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Effect of Fructose-1,6-diphosphate[FDP] on Red Blood Cells after Extracorporeal Circulation (체외순환후 fructose-1,6-diphosphatate[FDP]가 적혈구에 미치는 영향)

  • 이정렬
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.693-701
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    • 1992
  • Extracorporeal cardiopulmonary bypass[CPB] has been associated with a wide variety of hematologic derangements, including a transient deformation and hemolysis of red blood cells[RBCs], which is supposed to be due to mechanical trauma and/or metabolic alterations. Since membrane integrity is, in part, maintained by energy requiring process, inadequate function of erythrocyte glycolytic pathway, which is inevitalble during CPB, may cause depletion of high energy phosphate pool and result in hemolysis. The authors performed an investigation to assess whether administration of Fructose-l, 6-diphsphate [FDP], which has been known to enhance intracellular glycolytic activities, could counteract erythrocyte hemolytic events caused by CPB. Sixty pateints with cyanotic congenital heart diseases, who underwent open heart surgery under CPB longer than 60 minutes, were randomly divided into two groups depending on whether use of FDP[Group FDP] or not[Group Control]. The age, sex, CPB time, preoperative hemoglobin level, disease entities were all similar[Table 1], and membrane type oxygenators were used in all patients. In Group, FDP, a dose of 250mg/kg body weight of FDP was administered by intravenous dripping every 12 hours from the morning of the operation to postoperative 48 hours, To demonstrate the degree and pattern of hemolysis of erythrocyte, reticulocyte count, indirect /direct bilirubin, haptoglobin, plasma hemoglobin, lactate dehydrogenase were measured every 12 hours from the time of cessation of CPB to 48 hours and RBC morphologic study, osmotic fragility test were done every 24 hours. All parameters revealed less hemolytic in group FDP [Fig. 1~5], though the differences between two groups were not significant, except plasma hemoglobin, lactate dehydrogenase changes. A pattern of sequential changes of plasma hemoglobin, lactate deh-ydrogenase showed the highest level at the time of CPB stop and abrupt decrease in following 24 hours in both groups, and statistically significant differences were demonstrated in group FDP at least for the first 12 hours postoperatively[p<0.05]. The authors conclude that they can expect the benificial effect of FDP on the maintenance of membrane stability of RBC probably by energy enhancement during the shock status of CPB, but FDP could not completely prevent the damaging effect on RBC by cardiopulmonary bypass

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Clinical Evaluation of the Angell-Shiley Porcine Xenograft Valve (Angell-Shiley 판막의 임상적 평가)

  • 김종환
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.75-82
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    • 1986
  • The use of the Angell-Shiley porcine xenograft cardiac valve was limited in number at Seoul National University Hospital chiefly because of the cessation of supply from the manufacturer, Forty-eight Angell-Shiley valves along with the 5 other mechanical or tissue valves were used in 46 patients during the period from 1977 to 1980, and a total of consecutive cases was studied for their early and long-term clinical results. The operative mortality rate was 4.3%; no death after single and 2 deaths after double valve replacement within 30 days of surgery. The 44 early survivors were followed up for a total of 171.6 patient-years and a mean of 46.8$\pm$31.1 months. Four died during the follow-up period with a linealized late mortality rate of 2.33%/patient-year. Four patients had experienced 5 episodes of thromboembolism and one died; a linealized incidence of 2.91% emboli/patient-year. A single case each had a bleeding complication related to the anticoagulants, 0.58% bleeding/patient-year, and prosthetic valve endocarditis, 0.58% endocarditis/patient-year. The clinical improvement was excellent by 70% of the survivors having no cardiac symptoms at the end of the follow-up. The actuarial survival rates were 89.9$\pm$4.9% at 5 years and 69.2$\pm$15.0% at 9 years after surgery. The probabilities of freedom from thromboembolic complication were 92.3$\pm$5.5% and 80.9$\pm$9.0% at 5 and 9 years after surgery. And, the probability of freedom from overall valve failure was 83.4$\pm$6.3% at 5 years and it declined sharply down to 55.9$\pm$22.2% at 9th year of the follow-up. These results are comparable with those in the major reports, except a more accelerated and time-related increases in valve failure after 5 or 6 years after operation with the Angell-Shiley valve. The durability of the xenograft tissue valve remains as the most important debate and the need of more durable tissue valves was also discussed.

