• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.155-162
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• 2006

Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is glowing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 diabetic patients (64 male, mean age $64.1{\pm}9.0$ years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was $36{\pm}18$ months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.15-21
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• 2003

Background : There are many risk factors for osteoporosis in patients with chronic obstructive pulmonary disease(COPD). These include smoking, a low body mass index, insufficient exercise, and the use of glucocortcoids. However, there is lack of data on the incidence of osteoporosis according to the different glucocorticoid administration methods in patients with COPD. This study compared the incidence of osteoporosis according to the different administration methods of glucocorticoid. Methods : A matched case-controlled study (gender, age, cumulative steroid dose and pack-years of smoking) was conducted. Forty-five patients with documented COPD for at least a 3 year duration and a cumulative glucocorticoid dose above 1,000 mg were enrolled in study. The patients were classified into the following three groups. First, fifteen patients received continuous inhaled glucocorticoid with intermittent oral steroids but had no admission history due to an acute exacerbation(Group I). Secondly, fifteen patients received a multiple course of oral steroids with additional inhaled glucocorticoid but had no admission history due to their acute exacerbation(Group II). Lastly, fifteen patients received intermittent oral or inhaled glucocorticoids and had an admission history due to the acute exacerbation with intravenous steroid treatment for at least 2 weeks per year(Group III). The enrolled patients had apulmonary function test and bone densitometry performed at the lumbar spine and femoral neck. Results : The patients from Group III had significantly high incidence of osteoporosis in the lumbar and femoral neck compared to Group I and Group II (p<0.01). Conclusion : The incidence of osteoporosis in patients with COPD appears to be strongly affected by the method of steroid administration. This result suggests that intravenous steroid administration is strongly associated with the risk of osteoporosis.

• Therapeutic Science for Rehabilitation
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• v.8 no.3
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• pp.7-29
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• 2019

Objective: The purpose of this study is to analyze comprehensive lifestyle assessment and other assessments which evaluate essential lifestyle factors, including physical activity, nutrition and activity participation. Methods: To analyze the comprehensive lifestyle assessment, from January 2001 to June 2019, a literature search was conducted using the CINANL, NDSL, PubMed, and RISS databases. The search terms were 'lifestyle assessment' OR 'lifestyle profile' OR 'lifestyle test'. In terms of other assessments of essential factors of lifestyle, from January 2010 to June 2019, articles were searched using similar databases. The search terms were 'physical activity assessment' OR 'physical activity participation profile', 'nutrition assessment', 'activity participation assessment' OR 'activity participation and lifestyle'. Results: A total of 4,165 articles were obtained, and finally 31 articles were selected according to the inclusion criteria. Among 31 articles, there were five with comprehensive lifestyle assessments, and all of them were self-report questionnaires. The most popular assessments were the Health Enhancement Lifestyle Profile (HELP) and the Health-Promoting Lifestyle Profile (HPLP), which were used in three articles (33%). In terms of assessment of physical activity, the most frequently used evaluation method was the self-report questionnaire, which was used in seven articles (58%) followed by objective assessments, which were used in four articles (33%). It was demonstrated that the Mini-Nutritional Assessment (MNA) was the most frequently used for nutrition assessment in the elderly. There were five types of assessment tool used for activity participation. Among them, meaningful activity participation assessment (MAPA) was the most frequently used tool. Conclusion: As a result of the systematic review, it was found that there are 21 assessments related to the evaluation of lifestyle in the elderly. Most assessments employed the self-report questionnaire method and mainly evaluated frequency and duration of participation in drinking, smoking, exercise, nutrition and social activities. Assessments of essential lifestyle factors were the self-report questionnaire method and the participation and frequency of activity. Therefore, by analyzing assessment tools, types of items and measurement methods of comprehensive lifestyle assessments and other assessment of essential lifestyle factors, this study provides the basic data on which to develop a standardized assessment tool that can evaluate the multifaceted lifestyle profile of the elderly.

