• Korean Journal of Community Nutrition
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• v.19 no.6
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• pp.527-536
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• 2014

Objectives: The aim of this study was to assess how nutrient intakes are related to risk factors for metabolic syndrome according to dietary patterns in the middle-aged adults. Methods: The subjects (n = 187; 47 men, 140 women) consisted of middle-aged adults over 30 years old in Ilsan area. The metabolic syndrome was diagnosed according to the data collected from each subject, including anthropometric measurements and blood analyses. The dietary patterns were derived from the average of two-day dietary intake data. Results: Factor analysis identified three major dietary patterns which were "Meats and alcohol", "Mixed grains, vegetables and fruits", and "Rice, Kimchi and fish & shellfish". The daily intakes of energy, protein, and sodium increased across quartiles of "Meats and alcohol" pattern scores (p < 0.05), whereas the intakes of carbohydrates, potassium, calcium, and fiber increased across quartiles of "Mixed grains, vegetables and fruits" pattern scores (p < 0.001). The "Meats and alcohol" pattern scores were positively correlated with protein and sodium intakes but inversely correlated with carbohydrates, fiber and potassium intakes which were adjusted for age, sex and energy (p < 0.05). The highest quartile pattern score of "Meats and alcohol" pattern had elevated odds ratio of abdominal obesity and metabolic syndrome (p < 0.05). The risk of hypertriglyceridemia decreased in the highest quartile of "Mixed grains, vegetables and fruits" pattern (OR 0.35, 95% CI 0.12-1.00). Conclusions: Our results suggested that reducing the consumption of meat and alcohol along with increasing fruits, vegetables and mixed grains would be helpful for preventing the metabolic syndrome and chronic diseases.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.428-433
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• 2005

Advanced age in Esophagectomy increases the risk of postoperative morbidity and mortality. However, the recent development of operative technique and perioperative care might have decreased the postoperative morbidity and mortality after esophagectomy. Material and Method: From March 2001 to July 2004, 174 patients underwent esophageal resection for esophageal cancer in the Center for Lung Cancer, National Cancer Center. The patients were divided into two groups : group 1 consisted of 27 patients aged 70 years or more, and group 2 consisted of 147 patients under 70 years of age. The two groups were compared according to preoperative risk factors, postoperative morbidity, operative mortality and survival. Result: The mean age was 63_4. There were 159 men. On histopathological examination, $93.1\%$ had squamous cell carcinoma. On the locations, $78.7\%$ were in mid and lower esophagus. Curative resections for esophageal cancer were possible in $162(93.1\%)$ patients. Mean hospital stay was 19.4 days with out difference between the groups. The overall postoperative morbidity were occurred in 61 patients $(35.1\%)$. The most frequent morbidity was pulmonary complication in $30(17.2\%)$. Preoperative incidence of hypertension, cardiac and pulmonary dysfunction were more common in Group I. However, there was no difference in overall postoperative morbidity, operative mortality and survival rate between the two groups. Conclusion: Esophagectomy for esophageal cancer could be carried out safely in patients over 70 years of age with satisfactory short-term results. Advanced age is no longer a risk factor for esophagectomy.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.8
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• pp.910-918
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• 2017

Hyperlipidemia is known as a glucose and lipid metabolism-related disorder that is increasing in incidence in modern society. Red ginseng (RG) is a natural herb candidate with a positive effect on regulation of cholesterol and lipids. To observe the effects of RG on regulation of lipids, cholesterol, glucose, and oxidative stress, we examined the in vitro and in vivo effects of Chamdahan RG on differentiated 3T3-L1 adipocytes and high-fat diet-fed mice. RG ($50{\mu}g/mL$) significantly inhibited lipid synthesis in 3T3-L1 cells. In addition, a low concentration of RG (880 mg/kg/d) resulted in the lowest total blood cholesterol level. Moreover, high density lipoprotein-cholesterol quantity increased in RG-treated groups, consequently lowering the cardiovascular risk factor and atherosclerosis index. Moreover, RG increased activity of AMP-activated protein kinase, as a regulator of lipid and cholesterol synthesis, in adipose and liver tissues. Cumulatively, this paper suggests that RG has a positive effect on reducing the amounts of cholesterol and lipids and may be a good candidate for treating hyperlipidemia.

