• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.40.1-40.9
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• 2022

Background: According to the occupational accident status analysis in 2020, of 1,180 occupational deaths, 463 were caused by cardiovascular disease (CVD). Workers should be assessed for CVD risk at regular intervals to prevent work-related CVD in accordance with the rules on occupational safety and health standards. However, no previous study has addressed risk and mortality. Therefore, this longitudinal study was conducted to evaluate the relationship between 10-year cardiovascular risk of the general health checkup and mortality. Methods: The study included 545,859 participants who visited Kangbuk Samsung Total Healthcare Centers from January 1, 2002, to December 31, 2017. We performed 10-year cardiovascular risk assessment for the participants and the risk was divided into 4 groups (low, moderate, high, and very high). The study used death data from the Korea National Statistical Office for survival status as an outcome variable by December 31, 2019, and the cause of death based on the International Classification of Diseases, 10^th Revision (ICD-10) was identified. Statistical analysis was performed using Cox proportional hazards regression analysis, and the sum of the periods from the first visit to the date of death or December 31, 2019, was used as a time scale. We also performed a stratified analysis for age at baseline and sex. Results: During 5,253,627.9 person-years, 4,738 overall deaths and 654 cardiovascular deaths occurred. When the low-risk group was set as a reference, in the multivariable-adjusted model, the hazard ratios (HRs) (95% confidence interval [CI]) for overall mortality were 3.36 (2.87-3.95) in the moderate-risk group, 11.08 (9.27-13.25) in the high-risk group, and 21.20 (17.42-25.79) in the very-high-risk group, all of which were statistically significant. In cardiovascular deaths, the difference according to the risk classification was more pronounced. The HRs (95% CI) were 8.57 (4.95-14.83), 38.95 (21.77-69.69), and 78.81 (42.62-145.71) in each group. As a result of a subgroup analysis by age and sex, the HRs of all-cause mortality and cardiovascular mortality tended to be higher in the high-risk group. Conclusions: This large-scale longitudinal study confirmed that the risk of death increases with the 10-year cardiovascular risk of general health checkup.

• Journal of Korean Medical Science
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• v.33 no.53
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• pp.322.1-322.14
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• 2018

Background: Osteoprotegerin (OPG) plays protective roles against the development of vascular calcification (VC) which greatly contributes to the increased cardiovascular events in patients with chronic kidney disease (CKD). The present study aimed to find the non-traditional, kidney-related cardiovascular risk factors correlated to serum OPG and the effect of serum OPG on the arterial stiffness measured by brachial ankle pulse wave velocity (baPWV) in patients with the pre-dialysis CKD. Methods: We cross-sectionally analyzed the data from the patients in whom baPWV and the serum OPG were measured at the time of enrollment in a prospective pre-dialysis CKD cohort study in Korea. Results: Along with traditional cardiovascular risk factors such as age, diabetes mellitus, pulse pressure, and baPWV, non-traditional, kidney-related factors such as albuminuria, plasma level of hemoglobin, total $CO_2$ content, alkaline phosphatase, and corrected calcium were independent variables for serum OPG in multivariate linear regression. Reciprocally, the serum OPG was positively associated with baPWV in multivariate linear regression. The baPWV in the 3rd and 4th quartile groups of serum OPG were higher than that in the 1st quartile group after adjustments by age, sex and other significant factors for baPWV in linear mixed model. Conclusion: Non-traditional, kidney-related cardiovascular risk factors in addition to traditional cardiovascular risk factors were related to serum level of OPG in CKD. Serum OPG level was significantly related to baPWV. Our study suggests that kidney-related factors involved in CKD-specific pathways for VC play a role in the increased secretion of OPG into circulation in patients with CKD.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.148-154
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• 2019

Background: This study investigated the clinical outcomes of surgical treatment of primary chest wall soft tissue sarcoma (CW-STS). Methods: Thirty-one patients who underwent surgery for CW-STS between 2000 and 2015 were retrospectively reviewed. The disease-free and overall survival rates were estimated using the Kaplan-Meier method, and prognostic factors were analyzed using a Cox proportional hazards model. Results: The median follow-up duration was 65.6 months. The most common histologic type of tumor was malignant fibrous histiocytoma (29%). The resection extended to the soft tissue in 14 patients, while it reached full thickness in 17 patients. Complete resection was achieved in 27 patients (87.1%). There were 5 cases of local recurrence, 3 cases of distant metastasis, and 5 cases of combined recurrence. The 5-year disease-free rate was 49%. Univariate analysis indicated that incomplete resection (p<0.001) and stage (p=0.062) were possible risk factors for recurrence. Multivariate analysis determined that incomplete resection (p=0.013) and stage (p=0.05) were significantly associated with recurrence. The overall 5- and 10-year survival rates were 86.8% and 64.3%, respectively. No prognostic factor for survival was identified. Conclusion: Long-term primary CW-STS surgery outcomes were found to be favorable. Incomplete microscopic resection and stage were risk factors for recurrence.

