• 한국임상약학회지
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• 제27권4호
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• pp.276-283
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• 2017

Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

• Journal of Chest Surgery
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• 제39권10호
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• pp.782-785
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• 2006

복부 대동맥류의 수술에 있어서 만성 폐쇄성 폐질환은 수술 사망에 유의한 영향을 미치는 위험 인자로 알려져 있다. 따라서 수술 후 호흡기 합병증을 줄이기 위해서는 강제적 기계 호흡을 줄이고 가능한 환자의 자발 호흡을 유지하는 것이 수술 결과를 향상시킬 수 있다. 본 증례에서는 복부 통증을 주소로 내원한 77세의 남자 환자로 수술 전 검사에서 약 9 cm크기의 복부 대동맥류가 발견되었으나, 심한 만성 폐쇄성 폐질환이 동반되어 수술 후 사망률이 높을 것으로 예상된 경우에서 경막외 마취등을 통해 환자의 자발 호흡을 유지한 상태로 복부 대동맥류 절제 및 인조혈관 삽입술을 시행하여 좋은 결과를 얻을 수 있었다.

• Nutritional Sciences
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• 제6권4호
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• pp.232-238
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• 2003

Cardiovascular disease (CVD) is one of the most common causes of death in elderly Koreans, and HDL-cholesterol is known to have a pivotal role in protecting against CVD. This study was undertaken to study the relationships between plasma HDL-cholesterol levels and dietary, anthropometric, and biochemical factors in elderly Koreans. The 102 subjects, who were over 60 years old, were classified into two groups based on their plasma HDL-cholesterol levels: a risk group with plasma HDL-cholesterol < 40mg/dl in men or HDL-cholesterol < 50mg/d1 in women, and a control group with higher HDL-cholesterol levels. The subjects' mean intakes of energy, calcium, zinc, vitamin A, vitamin $B_2$, vitamin E, and folate did not meet the Korean RDA for elderly people. Vitamin $B_2$ and folate intakes were significantly lower (p<0.l) in the risk group compared to the control group. The consumption of seaweed was significantly lower (p<0.05), and fish intake was 33% lower, in the risk group compared to the control group. Subjects in the risk group showed a higher BMI, waist/hip ratio, triceps skinfold thickness, and % body fat, compared to control subjects. Plasma triglyceride levels and values of the atherogenic index were significantly higher (p<0.00l) in risk group subjects. Significant negative correlations between HDL-cholesterol level and plasma triglyceride level (r= 0.37), and values of the atherogenic index (r=-0.74), were found. In summary, subjects with low levels of HDL-cholesterol were found to have relatively low intakes of vitamin B$_2$, folate, and seaweed, and higher levels of the CVD risk factors: body fat, plasma TG, and AI. These results suggest that plasma HDL-cholesterol levels can be modified by dietary, anthropometric, and hematological means.

• Journal of Chest Surgery
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• 제30권1호
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• pp.17-26
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• 1997

경상대학교병원 흉부외과에서는 1988년 10월부터 1995년 12월까지 7년 2개월 동안 366례의 선천성 심장기형에 대한 수술을 시행하였다. 남자가 171례, 여자가 195례이었고, 생후 5일부터 64세에까지 분포하였으며 성인(만 15세 이상)이 80례이었다. 비청색증형이 313례(84.2%)이었으며 청색증이 53례(15.8%)이었다 전체 사망율은 10.4%이었는데, 6개월 미만 5)례 중 37%, 6개월과 1년 사이가48례 중 10.6%를 나타내어 12개월 미만 영아 사망율은 24.8%(25/101)이었으며, 50세 이상의 노년 환자 13례에서는 사망이 없었다. 비청색증군은 5.5%, 청색증군은 36.2%의 수술사망이 있었다. 수술사망율에 영향을 미치는 몇 가지 위험 인자들을 통계 분석하였다. 단변수 분석상 개심술의 사망율과 관계가 있는 위험 인자는 연령(p< 0.0001), 체중(p<0.0001), 체외순환시간(p< 0.0001) 및 심근허혈시간(p<0.0001), 완전순환정 지법의 이용 (P<0.0001)그리고 청색증질환(p<0.00이)이었다. 그러나, 다변량 분석상 개심술의 사망율과 관련이 있는 위험인자는 질환의 유형(p=0.002)이었고, 특히 활로4징증 이외의 청색증군이 사망율과 관련이 컸다 (odds ratio=15.3). 청색증군만\ulcorner 분석한 결과, 사망율의 위험인자로 단변수 분석상에서는 연령(p=0. 002)과 질환의 유형(p=0.008)이었으나, 다변량 분석에서는 질환의 유형(p=0.012) 뿐이었다. 저자들의 경험례 중 청색증군에서 사망율이 높았던 것은 질병자체의 영향임을 알 수 있었고,단변수 분석상 나타난 위험인자들 중 기술적 개선이 가능한 요인들에 대해서는 특별한 노력이 있어야 될 것으로 판단되는 것이다.

