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Echocardiographic Diagnosis of Pulmonary Arterial Hypertension in Chronic Lung Disease with Hypoxemia (만성 저산소성 폐질환의 폐동맥 고혈압에 대한 심초음파 검사)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.846-855
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    • 1999
  • Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

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Effect of Supplementation of Fermented Milk Containing Active Peptides(IPP, VPP) in Accordance with Medical Nutrition Therapy in Pre- and Hypertension Subjects (고혈압 전단계 및 고혈압 환자에서 의학영양치료와 병행한 생리활성 펩티드 함유 유산균 발효유 섭취가 혈압에 미치는 영향)

  • Kim, Ji-Young;Kim, Yun-Young;Kim, Hye-Rang;Yun, Sung-Seob;Kim, Wan-Sik;Yea, Hyun-Soo;Chung, Jin-Young;Lee, In-Hoe;Choue, Ryo-Won
    • Journal of the East Asian Society of Dietary Life
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    • v.18 no.6
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    • pp.918-926
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    • 2008
  • It is well known non-drug therapy for hypertension patients can reduce blood pressure. These types of therapy include maintaining ones ideal body weight, quitting smoking, consuming large amounts of fruits and vegetables consuming low levels of saturated fat and salt and regular exercise. Fermented milk protein derived biologically active peptides such as isoleucine-proline-proline_(IPP) or valine-proline-proline_(VPP) have been shown to lower blood pressure in hypertensive subjects. This study was conducted to investigate the antihypertensive effects of medical nutritional therapy _(MNT) in accordance with the consumption of fermented milk enriched with IPP and VPP. To accomplish this, we conducted a randomized case-controlled study of 43 subjects who had blood pressure levels greater than 120/80 mmHg. The subjects in the study group were randomly allocated into two groups, an MNT + fermented milk (100mL/day) group (n=21) and an MNT+L. helveticus fermented milk with tripeptides (IPP=2.2mg, VPP=2.6mg/100mL) group (n=22). The MNT included weight management, reduction of sodium, total fat and saturated fat intake, increased intake of fruits and vegetables, and increased intake of low fat dairy products. The treatments were administered for 12 weeks during which time no drug interventions were conducted. The daily intakes of total calories, fats, cholesterol and Na decreased significantly after 12 weeks of MNT in the control and the experimental groups. In addition, the systolic blood pressure de creased significantly in the control and experimental groups; however, the diastolic blood pressure only decreased significantly in the experimental group. Overall, the results of this study indicate that the intake of fermented milk containing IPP and VPP in conjunction with MNT exerted positive effects on the blood pressure of pre- and hypertensive subjects.

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Comparison of Tiletamine/Zolanzepam, Xylazine - Tiletamine/Zolazepam and Medetomidine-Tiletamine/Zolazepam Anesthesia in Dogs (개에서 Tiletamine/Zolazepam, Xylazine-Tiletamine/Zolazepam과 Medetomidine-Tiletamine/Zolazepam의 마취효과)

  • Kwon, Young-Sam;Jeong, Jae-Hoon;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.33-41
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    • 2003
  • The cardiopulmonary and anesthetic effects of tiletamine/zolazepam(TZ, 10 mg/kg IV), xylazine-tiletamine /zolazepam(XTZ, X: 1.1 mg/kg IM, TZ: 10 mg/kg IV) and medetomid-ine-tiletamine/zolazepam(MTZ, M: 30$\mu\textrm{g}$/kg IM, TZ: 10 mg/kg IV) were evaluated to 15 healthy mongrel dogs (4.16$\pm$0.65 kg). These dogs were randomly assigned to the three treatment groups(Control, XTZ, MTZ) with 5 dogs in each group. All experimental animals were premedicated with atropine(0.03 mg/kg, IM). Xylazine or medetomidine were administered to dogs in XTZ group and MTZ group 10 minutes after atropine injection. TZ was administered 20 minutes after atropine injection in all groups. The loss of pain response at pedal reflex and ear pinching tests in XTZ and MTZ groups were much longer compared with those of Control group(P < 0.01). All dogs in this study showed head rocking and hypersalivation during recovery time. Body temperature decreased progressively during experimental period in all groups, but it was not significant. After TZ injection, heart beat rate significantly increased 10 and 20 minutes in Control group, and 20 and 40 minutes in XTZ group(P < 0.05). Respiratory rate significantly decreased 0,10,20 and 40 minutes after 72 injection in XTZ and MTZ groups. In Control group, systolic arterial pressure (SAP) 20 minutes. diastolic arterial pressure(DAP) 10 minutes and mean arterial pressures (MAP) 10 and 20 minutes after 72 injection significantly decreased(P < 0.05). In XTZ group, SAP, DAP and MAP significantly decreased 20 and 40 minutes after 72 injection(P < 0.05). Thus, it was considered that XTZ and MTZ were useful in a canine surgical treatment that requires long anesthetic duration and deep analgesia.

Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: Protocol for a Randomized Controlled Pilot Trial (폐경 후 여성의 전단계 및 1기 고혈압에 대한 침 치료: 다기관 무작위 대조 예비연구)

  • Kim, Jung-Eun;Choi, Jin-Bong;Kim, Hyeong-Jun;Kang, Kyung-Won;Liu, Yan;Jung, Hee-Jung;Lee, Min-Hee;Shin, Mi-Suk;Kim, Jae-Hong;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.5-13
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    • 2014
  • Objectives : This study aims to evaluate the effectiveness and safety of acupuncture and explore the appropriate number of treatment for postmenopausal women diagnosed with prehypertension and stage 1 hypertension. Methods : A 4-arm randomized open label pilot trial will be performed at 2 centers. Sixty participants will be divided into 2 treatment groups and 2 control groups. Treatment groups will receive acupuncture at 8 points(bilateral GB20, LI11, ST36, SP6) for 4 weeks(treatment group A, 10 total sessions) or 8 weeks(treatment group B, 20 total sessions), while maintaining usual care. Control groups will not receive acupuncture but will be under usual care for 16 weeks(control group C) or 20 weeks(control group D). Each patient's living habits will be corrected and drugs that may affect blood pressure(BP) will be prohibited. Treatment group A and control group C will be evaluated at 4, 8, 12, and 16 weeks after randomization, while treatment group B and control group D will be evaluated at 4, 8, 12, 16, and 20 weeks after randomization. The major outcome variable is the magnitude of change in diastolic BP levels at 4 weeks after randomization; auxiliary outcome variables are (1) diastolic BP change at 8, 16, and 20 weeks, (2) systolic BP change, (3) BP control rate, (4) lipid profiles, and (5) high-sensitivity C-reactive protein. Patient safety will be assessed at every visit. Results and Conclusions : The study findings may help develop evidence for the effectiveness and safety of acupuncture for BP control.

An Association of Changed Levels of Inflammatory Markers with Hematological Factors during One-time Aerobic Exercise in Twenty-aged Young Men (20대 젊은이들에 있어 1회성 유산소운동 시 염증 표지자와 혈액변인들 간의 상관관계)

  • Hyun, Kyung-Yae
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1658-1665
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    • 2009
  • This study was carried out on thirty men to define the association of inflammatory markers with physiological factors on one-time aerobic exercise (for 15 min. Post-exercise interleukin-6 (IL-6), mean corpuscular hemoglobin concentration (MCHC), heart rate (HR), systolic blood pressure (SBP), and pulsatility and resistance index of middle cerebral artery (PI and RI, respectively) levels were elevated compared to those measured pre-exercise. Total leukocyte and platelet counts, high-sensitivity C-reactive protein (hs-CRP), free radical (FR), and low density lipoprotein cholesterol (LDL) levels tended to decrease after exercise. Pre-exercise IL-6 levels were positively correlated with pre-exercise SBP levels, while post-exercise IL-6 level was positively correlated with post-exercise PI and RI levels. Post-exercise, hs-CRP levels were negatively related to SBP and HR. Pre-exercise, FR levels were positively associated to SBP, DBP, and HR. Post-exercise FR levels were negatively related to the post-exercise blood flow velocity in middle cerebral artery. Pre-exercise erythrocyte indices (RBC, MCV, MCH, and MCHC levels) were in inverse proportion to pre-exercise IL-6 levels. Post-exercise FR levels were inversely related to post-exercise total leukocyte, lymphocyte, monocyte, and MCH levels. Pre-exercise $Mg^{++}$ levels were in inverse proportion to pre-exercise IL-6, hs-CRP, or FR levels. These findings suggest that one-time aerobic exercise offers a significant relationship between inflammatory markers and some biochemical markers or electrolytes. Further studies need to be carried out for investigation of differences between genders or age groups following one-time or regular aerobic exercise.

