• 보건의료산업학회지
• /
• 제7권3호
• /
• pp.71-82
• /
• 2013

Arterial stiffness(AS) is an important pathologic state of vascular injury. This study was carried out to elucidate the effect of physiological variables on brachial-ankle pulse wave velocity(BAPWV), index of AS. Four hundred adults(volunteers) participated in this study. Body indices, biochemical, cardiac and inflammatory markers, and right(Rt)- and left(Lt)-BAPWV were measured. Body mass index(BMI), Rt- and Lt-BAPWV, glucose, triglyceride, alkaline phosphatase(ALP), gamma-glutamyl transferase(GGT), creatinine, uric acid, troponin-I(TNI), NT-proBNP and high sensitivity C-reactive protein(hs-CRP) levels were higher than the reference value of each variable. Rt- and Lt-BAPWV were directly correlated with age, body weight, BMI, glucose, ketone, aspartate aminotransferase, alanine aminotransferase, ALP, GGT, total cholesterol, low density lipoprotein, lipoprotein(a), apolipoprotein-B, blood urea nitrogen, heart rate, TNI, creatine kinase, CK-MB, lactic dehydrogenase, myoglobin, hs-CRP, lipase, reumatoid factor, fibrinogen and D-dimer (P<0.05, P<0.01, P<0.001 or P<0.000, respectively), but inversely associated with total bilirubin, uric acid, apolipoprotein-A1 and GFR (P<0.05). These observations suggest that a variety of physiological variables may influence BAPWV, resulting in increased risk or prevention of cardiovascular and/or cerebrovascular attacks. Therefore, physiological variables affecting BAPWV should be regularly controlled.

• Clinics in Shoulder and Elbow
• /
• 제20권1호
• /
• pp.18-23
• /
• 2017

Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

• 디지털융복합연구
• /
• 제13권9호
• /
• pp.515-521
• /
• 2015

본 연구에서는 우리는 평균 연령이 높은 제주 해녀의 경-대퇴 맥파 전도 속도와 발목-상완지표를 측정하여 찬물에서 산소의 보조 없이 채취활동을 하는 제주 해녀의 동맥 혈관의 경직도를 측정하였으며, 결과는 다음과 같다. 첫째, 경-대퇴 맥파 전도 속도는 동연령대의 일반여성보다 유의하게 낮게 나타났다. 둘째, 발목-상완지표(ABI)는 해녀와 일반여성 모두 정상범위 안에 포함되어 있었으며, 일반여성보다 해녀집단이 높은 경향을 보였다. 이러한 결과는 고령의 나이임에도 불구하고 장기간 침수활동을 통해 신체의 적응이 이미 완료된 상태로써 저온 및 높은 수압환경에 대한 적응이 완료된 신체상태이며, 아울러 높은 신체활동 수준으로 인하여 말초혈관저항이 고연령임에도 불구하고 감소되지 않았으며, 오히려 동연령 여성들보다 양호한 수준임을 확인할 수 있었다. 하지만 해녀들의 고령화는 여전히 진행되고 있는 중요한 현상이기에 동맥혈관경직도에 대한 관심과 향후의 지속적인 연구는 반드시 더 필요할 것으로 보인다.

• Journal of Chest Surgery
• /
• 제54권3호
• /
• pp.179-185
• /
• 2021

Background: The use of ProGlide as a percutaneous vascular closure device in cardiac surgery remains inconclusive. This study investigated the clinical outcomes of using ProGlide in the percutaneous cannulation of femoral vessels in adult cardiac surgery. Methods: From September 2017 to July 2018, 131 consecutive patients underwent femoral vessel cannulation during cardiac surgery. The ProGlide (Abbott Vascular Inc., Santa Clara, CA, USA) with percutaneous cannulation was used in 118 patients (mean age, 55.7±15.5 years). The accessibility of femoral cannulation was evaluated through preoperative computed tomography. For cannulation, sonography was routinely used. The postoperative ankle-brachial index (ABI) was used to evaluate femoral artery stenosis. Results: Of the 118 patients, 112 (94.9%) and 6 (5.1%) underwent minimally invasive cardiac surgery and median sternotomy, respectively. Most femoral cannulations were performed on the right side (98.3%) using 15F to 19F arterial cannulas. The technical success rate of cannulation with ProGlide was 99.2%, with no delayed bleeding or cannulation site-related complications during hospitalization. During follow-up, only 1 patient showed femoral artery stenosis with claudication and was treated with interventional balloon angioplasty. The postoperative ABI revealed no significant difference in functional stenosis between the cannulation and non-cannulation sides (n=86; cannulation vs. non-cannulation, 1.2±0.1 vs. 1.1±0). Conclusion: Percutaneous femoral cannulation with ProGlide was safe and feasible in adult cardiac surgery. This technique may be a good alternative option in patients requiring femoral vessel cannulation for cardiac surgery.