• Journal of Chest Surgery
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• 제44권1호
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• pp.25-31
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• 2011

Background: Mature autogenous arteriovenous fistulas have better long term patency and require fewer secondary interventions compared to arteriovenous prosthetic graft. Our Study evaluated vascular patency rates and incidence of interventions in autogenous arteriovenous fistulas and grafts. Material and Methods: A total of 166 vascular access operations were performed in 153 patients between December 2002 and November 2009. Thirty seven caeses were excluded due to primary access failure and loss of follow-up. One group of 92 autogenous arterioveous fistulas and the other group of 37 arteriovenous prosthetic grafts were evaluated retrospectively. Primary and secondary patency rates were estimated using the Kaplan-Meier method. Results: The primary patency rate (84%, 67%, 51% vs. 51%, 22%, 9% at 1, 3, 5 year; p=0.0000) and secondary patency rate (96%, 88%, 68% vs. 88%, 65%, 16% at 1, 3, 5 year; p=0.0009) were better in autogenous fistula group than prosthetic graft group. Interventions to maintain secondary patency were required in 23% of the autogenous fistula group (average 0.06 procedures/patient/year) and 65% of prosthetic graft group (average 0.21 procedures/patient/year). So the autogenous fistula group had fewer intervention rate than prosthetic graft group (p=0.01) The risk factor of primary patency was diabetus combined with ischemic heart disease and the secondary patency's risk factor was age. Conclusion: Autogenous arteriovenous fistulas showed better performance compared to prosthetic grafts in terms of primary & secondary patency and incidence of interventions.

• 생명과학회지
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• 제25권8호
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• pp.932-935
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• 2015

본 연구는 30대 비만 남성을 대상으로 복합트레이닝 처치가 염증지표와 심혈관질환의 지표물질인 homocysteine에 미치는 영향을 규명하는데 목적이 있다. 본 연구의 대상자는 체지방률이 25% 이상인 30대 중반의 비만 남성(n=12)으로 의학적인 질환이 없고, 규칙적인 운동경험이 없는 자를 선정하였다. 본 연구의 목적을 달성하기 위하여 기본검사로 최대산소섭취량(VO_2max)과 5가지 기구의 1RM을 측정하였고, 이 결과를 토대로 유산소운동과 중량운동으로 구성된 복합트레이닝을 8주간 실시하여 트레이닝 전과 후에 체구성(체중, 체지방, BMI)과 혈액 내 염증지표(IL-6, TNF-α, CRP) 및 homocysteine의 변화를 분석하였다. 그 결과, 8주간의 복합트레이닝은 체중, 체지방, BMI를 유의하게 감소시켰으며(p<0.01), 염증지표 CRP와 심혈관질환지표 homocysteine을 유의하게 감소시켰다(p<0.05). 따라서 8주간의 복합트레이닝 처치를 통해 체구성의 변화를 확인할 수 있었고, 이러한 변화가 염증지표와 심혈관질환지표에 긍정적인 영향을 미친 것으로 사료된다.

