• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.275-285
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• 2011

Purpose: Head-up position during sleep is one of the non-pharmacologic interventions for the treatment of orthostatic hypotension. Because the head-up position causes discomfort in many patients, this approach may not be acceptable to all patients. We compared the systolic blood pressure in erect position, orthostatic hypotension, orthostatic disability score, and the improvement rates of orthostatic hypotension between the 20 cm head-up group and the 10 cm head-up group. Methods: A control pre/post-test design was used. Between August 1, 2009 and November 15, 2010, we consecutively enrolled patients who showed orthostatic hypotension in patients with Parkinsonian disorders. Sixty-seven patients were prospectively enrolled and forty-four patients were completed the study. Results: There were no statistically significant differences found in the systolic blood pressure in erect position, orthostatic hypotension, and orthostatic disability scores between the two groups. However, five patients showed improvement in 20 cm head-up group and one patient was showed improvement in 10 cm head-up Group. Conclusion: Orthostatic hypotension is decreased with 20 cm head-up position in some patients with Parkinsonian disorders (p=.034). Further research investigating the relationships between orthostatic hypotension and head-up position are warranted.

• The Korean Journal of Physiology and Pharmacology
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• v.25 no.3
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• pp.177-187
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• 2021

Metabolic syndrome (MBS) is a widespread disease that has strongly related to unhealthy diet and low physical activity, which initiate more serious conditions such as obesity, cardiovascular diseases and type 2 diabetes mellitus. This study aimed to examine the therapeutic effects of morin, as one of the flavonoids constituents, which widely exists in many herbs and fruits, against some metabolic and hepatic manifestations observed in MBS rats and the feasible related mechanisms. MBS was induced in rats by high fructose diet feeding for 12 weeks. Morin (30 mg/kg) was administered orally to both normal and MBS rats for 4 weeks. Liver tissues were used for determination of liver index, hepatic expression of glucose transporter 2 (GLUT2) as well as both inflammatory and fibrotic markers. The fat/muscle ratio, metabolic parameters, systolic blood pressure, and oxidative stress markers were also determined. Our data confirmed that the administration of morin in fructose diet rats significantly reduced the elevated systolic blood pressure. The altered levels of metabolic parameters such as blood glucose, serum insulin, serum lipid profile, and oxidative stress markers were also reversed approximately to the normal values. In addition, morin treatment decreased liver index, serum liver enzyme activities, and fat/muscle ratio. Furthermore, morin relatively up-regulated GLUT2 expression, however, down-regulated NF-κB, TNF-α, and TGF-β expressions in the hepatic tissues. Here, we revealed that morin has an exquisite effect against metabolic disorders in the experimental model through, at least in part, antioxidant, anti-inflammatory, and anti-fibrotic mechanisms.

• Journal of Chest Surgery
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• v.52 no.2
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• pp.78-84
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• 2019

Background: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of $6.8{\pm}5.4years$ (4.2 years). Methods: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. Results: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial b leeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5-78.5) to 31.0 (25.7-37.0, p<0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63-2.00) to 0.50 (0.50-1.00, p<0.05). The improvement lasted until the last echocardiographic follow-up. Conclusion: Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.

• Nutrition Research and Practice
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• v.15 no.2
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• pp.160-172
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• 2021

BACKGROUND/OBJECTIVES: Nutritional status and food intake during pregnancy and lactation can affect fetal programming. In the current metabolic syndrome epidemic, high-fructose diets have been strongly implicated. This study investigated the effect of maternal high-fructose intake during pregnancy and lactation on the development of metabolic syndrome in adult offspring. SUBJECTS/METHODS: Drinking water with or without 20% fructose was administered to female C57BL/6J mice over the course of their pregnancy and lactation periods. After weaning, pups ate regular chow. Accu-Chek Performa was used to measure glucose levels, and a tail-cuff method was used to examine systolic blood pressure. Animals were sacrificed at 7 months, their livers were excised, and sections were stained with Oil Red O and hematoxylin and eosin (H&E) staining. Kidneys were collected for gene expression analysis using quantitative real-time Polymerase chain reaction. RESULTS: Adult offspring exposed to maternal high-fructose intake during pregnancy and lactation presented with heavier body weights, fattier livers, and broader areas under the curve in glucose tolerance test values than control offspring. Serum levels of alanine aminotransferase, aspartate aminotransferase, glucose, triglycerides, and total cholesterol and systolic blood pressure in the maternal high-fructose group were higher than that in controls. However, there were no significant differences in mRNA expressions of renin-angiotensin-aldosterone system genes and sodium transporter genes. CONCLUSIONS: These results suggest that maternal high-fructose intake during pregnancy and lactation induces metabolic syndrome with hyperglycemia, hypertension, and dyslipidemia in adult offspring.

