• 한국임상약학회지
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• 제15권2호
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• pp.105-117
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• 2005

Following intracoronary stenting, antiplatelet therapy lead to greater protection from thrombotic complication. A few data are available about the effect of clopidogrel versus cilostazol, an antiplatelet commonly used after intracoronary stenting. To evaluate the efficacy and safety of clopidogrel plus aspirin compared with those of cilostazol plus aspirin in coronary stenting and to evaluate the efficacy of clopidogrel loading dose prior to coronary stealing in clopidogrel group. Data were retrospectively collected from medical charts of patients who had undergone coronary stenting and received either clopidogrel with or without loading 300 mg followed by 75 mg/d (n=58), or 200 mg/d cilostazol(n=72) for 1 year, between January 2000 and May 2002. All patients in both groups received aspirin 200 mg/d throughout the study. The primary endpoints at 7, 30, 180 and 365 days after stealing were the composite of death, Myocardial Infarction, stroke, angina, and revascularization in the intent to treat population and restenosis at follow up angiography. The secondary endpoints were the incidence of bleeding complications at 7, 30, and 365 days, and durg adverse effects at 365 days after stenting. At 180 and 365 days after stenting, the combined primary endpoints were significantly reduced in clopidogrel plus aspirin group (relative risk 0.39; 95% CI 0.17 to 0.92; p=0.021, RR 0.43; 95% CI 0.22 to 0.84; p=0.0085, respectively). However, the combined primary endpoints were not significantly different between the two groups at 7 and 30 days (p:1.00, p=0.79, respectively). Angiographic restenosis rate was 14.3% in clopidogrel plus aspirin uoup and 32.1% in cilostazol plus aspirin group (p=0.19). 300mg of clopidogrel loading dose did not significantly reduce the combined primary endpoints at 30 days after stenting (RR 0.14; 95% CI 0.01 to 2.65; p=0.23). The rate of bleeding complications and drug adverse effects were not different between the two groups. In patients undergoing intracoronary stenting, clopidogrel plus aspirin therapy is more beneficial than cilostazol plus aspirin in reducing major adverse cardiac events with similar rate of bleeding complication. A loading dose of clopidogrel did not lead to a statistically significant reduction in major adverse cardiac events.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.354-362
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• 2017

인구 고령화와 서구화된 생활로 인한 허혈성 심장질환이 지속적으로 증가하고 있으며, 우리나라는 OCED 국가 중에서 허혈성 심장질환의 재원일수가 높은 국가에 속한다. 재원일수 증가는 진료비 상승의 주요 원인이므로, 허혈성 심장질환의 재원일수 관리방안 마련이 필요하다. 이에 본 연구는 허혈성 심장질환자의 재원일수에 영향을 미치는 요인을 파악하여 재원 일수 관리에 필요한 기초자료를 제공하고자 시도되었다. 연구대상자는 일개 상급종합병원의 2015년1월1일부터 12월31일까지 순환기내과의 퇴원환자 중에서 주진단명이 허혈성 심장질환인 환자 566명이다. 자료분석은 IBM SPSS ver. 23.0을 이용하여 빈도분석, 교착분석, Fisher's test, One-way ANOVA, $Scheff{\acute{e}}$ test, 더미변수를 이용한 다중회귀분석을 실시하였다. 연구결과는 첫째, 흉통을 주호소로 입원한 환자가 가장 많았다. 둘째, 평균 재원일수는 4.89일이었으며, 허혈성 심장질환 종류별로 재원일수에 차이가 있었다. 셋째, 75세이상, 당뇨병, 호흡곤란 증상이 재원일수를 증가시키는 요인으로 나타났다. 따라서 허혈성 심장질환의 적정 재원일수 관리를 위해서는 당뇨병을 동반한 허혈성 심장질환자의 경우에는 혈당조절을 통해서 질병의 진행을 막는 것이 중요하며, 증상이 나타났을 경우 빠른 시간 내에 의료기관을 방문할 수 있는 체계마련이 필요하다.

• Biomolecules & Therapeutics
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• 제22권3호
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• pp.223-231
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• 2014

In this study, we prepared cordycepin-enriched (CE)-WIB801C, a n-butanol extract of Cordyceps militaris-hypha, and investigated the effect of CE-WIB801C on collagen-induced human platelet aggregation. CE-WIB801C dose-dependently inhibited collagen-induced platelet aggregation, and its $IC_{50}$ value was $175{\mu}g/ml$. CE-WIB801C increased cAMP level more than cGMP level, but inhibited collagen-elevated $[CA^{2+}]_i$ mobilization and thromboxane $A_2$ ($TXA_2$) production. cAMP-dependent protein kinase (A-kinase) inhibitor Rp-8-Br-cAMPS increased the CE-WIB801C-downregulated $[CA^{2+}]_i$ level in a dose dependent manner, and strongly inhibited CE-WIB801C-induced inositol 1, 4, 5-trisphosphate receptor ($IP_3R$) phosphorylation. These results suggest that the inhibition of $[CA^{2+}]_i$ mobilization by CE-WIB801C is resulted from the cAMP/A-kinase-dependent phosphorylation of $IP_3R$. CE-WIB801C suppressed $TXA_2$ production, but did not inhibit the activities of cyclooxygenase-1 (COX-1) and $TXA_2$ synthase (TXAS). These results suggest that the inhibition of $TXA_2$ production by WIB801C is not resulted from the direct inhibition of COX-1 and TXAS. In this study, we demonstrate that CE-WIB801C with cAMP-dependent $CA^{2+}$-antagonistic antiplatelet effects may have preventive or therapeutic potential for platelet aggregation-mediated diseases, such as thrombosis, myocardial infarction, atherosclerosis, and ischemic cerebrovascular disease.

