• Journal of Chest Surgery
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• v.36 no.10
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• pp.741-747
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• 2003

Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.8
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• pp.1320-1326
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• 2004

The purpose of this study is to verify the relation between vegetarian diet and the risk factors of cardiovascular disease. Results were summarized as follows: Levels of total cholesterol, LDL-cholesterol, atherogenic index (AI), diastolic blood pressure, blood sugar and HDL-cholesterol were significantly higher (p<0.01) in non-vegetarians than those of vegetarians, but ratio of HDL cholesterol/total-cholesterol was lower in non-vegetarians. The number of subjects with abnormal serum total-cholesterol, LDL-cholesterol, atherogenic index (AI) and systotic blood pressure were much more in non-vegetarians than those in vegetarians, it were confirmed clearly as the increment of ages. In the multiple regression analysis, we acknowledged that the main factors affecting on total-cholesterol in vegetarians were age, BMI and the systolic blood pressure (R-square: 0.21), while important factors were age, BMI, the systolic blood pressure and physical activity (R-square: 0.81) in the non-vegetarians. In the vegetarians, age and BMI were the main factors having influence on LDL-cholesterol (R-square: 0.18), while age, BMI, systolic blood pressure and the physical activity (R-square: 0.82) were main factors in the non-vegetarian. In conclusion, vegetable diet may improve blood lipid level, blood pressure, blood sugar.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.8
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• pp.1311-1319
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• 2004

The purpose of this study was to compare the serum lipid level, blood sugar and blood pressure in vegetarians and non-vegetarians. The subjects of the study were 127 Buddhist nuns (age: 23∼79 y) from Oonmoon Temple in Choungdo district Gyeongsang Bookdo province and 118 Buddhist nuns practicing Zen meditation at Soodeok Temple in Yeosan district Chongcheong Namdo province. For control subjects, 235 healthy female adults (age: 23∼79 y) were selected. They were the nurses in the Gyeongsang National University Hospital, teachers and housekeepers living in Jinju, Gyeongsang Namdo province. The period of this study was from October 1996 to February 1997. The contents were consisted of food consumption survey, anthropometric measurement, estimated amount of energy expenditure, physical activity and clinical examination. The mean ages of the subjects were 44.2 y for vegetarians and 40.5 y for non-vegetarians, respectively. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, WHR 0.85 and 0.84, percentage of body fat 28.79 and 26.55 respectively. The average duration of vegetarian diet of the vegetarians was 13.16 y. Levels of total cholesterol, LDL-cholesterol, atherogenic index (AI), diastolic blood pressure, blood sugar and HDL-cholesterol were significantly higher (p<0.01) in non-vegetarians than those of vegetarians. In both of subjects, levels of TG, total cholesterol, LDL-cholesterol, atherogenic index (AI) and systolic blood pressure were significantly higher (p<0.01) with an increment of age and the vegetarians showed a lower ratio of rise than the non-vegetarians. Levels of serum TG, LDL-cholesterol and AI were utmost in the 60 s and declined in the 70 s. Consequently, vegetarian diet can be considerably effective in reducing the level of the risk factors causing cardiovascular disease.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.447-453
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• 2003

Purpose : This study was performed to compare complications and perinatal factors according to the birth weight groups in the infants of diabetic mothers(IDM). Methods : Three hundred and one singleton diabetic mothers and their babies of more than 30 weeks' gestational age admitted in the department of Pediatrics, Chonnam University Hospital from January 1996 to March 2002 were enrolled. Complications and perinatal factors were compared between large for gestational age(LGA) and appropriated for gestational age(AGA) infants. Results : Hypomagnesemia was observed in 37.5%, jaundice in 21.3%, hypoglycemia in 11.1%, hypocalcemia in 7.0%, and birth injury in 19.6%. Congenital anomaly was noted in 24.9% with cardiovascular anomaly most commonly. In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, Cesarean section rate, maternal height, weight before pregnancy, weight gain during pregnancy, and the incidence of unawareness of gestational DM were significant compared with the AGA group. Conclusion : In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, maternal height, weight before pregnancy and weight gain during pregnancy were larger, and the incidence of unawareness of gestational DM was higher compared with the AGA group. These results suggest that careful examination and management are needed to detect the high risk, pregnant DM mothers with possible LGA babies.

