• Title/Summary/Keyword: CHD1

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Association between Serum Cystatin C and Vascular Complications in Type 2 Diabetes Mellitus without Nephropathy

  • Kim, Hye Jeong;Byun, Dong Won;Suh, Kyoil;Yoo, Myung Hi;Park, Hyeong Kyu
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.513-518
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    • 2018
  • Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

A Bicentric Propensity Matched Analysis of 158 Patients Comparing Porcine Versus Bovine Stented Bioprosthetic Valves in Pulmonary Position

  • Bunty Ramchandani;Raul Sanchez;Juvenal Rey;Luz Polo;Alvaro Gonzalez;Maria-Jesus Lamas;Tomasa Centella;Jesus Diez;Angel Aroca
    • Korean Circulation Journal
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    • v.52 no.8
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    • pp.623-631
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    • 2022
  • Background and Objectives: Pulmonary valve replacement (PVR) is the most common operation in adults with congenital heart disease (CHD). There is controversy regarding the best bioprosthesis. We compare the performance of stented bioprosthetic valves (the Mosaic [MedtronicTM] porcine pericardial against Carpentier Perimount Magna Ease [EdwardsTM] bovine) in pulmonary position in patients with CHD. Methods: Between January 1999 and December 2019, all the PVRs were identified from hospital databases in 2 congenital heart centres in Spain. Valve performance was evaluated using clinical and echocardiographic criteria. Propensity score matching was used to balance the 2 treatment groups. Results: Three hundred nineteen patients were retrospectively identified. After statistical adjustment, 79 propensity-matched pairs were available for comparison Freedom from reintervention for the porcine cohort was 98.3%, 96.1%, and 91.9% at 3, 5, and 10 years and 100%, 98%, and 90.8% for the bovine cohort (p=0.88). Freedom from structural valve degeneration (SVD) for the porcine cohort was 96.9%, 92.8% and 88.7% at 3, 5, and 10 years and 100%, 98%, and 79.1% for the bovine cohort (p=0.38). Bovine prosthesis was associated with a reintervention hazard ratio (HR), 1.12; 95% confidence intervals (CIs), 0.24-5.26; p=0.89 and SVD HR, 1.69 (0.52-5.58); p=0.38. In the first 5 years, there was no difference in outcomes. After 5 years, the recipients of the bovine bioprosthesis were at higher risk for SVD (reintervention HR, 2.08 [0.27-16.0]; p=0.49; SVD HR, 6.99 [1.23-39.8]; p=0.03). Conclusions: Both bioprosthesis have similar outcomes up to 5 years, afterwards, porcine bioprosthesis seem to have less SVD.

Novel Genetic Associations Between Lung Cancer and Indoor Radon Exposure

  • Choi, Jung Ran;Koh, Sang-Baek;Park, Seong Yong;Kim, Hye Run;Lee, Hyojin;Kang, Dae Ryong
    • Journal of Cancer Prevention
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    • v.22 no.4
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    • pp.234-240
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    • 2017
  • Background: Lung cancer is the leading cause of cancer-related death worldwide, for which smoking is considered as the primary risk factor. The present study was conducted to determine whether genetic alterations induced by radon exposure are associated with the susceptible risk of lung cancer in never smokers. Methods: To accurately identify mutations within individual tumors, next generation sequencing was conduct for 19 pairs of lung cancer tissue. The associations of germline and somatic variations with radon exposure were visualized using OncoPrint and heatmap graphs. Bioinformatic analysis was performed using various tools. Results: Alterations in several genes were implicated in lung cancer resulting from exposure to radon indoors, namely those in epidermal growth factor receptor (EGFR), tumor protein p53 (TP53), NK2 homeobox 1 (NKX2.1), phosphatase and tensin homolog (PTEN), chromodomain helicase DNA binding protein 7 (CHD7), discoidin domain receptor tyrosine kinase 2 (DDR2), lysine methyltransferase 2C (MLL3), chromodomain helicase DNA binding protein 5 (CHD5), FAT atypical cadherin 1 (FAT1), and dual specificity phosphatase 27 (putative) (DUSP27). Conclusions: While these genes might regulate the carcinogenic pathways of radioactivity, further analysis is needed to determine whether the genes are indeed completely responsible for causing lung cancer in never smokers exposed to residential radon.

