• 한국임상약학회지
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• 제26권2호
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• pp.172-180
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• 2016

Background: Ischemic heart disease is the most common type of heart disease and an important cause of death in Korea. Among marketed anti-anginal medications, molsidomine, nicorandil, and trimetazidine are approved in Korea with unique mechanism of actions. As these drugs are not approved by the US Food and Drug Administration, the access to the up-to-dated and comprehensive safety-related information has been less than optimal from drug information resources used by Korean pharmacists. Methods: A systematic review was conducted using Embase and Korean manuscripts to compile safety updates for these medications. Out of 418 articles from keyword searches, 52 studies were reviewed in full to compare adverse effects (AEs) with the approved package inserts (PI). Results: Molsidomine related adverse effects were mostly mild or moderate, but anxiety, palpitation, epigastric pain, and sexual potency reduction were additional AEs found from the review not listed in PI. Although PI has included ulceration in oral cavity and gastrointestinal tracts including anus by nicorandil, the Korea FDA recently recommended adding corneal, genital, and skin ulcers to the approved PI. Trimetazidine induced Parkinsonism, worsening of the symptoms for patients diagnosed with Parkinson's disease, gastrointestinal burning, and muscle cramps were additionally identified AEs not listed in PI for trimetazidine. Conclusion: Continuous evaluations of the safety profile of these agents are needed to balance the risks and benefits to provide evidence-based safety counseling to the patients. In addition, more focused efforts on spontaneous reporting are warranted by healthcare professionals to safeguard patients against AEs.

• 동의생리병리학회지
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• 제22권4호
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• pp.968-974
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• 2008

This study was aimed to investigate the electrolytes and its relationship with acute stroke patients in each stroke type by case-control study. 217 patients with first-ever acute stroke within 2 weeks as the case group(Cases), 146 people without four major risk factors(hypertension, diabetes mellitus, hyperlipidema 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 electrolytes in binary logistic analysis and evaluated each stroke type and general characteristics such as age, sex etc. The level of sodium(Na+) and potassium(K+) were significantly lower in LAA, SVO type of ischemic stroke and hemorrhagic stroke. But the level of chloride(Cl-) had no significant relation with stroke occurance. In this study we demonstrated that low sodium(Na+) and potassium(K+) have an influence on stoke occurance than chloride(Cl-). And we think that the electrolytes must be considered in risk factors of ischemic stroke in Korean and more prospective studies are needed.

• Clinical and Experimental Pediatrics
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• 제63권8호
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• pp.329-334
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• 2020

Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzyme-linked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.

• Journal of Chest Surgery
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• 제38권5호
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• pp.377-381
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• 2005

해부학적 회로 조성술을 이용할 수 없는 환자에게서 시행되는 해부외 회로 조성술에 대하여 이술식의 적정성을 알아보고자 본 연구를 시행하였다. 대상 및 방법: 부산대학교병원 흉부외과에서 해부외 회로 조성술을 시행받은 31명의 환자를 대상으로 동반질환, 원인질환, 수술 당시의 증상, 개존율과 개존율에 영향을 미치는 요인 등을 분석하였다. 결과: 31예의 수술 중 대퇴-대퇴동맥 우회술이 26예, 액와-대퇴동맥 우회술이 5예였고 평균 연령은 70.23세였다. 동반질환은 고혈압, 고지혈증, 허혈성심질환의 순이었고 수술 적응증은 파행, 조직괴사, 휴식기 통증 등의 순이었다. 대퇴-대퇴동맥 우회술을 대상으로 이식편의 일차 개존율에 영향을 미치는 요인들을 분석하였으나 나이(65세 이상), 흡연력, 고혈압, 허혈성 심장질환, 심한 하지 허혈, 고지혈증 등의 유무에 따른 개존율은 통계학적으로 유의한 차이가 없었다. Kaplan-Meier법을 이용한 이식편의 일차 개존율은 1년 $73.65\%$, 2년 $73.65\%$, 3년$65.46\%$였다. 결론: 수술의 위험도가 높은 환자들에게서 해부외 회로 조성술은 해부학적 회로 조성술에 비해서 개존율이 낮다고 알려져 있지만 술식이 간단하고 덜 위험하며 이식혈관 부전시 교정도 상대적으로 쉽게 할 수 있는 장점을 가진 치료법임을 알 수 있었다.

