• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.9-19
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• 2002

본 연구는 뇌졸중 발병 전과 후의 건강관련행위를 비교 분석하여 뇌졸중 발병전후의 건강행위 변화정도를 파악하고, 뇌졸중 환자의 건강행위 변화와 관련된 요인을 분석하여, 뇌졸중의 재발에 관련된 위험요인을 제거하거나, 감소시킬 수 있는 보건교육 프로그램을 개발하는 기초자료를 제공하고자 수행되었다. 자료는 1999년 7월 1일부터 8월 30일까지 경주시 보건소에 등록된 뇌졸중 환자 88명을 대상으로 수집하였으며, 구조화된 설문지를 이용하여 면접조사 하였다. 설문 조사 내용은 일반적 특성, 건강관련행위, 가족관련 특성, 뇌졸중 발병전후 건강행태 등이었다. 대상자의 흡연율은 51.1%에서 발병 후 25.0%로 감소하였고, 음주율은 52.3%에서 발병 후 17.0%로 감소하였고, 일일 흡연량은 뇌졸중 발병 전 20.1개피에서 발병 후 14.9개피로 유의하게 감소하였고, 1회 음주량은 92.4ml에서 23.7ml로 유의하게 감소하였다. 성별에 따른 흡연율은 남자의 흡연율이 뇌졸중 발병전 70.2%에서 발병 후 31.6%로 유의하게 감소하였으나, 발병 후에도 흡연율이 31.6%로 높았고, 여자의 흡연율은 뇌졸중 발병 전 16.1%에서 발병 후 12.9%로 감소하였다. 뇌졸중 발병 환자들의 건강관련행위 변화정도를 관찰한 결과 흡연율, 음주율, 규칙적 식사율 등의 행위 변화가 배우자가 있는 군, 재발방지 교육을 받은 군에서 높게 나타났다. 뇌졸중 환자들에게는 금연, 절주, 저지방 식이, 운동 및 규칙적인 식사에 대한 집중적인 교육이 필요할 것으로 생각되며 뇌졸중 환자를 대상으로 한 구체적이고 지속적인 보건교육프로그램이 개발되고, 교육이 제공되어야 할 것으로 생각된다.

• 동의생리병리학회지
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• 제23권3호
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• pp.740-743
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• 2009

Hypertension is one of the modifiable risk factors for stroke and heart disease. Lowering blood pressure is a primary or secondary preventative measure for stroke and heart disease. There are many antihypertension drugs. But these day there comes some side effect of antihypertension drugs. Headache, sexual dysfunction, inertia, dizziness, depression, and so on. So we use Bangpungtongsung -san to stage 1 hypertensive patients. After treatment with Bangpungtongsung-san, patients showed antihypertensive effect and improvement in general condition. The result of this study suggest that Bangpungtongsung-san might be usefully applied for the treatment of hypertension.

• 대한한의학회지
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• 제20권1호
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• pp.66-74
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• 1999

It is known that obesity is associated with chronic adult disease including stroke. However the relationship between stroke and obesity has not been discussed sufficiently, The purpose of this study was to confirm whether the serum Leptin levels related to BMI and these were associated with serum lipid levels and other risk factors in stroke patients. The subjects were 68 stroke patients(male 36. female 32) hospitalized in the Department of Circulatory Internal Medicine, College of Oriental Medicine, Kyung Hee University, Seoul. Obesity was shown in 16 patients(24%) whose BMI were above 25. and in 15 patients(22%) who represented higher values than normal in serum Leptin levels. BMI correlated with serum Leptin level(p=0.04), with Triglyceride(p=0.019) and with Total lipid(p=0.001) significantly. Meanwhile serum Leptin levels significantly correlated with Total cholesterol(p=0.013) only. BMI in the group with a history of smoking was significantly lower than that of the non-smoking group(p=0.01). Serum Leptin levels were higher in the group with Hypertension than the non-Hypertension group(p=0.026), lower in the non-Drinking group(p=0.006) and the smoking group(p=0.001) than the drinking group and the non-smoking group. respectively. So we concluded that BMI significantly correlates with serum Leptin levels and serum lipid levels in stroke patients.

