• Journal of Chest Surgery
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• v.37 no.4
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• pp.322-327
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• 2004

Coronary artery bypass grafting on the beating heart is no longer a new methods for any cardiac surgeon. We evaluated the application of the off-pump coronary artery bypass procedure relative to safety and efficiency as measured by postoperative complication and operative mortality. Material and Method: We used our retrospective database to compare the patients having off-pump coronary surgery (n=100) with those having on-pump coronary surgery (n=100) between June, 1999 and August, 2002. Patients whom underwent associated valvular or aortic aneurysmal operation were excluded. Result: Neither groups showed any differences in the patient's risk factors and extent of coronary disease. Off-pump CABG group did not have significantly less mean operation time (295$\pm$73 min vs 323$\pm$83 min, p=ns) and mean hospital day (15.34$\pm$6.02 day vs 13.80$\pm$4.95 day, p=ns). However, off-pump CABG group had significantly shorter mean ventilation time (17.3$\pm$11.27 hour vs 24.98$\pm$16.1 hour, p＜0.05). No patients were converted to on-pump CABG in off-pump CABG. Intraoperative hemodynamic instability in off-pump CABG were 6 cases, of whom 2 cases were in lateral wall approach and 4 cases in right coronary anastomosis. Postoperative mortality was 1 case in off-pump CABG and 2 cases in on-pump CABG. Intra-aortic ballon pump (IABP) was applied in 1 case with off-pump CABG and in 2 cases with on-pump CABG. No patients presented postoperative cerebral infarction ＆ stroke in off-pump CABG but 2 patients in on-pump CABG. Postoperative arrhythmia presented in 4 cases with off-pump CABG and in 6 cases with on-pump CABG. Acute renal failure (ARF) was complicated in 3 cases with off-pump CABG and in 2 cases with on-pump CABG. Conclusion: This study documented the immediate safety and efficiency of the off-pump CABG procedure.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.40-48
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• 1981

Total anomalous venous return defines a group of congenital heart disease which have in common the entire pulmonary venous drainage returning directly or indirectly to the right atrium instead of to the left atrium. Despite of recent advance in treatment, this severe malformation in its various anatomical forms has a high surgical mortality during early infancy. Because of the high mortality in the untreated infant and the surgical risk in the first year of life, the timing of the operation remains important for optimal result. Three cases of T APV R, two supracardiac types and one mixed type, were treated with extracorporeal circulation during last three years in the Dept. of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. The first one was 10 months old male with supracardiac type which drained through left innominate vein, and he was operated with profound hypothermia and total circulatory arrest but failed. The second case was 7 years old male with supracardiac type drained through left innominate vein, and he was well post operatively, and followed periodically for 12 months. The third case was 24 years old female with mixed type drainage (left upper pulmonary vein drained through left innominate vein, and the others through coronary sinus) was successfully corrected, and she was followed for 4 month without problem. All cases were diagnosed with cardiac catheterization and angiocardiogram, and also with echocardiogram in last two cases. In first two cases of supracardiac type, total circulatory arrest was used in brief period during anastomosis between common pulmonary venous trunk and left atrium. In the last case of mixed type, usual cardiopulmonary bypass with moderate hypothermia was used and total circulatory arrest was not needed.

• Journal of Acupuncture Research
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• v.19 no.3
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• pp.126-137
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• 2002