• Journal of Neurogastroenterology and Motility
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• v.25 no.3
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• pp.387-393
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• 2019

Background/Aims Delayed gastric emptying (GE) is associated with high morbidity and mortality in subjects with diabetes. The aim of this study is to investigate associations between GE time and the major cardiovascular events (coronary heart diseases and ischemic stroke) in diabetic subjects with upper gastrointestinal (UGI) symptoms. Methods Among 259 subjects with chronic UGI symptoms who underwent gastric emptying study (GES) over 13 years, 122 diabetic subjects without gastric surgery and/or rapid GE were enrolled in this study. We also gathered data about baseline demographics, clinical characteristics, estimated GE half-time (GE T½) and incidence of cardiovascular events following GES. Results The mean age of subjects was 64.0 ± 17.4 years. There were 86 women and 104 subjects with type 2 diabetes. There were 52 (42.6%) subjects with normal GE, 50 (41.0.%) subjects with mild delayed GE, and 20 (16.4%) subjects with marked delayed GE. During follow-up (median, 207 weeks), cardiovascular events occurred in 7 (13.5%) subjects with normal GE, 4 (8.0%) subjects with mild delayed GE and 7 (35.0%) subjects with marked GE (P = 0.015). Univariate analysis showed that GE T½ was significantly associated with incidence of cardiovascular events (crude OR, 1.74; 95% CI, 1.12-2.69; P = 0.014). In a multivariate model, association between GE T½ and incidence of cardiovascular events remained statistically significant after adjustment for baseline characteristics and comorbidities (adjusted OR, 1.94; 95% CI, 1.21-3.12; P = 0.006). Conclusion A delay of GE was associated with an increased incidence of cardiovascular events in diabetic subjects with chronic UGI symptoms.

• Korean Circulation Journal
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• v.54 no.4
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• pp.172-186
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• 2024

Background and Objectives: Long-term pathological myocardial hypertrophy (MH) seriously affects the normal function of the heart. Dronedarone was reported to attenuate left ventricular hypertrophy of mice. However, the molecular regulatory mechanism of dronedarone in MH is unclear. Methods: Angiotensin II (Ang II) was used to induce cell hypertrophy of H9C2 cells. Transverse aortic constriction (TAC) surgery was performed to establish a rat model of MH. Cell size was evaluated using crystal violet staining and rhodamine phalloidin staining. Reverse transcription quantitative polymerase chain reaction and western blot were performed to detect the mRNA and protein expressions of genes. JASPAR and luciferase activity were conducted to predict and validate interaction between forkhead box O3 (FOXO3) and protein kinase inhibitor alpha (PKIA) promoter. Results: Ang II treatment induced cell hypertrophy and inhibited sirtuin 1 (SIRT1) expression, which were reversed by dronedarone. SIRT1 overexpression or PKIA overexpression enhanced dronedarone-mediated suppression of cell hypertrophy in Ang II-induced H9C2 cells. Mechanistically, SIRT1 elevated FOXO3 expression through SIRT1- mediated deacetylation of FOXO3 and FOXO3 upregulated PKIA expression through interacting with PKIA promoter. Moreover, SIRT1 silencing compromised dronedarone-mediated suppression of cell hypertrophy, while PKIA upregulation abolished the influences of SIRT1 silencing. More importantly, dronedarone improved TAC surgery-induced MH and impairment of cardiac function of rats via affecting SIRT1/FOXO3/PKIA axis. Conclusions: Dronedarone alleviated MH through mediating SIRT1/FOXO3/PKIA axis, which provide more evidences for dronedarone against MH.

• Korean Journal of Occupational Health Nursing
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• v.25 no.1
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• pp.41-54
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• 2016

Purpose: The purposes of this study were to review the research trends and to identify developmental direction of studies on community interventions according to the ecological model for workers with cardiovascular diseases (CVD) risk factors. Methods: Electronic databases including PsycINFO, PubMed, EMBASE, CINAHL, and Cochrane Library and the reference lists of articles were searched. All articles were assessed in relation to inclusion and exclusion criteria, resulting in 29 researches being reviewed. Each review was critically appraised by two authors using a guideline of PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses). Results: Nowadays, interventions in organizational level, integrated and web-based interventions are increasing to prevent CVD risk factors for workers. Even though the importance of psychosocial aspects to prevent CVD, the only 2 studies included psychosocial factors in the outcome variables. Also, 14% among 29 researches were based on theories. Conclusion: Psychosocial factors such as job stress, depression, and emotional labor could be CVD risk factors. Therefore, interventions including psychosocial aspects are needed to prevent workers' CVD risks more effectively. Theory-based interventions are needed to support interventions' effects and to develop the nursing science.

