Gender-related Differences in Management of Nonvalvular Atrial Fibrillation in an Asian Population

Lee, Jung Myung,Kim, Tae-Hoon,Cha, Myung-Jin,Park, Junbeom,Park, Jin-Kyu,Kang, Ki-Woon,Shim, Jaemin,Uhm, Jae-Sun,Kim, Jun,Park, Hyung Wook,Lee, Young Soo,Choi, Eue-Keun,Kim, Chang-Soo,Joung, Boyoung,K The Korean Society of Cardiology 2018 Korean Circulation Journal Vol.48 No.6

<P><B>Background and Objectives</B></P><P>Gender-related differences in health care utilization for atrial fibrillation (AF) are increasingly recognized. However, large cohort data for examining gender-related differences in AF are lacking in Asian populations.</P><P><B>Methods</B></P><P>The Registry for Comparison Study of Drugs for Symptom Control and Complication Prevention of AF (CODE-AF Registry) is a prospective observational cohort-study that enrolled participants at 10 tertiary hospitals in South Korea. Baseline characteristics retrieved from the CODE-AF Registry were analyzed.</P><P><B>Results</B></P><P>A total of 6,274 patients were recruited (mean age 67±11 years, mean CHA<SUB>2</SUB>DS<SUB>2</SUB>-VASc score 2.7±1.7, 63% male, 65% paroxysmal AF) from June 2016 to April 2017. Women underwent less electric cardioversion (12.3% vs. 19.6%, p<0.001), less radiofrequency ablation (12.4% vs. 17.9%, p<0.001), and less antiarrhythmic drug therapy (44.7% vs. 49.5%, p<0.001), despite having more severe symptoms (symptom class III or IV, 45.8% vs. 37.5%, p<0.001). Among patients with a CHA<SUB>2</SUB>DS<SUB>2</SUB>-VA score of 2 or more, a slightly higher proportion of women were taking oral anticoagulants than men (85.7% vs. 81.9%, p=0.002), and non-vitamin K antagonist oral anticoagulant (NOAC) use was more prevalent in women than men (70.4% vs. 62.3%, p<0.001). Insufficient NOAC dosing was very common, more so in women than men (61.5% vs. 56.3%, p<0.001).</P><P><B>Conclusions</B></P><P>Female patients with AF were treated more conservatively and rhythm control strategies were used less frequently than in males, even though the female patients with AF had more severe symptoms. While insufficient NOAC dosing was common in both sex, it was significantly more frequent in women.</P>

Comparative occurrence of ischemic stroke with the rhythm versus rate control strategy in a national prospective cohort of atrial fibrillation

( Jae Guk Kim ),( Young Soo Lee ),( Ki-woon Kang ),( Eue-keun Choi ),( Myung-jin Cha ),( Jung-myung Lee ),( Jin-bae Kim ),( Junbeom Park ),( Jin-kyu Park ),( Tae-hoon Kim ),( Jae-sun Uhm ),( Jaemin Sh 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.1

Background/Aims: Comparative occurrence of ischemic stroke for rhythm versus rate control strategy in patients with non-valvular atrial fibrillation (NVAF) is still inconclusive. The purpose of this study was to investigate whether the rhythm control strategy is associated with a lower risk of ischemic stroke compared to the rate control strategy in NVAF patients. Methods: The CODE-AF registry prospectively enrolled 6,280 consecutive patients who were treated for NVAF at 10 tertiary referral centers in South Korea. Of these, 2,513 NVAF patients (age, 67 ± 10 years; male, 61.8%) were clinically followed up for over 1-year and divided into rate and rhythm control groups. Results: Those treated with the rhythm control strategy were younger and had less proportions of underlying disease compared to those treated with the rate control strategy. After the propensity matching analysis, those treated with the rhythm control strategy had similar baseline characteristics including the CHA₂DS₂-VASC score compared to those treated with the rate control strategy. The rate of oral anticoagulation, all bleeding, and hospitalization were also similarly between the two groups. The incidence rate of ischemic stroke in the rhythm control group was significantly lower than in the rate control group (0.7 vs. 6.9 per 1,000 person-years, p = 0.011). Conclusions: The rhythm control strategy demonstrated a beneficial effect to lower the risk of ischemic stroke during a 1-year follow-up compared to the rate control strategy.