• 한국직업건강간호학회지
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• 제21권3호
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• pp.209-220
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• 2012

Purpose: This study examined the influencing factors for metabolic syndrome and the annual medical expenditures of metabolic syndrome among public officials. Methods: The National Health Insurance data in 2009 were collected for 364,932 public officials and the heath examination results and annual medical expenditures were analyzed using PASW 18.0 program. Results: The prevalence of metabolic syndrome is 17.6%, and it was higher in male officials than that of females in all age groups. In men, the influencing factors for metabolic syndrome were: age, family history of stroke, cardiovascular disease, hypertension, and diabetes mellitus, smoking, alcohol consumption, exercise, and obesity. However, in women, health-related behaviors such as smoking, alcohol consumption and exercise did not affect metabolic syndrome. People who had metabolic syndrome showed significantly higher medical expenditures than those without metabolic syndrome. The odds ratios of having the highest quartile in medical expenditures were 1.372 (95% CI 1.252~1.504, p<.001) in women with metabolic syndrome and 1.213 (95% CI: 1.184~1.243, p<.001) in men. Conclusion: The results implied that health-related behaviors were associated with metabolic syndrome, and resulted in higher medical expenditures. In order not only to decrease the risk of metabolic syndrome but also reduce medical expenditures, nurses should plan health promotion strategies to educate public officials about healthy life strategies.

• 대한한방내과학회지
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• 제28권4호
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• pp.863-871
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• 2007

Objects : To gain better insights of East-west integrated treatment of ischemic stroke. We analyzed 89 patients with severe acute ischemic stroke who were admitted to the East-west integrated intensive care unit. Methods : Subjects enrollment was from the East-west integrated intensive care unit of Kyung Hee Medical Center from March 2006 to February 2007. Patients were admitted within 14 days after the onset of ischemic stroke. We assessed the subjects' general characteristics, risk factors, admitting routes and periods, diagnostic imaging, process of western treatment and Korean traditional treatment, complication and consequence. Results : The proportion of males was 50.6%, of females 49.4%, average age was male 66.0$\pm$10.3 and female 71.1$\pm$10.5. Average length of hospital stays was 19.5 days. Monthly admissions were highest in November and December. The admission route was through emergency room (61.8%) or ward (34.8%). Mean Glasgow coma scale score was 10.0$\pm$2.5, average time from symptom of onset to hospital admission was 2.3$\pm$2.2 days. Dominant ischemic vascular territory was middle cerebral artery (66.3%). Initial western treatment was argatroban (22.5%), urokinase (28.1%), and heparinization (38.2%). Distribution of Sasang constitution of So-yang to Tae-eum to So-eum was equal to 5.4 to 2.9 to 1.5. Major complications were observed in 40 (42.7%) patients. In hospital mortality was 12.4% (11 deaths), all of them caused by aggravation of neurological deficit and only 3 of them with major complications. There appears to be a significant positive relationship between length of hospital stay and occurrence of complications (P<0.05). After discharge from the ICU, 64 (71.9%) patients were improved, 11 (12.4%) patients had expired, and 14 (15.8%) patients were transferred. Conclusions : From this study, we suggest that patients with severe acute ischemic stroke should be treated with East-west integrated therapy for more favorable consequences and decreased mortality.

• Journal of Korean Neurosurgical Society
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• 제59권2호
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• pp.117-121
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• 2016

Objective : Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. Methods : This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. Results : Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate $5.8{\pm}1.4%/year$). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). Conclusion : Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.

• Korean Circulation Journal
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• 제54권1호
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• pp.13-27
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• 2024

Background and Objectives: Comprehensive epidemiological data are lacking on the incident atrial fibrillation (AF) in patients with cardiac implantable electronic devices (CIEDs). This study aimed to examine the incidence, risk factors, and AF-related adverse outcomes of patients with CIEDs. Methods: This was an observational cohort study that analyzed patients without prevalent AF who underwent CIED implantation in 2009-2018 using a Korean nationwide claims database. The subjects were divided into three groups by CIED type and indication: pacemaker (n=21,438), implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) with heart failure (HF) (n=3,450), and ICD for secondary prevention without HF (n=2,146). The incidence of AF, AF-associated predictors, and adverse outcomes were evaluated. Results: During follow-up, the incidence of AF was 4.3, 7.3, and 5.1 per 100 person-years in the pacemaker, ICD/CRT with HF, and ICD without HF cohorts, respectively. Across the three cohorts, older age and valvular heart disease were commonly associated with incident AF. Incident AF was consistently associated with an increased risk of ischemic stroke (3.8-11.4-fold), admission for HF (2.6-10.5-fold), hospitalization for any cause (2.4-2.7-fold), all-cause death (4.1-5.0-fold), and composite outcomes (3.4-5.7-fold). Oral anticoagulation rates were suboptimal in patients with incident AF (pacemaker, 51.3%; ICD/CRT with HF, 51.7%; and ICD without HF, 33.8%, respectively). Conclusions: A substantial proportion of patients implanted CIED developed newly diagnosed AF. Incident AF was associated with a higher risk of adverse events. The importance of awareness, early detection, and appropriate management of AF in patients with CIED should be emphasized.

