• 동아시아식생활학회지
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• 제18권4호
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• pp.436-445
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• 2008

뇌졸중은 그 발병 자체가 치명적일 뿐만 아니라 다양한 합병증과 후유증을 야기하여 환자에게 심각한 신체적 정신적 고통을 남기고 장기적인 재활치료를 요구하며 환자 가족들에게까지 정신적 경제적 고통을 야기시킨다. 본 연구는 대구 S병원의 뇌졸중 환자들의 생활 패턴 및 식행동 특성을 분석하고 뇌졸중을 일으키는 생활 습관 및 식생활 관련 위험요인을 파악하여 지역민의 뇌졸중 예방을 위한 영양교육의 기초자료를 얻고자 수행되었다. 연구 내용은 뇌졸중 환자들의 일반 특성, 생활 습관 및 식태도 등의 내용을 포함한 설문지를 이용하여 조사자와 직접면접을 통하여 이루어졌다. 2005년 2월부터 8월까지 뇌졸중으로 대구 S병원의 신경외과 병동에 입원한 환자와 신경외과 외래를 정기적으로 방문하는 환자를 환자군으로 선정하였다. 환자군의 선별은 임상적 증상에 의해 신경외과 의사의 진단을 받은 30세 이상의 경우로 국한하였다. 환자군 36명에 대한 정상 대조군은 동일병원에 뇌졸중 질환이 없고, 환자와 유사한 조건의 건강한 환자 보호자 및 원내 직원 36명을 대상으로 하였으며, 그 결과는 다음과 같다. 1) 뇌졸중 환자군에서 체질량 질수(BMI)는 건강인과 비슷하였으나 WHR은 대조군에 비해 유의적으로 높게 나타났다. 2) 뇌졸중 환자의 동반질병으로는 고혈압, 당뇨병, 위장질환 순으로 높게 나타나, 고혈압은 뇌졸중 발병 위험을 높여주는 위험요인으로 사료된다. 3) 뇌졸중 환자는 과거 흡연가와 현재 흡연가의 비율이 대조군에 비해 유의적으로 높게 나타나, 흡연이 뇌졸중 발병 위험을 높이는 위험 요인으로 사료된다. 4) 주당 음주 횟수에 관한 조사 결과, 환자군이 대조군에 비해 유의적으로 높게 나타나, 음주횟수 및 음주량 증가가 뇌졸중 발병 위험을 높이는 요인 중 하나로 사료된다. 5) 뇌졸중 환자군의 식욕을 돋우는 입맛으로 짠맛이 유의적으로 높게 나타나, 뇌졸중 동반 질병인 고혈압과 짜게 먹는 식습관이 뇌졸중 발병에 밀접한 관계가 있는 것으로 사료된다. 결론적으로 본 연구 결과, 뇌졸중 환자에 있어서 위험요인은 복부 비만, 흡연, 음주, 운동 부족, 짜게 먹는 식습관과 관련이 있는 것으로 나타났다. 그러므로 올바른 생활 습관 및 식습관을 유지하고 다양한 식품을 규칙적으로 섭취하면 뇌졸중을 예방에 도움이 될 수 있을 것으로 여겨진다. 아울러, 뇌졸중의 위험인자 관리를 위한 식이요법의 중요성과 이에 대한 구체적인 식이요법 교육 프로그램과 실천이 절실히 필요하다. 뇌졸중은 발병 후 치료하기보다는 위험성을 증가시키는 여러 위험요소를 찾아내어 이를 관리하고 예방하는 것이 더욱 중요하다고 하겠다. 뇌졸중은 다른 질환과 달리 위험인자가 알려져 있고, 위험인자를 관리하느냐에 따라 예방이 가능하며, 또 이미 발병한 환자의 경우 재발 방지도 가능한 것으로 보고되고 있다. 이미 서구에서는 뇌졸중 예방을 위한 범국민적 교육을 통해 뇌졸중에 의한 사망률이 현저히 감소했으나, 우리나라의 경우는 그렇지 않다. 한국인 사망률의 수위를 차지하는 뇌졸중의 인한 재발 방지를 위해서는 획일적 영양교육보다 환자 개인에 적합한 개별적 영양교육이 이루어져야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.550-558
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• 2020

