• Journal of Chest Surgery
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• v.52 no.1
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• pp.32-35
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• 2019

Surgical management of interrupted aortic arch (IAA) with systemic outflow tract obstruction is clearly a challenge. If both ventricles are adequate, the Yasui operation is a useful option. Otherwise, a staged approach through initial hybrid palliation and delayed biventricular repair, tailored to the degree of obstructed outflow, serves to avoid a high-risk neonatal procedure. Herein, we present a patient with IAA and severe systemic outflow tract obstruction whose treatment involved hybrid palliation, followed by a Yasui operation.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.208-213
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• 2002

Purpose : The major cause of cardiac dysfunction, after open heart surgery for congenital heart disease, is perioperative myocardial injury. Cardiac troponin I is found only within the myocardial cell, so it can be used as a biochemical marker of the myocardial injury. We performed this study to evaluate the worth of cardiac troponin I as a biochemical marker reflecting the extent of perioperative myocardial injury and recovery. Methods : Thirty-four patients who had undergone elective open heart surgery of congenital heart disease(CHD) from April to July 2001 were enrolled in this study. We measured types of CHD, serial cardiac troponin I(baseline 1 day before operation, postoperative day 1, 2, 3, 7), duration of cardiopulmonary bypass(CPB), aortic cross clamping(ACC), intubation and postoperative hospital stay. Results : Compared with the baseline before operation, there was a significant, increase of cardiac troponin I on the postoperative day 1 and a significant gradual decrease on the day 2, 3, 7. The levels of cardiac troponin I were the highest in the transposition of great artery(TGA) repair on the postoperative day 1 and high in the tetralogy of Fallot(TOF), atioventricular septal defect (AVSD), ventricular septal defect(VSD) and atrial septal defect(ASD) repair with decreasing sequence. The longer duration of CPB, ACC and intubation, the higher of cardiac troponin I, but there were no significant correlations between cardiac troponin I levels and duration of hospital stay. Conclusion : Because there was significant increases or decreases of cardiac troponin I according to the perioperative time and types of the congenital heart disease, it is a worthy biochemical marker which reflects the extent of perioperative myocardial injury and recovery after open heart surgery.

• Korean Journal of Community Nutrition
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• v.3 no.5
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• pp.695-706
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• 1998

This study was designed to investigate the associations of the percent body fat dietary intake, plasma lipoprotein profile, lipoprotein(a), and plasminogen activator inhibitor-1(PAI-1) concentrations of 1982 Korean subjects(men : 1000 and women : 982) between the ages of 40 and 59 years. The dietary assessment consisted of twenty-four hour dietary records and food frequency questionnaires. The subjects were identified into one of the five rating groups of % body fat : lean, underweight, normal, overweight and obese groups. The biochemical assessment included measurements of plasma total cholesterol(TC), HDL-cholesterol(HDL-C), LDL-cholesterol(LDL-C), triglyceride(TG), lipoprotein(a)(Lp(a)), and PAI-1. With respect to the ratio of percent energy intake of carbohydrate : protein : fat of the normal group of the women was 62% : 17% : 20%, respectively. Women apparently had a higher intake of carbohydrates than men(52% : 17 : 20%) did. There was a linear relationship between energy intake and % body fat in both mean and women(with the exception of the underweight group of women). The relationship of % body fat of men to the protein and fat intake was higher than that of the carbohydrate intake. Of the men in the study, intakes of energy, protein and alcohol were positively correlated to % body fat. In women, energy, carbohydrate and protein intake were positively correlated to % body fat, however, the fat, cholesterol and alcohol intake did not show any correlation to the % body fat in women. This study showed that % body fat was positively correlated with plasma TC, LDL-C, PAI-1 levels, and TG, but the % body fat was negatively correlated with plasma HDL-C level in both men and women. These results indicated that the high energy intake of obese or overweight subjects might contribute to several of the biochemical indices fo coronary heart disease(CHD) risk. In conclusion, increased energy intake is associated with overweight or obesity in middle aged Korean people. There was no relationship between % energy intake of fat and % body fat in the study, in middle-aged Korean men and women. The plasma lipid profile and PAI-1 level thought to be the risk factors of CHD were positively associated with percent body fat in middle aged Korean people.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.1
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• pp.22-29
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• 2016