• Korean Journal of Community Nutrition
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• v.12 no.4
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• pp.396-404
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• 2007

Increased oxidative stress contributes to the progression of atherosclerosis. We measured serum antioxidant mineral concentrations, capacities of serum antioxidant enzymes and fasting lipid profile in 97 male patients with coronary artery disease (CAD) and 21 male controls. Nutrient intake was assessed by the semi-quantitative food frequency method. CAD patients were divided into single-vessel disease (SVD, n=66) and multi-vessel disease (MVD, n = 31) groups on the coronary angiography. The ratio of serum LDL- to HDL-cholesterol elevated with an increasing number of diseased vessels compared to the control (control < SVD < MVD, p < 0.05). Patients with SVD and MVD had higher levels of serum lipoprotein (a) than the control (p < 0.05). The mean intake of carbohydrate, protein and cholesterol was higher in MVD patients and the intakes of vitamins C and E were lower in MVD and SVD patients than in the control (p < 0.05). Serum copper (Cu) and zinc (Zn) levels were higher in MVD and SVD patients than in the control (Cu: control $75.8{\pm}5.07$, SVD $99.2{\pm}2.90$, MVD $100.1{\pm}2.32{\mu}g/dL$, p<0.01; Zn: $76.8{\pm}5.36$, $119.0{\pm}5.95$, $129.1{\pm}2.70{\mu}g/dL$, p < 0.01). And the ratio of Zn to Cu was higher in SVD and MVD patients than in the control (control $0.78{\pm}0.06$, SVD $0.88{\pm}0.05$, MVD $0.99{\pm}0.04$, P < 0.05). The activity of glutathione peroxidase (GSH-Px) was lower in MVD than in SVD and the control (control $35.13{\pm}1.34$, SVD $35.30{\pm}1.01$, MVD $31.00{\pm}1.04 U/mg$ protein, p < 0.05). The ratio of the activities of superoxide dismutase (SOD) to GSH-Px was higher in MVD than in control and SVD (p < 0.05). In groups with CAD, serum Cu and Zn concentrations and their ratio were changed compared to the control. GSH-Px activity was decreased and the ratio of SOD to GSH-Px was increased in the patients with MVD. The balances between the activities of SOD and GSH-Px should also be considered a risk factor in CAD patients.

• Journal of Trauma and Injury
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• v.33 no.1
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• pp.1-12
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• 2020

Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

• Toxicological Research
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• v.25 no.4
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• pp.175-180
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• 2009

Lead (Pb) is a ubiquitously occurring environmental heavy metal which is widely used in industry and human life. Possibly due to a global industrial expansion, recent studies have revealed the prevalent human exposure to Pb and increased risk of Pb toxicity. Once ingested by human, 95% of absorbed Pb is accumulated into erythrocytes and erythrocytes are known to be a prime target for Pb toxicity. Most of the studies were however, focused on $Pb^{2+}$ whereas the effects of $Pb^{4+}$, another major form of Pb on erythrocytes are poorly understood yet. In this study, we investigated and compared the effects of $Pb^{4+}$, $Pb^{2+}$ and other heavy metals on procoagulant activation of erythrocytes, an important factor for the participation of erythrocytes in thrombotic events in an effort to address the cardiovascular toxicity of $Pb^{4+}$. Freshly isolated erythrocytes from human were incubated with $Pb^{4+}$, $Pb^{2+}$, $Cd^{2+}$ and $Ag^+$ and the exposure of phosphatidylserine (PS), key marker for procoagulant activation was measured using flow cytometry. As a result, while $Cd^{2+}$ and $Ag^+$ did not affect PS exposure, $Pb^{4+}$ and $Pb^{2+}$ induced significantly PS exposure in a dose-dependent manner. Of a particular note, $Pb^{4+}$ induced PS exposure with a similar potency with $Pb^{2+}$. PS bearing microvesicle (MV), another important contributor to procoagulant activation was also generated by $Pb^{4+}$. These PS exposure and MV generation by $Pb^{4+}$ were well in line with the shape change of erythrocyte from normal discocytes to MV shedding echinocytes following $Pb^{4+}$ treatment. Meanwhile, nonspecific hemolysis was not observed suggesting the specificity of $Pb^{4+}$-induced PS exposure and MV generation. These results indicated that $Pb^{4+}$ could induce procoagulant activation of erythrocytes through PS exposure and MV generation, suggesting that $Pb^{4+}$ exposure might ultimately lead to increased thrombotic events.

• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1076-1081
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• 2005