Nutritional and Health Status of the Elderly Living in Songnam - I. Anthropometric Measurements and Biochemical Nutritional Status - (성남지역 노인의 영양 및 건강상태 조사 I. 신체 계측 및 생화학적 영양상태)

  • 권종숙;이홍재
    • The Korean Journal of Food And Nutrition
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    • v.16 no.4
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    • pp.310-320
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    • 2003
  • To study the nutritional and health status of the elderly in Songnam, the anthropometic measurments, fat composition of body(FAT), blood pressure(BP) and blood test for analyzing biochemical indies of the elderly in seongnam were carried out in 338 free-living elderly (161 men, 177 women) aged from 58 to 92. Anthropometric measurements and blood pressure were assessed, and body fat was analyzed by BI(Bioelectrical Impedence) method. Biochemical measurements including blood glucose(BG), GPT, serum total cholesterol(TC) and albumin(AL) were analyzed. Average heights of the subjects were lower than the standards established in the Korean Recommended Dietary Allowances, and average weights were similar to the standards. FAT were significantly higher in women(36.4%) than men(27.7%), and both groups showed higher values than the reference. Mean systolic BP levels of men and women were 153.3mmHg and 153.7mmHg, and diastolic BP levels were 87.5mmHg and 86.0mmHg, respectively, and there were no significant differences between the sex. Mean BG levels of men and women were 115.9mg/㎗ and 123.7mg/㎗, respectively, and there were no significant differences between the sex and among the age groups. Mean GPT levels of men and women were 19.4unit and 18.1unit, respectively, and women older than 75 years showed significanly low levels of GPT compared to other women's age groups. Mean TC levels of men and women were 186.0mg/㎗ and 206.6mg/㎗, respectively, and significantly higher TC levels were shown in women than men. Mean AL levels of men and women were 4.8g/㎗ and 4.8g/㎗, respectively, and men aged 50 ∼ 64 years showed significant high AL levels compared to other age groups of men. It was suggested that nutrition education program was a good way to improve health status of the elderly.

Effects of a 12-week, school-based obesity management program on obese primary school children (12주간의 학교 비만 관리 프로그램이 초등학교 비만 아동에 미치는 효과)

  • Kim, Han Gyu;Lim, Goh-woon;Kim, Hae Soon;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.335-340
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    • 2010
  • Purpose : This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods : A total of 995 children (6-2 years old) in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI) ${\geq}95$ percentile) were enrolled for a study group. The schoo-lbased, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP), and bioelectrical impedance analysis (BIA) was performed before and after the program.Results : Height and weight increased significantly (P <0.05). The BMI and obesity index decreased significantly (P <0.01). Systolic and diastolic BP decreased significantly (P <0.01). BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR) increased significantly on the BIA (P <0.01). Fat decreased significantly (P <0.05). The total body water (TBW) and percent body fat (PBF) decreased significantly (P <0.01). The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P <0.05). In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P <0.01). Conclusion : The school-based obesity management program is a very effective way to manage obesity for obese primary school children.

Angiotensin Converting Enzyme Inhibition and Antihypertensive Effects of Phyllostachys pubescens Culm Extracts in Spontaneously Hypertensive Rats (맹종죽 줄기 추출물을 투여한 본태성 고혈압 쥐(SHR)의 ACE 저해 활성 및 혈압 강하 효과)

  • Kim, Jung-Suk;Kim, Mi-Jeong;Park, Min-Hee;Ryu, Bog-Mi;Moon, Gap-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.1
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    • pp.27-34
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    • 2008
  • This study investigated the anti-hypertensive effect of Phyllostachys pubescens culm extract (PCE) by examining its effects on renal angiotensin-converting enzyme (ACE) inhibition and blood pressure using the spontaneously hypertensive rat (SHR) system. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured weekly for 8 weeks. Also, total antioxidant capacity and protein oxidation of tissues were examined by plasma Trolox Equivalent Antioxidant Capacity assay (TEAC) and hepatic protein carbonyl values, respectively. Twenty male SHR were randomly divided into four groups: PCE50, PCE100, and PCE500 (50, 100, and 500 mg of PCE per kilogram bodyweight daily, respectively), and control group. At week 2, the SBP in all PCE groups appeared to be significantly lower than the control (p<0.05), whereas the DBP were not different until week 4 (p<0.05). At week 8, SBP in the PCE500 was lower by 20% than the control. PCE groups considerably suppressed ACE dose-dependently compared with the control. Plasma TEAC and hepatic protein carbonyl values indicated increased antioxidative activity due to the PCE feed. No adverse effect was observed on the liver of SHR as there was no difference for the GOT and GPT values among the groups. Results of this study suggest that ACE inhibition may be one possible mechanism for the blood pressure lowering effect of PCE; thus, long term consumption of PCE may be beneficial in preventing high blood pressure along with the increased antioxidative status.

