• Title/Summary/Keyword: hypertension and diabetes

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A genome-wide association study of the association between single nucleotide polymorphisms and brachial-ankle pulse wave velocity in healthy Koreans

  • Xu, EnShi;Shin, Jinho;Lim, Ji Eun;Kim, Mi Kyung;Choi, Bo Youl;Shin, Min-Ho;Shin, Dong Hoon;Lee, Young-Hoon;Chun, Byung-Yeol;Hong, Kyung-Won;Hwang, Joo-Yeon
    • Journal of Genetic Medicine
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    • v.14 no.1
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    • pp.8-17
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    • 2017
  • Purpose: Pulse wave velocity (PWV) is an indicator of arterial stiffness, and is considered a marker of vascular damage. However, a genome-wide association study analyzing single nucleotide polymorphisms (SNPs) associated with brachial-ankle PWV (baPWV) has not been conducted in healthy populations. We performed this study to identify SNPs associated with baPWV in healthy populations in Korea. Materials and Methods: Genomic SNPs data for 2,407 individuals from three sites were analyzed as part of the Korean Genomic Epidemiologic Study. Without replication samples, we performed multivariable analysis as a post hoc analysis to verify the findings in site adjusted analysis. Healthy subjects aged between 40 and 70 years without self-reported history or diagnosis of hypertension, diabetes, hyperlipidemia, heart disease, cerebrovascular disease and cancer were included. We excluded subjects with a creatinine level >1.4 mg/dL (men) and 1.2 mg/dL (women). Results: In the site-adjusted association analysis, significant associations (P<$5{\times}10^{-8}$) with baPWV were detected for only 5 SNPs with low minor allele frequency. In multivariable analysis adjusted by age, sex, height, body mass index, mean arterial pressure, site, smoking, alcohol, and exercise, 11 SNPs were found to be associated (P<$5{\times}10^{-8}$) with baPWV. The 5 SNPs (P<$5{\times}10^{-8}$) linked to three genes (OPCML, PRR35 and RAB40C) were common between site-adjusted analysis and multivariable analysis. However, meta-analysis of the result from three sites for the 11 SNPs showed no significant associations. Conclusion: Using the recent standard for genome-wide association study, we did not find any evidence of significant association signals with baPWV.

Clinical characteristics of heat stroke in bath facilities, and analysis of predictive factors of multiple major complications (목욕시설에서 발생한 열사병의 임상양상 및 열사병의 다발성 주요 합병증에 관한 예측인자 분석)

  • Park, Seok-Jin;Hyun, Sung-Youl;Lim, Yong-Su;Cho, Jin-Seong;Min, Kyoung-Jeen;Yang, Hyuk-Jun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.500-508
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    • 2018
  • Objective: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. Methods: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. Results: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2-29.9), Glasgow Coma Scale (GCS)${\leq}8$ (OR, 8.2; 95% CI, 1.3-49.4), and mean arterial pressure (MAP), body temperature above $40.5^{\circ}C$ (OR, 8.1; 95% CI, 1.1-58.8) <60 mmHg (OR, 14.8; 95% CI, 1.8-122.9). Conclusion: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ${\leq}8$, and MAP <60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

Anti-oxidative and Anti-inflammatory Effect of Fractionated Extracts of Smilacis Glabrae Rhizoma in Human Umbilical Vein Endothelial Cell (혈관내피세포에서 토복령(土茯苓)의 항산화 및 항염증 효과)

