performed to investigate the effect of soy isoflavone on plasma nitrite concentration and the antioxidant enzyme activities of erythrocyte and the liver using adult male rats fed high fat diet. Seven-week old male Sprague Dawley rats were divided into three groups and fed high fat diet (15% beef tallow, 1 % cholesterol; control: IF0) or high fat diets containing isoflavone 80 ppm (IF80) or 320 ppm (IF320) for 10 weeks. Plasma nitrite concentration as a vasodilator, and antioxidant enzyme activities in erythrocytes and the liver were measured. Plasma nitrite concentration was increased by 45% and 35%, respectively, in IF80 and IF320 than in IF0 group. Erythrocyte catalase, glutathione peroxidase (GPx) and glutathione reductase (GR) activities increased by 31 %, 30% and 40% in IF320 compared to IF0 group. Especially, erythrocyte GR activity increased by 61 % in IF80 group. However, catalase activity in the liver was decreased in IF80 group. GPx and GR activities in the liver were not differ among groups. The results suggest that soy isoflavone have the protective effect against risk factors related with cardiovascular disease by improving vasodilator factor, nitrite, and antioxidant enzyme activities in blood. (Korean J Nutrition 38(2): 89~95, 2005)
Purpose: The purpose of this study was to compare Preventive Health Behaviors (PHBs) in adults in Korea and the United States and identify factors influencing PHBs. Methods: This was a secondary data analysis study using data from the 2008 Korean National Health and Nutrition Examination Survey and the 2008 USA Behavioral Risk Factor Surveillance System. The PHBs were predicted using multiple linear regression analysis. Results: 1) The total score of PHBs was significantly higher in American males (5.11) than in Korean males (4.78). There was also a significant difference between Korean females' total score (6.57) and American females'(6.75). 2) Age, marriage, monthly income, subjective health status, and cardiovascular disease were significant factors of PHBs in Korean males (p<.001). However, age, marriage, education, monthly income, health insurance, subjective health status, and cardiovascular disease were significant factors in American males (p<.001). In Korean females, only age and education were significant predictors (p<.001). However, six variables(age, marriage, education, monthly income, health insurance, and subjective health status) were significant predictors in American females (p<.001). Conclusion: There were different variables in predicting PHBs between Koreans and Americans. Each country should focus on those significant predictors to promote the PHBs for adults.
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.3
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pp.1186-1193
/
2012
The purpose of the study is to provide the basic data for preventing and caring cardiovascular disease. The study was performed with the data from the same 1,668 persons who had medical checkup three times from 2004 to 2008 at a health promotion center. The related factors were examined with Cohort Study. The result of the study is as followed, The incidence of metabolic syndrome for the subjects from 2004 to 2008 increased; 0% in 2004, 8.3% in 2006 and 12.0% in 2008. Multiple logistic regression analysis showed that the related factors in the occurrence of metabolic syndrome which changed from the non metabolic syndrome group in 2004 to metabolic syndrome were age, smoking, total cholesterol, ALT, and uric acid etc.
Purpose: Supraventricular arrhythmia is a well-known complication of cardiothoracic surgery, and is common in patients wirth underlying cardiovascular disease. Also, it's treatment and prognosis are well known. However the incidence, the contributing factors, and the prognosis for supraventricular arrhythmias in noncardiothoracic surgical patients are less well known. This study was undertaken to investigate the incidence, the clinical presentation, the prognosis, and the factors comtributing to the prognosis for supraventricular arrhythmia in the surgical intensive care unit. Methods: We performed a retrospective study of 34 patients with newly developed or aggravated supraventricular arrhythmias in the surgical intensive care unit between March 2004 and February 2005. The incidence, the risk factors, and the prognosis of supraventricular arrhythmias were analyzed. Results: During a 12month period, the incidence of supraventricular arrhythmia was 1.79% (34/1896). Most patients had pre-existing cardiovascular disease and sepsis. The mortality rate was 29.4%, and the most common cause of death was multiple organ failure due to septic shock. The mean value of the APACHE II score was 20.9, and the surgical intensive care unit and the hospital lengths of stay were 9.9 days and 25.8 days, respectively. The APACHE II score measured when the arrhythmia developed was a significant factor in predicting mortality, Conclusion: Supraventricular arrhythmias result in increased mortality and increased length of stay in both the surgical intensive care unit and the hospital. The arrhythmia itself did not cause death, but a high APACHE II score incicated a poor prognosis. This may reflect the severity of the illness rather than an independent contributor to mortality.
Kim Jung-Sue;Song Jung-Han;Park Hye-Won;Cheong Hae-Il;Kim Jin-Q;Choi Yong;Ko Kwang-Wook
Childhood Kidney Diseases
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v.1
no.2
/
pp.109-116
/
1997
Purpose : Chronic renal failure is often accompanied by severe dyslipidemia, a known risk factor for cardiovascular disease. Lipoprotein(a) [Lp(a)] has recently been characterized as a risk factor for atherosclerosis and thrombosis. Cardiovascular disease is the leading cause of death in adult patients on dialysis. However, there are only limited data available concerning risk factors for atherosclerosis in uremic children. We have measured serum levels of lipids, lipoproteins, apolipoproteins and Lp(a) in uremic children with maintenance dialysis. Methods : Ten uremic children with hemodialysis (HD) and 14 with peritoneal dialysis (PD) in our dialysis unit were included in this study. The mean age of HD patients was $162{\pm}59$ months and the male to female ratio was 7:3. The mean age and sex ratio of PD patients were $123{\pm}63$ months and 6:8, respectively. The levels of cholesterol, triglyceride, lipoproteins, apolipoproteins and Lp(a) were measured from serum sampled after 14 hours of fasting. The normal control levels were cited from 2 articles presenting the normal blood lipid and lipoprotein levels of primary school and middle school children in Korea. Results : There was no difference in age, sex ratio, body mass index and duration of dialysis between the HD and the PD group. The serum concentration of the cholesterol, triglyceride and apolipoprotein B were significantly elevated in dialysis patients compared with normal subjects. The serum level of Lp(a) was significantly elevated in only PD group. The serum Lp(a) level was below 30 mg/dl in 13 and above 30 mg/dl in 11 patients. The serum albumin level was significantly decreased in high Lp(a) group than in low Lp(a) group. Conclusion : The uremic children receiving dialysis reveal abnormal serum lipid and lipoprotein profiles. These results suggest that they have a higher risk for coronary heart disease, although there has been no clinical evidence of coronary heart disease at present. A long-term follow-up study of these children to clarify the suggestion should be started now.
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