• 응용통계연구
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• 제27권5호
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• pp.705-715
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• 2014

대사증후군은 뇌졸중이나 심혈관 질환 등 다양한 합병증으로 발전될 수 있어 그 심각성이 커지고 있으며, 우리나라의 유병률이 증가하는 추세를 보이고 있어 연구의 필요성이 강조되고 있다. 본 연구는 베이지안 네트워크를 활용하여 대사증후군과 그 진단기준이 되는 5가지 이상 징후인 복부비만, 고중성지방혈증, 고혈압, 저 HDL 콜레스테롤혈증, 고혈당의 관계에 대한 모델을 구축 하고자 하였다. 추가적으로 대사증후군의 가장 위험한 진단조합을 선별하였고, 개개인의 특성에 따라 대사증후군의 특징도 다르게 나타난다는 것을 확인하였다. 사용된 데이터는 제5기 국민건강영양조사 중 2010년 자료로써 건강설문조사의 모든 문항에 응답한 성인 4,489명의 데이터이다.

• 대한의생명과학회지
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• 제8권4호
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• pp.275-282
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• 2002

This study was carried out to investigate the effect of fibrinogen genotype and other characteristics on the plasma fibrinogen levels. Many studies have conformed that high plasma fibrinogen levels are associated with the increased risk of ischaemic heart disease, stroke and arterial disease. And fibrinogen levels are related with age, obesity, cholesterol and alcohol consumption, genotypes. For this study the blood samples were collected from 93 healthy Koreans (66 males and 27 females). The blood samples were individually analyzed by smoking status, cholesterol levels, genotype, age, and gender. The plasma fibrinogen was assayed by clotting method (modified Clauss assay) and cholesterol was assayed by cholesterol oxidase method. Subjects were classified by current smokers, ex-smokers (<6 month), or nonsmokers. The $\beta$-fibrinogen genotype was detected by PCR of relevant region and digestion with HaeIII, with the H$_1$H$_1$ allele allowing cleavage by this restriction enzyme and H$_2$H$_2$ allele being refractory. In conclusion, the study shows that the factor of the increasement in the fibrinogen level was closely related with the cholesterol level, smoking status and genotype (H$_1$H$_2$); but there was no significant difference by gender, Especially, among the people over 50 years of age, fibrinogen level was higher with the increasement of cholesterol level (<200 mg/dl), current smoker, and genotype H$_1$H$_2$.

• 대한한의학회지
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• 제31권3호
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• pp.122-127
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• 2010

Objective: Hyperlipidemia is a main risk factor of stroke and cardiovascular disease. This study aimed to investigate characteristics of hyperlipidemia in adult subjects. Methods: Hyperlipidemia-related makers were analyzed using biochemical data from 1,180 (496 male and 684 female) subjects who took medical examination in an Oriental Hospital for the purpose of detecting cerebrovascular accident. Results: 19.7 % of subjects (male 14.7 %, female 23.2 %) had hypercholesterolemia while 21.9 % (male 25.8 %, female 19.0 %) had hypertriglyceridemia. 17.2 % of subjects (male 22.1 %, female 13.6 %) showed low HDL-cholesterol while 13.0% (male 10.3 %, female 14.9 %) showed high LDL-cholesterol. Conclusions: This study will provide helpful information for patients with hyperlipidemia and to develop therapeutics using traditional Korean medicine.

• 대한한방내과학회지
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• 제27권3호
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• pp.751-761
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• 2006

Atrial fibrillation (AF) is a common arrhythmia that is a potent independent risk factor for stroke. The incidence of AF increases with age and most affected people have underlying cardiac disease. An aging society increases the incidence of AF patients. The case was designed to evaluate the improving effect of Chengsim Yeunja-tang (CYT) for atrial fibrillation (AF) with Cb-infarction patients. This patient was treated with CYT and had significant improvement in symptoms and change of EKG. -Heart rate decreased in patients with higher than normal heart rate -RV5+SV1 voltage decreased (LVH improved) -Arrhythmia remained steady. -Palpitation. chest discomfort, dyspnea, headache, dizziness diminished. Results suggest that CYT is an effective treatment for Taeumin AF patients.