• 성인간호학회지
• /
• 제24권5호
• /
• pp.441-453
• /
• 2012

Purpose: This secondary data analysis study was aimed at identifying the factors related to the patterns of alcohol use (normal alcohol use, hazardous alcohol use, and alcohol dependence) in the Korean adult. Methods: This study analyzed the cross-sectional data from 230,715 Korean adults aged 19 year and older who participated in the 2009 Korean Community Health Survey. Multinomial logistic regression was used to uncover associations between demographic, health related factors and the patterns of alcohol use. Results: The patterns of alcohol use was differentiated from the sociodemographic variables (residential area, gender, age, marital status, educational level, monthly income, and occupation) and with health related factors (smoking status, hours of sleep, body mass index, pain or discomfort, subjective health, stress level, liver disease, cardio/cerebro vascular disease, and depression). Hazardous alcohol use was lower in rural areas and lower among women, but higher among people who smoke, reported severe stress, and/or depression. Similarly, alcohol dependence was lower among women and among those in rural areas, and was more likely associated with those who smoke, have severe stress and depression. Conclusion: A number of factors are associated with patterns of drinking. Smoking, severe stress and depression seems to confound the problems of alcohol use. Additional research is needed to isolate those factors that are the most important influencing the use of alcohol.

• 웰빙융합연구
• /
• 제4권1호
• /
• pp.27-34
• /
• 2021

Purpose: The number of people with disabilities and the elderly over 65 years of age is gradually increasing due to physical disabilities and social aging. Their typical physical disorders or chronic diseases include low back pain, sciatic pain, arthritis, and musculoskeletal systems such as discs. The average prevalence of disease is 78%. These are various physical obstacles and hindrances in daily life. Research design, data and methodology: From August 6, 2019 to September 24, 2019, the Senior Welfare Center in Gyeyang-gu, Incheon, operated a healthy body exercise and health education program for living health management. Results: The vascular health index using U-Bio pulse wave was relatively good at the first average of +7.4, but the second average of -6.3. This can be seen as a result of the combination of diet and lifestyle education along with the effect of corrective exercise. As a result of body shape measurement analysis, the number of persons requiring management with 3 or more body imbalances was found to be from 75% before to 62.5% afterwards. Conclusions: Exercise effect appears when exercise lasts for at least 10 weeks. Some performances were good, but there were limitations due to the operation of a short training period.

• Journal of Chest Surgery
• /
• 제39권8호
• /
• pp.579-587
• /
• 2006

배경 : 단심실 교정을 시행함에 있어 수술 전 위험 인자가 많지 않다고 판단되는 경우에도 수술 후 장기간의 흉관 배액, 단백 소모성 장질환, 폐혈관 색전증, 사망 등의 불량한 결과를 얻을 수 있다. 이러한 측면에서, 단심실 교정에 대한 기존의 위험 인자 분석은 수술 결과를 예측함에 있어 미흡한 점이 있다고 할 수 있다. 저자 등은 폐혈관 유순도를 새로이 정의하고, 낮은 폐혈관 유순도가 수술 후 흉관 배액 기간을 길게 한다는 가설을 세워 이를 증명하고자 하였다. 대상 및 방법 : 2002년 1월부터 2005년 5월까지 심장 외 도관을 이용한 단심실 교정을 받은 총 96 명의 환자들의 기록을 후행적으로 분석하였다. 동 기간 중 기존의 단심실 교정을 심장 외 도관으로 교체한 경우는 연구 대상에서 제외하였다. 수술 후 늑막 삼출 기간의 위험 인자 분석에는 12가지 수술 전 위험 인자들을 지수화한 Fontan risk score (FRS) 및 기타 다양한 수술 전, 수술 중 위험 인자들을 포함시켰으며, 본 연구를 위하여 전기로 analogue를 폐순환에 적용하여 계산된 폐혈관 유순도 (pulmonary vascular compliance, PVC, $mm^2/mmHg/m^2)$를 위험인자로 추가하였다. 전기 회로 analogue에 의하면 PVC는 폐동맥 지수 (pulmonary artery index, $mm^2/m^2$)를 총폐저항 (total pulmonary resistance, Wood $Unit{\cdot}m^2$) 및 폐 혈류량 (pulmonary blood flow, $L/min/m^2$) 으로 나눈 값으로 정의되며, 이는 폐혈관의 크기와 저항, 폐 혈류량 등을 동시에 고려하는 변수라고 할 수 있다. 결과 변수인 흉관 거치 기간은 자연로그를 취해 정규 분포화하고 이를 log indwelling time (LIT)으로 정의하였으며, 분석 대상 위험 인자들과 LIT 의 관계에 대한 다중 선형 회귀분석을 시행하였다. 결과 : 조기 사망은 없었고 만기 사망은 4 명 (4.2%)이었으며, 단심실 교정시 fenestration이 추가된 경우는 1예 있었다(1 %). 수술 전 PVC, 흉관 거치 기간, LIT는 각각 ${6{\sim}94.8\;mm^2/mmHg/m^2}$ (중간값:24.8), $3{\sim}268$일 ( 간값 : 20 일 ), $1.1{\sim}5.6$ ( 평균: 2.9, 표준 편차: 0.8) 이었다. 단변 수 분석상 FRS, PVC, 체외 순환시간 (CPB) 및 술 후 12 시간째의 중심 정맥압 등이 LIT와 연관되었으나, 다변수 분석상 PVC (p=0.0018) 및 CPB (p=0.0024)만이 독립적으로 LIT를 예측하였다. 두 변수는 LIT 변이에 대하여 21.7%의 설명력이 있었으며, 두 변수를 이용한 회귀 분석식은 다음과 같았다. LIT=2.74-0.0158 PVC+0.00658 CPB. 결론: 새로이 정의된 폐혈관 유순도는 심장 외 도관을 이용한 단심실 교정 후의 흉관 거치 기간을 결정하는 중요한 예측 인자로서, 수술 전 위험 인자 분석에 유용하게 사용될 수 있다.

