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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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Salt-Related Dietary Behaviors and Sodium Intakes of University Students in Gyeonggi-do (경기지역 대학생의 소금 관련 식행동 및 나트륨 섭취량)

  • Chung, Eun-Jung;Shim, Eu-Gene
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.5
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    • pp.578-588
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    • 2008
  • The objective of this study was to evaluate associations of dietary sodium (Na) intake with salt-related dietary behaviors of 218 university students (95 men; 123 women) living in Gyeonggi area. Dish frequency questionnaire (DFQ) was used to identify salt-related dietary behaviors and to determine Na intakes. In men, systolic & diastolic blood pressures, Na intakes and DFQ-15 scores were significantly higher than in women. High-salt intake group (HS), classified by DFQ-15, had higher scores of high-salt dietary attitude and more Na intakes than low-salt intake group (LS). HS took protein foods and had balanced diets less frequently than LS (p<0.05). HS had fried dishes & fatty meats, and added salt to dishes more frequently (p<0.05). HS and LS had differences in preference of soy-boiled and Chinese or Japanese foods, in intake frequency of bean-paste soup, in use of soy sauce with fried food or raw fish, and in salt addition to dishes at the table (p<0.05). HS, classified by Na intakes, had high-salt dietary attitudes such as preference of seasoned rice & soy-boiled foods and habitual addition of soy sauce or salt to dishes at the table. The subjects using food labels when purchasing had better salt-related attitudes & behaviors, and lower DFQ-15 scores & Na intakes than the non-users (p<0.01). Self-assessed HS (SHS) had worse salt-related attitudes and behaviors (p<0.05). Male self-assessed LS (SLS) had higher Na intakes, which indicated that self-assessment of salt preference did not actually reflect Na intake. In summary, male university students belonged to a high-risk group of salt intakes, and HS preferred soy-boiled foods or fatty dishes, frequently added salt to dishes and rarely had balanced diets. These results suggest that nutrition education programs for university students should include fundamental dietetics and a balanced diet, in addition to a low-Na diet.

Electrocardiographic and Echocardiographic Characterisitics of Wolff-Parkinson-White Syndrome in Preschool Children (학동전 아동에서 Wolff-Parkinson-White 증후군의 심전도 소견에 따른 유형 및 심초음파 소견)

  • Chu, Jeoung Min;Sim, Hyun Sup;Cho, Soo Chul;Joo, Chan Uhng
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1097-1105
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    • 2002
  • Purpose : This study was conducted to estabilish the prevalence, clinical features and relationship between ECG findings and echocardiographic findings of Wolff-Parkinsion-White(WPW) syndrome in asymptomatic preschool children. Methods : An electrocardiographic screening study was performed on 77,824 preschool children in Jeonbuk province from April, 1999 to August, 2001. Patients with WPW syndrome underwent echocardiographic study. Results : Twenty three patients with WPW syndrome were discovered by electrocardiographic screening of preschool children. The prevalence rate was 2.9 per 10,000 preschool children and there was no significant sexual difference. Two patients had a history of symptoms related to tachyarrythmia. According to the ECG classification of Rosenbaum et al., five patients were type A and 18 were type B. Utilizing the criteria of Gallagher et al, right anterior, 12 patients; right anteiror paraseptal, four patients; left anteiror, three patients. Nineteen of 23 patients underwent echocardiographic study. Four of five patients with type A WPW syndrome had abnormal early systolic anterior motion of left ventricular posterior wall. Twelve of 14 patients with type B had abnormal interventricular septal motion characterized by early sytolic posterior motion immediately after inscription of the delta wave. Conclusion : The prevalence rate of preschool children in Jeonbuk province was 2.9/10,000. By the classification according to the electrocardiographic findings, the accessory pathway location was dominant right side than left side. In the echocardiographic study, type A WPW syndrome showed abnormal left ventricular posterior wall motion and type B WPW showed abnormal interventricular septal motion.

