• 보건행정학회지
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• 제30권4호
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.693-704
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• 2021

Objective : Endovascular mechanical thrombectomy (MT) has been regarded as one of the standard treatments for acute ischemic stroke caused by large vessel occlusion. Despite the wide use of stent retrievers for MT, arterial intimal damage caused when deployed stent is pulled has been a certain disadvantage. We hypothesized that statin could protect and stabilize vessel damage after endovascular MT using a stent retriever. In this animal study, we observed the protective effects of the statins towards MT-induced vessel wall injury. Methods : Twenty-eight carotid arteries of fourteen rabbits were used in the experiments with MT using stent retriever. We divided the rabbits into four groups as follows : group 1, negative control; group 2, positive control; group 3, statin before MT; and group 4, statin after MT. After MT procedures, we harvested the carotid arteries and performed histomorphological and immunohistochemical analyses. Results : In histomorphological analysis with hematoxylin and eosin and Masson's trichrome stain, significant intimal thickening (p<0.05) was observed in the positive control (group 2), compared to in the negative control (group 1). Intimal thickening was improved in the statin-administered groups (groups 3 and 4 vs. group 2, p<0.05). We also observed that statin administration after MT (group 4) resulted in a more effective decrease in intimal thickness than statin administration before MT (group 3) (p<0.05). We performed immunohistochemical analysis with the antibodies for tumor necrosis factor-alpha (TNF-α), cluster of differentiation (CD)11b, and CD163. In contrast to the negative control (group 1), the stained percentage areas of all immunological markers were markedly increased in the positive control (group 2) (p<0.05). Based on statin administration, the percentage area of TNF-α staining was significantly reduced (p<0.05) in group 3, compared to the positive control group (group 2). However, significant differences were not observed for CD11b and CD163 staining. In group 4, no significant differences were observed for TNF-α, CD11b, and CD163 staining (p≥0.05). The differences in the percentage areas of the different markers between the statin-administered groups (groups 3 and 4) were also not revealed. Conclusion : We presented that statin administration before and after MT exerted protective effects towards vessel wall injury. The efficacy of statins was greater post-administration than pre-administration. Thus, statin administration in routine prescriptions in the peri-procedural period is strongly advised.

• Journal of Ginseng Research
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• 제46권4호
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• pp.515-525
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• 2022

Background: The incidence of ischemic cerebrovascular disease is increasing in recent years and has been one of the leading causes of neurological dysfunction and death. Ginsenoside Rg1 has been found to protect against neuronal damage in many neurodegenerative diseases. However, the effect and mechanism by which Rg1 protects against cerebral ischemia-reperfusion injury (CIRI) are not fully understood. Here, we report the neuroprotective effects of Rg1 treatment on CIRI and its possible mechanisms in mice. Methods: A bilateral common carotid artery ligation was used to establish a chronic CIRI model in mice. HT22 cells were treated with Rg1 after OGD/R to study its effect on [Ca²⁺]_i. The open-field test and poleclimbing experiment were used to detect behavioral injury. The laser speckle blood flowmeter was used to measure brain blood flow. The Nissl and H&E staining were used to examine the neuronal damage. The Western blotting was used to examine MAP2, PSD95, Tau, p-Tau, NOX2, PLC, p-PLC, CN, NFAT1, and NLRP1 expression. Calcium imaging was used to test the level of [Ca²⁺]_i. Results: Rg1 treatment significantly improved cerebral blood flow, locomotion, and limb coordination, reduced ROS production, increased MAP2 and PSD95 expression, and decreased p-Tau, NOX2, p-PLC, CN, NFAT1, and NLRP1 expression. Calcium imaging results showed that Rg1 could inhibit calcium overload and resist the imbalance of calcium homeostasis after OGD/R in HT22 cells. Conclusion: Rg1 plays a neuroprotective role in attenuating CIRI by inhibiting oxidative stress, calcium overload, and neuroinflammation.

