• Journal of Chest Surgery
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• v.36 no.3
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• pp.150-156
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• 2003

Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.

• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.224-230
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• 2005

Purpose: The maximal elastance ($E_{max}$) of myocardium has been established as a reliable load-independent contractility index. Recently, we developed a noninvasive method to measure the regional contractility using gated myocardial SPECT and arterial tonometry data. In this study, we measured regional $E_{max}(rE_{max}$ in the patients who underwent coronary artery bypass graft surgery (CABG), and assessed its relationship with other variables. Materials and Methods: 21 patients (M:F=17:4, $58{\pm}12$ y) who underwent CABG were enrolled. $^{201}TI$ rest/dipyridamole stress $^{99m}Tc$-sestamibi gated SPECT were performed before and 3 months after CABG. For 15 myocardial regions, regional time-elastance curve was obtained using the pressure data of tonometry and the volume data of gated SPECT. To investigate the coupling with myocardial function, preoperative regional $E_{max}$ was compared with regional perfusion and systolic thickening. In addition, the correlation between $E_{max}$ and viability was assessed in dysfunctional segments (thickening <20% before CABG). The viability was defined as improvement of postoperative systolic thickening more than 10%. Results: Regional $E_{max}$ was slightly increased after CABG from $2.41{\pm}1.64 (pre)\;to\;2.78{\pm}1.83 (post)$ mmHg/ml. $E_{max}$ had weak correlation with perfusion and thickening (r=0.35, p<0.001). In the regions of preserved perfusion (${\geq}60%$), $E_{max}$ was $2.65{\pm}1.67$, while it was $1.30{\pm}1.24$ in the segments of decreased perfusion. With regard to thickening, $E_{max}$ was $3.01{\pm}1.92$ mmHg/ml for normal regions (thickening ${geq}40%$), $2.40{\pm}1.19$ mmHg/ml for mildly dysfunctional regions (<40% and ${\geq}20%$), and $1.13{\pm}0.89$ mmHg/ml for severely dysfunctional regions (<20%). $E_{max}$ was improved after CABG in both the viable (from $1.27{\pm}1.07\;to\;1.79{\pm}1.48$ mmHg/ml) and non-viable segments (from $0.97 {\pm}0.59\;to\;1.22{\pm}0.71$ mmHg/ml), but there was no correlation between $E_{max}$ and thickening improvements (r=0.007). Conclusions: Preoperative regional $E_{max}$ was relatively concordant with regional perfusion and systolic thickening on gated myocardial SPECT. In dysfunctional but viable segments, $E_{max}$ was improved after CABG, but showed no correlation with thickening improvement. As a load-independent contractility index of dysfunctional myocardial segments, we suggest that the regional $E_{max}$ could be an independent parameter in the assessment of myocardial function.

• Journal of Nutrition and Health
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• v.48 no.1
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• pp.30-45
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• 2015

Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

• Journal of Ginseng Research
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• v.26 no.3
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• pp.111-131
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• 2002

Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

• Magazine of the Korean Society of Agricultural Engineers
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• v.16 no.2
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• pp.3361-3394
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• 1974

