• Title/Summary/Keyword: Cardiovascular disease

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Changes in Nutritional Status of General Medical Patients During Hospitalization (내과 환자의 입원후 영양상태 변화 연구)

  • 양영희;최스미;김은경
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.49-60
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    • 1997
  • The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular. renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment : patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of days of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements. including weight body mass index, lean body mass, body fat. and skin fold thickness. were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization, almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia. Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

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Clinical Pharmacogenomics of Drug Metabolizing Enzymes and its Clinical Application (약물대사효소의 유전적 다형성 및 임상적 응용)

  • Kim, Kyung-Im;Kim, Seung-Hee;Park, Ji-Eun;Chae, Han-Jung;Choi, Ji-Sun;Shin, Wan-Gyun;Son, In-Ja;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.155-164
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    • 2006
  • Great inter-variability in drug response and adverse drug reactions is related to inter-variability of drug bioavailability, drug interaction and patient's disease and physyological state that cause change in absorption, distribution, metabolism and excretion of drugs. However, these alone do not sufficiently predict and explain inter-variability in drug response. In recent studies, it is reported that inter-variability in drug response and adverse drug reactions may largely resulted from genetically determined differences in drug absoption, distribution, metabolism and drug target proteins. Especially, the major human drug-metabolizing enzymes such as CYP450, N-acetyl tranferase, thiopurine S-methyl transferase, glutathione S-transferase are identified as the major gene variants that cause inter-individual variability in drug's response and adverse drug reactions. These variations may have most significant implications for those drugs that have narrow therapeutic index and serious adverse drug reactions. Therefore, the genetic variation such as polymorphisms in drug metabolizing enzymes can affect the response of individuals to drugs that are used in the treatment of depression, psychosis, cancer, cardiovascular disorders, ulcer and gastrointestinal disorders, pain and epilepsy, among others. This review describes the pharmacogenomics of the drug metabolizing enzymes associated with the drug response and its clinical applications.

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A Case of Intermediate Grade Bronchial Mucoepidermoid Carcinoma and Review in Korean Cases (중간등급의 기관지 점액표피양 암종 1예와 국내 보고에 대한 고찰)

  • Cha, Sung Chul;Kim, Si Woo;Cho, Yoo Jin;Park, Sung Kyoon;Park, Hyun Keun;Kim, Jong Sang;Kwak, Jae Wook;Yoo, Moon Bin;Cho, Hye Jae;Lee, Jae Jin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.41-48
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    • 2008
  • Bronchial mucoepidermoid carcinoma is uncommon, representing 0.2% of all lung tumors. The disease usually presents with symptoms of airway obstruction and recurrent pneumonia. It is commonly classified into two grades in Korea, low and high. We report a case of a bronchial mucoepidermoid carcinoma in a 40-year-old woman who complained of symptoms of an upper respiratory infection. The histological grade after a bronchoscopic biopsy was intermediate. A left upper lobectomy was performed as treatment. The TNM stage of this case was IA (T1N0M0). In addition, 25 cases of bronchial mucoepidermoid carcinoma from 1984 in Korea are also reviewed from the viewpoint of the relationship between the histological grade, TNM stage and clinical course of the tumor.

The Relative Factors to Insulin Resistance and β Cell Function Determined by Homeostasis Model Assessment in Nondiabetic Adults

  • Kwon, Se-Young;Na, Young-Ak
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.4
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    • pp.131-138
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    • 2013
  • Insulin resistance and pancreatic beta cell dysfunction have been established as being related to the diabetes. Lately, what is emphasizing is that those have been shown as something related to the metabolic syndrome and cardiovascular disease. Homeostasis model assessment (HOMA), simple index is calculated on blood levels of fasting glucose and insulin. And HOMA has been widely validated and applied for insulin resistance and pancreatic beta cell dysfunction. We also assessed the factors relative to insulin resistance and ${\beta}$ cell function determined by HOMA. The data from the 2010 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 3,465 nondiabetic subjects (male 1,357, female 2,108). At baseline, anthropometric measurements were done and fasting glucose, insulin, lipid (Total cholesterol, HDL cholesterol, LDL cholesterol and Triglycerides) profiles were measured. HOMA-insulin resistance (HOMA-IR) and beta cell function (HOMA ${\beta}$-cell) were calculated from fasting glucose and insulin levels. In male, the value of HOMA-IR and HOMA ${\beta}$-cell was the highest among 30's and decreased as the age increased. In female, the value of HOMA-IR increased with age, while HOMA ${\beta}$-cell decreased. High HOMA-IR and low HOMA ${\beta}$-cell were associated with the highest value of fasting glucose and systolic blood pressure. Low HOMA-IR and high HOMA ${\beta}$-cell showed the lowest concentration of fasting glucose and the highest concentration of HDL cholesterol. High HOMA-IR and high HOMA ${\beta}$-cell were connected with BMI, Total cholesterol, LDL cholesterol, and Triglycerides. There was a negative correlation between HOMA ${\beta}$-cell and age. The correlation coefficients of HOMA-IR and HOMA ${\beta}$-cell showed the highest value among weight, BMI and WC.