• Journal of Preventive Medicine and Public Health
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• v.35 no.3
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• pp.205-213
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• 2002

Objective : Whether exposure to chronic noise induces an increase in blood pressure, or the development of hypertension, has not been established. A cohort study was performed to identify the effects of chronic noise exposure on blood pressure. Methods : 530 males working at a metal manufacturing factory in Busan, Korea were enrolled for the study. They were monitored for 9 consecutive years, from 1991 to 1999, with an annual health check-up. The subjects were divided into 4 groups, which were determines by noise level categories(NLC) according to noise intensity ; NLC-I: office workers, exposed to noise a level below 60dB(A) ; NLC-II: field technical supporters or supervisors, frequently exposed to workplace noise, wearing no hearing protection device; NLC-III: workers, exposed to workplace noise below 85dB(A), wearing ear plugs or muffs; NLC-IV: workers, exposed to workplace noise over 85 dB(A), wearing both ear plugs and muffs. Results : After controlling possible confoundens, such as baseline age, smoking, alcohol intake, exercise, family history of hypertension, systolic(SBP) of diastolic blood pressure(DBP) and changes in BMI (body mass index), the pooled mean for the systolic blood pressures, over the duration of the study period, were 3.8mmHg, 2.0mmHg and 1.7mmHg higher in NLC-IV, NLC-III NLC-II groups, respectively, than in the NLC-I group. There were no significant differences in the diastolic blood pressures between the groups. Conclusion : This study suggests that chronic noise exposure increases systolic blood pressure independently, among male workers.

• Journal of agricultural medicine and community health
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• v.34 no.3
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• pp.334-345
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• 2009

Objectives: This study was performed to investigate the management status of chronic disease at community health centers. Methods: The study subjects were 450 employed persons at community health centers in Jeonlanamdo. General characteristics, status of chronic disease management and health education were collected for statistical analysis. The differences on management status among working areas were assessed with chi-square test and ANOVA. Results: The mean values of work duration were 18.7 years in rural, 14.4 years in fishing village, and 17.4 years in urban-rural, respectively. The number of management registration was highest in hypertension. The ways of disease management were medication check-up, diet stopping smoking. The contents of group health education were exercise, diet and prohibition of smoking. The place of health education was town assembling hall. The fields which officials wanted to be educated were symptom, diagnosis, treatment and complication. The most important field was early detection of chronic disease patients and health education. Finally, the field requiring support was work standardization. Conclusions: Community health workers have worked positively in chronic disease management. The barriers to work were the lack of professional and preliminary data. The support system with other health organ and health education were needed for the improvement of working ability.

• Korean Journal of Clinical Pharmacy
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• v.16 no.2
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• pp.86-91
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• 2006

There are 3 different hypotheses on how statins may affect bones, through promoting bone formation, inhibiting bone resorption or through anti-inflammatory effect. In the 3 cross-sectional studies above, one showed increase BMD at hip and spine, one showed increase BMD only at mid-forearm and one showed that the risk reduction in fractures is not explained by the changes in BMD however, all 3 studies showed a decrease in risk of fracture associated with statins. In the 2 prospective cohort studies, one showed the use of statins was not associated with BMD at any skeletal site or decreasing the risk of fracture, and the other showed statins except pravastatin decreased in risk of vertebrate fracture but not affecting lumbar spine BMD. All of case-control studies indicated reduction in fracture risk but did not provide any data regarding BMD. 2 of the randomized, controlled studies showed no significant reduction in fracture risk as well as statins' effects on BMD. Finally, one longitudinal study showed statin use reduced fracture risk and increased BMD. Among the conflicting results shown above, even when statin use was shown to increase BMD, it does not seem to account for the reduction in fracture risk. There may be different ways that statins affect bone other than those hypotheses proposed above. Many studies seem to agree that pravastatin does not have any effect on bone. Some studies suggested that the reason statins did not achieve clinically significant increases in BMD in some studies, is due to the low affinity of statins on bone; statins are designed to act in the liver therefore their effective concentration in extrahepatic tissue is low. The limitations to those studies discussed above. Many studies did not account for the change of lifestyle while subjects' were on statins. Increases in weight bearing exercise and changes in diet might affect BMD and thus reduce risk of fractures. Mental alertness and vision acuity might prevent falls from occurring; many statin-users in the studies were young so the risk of fractures from falls would be decreased. Almost all of the studies failed exclude patients with neurological problems. During study periods, many subjects may have been started on drugs for diseases that usually occur with aging which could cause drowsiness and lead to falls. The sample sizes used in some of the trials were small and the duration of treatment and follow up might not have been long enough to see clinically relevant results.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.489-495
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• 2005

