• Journal of Korean Neurosurgical Society
• /
• v.55 no.6
• /
• pp.313-320
• /
• 2014

Objective : The purpose of this study is to demonstrate the technical feasibility and clinical efficacy of emergent carotid angioplasty and stenting (CAS) for acute stroke due to athero-thrombotic occlusion of the cervical internal carotid artery (ICA). Methods : Review of medical records identified 17 patients who underwent emergent CAS for treatment of athero-thrombotic occlusion of the cervical ICA with acute stroke between 2009 and 2013. Eleven patients (64.7%) presented with concomitant intracranial artery occlusion, which was treated primarily by mechanical thrombectomy after CAS. Results : Successful revascularization of the cervical ICA with emergent CAS was achieved in all patients. After CAS, intracranial recanalization with Thrombolysis in Cerebral Infarction ${\geq}2b$ flow was achieved in four of the 11 patients (36.4%). The overall recanalization rate (cervical ICA and intracranial artery) was 10 of 17 patients (58.8%). Symptomatic intracranial hemorrhage occurred in two patients (11.8%), resulting in death. Ten patients (58.8%) showed improvement (decrease in NIHSS score of ${\geq}4$ points) at seven days after recanalization. Nine patients (52.9%) showed a favorable outcome ($mRS{\leq}2$) at the last follow-up. A favorable outcome ($mRS{\leq}2$) was obtained in four of the six patients with isolated cervical ICA occlusion (4/6, 66.7%) and five of 11 patients with intracranial tandem occlusion (5/11, 45.5%). Conclusion : Emergent CAS for acute stroke due to athero-thrombotic occusion of the cervical ICA showed a good technical feasibility and favorable clinical outcome.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.2
• /
• pp.75-79
• /
• 2012

Objective : The study examined the difference in the incidence of symptomatic cerebral vasospasm with magnesium supplementation in aneurysmal subarachnoid hemorrhage (SAH) in a Korean population. Methods : This retrospective analysis was performed in 157 patients diagnosed with aneurysmal SAH from January 2007 to December 2011 at a single center. Seventy patients (44.6%) received a combination treatment of nimodipine with magnesium and 87 patients (55.4%) received only nimodipine. A matched case-control study using propensity scores was conducted and 41 subjects were selected from each group. A dosage of 64 mmol/day of magnesium was administrated. Results : The infusion of magnesium did not reduce the incidence of symptomatic cerebral vasospasm (n=7, 17.1%, p=0.29) compared with simple nimodipine injection (n=11, 26.8%). The ratios of good clinical outcome (modified Rankin scale 0-2) at 6 months were similar, being 78% in the combination treatment group and 80.5% in the nimodipine only group (p=0.79). The proportions of delayed cerebral infarction was not significantly lower in patients with combination treatment (n=2, 4.9% vs. n=3, 7.3%; p=0.64). There was no difference in the serum magnesium concentrations between the patients with symptomatic vasospasm and without vasospasm who had magnesium supplementation. No major complications associated with intravenous magnesium infusion were observed. Conclusion : Magnesium supplementation (64 mmol/day) may not be beneficial for the reduction of the incidence of symptomatic cerebral vasospasm in patients with aneurysmal SAH.

• Journal of Nutrition and Health
• /
• v.30 no.8
• /
• pp.976-986
• /
• 1997

Coronary artery disease (CAD) such as angina pectoris and myocardial infarction(MI) have been considered the major cause of death for decaddes . THeir incidence and prevalence are still increasing . Numerous studies have been done on the risk factor analysis of CAD in Western countries. Since the diet in Western countries is different from that in Korea it is difficult to assume that the Korean diet has the same effects as its western counterpeart on the development of CAD . THus the gudidelines for the Western CAD patients can no totally be applied to Koreans. This study was conducted to investigate the relationship between diet and CAD in Koreans. Subjects were comprised of patients admitted to the hospital for chest pain with poxxilbe CAD (men 129, women 65) . They were divided into the following three groups according to angiographic results ; angiogrphically normal coronary artery group (control), single vessel disease group(SVD) and multiple vessel disease group (MVD) . Intakes of dietary fatty acids and other nutrients were assessed by the semiquantitative food frequency method. Blood was also obtained from subjects for serum lipid analysis. Serum lipid profiles of men were clearly different form those of women. For men, serum choesterol levels (or LDL or LDL/HDL) seemed to be higher in the MVD group compared to the control and SVD groups, while TG level was significantly higher in the MVD group for women. Both men and women showed significantly higher caloric , fiber and vitamins C and A intakes in the MVD group than in the other two groups. Higher caloric intakes was due to higher intakes of carbohydrate and protein rather than fat intake. In terms of fatty acids intake, there were no significant differences among the three groups . Smoking seemed to have great effect on eating patterns in CAD patients. Smokers and ex-smokers showed significantly higher intakes of most nutrients including individual fatty acids that non-smokers. The results of stepwise regression showed that moderate alcohol intake decreases LDL levels and increases HDL levels and smoking seems to lowe HDL levels in CAD patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.3
• /
• pp.1515-1521
• /
• 2014

