• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.3
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• pp.719-727
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• 2003

Background and purpose: Hypertension and obesity has been implicated in the most important risk factors for stroke. The original finding that the G-protein beta3 subunit (GNB3) C825T allele associates with essential hypertension and obesity has been confirmed in several different populations. Hence, our objective was to determine whether the GNB3 C825T polymorphism predicts interindividual variation in stroke. Method: We recruited 361 stroke patients (cerebral infarction, n=278; intracerebral hemorrhage (ICH), n=83) and 199 healthy control subjects. Subjects were genotyped for GNB3 C825T mutation and findings were investigated for association with stroke. Result: The GNB3 T/T type was significantly associated with cerebral infarction prevalence (OR, 1.98; 95% Cl, 1.14-3.46; p=0.015). While, ICH was not found to be significantly associated with GNB3 T/T type (OR, 1.63; 95% ICH, 0.74-3.56; p=0.219). Similarly, no significant association was determined between GNB T/C type, and cerebral infarction (OR, 1.09; 95% Cl, 0.68-1.74; p=0.716), and ICH (OR, 1.14; 95% Cl, 0.59-2.21; p=0.697). Conclusion: In clinical characteristics, this study shows no differences among GNB3 genotypes, that are BMI, WH ratio. hypertension rate, and ischemic heart disease rate, total lipid level, triglycerides level, total cholesterol level, HDL cholesterol level, prothrombine time, with the exception of LDL cholesterol concentrations. However, our subjects showed an inverse relationship between LDL cholesterol level and the risk of cerebral infarction. We have shown that the GNB3 T/T genotype is strongly associated with cerebral infarction. (OR, 1.98; 95% Cl, 1.14-3.46; p=0.015).

• Annals of Clinical Neurophysiology
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• v.2 no.2
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• pp.101-106
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• 2000

Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.

• Investigative Magnetic Resonance Imaging
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• v.22 no.3
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• pp.150-157
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• 2018

Purpose: To assess associations between morphological characteristics of intracranial arteries in time-of-flight MR angiography (TOF-MRA) and atherosclerotic risk factors. Materials and Methods: From January 2014 to October 2015, a total of 129 patients (65 men and 64 women) without intracranial arterial stenosis > 50% were included in this study. All MRIs were performed using a 3T machine with 3D TOF-MRA sequences. We evaluated irregularity, tortuosity, and dilatation of intracranial arteries in maximal intensity projection (MIP) of TOF-MRA. Subjects' risk factors for atherosclerosis including history of hypertension and diabetes were collected by reviewing their medical records. Associations between morphological characteristics and each known atherosclerosis risk factor were examined using univariate regression analysis. Multivariate regression models were built to determine combined association between those risk factors and morphologic changes of intracranial arteries. Results: In multivariate analysis, hypertension (coefficient [95% CI]: 0.162 [0.036, 0.289], P = 0.012) and absence of diabetes (coefficient [95% CI]: -0.159 [-0.296, -0.023], P = 0.022) were associated with large diameter of intracranial arteries. Males (coefficient [95% CI]: 0.11 [-0.006, 0.23], P = 0.062) and higher age (coefficient [95% CI]: 0.003 [-0.001, 0.008], P = 0.138) had marginal association with increased diameter. Tortuosity was associated with old age (OR: 1.04 [1.02, 1.07], P < 0.001). Irregular contour of intracranial arteries was significantly associated with old age (OR: 1.05 [1.02, 1.09], P = 0.004), presence of diabetes (OR: 2.88 [1.36, 6.15], P = 0.0058), and previous ischemic stroke (OR: 3.91 [1.41, 11.16], P = 0.0092). Conclusion: Morphological characteristics (irregularity, tortuosity, dilatation) of intracranial arteries seen in TOF-MRA might be associated with atherosclerotic risk factors in subjects with no or mild stenosis.

