• Journal of Life Science
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• 제20권11호
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• pp.1683-1690
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• 2010

There is an increasing interest in the potential of isoflavone in reducing the risk of cardiovascular disease and cancer, however, although several effects of isoflavone as a component of soy protein are well established, the hypolipidemic and antioxidant effects of purified isoflavone are still controversial. This study was to investigate the effects of isoflavone on serum lipid profiles and antioxidant status in rats. 7-week old male Sprague Dawley rats were fed one of the following diets for 8 weeks: basal diet (B), basal+0.3% isoflavone (BI), basal+0.5% cholesterol (BC), or basal+0.3% isoflavone +0.5% cholesterol (BIC). Two-way ANOVA was used to test the effects of dietary isoflavone and cholesterol supplementation and their interaction on variables. Serum lipid profiles and total antioxidant status (TAS) were examined spectrophotometrically. Degree of serum lipid peroxidation was measured by malondialdehyde (MDA) assay. The activities of serum antioxidant enzymes (GSH-Px, total-SOD) was determined. Levels of serum total cholesterol, VLDL+LDL-cholesterol and Atherogenic index were significantly lower in BI than those levels in group B (p=0.0002, p<0.0001, and p=0.0042, respectively). Serum total antioxidant status (TAS) levels were significantly higher, in both isoflavone supplemented groups (BI, BIC) compared to those levels in each control group (B, BC) (p<0.0001). Activity of total-SOD was significantly higher in BI compared to the activities in group B (p=0.0317). There was no interaction between isoflavone and cholesterol supplementation. In conclusion, isoflavone supplementation showed positive effects on the serum lipid profiles and total antioxidant activities in both conditions, either when fed a diet with or without cholesterol. These effects of isoflavone were independent of cholesterol supplementation.

• Journal of Chest Surgery
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• 제36권5호
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• pp.348-355
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• 2003

Background: The prognostic significance of lymph node micrometastasis in non-small cell lung cancer remains controversial. We therefore investigated the clinicopathologic factors related to lymph node micrometastsis and evaluated the clinical relevance of micrometastasis with regard to recurrence. Material and Method: Five hundred six lymph nodes were obtained from 41 patients with stage 1 non-small ceil lung cancer who underwent curative resection between 1994 and 1998. Immunohistochemical staining using anti-cytokeratin Ab was used to detect micrometastasis in these lymph nodes. Result: Micrometastatic tumor cells were identified in pN0 lymph nodes in 14 (34.1%) of 41 patients. The presence of lymph node micrometastasis was not related to any clinicopathoiogic factor (p) 0.05). The recurrence rate was higher in patients with micrometastasis (57.1%) than in those without (37.0%), but the difference was not significant (p=0.22). Patients with micrometastasis had a lower 5-year recurrence-free survival rate (48.2%) than those without micrometastasis (64.1%), with a borderline significance (p=0.11), The S-year recurrence-free survival rate (25.0%) in the patients with 2 or more micrometastatic lymph nodes was significantly lower than that in the patients with no or single micrometastasis (p=0.02). In multivariate analysis, multiple lymph node micromestasis us was a significant independent predictor of recurrence (p=0.028, Risk ratio=3.568). Conclusion: Immunehistochemical anti-cytokeratin staining was a rapid, sensitive, and easy way of detecting lymph node micrometastasis. The presence of lymph node micrometastasis was not significantly associated with the recurrence, but had a tendency toward a poor prognosis in stage 1 non-small cell lung cancer. Especially, the presence of multiple micrometastatic lymph nodes was a significant and independent predictor of recurrence.

• Journal of the Korean Society of Food Science and Nutrition
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• 제31권2호
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• pp.306-314
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• 2002

