• Biomolecules & Therapeutics
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• 제16권1호
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• pp.54-60
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• 2008

Dyslipidemia is the multiple lipid metabolic disorders which is one of the high risk factors for the atherosclerotic diseases. It increases the morbidity and mortality and therefore, must be treated with antilipidemic agents. HMG-Co A reductase inhibitors (statins), one of many antidyslipidemic agents, have shown to be significant improvement from the various cholesterol levels. Especially, data from many comparative trials suggest that rosuvastatin is more effective than atorvastatin among many other statins. The aims of this study were to evaluate the efficacy and safety between rosuvastatin and atorvastatin in the treatment of Korean patients with dyslipidemia. Currently the Korean Society of Lipidology and Atherosclerosis based on the Korean health screening data suggests that Korean patients with dyslipidemia should be treated by the target cholesterol levels according to the Adult Treatment Panel III guidelines of the US National Cholesterol Education Program (NCEP-ATP III). We reviewed retrospectively all medical histories of the total 392 dyslipidemic patients with atorvastatin or rosuvastatin from June 1st, 2004 to August 31st, 2006 in Chungbuk National University Medical Center. Patients were classified as total 4 groups by the NCEP-ATP III Guidelines. The numbers of enrolled patients were each 5 mg atorvastatin (n=34), 10 mg atorvastatin (n=148), 5 mg rosuvastatin (n=94) and 10 mg rosuvastatin (n=82). In comparison between groups, rosuvastatin groups in the lowering LDL-C had better efficacies, and the results were each 22% (5 mg atorvastatin), 33.3% (10 mg atorvastatin), 35% (5 mg rosuvastatin) and 41.3% (10 mg rosuvastatin) with the dose relationship (P=0.000). Rosuvastatin groups also have shown to be more significantly reducing Total Cholesterol levels compared to atorvastatin groups with the no dose relationship (P=0.000). In the lowering of non-HDL cholesteroles, rosuvastatin groups showed significantly better efficacies than atorvastatin with the dose-relationship (P=0.000). Each medication groups did not demonstrate the differences in the changing of HDL cholesterol and triglyceride levels (P=0.096, 0.309, respectively). In conclusion, rosuvastatin was better efficacious than atrovastatin in reducing LDL-C Total Chol, and Tg. Therefore, rosuvastatin is a good antilipidemic agents for Korean patients with dyslipidemia and it can use to minimize the morbidity and mortality related to the cardiovascular diseases in Korean.

• Journal of Chest Surgery
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• 제16권4호
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• pp.602-614
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• 1983

Six hundred fourteen consecutive cases of bioprosthetic cardiac valve replacement performed during the period from March 1976 through December 1982 were reviewed. A total of 748 tissue valves [534 Ionescu-Shiley valves, 144 Hancock valves, 46 Angell-Shiley, and 24 Carpentier-Edwards] were implanted in 610 patients. Of these, 477 had single valve replacements [403 mitral, 60 aortic, and 14 tricuspid] including three REDO MVR and one REDO AVR. The remaining 129 had double valve replacements [95 AVR and MVR and 34 MVR and TVR] and 8 had triple valve replacement.592 cases were evaluated. Overall early mortality rate [within 30 days of operation] was 7.1% [6.2% in single valve replacement, 10.2% in double valve replacement, and 16.7% in triple valve replacement]. Leading causes of mortality were low cardiac output or myocardial failure and ventricular arrhythmias. The follow-up period was from one month to 7 years with a cumulative follow-up of 906.6 patient-years [mean 1.53 years]. The late mortality was 1.6%, 3.9%, 0%, 2.6%, 6.6% and 2.0% per patient-year for MVR, AVR, TVR or triple valve replacement, AVR+MVR, MVR+TVR and total, respectively. Actuarial analysis of late results including early mortalities indicates an expected survival rate of 87.6+1.8% at 3 years and 85.92.4% at 7 years for all cases. We also analyzed actuarial survival rate between groups of each valve replacement [AVR, TVR, Double valve, and Triple valve] and the tissue valve groups in MVR. We experienced 7 cases [0.77% per patient-year] of confirmed endocarditis, two of which were fatal. Valve failure-free rates calculated according to the confirmed cases were 97.5% at 4 years, 87.5% at 7 years, and 88.3% at 6 years for Ionescu-Shiley, Hancock and Angell-Shiley valves, respectively. The occurrence rate of thromboembolism was 2.0% per patient-year in total cases, although almost all the patients were given anticoagulant therapy for one year. The occurring rate in MVR was 1.5% and 2.7% per patient-year for Ionescu-Shiley and Hancock valve groups, respectively. The difference in actuarial rate free from thromboemboli between Ionescu-Shiley and Hancock groups was statistically significant [P value less than 0.001]. Thromboembolic events beyond the period of anticoagulation therapy mainly occurred in patients with atrial fibrillation. The actuarial thromboemboli free survival was 95.71.4% at 3 years and 80.17.3% at 7 years. The incidence of hemorrhagic complications was 1.2% per patient-year [fatality 0.55% per patient-year] for anticoagulated patients. Although our clinical data favorably compares with results from other reports, our results suggest that anticoagulant therapy be given on a short-term basis or not at all to hemodynamically stable patients. Long-term therapy with antiplatelet drugs is probably inevitable with patients who have thromboembolic risk factors [such as atrial fibrillation].