Angiotensinogen gene M235T polymorphism as a predictor of cardiovascular risk in hypertensive adolescents (고혈압 청소년의 심혈관계 위험요소로서 Angiotensinogen M235T 유전자 다형)

  • Gil, Joo Hyun;Lee, Jung Ah;Park, Eun Young;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.36-43
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    • 2009
  • urpose : The renin-angiotensin system (RAS) has been demonstrated to play a major role in regulating blood pressure. Therefore, components of the RAS are likely candidate genes that may predispose an individual to essential hypertension and cardiovascular complications. Among them, the M235T polymorphism of the angiotensinogen gene has been speculated to be associated with elevated circulating angiotensinogen concentrations and essential hypertension. This study aimed to analyze the angiotensinogen M235T polymorphism in hypertensive adolescents and investigate its relationship with cardiovascular risks. Methods : Forty Korean hypertensive adolescents (aged 16-17, systolic $BP{\geq}140 mmHg$ and/or diastolic $BP{\geq}90 mmHg$) and fifty seven normal adolescents were included. Obesity index (OI), body mass index (BMI) were calculated. BP was measured by oscillometric methods in resting state. Polymerase chain reaction (PCR) technique was performed on DNA from the hypertensives subjects to analyze the M235T polymorphism. Serum homocysteine, insulin, renin, aldosterone and angiotensin converting enzyme (ACE) were tested according to each genotype. The carotid intima-media thickness (IMT) and carotid artery diameter, Pulse wave velocity (PWV) and ankle-brachial index (ABI) were measured according to each genotype. Results : Genotype frequencies of T/T, M/T and M/M were 62.5%, 35.0%, 2.5%, respectively in hypertensive adolescents. The results were not significantly different compared to control group. Serum insulin, renin levels, BMI and OI were significantly higher in thoses with the M/M genotype as compared to those with the T/T of M/T genotype. Conclusion : This study showed that the M235T polymorphism was not associated with essential hypertension or any cardiovascular risks. Further clinical research is required to ascertain the relationship between this polymorphism and cardiovascular complications in Korean hypertensive adolescents.

Evaluation of short-term cardiac function by tissue Doppler imaging in pre and postoperative period of congenital heart disease (조직 도플러 영상을 이용한 선천성 심장병 수술 전후의 단기 심기능 평가)

  • Lee, Jun-Hwa;Kim, Yeo-Hyang;Hyun, Myung-Chul;Lee, Sang-Bum
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.476-483
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    • 2007
  • Purpose : The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease. Methods : This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio. Results : The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05). Conclusion : This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.

Cardiovascular and Perceived Exertion Response to Treadmill Running and Cycle Ergometer Exercise in Responder and Nonresponder Acute Coronary Syndrome Patients (심장재활에 참여한 급성 관상동맥증후군 환자에서 약물 반응과 운동 형태의 변화에 따른 심혈관과 운동자각도의 반응)

  • Kim, Young-Joo;Kim, Chul-Hyun
    • Journal of Life Science
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    • v.18 no.9
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    • pp.1263-1270
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    • 2008
  • The purpose of this study is to investigate the effect of exercise mode and anti-hypertensive drug responding status on the cardiovascular response and perceived exertion in acute coronary syndrome (ACS) patients. Seventy-five patients who participated in six-week exercise rehabilitation therapy performed a treadmill running and a cycle ergometer exercise at intensities of 60%HRR and 85%HRR respectively. Systolic and diastolic blood pressure, mean arterial blood pressure (MAP), rate pressure production (RPP), and ratings of perceived exertion (RPE) were measured. The results of cardiovascular response by the different exercise modes with moderate and intensive intensity of anti-hypertensive drug responder and nonresponder ACS patients were following: First cycle ergometer exercise induced significantly higher SBP, DBP, MAP, RPP and MAP than treadmill running exercise at the intensities of 60%HRR and 85%HRR in both anti-hypertensive responder and nonresponder ACS patients (p<0.05). Secondly anti-hypertensive nonresponder ACS patients had significantly higher DBP and MAP that anti-hypertensive responder ACS patients at all the exercise modes (p<0.05). Finally there was no difference of RPP between anti-hypertensive responder and nomresponder ACS patients, although anti-hypertensive nonresponder ACS patients showed higher blood pressure and RPP than anti-hypertensive responder ACS patients. In conclusion, cycle ergometer induced increased cardiovascular response at same intensities of treadmill running exercise and anti-hypertensive nonresponder ACS patients had even more increased cardiovascular response than anti-hypertensive responder ACS patients with no difference in perceived exertion during exercise. These results suggested that cycle ergometer exercise should be greatly careful with the risk of higher blood pressure, especially for those who are patients with hypertensive blood pressure.