The purpose of this study is to examine the relation between vegetarian diet and the risk factors of cardiovascular disease. The subjects of the study were 127 Buddhist nuns (age: 23 ~79 yr) for vegetarians and 235 healthy female adults (age: 23 ~79 yr) for non-vegetarians. This study covers food consumption survey, anthropometric measurement, amount of energy expenditure, physical activity and clinical examination. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, waist/hip ratio (WHR) was 0.85 and 0.84, percentage of body fat (%BF) was 28.79 and 26.55, respectively. Average duration of vegetarian diet of the vegetarians was 13.16 years. The triglyceride levee of the vegetarians was significantly lower for those who take nutrient tablet compared to those who either take vitamins or who do not take any nutrient supplement. Taking vitamins or nutrient tablet did not give any significant difference in total-cholesterol and LDL-cholesterol for vegetarians, while significantly high triglyceride was observed for the non-vegetarians taking nutrient tablet than the ether non-vegetarians. Taking vitamins or nutrient tablet did not affect the lever of HDL-cholesterol for either vegetarians or non-vegetarians. Athrogenic index (AI) was lower for the vegetarian group tailing nutrient tablet and for the non-vegetarian group not taking vitamins and nutrient tablet, than the other respective groups. Blood sugar of the vegetarians who take nutrient tablet was significantly lower than those tailing vitamins, while blood sugar of the non-vegetarians not taking any nutrient supplement was significantly lower than those taking nutrient tablet.

• Tuberculosis and Respiratory Diseases
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• 제55권4호
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• pp.353-360
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• 2003

Background : Although most patients with tuberculous pleurisy respond well to anti-tuberculous drugs, some are known to progress into severe pleural thickening which needs decortication despite adequate anti-tuberculous treatment. Therefore, the purpose of this study was to identify factors associated with the development of severe pleural thickening in patients who finally underwent pleural decortication in tuberculous pleurisy. Patients and Methods : From retrospective medical records review, 121 patients initially diagnosed as tuberculous pleurisy without initial pleural fluid loculation were enrolled between January 1998 and December 2002. They were separated into two groups: 85 patients in group 1 who improved by anti-tuberculous drugs only, and 36 patients in group 2 who had progressed into pleural adhesion and finally underwent pleural decortication despite adequate (more than 6 months) anti-tuberculous treatment. Results : Males were more common in group 2 (M/F=31/5) than in group 1 (M/F=53/32) (p=0.010). Group 2 patients tended to have lower pleural fluid glucose level ($58{\pm}4$ mg/dL) than group 1 ($89{\pm}3$ mg/dL) (p=0.001) and higher pleural fluid adenosine deaminase level ($86{\pm}5$ IU/L) than group 1 ($76{\pm}3$ IU/L), (p=0.038). There were no significant differences in age, symptom duration, pleural fluid amount, or pleural fluid LDH level between groups 1 and 2. Conclusions : There was a relative risk of tuberculous pleurisy progression into severe pleural thickening which needed decortication in the case of male patients, low pleural fluid glucose or high adenosine deaminase level. But further, large-scale, prospective studies should be investigated.

• Tuberculosis and Respiratory Diseases
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• 제39권6호
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• pp.511-516
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• 1992

Background: It is well known that cigarette smoking is the risk factor of lung cancer, chronic obstructive pulmonary disease and ischemic heart disease. But there are few reports about the immediate effect of cigarette smoking on the cardiopulmonary functions. The serum level of carbon monoxide increases during cigarette smoking. It is known that carbon monoxide increases respration rate, heart rate and cardiac output, with decrease in maximal oxygen consumption. So we have studied to determine the immediate effects of cigarette smoking on the cardiopulmonary function during exercise. Method: Thirteen healthy smoking male subjects were included in this study. Each subject was undertaken pulmonary function test and incremental exercise test on two separate days, one without smoking (control) and the other after smoking three cigarettes per hour for five hours. The order of the two tests was randomized. Results: 1) The mean age of the subjects was $25{\pm}4.9$ year-old and the mean smoking history was $6{\pm}5$ pack years. 2) The mean blood level of carbon monoxide on the smoking day was higher than that on the nonsmoking day ($5.97{\pm}1.34%$ vs. $1.45{\pm}0.83%$; p<0.01). 3) The mean maximal oxygen consumption on the smoking day was lower than that on the nonsmoking day ($2.09{\pm}0.32$ L/min vs. $2.39{\pm}0.32$ L/min; p<0.05). 4) The mean anaerobic threshold on the smoking day was lower than that on the nonsmoking day ($1.33{\pm}0.24$ L/min vs. $1.53{\pm}0.20$ L/min; p<0.05). 5) The mean heart rate at rest on the smoking day was higher than that on nonsmoking day ($84.38{\pm}11.06$ beats/min vs. $75.46{\pm}5.83$ beats/min; p<0.05). But the means of maximal heart rate on both days were not different. 6) The pulmonary function tests were similar on both days. Conclusion: There was no change in pulmonary function test, but the maximal oxygen consumption and anaerobic threshold were decreased on the smoking day. So it was concluded that cigarette smoking impaired the cardiovascular functions immediately during exercise.

