• Journal of Nutrition and Health
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• 제36권6호
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• pp.613-621
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• 2003

The purpose of this study was to investigate the association between dietary quality and the risk of coronary heart disease (CBD) among Korean men by a case-control study. Methods: The cases were 108 male patients with a first acute myocardial infarction or a new diagnosis of angina pectoris who were admitted to a university teaching hospital in Seoul. Controls were 142 age-matched patients admitted to the departments of ophthalmology and orthopedic surgery at the same hospital. Dietary information was assessed by a nutritionist using a semiquantitative food frequency questionnaire (FFQ), and dietary quality index (DQI) scores were calculated. Results: The intakes of total fat and cholesterol and body mass index (BMI) in cases were significantly higher than those in controls. The mean DQI scores were 8.6 for the cases and 9.4 for the controls. A higher DQI, which was indicative of a better quality diet, was inversely associated with the risk of CHD when comparing the highest to lowest quatiles, but borderline significant (odd ratios 0.60, 95% confidence interval 0.25-1.39, P for trend ＝ 0.05). Conclusions: Our findings suggest that better dietary quality may reduce the risk of CHD among Korean men.

• Journal of Nutrition and Health
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• 제33권8호
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• pp.873-881
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• 2000

Recent research reported health risks associate with high carbohydrates diets. Objectives of this study were to evaluate in a cross-sectional study if high carbohydrate diet is associated with coronary heart disease(CHD) risk factors: examined blood concnetration of triglyceride(TG), total cholesterol, high density lipoprotein cholesterol(HDL-C), plasma glucose, systolic blood pressure(BP), body mas index(BMI), wasit-hip ratio(WHR) and waist-stature ratio(WSR). Using the most recent US National Health and Nutrition Examination Survey(IIINHANES III) data, the nationally representative US population (3772 men, 4095 women of 25-64 years of age) was divided into low vs. high carbohydrate diet groups(below 40% vs. above 60% energy intake from cab carbohydrates) and compared by the CHD risk factors. Triglyceride was higher(p<0.001) in the high carbohydrate group, whereas high density-lipoprotein cholesterol(HDL-C)was lower(p<0.01) in the high carbohydrate diet group. In plasma glucose, there was no significant differences between high carbohydrate diet and low carbohydrate diet. In adiposity(BMI, WHR and WSR), it also showed no significant differences, After adjustment for age, ethnicity, alcohol and smoking in upper 60%-carbohydrate diet, Odds Ratio of TG and HDL-C were 1.42 and 1.23 in men and 1.22 and 1.17 in women. 50-60% carbohydrate diet was associated with decreased risk of CHD. Dietary guidelines for Koreans recommend 60-70% of total energy from carbohydrate, as Koreans traditionally consumed high carbohydrate diets. In a cross-sectional population of adults, diets containing 55-60% energy from carbohydrate were suggested as a dietary guideline of carbohydrate intake for Koreans. (Korean J Nutrition 33(8) : 873-881, 2000)

• Journal of Nutrition and Health
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• 제41권3호
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• pp.232-241
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• 2008

Moderate alcohol consumption has been known to be associated with reduced risk for coronary heart disease (CHD). We assessed the association between alcohol consumption and CHD-related risk factors [hypertension, diabetes mellitus (DM) , high total cholesterol, high triglyceride (TG), low HDL-cholesterol (HDL-C), and high LDL-cholesterol (LDL-C)] in Korean. After excluding those with extreme intake values, the number of final subjects included in the analysis was 4,662 Korean adults aged over 20 years (1,961 men, 2,701 women) who participate in the 2005 Korean National Health and Nutrition Examination Survey. The subjects were divided into four or five groups; none-alcohol consumption group, moderate alcohol consumption group (<15 or 15.0-29.9 g/d), heavy alcohol consumption group (30-69.9 g/d or ${\geq}$ 70 g/d in men, ${\geq}$ 30 g/d in women). Odds ratios (ORs) were estimated from logistic regression adjusting for potential covariates. Alcohol consumption was inversely associated with low HDL-C in both men and women. However, heavy alcohol intake (${\geq}$ 70 g/d) significantly increased risk for hypertension, DM, and hypertriglyceridemia in men. The frequency of alcohol intake was also associated with CHD risk. The risk for low HDLC was decreased with alcohol consumption (${\geq}$ 1 times/wk), but frequent alcohol intake (${\geq}$ 4 times/wk) increased the risk for hypertension. This study revealed that moderate alcohol consumption has protective effect on CHD-related risk factors in Korean population.

