We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; <1,000 g) or extremely preterm (EP; <28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.
Journal of the Korean Society of Food Science and Nutrition
/
v.36
no.2
/
pp.174-179
/
2007
This study was carried out to investigate the effect of Gastrodiae elata Blume fractions on systolic blood pressure and serum lipid profiles in spontaneously hypertensive rats (SHR/NCrj) fed high fat diet. Twenty-four males SHR weighing approximately 160 g were randomly divided into four groups; A (low molecule, GR-1), B (polysaccharide, GR-2), C (protein, GR-3) fractions of G. elata Blume, respectively, and D (high fat diet as control). After orally tube feeding the fractions of G. elata Blume, there were no differences in final body weights among the treatment groups. Diet intake was somewhat high in the control group (D), but there were no significant differences in feed efficiency ratios. In terms of serum lipid profiles, total-cholesterol level was statistically higher in the control group (D) than in G. elata Blume fraction groups (p<0.05). Triglyceride levels of low molecule (A) and polysaccharide (B) groups were lower by 16% and 11%, respectively than that of the control group (D). HDL-cholesterol level was remarkably higher (p<0.05), whereas LDL-cholesterol level was significantly lower (by 25%) in the group B as compared to the control group (D). Atherogenic index (AI) of G. elata Blume fraction groups were significantly lower than in the control group (p<0.05). Reference blood pressure (RBP) showed an average of $180\sim190mmHg$ at 8 weeks old after 3 weeks on feeding high fat diet. Compared with RBP, final blood pressure of treatment groups (35 days after feeding the fractions of G. elata Blume gractions) were decreased by 1.7% (A), 5.5% (B) and 3.6% (C), respectively, but the control group (D) contrarily showed an increase of 2.6%. Especially, final systolic blood pressure of the polysaccharide group (B) was lower by 22 mmHg than that of the control group (D). From these findings, it can be suggested that polysaccharide fraction may improve blood serum lipids and should be considered as effective in lowering of blood pressure.
Spontaneous intracranial hypotension(SIH) is a rare syndrome of spontaneously occurring postural headache associated with low CSF pressure. It usually occur without evidence of any preceeding events such as lumbar puncture, back trauma, operative procedure, or medical illness. This syndrome usually resolves spontaneously or with strict bed rest. When the headache persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of SIH. We experienced a case of SIH with downward displacement of brain in MRI and successfully treated with epidural blood patch.
The study aim was to examine the effect of sensory responses of subjects after 6-month dietary sodium reduction with the aid of nutritional education. Fourteen female college students voluntarily restricted their sodium intake for 6 months, during which time they received nutritional education on the low sodium diet. As a control group, 10 students, whose anthropometric measurement, sodium intake behavior, and blood pressure were not different from those of the experimental group, were maintained on a normal diet. For the sensory responses of subjects, the salt taste perception and pleasantness for graded (0.15-1.3%) NaCl solutions were measured by a 9-point hedonic scale. The optimum sodium concentration, urinary sodium excretion, and blood pressure were measured. All the measurements were done at the beginning and end of the experiment. The sensory evaluation revealed an absence of any difference between the two groups in salt taste perception and pleasantness responses at the beginning. After 6-month adaptation, the experimental group subjects showed higher responses to low NaCl solution (0.15, 0.3, 0.5%) in salt taste perception and pleasantness evaluation while the control group subjects exhibited the opposite response. The optimum sodium concentration was reduced from 105.6 mmol to 80.7 mmol (p = 0.015) and the urinary sodium excretion was also reduced from 1,398 mg to 906 mg (p = 0.041) only in the experimental group. Systolic blood pressure was significantly reduced in the experimental group, although there was no correlation between the urinary sodium excretion and blood pressure. The optimum sodium concentration was negatively correlated with the urinary sodium excretion (r = 0.418, p = 0.053), indicating that adaptation to low sodium diet can reduce sodium intake. Further study on the individual responses of subjects on a low sodium diet by periodical evaluation may provide useful data for setting the duration needed to stabilize a lowered appetite for sodium.
