• Korean Journal of Oriental Medicine
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• v.13 no.2 s.20
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• pp.65-69
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• 2007

Background and Purpose : The purpose of this case-control study was to show the relationship between risk factors(past medical history, BMI, WHR, smoking, drinking), warning signs(dyscinesia, sightless, dysarthria, sensory disorder, numbness, blephalospasm, facial spasm, tension) and the incidence of stroke in korean adults. Methods : 455 stroke patients were enrolled as the case group and 180 non-stroke patients as control group from Oct. 2005 to Feb. 2006. Patients were hospitalized within 2 weeks after the onset of stroke. Obesity were defined as $BMI{\geq}25kg/m2$, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Risk factors and warning signs were obtained from personal interview. The analysis of the data was done by chi-square test. Fisher's exact test and test-sample t-test. Results : The percentage of current smokers(or current drinkers) of case group is higher significantly than that of control group. The past medical history of risk factors were found to be transient ischemic attack(p=0.0698), facial palsy(p=0.4061), hypertension(p<0.0001), hyperlipidemia(p=0.1484), DM(p<0.0001), ischemic heart disease(p=0.0093), migraine(p=0.0014) and hypochondria(p=0.2370). $WHR{\geq}0.9$ in male had a 6.696 (3.711-12.082) odds ratio, $WHR{\geq}0.8$ in female had a 1.567 (0.659-3.726) odds ratio. $BMI{\geq}25kg/m2$ had a 2.017(1.263-3.222). The dyscinesia and sensory disorder of warning signs were found to be statistical difference between case and control group. Conclusions : According to the above results, it was found that smoking, drinking, BMI, WHR, hypertension, DM, ischemic heart disease, migraine affected to the incidence of stroke.

• Journal of Korean Medicine for Obesity Research
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• v.6 no.2
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• pp.17-27
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• 2006

Objectives : Ma-huang (Ephedra sinica) is frequently prescribed for obesity management in oriental medicine. The main component is ephedrine alkaloids which can have serious adverse side effects such as heart attack, stroke, sudden death. There are no scientific guidelines for Ma-huang usage in the safe treatment of obesity in oriental medicine. We reviewed published studies on its safety to make evidence based guidelines. Methods : We searched electronic databases up to May 2006. We limited evidence to controlled trials for efficacy or safety, case reports for safety, and studies for Ma-huang contents analysis. Results and Conclusions : In clinical trials for weight loss, Ma-huang and ephedrine promote modest short-term weight loss but have no serious adverse effects, have only a few adverse effects associated with increased risk of psychiatric, autonomic, gastrointestinal symptoms and heart palpitations. In case reports, there have been serious adverse effects including stroke, heart attack, and death using typical doses of ephedrine or no associated illness. There are factors related to serious adverse effects, such as overuse, lack of standardization, individual sensitivity, and interactions with other drugs. Studies relating to these factors should be analyzed for safe use of Ma-huang and ephedrine. After analyzing related studies, we suggest guidelines for Ma-huang usage. We propose that the dosage should be within 4.5-7.5g per day for up to 6 months for generally healthy individual. It's use is contraindicated in individuals with heart disease, thyroid disease, diabetes mellitus, hypertension, psychiatric disorders, glaucoma, urination disorders, enlarged prostate, persons using MAOIs, methyldopa and sympathomimetic agents.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.440-448
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• 2006

Background: Surgery of descending thoracic or thoracoabdominal aorta has the potential risk of causing neurological injury including spinal cord damage. This study was designed to find out the risk factors leading to spinal cord and brain damage after surgery of descending thoracic and thoracoabdominal aorta. Material and Method: Between October 1995 and July 2005, thirty three patients with descending thoracic or thoracoabdominal aortic disease underwent resection and graft replacement of the involved aortic segments. We reviewed these patients retrospectively. There were 23 descending thoracic aortic diseases and 10 thoracoabdominal aortic diseases. As an etiology, there were 23 aortic dissections and 10 aortic aneurysms. Preoperative and perioperative variables were analyzed univariately and multivariately to identify risk factors of neurological injury. Result: Paraplegia occurred in 2 (6.1%) patients and permanent in one. There were 7 brain damages (21%), among them, 4 were permanent damages. As risk factors of spinal cord damage, Crawford type II III(p=0.011) and intercostal artery anastomosis (p=0.040) were statistically significant. Cardiopulmonary bypass time more than 200 minutes (p=0.023), left atrial vent catheter insertion (p=0.005) were statistically significant as risk factors of brain damage. Left heart partial bypass (LHPB) was statistically significant as a protecting factor of brain (p=0.032). Conclusion: The incidence of brain damage was higher than that of spinal cord damage after surgery of descending thoracic and thoracoabdominal aorta. There was no brain damage in LHPB group. LHPB was advantageous in protecting brain from postoperative brain injury. Adjunctive procedures to protect spinal cord is needed and vigilant attention should be paid in patients with Crawford type II III and patients who have patent intercostal arteries.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.72-75
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• 2004

