• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.319-328
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• 2013

Objectives: This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea. Methods: In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics. Results: There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality. Conclusions: Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.321-328
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• 2018

The purpose of this study was to investigate factors affecting the heart rate, to analyze the relevance and to use it as a management index of factors of increase in heart rate. A total of 204 adults from November, 2016 to March, 2017 who responded to a personal questionnaire among the adults who underwent coronary computed tomography scans for health screening, were the target of the investigation. In the study, there was a statistically significant difference (p <.05) between the heart rate and the gender, CACS, Stenosis and the forces affecting cardiovascular disease. CACS, Stenosis had a statistically significant difference (p <.05) compared with the other groups in the group with a heart rate of 80 bpm or more, the ability to influence cardiovascular disease was different from that of other groups There was a meaning difference in the heart rate below 60 bpm group compared (p <.05). In conclusion, it is important and desirable to maintain heart rate below 60 bpm in order to prevent having cardiovascular disease history, and below 80 bpm to prevent CACS and stenosis.

• Korean Journal of Health Education and Promotion
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• v.20 no.2
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• pp.113-125
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• 2003

Background： Recently, adolescent obesity was increased and tended to become obese adults, facing increased risk for diabetes, cardiovascular disease. Even before reaching adulthood, adolescent obesity already was experiencing hypertension, dyslipidemia, and diabetes mellitus. The purpose of this study was to find prevalence of obesity of high school students in Jeju island and association between obesity and cardiovascular risk factors and association between childhood obesity and adolescent obesity. Method： The study subjects were 6,064 students of twenty-two high school in Jeju island and health survey data was gathered from high school health examination data and hospital health examination data from Aug. 1999 to Dec. 1999. Adolescent obesity was evaluated by ideal body weight method in 1998 and body mass index. Cardiovascular risk factors were checked total cholesterol, systolic and diastolic blood pressure, fasting blood sugar. In 1,534 students, obesity at primary school is checked by primary and middle school health record. Results： Prevalence of obesity in Jeju island high school students is 12.6% in male students, 13.3% in female students by ideal body weight method and 8.7% in male students, 8.5% in female students by body mass index. Prevalence of obesity of male students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 14.2% and not significantly different. Prevalence of obesity of male students in general and commercial school group were each 13.9%, 10.1% and that of general school group was significantly higher. In female students, Prevalence of obesity general and commercial school group was not significantly different. Total cholesterol, systolic and diastolic blood pressure were significantly associated with degree of obesity in male and female students(p＜0.05) and fasting blood sugar was only significantly associated with degree of obesity in male students(p＜0.05). In 1,514 students checked by health record, Odds ratio of obesity at primary and middle school that at high school were 12.96∼22.77 and was significantly associated. Conclusion： Prevalence of obesity of high school students in Jeju island is very high and adolescent obesity was significantly associated with cardiovascular risk factors. Mostly childhood obesity tended to become adolescent obesity and program of control of obesity at childhood and adolescence is required.

• Korean Journal of Health Education and Promotion
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• v.25 no.2
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• pp.47-59
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• 2008

Objectives: The objective of this study was held for prevention of coronary artery disease and improvement of health of local community residents by classifying the obesity types of their waist circumference and BMI, and appraising the coronary artery disease risk factors(CRF). Methods: We analyzed the data on the 1,914 adult cases (1,156 male and 758 female) during Nov, 2006 to Mar. 2007 on a general hospital in Daegu city, Korea. The obesity types in this research were classified into normal group, seeming obesity group, abdominal obesity group and obesity group. Also, CRF was classified by normal, mild, moderate, and severe, and each class was given the index from 0 to 3. The coronary artery disease risk factors index(CRFI) was defined as the sum of index, and we defined that if the sum is higher, higher chance of coronary artery disease risk exist. Results: According to the research, by the age group, normal group has higher percentage in age 30 to 40, and obesity group and abdominal obesity group has higher percentage in age 50 to 60. CRFI is increased by order of normal group, seeming obesity group, abdominal obesity group, and obesity group on both male and female groups, and male shows higher index than female on all four groups. CRFI will be influenced by order of obesity group, seeming obesity group, and abdominal obesity group on male, and obesity group, abdominal obesity group, and seeming obesity group on female according to the result of multiple regression between obesity type and CRFI. Conclusion: According to the result from our research, we have to have keen attention to not only seeming obesity group and obesity group, but also abdominal obesity group which has normal waist circumference influence to CRFI. So, those kinds of indexes have to be controled by controling their weight. Also, we believe that health behaviour can improve and CRF can be prevented by the early health care and early health education to those with no abnormal indication on clinical indicator but with abnormal BMI and waist circumference.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.835-843
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• 2005

