Purpose: The purpose of this study was to examine a combined influence of obesity and metabolic syndrome on ischemic heart disease in Korean middle aged and older adults. Methods: This study used secondary data from the 2013 Korea National Health and Nutrition Examination Survey. A total of 3,726 adults over age 40 were included. Logistic regression was used for analysis of complex samples. Gender, age, educational level, family income, family history of ischemic heart disease, physical activity, smoking, and heavy alcohol consumption were analyzed as covariates. Results: Ischemic heart disease was more prevalent among adults with metabolic syndrome regardless of obesity (non-obesity: Adjusted Odds Ratio [AOR]: 3.044, 95% Confidence Interval [CI]: 1.163-7.967, overweight: AOR: 2.805, 95% CI: 1.246-6.316, obese: AOR: 3.137, 95% CI: 1.548-6.358) compared to the reference group, defined as adults with non-obesity and non-metabolic syndrome. Odds of ischemic heart disease were not significant in the group with obesity and non-metabolic syndrome compared to the reference group. Conclusion: The results of this study show that the population with metabolic syndrome is an at-risk group for ischemic heart disease. Thus, management of metabolic syndrome is required for prevention of ischemic heart disease.
BACKGROUND: Kawasaki disease (KD) sometimes presents with only fever and cervical lymphadenopathy before other clinical signs materialize. This lymphadenopathy-first-presenting Kawasaki disease (LKD) may be misdiagnosed as bacterial cervical lymphadenitis (BCL). We investigated characteristic imaging and clinical data for factors differentiating LKD from BCL. METHODS: We compared imaging, clinical, and laboratory data of patients with KD and BCL. We included patients admitted to a single tertiary center between January 2015 and July 2018. RESULTS: We evaluated data from 51 patients with LKD, 63 with BCL, and 218 with typical KD. Ultrasound imaging revealed multiple enlarged lymph nodes in both LKD and BCL patients. On the other hand, computed tomography (CT) showed more abscesses in patients with BCL. Patients with LKD were younger and showed higher systemic and hepatobiliary inflammatory markers and pyuria than BCL patients. In multivariable logistic regression, younger age and higher C-reactive protein (CRP) retained independent associations with LKD. A comparison of the echocardiographic findings in LKD and typical KD showed that patients with LKD did not have a higher incidence of coronary artery abnormalities (CAA). CONCLUSIONS: LKD patients tend to have no abscesses on CT and more elevated systemic hepatobiliary inflammatory markers and pyuria compared to BCL patients. The absence of abscess on CT, younger age, and elevated CRP were the most significant variables differentiating LKD from BCL. There was no difference in CAA between LKD and typical KD.
The Journal of the Korean Society for Microbiology
/
v.35
no.3
/
pp.203-214
/
2000
Porphyromonas gingivalis has been implicated in periodontal diseases. Accumulating evidence suggests that cardiovascular disease is the most prevalent medical problem in patients with periodontal diseases. In order to check the possibility that P. gingivalis is involved in coronary heart disease, the present study was performed to observe P. gingivalis adherence and invasion of human coronary artery endothelial cells (HCAEC) and production of cytokines and growth factors by HCAEC upon P. gingivalis infection. $^3H$-labeled P. gingivalis 381 was incubated with HCAEC for 90 min. The radioactivity of the washed HCAEC was a measure of the absorbed (adhering and invading) P. gingivalis. The absorption radioactivity of the HCAEC infected by P. gingivalis was determined to be 59.58% of the input bacterial cells. In contrast, the absorption radioactivity of the cells infected by S. gordonii Challis which was employed as a control