• Journal of Biomedical Engineering Research
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• v.17 no.1
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• pp.79-84
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• 1996

A number of experimental evidences suggest that the rnun ventrolateral medulla(RVLM) is the final common pathway in the regulation of arterial blood pressure. A Voup of neurons in the RVLM, called the cardiovascular neurons (UN), show spontaneous activity temporally synchronized with the periodic cardiac cycle. These neurons affect the sympathetic nerve discharge(SND), thus are believed to be responsible for blood pressure control. The present experiment identified 98 UVNs in 42 cats based on the temporal relationships between each neuron's activity with both the cardiac cycle and SWD. In 20 UWL changes of spontaneous firing rate(FR) during the somatosympathetic reflex(SSR) were studied Five different firing patterns were observed during the pressor and depressor responses of SSR, implying that they form an interconnected neuronal circuit interacting with one another to generate efferent signals for blood pressure regulation. In the following companion paper, the firing patterns of CVN are analyzed to develop a minimal neuronal circuit model explaining the present experimental outcome.

• Journal of Veterinary Science
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• v.21 no.1
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• pp.6.1-6.12
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• 2020

Currently, the optimal resuscitation fluid remains debatable. Therefore, in the present study, we designed a trometamol-balanced solution (TBS) for use as a resuscitation fluid for hemorrhagic shock. Hemorrhagic shock was induced in 18 male Wistar-Kyoto rats, which were assigned to normal saline (NS), Ringer's solution (RS), and TBS groups. During the hemorrhagic state, their hemodynamic parameters were recorded using an Abbott i-STAT analyzer with the CG4+ cartridge (for pH, pressure of carbon dioxide, pressure of oxygen, total carbon dioxide, bicarbonate, base excess, oxygen saturation, and lactate), the CG6+ cartridge (for sodium, potassium, chloride, blood glucose, blood urea nitrogen, hematocrit, and hemoglobin), and enzyme-linked immunosorbent assay kits (calcium, magnesium, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, and albumin). Similar trends were found for the parameters of biochemistries, electrolytes, and blood gas, and they revealed no significant changes after blood withdrawal-induced hemorrhagic shock. However, the TBS group showed more effective ability to correct metabolic acidosis than the NS and RS groups. TBS was a feasible and safe resuscitation solution in this study and may be an alternative to NS and RS for resuscitation in hemorrhagic shock patients without liver damage.

• Journal of Biomedical Engineering Research
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• v.17 no.1
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• pp.43-48
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• 1996

We investigated the energistics of the physiological heart model by comparing predictive indexes of the myocardial oxygen consumption (MOC), such as tension-time index (R), tension-time or force-time inteual (FTI), rate-pressure product (RPP), pressure-work index, and systolic pressure-volume area (PVA) when using the electro-hydraulic left ventricular device (LVAD). We developed the model of LVAD incorporated the closed-loop cardiovascular system with a baroreceptor which can control heart rate and time-varying elastance of left and right ventricles. On considering the benefit of the LVAD, the effects of various operation modes, especially timing of assistance, were evaluated using this coupled computer model. Overall results of the computer simulation shows that our LVAD can unload the ischemic (less contractile) heart by decreasing the MU and increasing coronary flow. Because the pump ejection at the end diastolic phase of the natural heart may increase the afterload of the left ventricle, the control scheme of our LVAD must prohibit ejecting at this time. Since the increment of coronary flow is proportional to the peak aortic pressure after ventricle contraction, the LVAD must eject immediately following the closure of the aortic valve to increase oxygen availability.

• Journal of Biomedical Engineering Research
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• v.36 no.5
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• pp.183-190
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• 2015

Invasive blood pressure (IBP) is measured for the patient's real time arterial pressure (ABP) to monitor the critical abrupt disorders of the cardiovascular system. It can be used for the estimation of cardiac output and the opening and closing time detection of the aortic valve. Although the unexplained inflections on ABP make it difficult to find the mathematical relations with other cardiovascular parameters, the estimations based on ABP for other data have been accepted as useful methods as they had been verified with the statistical results among vast patient data. Previous windkessel models were composed with systemic resistance and vascular compliance and they were successful at explaining the average systolic and diastolic values of ABP simply. Although it is well-known that the blood pressure reflection from peripheral arteries causes complex inflection on ABP, previous models do not contain any elements of the reflections because of the complexity of peripheral arteries' shapes. In this study, to simulate a reflection wave of blood pressure, a new mathematical model was designed with four elements that were the impedance of aorta, the compliance of aortic arch, the peripheral resistance, and the compliance of peripheral arteries. The parameters of the new model were adjusted to have three types of arterial blood pressure waveform that were measured from a patient. It was used to find the relations between the inflections and other cardiovascular parameters such as the opening-closing time of aortic valve and the cardiac output. It showed that the blood pressure reflection can bring wide range errors to the closing time of aortic valve and cardiac output with the conventional estimation based on ABP and that the changes of one-stroke volumes can be easily detected with previous estimation while the changes of heart rate can bring some error caused by unexpected reflections.