• Journal of Chest Surgery
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• v.32 no.7
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• pp.603-612
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• 1999

Background : It has been documented that brief repetitive periods of ischemia and reperfusion (ischemic preconditioning, IP) enhances the recovery of post-ischemic contractile function and reduces infarct size after a longer period of ischemia. Many mechanisms have been proposed to explain this process. Recent studies have suggested that transient increase in the intracellular calcium may have triggered the activation of protein kinase C(PKC); however, there are still many controversies. Accordingly, the author performed the present study to test the hypothesis that preconditioning with high concentration of calcium before sustained subsequent ischemia(calcium preconditioning) mimics IP by PKC activation. Material and Method : The isolated hearts from the New Zealand White rabbits(1.5∼2.0 kg body weight) Method: The isolated hearts from the New Zealand White rabbits(1.5∼2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45-minute global ischemia followed by a 120-minute reperfusion with IP(IP group, n=13) or without IP(ischemic control, n=10). IP was induced by single episode of 5-minute global ischemia and 10-minute reperfusion. In the Ca2+ preconditioned group, perfusate containing 10(n=10) or 20 mM(n=11) CaCl2 was perfused for 10 minutes after 5-minute ischemia followed by a 45-minute global ischemia and a 120-minute reperfusion. Baseline PKC was measured after 50-minute perfusion without any treatment(n=5). Left ventricular function including developed pressure(LVDP), dP/dt, heart rate, left ventricular end-diastolic pressure(LVEDP) and coronary flow(CF) was measured. Myo car ial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific pepetide. The infarct size was determined using the TTC (tetrazolium salt) staining and planimetry. Data were analyzed using one-way analysis of variance(ANOVA) variance(ANOVA) and Tukey's post-hoc test. Result: IP increased the functional recovery including LVDP, dP/dt and CF(p<0.05) and lowered the ascending range of LVEDP(p<0.05); it also reduced the infarct size from 38% to 20%(p<0.05). In both of the Ca2+ preconditioned group, functional recovery was not significantly different in comparison with the ischemic control, however, the infarct size was reduced to 19∼23%(p<0.05). In comparison with the baseline(7.31 0.31 nmol/g tissue), the activities of the cytosolic PKC tended to decrease in both the IP and Ca2+ preconditioned groups, particularly in the 10 mM Ca2+ preconditioned group(4.19 0.39 nmol/g tissue, p<0.01); the activity of membrane PKC was significantly increased in both IP and 10 mM Ca2+ preconditioned group (p<0.05; 1.84 0.21, 4.00 0.14, and 4.02 0.70 nmol/g tissue in the baseline, IP, and 10 mM Ca2+ preconditioned group, respectively). However, the activity of both PKC fractions were not significantly different between the baseline and the ischemic control. Conclusion: These results indicate that in isolated Langendorff-perfused rabbit heart model, calcium preconditioning with high concentration of calcium does not improve post-ischemic functional recovery. However, it does have an effect of limiting(reducing) the infart size by ischemic preconditioning, and this cardioprotective effect, at least in part, may have resulted from the activation of PKC by calcium which acts as a messenger(or trigger) to activate membrane PKC.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.36-49
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• 1997

Background : Hypertension is one of the most important risk factors of the cerebrovascular accident and coronary artery disease which are the major causes of mortality in Korea. In Korea, the quality of care provided by office-based physicians has not been evaluated formally. The purpose of this study is to assess the quality of hypertension management of office-based physicians. Method : Self-administered questionnaires were mailed to the office-based physicians with the speciality of internal medicine, general surgery, family medicine, and general practitioners. Among 2,045 physicians, 981 doctors(48.0%) replied the questionnaires. Contents of questionnaires were based on the recommendation from the JNC-V report(the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure), and included the criteria of diagnosis, treatment, follow-up interval, and other characteristics of physicians(age, sex, type of speciality, and location of practice). Results : Eighty four percent of the office-based physicians made diagnosis of hypertension with less than 3 times of blood pressure measurements. The performance rate of required examination for hypertensives was very low in most items. Rate of fundoscopic examination is the lowest one among them(5.9%). The performance rate of laboratory examination was also low in most items. Internists tended to order more frequent laboratory examinations than any other type of physicians. Only 11.4% of the physicians did appropriate treatments for the mild hypertension case. The antihypertensives selected by the physicians as a first line drug were in the order of beta blocker(26.4%), calcium channel blocker(23.4%), diuretics(23.1%), ACE inhibitors(14.3%). The visit interval for established hypertensives was very short. Proportion of physicians with follow-up interval longer than 4 weeks was only 4.3%. Conclusions : The overall quality of hypertension management of office-based physicians in Korea is very problematic in many aspects. So further investigations to find out the reasons of low quality arid quality of care should be initiated.

