• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.332-346
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• 1993

성인 남성들에서 여가시간의 육체적 활동량의 분포를 파악하고 관상동맥질환의 위험인자들과의 관련성을 보기위해 경상북도에 소재하는 일개 제철회사의 남성 근로자 277명을 연구대상자로 선정하였다. CARDIA 연구의 Physical Activity History questionnaire를 변형한 설문지를 이용하여 연구대상자들의 여가시간의 육체적 활동에 대해 면담조사하였다. 공복시 혈액 5ml를 채취하여 혈청 총콜레스테롤, 중성지방 및 혈당량을 측정하였고, 신장, 체중 및 혈압을 측정하였다. 흡연습관과 음주습관, 교육 수준 및 그 밖의 사항들은 설문지를 이용하여 면담조사하였다. 연구대상자들의 여가시간의 육체적 활동에 의한 에너지 소모량의 기하 평균치는 212.80 kcal/week이었고, 전체 대상자 중 여가시간에 2,000 kcal/week이상 육체적 활동을 하는 사람의 비율은 22. 4%이었다. 설문지의 항목들 중 대상자들이 여가시간에 하는 운동으로 가장 많은 것은 산보나 등산, 조깅 혹은 달리기 등이었다. 전체 대상자들에서 연령별, 교육수준별, 근무기간별, 흡연 및 음주습관별 주당 여가시간의 육체적 활동량이 유의한 차이를 보이지 않았으나, 작업 중 격렬한 노동을 하는 사람들이 안 하는 사람들에 비해 주당 여가시간의 육체적 활동량이 많은 것으로 나타났다(p<0.05). 여가시간의 육체적 활동량과 관상동맥질환의 위험인자들과의 관련성을 보고자 여가시간의 육체적 활동량을 중등도 이상의 활동을 전혀 안 하는 경우, 총 활동량이 2,000 kcal/week 미만인 경우 그리고 총 활동량이 2,000 kcal/week 미만인 경우의 세 군으로 나눈 후 BMI, 수축기 및 이완기혈압, 혈청 총콜레스테롤, 중성지방, 공복시 혈당량의 평균을 비교하였으나 통계적으로 유의한 차이를 보인 것은 없었다.

• Journal of Preventive Medicine and Public Health
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• 제40권5호
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• pp.411-417
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• 2007

Objectives: Although risk factors for coronary artery disease are also associated with increased carotid intima-media thickness (IMT), there is little information available on the asymptomatic, young adult population. We examined the association between multiple cardiovascular risk factors and the common carotid IMT in 280 young Korean adults. Methods: The data used for this study was obtained from 280 subjects (130 men and 150 women) aged 25 years who participated in the Kangwha Study follow-up examination in 2005. We measured cardiovascular risk factors, including anthropometries, blood pressure, blood chemistry, carotid ultrasonography, and reviewed questionnaires on health behaviors. Risk factors were defined as values above the sex-specific 75th percentile of systolic blood pressure, body mass index, total cholesterol/ high-density lipoprotein cholesterol ratio, fasting blood glucose and smoking status. Results: The mean carotid IMT${\pm}$standard deviation observed was $0.683{\pm}0.079mm$ in men and $0.678{\pm}0.067mm$ in women (p=0.567) and the evidence of plaque was not observed in any individuals. Mean carotid IMT increased with an increasing number of risk factors(p for trend <0.001) and carotid IMT values were 0.665 mm, 0.674 mm, 0.686 mm, 0.702 mm, and 0.748 mm for 0, 1, 2, 3, and 4 to 5 risk factors, respectively. The odds ratio for having the top quartile carotid IMT in men with 3 or more risk factors versus 0-2 risk factors was 5.09 (95% CI, 2.05-12.64). Conclusions: Current findings indicate the need for prevention and control of cardiovascular risk factors in young adults and more focus on those with multiple cardiovascular risk factors.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1999년도 제38차 춘계학술대회
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• pp.205-208
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• 1999

재협착에 관여하는 인자는 매우 다양하다. 평활근 세포의 증식, ECM의 형성, 혈관벽의 초기 혈전형성, 그리고 혈관 재형성 등이 모든 것들이 재협착의 병인에 기여하고 있다. 환자마다 이런 요소들의 기여정도가 다르며 동일 환자에서도 병변에 따른 기여정도가 또한 다르리라 여긴다. 그러나 아직까지 우리는 외막섬유모세포의 역할, 내피세포의 재생, 증식세포의 계획된 죽음 등 재협착의 기전을 불완전하게 이해하고 있고 따라서 보다 완전한 이해를 통해 효과적인 재협착 예방치료가 시행될 수 있을 것이다.