• Journal of Chest Surgery
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• 제54권6호
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• pp.449-453
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• 2021

The 2020 American College of Cardiology focused update on the mitral regurgitation (MR) pathway provides an excellent summary of the decision-making trees in the treatment of severe MR, in which 2 main branches of the flowchart are suggested depending on whether MR is primary or secondary. Surgery is suggested as preferable over transcatheter edge-to-edge repair (TEER) in primary MR that needs intervention. The decision-making for secondary MR generally prioritizes TEER over surgery according to the guidelines, but further stratification is necessary based on the pathophysiologic mechanisms of MR. TEER is probably the more suitable option in secondary MR caused by left ventricular dysfunction or dilatation, given the high perceived surgical risks, despite the lack of sufficient evidence in support of overt clinical benefits from surgical therapy in these patients. In atrial functional MR associated with atrial fibrillation (AF), however, concomitant ablation of AF seems to be a desirable option, as it has been demonstrated to be a key factor leading to improved survival, reduced stroke risk, and more durable mitral and tricuspid function in patients undergoing mitral surgery. Therefore, atrial functional MR requiring intervention may be best treated by surgical therapy that combines mitral repair and AF ablation in the majority of patients. This particular issue, however, needs further research to obtain scientific evidence to guide optimal management strategies.

• Journal of Chest Surgery
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• 제50권2호
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• pp.86-93
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• 2017

Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• Korean Circulation Journal
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• 제48권12호
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• pp.1033-1080
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• 2018

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. The Korean Heart Rhythm Society organized a Korean AF Management Guideline Committee and analyzed all available studies regarding the management of AF, including studies on Korean patients. This guideline is based on recent data of the Korean population and the recent guidelines of the European Society of Cardiology, European Association for Cardio-Thoracic Surgery, American Heart Association, and Asia Pacific Heart Rhythm Society. Expert consensus or guidelines for the optimal management of Korean patients with AF were achieved after a systematic review with intensive discussion. This article provides general principles for appropriate risk stratification and selection of anticoagulation therapy in Korean patients with AF. This guideline deals with optimal stroke prevention, screening, rate and rhythm control, risk factor management, and integrated management of AF.

• 재활간호학회지
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• 제5권1호
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• pp.7-17
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• 2002

The purpose of this study was to investigate the effect of taping therapy on activities of daily livings (ADL), hand function and range of motion in poststroke-hemiplegic patients. Sample were selected from 20 poststroke-hemiplegic patients at public health center in the period from September 5 to November 21, 2001. The research design was one group pretest-posttest design. The hemiplegia period of the participants was from one year to five years. The pretest and posttest included measuring activity of daily livings(ADL), instrumental activity of daily livings(IADL), hand function, range of motion, quality of life. In this research design, a treatment were to expose taping therapy who were received self-help management program. This self-help management program was composed of five sessions and each session had health education on stroke, diet, risk factor, ROM exercise and recreation. 20 patients were treated with kinesio taping(Nippon Sigmax Co., Ltd., Benefact(r), width 50mm). Tapes were applied to the Deltoid, Supraspinatus, Infraspinatus, Brachioradialis with paralyzed upper extremity. The taping therapy was performed once a week for 5 weeks. SPSS Win 8.0 was used for the data analysis. The results of this study were as follows: 1) The score of BADL was increased from 30.5 to 33.95 after program, and that was statistically significant(p=.019). 2) The score of IADL was increased from 11.6 to 12.75 after program, but that was statistically insignificant(p=.161). 3) The score of hand function was increased from 17 to 20.35 after program, and that was statistically significant(p=.026). 4) The shoulder's ROM(p=.000) and wrist's ROM(p= .004) were significantly increased. According to the results of this study, taping therapy is effective for improving ADL, hand function, ROM, quality of life. However, this study found no significant differences in IADL. Consequently, these findings showed that the taping therapy was effective in improvement of physical aspects(BADL, hand function, upper extremity's ROM) in poststroke-hemiplegic patients.

• Clinical and Experimental Pediatrics
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• 제56권12호
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• pp.526-533
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• 2013

Purpose: Obesity is an important risk factor for hypertension in adolescents. We investigated the relationship of obesity-related indices (body mass index [BMI], waist-to-height ratio [WHR], and body fat percentage [%BF]) with blood pressure and the hemodynamic determinants of blood pressure in Korean adolescents. Methods: In 2008, 565 adolescents, aged 12-16 years, were examined. The %BF of the participants was measured by bioelectrical impedance analysis. Echocardiography and brachial artery pulse tracing were used to estimate the stroke volume (SV), cardiac output (CO), total vascular resistance (TVR), and total arterial compliance (TAC). Results: We noted that BMI, WHR, and %BF were positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The positive correlation between BMI and blood pressure (SBP and DBP) persisted after adjustment for WHR and %BF. However, after adjustment for BMI, the positive associations between blood pressure (SBP and DBP) and WHR as well as %BF, were not noted. With regard to the hemodynamic factors, BMI, but not WHR and %BF, was an independent positive factor correlated with SV and CO. TVR had an independent negative association with BMI; however, it was not associated with WHR or %BF. Moreover, we noted that BMI, WHR, and %BF did not affect TAC. Conclusion: In Korean adolescents, BMI had an independent positive correlation with SBP and DBP, possibly because of its effects on SV, CO, and TVR. WHR and %BF are believed to indirectly affect SBP and DBP through changes in BMI.