• Korean Circulation Journal
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• v.48 no.12
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• pp.1148-1156
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• 2018

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

• The Journal of Internal Korean Medicine
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• v.21 no.1
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• pp.39-45
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• 2000

Object : SPECT which can visualize the distribution of CBF was operated to find the basic evidence by objective and scientific inspection on the fact that how the oriental medical treatment for stroke patients can effect CBF. Method : This study made 18 cases an object of research. These patients came to the Dongshin Univ. Oriental Medical Hospical within 5 days from the first attack, were diagnosed as stroke from Brain CT and MAl and were in the hospital for over 4 weeks at least. They were taken acupunture treatment, negative technique and herbal medication. And this study operated SPECT at the instance of admission and at the 4th week after admission 2 times and compared the change of CBF. Results : I operated SPECT on 18 CVA patients and got a result on the change of blood supplies in brain as follows; In the 2nd SPECT compared with 1st, out of the 1st and 2nd SPECT, there are 10 cases(55.6%) of increase and 8 cases (44.4%) of decrease. According to L/Cb11 evauation standard, the 1 st and the 2nd changes of blood supplies in SPECT shows decrese from $0.830{\pm}0.071$ to $0.801{\pm}0.067$. On the other hand, according to L/C standard shows a minute increase from $0.894{\pm}0.079$ to $0.895{\pm}0.091$. But there is nothing meaningful. I treated patients' group with risk factors and the other patients' group without risk factors and observed the changes of blood supplies respectively. And therefore Patients' group without risk factors shows an meaningful increase of blood supplies from $0.835{\pm}0.076$ to $0.796{\pm}0.069$ L/Cbll and also an increase from $0.921{\pm}0.029$ to $0.939{\pm}0.029$ by L/C. But this result by L/C is not significant. Conclusion : As mentioned above, I treated CVA patients through oriental medical therapies using SPECT and researched the changes of blood supplies in their brains. But I could' t get any meaningful result. However, I think only after solving some problems in this treatment and quantifing the changes of blood supplies, this results can be the standard of scientific examination about oriental medical treatments.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.4
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• pp.138-144
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• 2011

Exaggerated blood pressure response during exercise has been found to increase the risk of future hypertension, left ventricular hypertrophy, cerebrovascular stroke, and CVD (cardiovascular disease) death. The aim of this study was to evaluate exercise capacity, cardiovascular factors in exaggerated blood pressure response during treadmill exercise testing. For research subjects, 72 subjects (normal blood response: 49 subjects, exaggerated blood response: 23 subjects) who received treadmill exercise test at J General Hospital were selected in this study. Exaggerated SBP (systolic blood pressure) response was defined as an SBP of 210 mmHg or greater during a maximal treadmill exercise test. The group with an exaggerated SBP response showed significantly higher values for RPP (rate pressure product) compared with the group with a normal SBP response. Subjects with METs (metabolic equivalents) had lower exaggerated SBP response than normal SBP response group. Subjects with recovery SBP had delayed exaggerated SBP response than normal SBP response group. Exaggerated SBP response to exercise is negative correlation with METs.

• Journal of Community Nutrition
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• v.8 no.2
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• pp.90-95
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• 2006

Asian Americans is a minority population contributing approximately 4% to the total population of the United States, however it is one of the fastest growing populations. Although Asian Americans as a group have socioeconomic profiles that are similar to white Americans, significant variations exists within and across Asian ethnic groups. The top ten leading causes of death for Asian Americans includes cancer, heart diseases, stroke, unintentional injuries, diabetes, influenza and pneumonia, chronic lower respiratory disease, suicide, nephritis, and septicemia. The prevalence of obesity is lower among Asian Americans, however this should be taken with considerations specific to Asians. High salt and low calcium consumption seem to be dietary risk factors for Asian Americans, although dietary patterns are changing with acculturation. Factors affecting dietary patterns are discussed in this paper. A proactive nutrition education approach for Asian Americans should be promoting maintaining 'healthy' aspects of ethnic diets and adopting 'healthy' American diets. Collaboration with nutrition educators in Asian countries would be helpful to overcome limited resources available for researching and developing nutrition education messages and materials for Asian Americans. (J Community Nutrition 8(2): 90-95, 2006)

• The Journal of Korean Medicine
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• v.15 no.2 s.28
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• pp.46-91
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• 1994