• Journal of Nutrition and Health
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• v.29 no.5
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• pp.489-498
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• 1996

In order to investigate the effect of smoking on serum lipid pattern and nutrient intake, the subjects, 134 smokers and 113 nonsmokers, were selected from college men student in Kwangju area. We examined the serum lipid pattern of 15 smokers and 18 non-smokers who agreed to venipunture among the subjects and also examined nutrients intake. The results obtained were as follows ; Mean concentrations of 새심 cholesterol, HDL-cholesterol and LDL-cholesterol were 187$\pm$12.1mg/dl, 41.5$\pm$1.7mg/dl, and 87.3$\pm$7.4mg/dl in smokers and 182.6$\pm$8.2mg/dl, 45.5$\pm$1.5mg/dl, and 96.3$\pm$4.3mg/dl in nonsmokers, respectively. The total energy intake was 2264kcal/day and mean constitutional rationof protein, fat and carbohydrate was 12.7 : 24.8 : 62.5 in smokes and 2287kcal/day, 14.1 :25.4 : 60.5 in nonsmokers, respctively. Mena daily intakes of calcium, iron, vitamin C and vitamin A were 612.2mg, 15.7mg, 48.2mg 2029.4 IU in smokers and 629.4mg, 15.3mg, 68.4mg 2339.1 IU in nonsmokers, respectively. Vitamin C intake was significantly different at p<0.05 between the smokers and nonsmokers. Intakes of cholesterol, SFA and MUFA were not significantly different between the two groups. Mean daily PUFA intake of smokers and nonsmokers were 5.5g and 6.9g respectively. PUFA intake was significantly different at p<0.05 between the two groups. The results of this study showed that smoking have a tendency to raise coronary heart disease occurrence in the respect of serum lipid levels and vitamin C, PUFA intake were significantly different.

• Nutritional Sciences
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• v.1 no.1
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• pp.29-33
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• 1998

The present study was designed to compare the nutrient intake and iron status of athletic female students majoring in aerobics (n=18) to those of age-matched(20-22 yr) sedentary controls (n=19). The athletic students were exercising regularly for 9.1$\pm$1.4 hrs/wk and the mean training period of aerobics was 2.9$\pm$0.2 years. Means of height, weight, and body mass index calculated as the Quetlet index were similar between athletic and sedentary students. However, mean body fat % of the athletic students (22.3$\pm$1.0%) was significantly lower than that of the sedentary controls (25.8$\pm$0.6%), indicating the effects of routine exercise. Mean daily iron intake was not significantly different between groups (9.9$\pm$0.7 mg vs. 10.9$\pm$0.8 mg), but much lower than the Korean RDA (18 mg/d) in both groups. Dietary calcium intake of the athletic students was significantly lower than that of the sedentary controls. Hematocrit (Hct) and hemoglobin (Hb) values were significantly lower in the athletic students than in the sedentary students (Hct : 40.0$\pm$0.7% vs. 43.8$\pm$0.5% ; Hb : 12.6$\pm$0.3g/dl vs. 14.8$\pm$0.3 g/dl). However, other iron status values such as serum iron, TIBC, and transferrin saturation were not significantly different between groups. Therefore, the low hemoglobin levels in the athletic group are probably due to plasma dilution in endurance-trained individuals. Serum ferritin level was a little lower in the athletic group, but no significant difference between groups was found. Serum triglyceride concentration in the athletic students was significantly lower than that in the control students. In conclusion the findings suggest that regular training of female athletes majoring in aerobics is associated with an increased risk of pseudoanemia due to plasma volume expansion and a decreased risk of coronary heart disease by decreasing body fat and blood lipid level.