The purpose of this thesis is to disclose some characteristics of water consumption in relation to the quantities of dry matters through the growing period for two statured varieties of paddy rice which are a tall statured variety and a short one, including the water consumption during seedling period, and to find out the various coefficients of evapotranspiration that are applicable for the water use of an expected yield of the two varieties. PAL-TAL, a tall statured variety, and TONG-lL, a short statured variety were chosen for this investigation. Experiments were performed in two consecutive periods, a seedling period and a paddy field period, In the investigation of seedling period, rectangular galvanized iron evapotranspirometers (91cm${\times}$85cm${\times}$65cm) were set up in a way of two levels (PAL-TAL and TONG-lL varieties) with two replications. A standard fertilization method was applied to all plots. In the experiment of paddy field period, evapotanspiration and evaporation were measured separately. For PAL-TAL variety, the evapotranspiration measurements of 43 plots of rectangular galvanized iron evapotranspirometer (91cm${\times}$85cm${\times}$65cm) and the evaporation measurements of 25 plots of rectangular galvanized iron evaporimeter (91cm${\times}$85cm${\times}$15cm) have been taken for seven years (1966 through 1972), and for TONG-IL variety, the evapotranspiration measurements of 19 plots and the evaporation measurements of 12 plots have been collected for two years (1971 through 1972) with five different fertilization levels. The results obtained from this investigation are summarized as follows: 1. Seedling period 1) The pan evaporation and evapotranspiration during seedling period were proved to have a highly significant correlation to solar radiation, sun shine hours and relative humidity. But they had no significant correlation to average temperature, wind velocity and atmospheric pressure, and were appeared to be negatively correlative to average temperature and wind velocity, and positively correlative to the atmospheric pressure, in a certain period. There was the highest significant correlation between the evapotranspiration and the pan evaporation, beyond all other meteorological factors considered. 2) The evapotranpiration and its coefficient for PAL-TAL variety were 194.5mm and 0.94∼1.21(1.05 in average) respectively, while those for TONG-lL variety were 182.8mm and 0.90∼1.10(0.99 in average) respectively. This indicates that the evapotranspiration for TONG-IL variety was 6.2% less than that for PAL-TAL variety during a seedling period. 3) The evapotranspiration ratio (the ratio of the evapotranspiration to the weight of dry matters) during the seedling period was 599 in average for PAL-TAL variety and 643 for TONG-IL variety. Therefore the ratio for TONG-IL was larger by 44 than that for PAL-TAL variety. 4) The K-values of Blaney and Criddle formula for PAL-TAL variety were 0.78∼1.06 (0.92 in average) and for TONG-lL variety 0.75∼0.97 (0.86 in average). 5) The evapotranspiration coefficient and the K-value of B1aney and Criddle formular for both PAL-TAL and TONG-lL varieties showed a tendency to be increasing, but the evapotranspiration ratio decreasing, with the increase in the weight of dry matters. 2. Paddy field period 1) Correlation between the pan evaporation and the meteorological factors and that between the evapotranspiration and the meteorological factors during paddy field period were almost same as that in case of the seedling period (Ref. to table IV-4 and table IV-5). 2) The plant height, in the same level of the weight of dry matters, for PAL-TAL variety was much larger than that for TONG-IL variety, and also the number of tillers per hill for PAL-TAL variety showed a trend to be larger than that for TONG-IL variety from about 40 days after transplanting. 3) Although there was a tendency that peak of leaf-area-index for TONG-IL variety was a little retarded than that for PAL-TAL variety, it appeared about 60∼80 days after transplanting. The peaks of the evapotranspiration coefficient and the weight of dry matters at each growth stage were overlapped at about the same time and especially in the later stage of growth, the leaf-area-index, the evapotranspiration coefficient and the weight of dry matters for TONG-IL variety showed a tendency to be larger then those for PAL-TAL variety. 4) The evaporation coefficient at each growth stage for TONG-IL and PAL-TALvarieties was decreased and increased with the increase and decrease in the leaf-area-index, and the evaporation coefficient of TONG-IL variety had a little larger value than that of PAL-TAL variety. 5) Meteorological factors (especially pan evaporation) had a considerable influence to the evapotranspiration, the evaporation and the transpiration. Under the same meteorological conditions, the evapotranspiration (ET) showed a increasing logarithmic function of the weight of dry matters (x), while the evaporation (EV) a decreasing logarithmic function of the weight of dry matters; 800kg/10a x 2000kg/10a, ET=al+bl logl0x (bl>0) EV=a2+b2 log10x (a2>0 b2<0) At the base of the weight of total dry matters, the evapotranspiration and the evaporation for TONG-IL variety were larger as much as 0.3∼2.5% and 7.5∼8.3% respectively than those of PAL-TAL variety, while the transpiration for PAL-TAL variety was larger as much as 1.9∼2.4% than that for TONG-IL variety on the contrary. At the base of the weight of rough rices the evapotranspiration and the transpiration for TONG-IL variety were less as much as 3.5% and 8.l∼16.9% respectively than those for PAL-TAL variety and the evaporation for TONG-IL was much larger by 11.6∼14.8% than that for PAL-TAL variety. 