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Relevance of Serum Vitamin D and Indices Related To Cardiovascular Disease Among Korean Adults (한국 성인의 혈청 비타민 D 수준과 심혈관 질환 관련 지표와의 관련성)

  • Kim, Han-Soo;Ryu, So-Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.365-374
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    • 2018
  • This study investigated the relationship between Vitamin D levels and indices related to cardiovascular disease in Korean adults aged ${\geq}19years$. The data for analysis were obtained from the sixth Korea National Health Nutrition Examination Survey in 2013 and 2014. The results showed that the incidence of Vitamin D deficiency was 73.1% among Korean adults and that indices related to cardiovascular disease showed an increasing trend (55.6% of Korean adults). The relationship between Vitamin D levels and indices related to cardiovascular disease with controlled physical activity status was also studied. The odds ratios (ORs) for age were 1.72 for the 4-62 years age group (95% CI, 1.53-1.93) and 2.05 for the ${\geq}65years$ age group (95% CI, 1.71-2.45). For blood pressure, the OR for pre-hypertension was 1.30 (95% CI, 1.15-1.47) and that for hypertension was 1.31 (95% CI, 1.11-1.54). For body mass index (BMI), the OR was 1.36 (95% CI, 1.11-1.66) and that for waist circumference (WC) was 1.36 (95% CI, 1.11-1.66). For fasting blood sugar (FBS), the OR for impaired fasting glucose (IFG) was 1.37 (95% CI, 1.21-1.55) and that for diabetes mellitus (DM) was 1.31 (95% CI, 1.05-1.65). The OR for total cholesterol (TC) was 1.30 (95% CI, 1.11-1.52) and that for triglycerides (TG) was 1.20 (95% CI, 1.04-1.37) in Korean adults. There was a significant relationship between Vitamin D and indices related to cardiovascular disease in Korean adults with respect to age, blood pressure, FBS, BMI, TC and TG. Confirmation of a causal relationship between Vitamin D and indices related to cardiovascular disease may require further research consisting of more systematic cohort studies.

Survey on Sodium Contents in Meals of School Foodservice and Sodium Intakes of Students in Busan and Gyeongsangbuk-do (부산.경북지역 초.중학교 급식메뉴의 나트륨 함량 및 학생들의 나트륨 섭취 실태 조사)

  • Lee, Hwee-Jae;Lee, Chang-Hee;Lee, Kwang-Su;Jung, Young-Ji;Ha, Sook-Hee;Jung, Yoo-Young;Kim, Dong-Sul
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.1
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    • pp.85-91
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    • 2010
  • Sodium is a major component that maintains homeostasis and physiological state in body. It is an essential mineral that the body cannot produce for itself, so it must be supplied from food. On the other hand, overindulgence is one cause of hypertension, stroke, stomach cancer, osteoporosis and kidney disease. The purpose of this study was to monitor sodium content in meals of school foodservice. In this study, 801 samples (main/side dishes) were collected from 8 school foodservice in Busan and Gyeongsangbuk-do, Korea. Samples were classified into 21 food items, which were cooked rices, cooked rice with seasoning, noodles, cooked gruels, soups, stews, tang and chon-gol, stir-fried foods, fried foods, pan-fried foods, hard-boiled foods, roasted foods, steamed foods, seasoned vegetables, preserved foods, kimchis, sauces, fruits, breads and snacks, beverages, and dairy products. The samples were analyzed by AAS (atomic absorption spectrometry) after microwave digestion. The sodium content of sauces (1459 mg/100 g) and preserved foods (1165 mg/100 g) was higher than those of other dishes. Aside from them, sodium contents of roasted foods (894 mg/100 g), hard-boiled foods (786 mg/100 g) and kimchis (737 mg/100 g) were relatively higher than the others. Sodium intakes from meals of school foodservice were calculated by multiplying food intakes by sodium contents. The average sodium intakes from one serving of school foodservice were 605 mg for younger boys, 572 mg for younger girls, 774 mg for older boys, 730 mg for older girls in elementary school. Boys in middle school took in 1423 mg Na whereas girls consumed 1063 mg Na in middle school. Results from this study can be useful for establishing database of sodium contents and intake in meals of school foodservice. The database will be helpful for providing information on managing food for children.