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An Experimental Study on the Effect of Hypothermic Oxygenated Cardioplegic Solution on Myocardial Protection during Prolonged Aortic Cross-clamping (대동맥 차단시 저온 산소화 심정지액이 심근보호에 미치는 영향)

  • Wang, Yeong-Pil;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.759-770
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    • 1985
  • This study was experimentally undertaken to evaluate the effect of hypothermic oxygenated cardioplegic solution on myocardial protection during prolonged aortic cross clamping under cardiopulmonary bypass. Dogs were divided into two groups control group [received hypothermic unoxygenated cardioplegic solution] and experimental group [received hypothermic oxygenated cardioplegic solution]. Coronary sinus effluent was obtained at once and 30, 60, 90 minutes after cross-clamping for the determination of pH, PCO2,PO2 and lactate level during the infusion of cardioplegic solution and myocardial biopsies were obtained after cessation of 90 minutes of aortic cross-clamping. The results obtained were as follows: 1. There was no significant differences in the pH and PCO2 between the oxygenated and unoxygenated cardioplegic solution but the PO2 of the oxygenated solution was 4 times greater than unoxygenated solution, and also the oxygenated solution had a significantly greater oxygen content [2.020.05 ml 02/min] and had much more oxygen delivery than unoxygenated solution. 2. The myocardial oxygen consumption and the myocardial oxygen extraction in oxygenated group were 1.63 ml 02/100 ml and 67.32% respectively, which was greater than those in unoxygenated group. 3. Regarding to pH and PCO2 of coronary sinus effluent, there was no significant differences between two groups in early period of infusion of cardioplegic solution, but the pH shifted to acidosis from 60 minutes, PCO2 increased from 90 minutes of aortic cross-clamping, and PO2 markedly decreased from 90 minutes of aortic cross-clamping in unoxygenated group. 4. The lactate concentration of coronary sinus effluent revealed relatively normal in both groups, but showed slight increase up to 27.54.56 mg/100 ml at 90 minutes of aortic cross-clamping in unoxygenated group. 5. On electron microscopic study, the ultrastructural integrity of myocardial cells in oxygenated group was well preserved within 90 minutes. Slight swelling and deformity of mitochondria, interfibrillar widening, and disarrangement of myofibrils were observed at 90 minutes after aortic cross-clamping in unoxygenated group. From these results, the use of hypothermic oxygenated cardioplegic solution seemed to be effective and better method for the preservation of ischemic myocardium during the prolonged aortic cross-clamping.

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Public Health Challenges of Electronic Cigarettes in South Korea

  • Lee, Sung-Kyu;Kimm, Hee-Jin;Yun, Ji-Eun;Jee, Sun-Ha
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.6
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    • pp.235-241
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    • 2011
  • Electronic cigarettes (e-cigarrettes) were recently introduced and advertised as a smoking cession device in South Korea. As the social norm to quit smoking has gained hold in the country, the number of e-cigarette users is growing rapidly. This phenomenon should be urgently considered, because of the lack of research that has been conducted to examine the safety of e-cigarettes and its efficacy as a smoking cessation aid. This paper raises several public health concerns on e-cigarettes in South Korea. Uncertain regulations of the government on e-cigarettes are contributing to an increase of e-cigarette users and allowing the e-cigarette industry to circumvent existing regulations. The aggressive marketing activity of this industry is also a core factor that is responsible for the rapid increase of e-cigarette use, in particular among the youth. Following the enforcement of tobacco control, some cigarette smokers may be encouraged to purchase e-cigarettes in order to circumvent the regulations, even though the dual use of e-cigarette and cigarette may be more harmful. Until there is clear evidence of the e-cigarette’s safety, it is recommended that the industry’s marketing and promotional activities be banned and closely monitored, and public campaigns be initiated to educate the public regarding e-cigarettes.

Build Capacity for International Health Agenda on the "Transforming Our World: The 2030 Agenda for Sustainable Development" (제2기 새천년 개발계획과 국제보건역량강화)

  • Park, Yoon Hyung
    • Health Policy and Management
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    • v.25 no.3
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    • pp.149-151
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    • 2015
  • United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (${\leq}70years$) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.