TOF complicated with pulmonary aspergilloma and frequent hemoptysis: a case report (폐 Aspergilloma 에 의한 심한 객혈이 동반된 TOF 의 치험 1례 보)

  • 박영식
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.484-487
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    • 1984
  • A 12-yr-old patient was admitted due to severe hemoptysis and known cyanotic CHD. In chest P-A and echocardiogram, pulmonary aspergilloma in left upper lobe was associated with TOF. The cardiac catheterization couldnt be done because of frequent hypoxic spell and severe hemoptysis. Surgical management was performed. After left posterolateral thoractomy, modified Blalock-Taussig shunt operation and left upper lobe lobectomy were done at same time. Postoperative PaO2 was elevated and hemoptysis was disappeared.

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The Effects of Endogenous and Exogenous Estrogen on Risk Factors of Coronary Heart Disease -Part I : On Serum Lipid Levels- (내인성 및 외인성 Estrogen이 관상심장질환 위험인자에 미치는 영향 -제1보 : 내인성 및 외인성 Estrogen이 혈액 지질 농도에 미치는 영향-)

  • 박유신
    • Journal of Nutrition and Health
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    • v.30 no.3
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    • pp.307-317
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    • 1997
  • To determine the effects of endogenous and exogenous strogen on serum lipid levels, twenty nonsmoking healthy Korean women were participated in this experiment for 12 weeks. They were assigned to three groups : (1) eight women aged 22 to 30(yr) for the premenopausal(Pre) group, (2) eight, aged 49 to 60(yr) for the postmenoparusal(Pst) group, (3) four, aged 23 to 30(yr) for the oral contraceptive(OC) group which used triphasic OC formulation. Fasting blood samples representing every phase of the hormonal levels were obtained from the subjects of the Pre and the OC group. From the subjects of the Pst group, fasting blood samples were obtained once per three weeks for 12 weeks. All the serum data were adjusted for dietary effects, exercise, personality type and body mass index(BMI) by using analysis of covariation(ANCOVA). Serum lipid levels of the three groups were significantly different. While serum levels of triglycerides(TG)(p<0.0001), low density lipoprotein-chloesterol(LDL-C)/high density liporotein-cholesterol(HDL-C) ratio (LDC-C/HDL-C)(P<0.01) and total cholesterol (TC)/HDL-C ratio (TC/HDL-C)(P<0.001) were significatnly high in the Pst group, serum HDL-C(P0.001) level was significantly high in the Pre group. The OC group showed significantly low serum TC(P<0.0001) and LDL-C(P<0.0001) levels. There was no signidicant difference in the fluictuation of serum lipid levels during the menstrual cycle of the Pre group. However, in the OC group, serum TG level was significantly increased at phase 2(P<0.05) where exogenous estrogen administration was highest. Even though other serum lipid levels of the OC group were not significantly fluctuated according to the exogenous estrogen administration, there was a trend of increased levels of serum TC, LDL-C, LDL-C/HDL-C and TC/HDL-C and decreased level of HDL-C during the menstruation period. Also, serum TC level was high(P<0.005) and serum TG level was low (P<0.005) at the baseline of the OC group compared with the periods of OC administration. When screening and counseling the female population at risk for coronary heart disease(CHD), the result of this study suggest that in may be desirable to divide the population into several groups according to their personal physiological characteristics, such as age, OC administration, menstrual cycle and menopause, as well as general risk factors for CHD.

