• 한국융합학회논문지
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• 제6권3호
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• pp.19-28
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• 2015

본 연구의 목적은 중년기 여성을 대상으로 비만의 원인을 규명하기 위하여 필요한 다양한 관련요인을 분석함으로서 향후 비만 정책방향에 기초자료를 제공하는데 있다. 2014년 4월부터~11월까지 인천지역의 N 병원 건강증진센터를 방문한 건강한 중장년 여성들 중 본 연구의 목적에 동의한 195명의 여성을 대상으로 실시하였으며, 신체계측, 체성분검사, 복부 지방분포는 복부지방단층촬영(Fat-CT)을 이용하였다. 그리고 골밀도는 정량적전산화 단층촬영(Q-CT)을 이용하여 측정하였다. 복부지방단층촬영 결과 '피하지방' 76명(39%), '내장지방'은 119명(61%)이었으며, 체질량지수(BMI)는 '저체중($18.5kg/m^2$)'은 13명(6.7%), '과체중($25kg/m^2$이상)'은 60명(30.8%), 평균값은 $23.5{\pm}4.11kg/m^2$이었다. 그리고 허리둘레, 확장기혈압, 수축기혈압, 중성지방에서 유의수준 5%내에서 통계적으로 유의한 것으로 나타났다. 본 연구의 결과를 통해 나이가 들수록 근육감소가 복부비만으로 인한 체중 증가를 상쇄시킨다는 점을 알 수 있었고, 따라서 비만에 대한 차후연구에서는 이러한 특성을 이해해야 한다.

• Journal of Chest Surgery
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• 제18권2호
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• pp.182-192
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• 1985

[here are so many reports that pulsatile blood flow provides physiologic organ perfusions during cardiopulmonary bypass. So, we compared the recent 30 cases undergoing cardiac surgery by Cobe-Stckert pulsatile roller pump with another 30 cases by Polystan nonpulsatile roller pump. Pulsatile flow was applied during aortic-cross clamping period when synchronized to internal EKG simulator, and perfusion mode was changed to continuous nonpulsatile flow after declamping of aorta. Age, sex, weight, and disease entities were comparable and operative techniques were similar between two groups. 1. There were no differences in average ACC time, ECC time, and Operation time. 2. Postoperative artificial respiration time was 6hrs 30mins in nonpulsatile group and 4hrs 48mins in pulsatile group, and detubation time after ventilator weaning was 2hrs 44mins in nonpulsatile group and 1hrs 43mins in pulsatile group. 3. Average pulse pressure was 8mmHg in nonpulsatile group and 55mmHg in pulsatile group, and a mean arterial pressure was 66.0mmHg in nonpulsatile group and 60.7mmHg in pulsatile group. 4. Mean urine-output during ACC;ECC period was 9.717.3;9.913.2ml/kg/hr in nonpulsatile group and 14.215.0;15.817.5 in pulsatile group [p<0, 05], and thereafter progressive decrease of differences in urine output between two groups until POD 2, and lesser amounts of diuretics was needed in pulsatile group during same postoperative period. Serum BUN/Cr level showed no specific difference and urine concentration power was well preserved in both groups. 5. Plasma proteins and other Enzymes showed no differences between two groups, but serum GOT/GPT level was higher in nonpulsatile group till POD 2. 6. Serum Electrolytes showed no differences between two groups. 7. WBC, RBC, Platelet counts, Hgb and Hct were not different and Coagulogram was well preserved in both groups. 8. Plasma free Hgb level was 7.09mg% in pulsatile group compared with 3.48mg% in pulsatile group on POD 1 but was normalized on POD 2. Gross hemoglobinuria after ECC was noted in 6 cases [20%] of pulsatile group and 4 cases [13%] of nonpulsatile group. 9. In both groups, most patients were included in NYHA class III to IV [28 cases;93% in nonpulsatile group, 22 cases;73% in pulsatile group] preoperatively, and well improved to class I to 11[22 cases; 73% in nonpulsatile group, 30 cases; 100% in pulsatile group] postoperatively. There were 7 operative mortalities in nonpulsatile group only, which were 5 cases of TOF with hepatic failure, 1 case of multiple VSDs with low out-put syndrome, and 1 case of mitral valvular heart disease with cardiomyopathy. We concluded that the new, commercially available Cobe-Stckert pulsatile roller pump device was safe, simple, and reliable.

