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대유행 인플루엔자(H1N1 2009) 환자 가족에서 인플루엔자 (H1N1 2009) 검사 양성률
김학령,전한호,김민,강철환,박경화 대한감염학회 2010 감염과 화학요법 Vol.42 No.2
Background: Influenza transmission in households a subject of renewed interest especially in pandemic situation. We performed this study to investigate the laboratory-confirmatory rate in household contacts with index cases of pandemic influenza (H1N1 2009). Materials and Methods: For three months from 1 September and 29 November 2009, people who had a history of close contact with confirmed cases of pandemic influenza (index case) were recruited. The information on the study participants was collected using a standardized questionnaire. Presence of the pandemic influenza (H1N1 2009) infection was confirmed by real-time reversetranscription polymerase chain reaction (RT-PCR). Results: A total of 113 index cases and 141 household contacts were investigated. One hundred and four index cases (92.0%) were younger than 20 years. The median age of household contacts was 40 years. Twenty eight household contacts (19.8%) had acute respiratory illness (ARI). Overall, 10.6% of enrolled household contacts were positive in RT-PCR for pandemic influenza (H1N1 2009). The positive rate of household contacts with ARI was 25.0% and it was 7.1% in household contacts without ARI. The positive rate was significantly higher in children and young adults under 30 years (28.3%) compared with that in household contacts older than 30 years (8.3%). Conclusions: This results showed a significant role of mild symptomatic or asymptomatic pandemic influenza (H1N1 2009) patients as a virus carriers in households.
Kim Hack-Lyoung,Park So-Jeong,Bae Yoon-Jong,Ihm Sang Hyun,Shin Jinho,Kim Kwang-il 대한고혈압학회 2024 Clinical Hypertension Vol.30 No.-
Background Improving adherence to antihypertensive medication (AHM) is a key challenge in hypertension management. This study aimed to assess the impact of ambulatory blood pressure monitoring (ABPM) on AHM adherence. Methods We utilized the Korean National Health Insurance Service database. Among patients newly diagnosed with hypertension who started AHM between July 2010 and December 2013, we compared clinical characteristics and adherence between 28,116 patients who underwent ABPM prior to starting AHM and 118,594 patients who did not undergo ABPM. Good adherence was defned as a proportion of days covered (PDC) of 0.8 or higher. Results The total study population was 146,710, with a mean age of 50.5±6.4 years; 44.3% were female. Comorbidities were noted in 4.2%. About a third of patients (33.1%) showed good adherence. The ABPM group had a notably higher PDC (total PDC: 0.64±0.35 vs. 0.45±0.39; P<0.001), irrespective of the number of medications, dos‑ ing frequency, or prescription duration. After adjusting for signifcant clinical variables, ABPM was still closely linked with good adherence (odds ratio, 2.35; 95% confdence interval, 2.28–2.41; P<0.001). Conclusions In newly diagnosed hypertension, undergoing ABPM prior to AHM prescription appears to enhance adherence to AHM. The exact mechanisms driving this association warrant further exploration. Improving adherence to antihypertensive medication (AHM) is a key challenge in hypertension management. This study aimed to assess the impact of ambulatory blood pressure monitoring (ABPM) on AHM adherence.We utilized the Korean National Health Insurance Service database. Among patients newly diagnosed with hypertension who started AHM between July 2010 and December 2013, we compared clinical characteristics and adherence between 28,116 patients who underwent ABPM prior to starting AHM and 118,594 patients who did not undergo ABPM. Good adherence was defined as a proportion of days covered (PDC) of 0.8 or higher. The total study population was 146,710, with a mean age of 50.5 ± 6.4 years; 44.3% were female. Co-morbidities were noted in 4.2%. About a third of patients (33.1%) showed good adherence. The ABPM group had a notably higher PDC (total PDC: 0.64 ± 0.35 vs . 0.45 ± 0.39; P < 0.001), irrespective of the number of medications, dosing frequency, or prescription duration. After adjusting for significant clinical variables, ABPM was still closely linked with good adherence (odds ratio, 2.35; 95% confidence interval, 2.28–2.41; P < 0.001). In newly diagnosed hypertension, undergoing ABPM prior to AHM prescription appears to enhance adherence to AHM. The exact mechanisms driving this association warrant further exploration.
Hack-Lyoung Kim,So Won Oh,Hyunjong Lee,Hee Jun Kim,You Nui Kim,Woo-Hyun Lim,Jae-Bin Seo,Sang-Hyun Kim,Myung-A Kim,Joo-Hee Zo 대한영상의학회 2018 Korean Journal of Radiology Vol.19 No.1
Objective: Unrecognized left main coronary artery disease (LMCD) is often fatal; however, accuracy of non-invasive tests for diagnosing LMCD is still unsatisfactory. This study was performed to elucidate single-photon emission computed tomography (SPECT) detection of LMCD using quantitative coronary angiography (QCA) data. Materials and Methods: Fifty-five patients (39 men; mean age, 68.1 ± 10.9 years) diagnosed with significant left main (LM) stenosis (≥ 50%) by invasive coronary angiography (ICA) were retrospectively reviewed. All study patients underwent SPECT with pharmacologic stress within 30 days of ICA. All coronary lesions were quantified via QCA, and SPECT findings were compared with QCA results. Results: Only four patients (7.3%) had isolated LMCD; all others had combined significant stenosis (≥ 70%) of one or more other epicardial coronary arteries. Patients with more severe coronary artery disease tended to have higher values for summed difference scores in a greater number of regions, but the specific pattern was not clearly defined. Summed stress score of SPECT did not differ according to LM stenosis severity. Only three patients (5.4%) had a typical LM pattern of reversible perfusion defect on SPECT. A significant negative linear correlation between stenosis severity and stress perfusion percent was found in the left anterior descending artery region (r = -0.455, p < 0.001) but not in the left circumflex artery. Conclusion: Single-photon emission computed tomography findings were heterogeneous, not specific and poorly correlated to QCA data in patients with significant LMCD. This may be due to highly prevalent significant stenosis of other epicardial coronary arteries.
