• Clinical and Experimental Pediatrics
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• v.57 no.5
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• pp.217-221
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• 2014

Purpose: The aim of this study was to determine whether school-aged children with Kawasaki disease (KD) have an increased risk for early atherosclerosis. Methods: The study included 98 children. The children were divided into the following groups: group A (n=19), KD with coronary arterial lesions that persisted or regressed; group B (n=49), KD without coronary arterial lesions; and group C (n=30), healthy children. Anthropometric variables and the levels of biochemical markers, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A, apolipoprotein B, homocysteine, highsensitivity C-reactive protein (hs-CRP), and brachial artery stiffness using pulse wave velocity were compared among the three groups. Results: There were no significant differences in blood pressure and body index among the three groups. Additionally, there was no sex-specific difference. Moreover, the levels of triglyceride, HDL-C, apolipoprotein A, and hs-CRP did not differ among the three groups. However, the levels of total cholesterol (P =0.018), LDL-C (P =0.0003), and apolipoprotein B (P =0.029) were significantly higher in group A than in group C. Further, the level of homocysteine and the aortic pulse wave velocity were significantly higher in groups A and B than in group C (P=0.0001). Conclusion: School-aged children after KD have high lipid profiles and arterial stiffness indicating an increased risk for early atherosclerosis.

• Journal of Preventive Medicine and Public Health
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• v.53 no.5
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• pp.313-322
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• 2020

Objectives: This study was conducted to determine the incidence and risk factors of myocardial infarction (MI) and stroke in farmers compared to the general population and to establish 5-year prediction models. Methods: The farmer cohort and the control cohort were generated using the customized database of the National Health Insurance Service of Korea database and the National Sample Cohort, respectively. The participants were followed from the day of the index general health examination until the events of MI, stroke, or death (up to 5 years). Results: In total, 734 744 participants from the farmer cohort and 238 311 from the control cohort aged between 40 and 70 were included. The age-adjusted incidence of MI was 0.766 and 0.585 per 1000 person-years in the farmer and control cohorts, respectively. That of stroke was 0.559 and 0.321 per 1000 person-years in both cohorts, respectively. In farmers, the risk factors for MI included male sex, age, personal history of hypertension, diabetes, current smoking, creatinine, metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). Those for stroke included male sex, age, personal history of hypertension, diabetes, current smoking, high γ-glutamyl transferase, and metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). The prediction model showed an area under the receiver operating characteristic curve of 0.735 and 0.760 for MI and stroke, respectively, in the farmer cohort. Conclusions: Farmers had a higher age-adjusted incidence of MI and stroke. They also showed distinct patterns in cardiovascular risk factors compared to the general population.

• Nutrition Research and Practice
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• v.10 no.1
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• pp.74-80
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• 2016

BACKGROUND/OBJECTIVES: Cardiovascular diseases is a major cause of death and is responsible for 23.8% of deaths in Korea. Clinical symptoms manifest in adulthood, but susceptibility begins in utero. Elevated homocysteine levels and adiposity might be linked to a greater risk in children as well as adults. We hypothesized that those who have simultaneous risk for folate and adiposity would be affected with elevated homocysteine levels at 3 years of age. SUBJECTS/METHODS: From the ongoing birth cohort at Ewha Womans University Mok-Dong Hospital, we compared adiposity parameters, serum homocysteine, and folate levels in 238 children (118 boys and 120 girls) at three years of age. The relationship between birth outcome, current weight and body mass index (BMI), postnatal growth, and homocysteine level were assessed using correlation and general linear model. Additionally, we assessed the combined effect between blood folate status and adiposity on current homocysteine levels. RESULTS: Birth characteristics were not correlated with homocysteine. Current weight, BMI, upper-arm circumference, skinfold thickness, waist circumference, and hip circumference were positively correlated with homocysteine at three years of age (P < 0.05). Folate level was negatively correlated with homocysteine at three years of age (P < 0.0001). A relative high anthropometric measure which is compatible with adiposity and low folate level was associated with high homocysteine levels. CONCLUSION: We found a combined effect of adiposity and folate levels with homocysteine levels at three years of age. This implicates the beneficial role of folate supplementation in the high-risk population at an early age.

• The Journal of the Society of Stroke on Korean Medicine
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• v.12 no.1
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• pp.50-60
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• 2011

Objectives : This study was aimed to clarify the relationship between the dampness-phlegm diagnosis and internal carotid artery stenosis by measuring carotid artery sonography in cerebral infarction patients. Methods : One hundred eighty subjects were recruited from the patients admitted to the Department of Internal Medicine at Kyunghee university oriental medical center from September 2008 to July 2010. We assessed one hundred eighty patients' carotid artery sonography data and diagnosed dampness-phlegm by oriental medical diagnosis. then, analyzed their characteristics, risk factor, lifestyle, metabolic syndrome, body mass index, Waist/Hip ratio(W/H ratio) and dampness-phlegm diagnosis. Results : On the demographic variables of the patients, age, smoking, W/H ratio and dampness-phlegm group were significantly higher in severe internal carotid artery(ICA) stenosis group than in the control group. According to the significant difference in dampness-phlegm group, we analyzed dampness-phlegm related index for pattern identifications by ICA stenosis. As a result, sputum, bowel sound, chest discomfort, slippery pulse were significantly higher in the severe ICA stenosis group than in the control group. In multivariate analysis, dampness-phlegm group showed close relationship with severe ICA stenosis group. Conclusion : According to the analysis, significance between dampness-phlegm diagnosed patients group and severe ICA stenosis were clarified. These results can be utilized in the future as a basis material.