• Journal of Chest Surgery
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• 제39권3호
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• pp.201-207
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• 2006

Background: Percutaneous cardiopulmonary support (PCPS) provides passive support of gas exchange and perfusion, allowing the use of other methods of care for organ recovery, and saves lives of patients with severe cardiopulmonary failure in a wide variety of clinical settings with a minimal risk of bleeding and need for chest re~ exploration. We summarized a single center's experiences with PCPS in patients with cardiogenic shock or cardiac arrest due to the ischemic heart disease. Material and Method: Among the 20 consecutive patients with cardiogenic shock or cardiac arrest from May 1999 to June 2005, Biopump (Medtronic, Inc, Minneapolis, MN) was used in 7 patients and the self-priming, heparin-coated circuit of EBS (Terumo, Japan) was applied to remaining 13 patients. Most of cannulations were performed percutaneously via femoral arteries and veins. The long venous cannulas of DLP (Medtronic inc. Minneapolis, MN) or the RMI (Edwards's lifescience LLC, Irvine, CA) were used with the arterial cannulae from 17 Fr to 21 Fr and the venous cannula from 21 Fr to 28 Fr. Result: The 20 consecutive patients who were severely compromised and received PCPS for the purpose of resuscitation were comprised of 13 cardiac arrests and 7 cardiogenic shocks in which by-pass surgery was performed in 11 patients and 9 ongoing PCls under the cardiopulmonary support. The mean support time on the PCPS was 38$\pm$42 hours. Of the 20 patients implanted with PCPS, 11 patients ($55\%$) have had the PCPS removed successfully; overall, 8 of these patients ($40\%$) were discharged from the hospital in an average surviving time for 27$\pm$17 days after removing the PCPS and survived well with 31$\pm$30 months of follow-up after the procedure. Conclusion: The use of PCPS appears to provide the hemodynamic restoration, allowing the survival of patients in cardiac arrest or cardiogenic shock who would otherwise not survive, and patients receiving PCPS had a relatively long-term survival.

• Journal of Chest Surgery
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• 제32권9호
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• pp.781-789
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• 1999

Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

• Journal of Chest Surgery
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• 제32권9호
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• pp.799-805
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• 1999

Background: Leakage, stricture formation, and tumor recurrence at the anastomotic site are serious problems after esophagectomy for cancer of the esophagus or cardia. The prevalence of these postoperative complications may be affected by whether an anastomosis is made in the neck or in the chest, therefore a comparison was made between anastomoses made at these two sites. Material and Method: Between 1987 and 1998, 36 patients with cancer of the esophagus underwent transthoracic esophagectomy with cervical(NA, n=20) or thoracic anastomosis(CA, n=16). The tumors were staged postoperatively(stage IIA, n=13; s tage IIB, n=7; stage III, n=16) and were located in the middle thoracic(n=22) or lower thoracic esophagus and cardia(n=14). Result: The overall operative mortality was 8.3%(5% for NA group, 12.5% for CA group). The anastomotic leak rate for the NA group was 15.0% and 12.5% for the CA group. The anastomotic leak rate differed according to the manual(27.3%) or stapled(8.0%) techniques(p < 0.05). The median proximal resection margins in the NA and CA groups were 9.6 cm and 5.8 cm, and the corresponding rates of anastomotic tumor recurrence were 5.3% and 28.6%(p < 0.05). The prevalence of benign stricture formation (defined as moderate/severe dysphagia) was higher in the NA group(36.8%) than in the CA group(21.4%). When an anastomosis was made by the stapled technique, smaller size of the staple increased the prevalence of stricture formation - 41.7% with 25-mm staple and 9.1% with 28-mm staple(p < 0.05). Conclusion: Wider resection margin could decrease the anastomotic tumor recurrence, and the stapled technique could decrease the anastomotic leak. The prevalence of benign stricture was higher in the cervical anastomosis but the anastomotic leak and smaller size(25-mm) of the staple should be considered as risk factors.