• Korean Circulation Journal
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• v.53 no.6
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• pp.406-417
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• 2023

Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO₂] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO₂ was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.

• The Journal of Korean Society for School & Community Health Education
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• v.18 no.1
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• pp.57-68
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• 2017

Objectives: The purpose of the study was to evaluate the effect of community intervention on reducing salt intake among college students on their knowledge, attitude and practice of low-salt diet. Methods: A community intervention planned to increase college students' knowledge, attitude and practice of low-salt diet. The intervention comprised of 1 lecture on salt and health, 4 campaigns on low-salt diet, and 2 taste testing was carried out from March 24 to May 19, 2015. All the intervention was open to entire university while data was collected from a panel of convenient sample. We used the baseline data of 251 students, 226 students completed post-test. Post-test data on knowledge, attitude, and practice, blood pressure measurement, and urine salt test were collected on May 25 and 26 by trained nursing students and graduates. Baseline data were collected on March 17 and 18. Data were analyzed using IBM-SPSS 21.0 for t-test and ANCOVA. Results: Regarding a general characteristic and health behavior, there was statistically significant difference in living arrangement(p<0.001), amount of monthly allowance(p=0.005) and frequency of eating-out(p<0.001) between the two regions in this study. However, there was no statistically significant difference in gender, major, smoking, drinking and frequency of breakfast. Regarding a characteristic related to low-salt diet, there was statistically significant difference in diastolic blood pressure level(p=0.002), urine test(p=0.001). But there was no statistically significant difference in knowledge, attitude, practice of low-salt diet and systolic blood pressure. There was no statistically significant difference in their knowledge of low-salt diet(F=1.588, p=0.209), attitude(F=2.182, p=0.141), practice(F=3.507, p=0.062) and systolic blood pressure(F=1.723, p=0.191), diastolic blood pressure(F=1.552, p=0.214), urine test after a community intervention. Conclusions: Community intervention that does not have concrete target group doesn't seem to be effective on increasing knowledge, attitude and practice of the entire community, not even in university-a somewhat closed community. It is suggested to apply a target specific intervention in order to have efficient and effective outcome from a intervention.

• Journal of Korean society of Dental Hygiene
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• v.1 no.1
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• pp.63-76
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• 2001

This study was designed to evaluate the effects of music on dental pain and anxiety during ultrasonic scaling. One hundred and twenty five patients visited dental unit of Soonchunhyang University Chunan hospital for scaling were enrolled during August 1999 and February 2000. The patients were allocated randomly into two groups. music (n = 61) and control groups (n = 65). The music group patients listened to self-selected music using an earphone during scaling. Standardized questionnaire were used to assess the subjective denial pain and anxiety before and after scaling in both groups. In music group, more information on music effect was collected. To evaluate changes of physical signs by scaling, blood pressure and pulse were checked by a wrist check oscillometric. The results were as follows: 1. No significant difference in dental pain and anxiety between before and after scaling was observed in music group. However, the music group patients were satisfied with music because of reduction of pain(93.5%) and anxiety(93.4%), 96.7% of music subjects wanted to listen to music in next scaling. 2. While no significant difference in systolic blood pressure before scaling between music and control groups, systolic blood pressure of control group during scaling was significantly higher than that of music group(P<0.05). 3. In multiple logistic regression. the odds ratio(OR) of pain was decreased with age and female patients had higher OR (1.7, p>0.05). Patients with previous scaling experience complained of more dental pain during scaling than patients without experience. Music was not a significant predictor of denial pain during scaling, controlling for possible confounders. 4. While age. music. and scaling experience were not related to dental anxiety during scaling, sex and dental hygiene index were significant predictors of dental anxiety in multiple logistic regression. 5. Both during and after scaling. mean blood pressure of music patients were significantly lower than control patients after controlling for age, sex, and BMI. In conclusion, our data demonstrated that although listening to music did not disappear the dental pain and anxiety. but reduced the intensity of pain and anxiety during scaling. Furthermore, our data imply thai music has a effect of reduction of increasing blood pressure by scaling.

• Biomedical Science Letters
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• v.19 no.3
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• pp.254-260
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• 2013