• Journal of Nutrition and Health
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• v.32 no.1
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• pp.30-39
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• 1999

This study was designed to investigate the effect of Ca supplementation of 1,000mg per day for 53 weeks on lipid, Na, and K metabolism and on blood pressure in postmenopausal women. The subjects were 12 healthy women aged from 60 to 70 years. They were divided into two groups : the placebo(control group) and the Ca supplemented(1,000 mg/day) group(Ca group). Metabolic studies were conducted twice in the 1st and the 53rd weeks. The results were as follows : Serum triglyceride, total cholesterol and LDL-choesterol levels tended to be decreased after the experiment. Serum VLDL-cholesterol lowering effect was observed with Ca supplementation(p<0.05), and also the significantly elevated HDL/(LDL+VLDL) ratio in Ca supplemented subjects whose average Na intake was as high as 4.9g per day. This phenomena was accompanied with increased Na retention and increased Na excretion in feces, but with decreased urinary Na in Ca supplemented group. However, considering much higher Na reteniton in the control group at the end of experiment(control va Ca ; 1272.3mg vs 732.9mg), Ca supplementation may have some beneficial effects on Na blance. Serum aldosterone level increased significantly in the Ca group after the exsperiment(p<0.05). With these normotensive subjects, there were no level increased significantly in the Ca group after the experiment(p<0.05). With these normotensive subjects, there were no pronounced effect of Ca supplementation on blood pressure, however, decrease in diastolic blood pressure were observed at the 14th week and end of the experiment(p<0.05). In summary, the Ca supplementation on postmenopausal Koran women appears to exert a desirables effect on blood lipid patterns related to the coronary heart diseases and to be beneficial in controlling diastolic blood pressure. Further studies with hypertensive or/and hyperlipidemic subjects are required to clarify the effect of Ca supplementation in Koreans.

• The Korean Journal of Physiology
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• v.18 no.1
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• pp.19-35
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• 1984

Since the first report of Drury and $Szent-Gy{\ddot{o}}rgyi$ in 1929, the inhibitory influences of adenosine on the heart have repeatedly been described by many investigators. These studies have shown that adenosine and adenine nucleotides have overall depressant effects, similar to those of acetylcholine. Heart beats become slow and weak. It is also well known that adenosine is a potent endogenous coronary vasodilator. Many investigations on the working mechanisms of adenosine have been focused mainly on the effects of the coronary blood flow. However, the cellular mechanisms underlying the inhibitory action of adenosine on sinus node are not well understood yet. Thus, this study was undertaken to examine the behavior of rabbit SA node under influence of adenosine. In these series of experiments three kinds of preparations were used: whole atrial pair, left atrial strip, and isolated SA node preparations. The electrical activity of SA node was recorded with conventional glass microelectrodes 30 to 50 $M{\Omega}$. The preparations were superfused with bicarbonate-buffered Tyrode solution of pH 7.35 and aerated with a gas mixture of $3%\;CO_2-97%\;O_2$ at $35^{\circ}C$. In whole atrial pair, adenosine suppressed sinoatrial rhythm in a dose-dependent manner. Effect of adenosine on atrial rate appeared at the concentration of $10^{-5}M$ and was enhanced in parallel with the increase in adenosine concentration. Inhibitory action of adenosine on pacemaker activity was more prominent in the preparation pretreated with norepinephrine, which can steepen the slope of pacemaker potential by increasing permeability of $Ca^{+2}$. Calcium ions in perfusate slowly produced a marked change in sinoatrial rhythm. Elevation of the calcium concentration from 0.3 to 8 mM increased the atrial rate from 132 to 174 beats/min, but over 10 mM $Ca^{+2}$ decreased. The inhibitory effect of adenosine on sinoatrial rhythm developed very rapidly. Atrial rate was recovered promptly from the adenosine-induced suppression by the addition of norepinephrine, but extra $Ca^{+2}$ was less suitable to restore the suppression of atrial rate. Adenosine suppressed also atrial contractility in the same dosage range that restricted pacemaker activity, even in the reserpinized preparation. In isolated SA node preparation, spontaneous firing rate of SA node at $35^{\circ}C$(mean{\pm}SEM, n=16) was $154{\pm}3.3\;beats/min. The parameters of action potentials were: maximum diastolic potential(MDP), $-73{\pm}1.7\;mV: overshoot(OS), $9{\pm}1.4\;mV: slope of pacemaker potential(SPP), $94{\pm}3.0\;mV/sec. Adenosine suppressed the firing rate of SA node in a dose-dependent manner. This inhibitory effect appeared at the concentration of $10^{-6}M$ and was in parallel with the increase in adenosine concentration. Changes in action potential by adenosine were dose-dependent increase of MDP and decrease of SPP until $10^{-4}M$. Above this concentration, however, the amplitude of action potential decreased markedly due to the simultaneous decrease of both MDP and OS. All these effects of adenosine were not affected by pretreatment of atropine and propranolol. Lowering extra $Ca^{2+}$ irom 2 mM to 0.3 mM resulted in a marked decrease of OS and SPP, but almost no change of MDP. However, increase of perfusate $Ca^{2+}$ from 2 mM to 6 or 8 mM produced a prominent decrease of MDP and a slight increase of OS and SPP. Dipyridamole(DPM), which is known to block the adenosine transport across the cell membrane, definately potentiated the action of adenosine. The results of this experiment suggest that adenosine suppressed pacemaker activity and atrial contractility simultaneously and directly, by decreasing $Ca^{2+}-permeability$ of nodal and atrial cell membranes.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.199-207
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• 1996

