• Journal of Chest Surgery
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• v.26 no.2
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• pp.141-147
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• 1993

A total of 40 patients having a diagnosis of atherosclerotic coronary arterial disease were analysed on the operative outcomes according to variables as follows: 1) preoperative risk factors such as age, sex, CCS (Canadian Cardiovascular Society) functional class, type of angina, number of diseased vessel, presence of left main coronary artery stenosis, previous history of habitual smoking and presence of other medical diseases (diabetes mellitus, essential hypertension), 2) preoperative management such as intravenous infusion of nitroglycerine, preoperative IABP (intra-aortic balloon pump) support and whether the operation was scheduled as emergency or not, 3) intraoperative variables such as infusion method and composition of cardioplegic solutions, number of distal anastomosis, use of internal mammary artery, total cardiopulmonary bypass time and total cross clamp time. Complications included operative death in 12.5％, perioperative myocardial infarction in 25.0％ and perioperative arrhythmia in 17.5％. Nineteen perioperative variables were analyzed to identify risk factors for these end points. For operative death, presence of left main coronary artery stenosis (p = 0.056) and cardiopulmonary bypass time (p = 0.029) were significant in the univariate analysis, but presence of left main coronary artery lesion (p = 0.011, $\chi$$^2$= 6.45) and abscence of preoperative of IABP support (p = 0.069, $\chi$$^2$ = 3.30) were independent predictor in multivariate analysis (stepwise linear logistic regression).

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.249-264
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• 1998

Reports on a potential relationship between sensory neural hearing loss(SNHL) and cardiovascular or hematologic factor show that the results are controversial. A detailed analysis of risk factors in the development of SNHL was carried out in 3,050 non-noise exposed healthy worker. The mean hearing threshold of both ears at 500, 1000, 2000, 4000, 8000Hz was measured and the effect of age, possible cardiovascular risk factor and hematologic factor (blood viscosity and hemostatic factors) on SNHL were evaluated. first, each of these were associated with loss of hearing sensitivity when univariately and multivariatively analysed. In a multiple regression model, age, sex, body mass index, WBC and total cholesterol level were independently associated with the mean of hearing sensitivity decrease at 4000 and 8000Hz. Second, study subjects were divided into two group (normal vs SNHL) and we compare the possible risk between both groups, and analysed univariate and multivariative logistic model. In a multiple logistic regression model, age, sex, body mass index, WBC and total cholesterol level, total protein, platelet were independently associated with SNHL. Our results show that we have some reliable indices of susceptibility to SNHL using cardiovascular measures or biochemical factor, but future, more extensive studies are required.

• Journal of Chest Surgery
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• v.50 no.6
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• pp.415-423
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• 2017

Background: Recently, many surgeons have chosen sublobar resection for the curative treatment of lung tumors with ground-glass opacity, which is a hallmark of lepidic lung cancer. The purpose of this study was to evaluate the oncological results of sublobar resection for non-lepidic lung cancer in comparison with lobectomy. Methods: We conducted a retrospective chart review of 328 patients with clinical N0 non-small cell lung cancer sized ${\leq}2cm$ who underwent curative surgical resection from January 2009 to December 2014. The patients were classified on the basis of their lesions into non-lepidic and lepidic groups. The survival rates following lobectomy and sublobar resection were compared within each of these 2 groups. Results: The non-lepidic group contained a total of 191 patients. The 5-year recurrence-free survival rate was not significantly different between patients who received sublobar resection or lobectomy in the non-lepidic group (80.1% vs. 79.2%, p=0.822) or in the lepidic group (100% vs. 97.4%, p=0.283). Multivariate analysis indicated that only lymphatic invasion was a significant risk factor for recurrence in the non-lepidic group. Sublobar resection was not a risk factor for recurrence in the non-lepidic group. Conclusion: The oncological outcomes of sublobar resection and lobectomy in small-sized non-small cell lung cancer did not significantly differ according to histological type.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.359-364
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• 2006

