• Childhood Kidney Diseases
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• 제11권2호
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• pp.294-298
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• 2007

모야모야병은 주로 뇌혈관 협착을 유발하여 측부순환을 생성하는 질환으로 최근 뇌혈관 이외의 혈관에도 침범할 수 있음이 보고되고 있다. 지금까지 모야모야병에서 폐동맥, 관상동맥, 말초동맥 및 신동맥의 협착을 동반한 증례들이 발표되고 있다. 이 중 신동맥 협착을 동반한 경우 이로 인한 신성고혈압을 보이는 증례들이 보고되고 있으며 이는 모야모야병에서 지속적인 고혈압을 보여 2차적인 뇌경색이나 뇌출혈 등의 합병증을 유발할 수 있으므로 모야모야 환자의 치료에 있어서 항상 면밀하게 평가되어야 할 부분이다. 저자들은 모야모야병으로 양측 뇌경질막동맥간접문합술을 시행 받고 경과관찰 하던 환아에서 지속되는 고혈압으로 인해 발견된 신동맥 협착 및 이로 인한 신성 고혈압을 경험하였기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제19권4호
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• pp.569-577
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• 1986

Between October 1979 and June 1986, modified Fontan procedures have been performed on 22 patients by the Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine. Twelve patients had tricuspid atresia; one, congenital tricuspid stenosis; five, single ventricle; two, I-transposition of the great vessels; one, double outlet right ventricle, and one, pulmonary atresia with an intact ventricular septum. There were 9 operative deaths [mortality; 40.9%]. The causes of death were right heart failure in six patients and pulmonary venous hypertension in one who misdiagnosed preoperatively. Another two were deceased due to sepsis and cerebrovascular accident at postoperative 35 and 34 days in each. There were 7 patients below 4 years of age at the time of operation and among them 4 patients were deceased. The operative death was not related with patients` age above and below 4[p=0.211]. The relation between operative death of tricuspid anomaly and another cardiac malformations was statistically significant [p=0.048]. The operative procedures with or without valved conduit [woven dacron] was related significantly [p=0.043] in the case of the 21 of the patients, but the modified Fontan operation with a valved conduit was performed early stage in this series. Since 1982, we operated on 4 patients, doing a right atrium-right ventricle anastomosis without a conduit. All survived and remained in functional class I [NYHA]. The right atrial pressure [RAP] was elevated significantly after operation [mean 9.9$\pm$4.8 ~16.9$\pm$3.6 mmHg, p<0.001]. The relation between the postoperative RAP of the survival group [16.5$\pm$4.3 mmHg] and the group who died [17.4$\pm$2.2 mmHg] was statistically significant [p=0.047]. There was no relation between any operative death and any previous palliation. All patients were followed for 4 months to 80 months, except one who was lost to follow up at 2 months following surgery [mean 11.4 months, 238 patient. months]. All were in functional class I with 5 on medications and 7 not. One was reoperated at 70 months following the first operation, due to conduit stenosis. She was moderately impaired in activity, with hepatomegaly after the second operation.

• Journal of Preventive Medicine and Public Health
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• 제27권2호
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• pp.175-185
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• 1994

In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.

• 동의생리병리학회지
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• 제19권6호
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• pp.1676-1680
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• 2005

There are few topic about a pulmonary thromboembolism(PTE) especially in Korean medical research. This case report is dealt with a rare situation that a PTE and a lacunar infarction are complicated in one patient. They have a similarity in that both are caused by the thrombosis. The former is the thrombosis in lung and the latter is the cerebral infarcion within the territory of a single perforating artery Recently the attack rate of PTE somewhat grow because of the development of medicine such as the increasing use of indwelling catheters, trauma or surgery of pelvis and lower extrimity, major surgery especially in senior, the use of estrogen containing compounds, cerebrovascular disease, obesity, etc. A 70 year-old lady was stroked by the cerebral infarction and has been getting rehabilitating therapy. She had the sudden onset of dyspnea, chest pain and those symptoms looked like a myocardial infarction. But she was diagnosed as PTE by ventilation perfusion lung scan. We cured her with the integrated therapy of Korean and Western medicine.