l. Backgrounds of Studies Cerebrovascular accident. one of the three major causes of death among audults with cardiopathy and malignancy, has been on the increase in korea while it is on the decrease in European countries and Japan. Types of stroke undergo changes caused by prolongment of life expectancy. and social and economic variety. More patients of ischemic stroke show a tendency to increase now than those of hemorrhagic stroke in the past. Many clinical studies on medical cerebrovascular and oriental stroke of paralysis have been published. but few clinical studies on therapeutics of integrated oriental and western medicine are to be found. So I have made an attempt to study clinical observations and therapeutic responses of ischemic stroke under integrated oriental and western medicine. 2.Methods. Among the patients admitted into the clinic of Joong-Poong, Woo-Suk University Hospital from May 1. 1993 until April 30. 1994 those 56 patients who were diagnosed as ischemic stroke on Computed Tomography(CT) and showed no dubious symptom after examination of coagulation and bleeding time were classified into the following six steps and treated: l)diagnosis 2)emergency treatment 3)basic treatment 4)treatment of risk and provoking factors. and preceeding disease 5)complications and conservative therapy 6)rehabilitation. For a period of basic treatment both herb medication and urokinase therapy were applied at the same time. Intravenous injection has been given at a unit of 300.000 dosage a day as urokinase therapy during basic treatment. If they showed any dubious symptom in glucose tolerance test. fructose 500ml and urokinase 300.000 dosage were mixed and injected. In case of no symptom 5% DW 500ml was mixed with urokinase 300.000 unit. and injected at a speed of 15gtt per minute. 3. Results and Conclusions 1) The level of ambulation has been improved from 42.9% when admitted to 73.2% when discharged in the degree of recovery. The level of severe function disorder has been remarkably decreased from 55.4% when admitted to 19.6% when discharged. 2) The treatment effect on the basis of therapeutic response of clinical and subjective symptom shows as follows: 7.1% Excellent. 35.7% Good. 37.5% Effective. 10.7% Stationary. and 8.9% Aggravated. The total recovery above effective shows 80.3%. Judging from the above results I think it proper to develop the model of better preventing and treating ischemic stroke through effective therapeutic and clinical studies of integrated oriental and western medicine.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.355-362
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• 2017

Background: Off-pump coronary artery bypass grafting (OPCABG) procedures can avoid the complications of an on-pump bypass. However, some cases unexpectedly require conversion to cardiopulmonary bypass during OPCABG. The risk factors associated with a sudden need for cardiopulmonary bypass were analyzed. Methods: This retrospective study included 283 subjects scheduled for OPCABG from 2001 to 2010. These were divided into an OPCABG group and an on-pump conversion group. Preoperative, operative, and postoperative variables were compared between the 2 groups. Results: Of the 283 patients scheduled for OPCABG, 47 (16%) were switched to on-pump coronary artery bypass grafting (CABG). The mortality of the both the OPCABG and on-pump conversion groups was not significantly different. The major risk factors for conversion to on-pump CABG were congestive heart failure (CHF) (odds ratio [OR], 3.5; p=0.029), ejection fraction (EF) <35% (OR, 4.4; p=0.012), and preoperative beta-blocker (BB) administration (OR, 0.3; p=0.007). The use of intraoperative (p=0.007) and postoperative (p=0.021) inotropics was significantly higher in the conversion group. The amount of postoperative drainage (p<0.001) and transfusion (p<0.001) also was significantly higher in the conversion group. There were no significant differences in stroke or cardiovascular complications between the groups over the course of short-term and long-term follow-up. Conclusion: Patients who undergo OPCABG and have CHF or a lower EF (<35%) are more likely to undergo on-pump conversion, while preoperative BB administration could help prevent conversions from OPCABG to on-pump CABG.

• Korean Journal of Adult Nursing
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• v.28 no.4
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• pp.424-435
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• 2016

Purpose: This study examined knowledge about cardio-cerebrovascular disease (CVD) and its relationship to health behaviors among middle-aged postmenopausal women with CVD risk factors. Methods: The study was a cross-sectional descriptive study. One hundred and thirty-six postmenopausal women were recruited from outpatient departments of four hospitals. The women were $60.69{\pm}6.5$ years old. Self-reported questionnaires were administered, and waist-hip ratios (WHR) were measured. Results: Among the women, 72.8% reported hypertension, 19.1% reported diabetes, 33.8% reported hypercholesterolemia, and 24.2% reported angina pectoris. Moreover, 73.9% of the women reported not knowing of CVD prevention, and only 26.1% reported exercising regularly. A majority of the women (80.9%) had a WHR > 0.85. Multiple linear regression analysis after adjusting for age and marital status indicated that the risk of myocardial infarction and stroke increased (p<.001). Waist-hip ratio${\leq}0.85$ (p=.022) and living with family members (p=.006) were significant predictors of healthier behaviors ($R^2$=0.21, p<.001). Knowledge of CVD and health behaviors were not correlated. Conclusion: Obese women and women who live alone are no more likely to practice health behaviors aimed at CVD prevention than their counterparts in the sample. Education and exercise interventions are needed, especially for obese women, to promote healthy behaviors among middle-aged postmenopausal women with CVD risk factors.