• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.729-738
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• 1998

Background and purpose : Stroke is a leading cause of death in Korea. Early measures to prevent stroke are extremely important since it has no cure. Korean might have different risk factors since their dietary habits and socio-economical status differ from most western countries. However, the risk factors for stroke in Korea have not yet been identified. Moreover, the lifestyle of healthy Korean adults has not been investigated. In this study we investigate the lifestyle of healthy adults living in Seoul and rural areas and compare the lifestyles of the two. Methods : One hundred seventy one subjects were studied. Among the subjects studied, 128 were from Seoul, the other 43 were from the country area. The age of the subjects was limited to over 40 years. Blood pressure, fast blood sugar, and cholesterol were measured. The subjects' height, weight, body mass index, total body fat, skinfolds thickness of triceps, subscapular and abdomen were measured to determine obesity. Using a structured interview, we assessed : sodium intake, physical activity and exercise, consumption of vegetables, fat, fish and fruits. The results of the two groups were compared. Results : There were no statistical differences in age and education between the two groups of subjects. The mean age of the subjects were 66 years old. The subjects residing in rural areas had a higher intake of sodium(p<0.05), lower physical activity(P<0.05), and higher BMI and body fat (p<0.05) as compared to the subjects in Seoul. Subjects with hypertension were between 24% and 33% and the prevalence of hypertension was the highest when compared to the prevalence of DM or hypercholesterolemia. However, the prevalence of hypertension, DM, hypercholesterolemia, were not significantly different in these areas. Conclusion : Our results show that subjects living in rural areas eat more salty food, exercise less, and tend to be obese. The finding of this study lead to speculation that Korean living in rural areas have less information about the effects of diet on health than city dwellers do. General health and nutrition education programs aimed at the prevention of stroke and other such conditions for rural area Koreans may close the risk factor gap between rural and urban dwellers.

• 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.

• Annals of Clinical Neurophysiology
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• v.17 no.2
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• pp.68-72
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• 2015

Background: The effects of omega-3 polyunsaturated fatty acids (PUFAs) on cerebral vessels have not been clarified until now. Thus we investigated the efficacy of omega-3 PUFAs supplementation on cerebral blood flow velocity and vascular resistance via transcranial doppler (TCD). Methods: Consecutive twenty patients (13 male and 7 female) with at least 1 cerebrovascular risk factor or a known cerebrovascular disease were enrolled. Patients were treated with omega-3 PUFAs (1 g, two times per day) for 12 weeks. Cerebral blood flow velocity, resistance index, and pulsatile index were checked before and after 12 weeks of treatment using TCD. Results: The change of resistance index in right MCA (from $0.58{\pm}0.07$ to $0.55{\pm}0.07$, p = 0.042) and left PCA (from $0.56{\pm}0.07$ to $0.53{\pm}0.06$, p = 0.037) showed significant improvement after 12 weeks of omega-3 PUFAs treatment. The changes in other vessels, however, failed to show any significant changes compared to the baseline. Conclusions: Omega-3 PUFAs treatment showed feasible efficacies for cerebral vascular resistances in this open label trial. To confirm these results, larger samples of patients and longer period of follow-up is warranted.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.253-263
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• 2018

Purpose: With increasing life expectancy, the presence of comorbidities has become a major concern in elderly patients who require surgery. However, little is known about the impact of different comorbidities on the outcomes of laparoscopic total gastrectomy (LTG). In this study, we investigated the impact of comorbidities on postoperative complications in patients undergoing LTG for gastric carcinoma. Materials and Methods: We retrospectively reviewed the cases of 303 consecutive patients who underwent LTG for gastric carcinoma between 2005 and 2016. The associations between each comorbidity and postoperative complications were assessed using univariate and multivariate analyses. Results: A total of 189 patients (62.4%) had one or more comorbidities. Hypertension was the most common comorbidity (37.0%), followed by diabetes mellitus (17.8%), chronic viral hepatitis (2.6%), liver cirrhosis (2.6%), and pulmonary (27.1%), ischemic heart (3.3%), and cerebrovascular diseases (2.3%). The overall postoperative morbidity and mortality rates were 20.1% and 1.0%, respectively. Patients with pulmonary disease significantly showed higher complication rates than those without comorbidities (32.9% vs. 14.9%, respectively, P=0.003); patient with other comorbidities showed no significant difference in the incidence of LTG-related complications. During univariate and multivariate analyses, pulmonary disease was found to be an independent predictive factor for postoperative complications (odds ratio, 2.14; 95% confidence interval, 1.03-4.64), along with old age and intraoperative bleeding. Conclusions: Among the various comorbidities investigated, patients with pulmonary disease had a significantly higher risk of postoperative complications after LTG. Proper perioperative care for optimizing pulmonary function may be required for patients with pulmonary disease.