Objective : There is accumulating data that cardiovascular diseases, including hypertension, cerebro-vascular accident, coronary heart disease, relate to atherosclerotic changes. Increased serum levels of lipids could play a role in these circumstances. the SDPTG(the second derivative of photoplethysmogram waveform) is noninvasive methods for evaluating the pulse wave and is correlated with age and other risk factors for atherosclerosis. Methods : To study the effects of serum lipid levels on the SDPTG in the middle-age adults, data on serum lipid levels and the SDPTG were collected in 80 healthy middle age with varying serum lipid concentrations. Biological vascular age was assessed using the SDPTG. the SDPTG consists of an a, b, c, and d wave in systole and an e wave in diastole; an SDPTG aging index(Al) was calculated as (b-c-d-e)/a. Results : Serum triglyceride, total cholesterol, total lipid, phospholipid, HDL cholesterol levels were respectively and significantly correlated with SDPTG Al. Serum lipid levels and blood pressure are age-dependent and the SDPTG is blood pressure-dependent. Restricting analysis to age and blood pressure yield strong positive correlations between serum triglyceride, total lipid levels and SDPTG Al, but no correlations between serum total cholesterol, phospholipid levels and SDPTG Al. Conclusion : The results of this study suggest that preventive acupuncture programs or herbal medications for reducing serum lipid, especially triglyceride, levels in middle-age should include a evaluation of biological vascular aging with the second derivative of photoplethysmogram waveform.

• Korean Journal of Community Nutrition
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• v.4 no.2
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• pp.186-193
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• 1999

Recent epidemiologic and clinical students have shown that plasma cholesterol and triglyceride levels are independent risk factors for coronary heart disease. However, there is not much data on the characteristics of anthropometry and lipid profiles of hypercholesterolemia patients with hypertiglyceridemia. In this study, 112 hypercholesterolemic subjects$(T.C{\ge}240mg/dl)$ were divided into two groups by their plasma triglyceride levels. We compared the anthropometric measurements and lipid profiles of the subjects between the two groups : the simples hypercholesterolemic group(SHC, TG<200mg/dl) and the combined hypercholesterolemic group$(CHC, TG{\ge}250mg/dl)$. The distribution of the subjects into the SHC and CHC groups was 36.6% and 47.3%, respectively. The frequency of the CHC patients decreased with age. The subjects in this group had higher weight, BMI, HWR, cricumferences of mid arm, waist, hip and thigh, and skinfold thicknesses of biceps and triceps than those of the SHC subjects. The difference of plasma total cholesterol level was mainly due to the difference of VLDL-C levels. These differences resulted in the CHC subjects having higher atherogenic indexes and T-C/HDL-C ratios than those of the SHC subjects. Also, the former had higher Apo-B and insulin levels than those the latter. However, blood pressure, fasting blood glucose and HDL-C levels were not significantly different between the two groups. These results suggest that hypercholesterolemic patients with hypertriglyceridemia have riskier lipid profiles for CHD than those of patients with normal triglyceridemia. They also indicate that CHC is closely associated with glucose resistance syndrome(obesity, hyperglycemia, hyperinsulinemia and hypertriglyceridemia), and more prevalent in young people.

• Journal of Dairy Science and Biotechnology
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• v.22 no.1
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• pp.13-25
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• 2004

High concentration of cholesterol in the blood streams of humans has been recognized as a risk factor in the coronary heart disease. Recently, lactobacilli having high bile salt hydrolase activity have been claimed to decrease the concentration of the blood stream cholesterol in humans. In particular, many studies have been reported on the hypocholesterolemic effect of Lactobacillus acidophilus, a normal component of the microflora of the small intestine. Bile salts are excreted as bile into duodenum in the form of N-acyl compounds conjugated with glyine or taurine. Bile excretion is the major route of eliminating cholesterol from the body as well as one of the important pathways of cholesterol metabolism. Since conjugated bile salts are necessary to emulsify cholesterol, deconjugation of bile salts by lactobacilli could decrease intestinal absorption of cholesterol. Free bile salts as well as cholesterol are less soluble than the conjugated bile salts. Therefore, few free bile salts and cholesterol are absorbed through the enterohepatic circulation and most of them are easily excreted via feces. Thus, serum cholesterol could be removed from the body pool by synthesizing new conjugated bile salts to replace the excreted ones.