Temporal trends of the prevalence and incidence of atrial fibrillation and stroke among Asian patients with hypertrophic cardiomyopathy: A nationwide population-based study

Choi, You-Jung,Choi, Eue-Keun,Han, Kyung-Do,Jung, Jin-Hyung,Park, Jiesuck,Lee, Euijae,Choe, Wonseok,Lee, So-Ryoung,Cha, Myung-Jin,Lim, Woo-Hyun,Oh, Seil Elsevier 2018 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.273 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Atrial fibrillation (AF) and stroke are common in hypertrophic cardiomyopathy (HCM). We aimed to determine the prevalence and incidence of AF and stroke in patients with HCM during a 10-year period.</P> <P><B>Methods</B></P> <P>Using the Korean National Health Insurance Services database, we identified patients diagnosed with HCM from the entire Korean population between 2005 and 2015. The annual prevalence and incidence of AF and stroke in HCM patients were estimated.</P> <P><B>Results</B></P> <P>The prevalence of AF in HCM patients has gradually increased to 1.6-fold from 13.4% in 2005 to 20.9% in 2015. The incidence of AF ranged from 4.1 to 5.5%, a similar trend was observed for each year in HCM patients. The prevalence of stroke in HCM patients was approximately 10%, while that in HCM patients with AF was about 20%. During 8741 person-years, AF-related stroke occurred in 257 subjects among 2309 HCM patients with new-onset AF. The overall incidence rate of AF-associated stroke was 2.94 per 100 person-years. In subgroup analysis, the incidence rate of AF-associated stroke was 1.49 per 100 person-years in the under 45 year-old group and 1.48 per 100 person-years in the group with CHA<SUB>2</SUB>DS<SUB>2</SUB>­VASc score of 0 or 1 point in HCM patients.</P> <P><B>Conclusions</B></P> <P>The prevalence of AF in HCM patients gradually increased over 10 years. The annual risk of AF-associated stroke in HCM was over 1% even in younger patients and those with CHA<SUB>2</SUB>DS<SUB>2</SUB>­VASc score of 0 or 1 point, which provide evidence to support the prevention of stroke in HCM patients with AF.</P> <P><B>Highlights</B></P> <P> <UL> <LI> This is the first largest nationwide study on hypertrophic cardiomyopathy (HCM), a rare myocardial disease in Korea. </LI> <LI> The prevalence of AF in HCM patients gradually increases to 1.6-fold from 13.4% in 2005 to 20.9% in 2015. </LI> <LI> The annual incidence of AF in HMC patients was about 5%, and higher in female and the elderly. </LI> <LI> The prevalence of stroke in HCM patients with AF was about 20%, which were more than twice that in overall HCM patients. </LI> <LI> The risk of AF-related stroke in HCM patients was >1% per person-year even in younger patients or low CHA<SUB>2</SUB>DS<SUB>2</SUB>­VAS<SUB>C</SUB> score. </LI> </UL> </P>

양수 다발성 수지 재접합수의 치험례 : 4 cases report

차진한,박명철,김우경,한근태,김수신,백세민 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.2

Since the first successful replantation operation, several reports have been recorded replantated finger survival with high success rates. But ten and nine digits amputations are not common. It is even more unusual to have all digits suitable for replantation. 4 cases are presented where replantation of ten and nine digits were done at the department of PRS. Guro Hospital, Korea University from March 1987 to Jun 1988. In these cases, the patients were young and healthy, all of ten and nine digits were sharply amputed near the proximal phalanx, so a replantation team of 8 surgeons in alternating fashion replanted all ten and nine digits over 30 hours and each patient received 28 pints of whole blood during the procedure. Under general anesthesia, replantatin of both started simultaneously. All digits survived completely except partial necosis of right little finger in case 1. The ischemic time of each digit ranged from 4 hours and 45 minutes to 31 hours as shown in table 5. The long ischemic time did not criticaly affected the survival of amputated digit. Follow-up was from 12 months to 20 months postoperatively. The functional evaluation revealed as follows: 1. The grasping power ranged 13 lb to 65 lb(average;39.7lb) 2. The pinching power with index finger ranged 5 lb to 15 lb(average:10.2 lb) 3. The palm to pulp distance ranged 0 cm to 6 cm.(average;2.2cm) 4. The two point discrimination ranged 2.5mm to 22mm.(average;7.8mm) 5. The shape of digits were acceptable aesthetically. 6. All 4 patients were able to use both hands well in all activities of daily living.

청소년자녀와 어머니를 위한 세대간 이해증진 프로그램 개발 및 실시

김명자,이정우,계선자,박미선,송말희,김경아,박수선,유을용,정진희 대한가정학회 2003 Human Ecology Research(HER) Vol.41 No.1

The relationship between adolescent children and parents has a profound effect on not only the adolescents development into healthy adults but also the psychological welfare of the parent. A program focused to improve adolescents relationship with parents has not been developed until now. To achieve the educational goals enhancing mutual understanding, it is more effective to educate both the parents and adolescent childern. Thus, this study developed and carried out a program in which adolescent children and mothers, being fully in charge of raising children, participated. The study analyzed the program effects after implementing on 6 pairs of adolescent children and mothers. The results are as follows: 1) adolescent children and mothers placed high values on the fact that they can understand each other well, 2) both parties accepted each other by recognizing the inevitability of the generation gap, and 3) the program gave them a chance to admit that they should try to communicate openly. Most of all, adolescent children could find self-confidence while mothers could collect valuable data essential to raise children and build a new mother's role model adapting to social changes.