• 보건교육건강증진학회지
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• 제17권1호
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• pp.115-130
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• 2000

This study was conducted to examine health behaviors in hypertensive patients and the factors that would affect these healthy life-styles. and to provide basic data for effective and continuous hypertension control in private medical facilities. Among those patients diagnosed as hypertension who had visited the Department of Internal Medicine of Yeungnam University Hospital during the two month period from August 2 to September 30, 1999, the present study included 222 patients who were in more than one month after the initial diagnosis of hypertension and those who had hypertension for less than 10 years. Using a structured questionnaire, the present study was conducted by a self-administered survey method, and the obtained data were analyzed with t-test, $x^2$-test and one-way analysis of variance using the SPSS statistical program. The scores on knowledge related to hypertension were higher as the education level of a patient was higher(p〈0.05). As for occupation, those who performed office or management jobs showed higher scores than those who were into manufacturing jobs, and as for economic status, although those patients who were in middle class showed highest scores, however, no statistical significance was observed. The scores of knowledge on hypertension was higher when the family history of hypertension was present(p〈0.05). The scores of health-related behaviors were higher with higher education level and higher economic status, higher in those with family history of hypertension, and higher in those with office or management jobs than those who had manufacturing jobs(p〈0.05). Blood pressure measurement on regular basis was performed most frequently in those who were between 50-59 years old with 83.3% and was least frequent in those who were older than 70 years old with 50%(p〈0.05). The frequency of regular blood pressure measurement was higher with higher education level, higher economic status, higher in those with family history of hypertension, and the highest in those with management position with 93.5%, however, on statistical significance was observed. Changes in health-related behaviors after hypertension diagnosis were higher with higher education level, higher economic status, and in those patients performed office or management work. In particular, diet change was observed in female and higher economic status and smoking cessation was observed in 60-69 years old. Housewives and office workers or managers have taken exercise more regularly and those who had management jobs and had high scores on knowledge related to hypertension would participate health education program more actively. Thus, for improving health-related behaviors for continuous management of hypertension, changes in health-related behaviors can be followed through conduction health education to improve understanding of knowledge related to hypertension as the method of helping to improve changes in health life-styles in those with little education and those in low economic status.

• Clinical and Experimental Pediatrics
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• 제56권1호
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• pp.32-36
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• 2013

Purpose: Chronic day-to-day symptoms of orthostatic intolerance are the most notable features of postural orthostatic tachycardia syndrome (POTS). However, we have encountered patients with such symptoms and excessive tachycardia but with no symptoms during the tilt-table test (TTT). We aimed to investigate whether POTS patients with chronic orthostatic intolerance always present orthostatic symptoms during the TTT and analyze the factors underlying symptom manifestation during this test. Methods: We retrospectively examined patients who presented with POTS at the Gyeongsang National University Hospital between 2008 and 2011. Diagnosis of POTS was based on chronic day-to-day orthostatic intolerance symptoms as well as excessive tachycardia during the TTT. The patients were divided two groups depending on the presentation of orthostatic symptoms during the TTT. Clinical data and the results of the TTT were compared between these groups. Results: In 22 patients, 7 patients (31.8%) did not present orthostatic symptoms during the test. Diastolic blood pressure (BP) was significantly lower in the symptom-positive group. The head-up tilt resulted in a significant increase in diastolic BP in the symptom-negative group (P=0.04), while systolic BP had a tendency to decrease in the symptom-positive group (P=0.06). Conclusion: Significant patients with POTS did not present orthostatic symptoms during the TTT despite having chronic daily symptoms. This finding may be important for establishing definitive diagnostic criteria for pediatric POTS. Development of symptoms during TTT might be related to low diastolic BP and abnormal compensatory responses to orthostasis.

• 대한한방내과학회지
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• 제19권2호
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• pp.159-184
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• 1998

The aim of the study was the experiment of the effect that Kami-Daesihotang had on the essential hypertension and hyperlipidemia. Rats were orally administered with Kami-Daesihotang for 30days and the constituent of the plasma and serum were analysed at the 10th, 20th and 30th day from the first day of experiment, respectively. The heart rate, blood pressure, plasma renin activity, plasma level of aldosterone, catecholamine, sodium and angiotensin II were measured after an oral administration of Kami-Daesihotang in SHR. In addition, serum levels of total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and total lipid were measured with cholesterol-fed rats. The results were summarized as following ; 1. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang remarkably decreased the blood pressure in SHR. 2. Double-dosage Kami-Daesihotang were recognized as having the effect on the decreased of the pulse rate in SHR. 3. Plasma renin activity was significantly decreasd in SHR after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 4. Double-dosage Kami-Daesihotang considerably reduced the plasma angiotensin level in SHR. 5. Noticeable decreased of plasma norepinephrine level was showed in SHR, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 6. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang noticeable reduced body weight in hyperlipidemia rats which had fed with 1% cholesterol. 7. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang had a significantly decreasing effect on serum total cholesterol in hyperlipidemia rats which had fed with 1% cholesterol. 8. Serum triglyceride level was importantly decreased in hyperlipidemia rats which had fed with 1% cholesterol, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 9. Remarkable decreased of serum low density lipoprotein cholesterol level was found in hyperlipidemia rats which had fed with 1% cholesterol, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 10. Double-dosage Kami-Daesihotang was showed a significantly decreasing effect on serum total lipid level in hyperlipidemia rats which had fed with 1% cholesterol. 11. Single-dosage Kami-Daesihotang noticeably reduced organ weight of liver, kidney, spleen and testis in hyperlipidemia rats which had fed with 1% cholesterol. Double-dosage Kami-Daesihotang significantly decreased organ weight of liver, kidney and spleen in hyperlipidemia rats. These Findings suggest a possible anti-hypertensive and hyperlipidemic effect of Kami-Daesihotang.