Separate and Combined Effect of Cadmium and Nickel on Blood Pressure in Rats (흰쥐에서 카드뮴과 니켈이 혈압에 미치는 효과)

  • Cha, Bong-Suk;Wang, Seung-Jun
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.2
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    • pp.127-130
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    • 2001
  • Objective : To verify the separate and combined effects of cadmium and nickel on blood pressure in rats. Methods : Following the daily administration of cadmium chloride$(CdCl_2)$ and nickel chloride$(NiCl_2)$ to rats both individually and in combination with intraperitoneal injection method for one week, systolic blood pressure of the tail was measured at 1 day and 5, 10, 20, 30 days after administration. Each substance was injected into the rats with 0.1 mg/kg bw and 1.0 mg/kg bw concentration. Results : After 0.1 mg/kg bw $CdCl_2$ was injected, a statistically significant difference was found as compared with the control group(only saline) after 1, 5 and 10 days. After 0.1 mg/kg bw $NiCl_2$ was injected, a statistically significant difference was not found compared with the control group. After 0.1 mg/kg bw $CdCl_2$ and 0.1 mg/kg bw $NiCl_2$ were injected simultaneously, a statistically significant difference was found as compared with the control group after 1,5 and 10 days and compared with 0.1 mg/kg bw $CdCl_2$ group after 5 days and as compared with 0.1 mg/kg bw $NiCl_2$ group after 5 and 10 days. After 1.0 mg/kg bw $CdCl_2$ was injected, a statistically significant difference was found as compared with the control group after 1, 5, 10 and 20 days. After 1.0 mg/kg bw $NiCl_2$ was injected, a statistically significant difference was found as compared with the control group after 1 day and 5 days. After 1.0 mg/kg bw $CdCl_2$ and 1.0 mg/kg bw $NiCl_2$ were injected in combination, a statistically significant difference was found after 1, 5, 10, 20 and 30 days as compared with 1.0 mg/kg bw $CdCl_2$ after 10, 20 and 30 days and as compared with 1.0 mg/kg bw $NiCl_2$ after 5, 10, 20 and 30 days. Conclusion : It was found that the effect of $CdCl_2$ on blood pressure was much more than $NiCl_2$ and a high concentration $CdCl_2\;and\;NiCl_2$ in combination delayed the recovery of blood pressure.

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A Study on Health Status of the 1,559 Korean Applicants Applying for the Coal Miners in West Germany during the Year of 1972 and 1973 (우리나라 독일광부(獨逸鑛夫) 지원자(志願者)에 대(對)한 건강상태(健康狀態)에 관(關)한 조사연구(調査硏究))

  • Jun, Hyun-Sook;Choi, Sam-Sup
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.383-393
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    • 1974
  • The importance of the health care for the miners not only concerns the productivity of the enterprises but also as a fundamental human right, it has to be secured and protected by the society and the government. The Korean coal miners began to find their works at overseas since 1963 when the Korean government selected and dispatched its miners to West Germany. As years go by, the demand and the supply of the coal miners, the program of the coal miners health care became the important tasks to be solved and the further studies and research were necessary to support these tasks achievement. The writers made a statistical analysis on health status of the 1,559 Korean applicants applying for the coal miners in West Germany during the year of 1972 and 1973 by the using of the data of physical examination which were directed by the Korea Overseas Development Cooperation. The standard of physical examination which was applied for coal miners applying the jobs in West Germany was authorized by the Government Office of Labor in 1967. The results are as following; 1. The applicants were from the various provinces throughout Korea; Gang Weon 50.2%, Jeon-Nam 16.8%, Chung-Nam 13.7%, Gyeong-Nam 10.5%, City of Seoul 5.4%, and others 3.7%. 2. The ages of the applicants were from 20 to 44. The age group of 25-29(36.3%) and of 30-34(55.2%) together occupied the 91.5 per cent of the total applicants. 3. Among the 1,559 applicants 52.1 per cent passed the physical examinations. The tendency were shown that as the age increased, the passing rate decreased, and the married applicnts had lower passing rates compared to the unmarried applicants. 4. The height of the applicants averaged $168.4{\pm}4.74(cm)$ and the weight averaged $61.3{\pm}5.65(kg)$. 5. The average vision of the left eye of the applicants was $0.92{\pm}0.23$ and the right eye was $0.91{\pm}0.30$. 6. The mean value of the systolic blood pressure of the applicants was $145{\pm}13(mmHg)$ and the diastolic blood pressure was $85{\pm}8(mmHg)$. 7. Fifteen hundred and fifty-nine applicants were taken chest X-ray and 17.2 per cent were found abonrmal. For each 1,000 applicants, 46 Pulmonary calcification and fibrosis, 45 chronic bronchitis, 27 pleural thickening and adhesion, 20 pulmonary tuburculosis, 11 anomalies of the rib, 10 pulmonary infiltration and 21 others diseases were found. 8. Lumber X-ray examination showed that 23.9 per cent (372 applicants) were found abnormal. For each 1,000 applicants, 77 osteoarthritis, 56 lumbarization, 15 fracture of vertebrae, 15 spondyloarthritis, 14 deformity of vertebrae, 13 spina bifida, 12 sacralization, 12 spondylolysis, and 5 others diseases were found. 9. In total, 47.9 per cent of 1,559 applicants failed the physical examinations, and the main causes for the failure were shown to be 7.1% of anomalies of spine, 6.3% of osteoarthritis, 4.7% of pulmonary calcification and fibrosis, 4.6% of chronic brochitis, 3.6% of hypertension (only), 3.4% of fracture of vertebrae. 3.1% of underweight(under 57.0kg), 2.0% of spondyloarthritis, 2.0% oe pulmonary tuberculosis, 1.7% of pleurisy, 1.0% of spina bifida, 1.5% of syphilis, 1.5% of color blindess, and 1.0% of underheight(under 160.0cm).