Purpose : Insulin resistance is the most important risk factor linked to the development of impaired glucose tolerance(IGT), diabetes mellitus and cardiovascular diseases in childhood and adolescent obesity, The purpose of this study was to see whether insulin resistance of obese adolescent is higher than that of obese children. and to analyze gender difference and affecting factors of insulin resistance. Methods : Of the 9,837 school children from 5 to 16 tears old, 92 obese children and 187 adolescent, underwent a two-hour oral glucose tolerance test and plasma glucose, insulin, lipid profiles, leptin and high sensitive C-reactive protein(hs-CRP) were measure. Results : Plasma insulin levels of female were higher compared to those of males during oral glucose tolerance test(P<0.05). Four(4.3%) in obese children and twenty five(13.3%) in obese adolescents met the criteria of IGT. Female, leptin, adiponectin and triglyceride concentrations were strongly correlated with homeostatic model assessment insulin-resistance(HOMA-IR) by multiple linear regression analysis(P<0.05). Conclusion : Obese adolescents might have higher insulin concentrations compared to obese children and obese girls higher insulin concentrations than obese boys. Obese boys and children with impaired glucose tolerance have higher insulin concentrations than those with normal glucose tolerance. HOMA-IR was significantly correlated with female, plasma leptin, adiponectin and triglyceride concentrations.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.1
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• pp.73-78
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• 2012

Excessive intake of trans fats is known to be a risk factor for cardiovascular diseases. Previously, we have shown that green tea extract (GTE) lowers the intestinal absorption of lipids and lipid-soluble compounds in rats. This study was conducted to investigate a possible role of GTE on the lymphatic absorption of elaidic acid, a major trans fat in the diet. Adult male Sprague-Dawley rats with lymph duct cannula were infused via an intraduodenal catheter at 3.0 mL/hr for 8 hr with a lipid emulsion containing $180.0{\mu}mol$ elaidic acid, $400.0{\mu}mol$ triolein, $20.7{\mu}mol$ cholesterol, $3.1{\mu}mol$ ${\alpha}$-tocopherol, and $396.0{\mu}mol$ sodium-taurocholate with or without (control) GTE in a 24 mL PBS buffer (pH, 6.4). Simultaneously, lymph was collected hourly for 8 hr via the lymph duct cannula. There was a significant difference in lymph flow by GTE. Also, the lymphatic absorption of elaidic acid for 8 hr was significantly lower in rats infused with GTE than in those not infused with GTE. Similarly, GTE infusion decreased the lymphatic outputs of cholesterol, oleic acid, and phospholipids, compared with the controls. These findings provide clear evidence that GTE has an inhibitory effect on the intestinal absorption of elaidic acid and other lipids. Our work here provides the foundation for further studies to examine and evaluate dietary strategies to ameliorate dietary trans fats from the diet.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.785-791
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• 2000

Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. Material and Method: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period Result : Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42$\pm$8.0mm and 42$\pm$8.3mm left ventricular diastolic dimensions(LVIDd) were 64$\pm$10.0mm and 56$\pm$7.4mm left ventricular end systolic volumes(LVESV) were 62$\pm$19cc (z=1.87$\pm$0.06) and 59$\pm$24cc(z=1.78$\pm$0.08) left ventricular end diastolic volumes(LVEDL) were 169$\pm$40cc(z-1.17$\pm$0.1) and 112$\pm$29cc(z=0.85$\pm$0.1) and ejection fractions(EF) were 66$\pm$6.7% and 48$\pm$12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis ($\Delta$LVEF=-13.3-4.62$\times$LVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. Conclusion ; Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.258-264
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• 2015

Background: This study aimed to evaluate the therapeutic results and safety of pectoralis major muscle turnover flaps in the treatment of mediastinitis after coronary artery bypass grafting (CABG) procedures. Methods: Data regarding 33 patients with post-CABG deep sternal wound infections (DSWIs) who underwent pectoralis major muscle turnover flap procedures in the Emam Reza and Ghaem Hospitals of Mashhad, Iran were reviewed in this study. For each patient, age, sex, hospital stay duration, remission, recurrence, and associated morbidity and mortality were evaluated. Results: Of the 2,447 CABG procedures that were carried out during the time period encompassed by our study, DSWIs occurred in 61 patients (2.5%). Of these 61 patients, 33 patients (nine females [27.3%] and 24 males [72.7%]) with an average age of $63{\pm}4.54$ years underwent pectoralis major muscle turnover flap placement. Symptoms of infection mainly occurred within the first 10 days after surgery (mean, $10.24{\pm}13.62days$). The most common risk factor for DSWIs was obesity (n=16, 48.4%) followed by diabetes mellitus (n=13, 39.4%). Bilateral and unilateral pectoralis major muscle turnover flaps were performed in 20 patients (60.6%) and 13 patients (39.4%), respectively. Complete remission was achieved in 25 patients (75.7%), with no recurrence in the follow-up period. Four patients (12.1%) needed reoperation. The mean hospitalization time was $11.69{\pm}6.516days$. Four patients (12.1%) died during the course of the study: three due to the postoperative complication of respiratory failure and one due to pulmonary thromboembolism. Conclusion: Pectoralis major muscle turnover flaps are an optimal technique in the treatment of post-CABG mediastinitis. In addition to leading to favorable therapeutic results, this flap is associated with minimal morbidity and mortality, as well as a short hospitalization time.