Ischemic myocardial damage is inevitable to cardiac surgery. Myocardial damage after initiation of reperfusion through the coronary arteries is one of the most important determinants of a successful surgery. Adenosine is a potent vasodilator, and is also known to induce rapid cardioplegic arrest by its property of antagonizing cardiac calcium channels and activating the potassium channel. Thus, we initiated this study with adenosine to improve postischemic recovery in the isolated rat heart. We tested the hypothesis that adenosine could be more effective than potassium in inducing rapid cardiac arrest and enhancing postischemlc hemodynamic recovery. Isolated rat hearts, connected to the Langendorff appratus, were perfused with Krebs-Henseleit buffer and all hearts were subjected to arrest for 60 minutes. Three groups of hearts were studied according to the composition of cardioplegic solutions : Group A (n=10), adenosine 10mmo1/L+potassium free modified St. Thomas cardioplegia : Group B (n=10), adenosine 400mo1/L+S1. Thomas cardioplegia:Group C(control, n=10), St. Thomas cardioplegia. Adenosine-treated groups (group A & B) resulted in more rapid cardiac arrest than control group (C) (p< 0.01). There was greater improvement in recovery of coronary blood flow at 20 and 30 minutes of reperfusion in group A and at 20 minutes in group B when compared with control group(p<0.01). Recovery of systolic blood pressure at 10 minutes after reperfusion in group A and B was significantly superior to that in group C (p<0.01). Recovery of dp/dt at 10 minute after reperfusion in group A was also significantly superior to group C (p<0.05). Group A and B showed better recovery rates than control group in aortic blood flow, cardiac output, and heart rate, but there were no statistical differences. CPK levels of coronary flow in group A were significantly low (p< 0.01). We concluded that adenosine-enriched cardioplegic solutions have better effects on rapid cardiac arrest and postischemic recovery when compared with potassium cardioplegia.

• Korean Journal of Community Nutrition
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• v.15 no.1
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• pp.15-26
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• 2010

The purpose of this study was to compare nutrient intakes and blood lipids of middle-aged women according to the obesity index by %Fat. Subjects were assigned to one of the following groups based on percentage of body fat (%Fat): normal weight (18% ~ < 28%), overweight (28% ~ < 33%) and obesity (over 33%). Nutrient intakes were evaluated based on questionnaires of 24 hours recall method and blood lipids were analyzed by blood analyzer. The results were as follows. 1) Nutrient intakes were that carbohydrates and fat intakes in obesity group were higher than normal and overweight group but the difference was not significant, and protein intake rate was similar all groups. The intake rate of calcium was higher in normal group than obesity group (p < 0.05), and obesity group ingested under dietary reference intakes. The intake rate of iron was higher in obesity group than normal group (p < 0.05). 2) TG, TC, VLDL and TC/HDL in obesity group were higher than normal group (p < 0.001). The attack rate of coronary heart disease in obesity group is higher than normal group (p < 0.01), LDL, blood glucose and blood pressure in obesity group were higher than normal group (p < 0.01), and HDL was a little higher in normal group than obesity group, but the difference was not significant. 3) The correlation of anthropometric measurements, blood glucose, blood lipid, and blood pressure had significant results. Weight was associated positive level with blood glucose, blood lipid and blood pressure. Waist and WHR were associated positive level with blood glucose and blood lipid but weren't associated with blood pressure. BMI was associated positive level with blood glucose, blood lipid and blood pressure, %Fat was associated positive level with blood lipid and blood pressure, but wasn't associated with blood glucose. These results suggest that the decrease of waist on blood glucose control is better than decrease of % Fat and BMI, the decrease of %Fat and BMI on blood pressure control is better than decrease of waist, and the decrease of %Fat on blood lipid control is better than waist and BMI. The nutritional education for obesity treatment must perform to analyze the blood and assess the obesity degree by %Fat, waist and BMI before nutritional education, so the obesity treatment will be effectively.