  • Lee, Chang-Hyun;Yi, Hyo-Seung;Kim, Jae-Eun;Heo, Sook-Kyoung;Cha, Chang-Min;Won, Chan-Wook;Park, Sun-Dong
    • The Korea Journal of Herbology
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    • v.24 no.3
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    • pp.39-50
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    • 2009
  • Objectives : Smilacis glabrae rhizoma (SG) has been traditionally used as a herbal medication of musculoskeletal disorders like arthritis, pain, convulsions, and syphilis in traditional Korean medicine. This study was investigated anti-oxidative and anti-inflammatory effect of fractionated extracts of Smilacis Glabrae Rhizoma in Human Umbilical Vein Endothelial Cell (HUVEC). Methods : SG extract prepared with methanol, and then fractionated with hexane, dichloromethane, ethylacetate, n-butanol and water. Inhibitory effect of SG onto free radical generation was determined by measuring DPPH, superoxide anions and nitric oxide scavenging activities in vitro. Cytotoxic activity of extracts on RAW 264.7 cells was measured using 5-(3-caroboxymethoxyphenyl)-2H-tetra-zolium inner salt (MTS) assay. Intracelluar oxidation was analysed by DCF-DA assay. The nitric oxide (NO) production was measured by Griess reagent system. The levels of ICAM-1 and VCAM-1 expression were confirmed by western blot. And proinflammatory cytokines were measured by ELISA kit. Results : Our results indicated that fractionated extracts, especially ethyl acetate (EA) extract, significantly inhibited free radical generation, the TNF-$\alpha$-induced intracellular oxidation. Furthermore, the EA extract protected TNF-$\alpha$-induced adhesion to THP-1, expression of adhesion molecules accompanied by an attenuation of IL-6 and IL-8 formation in HUVEC. Conclusions : These results indicate that EA extract of SG have potential as an agent of atherosclerosis and other chronic inflammatory diseases including diabetes, hypertension, and arthritis.

Streptococcal Toxic Shock Syndrome Occurred during Postoperative Radiotherapy in a Cancer Patient with Preexisting Lymphedema and Chronic Illness -Case Report- (수술 후 림프부종과 만성질환을 동반한 종양 환자에서 방사선치료 기간 동안 발생한 연쇄구균독소충격증후군 예)

  • Jang, Ji-Young;Oh, Yoon-Kyeong;Kim, Dong-Min
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.317-321
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    • 2006
  • A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

A Case-control Study on Risk Factors of Osteoporosis in Some Korean Outpatient Women of One General Hospital of Seoul (여성 골다공증의 위험요인에 관한 환자-대조군 연구 - 서울지역 1개 병원 내원환자를 중심으로 -)

  • Woo, Sun-Ok;Bae, Sang-Soo;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.3 s.51
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    • pp.609-622
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    • 1995
  • Until now there are few available epidemiologic data of osteoporosis in Korea, and the severity of osteoporosis-related health problem has not been widely recognized yet. But the numbers of the old people are increasing in Korea, and in 2000, the proportion of people over 65 will be up to about 6.8% of total population. Therefore, osteoporosis, one of the most common metabolic bone disease among the old people, will be one of the most important public health problem. On this background this study was performed to find out risk factors of the development of osteoporosis in Korean women through case-control approach. The subject of this study were selected among the women who visited menopause clinic in one general hospital in Seoul and were checked bone density from Sep. 1988 to Sep. 1993. Those who were diagnosed to have hypertension, diabetes mellitus, thyroid disease, breast disease, or liver disease, which are thought to influnce bone density, were excluded. Also excluded those who are age-unknown. Finally the subjects were 2,139 women aged between 18 and 79. We operatively defined patient group as those whose bone density is below $1.039/cm^2$, 90% of average bone density of women of 4th decade who visited the same hospital. And we defined control group as whose bone dendity is above $1.15g/cm^2$. We randomly selected 201 women from the patient group and 202 from the control. As independent variables we chose age, menarche age, menopause age, menopause type, the number of siblings, the number of pregnancies, body mass index, taking oral pill or not, feeding type, and educational state. Multiple logistic regression analysis was done to see the influence of these variables on the risk of osteoporosis. Results are as follows; 1. menopausal status was statistically significant risk factor to all women irrespective of her age, while obesity and later menopause age were found to be statistically significant protective factors. 2. The more siblings and pregnancies, the greater tile risk of osteoporosis, but these factors were not statistically significant. This result is not consistent with other studies. Further studies are strongly needed.