Serum gamma-glutamyltransferase (GGT) has been widely used as a marker of alcohol intake and liver failure. Recently, the relativity between GGT and various diseases has been identified with growing interest. In this study, we examined relativity between GGT value and risk factors of coronary heart diseases among those with normal GGT value, excluding heavy drinkers. Specifically, we compared the differences based on age and gender. Data from the 2011 KNHNES were used (N=3,619). When the subjects were categorized according to quartile based on the serum GGT levels, there was 10~20, 21~27, 28~38, 39~71 IU/L in men, and 6~12, 13~16, 17~22, 23~42 IU/L in women. The mean of most variables was the highest in the $4^{th}$ quartile (Q4), however age and LDL Cholesterol were the highest in the $2^{nd}$ quartile (Q2) in men. The FRS and 10-year CHD risk was the highest in the $2^{nd}$ quartile in men, and the highest in the $4^{th}$ quartile in women. Increased GGT was correspondingly linked with age in women but age was the highest in GGT in the $2^{nd}$ quartile in men. In the 70's, the highest Q1 and Q2 was in men and the highest Q3 and Q4 in women. Although GGT value was within the normal range, increased GGT showed correlation with various risk factors. The FRS and 10-year CHD risk showed different patterns according to age and gender along with increased GGT value.

• Korean Journal of Clinical Pharmacy
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• v.12 no.1
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• pp.39-50
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• 2002

Hypercholesterolemia is one of main causes of coronary heart disease(CHD). Clinical trials demonstrated that lowering serum cholesterol levels would reduce incidence of new cardiovascular events and mortality by primary or secondary preventions. The objective of this retrospective study was to compare efficacy and side effects of lovartatin and simvastatin in treatement of hypercholesterolemia. In Boramae Hospital, patients were included when they have taken lovastatin 20 mg or simvastatin 10 mg for 52 weeks with laboratory monitoring for cholesterol at baseline, 3, 6 and 12 month period. As results, total 128 outpatients were included with their total cholesterol level <240 mg/dl and triglyceride level <400 mg/dl at baseline. Total cholesterol and LDL cholesterol of lovastatin group (n=60) and simvastatin group (n=68) were significantly reduced from baseline (p=0.001). Lovastatin maximally reduced total cholesterol by $23.9\%,\;triglyceride\;by\;12.3\%$, LDL cholesterol by $36.1\;\%$ and increased HDL cholerterol by $7.8\%$ and simvastatin reduced by $24.1\%,\;20.5\%,\;34.3\%\;respectively$ and HDL increased by $11.2\%$. There were no significant differences between lovastatin and simvastatin in mean percent change of lipid levels at 12, 24 and 52 weeks from baseline. Cumulative percentage of patients reaching the target LDL cholesterol concentration by 24 weeks was $61.7\%$ in lovastatin and $64.7\%$ in simvastatin. Average time to reach the target LDL goal was 100.1 days in lovastatin and 99.8 days in simvastatin. Both lovastatin and simvastatin also significantly reduced total cholesterol and LDL cholesterol in all subgroups (diabetes mellitus, hypertension, and coronary heart disease). In this study, treatment efficacy in patients with coronary heart disease was lower than other patients. Considering clinical importance of secondary prevention, more intensive treatment is necessary to decrease LDL cholesterol level of 100 mg/dl or lower in patients with coronary heart disease or other clinical atherosclerotic disease. There were no serious side effects during the study period. Digestive side effects were most frequently reported (lovastatin $8.3\%\;vs\;simvastatin\;8.8\%$). In conclusion, both lovastatin and simvastatin were similar in lipid lowering effects and there was no difference in incidence of side effects.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.402-415
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• 1989