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Open Heart Surgery:Clinical Analysis of 180 Cases (개심술 180례에 대한 임상적 고찰)

  • 나명훈
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.460-471
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    • 1994
  • Between Feb. 1990 and Aug. 1993, 180 cases of the open heart surgery were performed under cardiopulmonary bypass in the Department of Thoracic & Cardiovascular surgery, Gil General Hospital. There were 83 cases with congenital heart diseases [CHD] and 97 cases with acquired heart diseases [AHD]. The CHD consisted of 78 acyanotic[mortality: 3.8 %] and 5 cyanotic cases with heart anomaly[mortality:l case]. The AHD were 97 cases, which contained 53 valvular, 27 ischemic heart diseases, 10 aortic diseases, 5 cases with myxoma, 1 case with post-infarct VSD, and 1 case with removal of infected pacing wire in right ventricle. In the 53 valvular heart diseases, there were 45 cases with valve replacement[MVR 27, AVR 9,MVR + AVR 9] and 8 cases with valvuloplasty. The number of the implanted prosthetic valves were 53. In MVR, 25 St. Jude, 6 Sorin, 3 Carpentier-Edward and 2 Intact medical valves were used. In aortic position, 13 St. Jude, 3 Sorin and 1 Intact medical valves were applied. The operative mortality was 5.6 % [3/53]. The annuloplasty applying artificial ring was performed in 17 patients[4 cases associated with MVR] and the number of the implanted ring was 19, which included 14 Duran ring[10 mitral, 4 tricuspid] and 5 Carpentier ring [3 mitral, 22 tricuspid]. In the 27 ischemic heart diseases, there were 9 cases with left main coronary artery lesions, 7 one vessel, 5 two vessels, and 6 three vessels. Average number of anastomosis was 2.8 per patient. The operative mortality was 14.3 % [4/27]. Among the 10 patients with aortic diseases, 7 cases were aortic dissection[type A: 5, type B: 2] and 3 cases were descending thoracic aortic aneurysm. The operative morality occurred in 3 cases. The overall mortality and the operative mortality of congenital and acquired heart disease was 7.8 %, 4.8% and 10.4%, respectively.

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Clinical Experiences of Open Heart Surgery (개심술(開心術) 2,000례의 임상적 고찰)

  • 김하늘루;박경택;곽기오;한일용;소영환;최강주;이양행;조광현
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1183-1194
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    • 1998
  • Background: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery(OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. Material and Method: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease(CHD) and 468 cases were acquired heart disease(AHD). The age distribution was 9 days(4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. Result: The CHD cases consisted of 940 ventricular septal defects(61.4%), 324 atrial septal defects(21.1%), 112 tetralogy of Fallot(7.3%), 46 pulmonary stenosis(3%), 38 endocardial cushion defects(2.5%), 15 valsalva sinus ruptures(1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles(0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements(36 aortic valve replacements(AVR), 188 mitral valve replacements(MVR), and 2 tricuspid valve replacements(TVR), among these were 71 cases of double valve replacements(AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty(TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery(CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. Conclusion: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6%(72/2,000).

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A Study on Behavior Patterns Between Smokes and Non-Smokers (흡연자와 비흡연자의 행동양상 연구)

  • 김화신
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.79-87
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    • 1990
  • Clinical and epedemiologic studies of coronary heart disease(CHD)have from time to time over the last three decades found associations between prevalence of CHD and behavioral attributes and cigarette smoking. The main purpose of this study is reduced to major risk factor of coronary heart disease through prohibition of smoking and control of behavior pattern. The subjects consisted of 120 smokers and 90 non-smokers who were married men older than 30 years working in officers. The officers were surveyed by means of questionnaire September 26 through October 6, 1989. The Instruments used for this study was a self-administered measurement tool composed of 59 items was made through modifications of Jenkuns Activity Survery(JAS). The Data were analysed by SAS(Statistical Analsis System) program personal computer. The statistical technique used for this study were Frequency, x$^2$-test, t-test, ANOVA, Pearson Correlation Coefficient. The 15 items were chosen with items above 0.3 of the factor loading in the factor analysis. In the first factor analysis 19 factors were extracted and accounted for 86% of the total variance. However when the number of factors were limited to 3 in order to derive Jenkins classification, three factors were derived. There names are Job-Involvement, Speed & Impatience, Hard-Driving. Each of them includes 21 items, 21 and 9, respectively. The results of this study were as follow : 1. The score of the smoker group and non-smoker group in Job-Involvement(t=5.7147, p<0.0001), Speed & Impatience(t=4.6756, p<.0001), Hard-Driving(t=8.0822, p<.0001) and total type A behavior pattern showed statistically significant differences(t=8.1224, p<.0001). 2. The score of type A behavior pattern by number of cigarettes smoked daily were not statistically significant differences. 3. The score of type A behavior pattern by duration of smoking were not significant differences. It was concluded that the relationship between smokers and non - smokers of type A behavior pattern was statistically significant difference but number of cigarettes smoked daily and duration of smoking were not significant differences. Therefore this study is needed to adequate nursing intervention of type A behavior pattern in order to elevated to educational effect for prohibition of cigarette smoking.