• 지질동맥경화학회지
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• 제7권2호
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• pp.110-121
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• 2018

Objective: We developed a new equation for predicting coronary heart disease (CHD) risk in Korean diabetic patients using a hospital-based cohort and compared it with a UK Prospective Diabetes Study (UKPDS) risk engine. Methods: By considering patients with type 2 diabetes aged ${\geq}30years$ visiting the diabetic center in Boramae hospital in 2006, we developed a multivariable equation for predicting CHD events using the Cox proportional hazard model. Those with CHD were excluded. The predictability of CHD events over 6 years was evaluated using area under the receiver operating characteristic (AUROC) curves, which were compared using the DeLong test. Results: A total of 732 participants (304 males and 428 females; mean age, $60{\pm}10years$; mean duration of diabetes, $10{\pm}7years$) were followed up for 76 months (range, 1-99 month). During the study period, 48 patients (6.6%) experienced CHD events. The AUROC of the proposed equation for predicting 6-year CHD events was 0.721 (95% confidence interval [CI], 0.641-0.800), which is significantly larger than that of the UKPDS risk engine (0.578; 95% CI, 0.482-0.675; p from DeLong test=0.001). Among the subjects with <5% of risk based on the proposed equation, 30.6% (121 out of 396) were classified as ${\geq}10%$ of risk based on the UKPDS risk engine, and their event rate was only 3.3% over 6 years. Conclusion: The UKPDS risk engine overestimated CHD risk in type 2 diabetic patients in this cohort, and the proposed equation has superior predictability for CHD risk compared to the UKPDS risk engine.

• Clinical and Experimental Pediatrics
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• 제46권3호
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• pp.302-307
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• 2003

환아는 3개월된 영아로 발병 10일째에 본원에 내원하여 초기에 적절한 진단과 치료를 받지 못했으며 발병 2주에 시행한 심초음파상 거대 관상동맥류를 보였다. 이에 정맥용 면역글로불린 투여와 aspirin과 dipyridamole로 치료 중 발병 24일째 혈전증이 동반되어 urokinase와 heparin의 IV 투여를 통한 혈전용해 치료로 혈전을 완전히 제거할 수 있었다. 이후 5년간 aspirin, dipyridamole, coumadin을 투여하면서 심전도와 심초음파검사를 반복하며 외래 추적 관찰 중 점차 좌측관상동맥내 혈전이 증가하고 내경이 점차 좁아지는 소견과 함께 협착이 의심되었다. 발병 5년 후 시행한 관상동맥 혈관조영술상 관상동맥 좌측 전하지가 완전 폐색되고 우측관상동맥으로부터 발달한 측부순환에서 혈류를 공급받고 있었고, 핵의학 검사상 좌심실의 전벽과 중격, 일부 외벽에 완전 가역적 관류 결손을 보였던 가와사끼병 환아 1례를 경험하여 보고한다.

• 생명과학회지
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• 제20권4호
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• pp.584-588
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• 2010

Clusterin은 Apolipoprotein J 등으로도 불리우기도 하는데 이 유전자의 발현이 동맥경화의 진행에 영향을 미치며[4], 관상동맥질환과 같은 혈관질환에도 중요한 역할을 하는 것으로 보고되어 있다[9,10,18] 최근 연구결과에 따르면, clusterin 유전자 다형성 중 10580 C>A, 10613 A>G이 아프리카인에게서 HDL-C의 serum level에 영향을 미치며, 이들 변이가 African-American에게서 Caucasian보다는 드물게 나타나지만, Hispanic에게서는 빈번하게 일어나는 것으로 보고되어 있다[11]. 또 다른 연구에서는 11개의 유전자 다형성을 조사한 결과 -4453G >T, 4183 A>G, 5608 C>T 는 상관관계가 없는 것으로 나타났으나, 6316 delT 유전자 다형성은 상관관계가 있는 것으로 보고되었다[8]. 본 연구에서는 관상동맥질환 환자군과 대조군을 각각 100명으로 하여 한국인에서 clusterin 유전자 다형성을 조사하였고, 특히 -4453 T>G에서 유의한 차이를 보였다. 이는 이전의 연구결과[8]와는 다소 차이가 있는데, Miwa 등의 결과에 따르면 일본인에게서는 6316 delT가 4183 A>G 다형성보다 동맥경화와 상관관계가 크다고 보고되었으나, 본 연구결과를 분석해보면 5608 C>T 는 상관관계가 없었으며, -4453 T>G 다형성만 상관관계를 가지는 것으로 나타났다. 이러한 차이를 보이는 원인은 정확하게 지적할 수는 없으나, 다형성이 미치는 영향력이 서로 다른 유전적 그리고 환경적인 요인의 차이에 의해서 일어나는 것으로 추정된다. 따라서 본 연구결과의 의의를 확인하기 위하여서는 대상 환자 수와 대조군을 늘리고 clusterin 유전자의 여러 다형성에 대한 추가적인 연구를 할 필요가 있을 것으로 판단된다.