• 정신신체의학
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• 제15권1호
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• pp.51-55
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• 2007

연구목적 : 비만과 우울증은 모두 심각한 공공 의료 문제이고 특히 주된 심혈관계 질환 위험인자이다. 비만과 우울증 상에 관한 해외 연구는, 일정한 결론은 아니나, 여러 연구에서 연관성 존재를 보고하고 있고 특히 일부 연구는 여성에서 그 연관 정도가 큼을 보고 한 바 있다. 본 연구는 한국 여성에서 있어 비만, 특히 복부비만과 우울증상의 연관성을 분석하고자 한다. 방법: 여성 연구 대상자 4,609명을 대상으로 Beck 우울 척도 및 체계측을 시행한 결과를 이용 우울증상과 비만과의 연관성을 분석하였다. 비만도는 체질량지수로 정하였으며 체질량지수 $25kg/m^2$ 이상을 비만으로 하였고 복부비만은 허리둘레 85cm 이상으로 정의하였다. 임상적으로 우울증을 의심할 수 있는 Beck 우울척도 분할점은 16점으로 하였다. 결과: 정상 체중군에 비해 비만 여성군에서 우울 여성의 비율이 유의미하게 높았고(27.6% VS. 23.2%, p<0.01), 복부 비만 여성에서도 우울 여성군의 비율이 통계적으로 유의하게 높았고(26.9% VS. 22.7%, p<0.01), 비만 여성군 중 우울 여성에서 복부 비만 가진 비율이 통계적으로 유의미하게 높았다(93.2% VS. 86.9%, p<0.01). 결론 : 본 연구의 결과는 한국 여성에서 비만, 특히 복부비만과 우울증간 연관성이 존재함을 보였고 향후 전향적 연구를 통한 비만과 우울증간 상호 역할에 대한 적극적 이해가 필요함을 시사한다.

• Journal of Chest Surgery
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• 제32권1호
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• pp.32-37
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• 1999