• Journal of Chest Surgery
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• 제29권12호
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• pp.1306-1315
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• 1996

This study reviewed the changes of hemodynamlcs and centrAl pulmonary artery dimension in 54 patients who underwent bidirectional cavopulmonary shunt(BCPS) between February 1992 and December 1995 at Seoul National University Childrell's Hospital. Ag and body weight of patients averaged 36.8 $\pm$ 37.7 months and 8.0$\pm$3.0 kg, respectively Eightynine percent of patients had more than 2 violations of the risk factors for Fontan operation, resulting overall hospital mortality of 16.6%(9154). Serial hemodynamic and anglographic examinations before and mean 16.3 $\pm$ 14.3 months iirter BCPS were compared. The arterial oxygen saturation improved from a preoperative value of 71 9: 10.1 % to 79.H $\pm$ 8. 5% (n:4), p<0.05). The values of arterial oxygen saturation were lower as the age of the patients with BCPS in place was older(n=22, R'=0.341, p=0.004). A mean pulmonary artery pressure and pulmonary vascular resistance reduced from 31 $\pm$17 to 1).5$\pm$3.SmmHg(n=22, p<0.05) and from ).2$\pm$2.1 to 2.3$\pm$2.7 unit (n=7. p>0.05), respectively. Follow-up study showed a significant Increase of absolute values of ipsilateral pulmoanry artery (n: 14, p<0.05), but no change of contralateral pulmonary artreries (n: 14. p=not significant(HSI). However, there w re significant decreases in diameters of both ipsilateral and contralateral pulmonary arteries standardized by patients' body surface areas(16.8% decrease, n: 14, p< 0. 05 for ipsilatreal, 25.1%, n=14, p<0.05 for contralateral). Pulmonary artery indices for cross sectional areas of both pulmonary arterises decreased 9.3 $\pm$ 13.8% with showing a trend of more decrease as the follow-up duration was longer, We conclude that the bidirectional cavopulmonary shunt provide an excellent.

• Journal of Chest Surgery
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• 제35권6호
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• pp.430-438
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• 2002

It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects. We reviewed our recent surgical experiences on congenital heart defect (other than patent ductus arteriosus) in low birth weight babies. Material and Method: From September 1994 to February 2001, 31 consecutive infants weighing 2500 g or less underwent cardiac surgery with (OHS group n=12) or without cardiopulmonary bypass (CHS group n=19). A retrospective study was carried out to evaluate short-and intermediate-term outcome. Mean gestational age and age at operation were 36.9 weeks(range, 32.3-42weeks) and 32.1days (range, 0-87days) respectively. Mean body weight at birth and operation were 1972g (range, 1100-2500g) and 2105g (range, 1450-2500 g) respectively. There was no difference between the two groups in age and body weight. Defects included ventricular septal defect (VSD) (n=3), VSD with arch anomaly (n=2), total anomalous pulmonary venous return (n=2), transposition of the great arteries (TGA) (n=2), truncus arteriosus (n=2), and univentricular heart with cor triatriatum (n=1) in OHS group, and coarctation of aorta (n=7), tetralogy of Fallot (TOF) (n=3), TOF with pulmonary atresia (n=3), multiple muscular VSDs (n=1), double outlet right ventricle (n=1), pulmonary atresia with intact ventricular septum (n=2), tricuspid atresia (n=1), and TGA with multiple VSD (n=1) in CHS group. 13 patients (41.9%) were intubated pre-operatively. Result: There were 4 early deaths(＜30 days); 1 (8.3%) in OHS group and 3 (15.8%) in non-OHS group. All these early deaths were related to the pulmonary artery banding(PAB). There was no operative mortality in infants undergoing complete repair and palliative operations other than PAB. Delayed sternal closure was required in 3 patients. Prolonged postoperative mechanical ventilation (>7 days) was required in 7 patients(58.3%) in OHS and 7(38.8%) in CHS group. Late mortality occurred in 3 patients, two of which were non-cardiac. A patient in OHS group was documented to have neurologic sequelae. All the survivors except two are in NYHA class 1. Conclusion: Complete repair and palliative operations other than PAB can be performed in low birth weight infants with low operative mortality and an acceptable intermediate-term result. However, about a half of the patients required long-term postoperative mechanical ventilation.