• Journal of radiological science and technology
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• v.36 no.3
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• pp.209-217
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• 2013

Adiponectin (AdipoN), brain-derived nerotrophic factor (BDNF) and leptin (LeP) are mainly secreted from adipose tissue and are known to be involved in regulation of the development of obese. However, there are not many studies on the association between abdominal fat and neuropeptides such as AdipoN, BDNF and LeP. The aim of this study was undertaken to investigate the association between abdominal fat thickness, neuropeptides and cardiovascular disease (CVD) risk factors. The participants in the study were 138 male employees without CVD. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. We obtained subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) by using ultrasonography and neuropeptides levels were measured with ELISA kit according to the method suggested by kit manufacturer. The mean SFT and VFT were $1.58{\pm}0.51$ and $4.52{\pm}1.44$ cm. The mean concentrations of AdipoN, BDNF and LeP were $3.14{\pm}3.52$ ng/ml, $24.11{\pm}8.52$ pg/ml and $4.27{\pm}2.38$ ng/ml, respectively. VFT were positively correlated with total cholesterol (r=0.217, p<0.05), LDL-cholesterol (r=0.271, p<0.01), triglyceride (r=0.233, p<0.05) and insulin (r=0.338, p<0.01), but was inversely correlated with HDL-cholesterol (r=-420, p<0.01). AdipoN levels were positively correlated with HDL-cholesterol (r=0.220, p<0.05) and were inversely correlated with total cholesterol (r=-0.196, p<0.05), LDL-cholesterol (r=-0.190, p<0.05), triglyceride (r=-0.199, p<0.05), SFT (r=-0.195, p<0.05) and VFT (r=-0.412, p<0.01). However, LeP levels showed a reverse trend to AdipoN. AdipoN level was significantly higher in non-obese participants (BMI<25 kg/m), but LeP concentration was significantly higher in obese participants (BMI>25 kg/m) than in non-obese. On multiple logistic regression analysis, obese were significantly associated with AdipoN (odds ratio=0.784) and LeP (odds ratio=1.494). These results suggested that AdipoN and LeP concentrations are affected abdominal fat and that dysfunction and/or declination in the production and secretion of neuropeptides might induced ultimately obese and CVD.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.739-748
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• 1998

Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.179-189
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• 1993

It has recently become possible to record electrical activity originating from abnormally conducting myocardium from the body surface with high - gain amplification and averaging technique. These signals, which result from delayed ventricular activation(late potentials), have been recorded in patients with documented ventricular tachyarrythmia. Several electrode lead system for detecting ventricular late potential were introduced. Pyramidal electrode lead system(PLS) is useful. Also interpretation of SAECG in the young could be of value in detecting those at risk for episodic ventricular tachycardia, but suffer from a lack of data in normal young people. Selection of subjects : For this study, normal healthy young adult volunteers (age: mean 24 years) were recruited from the medical students at Yeungnam University Hospital, Internal Medicine. Twenty fourths male and seventeenths female subjects were selected. All subjects had normal resting ECGs as judged from both the standard 12 channel lead and echocardiography, and none had a history of cardiovascular disease. All subjects were considered to be in good general physical condition. Signal-averaged electrocardiography : In order to obtain low noise recordings with a small number of averaging cycles, all subject ware asked to relax completely in the supine position. Silver/silver chloride electrodes were attached after the skin was cleaned with alcohol, to constitute classic flank lead system(FLS) and pyramidal lead system(PLS). Signals were recorded and processed using a commercially available microprocessor-augmented ECG cart(Marquette Electronics, USA) suitable for portable bedside recording. There was no difference between normal values, determined by FLS and PLS at high pass filtering of 25 Hz and 80 Hz, but significant, difference was found in HFLAD and RMS-40 of 40 Hz(p<0.05). These results will provide a basis for interpretations of SAECG, determined by FLS and PLS in healthy young adults with normal QRS duration.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1093-1099
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• 2006

