• Journal of Chest Surgery
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• v.52 no.1
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• pp.9-15
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• 2019

Background: Although aortic valve repair can reduce prosthesis-related complications, rheumatic aortic regurgitation (AR) caused by leaflet restriction is a significant risk factor for recurrent AR. In this study, we evaluated the long-term results of the leaflet extension technique for rheumatic AR. Methods: Between 1995 and 2016, 33 patients underwent aortic valve repair using the leaflet extension technique with autologous pericardium for rheumatic pure AR. Twenty patients had severe AR and 9 had combined moderate or greater mitral regurgitation. Their mean age was $32.2{\pm}13.9$ years. The mean follow-up duration was $18.3{\pm}5.8$ years. Results: There were no cases of operative mortality, but postoperative complications occurred in 5 patients. Overall survival at 10 and 20 years was 93.5% and 87.1%, respectively. There were no thromboembolic cerebrovascular events, but 4 late deaths occurred, as well as a bleeding event in 1 patient who was taking warfarin. Twelve patients underwent aortic valve reoperation. The mean interval to reoperation was $13.1{\pm}6.1$ years. Freedom from reoperation at 10 and 20 years was 96.7% and 66.6%, respectively. Conclusion: The long-term results of the leaflet extension technique showed acceptable durability and a low incidence of thromboembolic events and bleeding. The leaflet extension technique may be a good option for young patients with rheumatic AR.

• Korean Journal of Occupational Health Nursing
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• v.28 no.4
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• pp.262-270
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• 2019

Purpose: This study aims to provide preliminary data for weight management, and prevention and management of cardiovascular and cerebrovascular diseases. We examined the effect of changes in the weight of workers at a manufacturing company over three years on their metabolic syndrome and metabolic syndrome diagnosis components. Methods: Necessary data were collected from the questionnaire and the results of the Korean National Health Screening of 2015 and 2017, which included 228 workers at a manufacturing company in G region. The collected data were analyzed using the SPSS/WIN 23.0 program. ANCOVA was used to examine the differences in the metabolic syndrome diagnosis components according to weight change. In addition, multiple logistic regression analysis was used to obtain the odds ratios of metabolic syndrome and metabolic syndrome analysis component, based on the weight changes in the normal weight group and the obesity group. Results: Waist measure, systolic blood pressure, and blood pressure were found to have significant effects based on participants' weight change over three years. These factors increased with a larger increase in weight at a statistically significant level. This study analyzed the weight changes of the normal weight group and the obesity group considering the data from the National Health Screening of 2015, and found that the risk of metabolic syndrome increased at a statistically significant level as body weight increased; thus, the obesity group showed a higher risk in this regard. It was also found that waist measure, fasting blood sugar, and high-density low cholesterol increased at a statistically significant level as body weight increased. Conclusion: Health administrators need to recognize the importance of workers' weight management, select an intensive management group based on a time series analysis of weight changes, and develop and implement programs to manage the metabolic syndrome diagnosis components.

• BMB Reports
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• v.54 no.5
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• pp.278-283
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• 2021

Our understanding of the differential effects between specific omega-3 fatty acids is incomplete. Here, we aimed to evaluate the effects of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on T-helper type 1 (Th1) cell responses and identify the pathways associated with these responses. Naïve CD4⁺ T cells were co-cultured with bone marrow-derived dendritic cells (DCs) in the presence or absence of palmitate (PA), DHA, or EPA. DHA or EPA treatment lowered the number of differentiated IFN-γ-positive cells and inhibited the secretion of IFN-γ, whereas only DHA increased IL-2 and reduced TNF-α secretion. There was reduced expression of MHC II on DCs after DHA or EPA treatment. In the DC-independent model, DHA and EPA reduced Th1 cell differentiation and lowered the cell number. DHA and EPA markedly inhibited IFN-γ secretion, while only EPA reduced TNF-α secretion. Microarray analysis identified pathways involved in inflammation, immunity, metabolism, and cell proliferation. Moreover, DHA and EPA inhibited Th1 cells through the regulation of diverse pathways and genes, including Igf1 and Cpt1a. Our results showed that DHA and EPA had largely comparable inhibitory effects on Th1 cell differentiation. However, each of the fatty acids also had distinct effects on specific cytokine secretion, particularly according to the presence of DCs.

• Health Policy and Management
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• v.32 no.4
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• pp.389-399
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• 2022

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.

