• Journal of the Korea Society for Simulation
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• v.29 no.1
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• pp.11-21
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• 2020

Cardio-cerebrovascular diseases (CCD) account for 24% of the causes of death to Koreans and its proportion is the highest except cancer. Currently, the risk of the cardiovascular disease for domestic patients is based on the Framingham risk score (FRS), but accuracy tends to decrease because it is a foreign guideline. Also, it can't score the risk of cerebrovascular disease. CCD is hard to predict, because it is difficult to analyze the features of early symptoms for prevention. Therefore, proper prediction method for Koreans is needed. The purpose of this paper is validating IG-MLP (Information Gain - Multilayer Perceptron) evaluation based feature selection method using CCD data with simulation. The proposed method uses the raw data of the 4^th ~ 7^th of The Korea National Health and Nutrition Examination Survey (KNHANES). To select the important feature of CCD, analysis on the attributes using IG-MLP are processed, finally CCD prediction ANN model using optimize feature set is provided. Proposed method can find important features of CCD prediction of Koreans, and ANN model could predict more accurate CCD for Koreans.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.167-179
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• 2009

Hypertension is one of the most common chronic diseases and it causes cardiovascular and cerebrovascular disease. While antihypertensive drug use increased, it took 15% of national health insurance drug expenditure. This study aimed to examine the pattern of antihypertensive drug prescription using National Health Insurance claims database and compare it with recommendations of Korea Hypertension Treatment Guidelines. Among the antihypertensive drugs, calcium channel blocker(64.4%) was most commonly prescribed class, and diuretics(44.6%), angiotensin II receptor blocker(33.3%), angiotensin converting enzyme inhibitor(11.7%) was followed. Approximately 81% of antihypertensives prescription were without cardiovascular or cerebrovascular disease, and among the comorbid conditions, diabetes(10.7%) was most common. calcium channel blocker(62.3%) was mostly prescribed class for hypertension with angina pectoris, angiotensin receptor blocker(45.3%) with myocardial infarction, diuretics(70.2%) and calcium channel blocker(49.5%) with congestive heart failure. For Hypertension with cerebrovascular disease, calcium channel blocker(68.0%) and angiotensin receptor blocker(43.3%) were prescribed mainly. When it comes to diabetes, calcium channel blocker(57.2%) was still mostly prescribed and angiotensin receptor blocker(45.9%) followed. But in hospitals and tertiary hospitals, angiotensin receptor blocker(65.7, 66.1%) was mostly prescribed for the patients with diabetes. For Hypertension with chronic renal disease, angiotensin receptor blocker(59.5%), calcium channel blocker(56.5%), diuretics(54.6%) were mainly used. Average number of classes per prescribing was $1.89{\pm}0.89$ class, average days per prescribing was $33{\pm}19$ day. Among the hypertension without comorbidity, 40.5% of prescription was monotherapy and 58.8% of polytherapy included diuretics. Among the outpatient prescriptions, calcium channel blocker was the most commonly used class, and the prescription pattern in clinic did not closely followed recommendations of Hypertension Treatment Guidelines.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.1-12
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• 2009

Objectives: The aim of this study was to characterize the community health indicators affecting standardized mortality rate of cerebrovascular diseases(CVD) and to identify the relationship between CVD mortality and community health indicators in Gangwon-do. Methods: The community health indicators included material deprivation index, medical resource, rates of road pavement and local tax. CVD mortality and the material deprivation index were calculated in the registered death data and the 2000 census which were obtained from the Korean National Statistics Office. The community health indicators were measured using 2001 statistical year book of Ganwon-do. Data were analyzed by using Excel 2003, SAS 9.1. CVD mortality and material deprivation index were visualized by Arcview 9.1. Results: CVD mortality varied by region and sex in Gangwon-do. The highest CVD mortality in male and female were noted at Goseong-gun, the lowest CVD mortality in male was at Yangyang-gun as it of female at Pyeongchang-gun. In Taebaek city where material deprivation index was also the highest; in Pyeongchang-gun was the lowest. Also the higher material deprivation index in some regions was the higher CVD mortality was. CVD mortality was not related with community health indicators. Conclusions: The results showed the regional difference of mortality of CVD among counties and cities in Gangwon-do. It is recommended that other community health indicators besides material deprivation index, road pavement rate, medical resources and local tax affecting CVD mortality need to be considered to improve the preventive strategies.

• The Journal of Internal Korean Medicine
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• v.41 no.4
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• pp.658-667
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• 2020

Objectives: The purpose of this study was to analyze trends in Korean-Western Collaborative Medicine studies by disease group. Methods: Articles published until May 2020 were searched in domestic databases (NDSL, RISS, KISS, DBPIA, and KoreanTK) using the keywords '한양방', '양한방', '협진', '협의진료', '의한의', '의·한의', and '통합의학'. The articles were analyzed according to the publication year, journal type, research methodology, and disease group using the major and intermediate classifications of the Korean Standard Classification of Diseases (KCD-7). Results: In total, 112 articles were selected. The most frequent major disease groups were disease codes G, C (D), I, and M, in that order. The medium disease groups numbered 41 and most commonly involved collaborative studies on cerebrovascular diseases. Among the three top KCD-7 major group diseases, publications on Group C (D) were increasing significantly, publications on Group G were slightly increasing, but, publications on Group I decreased in the 2010s compared to the 2000s. Conclusions: In this study, we analyzed the frequent disease groups treated with domestic Korean-Western medicine in collaborative studies using the major and medium classifications of KCD-7. Well-designed clinical trials and economic evaluation research are needed, and this study can provide directions for future collaborative studies using Korean-Western medicine.