Background: Cancer of the esophagus is one of the most malignant tumors with poor prognosis. The p53 gene alteration, over expression of Cyclin D1, and Ki67 index were thought to be the prognostic factors. However, their clinical significances in esophageal squamous cell carcinoma are controversial and p53 accumulation may not correlate with genetic mutation. The current study investigates their prognostic significance in squamous cell carcinoma of the esophagus. Material and Method: The Subjects studied were 124 esophageal squamous cell carcinoma patients who underwent esophagectomy. The mutation of p53, over expression of Cyclin D1, Ki67 labelling index, mitotic index were examined by using an immunohistochemical staining. We compared the results and investigated the correlation with the mutation of p53, overexpression of Cyclin D1, Ki67 labelling index, mitotic index and tumor size, and duration of survival. Result: There was no correlation between the results in immunohistochemical staining according to age, sex, tumor size, Iymph node status, and clinical stage of the disease. Mutant p53 protein was found in 69 cases (55.6$\%$). Median survival time was 21 months in cases with negative for mutant p53 protein and 22 months in positive cases. There was no significant difference in survival (p=0.46). Median survival time was 22 months in cases with negative for Cyclin D1 and 16 months in positive cases (p=0.18). Median and mean survival time was 22 months and 36 months when Ki67 labeling index was 40 or less (102 cases). Median and mean survival was 16 months and 23 months, when Ki67 labeling index was more than 40 (22 cases). There was significant difference in survival rate (p=0.011). Conciusion: Positivity of p53 and cyclin D1 was not useful in predicting the prognosis in our study. There was no significant correlation among mutant p53 protein accumulation, Cyclin D1 over expression, and Ki67 labeling index. However, in several studies, PCR single strand conformational polymorphism analysis of p53 showed a correlation to the prognosis. We thought that there was a significant discordance between p53 gene mutation and mutant p53 protein accumulation. When Ki67 labeling index was more than 40, prognosis was poorer, Ki67 seems to be a prognostic factor in our study. Therefore, we confirmed the possibility of using molecular markers as prognostic factors.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.434-446
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• 2020

Objectives: The cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) are non-invasive methods to evaluate cardiovascular disease and arteriosclerosis. This study investigated the relationship between CAVI, ABI, and factors related to arteriosclerosis. Methods: This study included 535 healthy adults who underwent health examinations in 2019. We analyzed the correlation between CAVI, ABI and clinical variables. Multiple regression analysis was performed on the independent clinical variables associated with CAVI and ABI. Results: The correlation analysis of CAVI showed that body mass index (BMI) and HDL-cholesterol (HDL-C) had a negative correlation, and the other variables had a significant positive correlation. The correlation analysis with ABI on the right side showed that age, diastolic blood pressure (DBP), gender, and LDL-cholesterol (LDL-C) had a significant positive correlation, while HDL-C had a significant negative correlation. There was no statistical significance on the left. In the multiple regression analysis, DBP, age, BMI, gender, and HDL-C were proved to be independent factors in CAVI (right) (R²=0.365); DBP, age, gender, BMI, fasting blood sugar, and total cholesterol in CAVI (left) (R²=0.357); and age, gender, DBP, and systolic blood pressure in ABI (right) (R²=0.133). There were no statistically significant factors in ABI (left). It could be inferred that smoking and drinking are determinants that play an important role in CAVI. Conclusion: CAVI showed a high correlation with gender, age, and blood pressure. A significant correlation between CAVI and serum lipid values could be observed, but this showed a low correlation coefficient. ABI showed a high correlation with age and DBP. These results support the use of CAVI and ABI as primary diagnostic devices in medical treatment.

