• Journal of Yeungnam Medical Science
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• 제28권1호
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• pp.20-30
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• 2011

Background: Little IS known about predictors of lifestyle modification in overweight or obese patients with acute myocardial infarctions. Methods: Between October 2005 and May 2007, 311 overweight or obese patients with an AMI visited Kyungpook National University Hospital. Among them, 216 patients ($63{\pm}11$ years old, 144 males) with ${\geq}1$ year of follow-up were included. Results: Body weight of all patients showed a significant decrease and 20% showed a >3% weight reduction at 1 year of follow-up. Ninety-six (44%) patients were smoking at baseline, and 52% of them had quit by 1 year of follow-up. Only six smokers were successful with both a >3% weight reduction and smoking cessation. In multivariate analysis, age (OR 1.084, 95% CI 1.028-1.144, p=0.003) and smoking cessation (OR 0.167, 95% CI 0.048-0.575, p=0.005) were independent predictors of weight reduction. Abdominal circumference was a negative predictor of smoking cessation (OR 0.903, 95% CI 0.820-0.994, p=0.037). Conclusions: Mean body weight of all patients showed a significant decrease at follow-up. Smoking cessation and age were independent predictors of weight reduction, and abdominal circumference was a negative predictor of smoking cessation.

• Journal of Chest Surgery
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• 제30권11호
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• pp.1077-1082
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• 1997

1967년 Killip 등은 급성 심근 경색의 내과적 치료 결과 27%의 높은 사망률을 발표하였으며 급성 심근경색은 내과적 치료만으로는 사망를이 10%에 달하는 질환으로서 특히 급성 심근경색후 협심증의 경우 이것이 심실성 부정 맥이나 심근경색의 확대 및 좌심실 기능 부전의 전조증상인 경우가 많으며 따라서 적극적인 치료가 필요하다 하겠다. 그러나 과거에는 심근경색환자에 대한 수술 사망률이 높아 심근경색 후 조기에 수술하는 것을 회피하는 경향이 있었으나 최근 심근보호벌 및 수술 수기의 발달로 좋은 성적이 발표되고 있다. 한림대학교 강동성심병원에서는 1994년 6월부터 1996년 10월까지 내원한 급성 심근 경색 환자중 19명을 대상으로 급성 심근경색후 1개월 이내에 조기 관상동맥 우회술을 실시하였다. 환자는 남자가 14명, 여자가 5 명이었으며 이들의 평균 연령은 60.6세였다. 급성 심근 경색후 관상동맥 우회술까지의 기간은 8시간부터 24 일까지로 평균 10.6일이었다. 심근 경색은 전층 경색이 11명, 심내막하 경색이 8 명이었다. 한편 경색 부위는 하벽부가 11예, 전벽 및 중격 부위가 8 예였다. 수술중 원위부 문합은 모두 대동맥을 차단한 후 쳬璿臼느만\ulcorner심근보호는 온혈 심정저택과 냉혈 심정지액을 병행하여 시행하였다. 평균 대동맥 차단시간은 101.7분이었으며 체외순환시간은 225.6분이었으며 환자당 평균 3.6 개의 원위부 문합을 시행하였다. 수술전 IABP를 삽입한 경우는 3예였으며 수술중에는 심폐기 이탈 을 위해서 4명에게 IABP를 사용하였다. 1명의 환자가 수술후 21일째 급작스러운 폐렴 및 호흡부전으로 사망하여 사망률은 5.3%(1/19)였다. 수술후 합병증은 수술주기 심근 경색이 2례, 상심실성 부정맥이 2예있었으며 심실성 부정맥과 폐렴이 각 1례였다. 심실성 부정맥을 보인 환자가 술후 77일째 사망하여 말기 사망률은 5.5%(1/18)이었다. 수술후 추적 기간은 평균 13.4개월로 모두 외래에서 추적 진료 중이며 2년 생존율은 89.5%로 예측되었다. 수술후 사망과 관련된 위험요소로서는 수술전 심박출 계수가 30% 이하인 경우와 수술중 인공 심폐기의 이탈을 위하여 IABP(intra-aortic balloon pump, 대동맥내 풍선 펌프)를 사용한 경우 통계학적 의미를 찾을 수 있었다. 결론적으로 진행성 심근 경색 환자들이나, 지속적인 협심증 또는 심각한 관상동맥 경화증이 의 경우 급성 심근 경색이 발생\ulcorner 직후라도 술전 심박출 계수가 30% 이상 유지될 수 있는 심장 있는 환자에서 선택수술 (elective coronary artery bypass graft)에 비하여 특별한 위험 요소의 증가 관상 동맥 우회술을 적용하여 좋은 결과를 얻을 수 있었으며 이들에 대한 장기 추적이 릴요할 된다.