• 한국융합학회논문지
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• 제11권8호
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• pp.323-330
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• 2020

본 연구는 12주간의 규칙적인 신체활동 참여가 여성노인의 노화관련 호르몬(성장호르몬, DHEA-S, 에스트로겐) 및 심혈관 위험요소(아디포넥틴, hs-CRP)에 어떠한 영향을 미치는지 알아보는데 그 목적이 있다. 연구대상자는 65세-75세 여성노인 20명(운동집단 10명, 비교집단 10명)을 대상으로 하였다. 주 3회(60분씩) 12주간 한국무용 프로그램을 실시하였고 집단내 차이검증은 paired t-test로, 집단별 항목들의 변화량 차이 검증은 independent t-test를 실시하였다(p<0.05). 본 연구의 결과 에스트로겐(p=0.025), 성장호르몬(p=0.009), DHEA-S(p=0.009), 아디포넥틴(p=0.014)은 운동집단에서 운동 12주 후 유의하게 증가하였고 hs-CRP(p=0.010)는 운동 12주 후 유의하게 감소하였다. 에스트로겐(p=0.006), DHEA-S(p=0.002), 아디포넥틴(p=0.008), hs-CRP(p=0.004)는 집단간 변화량의 차이도 나타났다.

• 한국임상약학회지
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• 제24권1호
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• pp.15-25
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• 2014

Background: Elderly patients with gastrointestinal (GI) and cardiovascular (CV) risk factors may be more easily exposed to NSAID-related side effects (SEs). Based on the ACG guideline of year 2009, the aim of the study is to evaluate proper use of NSAIDs and gastroprotective drugs according to the degree of GI and CV risk strengths in the patients. Methods: Retrospectively surveyed 410 elderly patients with NSAIDs for more than 30 days at a general hospital in Korea. GI risk factor includes age, ulcer history, high-dose NSIADs, concurrent aspirin use, steroids or anticoagulants. CV risk factor includes angina, myocardial infarction, cerebral infarction, atrial fibrillation or coronary intervention requiring low-dose aspirin. These factors were classified as high/low cardiovascular groups and high/moderate/low GI groups. Results: There were 14 patients in high CV risk group and high GI risk group. The group was recommended not to use NSAIDs as it is not adequate. There were 101 patients in high CV risk group and moderate GI risk group. This group was recommended to use naproxen and PPI/misoprostol. But all patients except one were not adequate. There were 9 patients in low CV risk group and high GI risk group. This group was recommended to use selective COX-2 inhibitor and PPI/misoprostol. 5 cases were proper while 4 cases did not. There were 285 patients in low CV risk and moderate GI risk group who were recommended to use non selective NSAIDs and PPI/misoprostol or selective COX-2 inhibitor only. 103 patients were proper while 182 patients not adequate. Overall, the SEs were higher in those cases for inadequate use of drugs comparing to the adequate. CV SEs were statistically significant. However, SEs for each risk groups were different. For the case of low CV risk group and high/moderate GI risk group, the inadequate use of drugs makes the SE high and the other groups are not. Also, it was not statistically significant. Conclusions: In elderly patients, the inappropriate use of NSAIDs can increase the risk of the disease. Therefore, GI and CV risk must be considered simultaneously, and the proper use of NSAIDs and gastroprotective drugs for each risk groups should be reconsidered.

• 대한한방내과학회지
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• 제28권4호
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• pp.850-862
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• 2007

Background : Cerebrovascular disease is a major cause of death and disability in adults. Silent cerebral infarction (SCI) portends more severe cerebral infarction or may lead to insidious progressive brain damage resulting in vascular dementia. Known cardiovascular risk factors, such as arterial hypertension, diabetes mellitus, smoking, hyperlipidemia and ischemic heart disease may increase the risk of SCI. This study was designed to evaluate the risk factors of SCI in an apparently normal adult population. Methods : We divided 340 neurologically normal adults (mean age=59.90$\pm$8.30, men:women = 146:194) who underwent brain computed tomography (CT) or magnetic resonance imaging (MRI) at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital in two groups, Silent inf. and Controls,and analyzed risk factors of SCI by interview, physical examination and blood test. Risk factors of SCI were assessed by interview, physical examination and blood test. We performed Pearson's chi-square test and two-sample t-test for univariate analysis and multiple logistic regressions for multivariate analysis to evaluate risk factors of SCI. Results : Old age, diabetes mellitus, and high lactate dehydrogenase (LDH) levels were associated with SCI on univariate analysis. Diabetes mellitus was demonstrated to be an independent risk factor for SCI on multivariate analysis. Conclusions : Advanced age, diabetes mellitus, and LDH levels are associated with SCI.

• 대한중풍순환신경학회지
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• 제12권1호
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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.