• Journal of Chest Surgery
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• v.50 no.3
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• pp.163-170
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• 2017

Background: The absence of atrial contraction (AC) after the maze procedure has been reported to cause subsequent annular dilatation and to increase the risk of embolic stroke. We hypothesized that the lack of AC could increase the risk of permanent pacemaker (PPM) implantation in patients undergoing the maze procedure. Methods: In 376 consecutive patients who had undergone a cryo-maze procedure and combined valve operation, recovery of AC was assessed at baseline and at immediate (${\leq}2$ weeks), early (${\leq}1$ year, $4.6{\pm}3.8$ months), and late (>1 year, $3.5{\pm}1.1$ years) postoperative stages. Results: With a median follow-up of 53 months, 10 patients underwent PPM implantation. Seven PPM implants were for sinus node dysfunction (pauses of $9.6{\pm}2.4$ seconds), one was for marked sinus bradycardia, and two were for advanced/complete atrioventricular block. The median (interquartile range) time to PPM implantation was 13.8 (0.5-68.2) months. Our time-varying covariate Cox models showed that the absence of AC was a risk factor for PPM implantation (hazard ratio, 11.92; 95% confidence interval, 2.52 to 56.45; p=0.002). Conclusion: The absence of AC may be associated with a subsequent risk of PPM implantation.

• Journal of the Korean Applied Science and Technology
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• v.36 no.1
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• pp.237-247
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• 2019

The purpose of this study was to investigate the effect of cardiocerebrovascular disease prevention program on cardiovascular risk factors and quality of life in the elderly. A non-equivalent control group pretest-posttest design was used. Participants were 44 elderly who registered at the public health center. The experimental group(n=22) received the cardiocerebrovascular disease prevention program for the elderly 8 times. There were significant differences in the systolic blood pressure(t=-2.419, p= .020), diastolic blood pressure(t=-2.226, p= .031), blood glucose(t=-2.071, p= .045) and quality of life(t=2.511, p= .016) between the experimental group and the control group. The results suggest that cardiovascular disease prevention program can be an effective strategy to reduce cardiovascular risk factors and improve the quality of life of the elderly.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.262-268
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• 2014

Background: The development of diagnostic techniques and an awareness of health examinations can bring about an early diagnosis of lung cancer. However, appropriate postoperative management and adjuvant chemotherapy remain under debate in postoperative therapeutic strategy. The present study was conducted to assess the clinicopathologic factors that influence recurrence and prognosis after complete resection of lung cancer. Methods: The present study analyzed 62 patients with lung cancer who underwent complete resection of diagnosed adenocarcinoma between 1994 and 2007. In addition to conventional factors, which include staging factor and histological evaluation, the present study also performed univariate and multivariate analyses to consider claudin, a cell adhesion molecule, as a prognostic factor by immunohistochemical staining. Results: There was no correlation between conventional factors, including lymphatic and vascular invasion, and recurrence. However, there was a significant correlation between high expression of claudin 4 and cancer recurrence. In particular, there was a correlation between high expressions of claudin 1, 4, and 5 and a reduction of disease-free survival. Conclusion: Increased expressions of claudin 4 were negative prognostic factors in adenocarcinoma of the lung and thus could be used to identify high-risk patients for adjuvant chemotherapy, even if they had early-stage lung cancer. The present findings collectively suggest that consideration of claudin as a prognostic factor in the active postoperative treatment in patients at high risk will lead to better therapeutic outcomes with fewer side effects.

• Journal of Medicine and Life Science
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• v.17 no.2
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• pp.47-52
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• 2020

Glucagon regulates glucose and fat metabolism as well as being involved in the production of ketone bodies. The new antidiabetic drug, a sodium-glucose co-transporter-2 inhibitor, increases glucagon, and reduces the risk of cardiovascular death and hospitalization due to heart failure. The presence of metabolic syndrome is an important risk factor for cardiovascular diseases(CVD) in type 2 diabetes(T2DM) patients. We, thus, investigated the association between glucagon levels and metabolic syndrome in T2DM patients. This cross-sectional study involved 317 T2DM patients. Fasting and postprandial (30 min after ingestion of a standard mixed meal) glucagon levels were measured. Metabolic syndrome was defined according to the criteria of the International Diabetes Federation. A multiple regression logistic analysis was employed for statistical evaluation. A total of 219 (69%) subjects had metabolic syndrome. The fasting and postprandial glucagon levels did not differ between the group with metabolic syndrome and the group without. Postprandial glucagon levels increased significantly with the increase in the number of metabolic syndrome components, but the fasting levels did not. However, a hierarchical logistic regression analysis revealed that the postprandial glucagon levels did not contribute significantly to metabolic syndrome even after adjusting for other covariates. Fasting and postprandial glucagon levels are not associated with metabolic syndrome in T2DM patients. However, further studies are needed to investigate the relationship between glucagon and cardiovascular risk in patients with T2DM.

