• Journal of Chest Surgery
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• v.34 no.6
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• pp.485-489
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• 2001

Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.901-908
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• 2001

Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1％) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98％) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84％) and first degree of Rentrop classification(16 cases, 52％) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.281-286
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• 1999

Background: The purpose of this study is to analyze the types of complications, the incidences of complications, and preoperative and postoperative risk factors affecting the incidence of the complication. Material and Method: Between August 1990 and August 1997 in Asan Medical Center, 42 patients(24 men and 18 women) underwent surgical resection for pulmonary aspergilloma. The mean age was 46.6${\pm}$11.5 years(range 29 to 69 years). Hemoptysis(90%) was the most common presentation. Pulmonary tuberculosis was the most common predisposing cause(81%). The associated diseases were bronchiectasis(n=11), active puolmonary tuberculosis(n=9), diabetes mellitus(n=8), lung carcinoid(n=1), and acute myeloblastic leukemia(n=1). Lobectomy was done in 32 cases(76%), segmentectomy or wedge resection in 4, pneumonectomy in 2, and lobectomy combined with segmentectomy in 4. Result: Operative mortality was 2%. The most common postoperative complication was persistent air leakage(n=6). The variables such as age, sex, pulmonary function test, amount and duration of hemoptysis, associated diseases(diabetes mellitus, active pulmonary tuberculosis), mode of preoperative management(steroid, antifungal agent, bronchial arterial embolization), and modes of operative procedures were statistically insignificant. The radiologic extent of infiltration to normal lung parenchyme was statistically significant(p=0.04). Conclusion: We conclude that the extent of the infiltration to normal lung parenchyme in preoperative radiologic studies should be carefully evaluated to reduce the postoperative complications in surgery for pulmonary aspergilloma.

• Journal of Nutrition and Health
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• v.55 no.3
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• pp.359-375
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• 2022

Purpose: Adult Korean men belonging to the main economically active population are known to have long sedentary hours. This study was undertaken to determine the difference and relevance of sedentary hours on the nutrition, diet, and health status of adult men, and to suggest how to prevent health risk factors. Methods: Subjects (n = 1,068) were classified into 4 groups based on their sedentary hours, ranging from the first quartile (Q1) having the least hours spent sitting, to the fourth quartile (Q4) spending the longest hours. Results: Subjects belonging to Q4 had the lowest average age, the largest waist circumference, and the highest level of education. Among those engaged in economic activities, the ratio of white-collar workers was significantly higher in Q4. Accordingly, the rate of not doing high-intensity or moderate-intensity physical activity while working was also the highest in Q4. A significant difference was obtained in the drinking frequency between groups, but this was found to be associated with the average working hours rather than sedentary hours. The proportion of not doing aerobic exercise was higher with longer sitting hours. The highest diagnosis of diabetes (8.8%) was obtained in the Q4 group. Among the factors related to cardiovascular disease, only low density lipoprotein-cholesterol showed a significant difference, with Q4 being significantly higher than Q1. Considering energy and nutrient intake, vitamin B₁ and calcium intake were the lowest in the group with the longest sitting hours, as well as the least consumption of vitamin C than the recommended estimated average requirement. Conclusion: The results of this study suggest that the health and nutritional status of Korean adult men are affected by sedentary hours. This should be recognized as a health risk factor and guidelines need to be developed for sedentary lifestyle management.

• Journal of Nutrition and Health
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• v.56 no.2
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• pp.168-183
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• 2023

