• Journal of Nutrition and Health
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• v.50 no.1
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• pp.98-110
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• 2017

Purpose: The purpose of this study was to evaluate the dietary potassium intake, Na/K intake molar ratio, consumption of 18 food groups, and foods contributing to potassium intake of Korean adults as well as the relationships among quartile of potassium intake level and blood pressure, blood biochemical index. Methods: This study was conducted using the Korea National Health and Nutrition Examination Survey, 2007~2010. The total number of subjects was 20,291. All analyses were conducted using a survey weighting to account for the complex survey design. Results: Overall average intakes of potassium were 2,934.7, 3,070.6, 3,078.1, and 3,232.0 mg/day, and they significantly increased by year in Korean adults. The average dietary potassium intake was close to adequate intake (AI), whereas that of women was considerably lower than the AI. The Na/K intake molar ratio in males (2.89~3.23) was higher than in females (2.62~2.95). The major food groups contributing to potassium intake were vegetables, cereals, and fruits/meats. The two major foods contributing to potassium intake were polished rice and cabbage kimchi. The rankings of food source were as follows; polished rice > cabbage kimchi > potato > oriental melon > sweet potato > seaweed > radish > apple > black soybean. In 50~64 year old females, systolic blood pressure (SBP) significantly decreased (p < 0.01) and HDL-cholesterol significantly increased (p < 0.05) as potassium intake increased. Triglyceride (TG) was significantly higher in the other quartile of potassium intake level than in the first quartile (p < 0.05). Conclusion: In conclusion, our study suggests the need for an appropriate set of dietary reference intakes according to caloric intake by sex and age groups and for development of eating patterns to increase potassium intake and decrease sodium intake.

• Journal of Nutrition and Health
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• v.51 no.3
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• pp.228-241
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• 2018

Purpose: The health risk of women increases after menopause. This study evaluated the effectiveness of a public health center-based nutrition education program for hypertension in women older than 50 years of age. Methods: The program included 8-week nutrition education and 8-week follow-up with keeping a health diary and nutrition counseling. The program was evaluated three times: before and after the nutrition education, and after the follow-up. The subjects were classified into hypertensives (n = 44) or normotensives (n = 71). Results: The rate of taking antihypertensive drugs in the hypertensive group was 86.4%. The systolic blood pressure decreased in the hypertensive and normotensive groups after nutrition education (p < 0.05). The body weight (p < 0.001), BMI (p < 0.001), waist circumference (p < 0.001), and percent body fat (p < 0.01) were also decreased after nutrition education in both groups. The hypertensive group showed an increase in HDL-cholesterol level (p < 0.001) and decreases in triglycerides (p < 0.01) and LDL-cholesterol (p < 0.05) levels after completion of the program. The normotensive group also displayed significant changes in HDL-cholesterol (p < 0.001) and triglycerides (p < 0.01). The dietary habits and nutrition knowledge on sodium and hypertension were improved in both groups (p < 0.001). The total score of dietary behavior related to the sodium intake was improved in the normotensive group (p < 0.001). The total score of the high sodium dish frequency questionnaire decreased in both groups after nutrition education and completion of the program compared to that before the program. Decreases in the consumption frequencies of noodles, pot stews and stews, Kimchi, and beverages were significant. The total self-efficacy score was increased in both groups by the program (p < 0.001). In particular, the hypertensive group showed improvement in all items. Conclusion: This public health center-based nutrition education program may contribute to the prevention and management of hypertension and chronic diseases in women over 50 years of age.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.827-836
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• 1998

Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.837-844
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• 1998

