• Journal of Preventive Medicine and Public Health
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• v.53 no.5
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• pp.313-322
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• 2020

Objectives: This study was conducted to determine the incidence and risk factors of myocardial infarction (MI) and stroke in farmers compared to the general population and to establish 5-year prediction models. Methods: The farmer cohort and the control cohort were generated using the customized database of the National Health Insurance Service of Korea database and the National Sample Cohort, respectively. The participants were followed from the day of the index general health examination until the events of MI, stroke, or death (up to 5 years). Results: In total, 734 744 participants from the farmer cohort and 238 311 from the control cohort aged between 40 and 70 were included. The age-adjusted incidence of MI was 0.766 and 0.585 per 1000 person-years in the farmer and control cohorts, respectively. That of stroke was 0.559 and 0.321 per 1000 person-years in both cohorts, respectively. In farmers, the risk factors for MI included male sex, age, personal history of hypertension, diabetes, current smoking, creatinine, metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). Those for stroke included male sex, age, personal history of hypertension, diabetes, current smoking, high γ-glutamyl transferase, and metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). The prediction model showed an area under the receiver operating characteristic curve of 0.735 and 0.760 for MI and stroke, respectively, in the farmer cohort. Conclusions: Farmers had a higher age-adjusted incidence of MI and stroke. They also showed distinct patterns in cardiovascular risk factors compared to the general population.

• CELLMED
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• v.8 no.4
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• pp.20.1-20.5
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• 2018

Cancer is considered one of the deadly diseases in the world. According to WHO cancer now causes more deaths than all coronary heart disease. The incidence and mortality of the worldwide major cancers are now available in the GLOBOCAN series of the International Agency for Research on Cancer. The transition of global demographic and epidemiologic shows that burden of cancer will increase particularly in low and middle income countries, with over 20 million new cancer cases expected annually as early as 2025. Medicinal plants made known to be prospective and useful job for the treatment of several diseases and disorders from prehistoric days to nowadays. One of the commonly used plants, which have supporting evidences from the recent scientific data for the different types of cancers, is Carica papaya. Papaya (Carica papaya) is widely used as folk caloric herbal medicine, being a powerhouse of nutrients and accessible throughout the year. It is a rich source of three powerful antioxidants, the minerals, vitamins and contains high content of fibre. Carica papaya has provided many remedies for various diseases from ancient days to nowadays, and is regarded as a Nutraceutical. Because of this comprehensive medicinal value of Carica papaya, we are trying here to convey the reports studied especially for the anticancer activities of the age-old fruit, which will help researchers to pull in concert data and may be a "lead" for the one of the dangerous disease in the world.

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.438-442
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• 2005

Kawasaki disease is an acute febrile vasculitis that occurs predominantly in young children under 5-years-old. The patients present generally with a high spiking fever that is unresponsive to antibiotics and lasts for more than five days at least. Prolonged fever has been shown to be a risk factor in the development of coronary artery disease. It seems to be certain that infectious agents are associated with the pathogenesis of Kawasaki disease. The differential diagnosis of Kawasaki disease must rule out infectious diseases including scarlet fever, toxic shock syndrome, measles, and so on. This is very important for adequate treatment and prevention of cardiac complications of Kawasaki disease. We experienced a 25-month-old boy who had high fever and pneumonic consolidation in the right middle and lower lobe of the lung that was considered as mycoplasma pneumonia on admission and developed coronary artery aneurysmal dilatation during treatment with roxythromycin.

• Clinical and Experimental Pediatrics
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• v.57 no.5
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• pp.217-221
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• 2014

Purpose: The aim of this study was to determine whether school-aged children with Kawasaki disease (KD) have an increased risk for early atherosclerosis. Methods: The study included 98 children. The children were divided into the following groups: group A (n=19), KD with coronary arterial lesions that persisted or regressed; group B (n=49), KD without coronary arterial lesions; and group C (n=30), healthy children. Anthropometric variables and the levels of biochemical markers, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A, apolipoprotein B, homocysteine, highsensitivity C-reactive protein (hs-CRP), and brachial artery stiffness using pulse wave velocity were compared among the three groups. Results: There were no significant differences in blood pressure and body index among the three groups. Additionally, there was no sex-specific difference. Moreover, the levels of triglyceride, HDL-C, apolipoprotein A, and hs-CRP did not differ among the three groups. However, the levels of total cholesterol (P =0.018), LDL-C (P =0.0003), and apolipoprotein B (P =0.029) were significantly higher in group A than in group C. Further, the level of homocysteine and the aortic pulse wave velocity were significantly higher in groups A and B than in group C (P=0.0001). Conclusion: School-aged children after KD have high lipid profiles and arterial stiffness indicating an increased risk for early atherosclerosis.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.9 no.2
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• pp.196-204
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• 2016