Kim Sun-Hee;Yu Choon-Hie;Kim Jung Yun;Lee Sang Sun
Journal of Nutrition and Health
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v.38
no.7
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pp.561-569
/
2005
This research was conducted to study the effect of milk consumption on blood lipid levels of Korean college women. According to milk intake from food frequency questionnaire (FFQ), top $20\%$ of subjects were classified as high group (HG) and bottom $20\%$ as low group (LG). Body weight, height and blood pressure were measured and BMI was calculated from the anthropometric data, but there was no significant difference between the groups. Blood samples were collected and analyzed for total cholesterol (TC), triglycerides (TG) and lipoprotein fractions. There was no significant difference in the blood level of albumin, total protein and hemoglobin between two groups, and all blood parameters were in the normal range. Blood lipid levels of two groups were not significantly different, but HDL-cholesterol level were higher in HG (p < 0.05). Therefore, according to the result of the research, it is considered that drinking a pack of milk (200 ml) everyday, the average intake of dairy products of HG, is advisable to promote good health without increasing of cardiovascular disease (CVD) risk.
This study was conducted to assess nutritional status of the elderly from low-income urban area and to investigate environmental and health risk factors that may influence to nutrient intakes. One hindered eighty three(males 53, females 130) healthy homestaying subjects aged over 65 years in Seoul were assessed with anthropometric measurements and dietary intake in August, 1994. HT and BW for females were decreased with aging. The proportion of hypertension was 36% with indite of $SBP{\;}(SBP{\;}{\gg}{\;}160mmHg)$ and 52% with indice of DBP $(DBP{\;}\gg{\;}97mmHg)$. Distribution of BMI, OR and PIBW indicated that BMI was more sensitive for identifying underweight whereas PIBW was more sensitive for identifying overweight. for group aged over 75, males had significantly lower intake of energy, protein, fat, calcium, iron, vitamin A and $\beta$ carotene compared to the group aged 67~74, while females had lower intake of calcium and vitamin A. Elderly group with smoking, less familly size and living alone had lower nutrient intakes. Blood pressure in the elderly subjects did not influence to nutrient intakes, except elderly with normal blood pressure were taking increased amount of thiamin and niacin.
Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.
It has been reported by some investigators that pressor response of rabbits to sympathetic ganglionic stimulants was weak. In this paper it was attempted to investigate this problem more thorouglhy in urethane anesthetized rabbits. 1) In rabbits the approximate doses to elicit increase of about 20 mmHg of blood pressure were $100\;{\mu}g/kg$ with DMPP, $50\;{\mu}g/kg$ with Wy-615, $500\;{\mu}g/kg$ with TMA and with nicotine. The pressor activity of these substances was markedly augmented by treating animals with syrosingopine. 2) In adrenal-ligated rabbits pressor activity of the substances was markedly reduced. Treating the adrenal-ligated animals with syrosingopine augmented significantly the pressor activity of these substances except DMPP. Direct injection of DMPP and TMA into the adrenal produced mole pressor response than intravenous injection did. These date suggest that DMPP has greater effect on the adrenal medulla than the other substances. 3) In vagotomized and atropinized rabbits the pressor activity of these compounds was more marked than in normal rabbits. 4) The above facts indicate that the pressor activity of the ganglionic stimulants in rabbits was definitely low than in cats and dogs. The low responsiveness of the rabbits to these agents was discussed in the light of catecholamine releasing mechanisms, and extraganglionic actions of these substances.