Effect of Fish Oil Diet on Blood Pressure and Lipid Metabolism in Spontaneously Hypertensive Rat -Changes in Serum Lipid Status- (어유식이가 본태성고혈압쥐(SHR)혈압 및 지질대사에 미치는 영향 -혈청지질상태를 중심으로-)

  • Shin, Eung-Nam;Bae, Bok-Seon;Lee, Won-Jong;Cho, Sung-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.18 no.1
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    • pp.1-13
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    • 1989
  • The present study was designed to examine the effect of dietary fish oil on blood pressure and lipid status of serum. Weanling SHRs and normotensive Wistars were fed a diet containing 5%(w/w) mackerel oil(MO), soybean oil(SO) or beef tallow(BT) for 8 weeks. Growth rate was not significantly different among three dietary groups, but that of SHRs was silightly lower than that of Wistars. SHRs showed higher systolic blood pressure than Wistar rats from the beginning and become hypertensive (over 150mmHg) after 6 week s of feeding period. The MO group of SHRs showed the lowest blood pressure at the 8th week of feeding period but that of Wistars showed similar values with other groups. Tissue weights of liver, heart and kidney were not different amongdietary aroups in Wistars and SHRs. However, heart and kidney weights of SHRs were significantly higher than those of Wistars. Microscopic examination revealed that endomysium of heart tissue and urinary space of kidney were narrowed in SHRs. Serum total and HDL-cholesterol showed similar values among three different dietary fat groups but triglyceride levels were significantly low in MO groups. HDL-cholesterol levels of SHRs were lower than those of Wistars, as well as the fractions of total HDL, the sum of HDL and $HDL_{2+3}$, while VLDL fractions were higher in SHRs. MO groups had the lower values of $HDL_1,\;HDL_{2+3}$ratio than SO and BT groups. Major dietary fatty acids were more or less incorporated into serum phospholipid and triglyceride, resulting in the characteristic fatty acid profile of each dietary group. Incorporation of $C_{18:2}({\omega}_6)$ in SO groups were pronounced, but the degree of incorporation was lower in SHRs. In Mo groups, $C_{22:6}({\omega}_3)$ levels were inreased in triglyceride. It is suggested that these changes in serum lipid fatty acid composition are related to the different patterns of serum lipid by alteration of dietary fats.

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Social Networks and hypertension in Some rural residents Aged 60-64 (일부 60~64세 농촌 인구에서 사회조직망과 고혈압)

  • Lee, Choong-Won;Cho, Hee-Young;Lee, Mi-Young;Kim, Gui-Yeon;Park, Jong-Won;Kang, Mi-Jung;Suh, Suk-Kwon
    • Journal of agricultural medicine and community health
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    • v.23 no.2
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    • pp.229-242
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    • 1998
  • Face-to-face interviews were carried out to investigate the relationship between social networks and hypertension in 958 rural residents(males=440, females=518) aged 60-64 of a community-dwelling sample of Dalsung County from April to September in 1996. Eight elements of social network were measured : marital status, regular religious attendance, membership in groups, number of friends, relatives, siblings, children, grandchildren. Hypertensives were defined as meeting at least one of following criteria : hypertension history, systolic blood pressure more than 160 mmHg, diastolic blood pressure more than 95 mmHg. In univariate logistic regression for males, having 1-4 friends vs. none showed odds ratio 0.43 (95% Confidence interval CI 0.19-0.96) and having 2-3, 4 and more than 5 children had reduced prevalence of hypertension with odds ratios 0.21 (95% CI 0.06-0.72), 0.14 (95% CI 0.04-0.49), 0.24 (95% CI 0.07-0.82), respectively when compared with persons without children. In females, there was no elements of social network statistically significant. Having 5-9 grandchildren vs. none showed a marginally significant odds ratio 0.42. In multivariate logistic regression models for males with adjustment for age, education, body mass index, smoking and drinking, number of friends and children showed increased odds ratios and number of close relatives gained a statistically significant odds ratios (0.44-0.50). In females, the adjustment yielded little changes of odds ratios except number of grandchildren which gained a statistically significance. These results suggest that only a certain elements of social network may be associated with reduced risk of hypertension and they may be different between genders in rural resident aged 60-64.

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