• Archives of Pharmacal Research
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• 제10권4호
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• pp.245-249
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• 1987

Cardiovascular disease is at present the leading cause of deth in the United States and other in dustrilized countries. A major contributing factor of cardiovascular disease is essential hypertension. Untreated, essential hypertension is considered a risk factor for sudden death due to myocardial infarctions, as well as a risk factor for cerebral vascular disease, renal failure and congestive heart failure. During the last decade, significant progress has been made in the basic knowledge of the pathogenesis of hypertension as well as in the development of new antihypertensive drugs.

• 대한수의학회지
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• 제37권3호
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• pp.669-685
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• 1997

The present study was performed to evaluate the effects of xylazine and tiletamine + zolazepam on echocardiograms before and after experimental myocardial infarctions in clinically normal dogs taken preliminary examinations related to cardiac function. The results are as follows. With xylazine administration, left ventricle end-diastolic dimension, left ventricle end-systolic dimension, left atrium/aorta, ejection time and velocity of circumferential fiber shortening increased and mitral valve CD slope, % delta D decreased(p<0.01). In tiletamine+zolazepam administered group, interventricular septum amplitude(p<0.01), mitral valve DE slope(p<0.05) and ejection time(p<0.01) decreased and left atrium/aorta, ejection time also decreased compared with xylazine group(p<0.01). In 48 hours after experimental myocardial infarction group, anterior aortic wall amplitude decreased compared with control, xylazine, tiletamine + zolazepam group, respectively(p<0.01). Posterior aortic wall amplitude decreased compared with control(p<0.01). Left ventricle end systolic dimension increased compared with control and tiletamine + zolazepam group, respectively(p<0.01). Left ventricular posterior wall end systolic dimension decreased compared with control(p<0.01). Left ventricular posterior wall amplitude decreased compared with control and tiletamine+zolazepam group(p<0.01). Left atrium/aorta decreased compared with xylazine group(p<0.01). % thickening left ventricular posterior wall decreased compared with control(p<0.05). % delta D decreased compared with control and tiletamine+zolazepam group(p<0.01). Ejection time decreased compared with xylazine(p<0.01). Velocity of circumferential fiber shortening increased compared with control and tiletamine + zolazepam group(p<0.01). With xylazine administration 48 hours after experimental myocardial infarction, anterior aortic wall amplitude, posterior aortic wall amplitude decreased compared with control(p<0.01). Left ventricle end-diastolic dimension increased compared with control(p<0.01). Left ventricle end-systolic dimension increased compared with control and tiletamine + zolazepam group, respectively(p<0.01). Left ventricular posterior wall end-systolic dimension and left ventricular posterior wall end-diastolic dimension decreased compared with control(p<0.01). Left atrium/aorta decreased compared with xylazine group(p<0.01). % thickening left ventricular posterior. wall(p<0.05) and % delta D(p<0.01) decreased compared with control. Velocity of circumferential fiber shortening increased compared with tiletamine + zolazepam group(p<0.01). With tiletamine + zolazepam administration 48 hours after experimental myocardial infarction, anterior aortic wall amplitude decreased compared with control, xylazine and tiletamine+zolazepam group, respectively(p<0.01). Posterior aortic wall amplitude decreased compared with control(p<0.01). Left ventricle end-systolic dimension increased compared with control and tiletamine+zolazepam group(p<0.01). Left ventricular posterior wall end-systolic dimension, left ventricular posterior wall end-diastolic dimension and interventricular septum amplitude decreased compared with control(p<0.01). Left atrium/aorta decreased compared with xylazine group(p<0.01). % delta D decreased compared with control and tiletamine + zolazepam group(p<0.01). Ejection time decreased compared with xylazine group and velocity of circumferential fiber shortening increased compared withtiletamine+zolazepam group(p<0.01). Conclusively, echocardiography was proved to be a useful, diagnostic, non-invasive and simple method for establishing the diagnosis of myocardial infarction and evaluating the effects of drug on cardiac function before and after myocardial infarction.