배경: 폐암의 완치를 위한 가장 효과적인 치료 방법은 조기 진단과 외과적인 절제술이다. 고령의 환자군에서는 젊은 환자군에 비하여 폐암으로 진단된 경우 전신 건강 상태, 잔여 폐기능의 제한에 의하여 사용 가능한 모든 유용한 치료 방법을 최대한 이용하는 것이 불가능한 경우가 많다. 저자들은 외과적인 폐절제술을 시행한 환자군을 대상으로 후향적인 연구를 통하여 연령인자가 폐암의 병기, 조직학적 진단, 수술 방법, 합병증의 이환율과 사망률에 어떤 영향을 미치는 지 조사하였다. 대상 및 방법: 비소세포 폐암으로 진단받고 외과적인 절제술을 시행한 211명의 환자를 대상으로 하였다. 환자는 1994년 10월부터 1997년 6월까지 수술 받은 환자였다. 환자들을 인위적으로 70세 이상군(35명)과 미만군(176 명)으로 나누어 두 군을 의무기록을 참조로 비교 조사하였다. 결과: 폐암의 병기및 조직학적 진단은 두 군에서 차이가 없었다. 그러나 수술 방법, 합병증의 이환율, 사망률은 두 군 사이에 차이가 있었고, 70세 이상군에서 합병증의 이환율이 높은 것으로 나타났다(p = 0.02). 수술 방법에서 70세 이상군에서는 가능한 잔여 폐기능을 보존하는 덜 침습적인 시술이 선호되었다. 결론: 수술후 합병증의 이환율과 사망률은 70세이상 군에서 높아서 수술의 위험도가 높은 것으로 나타났다. 흉부 수술이 폐암의 완치를 목적으로 권유되어 질 수 있는 최선의 치료 방법이다. 그렇지만, 고령의 환자에서는 합병증의 이환율 및 사망률이 높게 발생한다. 따라서, 고령의 폐암 환자의 수술을 결정할 때, 수술 적응증과 수술 방법을 신중히 고려하여야 된다고 생각한다.

• 동의생리병리학회지
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• 제20권6호
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• pp.1732-1741
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• 2006

Obesity is chronic disease which influenced on health severly. The causes of obesity have been known as life change, lack of excercise, genetic factor, mental and social economic factors. Especially the obesity of women increased the risk of the diseases such as DM, osteoarthritis, cardiovascular disease, breast cancer and infertility. The limitations of the widely used negative definition of health as the absence of disease and WHO's 1946 definition of health as total social, psychological and physical well-being have long been recognized (WHO 1958). The Quality of Life (QoL) includes functional ability, the degree and quality of social and community interaction, psychological well-being as somatic sensation and life satisfaction. I investigated to compare the differences between obese women (n=63), non-obese women (n=37) in clinic and general women (n=43, control) on baseline characteristics and WHO QoL-BREF. The purpose of this study is to assist the diagnosis and treatment of obesity. WHO QoL-BREF is self administered type which consisted of 26 questions. The prospective question is calculated with 5 scores by Likert's method. The results are as follows : The means of physical, psychological, social, overall and total scores of QoL were significant among BMI group (P<0.05). The score of control group (BMI < 25) was higher than other groups significantly (P<0.05). In multiple regression analysis, the variable of high school/below middle school was significant in environmental and overall domain of QoL scores (P<0.05). The variable of college/below middle school was significant in environmental, overall domain and total score of QoL scores (P<0.05). The variable of above university/below middle school was significant in physical health, environmental, overall domain and total score in QoL scores (P<0.05). The variable of Health perception (moderate/bad) was positively significant in physical health, environmental, overall domain and total score of QoL scores (P<0.05). The variable of Health perception (good/bed) was positively significant in physical health, environmental, social, overall domain and total score of QoL scores (P<0.05). The variable as BMI non-=obese women/control was negatively significant in social domain of QoL scores (P<0.05). Above the results, It suggests that the variable as BMI did't affect on the QoL in patients and control, but the variables as education and health perception affected on the QoL scores. Further study is required to conduct QoL differences between before and after treatment of obese patients.

