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ATHEROSCLEROSIS, CHOLESTEROL AND EGG - REVIEW -

  • Paik, I.K.;Blair, R.
    • Asian-Australasian Journal of Animal Sciences
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    • v.9 no.1
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    • pp.1-25
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    • 1996
  • The pathogenesis of atherosclerosis can not be summarized as a single process. Lipid infiltration hypothesis and endothelial injury hypothesis have been proposed and investigated. Recent developments show that there are many points of potential interactions between them and that they can actually be regarded as two phases of a single, unifying hypothesis. Among the many risk factors of atherosclerosis, plasma homocysteine and lipoprotein(a) draw a considerable interest because they are independent indicators of atherogenicity. Triglyceride (TG)-rich lipoproteins (chylomicron and VLDL) are not considered to be atherogenic but they are related to the metabolism of HDL cholesterol and indirectly related to coronary heart disease (CHD). LDL can of itself be atherogenic but the oxidative products of this lipoprotein are more detrimental. HDL cholesterol has been considered to be a favorable cholesterol. The so-called 'causalist view' claims that HDL traps excess cholesterol from cellular membranes and transfers it to TG-rich lipoproteins that are subsequently removed by hepatic receptors. In the so-called 'noncausalist view', HDL does not interfere directly with cholesterol deposition in the arterial wall but instead reflects he metabolism of TG-rich lipoproteins and their conversion to atherogenic remnants. Approximately 70-80% of the human population shows an effective feedback control mechanism in cholesterol homeostasis. Type of dietary fat has a significant effect on the lipoprotein cholesterol metabolism and atherosclerosis. Generally, saturated fatty acids elevate and PUFA lower serum cholesterol, whereas MUFA have no specific effect. EPA and DHA inhibit the synthesis of TG, VLDL and LDL, and may have favourable effects on some of the risk factors. Phospholipids, particularly lecithin, have an antiatherosclerotic effect. Essential phospholipids (EPL) may enhance the formation of polyunsaturated cholesteryl ester (CE) which is less sclerotic and more easily dispersed via enhanced hydrolysis of CE in the arterial wall. Also, neutral fecal steroid elimination may be enhanced and cholesterol absorption reduced following EPL treatment. Antioxidants protect lipoproteins from oxidation, and cells from the injury of toxic, oxidized LDL. The rationale for lowering of serum cholesterol is the strong association between elevation of plasma or serum cholesterol and CHD. Cholesterol-lowing, especially LDL cholesterol, to the target level could be achieved using diet and combination of drug therapy. Information on the link between cholesterol and CHD has decreased egg consumption by 16-25%. Some clinical studies have indicated that dietary cholesterol and egg have a significant hypercholesterolemic effect, while others have indicated no effect. These studies differed in the use of purified cholesterol or cholesterol in eggs, in the range of baseline and challenge cholesterol levels, in the quality and quantity of concomitant dietary fat, in the study population demographics and initial serum cholesterol levels, and clinical settings. Cholesterol content of eggs varies to a certain extent depending on the age, breed and diet of hens. However, egg yolk cholesterol level is very resistant to change because of the particular mechanism involved in yolk formation. Egg yolk contains a factor of factors responsible for accelerated cholesterol metabolism and excretion compared with crystalline cholesterol. One of these factors could be egg lecithin. Egg lecithin may not be as effective as soybean lecithin in lowering serum cholesterol level due probably to the differences of fatty acid composition. However, egg lecithin may have positive effects in hypercholesterolemia by increasing serum HDL level and excretion of fecal cholesterol. The association of serum cholesterol with egg consumption has been widely studied. When the basal or control diet contained little or no cholesterol, consumption of 1 or 2 eggs daily increased the concentration of plasma cholesterol, whereas that of the normolipemic persons on a normal diet was not significantly influenced by consuming 2 to 3 eggs daily. At higher levels of egg consumption, the concentration of HDL tends to increase as well as LDL. There exist hyper-and hypo-responders to dietary (egg) cholesterol. Identifying individuals in both categories would be useful from the point of view of nutrition guidelines. Dietary modification of fatty acid composition has been pursued as a viable method of modifying fat composition of eggs and adding value to eggs. In many cases beneficial effects of PUFA enriched eggs have been demonstrated. Generally, consumption of n-3 fatty acids enriched eggs lowered the concentration of plasma TG and total cholesterol compared to the consumption of regular eggs. Due to the highly oxidative nature of PUFA, stability of this fat is essential. The implication of hepatic lipid accumulation which was observed in hens fed on fish oils should be explored. Nutritional manipulations, such as supplementation with iodine, inhibitors of cholesterol biosynthesis, garlic products, amino acids and high fibre ingredients, have met a limited success in lowering egg cholesterol.