• Journal of Chest Surgery
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• 제37권9호
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• pp.749-754
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• 2004

심장박동 상태에서 시행하는 관상동맥우회술 (Off-Pump CABG)은 심폐체외순환을 이용한 관상 동맥우회술 (On-Pump CABG)보다 낮은 위험률과 빠른 회복을 가져오는 것으로 알려져 있으며, 특히 수술 전 고위험인자를 가진 환자에서 심폐체외순환의 부작용을 피할 수 있는 이점이 있다. 저자들은 수술 전 고위험인자를 가진 환자들에 있어서 Off-Pump CABG와 On-Pump CABG의 수술성적을 비교하여 고위험군에서 Off-Pump CABG의 효율성에 대해 알아보고자 하였다. 대상 및 방법: 2001년 1월부터 2003년 6월까지 관상동맥우회술만을 시행한 환자 682명(Off-Pump CABG군: 424명, On-Pump CABG: 258명) 중 수술 전 고위험인자를 가진 환자를 대상으로 그 결과를 분석하였다. 수술 전 심장 박출계수 35% 이하, 70세 이상 고령의 환자, 뇌경색의 과거력, 최근 심근경색의 과거력, 과거 관상동맥우회술을 시행받았던 환자, 경동맥 및 말초동맥의 협착, 심부전증의 기왕력이 있는 환자, 신부전증환자 및 만성폐쇄성폐질환 환자 등 9가지 위험인자 중에서 한 가지 이상을 가지고 있는 환자를 고위험군으로 분류하여 대상으로 삼았다. 대상 환자는 Off-Pump CABG군이 192명, On-Pump CABG군이 100명으로, 각 군의 수술 전 위험인자 및 수술 후 결과를 비교하였다. 결과: 남녀 비, 연령 및 수술 전 고혈압 등의 위험요소는 두 군에서 차이를 보이지 않았다. Off-Pump CABG군에서 On-Pump CABG군에 비해 더 많은 동맥편을 사용하였으며, 수술시간, 수술 후 측정한 CK-MB, 뇌경색의 발생률, 강심제사용빈도, 호흡기의 사용시간 및 입원기간이 Off-Pump CABG군에서 통계적으로 유의하게 낮았으며, 이식편수는 On-Pump CABG군에서 유의하게 많았다. 수술 후 사망은 Off-Pump CABG와 On-Pump CABG를 시행 받았던 군에서 각각 0.5% 및 2%로 두 군간의 유의성은 없었으나 Off-Pump CABG를 시행 받았던 군에서 더 낮은 경향을 보여주었다. 그러나 출혈로 인한 재수술, 수술 후 심근경색증, 감염 및 신부전증 등은 두 군간에 통계적 유의성이 없었다. 결론: Off-Pump CABG는 On-Pump CABG 에 비해 수술 후 심근손상을 줄이고, 합병증을 감소시키며 빠른 회복을 보여 주었다. 따라서 고위험 군 환자들의 관상동맥우회술은 Off-Pump CABG로 시행하는 것이 더 좋은 수술방법이 될 것으로 생각한다. 그러나 전향적인 연구 등 더 많은 연구가 필요하리라 생각한다.

• 대한의생명과학회지
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• 제17권4호
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• pp.329-336
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• 2011

The female has previously been shown to be an independent risk factor for mortality and morbidity after coronary artery bypass grafting surgery (CABG). The aim of this retrospective study is to evaluate gender differences of the perioperative outcomes in elderly patients underwent CABG. Data for seventy elderly patients (>70 years) that underwent CABG (between January 2005 and July 2011) were divided into two groups: male patients (n=33, male group) and female patients group (n=37, female group). Heights, body weights, body surface area and coronary artery obstruction rate (right coronary artery territory) in the female group were lower than those of the male group ($P$ <0.05). History of hypertension, hyperlipidemia, congestive heart failure and percutaneous coronary artery intervention in the female group was higher than that of the male group ($P$ <0.05). Total cholesterol and brain natriuretic peptide levels in the female group were higher than those of the male group ($P$ <0.05). Platelet count in the female group was higher than the male group at preoperative (Pre-OP) period ($P$ <0.05). Erythrocyte count, hematocrit and hemoglobin levels in the female group were lower than those of the male group at Pre-OP period ($P$ <0.05). But, erythrocyte count, hematocrit and hemoglobin levels in the female group were higher than those of the Male group at postoperative (Post-OP) period ($P$ <0.05). Left ventricular ejection fraction in the female group was higher than the male group at Post-OP period ($P$ <0.05). Hospital stay length in the female group was higher than the male group ($P$ <0.05). Post-OP bleeding volume and incidence of ventricular premature contraction in the female group were lower than those of the male group ($P$ <0.05). These results suggest that despite female gender have a greater risk factors and require a longer hospitalization than male, there was no significant difference incidence of mortality and complication.