This study applies simulation-based education and care for acute myocardial infarction nursing students to investigate the effect of critical thinking, problem solving, and academic achievement of a single group before and after the raw experimental design. A total of 137 subjects were arbitration period September-October 2011, enforcement and arbitration were evaluated after simulation-based training six weeks total. Data analysis was performed using SPSS Win17.0, Paired t-test, the mean and standard deviation, Pearson's correlation coefficient was used. Research results of simulation-based training program to improve critical thinking, problem solving, and academic achievement were As increase critical thinking and problem solving ability was improved. whereas, Critical thinking skills and problem solving ability was no significant difference with academic achievement. Simulation-based training program to improve the practical skills of nursing students learning was found how useful it, that there is a need to take advantage of hands-on training in a variety of cases that can be common in the field of clinical scenarios developed by. To do this, It seems to be necessary to the development and operation more varied and appropriate hands-on training method.

• The Journal of Korean Society of Virology
• /
• v.30 no.1
• /
• pp.29-37
• /
• 2000

The aim of this study was to investigate viral etiology in dilated cardiomyopathy (DCM) by polymerase chain reaction (PCR) or nested reverse transcription PCR (RT-PCR), and characterize the enteroviral RNA presented in the clinical specimens. Twenty-eight paraffin-embedded heart tissue samples were assayed to detect cytomegalovirus, herpes simplex virus type 1, type 2, parvovirus, adenovirus, and enterovirus (EV) with each specific primer. Of these 28 patients (mean age: 27, M: 24, F: 4), 26 were histologically diagnosed as DCM and 2 as myocardial infarction (MI). Nested RT-PCR detected enteroviral RNA in 7 (26.9%) of 26 patients with DCM, and none of patients with MI. And none of DNA viruses tested were detected from the samples. Amplified products were also genotyped by single-strand conformation polymorphism (SSCP). Three subtypes can be differentiated from 7 clinical specimens. Furthermore, direct sequence analysis was performed to determine whether genetic variation of EV is present in the explanted heart tissues from patients with DCM. Although most of the sequences among the wild isolates have the greatest similarity to those of coxsackievirus B3, there are specific regions of variable sequences (no 490 - no 510). The data suggest that enterovirus may be a major viral pathogen for the DCM in Korea and nucleotide sequence data indicate that coxsackievirus B3 may be a leading etiologic agent of DCM.

• Journal of Acupuncture Research
• /
• v.23 no.2
• /
• pp.173-179
• /
• 2006

Objectives : In this study, we investigated the SNP (single-nucleotide polymorphism) of IL10 in patients with stroke. The present study was undertaken to see if specific genotypic and allelic variations are associated with stroke in the Korean population. Methods : Blood samples from all subjects were obtained for DNA extraction and collected in EDTA tube. Genomic DNA was extracted using DNA isolation kit for Mammalian Blood (Boehringer Mannheim, IN, USA). The extracted DNA was amplified by polymerase chain reaction (PCR). Pyrosequencing was performed according to manufacturer's standard protocol. Results : There was no statistically significant genotypic distribution difference between control and stroke group. The frequencies of A/A homozygotes and A/C heterozygotes among control subjects were 91 (87.5%) and 13 (12.5%). The frequencies of A/A and A/C among the stroke patients were 85 (89.5%) and 10 (10.5%). There was not statistically significant allelic frequency difference between control and stroke group. The allelic frequency of A and C was 195 (93.8%) and 13 (6.2%) among the control subjects and 180 (94.7%) and 10 (5.3%) in stroke patients, respectively. Conclusion : The cytokine IL10 may not be pathogenetic factors in stroke. But further studies including different cytokine gene can be a useful for predicting stroke. Establishment of more systemic approach and high quality of prospective cohorts will be necessary for the good prediction of genetic markers.

• The Korean Journal of Physiology and Pharmacology
• /
• v.25 no.4
• /
• pp.281-296
• /
• 2021

The beneficial effects of hypoxic preconditioning are abolished in the diabetes. The present study was designed to investigate the protective effects and mechanisms of repeated episodes of whole body hypoxic preconditioning (WBHP) in db/db mice. The protective effects of preconditioning were explored on diabetes-induced vascular dysfunction, cognitive impairment and ischemia-reperfusion (IR)-induced increase in myocardial injury. Sixteen-week old db/db (diabetic) and C57BL/6 (non-diabetic) mice were employed. There was a significant impairment in cognitive function (Morris Water Maze test), endothelial function (acetylcholine-induced relaxation in aortic rings) and a significant increase in IR-induced heart injury (Langendorff apparatus) in db/db mice. WBHP stimulus was given by exposing mice to four alternate cycles of low (8%) and normal air O₂ for 10 min each. A single episode of WBHP failed to produce protection; however, two and three episodes of WBHP significantly produced beneficial effects on the heart, brain and blood vessels. There was a significant increase in the levels of brain-derived neurotrophic factor (BDNF) and nitric oxide (NO) in response to 3 episodes of WBHP. Moreover, pretreatment with the BDNF receptor, TrkB antagonist (ANA-12) and NO synthase inhibitor (L-NAME) attenuated the protective effects imparted by three episodes of WBHP. These pharmacological agents abolished WBHP-induced restoration of p-GSK-3β/GSK-3β ratio and Nrf2 levels in IR-subjected hearts. It is concluded that repeated episodes of WHBP attenuate cognitive impairment, vascular dysfunction and enhancement in IR-induced myocardial injury in diabetic mice be due to increase in NO and BDNF levels that may eventually activate GSK-3β and Nrf2 signaling pathway to confer protection.

