• Sleep Medicine and Psychophysiology
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• v.18 no.2
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• pp.87-94
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• 2011

Objective: OSAS (obstructive sleep apnea syndrome) is a common disorder and its consequences are often serious. It is important to detect the disorder early in the course for proper treatment. This study is to grasp the snoring clinic visitors' knowledge level of OSAS. Method: One hundred and seventy-nine visitors at the of snoring clinic of Seoul National University Hospital were surveyed by questionnaire about reasons of visit and knowledge of treatment methods of snoring and OSAS, diagnostic method, OSAS-related symptoms, and complications. Results: Most of the respondents (89.4%) "have already heard about OSAS" and the major sources of information was the mass media (58.1%) such as television and radio. More than half (60.3%) were aware that snoring is closely related to OSAS. More than half (59.8%) recognized that a nocturnal polysomnograpy was necessary for proper diagnosis. Two thirds (67%) of the respondents noted surgery as a treatment for snoring. More than half (55.9%) answered that they would follow the doctor's advice on the treatment choice. Only 12.3% of respondents "have heard about nCPAP". No one chose nCPAP (nasal continuous positive airway pressure) as a treatment for either snoring or OSAS. About one third (34.6%) of the respondents were aware that OSAS is related to hypertension. Only 12.8% noted that OSAS is related to diabetes mellitus. Conclusion: Visitors at the snoring clinic were found to have substantially limited knowledge of health risks and proper treatments of OSAS. We suggest that it is crucially important to educate patients and offer easy-to-understand information on snoring and OSAS. We predict that provision of educaiton and information to patients and general public will faciliate the diagnosis and treatment of snoring and OSAS and reduce the related disorders such as hypertension, stroke, and diabetes mellitus.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.333-340
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• 1999

Background: Plasminogen activator inhibitor-1(PAI-1) is known as the primary physiological inhibitor of tissue-type plasminogen activator(t-PA) in the plasma, and is present within the atherosclerotic vessels. Increased plasma levels of PAI-1 are one of the major disturbances of the hemostatic system in patients with diabetes and/or hypertension, and may have multiple interrelations with the important risk factors in the development of atherosclerosis. This study was performed to determine whether altered gene expression of PAI-1 occurs within the arterial wall, and thereby potentially contributing to the increase of cardiovascular risks associated with diabetes and/or hypertension. Material and Method: The aortic vascular smooth muscle cells of the rat were exposed to 22 mM glucose, angiotensin II, and insulin increased PAI-1 mRNA expression with the use of Northern blotting were examined. Also examined were the effects of 22 mM glucose, angiotensin II and insulin on the growth of the rat's aortic smooth muscle cells by using MTT assay. Result: Twenty-two mM glucose treatment increased the PAI-1 mRNA expression in a time- and dose-dependent manner. Aniotensin II treatment synergistically increased the glucose-induced PAI-1 mRNA expression. In contrast, addition of insulin attenuated the increase of 22 mM glucose and angiotensin II induced PAI-1 mRNA expression. Furthermore, treatment of 22 mM glucose, angiotensin II and insulin resulted in a significant increase in cell numbers. This study demonstrated that 22 mM glucose and angiotensin II have a synergistic effect in stimulating the PAI-1 mRNA expression and in the cell growth of the rat's aortic smooth muscle cells. Conclusion: Elevation of glucose and angiotensin II may be important risk factors in impairing fibrinolysis and developing atherosclerosis in diabetic patients.

• Journal of Nutrition and Health
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• v.39 no.7
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• pp.624-640
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• 2006