Background: Adenosine is secreted by myocardial cells during myocardial ischemia or hypoxia. It has many beneficial effects on arrhythmias, myocardial ischemia, and reperfusion ischemia. Although many investigators have demonstrated that cardioplegia that includes adenosine shows protective effects in myocardial ischemia or reperfusion injury, reports of the optimal dose of adenosine in cardioplegic solutions vary. We reported the results of beneficial effects of single dosage(0.75 mg/Kg/min) adenosine by use of self-made Langendorff system. But it is uncertain that dosage was optimal. The objective of this study is to determine the optimal dose of adenosine in cardioplegic solutions. Material and Method: We used a self-made Langendorff system to evaluate the myocardial protective effect. Isolated rat hearts were subjected to 90 minutes of deep hypothermic arrest(15$^{\circ}C$) with modified St. Thomas' Hospital cardioplegia including adenosine. Myocardial adenosine levels were augmented during ischemia by providing exogenous adenosine in the cardioplegia. Three groups of hearts were studied: (1) group 1 (n=10) : adenosine - 0.5 mg/Kg/min, (2) group 2(n=10): adenosine -0.75 mg/Kg/min, (3) group 3 (n=10) : adenosine -1 mg/Kg/min. Result: Group 3 resulted in a significantly rapid arrest time of the heart beat(p<0.05) but significantly slow recovery time of the heart beat after reperfusion(p<0.05) compared to groups 1 and 2. Group 2 showed a better percentage of recovery(p<0.05) in systolic aortic pressure, aortic overflow volume, coronary flow volume, and cardiac output compared to groups 1 and 3. Group 1 showed a a better percentage of recovery(p<0.05) in the heart rate compared to the others. In biochemical study of drained reperfusates, CPK and lactic acid levels did not show significant differences in all of the groups. Conclusion: We concluded that group 2 [adenosine(0.75 mg/Kg/min) added to cardioplegia] has better recovery effects after reperfusion in myocardial ischemia and is the most appropriate dosage compared to group 1 and 3.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1329-1336
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• 1996

From January, 1994 to January. 1996, mitral valve replacement was performed in 27 patients. Among these, 17 patients underwent mitral valve replacement(MVR) with preservation of the annulo-papillary continuity(PAPCMVR) (-Group I), and 10 patients underwent conventional methods of excision of all the chordae(Group II). The operative technique for PAPCM VR consists of the division of the anterior leaflet into anterior and posterior segments, shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas. This retrospective study has been designed to evalute the postoperative left ventricular function in the two groups. In the group 1, LVEF(Left Vnetricular Ejection Fraction : %) was 52 $\pm$ 3 preoperatively And 50$\pm$3 postoperatively, LVESI Vent icular End Systolic Volume Index/mL/m2) wIns 59 :6 and 51 $\pm$ 7, LVEDI Ventricular End Diastolic Volume Index/mL/m2) was 124$\pm$ 11 and 91 :8. In the group II, LVEF was 56$\pm$1 and 47:), LVESVI 62$\pm$12 and 61$\pm$15, LVEDVI 133$\pm$27 and 104$\pm$17. : the variation of the LVEF in these two group was statistically different(p(0.05). A comparison of left ventricular function data between Group I(n: 17) and Group II(n: 10) revealed better results in echocardiographic LVEF(p<0.05), LVEDVI(p<0.01) in the former group. The mean functional class(UYHA) was 2.6 preoperative and improved to 1.0 postoperatively In group 1, and 2.8 and to 1.0 in group II. We conclude that maintenance of continuity between the mitral annulus and papillary muscles is expected to have a beneficial effect on postoperative left ventricular performance.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.591-597
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• 1997

Cardiopulmonary bypass in children is associated with capillary leak which results in an increase in total body water after open heart surgery The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery Study h: Twenty-six consecutive children aged 0.1 ~ 10 years(median 7 months) underwent cardiac operation inc rporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~ 15011min for 3 ~ 14 min. After modified ultrafiltration, elevation of hematocrit(28.3% $\pm$ 3.6% vs. 33.8olo $\pm$ 4.Ooloi p < 0.001), increased systolic 1)loots Pressure(66.7 $\pm$ 11.2mmHg vs. 76.2$\pm$ 11.BmmHg, p < 0.02), and decreased central venous pressure(7.8 $\pm$ 3.7mmHg vs. 6.9$\pm$ 2.gmmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n= 14) or modified ultrafiltration(n= 12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0$\pm$ 2.4 cmH20 vs.22.4$\pm$ 2.3cmH20, p < 0.03). Modified ultrafiltration after cardiopillmonary bypass in children improves early homodynamics and pulmonary mechanics, and represents an excellent option for perioperative managemen of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.456-465
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• 1998