A Need Assessment on Establishment of Oriental Health Promotion Center (한방건강증진센터 설립에 대한 인식 및 요구조사)

  • Lee, Hyang-Yeon;Kim, Kwuy-Bun;Cho, Kyoul-Ja;Shin, Hye-Sook;Kim, Kwang-Joo;Moon, Heui-Ja;Park, Shin-Ae;Kim, Yoon-Hee;Kang, Hyun-Sook
    • Journal of East-West Nursing Research
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    • v.5 no.1
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    • pp.90-101
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    • 2000
  • The study attempts to examine the degree of cognition and demand on health promotion center of oriental nursing. It puts unique nursing intervention using traditional health promotion connected with oriental medicine to practical use for residents' health promotion and prevention of disease. With the study design of cross-sectional descriptive study, 516 residents who live in 26 Dongs, Dongdaemoon-gu were selected. The tool of study consists of 30 questions which the study team made for the degree of cognition and demand on health promotion center of oriental nursing. Cronbach's $\alpha$ in the degree of cognition was .8028. Collection of research data had been done from October 1 to October 30, 1999 with help of Dongdaemoon-gu office after pretest from 20 residents. Collected data were analyzed into the number and percentage in the characteristic of a subject and connected with demand on the establishment of center, the mean and the standard deviation in the degree of cognition and F-tests in the difference of the degree of cognition by characteristics. The results were as follow; 1) The characteristic of subject of this study was male 50.6%, and average age was 38.5 years old and 30-39 years old occupied the highest percentage with 31.6%. The married were 71.8%, over high school graduates was 85.6%, monthly income from 500 thousand won to 2 million won was 86.1%. 50.8% was the type living with parents, children and sibling. 2) When they were sick, the institution which residents used at first was a pharmacy(69.2%) and hospital(27.5%), but oriental medicine hospital was just 1.4%. As for subjective health condition, 82.5% answered over average, and 28.7% answered that they had chronic illness such as arthritis, chronic digestion problem, hypertension and so on. As for information collection on health, mass communication(34.9%) and medically concerned people(28.1%) occupied relatively high rate. Free health diagnosis system(36.8%) and establishment of health promotion center(31.5%) among welfare programs that residents want to enjoy were high ranked. The rate using a special institution for health was 17.8%, and among these institutions, the rate using aerobic exercises, health center(7.0%) and steamed room(5.4%) was high. Besides, other institutions such as breathing at the abdomen, finger-pressure therapy, meridian massage, foot massage, and so on were being used. 3) As the average of the degree of cognition on health promotion center of oriental medicine was 2.92, the degree of cognition was medium. The description, "health promotion center of oriental medicine is necessary for health keeping of healthy people, including people who have a problem in health" showed the highest degree of cognition(3.04, ${\pm}0.64$). 4) As for the intention on using health promotion center of oriental nursing, 61.4% said "yes", "no" was just 1.4%. The services that people relatively high wanted to be served from the center were measures reducing stress(68.0%) (relaxation therapy, meditation, breathing at the abdomen and so on), acupuncture(66.5%), finger-pressure(61.6%), moxibustion(57.6%), meridian massage(44.2%), postpartum care(40.3%) and so on. 5) As for the degree of cognition on the establishment of health promotion center of oriental nursing by characteristics of subject, there was significant difference(F=4.03, p=.046) between male(3.01) and female(2.91). But there was no significant difference by age, marital status, level of educational achievement and monthly income. As the above result, cognition on the establishment of health promotion center of oriental nursing was relatively low because people were not familiar with about the health promotion center of oriental nursing yet. However once the center will be established, the degree of demand on the center will be relatively high. So positive advertisement will be necessary, and the management of useful programs will be also required in order to make people recognize the advantage when they actually will use the center. On the other hand, as the subject of the study consists of many young people of below 30, the health problem came to be low. And in the case of sampling, the study using random sampling that can represent population will be required.