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Cigarette Smoking and Serum Bilirubin Subtypes in Healthy Korean Men: The Korea Medical Institute Study

  • Jo, Jae-Seong;Kimm, Hee-Jin;Yun, Ji-Eun;Lee, Kyu-Jang;Jee, Sun-Ha
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.2
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    • pp.105-112
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    • 2012
  • Objectives: Cigarette smoking is a modifiable risk factor for cardiovascular disease. Bilirubin is a potent antioxidant and its concentration decreases in smokers. However, studies about the association between cigarette smoking and bilirubin are scarce and most are limited to total bilirubin. Additionally, bilirubin is highly related to hemoglobin. Therefore, this study evaluates the association between bilirubin subtypes and cigarette smoking in healthy Korean men independently of hemoglobin. Methods: This study included 48 040 Korean men aged 30 to 87 years who visited the Korea Medical Institute for routine health examinations from January to December, 2007. The association of smoking with total, direct, and indirect bilirubin was assessed by logistic regression analysis taking into consideration differences in subjects and smoking characteristics. Results: Current smokers had lower bilirubin concentrations than never-smokers and ex-smokers. Smoking amount and duration were inversely significantly associated with total, direct, and indirect bilirubin. In a multivariable adjusted model, compared to never-smokers, the odds ratios (ORs) and 95% confidence intervals (CIs) of current smokers with the highest number of pack-years were 1.7 (1.6 to 1.9) for total, 1.5 (1.4 to 1.6) for direct, and 1.7 (1.6 to 1.9) for indirect bilirubin. After further adjustment for hemoglobin, this association became stronger (OR [95% CI], 2.1 [1.9 to 2.2] for total; 1.9 [1.8 to 2.0] for direct; 2.0 [1.9 to 2.2] for indirect bilirubin). Conclusions: In this study, bilirubin subtypes are inversely associated with smoking status, smoking amount, and smoking duration in healthy Korean men independently of hemoglobin. Further studies are needed to investigate this association in healthy Korean women.

Replication of Early B-cell Factor 1 (EBF1) Gene-by-psychosocial Stress Interaction Effects on Central Adiposity in a Korean Population

  • Kim, Hyun-Jin;Min, Jin-Young;Min, Kyoung-Bok
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.5
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    • pp.253-259
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    • 2016
  • Objectives: Central obesity plays a major role in the development of many chronic diseases, including cardiovascular disease and cancer. Chronic stress may be involved in the pathophysiology of central obesity. Although several large-scale genome-wide association studies have reported susceptibility genes for central adiposity, the effects of interactions between genes and psychosocial stress on central adiposity have rarely been examined. A recent study focusing on Caucasians discovered the novel gene early B-cell factor 1 (EBF1), which was associated with central obesity-related traits via interactions with stress levels. We aimed to evaluate EBF1 gene-by-stress interaction effects on central adiposity traits, including visceral adipose tissue (VAT), in Korean adults. Methods: A total of 1467 Korean adults were included in this study. We selected 22 single-nucleotide polymorphisms (SNPs) in the EBF1 gene and analyzed their interactions with stress on central adiposity using additive, dominant, and recessive genetic modeling. Results: The four SNPs that had strong linkage disequilibrium relationships (rs10061900, rs10070743, rs4704967, and rs10056564) demonstrated significant interactions with the waist-hip ratio in the dominant model ($p_{int}$<0.007). In addition, two other SNPs (rs6556377 and rs13180086) were associated with VAT by interactions with stress levels, especially in the recessive genetic model ($p_{int}$<0.007). As stress levels increased, the mean values of central adiposity traits according to SNP genotypes exhibited gradual but significant changes (p<0.05). Conclusions: These results suggest that the common genetic variants for EBF1 are associated with central adiposity through interactions with stress levels, emphasizing the importance of managing stress in the prevention of central obesity.

The Effect of Galkunhwanglyeonhwanggum-tang (GGT) and Sopunghwalhyeol-tang (SPT) on Gene Expression Levels of MCP-1, ICAM-1, VCAM-1, and eNOS in HUVECs (갈근황연황금탕(葛根黃蓮黃芩湯)과 소풍활혈탕(疎風活血湯)이 HUVEC 내에 MCP-1, ICAM-1, VCAM-1 and eNOS의 유전자 발현량에 대해 미치는 영향)