• 대한지역사회영양학회지
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• 제2권5호
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• pp.728-734
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• 1997

Plasma carotenoid levels were compared among 64 healthy male subjects (control) and 38 patients of ischemic heart disease(IHD) and 20 ones of cerebral infarction(CI) all of whom were over 50years of age. Another 98 healthy male subjects aged 23 to 58 were selected to compare their plasma carotenoid levels by age groups, Levels of lutein ,zeaxanthin and crpytoxanthin were lower in IHD(34$\pm$2, 13$\pm$1 and 62$\pm$7$\mu g$/dl)and CI(36$\pm$3, 12$\pm$2 and 41$\pm$6$\mu g$/dl)patient groups than in control group (84$\pm$5, 16$\pm$2 and 69$\pm$3$\mu\textrm{g}$/dl) while those of lycopene, $\alpha$-and $\beta$-carotene varied little among the three groups. The sum of the six carotenoid levels were levels were, therefore,highest(205$\pm$14$\mu\textrm{g}$/dl) in the control group followed by IHD(155$\pm$15$\mu g$/dl) and CI(128$\pm$17$\mu g$/dl) patient groups, Among the 98 healthy male subject for the age group study, levels of the three major carotenoids increased with age from the twenties to the fifities ; lutein, from 64$\pm$6 to 89$\pm$8$\mu g$/dl, cryptoxanthin, 57$\pm$8 to 73$\pm$4$\mu\textrm{g}$/dl and $\beta$-carotene were more significantly correlated(r=0.30 to 0.61, p<0.01), whereas levels of lycopene and $\alpha$-caroteme were significantly(r=0.21 - 0.23, p<0.05) correlated. (Korean J Community Nutrition 2(5) : 728~734, 1997)

• Journal of Preventive Medicine and Public Health
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• 제55권1호
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• pp.19-27
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• 2022

This study estimated the direct and indirect socioeconomic costs of 238 diseases and 22 injuries from a social perspective in Korea from 2007 to 2015. The socioeconomic cost of each disease group was calculated based on the Korean Standard Disease Classification System. Direct costs were estimated using health insurance claims data provided by the National Health Insurance Service. The numbers of outpatients and inpatients with the main diagnostic codes for each disease were selected as a proxy indicator for estimating patients' medical use behavior by disease. The economic burden of disease from 2007 to 2015 showed an approximately 20% increase in total costs. From 2007 to 2015, communicable diseases (including infectious, maternal, pediatric, and nutritional diseases) accounted for 8.9-12.2% of the socioeconomic burden, while non-infectious diseases accounted for 65.7-70.7% and injuries accounted for 19.1-22.8%. The top 5 diseases in terms of the socioeconomic burden were self-harm (which took the top spot for 8 years), followed by cirrhosis of the liver, liver cancer, ischemic heart disease, and upper respiratory infections in 2007. Since 2010, the economic burden of conditions such as low back pain, falls, and acute bronchitis has been included in this ranking. This study expanded the scope of calculating the burden of disease at the national level by calculating the burden of disease in Koreans by gender and disease. These findings can be used as indicators of health equality and as useful data for establishing community-centered (or customized) health promotion policies, projects, and national health policy goals.

• Journal of Chest Surgery
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• 제37권7호
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• pp.547-552
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• 2004

최근 들어 심부전증을 치료하기 위한 새로운 방법으로 골수줄기세포를 심근에 이식하여 신생혈관을 생성하거나 새로운 심근 생성을 조장하여 심장기능을 개선시키려는 노력이 활발히 진행되고 있다. 저자들은 심근경색 후 심근의 기능이 저하된 환자에서 심장박동 상태에서 관상동맥우회술 (OPCAB)과 우회술이 불가능한 부위의 골수줄기세포 이식을 동시에 시행한 연구결과를 보고하고자 한다. 대상 및 방법: 관상동맥우회술과 골수줄기세포 이식을 동시에 시행 받았던 4명의 남자 환자를 대상으로 하였다 대상 환자의 평균연령은 58세(48∼73세)로 모두 불안정성 협심증으로 심근경색의 기왕력이 있었다. 환자의 장골에서 골수를 채취한 후 단핵세포만을 분리하였으며(평균 세포 수 1.5 ${\times}$ $10^{9}$ 개), 이 중에는 평균 6.7${\times}$$10^{6}$ CD34 + 세포와 3.7 ${\times}$ $10^{6}$ AC133 + 세포가 포함되었다. 분리된 단핵세포는 10 cc로 농축하였다. 수술은 관상동맥우회술이 가능한 좌전하행지 부위에는 OPCAB을 시행하고, 나머지 우회로술이 불가능한 심근에는 분리한 단핵세포를 이식하였다. 이식 전 모든 환자는 심초음파, MIBI scan 및 자기공명영상(MRI)으로 심근의 기능을 검사하였다. 수술 후 1개월에 심초음파 및 MIBI scan을 시행하여 수술 전과 비교하였다 결과: 평균 이식편수는 2개였으며, 수술 후 사망이나 부정맥 등 합병증은 없었다. 수술 후 1개월 추적검사에서 모든 환자의 증상은 호전되었으며, 심초음파상에서 좌심실 박출계수는 49%에서 55%로 개선되었고, MIBI scan에서 세포이식 부위의 현저한 관류 개선이 모든 환자에서 있었다. 결론: 심장박동 상태에서 관상동맥우회술(OPCAB)과 우회술이 불가능한 부위에 골수줄기세포 이식을 동시에 시행하는 것은 안전하면서도 심장기능의 개선을 보여주었다. 그러나 심장기능의 개선이 골수줄기세포 단독의 효과라고 단정하기는 어려우며, 따라서 대조군을 이용한 연구가 이어져야 할 것으로 생각된다.