was negligible (0.59%). DPG3, a P. gingivalis mutant defective of fimbriae, appeared to be impaired to some extent in capability of adherence/invasion as compared to that of the parental strain 381, showing 43.04% of the absorption radioactivity. The absorption radioactivity of the HCAEC infected by P. gingivalis 381 in the presence of excessive fimbriae at the concentrations of $50\;{\mu}g$ and $100\;{\mu}g/ml$ was 57.27 and 45.44%, respectively. Invasion of HCAEC by P. gingivalis 381 was observed by an antibiotic (metronidazole) protection assay and transmission electron microscopy (TEM). In the antibiotic protection assay, invasion by the bacterium was measured to be 0.73, 1.09, and 1.51% of the input bacterial cells after incubation for 30, 60, and 90 min, respectively. Invasion by DPG3 was shown to be 0.16% after 90-min incubation. In comparison of invasion efficiency at 90 min of the incubation, the invasion efficiency of DPG3 was 0.37% while that of its parental strain 381 was 2.54%. The immunoblot analysis revealed fimbriae of P. gingivalis did not interact with the surface of HCAEC. These results suggest that fimbriae are not the major contribution to the adherence of P. gingivalis to HCAEC but may be important in the invasion of HCAEC by the bacterium. The presence of cytochalasin D ($1\;{\mu}g/ml$) and staurosporine ($1\;{\mu}M$) reduced the invasion of HCAEC by P. gingivalis 381 by 78.86 and 53.76%, respectively, indicating that cytoskeletal rearrangement and protein kinase of HCAEC are essential for the invasion. Infection of P. gingivalis induced HCAEC to increase the production of TNF-${\alpha}$. by 60.6%. At 90 min of the incubation, the HCAEC infected with P. gingivalis cells was apparently atypical in the shape, showing loss of the nuclear membrane and subcellular organelles. The overall results suggest that P. gingivalis may cause coronary heart disease by adhering to and invading endothelial cells, and subsequently damaging the cells.
This study investigated the association between dietary intake and 10-year risk for CHD predicted from Framingham risk score in Korean adults using the Korea National Health and Nutrition Examination Survey 2019-2020. Eight thousand subjects (3,382 men and 4,618 women) aged 30 years or older were classified into three groups according to the 10-year CHD risk (%). The sociodemographics, anthropometrics indices, blood profiles, and dietary intake were collected. After adjusting for confounding variables, the mean adequacy ratio (MAR) decreased for both men and women as the disease risk increased. The high-risk group was below the MAR criteria, indicating that the overall quality of the meal was not good. The highest consumers of legumes (OR 0.56, 95% CI 0.37-0.84), fruits (OR 0.67, 95% CI 0.48-0.93), and fish (OR 0.60, 95% CI 0.42-0.87) had a 44%, 33%, and 40% lower 10-year CHD risk than lowest consumers in men, respectively. In women, there is no significant relationship between food groups and disease risk. Therefore, improving lifestyle habits such as weight control, increased activity, and adequate food intake, especially legumes, fruits, and fish rich in antioxidant nutrients and bioactive substances, appears to have a potential association with preventing coronary heart disease in Korean adults.
Kim, Tae-Sik;Na, Chan-Young;Baek, Jong-Hyun;Kim, Jae-Hyun;Oh, Sam-Sae
Journal of Chest Surgery
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v.44
no.3
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pp.236-239
/
2011
Indication for extracorporeal membrane oxygenation (ECMO) has been extended as the experience of ECMO in various clinical settings accumulates and the outcome after ECMO installation improves. We report two cases of successful mitral valve surgery for severe ischemic mitral regurgitation in patients on ECMO support for cardiogenic shock which developed upon coronary angiography.