• Journal of Chest Surgery
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• 제55권1호
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• pp.69-76
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• 2022

Background: While the use of bioprosthetic valves for mitral valve replacement (MVR) is increasing, very few studies have compared bovine pericardial and porcine valves in the mitral position to help guide bioprosthetic selection. Methods: In the present study, patients who underwent MVR using bovine pericardial valves were compared with those who underwent MVR with porcine bioprostheses between January 1996 and July 2018. Those with prior MVR, infective endocarditis, congenital mitral valve disease, or ischemic mitral regurgitation were excluded. The primary outcomes were structural valve deterioration (SVD) and mitral valve reoperation from any cause, and death was regarded as a competing risk. Competing risk analysis and propensity score-matching were used for comparisons. Results: Among the 388 patients enrolled, pericardial and porcine bioprostheses were implanted in 217 (55.9%) and 171 (44.1%), respectively. Propensity score-matching yielded 122 pairs of patients that were well-balanced for all baseline covariates. No significant differences were observed between the groups in unadjusted (p=0.09) and adjusted overall survival (hazard ratio [HR], 1.13; 95% confidence interval [CI], 0.72-1.76; p=0.60). Competing risk analysis revealed no significant differences in the risks of mitral reoperation (HR, 1.07; 95% CI, 0.50-2.27; p=0.86) and development of SVD (HR, 1.57; 95% CI, 0.56-4.36; p=0.39) between the groups. Matched population analysis confirmed similar results regarding reoperation (HR, 0.99; 95% CI, 0.40-3.22; p=0.98) and SVD (HR, 1.39; 95% CI, 0.41-4.73; p=0.60). Conclusion: No significant differences in survival or valve durability were observed between bovine pericardial and porcine bioprosthetic MVR. These findings require further validation through studies with larger sample sizes.

• 대한본초학회지
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• 제32권2호
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• pp.25-32
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• 2017

Objectives : This study was conducted to investigate candidate materials as anti-inflammatory agent from extracts of Korean medicinal plants in Hwaak mountain. Ligustrum obtusifolium (LO) is a Korea medicinal plants that commonly used for robustness and hemostasis. It has been reported that LO has exhibited anti-ischemic, anti-oxidative, anti-hypolipidemic, anti-tumor and hypoglycemic effects. However, LO has not been previously reported to have an anti-inflammatory effect. Therefore, we have evaluated the anti-inflammatory effects of LO and its underlying molecular mechanisms in LPS-induced RAW 264.7 macrophages. Methods : Cell viability was determined by MTT assay in RAW 264.7 macrophages. Nitric Oxide (NO) was measured with Griess reagent and pro-inflammatory cytokines were detected by ELISA in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages. Protein expressions of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and p65 subunit of nuclear $factor-{\kappa}B$ ($NF-{\kappa}B$) were determined by Western blot analysis. Results : Among 15 extracts of Korean medicinal plants tested, Ligustrum obtusifolium (LO) showed the inhibition of NO production without cytotoxicity. LO reduced the expression levels of iNOS and COX-2 proteins in LPS-simulated RAW 264.7 macrophages in dose-dependent manner. Consistent with these data, LO inhibited the productions of $TNF-{\alpha}$, IL-6, and $IL-1{\beta}$ in LPS-simulated RAW 264.7 macrophages. Furthermore, LO attenuated the LPS-induced nuclear translocation of p65 $NF-{\kappa}B$ in RAW 264.7 macrophages involving suppression of $NF-{\kappa}B$ activation. Conclusions : Taken together, these results suggest that the anti-inflammatory effects of LO is associated with regulation of inflammatory mediators via inhibition of $NF-{\kappa}B$ activation in LPS-treated RAW 264.7 macrophages.

• 생명과학회지
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• 제33권1호
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• pp.64-72
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• 2023