• The Korean Journal of Pain
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• 제7권2호
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• pp.175-180
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• 1994

The impact of cardiovascular changes occurred by endotracheal intubation is risky for patients with ischemic heart disease, or intracranial pathologic conditions typically impairing cerebral autoregulatory mechanisms. Therefore, multiple approaches have been utilized to limit the impact of intubation and reduce damage of central nervous and cardiovascular systems. These approaches include modifications in intubation technique to diminish circulatory stimuli and pharmacologic modifications of either the sensory afferent path or the circulatory response itself. We tried the stellate ganglion block, a kind of sympathetic block, for the same purpose and evaluated the results. The results of study are as follows, 1) Blood pressure and heart rate increased significantly after intubation as compared with preintubation in both control group and SGB group. 2) The difference of the two groups is not found. We conclude the above method does not control cardiovascular consequences of endotracheal intubation.

• Journal of Preventive Medicine and Public Health
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• 제37권2호
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• pp.120-126
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• 2004

Objectives : This study sought to examine relationships between alcohol drinking and cardiovascular disease mortality and all-cause mortality. Methods : From March 1985 through December 1999, 2,696 males and 3,595 females aged 55 or over as of 1985 were followed up for their mortality until 31 December 1999. We calculated the mortality risk ratios by level of alcohol consumption. Among the drinker, the level of alcohol consumption was calculated by the frequency of alcohol comsumption and the type of alcohol. Cox proportional hazard model was used to adjust for confounding factors. Results : Among males, compared to abstainer, heavy drinker had significantly higher mortality in all cause(Risk ratio=1.35), cardiovascular disease(Risk ratio=1.52) and cerebrovascular disease(Risk ratio =1.66). Although not significant, moderate drinker had lower ischemic heart disease mortality(Risk ratio =0.38). Among females, there was no statistically significant association between alcohol comsumption and mortality. Conclusion : The results of this study suggest that alcohol drinking has harmful effect on all-cause mortality, cardiovascular disease mortality and cerebrovascular disease mortality among males, especially in heavy drinker among males. Minimal evidence on protective effect for cardiovascular disease mortality in low or moderate drinker is observed.

• 한국환경보건학회지
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• 제37권5호
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• pp.387-395
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• 2011

Purpose: This study measured the burden of disease in Korea related to outdoor air pollution using disability-adjusted life year (DALY). Materials and Methods: As a risk factor of outdoor air pollution, particulate matter with a diameter less than 10 ${\mu}m$($PM_{10}$) was used. First, $PM_{10}$-related diseases and their relative risk (RR) were selected by means of a literature review. Second, population attributable fractions were computed by using formulae including RR and population exposure to $PM_{10}$. Third, DALYs of $PM_{10}$-related diseases in Korea were estimated. Finally, the attributable burden of disease due to $PM_{10}$ was measured as the sum of the products that multiplied the DALYs of $PM_{10}$-related diseases by their population attributable fractions. Results: The disease burden of PM10 was 6.9 DALY per 1,000 persons in 2007. The attributable burden of $PM_{10}$ was 2.68 for lung cancer, 2.41 for COPD, 0.62 for ischemic heart disease, 0.61 for pneumonia, 0.55 for asthma, and 0.03 for preterm. Conclusions: This study showed the environmental burden of disease of $PM_{10}$ and burden of $PM_{10}$-related disease through objective data. It also suggested that active efforts are needed to continuously measure and reduce the burden of environmental diseases in Korea.