• Journal of Preventive Medicine and Public Health
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• v.51 no.2
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• pp.71-82
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• 2018

Objectives: Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.

• Biomedical Science Letters
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• v.24 no.4
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• pp.405-410
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• 2018

Stroke is a leading cause of death in the Korean population and remains a major health burden worldwide. The two main pathologic types of stroke are ischemic stroke and intracranial hemorrhage (ICH), but comparisons of risk factors for these have been limited. We under took a nationwide population-based study to analyze the relationship between these risk factor sand ischemic stroke and ICH. From January 2003 to December 2013, a total of 37,561 patients with newly diagnosed ischemic stroke or ICH were identified using the National Health Insurance Service data base as the study population. Multivariable logistic regression analysis was used to determine the association between baseline risk factors and presentation with ICH versus ischemic stroke. The incidence of ischemic stroke showed an increasing rend every year, while there was no significant change in the incidence of ICH. Of the several risk factors associated with stroke, old age (OR 2.35, 95% CI 2.12~2.49, P < 0.001) was more closely associated with ischemic stroke than ICH, whereas renal disease (OR 0.74, 95% CI 0.55~0.99, P = 0.04) and carotid disease (OR 0.25, 95% CI 0.17~0.35, P < 0.001) were more strongly associated with ICH. In addition, diabetes mellitus, dyslipidemia, hypertension, ischemic heart disease and male sex was associated with an increased risk of ischemic stroke. Old age was more strongly associated with ischemic stroke than ICH, while carotid stenosis and renal impairment were more closely associated with ICH risk. Classic risk factors for stroke have considerably different associations with the two main pathologic types of stroke.

• Tuberculosis and Respiratory Diseases
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• v.64 no.4
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• pp.259-265
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• 2008

Background: Patients with diabetes mellitus are highly sensitive to infections, including tuberculosis, and the longer the duration of DM, the greater is the prevalance of tuberculosis. We studied the difference of the clinical manifestations, radiologic findings, resistance and others factors of patients with diabetic and non-diabetic pulmonary tuberculosis. Methods: The patients we enrolled in this study were newly diagnosed with pulmonary tuberculosis from January 2003 to December 2005. Results: 159 patients were enrolled in this study. There were 30 pulmonary tuberculosis patients with diabetic mellitus (DMTB) and 129 pulmonary tuberculosis patients without diabetic mellitus (non-DMTB). There was no difference in the basic characteristics and clinical manifestation between both the groups. For the chest X-ray findings, the moderately advanced tuberculosis patients were the most common (43.3% in the DMTB group and 49.6% in the non-DMTB group). There was no relation between the severity of tuberculosis activity on chest x-ray and the presence of diabetes. The prevalence of cavitory lesions in the DMTB group was significantly higher than that in the non-DMTB group, but the prevalence of atelectasis was higher in the non-DMTB group (p<0.05). There was no difference in the incidence of lower lung involvement, the number of involved lobes, the number of treatment days and the radiological sequelae in both groups. Conclusion: The DMTB patients had a higher incidence of cavitory lesions and a higher incidence of atelectasis than the non-DMTB patients.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.348-356
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• 2019

Background: Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients. Methods: Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed. Results: Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of $3.3{\pm}2.8years$ post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%). Conclusion: Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.3
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• pp.319-332
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• 2009

The present study was performed to analyze the life style and eating behavior of stroke patients and to find the risk factors related to stroke incidence in Daegu and Gyeongbuk Province, Korea. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community inhabitants who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews using questionnaires on the general characteristics, life-style, eating behavior, food intake frequency and food preference. The high body mass index, preexisting diseases such as diabetes and hypertension, stroke family history, smoking, overeating habit and high preference for sweet, greasy and meat foods appeared to be the risk factors for stroke incidence. On the other hand, the results suggest that life style of regular exercise and nonsmoking, food habits of green tea drinking and enough chewing, preference for Korean meal type, high intake frequency for legumes, vegetables, mushrooms, seaweeds, fishes and shell fishes, soy milk and green tea might be the protective factors for the stroke. Therefore, maintenance of healthy weight, the prevention and management of the deteriorative chronic diseases, change of life style and improvement of eating behaviors are considered to be important for stroke prevention.