A Study of Nutrient Intakes and Psychosocial Factors Associated with Smoking among Female High School Students (여고생 흡연자의 영양소 섭취 실태 및 흡연관련 사회심리적 요인에 관한 연구)

  • 김경원
    • Journal of Nutrition and Health
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    • v.32 no.8
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    • pp.908-917
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    • 1999
  • This study was done to compare nutrient intakes, anthropometric indices, and psychosocial factors related to smoking by smoking status among adolescent girls in Seoul. Subjects were high school students, and smokers were 17.6%. Nutrient intakes were analyzed by convenient method, and anthropometric measurements were done by Inbody 2.0. Psychosocial factors of smoking were examined based on the Theory of Planned Behavior : 26 attitudinal, 9 normative, and 17 control beliefs were used. Smokers smoked 5-7 cigarettes a day on average, with 1.26 pack-years of smoking, There were no significant differences in anthropometric characteristics, except fat distribution, between smoking(n=92) and nonsmoking(n=92) and nonsmoking(n=94) group. The percentage of alcohol groups. Especially, caloric intake (63.6% of RDA) were much below the recommended level. With respect to psychosocial factors, 18 out of 26 attitudinal beliefs were significantly different between smokers and nonsmokers. Smokers responded less negatively on the items of bad health effects of relax(p<0.001). In addition, smokers were more convinced of advantages of smoking (test, etc.)but responded less negatively on the disadvantages of smoking(bothering others, yellow teeth, bad breath, etc.). Smokers expressed less pressure for not smoking from siblings, friends, school seniors than nonsmokers. In addition, smokers, expressed less confidence in controlling the urge to smoker or quitting smoking in several situations, such as 'after a meal', 'feel bored', 'with friends', 'when angry' offered a cigarette by friends', 'drinking coffee or tea', 'drinking alcohol', 'seeing others smoke'(p<0.001). Smokers also felt less developing in applying specific skills for controlling the urge to smoker or quitting smoking. These findings suggest the need for developing smoking cessation programs for adolescent females, focusing on specific beliefs identified in this study.

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Long-term repeated rituximab treatment for childhood steroid-dependent nephrotic syndrome

  • Kim, Ji Hyun;Park, Eujin;Hyun, Hye Sun;Cho, Myung Hyun;Ahn, Yo Han;Choi, Hyun Jin;Kang, Hee Gyung;Ha, Il-Soo;Cheong, Hae Il
    • Kidney Research and Clinical Practice
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    • v.36 no.3
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    • pp.257-263
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    • 2017
  • Background Rituximab (RTX) can be used as a rescue therapy for steroid-dependent nephrotic syndrome (SDNS). However, the efficacy and safety of long-term, repeated use of RTX are not established. This study was conducted to assess the efficacy and safety of long-term, repeated RTX treatment in children. Methods Eighteen consecutive child patients with SDNS who were treated with three or more cycles of RTX for one year or longer were recruited, and their medical records were retrospectively reviewed. Results The patients were followed for $4.7{\pm}1.9years$ and received $5.2{\pm}2.3cycles$ of RTX over $2.8{\pm}1.1years$. Approximately 70% of the additional RTX cycles were administered due to recovery of B-cells without relapse. The relapse rate decreased from $3.4{\pm}2.0per$ year initially to $0.4{\pm}0.8per$ year at the third year after RTX treatment. Approximately 10% of the RTX infusions were accompanied by mild infusion reactions. Eight patients showed sustained remission without any oral medication after the last cycle of RTX, while 10 patients had one or more episodes of relapse after the last cycle of RTX. The relapse rate in the latter group decreased from $2.8{\pm}1.5per$ year before RTX treatment to $1.3{\pm}0.8per$ year after cessation of RTX treatment. No significant differences in clinical parameters were found between the two groups. Conclusion This retrospective study showed that pre-emptive and long-term, repeated RTX treatment is relatively effective and safe in children with SDNS. However, well-designed prospective studies are needed to confirm these findings.