Aortic Valvuloplasty Using Leaflet Extension Technique (판막첨 연장술을 이용한 대동맥판막 성형술의 중기성적 평가)

  • Ahn, Hyuk;Kim, Hyun-jo
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.656-662
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    • 1997
  • Aortic valvuloplasty has recently gained attention as an attractive alternative procedure for aortic valvular disease. Between March 1995 to August 1996, 14 patients with pure aortic regurgitation(AR) underwent aortic alvuloplasty using leaflet extension with glutaraldehydepreserved autologous pericardium. There were 11 males and 3 females, and the mean age was 34.8 $\pm$ 15.3 years. Preoperative echocardiography and cardiac catheterization revealed that the degree of AR was mean 3.4$\pm$0.65, and more than moderate degree of mitral regurgitation(MR) were detected in 4 patients. In 12 patients, 3 leaflets were extended and in another 2 patients only one deformed leaflet was extended. Concomitant mitral valvuloplasty (MVP) was performed in 4 patients. The competency of the aortic valve after completion of repair was evaluated by the transesophageal echocardiography in operating theater, and there was no aortic and mitral stenosis or regurgitation. In an early postoperative echocardiography, trivial AR was detected in 3 patients and mild MR in 1 patient. The end-systolic and end-diastolic dimensions of the left ventricle were decreased significantly(p<0.05) as compared with those of preoperative values. T ere was no mortality and no significant postoperative complication encountered. Late complication developed in 2 patients during the follow-up period(mean 7.9$\pm$ 5.9 months). One patient underwent AVR on postoperative 7th month due to endocarditis, and the another patient with Behcet's disease underwent Ross operation at postoperative 4th month. In conclusion, AVP of leaflet extension technique offers an excellent early clinical result and represents a good alterna!ivy surgical treatment for the pure AR especially in young age group, although long-term follow-up is necessary to determine the durability of glutaraldehyde-preserved autologous pericardium as a valve leaflet.

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The In-hospital Clinical Outcomes of Extracorporeal Life Support after Adult Cardiovascular Surgery (성인 심혈관 수술 후 시행한 체외순환보조의 조기 임상결과)

  • Yie, Kil-Soo;Na, Chan-Young;Oh, Sam-Sae;Kim, Jae-Hyun;Ryu, Se-Min;Park, Sung-Min;Cho, Seong-Joon
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.464-472
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    • 2009
  • Background: We analyzed the clinical results and the factors for survival of patients who underwent extracorporeal life support system after adult cardiovascular surgery. Material and Method: We retrospectively reviewed the medical record of 44 patients (1.6% of the total adult cardiovascular surgical cases) who underwent the use of a ventricular assisted device or extracorporeal membrane oxygenation from January 2002 to August 2008. There were 32 (72.7%) males and their mean age was 61.7$\pm$14.9(range: 20$\sim$73) years old. The mean duration of extracorporeal life support system was 5.3$\pm$3.0 (range: 1$\sim$12) days. Result: Of these 44 patients, 24 (54.5%) patients were successfully weaned from the extracorporeal device. Eighteen (40.9%) survivors were able to be discharged from the hospital. Complications were noted in 38 patients (86.4%). An emergency operation, no usage of a concomitant intraaortic balloon pump and major complications during use of the extra corporeal life support system such as bleeding, flow instability and renal failure were identified as significant risk factors for poor survival on univariated analysis. Owing to educational support and a continuous renal replacement therapy system, the clinical outcomes of these patients have improved since 2006. On multivariated analysis, renal failure and bleeding during extracorporeal life support were significant risk factors for poor survival. Conclusion: Although using. extracorporeal life support systems after adult cardiovascular surgery revealed acceptable clinical results, determining the optimal treatment strategy and further well designed larger studies are needed to improve the survival rate of patients who undergo extracorporeal life support after adult cardiovascular surgery.