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TI-201 Redistribution SPECT and N-13 Ammonia PET Images in Patients with Old Myocardial Infarction and Left Ventricular Dysfunction: Segmental Comparison and Discordance Analysis (좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 TI-201 재분포 SPECT와 휴식기 N-13 Ammonia PET: 분절 비교 및 불일치 분석)

  • Choi, Joon-Young;Lee, Kyung-Han;Kim, Young-Hwan;Lee, Eun-Jeong;Chung, Hyun-Woo;Lee, Su-Jin;Lee, Sang-Hoon;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.218-224
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    • 2004
  • We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose dipyridamole - 4hr redistribution TI-201 SPECT showed one or more severe fixed defects. Regional perfusion and metabolism were evaluated visually and quantitatively with 5-segment myocardial model. Results: There were high concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis (R=0.81, p<0.001) between redistribution TI-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients showed SPECT-PET discordant pattern with abnormal TI-201 defect and near normal N-13 ammonia uptake (Group II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted in PET images with severe inferior wall defects nearly identical to those seen in redistribution TI-201 SPECT images. Conclusion: Redistribution TI-201 SPECT images showed high concordant rate and correlation with rest N-13 ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left hemidiaphragm and cardiac blood pool.

Effects of Antihypertensive Drugs on Renal Function and Glomerular Morphology in Chronic Renal Failure Rats (만성신부전 백서에서 항고혈압제의 종류에 따른 신부전의 진행과 사구체의 형태학적 변화)

  • Hong Sung-Jin;Kim Kyo-Sun;Kim Pyung-Kil;Park Kyung-Hwa;Kim Kee-Hyuck
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.169-177
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    • 2002
  • Purpose: Hypertension accelerates the progression of chronic renal disease, whether it results from, or causes, the renal disease. Therefore, the control of hypertension is one of the important factors that retard the rate of renal deterioration. We compared the effects of different antihypertensive agents on renal function and glomerular morphology In subtotal nephrectomized rats. Materials and methods: After induction of chronic renal failure with 5/6 nephrectomy, the rats were divided into three groups; control group (Group C), enalapril group (Group E), and nicardipine group (Group N). Systolic blood pressure was measured by tail cuff method every 4 weeks until 12 weeks after nephrectomy. At 12 weeks after nephrectomy, all rats were placed in metabolic cages for 24 hour urine collections to measure urinary protein and creatinine excretion. After urine collection and blood sampling for serum creatinine, all rats were sacrificed. The renal tissue was processed for morphometric study with light microscope and electron microscope. Results: 1. The blood pressure of Group C increased progressively, but both enalapril and nicardipine prevented the development of hypertension, and the two drugs were equally effective in maintaining normal blood pressure throughout the study. 2. Twenty-four hour urinary protein excretion was lower in Group E compared to Group C and Group N 3. Mesangial expansion score in both treated groups were significantly lower than the control group. Mean glomerular volume in Group E was significantly reduced compared to Group C and Group N. There was no significant difference in mean glomerular volume between Group C and Group N. 4. There was no significant difference in podocyte structural changes, estimated by filtration slit length density, among control, enalapril and nicardipine treated groups. Conclusion: Control of hypertension with enalapril or nicardipine afforded considerable protection from mesangial expansion in the rat remnant kidney model. But protein excretion and glomerular growth were significantly reduced in Group E compared to Group N. There was no significant difference in podocyte structural changes among the 3 groups.

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