Journal of Yeungnam Medical Science

Case report

Safety and effectiveness of early cardiac rehabilitation in a stroke patient with heart failure and atrial fibrillation: a case report: Sang Cheol Lee, Eun Jae Ko, Ju Yeon Lee, Ae Lee Hong; Yeungnam Univ J Med. 2021;38(4):361-365. Published online March 22, 2021; DOI: https://doi.org/10.12701/yujm.2020.00885

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Abstract PDF: Stroke patients have reduced aerobic capacity. Therefore, intensive structured exercise programs are needed. We report the case of a patient with stroke and cardiac disease who underwent early inpatient cardiac rehabilitation (CR). A 38-year-old male patient with atrial fibrillation, heart failure, and cerebral infarction underwent a symptom-limited exercise tolerance test (ETT) without any problems on day 45 after admission. He completed a 2-week inpatient program and an 8-week home-based CR program. Follow-up ETT showed increased exercise capacity. The present case might be the first to report a safely performed CR program in a patient with stroke and cardiac comorbidity in Korea. Systematic guidance is needed for post-stroke patients to receive safe and effective CR for the secondary prevention of stroke and cardiovascular risk.

Original Articles

Effect of Exercise on Antioxidant Enzyme Activities of Skeletal Muscle and Liver in STZ-diabetic Rats.: Kwang Ho Seok, Suck Kang Lee; Yeungnam Univ J Med. 2000;17(1):21-30. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.21

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Abstract PDF: BACKGROUND
The purpose of the present study was to investigate the effect of exercise on the activities of antioxidant enzymes, superoxide dismutase(SOD), glutathione peroxidase(GPX) and catalase(CAT) of skeletal muscle(gastrocnemius) and liver in streptozotocin(STZ) induced diabetic rats. The malondialdehyde(MDA) concentration was also measured as an index of lipid peroxidation of the tissues by exercise-induced oxidative stresses in the diabetic rats. MATERIAL AND METHODS: Male Sprague-Dawley rats were randomly divided into control and STZ-induced diabetic rats. The STZ in citrate buffer solution was injected twice at 5 days intervals intraperitoneally(50, 70 mg/kg respectively). On the 28th day after the first STZ injection, the diabetic animals were randomly divided into pre- and post-exercise groups. The exercise was introduced to the rats of post-exercise group by treadmill running till exhaution with moderate intensity (VO2max: 50-70%) of exercise. The duration of average running time was 2 hours and 19 minutes. RESULTS: The blood glucose concentration was increased(p<0.001) and plasma insulin concentration was decreased(p<0.001) in the diabetic rats. The glycogen concentration in the muscle and liver was decreased by exhaustive exercise in the diabetic rats(p<0.001). In the skeletal muscle, the activities of GPX was increased(p<0.05) and the activities of SOD and CAT were not changed in the diabetic rats compare to the control rats. The activities of GPX was not changed by exercise but the activities of SOD(p<0.01) and CAT (p<0.01) were decreased by exercise in the diabetic rats. The concentration of MDA was not changed by exercise in diabetic rats. and the values of pre-exercise and post-exercise diabetic rats were not different from the value of control rats. In the liver, the activities of SOD was decreased(p<0.01) and the activities of GPX and CAT were not changed in diabetic rats compared to the values of control rats. The activities of SOD, GPX and CAT were not changed by exercise in diabetic rats but the the slight decreasing tendency of the activity of SOD was observed. The MDA concentration was increased in the diabetic rats compared to the values of control rats(p<0.001) but there was no change of MDA concentration by exercise in diabetic rats. CONCLUSIONS: In summary, the exhaustive physical exercise has not been shown to impose oxidative stress on skeletal muscle due to oxygen free radicals regardless of decreament of SOD and CAT in the diabetic rats. In liver tissue, the tissue damage by oxidative stress was observed in diabetic rats but the additional tissue damage by the exhaustive physical exercise was not observed.

Effect of Hyperglycemia and Hyperlipidemia on Cardiac Muscle Glycogen Usage during Exercise in Rats.: Suck Kang Lee, Eun Jung Kim, Yong Woon Kim; Yeungnam Univ J Med. 1998;15(1):29-35. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.29

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Abstract PDF

Rats were studied during 45 minutes treadmill exercise to determine the effects of hyperglycemia and hyperlipidemia on the utilization of cardiac muscle glycogen, and the utilization of diaphragm muscle glycogen was also studied for comparing to cardiac muscle. The hyperglycemia was produced by ingestion of 25% glucose solution(1ml/100gm, BW) and the hyperlipidemia by 10% intralipose ingestion(1ml/100gm, BW) with intraperitoneal injection of heparin(500 IU) 15 minutes before treadmill exercise. The mean blood glucose concentrations(mg/dL) in control and hyperglycemic rats were 110 and 145, respectively, and the mean plasma free fatty acid concentrations(micronEq/L) in control, control exercise(control-E) and hyperlipidemia exercise(HL-E) rats were 247, 260 and 444, respectively. In the hyperglycemic trial, the cardiac muscle glycogen concentration was not significantly decreased by the exercise but the concentration in control rats was decreased to 73.9%(p<0.05). The glycogen concentration of diaphragm was significantly decreased in both groups by the exercise, but the hyperglycemia decreased the glycogen utilization by approximately 10% compared to the control. The cardiac muscle glycogen concentration was not decreased by the exercise in control and hyperlipidemic rats but the utilization of glycogen in hyperlipidemic rats is lower than that of the control. These data illustrate the sparing effect of hyperglycemia on cardiac muscle glycogen usage during exercise, but the effect of hyperlipidemia was not conclusive. In the skeletal muscle, the usage of glycogen by exercise was spared by both hyperglycemia and hyperlipidemia.