• Journal of Chest Surgery
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• 제48권6호
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• pp.381-386
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• 2015

Background: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. Methods: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counterpulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was $26.2{\pm}18.6months$. Results: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. Conclusion: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

• Korean Circulation Journal
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• 제48권12호
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• pp.1148-1156
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• 2018

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

• 대한핵의학회지
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• 제21권2호
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• pp.167-174
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• 1987

Among noninvasive approaches for the evaluation of left ventricular performance, radionuclide ventriculography (RVG) has been shown to be of particular values. Phase analysis, recently introduced as more objective means for evaluating the temporal sequence of systolic ventricular wall motion than cine image of RVG comprises a pixel by pixel Fourier transformation of the time activity curve of a multiple gated acquisition equilibrium blood pool study. To examine the regional wall motion of ventricles in myocardial infarctions, we evaluated the phase image and histogram constructed for each ventricle by total phase angle range and full width of half maximum (FWHM). This study consisted of 7 normal subjects and 23 subjects with acute myocardial infarction. Contrast ventriculography and coronary angiography was performed in all partients with myocardial infarction. And we compared the result of phase analysis with cine image of RVG and examined the interrelationship between phase analysis and contrast ventriculography with coronary angiography. The results were as follows; 1) The total phase angle range and FWHM of LV phase histogram in myocardial infarction ($86^{\circ}\;and\;32^{\circ}$, repectively) were wider than those in normal control ($38^{\circ}\;and\;18^{\circ}$, respectively p<0.01). 2) RV phase angle range and FWHM in patients with right coronary artery (RCA) occlusion ($79^{\circ}\;and\;37^{\circ}$, respectively) were wider than those in normal control ($39^{\circ}\;and\;18^{\circ}$, respectively p<0.001) and the patients without RCA occlusion ($52^{\circ}\;and\;19^{\circ}$, respectively p<0.01). 3) Phase analysis was more sensitive (95%) than cine image of RVG (70%) for the detection of regional wall motion abnormality of LV.

• JSTS:Journal of Semiconductor Technology and Science
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• 제7권3호
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• pp.151-160
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• 2007

We report the label-free biomolecules detection based on nanomechanical micro cantilevers operated in dynamic mode for detection of two marker proteins (myoglobin and creatin kinase-MB (CK-MB)) of acute myocardical infarctions. When the specific binding between the antigen and its antibody occurred on the fuctionalized microcantilever surface, mechanical response (i.e. resonant frequency) of microcantilevers was changed in lower frequency range. We performed the label-free biomolecules detection of myoglobin and CK-MB antigen in the low concentration (clinical threshold concentration range) as much as 1 ng/ml from measuring the dynamic response change of micro cantilevers caused by the intermolecular force. Moreover, we estimate the surface stress on the dynamic microcantilevers generated by specific antibody-antigen binding. It is suggested that our dynamic microcantilevers may enable one to use the sensitive label-free biomolecules detection for application to the disease diagnosis system based on mechanical immuno-sensor.