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Analysis of Risk Factors for Postoperative Morbidity in Perforated Peptic Ulcer

  • Kim, Jae-Myung;Jeong, Sang-Ho;Lee, Young-Joon;Park, Soon-Tae;Choi, Sang-Kyung;Hong, Soon-Chan;Jung, Eun-Jung;Ju, Young-Tae;Jeong, Chi-Young;Ha, Woo-Song
    • Journal of Gastric Cancer
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    • v.12 no.1
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    • pp.26-35
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    • 2012
  • Purpose: Emergency operations for perforated peptic ulcer are associated with a high incidence of postoperative complications. While several studies have investigated the impact of perioperative risk factors and underlying diseases on the postoperative morbidity after abdominal surgery, only a few have analyzed their role in perforated peptic ulcer disease. The purpose of this study was to determine any possible associations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. Materials and Methods: In total, 142 consecutive patients, who underwent surgery for perforated peptic ulcer, at a single institution, between January 2005 and October 2010 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. Results: The postoperative morbidity rate associated with perforated peptic ulcer operations was 36.6% (52/142). Univariate analysis revealed that a long operating time, the open surgical method, age (${\geq}60$), sex (female), high American Society of Anesthesiologists (ASA) score and presence of preoperative shock were significant perioperative risk factors for postoperative morbidity. Significant comorbid risk factors included hypertension, diabetes mellitus and pulmonary disease. Multivariate analysis revealed a long operating time, the open surgical method, high ASA score and the presence of preoperative shock were all independent risk factors for the postoperative morbidity in perforated peptic ulcer. Conclusions: A high ASA score, preoperative shock, open surgery and long operating time of more than 150 minutes are high risk factors for morbidity. However, there is no association between postoperative morbidity and comorbid disease in patients with a perforated peptic ulcer.

A Clinical Study of Dyslogia Patients after Stroke (중풍(中風) 환자(患者) 중(中) 언어장애(言語障碍)에 대한 임상적(臨床的) 고찰(考察))

  • Shin, Woo-Jin;Seo, Soo-Hyun;Hong, Hyun-Woo;Lee, Sung-Do;Kim, Jae-Yun;Kam, Chul-Woo;Park, Dong-Il
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.529-538
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    • 2004
  • This clinical study on 93 cases of Dyslogia after stroke confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Dong-Eui University from january to September 2003. The following results were found: I. The ratio between males and females was 1.6:1. Of Dyslogia p who had suffered stroke, most were in their sixties. 2. Categorized by attack site, right hemiplegia patients comprised 15 cases(l6.1%), and left hemiplegia patients, 71 cases(54.8%), so the ratio between Rt. and Lt. was 1:4.7. 3. Categorized by preceeding disease, hypertension was seen 51 cases(54.8%), and diabetes mellitus was seen 21 cases(22.6%). 4. Categorized by repeat attack, it was the first attack for 71 cases(76.3%), and the second attack for 13 cases(l4.0%), and for 9 cases(9.7%) it was the third or nth attack. 5. According to the classification of Zhang Zhongjing, apoplexy involving Bu-organs comprised 42 cases(45.2%), apoplexy involving meridians 39 cases(41.9%), apoplexy involving Jang-organs 11 cases(11.8%), and for apoplexy involving collaaterals there was one case(1.1%). 6. According to the classification of Cheng Zhongling, 43 cases(46.7%) were classed heart meridian, 25 cases(27.2%) were classed Spleen meridian, and 24 cases(26. 1%) were classed Kidney meridian. 7. According to the classification of Sun Simiao, 49 cases(52.7%) were classed Pyungo, two cases(2.2%) were classed Pungeui, ,seven cases(7.5%) were classed Pungbi( I ), and two cases(2.2%) were classed Pungbi( II ).

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The Clinical Outcome of Twin Pregnancies after IVF (체외수정 후 출산한 쌍태아의 임상적 고잘)