The purpose of this study was to survey the effects of Karvonen exercise prescription in coronary artery disease patients reaching age-predicted maximal heart rates with the exercise stress test on hemodynamic responses and cardiorespiratory fitness. The subject group was comprised of acute coronary syndrome (ACS) patients, who were divided into the maximal heart rate (MHR) group that included those who completed the test with their heart rates reaching the number of 220-age and the maximal dyspnea (MD) group that included those who could not continue the test due to respiratory difficulty and were asked to stop the test. Both groups had the exercise stress test before and after the experiment. In the exercise stress test before the experiment, the exercise prescription intensity of Karvonen was set at the target heart rates of 50~85% with a six-week exercise monitoring arrangement. As a result, there were no interactive effects in rest heart rate (RHR) according to time and group, but interactive effects were observed in maximal heart rate (MHR) (P=0.000). Both rest systolic blood pressure (RSBP) and rest diastolic blood pressure (RDBP) had no interactive effects according to time and group. Maximal systolic blood pressure (MSBP) showed significant interactive effects according to time and group (P=0.017). Maximal diastolic blood pressure (MDBP) showed no interactive effects according to time and group, while maximal rate pressure product (MRPP) showed significant interactive effects according to time and group (P=0.003). Maximal time (MT) had no interactive effects according to time and group. $VO_{2max}$ and maximal metabolic equivalent (MMET) showed significant interactive effects according to time and group (P=0.000, P=0.002, respectively), whereas maximal respiratory exchange ratio (MRER) and maximal rating of perceived exertion (MRPE) showed no interactive effects according to time and group. The exercise test that was discontinued as the subjects reached the predicted maximal heart rates considering age did not reach the maximal exercise intensity and accordingly showed low exercise effects when applied to Karvonen exercise prescription intensity. That is, the test should keep going by monitoring cardiac events, MRER and MRPE until the heart rates exceed the predicted MHR by up to 10~12 even after the subject reaches the predicted MHR considering age in the exercise stress test.

• Journal of Life Science
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• v.22 no.5
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• pp.665-670
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• 2012

This study investigated the effect of endurance exercises on blood pressure, angiogenesis, and the vascular endothelial growth factor (VEGF) expression in the skeletal muscle of spontaneously hypertensive rats (SHR). Five week old SHRs and Wistar-Kyoto rats (WKY) were randomly divided into 3 groups: Wistar-Kyoto rats (WKY, n=9), SHR control (SHR-C, n=9), and SHR endurance exercise training (SHR-E, n=9). Endurance exercise training was performed on a treadmill (12-20 m/min, 0% grade, 60 min/day, 5 days/week, 16 weeks). Systolic blood pressure was monitored with the tail-cuff method. The expression of VEGF protein and capillary density were identified using western blotting and H&E staining in the soleus muscle, respectively. Systolic blood pressure was reduced by endurance exercise in SHR ($p$ <0.05). The capillary density of skeletal muscles in SHR-C was lower than in WKY ($p$ <0.05), but it was recovered by endurance exercise training (SHR-E) compared to SHR-C ($p$ <0.05), and VEGF protein was also increased by endurance exercise training compared to SHR-C ($p$ <0.05). These data suggest that the enhancement of capillary density via an increase of VEGF expression in skeletal muscles by endurance exercise training could be an important factor to inhibit blood pressure elevation in SHR.

• Journal of Chest Surgery
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• v.33 no.6
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• pp.469-475
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• 2000

Background: Thoracic aortomyoplasty is one of the surgical treatment for heart failure and has advantages over artificial heart or intraaortic balloon pumps. It uses autogenous skeletal muscles and solves problems such as energy source. However its use in clinical settings has been limited. This preliminary study was designed to develop surgical technique and to determine the effect of acute descending thoracic aortomyoplsty. Material and Method: Thirteen adult Mongrel dogs were used. The left latissimus dorsi muscle was wrapped around the descending aorta under general anesthesis. Swan-Ganz and microtipped Millar catheter were used for the hemodynamics and endocaridial viability ratio. Data were collected with myostimulator on and off in normal hearts and the ischemic hearts. Result: In normal hearts, the mean aortic diastolic pressure increased from 72$\pm$15mmHg at baseline to 78$\pm$13mmHg with stimulator on. Coronary perfusion pressure increased from 61$\pm$11mmHg to 65$\pm$9mmHg. Diastolic time increased from 0.288$\pm$0.003 msec to 0.290$\pm$0.003msec. Systolic time decreased from 0.164$\pm$0.002msec to 0.160$\pm$0.002 msec. Endocardial viability ratio increased from 1.21$\pm$0.22 to 1.40$\pm$0.18. In ischemic hearts, mean aortic diastolic pressure incrased from 56$\pm$21mmHg at baseline to 61$\pm$15mmHg with stimulator on. Coronary perfusion pressure increased from 48$\pm$17mmHg to 52$\pm$15mmHg. Diastolic time increased from 0.290$\pm$0.003 msec to 0.313$\pm$0.004msec. Systolic time decreased from 0.180$\pm$0.002 msec to 0.177$\pm$0.003 msec. Endovascular viability ratio increased from 0.9$\pm$0.31 to 1.1$\pm$0.31. The limited number of cases ruled out the statistic significance. Conclusion: Descending thoracic aortomyoplasty is a simple operation designed to use patient's own skeletal muscles. It trends to increase diastolic augmentation and coronary perfusion pressure. Modification of surgical technique and stimulator protocol would maximize the effect to assist the heart.