• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.816-829
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• 2007

Objectives : This study investigated warning signs and stroke presymptoms and their relationship with acute stroke patients in each stroke type. Methods : 217 patients with first-ever acute stroke within 2 weeks as the case group, 146 people without four major risk factors (hypertension, diabetes mellitus, hyperlipidemia and ischemic heart disease) as the healthy control group (Normals), and 160 people as the general control group (Controls) were recruited at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital from July 2005 to March 2007 for this case-control study. We analyzed the odds ratio of each warning sign or presymptom by multivariate logistic analysis and evaluated each stroke type, as well as general characteristics such as age, sex, etc. Results : Paralysis or weakness of the face and limbs, visual field disorder or loss of vision or blurred and double vision in eyes or both eyes, and sudden difficulty in speaking or dysarthria showed significant increase respectively in each stroke type. In contrast, numbness or tingling sensation or lowering sensation of the face and limbs, numbness or dead sensation of 1st and 2nd fingers, tension at cervical lesion, blepharospasm, facial spasm, etc. had no significant relation with stroke occurrence. Conclusions : In this study we demonstrated that each presymptom have an influence on each stroke type and have different odds ratio for stroke. We believe this may contribute to interpreting the importance of warning signs or presymptoms for each type of stroke, and more prospective studies are needed.

• Journal of the Korean Society of School Health
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• v.19 no.1
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• pp.1-15
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• 2006

Purpose : This study was to identify the incidence, trend, and situation of the unexpected sudden death of elementary, middle, and high school students in school for 17 years from 1988 to 2004 in seoul. Methods : We used the data of The Seoul Safety Mutual aid Association in seoul. Subjects were 53 unexpected sudden death in school from elementary, middle, and high school students, and we explored the gender, month, a day of the week, year, contents of situation, and medical certificate of death. Statistic analysis were chi-square test, Cochran-Armitage trend test, and the tool was SAS 9.1.Results : There were 53 unexpected sudden death students(male 42 and female 11). The incidence of male students was higher than that of female during 16 years except in 1995. The incidence occurred in middle school students were 31 (58.5%) of 53 and were also most frequent in middle school students in both of male and female students. In 1990, the incidence was 8(15.1%) students, 6(11.3%) in 1992 , and 5(9,4%) in 2000 respectively. The frequency of unsuspected sudden death in March was 11(20.8%) of 53 students, 11 (20.8%) in September, 7(13.2%) in October. In Thursday, it was 12(22.6%) of 53 students. Only 14(26.4%) students of 53 died during general life, but 39(73.6%) were related to excercise. The diagnosis of 14 students died during general life were cardiac arrest 7(50.5%), brain disorder 3(21.4%) which were based on medical certificate. But the diagnosis of 39 students died during or after excercise were brain disorder including cerebral hemorrhage 9(23.1%), heart disease 9(23.1%), cardiac arrest 8(20.5%), and unknown 6(15.4%), respectively. Conclusion : The incidence of unexpected sudden death were more frequent in male students, in middle school, and in excercise-related situation and the trend was similar for 17 years. Therefore, to prevent the unexpected sudden death, it needs to further study substantially the risk factors of unexpected sudden death including past history, life-style, nutrition and development, family history, and learning environment.

• Journal of Preventive Medicine and Public Health
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• v.19 no.2 s.20
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• pp.203-212
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• 1986

Hypertension is one of the most well known risk factors for cerebrovascular or coronary heart disease and is a major public health problem. Early detection and treatment of hypertension are essential, but the compliance of treatment on hypertension is not easy to achive. Hypertensive workers are being detected by the annual screening under the Labour Standard Law in Korea but the solidified control system for them is not existing. This study about workers 'Motive-Belief-Action in non-drug and drug treatment of their hypertension would be worthwhile to interpret how the workers actually behave in coping with hypertension, and also would be advisable to construct the follow-up program in Korea. In the field research process two criteria were used to select sample group. The first criterion included the workers who were screened to be hypertensive with their blood pressure above 160/95 in this survey. The second one was used to classify study-group respondents who had known their hypertension by successive annual screening. From such criteria a total of 156 male workers were sampled in 21 industries, the author interviewed them using the structured questionnaire which consisted of Belief-Motive-Action items about non-drug and drug treatment for hypertension with open-ended question on symptom of hypertension. The summary is as follows: 1) Sixty-one percent of respondents had ever checked their blood pressure somewhere besides the annual screening. 2) Most respondents(97.2%) complained no symptoms of hypertension at all. 3) Belief level of non-drug treatment was relatively high (82.1%-64.7%), but motive(55.1%-28.2%) and action(38.5%-16.7%) levels were low. 4) Belief level of drug treatment was relatively lower than that of non-drug treatment, blue collar workers showed higher artier level of drug treatment than white collar workers, and correlation coefficient between belief and motive on drug treatment was lower in group of not-recognizing their family history of hypertension than recognized group. Such findings indicated that belief on drug treatment of hypertensive workers would be problematic. 5) White collar workers showed significant lower correlation coefficients between Motive and Action of salt restriction, restriction of fatty diet and relaxation than blue collar workers. 6) Mild hypertension group showed low levels of Motive and Action of non-drug treatment(salt restriction, restriction of fatty diet and relaxation) and also showed low correlation coefficient between Belief and Motive of above non-drug treatment.