Midterm Results of the Bioprosthesis in Mitral Position (조직판막을 이용한 승모판 치환술의 중기 성적)

  • Cho, Hyun-Jin;Lee, Jae-Won;Jung, Sung-Ho;Je, Hyoung-Gon;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.695-702
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    • 2008
  • Background: The choice between a bioprosthetic and a mechanical valve is an important decision in cardiac valve surgery, and the durability of the tissue valve is a major decision factor. We retrospectively evaluated the midterm results of bioprosthetic valve replacement in the mitral position. Material and Method: The subjects were all patients who had undergone mitral bioprosthesis replacement between July 1989 and August 200.7. Among the 216 patients, there were 236 surgical cases. The mean age was $63{\pm}15$ years, and the male to female ratio was 1 : 3. We retrospectively analyzed hospital and outpatient records such that the total follow-up duration amounted to 760.2 patient-years, and the mean follow-up duration was $41.9{\pm}40.7$ months (range $0{\sim}212$ months). Result: Early death occurred in 18 patients (8.3%), and 13 of these underwent concomitant cardiac procedures. The survival rate after 5 years was $79.9{\pm}3.5%$, and the survival rate after 8 years was $65.5{\pm}5.5%$, while freedom from structural valve deterioration (SVD) was $96.2{\pm}2.2%$ at 5 years and $85.9{\pm}5.3%$ at 8 years. Freedom from reoperation was $90.6{\pm}1.7%$ at 5 years and $90.4{\pm}4.2%$ at 8 years, while freedom from reoperation for SVD was $98.1{\pm}1.2%$ at 5 years and $92.3{\pm}4.1%$ at 8 years. On multivariate analysis of preoperative risk factors, small valve size (between 25mm and 27mm) was a significant risk factor for reoperation, and low LV ejection fraction (<40%) was a significant risk factor for SVD and mortality. Conclusion: Survival and freedom from reoperation for SVD in mitral bioprosthesis replacement had acceptable midterm results, but freedom from SVD Was relatively low. In particular, since SVD increased sharply at the eighth postoperative year, frequent follow-up and echocardiograms around that time will be helpful for the early detection of SVD. It will be necessary to conduct further studies involving long-term follow-up and more patients.

Regulatory Mechanism of Radiation-induced Cancer Cell Death by the Change of Cell Cycle (세포주기 변화에 타른 방사선 유도 암세포 사망의 조절기전)

  • Jeong Soo-Jin;Jeong Min-Ho;Jang Ji-Yeon;Jo Wol-Soon;Nam Byung-Hyouk;Jeong Min-Za;Lim Young-Jin;Jang Byung Gon;Youn Seon-Min;Lee Hyung Sik;Hur Won Joo;Yang Kwang Mo
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.306-314
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    • 2003
  • Purpose : In our Previous study, we have shown the main cel1 death pattern Induced by irradiation or protein tyrosine kinase (PTK) inhibitors in K562 human myeiogenous leukemic cell line. Death of the cells treated with irradiation alone was characterized by mitotic catastrophe and typical radiation-induced apoptosis was accelerated by herblmycin A (HMA). Both types of cell death were inhibited by genistein. In this study, we investigated the effects of HMA and genistein on cell cycle regulation and its correlation with the alterations of radiation-induced cell death. Materials and Methods: K562 cells In exponential growth phase were used for this study. The cells were Irradiated with 10 Gy using 6 MeV Linac (200-300 cGy/min). Immediately after irradiation, cells were treated with 250 nM of HMA or 25 $\mu$N of genistein. The distributions of cell cycle, the expressions of cell cycle-related protein, the activities of cyclin-dependent kinase, and the yield of senescence and differentiation were analyzed. Results: X-irradiated cells were arrested In the G2 phase of the cell cycle but unlike the p53-positive cells, they were not able to sustain the cell cycle arrest. An accumulation of cells in G2 phase of first ceil-cycle post-treatment and an increase of cyclin Bl were correlated with spontaneous, premature, chromosome condensation and mitotic catastrophe. HMA induced rapid G2 checkpoint abrogation and concomitant p53-independent Gl accumulation. HMA-induced cell cycle modifications correlated with the increase of CDK2 kinase activity, the decrease of the expressions of cyclins I and A and of CDK2 kinase activity, and the enhancement of radiation-induced apoptosis. Genistein maintained cells that were arrested in the G2-phase, decreased the expressions of cyclin Bl and cdc25c and cdc25C kinase activity, increased the expression of pl6, and sustained senescence and megakaryocytic differentiation. Conclusion: The effects of HMA and genistein on the radiation-induced cell death of KS62 cells were closely related to the cell cycle regulatory activities. In this study, we present a unique and reproducible model in which for investigating the mechanisms of various, radiation-induced, cancer cell death patterns. Further evaluation by using this model will provide a potent target for a new strategy of radiotherapy.