• Biomolecules & Therapeutics
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• 제22권3호
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• pp.223-231
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• 2014

In this study, we prepared cordycepin-enriched (CE)-WIB801C, a n-butanol extract of Cordyceps militaris-hypha, and investigated the effect of CE-WIB801C on collagen-induced human platelet aggregation. CE-WIB801C dose-dependently inhibited collagen-induced platelet aggregation, and its $IC_{50}$ value was $175{\mu}g/ml$. CE-WIB801C increased cAMP level more than cGMP level, but inhibited collagen-elevated $[CA^{2+}]_i$ mobilization and thromboxane $A_2$ ($TXA_2$) production. cAMP-dependent protein kinase (A-kinase) inhibitor Rp-8-Br-cAMPS increased the CE-WIB801C-downregulated $[CA^{2+}]_i$ level in a dose dependent manner, and strongly inhibited CE-WIB801C-induced inositol 1, 4, 5-trisphosphate receptor ($IP_3R$) phosphorylation. These results suggest that the inhibition of $[CA^{2+}]_i$ mobilization by CE-WIB801C is resulted from the cAMP/A-kinase-dependent phosphorylation of $IP_3R$. CE-WIB801C suppressed $TXA_2$ production, but did not inhibit the activities of cyclooxygenase-1 (COX-1) and $TXA_2$ synthase (TXAS). These results suggest that the inhibition of $TXA_2$ production by WIB801C is not resulted from the direct inhibition of COX-1 and TXAS. In this study, we demonstrate that CE-WIB801C with cAMP-dependent $CA^{2+}$-antagonistic antiplatelet effects may have preventive or therapeutic potential for platelet aggregation-mediated diseases, such as thrombosis, myocardial infarction, atherosclerosis, and ischemic cerebrovascular disease.

• 대한한방내과학회지
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• 제10권1호
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• pp.25-38
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• 1989

Clinical observation was done on 1092 cases of cerebrovascular disease which were confirmed by Brain CT scan in Oriental Medical Hospital in Kyung Hee Univ. from May 1987 to May 1988. Specially, clinical prognosis of 250 patients who had been hospitalized for over 4 weeks, were obserbed. The results were obtained as follows; 1. In this study, Occlusive CVD was 77.9%, Cerebral hemorrhage was 18.8%, Subarachnoid hemonhage was 0.8%. 2. The ratio of male to female was 1.4:1. In the age distribution, 60th decade, 50th decade, 40th decade, 30th's, 20th's were in order of frequency and specially 60th decade was 35.53% over 70th decade was 17.1% in ratio. 3. The most common preceding disease of CVD was hypertension (54.21%) and diabetes mellitus (19.96%) was second. 4. Almost, the duration of hospitalization was 2-4 weeks in 34.8%, within 4 weeks in 78.02%. 5. Primary attack was 75.7%, 2nd attack was 17.9%, over 3rd attack was 3.1% in ratio of recurrence. 6. The level of consciousness was Grade I in 96.4%, Grade II in 3.2%, Grade III in 1% at attack. 7. A few complications of C.V.A. were observed in the studies: pneumonia was noted frequently in 3.2%, bed sore, urinary tract infection, gastro intestinal bleeding in order of frequency. 8. The ratio of neurologic deficiency in occlusive CVD decreased from 51.9% to 29.3% in upper limb, 52.6% to 24.4% in lower limb, and that in cerebral hemorrhage decreased from 69.5% to 25% in upper limb, 50% to 20% in lower limb. 9. The ratio of left side hemiplegia to right was 1.04:1 in male, 1:1.18 in female. 10. The herb medications for C.V.A. were various Chungg-Paesagantang, Sunghanggeonggisan were used most frequently to Chungyeold, Geopung, Soongi, Haldam and Chungsimtang, the drugs for Bogiheol were used as discharge. In these oriental medical therapy of C.V.A. objective diagnosis and more various therapeutic method must be obtained through east-west medical co-operation.

• Journal of Pharmaceutical Investigation
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• 제40권2호
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• pp.117-123
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• 2010

Ibudilast, 3-isobutyryl-2-isopropyrazolo[1,5-a]pyridine, is a nonselective inhibitor of cyclic nucleotide phosphodiesterase (PDE). It preferentially inhibits PDE 3A, PDE4, PDE10 and PDE11 as well as a number of the other PDE families, albeit to a lesser extent. Ibudilast is used clinically to treat bronchial asthma and cerebrovascular disorders. Thes e clinical uses are based on the ability of ibudilast to inhibit platelet aggregation, improve cerebral blood flow and attenuate allergic reactions. The purpose of the present study was to evaluate the bioequivalence of two ibudilast capsules, Ketas capsule (Handok Pharmaceuticals Co., Ltd.) and Pinatos capsule (Sam Chun Dang Pharm. Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The in vitro release of ibudilast from the two ibudilast formulations was tested using KP Apparatus method with various dissolution media. Twenty six healthy male subjects, 23.31${\pm}$1.09 years in age and 70.45${\pm}$8.51 kg in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After a single capsule containing 10 mg as ibudilast was orally administered, blood samples were taken at predetermined time intervals and the concentrations of ibudilast in serum were determined using HPLC/UV detector. The dissolution profiles of two formulations were similar in all tested dissolution media. The pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and computer programs (Equiv Test and K-BE Test 2002) were utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, Ketas, were 6.99%, -2.48% and 9.93% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.8791~log 1.1861 and log 0.8347~log 1.1199 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Pinatos capsule was bioequivalent to Ketas capsule.