Purpose: Cardiovascular disease is one of the major causes of death not only in Korea but also worldwide. Atherogenic index of plasma (AIP) has been extensively investigated, but studies on nutritional intake and eating habits are scarce. The purpose of this study was to analyze the general characteristics, dietary habits, and nutritional status of Korean adults based on their AIP values using data from the 2013-2015 Korea National Health and Nutrition Examination Survey. Methods: A total number of 3,040 adults in their 20s and 30s were included as study subjects. They were divided into quintiles according to their AIP values. Comparisons were then made among the general information, eating habits, and nutritional intake statuses of the groups. Results: The averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, smoking, and exercise in men. As for women, the averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, and smoking status. Except for high-density lipoprotein (HDL)-cholesterol, higher AIP values in men were associated with significant increasing trends in health indicators, including systolic and diastolic blood pressure, fasting blood glucose, insulin, hemoglobin A1c, total cholesterol, triglyceride, and low-density lipoprotein (LDL)-cholesterol. As for women, as AIP increased, systolic and diastolic blood pressure, fasting blood glucose, insulin, total cholesterol, triglyceride, and LDL-cholesterol showed significant increasing trends except HDL-cholesterol. HDL-cholesterol showed a significant decreasing trend as AIP increased in men and women. In the high AIP group of women, the frequency of breakfast was lower, whereas the frequency of alcohol beverage consumption was higher. Conclusion: Among young adults, the risk of arteriosclerosis was higher in obese, smoking, and non-exercise individuals. More frequent alcohol drink consumption in women is associated with a higher risk of arteriosclerosis. Therefore, weight and lifestyle management are necessary for the prevention of atherosclerosis among young adults.

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.1
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• pp.42-56
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• 2005

Hyperlipidemia is one of the risk factors for coronary artery disease. Despite of epidemiological evidence that tea consumption is associated with the reduced risk of coronary heart disease, experimental studies designed to show that drinking tea affects blood lipid concentration or oxidative stress have been unsuccessful. The purpose of this study was to investigate whether functional tea (three servings/day) supplement with medical nutrition therapy (MNT) lead to a beneficial outcomes in mildly hyperlipidemic adults. From February to October, 2003, the 43 hyperlipidemic (23 men, 20 women) subjects (total cholesterol$\geq$200 mg/dL or triglyceride$\geq$150 mg/dL) admitted to K Medical Center were studied. Subjects were randomly divided into 3 groups; placebo tea (PT), half dose of functional tea (HFT), full dose of functional tea (FFT). During 12 weeks of study period, the subjects were given placebo or functional tea daily with MNT. Anthropometric measurements, blood chemical analysis including lipid levels, total superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, and dietary assessment were carried out at the beginning and end of experiment. The effects of functional tea were compared with the placebo in randomized clinical trial study. The placebo was prepared to match with the functional tea in color and taste. After the 12 weeks of MNT, the subjects had regular and balanced meal pattern. Consumption of foods high in cholesterol and saturated fat, salty foods, fried foods, and instant foods decreased significantly in all three groups (p<0.05). Intake of energy and cholesterol also decreased (p<0.05). Drinking three servings per day (390 mL/day) of functional tea significantly reduced the levels of blood triglyceride (HFT, 42.5%; FFT, 29.4%), total cholesterol (HFT, 8.5%; FFT, 13.7%), and atherogenic index (HFT, 14.6%; FFT, 21.7%). Whereas no changes were found in the LDL-, HDL-cholesterollevels, and LDL/HDL ratio. Plasma homocysteine (Hcy) concentration decreased significantly (p<0.05) in functional tea groups (HFT, 14.9%; FFT, 14.1%). SOD increased significantly (p<0.05) in HFT (8.3%). GSH-Px increased significantly (p<0.05) in FFT (12.8%). In conclusion, the MNT improved the dietary habits, in addition, functional tea supplement decreased blood lipid levels and Hcy, and increased SOD and GSH-Px levels. These results indicate that functional tea consumption may decrease the risk of cardiovascular disease via improving blood lipid levels and antioxidant status.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.643-652
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• 2002

As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF＜40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.28-32
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• 2007