Metamorphism and Deformation of the Late Paleozoic Pyeongan Supergroup in the Taebaeksan Basin: Reviews on the Permo-Triassic Songrim Orogeny (태백산분지에 분포하는 후기 고생대 평안누층군의 변성-변형작용: 페름-삼첩기 송림 조산운동의 고찰)

  • Kim, Hyeong-Soo
    • The Journal of the Petrological Society of Korea
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    • v.21 no.2
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    • pp.151-171
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    • 2012
  • The Permo-Triassic Songrim orogeny in the Korean peninsula was a major tectonic event involving complicated continental collisions at the eastern margin of Eurasia. Based on the previous studies on the metamorphic and deformations features of the Songrim orogeny, this paper presents metamorphic and structural characteristics and timing of the Songrim orogeny in the Taebaeksan basin, and discuss about correlation of the tectono-metamorphic evolution of the Taebaeksan basin with the Okcheon basin and the Imjingang belt with a combined analysis of bulk crustal shortening direction, metamorphic P-T and T-t (time) paths. The metapelites in the Pyeongan Supergroup in the northeastern margin of the Taebaeksan basin have experienced lower-temperature/medium-pressure (LT/MP) regional metamorphism followed by high-temperature contact metamorphism due to the Jurassic granite intrusion. The earlier LT/MP regional metamorphism produced two loops of clockwise P-T-d (deformation) paths combined with four deformation events ($D_1-D_4$). The first loop concomitant with $D_1$ and $D_2$ occurred at $400-500^{\circ}C$, 1.5-3.0 kbar, and related with growth of syn-$D_1$ chloritoid and andalusite, post-$D_1$ margarite, Ca-rich syn-$D_2$ or post-$D_2$ plagioclase. The second loop accompanying $D_3$ and $D_4$ occurred at $520-580^{\circ}C$, 2.0-6.0 kbar, and associated with the growth of syn-$D_3$ garnet and staurolite, and syn-$D_4$ and/or post-$D_4$ andalusite porphyroblasts. Furthermore the syn-$D_1$ chloritoid and andalusite porphyroblasts grew during E-W bulk crustal shortening, whereas the syn-$D_3$ garnet and staurolite, and the syn-$D_4$ and/or post-$D_4$ andalusite porphyroblasts have grown under N-S bulk crustal shortening. The similarity in the characteristics and timing of the metamorphism and bulk crustal shortening directions between the Okcheon and Imjingang belts suggest that the peak metamorphic conditions tend to increase toward the western part (Imjingang belt and southwestern part of the Gyeonggi Massif) from the eastern part (Taebaeksan basin). The E-W bulk crustal shortening influenced the eastern part of the Okcheon belt, whereas the N-S bulk crustal shortening resulted in strong deformation in the Imjingang and Okcheon belts. Consequently, the Permo-Triassic Songrim orogeny in the Korean peninsula is probably not only related to collision of the North and South China blocks, but also to the amalgamation of terrane fragments at the eastern Eurasia margin (e.g., collision of the Sino-Korean continent and the Hida-Oki terrane).

Correction of positional change of frontal cephalometric landmarks caused by vertical head rotation (두부의 수직회전 시 정모두부방사선사진상의 계측점 변화와 이의 보정)

  • Kim, Mi-Young;Lee, Kyung-Min;Cho, Jin-Hyoung;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.41 no.2
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    • pp.98-111
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    • 2011
  • Objective: Superimposition of frontal cephalograms cannot be performed when the cephalograms are taken with different vertical head rotations. The purpose of the present study was to evaluate the validity of correcting the positional change of frontal cephalometric landmarks caused by vertical head rotation. Methods: In 30 adult individuals, frontal and lateral cephalograms were taken at a $90^{\circ}$ angle. Geometric principles of radiography were used to calculate the possible vertical and horizontal landmark changes if the head should be rotated down $5^{\circ}$ about an ear rod axis. The calculated changes were then compared with cephalometric changes measured on frontal cephalogram actually taken with the head rotated down $5^{\circ}$. Results: When the frontal cephalograms were taken with the head rotated down $5^{\circ}$ about an ear rod axis, significant changes in the vertical position of the landmarks occurred, particularly in the landmarks located farther anteriorly from the ear rod axis. The comparison of calculated changes and real cephalometric changes showed that the differences were less than 0.4 mm in the vertical direction and less than 0.2 mm in the horizontal direction. The differences between calculated and real changes were smaller in the landmarks less affected by vertical head rotation. Conclusions: Even when frontal cephalograms are taken at different vertical head rotations, the concomitant changes in the position of the landmarks can be corrected through calculation using the geometric principle of radiography as long as frontal and lateral cephalograms are taken perpendicular to each other.