Objectives: The object of this study is to assess the relationship between socioeconomic factors and the predicted 10-year risk of cardiovascular disease by using health risk appraisal of ischemic heart disease. Methods: The study population was taken from The 2001 Korea National Health and Nutrition Survey, and it consisted of 1,566 men and 1,984 women aged 30-59. We calculated 10-year risk using the risk function of ischemic heart disease as developed by Jee. The educational level and equivalized household income were dichotomized by a 12 years education period and the median income level. Occupation was dichotomized into manual/non-manual work. We stratified the population by age(10 years) and sex, and then we rated the risk differences according to socioeconomic factors by performing t-tests for each strata. Results: There were gradients of the predicted 10-year risk of ischemic heart disease with the educational level and the equivalized household income, and thet was an increasing tendency of risk differences with age. Manual workers didn't show significant risk difference from non-manual workers. Conclusions: There was definite relationship between low socioeconomic position and the predicted risk of ischemic heart disease in the future.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.346-354
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• 2017

Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score. Results: Forty-six patients (45.5%) had at least 1 episode of VAP, 10 (21.7%) of whom died in the ICU. Of the 55 (54.5%) patients who did not have pneumonia, 9 (16.4%) died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029). Conclusion: Severe pulmonary contusion (pulmonary lung contusion score 6-12) is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.148-154
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• 2019

Background: This study investigated the clinical outcomes of surgical treatment of primary chest wall soft tissue sarcoma (CW-STS). Methods: Thirty-one patients who underwent surgery for CW-STS between 2000 and 2015 were retrospectively reviewed. The disease-free and overall survival rates were estimated using the Kaplan-Meier method, and prognostic factors were analyzed using a Cox proportional hazards model. Results: The median follow-up duration was 65.6 months. The most common histologic type of tumor was malignant fibrous histiocytoma (29%). The resection extended to the soft tissue in 14 patients, while it reached full thickness in 17 patients. Complete resection was achieved in 27 patients (87.1%). There were 5 cases of local recurrence, 3 cases of distant metastasis, and 5 cases of combined recurrence. The 5-year disease-free rate was 49%. Univariate analysis indicated that incomplete resection (p<0.001) and stage (p=0.062) were possible risk factors for recurrence. Multivariate analysis determined that incomplete resection (p=0.013) and stage (p=0.05) were significantly associated with recurrence. The overall 5- and 10-year survival rates were 86.8% and 64.3%, respectively. No prognostic factor for survival was identified. Conclusion: Long-term primary CW-STS surgery outcomes were found to be favorable. Incomplete microscopic resection and stage were risk factors for recurrence.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.263-271
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• 2024

Background: Delirium is a recognized neurological complication following cardiac surgery and is associated with adverse clinical outcomes, including elevated mortality and prolonged hospitalization. While several clinical risk factors for post-cardiac surgery delirium have been identified, the pathophysiology related to the immune response remains unexamined. This study was conducted to investigate the immunological factors contributing to delirium in patients after thoracic aortic surgery. Methods: We retrospectively evaluated 43 consecutive patients who underwent thoracic aortic surgery between July 2017 and June 2018. These patients were categorized into 2 groups: those with delirium and those without it. All clinical characteristics were compared between groups. Blood samples were collected and tested on the day of admission, as well as on postoperative days 1, 3, 7, and 30. Levels of helper T cells (CD4), cytotoxic T cells (CD8), B cells (CD19), natural killer cells (CD56+CD16++), and monocytes (CD14+CD16-) were measured using flow cytometry. Results: The median patient age was 71 years (interquartile range, 56.7 to 79.0 years), and 21 of the patients (48.8%) were male. Preoperatively, most immune cell counts did not differ significantly between groups. However, the patients with delirium exhibited significantly higher levels of interleukin-6 and lower levels of tumor necrosis factor-alpha (TNF-α) than those without delirium (p<0.05). Multivariate analysis revealed that lower TNF-α levels were associated with an increased risk of postoperative delirium (p<0.05). Conclusion: Postoperative delirium may be linked to perioperative changes in immune cells and preoperative cytokine levels. Additional research is required to elucidate the pathophysiological mechanisms underlying delirium.