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Effect of Short Term Treatment with Different Dosage of Inhaled Flucatisone Propionate on Basal Cortisol Concentration (단기간 Fluticasone Propionate 투여 용량에 따른 가저 코르티솔 농도의 변화)

  • Kim, Hyun-Jung;Kim, Hyoung-Sik;Lee, Hong;Moon, Sung-Gi;Lim, Seok-Tae;Park, Ji-Hyun;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1063-1071
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    • 1997
  • Backgroung : The efficacy of oral corticosteroids in the treatment of chronic asthma is undisputed, but their long-term use is associated with adverse side-effects, including supression of the hypothalamic-pituitary adrenal axis function, osteoporosis, weight gain, hypertension and impaired glucose tolerance. The introduction of inhaled corticosteroids in the early 1970's represented a significant therapeutic advance in the management of asthma, since these compounds combined high topical potency with low systemic activity. Fluticasone propionate is a new topically active synthetic glucocorticosteroid that combinds a high degree of efficacy with negligible systemic bioavailability. This study was perfomed to determine the effect of inhaled fluticasone propionate on the adreocortical supression in patients with bronchial asthma or chronic obstructive pulmonary disease. Method : The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o'clock in morning and free cortisol in 24 hour urine collection at interval. Absolutely, no steroid was taken during pretreatment period of 10days. There after each subject inhaled fluticasone aerosol, in daily doses of 500 or 1000micrograms for 12days. The dose was delivered by metered dose inhaler(MDI). Results : The serum cortisol and 24hour urinary free cortisol were not decreased during the treatment period in patients with inhaled fluticasone propionate in daily doses of 500 micrograms. In contrast, serum cortisol was significantly decreased on 9th and 12th day(p less than 0.05). And, 24hour urinary free cortisol was also significantly decreased on 3rd and 12th day of treatement period(p less than 0.05) in patients with inhaled fluticasone in daily doses of 1000 micrograms. Conclusion : These results suggested that endogenous cortisol secretion was not supressed after short-term inhalation of fluticasone in daily dose of 500 micrograms, but in daily dose of 1000 micrograms, the endogenous cortisol secretion was supressed.

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Characteristic Findings of Exercise ECG Test, Perfusion SPECT and Coronary Angiography in Patients with Exercise Induced Myocardial Stunning (게이트 심근관류 SPECT상 운동 유발성 기절심근을 보이는 환자의 운동부하 심전도, 관류 SPECT 및 심혈관 조영술 소견)

  • Ahn, Byeong-Cheol;Seo, Ji-Hyoung;Bae, Jin-Ho;Jeong, Shin-Young;Park, Hun-Sik;Lee, Jae-Tae;Chae, Shung-Chul;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.225-232
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    • 2004
  • Purpose : Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Materials and Methods : Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV election fraction (LVEF) was $\geq5%$ lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1 %(non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Results : Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs. 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs. 9.2%, p=0.029; severity 13.5 vs. 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis ($80{\sim}99%$) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Conclusion : Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than patients without post-stress LV dysfunction. All of the patients without perfusion defect in stunning group had significant coronary artery stenosis and needed revascularization. Therefore, we suggest that invasive diagnostic procedures and therapeutic interventions might be needed in patients with post-stress LV dysfunction.

Associations of Depressive Symptoms and Brachial Artery Reactivity among Police Officers

  • Violanti, John M.;Charles, Luenda E.;Gu, Ja K.;Burchfiel, Cecil M.;Andrew, Michael E.;Joseph, Parveen N.;Dorn, Joan M.
    • Safety and Health at Work
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    • v.4 no.1
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    • pp.27-36
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    • 2013
  • Objectives: Mental health has been shown to be linked with certain underlying physiological mechanisms. The objective of this cross sectional study was to investigate the relationship between depressive symptoms and brachial artery reactivity (BAR) in an understudied population: police officers. Methods: Participants were 351 police officers who were clinically examined in the Buffalo Cardio-Metabolic Police Stress (BCOPS) study. BAR was performed using standard B-Mode ultrasound procedures. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Mean values of the difference between the baseline and maximum diameters of the brachial artery were determined across three categories of CES-D score using the analysis of variance and the analysis of covariance. p-values for linear trends were obtained from linear regression models. Results: The mean age (${\pm}$ standard deviation) of all officers was $40.9{\pm}7.2$ years. Women had a slightly higher mean CES-D score than men ($8.9{\pm}8.9$ vs. $7.4{\pm}6.4$) and a slightly higher percentage increase of BAR than men (6.90 vs. 5.26%). Smoking status significantly modified the associations between depressive symptoms and BAR. Among current smokers, mean absolute values of BAR significantly decreased as depressive symptoms increased after adjustment for age, gender, race/ethnicity, hypertension, and diabetes; the multivariate-adjusted p-values were 0.033 (absolute) and 0.040 (%). Associations between depressive symptoms and BAR were not statistically significant among former smokers or never smokers. Conclusion: Depressive symptoms were inversely associated with BAR among police officers who were current smokers and together may be considered a risk factor for cardiovascular disease among police officers. Further prospective research is warranted.