The Fontan operation is commonly practiced for the physiologic correction of univentricular heart diseases. However, for the patients who have risk factors against this operation, it is recommended to take the initial palliative operation rather than going to the Fontan operation at once. The proper timing to the Fontan operation after palliation is decided by assessing several factors such as patient's age and other risks of maintaining palliative state, etc. Usually, the Fontan operation is done relatively early after palliation stage. Here, we report a 36 years old-adult-female with univentricular heart disease who underwent the successful Fontan operation at 17 years after unidirectional Glenn procedure.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.630-634
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• 2009

According to the 2007 International Society for Heart and Lung Transplantation (ISHLT) report, a congenital diagnosis, infantile transplantation and being on extracorporeal membrane oxygenation (ECMO) at the time of transplant are risk factors for mortality for the patients who undergo a heart transplant, and a large body weight ratio also increases the risk of mortality. The patient of this case underwent a Ross operation and mitral valve repair due to left ventricle outflow track obstruction and mitral regurgitation. But the baby was treated with ECMO due to heart failure after the operation. When he was 3-months-old and had been. on 30 days of ECMO, he underwent a heart transplant with a heart that had a high donor-recipient weight ratio (4.42). We present this case from a technical standpoint and we include a review of the relevant literature.

• Journal of Nutrition and Health
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• v.30 no.3
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• pp.307-317
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• 1997

To determine the effects of endogenous and exogenous strogen on serum lipid levels, twenty nonsmoking healthy Korean women were participated in this experiment for 12 weeks. They were assigned to three groups : (1) eight women aged 22 to 30(yr) for the premenopausal(Pre) group, (2) eight, aged 49 to 60(yr) for the postmenoparusal(Pst) group, (3) four, aged 23 to 30(yr) for the oral contraceptive(OC) group which used triphasic OC formulation. Fasting blood samples representing every phase of the hormonal levels were obtained from the subjects of the Pre and the OC group. From the subjects of the Pst group, fasting blood samples were obtained once per three weeks for 12 weeks. All the serum data were adjusted for dietary effects, exercise, personality type and body mass index(BMI) by using analysis of covariation(ANCOVA). Serum lipid levels of the three groups were significantly different. While serum levels of triglycerides(TG)(p<0.0001), low density lipoprotein-chloesterol(LDL-C)/high density liporotein-cholesterol(HDL-C) ratio (LDC-C/HDL-C)(P<0.01) and total cholesterol (TC)/HDL-C ratio (TC/HDL-C)(P<0.001) were significatnly high in the Pst group, serum HDL-C(P0.001) level was significantly high in the Pre group. The OC group showed significantly low serum TC(P<0.0001) and LDL-C(P<0.0001) levels. There was no signidicant difference in the fluictuation of serum lipid levels during the menstrual cycle of the Pre group. However, in the OC group, serum TG level was significantly increased at phase 2(P<0.05) where exogenous estrogen administration was highest. Even though other serum lipid levels of the OC group were not significantly fluctuated according to the exogenous estrogen administration, there was a trend of increased levels of serum TC, LDL-C, LDL-C/HDL-C and TC/HDL-C and decreased level of HDL-C during the menstruation period. Also, serum TC level was high(P<0.005) and serum TG level was low (P<0.005) at the baseline of the OC group compared with the periods of OC administration. When screening and counseling the female population at risk for coronary heart disease(CHD), the result of this study suggest that in may be desirable to divide the population into several groups according to their personal physiological characteristics, such as age, OC administration, menstrual cycle and menopause, as well as general risk factors for CHD.