• Nutritional Sciences
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• v.7 no.3
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• pp.174-182
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• 2004

Women have a greater incidence of coronary heart disease (CHD) after menopause. This relates to hormone imbalance-induced changes in known CHD risk factors, especially hyperlipidemia. The purpose of this study was to explore d1e differences in food consumption and food sources of nutrients in the Korean diet between postmenopausal women aged 50-74 years with normocholesterolemia(NC) and those with hypercholesterolemia(HC). Each subject was either classified as part of the NC group (n=39, serum total cholesterol con. ＜200 mg/$dl$) or the HC group (n=31, serum total cholesterol con. $\geq$240 mg/dl) based on the Guideline for Korean Hyperlipidemia.l Diet was assessed through a validated semi-quantitative food frequency questionnaire. Consumption of foods such as biscuits and/or crackers, squid and eggs was significantly (p＜0.05) higher in the HC group than in the NC group. On the other hand, consumption of potatoes/starches and carrots was significantly (p＜0.05) lower in the HC group than in the NC group. There was no significant difference between the two groups in terms of the consumption of legumes and legume products containing phytoestrogen and we could not find a relationship between legumes and legume products and serum cholesterol levels. Consumption of green tea tended to be lower in the HC group than in the NC group. Major sources of cholesterol, cholesterol-saturated index and vitamin A in the diets of the HC group consisted of foods high in cholesterol. Our results confirm that postmenopausal women with hypercholesterolemia in Korea tend to consume cholesterol-rich foods and dishes.

• Journal of Nutrition and Health
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• v.42 no.6
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• pp.547-558
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• 2009

This study was carried out to compare the effect of smoking on dietary habits, nutrient intakes and blood lipid profiles in 173 adult male drinkers. Subjects were classified by two groups, alcohol-only and alcohol-smoking, based on their alcohol or smoking habits. The BMI of the alcohol-smoking group was significantly lower than those of alcohol-only group. In dietary habits, the alcohol-smoking group had higher irregular breakfast and dinner intakes than alcoholonly group (p < 0.05). Plant lipid intake of the alcohol-smoking group was higher than those of alcohol-only group (p < 0.05) and the vitamin C intake of the alcohol-smoking group was lower than those of alcohol-only group (p < 0.05). With regard to the diet quality evaluation of subjects, the alcohol-smoking group showed significantly lower values than alcohol-only group in the nutrient density of carbohydrate, dietary fiber, sodium, potassium, vitamin $B_6$, and vitamin C. Also, with regard to the index of nutrition quality (INQ) and the nutrient adequacy ratio (NAR), the alcohol-smoking group showed significantly lower value than alcohol-only group in vitamin C. With these results, we found that the alcohol-smoking group had lower diet quality evaluation. The results of blood analysis showed that HDL-cholesterol in the alcohol-smoking group was significantly lower than that in the alcohol-only group. In conclusion, the alcohol-smoking group had greater health risk than the alcohol-only group. Particularly, alcohol-smoking caused irregular eating patterns and unbalanced nutrition intakes compared to alcohol-only and also changed blood composition as shown in the decrease of HDL-cholesterol. Besides, the index of coronary heart disease such as AI was higher in both groups suggesting that alcohol-only or alcohol-smoking cause health problems. Since there is the limiting point in which the comparative analysis of non-drinkers and non-smokers is unable to be performed in this study, further wide research is needed on that matter.

• Journal of the Korean Dietetic Association
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• v.7 no.4
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• pp.331-348
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• 2001