심장 발생과정에 관여하는 주요 전사인자들의 기능에 대한 규명 등의 발전에도 불구하고 줄기 세포에서 매우 효율적인 심근 세포로의 분화를 촉진하는 새로운 생체 활성 분자를 찾는 것이 여전히 필요하다. 마우스배아줄기세포(mESC) 유래 심근세포의 Illumina 발현 마이크로어레이 데이터를 분석하였다. 미분화 mESCs와 비교하여 mESC 유래 심근세포에서 4배 이상 유전자 발현이 증가한 276개 유전자가 스크리닝되었다. Secreted phosphoprotein 2 (Spp2)는 후보물질 중 하나이며 bone morphogenetic protein 2 (BMP2)에 대한 슈도수용체로서 BMP2 신호 전달을 억제하는 것으로 알려져 있다. 그러나 심근 형성과의 연관성은 알려진 바 없다. 우리는 mESC 세포주인 TC-1/Kh2와 E14를 이용하여 기능성 심근세포로 분화하는 동안 Spp2 발현이 증가함을 검증하였다. 흥미롭게도, Spp2 분비는 배아체(embryoid body, EBs) 형성 후 3일차에 일시적으로 증가했는데, 이는 Spp2의 분비가 ESCs의 심근세포로의 분화에 관여함을 시사한다. Spp2의 기능을 분석하기 위해, 우리는 BMP2를 처리하면 분화 경로를 근모세포에서 골모세포로 전환되는 특성을 가진 C2C12 마우스 근모세포 세포주를 사용하여 실험을 수행하였다. mESCs의 분화와 유사하게, Spp2의 전사는 C2C12 근모세포가 근관으로 분화됨에 따라 증가하였다. 특히, 분화 초기 단계에서 Spp2의 세포외 분비가 극적으로 증가하였다. 또한, Spp2-Flag 재조합 단백질로 처리하면 C2C12 근모세포의 근관으로의 분화가 촉진되었다. 종합하면, ESCs를 심근 세포로 분화시키는 새로운 생체 활성 단백질로 Spp2를 제안한다. 이것은 심근형성의 분자 경로를 이해하고 허혈성 심장질환에 대한 줄기세포 요법의 실험적 또는 임상적 발전을 촉진하는 역할을 할 것으로 기대한다.

• 대한한의학방제학회지
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• 제31권3호
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• pp.157-169
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• 2023

Gracilaria Verrucosa (GV), a seaweed used in traditional Korean medicine, was studied for its effects on MI-induced heart failure in rats. MI is caused by a blocked coronary artery, leading to severe cardiac dysfunction. The study used a rat model to assess cardiac changes over time and evaluate the impact of GV on heart failure. Ischemia was induced through LAD ligation surgery, and the extent of ischemic area was measured as a prognostic factor. GV extract administration significantly improved cardiac morphology and reduced cardiac weight compared to the MI group. GV treatment also improved cardiac function, as evidenced by positive effects on chamber dilation during MI-induced heart failure. Parameters such as ejection fraction (EF) and fractional shortening (FS) were measured. The MI group showed decreased EF and FS compared to the sham group, while these parameters improved in the GV group. GV treatment also reduced levels of LDH, CPK, and CK-MB in the serum, indicating reduced myocardial damage. Histological analysis revealed that GV treatment attenuated cardiac hypertrophy and fibrosis, with reduced collagen deposition in the myocardium. Immunohistochemistry analysis showed suppressed expression of TGF-β1 and collagen 1, involved in fibrosis. In conclusion, GV showed potential in improving cardiac function in a rat model of MI-induced heart failure. It alleviated myocardial damage, attenuated cardiac hypertrophy and fibrosis, and suppressed fibrotic markers. Further studies are needed to explore its clinical efficacy and underlying mechanisms in cardiac diseases beyond animal models.

• Korean Journal of Acupuncture
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• 제40권3호
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• pp.79-89
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• 2023

Objectives : The purpose of this study is to investigate various application methods of focused ultrasound and apply them to clinical use in Korean medicine. Methods : Search was performed using the search engines of electronic databases, including PubMed, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), China National Knowledge Infrastructure (CNKI), Wanfang Data, Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii), from inception to July 2023 without language limitation. Inclusion criteria were clinical studies including randomized controlled trials (RCTs), and animal experimental studies related with focused ultrasound treatments for acupoints or meridian sinews. Results : Total 17 papers, 7 for RCT, 6 for in vivo animal studies, and other experimental studies, were finally selected. Indications used in studies were shoulder pain, back pain, chronic back pain, and degenerative knee arthritis. In experimental studies, studies on animal models of hypoxic ischemic brain damage and hyperlipidemia were also conducted. As for the acupoints, LR3, LI4, and ST36 were used in clinical studies and, in animal experimental studies, GV20, KI1, and ST36 were used. As for the dose, 4 studies below 3 W/cm² and 3 studies in the range of 0.625 to 5 W/cm² in clinical studies, and all studies did not exceed 5 W/cm². In animal experimental studies, 0.5 W/cm², 2 W/cm², 7.5 WW/cm², 15 W/cm², 10~20 W/cm² were used. In all three studies describing the penetration depth during irradiation, it was less than 1 cm. Conclusions : We suggest that focused ultrasound is an appropriate treatment tool for stimulating the acupoints to transfer heat energy. Future studies with rigorous and well-designed RCTs for various diseases will be required to ascertain the focused ultrasound stimulate acupoints or meridian sinews.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.422-429
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• 2022