• 대한간호학회지
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• 제30권3호
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• pp.549-559
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• 2000

The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

• Journal of Chest Surgery
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• 제18권4호
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• pp.753-758
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• 1985

Hemorrhage is an important complication after operation with cardiopulmonary bypass and sometimes necessitates a further emergency operation. Between July, 1962 and June, 1985, reoperation for hemorrhage was carried out on 81 patients [3.1%] out of a total 2634 patients who had previously undergone cardiopulmonary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Yonsei University Medical Center. There were 38 males and 43 females, with an average age of 25 years [ranging 6 months to 60 years] and an average body weight of 38 kg [ranging 5 to 77 kg].There were 43 patients of cyanotic heart disease, 32 patients of acquired valvular heart disease, 4 patients of coronary artery occlusive disease, 2 patients of ascending aorta aneurysm and annuloaortic ectasia. The average amount of blood loss in the case of cyanotic heart disease was 71.7140ml/kg, in acyanotic heart disease 45.16.3ml/kg, in acquired heart disease, 56.514.4ml/kg and in coronary artery occlusive disease, 50.618.7ml/kg during first post operative day. But there was no statistical difference [p>0.05]. The mean blood loss below 10 years old was 70.412.1 ml/kg. Those below 10 years old were believed to bleed more than any other group. But there was also no statistical difference [p>0.05]. Indications for reoperation were continued excessive blood loss [74%], cardiac tamponade or hypotension [23%] and radiological evidence of a large hematoma in the thorax and pericardium [2%]. Average bypass time was 2.10.1 hours [ranging 30 minutes to 5 hours]. The interval between operation and reoperation was as follows; less than 12 hours in 49 patients [60%], 12 to 24 hours in 20 patients [25%], 24 to 48 hours in 8 patients [10%], more than 48 hours in 4 patients [5%]. The commonest sites for bleeding were chest wall [36%], heart [34%], aorta [12%], pericardium [6%], thymus [5%] and others [6%]. But no definite source was found in ll patients [31%]. Twenty seven out of 81 patients [31%] had wound problems and 5 patients [6%] were expired. [Mean SEM]. In conclusion, in order to decrease the amount of blood loss after open heart surgery with cardiopulmonary bypass, shortening of bypass time and bleeding control at the wire suture site during chest wall closure were important. If the amount of blood loss was over 45 ml/kg or 8 m/kg/hour, reoperation should be considered as soon as possible. After operating, careful wound dressings were applied to prevent wound problems.

• 대한핵의학회지
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• 제25권2호
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• pp.177-185
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• 1991

Dipyridamole thallium imaging is one of the most widely accepted means of evaluating patients with suspected or known coronay artery disease. The results of thallium imaging help diagnose coronary artery disesse (CAD), determine the hemodynamic significance of coronary stenosis, evaluate viability of myocardium, assess the outcome of therapeutic interventions and stratify patients according to their risk for luther cardiac events. An increased lung thallium uptake and transient LV dilation has been reported as poor prognostic indicator and associated with extensive and severe coronary artery disease. We quantitated lung/heart uptake ratio (l/HUR) and transient left ventricular dilation ratio in 44 patients and 17 controls undertaking dipyridamole thallium-201 scintigraphy. The results are as follows: 1) The lung/heart uptake ratio was high in patients with CAD and which became higher according to increasing number of diseased vessel. The L/HUR of patients with low LVEF (<35%) was lower than those with normal LVEF. 2) Transient left ventricular dilation ratio of CAD patients had no close relation between numbers of diseased vessels and was not higher than normals. But transient left ventricular dilation ratio of patients with myocardial infartion was higher than normals. We concluded that lung/heart uptake ratio seems to be sensitive marker for severity of CAD and myocardial function, but transient left ventricular dilation ratio alone is not sufficient to be a marker for severe and extensive CAD.

• 한국식품영양학회지
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• 제27권3호
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• pp.484-494
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• 2014

The purpose of this study was to evaluate dietary intake according to the risk of coronary heart disease (less than 10% = low-risk group; 10~20% = middle-risk group) based on Framingham risk score (FRS), on 122 male adult subjects. The body weight and body mass index were not significantly different between the groups, while height of the low-risk group was shown to be significantly high compared to that of the middle-risk group. The daily energy intake was shown to be significantly high in the low-risk group with 1,910.88 kcal, compared to 1,606.63 kcal of the middle-risk group. As a result of analyzing nutrient intake per 1,000 kcal of energy, while the low-risk group had significantly high intake of animal protein, fat, and animal fat compared to the middle-risk group, the intake of plant protein, carbohydrate, and plant iron was found to be significantly low. The daily food intake was shown to be significantly high in the low-risk group (1,445.16 g), compared to the middle-risk group (1,075.12 g). The low-risk group was found to have significantly high intake of sugars, eggs, and beverages compared to the middle-risk group, while mushrooms intake was significantly high in the middle-risk group. Dietary variety score (DVS) was significantly high in the low-risk group with 26.42, compared to 22.66 of the middle-risk group. Dietary diversity score (DDS) was indicated to be significantly high in the low-risk group with 3.70, compared to 3.27 of the middle-risk group. The low-risk group was indicated to have significantly high score in DDS of dairy products and fruit group, compared to the middle-risk group. In the correlation between diversity index of food intake (DVS and DDS) and FRS, DDS was shown to have significantly negatively correlation with FRS after adjusting for confounding factors. To sum up these results, the adult males with low-risk of coronary heart disease had more various consumptions of fruits and milk, compared to the subjects with the middle-risk. The proportion of consuming major food groups such as cereals, meat group, milk, fruits, and vegetables more than a fixed quantity was indicated to be high. Accordingly, dietary habit for intake of various food seems to be necessary, to prevent coronary heart disease.