• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.101-106
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• 2005

Objectives : We conducted this study to examine the association between serum GGT levels within the normal range and the risk factors of cardiovascular diseases Methods : We examined the cross-sectional association between serum GGT and the systolic and diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol (HDLcholesterol), and uric acid among 975 subjects that participated in the health examination of a university hospital located in Daegu city. All the patients' GGT levels were within the normal range. Results : After adjustment were made for age, body mass index (BMI), smoking status, drinking frequency, exercise frequency and coffee intake, the serum GGT level was positively associated with fasting blood glucose (p<0.01), total cholesterol (p<0.01), and triglyceride (p<0.01) in men, and it was positively associated with fasting blood glucose (p<0.01), total cholesterol (p<0.05), triglyceride (p<0.01), and uric acid (p<0.01) in women. The associations were not significantly different depending on the status of alcohol drinking or obesity, except for the associations of serum GGT with diastolic blood pressure (P for interaction=0.04) and uric acid (P for interaction=0.04) between the lean and obese subjects. Conclusions : Serum GGT levels within the normal range were positively associated with fasting blood glucose, triglyceride and uric acid in most subgroups irrespective of the drinking or obesity status. These results suggest that GGT has important clinical implications as being more than just a marker of alcohol consumption and hepatobiliary disease.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.607-622
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• 2004

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.496-512
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• 2018

Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.687-693
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• 2010

Background: It is controversial whether the presence of bullae on the contralateral lung on HRCT plays a role in occurrence of contralateral primary spontaneous pneumothorax. We analyzed the significance of bullae on the contralateral lung and the risk factors associated with contralateral occurrence of primary spontaneous pneumothorax. Material and Method: Three hundred ninety four patients who were undergone Video-Assisted Thoracoscopic Surgery for primary spontaneous pneumothorax between January 2004 and December 2009 were reviewed. The clinical features, HRCT and treatment of these patients were analyzed retrospectively. Result: Twenty eight of 394 patients had contralateral occurrence (7.10%). The average time was $13.06{\pm}9.79$ months. A presence of contralateral bullae of lung on HRCT may not seem to be significant for occurrence of contralateral primary spontaneous pneumothorax (p=0.059). But bullae numbers were much more in contralateral pneumothorax patients (p=0.011). Younger than 20, being underweight (Body Mass Index < $18.5 kg/m^2$) are independent risk factors for contralateral occurrence (odds ratio, 5.075 (1.679~5.339), 2.366 (1.048~5.339) respectively). Conclusion: The presence of bullae on the contralateral lung on HRCT was not significantly influenced the occurrence of contralateral primary spontaneous pneumothorax. However, age, body mass index, and the number of bullae were significant factors for the contralateral pneumothorax. We suggest that those high risk patients may require special attentions and general supportive care to prevent occurrence of contralateral primary spontaneous pneumothorax during the follow-up.

• The Journal of Internal Korean Medicine
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• v.25 no.2
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• pp.195-201
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• 2004

Background and Purpose : Hypertension is one of the modifiable risk factors for stroke. Lowering blood pressure is a primary or secondary preventative measure for stroke. This study aims to assess the efficacy of Chunghyul-dan(Qingxue-dan) in stage 1 hypertensive patients who have suffered a stroke by 24 hour ambulatory blood pressure monitoring(24ABPM). Subjects& Methods : We enrolled 40 hospitalized stroke patients with stage 1 hypertension and divided them into 2 groups by stratified randomization; group A took 1200mg of Chunghyul-dan(Qingxue-dan) at 8:00 a.m. for two weeks without changing herbal medicine, and group B was the control group. 28 patients were included in the final analysis(15 in group A. 13 in group B). Blood pressure is monitored from 8:00 am to 7:30 am every 30 minutes for 24 hours. Blood pressure was monitored two times at baseline and again two weeks later. We used 3 parameters for evaluating the efficacy of Chunghyul-dan(Qingxue-dan); The first parameter is change from baseline to two weeks later in blood pressure and pulse rate. The second parameter is the trough/peak ratio(TPR) and smoothness index(SI). The third parameter is antihypertensive rate by antihypertensive efficacy guideline. Results : There is no significant difference in the baseline assessment hetween the two groups. Systolic blood pressure $(141.37{\pm}8.96\;mmHg\;vs\;132.28{\pm}9.46\;mmHg)$ decreased after two weeks of 1200mg(P=0.03) intake of Chunghyul-dan(Qingxue-dan). Systolic TPR and SI was 0.87 and 1.04 in group A. Antihypertensive rate was higher in group A. Conclusion: These results suggest that 1200mg doses of Clunghyul-dan(Qingxue-dan) is an effective antihypertensive agent on stage 1 hypertension patients who have suffered a stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.3
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• pp.39-47
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• 2016

