• Title/Summary/Keyword: cardiovascular system

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Strategies for Public Health Service Development in the Times of Local Autonomy (지방자치시대의 공공보건사업 발전 전략)

  • 박정한
    • Health Policy and Management
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    • v.12 no.3
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    • pp.1-22
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    • 2002
  • Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

Short-term Mechanical Circulatory Support with Centrifugal Pump in Cardiac Arrest or Cardiogenic Shock - Report of 5 cases- (심정지 혹은 심인성 쇼크에서 원심성 펌프를 이용한 단기목표의 기계적 순환 보조)

  • 양희철;성기익;뱍계현;전태국;박표원;양지혁;이영탁
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1003-1009
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    • 2004
  • Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.

Inhibitory Potential of Thelephoric Acid on CYP2J2 Activities in Human Liver Microsomes (Thelephoric acid의 CYP2J2 효소 활성 저해제 평가)

  • Wu, Zhexue;Lee, Boram;Song, Kyung-Sik;Liu, Kwang-Hyeon
    • Journal of Life Science
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    • v.23 no.9
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    • pp.1126-1132
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    • 2013
  • Cytochrome P450 2J2 (CYP2J2) is an enzyme mainly found in human extrahepatic tissues, with predominant expression in the cardiovascular system. CYP2J2 plays important roles in the metabolism of endogenous metabolites and therapeutic drugs, such as arachidonic acid, astemizole, ebastine, and terfenadine. CYP2J2 is also overexpressed in human cancer tissues and cancer cell lines and may represent a potential target for therapy of human cancers. In this study, 10 natural products obtained from plants and microorganisms were screened as potential CYP2J2 inhibitors. Among them, thelephoric acid showed strong inhibition of astemizole O-demethylation activity ($IC_{50}=3.23{\mu}M$) in a dose-dependent manner. Evaluation of the substrate dependency of the inhibitory activity of thelephoric acid showed that it strongly inhibited CYP2J2-mediated ebastine hydroxylation ($IC_{50}=5.32{\mu}M$) and terfenadine hydroxylation ($IC_{50}=3.27{\mu}M$) in a substrate nondependent manner. The present data suggest that this compound might be a potential candidate for further evaluation for anticancer activity.

Dental anomalies associated with Axenfeld-Rieger syndrome (Axenfeld-Rieger 증후군과 연관된 치과적 이상)

  • Kim, Ki-Rim;Lee, Doo-Young;Kim, Seung-Hye;Lee, Sang-Hui;Choi, Byung-Jai;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.6 no.2
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    • pp.94-98
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    • 2010
  • Axenfeld-Rieger syndrome is a rare autosomal dominant disorder characterized by various ocular and extraocular malformations. The incidence of Axenfeld-Rieger syndrome has been estimated to be 1 per 200,000. The syndrome is characterized by short body stature, delayed bone age, and deficient or arrested development of neural crest cells involving the anterior chamber of the eyes, facial bones, teeth, periumbilical skin, and cardiovascular system. This is a case of a 6 year-old girl, who came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of multiple congenital missing permanent teeth. The patient presented typical dental, craniofacial, and systemic features of Axenfeld-Rieger syndrome, such as glaucoma, oval pupil, heterochromatic iris, umbilical hernia, and delayed bone age. On the panoramic view, 3 primary teeth were missing and 13 permanent tooth germs were absent. On the lateral cephalograph, underdevelopment of the maxilla and normal growth pattern of the mandible were confirmed. Periodic dental follow-up is planned for evaluation and interceptive treatment of her dental and craniofacial problems. Denture or removable space maintainer with a pontic is considered for esthetic and functional restoration. In addition, orthognathic surgery is also planned in future to prevent further midfacial skeletal deformation. Early diagnosis of Axenfeld-Rieger syndrome is very important to prevent exacerbation of complications, such as glaucoma and skeletal deformities.

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Association Between Air Conditioning Use and Self-reported Symptoms During the 2018 Heat Wave in Korea

  • Lee, Yong-Han;Bae, Sanghyuk;Hwang, Seung-sik;Kim, Jong-Hun;Kim, Kyoung-Nam;Lim, Youn-Hee;Kim, Miji;Jung, Sohwa;Kwon, Ho-Jang
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.1
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    • pp.15-25
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    • 2020
  • Objectives: The purpose of this study was to investigate the health effects of air conditioning use during the 2018 heat wave in Korea, included the highest temperature ever recorded in the nation. Methods: The participants in this study were 1000 adults aged 19 years and older recruited from across Korea. The participants were asked about their experience of symptoms of various diseases, disruptions of their daily lives, and use of air conditioning during the heat wave. The associations between air conditioning use during the heat wave and health outcomes were analyzed using the chisquare test and multiple logistic regression models. Results: Among participants who lacked air conditioning in the main space where they spent time outside the home, 33.9%, 8.1%, 43.5%, and 19.4% experienced symptoms of heat-related, cardiovascular, nervous system diseases, and air-conditioningitis, respectively. In comparison, participants who did have air conditioning outside the home experienced the same symptoms at proportions of 21.0%, 1.9%, 26.8%, and 34.2%, respectively (p=0.027, 0.007, 0.007, and 0.023, respectively). Among participants who had no air conditioner at home, 10.0% were absent from school or work due to the heat wave. In contrast, among participants who had an air conditioner at home, only 3.7% were absent as a result of the heat wave (p=0.007). Conclusions: When air conditioning was not used at home or in the main space where participants spent time outside the home during the 2018 heat wave, adverse health effects were more prevalent, but the risk of air-conditioningitis was reduced.