World Health Organization reported that heart-related diseases such as coronary artery stenoses show the highest occurrence rate which may cause heart attack. Using Computed Tomography angiography images will allow radiologists to detect and have intervention by creating 3D roadmapping of the vessels. However, it is often complex and difficult do reconstruct 3D vessel which causes very large amount of time and previous researches were studied to segment vessels more accurate automatically. Therefore, in this paper, Region Competition, Geodesic Active Contour (GAC), Multi-atlas based segmentation and Active Shape Model algorithms were applied to segment aortic root from CTA images and the results were analyzed by using mean Hausdorff distance, volume to volume measure, computational time, user-interaction and coronary ostium detection rate. As a result, Extracted 3D aortic model using GAC showed the highest accuracy but also showed highest user-interaction results. Therefore, it is important to improve automatic segmentation algorithm in future

• Journal of Chest Surgery
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• v.30 no.10
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• pp.961-965
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• 1997

From October 1991 to April 1996, 27 patients underwent aortocoronary bypass graft. There were 17 men, 10 women. The mean age was 65 years(range 45 to 76). The preoperative clinical status were chronic stable angina in 11 cases, unstable angina in 13 cases and postinfarction angina in 3 cases. The involved ri k factors were as follows: Hypertension in 7 cases, Diabetes Mellitus in 5 cases and any other diseases in 3 cases We divided these patients into two groups in this survey: The A group was 15 patients who were managed with cardioplegia from 1991 to 1994. The B group of 12 patients was done with intermittent aortic clamping without cardioplegia from 1995 to 1996. The mean numbers of graft per patient was 2.0 in A group and 2.83 in B group. The ischemic time per graft was 27.3 minute in A group and 18.5 minute in B group respectively. The morbidity was occlusion of grafted vessel in one patient and one of postoperative angina in A group. The total mortality was 14.8%(4/27), but mortality of B group was 8.35 (1/12)

• Nutritional Sciences
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• v.7 no.4
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• pp.214-217
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• 2004

Dietary intervention and simvastatin is beneficial in the prevention cardiovascular diseases by lowering plasma lipid levels. Endothelial dysfunction is associated with coronary artery disease and its risk factors and is reversed by dietary intervention. It has been suggested that hyperlipidemia contributes to the development of atherosclerosis by increasing inducible nitric oxide synthase (iNOS) expression via intimal thickening. Statins treatment has been found to decrease iNOS expression and atherogenensis in animal models. We hypothesized that dietary intervention and simvastatin therapy could decrease plasma nitric oxide in hypercholesterolemic patients, which would suggest the opportunity for modulation of iNOS expression through the use of statins in a clinical situation. We measured the plasma levels of nitrite and nitrate (NOx) in 19 hyperlipidemia patients. The subjects were under dietary intervention following simvastatin therapy for 12 weeks. As a result, the plasma level of NOx, stable metabolites of nitric oxide (NO), saw a two-fold elevation in hyperlipidemic patients as compared to normal levels. Although 12 weeks of dietary intervention did not lower NOx levels, subsequent 12-week simvastatin (10 mg/day) treatment, along with dietary intervention, lowered NOx levels significantly. This NOx reduction, induced by simvastatin therapy, positively correlated with lowered coronary risk factors (r=0.40, p=0.02). It indicated that simvastatin therapy decreases plasma NOx levels by, perhaps, decreasing iNOS expression or activity leading to the attenuation of the development of neointima.

• Health Policy and Management
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• v.26 no.4
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• pp.333-342
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• 2016

Background: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. Methods: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. Results: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. Conclusion: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.