• Clinical and Experimental Pediatrics
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• 제59권5호
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• pp.231-238
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• 2016

Purpose: Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute phase protein, derived from the liver, which is present in high concentrations in plasma. Data regarding the association between circulating plasma LBP levels and obesity-related biomarkers in the pediatric population are scarce. We aimed to determine whether there was a difference in plasma LBP levels between overweight/obese and normal-weight adolescents and to assess the correlation of circulating LBP levels with anthropometric measures and obesity-related biomarkers, including insulin resistance, liver enzyme levels, and lipid profiles. Methods: The study included 87 adolescents aged 12-13 years; 44 were overweight/obese and 43 were of normal-weight. We assessed anthropometric and laboratory measures, including body mass index (BMI), blood pressure, insulin resistance, liver enzyme levels, and lipid profiles. Plasma LBP levels were measured using an enzyme-linked immunosorbent assay. Results: The mean age of the participants was $12.9{\pm}0.3$ years. Circulating plasma LBP levels were significantly increased in overweight/obese participants compared with those in normal-weight participants ($7.8{\pm}1.9{\mu}g/mL$ vs. $6.0{\pm}1.6{\mu}g/mL$, P<0.001). LBP levels were significantly and positively associated with BMI, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose and insulin, and insulin resistance as indicated by the homeostatic model assessment of insulin resistance (HOMA-IR) (all P<0.05). In multivariate linear regression analysis, BMI and HOMA-IR were independently and positively associated with plasma LBP levels. Conclusion: LBP is an inflammatory biomarker associated with BMI and obesity-related insulin resistance in adolescents. The positive correlation between these parameters suggests a potentially relevant pathophysiological mechanism linking LBP to obesity-related insulin resistance in adolescents.

• Journal of Chest Surgery
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• 제12권3호
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• 제12권3호
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• pp.289-296
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Community Nutrition
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• 제6권3호
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• pp.131-136
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• 2004

The purpose of this study is to compare the relative risk of metabolic syndrome (MS) in middle aged adults with different body weights. 155 subjects living in urban Beijing were recruited from 24 neighborhood committees of urban Beijing. They were divided into normal weight, overweight and obese groups according to their BMIs. The general information of the subjects was collected using an interview-administered questionnaire. Standard procedure was followed to measure subject's weight, height and waist. Biochemical parameters (total cholesterol (TC), low- and high­density lipoprotein cholesterol (LDL-C ; HDL-C), triglyceride (TG), and fasting glucose) and blood pressure were also determined. The results indicated that the systolic and diastolic blood pressure, HDL-C of obese group was lower than that of the normal weight group. Fasting glucose of obese males was significantly higher than that of normal weight males. No significant difference of fasting glucose was found among female groups. No significant difference of TG was found among male groups, while TG of overweight and obese females was both significantly higher than normal weight females. There was no significant difference of TC and LDL-C among normal weight, overweight and obese groups in both males and females. The MS rate of obese males was significantly higher than the normal weight and overweight males, as was the female. The relative risk of MS in obese group was about 11 times higher (OR=11.249, $95\%CI$ = 3.812 - 33.191) than the normal weight group after adjusting for age, gender, smoking, drinking, family economic level and education status. It is concluded that obesity contributed to lower HDL-C, hypertriglyceride, hypertension and MS after controlling the effects of age, gender, socioeconomic status, alcohol drinking and smoking. Obese individuals have a higher risk of having MS than their normal weight counterparts.

• 대한간호학회지
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• 제38권6호
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• pp.822-830
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• 2008

Purpose: The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community. Methods: The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence. Results: Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months. Conclusion: The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.