• Title/Summary/Keyword: Cardiovascular disease

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Surgical treatment of Metastatic Lung Cancer (전이성 폐암에 대한 외과적 치험)

  • 이종호;임용택;신용철;정승혁;김병열
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.27-31
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    • 1999
  • Background: In spite of the development of chemotherapy, prognosis of metastatic lung cancer was poor. On the other hand, surgical intervention has proven itself to bring out superior results, therefore more operations are being praticed based on this superiority against chemotherapy and other modalities on metastatic lung cancer. Material and Method : We analyzed the surgical cases performed from 1983 to 1997 on 17 cases and estimated 5 year survival rate using Kaplan-Meier method. Result: Average age was 42.8, ratio between male and female was 10:7. We had 8 single lobe resections,3 pneumonectomies,1 wedge resection,2 bilobectomy and 3 cases of lobar resection with wedge resection. 5 deaths have occured and among the 5, 3 patients were caused by recurrence of ca. The remaining 12 patients are being followed up in OPD basis among these, 3 recurrence were observed and 9 are still free of cancer. The average survival time was 40.5 months and 5 year survival rate obtained through the Kaplan-Meier method was 60.4%. Conclusion: Even though we are a bit short of cases, we recommend that a thoracic surgeon approach this disease through a surgical method as possibly as he could.

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Pulmonary Air Leak in the Neonatal Respiratory Distress Syndrome (신생아 호흡 장애 증후군에서 폐외공기누출의 임상적 고찰)

  • 우석정
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.38-42
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    • 1999
  • Background: In neonatal respiratory distress syndrome patients, various types of pulmonary air leak contributes to elevate morbity and mortality. Although early surgical interventions can provide better results in several cases, whole clinical outcomes are poor. This study was designed to investigate the clinical aspects of pulmonary air leak in the neonatal respiratory distress syndrome patients and major contributing factors to mortality. Material and Method : We retrospectively evaluated 48 cases of pulmonary air leak in the neonatal respiratory distress syndrome patients from September 1994 to May 1997. Result: There were 15 cases of primary and 33 cases of secondary pulmonary air leakages. The prominent manifestations were pure interstitial emphysema in 19 cases(39.9%) and combined pneumothorax in 19 cases(39.9%). In clinical aspects, normal birth weight was dominant(83.4%), the onset occurred within 24 hours was in 28 cases(58.8%). The pulmonary diseases were meconium aspiration syndrome(25.2%) and hyaline membrane disease(33.2%). The overall hospital mortality was 25.2%, and the majority were hyaline membrane diseases. Conclusion: Although the overral mortality rate of these diseases were high, more detailed studies about immediate treatement, perinatal prevention, intensive care to geriatric problems were needed individually to improve outcomes.

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Prognostic Factors Affecting Long Term Survival after Operation in Metastatic Lung Cancer (전이성 폐암에서 수술 후 장기 생존에 영향을 미치는 예후 인자)

  • 홍기표;정경영;김길동;박인규
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.916-923
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    • 1999
  • Background: Many institutes are interested in lung metastatectomy than before because of the improved long term survival, low mortality, and low morbidity after lung metastatectomy. However, prognostic factors affecting long term survival are controversial. We attempt to analyze the prognostic factors affecting retrospectively by comparing the results of lung metastasectomy. Material and Method: Between Jan. 1990 and Dec. 1997, 74 operations were taken in 63 patients with pulmonary metastases in various primary sites. We analyzed the postoperative long term survival according to sex, cell type, laterality, disease free interval(DFI), operation, the number of metastases, and the size of the largest metastasis. Result: There were 27 male and 36 female patients. Sex did not appeared to affect survival time(p=0.849). The primary tumor was carcinoma in 32, sarcoma in 28, and others in 3. Cell type, considering carcinoma and sarcoma, did not relate to survival time(p=0.071). DFI had no influence on the outcome(p=0.902). The type of operative procedure had no influence on the outcome(p=0.556). The laterality of metastases, 47 unilateral(74.6%) and 16 bilateral(25.4%), had no influence on the outcome(p=0.843). The number of metastases excised(one, two or three, four or more) did not appear to affect survival(p=0.263). The size of largest metastasis(<=10mm, 11mm-30mm, and >30mm) did not appear to affect survival(p=0.751). Previous factors were evaluated in both the carcinoma and sarcoma patients respectively. DFI was the only significant prognostic factor in metastatic lung sarcoma(p=0.0026). Conclusion: Survival was not related to sex, cell type, laterality, DFI, operative procedure, number of metastases, nor the size of the largest metastasis. DFI was related to the survival time in sarcoma group but further study is needed.