Occlusive coronary artery disease presents a potential threat to a significant population in the United States. According to many case reports, the increasing incidence of coronary artery disease due to atherosclerosis is noted in Korean, recently. Operative vascular procedures have increased steadily in number over the past 20 years in the United States. There have been many isolated case reports about coronary artery surgery, but these had little clinical impact. Nowadays, major three coronary bypass surgery has developed principally at three cardiac centers in the United States since 1967. Among three coronary bypass operation, the aorta-coronary artery saphenous vein bypass graft was first demonstrated by Favolaro and Effler at the Cleveland Clinic in 1967. We experienced one case of coronary artery disease, which was treated successfully by aorta-coronary saphenous vein graft with mild hypothermia under extracorporeal circulation in May, 1977. Saphenous vein was removed from above the knee and was 2.5 mm in diameter. The left ventricle was not vented for the left ventricle was not overdistended. Temporary artificial pace-maker-Medtronic-was implanted for the prevention and treatment of post-operative arrhythmia and heart block in post-operative first day. He is a 57 year old male businessman who had been suffered from hypertension [200 mmHg in systolic pressure] since 4 years ago, who had intermittent conservative treatment at local clinic. He had been afflicted with severe chest pain with choking sensation for 50 days. This symptom was aggravated exposing cold weather, or cold water, but was respond to rest. Pre-operative ECG revealed no any other ischemic sign except sinus bradycardia. Significant S-T segment depression was noted at lead II, AVF after double 5 minutes exercise, indicating positive Master`s test. Serum cholesterol was slight elevated to 253 mg/dl. Final pre-operative diagnosis was made by coronary arteriogram, which showed about 1.0-cm segmental 90 % occlusive atherosclerotic lesion in the proximal part of right coronary artery above the origin of acute marginal artery. Left coronary artery revealed good patency and there was no collateral circulation between right and left coronary artery .Hospital course was not eventful. He was discharged with good result on the post-operative day. He has been free from chest pain for longer than 2 years. And also the arterial flow in the coronary bypass graft is auscultated with the pocket-sized ultrasonic velocity detector, which shows the patency of the coronary bypass graft good.
Kim Wuon-Shik;Bae Jang-Ho;Choi Hyoung-Min;Lee Sang-Tae
Science of Emotion and Sensibility
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v.8
no.2
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pp.95-101
/
2005
This study is based on previous information regarding reduced cardiac vagal activity in patients with coronary artery disease(CAD), on reduced variance(SDNN : standard deviation of all normal RR intervals), low-frequency power(LF), and the complexity of heart rate variability(HRV) in patients with chronic heart failure(CHF), and on the normalized high-frequency power of HRV is the highest in the right lateral decubitus position among 3 recumbent postures in patients with CAD, However, nothing is known about the nonlinear dynamics of HRV for the 3 recumbent postures in patients with CAD. To investigate the linear and non-linear characteristics of HRV in patients with CAD, 29 patients as CAD group and 23 patients as control group were studied. Electrocardiogram(ECG) with lead II channel was measured on these patients for 3 recumbent postures in random order. The HRV from ECG was analyzed with linear method(for time and frequency domains) and nonlinear method. The lower the high-frequency power in normalized unit(nHF) in the supine or left lateral decubitous position, the higher the increase in nHF when the position was changed from supine or left lateral decubitous to right lateral decubitous. Among the 3 recumbent postures in patients with severe CAD, the right lateral decubitus position was observed to induce the highest vagal modulation, the lowest sympathetic modulation, and the highest complexity of human physiology system.
Electrocardiogram(ECG) being the recording of the heart's electrical activity provides valuable clinical information about heart's status. Many researches have been pursued for heart disease diagnosis using ECG so far. However, electrocardio-graph uses foreign diagnosis algorithm in the con due to inaccuracy of domestic diagnosis results for a heart disease. This paper proposes ST-segment extraction technique diagnosing heart disease parameter from raw ECG data. As the ST-segment is used for prediction of Coronary Artery Disease, we can predict heart disease using classification approach in data mining technique. We can also predict patient's clinical characterization from patient clinical data.
Anomalous origin of the coronary artery from the pulmonary artery is a rare congenital coronary artery disease and the origin of the left coronary artery from the pulmonary artery represents the commonest form of these unusual lesions. Because of differences in symptomatology, clinical course and prognosis, this malformation has been divided into infant type[Bl-and-White-Garland syndrome] and adult type on the basis of the absence or presence of collateral circulation between the right and left coronary artery. The latter type has been reported relatively few cases. A 21-year-old male was admitted to the Yeungnam University Hospital, due to study of incidentally noticed heart murmur. At that time he was asymptomatic and past medical history was noncontributory. Chest roentgenogram was within normal limit and electrocardiogram was consistent with hypertrophy of left ventricle. Echocardiogram and aortogram demonstrated markedly dilated and tortuous right coronary artery and anomalous origin of the left coronary artery from the pulmonary artery. To prevent arteriosclerosis, progressive myocardial infarction, infection and aneurysmal rupture, Takeuchi operation which establish a two coronary system by transpulmonary arterial reconnection of the anomalous left coronary artery was done. Postoperative course was uneventful.
Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.
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