Calcium Channel Blockers Suppress the Responses of Rat Dorsal Horn Cell to Nociceptive Input (쥐 척수후각세포의 유해자극 반응에 대한 칼슘이온통로 차단제의 억제작용)

  • Kang, Sok-Han;Kim, Kee-Soon;Shin, Hong-Kee
    • The Korean Journal of Physiology and Pharmacology
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    • v.1 no.6
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    • pp.625-637
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    • 1997
  • Calcium ions are implicated in a variety of physiological functions, including enzyme activity, membrane excitability, neurotransmitter release, and synaptic transmission, etc. Calcium antagonists have been known to be effective for the treatment of exertional angina and essential hypertension. Selective and nonselective voltage-dependent calcium channel blockers also have inhibitory action on the acute and tonic pain behaviors resulting from thermal stimulation, subcutaneous formalin injection and nerve injury. This study was undertaken to investigate the effects of iontophoretically applied $Ca^{++}$ and its antagonists on the responses of WDR (wide dynamic range) cells to sensory inputs. The responses of WDR cells to graded electrical stimulation of the afferent nerve and also to thermal stimulation of the receptive field were recorded before and after iontophoretical application of $Ca^{++}$, EGTA, $Mn^{++}$, verapamil, ${\omega}-conotoxin$ GVIA, ${\omega}-conotoxin$ MVIIC and ${\omega}-agatoxin$ IVA. Also studied were the effects of a few calcium antagonists on the C-fiber responses of WDR cells sensitized by subcutaneous injection of mustard oil (10%). Calcium ions and calcium channel antagonists ($Mn^{++}$, verapamil, ${\omega}-conotoxin$ GVIA & ${\omega}-agatoxin$ IVA) current-dependently suppressed the C-fiber responses of WDR cells without any significant effects on the A-fiber responses. But ${\omega}-conotoxin$ MVIIC did not have any inhibitory actions on the responses of WDR cell to A-fiber, C-fiber and thermal stimulation. Iontophoretically applied EGTA augmented the WDR cell responses to C-fiber and thermal stimulations while spinal application of EGTA for about $20{\sim}30\;min$ strongly inhibited the C-fiber responses. The augmenting and the inhibitory actions of EGTA were blocked by calcium ions. The WDR cell responses to thermal stimulation of the receptive field were reduced by iontophoretical application of $Ca^{++}$, verapamil, ${\omega}-agatoxin$ IVA, and ${\omega}-conotoxin$ GVIA but not by ${\omega}-conotoxin$ MVIIC. The responses of WDR cells to C-fiber stimulation were augmented after subcutaneous injection of mustard oil (10%, 0.15 ml) into the receptive field and these sensitized C-fiber responses were strongly suppressed by iontophoretically applied $Ca^{++}$, verapamil, ${\omega}-conotoxin$ GVIA and ${\omega}-agatoxin$ IVA. These experimental findings suggest that in the rat spinal cord, L-, N-, and P-type, but not Q-type, voltage-sensitive calcium channels are implicated in the calcium antagonist-induced inhibition of the normal and the sensitized responses of WDR cells to C-fiber and thermal stimulation, and that the suppressive effect of calcium and augmenting action of EGTA on WDR cell responses are due to changes in excitability of the cell.