PURPOSE : This study attempts to find the effects of water perturbation exercise performed on stroke patients in their physiological cost index and gait ability tests. METHOD : The subjects were 30 stroke patients, water perturbation exercise group was performed 3 day per week, for 40 minutes a day, for a period of eight weeks. The physiological cost index and gait of all subjects were assessed by using the polar, 6 Minute Walk Test (6MWT), and 10 meter Walk Test(10mWT) at pre training and post training. Paired t-test was used to analyze change before and after intervention in group. Pearson's correlation was used to analyze correlation of all variables. RESULT : Water perturbation exercise group showed increased physiological cost index. Water perturbation exercise increased gait ability, showing a significant difference. Showing the correlation between the relatively high amount between physiological cost index and 6 minutes walking test. CONCLUSION : From the result of the study, we found that water perturbation exercise was effective in improving physiological cost index and gait ability. The patient is considered to be used by itself to involve the treatment and the risk of falling from the lowered state into the treatment method for the intensive treatment of stroke patients to be useful in improving the cardiovascular system and ability to walk. Through underwater training for stroke patients in the future on the basis of this study it is considered to require additional clinical studies on the impact on daily living and quality of life of stroke patients.

• Journal of Chest Surgery
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• v.53 no.5
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• pp.270-276
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• 2020

Background: We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF). Methods: Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history. Results: All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant. Conclusion: Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.3
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• pp.399-407
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• 2012

To evaluate age and gender differences in the relation of cardiovascular risk factors, cognitive impairment, and subclinical carotid atherosclerosis from aged people using by a cross sectional method. Sixty-nine healthy elders living in the community who had not previously undergone carotid ultrasonography were included. We conducted life style surveys, and cognitive function tests including Korean-mini-mental state examination (K-MMSE) and clinical dementia rating-Korean. Various biomarkers from blood were assessed; fasting insulin-like growth factor-1, lipid-profile, high sensitivity C-reactive protein, total homocysteine, glucose, insulin, Homeostasis model assessment (HOMA) for insulin resistance index, vitamin B12, and folate level. Carotid intima-media thickness (C-IMT), and plaques were measured using carotid ultrasonography and aortic ultrasonography, a valid index of atherosclerosis. For the elderly subjects (aged 65-82 years), cognition impairment was more prevalent in females while subclinical atherosclerosis was more prevalentin males. Increased C-IMT has been kept in males, and C-IMT shows increasing trend and the peak at about 80 year-old in females with increasing age. The significant correlations between C-IMT and many vascular risk factors including age, triglyceride, abnormal homocysteinein male, and K-MMSE, insulin, HOMA index and abnormal aortic ultrasonography in female were different in each gender, with the exception of homocysteine (p<0.05). This data suggests that there were differences of age and gender characteristics in terms of subclinical atherosclerosis, cognitive impairment and vascular risk factors in community-living elders. Further larger and longitudinal studies across entire age are required to better understand the effects of risk factors on subclinical atherosclerosis.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.139-146
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• 2012

Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni- and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

• Journal of the Korean Dietetic Association
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• v.8 no.3
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• pp.250-259
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• 2002

The purpose of this study was to confirm that calcium intake and healthy status play a role in reducing the risk of cardiovascular disease, to assure that calcium intake and regular exercise are important in reducing serum lipid levels in middle-aged women. Daily nutrient intakes were analyzed by convenient method. Anthropometric measurement such as body weight and height and blood pressure were measured. The subjects divided into two groups : women in group I under 50 years of age($\leq$49 yr group) and those in group II 50 years up($\geq$50 yr group). Average ages of group I and II were 43.87 and 53.46 years. The nutrients intake of subjects were higher than Korean recommended dietary allowances(KRDA) except calorie, iron, calcium, vitamin B1. They showed significant difference each other in vitamin B2(p<0.05), calcium(p<0.01) intake. Mean daily calcium intake was 540.88mg in $\leq$49 yr group and 519.50mg in $\geq$50 yr group. The levels of serum cholesterol, triglyceride, blood pressure, Atherogenic Index(AI), LDL/HDL and Cardiac Index(CI) were increased with age. The triglyceride and total cholesterol concentrations and LDL/HDL in $\geq$50 yr group were significantly higher than those of $\leq$49 yr group. There was a highly significantly positive correlation between age and triglyceride, total cholesterol and Atherogenic Index(AI). Triglyceride, total cholesterol, LDL-cholesterol concentration and Atherogenic Index(AI) were positively correlated with body weight and WHR(waist-hip ratio). Also ther was a significantly negative correlation between exercise and Cardiac Index(CI). Also a significantly negative correlation was found between Ca intake and LDL-cholesterol. Exercise and Cardiac Index(CI) also had a significantly negative relation. The results suggest that increased habitual physical activity and calcium intake should be recommended as a way of decreasing blood lipids and blood pressure in middle-aged women.