Extracorporeal circulation leads to functional disorder and structural damage of organs, especially hematologic and pulmonary system, mainly by sequestration of neutrophils and deposition of macrophages at lung. Then, proteases are secreted, which insult vascular basement membrane of pulmonary capillary and alveolar septa of the lung. Among these, the most important protease at lung is elastase, because major component of lung is elastin. For prevention of lung injury, inactivators or antidotes to elastase should be necessary and Alpha 1-Proteinase Inhibitor is the elastase inactivator. Clinical experimental study was carried out to investigate the immediate postoperative change of serum Alpha 1-PI level following cardiopulmonary bypass for 20 heart cases [congenital 16 cases, acquired 4 cases] and 10 control [subtotal gastrectomy] cases. Also preliminary study was performed for 31 cases of open heart patients. The results were as follows: l. Immediate postoperative serum levels of Alpha 1-PI was significantly decreased at open heart surgery group [P< 0.005], but not decreased at control group. 2. There were no significant difference in change of serum Alpha 1-PI level between and membrane and bubble oxygenator group.Z 3. There were no significant difference in changes of serum Alpha 1-PI level between CHD and AHD. Alpha 1-PI is consumed at lung during cardiopulmonary bypass and increase after operation compensatedly and protect multiple organic damage especially lung. Therefore, Alpha 1-PI can be indicator for evaluation of prevention and treatment of pump-lung syndrome.

• Asian-Australasian Journal of Animal Sciences
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• v.9 no.1
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• pp.1-25
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• 1996

The pathogenesis of atherosclerosis can not be summarized as a single process. Lipid infiltration hypothesis and endothelial injury hypothesis have been proposed and investigated. Recent developments show that there are many points of potential interactions between them and that they can actually be regarded as two phases of a single, unifying hypothesis. Among the many risk factors of atherosclerosis, plasma homocysteine and lipoprotein(a) draw a considerable interest because they are independent indicators of atherogenicity. Triglyceride (TG)-rich lipoproteins (chylomicron and VLDL) are not considered to be atherogenic but they are related to the metabolism of HDL cholesterol and indirectly related to coronary heart disease (CHD). LDL can of itself be atherogenic but the oxidative products of this lipoprotein are more detrimental. HDL cholesterol has been considered to be a favorable cholesterol. The so-called 'causalist view' claims that HDL traps excess cholesterol from cellular membranes and transfers it to TG-rich lipoproteins that are subsequently removed by hepatic receptors. In the so-called 'noncausalist view', HDL does not interfere directly with cholesterol deposition in the arterial wall but instead reflects he metabolism of TG-rich lipoproteins and their conversion to atherogenic remnants. Approximately 70-80% of the human population shows an effective feedback control mechanism in cholesterol homeostasis. Type of dietary fat has a significant effect on the lipoprotein cholesterol metabolism and atherosclerosis. Generally, saturated fatty acids elevate and PUFA lower serum cholesterol, whereas MUFA have no specific effect. EPA and DHA inhibit the synthesis of TG, VLDL and LDL, and may have favourable effects on some of the risk factors. Phospholipids, particularly lecithin, have an antiatherosclerotic effect. Essential phospholipids (EPL) may enhance the formation of polyunsaturated cholesteryl ester (CE) which is less sclerotic and more easily dispersed via enhanced hydrolysis of CE in the arterial wall. Also, neutral fecal steroid elimination may be enhanced and cholesterol absorption reduced following EPL treatment. Antioxidants protect lipoproteins from oxidation, and cells from the injury of toxic, oxidized LDL. The rationale for lowering of serum cholesterol is the strong association between elevation of plasma or serum cholesterol and CHD. Cholesterol-lowing, especially LDL cholesterol, to the target level could be achieved using diet and combination of drug therapy. Information on the link between cholesterol and CHD has decreased egg consumption by 16-25%. Some clinical studies have indicated that dietary cholesterol and egg have a significant hypercholesterolemic effect, while others have indicated no effect. These studies differed in the use of purified cholesterol or cholesterol in eggs, in the range of baseline and challenge cholesterol levels, in the quality and quantity of concomitant dietary fat, in the study population demographics and initial serum cholesterol levels, and clinical settings. Cholesterol content of eggs varies to a certain extent depending on the age, breed and diet of hens. However, egg yolk cholesterol level is very resistant to change because of the particular mechanism involved in yolk formation. Egg yolk contains a factor of factors responsible for accelerated cholesterol metabolism and excretion compared with crystalline cholesterol. One of these factors could be egg lecithin. Egg lecithin may not be as effective as soybean lecithin in lowering serum cholesterol level due probably to the differences of fatty acid composition. However, egg lecithin may have positive effects in hypercholesterolemia by increasing serum HDL level and excretion of fecal cholesterol. The association of serum cholesterol with egg consumption has been widely studied. When the basal or control diet contained little or no cholesterol, consumption of 1 or 2 eggs daily increased the concentration of plasma cholesterol, whereas that of the normolipemic persons on a normal diet was not significantly influenced by consuming 2 to 3 eggs daily. At higher levels of egg consumption, the concentration of HDL tends to increase as well as LDL. There exist hyper-and hypo-responders to dietary (egg) cholesterol. Identifying individuals in both categories would be useful from the point of view of nutrition guidelines. Dietary modification of fatty acid composition has been pursued as a viable method of modifying fat composition of eggs and adding value to eggs. In many cases beneficial effects of PUFA enriched eggs have been demonstrated. Generally, consumption of n-3 fatty acids enriched eggs lowered the concentration of plasma TG and total cholesterol compared to the consumption of regular eggs. Due to the highly oxidative nature of PUFA, stability of this fat is essential. The implication of hepatic lipid accumulation which was observed in hens fed on fish oils should be explored. Nutritional manipulations, such as supplementation with iodine, inhibitors of cholesterol biosynthesis, garlic products, amino acids and high fibre ingredients, have met a limited success in lowering egg cholesterol.