Analysis of Effectiveness of Spectrum of Energy and Image Quality Evaluation by Aluminium Filter in the added Compound Filtration (에너지 스펙트럼과 화질평가를 통한 복합부가여과에서 알루미늄 여과판의 효율성 분석)

  • Kim, Sang-Hyun;Choi, Jae-Ho
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.187-197
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    • 2015
  • This study analysed the effectiveness of aluminium(Al) filter in the added compound filtration for the removal of characteristic radiation by energy spectrum and image evaluation. 0.1, 0.2, 0.3 mm copper with and without 1 mm Al were evaluated. The energy spectrum was measured using the GATE and evaluated separately by each energy. Image quality was evaluated by PSNR, MAE, MSE, CNR, SNR and qualitative analysis was performed by seven items for resolution and contrast from chest x-ray criteria of National Cancer Screening and Cardiovascular evaluation table. In the analysis of the quality of the energy per photon spectrum with the exception of a low energy region, without Al were superior in all area. PSNR MAE, MSE, CNR, SNR and qualitative analysis were the same or slightly better. PSNR was over 30 dB and all significant and the p>0.05 in the T-test of qualitative analysis. The energy spectrum and image quality have little difference between before and after use of Al filter. Therefore, it is effective to use the Al filter for the radiation dose management with the compensation capability of DR system.

A Comparative Study on Isoflavone Intakes and Blood Lipids between Hypertensive and Normotensive (고혈압 환자와 정상인의 이소플라본 섭취와 혈중 지질상태 비교연구)

  • Choi Mi-Kyeong;Jun Ye-Sook
    • Korean Journal of Community Nutrition
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    • v.11 no.2
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    • pp.271-278
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    • 2006
  • It has been suggested that isoflavones protect the cardiovascular system, in part by attenuating blood pressure. The purpose of the present research was to compare the isoflavone intake and blood lipids between hypertensive and normotensive and to examine dietary management for prevention of hypertension. Anthropometrical measurements, blood pressures, nutrients and isoflavone intakes using the 24-hour recall method, and serum lipids of 81 hypertensives and 77 normotensives were estimated. The average age, height, weight, and BMI were 58.2 years, l58.5 cm, 64.3 kg, and $25.6kg/m^2$ for the hypertensive and 58.0 years, 159.4 cm, 63.0 kg, and $24.8kg/m^2$ for the normotensive, respectively. Systolic and diastolic blood pressures of the hypertensive were significantly higher than those of the normotensive (p<0.001, p<0.001). The daily food intake of the hypertensive was significantly lower than that of the normotensive (p<0.01). The daily energy intakes of hypertensive and normotesive were 1479.8 kcal and 1590.9 kcal and there was no significant difference between the two groups. Carbohydrate intake of the hypertensive was significantly higher than that of the normotensive (p<0.05). However, daily intakes of plant protein, fiber, ash, calcium, sodium, potassium, and vitamin $B_1$ of the hypertensive were significantly lower than those of the normotensive (p<0.05, p<0.01, p<0.01, p<0.01, p<0.05, p<0.05, p<0.05). The daily intakes of daidzein, genistein, isoflavone of the hypertensive were significantly lower than those of the normotensive (p<0.05, p<0.05, p<0.05). However, isoflavone intakes per 1000 kcal showed no significant difference between the two groups. Serum lipids of the hypertensive and normotensive were l89.6 mg/dL and l87.2 mg/dL for total cholesterol, 157.3 mg/dL and 161.9 mg/dL for triglyceride, 42.9 mg/dL and 43.5 mg/dL for HDL-cholesterol, 115.2 mg/dL and 111.4 mg/dL for LDL-cholesterol, and 3.5 and 3.4 for atherogenic index. In the total subjects, there was a significantly negative correlation between systolic blood pressure and genistein intake (p<0.05). Based on these results, we concluded that the daily intakes of food, energy, and isoflavones of hypertensives were lower than normotensives. Therefore, it should be emphasized that proper dietary management considering these dietary factors for prevention of hypertension.

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.

A Case of Thyroid Cancer Combined with Pulmonary Sarcoidosis (사르코이드증에 동반된 갑상샘 암 1예)

  • Kim, Su-Jin;Lim, Tae Kyung;Kim, Chang-Hwan;Hwang, Yong-Il;Park, Sung-Hoon;Jang, Seung-Hun;Min, Kwang-Seon;Lee, In-Jae;Hwang, Hee-Sung;Lee, Jae-Woong;Kim, Dong-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.52-56
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    • 2008
  • Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. Since Brincker first noted a statistically significant increase of malignant tumors among sarcoidosis patients, there have been several reports on simultaneously developed sarcoidosis and malignancy. A 30-year-old man was admitted to our hospital because of multiple enlarged mediastinal lymph nodes. The patient had been well until approximately 10 days before admission, when he developed a cough. Chest X-ray and computed tomography (CT) of the chest that were performed at the outpatient department revealed multiple enlarged mediastinal lymph nodes. Cervical lymph node biopsy revealed both non-caseating granuloma and metastatic papillary carcinoma, whereas the mediastinal lymph node showed only non-caseating granuloma. The thyroid gland surgical specimen showed papillary carcinoma. We report here on a case of a 30-year-old man who had sarcoidosis and thyroid cancer, and we include a review of the literature.

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology

  • Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.1-12
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    • 2020
  • Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.