• Title/Summary/Keyword: Cardiovascular Risk Factor

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Prognostic Analysis of Stage I Non-Small Cell Lung Cancer Abutting Adjacent Structures on Preoperative Computed Tomography

  • Soohwan Choi;Sun Kyun Ro;Seok Whan Moon
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.136-144
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    • 2024
  • Background: Early non-small cell lung cancer (NSCLC) that abuts adjacent structures requires careful evaluation due to its potential impact on postoperative outcomes and prognosis. We examined stage I NSCLC with invasion into adjacent structures, focusing on the prognostic implications after curative surgical resection. Methods: We retrospectively analyzed the records of 796 patients who underwent curative surgical resection for pathologic stage IA/IB NSCLC (i.e., visceral pleural invasion only) at a single center from 2008 to 2017. Patients were classified based on tumor abutment and then reclassified by the presence of visceral pleural invasion. Clinical characteristics, pathological features, and survival rates were compared. Results: The study included 181 patients with abutting NSCLC (22.7% of all participants) and 615 with non-abutting tumors (77.3%). Those with tumor abutment exhibited higher rates of non-adenocarcinoma (26.5% vs. 9.9%, p<0.01) and visceral/lymphatic/vascular invasion (30.4%/33.1%/12.7% vs. 8.5%/22.4%/5.7%, respectively; p<0.01) compared to those without abutment. Multivariable analysis identified lymphatic invasion and male sex as risk factors for overall survival (OS) and disease-free survival (DFS) in stage I NSCLC measuring 3 cm or smaller. Age, smoking history, vascular invasion, and recurrence emerged as risk factors for OS, whereas the presence of non-pure ground-glass opacity was a risk factor for DFS. Conclusion: NSCLC lesions 3 cm or smaller that abut adjacent structures present higher rates of various risk factors than non-abutting lesions, necessitating evaluation of tumor invasion into adjacent structures and lymph node metastasis. In isolation, however, the presence of tumor abutment without visceral pleural invasion does not constitute a risk factor.

Changes of Plasma Cardiovascular Disease Risk Factors according to the Health Practice and Dietary Habits in Healthy Male University Studnets

  • Kyeong Sook Yim
    • Korean Journal of Community Nutrition
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    • v.3 no.5
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    • pp.685-694
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    • 1998
  • This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index$(kg/m^2$, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model $R^2$=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model $R^2$=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.

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An Evaluation Study on the Cardiovascular Risk Factors in a Rural Adult Population (농촌지역 주민의 심혈관 질환 위험요인 평가)

  • Na, Baek-Ju;Park, Kyung-Soo;Lim, Jung-Su;Sun, Byeong-Hwan;Nam, He-Sung;Sohn, Seok-Joon
    • Journal of agricultural medicine and community health
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    • v.23 no.2
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    • pp.193-204
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    • 1998
  • Cardiovascular diseases are the leading cause of death and disability in Korea. Their risk factors can be classified as either modifiable or nonmodifiable and among modifiable factors are high bood pressure, elevated blood cholesterol, obesity and cigarette smoking. The purpose of this study was to evaluate the risk factors for the cardiovascular diseases in a rural community and to get basic data for the development of a community-based rick reduction intervention program. Evaluation involved population-based, cross-sectional samples of adult residents in a rurual community. We measured blood pressure, body fat percent by bioelectric impedance fatness analyzer and serum cholesterol and interviewed adult residents over 20-year-old age. Blood pressure was checked twice and hypertension was classified by the sixth report of the Joint National Committee on Detection. Evaluation, and Treatment of High Blood Pressure. The Cutpoints for high blood cholesterol was used National Cholesterol Treatment Guidelines and those for obesity was 25% in male. 30% in female. The results were as follows: 1. Prevalence of definitive hypertension was 59.7% in males and 54.4% in female. 2. Prevalence of hypercholesterolemia was 14.3% in male and 18.2% in female. 3. Prevalence of obese was 10.7% in male and 41.1% in female. 4. Among definitive hypertension, hypercholesterolemia, and obesity 52.1% possessed one risk factor, 12.6% two risk factors and 2.5% three risk factors in males. In females 41.4% possessed one risk factor and 27.6%. 5.7% respectively. 5. The smoking rate was 65.8% in males and 5.2% in females. Our results are used effectively for the community-based intervention towards cardiovascukr diseases risk reduction. However, because of limitations in our study design, further datas are needed including other risk factors and in-person clinical datas.

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The Relative Risk Assessment of Leptin for Stroke in Korea

  • Cho, Ki-Ho;Jung, Woo-Sang;Bae, Jong-Myon;Go, Chang-Nam;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.24 no.4
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    • pp.1-5
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    • 2003
  • Leptin has a close correlation with obesity, which is known to be a major factor for stroke. This study was performed to determine whether serum leptin level would be an independent risk factor for stroke and whether it would change significantly early after stroke. Subjects were selected from those within I month after onset and non-stroke referents at Kyung Hee Oriental Medical Center in Seoul, Korea. We compared leptin and the other characteristics between stroke subjects and referents. Body mass index, hypertension history, presence of drinking and smoking, waist/hip ratio, total cholesterol and triglyceride were recorded. To assess odds ratio of leptin for stroke, we used logistic regression analysis. Leptin was rechecked 2 weeks later and compared with the former value in acute stroke subjects. In this study, serum leptin did not differ significantly between stroke subjects and referents, and its odds ratio was not significant in male (OR=0.52, 95% Cl; 0.13-2.08) and female (OR=1.57, 95% Cl; 0.53-4.67). In acute stroke subjects, leptin did not change significantly 2 weeks later. Hypertension had a significant odds ratio in male (OR=3.39, 95% Cl; 1.02-11.24) and female (OR=12.37, 95% Cl; 3.67-41.65). High waist/hip ratio was only in female (OR=6.70, 95% Cl; 1.73-26.02). In conclusion, leptin was not an independent risk factor for stroke and its serum level did not change significantly early after stroke. Hypertension and waist/hip ratio had significant relative risks.