Citations

Citations to this article as recorded by

The Effects of Treadmill Exercise on Blood components, Antioxidant enzymes and Reactive Oxygen in Hyperlipidemic Rats
Byeong-Ok Jung, Sang-Hun Jang, Hyun-Soo Bang
Journal of the Korean Society of Physical Medicine.2013; 8(1): 71. CrossRef

The Charateristics of Glycogen Metabolism of Diaphragm in Rats.: Bok Hyun Nam, Eun Jung Kim, Suck Kang Lee; Yeungnam Univ J Med. 1997;14(1):46-52. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.46

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Abstract PDF: Diaphragm is though to play the most role in breathing and has a substantially greater proportion of slow oxidative and fast glycolytic fibers, and low proportion of fast oxidative fibers. The respiratory muscle, diaphragm, has the functional characteristics of slow speed of contraction, high resistance to fatigue and the ability to respond to intermittent ventilatory loads, for example of exercise. In the present study, the characteristics of the metabolism (depletion and repletion) of glycogen and the structural changes of diaphragm during depletion and repletion of glycogen were observed in rats. For comparison, the red gastrocnemius muscle which has a greater proportion of fast oxidative glycolytic (FOG) and slow oxidative (SO) fibers, and low proportion of fast glycolytic (FG) fiber, was also studied. The glycogen concentration of diaphragm in overnight fasted rats was 2.30+/-0.14mg/gm wet weight. The values of glycogen concentration at 60, 90 and 120minutes of treadmill exercise loaded rats was significantly decreased compared to that of the overnight fasted rats. There was no significant difference among the glycogen concentration of diaphragm at 60, 90 and 120minutes of exercises. The glycogen concentration of diaphragm was decreased to 1.12+/-0.17 from 2.30+/-0.14mg/gm wet weight by treadmill exercise. The glycogen depletion rats of diaphragm during exercise was faster than that of red gastrocnemius in both of the first 60minutes and 120minutes duration of exercise. The glycogen repletion of diaphragm after intragastric glucose administration by stomach tube was studied in control and exercise groups. The glycogen concentration was significantly increased after glucose administration in both of the control and exercise groups. All of the concentration of exercise group at 60, 120 and 180minutes after glucose administration was significantly higher than those of control group. In conclusion, one of the characterics of diaphragm in glycogen metabolism is fast glycogen depletion during exercise, and slowness of glycogen repletion after glucose ingestion in rats.

Utilization of Supercompensated Glycogen of Hindlimb Muscles during Strenous Exercise in Rats.: Chun Bae Jun, Jong Chul Ahn, Dae Deup Song, Suck Kang Lee; Yeungnam Univ J Med. 1997;14(1):137-154. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.137

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Abstract PDF: The aim of the present investigation has been to evaluate the depletion pattern of the supercompensated glycogen of hindlimb muscles during strenous exercise in rats. The plan of the maximizing muscle glycogen stores is based on the fact that a glycogen-depleted muscle by exercise will have an increased avidity for glycogen when exposed to a high carbohydrate diet. The glycogen concentration of soleus, red gastrocnemius and plantaris muscle, and liver was measured at 0, 30 and 60 minutes during treadmill exercise. The experimental animals were divided into 5 group - Normal(N), Control(C), 1Hour(1HR:after 1hour of glucose ingestion), 2Hour(2HR:after 2hour of glucose ingestion) and Exercise-1Hour(EX-1HR:glucose ingestion after 1 hour of preloading treadmill exercise)group - for glycogen storage study. The glycogen concentration of soleus, red gastrocnemius and plantaris muscles in N group was 4.57+/-0.34, 5.11+/-0.24 and 6.55+/-0.20 mg/gm wet wt., respectively. The glycogen concentration of soleus and red gastrocnemius in EX-1HR group were about 1.9 and 1.8 times than that of N group, respectively, but the concentration of plantaris was not higher than that of N group. The glycogen concentration of liver in N group was 41.0+/-1.47mg/gm wet wt. and the concentration of the overnight fasted C group wad only 2.9% of the value of N group. The level of glycogen concentration of liver in the other glucose ingested groups(1HR, 2HR, including EX-1HR) was within 19 - 32% of that of N group. The blood glucose concentration of EX-1HR group was higher than that of N group, the plasma free fatty acid concentration of C and 2HR group was higher than that of N group, and the plasma insulin concentration of EX-1HR group was higher than that of N group. The concentration of supercompensated glycogen of soleus and red gastrocnemius were rapidly decreased during 30 minutes of exercise but there was almost no changes of the concentration during the other 30 minutes of continuing exercise. The concentration of N group during 30 minutes of exercise was decreased but more slowly than those of EX-1HR group. The remaining level of glycogen after 60 minutes of exercise in EX-1HR group was higher than that of N group. Taken together, the mobilization of endogenous muscle glycogen at the first stage of exercise was proportioned to the intial level of glycogen concentration, and later on, when exercise continued, the muscle glycogen level was stabilized. And the remaining level of supercompensated muscle glycogen after 60 minutes of exercise was higher than that of normally stored glycogen level. The mobilization of the glycogen stroed in slow and fast oxidative muscle fibers is faster than in the fast glycolytic muscle fibers during strenous exercise.

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