• 대한핵의학회지
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• 제31권1호
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• pp.67-72
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• 1997

1991년 7월부터 1994년 12월 사이에 흉통을 주소로 내원하여 심근관류 SPECT를 시행한 결과 정상소견을 보인 393명 중 추적조사가 가능했던292명 (74%, 남:여=150:142 평균연령 $53{\pm}12$세)를 대상으로 이들의 예후를 알아보고, 특히 이들 중 관동맥조영술에 이상이 있는 군과 이상이 없는 군 사이에 예후의 차이가 있는지 알아보고자 하였다. 모든 환자에서 심근부하를 위하여 디피리다몰(0.56mg/kg)을 4분간 사용하였으며, 173명은 Tc-99m MIBI로, 74명은 Tc-99m TF로, 나머지 45명은 T1-201로 SPECT를 시행하였다. 추적기간은 평균 25개월(7-58개월)이었으며, 예후판정은 심장사건과 허혈사건으로 나누었고, 심장사건은 심장사와 비치명적 심근경색으로, 그리고 허혈사건은 재관류 치료가 필요했던 협심증으로 정의하였다. 관동맥조영술은 57명(20%)의 환자에서 시행하여, 이 중 30명(53%)이 정상, 27명(47%)이 관동맥 병변을 보였다. 대상환자의 추적기간 중 심장사건의 발생은 총 4명(1.37% 연간 0.66%)에서 심장사건이 발생하였고 7명(2.40% 연간 1.15%)에서 허혈사건이 발생하였다. 관동맥조영술상 관동맥질환이 발견된 27명의 환자중 심장사건은 심장사 1명(3.70%), 비치명적 심근경색1명(3.70%)의 2명(7.41%)이었고, 허혈사건은 재관류 치료 7명(25.93%, PTCA 6명, CABG 1명)이었다. 관동맥조영술상 정상이었던 30명 중 심장사건은 비치명적 심근경색 1명(3.33%)으로 두 군간에 1차 심장사건의 발생율에는 차이가 없었다(chi square test, p=0.60). 관동맥조영술을 받지 않은 235명 중 심장사건은 심장사1명(0.4%)으로 관동맥조영술을 시술받은 환자 군에 비해 유의하게 낮았다(p<0.01). 결론적으로, 흉통을 호소한 환자에서 심근관류 신티그라피상 정상인 경우에는 심장사건의 발생율이 낮음을 알 수 있었고, 특히 관동맥조영술에 관동맥병변이있는 환자와 없는 환자간에 1차 심장사건의 발생율에 유의한 차이가 없는 것을 고려하면, 심근관류 신티그라피가 정상소견을 보이는 흉통환자는 정상 관동맥조영술 소견을 보이는 환자에 준하여 치료하여도 좋을 것으로 사료되었다.

• Journal of Microbiology and Biotechnology
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• 제30권1호
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• pp.38-43
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• 2020

Hand, foot, and mouth disease (HFMD) is caused by enterovirus 71 (EV71) in infants and children under six years of age. HFMD is characterized by fever, mouth ulcers, and vesicular rashes on the palms and feet. EV71 also causes severe neurological manifestations, such as brainstem encephalitis and aseptic meningitis. Recently, frequent outbreaks of EV71 have occurred in the Asia-Pacific region, but currently, no effective antiviral drugs have been developed to treat the disease. In this study, we investigated the antiviral effect of salvianolic acid B (SalB) on EV71. SalB is a major component of the Salvia miltiorrhiza root and has been shown to be an effective treatment for subarachnoid hemorrhages and myocardial infarctions. HeLa cells were cultured in 12-well plates and treated with SalB (100 or 10 ㎍/ml) and 10⁶ PFU/ml of EV71. SalB treatment (100 ㎍/ml) significantly decreased the cleavage of the eukaryotic eIF4G1 protein and reduced the expression of the EV71 capsid protein VP1. In addition, SalB treatment showed a dramatic decrease in viral infection, measured by immunofluorescence staining. The Akt signaling pathway, a key component of cell survival and proliferation, was significantly increased in EV71-infected HeLa cells treated with 100 ㎍/ml SalB. RT-PCR results showed that the mRNA for anti-apoptotic protein Bcl-2 and the cell cycle regulator Cyclin-D1 were significantly increased by SalB treatment. These results indicate that SalB activates Akt/PKB signaling and inhibits apoptosis in infected HeLa cells. Taken together, these results suggest that SalB could be used to develop a new therapeutic drug for EV71-induced HFMD.