• Journal of Korean Biological Nursing Science
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• v.22 no.2
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• pp.139-147
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• 2020

Purpose: The purpose of this study was to determine the effects of different intensity of aerobic exercise for four weeks on cardiovascular risk factors, reactive oxygen, and antioxidant enzymes in old mice. Methods: Eighteen male C57BL/6 mice age 18 months were randomly classified into the control group (n= 6), the moderate intensity exercise group (n= 6), and the low intensity exercise group (n= 6). The training groups performed the aerobic exercise twice daily for 20 minutes, five days weekly for four weeks. Data were analyzed using descriptive statistics, analysis of variance (ANOVA), the Chi-square test, and the Tukey's test with the SPSSWIN 21.0 program. Results: In this study, among the risk factors of cardiovascular disease, blood sugar (BS) (p= .023) and total cholesterol (TC) (p= .001) were significantly different between the moderate intensity exercise group and the control group. Additionally, there were significant differences in the reactive oxygen malondialdehyde (MDA) (p= .001), the antioxidant enzymes superoxide dismutase (SOD) (p< .001) and glutathione reductase (GR) (p= .015) between the moderate intensity exercise group and the control group. Conclusion: This finding suggests that moderate intensity aerobic exercise promotes the activity of antioxidant enzymes and lowers cardiovascular risk factors in older mice.

• Korean Journal of Clinical Pharmacy
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• v.27 no.4
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• pp.276-283
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• 2017

Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.111-116
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• 2006

Background: Perforation of the esophagus is a deadly injury that requires expert management for survival. The mediastinal contamination with microorganisms, gastric acid, and digestive enzymes results in a mediastinitis that is often fatal if untreated. Material and Method: Between January 1990 and June 2004, 38 patients with esophageal perforation were treated in our hospital. Retrospective review of these cases has been performed. Result: There were 28 males and 10 females. The mean age was 43.84$\pm$18.89 years (range $1{\~}73$ years). Spontaneous rupture was found in $34\%$ of perforations, iatrogenic perforation in $32\%$ and traumatic perforation in $34\%$. Perforation occurred in the cervical esophagus in 8 cases, thoracic esophagus in 29 and abdominal esophagus in 1. In the cervical esophageal perforation, managements were primary closure in 8 and drainage in 2. In the thoracic esophageal perforation, managements were primary closure in 14, resection in 3 and conservative management in 12. The mortality rate was $25\%$ in cervical esophageal perforation and $34.5\%$ in thoracic esophageal perforation. We revealed risk factor of esophageal perforation to be peropertaive septic condition (p=0.005). Conclusion: Most important risk factor of esophageal perforation was preoperative septic condition. Preoperative prompt and aggressive preoperative treatment may improve the survival rate of esophageal perforation.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.732-738
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• 1999

Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

• Journal of Korean Biological Nursing Science
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• v.18 no.3
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• pp.135-143
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• 2016

Purpose: This study was conducted to identify the factors associated with obstructive sleep apnea (OSA) risk in patients with metabolic syndrome (MS). Methods: Patients with MS between 30 and 74 years of age were recruited in an outpatient clinic of a cardiovascular center in Seoul, South Korea. MS and the risk of OSA were evaluated by Berlin questionnaire survey, the medical records of the participants were reviewed and a comprehensive lifestyle survey was performed. SPSS WIN 21.0 was used for statistical analysis. Results: BMI (OR: 1.31, CI: 1.14-1.51, p<.001) and lifestyle score (OR: 0.96, CI: 0.93-0.99, p=.028) were associated with the risk of OSA. Physical activity, weight control and diet were specifically associated with the risk of OSA after controlling for age, gender and BMI. Conclusion: This study demonstrated that lifestyle was an important factor associated with OSA risk in patients with MS.

• Korean Journal of Community Nutrition
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• v.4 no.4
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• pp.521-528
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• 1999

Cardiovascular disease is very prevalent in Korea, and many risk factors, if properly identified are possibly corrected. However, the study results on prevalence and distribution of risk factors may not be reliable while the risk factors of disease are always issued on health promotion projects conducted recently in a community. The subjects of this study were 854 adults who participated in the health and nutrition survey in a community. They were aged between 20 and 69 and sampled representatively. This study intended to estimate the prevalence and the distribution of risk factors of cardiovascular disease such as hypertension, diabetes mellitus, hypercholesterolemia, and obesity. Systolic blood pressure and diastolic blood pressure levels were estimated at $123.9{\pm}2.2mgHg(men)$, $117.9{\pm}1.7mgHg$(women), and $80.4{\pm}1.5mg(men)$, $74.9{\pm}1.1mgHg(women)$, respectively. Glucose level was estimated at $99.1{\pm}2.3mg/dl$ in men, and $95.7{\pm}1.7mg/dl$ in women. The estimated level of total cholesterol and HDL-cholesterol were $183.4{\pm}3.8mg/dl(men)$, $181.7{\pm}3.1mg/dl(men)$, and $122.0{\pm}4.5mg/dl(women)$, and body mass index was estimated at $24.0{\pm}0.4kg/m^2$ in men and $23.9{\pm}0.4kg/m^2$ in men and $23.9{\pm}0.3kg/m^2$ in women. The prevalence of hypertension was 20.5% for men, and 14.4% for women. The prevalence of diabetes mellitus was estimated to 6.9% for men, and 6.1% for women. The estimated prevalence of hypercholesterolemia was 3.8%(men), 3.9%(women). The rate of obesity was estimated to 28.5%(men), 28.4% (women), respectively. The levels of blood pressure, glucose, and cholesterol were higher in men than in women in almost all the almost ate groups. The prevalence of hypertension for men is about 20%. It was found that the prevalence of diabetes mellitus for males aged between 40 and 59 was rapidly increased. The risk factor with highest prevalence was obesity, and hypertension and diabetes mellitus were the second and third most prevalent.