Purpose : Human angiotensin converting enzyme (ACE) gene shows an insertion/deletion polymorphism in 16 intron, and three genotypes are determined by whether a 287 bp fragment of the DNA is present or not; II, ID and DD genotype. DD genotype has been suggested as a risk factor of chronic nephrotic disease such as IgA nephropathy and diabetic nephropathy, various cardiovascular diseases and several other diseases. ACE activity increases in acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and cirrhosis. On the other hand, patients with fatty livers have normal ACE activity. This study was designed to find out the relation between polymorphsims of the ACE genes and neonatal hyperbilirubinemia in Koreans. Methods : The genomic DNA was isolated from 110 full-term Korean neonates who had hyperbilirubinemia with no obvious causes (serum bilirubin$${\geq_-}12mg/dL$$) and 164 neonates of a control population (serum bilirubin <12 mg/dL). We performed polymerase chain reaction (PCR) to see the allele of the ACE gene. Electrophoresis was done in the PCR products in 1.5 percent agarose gel, and then DNA patterns were directly visualized under ethidium bromide staining. Results : ACE genotypes in the hyperbilirubinemia group are as follows; 26.36 percent for II, 53.64 percent for ID, 20.00 percent for DD, 0.532 for I allele and 0.468 for D allele. These distributions were not significantly different from those in the control group; 24.39 percent for II, 51.83 percent for DI, 23.78 percent for DD, 0.503 for I allele and 0.497 for D allele. Conclusion : In this study, ACE gene polymorphism was detected in the neonatal hyperbilirubinemia and control group. The most frequent genotype was ID. Our results indicate that the ACE gene polymorphism is not associated with the prevalence of neonatal hyperbilirubinemia in Koreans.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.983-988
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• 1996

Aneurysm of the sinus of Valsalva is fairly rare. Between 1987 and 1994, we operated on a total of 12 cases of aneurysm of the sinus of Valsalva at the Inje University Seoul Paik Hospital. This represents 0.7% of all cardiac operation under cardiopulmonary bypass. There were eight male and four female patients aged from 8 to 38 years(mean, 19.2 years). 8 of 12 patients had ruptured aneurysms. The origin of aneurysm of the sinus of Valsalva was the right coronary sinus in 10(83. 3%), and the noncoronary sinus in 2(16.6%). In ruptured aneurysm, the origin was the right oronary sinus in 6, and the noncoronary sinus in 2. The aneurysms originating from the right coronary sinus ruptured into the right ventricle in 5, and into both the right atrium and right ventricle in 1. The aneurysms originating from the noncoronary sinus ruptured into the right ventricle in 1, and into the right atrium in 1. Associated congenital cardiac defects included ventricular septal defect in 10(83.3%) patients 39 cases of these were associated with the aneurysms of the right coronary sinus), aortic regurgi- tation in 3 (all of these had an additional ventricular septal defect), mitral regurgitation in 1, and double chambered right ventricle in 1. No hospital deaths occurred, although one late death occurred as a result of endocarditis 15 months after the first operation. The mean follow-up period was 29 months, range from 4 to 60 months. Eleven patients except one late death were in New York Heart Association class 1. Due to the low mortality risk o( an operation for aneur sm of the sinus of Valsalva, a ruptured aneurysm of the sinus of Valsalva should be corrected surgically when the diagnosis is mane, and unruptured aneurysm of the sinus of Valsava with complication should also be operated. In most cases the aorta was opened to examine the morphology of the aneurysm and the aortic cusps, and an associated aortic valve defect should be corrected simultaneously.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.48 no.6
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• pp.429-433
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• 2003

trans-Resveratrol(3,5,4'-trihydroxystilbene) is phenolic compound present in grapes, wines, and peanuts, has been reported to have health benefits including anticarcinogenic effects, protection against cardiovascular diseases and reduced cancer risk. A simple method for the quantitative extraction of trans-resveratrol from peanut has been developed. Optimal conditions for extraction were investigated. Type of solvent, time, and temperature assayed influenced trans-resveratrol yield. Adequate extraction condition was decided to ethanol/water (80:20v/v) maintained at $25^{\circ}C$ for 45 min. After extraction, the protocol consists of sample preparation using a $\textrm{C}_{18}$ solid-phase extraction (SPE) cartridge after concentrate with rotary evaporator and quantified by reversed phase HPLC using a $\textrm{C}_{18}$ column at 308 nm. Analytical methods for measuring trans-resveratrol in peanut were adapted to isolate, identify, and quantify trans-resveratrol in 11 peanut varieties by HPLC (high-performance liquid chromatography) with UV detector, The 11 peanut varieties content ranged from 0.018 to 1.125 $\mu\textrm{g}/\textrm{g}$ with an average of 0.289 $\mu\textrm{g}/\textrm{g}$. The contents were higher in the seeds with than without testa, regardless of varieties. The trans-resveratrol content was Higher in 110, 130 days after sowing than that of other period.