• The Journal of the Society of Stroke on Korean Medicine
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• v.6 no.1
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• pp.25-32
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• 2005

Background and purpose: Arterial stiffness is an important, independent determinant of cardiovascular risk. Pulse wave velocity (PWV) has been used as a valuable index of arterial stiffness and as a surrogate marker for atherosclerosis. The Framingham risk score was developed using categorized risk factors to predict the 10 year absolute risk of developing coronary heart disease (CHD). This algorithm is established using recommended guidelines for blood pressure, total cholesterol, and high density lipoprotein cholesterol in addition to age, smoking history and history of diabetes. Tongxinluo(TXL) has been shown to have anti hyperlipidemic activity and anti atherogenic effects. To determine its efficacy and safety, we examined whether TXL improves PWV, ABI, Framingham score, blood pressure, and lipid profile in high risk group of cardiovascular diseases. Subjects and methods: 49 subjects with the high risk of cardiovascular diseases were recruited. Subjects were administered TXL with the dose of 1110mg three times a day for 8 weeks. baPWV, ABI, Framingham risk score, Blood pressure and serum lipid profile were assessed at baseline and after 4 and 8weeks. Results: Total cholesterol, LDL cholesterol, triglyceride, total lipid and phospolipid significantly decreased after 4 weeks of medication. Total cholesterol, total lipid and phospolipid significantly decreased after 8 weeks of medication. There were no significant changes in Framingham risk scores, ABI, PWV and blood pressure. On safety assessment, there were no adverse effects, hepatic or renal toxicity. Conclusion: We suggest that TXL is a safe and useful herbal medicine for hyperlipidemia and as for anti-atherognic effects, further research would be necessary.

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.229-242
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• 2023

Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion: Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.970-978
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• 1988

There is tendency of increasing number and decreasing age of patients who are indicated for Rastelli operation for their cyanotic congenital heart disease. So there is the need to find the criterion which saves the patients from early postoperative hemodynamic disturbances. We reviewed the 26 patients who had been performed Rastelli operation at Seoul national University Hospital from January 1981 to June 1988. mean age of the patients was 7.8*3.4 years[range 2.5-15years], mean body surface area[BSA] 0.79*0.25m2[range 0.49-1.51m2] and mean hematocrit 57.95*12%[range 48-80%]. We divided these patients into survived group and died group before postoperative 72 hours, and analyzed preoperative arterial oxygen saturation[SaO2], the ratio of diameter of right pulmonary artery to ascending aorta[RPA/AA], the ratio of both right and left pulmonary artery diameter to descending thoracic aorta[RPA+LPA/DTA], pulmonary artery index[PA index], cardiopulmonary bypass time, aorta cross-clamping time, postoperative perfusion state and total amount of dopamine infused postoperatively. The results showed that RPA+LPA/DTA and PA index were statistically significant factors to influence early postoperative cardiac death rate[P< 0.05]. Especially there were good linear correlations between PA index[X] and peripheral perfusion index[Y][Y= - 1.15+0.02 X, r=0.86, P<0.01]and between PA index[X] and total amount of dopamine infused before postoperative 72 hours[mg/kg, Y][Y=61.94 - 0.15 X, r=-0.80, P < 0.01]. Also there were tendencies that the higher RPA+LPA/DTA[Y], the better peripheral perfusion [X] and the lower need of dopamine[X], but no statistical significance.[Y=0.78+1.60 X, r =0. 49, P >0.05] And the discriminate analysis showed that patients with PA index over 221 mm2/BSA could undergo correction with 25 per cent of error rate. In conclusion, early postoperative hemodynamic states could be predicted by preoperatively measured PA index, and which can be used as a criterion for Rastelli operation performed on cyanotic congenital heart disease.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.217-223
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• 2003

Purpose : Every year, there is a remarkable increase in the prevalence of children with excess body fat. The aim of this study is to find a useful screening method in assessing adolescent, obesity and to specify the predictable risk factors that are related to adult cardiovascular disease according to BMI and obesity index. Methods : From July to November in 2001, a total of 2,814(male : female=2,011 : 803) mid to high school students who were in the obesity range according to obesity index(>20%) were evaluated according to height, weight, body mass index(BMI), obesity index, and serum lipid levels. Results : Among the obese students over 20% by obesity index, 86.6% were over the range of 95 percentile by BMI. Among students defined as obese by BMI, 21.0% of males and 21.4% of females students had hypercholesterolemia; by obesity index, the ratio was 20.7% male and 19.0% female. The frequency of hypertriglyceremia in male students was 15.0% in group I(overweight group, 85P97p); in female students 11.8%, 20.7% and 28.2% respectively. Conclusion : In this study, using BMI alone to test the serum lipid level in adolescent obesity had a limit of 10.0-17.0% omission. Therefore using obesity index as a screening method to find the adult cardiovascular disease would rather reduce the omission rate. The risk factor of cardiovascular disease according to BMI was the increasing level of triglyceride in both male and female students. We think that using the obesity index has more rationale rather than BMI in assessing lipid profiles.