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Development and Validation of Computerized Semiquantitative Food Frequency Questionnaire for Koreans with High-Risk of Hypercholesterolemia

  • Kim, Hyung-Sook;Lee, Kyoungsin;Park, Haymie
    • Journal of Community Nutrition
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    • v.6 no.1
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    • pp.35-41
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    • 2004
  • Cardiovascular disease has the highest mortality rate in South Korea. Previous studies have reported that serum cholesterol level relates to intake of dietary fat and cholesterol. Therefore, in this study we developed a semiquantitative food frequency questionnaire (FFQ) for Koreans with a high-risk of hypercholesterolemia and to validate the FFQ. Semiquantitative FFQ, which includes 160 food items, reflects intakes of energy, fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUPA), polyunsaturated fatty acid (PUPA) and cholesterol. We chose food items from the previous study of our research group (Suh 1999) which reported a nutritional status of Korean adults with normocholesterolemia, borderline and hypercholesterolemia. To validate the FFQ, we compared the results of the FFQ with those of a 3-day food record using a paired t-test. In addition, we calculated Pearson's and Spearmen's correlation coefficients. Intakes assessed by the FFQ and a 3-day food record were classified into quartile and the degree of agreement was obtained. Fifty-five participants responded for the validation study by completing both the FFQ and a 3-day food record. Pearson's correlation coefficients between estimated intakes by respective methods for energy, fat, SF A, MUPA, PUPA and cholesterol were 0.32,0.41,0.37,0.41,0.37 and 0.21, respectively. Spearman's correlation coefficients of energy, fat, SF A, MUPA, PUPA, cholesterol were 0.31, 0.44, 0.39, 0.46, 0.46, and 0.37, respectively. Nutrient densities in 1000kcal were compared. Pearson's correlation coefficient of cholesterol density increased and other values were similar with original values. The average degree of agreement was 67% that intakes of energy, fat, SF A, MUPA, PUPA and cholesterol assessed by the FFQ and 3-day food records were classified within the same and the adjacent quartile. On the average, 8% were misclassified into the extreme opposite quartile. The average of weighted kappa was 0.46. In conclusion, the FFQ developed in this study is considered to be a reliable tool to assess nutrient intakes for Koreans with a risk of hypercholesterolemia because the FFQ reflects the intakes of energy, fat, SFA, MUFA, PUPA, and cholesterol.

Nutrient Supplementation in the Elderly

  • Meydani, Mohsen
    • Journal of Community Nutrition
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    • v.2 no.1
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    • pp.5-11
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    • 2000
  • Populations both in the US and worldwide are aging. It is projected that by the year 2030 the population of Americans over 65 will increase to 70 million, more than twice their number in 1998. About one-third of elderly over the age of 65 have debilitating chronic health conditions that greatly impede their activities. Age-associated chronic diseases are believed to be associated with free radicals and the imbalance in antioxidant and oxidative stress contributes to development of several chronic health conditions. Diet and nutrients can have great impact in the health status of elderly. Several factors may contributor to the inadequate consumption of nutrients in elderly, including an inability to chew food adequately, polypharmacy, living along and limited income. Low intake of energy and several micronutrients are common among the elderly. Although overt deficiency of nutrients among the elderly is not common. a recent study showed that while elderly consume more fat, the total energy intake is low among the elderly. Inadequate intake of antioxidant nutrients such as vitamin E in elderly may contribute to the development of chronic health problems. Intake of higher than normal RDA levels of vitamin E for long periods of time has been shown to reduce the risk of many degenerative diseases, such as cardiovascular diseases(CVD) and cancer, and improve immune response in elderly. High intake of other antioxidants is also associated with reduced risk chronic diseases. Dietary antioxidants are abundant in fruits and vegetables. However, due to variety of factors, the elderly may not be able to receive these and other micronutrients through diet. Therefore, supplemental intake of micronutrients in the form of multi vitamins/minerals and/or specific micronutrients is a more practical approach to the maintenance of health status in the elderly.