Hack-Lyoung Kim,Myung-A Kim 대한심장학회 2023 Korean Circulation Journal Vol.53 No.10
Interest in sex differences in coronary artery disease (CAD) has been steadily increasing. Concurrently, most of the data on these differences have primarily been Western-oriented. The KoRean wOmen’S chest pain rEgistry (KoROSE), started in 2011, has since published numerous research findings. This review aims to summarize the reported differences between men and women in CAD, integrating data from KoROSE. Cardiovascular risk in postmenopausal women escalates dramatically due to the decrease in estrogen levels, which normally offer cardiovascular protective effects. Lower estrogen levels can lead to abdominal obesity, insulin resistance, increased blood pressure, and endothelial dysfunction in older women. Upon analyzing patients with CAD, women are typically older and exhibit more cardiovascular risk factors than men. Diagnosing CAD in women tends to be delayed due to their symptoms being more atypical than men’s. While in-hospital outcome was similar between sexes, bleeding complications after percutaneous coronary intervention occur more frequently in women. The differences in long-term prognosis for CAD patients between men and women are still a subject of ongoing debate. Pregnancy and reproductive factors also play a significant role as risk factors for cardiovascular disease in women. A notable sex disparity exists, with women found to use fewer cardiovascular protective drugs and undergo fewer interventional or surgical procedures than men. Additionally, women participate less frequently than men in clinical research. Through concerted efforts to increase awareness of sex differences and mitigate sex disparity, personalized treatment can be provided. This approach can ultimately improve patient prognosis.
Cilostazol eliminates adverse smoking outcome in patients with drug-eluting stent implantation.
Kim, Hack-Lyoung,Suh, Jung-Won,Lee, Seung-Pyo,Kang, Hyun-Jae,Koo, Bon-Kwon,Cho, Young-Seok,Youn, Tae-Jin,Chae, In-Ho,Choi, Dong-Ju,Rha, Seung-Woon,Bae, Jang-Ho,Kwon, Taek-Geun,Bae, Jang-Whan,Cho, Myeo Japanese Circulation Society 2014 CIRCULATION JOURNAL Vol.78 No.6
<P>The present study investigated whether cilostazol can eliminate adverse smoking outcome after percutaneous coronary intervention (PCI).</P>
Arterial stiffness and hypertension
Kim Hack-Lyoung 대한고혈압학회 2023 Clinical Hypertension Vol.29 No.-
Arterial stifness and hypertension are closely related in pathophysiology. Chronic high blood pressure (BP) can lead to arterial wall damage by mechanical stress, endothelial dysfunction, increased infammation, oxidative stress, and renin–angiotensin–aldosterone system (RAAS) activation. Hypertension also increases collagen fber production and accelerates elastin fber degradation. Stifened arteries struggle with BP changes, raising systolic BP and pulse pressure. The resulting increased systolic pressure further hardens arteries, creating a harmful cycle of infammation and calcifcation. Arterial stifness data can predict target organ damage and future cardiovascular events in hyper‑ tensive patients. Thus, early detection of arterial stifness aids in initiating preventive measures and treatment plans to protect against progression of vascular damage. While various methods exist for measuring arterial stifness, pulse wave velocity is a non-invasive, simple measurement method that maximizes efectiveness. Healthy lifestyle changes, RAAS blockers, and statins are known to reduce arterial stifness. Further research is needed to ascertain if improving arterial stifness will enhance prognosis in hypertensive patients.
Factors Associated with Low Awareness of Heart Failure in the General Population of Korea
Hack-Lyoung Kim,Mi-Hyang Jung,Jae Hyuk Choi,Sunki Lee,Min Gyu Kong,Jin Oh Na,조양현,Kyoung-Im Cho,Dong-Ju Choi,Eung Ju Kim 대한심장학회 2020 Korean Circulation Journal Vol.50 No.7
Background and Objectives: Factors associated with low heart failure (HF) awareness have not been well-evaluated. This study was conducted to find out which demographic features would be associated with low HF awareness in the general population of Korea. Methods: A telephone interview was conducted with 1,032 adults (58 years and 50.6% were male) across the country. Based on answer to 15 questions about HF, we scored from 0 to 15 points (mean, 7.53±2.75; median, 8; interquartile range, 6–9). A score of <8 was defined as low HF awareness, and a score of ≥8 was defined as high HF awareness. Results: A total of 478 subjects (46.3%) had low HF awareness. HF awareness scores were 5.18±1.85 and 9.55±1.50 in subjects of low and high HF awareness groups, respectively. Subjects with low HF awareness were older, more female-dominant, more diabetic, lower educational and house hold income levels, and more frequently living in rural areas, compared to those with high HF awareness (p<0.05 for each). In multivariable logistic regression analyses, older age (≥67 years: odds ratio [OR], 1.61; 95% confidence interval [CI], 1.16–2.19; p=0.004), female sex (OR, 1.33; 95% CI, 1.02–1.73; p=0.034) and low educational level (high school graduate or less vs. college graduate: OR, 2.38; 95% CI, 1.75–3.22; p<0.001) were significantly associated with low HF awareness even after controlling for potential confounders. Conclusions: Older age, female sex, and lower level of education were independently associated with low HF awareness in the general Korean population. More attention and education are needed for these vulnerable groups to improve HF awareness.