6) The evapotranspiration coefficient, the evaporation coefficient and the transpiration coefficient and the transpiration coefficient were affected by the weight of dry matters much more than by the meteorological conditions. The evapotranspiratioa coefficient (ETC) and the evaporation coefficient (EVC) can be related to the weight of dry matters (x) by the following equations: 800kg/10a x 2000kg/10a, ETC=a3+b3 logl0x (b3>0) EVC=a4+b4 log10x (a4>0, b4>0) At the base of the weights of dry matters, 800kg/10a∼2000kg/10a, the evapotranspiration coefficients for TONG-IL variety were 0.968∼1.474 and those for PAL-TAL variety, 0.939∼1.470, the evaporation coefficients for TONG-IL variety were 0.504∼0.331 and those for PAL-TAL variety, 0.469∼0.308, and the transpiration coefficients for TONG-IL variety were 0.464∼1.143 and those for PAL-TAL variety, 0.470∼1.162. 7) The evapotranspiration ratio, the evaporation ratio (the ratio of the evaporation to the weight of dry matters) and the transpiration ratio were highly affected by the meteorological conditions. And under the same meteorological condition, both the evapotranspiration ratio (ETR) and the evaporation ratio (EVR) showed to be a decreasing logarithmic function of the weight of dry matters (x) as follows: 800kg/10a x 2000kg/10a, ETR=a5+b5 logl0x (a5>0, b5<0) EVR=a6+b6 log10x (a6>0 b6<0) In comparison between TONG-IL and PAL-TAL varieties, at the base of the pan evaporation of 343mm and the weight of dry matters of 800∼2000kg/10a, the evapotranspiration ratios for TONG-IL variety were 413∼247, while those for PAL-TAL variety, 404∼250, the evaporation ratios for TONG-IL variety were 197∼38 while those for PAL-TAL variety, 182∼34, and the transpiration ratios for TONG-IL variety were 216∼209 while those for PAL-TAL variety, 222∼216 (Ref. to table IV-23, table IV-25 and table IV-26) 8) The accumulative values of evapotranspiration intensity and transpiration intensity for both PAL-TAL and TONG-IL varieties were almost constant in every climatic year without the affection of the weight of dry matters. Furthermore the evapotranspiration intensity appeared to have more stable at each growth stage. The peaks of the evapotranspiration intensity and transpiration intensity, for both TONG-IL and PAL-TAL varieties, appeared about 60∼70 days after transplanting, and the peak value of the former was 128.8${\pm}$0.7, for TONG-IL variety while that for PAL-TAL variety, 122.8${\pm}$0.3, and the peak value of the latter was 152.2${\pm}$1.0 for TONG-IL variety while that for PAL-TAL variety, 152.7${\pm}$1.9 (Ref.to table IV-27 and table IV-28) 9) The K-value in Blaney & Criddle formula was changed considerably by the meteorological condition (pan evaporation) and related to be a increasing logarithmic function of the weight of dry matters (x) for both PAL-TAL and TONG-L varieties as follows; 800kg/10a x 2000kg/10a, K=a7+b7 logl0x (b7>0) The K-value for TONG-IL variety was a little larger than that for PAL-TAL variety. 10) The peak values of the evapotranspiration coefficient and k-value at each growth stage for both TONG-IL and PAL-TAL varieties showed up about 60∼70 days after transplanting. The peak values of the former at the base of the weights of total dry matters, 800∼2000kg/10a, were 1.14∼1.82 for TONG-IL variety and 1.12∼1.80, for PAL-TAL variety, and at the base of the weights of rough rices, 400∼1000 kg/10a, were 1.11∼1.79 for TONG-IL variety and 1.17∼1.85 for PAL-TAL variety. The peak values of the latter, at the base of the weights of total dry matters, 800∼2000kg/10a, were 0.83∼1.39 for TONG-IL variety and 0.86∼1.36 for PAL-TAL variety and at the base of the weights of rough rices, 400∼1000kg/10a, 0.85∼1.38 for TONG-IL variety and 0.87∼1.40 for PAL-TAL variety (Ref. to table IV-18 and table IV-32) 11) The reasonable and practicable methods that are applicable for calculating the evapotranspiration of paddy rice in our country are to be followed the following priority a) Using the evapotranspiration coefficients based on an expected yield (Ref. to table IV-13 and table IV-18 or Fig. IV-13). b) Making use of the combination method of seasonal evapotranspiration coefficient and evapotranspiration intensity (Ref. to table IV-13 and table IV-27) c) Adopting the combination method of evapotranspiration ratio and evapotranspiration intensity, under the conditions of paddy field having a higher level of expected yield (Ref. to table IV-23 and table IV-27). d) Applying the k-values calculated by Blaney-Criddle formula. only within the limits of the drought year having the pan evaporation of about 450mm during paddy field period as the design year (Ref. to table IV-32 or Fig. IV-22).