To perform a systematic review of the data collected from case-control studies conducted earlier to investigate the correlation between E-selectin S128R polymorphism and ischemic stroke (IS) risk among the Chinese population. The PubMed, Web of Science, Chinese biomedical literature database (CBM), Chinese databases China National Knowledge Infrastructure (CNKI), WanfangData knowledge service platform (Wanfang Data), and information resource integration service platform (VIP) Databases were searched to retrieve case-control studies on the correlation between E-selectin gene S128R polymorphism and IS from the inception of the database till June 2019. The literature was screened, data were extracted, the risk of bias was reviewed, and the studies included were assessed independently by two reviewers. Stata ver. 12.0 software (Stata Corp LLC, College Station, TX, USA) was used to perform the meta-analysis. A total of 2907 cases from eight case-control studies involving 1478 IS patients and 1429 controls were included in this study. The R allele and RS genotype in E-selectin were found to be associated with the risk of IS as per the results of the meta-analysis (R vs. S : odds ratio [OR], 2.75; 95% confidence interval [CI], 2.15-3.51; p<0.00001; RS vs. SS : OR, 2.50; 95% CI, 1.95-3.19; p<0.00001; RR+RS vs. SS : OR, 2.85, 95% CI, 2.21-3.67; p<0.00001). The E-selectin gene S128R polymorphism is likely related to IS based on the results of a meta-analysis in the Chinese population, and the R allele and RS genotype of E-selectin may be IS risk factors.

• Korean Circulation Journal
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• 제52권8호
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• pp.563-575
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• 2022

Hypertrophic cardiomyopathy (HCM) is one of the most common inheritable cardiomyopathies. Contemporary management strategies, including the advent of implantable cardioverter-defibrillators and effective anticoagulation, have substantially improved the clinical course of HCM patients; however, the disease burden of HCM is still high in Korea. Sudden cardiac death (SCD), atrial fibrillation and thromboembolic risk, dynamic left ventricular outflow tract (LVOT) obstruction, and heart failure (HF) progression remain important issues in HCM. SCD in HCM can be effectively prevented with implantable cardioverter-defibrillators. However, appropriate patient selection is important for primary prevention, and the 5-year SCD risk score and the presence of major SCD risk factors should be considered. Anticoagulation should be initiated in all HCM patients with atrial fibrillation regardless of the CHA2DS2-VASc score, and non-vitamin K antagonist oral anticoagulants are the first option. Symptomatic dynamic LVOT obstruction is first treated medically with negative inotropes, and if symptoms persist, septal reduction therapy is considered. The recently approved myosin inhibitor mavacamten is promising. HF in HCM is usually related to diastolic dysfunction, while about 5% of HCM patients show reduced left ventricular ejection fraction <50%, also referred to as "end-stage" HCM. Myocardial fibrosis plays an important role in the progression to advanced HF in patients with HCM. Patients who do not respond to guideline-directed medical therapy can be considered for heart transplantation. The development of imaging techniques, such as myocardial deformation on echocardiography and late gadolinium enhancement on cardiac magnetic resonance, can provide better risk evaluation and decision-making for management strategies in HCM.

• Environmental Analysis Health and Toxicology
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• 제19권3호
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• pp.287-294
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• 2004

Diabetic complication is one of major risk factors leading to vascular disease such as atherosclerosis, stroke, coronary heart disease and etc. Several factors affecting the acceleration of diabetic vascular complication have been known such as hypertension, hyperlipidemia, immune complex and genetic factors. To screen and develop new therapeutics agents for diabetic vascular complication, it is strongly needed to develop animal models for diabetic complications. However in rodents models, diabetic complications is not well developed. Furthermore to assess the possibility of new therapeutics for diabetic vascular complications, diabetic animal models which have the risk factors of diabetic complications is needed. We aim to develop and establish an diabetic animal model which have diabetic complications with hyperlipidemia which is one of risk factors for diabetic complications. We induced insulin -dependent diabetes by intra. venous injection of streptozotocin (35 mg/kg/day) in RICO rats which is a spontaneous animal model for hyperlipidemia. Our models (STZ RICO) showed hyperglycemia, persistent high level of plasma cholesterol and triglyceridemia with severe diabetic renal changes until 28 weeks after induction of diabetes. STZ-RICO rats could be used for the evaluations of newly developed diabetic drugs.