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Heart Transplantation in the Elderly Patients: Midterm Results

  • Yeom, Sang Yoon;Hwang, Ho Young;Oh, Se-Jin;Cho, Hyun-Jai;Lee, Hae-Young;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.111-116
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    • 2013
  • Background: Heart transplantation in elderly patients has raised concerns because of co-morbidities and limited life expectancy in the era of donor shortage. We examined the outcomes after heart transplantation in elderly patients. Materials and Methods: From March 1994 to December 2011, 81 patients (male:female=64:17, $49.1{\pm}14.0$ years) underwent heart transplantation. The outcomes after heart transplantation in the younger patients (<60 years; group Y, n=60) were compared with those in the elderly patients (${\geq}60$ years; group O, n=21). The follow-up duration was $51.8{\pm}62.7$ months. Results: Early mortality (${\leq}30$ days) occurred in 5.0% (3/60) and 4.8% (1/21) of groups Y and O, respectively (p>0.999). There were no differences in overall survival between the two groups (p=0.201). Freedom from rejection was higher in group O than in group Y (p=0.026). Multivariable analysis revealed that age ${\geq}60$ years was not a significant risk factor for long-term survival; postoperative renal failure was the only significant risk factor for long-term survival (p=0.011). Conclusion: Early and mid-term results of heart transplantation in elderly patients were similar to those in younger patients.

Outcomes of Surgical Repair for Truncus Arteriosus: A 30-Year Single-Center Experience

  • Yu Ri Lee;Dong-Hee Kim;Eun Seok Choi;Tae-Jin Yun;Chun Soo Park
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.75-86
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    • 2023
  • Background: We investigated the long-term outcomes of truncus arteriosus repair at a single institution with a 30-year study period. Methods: Patients who underwent repair of truncus arteriosus between 1993 and 2022 were reviewed retrospectively. Factors associated with early mortality, overall attrition, and reintervention were identified using appropriate statistical methods. Results: In total, 42 patients were enrolled in this study. The median age and weight at repair were 26 days and 3.5 kg, respectively. Thirty patients (71.4%) underwent 1-stage repair. There were 8 early deaths (19%). In the univariable analysis, undergoing surgery before 2011 was associated with early mortality (p=0.031). The overall survival rate at 10 years was 73.8%. In the multivariable analysis, significant truncal valve (TrV) dysfunction (p=0.010), longer cardiopulmonary bypass time (p=0.018), and the earlier era of surgery (p=0.004) were identified as risk factors for overall mortality. During follow-up, 47 reinterventions were required in 27 patients (64.3%). The freedom from all-cause reintervention rate at 10 years was 23.6%. In the multivariable analysis, associated arch obstruction (p<0.001) and significant TrV dysfunction (p=0.011) were identified as risk factors for all-cause reintervention. Arch obstruction (p=0.027) and a number of TrV cusps other than 3 (p=0.014) were identified as risk factors for right ventricle to pulmonary artery (RV-PA) reintervention, and significant TrV dysfunction was identified as a risk factor for TrV reintervention (p=0.002). Conclusion: Despite recent improvements in survival outcomes after repair of truncus arteriosus, RV-PA or TrV reinterventions were required in a significant number of patients during follow-up.

Complete Repair of Coarctation of the Aorta and a Ventricular Septal Defect in a 1,480 g Low Birth Weight Neonate

  • Lee, Hong-Kyu;Cho, Joon-Yong;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.183-185
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    • 2011
  • Although outcomes of neonatal cardiac surgery have dramatically improved in the last two decades, low body weight still constitutes an important risk factor for morbidity and mortality. In particular, cardiac surgery in neonateswith very low birth weight (${\leq}$1.5 kg) is carried out with greater risk because most organ systems are immature. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,480 gram neonate.

Underreporting of dietary intake by body mass index in premenopausal women participating in the Healthy Women Study

  • Park, Hyun-Ah;Lee, Jung-Sun;Kuller, Lewis H.
    • Nutrition Research and Practice
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    • v.1 no.3
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    • pp.231-236
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    • 2007
  • Underreporting patterns by the level of obesity have not been fully assessed yet. The purpose of this study was to examine the differential underreporting patterns on cardiovascular risk factor, macronutrient, and food group intakes by the level of Body Mass Index (BMI). We analyzed cross-sectional baseline nutritional survey data from the population-based longitudinal study, the Healthy Women Study (HWS) cohort. Study subjects included 538 healthy premenopausal women participating in the HWS. Nutrient and food group intakes were assessed by the one-day 24-hour dietary recall and a semi-quantitative food frequency questionnaire, respectively. The ratio of reported energy intake (EI) to estimated basal metabolic rate (BMR) was used as a measure of relative energy reporting status and categorized into tertiles. Overweight group ($BMI{\geq}25kg/m^2$) had a higher ratio of EI to BMR (EI/BMR) than normal weight group ($BMI<25kg/m^2$). Normal weight and overweight groups showed similar patterns in cardiovascular risk factors, nutrient intake, and food group intake by the EI/BMR. Fat and saturated fat intakes as a nutrient density were positively associated with the EI/BMR. Proportion of women who reported higher consumption (${\geq}4\;times/wk$) of sugar/candy, cream and red meat groups was greater in higher tertiles of the EI/BMR in both BMI groups. Our findings suggest similar patterns of underreporting of cardiovascular risk factors, and macronutrient and food group intakes in both normal and overweight women.