• The Journal of Korean Medicine
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• v.31 no.3
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• pp.122-127
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• 2010

Objective: Hyperlipidemia is a main risk factor of stroke and cardiovascular disease. This study aimed to investigate characteristics of hyperlipidemia in adult subjects. Methods: Hyperlipidemia-related makers were analyzed using biochemical data from 1,180 (496 male and 684 female) subjects who took medical examination in an Oriental Hospital for the purpose of detecting cerebrovascular accident. Results: 19.7 % of subjects (male 14.7 %, female 23.2 %) had hypercholesterolemia while 21.9 % (male 25.8 %, female 19.0 %) had hypertriglyceridemia. 17.2 % of subjects (male 22.1 %, female 13.6 %) showed low HDL-cholesterol while 13.0% (male 10.3 %, female 14.9 %) showed high LDL-cholesterol. Conclusions: This study will provide helpful information for patients with hyperlipidemia and to develop therapeutics using traditional Korean medicine.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.2
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• pp.234-240
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• 2012

The purpose of this case-control study is to investigate the relationship between storke and stroke risk factors, such as family history and past history. The case-control study over clinical data registered from Daejeon Oriental Medical Hospital in the period of November 2006 to July 2010. Study subjects consisted of 108 patients with acute stroke within 1 month as the case group (Cases) and 108 people who visited hospital for health care as the genreral control group (Controls). The participants had been interviewed by residents to find out their family history and past history. Their blood was taken to check the blood lipid level and liver function. 1. The people whose family history included cerebrovascular accident had more probability of stroke than the people who did not have cerebral vascular accident as their family history. 2. The people who suffered from hypertension had more probability of stroke than the people who did not suffer from hypertension. 3. The people who suffered from diabetes mellitus had more probability of stroke than the people who did not suffer from diabetes mellitus. Based on this study, the people who had cerebral vascular accident as their family history should thoroughly treat their blood pressure and blood sugar level to prevent the cerebral vascular accident.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1049-1055
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• 1998

Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.342-352
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• 2018

This study was conducted to evaluate the effects of physical activity practice rates and knowledge related to cardiocerebrovascular disease prevention on the health behavior of middle aged women. Data were collected from Oct to Nov 2017 from 142 middle-aged women living in 24 Eup, Myeon, and Dong areas in North Gyeongsangbuk-do Province using a structured questionnaire. The obtained data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation, and stepwise multiple regression analysis. The major factors influencing health behavior were found to be alcohol consumption (${\beta}=0.15$, p=0.009), diet (${\beta}=0.16$, p=0.003), vigorous intensity (${\beta}=0.14$, p=0.011), marriage (${\beta}=0.19$, p<0.001), interest in one's own health (${\beta}=0.23$, p<0.001), and health recognition (ill: ${\beta}=0.31$, p<0.001). Alcohol consumption and diet were factors of cardiocerebrovascular knowledge, vigorous intensity was a factor of physical activity practice rate, marriage and interest in one's own health were factors of general characteristics, and health recognition was a factor in health-related characteristics. Health-promotion activity was positively correlated with knowledge regarding cardiocerebrovascular disease prevention (r=0.41, p<0.001) and physical activity practice rate (r=0.44, p<0.001). It will be necessary to develop and apply practical intervention programs based on disease prevention knowledge and physical activity to enhance the health behavior of middle aged women.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• Journal of agricultural medicine and community health
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• v.33 no.1
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• pp.71-81
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• 2008

Objectives: Recently the care of cerebrovascular and cardiovascular disease is important as much as that of cancer care in public health, so the control of diabetes mellitus(DM) which is a risk factor of cerebrovascular and cardiovascular disease has been also important consideration.class(DM class) of a health center. Methods: Study subjects were 54 participants of DM class in a health center that had been held once a month, from January 2005 to March 2006.Results: Among the DM class participants, 67.3% participated by 50% or over in the DM clas.participants(p<0.05). In a comparison betwen more than 50% participation group and les than 50% participation group, more than 50% participation group got decreased level of blood sugar from 182mg/dl to 155mg/dl and less than 50% participation group also got decreased level from 172mg/dl to 156mg/dl. But Conclusion: DM clas of health center was effective program to manage diabetes mellitus patients in comunity.