• Korean Circulation Journal
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• v.53 no.11
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• pp.744-755
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• 2023

Background and Objectives: Aortic valve replacement (AVR) is considered a class I indication for symptomatic severe aortic stenosis (AS). However, there is little evidence regarding the potential benefits of early AVR in symptomatic patients diagnosed with normal-flow, low-gradient (NFLG) severe AS. Methods: Two-hundred eighty-one patients diagnosed with symptomatic NFLG severe AS (stroke volume index ≥35 mL/m², mean transaortic pressure gradient <40 mmHg, peak transaortic velocity <4 m/s, and aortic valve area <1.0 cm²) between January 2010 and December 2020 were included in this retrospective study. After performing 1:1 propensity score matching, 121 patients aged 75.1±9.8 years (including 63 women) who underwent early AVR within 3 months after index echocardiography, were compared with 121 patients who received conservative care. The primary outcome was a composite of all-cause death and heart failure (HF) hospitalization. Results: During a median follow-up of 21.9 months, 48 primary outcomes (18 in the early AVR group and 30 in the conservative care group) occurred. The early AVR group demonstrated a significantly lower incidence of primary outcomes (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.29-0.93; p=0.028); specifically, there was no significant difference in all-cause death (HR, 0.51; 95% CI, 0.23-1.16; p=0.110), although the early AVR group showed a significantly lower incidence of hospitalization for HF (HR, 0.43; 95% CI, 0.19-0.95, p=0.037). Subgroup analyses supported the main findings. Conclusions: An early AVR strategy may be beneficial in reducing the risk of a composite outcome of death or hospitalization for HF in symptomatic patients with NFLG severe AS. Future randomized studies are required to validate and confirm our findings.

• Journal of Nutrition and Health
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• v.51 no.6
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• pp.556-566
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• 2018

Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.

• Journal of Preventive Medicine and Public Health
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• v.39 no.6
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• pp.477-484
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• 2006

Objectives : This study was conducted to examine the association between the carotid artery intima-media thickness (IMT), plaque and cardiovascular risk factors according to gender and age. Methods : The data used for this study were obtained from 1,507 subjects (691 men, 816 women), aged 20-74 years, who participated in 'Prevalence study of thyroid diseases' in two counties of Jeollanam-do Province during July and August of 2004. The body mass index (BMI) and waist hip ratio (WHR) were calculated by anthropometry The blood pressure, pulse rate, pulse pressure, total cholesterol, triglyceride, HDL cholesterol and fasting blood sugar level were also measured. Ultrasonography was used to measure the carotid artery IMT and plaque. IMT measurements were performed at 6 sites, including both common carotid arteries, and the bulb and internal carotid arteries. The definition of the 'mean IMT' was mean value obtained from these 6 sites. Results : The ${\pm}$ standard deviation IMT values were $0.65{\pm}0.14\;and\;0.60{\pm}0.13mm$ in men and women (p<0.001), respectively. The data were analyzed according to gender and the 50 year age groups. In a multiple linear regression analysis, age and hypertension were positively associated with the mean IMT in both men and women, aged<50 years. Age, total cholesterol and smoking (current) were positively associated with the mean IMT in men $(\geq50\;years)$. Age was positively associated with the mean IMT in women $(\geq50\;years)$, but the HDL cholesterol level was negatively associated. The prevalence of plaques was 44.2%(196/443) in men and 19.4%(89/459) in women, for those greater than 50 years of age. In a multiple logistic regression analysis, age (OR=1.090, 95%CI=1.053-1.129), HDL cholesterol (OR=0.964, 95%CI=0.944-0.984), total cholesterol (OR=1.009, 95%CI=1.002-1.017)and BMI (OH=0.896, 95%CI=0.818-0.983) were independently associated with plaques in men; whereas, age (OR=1.057, 95%CI=1.012-1.103), HDL cholesterol (OR=0.959, 95%CI=0.932-0.986), pulse pressure (OR=1.029, 95%CI=1.007-1.050) and triglycerides (OR=0.531, 95%CI=0.300-0.941) were independently associated with plaques in women. Conclusions: There were significant gender and aging differences in the association between the IMT, plaque and cardiovascular risk factors. Therefore, for the prevention of atherosclerosis, selective approaches should be considered with regard to gender and age factors.

• Journal of radiological science and technology
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• v.39 no.1
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• pp.81-88
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• 2016

The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDL-cholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease.

• Sleep Medicine and Psychophysiology
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• v.23 no.2
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• pp.93-96
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• 2016

Obstructive sleep apnea syndrome (OSAS) has negative effects on health, including increased mortality, risk of cardiovascular disease, and neurocognitive difficulties. OSAS is common in obese patients and obesity is an important risk factor of OSAS. A 41-year-old female OSAS patient with severe obesity (body mass index [BMI] ${\geq}35$) who failed dietary weight loss underwent bariatric surgery. After surgery, there were improvements in BMI (from 36.9 to $31.7kg/m^2$) and polysomnographic data, including the apnea-hypopnea index (from 25.1 to 11.2 events/hr) and minimum SaO2 (from 69 to 82%). This case demonstrates that bariatric surgery may be an effective therapeutic option to reduce sleep-disordered breathing in severely obese patients with moderate OSAS. Bariatric surgery as a treatment option for OSAS should be considered in OSAS patients with severe obesity who failed dietary weight loss.

• Research in Community and Public Health Nursing
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• v.28 no.2
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• pp.206-215
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• 2017

Purpose: This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults. Methods: A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI. Results: The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased. Conclusion: The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.