• The Korean Journal of Medicine
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• 제93권6호
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• pp.548-555
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• 2018

목적: 혈액투석 환자에서 체수분 상태는 중요한데 혈액투석 이후의 과수분 상태는 고혈압, 부종, 심혈관계 합병증을 유발할 수 있다. 혈액투석 환자의 근육량 평가 및 체수분 상태를 측정할 수 있는 BIA 검사를 이용하여 혈액투석 환자에서 이환율, 생존율과 관련된 인자를 알아보고자 하였다. 방법: 본 연구는 후향적 연구로 2010년 1월부터 2015년 5월 30일까지 BIA를 측정한 말기 신부전으로 진단받고 투석을 3개월 이상 시행한 환자를 대상으로 하였으며, 2017년 6월 30일까지 추적 관찰하였다. 혈액투석 환자에서 시행하는 기본 혈액 검사와 BIA data (ECW, ICW, TBW, SLM, FFM, SMM 등)를 참조하여 환자의 이환율, 생존율 등을 분석하였다. 결과: 사망군과 생존군에서 SLM, SMM, FFM의 차이는 없었다. 생존군에서 사망군보다 나이, C-반응단백 수치가 낮았고, 혈청 알부민, 부갑상샘호르몬, 인이 높았으며, 총 체액량(TBW) 중 세포외액량(ECW)의 비율은 사망군에서 좀 더 높은 결과를 보였다($0.39{\pm}0.01$ vs. $0.40{\pm}0.01$; p < 0.05). 과수분군을 ECW/TBW ratio > 0.4로 정의하였을 때 Kaplan-Meier 생존분석에서 과수분군에서 통계적으로 유의하게 사망률이 높았다. 결론: 혈액투석 환자에서 BIA로 측정한 근육량 감소과 과수분 상태는 환자의 사망률과 이환율과 관련된 중요한 인자로 생각되며, 근육량 감소보다는 과수분 상태가 사망률과 좀 더 밀접한 관련이 있을 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.105-114
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• 2021

Background: Complementary and alternative medicine (CAM) has been used frequently, and its use continues to increase in lung cancer patients, despite insufficient scientific of its efficacy. To investigate this situation, we analyzed the current awareness and use of CAM in Korean lung-cancer patients. Methods: This prospective survey-based study was performed at seven medical centers in South Korea between August and October 2019. The survey assessed general patient characteristics and the awareness and use of CAM. We analyzed differences in the clinical parameters of patients aware and not aware of CAM and of CAM non-users and users. Results: Of the 434 patients included in this study, 68.8% responded that they were aware of CAM and 30.9% said they had experienced it. In univariate analysis, the patients aware of CAM were younger with poor performance status, had advanced-stage lung cancer, received more systemic therapy, and received concurrent chemoradiation therapy (CCRT). By multiple logistic regression, younger age, poor performance status, advanced stage, and prior CCRT were identified as independent risk factors for CAM awareness. There were no significant differences in the general characteristics and cancer-associated clinical parameters of CAM non-users and users. Conclusion: Specific clinical parameters were associated with patients' awareness of CAM, although there were no significantly different characteristics between CAM users and non-users.

• 분석과학
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• 제36권3호
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• pp.105-112
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• 2023

라이코펜은 카로티노이드의 일종으로 심혈관계 위험인자, 혈중지질, 혈압 등을 낮추는 효과를 가지는 것으로 알려져 있어, 액상 내용물이 충진된 연질캡슐, 고상 내용물이 충진된 경질캡슐을 포함하는 다양한 제형의 라이코펜 건강기능식품이 유통되고 있다. 그러나, 최근 본 연구진은 현 건강기능식품공전 중 라이코펜 시험법의 고상 건강기능식품 적용에 한계가 있음을 확인하였다. 따라서, 본 논문에 비누화 반응 및 액체크로마토그래프에 기반한 신규 고상 건강기능식품 중 라이코펜 시험법의 개발을 보고하는 바이다. 신규 개발 시험법은 식품의약품안전평가원 가이드라인에 의거하여 밸리데이션 되었고, 모든 항목 결과가 가이드라인 기준을 만족함(특이성, 직선성 r²≥0.991, 정량한계 0.0149 mg/mL, 정확도(회수율) 92.70~97.18 %, 반복성(회수율의 상대표준편차) 0.85~1.59 %, 재현성(실험실 간 회수율의 상대표준편차) 3.70 %)을 확인하였다. 또한 인증표준물질을 활용한 적용성 평가에서도 높은 정확도(98.81~101.59 %)가 관찰되어, 신규 시험법의 개발이 성공적이었음을 재확인하였다. 따라서, 신규 개발 시험법은 향후 고상 라이코펜 건강기능식품 관리에 활용되어 국내 건강식품안전관리에 기여할 수 있을 것으로 판단된다.

