• Journal of Life Science
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• v.34 no.1
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• pp.1-8
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• 2024

Brain-type natriuretic peptide (BNP) is a cardiac hormone that exerts cardiovascular and renal effects and regulates metabolic processes. In the current study, to determine the hepatic effects of BNP, we investigated whether it improves high-fat diet (HFD)-induced hepatic IR and characterized its possible mechanism. No significant differences in body weight, fat mass, or lean mass were observed between the saline- and BNP-treated groups of normal diet-and HFD-fed mice. During the clamp test, the BNP infusion into HFD-fed mice led to lower blood glucose levels and increased glucose infusion rates versus that into saline-treated HFD-fed mice. The BNP infusion also inhibited hepatic glucose production and decreased hepatic triglyceride levels concomitant with decreased expression of gluconeogenesis and lipogenesis-related genes, resulting in reduced levels of alanine aminotransferase and aspartate aminotransferase. BNP increased the phosphorylation of Akt and AMP-acti- vated protein kinase (AMPK) in the livers of HFD-fed mice compared to saline-fed HFD mice. The incubation of AML12 murine hepatocytes with BNP increased the basal levels of phosphorylated Akt and AMPK and recovered the phosphorylated Akt and phosphorylated AMPK levels reduced by palmitate treatment. Furthermore, BNP incubation prevented palmitate-induced increases in lipo- genesis gene expressions. Taken together, the current study's findings indicated that BNP ameliorates hepatic IR, resulting in reduced hepatic glucose production and hepatic steatosis.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.233-241
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• 1998

To define the risk factors affecting the early major morbidity and mortality after multiple- valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9$\pm$11.5(mean$\pm$SD) years. Using the New York Heart Association(NYHA) classification, 41 patients(33.1%) were in functional class II, 60(48.4%) in class III, and 20(16.1%) in class IV preoperatively. Seven patients(5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients(61.3%), a history of cerebral embolism in 5(4.0%), and left atrial thrombus in 13(10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57(46.0%) of combined mitral valve replacement(MVR) and aortic valve replacement(AVR), 48(38.7%) of combined MVR and tricuspid annuloplasty(TVA), 12(9.7%) of combined MVR, AVR and TVA, 3(2.4%) of combined MVR and aortic valvuloplasty, 2(1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A(27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B(97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time(ACT, group A:153.4$\pm$42.4 minutes, group B:134.0$\pm$43.7 minutes, p=0.042), total bypass time(TBT, group A:187.4$\pm$65.5 minutes, group B:158.1$\pm$50.6 minutes, p=0.038), and NYHA functional class(I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death(n=10) and survivor(n=114), there were significant differences in age(early death:45.2$\pm$8.7 years, survivor:37.2$\pm$11.6 years, p=0.036), sex(female:12.7%, male:1.9%, p=0.043), ACT(early death:167.1$\pm$38.4 minutes, survivor:135.7$\pm$43.7 minutes, p=0.030), and NYHA functional class(I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.387-391
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• 2002

Background: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. Material and method: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of peroperative empyema, operation timing, the side of operation, duration of operation, and operation type. Result: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculos empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10,7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity, If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. Conclusion: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.

• Journal of radiological science and technology
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• v.37 no.2
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• pp.109-116
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• 2014