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A Study of the Dietary Intake Status and One Portion Size of Commonly Consumed Food and Dishes in Korean Elderly Women (노년기 여성의 식이 섭취실태와 주요 음식의 1일 1회 섭취분량 조사연구)

  • 김상연;정경아;이보경;장유경
    • Korean Journal of Community Nutrition
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    • v.2 no.4
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    • pp.578-592
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    • 1997
  • The use of semiquantitative food frequency questionnaires to estimate dietary intake has become widespread in nutritional epidemiologic studies. It had been suggested that knowledge about a person's usual portion size of each meal in addition to consumption frequency will improve the accuracy of this method. This study was performed to investigate the dietary intake status(nutrient, food, and dish intake) and one portion size of commonly consumed food and dishes to develop a semiquantitative food frequency questionnaire that will be used to expore the relationship between the incidence of cardiovascular disease and diet in Korean women after menopause. Intake of food or dish in 123 elderly women were measured by 3-day food records in March to May, 1996. The results obtained in this study were summarized as follow : 1) Calcium, vitamin A, and vitamin E intakes were less adequate than Recommended dietary allowances(RDA). 2) The subjects who consumed more than 20% of the energy from fat were 35% and the subjects consumed dietary cholesterol more than 300mg were 18$\%$. 3) The most frequently consumed foods or dishes by the subjects were Korean cabbage kimchi〉cooked rice, well-milled〉laver〉apple〉strawberry〉mixed rice〉soybean soup. 4) The major dish groups which contributed to most daily nutrient intakes were cooked rice, Korean cabbage kimchi, soybean soup because of large amount and high frequency of intake although they do not contain large amount of most nutrients. 5) One portion size of commomly consumed foods and dishes in elderly women was different from one portion size suggested in the Korean nutrition society. This study provides information for the design of data-based semiquantitative food frequency questionnaire. for Korean elderly women. In addition, they may be useful to health care planners or nutrition educators. (Korean J Community Nutrition 2(4) : 578-592, 1997)

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Effects of Silver Spike Point Low Frequency Electrical Stimulation on Alteration of $Na^+$, $K^+$ and $Ca^{2+}$ Ions (은침점전기자극이 $Na^+$, $K^+$ 이온과 $Ca^{2+}$ 이온변동에 미치는 효과)

  • Chon, Ki-Young;Kim, Jung-Hwan;Kim, Soon-Hee;Min, Kyung-Ok
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.158-169
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    • 2003
  • The present study examined that in vivo test is investigated in sham-operated(control group) and aldosterone-analogue deoxycorticosterone acetate (DOCA)-salt hypertensive animals(experimental group) and that the antihypertensive effect was induced by silver spike point(SSP) low frequency electrical stimulation at meridian points(CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52), specifically, such as diuretic action in 24 hour urine analysis from normal volunteer. The $Na^+$ and $Ca^{2+}$ ions were significantly increased in aldosterone-analogue DOCA-salt hypertensive rats than that in sham-operated rats. However, the $K^+$ ions were significantly decreased in aldosterone-analogue DOCA-salt hypertensive rats than that in sham-operated rats. The current of 1 Hz continue type of SSP low frequency electrical stimulation significantly increased in excretion of urine $Na^+$ and $K^+$ ions from normal volunteer. However, the excretion of $Ca^{2+}$ ion were significantly decreased by SSP electrical stimulation in volunteer. These results suggest that the development of aldosterone analogue-DOCA-salt hypertension is associated with changed $Na^+$, $K^+$ and $Ca^{2+}$ ions of urine. which directly affects blood pressure. Therefore, the hypertension is a risk factor on cardiovascular disease. Moreover, These results demonstrate that the SSP low frequency electrical stimulation, especially current of 1 Hz continue type, significantly regulates $Na^+$, $Ca^{2+}$ and $K^+$ ions from volunteer. Therefore, the SSP low frequency electrical stimulation is a good regulator through a diuretic action of aldosterone-induced hypertension.

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Association of Daily Sleep Duration with Obesity, Macronutrient Intake, and Physical Activity (수면시간과 비만, 열량영양소 섭취비율 및 신체 활동량과의 관련성)