• Korean Journal of Transplantation
• /
• v.32 no.4
• /
• pp.84-91
• /
• 2018

Background: This study examined the outcomes of ABO incompatible living donor liver transplantation (LDLT). The changes in the immunologic factors that might help predict the long term outcomes were also studied. Methods: Twenty-three patients, who underwent ABO incompatible LDLT from 2010 to 2015, were reviewed retrospectively. The protocol was the same as for ABO compatible LDLT except for the administration of rituximab and plasma exchange. The clinical outcomes and immunologic factors, such as isoagglutinin titer and cluster of differentiation 20+ (CD20+) lymphocyte levels were reviewed. Results: The center showed a 3-year survival of 64% with no case of antibody-mediated rejection. When transplantation-unrelated mortalities (for example, traffic accidents and myocardial infarction) were removed from statistical analysis, the 3-year survival was 77.8%. Although isoagglutinin titers continued to remain at low levels, the CD20+ lymphocyte levels recovered to the pre-Rituximab levels at postoperative one year. Conclusions: As donor shortages continue, ABO incompatible liver transplantation is a feasible method to expand the donor pool. On the other hand, caution is still needed until more long-term outcomes are reported. Because CD20+ lymphocytes are recovered with time, more immunologic studies will be needed in the future.

• Journal of Chest Surgery
• /
• v.52 no.3
• /
• pp.155-161
• /
• 2019

Background: Coronary artery bypass grafting (CABG) is being offered increasingly frequently to octogenarians. However, old age is known to be an independent risk factor in CABG. The aim of this study was to compare the outcomes of off-pump coronary artery bypass (OPCAB) between octogenarians and septuagenarians. Methods: We retrospectively reviewed the data of 1,289 consecutive patients aged ${\geq}70years$ who underwent OPCAB at a single institution between 2001 and 2016. We compared the outcomes of 115 octogenarians and 1,174 septuagenarians. Using propensity score matching, based on preoperative clinical characteristics, 114 octogenarians were matched with 338 septuagenarians. Results: Propensity score analysis revealed that the incidence of acute kidney injury (14.9% vs. 7.9%, p=0.028) and respiratory complications (8.8% vs. 4.2%, p=0.040) was significantly higher in octogenarians. The early mortality rate (2.6% vs. 1.0%, p=0.240) and 1-year survival rate (89.5% vs. 94.4%, p=0.097) were not statistically significant between the groups. However, the 5-year survival rate (67.3% vs. 79.9%, p<0.001) was significantly lower in octogenarians. Previous myocardial infarction and a left ventricular ejection fraction ${\leq}35%$ were associated with a poor 1-year survival rate. Conclusion: Early and 1-year outcomes of OPCAB in octogenarians were tolerable when compared with those in septuagenarians. OPCAB could be a suitable option for octogenarians.

• Health Policy and Management
• /
• v.31 no.3
• /
• pp.292-300
• /
• 2021

Background: Medication adherence in hypertension is the most important to control blood pressure and prevent major complications. The purpose of this study was to identify factors affecting medication adherence and to examine the relationship between medication adherence and blood pressure control in Korea. Methods: This study used data from the 7th Korea national health and nutrition examination survey (2016-2018) of the Korea Disease Control and Prevention Agency. We selected 4,063 hypertensive patients from the data. And we choose socio-demographic, health behavior, healthcare utilization, and severity characteristics as hypertensive patient characteristics. Results: Of the patients with hypertension, 92.3% had shown adherence to medication as of 2016-2018 and shows variation according to the characteristic of patients. The cases with male, under 50 years old, urban area, single household, unmet medical services, less than 5 years of hypertension duration, no comorbidities (diabetes mellitus, myocardial infarction) showed significantly low medication adherence. After adjusting for confounders, adherent patients tended to have lower current systolic blood pressure (β=-10.846, p<0.001) and diastolic blood pressure (β=-5.018, p<0.001) than nonadherent patients. And, adherent patients increased the control odds of blood pressure compared with nonadherent patients (odds ratio, 3.02; 95% confidence interval, 2.21-4.12). Conclusion: This study confirmed that adherence to antihypertensive drugs was effective in controlling blood pressure. In order to more actively manage hypertensive patients at the national level, it is necessary to make an effort to improve the medication compliance of nonadherent groups, such as early-diagnosis patients, young patients under 50 years of age, and patients living alone.