In the surgical treatment of aortic dissection, aortic arch replacement under total circulatory arrest is often performed after careful inspection to determine the severity of disease progression. Under circulatory arrest, antegrade or retrograde cerebral perfusion is required for brain protection. Recently, antegrade cerebral perfusion has been used more, because of the limitation of retrograde cerebral perfusion. This study is to compare these two methods especially in the respect to neurological complications. Material and Method: Forty patients with aortic dissection involving aortic arch from May 2000 to May 2004 were enrolled in this study, and the methods of operation, clinical recovery, and neurological complications were retrospectively reviewed. Result: In the ACP (antegrade cerebral perfusion) group, axillary artery cannulation was performed in 10 out of 15 cases. In the RCP (retrograde cerebral perfusion) group, femoral artery Cannulation was performed in 24 out of 25 cases. The average esophageal and rectal temperature under total circulatory arrest was $17.2^{\circ}C\;and\;22.8^{\circ}C$ in the group A, and $16.0^{\circ}C\;and\;19.7^{\circ}C$ in the group B, respectively. Higher temperature in the ACP group may have brought the shorter operation and cardiopulmonary bypass time. However, the length of period for postoperative clinical recovery and admission duration did not show any statistically significant differences. Eleven out of the total 15 cases in the ACP group and thirteen out of the total 25 cases in the RCP group showed neurological complication but did not show statistically significant difference. In each group, there were 5 cases with permanent neurological complications. All 5 cases in the ACP group showed some improvements that enabled routine exercise. However all 5 cases in RCP group did not show significant improvements. Conclusion: The Antegrade, cerebral perfusion, which maintains orthordromic circulation, brings moderate degree of hypothermia and, therefore, shortens the operation time and cardiopulmonary bypass time. We concluded that Antegrade cerebral perfusion is safe and can be used widely under total circulatory arrest.

• Journal of the East Asian Society of Dietary Life
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• v.19 no.6
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• pp.891-908
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• 2009

This study was performed to investigate the dietary habits, body weight satisfaction and eating disorder tendencies of female university students in Kyungnam province. Anthropometric measurements, dietary habits, body weight satisfaction, food preferences, disordered eating, and nutrient intakes were assessed in 132 female students at Kaya University. The results were analyzed with $x^2$- and ANOVA tests using the SPSS package program. The average age of the subjects was 20.1 years and average body mass index (BMI) were $21.1\;kg/m^2$. According to BMI, the percentages of students who were underweight, normal weight and overweight by BMI were 21.2, 55.3, and 23.5, respectively. Duration of exercise was significantly different by BMI. Index scores for a mini dietary assessment were significantly higher in the normal and overweight groups than in the underweight group. Scores for sweet, salty, and meat preferences were highest and scores for bean and vegetable preferences were lowest, in the underweight group. Satisfaction for present body weight was lowest, and self-perception of body image and weight control experiences were highest in the overweight group. All subjects in the overweight group wanted to be slim, and those in the normal and underweight groups, preferred to be more slim despite their current body weight being in the normal or below normal range. The percentage of the subjects who were at risk for eating disorders (based on scores from the Eating Attitude Test-26, EAT-$26{\geqq}20$) was 11.3%. Scores for EAT-26 were higher in the overweight group than in the underweight and normal weight groups. Nutrient intakes were not different among the groups. Therefore, dietary habits, taste and food preferences, satisfaction for present body weight, and disordered eating were significantly different according to BMI. These results suggest that overweight female university students need help correcting disordered eating, and nutrition counseling should be established to aid desirable weight control methods. Those who are underweight and normal weight need help establishing proper perceptions of their normal body weight and body image as well as nutrition counseling for health.