Effects of a voltage dependent calcium channel antagonist, nifedipine, on the responses of blood pressure, and secretion of atrial natriuretic peptide (ANP) and aldosterone to angiotensin II (Ang II) were compared in male Wistar and spontaneously hypertensive rats (SHR). A low, control or high sodium diet (2, 10 or 25 mmol Na/100 g diet) was fed for 6 weeks from the age of 6 weeks. On the morning of the experiment catheters were inserted under ether anesthesia in the femoral artery for pressure recording and blood sampling, and in the femoral vein for drug infusion. Ang II was infused at a rate of 250 ng/kg/min for 20 min. Nifedipine mixed with Ang II was infused at a rate of $16{\mu}g/kg/min$ for 20 min. Arterial blood samples were collected before and after infusion of Ang II with or without nifedipine. The control plasma level of aldosterone was inversely related to the amount of salt intake, whereas the plasma ANP level was not different between the salt groups. SHR showed a higher basal plasma ANP but a lower aldosterone concentration than Wistar rats. Infusion of Ang II produced a significant increase in blood pressure and plasma levels of aldosterone and ANP: The % increase was not significantly different either between the salt groups or between SHR and Wistar rats. SHR showed a greater pressor response to Ang II but a remarkably smaller decrease in heart rate after Ang II infusion than Wistar rats, With increasing sodium intake, the effect of Ang II on aldosterone secretion was decreased, whereas that on ANP secretion or blood pressure was not changed. Nifedipine decreased the responses of blood pressure and heart rate to Ang II in all groups. Nifedipine caused almost a complete inhibition of Ang II induced ANP secretion, but only a partial inhibition of Ang II induced aldosterone secretion or vasoconstriction. These results indicate that calcium dependent processes were involved in Ang II induced vasoconstriction, and secretions of aldosterone and ANP. However, the calcium dependent process far ANP secretion was considerably different from that for aldosterone secretion or vasoconstriction evoked by ang II. The ang II induced increase in ANP secretion appeared to be caused primarily by activating voltage-dependent calcium channels, whereas Ang II induced aldosterone secretion and vasoconstriction was not.
This study was attempted to provide us with basic information on how to improve understanding with patients for operation, and to offer then better nursing and treatment. This kind of study will help scientific application to nursing practice and operating room. The data was collected by interviewing 29 patients who underwent the elective surgery under the general anesthesia at Y hospital in Seoul. The interview ran from October 15 to December 15, 1989. The research instrument was a anxiety measurement device (SAAI) originally developed by Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing Hypothesis one was that there would be a difference in state anxiety level according to a time difference in watiting for operation. This hypothesis was rejected(state.anxiety level one hour before operation P>.05, r-.747, State anxiety level half an hour before operation P>.05, r-.1550, state anxiety level just before operation, P>.05, r=.1099). However, state anxiety, evel appeared to be associated with a longer watiting period, like one day before operation (P<.05, r-.4628). Hypothesis two was that there would be a difference according to state anxiety level of patients for operation. This was rejected. (Change of blood perssure in systolie P>.05 r=.1082, Change of blood pressure in diastolic P>.05, r=.088, Change of pulse rate, P>.05, r-1.909) 2. Examining trait anxiety and state anxiety levels, the average level of trait anxiety was 42.034, and the average level of state anxiety one day before operation was 43,000. The average level of state anxiety was averaged 42.356 in a waiting room for operation. 3. Examining the state anxiety level by time period, the one hour before was 42.379 the level half an hour before 42.276, and the level just before operation 42.414. The low level of state anxiety was due to the fact that premedication was not eliminated. 4. Age and time period like one day before operation was related to state anxiety level (F=5.271, P<.0.01) and blood pressure in waiting room for operation. That is, state anxiety level and blood pressure of patients one day before operation appeared high. Sex was relation to changes of blood pressure ; the blood pressure of male patients appeard higer than of female patients. A marital status was also related anxiety level one hour before operation the married patient for operation showed a higher state anxiety level than that of the unmarried patient for operation. Education was similarily related to trait anxiety level in which highly educated patients show lower levels of trait anxiety than poorly educated ones. Motive for hospitalization was related to state anxiety level for patient one hour before operation (F=6.464, P<.05) likewise, patients who are supposed to undergo operation hastily showed higher levels of anxiety than patients who expect elective surgeries.
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