• Women's Health Nursing
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• v.28 no.2
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• pp.112-122
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• 2022

Purpose: The prevalence of osteoporosis in postmenopausal women is increasing, and diabetes patients have decreased bone density. Their health-related quality of life (HRQoL) is diminished by the resultant physical dysfunction and depression. The purpose of this study was to identify factors influencing HRQoL in postmenopausal women with diabetes and osteoporosis. Methods: This was a secondary data analysis of the Seventh Korea Health and Nutrition Examination Survey (2016-2018), which utilized a complex, multistage probability sample design. The participants in the study were 237 women with diabetes and osteoporosis. To evaluate the factors that influenced HRQoL, a complex-samples general linear model was constructed, and the Bonferroni correction was performed. Results: In this sample of women aged 45 to 80 years (mean±standard deviation, 71.12±7.21 years), the average HRQoL score was 0.83±0.18 out of 1.0. Factors influencing HRQoL were age (70s: t=-3.74, p<.001; 80s: t=-3.42, p=.001), walking for exercise more than 5 days a week (t=-2.83, p=.005), cerebrovascular disease (t=-8.33, p<.001), osteoarthritis (t=-2.04, p=.014), hypertension (t=2.03, p=.044), higher perceived stress (t=-2.17, p=.032), poor glycemic control (t=3.40, p=.001), waist circumference (t=-2.76, p=.007), sitting time per day (t=-2.10, p=.038), and a longer postmenopausal period (t=3.09, p=.002). Conclusion: In order to improve the HRQoL of postmenopausal women with osteoporosis and diabetes, it is necessary to implement intervention strategies that enable the effective management of chronic diseases, while preventing the complications of diabetes and minimizing stress through physical activity.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2021.10a
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• pp.167-169
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• 2021

There are only 14 public medical facilities available to residents regularly in the island area of Chungcheongnam-do, one health life support center, and one hospital ship, and these facilities and equipment cannot effectively respond to emergency patients such as severe trauma, cerebrovascular and cardiovascular diseases. The fastest means of transporting emergency patients is to use a doctor helicopter deployed at Dankook University Hospital (based in Cheonan). However, there is only one doctor helicopter deployed, and it cannot operate at night, and since it is in charge of all areas of Chungcheongnam-do, there is a limit to rapid transport in the event of a large number of patients. Therefore, we would like to review the necessity of "Chungnam-type Doctor UAM Development" to compensate for the problems of the urban aviation mobility (UAM) industry and the emergency patient transport system in islands, a field of the 4th industry.

• The Journal of Korean Medicine
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• v.44 no.2
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• pp.201-201
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• 2023

Objectives: Cupping therapy (CT) has been widely used in traditional medicine worldwide for various indications, including stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.65-76
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• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• Journal of Oriental Medical Thermology
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• v.6 no.1
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• pp.23-31
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• 2008

Objective: The purpose of this study is to identify relationship between the PWV and the temperature difference. Methods: When it comes to senile patients who suffer from cold limbs, there is need to see whether or not the patient's low temperature of the limbs is do to arteriosclerosis. The Pulse Wave Velocity(PWV) is a non-invasive method measuring the artery's rigidness. And the Digital Infrared Thermal Imaging(D.I.T.I) is a non-invasive method to see the body's thermal change. Research on the interrelationship of the artery's rigidness and body's thermal distribution was done by using these two tests. The subjects of this research were patients between the age 40~65 who have done both the D.I.T.I and PWV in March 2005~ September 2005. They had to have no history of diabetes, coronary illnesses or cerebrovascular diseases which are diseases that can effect the outcome of the PVW, nor history of spondylopathy or dermatosis which can effect the outcome of the D.I.T.I. Results: The results were as follows. 1. There was a significant interrelationship between the right wrist-ankle PWV and the temperature difference of the right wrist-palm. 2. There was a significant interrelationship between the left wrist-ankle PWV and the temperature difference of the left wrist-palm. 3. There was no significant interrelationship between the right wrist-ankle PWV and the temperature difference of the right thigh-dorsum of foot. 4. There was no significant interrelationship between the left wrist-ankle PWV and the temperature difference of the left thigh-dorsum of foot. 5. The right ABI showed no significant interrelationship between the temperature difference of the right wrist-palm and the right thigh-dorsum of foot. 6. The left ABI showed no significant interrelationship between the temperature difference of the left wrist-palm and the left thigh-dorsum of foot. Conclusion: The study shows that there was a significant interrelationship between wrist-ankle PWV and the temperature difference of wrist-palm.