• 한방비만학회지
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• 제6권2호
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• pp.17-27
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• 2006

Objectives : Ma-huang (Ephedra sinica) is frequently prescribed for obesity management in oriental medicine. The main component is ephedrine alkaloids which can have serious adverse side effects such as heart attack, stroke, sudden death. There are no scientific guidelines for Ma-huang usage in the safe treatment of obesity in oriental medicine. We reviewed published studies on its safety to make evidence based guidelines. Methods : We searched electronic databases up to May 2006. We limited evidence to controlled trials for efficacy or safety, case reports for safety, and studies for Ma-huang contents analysis. Results and Conclusions : In clinical trials for weight loss, Ma-huang and ephedrine promote modest short-term weight loss but have no serious adverse effects, have only a few adverse effects associated with increased risk of psychiatric, autonomic, gastrointestinal symptoms and heart palpitations. In case reports, there have been serious adverse effects including stroke, heart attack, and death using typical doses of ephedrine or no associated illness. There are factors related to serious adverse effects, such as overuse, lack of standardization, individual sensitivity, and interactions with other drugs. Studies relating to these factors should be analyzed for safe use of Ma-huang and ephedrine. After analyzing related studies, we suggest guidelines for Ma-huang usage. We propose that the dosage should be within 4.5-7.5g per day for up to 6 months for generally healthy individual. It's use is contraindicated in individuals with heart disease, thyroid disease, diabetes mellitus, hypertension, psychiatric disorders, glaucoma, urination disorders, enlarged prostate, persons using MAOIs, methyldopa and sympathomimetic agents.

• Clinical and Experimental Vaccine Research
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• 제12권2호
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• pp.172-175
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• 2023

Coronavirus disease 2019 (COVID-19) has become a part of our lives now and we have no more effective way of coping than a vaccine. COVID-19 is a disease that causes severe thrombosis outside the respiratory tract. Vaccines also protect us in this respect, but in some rare cases, thrombosis has been found to develop after vaccination (much less frequently than COVID-19). What was interesting in our case was that it showed how a disaster could happen under three factors that predispose to thrombosis. A 65-year-old female patient with disseminated atherosclerosis was admitted to the intensive care unit with complaints of dyspnea and dysphasia. In the evening of the day, the patient had the vaccination 2 weeks ago, she had active COVID-19. On examination, lower extremity pulses could not be detected. The patient's imaging and blood tests were performed. Multiple complications such as embolic stroke, venous and arterial thrombosis, pulmonary embolism, and pericarditis were observed in the patient. This case may give consideration to anticoagulant therapy studies. We give effective anticoagulant therapy in the presence of COVID-19 in patients at risk of thrombosis. Can anticoagulant therapy be considered after vaccination in patients at risk of thrombosis such as disseminated atherosclerosis?

• 대한의생명과학회지
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• 제14권4호
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• pp.275-281
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• 2008

Plasma fibrinogen is risk factor of vascular disease including stroke, ischemic heart disease, atherosclerosis and thrombosis. Many studies have confirmed that high plasma fibrinogen levels are related with age, obesity, cholesterol, alcohol consumption, and genotype. This study was carried out to investigate the effect of fibrinogen genotype and other characteristics on the plasma fibrinogen levels in the elderly Koreans. For this study the blood samples were collected from 178 healthy elderly Koreans (102 males and 76 females, $55{\sim}80$ year olds). The blood samples were analyzed by smoking status, cholesterol levels, genotype, age, exercise, drinking, and gender. The plasma fibrinogen was assayed by clotting method, cholesterol being assayed by cholesterol oxidase method. The $\beta$-fibrinogen genotype was detected by PCR of relevant region and digestion with Alu I. The alleres with the restriction site and the non cleavable alleres were designated $A_1$ and $A_2$. In conclusion, genotype $A_1A_2$ and exercise are increased and associated with plasma fibrinogen levels. But, there were no significant differences by smoking, gender, age, drinking and cholesterol.