Objective : Extracranial supra-aortic dissections (ESADs) with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke. Endovascular stenting to reconstruct non acute phase ESADs (NAP-ESADs) is an alternative to anticoagulant or antiplatelet therapy. However, its feasibility, safety and efficacy of stenting in NAP-ESADs is unclear. This study aims to investigate the long-term outcomes of the feasibility, safety and efficacy of stenting in NAP-ESADs. Methods : Seventy-four patients with 91 NAP-ESAD vessels with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke who underwent stent remodeling were enrolled into this respective study from December 2008 to March 2020. Technical success rate, complications, clinical and angiographic results were harvested and analyzed. Results : Success rate of stent deployment was 99% (90/91) with no procedural mortality or morbidity. Transient ischemic attack occurred in three patients during operation (4.1%, 3/74). Asymptomatic embolisms of distal intracranial vessels were found in two patients (2.7%, 2/74). One hundred and forty-two stents deployed at 85 carotid (135 stents) and six vertebral (seven stents) vessels. Six stent types (Wingspan, 28/135, 20.7%; Solitaire, 10/135, 7.4%; Neuroform, 8/135, 5.9%; LVIS, 2/135, 1.5%; Precise, 75/135, 55.6%; Acculink, 12/135, 8.9%) were deployed at carotid arterial dissection while two types (Wingspan, 5/7, 71.4%; Solitaire 2/7, 28.6%) at vertebral arterial dissection. Digital subtracted angiography (56%, 51/91), computational tomography angiography (41.8%, 38/91) and high resolution magnetic resonance imaging (2.2%, 2/91) were adopted for follow up, with a mean time of 17.2±15.4 months (5-77). All patient modified Rankin Scale scores showed no increase at discharge or follow-up. Angiographically, dissections in 86 vessels in 69 patients (94.5%, 86/91) were completely reconstructed with only minor remnant dissections in four vessels in four patients (4.4%, 4/91). Severe re-stenosis in the stented segment required re-stenting in one patient (1.1%, 1/91). Conclusion : Stent remodeling technique provides feasible, safe and efficacious treatment of ESADs patients with severe stenosis, occlusion and/or pseudoaneurysm.

• 대한중풍순환신경학회지
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• 제9권1호
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• pp.25-32
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• 2008

Objectives : Metabolic syndrome (MetS) is associated with increasing risk of cardiovascular morbidity and mortality but the risk of stroke associated with the MetS is less well established. The objective of this study was to evaluate the prevalence of MetS in stroke patients. Methods : We analyzed the data of 806 patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Subjects' enrollment was done in the oriental medical hospitals of 4 universities located in the metropolitan region from April 2007 to August 2008. We analyzed all registered data and evaluated the prevalence of MetS and specific components of MetS. Results : The prevalence of MetS in stroke patients according to American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) criteria was 59.6%. The prevalence according to the International Diabetes Federation (IDF) criteria was 41.6%. The prevalence of female patients was higher than that of male patients (71.8% vs 51% by AHA/NHLBI criteria; 61.7% vs 27.7% by IDF criteria). The prevalence of central obesity, low HDL cholesterol and hypertension was higher in female patients. There was no significant relationship between MetS and stroke subtype. Conclusions : This work gives us the basic data on the association between MetS and risk of stroke. There should be the prospective cohort studies to evaluate MetS and the risk of stroke.