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.1-10
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• 1994

Background: Patients with mitral stenosis(MS) have been demonstrated to have a variable degree of pulmonary dysfunction and exercise impairment. The hemodynamic changes of MS can be reversed after percutaneous mitral balloon valvuloplasty(PMV), but the extent and time course of the imporvement in pulmonary function and exercise capacity are not defined. Methods: In order to investigate the early(3 weeks or less)and late(3 months or more) effects of PMV on pulmonary function and determine if the pulmonary dysfunction is reversible even in patients with moderate to severe pulmonary hypertension, we performed the spirometry, measurements of diffusing capacity and lung volumes, and incremental exercise tests in patients with MS before and after PMV. Results: In 46 patients with MS(age: $40{\pm}12$years, male to female ratio: 1:2, mitral valve area: $0.8{\pm}0.2cm^2$) there was a significant increase in FVC(P<0.0025), $FEV_1$(P<0.001), $FEF_{25-75%}$(P<0.001, $FEF_{50%}$(P<0.001), PEF(P<0.0005), MVV(P<0.005), $\dot{V}O_2$max (P<0.0001), and AT(P<0.0001) after average 10 days of PMV. Also there was a significant decrease in DLco(P<0.0001) and DL/VA(P<0.0001). At later($5{\pm}2$months) follow-up in 11 patients, there was no further improvement in any parameters of pulmonary function and exercise test. Twenty nine patients with sinus rhythm were divided into 16 patients with pulmonary arterial pressure(PAP) more than 35mmHg and/or tricuspid regurgitation grade n or more(group A) and 13 patients with PAP less than 35mmHg(group B). Group A Patients had significantly lower FVC(P<0.001), $FEV_1$(P<0.001), DLco(P<0.05), $\dot{V}O_2$ max(P<0.025) and mitral valve area(P<0.025) than group B patients. Group A patients after PMV, showed significant increase in FVC(P<0.001), maximum $O_2$ pulse(P<0.00001) and $\dot{V}O_2$ max(P<0.00025). Both group showed an increase in AT(P<0.0001, P<0.005), but group A showed greater decrease in $\dot{V}E/\dot{V}O_2$ and $\dot{V}E/\dot{V}CO_2$ both at AT(P<0.001, P<0.001) and $\dot{V}O_2$ max(P<0.0001, P<0.0001) after PMV compared with group B. Conclusion: These data suggest that patients with MS can show increased pulmonary function and exercise performance within 1 month after PMV. Patients with moderate to severe pulmonary hypertension had a significant increase in exercise performance compared with those with mild to no pulmonary hypertension and it is thought to be related to a significat decrease of ventilation for a given oxygen consumption at maximum exercise.