• Korean Circulation Journal
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• v.52 no.1
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• pp.47-59
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• 2022

Background and Objectives: The influence of pre-intervention coronary physiologic status on outcomes post percutaneous coronary intervention (PCI) is not well known. We sought to investigate the prognostic implications of pre-PCI fractional flow reserve (FFR) combined with post-PCI FFR. Methods: A total of 1,479 PCI patients with pre-and post-PCI FFR data were analyzed. The patients were classified according to the median values of pre-PCI FFR (0.71) and post-PCI FFR (0.88). The primary outcome was target vessel failure (TVF) at 2 years. Results: The risk of TVF was higher in the low pre-PCI FFR group than in the high pre-PCI FFR group (hazard ratio, 1.82; 95% confidence interval, 1.15-2.87; p=0.011). In 4 group comparisons, the cumulative incidences of TVF at 2 years were 3.8%, 4.1%, 4.8%, and 10.2% in the high pre-/high post-, low pre-/high post-, high pre-/low post-, and low pre-/low post-PCI FFR groups, respectively. The risk of TVF was the highest in the low pre-/low post-PCI FFR group among the groups (p values for comparisons <0.05). In addition, the high pre-/low post-PCI FFR group presented a comparable risk of TVF with the high post-PCI FFR groups (p values for comparison >0.05). When the prognostic value of the post-PCI FFR was evaluated according to the pre-PCI FFR, the risk of TVF significantly decreased with an increase in post-PCI FFR in the low pre-PCI FFR group, but not in the high pre-PCI FFR group. Conclusions: Pre-PCI FFR was associated with clinical outcomes after PCI, and the prognostic value of post-PCI FFR differed according to the pre-PCI FFR.

• Journal of Nutrition and Health
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• v.48 no.2
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• pp.167-179
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• 2015

Purpose: This study was conducted to evaluate the association between intakes of potassium, magnesium, and calcium and diet quality in ischemic stroke patients. Methods: This study analyzed data from 285 subjects recruited from February 2011 to August 2014 in Seoul, Korea. Nutrition intakes were obtained from a semi-quantitative food frequency questionnaire composed of 111 food items. The subjects were divided into 4 groups by quartiles according to intakes of potassium, magnesium, and calcium. Index of Nutritional Quality (INQ), Mean Adequacy Ratio (MAR), and DQI-International (DQI-I) were analyzed for assessment of diet quality. Results: We found a positive association of intakes of these three minerals with MAR and DQI-I after adjustment for age, sex, education level, smoking, atrial fibrillation, and total energy intake. However, total moderation of DQI-I score in the Q4 group was significantly lower than that of the Q1 group. The age, sex, education level, and smoking, atrial fibrillation, and total energy intake-adjusted odds ratios of extensive cerebral atherosclerosis were inversely associated with intake of magnesium (Ptrend = 0.0204). However, this association did not exist with intakes of potassium and calcium. Conclusion: Potassium, magnesium, and calcium rich and high quality diet could be associated with decreased risk of ischemic stroke, in part, via effect on extensive cerebral atherosclerosis.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.210-214
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• 2006

Objective : We investigate risk factors of cerebral microbleeds[MBs] and their relation to concomitant magnetic resonance[MR] findings in intracerebral hemorrhages[ICHs] patients. Methods : We studied 100 consecutive patients with primary ICH over a 1-year period. These patients underwent brain MR images using 3.0-T scanners within the first week of the hemorrhage. MBs and old hematomas were located and counted by using $T2^*-weighted$ gradient-echo MR imaging. We also counted lacunes and graded white matter and periventricular hyperintensity on T1- and T2-weighted spin-echo sequences. The association between MBs and vascular risk factors and MR abnormalities were analyzed. Results : MBs were seen in 77 of ICH patients, and their number ranged from 1 to 65 lesions [mean 11, median 6]. The locations of MBs were subcortex-cortex [40.6%], basal ganglia [26.7%], thalamus [14.1 %], brain stem [12.5%], and cerebellum [9.1 %]. Analysis of clinical data revealed that age, hypertension, history of stroke, and duration of hypertension were frequently associated with MBs. The incidence of lacunes, old hematomas, and advanced leukoaraiosis was significantly higher in the MBs group, compared with the patients without MBs. Conclusion : MBs are frequently observed in ICH patients with advancing age, chronic hypertension, and previous hemorrhagic stroke, and are also closely related with morphological signs of occlusive type microangiopathy, such as lacunar infarct and severe leukoaraiosis.

• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.42-49
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• 2024

Objective : There is still controversy regarding whether neck remodeling stent affects the occurrence of silent embolic infarction (SEI) after aneurysm coiling. Thus, the aim of the present study is to investigate the incidence of SEI after stent-assisted coiling (SAC) using Neuroform Atlas Stent (NAS) and possible risk factors. This study also includes a comparison with simple coiling group during the same period to estimate the impact of NAS on the occurrence of SEI. Methods : This study included a total of 96 unruptured intracranial aneurysms in 96 patients treated with SAC using NAS. Correlations of demographic data, aneurysm characteristics, and angiographic parameters with properties of SEI were analyzed. The incidence and characteristics of SEI were investigated in 28 patients who underwent simple coiling during the same period, and the results were compared with the SAC group. Results : In the diffusion-weighted imaging obtained on the 1st day after SAC, a total of 106 SEI lesions were observed in 48 (50%) of 96 patients. Of these 48 patients, 38 (79.2%) had 1-3 lesions. Of 106 lesions, 74 (69.8%) had a diameter less than 3 mm. SEI occurred more frequently in older patients (≥60 years, p=0.013). The volume of SEI was found to be significantly increased in older age (≥60 years, p=0.032), hypertension (p=0.036), and aneurysm size ≥5 mm (p=0.047). The incidence and mean volume of SEI in the SAC group (n=96) were similar to those of the simple coiling group (n=28) during the same period. Conclusion : SEIs are common after NAS-assisted coiling. Their incidence in SAC was comparable to that in simple coiling. They occurred more frequently at an older age. Therefore, the use of NAS in the treatment of unruptured intracranial aneurysm does not seem to be associated with an increased risk of thromboembolic events if antiplatelet premedication has been performed well.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.8
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• pp.449-455
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• 2018

This study was conducted to analyze the correlation between changes in white matter and homocysteine concentration through brain computed tomography of healthy 50-75 year old subjects without stroke or dementia history. We studied 722 out of 900 patients who underwent health screening at one hospital from 2016 to 2017. Based on the medical records, retrospective studies were conducted and analyzed using SPSS. A chi-square test, T-test and univariate logistic regression analysis were used for analysis. After the subjects were divided into the group with and without white matter changes, the population characteristics were analyzed. The mean age, homocysteine concentration and prevalence of hypertension and diabetes were higher and the duration of education was shorter in the group with white matter changes. In the group with white matter changes, the population increased as homocysteine concentration increased. When the odds ratio was compared based on the lowest group (Q1), age [p<0.001], hypertension [p<0.001] and hyperhomocysteinemia [p=0.021] were risk factors for white matter changes. We also identified modifiable risk factors such as hypertension and hyperhomocysteinemia to prevent complications of white matter changes. However, there has been no report of risk for the each causes of hyperhomocysteinemia and relationship between white matter changes and homocysteine concentration in Koreans. Therefore, large scale prospective studies are needed to better understand this topic.

• Journal of Community Nutrition
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• v.8 no.2
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• pp.90-95
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• 2006

Asian Americans is a minority population contributing approximately 4% to the total population of the United States, however it is one of the fastest growing populations. Although Asian Americans as a group have socioeconomic profiles that are similar to white Americans, significant variations exists within and across Asian ethnic groups. The top ten leading causes of death for Asian Americans includes cancer, heart diseases, stroke, unintentional injuries, diabetes, influenza and pneumonia, chronic lower respiratory disease, suicide, nephritis, and septicemia. The prevalence of obesity is lower among Asian Americans, however this should be taken with considerations specific to Asians. High salt and low calcium consumption seem to be dietary risk factors for Asian Americans, although dietary patterns are changing with acculturation. Factors affecting dietary patterns are discussed in this paper. A proactive nutrition education approach for Asian Americans should be promoting maintaining 'healthy' aspects of ethnic diets and adopting 'healthy' American diets. Collaboration with nutrition educators in Asian countries would be helpful to overcome limited resources available for researching and developing nutrition education messages and materials for Asian Americans. (J Community Nutrition 8(2): 90-95, 2006)

• The Korean Journal of Pharmacology
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• v.32 no.2
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• pp.169-175
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• 1996