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Preliminary Study on the Standardization of Korean Version of Type D Personality Scale 14 : Internal Consistency and Construct Validity (D형 인격 척도의 표준화 예비연구 : 내적일치도 및 구성타당도)

  • Lee, Moon-Soo;Park, Young-Min;Lim, Hong-Euy;Song, Woo-Hyuk;Ahn, Jung-Chun;Kim, Seong-Hwan;Lee, Bun-Hee;Han, Chang-Su;Kim, Yong-Ku;Joe, Sook-Haeng;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.81-87
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    • 2007
  • Objectives : The distressed personality (type-D) pattern, consisting of negative affectivity and social inhibition, has been shown by Denollet et al. For measuring the Type D characteristics, Denollet has devised the 14 item Type D scale (DS14). In the present study, this instrument was translated into Korean. The reliability and validity of the Korean DS14 was pilot tested. Methods : Preliminary version of the total 17-item DS14 scale was translated into Korean. 372 controls that did not have any coronary heart diseases (CHD) were randomly sampled in Seoul and Gyeonggi province. Preliminary Korean version was applied to controls and 14 items were finally selected to maximize reliability of the scale. We compared the distribution of type-D personality among the normal controls, hypertensive patients, and the CHD patients. Results : 7 of 10 items in social inhibition were selected and final 14-item version was made. The internal consistency of negative affectivity (0.817) and social inhibition (0.797) were high. In addition, the prevalence of type-D personality in the CHD patients group was significantly higher than normal controls. Conclusion : These findings suggest that Korean version of DS14 is a valid tool for measuring the type D characteristics. Type-D characteristics can be suggested to predict adverse prognosis in patients with CHD.

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Comparisons of Food Consumption and Food Sources of Nutrients in the Diets of Postmenopausal Women with Normocholesterolemia and Hypercholesterolemia in Seoul, Korea

  • Kim, Sangyeon;Kyungah Jung;Yukyung Chang
    • Nutritional Sciences
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    • v.7 no.3
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    • pp.174-182
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    • 2004
  • Women have a greater incidence of coronary heart disease (CHD) after menopause. This relates to hormone imbalance-induced changes in known CHD risk factors, especially hyperlipidemia. The purpose of this study was to explore d1e differences in food consumption and food sources of nutrients in the Korean diet between postmenopausal women aged 50-74 years with normocholesterolemia(NC) and those with hypercholesterolemia(HC). Each subject was either classified as part of the NC group (n=39, serum total cholesterol con. <200 mg/$dl$) or the HC group (n=31, serum total cholesterol con. $\geq$240 mg/dl) based on the Guideline for Korean Hyperlipidemia.l Diet was assessed through a validated semi-quantitative food frequency questionnaire. Consumption of foods such as biscuits and/or crackers, squid and eggs was significantly (p<0.05) higher in the HC group than in the NC group. On the other hand, consumption of potatoes/starches and carrots was significantly (p<0.05) lower in the HC group than in the NC group. There was no significant difference between the two groups in terms of the consumption of legumes and legume products containing phytoestrogen and we could not find a relationship between legumes and legume products and serum cholesterol levels. Consumption of green tea tended to be lower in the HC group than in the NC group. Major sources of cholesterol, cholesterol-saturated index and vitamin A in the diets of the HC group consisted of foods high in cholesterol. Our results confirm that postmenopausal women with hypercholesterolemia in Korea tend to consume cholesterol-rich foods and dishes.