American ginseng attenuates azoxymethane/dextran sodium sulfate-induced colon carcinogenesis in mice

  • Yu, Chunhao;Wen, Xiao-Dong;Zhang, Zhiyu;Zhang, Chun-Feng;Wu, Xiao-Hui;Martin, Adiba;Du, Wei;He, Tong-Chuan;Wang, Chong-Zhi;Yuan, Chun-Su
    • Journal of Ginseng Research
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    • v.39 no.1
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    • pp.14-21
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    • 2015
  • Background: Colorectal cancer is a leading cause of cancer-related death, and inflammatory bowel disease is a risk factor for this malignancy. We previously reported colon cancer chemoprevention potential using American ginseng (AG) in a xenograft mice model. However, the nude mouse model is not a gut-specific colon carcinogenesis animal model. Methods: In this study, an experimental colitis and colitis-associated colorectal carcinogenesis mouse model, chemically induced by azoxymethane/dextran sodium sulfate (DSS) was established and the effects of oral AG were evaluated. The contents of representative ginseng saponins in the extract were determined. Results: AG significantly reduced experimental colitis measured by the disease activity index scores. This suppression of the experimental colitis was not only evident during DSS treatment, but also very obvious after the cessation of DSS, suggesting that the ginseng significantly promoted recovery from the colitis. Consistent with the anti-inflammation data, we showed that ginseng very significantly attenuated azoxymethane/DSS-induced colon carcinogenesis by reducing the colon tumor number and tumor load. The ginseng also effectively suppressed DSS-induced proinflammatory cytokines activation using an enzyme-linked immunosorbent assay array, in which 12 proinflammatory cytokine levels were assessed, and this effect was supported subsequently by real-time polymerase chain reaction data. Conclusion: AG, as a candidate of botanical-based colon cancer chemoprevention, should be further investigated for its potential clinical utility.

Factors Associated with Hazardous Drinking in the Male and Female Elderly with Hypertension (남녀 고혈압 노인의 위험음주 관련 요인)

  • Choi, Hye Young;Kim, Eunha
    • Journal of Korean Public Health Nursing
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    • v.35 no.1
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    • pp.135-148
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    • 2021
  • Purpose: This study examined socio-demographic and health status factors associated with hazardous drinking in male and female elderly with hypertension. Methods: The sample consisted of 2,322 seniors with hypertension and was obtained from the Seventh Korean National Health and Nutrition Examination Survey (VII-1, VII-2, VII-3). Complex sample analysis was performed using the independent t-test, the Chi-square test and multiple logistic regression in SPSS/WIN 24.0 program. Results: The factors associated with hazardous drinking in the male hypertensive seniors were age (OR=2.13, CI=1.37-3.32), weekly drink number (OR=0.11, CI=0.07-0.16) and weight gain control (OR=0.44, CI=0.21-0.94), and corresponding factors in female hypertensive seniors were age (OR=4.56, CI=2.37-8.80), income level (OR=1.88, CI=1.05-3.37), weekly drink number (OR=0.09, CI=0.04-0.17), current smoking (OR=6.88, CI=2.29-20.64), weight loss control (OR=1.99, CI=1.14-3.47), hypertension treatment (OR=35.62, CI=2.02-629.43), and hypertension drug (OR=0.06, CI=0.01-0.61). Conclusion: Risk drinking in elderly with hypertension was found to be related to personal characteristics and health status. Therefore, to manage hypertension effectively in the elderly, drinking patterns should be improved and active participation in the practice of healthy activities such as weight control, smoking cessation, and decreased alcohol intake, should be encouraged.

A Systematic Review of The Health Promotion for Workers; Participatory Action Research and Community Based participatory Research (근로자의 건강증진에 대한 체계적 문헌고찰 참여적 실행연구와 지역사회기반 참여연구 중심으로)

  • Hwang, Won Ju;Ha, Ji Sun;Jo, Hyun Hee
    • Journal of the Korea Convergence Society
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    • v.9 no.12
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    • pp.459-466
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    • 2018
  • This study investigated a systematic literature review on local and international literatures focusing on Participatory Action Research(PAR), Community Based Participatory Research(CBPR) in workplace and community. Eighty percent of the 10 studies reviewed included research involving health professionals, community networks, workers, and university researchers. Health promotion programs varied from health and safety awareness, smoking cessation, diabetes management, physical activity, self-efficacy enhancement, cardiovascular disease, musculoskeletal disorders and mental health. PAR, CBPR are required to participate actively in research through community collaboration to promote health. We can solve problems at the community level. And identified sustainable effects when developing and implementing a health promotion program. PAR and CBPR are expected to continuously pursue change by adjusting the scope of individuals, organizations, communities, and institutional dimensions. They are also expected to be implemented for workers in the various workplace.