• Bulletin of the Korean Chemical Society
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• v.29 no.1
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• pp.177-180
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• 2008

Laser induced fluorescence studies of hydrogen atom using four wave mixing technique are reported for the photodissociation of CH4 and its isotopomers at Lya (121.6 nm). The source of dissociating and probe radiation is one and the same (delay time??20 nsec). The average translational energy of ejected hydrogen atoms (50 Kcal/mol) reveals that CH4 + hn??CH3 + H(2S) and CH4 + hn??CH2(a1A1) + H2(1Sg) are the main dissociation processes. The absolute quantum yield for CH4 and CD4 are the same, FH(CH4) = FD(CD4) = 0.31 0.05. If one divides the experimental H/D ratios from the isotopomers CH3D, CH2D2, CHD3 by the isotopic H/D ratios, a value 2 is obtained in all three cases. Overall, the heavier D atoms are more likely than the H atoms to remain attached to the carbon atom.

• Journal of Korean Biological Nursing Science
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• v.5 no.1
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• pp.5-12
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• 2003

The purpose of this study to compare of clinical profile between obese and nonobese type 2 diabetic patients. The subjects were consist of 111 obese (50 male, 61 female) and 159 non obese (79 male, 80 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, fasting C-peptide and 2-hour postprandial C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association (ADA) criteria. Obesity was defined as body mass index (BMI, kilograms per meters squared) ${\geq}23$. Data analyses were t-test, chisquare test in SAS program. The results were as follows : 1) Triglycerides and 2-hour postprandial C-peptide were significant higher in obese than non-obese patients. 2) Systolic blood pressure, Diastolic blood pressure, fasting blood sugar, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high-density lipoprotein, microalbuminuria and fasting C-peptide were no difference between obese and non-obese groups. These data indicate that obesity is a risk factor for the development of coronary heart disease (CHD) in diabetic patients. Therefore, weight reductions have beneficial effects on insulin action and glycemic control in obese type 2 diabetic patients.

• Journal of Korean Biological Nursing Science
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• v.4 no.2
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• pp.41-49
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• 2002

Aim To evaluate blood pressure, blood glucose and serum lipid level in obese and nonobese type 2 diabetic patients. Methods 206 obese(76 male, 130 female) and 442 nonobese(208 male, 234 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$ total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, blood urea nitrogen, creatinine and C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association(ADA)criteria. Obesity was defined as body mass index(BMI, kilograms per meters squared)${\geq}25$. Results In male, systolic blood pressure, triglycerides, microalbuminuria and C-peptide were significant higher in obese than nonobese patients. Fasting blood glucose were significantly lower in obese than nonobese patients. Diastolic blood pressure, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high density lipoprotein, blood urea nitrogen, and creatinine were no difference between 2 groups. In female, triglycerides and C-peptide were significant higher in obese than nonobese patients, Blood pressure, fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high density lipoprotein, microalbuminuria, blood urea nitrogen, and creatinine were no difference between 2 groups. Conclusion Our present study supports that increased triglycerides play a major role in increasing the risk of coronary heart disease(CHD) in obese women type 2 diabetic patients.