• 혜화의학회지
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• 제13권2호
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• pp.221-229
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• 2004

1.Purpose Stroke is the most frequent cause of mortality and morbidity rate in Korea with ischemic heart disease and cancer. Recent recurrence rate of stroke is high, but little attention had been given to the features of its' cause. The purpose of this studies is to examine the hematologic states in Korean normal adults through premature-examination of stroke(PES). 2.Method The study group consisted of 326 cases that they had no significant results by CT through premature examination of stroke(PES) in Cheonan oriental hospital of Daejeon university. We tested RBC, hemoglobin, hematocrit, WBC, PT, PTT, PLT, total protein, albumin, total bilirubin, direct bilirubin, GOT, GPT, $\gamma$-GTP, total cholesterol, triglyceride, HDL-C, glucose, BUN, creatinine, Na, K and evaluated by cross sectional study. 3.Result In the PES, there were many patients with low RBC(11%), shorten PT(26.7%), delayed PTT(19.3%), high TP, GPT, ${\gamma}$ -GTP(respective1y 16.9%, 14.4%, 13.5%), high cholesterol level and triglyceride level(respectively 18.7%, 28.2%). We didn't found significant cases in hemoglobin, hematocrit, WBC, PLT, albumin, total bilirubin, direct bilirubin, GOT, HDL-C, glucose, BUN, creatinine, Na, K. 4.Conclusion In this study, we demonstrated that short PT, high triglyceride level are special views in PES. Also prospective studies are needed continuously to search the preventing methods of the CVA.

• 대한한방내과학회지
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• 제21권4호
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• pp.583-590
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• 2000

Objective : The major risk factors of stroke are hyperlipemia, ateriosclerosis, hypertension, diabetis mellitus, smoking, drinking, age, personal history, family history etc. Hypertension, smoking and hyperlipemia are very important factor to promote stroke. We intended to observe the serum lipid density of 51 patients come to Joongpoong & Chronic Disease Center of Conmaul Oriental hospital, comparing with already reported study. Methods : We studied 51 stroke-patients( 38 cerebral infarction, 13 intracerebral hemorrhage) of Conmaul Oriental hospital, Department of oriental internal medicine, Joongpoong & Chronic Disease Center from January 1. 1999 to August 31. 2000, which examined by neurologic test, brain-CT, brain-MRI. . We used DOSHISA TBA-30FR(Japan) as instrument for measuring total cholesterol and triglyceride of serum. Results and conclusions : The results are as follows 1. The rate of hyperlipemia and presumed-hyperlipemia is higher in female patient-group than male patient-group. 2. The rate of hyperlipemia and presumed-hyperlipemia is higher in drinking group than non-drinking group. 3. The rate of hyperlipemia and presumed-hyperlipemia is higher in hypertension group than normotention group.

• 노인간호학회지
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• 제20권3호
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• pp.167-176
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• 2018

Purpose: Post Stroke Depression (PSD) is one of the most common complications for stroke survivors and is associated with negative health outcomes such as disability, death. The purpose of this study was to investigate the prevalence and predictors of PSD among older Korean adults living in the community. Methods: Data collection was done using the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults. Participants were 706 older adults who had a stroke. Logistic regression analysis was used to determine the predictors of PSD. Results: The prevalence of PSD which was assessed by the short form of the geriatric depression scale was 49.4%. In a logistic regression model, the predictors of PSD were self-rated health (OR=5.90, CI=3.70~9.40), economic state (OR=2.97, CI=2.07~4.24), independent activities of daily living (IADL) (OR=2.17, CI=1.30~3.63), Activities of Daily Living (ADL) (OR=2.02, CI=1.07~3.80), and education (OR=1.53, CI=1.05~2.24). Conclusion: PSD was common among older Korean adults living in the community. Poor self-rated health status, lower economic state, lower levels of Instrumental Activities of Daily Living (IADL) and ADL, lower levels of education should be considered when conducting activities related to prevention and management of PSD in older adults.

• Journal of Korean Biological Nursing Science
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• 제18권4호
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• pp.193-202
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• 2016

Purpose: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. Methods: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. Results: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. Conclusion: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.

• Journal of Chest Surgery
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• 제49권1호
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• pp.15-21
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• 2016

Background: We aimed to evaluate the incidence, predictive factors, and impact of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR). Methods: A total of 53 patients who underwent 57 TEVAR operations between 2008 and 2015 were reviewed for the incidence of AKI as defined by the RIFLE (risk, injury, failure, loss, and end-stage kidney disease risk) consensus criteria. The estimated glomerular filtration rate was determined in the perioperative period. Comorbidities and postoperative outcomes were retrospectively reviewed. Results: Underlying aortic pathologies included 21 degenerative aortic aneurysms, 20 blunt traumatic aortic injuries, six type B aortic dissections, five type B intramural hematomas, three endoleaks and two miscellaneous diseases. The mean age of the patients was $61.2{\pm}17.5years$ (range, 15 to 85 years). AKI was identified in 13 (22.8%) of 57 patients. There was an association of preoperative stroke and postoperative paraparesis and paraplegia with AKI. The average intensive care unit (ICU) stay in patients with AKI was significantly longer than in patients without AKI (5.3 vs. 12.7 days, p=0.017). The 30-day mortality rate in patients with AKI was significantly higher than patients without AKI (23.1% vs. 4.5%, p=0.038); however, AKI did not impact long-term survival. Conclusion: Preoperative stroke and postoperative paraparesis and paraplegia were identified as predictors for AKI. Patients with AKI experienced longer average ICU stays and greater 30-day mortality than those without AKI. Perioperative identification of high-risk patients, as well as nephroprotective strategies to reduce the incidence of AKI, should be considered as important aspects of a successful TEVAR procedure.