Many studies have suggested that in the era of Drug-Eluting Stents(DES) are one of the causes of In-Stent Restenosis(ISR) of Stent Fracture(SF). The present study sought to evaluate clinical characteristics of patients with stent fracture after successful DES implantation. The 4,701 patients were selected for analysis who underwent a follow-up coronary angiography irrespective of ischemic symptoms. The overall incidence of SF was 32 patients(male:female=19:13, Av. age $62.44{\pm}9.8$year, 0.68%). Fractures of Sirolimus-Eluting Stents(SES), Paclitaxel-Eluting Stents(PES), Biolimus A9-Eluting Stents(BES), Everolimus-Eluting Etents(EES), Endothelial Progenitor Cell Capture Stent(EPC) and Zotarolimus-Eluting Stents(ZES) are accounted for 19(59.4%), 9(28.1%), 2(6.3%), 1(3.1%), 1(3.1%) and 0(0%) respectively. SF developed in the left Anterior Dscending(LAD) artery in 16 patients(50%) and in complex(type B2, C) lesions in 25 patients(69.4%). Ten patients were treated with heterogenous DES, the rest being treated with either homogenous DES(3 patients), plain old balloon angioplasty(3 patients), or conservative medical treatment(17 patients). None of the patients with SF suffered from cardiac death during a follow-up period of $32.9{\pm}12.4$ months. The overall rate of DES fracture over up to 3.7 years of follow-up was 0.68% with higher incidence in SES than in PES. SF frequently occurred in the LAD artery and in complex lesions. Of the patients with SF, coronary intervention was performed only when the binary restenosis lesion was significant. During the follow-up, patients with SF have continued on combination antiplatelet therapy. There is a very low rate of major adverse cardiac events(post-detection of SF), especially cardiac death associated with SF.

• 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.42 no.5
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• pp.561-565
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• 2009

Background: There haven't been any papers that have analyzed the recent trends in the changing attitudes and results of Korean thoracic and cardiovascular surgeons who submit scientific papers to the major cardiothoracic journals. Material and Method: I analyzed the original articles that were published in the major cardiothoracic surgery journals from 1995 to 2008 by Korean thoracic and cardiovascular surgeons. The data was retrieved from the internet websites of Pubmed, three major international SCI (Science Citation Index) journals and the Korean Journal of Thoracic and Cardiovascular Surgery. I then analyzed the data according to the chronological year, the subjects and the subspecialties. Result: The total number of original articles in the three international journals was 14,629. Among them, the number of articles written by Korean scientists was 157 (1.07%). A sharp increase was identified from 28 articles out of 7,674 articles (0.36%) prior to 2002, to 129 articles out of 6,955 articles (1.83%) after 2003. On the other hand, the annual number of articles in the Korean Journal was markedly decreased from 126.8 articles by 1999 to 80.0 articles after 2000. The annual number of articles in the Korean Journal was also decreased from 58.8% by 1999 to 48.3% after 2000. Conclusion: There was an observed increase in submitting articles to the international SCI journals after 2000 rather than to the Korean journal. The proportion of original articles in the Korean journal is also decreasing. I think we need to pay special attention to improve the quality and quantity of articles published in the Korean journal.

• Journal of the East Asian Society of Dietary Life
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• v.21 no.5
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• pp.649-660
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• 2011

The purpose of this study was to compare the dietary life and nutrient intakes among elderly persons residing at nursing homes and their homes in order to provide fundamental data for improved foodservice and dietary management. We recruited 150 subjects at a nursing home stay and 150 home stay elderly persons for a survey. The results were as follows. There was no significant difference in frequency of napping between the two groups. The frequency of going out was higher in the home stay subjects, but regular exercise was higher in nursing home stay subjects. Subjects possessed the following diseases: dementia and digestive disorders for nursing home stay elderly men, blood vessel disorder and diabetes for home stay elderly men, digestive and blood vessel disorders for nursing home stay elderly women, and blood vessel and heart disease for home stay elderly women. In a health-related assessment, smoking, drinking, and teeth condition of nursing home stay subjects were not higher than those of home stay subjects. The ratio of subjects who ate meals everyday was higher in nursing home stay elderly women than in home stay women. While most nursing home subjects ate adequate amount of meals, home stay subjects ate until they were full. The daily energy intakes of men and women were 2,229.9 kcal and 2,302.1 kcal for nursing home subjects and 1,894.0 kcal and 1,885.9 kcal for home subjects, respectively. Nutrient intake was also higher in nursing home than home stay subjects. In summary, the dietary life of elderly persons residing in a nursing home was higher than that of elderly persons residing at their home from the view point of meal frequency, meal intake, and nutrient intakes. Therefore, systematic assessment and management of nutrition for elderly staying at a nursing home or at home alone should be conducted continually.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.321-328
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• 2007