• 대한한방내과학회지
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• 제26권1호
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• pp.182-198
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• 2005

Object : This study was designed to research whether the protection and inhibitory effects of cardiovascular diseases in L-NAME induced rat or ECV 304 cell lines through the Cell morphological pattern, Tunel assay, LDH activity, heart rate, blood pressure and immunohistochemistric analysis by Boonsimgieum water extract Methods : Nitric oxide(NO) play an important role in normal and pathophysiological cells including as a messenger molecule, neurotransmitter, microbiocidal agent, or dilator of blood vessels and artheriosclerosis, hypertension, myocardial infarction, respectively. Endothelial cell products can modulate the magnitude of a response to a vasoconstrictor, as evinced by the greater constriction after endothelium removal or NO synthesis blockade. To investigate that Boonsimgieum in the potential contribution of the levels of nitric oxide generated by endothelial nitric oxide synthase (eNOS) and the mechanisms of protection against NG-nitro-L-arginine methyl ester (L-NAME), human ECV 304 cells, which normally do not express eNOS, were expressed by L-NAME. L-NAME stimulated rat or cells were found to be resistant to injury and delayed death following the Boonsimgieum. Inhibition of nitric oxide synthesis abolished the protective effect against L-NAME, thrombin and collagen exposure. Interestingly, such effects have been observed during stimulation with agents such as phenylephrine and KCl on L-NAME mediate rats, were damaged by the NOS inhibitor L-NAME. Result : As the result of this study, In group, the anti-apoptosis and necrosis in the cardiovascular system have a potential capacity for prevented, protected and treating the diseases of cardiovascular system, against the necrosis of rat and ECV 304 cells with Caspase 3 and calpain expression by L-NAME is promoted. Conclusion : these results demonstrate neuroprotective and memory enhancing effects of ZIBU, suggesting its beneficial actions for the treatment of AD.

• 한국산학기술학회논문지
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• 제14권10호
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• pp.4910-4918
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• 2013

본 연구는 급성심근경색환자의 효율적인 재원일수 관리를 위해 재원일수에 대한 중증도 보정 모형을 개발하고자 하였다. 2004-2009년 퇴원손상심층조사 자료에서 주진단이 I21인 급성심근경색환자 6,074명을 추출하였으며, 모형 개발 시 데이터마이닝 기법(다중회귀분석, 의사결정나무, 신경망 기법)을 적용하였다. 개발된 모형들 중에서 의사결정나무 모형이 가장 우수한 모형으로 판정되어 이를 본 연구의 중증도 보정 모형으로 채택하였다. 급성심근경색 환자의 재원일수의 중증도 보정에 영향을 미치는 주요한 요인은 관상동맥우회술 시행유무, 퇴원 시 사망유무, 동반지수 등 이였으며, 병상규모와 의료기관 소재지 별로 중증도 보정 재원일수와 실제 재원일수에 차이가 있었다. 급성심근경색환자의 재원일수 변이를 줄이고 효율적으로 관리하기 위해서는 개발된 모형에 각 의료기관의 자료를 적용하여 중증도를 보정한 후, 차이가 나는 요인을 규명하여 이를 해결하는 활동이 수행되어야 할 것이다.

• 한국콘텐츠학회논문지
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• 제12권7호
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• pp.273-283
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• 2012