• Journal of Nutrition and Health
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• v.38 no.9
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• pp.706-716
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• 2005

High blood pressure is an important determinant of the incidence of coronary heart disease, stroke, congestive heart failure, renal failure, and peripheral vascular disease. Recommendations for control of high blood pressure emphasize lifestyle modification, including weight control, reduced sodium intake, increased physical activity. Subjects who were normotensive (n=19, $47.2\pm9.0$ y, BP l16/81 mmHg) ,treatment hypertensive (n=33, $54.2\pm6.9$ y, BP 132/85 mmHg) and non-treatment hypertensive (n=14, $50.1\pm11.0$ y, 149/94 mmHg) recruited. Anthropometric assessment (height weight waist circumference, hip circumference, fat$\%$, fat mass, and lean body mass) and dietary assessments (using 3-days food records, daily nutrient intakes were inuysed by CAN PRO 2.0 were carried out. Blood and 24-hour urine were collected). Test of recognition for salt taste threshold were performed. In non-treatment hypertensive male subjects, weight, $\%$IBW, BMI, and waist circumference were significantly higher than those of normotensive and treatment hypertensive subjects (p<0.05) .Food habits were not significantly different among the three groups. Intakes of vitamin A, vitamin B,, and vitamin B, were significantly higher in normotensive group (p<0.05). Intakes of sodium and salt taste recognition threshold were the highest in normotensive group and the lowest in treatment hypertensive group (p<0.05). Blood levels of lipids and minerals were not significantly different among the three groups. Urinary calcium level of normotensive group were significantly higher than that of treatment hypertensive and non-treatment hypertensive groups (p<0.05). These results indicate that continuous management of hypertension by drug and non-drug treatment affects salt taste recognition threshold and reduced the consumption of sodium. However, dietary sodium intake exceed recommended sodium intake to prevent and treat hypertension. It is necessary to develop the lifestyle modification program that may have beneficial effects on hypertension treatment.

• Journal of Food Hygiene and Safety
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• v.11 no.4
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• pp.243-259
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• 1996

This study was performed to investigate the induction of experimental atherosclerosis in rats and inhibitory effects of aloe vera on progression of atherosclerosis in rats. Adose range finding study of cholesterol and vitamin D2 for the induction of atherosclerosis and studies on the subchronic effect of aloe vera and on the chronic effect of aloe vera were carried out. A total of 3-week old 125 male rats of Sprague-Dawley were divided into 25 groups and fed with the diet containing cholesterol (0.1, 0.2, 0.3, 0.5, 1.0 and 2.0%) and vitamin D2 (500, 5000, 50000 and 500, 000 IU/100 g) for 4 weeks. 35 male rats were divided into 7 groups and fed with the diet containing aloe vera with 1.0% of cholesterol and 50, 000 IU/100 g of vitamin D2 for 4 weeks. 200 male rats were divided into 5 groups and fed with cholesterol and vitamin D2 for 6 and 12 months. Growth, clinical and pathological changes of rats in the three experiments were observed. The results were as follows: 1. In the dose-range finding study, feed intake, feed efficiency ratio and weight to body weight were increased in all of the feed groups containing 500, 000 IU/100 g of vitamin D2. Serum biochemical values of total cholesterol, high-density lipiprotein cholesterol (HDL-cholesterol), triglyceride, calcium, inorganic phosphorous and chloride of male rats in treated groups. The aorta and coronary artery of rats in all of the diet group containing 500, 000 IU/100 g of vitamin D2 showed typical atherosclerotic lesions. 2. Male rats fed with the diet containing aloe vera with 1.0% cholesterol and 50, 000 IU/100 g of vitamin D2 for 6 and 12 months did not show significant difference of diet intake and weight gain, and relative organ weight. The level of serum HDL-cholesterol and triglyceride recovered to the normal range by the aloe vera ingestation. 3. The aorta showed irregular appearence in the tunica intima with swelling, necrosis and calcification. The aorta of rat fed aloe vera diet showed no pathological lesions such as atherosclerosis of aorta. Aloe vera could have a helpful effect of vitamin D2 and cholesterol induced atherosclerosis in rats. Long-term supplementation of aloe vera may slow down the process of experimental atherosclerosis in rats have effects on the development of atherosclerosis.