• Integrative Medicine Research
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• v.3 no.4
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• pp.204-210
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• 2014

The aim of this review was to understand the effects of ${\beta}$-adrenergic stimulation on oxidative stress, structural remodeling, and functional alterations in the heart and cerebral artery. Diverse stimuli activate the sympathetic nervous system, leading to increased levels of catecholamines. Long-term overstimulation of the ${\beta}$-adrenergic receptor (${\beta}AR$) in response to catecholamines causes cardiovascular diseases, including cardiac hypertrophy, stroke, coronary artery disease, and heartfailure. Although catecholamines have identical sites of action in the heart and cerebral artery, the structural and functional modifications differentially activate intracellular signaling cascades. ${\beta}AR$-stimulation can increase oxidative stress in the heart and cerebral artery, but has also been shown to induce different cytoskeletal and functional modifications by modulating various components of the ${\beta}AR$ signal transduction pathways. Stimulation of ${\beta}AR$ leads to cardiac dysfunction due to an overload of intracellular $Ca^{2+}$ in cardiomyocytes. However, this stimulation induces vascular dysfunction through disruption of actin cytoskeleton in vascular smooth muscle cells. Many studies have shown that excessive concentrations of catecholamines during stressful conditions can produce coronary spasms or arrhythmias by inducing $Ca^{2+}$-handling abnormalities and impairing energy production in mitochondria, In this article, we highlight the different fates caused by excessive oxidative stress and disruptions in the cytoskeletal proteome network in the heart and the cerebral artery in responsed to prolonged ${\beta}AR$-stimulation.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.34-40
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• 2008

Background: Off-pump coronary artery bypass grafting (OPCAB) shows fewer side effects than cardiopulmonary by. pass, and other benefits include myocardial protection, pulmonary and renal protection, coagulation, inflammation, and cognitive function. We analyzed the clinical results of our cases of OPCAB. Material and Method: From May 1999 to August 2007, OPCAB was performed in 100 patients out of a total of 310 coronary artery bypass surgeries. There were 63 males and 37 females, from 29 to 82 years old, with a mean age of $62{\pm}10$ years. The preoperative diagnoses were unstable angina in 77 cases, stable angina in 16, and acute myocardial infarction in 7. The associated diseases were hypertension in 48 cases, diabetes in 42, chronic renal failure in 10, carotid artery disease in 6, and chronic obstructive pulmonary disease in 5. The preoperative cardiac ejection fraction ranged from 26% to 74% (mean $56.7{\pm}11.6%$). Preoperative angiograms showed three-vessel disease in 47 cases, two-vessel disease in 25, one-vessel disease in 24, and left main disease in 23. The internal thoracic artery was harvested by the pedicled technique through a median sternotomy in 97 cases. The radial artery and greater saphenous vein were harvested in 70 and 45 cases, respectively (endoscopic harvest in 53 and 41 cases, respectively). Result: The mean number of grafts was $2.7{\pm}1.2$ per patient, with grafts sourced from the unilateral internal thoracic artery in 95 (95%) cases, the radial artery in 62, the greater saphenous vein in 39, and the bilateral internal thoracic artery in 2. Sequential anastomoses were performed in 46 cases. The anastomosed vessels were the left anterior descending artery in 97 cases, the obtuse marginal branch in 63, the diagonal branch in 53, the right coronary artery in 30, the intermediate branch in 11, the posterior descending artery in 9 and the posterior lateral branch in 3. The conversion to cardiopulmonary bypass occurred in 4 cases. Graft patency was checked before discharge by coronary angiography or multi-slice coronary CT angiography in 72 cases, with a patency rate of 92.9% (184/198). There was one case of mortality due to sepsis. Postoperative arrhythmias or myocardial in-farctions were not observed. Postoperative complications were a cerebral stroke in 1 case and wound infection in 1. The mean time of respirator care was $20{\pm}35$ hours and the mean duration of stay in the intensive care unit was $68{\pm}47$ hours. The mean amounts of blood transfusion were $4.0{\pm}2.6$ packs/patient. Conclusion: We found good clinical outcomes after OPCAB, and suggest that OPCAB could be used to expand the use of coronary artery bypass grafting.