• Clinical and Experimental Pediatrics
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• v.64 no.9
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• pp.480-488
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• 2021

Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study established the National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008) based on data from a nationwide population-based health screening program and data on healthcare utilization for children. Methods: The NICKs-2008 study consisted of the Korean National Health Insurance System (NHIS) and the National Health Screening Program for Infants and Children (NHSPIC) databases comprising children born in 2008 (n=469,248) and 2009 (n=448,459) in the Republic of Korea. The NHIS database contains data on age, sex, residential area, income, healthcare utilization (International Classification of Diseases10 codes, procedure codes, and drug classification codes), and healthcare providers. The NHSPIC consists of 7 screening rounds. These screening sessions comprised physical examination, developmental screening (rounds 2-7), a general health questionnaire, and age-specific anticipatory guidance. Results: During the 10-year follow-up, 2,718 children (0.3%) died, including more boys than girls (hazard ratio, 1.145; P<0.001). A total of 848,048 children participated in at least 1 of the 7 rounds of the NHSPIC, while 96,046 participated in all 7 screening programs. A total of 823 infants (0.1%) weighed less than 1,000 g, 3,177 (0.4%) weighed 1,000-1,499 g, 37,166 (4.4%) weighed 1,500-2,499 g, 773,081 (91.4%) weighed 2,500-4,000 g, and 32,016 (5.1%) weighed over 4,000 g. There were 23,404 premature babies (5.5%) in 2008 compared to 23,368 (5.6%) in 2009. The developmental screening test indicated appropriate development in 95%-98% of children, follow-up requirements for 1%-4% of children, and recommendations for further evaluation for 1% of children. Conclusion: The NICKs-2008, which integrates data from the NHIS and NHSPIC databases, can be used to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors.

• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.538-544
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• 2005

Background: Pulmonary artery banding (PAB) is an initial palliative procedure for a diverse group of patients with congenital cardiac anomalies and unrestricted pulmonary blood flow. We proved the usefulness of PAB through retrospective investigation of the surgical indication and risk analysis retrospectively. Material and Method: One hundred and fifty four consecutive patients (99 males and 55 females) who underwent PAB between January 1986 and December 2003 were included. We analysed the risk factors for early mortality and actuarial survival rate. Mean age was $2.5\pm12.8\;(0.2\sim92.7)$ months and mean weight was $4.5\pm2.7\;(0.9\sim18.0)\;kg$. Preoperative diagnosis included functional single ventricle $(88,\;57.1\%)$, double outlet right ventricle $(22,\;14.2\%)$, transposition of the great arteries $(26,\;16.8\%)$, and atrioventricular septal defect $(11,\;7.1\%)$. Coarctation of the aorta or interrupted aortic arch $(32,\;20.7\%)$, subaortic stenosis $(13,\;8.4\%)$ and total anomalous pulmonary venous connection $(13,\;8.4\%)$ were associated. Result: The overall early mortality was $22.1\%\;(34\;of\;154)$, The recent series from 1996 include patients with lower age $(3.8\pm15.9\;vs.\;1.5\pm12.7,\;p=0.04)$ and lower body weight $(4.8\pm3.1\;vs.\;4.0\pm2.7,\;p=0.02)$. The early mortality was lower in the recent group $(17.5\%;\;16/75)$ than the earlier group $(28.5\%;\;18/45)$. Aortic arch anomaly (p=0.004), subaortic stenosis (p=0.004), operation for subaortic stenosis (p=0.007), and cardiopulmonary bypass (p=0.007) were proven to be risk factors for early death in univariate analysis, while time of surgery (<1996) (p=0.026) was the only significant risk factor in multivariate analysis. The mean time interval from PAB to the second-stage operation was $12.8\pm10.9$ months. Among 96 patients who survived PAB, 40 patients completed Fontan operation, 21 patients underwent bidirectional cavopulmonary shunt, and 35 patients underwent biventricular repair including 25 arterial switch operations. Median follow-up was $40.1\pm48.9$ months. Overall survival rates at 1 year, 5 years and 10 years were $81.2\%\;65.0\%,\;and\;63.5\%$ respectively. Conclusion: Although it improved in recent series, early mortality was still high despite the advances in perioperative management. As for conventional indications, early primary repair may be more beneficial. However, PA banding still has a role in the initial palliative step in selective groups.