• The Journal of Internal Korean Medicine
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• v.22 no.3
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• pp.423-430
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• 2001

Objects: The purpose of this case-control study was done to examine the relationship between stroke prevalence and the anthropometric indices(body mass index(BMI), modified Broca's method(Broca's index), waist circumference(WC), waist-hip ratio(WHR)), dyslipidemia, past medical history(heart disease, hypertension, diabetes mellitus(DM)), life-style factors(smoking, drinking) in Korean adults. Methods : The study group consisted of neurologically confirmed 116 stroke patients as the case group and 116 non-stroke patients as control group. Obesity were defined as $BMI{\geq}25kg/m^2,\;Broca's\;index{\geq}30%$, WC >94cm in male and WC >80cm in female, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Oyslipidemia were defined as total $cholesterol{\geq}200mg/dl,\;triglyceride{\geq}200mg/dl,\;HDL-cholesterol {\leq}35mg/dl,\;LDL-cholesterol{\geq}160mg/dl$. Information on life-style factors and past medical history was obtained from personal interview. The analysis of the data was done by means of chi-square test(Pearson's chi-square test, Fisher's exact test) and student t-test. Results: The results were as follow. In the study group: Hypertension had a 4:05 odds ratio, Broca's $index{\geq}30%$ had a 1.98 odds ratio, WC >94cm in male had a 2.17 odds ratio, WC >80cm in female had a 2.80 odds ratio, $WHR{\geq}0.9$ in male had a 4.66 odds ratio, $WHR{\geq}0.8$ in female had a 5.35 odds ratio, but heart disease, DM, life-style factors, serum lipid and 8MI had no direct relationship with odds ratio(nonsignificant). By student t-test, risk factors for stroke were found to be total cholesterol(p=0,025), LDL-cholesterol(p=0.013), WC(p=0.000) and WHR(p=0.000). Conclusions: This study suggests that people should be advised to control hyperlitension, hyperlipidemia and obesity since these carry a risk of stroke.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.136-145
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• 2010

Objectives: Electroacupuncture according to Voll (EAV) has been used to quantify the skin's electrical resistance and conductance over acupuncture points that, based on traditional Chinese medicine, represent the state of health or disease of the organ or tissue. However, it doesn't have enough objective data yet, so the purpose of this study was to aid in the use of EAV in analysis of cerebrovascular disease risk factors. Methods: This study researched the clinical statistics of 216 cases: cerebrovascular attack (CVA) group 43, control group 173. We measured control meridian points (CMP) on hands and feet and the cardio ankle vascular index (CAVI) which represents atherosclerosis severity, and sex, age, hypertension, diabetes, dyslipidemia, and obesity. The data were then analyzed by t-test, chi-square test and logistic regression. Results: Between the CVA and control groups, there were not statistically significant differences in CMP. However, logistic regression analysis of the presence of CVA, mean of CMP heart and lung, sex, age, DBP (diastolic blood pressure), and HDL (high density lipoprotein) cholesterol showed that the risk of CVA was 1.1 times increased with CMP heart (p=0.002), in men was 4.12 times higher than in women (p=0.001), 1.09 times higher with age (p=0.000), 1.04 times higher with DBP (p=0.045), while was lower by 0.924 times with CMP lung (p=0.005) and 0.957 times with HDL cholesterol (p=0.006). Conclusion: Although there were not clear evidence or mechanisms about EAV, this study showed that if we study EAV further, we may be able to apply EAV as an objective instrument of oriental medicine in cerebrovascular disease.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.1
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• pp.22-29
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• 2016

Serum gamma-glutamyltransferase (GGT) has been widely used as a marker of alcohol intake and liver failure. Recently, the relativity between GGT and various diseases has been identified with growing interest. In this study, we examined relativity between GGT value and risk factors of coronary heart diseases among those with normal GGT value, excluding heavy drinkers. Specifically, we compared the differences based on age and gender. Data from the 2011 KNHNES were used (N=3,619). When the subjects were categorized according to quartile based on the serum GGT levels, there was 10~20, 21~27, 28~38, 39~71 IU/L in men, and 6~12, 13~16, 17~22, 23~42 IU/L in women. The mean of most variables was the highest in the $4^{th}$ quartile (Q4), however age and LDL Cholesterol were the highest in the $2^{nd}$ quartile (Q2) in men. The FRS and 10-year CHD risk was the highest in the $2^{nd}$ quartile in men, and the highest in the $4^{th}$ quartile in women. Increased GGT was correspondingly linked with age in women but age was the highest in GGT in the $2^{nd}$ quartile in men. In the 70's, the highest Q1 and Q2 was in men and the highest Q3 and Q4 in women. Although GGT value was within the normal range, increased GGT showed correlation with various risk factors. The FRS and 10-year CHD risk showed different patterns according to age and gender along with increased GGT value.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.607-622
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• 2004

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.