• Korean Journal of Radiology
• /
• 제21권7호
• /
• pp.900-907
• /
• 2020

Objective: To investigate the predictive value of intraplaque neovascularization (IPN) for cardiovascular outcomes. Materials and Methods: We evaluated 217 patients with coronary artery disease (CAD) (158 men; mean age, 68 ± 10 years) with a maximal carotid plaque thickness ≥ 1.5 mm for the presence of IPN using contrast-enhanced ultrasonography. We compared patients with (n = 116) and without (n = 101) IPN during the follow-up period and investigated the predictors of major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, coronary artery revascularization, and transient ischemic accident/stroke. Results: During the mean follow-up period of 995 ± 610 days, the MACE rate was 6% (13/217). Patients with IPN had a higher maximal thickness than those without IPN (2.86 ± 1.01 vs. 2.61 ± 0.84 mm, p = 0.046). Common carotid artery-peak systolic velocity, left ventricular mass index (LVMI), and ventricular-vascular coupling index were significantly correlated with MACE. However, on multivariate Cox regression analysis, increased LVMI was independently related to MACE (p < 0.05). The presence of IPN could not predict MACE. Conclusion: The presence of IPN was related to a higher plaque thickness but could not predict cardiovascular outcomes better than conventional clinical factors in patients with CAD.

• 보건행정학회지
• /
• 제29권3호
• /
• pp.303-311
• /
• 2019

Background: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. Methods: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. Results: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963-0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342-0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. Conclusion: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권3호
• /
• pp.1187-1192
• /
• 2014

Background: To correlate breast cancer subtypes with prognostic factors, microvessel density (MVD), vascular endothelial growth factor (VEGF) expression and clinical features. Materials and Methods: One hundred cases of primary breast carcinoma were classified using biomarkers on tissue microarray as: luminal A [estrogen receptor (ER)+, HER2-, $Ki-67{\leq}14%$], luminal B [ER+, HER2+ or ER+, HER2-, Ki-67>14%], HER2, triple negative basal-like (TNB) [any basal cytokeratins (CKs, 5, 14, 17) and/or endothelial growth factor receptor (EGFR) expression], and TN without such markers [TNN, null], and assessed for p53, vimentin, VEGF and CD31 immunoperoxidase. Results: Of the 100 cases (mean age, 51 years; mean tumor size, 3.2cm; 56% with nodal metastasis; 89 invasive ductal carcinomas, not otherwise specified, 4 invasive lobular carcinomas, 3 metaplastic carcinomas, and 4 other types) there were 39 luminal A, 18 luminal B, 18 HER2, 15 TNB and 10 TNN. The positivities of basal-like markers in the basal-like subtype were 78.3% for CK5, 40% for CK14, 20% for CK17, 46.7% for EGFR. There was no significant difference in age distribution, tumor size, degree of tubular formation, pleomorphism, lymphovascular invasion, nodal metastasis, MVD, VEGF expression and survival among subgroups. TNs demonstrated significantly higher tumor grade, mitotic count, Ki-67 index, p53 and vimentin and decreased overall survival compared with nonTN. Conclusions: The distribution of breast cancer subtypes in this study was similar to other Asian countries with a high prevalence of TN. The high grade character of TN was confirmed and CK5 expression was found to be common in our basal-like subtype. No significant elevation of MVD or VEGF expression was apparent.