• 한국산학기술학회논문지
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• 제16권8호
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• pp.5492-5500
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• 2015

LDL-콜레스테롤(LDL-C)은 심뇌혈관질환의 주된 교정 가능한 위험인자로서, 정확한 측정값을 임상에 적용하는 것이 중요하다. 하지만 LDL-C의 측정은 실제 측정이 아닌 Friedewald 공식에 의한 계산방법이 널리 이용되고 있다. 본 연구의 목적은 LDL-C의 Friedewald-추정값과 실측값을 비교하고, 두 방법의 LDL-C 위험수준 분류 일치도를 평가하는 것이다. 표본은 국민건강영양조사 2개년(2009년과 2010년)의 공개된 자료에서 추출되었고, 혈액 검사에서 총 콜레스테롤, HDL-콜레스테롤, 직접 측정한 LDL-C, 그리고 중성지방 중 어느 한 결측치도 없는 4,319명을 연구대상으로 하였다. 중성지방 400 mg/dL 미만일 때, Friedewald-추정값과 실측값은 높은 상관관계를 보였고 (r = 0.958, p < 0.001), 위험수준 분류 일치 백분율은 82.7%이었다. 중성지방 수준이 높을수록, 일치 백분율은 낮았다. 중성지방 수준 150 mg/dL 미만, 150-200 mg/dL, 그리고 200-399 mg/dL일 때, 일치 백분율은 각각 85.4%, 78.2%, 그리고 71.4%이었다. Friedewald 공식은 중성지방 농도 150 mg/dL 미만에서는 LDL-C를 과대평가하는 반면, 중성지방 농도 150 mg/dL 이상에서는 과소평가하는 경향이 있었다. 이에 따라 LDL-C 위험수준 분류에 있어 그 범주가 과대평가된 사람은 382명 (9.1%)인 반면, 과소평가된 사람은 348명 (8.3%)이었다. 이러한 결과는 Friedewald-추정값의 LDL-C 과소평가뿐만 아니라, 과대평가도 심각한 문제일 수 있음을 제시한다.

• 가정간호학회지
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• 제5권
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• 대한한방소아과학회지
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• 제15권1호
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• pp.117-129
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• 2001

Objective : Hyperlipidemia and hypertension are well recognized risk factors of cerebrovascular disease. So it's very important to evaluate blood pressure and s-cholesterol in adolescence. Material and Methods : April 1999, we were requested health examinaion for high school students of a boys high school and a girls high school in Jeonbuk, Korea. The subjects were 360 students, boys were 317 and girls were 343. They were checked their height, body weight, blood pressure, and s-cholesterol. Results and Conclusion : The mean of systolic blood pressure of study subjects was $111.89{\pm}12.43mmHg$. In boys, it was $116.25{\pm}11.78mmHg$, and in girls, it was $107.87{\pm}11.64mmHg$. The mean of diastolic blood pressure of study subjects was $68.45{\pm}9.40mmHg$. In boys, it was $66.92{\pm}10.00mmHg$, and in girls it was $69.85{\pm}9.40mmHg$. Hypertensives were 18(5.68%) in boys, 10(2.92%) in girls. The mean of s-cholesterol of study subjects was $174.95{\pm}32.28mg/dL$. In boys, it was $178.91{\pm}34.51mg/dL$, and in girls, it was $171.29{\pm}29.66mg/dL$. Hypercholesterolemias were 91(28.71%) in boys, 39(11.37%) in girls. The mean of BMI of study subjects was $21.12{\pm}3.27kg/m2$. In boys, it was $21.05{\pm}3.26kg/m2$, and in girls, it was $21.18{\pm}3.29kg/m2$. Obese boys were 18(5.68%), obese girls were 13(3.79%). The mean of diastolic blood pressure in obese boys was significantly higher than that of normal boys(p=0.001, Mann-Whitney test). The mean of s-cholesterol in obese boys($BMI{\ge}274$) was significantly higher than that of normal boys.(P=0.26, Mann-Whitney test).