• 한국식품영양과학회지
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• 제38권3호
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• pp.319-332
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• 2009

본 연구는 대구 경북지역 뇌졸중 환자들의 생활습관 및 식행동 특성을 분석하여 뇌졸중과 관련 있는 위험요인을 파악함으로써 지역민의 뇌졸중 예방을 위한 영양교육의 기초자료를 얻고자 수행되었다. 조사 대상자는 뇌졸중으로 처음 진단받은 입원 환자 100명(남자 50명, 여자 50명)을 환자군으로 하고 같은 기간 동안 뇌졸중 병력이 없고 환자군과 연령이 비슷한 지역 사회 주민 150명(남자 75명, 여자 75명)을 대조군으로 하였다. 조사는 일반특성, 생활습관, 식행동 특성, 식품섭취빈도, 식품 기호도 등의 내용을 포함한 설문지를 이용하여 조사자와 직접 면접을 통하여 실시하였으며 연구의 결과를 요약하면 다음과 같다. 뇌졸중 환자의 평균 연령은 남자 63.5세, 여자 69.9세였으며 일반 특성사항에서 환자군이 대조군에 비해 유의적으로 높은 것은 BMI, 당뇨병 고혈압과 심장병의 유병율, 뇌졸중과 당뇨병 고혈압의 가족력과 시골 거주율이었고, 유의적으로 낮은 것은 교육수준이었다. 생활습관에서 전체적으로 환자군은 대조군에 비해 흡연율이 유의적으로 높았고 녹차섭취와 규칙적 운동습관이 유의적으로 낮았다. 성별로는 남자는 흡연율과 규칙적인 운동 여부에서, 여자는 녹차섭취와 규칙적인 운동 유무에서 환자 대조군 간 유의한 차이를 보였다. 식행동 특성에서는 환자군은 대조군에 비해 불규칙한 식사, 과식, 육식의 비율이 높았고, 충분히 씹는 습관과 한식 섭취 비율이 유의적으로 낮았다. 식품섭취빈도는 전체적으로 환자군은 식용유, 참기름의 섭취 빈도가 대조군에 비해 유의하게 높았으나 콩제품, 채소류, 버섯류, 해조류, 종실류, 생선 어패류, 올리브유, 두유, 녹차, 과일 주스의 섭취 빈도가 유의하게 낮았다. 식품 기호도에서는 환자군은 대조군에 비해 닭고기, 계란, 볶음, 짠맛, 단맛의 선호도가 유의적으로 높았고 국류, 찌개류, 김치류, 해조류, 생선류, 우유 및 유제품, 콩유, 채소류, 과일류, 무침조리법의 선호가 유의적으로 낮았다. 본 연구 결과, 높은 BMI, 당뇨병과 고혈압의 유병, 뇌졸중 가족력, 흡연, 과식과, 육식의 식습관은 뇌졸중의 위험인자로 나타났고, 규칙적 운동습관과 녹차 섭취, 음식을 충분히 씹는 습관, 한식의 섭취, 콩 제품과 채소류, 버섯류, 해조류 생선 어패류, 두유, 녹차의 잦은 섭취가 보호인자로 나타났다. 따라서 정상 체중을 유지하고 고혈압, 당뇨병과 같은 선행질환을 예방하고 관리하는 것이 뇌졸중을 예방하기 위한 중요한 생활습관이라 생각된다. 또한 녹차의 섭취와 금연, 규칙적인 운동은 남녀 모두에서 뇌졸중을 예방하는 좋은 생활습관이며 규칙적인 식사와 과식금지, 충분히 씹는 습관, 단 음식의 절제, 채식과 육식을 가리지 않고 골고루 섭취하는 것, 조리법으로는 무침, 초무침을 선택하는 것이 뇌졸중을 예방하는 좋은 식습관인 것으로 나타났다.