Dialysis patients are at risk of malnutrition not only because of losses of nutrients during peritoneal dialysis but also because of anorexia that results in inadequate nutrient intakes. The aim of this study was to estimate the nutritional status of 154 patients receiving continuous ambulatory peritoneal dialysis (CAPD), especially focused on protein-energy malnutrition and vitamin and mineral status. The mean age of the subjects was $5.12\;{\pm}\;12.4\;y$ with educational years of $12.3\;{\pm}\;0.4\;y$ for male and $9.6\;{\pm}\;0.4\;y$ for female. The mean duration of dialysis was $22.7\;{\pm}\;21.7\;mo$. The causes of renal failure included diabetes (32.7), chronic glomerulonephritis (15.0%), and hypertension (8.5%). The main complications associated with chronic renal failure were hypertension (86.1%), diabetes (35.4%) and liver disease (9.0%). The mean daily energy intake was $1216.8\;{\pm}\;457.3\;kcal$ and increased to $1509.2\;{\pm}\;457.2\;kcal$ when added with the energy from dextrose in dialysate. The latter was still much lower than estimated energy requirement but energy intake per kg of body weight (28.1 kcal/1 g) was within the range of that recommended for CAPD patients' diet therapy (25 - 30 kcal/kg). The average daily intake of protein was $49.2\;{\pm}\;25.1\;g$ with 37.6% of the patients showing their intakes less than Estimated Average Requirement. The average protein intake per kg of weight was 0.9 g/kg, which is less than that recommended for CAPD patients (1.2-1.5g/kg) with mean serum albumin level $3.2\;{\pm}\;0.5\;g/dl$. The proportion of the patients with dietary calcium intake less than EAR was 90.9%, but when added with supplementary calcium (phosphorus binder), most patients showed their total calcium intake between EAR and UL. Fifty percent of the patients were observed with dietary iron intake less than EAR, however most patients revealed their total iron intake with supplementation above UL. The addition of folic acid with supplementation increased mean total folic intake to $1126.0\;{\pm}\;152.4\;{\mu}g$ and ninety eight percent of the subjects showed their total folic acid intake above UL. The prevalence of anemia was 83.1 % assessed with hemoglobin level, even with high intakes of iron with supplementation. Thirty four percent of the patients showed their fasting blood glucose was not under control $(\geq\;126\;mg/dl)$ even with medication or insulin probably due to dextrose from dialysate. The mean blood lipid levels were within the reference levels of hyperlipidemia, but with 72.1 % of the patients showing lower HDL-C. In conclusion, Fairly large proportion of the patients were observed with protein malnutrition with low intake of protein and serum albumin level. Few patients showed their vitamins and minerals intake less than EAR with supplementation. For iron and folic acid, their intakes were increased to above UL for large proportion of he patients. However, more than eighty percent of the patients were still anemic associated with decreased renal function. The serum blood glucose and lipid level were not under control for some patients with medication. It seems that supplementation and medications that patients are taking should be considered for dietary consulting of CAPD patients.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.391-397
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• 2021

Purpose: Tranexamic acid (TXA) can reduce perioperative blood loss and the frequency of blood transfusions in lower extremity surgery. On the other hand, the effects of TXA on reverse total shoulder arthroplasty (rTSA) remain undetermined. This study evaluated the efficacy of TXA on perioperative blood loss, transfusion requirements, and the change in the hemotologic index. Materials and Methods: This study evaluated patients who underwent rTSA from September 2009 to July 2020. The patients were classified into two groups. The TXA group were administered TXA intravenously and topical TXA during surgery. The non-TXA group was not administered TXA. The quantity of hemovac drainage, which represented the postoperative blood loss, transfusion requirements, and postoperative change in hemoglobin and hematocrit level, were recorded. Results: The TXA and non-TXA groups consisted of 93 and 84 patients, respectively. The preoperative demographics showed no significant differences in age (72.0±7.0 vs. 71.5±5.8, p=0.656), sex (male:female, 28:65 vs. 23:61, p=0.689) and the prevalence of hypertension and diabetes (hypertension:diabetes:both, 36:3:13 vs. 32:3:8, p=0.806) between the two groups. There were significant differences in the requirements of transfusion (0 vs. 9, p=0.001), hemovac drainage at the 1^st (98.8±61.2 ml vs. 162.7±98.8 ml, p<0.001), the 2^nd postoperative day (73.8±48.4 ml vs. 91.5±54.5 ml, p=0.024), hemoglobin level at the 1^st (11.7±1.2 g/dl vs. 11.2±1.4 g/dl, p=0.048), 3^rd (10.9±1.2 g/dl vs. 10.2±1.2 g/dl, p<0.001), and 6^th (11.2±1.3 g/dl vs. 10.7±1.3 g/dl, p=0.020) postoperative day, and the hematocrit level at the 1^st (35.0%±3.6% vs. 32.5%±3.8%, p=0.001), 3^rd (32.3%±5.0% vs. 29.8%±3.6%, p<0.001), and 6^th (33.5%±3.8% vs. 31.5%±3.7%, p<0.001) postoperative day between the two groups. Conclusion: Intravenous and topical intra-articular TXA can reduce the transfusion requirement and blood loss in rTSA.

• The Journal of Internal Korean Medicine
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• v.28 no.1
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• pp.47-67
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• 2007

Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.

• Journal of Ginseng Research
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• v.35 no.3
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• pp.352-359
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• 2011

Korean red ginseng (KRG) is used worldwide as a popular traditional herbal medicine. KRG has shown beneficial effects on cardiovascular diseases, such as atherosclerosis, diabetes, and hypertension. Up-regulation of a cytoprotective protein, heme oxygenase (HO)-1, is considered to augment the cellular defense against various agents that may induce cytotoxic injury. In the present study, we demonstrate that KRG water extract induces HO-1 expression in human umbilical vein endothelial cells (HUVECs) and possible involvement of the anti-oxidant transcription factor nuclear factor-eythroid 2-related factor 2 (Nrf2). KRG-induced HO-1 expression was examined by western blots, reverse transcriptase polymerase chain reaction and immunofluorescence staining. Specific silencing of Nrf2 genes with Nrf2-siRNA in HUVECs abolished HO-1 expression. In addition, the HO inhibitor zinc protoporphyrin blunted the preventive effect of KRG on $H_2O_2$-induced cell death, as demonstrated by terminal transferase dUTP nick end labeling assay. Taken together, these results suggest that KRG may exert a vasculoprotective effect through Nrf2-mediated HO-1 induction in human endothelial cell by inhibition of cell death.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.9
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• pp.3973-3982
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• 2012