The purpose of this study was to obtain basic data for nutrition education of the children in a health promoting elementry school. The data was collected by a questionaire of food habits, and anthropometric measurement and biochemical test in comparison with obesity index. The study subjects were boys and girls aged 10 to 12 years who participated in the “99 Children Nutrition Camp”. The average obesity index was 1.7$\pm$21.6% in boys and -11.4$\pm$12.6% in girls. After school, major leisure items were significnatly different by gender but both boys and girls played mainly computer game. In concern for body image and eating habits, girls had more concern and girls had attempted weight control more than boys. 80.2% of subjects had prejudice for special food, especially, all subjects in the severely underweight group had prejudice. But this tendency was significantly decreased with the increasing obesity index. The lowest preferency was for vegetables(64.4%). The tendency of prejudice of subjects was higher whose mother are thirties than those of subjects whose mother are in fourties. The serum GOT and GPT values were significantly higher in overweight and obese group than the other groups. The only serum T-chol was significantly higher in boys than in girls. The number of risk factors related to coronary heart disease(CHD) based on coresponding criteria of TG, T-chol, HDL-chol, and LDL-chol was not increased significantly with the degree of obesity index. The results indicated the need of nutritional management for the children. At a point of view, to educate children early who are able to change food habits and life-styles means to help heathy growth and to deliver up heathy adults. Active nutrition education for both children and mothers will be recommended with joint participation of nutritionists in community public health center and elementary school.

• Journal of the Korean Dietetic Association
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• v.7 no.4
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• pp.313-319
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• 2001

High serum cholesterol level is a major risk factor for coronary heart disease(CHD). Nutrition therapy of hypocholesterolemic diets with increased physical activity is the essential step in the treatment of the hypercholesterolemic patients. The purpose of this study was to evaluate the short-term effect of intensive dietary therapy combined with regular exercise in lowering serum cholesterol level. Seventy three hypercholesterolemic outpatients(mean: 268.0$\pm$24.7mg/dL), aged 34 to 73(mean: 56$\pm$9.8yrs), who visited cardiology OPD of Yonsei Cardiovascular Center from April through October, 1998 were studied. Anthropometric measurements, usual nutrient intake survey using semiquantitative food frequency questionnaire, and daily nutrient intake analysis were performed. The nutrition counseling for the hypocholesterolemic diet and exercise therapy was performed individually. After a 4 week intensive dietary therapy, comparisons of body weight, nutrient intakes, and blood lipid concentrations were evaluated for the hypocholesterolemic effect of intensive diet therapy. After 4 weeks of intensive diet therapy, significant reductions in percent ideal body weight(p<0.01), saturated fat intake(p<0.01), and cholesterol intake(p<0.01) were observed. There were significant reductions in serum total cholesterol and LDL-cholesterol levels after 4 weeks of therapy by 8.1%(p<0.01) and 9.7%(p<0.01), respectively. Our results showed that intensive dietary therapy was effective in reductions of serum total and LDL-cholesterol levels. The goal for this dietary modification should not be temporary but rather be permanent in eating behavior accompanied by appropriately increased physical activity.

• The Journal of Korean Medicine
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• v.35 no.1
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• pp.124-134
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• 2014

Objectives: Metabolic syndrome is considered a coronary heart disease risk factor and its prevalence rate is increasing in Korea. Because obesity is relevant to metabolic syndrome, we investigated the relationship between metabolic syndrome and the Obesity Pattern Identification Questionnaire in middle-aged health check-up examinees. Methods: This was a cross-sectional study with 125 patients who visited a health promotion center of university hospital from October 2012 to January 2013. We analyzed the association of Obesity Pattern Identification Questionnaire and the diagnostic criteria of metabolic syndrome. Results: Pi deficiency (脾虛), phlegm (痰飮), liver stasis (肝鬱) and food accumulation (食積) pattern showed significantly highs score in the group with hypertriglyceridemia. Also, females demonstrated significantly high scores of liver stasis (肝鬱) and food accumulation (食積) in the group with hypertriglyceridemia. The questions of Pattern Identification that showed especially significant high score in the group of hypertriglyceridemia are as follows: 'Easily get annoyed', 'Usually worried', 'Frequently overeating or bingeing', and 'Having more after getting full'. There are positive correlations between triglyceride and the score of Pi deficiency (脾虛), phlegm (痰飮) and food accumulation (食積) pattern. Conclusions: Obesity Pattern Identification Questionnaire can be used for the management of hypertriglyceridemia in an effort to prevent metabolic syndrome.