Purpose : Homocysteine is a strong and independent risk factor for cardiovascular disease. The deleterious effects of homocysteine included endothelial dysfunction, arterial intimal-medial thickening, wall stiffness and procoagulant activity. However, the precise mechanism responsible for homocysteine release in children with coronary artery disease is still unknown. The purpose of this study was to investigate serum homocysteine and tumor necrosis $factor(TNF)-{\alpha}$ levels and identify whether these levels had any association with the development of coronary artery lesions in Kawasaki disease(KD). Methods : Serum homocysteine and $TNF-{\alpha}$ levels were measured in 24 KD patients(group 1, eight patients with normal coronary artery; group 2, 16 patients with coronary artery lesions) and 21 controls(group 3, 10 afebrile controls; group 4, 11 febrile controls). Blood samples were drawn from each study group before and after intravenous immunoglobulin(IVIG) therapy and in the convalescent stage. Results : The homocysteine levels before IVIG therapy were significantly higher in group 1 than in group 3, and in group 2 than in group 3 and 4. The $TNF-{\alpha}$ levels before IVIG therapy were significantly higher in group 2 than group 3 and 4. Serum homocysteine and $TNF-{\alpha}$ levels were highest in group 2 before IVIG therapy. In the acute KD patients, serum homocysteine levels correlated significantly with $TNF-{\alpha}$ levels. Conclusion : The increased serum homocysteine levels in the acute stage increase the susceptibility to coronary arterial lesions in KD. $TNF-{\alpha}$ may also play an important role in the formation of coronary arterial lesions in KD.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.591-596
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• 2004

Recently, thoracic sympathicotomy for craniofacial hyperhidrosis (FH) is increasingly avoided contrast to palmar hyperhidrosis. We recently demonstrated that selective T2 sympathicotomy for FH in woman might be recommended because of differences of the postoperative satisfaction between man and woman. Therefore, this study was designed to analyze the postoperative long term results, evaluate the effectiveness of T2 sympathicotomy and establish the new strategy in treatment of FH in woman. Material and Method: From May 1998 to July 2001, 27 cases of FH in woman that were performed T2 sympathicotomy and minimum 2 years have passed since then at the follow up period. Among them, 20 cases were evaluated by telephone review and medical record. Bilateral sympathetic trunks were severed on the 2nd rib with 2mm thoracoscopic instruments. 7 patients combined with gustatory sweating (GS). Ages ranged from 25 to 62 (mean age, 46.4 years). Result: All patients were relieved of symptom immediately after operation. At postoperative 1 week, all patients were satisfied: 15 patients, “very satisfaction” and 5 patients, “relatively satisfaction”. However, during long term follow up period (from 25 to 63 months postoperatively), 9 patients (45%) were relatively satisfied, 8 patients (40%) complained that there was no difference of postoperative satisfaction and 3 patients (15%) complained of non satisfactory results (regret for surgery). 16 patients (80%) had complaint of uncomfortable feeling because of postoperative GS. Some degree of compensatory sweating (CS) had occurred in all patients: severe 10 patients (50%), severe but acceptable 6 patients (30%), and just conventional 4 patients (20%). The sites of CS were trunk, back, axilla and extremities. Conclusion: Thoracoscopic T2 sympathicotomy is relatively considerable method for FH in woman and the postoperative satisfaction depends on GS and the degree of individual adaptation for CS. Therefore, it is required that the prediction of preoperative risk factors for GS and CS and then careful selection of patients to increase the postoperative satisfaction, and the development of acceptable new treatment modalities.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.510-517
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• 1999

Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.