Cardiopulmonary bypass(CPB) in children is associated with the accumulation of body water after cardiac operation, as a consequence of an inflammatory capillary leak. Following work by Elliott in 1991, modified ultrafiltration(MUF) was introduced after bypass as a means of hemoconcentrating patients and a potential way of removing water from the tissues. We have carried out a prospective randomized study of 20 children undergoing open heart surgery, comparing MUF with nonfiltered controls. MUF was carried out for a mean of 18.9 minutes after completion of CPB to a hematocrit of 37.1%(mean). The mean water volulme removed by the ultrafiltration was 38.4 ml/kg and the mean blood volume retransfused from the oxygenator during the ultrafiltration was 32.1 ml/kg. Fluid balance, hemodynamics, hematocrit, osmolarity and dosage of drug treatment were recorded for 4∼12 hours postoperatively. The results were analyzed using Student t-test and ANOVA, comparing controls(n=10) to MUF(n=10). Blood loss(ml/kg/24hr) was 14.5(mean) in MUF versus 13.7 in controls; blood transfused(ml/kg/24hr) 6.6 in MUF versus 15.2 in controls; plasma transfused(ml/kg/24hr) 65.7 in MUF versus 59.6 in controls. There was rise in arterial blood pressure and hematocrit during MUF. Percent rise of systolic blood pressure was 28.8% in MUF versus 18.7% in controls(p=0.366); percent rise of diastolic blood pressure was 28.8% in MUF versus 8.5% in controls(p=0.135); and percent rise of mean blood pressure was 36.2% in MUF versus 8.2% in controls (p=0.086). Percent rise of hematocrit was 40.0% in MUF versus 23.5% in controls(p=0.002). There was no significant difference in the inotropic requirement and the postoperative serum osmolarity between two groups. The number of days on the ventilator, the duration of stay in the intensive care unit, and the postoperative hospital stay were not significantly different between the two groups.

• Journal of Veterinary Clinics
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• v.32 no.6
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• pp.491-498
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• 2015

We investigated the effect of constant rate infusion (CRI) with doxapram on cardiopulmonary function during total intravenous anesthesia (TIVA) with remifentanil and propofol CRI in dogs. Fifteen male Beagle dogs were randomly divided into 3 groups. All groups were premedicated with medetomidine ($20{\mu}g/kg$, IV) and anesthetized by remifentanil/propofol CRI for one and half hour. At the initiating of the anesthesia, different doses of doxapram for each group were administrated as the followings; D1 group - doxapram 0.25 mg/kg bolus followed by doxapram $8.33{\mu}g/kg/min$, D2 group - doxapram 2 mg/kg bolus followed by doxapram $66.66{\mu}g/kg/min$, control group - normal saline. The anesthetic depth for surgery was well maintained in all groups throughout the anesthetic periods. The respiratory rate was significantly higher in D2 group than that of control group (p < 0.05). The values of $PaO_2$ and $SaO_2$ were significantly increased in both D1 and D2 groups compared with control group (p < 0.05). High dose of doxapram (D2 group) significantly decreased the level of $PaCO_2$ compared with control group (p < 0.05). The values of systolic, mean and diastolic arterial pressure were significantly increased in doxapram 2 group (p < 0.05). There were no significant differences in the values of heart rate and pH of arterial blood. Therefore, doxapram CRI may be useful to alleviate the suppression of cardiopulmonary function including hypoxia and hypotension during TIVA with remifentanil and propofol in dogs.