  • Baik, In-Kyung;Shin, Chol
    • Korean Journal of Community Nutrition
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    • v.16 no.3
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    • pp.315-323
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    • 2011
  • There are a few studies that reported the association of sleep duration with calorie intake and energy expenditure. Using cross-sectional data from a population-based prospective study, we evaluated the association of sleep duration with indicators of obesity including body mass index and waist circumference, calorie intake and its proportion of macronutrients, and physical activity. The study subjects were 4,226 male and female adults, who were aged 40 to 69 years and were free of diagnosed cardiovascular disease, diabetes mellitus, and dyslipidemia at baseline. Robust regression analysis was used to analyze associations. The study found that sleep duration is inversely associated with waist circumference, calorie intake, and percent of calories from fat intake and is positively associated with percent of calories from carbohydrate intake and physical activity. The inverse association between sleep duration and waist circumference was stronger among men than among women. The inverse association between sleep duration and calorie intake was stronger among women than among men and such association was also stronger among obese persons than those with a normal body mass index. The positive association between sleep duration and physical activity was strongly demonstrated regardless of sex or obesity. Physical activity is positively associated with sleep duration independent of potential confounding factors including age, sex, income, occupation, marital status, education, smoking status, waist circumference, calorie and macronutrient intake, and alcohol intake.

Validity for Use of Non-HDL Cholesterol Rather than LDL Cholesterol

  • Kwon, Se-Young;Na, Young-Ak
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.2
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    • pp.54-59
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    • 2013
  • NonHDL cholesterol values have been suggested as a risk marker for cardiovascular disease. NonHDL cholesterol values were calculated, using a very simple measurement [nonHDL cholesterol=serum total cholesterol-HDL cholesterol]. This formula is very useful as a screening tool for identifying dyslipoproteinemias, risk assessment, and assessing the results of hypolipidemic therapy. The data from the 2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,992 subjects with lipid panels (Cholesterol, HDL, LDLdirect and Triglycerides) results. We studied the relationship between nonHDL cholesterol and LDL cholesterol. As a result, nonHDL cholesterol values were plotted against the LDL direct and calculated values. The linear regression equation for nonHDL cholesterol and direct LDL cholesterol was $nonHDLchol=23.60+1.03{\times}LDLdirect$ (p<0.0001, $r^2=0.80$) in all subjects. The subjects were classified into triglyceride values. When triglycerides are below 400 mg/dL, the linear fit to LDL direct is found to be $[nonHDLchol=17.34+1.07{\times}LDLdirect]$ (p<0.0001, $r^2=0.88$) and to the Friedewald LDL calculation is $[nonHDLchol=23.10+1.02{\times}LDLcalc]$ (p<0.0001, $r^2=0.82$). For triglycerides above 400 mg/dL, the linear fit equation is $[nonHDLchol=87.57+0.92{\times}LDLdirect]$ (p<0.0001, $r^2=0.50$) and to the LDL calculated, it is $[nonHDLchol=142.70+0.50{\times}LDLcalc]$ (p<0.0001, $r^2=0.32$). This study provides examples of the utility of nonHDL cholesterol concentrations in clinical medicine.

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Estimation of Productivity Losses due to Smoking (흡연으로 인한 생산성 손질 추정)

  • 김태현;문옥륜;김병익
    • Health Policy and Management
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    • v.10 no.3
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    • pp.169-187
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    • 2000
  • Cigarette smoking has been identified as the most important source of preventable morbidity and premature mortality (WHO, 1995), The prevalence of smoking among men is very high in Korea. This study estimated productivity losses due to smoking in Korea, 1997. The derivation of cost estimates for mortality, disability, hospitalization and use of physician services related to cigarette smoking is bas 어 on the calculation of attributable fractions suggested by MacMahon and Cole and Smoking-Attributable Mortality, Morbidity, and Economic Cost(SAMMEC) software. To estimate the number of deaths from neoplastic, cardiovascular, respiratory diseases associated with cigarette smoking, estimates for adults(aged 20 years and over) were based on 1997 mortality data, 1995 data on smoking prevalence from Korea Institute for Health and Social Affairs. Smoking-attributable indirect morbidity cost data were obtained from the National Federation of Medical Insurance. As the result of cost estimation, these productivity losses were 336-430 billion won. During 1997, 8,620-10,804 deaths were attributed to smoking. Cigarette smoking resulted in 133,991-169,422 Years of Potential Life Lost (YPLL) to life expectancy. For smoking -attributable indirect mortality costs, the present value of future earnings(PVFE) for the age at death are 299-384 billion won. Smoking-attributable indirect morbidity costs, the costs of lost productivity for persons who are disabled by smoking-related chronic diseases are 37-46 billion won. In this study the productivity losses due to smoking were restricted to the health effects of smoking. It is possible that these costs were underestimated with the limitation of the data. Smoking is the leading preventable cause of illness and death. The results of this study can be used as elementary data for antismoking policy.

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