• Journal of the Korean Society of Radiology
• /
• v.82 no.2
• /
• pp.429-434
• /
• 2021

Amyloidosis is a multisystemic disease characterized by the accumulation of abnormal proteins in extracellular spaces in various organs, with frequent involvement of the myocardium. We report a case of a patient who had cardiac amyloidosis with a trend of reduction in native T1 and T2 values and extracellular volume fraction on serial cardiac magnetic resonance imaging after chemotherapy and stem cell transplantation. The native T1 value and the extracellular volume fraction are closely associated with tissue amyloid burden in amyloidosis patients. This case demonstrated that cardiac magnetic resonance imaging may be used as a non-invasive and quantitative biomarker in the treatment monitoring of amyloidosis.

• Clinical and Experimental Vaccine Research
• /
• v.13 no.2
• /
• pp.121-131
• /
• 2024

Purpose: The global burden of disease and mortality is greatly influenced by malaria, particularly in children. Nigeria alone accounts for about 25% of global malaria cases and fatalities. Despite efforts to control and eliminate malaria, conventional treatments have limitations, prompting the need for a vaccine. However, while efforts have focused on researching and developing malaria vaccines, less attention has been given to public acceptance and preparedness for vaccination. Materials and Methods: The study employed a cross-sectional approach to assess the knowledge, perceptions, and readiness of caregivers towards the malaria vaccine. Data were collected through a physical and online survey among a representative sample of caregivers across the six geopolitical regions of Nigeria. The data was analyzed using principal component analysis and percentages. Results: Out of 347 respondents, 180 (51%) men, 165 (46.6%) women, 2 (0.5%) transgender, 156 (45%) rural settlers, and 191 (55%) urban settlers were identified in this study. The study reported an overall acceptance rate of 78.4% and 21.6% resistance rate. The age group between 21-30 years recorded the highest 207 (59.6%). A significant number of participants, 252 (59.6%), held at least a higher or post-secondary certificate, out of which 193 (55.6%) demonstrated strong readiness to accept the malaria vaccine. The study showed that fear of adverse effects was the main reason for malaria vaccine resistance among caregivers. Conclusion: This study's findings offer valuable insights into caregivers' knowledge about the malaria vaccine, highlighting the factors that impact the acceptance of the malaria vaccine.

• Korean Circulation Journal
• /
• v.52 no.5
• /
• pp.382-392
• /
• 2022

Background and Objectives: As the Korean population ages fast, it is estimated that the people with hypertension, especially female patients, will increase rapidly. However, there are few data comparing the size of female and male hypertensive patients in the Korean population. Thus we assessed sex-specific trends in the prevalence and the number of people with hypertension. Methods: We analyzed data for 128,949 adults aged ≥20 years with valid blood pressure measurements from the 1998 to 2018 Korea National Health and Nutrition Examination Survey (KNHANES). The prevalence and the absolute number of hypertension were estimated with taking into the sampling weights separately for women and men. Results: Overall prevalence of hypertension is higher in men than in women. But, in older adults, women show higher prevalence and the number of people with hypertension. Between 1998 and 2018, prevalence of hypertension increased from 61.8% to 65.9% in elderly (age 65+) women, and from 49.0% to 59.4% in elderly men. During the same period, the number of elderly women with hypertension increased from 1.18 to 2.70 million, while the number of elderly men with hypertension increased from 0.57 to 1.78 million. Among hypertensive patients, undiagnosed hypertension and diagnosed-but-untreated hypertension were more common in men, while treated-but-uncontrolled hypertension were more common in women. Conclusion: The fast-growing number of elderly women with hypertension will be an important public health challenge for the Korean society to solve in order to reduce the burden of cardiovascular disease.

• Korean Circulation Journal
• /
• v.52 no.8
• /
• pp.563-575
• /
• 2022

Hypertrophic cardiomyopathy (HCM) is one of the most common inheritable cardiomyopathies. Contemporary management strategies, including the advent of implantable cardioverter-defibrillators and effective anticoagulation, have substantially improved the clinical course of HCM patients; however, the disease burden of HCM is still high in Korea. Sudden cardiac death (SCD), atrial fibrillation and thromboembolic risk, dynamic left ventricular outflow tract (LVOT) obstruction, and heart failure (HF) progression remain important issues in HCM. SCD in HCM can be effectively prevented with implantable cardioverter-defibrillators. However, appropriate patient selection is important for primary prevention, and the 5-year SCD risk score and the presence of major SCD risk factors should be considered. Anticoagulation should be initiated in all HCM patients with atrial fibrillation regardless of the CHA2DS2-VASc score, and non-vitamin K antagonist oral anticoagulants are the first option. Symptomatic dynamic LVOT obstruction is first treated medically with negative inotropes, and if symptoms persist, septal reduction therapy is considered. The recently approved myosin inhibitor mavacamten is promising. HF in HCM is usually related to diastolic dysfunction, while about 5% of HCM patients show reduced left ventricular ejection fraction <50%, also referred to as "end-stage" HCM. Myocardial fibrosis plays an important role in the progression to advanced HF in patients with HCM. Patients who do not respond to guideline-directed medical therapy can be considered for heart transplantation. The development of imaging techniques, such as myocardial deformation on echocardiography and late gadolinium enhancement on cardiac magnetic resonance, can provide better risk evaluation and decision-making for management strategies in HCM.