• 보건교육건강증진학회지
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• 제32권5호
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• pp.73-81
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• 2015

Objectives: We tried to confirm physical activity of 1,000 Kcal per week was a meaningful point in controlling coronary artery disease risks in female older adults. Methods: Participants were 66 female older adults recruited from senior welfare center. Participants were provided with accelerometer (e-step, Kenz, Japan) for measuring daily energy expenditure. Graded exercise test was done for measuring aerobic fitness. Blood glucose and lipid were analyzed. Framingham risk score was calculated based on blood glucose, blood lipid, and smoking. These variables were compared between the group expended more than 1,000 Kcal/week and the group with energy expenditure below 1,000 Kcal/week. Results: The group expended over 1,000kcal/week showed to be superior to the counterpart group in following variables; AC(Abdominal Circumference), %BF, $HR_{rest}$(resting heart rate), $VO_{2peak}$, FBG, LDL-C, TG, BDI-II, QOL, AR(Absolute Risk), RR(Relative Risk). Conclusions: The group expended over 1,000 Kcal/week was likely to have less probability in CAD than group expended less than 1,000 Kcal/week. The result of this study suggests the important role of active daily life that can be replaced with that of regular exercise especially for those who are not available to do structured exercise.

• Biomolecules & Therapeutics
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• 제26권6호
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• pp.521-532
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• 2018

Dementia, characterized by a progressive cognitive decline and a cumulative inability to behave independently, is highly associated with other diseases. Various cardiovascular disorders, such as coronary artery disease and atrial fibrillation, are well-known risk factors for dementia. Currently, increasing evidence suggests that sex factors may play an important role in the pathogenesis of diseases, including cardiovascular disease and dementia. Recent studies show that nearly two-thirds of patients diagnosed with Alzheimer's disease are women; however, the incidence difference between men and women remains vague. Therefore, studies are needed to investigate sex-specific differences, which can help understand the pathophysiology of dementia and identify potential therapeutic targets for both sexes. In the present review, we summarize sex differences in the prevalence and incidence of dementia by subtypes. This review also describes sex differences in the risk factors of dementia and examines the impact of risk factors on the incidence of dementia in both sexes.

• 대한간호학회지
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• 제28권1호
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• pp.184-192
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• 1998

This study was done to examine the correlations between weight, BMI and risk factors of coronary heart disease in men and women in their forties and fifties. The subjects were 412 adults. who had regular health examinations between January and December of 1996 at S-Hospital in Seoul. The data were analyzed using ANOVA, Scheffe test, and Pearson correlation coefficient. The results are as follows : 1. The men between 50 and 59 years of age had higher levels for BMI, weight, systolic blood pressure, diastolic blood pressure, total cholesterol. LDL-cholesterol, triglyceride, fasting blood sugar, plasminogen activator-1, and hemoglobin A,C than the group of women in their forties. Yet. HDL-cholesterol was lower than in the former group. 2. In the group of men in their forties, weight was significantly correlated to diastolic blood pressure(r=.22), LDL-cholesterol(r=.20), plasminogen activator-inhibitor-1(r=.35) HDL-cholesterol(r=-.19). Their BMI was significantly correlted to systolic blood pressure(r=.27), diastolic blood pressure (r=.33), total cholesterol(r=.23), LDL-cholesterol (r=.26), plasminogen activator-1(r=.36) and HDL-cholesterol(r=-.25). 3. As for the group of women in their forties weight was significantly correlated to systolic blood pressure(r=.20), diastolic blood pressure(r=.22), triglyceride(r=.32) , plasminogen activator inhibitor-1 (r=.30) and HDL-cholesterol(r= -.37). Their BMI was significantly correlated to diastolic blood pressure (r=.25) triglyceride(r=.47), plasminogen activator-1 (r=.35), fibrinogen(r=.27) and HDL-cholesterol(r=-.47). 4. In the group of men in their fifties. weight was significantly correlated to total cholesterol (r=32), LDL-cholesterol(r=.29). plasminogen activator inhibitor-1(r=.26). Their BMI was significantly correlated to systolic blood pressure(r=.24), diastolic blood pressure (r=.22), total cholesterol (r=.34), LDL-cholesterol (r=.32), and plasminogen activator-1(r=.25). 5. In the group of women in their fifties, weight was significantly correlated to diastolic blood pressure(r=.33), total cholesterol(r=.21), LDL-cholesterol(r=.20), plasminogen activator inhibitor-1 (r=.43) and HDL-cholesterol(r=-.21). Their BMI was significantly correlated to systolic blood pressure(r=.25), diastolic blood pressure(r=.40), total cholesterol(r=.24), LDL-cholesterol(r=.24), triglyceride(r=22), and HDL-cholesterol (r=-.30). The above findings indicate that the BMI was more predictive than weight as a risk factor for coronary artery disease for men and women in their forties and fifties.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.9-20
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• 2001

Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

• Journal of Chest Surgery
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• 제50권1호
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• pp.14-21
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• 2017

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was $55{\pm}26months$, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.