  • Jeong, Hyun-jin;Jeon, Sang-yoon;Jang, Hye-yeon;Kim, Min-wook
    • The Journal of Internal Korean Medicine
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    • v.41 no.4
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    • pp.668-675
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    • 2020
  • Objectives: The aim of this study was to compare the effects of Galkunhwanglyeonhwanggum-tang (GGT), and Sopunghwalhyeol-tang (SPT) on gene expression of MCP-1, ICAM-1, VCAM-1, and eNOS in human umbilical vein endothelial cells (HUVECs). Methods: HUVECs were treated with GGT and SPT at concentrations of 50, 100, and 200 ㎍/mL. Gene expression of MCP-1, ICAM-1, VCAM-1, and eNOS in HUVECs was analyzed by the polymerase chain reaction (PCR), and electrophoresis was performed to verify the gene expression level. Results: 1. MCP-1 gene expression was more strongly decreased by SPT than by GGT. 2. ICAM-1 and VCAM-1 gene expressions were more strongly decreased by SPT than by GGT 3. GGT significantly increased eNOS gene expression, but SPT did not. Conclusions: These findings suggest that GGT and SPT regulate gene expression related to anti-inflammatory effects in HUVECs. Clinical application of these Korean medicines to diseases related to dyslipidemia, such as cardiovascular disease, will require additional in vivo experiments to verify the anti-inflammatory effects of GGT and SPT.

Case Report : The Hypoglycemic Effect of Gamiyookmigihwang-tang on A Mild Diabetes Mellitus patient with Impaired Glucose Tolerance & Impaired Fasting Glucose (가미육미지황탕(加味六味地黃湯)이 공복혈당장애와 내당능장애를 가진 경증 당뇨병환자의 혈당조절에 미치는 영향 1례)

  • Kim, In Soo;Kim, Myeong Sin;Lee, Young Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.5
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    • pp.677-682
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    • 2013
  • Impaired glucose tolerance(IGT) & Impaired fasting glucose(IFG) were standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes. The main clinical significance of IGT & IFG shows some risk factors on type 2 diabetes, cardiovascular disease and component of the metabolic syndrome. In 1997, the American Diabetes Association(ADA) proposed the new classification and diagnostic criteria for diabetes, which wss striction on the diagnostic baseline of Diabetes from 140 mg/dl to 126 mg/dl. This is because that the early diagnosis and treatments can prevent chronic complications. In the oriental medicine, Gamiyookmigihwang-tang has been using for the treatments of Diabetes including IGT & IFG; however, there have not been enough studies about the effect of the glycemic control objectively. So clinical studies have been performed on a mild DM(Diabetes Mellitus) patient with IGT and IFG in order to investigate whether there is hypoglycemic effect of Gamiyookmigihwang-tang. Prior to the study, for two weeks fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. in addition ECG, T-cholesterol, TG, HbA1c levels were measured; then, Gamiyookmigihwang-tang has administrated for 4 weeks. and FBS, PP2hrs, T-cholesterol, TG, HbA1c were measured again after the herb medicine treatment. FBS, PP2hrs glucose levels and other measuring levels (T-cholesterol, TG, HbA1c) were decreased by the administration of Gamiyookmigihwang-tang. Gamiyookmigihwang-tang has hypoglycemic effects on a mild DM patient with IGT and IFG.

Association between Dietary Habits and Self-rated Health According to Sasang Constitution (사상체질에 따른 식습관과 주관적 건강상태와의 연관성)

  • Jeong, Kyoungsik;Kim, Hoseok;Lee, Siwoo;Baek, Younghwa
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.1
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    • pp.53-59
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    • 2020
  • Dietary habits are known to be closely related not only to chronic diseases such as cardiovascular disease and diabetes, but also to self-rated health (SRH). Consequently, there is a highly important lifestyle component in maintaining a healthy life. The aim of the present study was to determine the correlation between diverse dietary habits based on the Sasang constitutions (SC) and SRH. The data were collected from 2,984 participants who met the constitution pharmacology criteria and whose SC were clinically confirmed by SC professionals. Dietary habits were observed by assessing the regularity of diet, meal volume, and meal speed; single-answer questions were used for SRH. Fisher's exact/chi-square test and logistic regression were used to analyze the correlation between dietary habits depending on constitutional type and SRH. In association with constitutional SRH, the Taeum type is related to the amount of meal, the Soeum and Soyang types are related to the regularity of meal and meal volume. In the Taeum type, there was a significantly higher risk of lower SRH when meal volumes were irregular less than previous amounts. Irregular diet, as well as increased or decreased meal volume, negatively correlated with SRH in the Soeum type; in the Soyang type, irregular diet and decreased or irregular meal volume negatively affected SRH. This showed the presence of the different effects of dietary habits on health depending on constitution and also confirmed the association of the regularity of diet and meal volume based on constitution and the frequency of bad dietary habits with SRH. We suggest that personalized healthcare with adequate dietary improvement considering constitution is needed for health management or improvement.

Chest Wall Implantation of Lung Cancer after Fine Needle Aspiration Biopsy - 2 cases - (세침 흡입생검 후 발생한 폐암의 흉벽전이 -2례 보고-)

  • 강정신;조현민;윤용한;이두연
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.629-633
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    • 1998
  • Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

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