• Journal of Veterinary Clinics
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• v.28 no.5
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• pp.479-485
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• 2011

The cardiopulmonary responses during total intravenous anesthesia (TIVA) between remifentanil/propofol infusion and remifentanil/ketamine infusion in dogs were compared. Fourteen healthy adult beagle dogs were premedicated with acepromazine (0.1 mg/kg, SC) and medetomidine (20 ${\mu}g$/kg, IV), and anesthetized for 3 hr with remifentanil (0.5 ${\mu}g$/kg/min)/propofol (loading dose: 1 mg/kg, CRI: 0.3 mg/kg/min) CRI (group 'P') or remifentanil/ ketamine (loading dose : 5 mg/kg, CRI: 0.1 mg/kg/min) CRI (group 'K'), respectively. Hemodynamics, blood gas analysis and behavioral changes during recovery were measured. The level of anesthesia was determined by toe-web clamping test. The level of surgical anesthesia was maintained throughout the experiment in both groups. Systolic arterial pressure, mean arterial pressure, $PaO_2$ and $SpO_2$ in group 'K' were significantly higher than in group 'P', and were maintained near the normal ranges. In addition, $PaO_2$ in group 'K' was significantly lower than in group 'P'. However, diastolic arterial pressure, heart rate and respiratory rate were not significantly differed. Mean extubation time from the end of infusion was significantly reduced in group 'K', but mean sitting time was significantly reduced in group 'P'. Mean head-up time and mean walking time were not significantly differed. In group 'K', brief muscle rigidity, head waving and licking during recovery were observed. In conclusion, infusion rate of ketamine (0.1 mg/ kg/min) with remifentanil (0.5 ${\mu}g$/kg/min) is an appropriate for obtaining the surgical plane of anesthesia. These results showed that group 'K' had better cardiopulmonary function than group 'P'. That is, remifentanil/ketamine CRI is better TIVA protocol than remifentanil/propofol CRI for 3 hr surgery.

• The Korean Journal of Nuclear Medicine
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• v.36 no.6
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• pp.381-391
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• 2002

Purpose: The presence of perfusion defect may influence the left ventricular mass (LVM) measurement by quantitative gated myocardial perfusion SPECT (QGS), and ischemic myocardium, usually showing perfusion defect may produce post-stress LV dysfunction. This study was aimed to evaluate the effects of extent and reversibility of perfusion defect on the automatic measurement of LVM by QGS and to investigate the effect of reversibility of perfusion defect on post-stress LV dysfunction. Subjects and Methods: Forty-six patients (male/female=34:12, mean age=64years) with perfusion defect on myocardial perfusion SPECT underwent rest and post-stress QGS. Forty patients (87%) showed reversible defect. End-diastolic volume (EDV), end-systolic volume (ESV), LV ejection fraction (EF), and LV myocardial volume were obtained from QGS by AutoQUANT program, and LVM was calculated by multiplying the LV myocardial volume by the specific gravity of myocardium. Results: LVMs measured at rest and post-stress QGS showed good correlation, and higher correlation was founded in the subjects with fixed perfusion defect and with small defect (smaller than 20%). There were no significant differences in EDVs, ESVs and EFs between obtained by rest and post-stress QGS un patients with fixed myocardial defect. Whereas, EF obtained by post-stress QGS was lower than that by rest QGS in patients with reversible defect and 10 (25%) of them showed decreases in EF more than 5% in post-stress QGS, as compared to that of rest QGS. Excellent correlations of EDVs, ESVs, EFs between rest and post-stress QGS were noted. Patients with fixed defect had higher correlation between EDVs, ESVs, EFs than patients with reversible defect. Conclusion: These results suggest that perfusion defect can affect LVM measurement by QGS and patients with reversible defect shows post-stress LV dysfunction more frequently than patients with fixed perfusion defect.