  • Han, Myoung-Seok;Park, Eun-Ku-Seul
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.173-178
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    • 2007
  • Objective: To compare the outcome of twin pregnancies after in-vitro fertilization (IVF) with that of spontaneously conceived twins. Methods: We analyzed 146 twins retrospectively, who had been delivered between January 2000 and July 2005. After reviewing their obstetric medical records, 72 twins conceived with IVF (IVF group) and 51 spontaneously conceived twins (spontaneous group), whose gestational age was over 24 weeks, were recruited for this study. Results: There were no significant statistical differences of demographic features such as maternal age, gestational age and fetal weight between the two groups. However, the risk of pregnancy-induced hypertension (PIH) and gestational diabetes (G-DM) had significantly increased in the group of IVF (OR 2.59; 95% CI 1.01$\sim$6.66). The risk of fetal weight discordancy rate (>20%) and fetal-sex homology rate in IVF group were decreased (OR 0.37; 95% CI 0.14$\sim$0.96, OR 0.45; 95% CI 0.21$\sim$0.99). Conclusion: In this comparative study, maternal PIH and G-DM risks of IVF group are higher than that of spontaneous group. But, fetal-weight discordancy risk and fetal-sex homology rate were lower in IVF group.

A Study on the Health Status and Health Promoting Behavior of Older Adults in a Rural Area (일 농촌노인의 건강상태 및 건강증진행위에 관한 연구)

  • Kim, Jung-Soon
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.187-201
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    • 2001
  • This study was conducted to investigate the health status and health promoting behavior of older adults in rural area. The design of research was descriptive study. 883 older adults over sixty years living in the rural area of Pusan city were surveyed from July 9. 1999 to July 20. 1999 through direct interview using a questionnaire and physical examination. The collected data were analyzed for percentage. mean. Chi square-test. ANOVA using the SPSS computerized program. The main results were as follows: 1. 43.4% of subjects lived alone or with only partner. 2. 37.13% of subjects had perceived own health condition as bad. 3. Major 'chronic diseases that the subjects were suffered were diabetes(25.94%) and hypertension(9.11%). 4. The mean score of perceived depression was 17.71 of 44. 5. 87.98% of subjects replied that they had good relationship with their family and friends. 6. 8.57% of subjects were identified as over weight. while 10.85% were low weight. 7. 29.93% of subjects replied that they were smoking. By the group. the rate of smoking of man was significantly higher than women. and lower age group than higher age group, and higher education group than lower education group. 8. 70.38% of subjects didn't practice exercise. By the group, the rate of exercise of woman was significantly lower than man, and higher age group than lower age group, and lower education group than higher education group. 9. 12.33% of subjects replied for the frequency of drinking as more three -times a week. By the groups. man showed significantly more frequency than woman. the lower age group than higher age group, the lower education group than the higher education group. 11. The mean score of nutrition state was 3.73 which means moderate risk state. 12. The 57.53% of subjects replied, their sleeping time as below 7 hours. 13. The 15.75% of subjects had experience a periodical inspection. In conclusion, older adults in rural area were identified having various health risk factor, Looking at the results. It is necessary to develope health promotion program which enhances older adults to practice health promoting behavior and to manage their chronic disease.

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An extension of multifactor dimensionality reduction method for detecting gene-gene interactions with the survival time (생존시간과 연관된 유전자 간의 교호작용에 관한 다중차원축소방법의 확장)

  • Oh, Jin Seok;Lee, Seung Yeoun
    • Journal of the Korean Data and Information Science Society
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    • v.25 no.5
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    • pp.1057-1067
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    • 2014
  • Many genetic variants have been identified to be associated with complex diseases such as hypertension, diabetes and cancers throughout genome-wide association studies (GWAS). However, there still exist a serious missing heritability problem since the proportion explained by genetic variants from GWAS is very weak less than 10~15%. Gene-gene interaction study may be helpful to explain the missing heritability because most of complex disease mechanisms are involved with more than one single SNP, which include multiple SNPs or gene-gene interactions. This paper focuses on gene-gene interactions with the survival phenotype by extending the multifactor dimensionality reduction (MDR) method to the accelerated failure time (AFT) model. The standardized residual from AFT model is used as a residual score for classifying multiple geno-types into high and low risk groups and algorithm of MDR is implemented. We call this method AFT-MDR and compares the power of AFT-MDR with those of Surv-MDR and Cox-MDR in simulation studies. Also a real data for leukemia Korean patients is analyzed. It was found that the power of AFT-MDR is greater than that of Surv-MDR and is comparable with that of Cox-MDR, but is very sensitive to the censoring fraction.