SURVEY OF SELF-CONCEPT AND DEPRESSION-ANXIETY OF THE ELEMENTARY SCHOOL BOYS WITH LEARNING DISABILITIES (학습장애를 가진 초등학교 남학생의 자아상 개념과 우울-불안 특성 조사)

  • Kim, Bong-Soo;Seong, Deock-Kyu;Jung, Yeong;Yoo, Hee-Jung;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.125-137
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    • 2001
  • We investigated the self-concept, subjective depression, and state-trait anxiety of the school boys with learning disabilities(abbr. LD, n=86) and compared them with normal boys(n=52) using Piers-Harris Self-Concept Inventory, Child Depression Inventory(abbr. CDI), and State-Trait Anxiety Inventory(abbr. STAI). With regard to Piers-Harris Self-Concept Inventory total scores, there was no significant difference between two groups, but normal boys showed higher scores in intellectual and school status, physical appearance, and happiness-satisfaction subscales than patients with LD. The male patients with LD showed significantly higher ratings in CDI total scores, and CDI subscales - ineffectiveness, anhedonia, negative self-esteem than normal children. The patients with LD reported significantly higher state anxiety, but not trait anxiety. Correlation analyses revealed that self-concept decreased over time, and depression-anxiety increased across grades in the patients with LD, but not in normal children. Especially, negative mood, anhedonia, negative self-esteem subscales of CDI, and state-trait anxiety showed significant positive correlation with grades. In both groups, CDI scores were inversely correlated with Piers-Harris Self-Concept and positively with State-Trait anxiety. In conclusion, self-concept problems which were related with school achievement and self-esteem were more abundant in the patients with LD than normal children, self-image problem, depression and anxiety increased across grades. According to regression analysis, age, behavior subscale, intellectual-school status, anxiety, popularity, happiness-satisfaction, CDI-ineffectiveness, interpersonal problem, negative self-esteem, and state anxiety could explain the self-concept in the patients with LD, not in normal children. So, the self-concept of the patients with LD were found to be related to the school achievement and stress when comparing with peers. In conclusion, elementary school boys with LD showed lower self-concept, higher depression and anxiety, and these differences increased across grades. Since the patients with LD have concomitant depression and anxiety disorders, it is important that comorbidity with emotional problems should be explored and managed properly.

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Clinical Significance of Tumor Markers in Gastric Cancer Patients after Curative Resection (근치적 절제술을 시행한 위암 환자에서 종양 표지자의 임상적 의미)

  • Kim, Sa-Young;Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.136-142
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    • 2009
  • Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.

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The Effect of Combined Estrogen/calcium Therapy on Bone Metabolism in Ovariectomized Rats I. A Study on Biochemical Parameters in Ovariectomized Rats (에스트로겐/칼슘 혼합요법이 난소절제 쥐의 골대사에 미치는 영향 I. 생화학적 변화에 관한 연구)

  • 이경화;오승호
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.6
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    • pp.993-1005
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    • 1996
  • This study was implemented in order to investigate the effects of dietary calcium-salt, estrogentreatment, and estrogen/calcium treatment on bone metabolism. Ovariectomized rats were used as animal models. Female Sprague-Dawley rats with a body weight of 250~280g were underwent ovariectomy or sham-operation. The ovariectomized rats were divided into 9 different experimental groups including the saline-treated group, the estrogen-treated group, the high calcium salt-treated group, and the estrogen/calcium treated groups and fed for 6 weeks. Creatinine and hydroxyproline in urine were analyzed. Creatinine, calcitonin, osteocalcin, alkaline phosphatase and parathyroid hormone in plasma were also determined. The results of the experiment are as follows : The ovariectomy caused a significant increase in the level of food intake, food effciency ratio and body weight gain in comparison with sham-operation. The overall food intake, food effciency ratio and body weight gain were significantly decreased by estrogen. The ovariectomized animals developed obesity as a result of increased food intake. In addition, estradiol injections suppressed food intake with a concomitant loss in body weight. The level or urinary hydroxyproline, as an indicator or bone resorntion, was higher in the ovariectomized rats compared to sham-opertion, while these decresed in the estrogen/calcium treated group. Parathyroid hormone and calcitonin in the plasma, that were used as the indicator of calcium homeostasis, parathyroid hormone higher in the ovariectomized rats compared to sham-operation. It was lowered by estrogen and high calcium treated groups; thus, estrogen and estrogen/calcium treated groups were decreased by 32% compared to saline treated group. Osteocalcin and alkaline phosphatase which are indicators of bone formation, were significantly higher in ovariectomized group, while this showed to be decreased in the estrogen and the ostrogenicalcium treated groups. Estrogen and estrogen/calcium in ovariectomized rats resulted in lower bone loss. However, estrogen treated group its gradual reduction showed little effect on bone loss, while the gradual reduction of estrogen had a preventive effect on bone loss when the treatment was combined with calcium intensification.

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