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An Assessment of the Needs of Crippled Persons Staying at Home (지역사회중심 재활서비스를 위한 재가 장애인의 요구 사정에 관한 연구)

  • Yang, Sook-Ja;Kim, Hee-Jeoung
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.280-290
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    • 1998
  • This study was carried out to idenify the health problems and needs of crippled persons in order to develop a community based rehabilitation service program through public health center. Information on health problems and needs were obtained from 120 crippled persons staying at home by questionaire and a measuring ADL. The results were summarized as follows 1. Among 120 subjects, male crippled (70.3%) outnumbered female crippled (29.7%). Many crippled persons belonged to the 40-49 age group (33.6%) while others were over 60 years (17.4%). There were 36.8% crippled persons with an elementary education, 26.5% had completed high school, 14.5% had completed middle school. 31% of the crippled persons were employed but most of them had unskilled jobs. 80% of the respondents replied that their monthly income was under 800,000 won. 2. The major causes of their handicap were due to acquired factors(92%) such as accidents, in fectious & communicable diseases and chronic diseases rather than congenital factors(8%). Crippled persons who belong to the first grade of disabilities were 14.8%, the second grade 35.7%, the third grade 21.7%, the forth grade 12.2%, the fifth grade 12.2% and the sixth grade 3.5%. 3. This study measured the degree of the ADL of crippled persons by a modified Barthel Index including 11 items. 73.5% of them were fully independent, 8.5% required minimal help, 2.7% required moderate help, 6.0% required substantial help and 9.4% were unable to perform task. In response to the 11 items of ADL, crippled persons required more help in stair climbing, ambulation and bathing than in other items. 4. In responding to concerning health problems, 10.3% of the subjects replied with incontinence, 8.5% malnutrition, 7.6% fecal incontinence and bedsores 2.6%. Chronic diseases which needs treatment were chronic pain(61.0 %), hypertension(16.5%) and diabetes(16.5%) 5. To the question of what type of rehabilitation services subjects required, chronic diseases management(52.1%) and physical therapy (41.2%) were the highest. The most important social welfare services subjects required were economics support (51.3%) and introductions to job opportunities(42%).

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Appropriateness Evaluation of Hospitalization for the Cerebral Ischemia Patients (허혈성 뇌졸중 환자의 재원적절성 평가)

  • Yoem, Hyo-Young;Kim, Soon-Lae
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.80-92
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    • 1999
  • The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

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Interaction Effects of Lipoprotein Lipase Polymorphisms with Lifestyle on Lipid Levels in a Korean Population: A Cross-sectional Study

  • Pyun, Jung-A;Kim, Sun-Shin;Park, Kyung-Chae;Baik, In-Kyung;Cho, Nam-H.;Koh, In-Song;Lee, Jong-Young;Cho, Yoon-Shin;Kim, Young-Jin;Go, Min-Jin;Shim, Eu-Gene;Kwack, Kyu-Bum;Shin, Chol
    • Genomics & Informatics
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    • v.10 no.2
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    • pp.88-98
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    • 2012
  • Lipoprotein lipase (LPL) plays an essential role in the regulation of high-density lipoprotein cholesterol (HDLC) and triglyceride levels, which have been closely associated with cardiovascular diseases. Genetic studies in European have shown that LPL single-nucleotide polymorphisms (SNPs) are strongly associated with lipid levels. However, studies about the influence of interactions between LPL SNPs and lifestyle factors have not been sufficiently performed. Here, we examine if LPL polymorphisms, as well as their interaction with lifestyle factors, influence lipid concentrations in a Korean population. A two-stage association study was performed using genotype data for SNPs on the LPL gene, including the 3' flanking region from 7,536 (stage 1) and 3,703 (stage 2) individuals. The association study showed that 15 SNPs and 4 haplotypes were strongly associated with HDLC (lowest $p=2.86{\times}10^{-22}$) and triglyceride levels (lowest $p=3.0{\times}10^{-15}$). Interactions between LPL polymorphisms and lifestyle factors (lowest $p=9.6{\times}10^{-4}$) were also observed on lipid concentrations. These findings suggest that there are interaction effects of LPL polymorphisms with lifestyle variables, including energy intake, fat intake, smoking, and alcohol consumption, as well as effects of LPL polymorphisms themselves, on lipid concentrations in a Korean population.