The reactivity of the sulfhydryl (thiol) group of homocysteine has been associated with an Increased risk of atherosclerosis, thrombosis and stroke. Thiols also react with nitric oxide (NO, an endothelium-derived relaxing factor (EDRF) ), forming S-nitrosothiols that have been reported to have potent vasodilatory and antiplatelet effects and been expected to decrease adverse vascular effects of homocysteine. The present study was aimed to Investigate whether the S-nitrosation of homocysteine modulates the neurotoxic effects of homocysteine. An 18 hour-exposure of cultured rat cortical neurons to homocysteine ( >1 mM) resulted in a significant neuronal cell death. At comparable concentrations ( <10 mM), however, S-nitrosohomocysteine did not induce neuronal cell death. Furthermore, S-nitrosohomocysteirle partially blocked NMDA-mediated neurotoxicity. S-nitrosohomocysteine also decreased NMDA-mediated increases in intracellular calcium concentration. The present data indicate that in brain nitric oxide produced from neuronal and nonneuronal cells can modulate the potential, adverse properties of homocysteine.

• Korean Journal of Clinical Pharmacy
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• v.15 no.1
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• pp.1-8
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• 2005

Clopidogrel is used to reduce the risk of cardiovascular events in patients with atherosclerosis documented by recent ischemic stroke, recent myocardial infarction (MI), or established peripheral arterial disease (secondary prevention). Clopidogrel is metabolized by CYP3A4, and the active metabolites inhibit platelet aggregation. The purpose of this study was to assess clopidogrel only versus clopidogrel + others (aspirin, CYP3A4 inhibitor, and CYPBA4 inducer) in terms of cardiovasculalr events and bleeding complications. We reviewed the charts of patients who visited between August 1, 2002 and August 31, 2003, retrospectively. Total 72 patients were included and they consisted of 5 groups; clopidogrel group (n=36), clopidogrel + aspirin group (n=11), clopidogrel + CYP3A4 inhibitor group (n=15), clopidogrel + aspirin + CYP3A4 inhibitor group (n=6), clopidorel + CYP3A4 inducer group (n=4). The primary endpoints at 6 months, 12 months were the composite of cardiovascular (CV) events. The secondary end-point was the incidence of bleeding events at 6months, and 12months. At 12months, the primary endpoint was not significantly different among the five groups (p=0.056). In comparison of two groups as clopidogrel only versus clopidogrel + others (aspirin, CYP3A4 inhibitor and CYP3A4 inducer), the primary endpoint was significantly different (p=0.02). The CV events were increased in the clopidogrel + others group. The secondary end point was not significantly different among the five groups (p=0.52). However, time to bleeding events was 230.8 in the clopidogrel group and 74.7 in the clopidogrel + others group (p = 0.046). In conclusion, clopidogrel interaction with aspirin, CYP3A4 inhibitor, and CYP3A4 inducer affected cardiovascular events and bleeding events. Drug interaction of clopidogrel with concurrent medications should be considered cautiously.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.473-481
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• 2004

Objective : In this study old BCAO rats were observed for effects of 'Dea-Hwang' on brain ischema injury, because risk of stroke increases with age. Method : The brain ischema injury was induced by temporarily closing carotids on both sides in a low blood pressuer state and Dea-Hwang was administered orally to 18 month-old BCAO rats. Results and Conclusions : The ischemically damaged Hippocampus and c-fos and c-jun expression were analyzed by immunohistochemical staining and results are summarized as follows: 1. The c-fos expression after inducing a brain ischema injury in the hippocampus was more inhibited in the dosed group than in the control group. 2. The normalized optical density of c-fos expression was more reduced in the CA1, CA2, and DG areas of the dosed group than in those of the control group. 3. The c-jun expression after inducing brain ischema injury in the hippocampus was more inhibited in the dosed group than in the control group. 4. The normalized optical density of c-jun expression was more reduced in the CAI area of the dosed group than in that of the control group.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.392-399
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• 2016

This study examined the distribution of metabolic syndrome according to the age groups among the elderly people to reveal the sociodemographic and health related factors. The survey in 2011~2014 from the National Health Insurance Corporation under regular medical check-ups, which received a recognition survey targeted 1,756 people aged over 70. Multiple logistic regression was performed on the relation metabolic syndrome and its related factors. As a result, the risk ratio for metabolic syndrome increased significantly in females than in males, living with a family than living alone, high economic status than in the low group, obese than in the normal weight group, have a history of stroke group than the no history group, smoking group than the non-smoking group, and drinking group than the non-drinking group. The distribution of metabolic syndrome differed significantly according to the sociodemographic characteristics and health-related variables.