The purpose of this study was to identify cognitive impairment and it's related factors of the elderly in long term care facilities. The participants of this study were 229 residents of five nursing homes. Data were analyzed using two sample t-test, ${\chi}^2$-test, and logistic regression. The results revealed eight factors related to cognitive impairment: gender(OR=2.41, p=.035), age(75-84: OR=3.26, p=.002, Over 85: OR=4.46, p<.001), living with family before admission(OR=2.17, p=.015), hearing(OR=8.88, p=.004), family history of dementia(OR=4.39, p=.009), ADL(OR=0.82, p<.001), hypertension(OR=4.07, p<.001), and diabetes(OR=3.42, p=.001). Based on the findings of this study, continuous nursing intervention focused on adjustable factors would be helpful in order to improve nursing home elderly people's quality of life.

• Genomics & Informatics
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• v.10 no.4
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• pp.256-262
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• 2012

Most common complex traits, such as obesity, hypertension, diabetes, and cancers, are known to be associated with multiple genes, environmental factors, and their epistasis. Recently, the development of advanced genotyping technologies has allowed us to perform genome-wide association studies (GWASs). For detecting the effects of multiple genes on complex traits, many approaches have been proposed for GWASs. Multifactor dimensionality reduction (MDR) is one of the powerful and efficient methods for detecting high-order gene-gene ($G{\times}G$) interactions. However, the biological interpretation of $G{\times}G$ interactions identified by MDR analysis is not easy. In order to aid the interpretation of MDR results, we propose a network graph analysis to elucidate the meaning of identified $G{\times}G$ interactions. The proposed network graph analysis consists of three steps. The first step is for performing $G{\times}G$ interaction analysis using MDR analysis. The second step is to draw the network graph using the MDR result. The third step is to provide biological evidence of the identified $G{\times}G$ interaction using external biological databases. The proposed method was applied to Korean Association Resource (KARE) data, containing 8838 individuals with 327,632 single-nucleotide polymorphisms, in order to perform $G{\times}G$ interaction analysis of body mass index (BMI). Our network graph analysis successfully showed that many identified $G{\times}G$ interactions have known biological evidence related to BMI. We expect that our network graph analysis will be helpful to interpret the biological meaning of $G{\times}G$ interactions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.11
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• pp.526-535
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• 2017

This study was conducted to identify the effects of a comprehensive health care program for elderly living alone on blood pressure, fasting glucose, body composition, and depression at a senior welfare center in M city. The study employed a one-group, pre-posttest design. The comprehensive health care program lasted for three months, from March to June in 2015, and consisted of open health education, exercise class, health consulting and personal education, nutritional consultation, and a self-support group. The sample elements of this study were individuals over 65-years-old with hypertension or diabetes mellitus, living near a welfare center in M city. A total of 34 participants were initially selected, but five subjects who were attended less than five times were excluded; therefore, a total of 29 individuals were included. The t-test and Pearson's correlation were used to analyze the data. The characteristics of subjects were 19 male(65.52%) and 10 female(34.48%). The most common age was 70 (16 subjects;55.17%). Additionally, 14 subjects were suffering from hypertension and diabetes mellitus (48.27%), which were occupied in the largest number in this study. The average attendance number of health programs was 10.28 times(${\pm}4.17$). In this study of subjects were significantly lower systolic blood pressure(t=3.275, p=0.004), body weight(t=3.878, p=0.001), depression(t=3.308, p=0.004) compared to pre-test. As the elderly population has increased, the number of individuals living alone has also increased. Accordingly, then need for physical and psycho-social health programs targeting the elderly is greater.

• Journal of Convergence for Information Technology
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• v.9 no.8
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• pp.248-253
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• 2019

Early diagnosis of mild cognitive impairment (MCI) can reduce the incidence of dementia. This study developed the MCI prediction model for the elderly in Korea. The subjects of this study were 3,240 elderly (1,502 men, 1,738 women) aged 65 and over who participated in the Korean Longitudinal Survey of Aging (KLoSA) in 2012. Outcome variables were defined as MCI prevalence. Explanatory variables were age, marital status, education level, income level, smoking, drinking, regular exercise more than once a week, average participation time of social activities, subjective health, hypertension, diabetes Respectively. The prediction model was developed using Restricted Boltzmann Machine (RBM) neural network. As a result, age, sex, final education, subjective health, marital status, income level, smoking, drinking, regular exercise were significant predictors of MCI prediction model of rural elderly people in Korea using RBM neural network. Based on these results, it is required to develop a customized dementia prevention program considering the characteristics of high risk group of MCI.