• IMMUNE NETWORK
• /
• v.24 no.3
• /
• pp.19.1-19.15
• /
• 2024

The influenza virus poses a global health burden. Currently, an annual vaccine is used to reduce influenza virus-associated morbidity and mortality. Most influenza vaccines have been developed to elicit neutralizing Abs against influenza virus. These Abs primarily target immunodominant epitopes derived from hemagglutinin (HA) or neuraminidase (NA) of the influenza virus incorporated in vaccines. However, HA and NA are highly variable proteins that are prone to antigenic changes, which can reduce vaccine efficacy. Therefore, it is essential to develop universal vaccines that target immunodominant epitopes derived from conserved regions of the influenza virus, enabling cross-protection among different virus variants. The internal proteins of the influenza virus serve as ideal targets for universal vaccines. These internal proteins are presented by MHC class I molecules on Ag-presenting cells, such as dendritic cells, and recognized by CD8 T cells, which elicit CD8 T cell responses, reducing the likelihood of disease and influenza viral spread by inducing virus-infected cell apoptosis. In this review, we highlight the importance of CD8 T cell-mediated immunity against influenza viruses and that of viral epitopes for developing CD8 T cell-based influenza vaccines.

• Journal of agricultural medicine and community health
• /
• v.26 no.1
• /
• pp.65-79
• /
• 2001

Cerebrovascular disease(CVD) is one of the major causes of death in Korea as well as most countries in the world and the disease gives great burden to humans socio-economically due to its high fatality and common occurrence of disability as the sequelae. This study was performed to investigate the utilization of western hospital(WH) or oriental hospital(OH) due to CVD and compare the type and the clinical characteristics of patients with CVD between WH and OH located in Kwangju City, Chonnam Province and Chonbuk Province. We reviewed the medical records of 1,070 patients who were discharged from 12 WIT and 6 OH from January to March, 2000 and confirmed for the diagnosis of CVD. Fifty-one percent of the subjects were treated at WH and forty-nine percent at OH. Females were more prevalent than males. As well, the most common age group among these subjects was found to be 70 years and older. About 92% in W~H and 80% in OH received brain imaging diagnostic procedures such as CT or MRI. The cerebral infarction was the most common type of CVD when compared by the kind of utilized hospitals, sex, age group except patient Group who was treated at WH and whose age was lower than 50 years old. The cerebral hemorrhage was more frequent than cerebral infarction among this group. The proportion of cerebral hemorrhage was decreasing and that of cerebral infarction was increasing with age. The most common clinical manifestations of undetermined type of CVD was paralysis of lower extremity in WIT and paralysis of upper extremity in OH. In cerebral hemorrhage loss of consciousness in WIT and dysarthria in OH were most frequently manifested, while in the case of cerebral infarction hemiplegia in WIT and dysarthria in OH were the most common complaints. The interval from the onset of disease to admission to the hospital was 5.5 days in WH arid 31.4 days in OH and the difference was statistically significant. Average admission duration of patients at OH was longer than WH, but it was not statistically significant. In conclusion these results suggest that the effort for systematic and efficient management of CVD patients was necessary for close co-operation and role arrangement between WH and OH considering the positive and negative points of western and oriental medicines.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.9
• /
• pp.4517-4525
• /
• 2016

Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

• Pediatric Infection and Vaccine
• /
• v.8 no.2
• /
• pp.160-167
• /
• 2001

Purpose : To assess the immunogenicity, safety, and tolerability of hepatitis A vaccine ($VAQTA^{TM}$) in healthy children and adolescents. Methods : Eligible subjects aged 2 to 17 years received 25 U/0.5 mL of $VAQTA^{TM}$ intramuscularly at 0 and 24 week schedule. Bleeds were obtained prior to vaccination and 4 weeks after the second dose to ascertain serostatus. To detect antibody to HAV after vaccination with an inactivated HA vaccine, a modification of the $Abbott^{(R)}$ HAVAB kit was used. Sample with titers ${\geq}10$ mIU/mL were considered seroconverted. Adverse experiences were monitored. Results : 102 subjects(54 male, 48 female) were enrolled. The mean age was $6.8{\pm}3.5$ years. Two subjects were seropositive, two were lost of follow up. 88 subjects were available for a per protocol analysis and 90 for all subjects with serology after the second dose, and ten withdral. All subjects(95% CI, 94.8~100) seroconverted. Geometric mean titers was 7,991.1(95% CI, 6,481.1~9,852.7) with very little difference in per protocol analysis and all subjects analysis. Adverse experiences to $VAQTA^{TM}$ were generally mild and transient. Conclusion : The pediatric two-dose regimen of $VAQTA^{TM}$ was found to be highly immunogenic, generally well tolerated and resulted in 100% seroconversion. Regarding Korea is in transition from a high to low risk region resulting in a paradox increase of clinical disease and disease burden, routine vaccination should be considered in order to control hepatitis A effectively.

• Health Policy and Management
• /
• v.9 no.1
• /
• pp.30-71
• /
• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• Journal of agricultural medicine and community health
• /
• v.34 no.1
• /
• pp.34-46
• /
• 2009

Objectives: This study was conducted to estimate health service weight for resource allocation and performance monitoring using Basic Priority Rating System. Methods: The Health service would be classified according to New Health Plan 2010, and Burden of disease collected from preceding studies. The data of severity of health problem and effectiveness of intervention were collected through the survey of experts' suggestion. The health service weight was estimated in the formula which is Basic Priority Rating System. Results: In the result of analysis, the health service weight of Infectious disease was ranked highest at 58.97% followed by Anti-smoking campaign(14.07%), Hypertension(3.87%), Diabetes mellitus(3.40%), Cancer(2.90%), Cardiovascular-Cerebrovascular diseases(2.86%), Physical activity(2.10%), Moderate drinking(2.07%), Medical examination(1.92%), Mental health promotion(1.72%), Serious mental illnesses(1.62%), Nutrition(1.52%), Oral health promotion(1.15%), Oral diseases(1.10%), Addiction(0.73%). Conclusions: We think the result of this study provides a rational basis for resource allocation and performance monitoring of health service.