• Clinical and Experimental Pediatrics
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• v.52 no.7
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• pp.745-751
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• 2009

Hypertension is a major risk factor for myocardial infarction, stroke, and cardiovascular mortality in adults; its treatment reduces the risk of cardiovascular events. In recent times, attention is being paid to monitoring of blood pressure from childhood to adulthood. Childhood hypertension is associated with hypertension in later life, and early intervention is important. In the Korean socioeconomic background, a rapid increase is observed in the number of obesity cases and the rate of increase in the incidence of obesity is more in childhood. The strong association of high blood pressure with obesity and the marked increase in the incidence of childhood obesity indicate that both hypertension and prehypertension are becoming significant health issues. In this comprehensive review, we acquaint the clinician with the available literature on childhood hypertension to provide recommendations for the diagnosis, evaluation, and treatment of hypertension based on the available evidence and consensus in Korean clinical conditions.

• Nutrition Research and Practice
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• v.6 no.3
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• pp.246-253
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• 2012

The Framingham risk score (FRS) has been used to assess the risk of a cardiovascular event and to identify patients for risk factor modifications. Therefore, the purpose of this study was to evaluate the relationship of the FRS with dietary intake and inflammatory biomarkers. We conducted a cross-sectional study of 180 men ($49.2{\pm}10.2$ years) with MS. Serum levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and adiponectin were examined. Participants were asked to complete the food frequency questionnaire (FFQ) using the previous 1 year as a reference point. The absolute cardiovascular disease (CVD) risk percentage over 10 years was calculated to estimate the FRS, which was classified as low risk (< 10%), intermediate risk (10-20%), and high risk (> 20%). Mean intake of polyunsaturated fatty acids was lower in subjects who had > 20% FRS than in subjects who had < 10% FRS ($3.7{\pm}1.9$ g/day vs. $4.7{\pm}1.9$ g/day; P < 0.05). Significant differences in the Index of Nutritional Quality of protein, phosphorus, iron, vitamin A, vitamin $B_1$, niacin, vitamin $B_6$, and vitamin C were observed between the > 20% FRS group and the < 10% FRS group (P < 0.05). IL-6 concentrations were significantly lower in subjects with a < 10% FRS than in subjects who were 10-20% FRS or > 20% FRS ($0.91{\pm}0.26$ vs. $1.48{\pm}033$ vs. $2.72{\pm}0.57$ pg/mL, respectively; P < 0.05). IL-6 and dietary intake of polyunsaturated fatty acids together explained 6.6% of the variation in FRS levels in a stepwise multiple regression model. Our results provide some evidence that dietary intake in the higher CVD risk group was inferior to that in the lower risk group and that dietary fat intake and IL-6 were associated with FRS and MS in Korean men.

• Journal of Chest Surgery
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• v.48 no.3
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• pp.174-179
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• 2015

Background: The endoscopic vein harvesting (EVH) method has been used in coronary artery bypass surgery in many countries. We started using the EVH method recently, and investigated the results during the early learning period. Methods: Between March 2012 and June 2014, 75 patients (31 patients in the EVH method group, and 44 patients in the open method group) who underwent isolated first-time coronary artery bypass grafting using vein grafts were retrospectively analyzed with respect to the early outcomes including graft patency and risk factors for leg wound complications. For assessing the patency of vein graft, we performed coronary computed tomography angiography during the immediate postoperative period and 6 months later. Results: Mean harvesting time of endoscopic method was about 15 minutes. Patency rate during the immediate operative period and the 6-month patency rate were similar between the two groups (postoperative period: EVH 100% vs. open method 94.4%, p=0.493; at 6 months: EVH 93.3% vs. open method 90.9%, p=0.791). Leg wound complications occurred more frequently in the open method group (EVH 3.2% vs. open method 13.6%, p=0.127). According to the analysis, age was an independent risk factor for leg wound complications. Conclusion: EVH is a feasible method even for beginners and can be performed satisfactorily during their learning period.