급성심근경색증 환자에서 약물 용출 스텐트(drug-eluting stents, DES)는 일반 금속 스텐트(bare-metal stents, BMS)에 비해 재협착은 감소하지만 구조적인 특성으로 스텐트 혈전증(stent thrombosis, ST)이 증가한다고 알려져 있다. 이에 본 연구에서는 ST의 발생빈도, 임상양상, 그리고 1년간 예후를 알아보고자 하였다. 대학병원 심혈관센터에서 급성심근경색증으로 관상동맥 중재술을 받은 2,667명에서 스텐트 혈전증이 발생한 환자 80명을 대상으로 DES-ST를 I군(n=57), BMS-ST(n=23)를 II군으로 분류하여 양군 간의 특징을 분석하였다. 양군간의 ST는 I군에서 57명(2.7%)과 II군에서 23명(4.3%)로 양군 간에 유의한 차이는 없었다(p>0.064). ST의 유형으로는 acute ST는 I군5(8.8%), II군3(2.3%), subacute ST는 I군 29(50.9%), II군14(60.9%), late ST 는 I군11(19.3%), II군2(8.7%), very late ST는 I군12(21.1%), II군 4(17.4%)로 양군간의 차이는 없었다(p>0.605). DES와 BMS를 삽입 후 1년 예후에 미치는 인자로는 ST(OR 8.166 95% CI 2.825-23.608 p<0.001), 좌심실구혈율(<40) (OR 6.409 95% CI 2.422-16.955 p<0.001), 나이(${\geq}$75세) (OR 4.979 95% CI 1.946-12.744 p=0.001) 이었다. ST의 발생율은 양군 사이에 차이가 없었고, 1년 예후에 미치는 인자로는 ST의 발생, 좌심실 구혈률의 저하 및 환자의 연령 등 이었다.

• Genomics & Informatics
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• 제9권4호
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• pp.152-160
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• 2011

Hypertension is the major factor of most death and high blood pressure (BP) can lead to stroke, myocardial infarction and cardiac failure. Moreover, hypertension is strongly correlated with body mass index (BMI). Although the exact causes of hypertension are still unclear, some of genetic loci were discovered from genome-wide association study (GWAS). Therefore, it is essential to study genetic variation for finding more genetic factor affecting hypertension. The purpose of our study is to conduct a CNV association study for hypertension-related traits, BP and BMI, in Korean individuals. We identified 2,206 CNV regions from 3,274 community-based Korean participants using the Affymetrix Genome-Wide Human SNP Array 6.0 platform and performed a logistic regression analysis of CNVs with two hypertension-related traits, BP and BMI. Moreover, the 4,692 participants in an independent cohort were selected for respective replication analyses. GWAS of CNV identified two loci encompassing previously known hypertension-related genes: LPA (lipoprotein) on 6q26, and JAK2 (Janus kinase 2) on 9p24, with suggestive p-values (0.0334 for LPA and 0.0305 for JAK2 ). These two positive findings, however, were not evaluated in the replication stage. Our result confirmed the conclusion of CNV study from the WTCCC suggesting weak association with common diseases. This is the first study of CNV association study with BP and BMI in Korean population and it provides a state of CNV association study with common human diseases using SNP array.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.9-20
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• 2001

Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

• 한국임상약학회지
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• 제12권1호
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• pp.29-38
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• 2002

Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.

• 한국한의학연구원논문집
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• 제16권1호
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• pp.119-134
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• 2010

Objectives & Method：Based on the statistic from January 2008 to December 2008 include 66-year-old 375 people (159 men, 216 women) who got examined in National Health Insurance Corporation, this study set a goal to establish a new health index by analyzing the relation between the cardio-cerebra vascular disease and risk factor such as obesity, smoking, exercise, alcohol consumption, blood pressure, blood sugar and cholesterol. Results：1) Examine results, health status according to gender；People who are diagnosed as abnormal health status have higher risk for both men and women. As for the detailed diseases, high blood pressure was highest followed by hyperlipidemia and obesity. In case of the women, 96.3% in bone mineral density was highest. 2) Correlation of disease and health risk factors based on gender；Correlation of disease according to gender in the obesity(p<0.001), lipid abnormalities(p<0.001), kidney diseases(p<0.001), chest diseases(p<0.05), osteoporosis(p<0.001) showed a statistically significant difference. The analysis showed that the men have more obesity and lipid abnormalities as well as thoracic disease than the women, but the women have more kidney disease than the men. As for the osteoporosis examine which is conducted only for the women, most of the women were abnormal even though it cannot compare the result according to gender. Obesity(p<0.001), alcohol(p<0.001), smoking(p<0.001) and LDLcholesterol(p<0.001) showed statistical correlation between gender and health risk factor. And only high blood pressure(p<0.001) showed a statistical correlation between gender and risk of cardio-cerebra vascular disease. 3) Risk of cardio-cerebra vascular disease related to health risk factor characteristic；Obesity assessment(p<0.001), alcohol(p<0.05), smoking(p<0.05), blood pressure(p<0.001), glucose(p<0.001) showed correlation between health risk factor and stroke. Drinking(p<0.001), smoking(p<0.05), exercise(p<0.001), blood pressure(p<0.001), LDL cholesterol(p<0.001) showed health risk factor and myocardial infarction. Obesity assessment(p<0.001), smoking(p<0.05), blood pressure(p<0.001), glucose(p<0.001) and showed correlation between health risk factor and diabetes. Obesity assessment(p<0.001), blood pressure(p<0.001) showed correlation between health risk factor and high blood pressure. Conclusion：Therefore, we have to take one step farther after the health examination. In order to prevent and reduce the risk of disease, people have to understand their health status exactly first, and correct their habit with recognizing the amount of risk related to cardio-cerebra vascular disease.