• Health Policy and Management
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• v.24 no.1
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• pp.24-34
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• 2014

Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

• Journal of Preventive Medicine and Public Health
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• v.53 no.5
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• pp.313-322
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• 2020

Objectives: This study was conducted to determine the incidence and risk factors of myocardial infarction (MI) and stroke in farmers compared to the general population and to establish 5-year prediction models. Methods: The farmer cohort and the control cohort were generated using the customized database of the National Health Insurance Service of Korea database and the National Sample Cohort, respectively. The participants were followed from the day of the index general health examination until the events of MI, stroke, or death (up to 5 years). Results: In total, 734 744 participants from the farmer cohort and 238 311 from the control cohort aged between 40 and 70 were included. The age-adjusted incidence of MI was 0.766 and 0.585 per 1000 person-years in the farmer and control cohorts, respectively. That of stroke was 0.559 and 0.321 per 1000 person-years in both cohorts, respectively. In farmers, the risk factors for MI included male sex, age, personal history of hypertension, diabetes, current smoking, creatinine, metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). Those for stroke included male sex, age, personal history of hypertension, diabetes, current smoking, high γ-glutamyl transferase, and metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). The prediction model showed an area under the receiver operating characteristic curve of 0.735 and 0.760 for MI and stroke, respectively, in the farmer cohort. Conclusions: Farmers had a higher age-adjusted incidence of MI and stroke. They also showed distinct patterns in cardiovascular risk factors compared to the general population.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.131-136
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• 2021

Duplex sonography is used widely in various medical fields because of its repeatability and low cost. In particular, the carotid duplex sonography is a useful non-invasive test for diagnosing cerebrovascular disease and predicting the prognosis. In clinical practice, it is very important to reduce the test time and improve accuracy. The patient's clinical information must be known in advance to perform carotid duplex sonography quickly and accurately. Despite this, there are often difficulties finding new cervical vascular diseases that are not mentioned in the clinical information. Therefore, knowing a variety of cases can lead to fast and accurate results. In this context, this paper reports three cases of cervical vascular disease discovered unexpectedly during carotid duplex sonography: CASE 1, internal carotid artery occlusion and cerebral arteries branched from the external carotid artery; CASE 2, internal jugular vein thrombosis; CASE 3, microembolism observed in the vertebral artery.

• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.70-88
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• 2022

Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake-response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.260-265
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• 2010

Background: A composite valve graft replacement has been used for a variety of aortic root diseases. The aim of this study was to evaluate the mid-term results of this technique. Material and Method: We conducted a retrospective analysis of aortic root composite valve graft replacements in 39 patients and these procedures were done at our institution between 1992 and 2009. The mean age of the patients was $49.2{\pm}16.4$ years. The mean follow-up was $64.2{\pm}53.4$ months (maximum: 176 months). Result: There were 4 hospital deaths (8.6%) due to emergency aortic dissection and 4 late deaths owing to several causes. The causes of late death were 2 ruptures of a remnant aneurysm, 1 subdural hemorrhage and 1 paravalvular leakage. The calculated survival rate was 93.5%, 85.0% and 85.0% at 1, 5 and 10 years, respectively. There were 3 cerebrovascular accidents during the follow up period. The rate of freedom from cerebrovascular accidents was 97.0%, 92.0% and 80.0% at 1, 5 and 10 years, respectively. All of these brain accidents were hemorrhage-related complications. Conclusion: A composite valve graft replacement of the aortic root was associated with favorable results. So, this technique seems to be a good method to treat various aortic root diseases.

• The Journal of Dong Guk Oriental Medicine
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• v.8 no.1
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• pp.107-116
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• 1999

The effects of Sosokmyung-tang(小續命湯) on global cerebral ischemia and cerebral in farction by MCA(middle cerebral artery) occlusion were evaluated in this study. This study was performed to investigate that Sosokmyung-tang would be useful for cerebrovascular diseases. In the case of global cerebral ischemia, ICR mice were used and divided into three group at random. Control group was treated after oral administration of normal saline, experimental group was treated after oral administration of 10.4mg/20g/day of Sosokmyung-tang extract. The multiple parameter of global cerebral ischemia included the duration of coma of KCN(potassium cyanide)-injected(1.2mg/kg, i.v) group and the survival time of KCN-injected(3.0mg/kg, i.v) group. In the case of cerebral infarction by MCA occlusion, Sprague-Dawley rats were used and divided into three group at random. Control group was given nothing before MCA occlusion, experimental group was given 157.2mg/250g/day of Sosokrnyung-tang extract before MCA occlusion. We investigated edema and ischemic ratio in 8 slices of rats' brain after MCA occlusion. The results were obtained as follows : 1. Sosokrnyung-tang significantly shortened the duration of coma of KCN-injected(1.2mg/kg,i.v) group and lengthened the survival time of KCN-injected(3.0mg/kg, i.v) group. 2. Sosokmyung-tang significantly decreased cerebral edema and ischemic ratio in rats after MCA occlusion. From the above results, it was concluded that Sosokmyung-tang can be effectively applied to cerebrovascular diseases.