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.1
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• pp.42-56
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• 2005

Hyperlipidemia is one of the risk factors for coronary artery disease. Despite of epidemiological evidence that tea consumption is associated with the reduced risk of coronary heart disease, experimental studies designed to show that drinking tea affects blood lipid concentration or oxidative stress have been unsuccessful. The purpose of this study was to investigate whether functional tea (three servings/day) supplement with medical nutrition therapy (MNT) lead to a beneficial outcomes in mildly hyperlipidemic adults. From February to October, 2003, the 43 hyperlipidemic (23 men, 20 women) subjects (total cholesterol$\geq$200 mg/dL or triglyceride$\geq$150 mg/dL) admitted to K Medical Center were studied. Subjects were randomly divided into 3 groups; placebo tea (PT), half dose of functional tea (HFT), full dose of functional tea (FFT). During 12 weeks of study period, the subjects were given placebo or functional tea daily with MNT. Anthropometric measurements, blood chemical analysis including lipid levels, total superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, and dietary assessment were carried out at the beginning and end of experiment. The effects of functional tea were compared with the placebo in randomized clinical trial study. The placebo was prepared to match with the functional tea in color and taste. After the 12 weeks of MNT, the subjects had regular and balanced meal pattern. Consumption of foods high in cholesterol and saturated fat, salty foods, fried foods, and instant foods decreased significantly in all three groups (p<0.05). Intake of energy and cholesterol also decreased (p<0.05). Drinking three servings per day (390 mL/day) of functional tea significantly reduced the levels of blood triglyceride (HFT, 42.5%; FFT, 29.4%), total cholesterol (HFT, 8.5%; FFT, 13.7%), and atherogenic index (HFT, 14.6%; FFT, 21.7%). Whereas no changes were found in the LDL-, HDL-cholesterollevels, and LDL/HDL ratio. Plasma homocysteine (Hcy) concentration decreased significantly (p<0.05) in functional tea groups (HFT, 14.9%; FFT, 14.1%). SOD increased significantly (p<0.05) in HFT (8.3%). GSH-Px increased significantly (p<0.05) in FFT (12.8%). In conclusion, the MNT improved the dietary habits, in addition, functional tea supplement decreased blood lipid levels and Hcy, and increased SOD and GSH-Px levels. These results indicate that functional tea consumption may decrease the risk of cardiovascular disease via improving blood lipid levels and antioxidant status.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.7
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• pp.858-868
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• 2008

This study was carried out to investigate the effects of Gastrodiae Rhizoma powder on plasma lipid profiles in elderly volunteers with hyperlipidemia, hypertension, diabetes or heart disease. 32 elderly people, 11 males and 21 females aged $60{\sim}77$ years, were given Gastrodiae Rhizoma powder 15 g twice daily for 6 months. We investigated the antheropometric data, general characteristics and dietary habit by using questionnaires. Fasting blood samples were collected from the subjects before and after this 6 months intervention study. Blood pressure, glucose, hemoglobin and lipid levels of plasma, atherogenic index (AI) and cardiac risk factors (CRF, LHR, HTR) were determined before and after consumption of Gastrodiae Rhizoma powder. The mean body mass index (BMI) of the male and female subjects were 22.4 and 23.6, respectively. The percent of ideal body weight (PIBW) of males and females were 105.6% and 122.3%, respectively. The subjects had decreased intake frequency of fish and meat in their dietary habit. After consumption of Gastrodiae Rhizoma powder, there were no significant differences in blood pressure; however, the blood glucose significantly decreased with Gastrodiae Rhizoma intake in the males. In the subjects, the levels of plasma total cholesterol, triglyceride, and LDL-cholesterol were decreased by the consumption of Gastrodiae Rhizoma powder; while the levels of plasma LDL-cholesterol was significantly decreased in female. Blood pressure and biochemical assessment (blood glucose, hemoglobin, triglyceride, total cholesterol, LDL and HDL-cholesterol) of the subjects were within the normal range. It was found that AI, CRF and LHR were significantly decreased by Gastrodiae Rhizoma intake. The present results indicate that dietary supplementation of Gastrodiae Rhizoma improved lipid metabolism and cardiac risk factor in cardiovascular disease.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.299-304
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• 2009

Background: Although the results of the surgical management for complete atrioventricular septal defect (c-AVSD) have improved, the optimal surgical strategy is still controversial. The aims of this study are to evaluate the outcome of c-AVSD repair and to define the risk factors related to reoperation. Material and Method: We retrospectively reviewed the medical records of 35 patients (8 males and 27 females) who underwent the total correction of c-AVSD from August 1996 to March 2008. The median age at repair was 5.2 months (range: 3 days$\sim$82 months). Sixteen patients (45.7%) were associated with Down syndrome. Prior palliative operations were performed in 4 patients. The one-patch techniques were performed in 3 patients, and the two-patch techniques were done in 32 patients. Result: There was 1 early death (2.9%). The median follow-up period was 68 months (range: $2\sim134$ months) for 34 survivors. There was no late death. Reoperations were performed in 5 patients (14.3%) for severe left atrioventricular valvular regurgitation (AVVR). Nine patients (25.7%) showed left an AVVR of more than grade III. Associated major cardiac anomalies and the use of Gore-Tex patch for ventricular septal closure were the risk factors for postoperative left atrioventricular valve failure and reoperation. Conclusion: In this study, we found that surgical repair of c-AVSD was safe and effective. However, the high reoperation rate after repair remains a problem to be solved.

• Pediatric Infection and Vaccine
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• v.30 no.1
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• pp.20-32
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• 2023

Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.754-759
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• 1998

Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.