Background: It is very important to determine the surgical anatomy of the aortic root when performing spreading aortic root preserving heart surgery. This study focuses on the surgical aspect of the aortic root anatomy by performing dissection of Korean cadavers. Material and Method: The subjects were 62 cadavers. We measured the intercommissural distances, heights of the sinuses and the circumference of the sinotubular junction and the aortic annulus. Result: The mean age of death was 61.3 years. The intercommissural distance for the right coronary sinus was $0.73{\pm}2.23mm$, that for the non coronary sinus was $19.34{\pm}2.03mm$, and that for the left coronary sinus was $18.58{\pm}2.15mm$. The height of sinus was $20.59{\pm}2.48mm$ for the right coronary sinus, $18.61{\pm}2.26mm$ for the non coronary sinus and $17.95{\pm}19mm$ for the left coronary sinus. The circumference of the sinotubular junction was $70.73{\pm}5.94mm$ and that of the aortic annulus was $77.94{\pm}5.63mm$. There is no correlation between age and STJ, aortic annulus and the ratio of STJ of aortic annulus respectively (p=0.920, p=0.111, p=0.073). The tilting angle of the sinotubular junction and aortic annulus is from $2.03^{\circ}$ to $7.77^{\circ}$ $(mean=4.90^{\circ})$. Conclusion: The intercommissural distance and the height of the sinus were largest in the right coronary sinus, and the position of the sinotubular junction to the aortic annulus is obliquely tilted levo-posteriorly.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.563-567
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• 2008

Background: The histomorphological properties of the left anterior desecending artery (LAD), the left internal thoracic arteries (LITA), the radial arteries (RA) and the intercostal arteries (ICA) were studied for their use as a conduit for coronary artery bypass grafting (CABG), and we compared them with each other. Material and Method: All the vessels were harvested from nineteen cadavers (17 males and 2 females). The mid-portion of the LAD, the mid-portion of the LITA, the distal RA and the mid-portion of the 5th ICA were obtained. All of them were stained with hematoxylin-eosin and with Van Gieson's elastin stain. The morphological characteristics were examined and the thicknesses of the intima and media (I/M ratio: the intima to media ratio) were compared using one-way ANOVA tests. Result: The mean age of the cadavers was $61.5{\pm}9.6$ years. The LITA and ICA were elastic arteries, and the LAD and RA were muscular arteries. The I/M ratio showed statistically significant differences: $0.07{\pm}0.03$ in the LITA, $0.16{\pm}0.11$ in the ICA, $0.45{\pm}0.29$ in the RA and $0.93{\pm}0.52$ in the LAD, respectively. Conclusion: This study showed that the degrees of intimal hyperplasia of the CA and the various conduits for CABG were different significantly. The ICA was found to have relatively favorable characteristics as a coronary by pass conduit, but its suitability for clinical use is a challenging issue.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.945-950
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• 1996

Twelve patients with left ventricular-right atrial shunt (LV-RA shunt) underwent surgical correction be- tween April 1982 and March 1995. Seven patients were male and five patients were female. Age ranged from 3 to 26 years with mean age of 8.5 years. On the preoperative chest PA views, increased pulmonary vascularity was noted in 3 cases and enlargement of right atrium in 4 cases. The mean preoperative cardiothoracic ratio was 0.59. Echocardiographic studies were obtained in 9 patients and the preoperative echocardiographic diagnoses were LV-RA shunt in 2 cases, ventricular septal defect (VSD) in 6 casei, and atrial septal defect (ASD) in 1 case. The preoperative ngiographic diagnoses which were obtained in all patients were LV-RA shunt in 5 cases, VSD in 5 cases, ASD in 1 case, and VSD with ASD in 1 case. The descriptions of defect of LV-RA shunt according to intraoperative findings were supravalvular defect in 5 cases(42%), infravalvular defect in 4 cases (33%), and combined defect in 3 cases (25%). Associated anomalies of tricuspid valve in 4 cases of infravalvular defect were perforation (3 cases) and cleft (1 case). Primary closure of the septal defect was performed through the right atriotomy in all but one patient. There was no operative death. One patient underwent reoperation because of the residual interventricular shunt. All patients have been in good condition.