• Journal of Chest Surgery
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• 제57권2호
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• pp.160-168
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• 2024

Background: Data on perioperative outcomes of emergent versus elective resection in esophageal cancer patients requiring esophagectomy are lacking. We investigated whether emergent resection was associated with increased risks of morbidity and mortality. Methods: Data on patients with esophageal malignancy who underwent esophagectomy from 2005 to 2020 were retrospectively analyzed from the American College of Surgeons National Surgical Quality Improvement Program database. Thirty-day complication and mortality rates were compared between emergent esophagectomy (EE) and non-emergent esophagectomy. Logistic regression assessed factors associated with complications and mortality. Results: Of 10,067 patients with malignancy who underwent esophagectomy, 181 (1.8%) had EE, 64% had preoperative systemic inflammatory response syndrome, sepsis, or septic shock, and 44% had bleeding requiring transfusion. The EE group had higher American Society of Anesthesiologists (ASA) class and functional dependency. More transhiatal esophagectomies and diversions were performed in the EE group. After EE, the rates of 30-day mortality (6.1% vs. 2.8%), overall complications (65.2% vs. 44.2%), bleeding, pneumonia, prolonged intubation, and positive margin (17.7% vs. 7.4%) were higher, while that of anastomotic leak was similar. On adjusted logistic regression, older age, lower albumin, higher ASA class, and fragility were associated with increased complications and mortality. McKeown esophagectomy and esophageal diversion were associated with a higher risk of postoperative complications. EE was associated with 30-day postoperative complications (odds ratio, 2.39; 95% confidence interval, 1.66-3.43; p<0.0001). Conclusion: EE was associated with a more than 2-fold increase in complications compared to elective procedures, but no independent increase in short-term mortality. These findings may help guide data-driven critical decision-making for surgery in select cases of complicated esophageal malignancy.

• 대한치매학회지
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• 제22권1호
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• pp.28-42
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• 2023

Background and Purpose: We investigated the correlation between the deep distribution of white matter hyperintensity (WMH) (dWMH: WMH in deep and corticomedullary areas, with minimal periventricular WMH) and a positive agitated saline contrast echocardiography result. Methods: We retrospectively recruited participants with comprehensive dementia evaluations, an agitated saline study, and brain imaging. The participants were classified into two groups according to WMH-distributions: dWMH and dpWMH (mainly periventricular WMH with or without deep WMH.) We hypothesized that dWMH is more likely associated with embolism, whereas dpWMH is associated with small-vessel diseases. We compared the clinical characteristics, WMH-distributions, and positive rate of agitated saline studies between the two groups. Results: Among 90 participants, 27 and 12 met the dWMH and dpWMH criteria, respectively. The dWMH-group was younger (62.2±7.5 vs. 78.9±7.3, p<0.001) and had a lower prevalence of hypertension (29.6% vs. 75%, p=0.008), diabetes mellitus (3.7% vs. 25%, p=0.043), and hyperlipidemia (33.3% vs. 83.3%, p=0.043) than the dpWMH-group. Regarding deep white matter lesions, the number of small lesions (<3 mm) was higher in the dWMH-group(10.9±9.7) than in the dpWMH-group (3.1±6.4) (p=0.008), and WMH was predominantly distributed in the border-zones and corticomedullary areas. Most importantly, the positive agitated saline study rate was higher in the dWMH-group than in the dpWMH-group (81.5% vs. 33.3%, p=0.003). Conclusions: The dWMH-group with younger participants had fewer cardiovascular risk factors, showed more border-zone-distributions, and had a higher agitated saline test positivity rate than the dpWMH-group, indicating that corticomedullary or deep WMH-distribution with minimal periventricular WMH suggests embolic etiologies.