숙시닐화에 따른 참깨박 농축 단백질의 성분 변화

김진아,박정륭,차명화,김진,전정례 동아시아식생활학회 1996 동아시아식생활학회지 Vol.6 No.3

Addition of 0.5, 1.0 and 2.0g of succinic anhydride to 2g of sesame protein concentrates succinylated 44.9, 70.0 and 83.1% of the available amino groups, respectively. Considerable amount of phytate were removed in all sesame protein concentrates and the highest reduction was obtained by addition of 2.0g of succinic anhydride. Among the minerals investigated, high amount of calcium and magnesium were presented in defatted sesame flour. In the case of calcium, magnesium and iron, the contents were decreased as the degree of succinylation was increased. Most amino acid content of sesame protein concentrates was not changed by succinylation but lysine was slightly decreased. Result of color measurement showed that the higher degree of succinylation, the higher values of L and b were founded.

남녀 대학생의 성역할관이 취업행동에 미치는 영향

김명자,김형진 숙명여자대학교 건강·생활과학연구소 2004 生活科學硏究誌 Vol.- No.20

The purpose of this study was to clarify the impact of gender role attitude on career-hunting activity. Moreover, this study attempts to provide basic data for career education of college students. For this purpose, the Gender Role Attitude scale and the career-hunting activity scale were administered to 500 college students in Seoul area, and 471 students data were used for final analysis. For data analysis, SPSS/PC+ was used, and also statistical methods including Cronbach'α coefficient, frequency, percentage, means score, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis were performed. The results of this study is as follows: First, the influential factors in the career-hunting activity of college students were represented as sex distinction, academic year, one's major, birth order, mother's academic background and economic status of family. Career-hunting activity is made vigorously in male, high academic year and law business departments. This means that the senior students have the more burden, and as the distribution of male students is higher in law business departments than that of female students, there is a high degree of Career-hunting activity. Second, there was a significant difference between male and female college students regarding the influence of their gender role attitude to their career-hunting activity, that is female students with modern attitude on gender role showed more active career-hunting activity. Through the above results, it can be confirmed that there is meaningful relation between the gender role attitude and career-hunting activity of male and female college students. Therefore, the importance of modern attitude on gender role is essential to inspire the preparation, for employment.

피로와 의료이용, 업무상 사고 및 질병결근

장세진,고상백,강동묵,김성아,정진주,이철갑,강명근,현숙정,조정진,차봉석,박종구 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study examined the relationship of fatigue to medical utilization, occupational accident and sickness absence. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002~2004). A total of 30,146 employees categorized within the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were recruited. A structured-questionnaire was used to assess the participants' sociodemo-graphics, job-related factors, health-related behaviors, personality trait, self=perceived fatigue (MFS) and the frequency of medical utilization, occupational accident and sickness absence. Data on medical utilization and occupational accident were confirmed from company health records. Chi-square test and logistic regression analysis were used to elucidate the relationship of self-perceived fatigue to medical utilization, occupational accident and sickness absence. Results: In logistic regression analyses, self-perceived fatigue was associated with medical utilization (outpatient), occupational accident and sickness absence although the strength of the associations was higher in the blue collar workers except for medical utilization. For medical utilization, the white collar worker's adjusted odds ratios of outpatient utilization for workers scoring in the third quartile and the highest quartile, compared to workers scoring in the lowest quartile were 1.50 (95% CI: 1.20-1.87) and 2.16 (95% CI: 1.69-2.75), respectively. The blue collar workers' adjusted odds ratios of outpatient utilization for workers scoring in the second (OR: 1.23, 95% CI: 1.06-1.43), third (OR: 1.42, 95% CI: 1.22-1.66) and highest quartile (OR:1.83, 95% CI: 1.55-2.17), respectively, compared to workers scoring in the lowest quartile were statistically significant. However, no associations were found between fatigue and inpatient utilization for either the white or blue collar workers. The blue collar workers' adjusted odds ratios of being injured for workers scoring in the second, third and highest quartile were 1.41 (95% CI: 1.00-2.00), 1.57 (95% CI: 1.10-2.22) and 2.41 (95% CI: 1.69-3.44), respectively, compared to those scoring in the lowest quartile, but, those of the white collar workers were not significant. There was more likely to an increased risk of sickness absence in workers scoring in the second, third and highest quartile compared to those scoring in the lowest quartile in both white and blue collar workers, but the magnitudes of risk were higher in the blue collar workers than the white collars workers. Conclusion: This result suggests that fatigue is a determinant predictor of medical utilization, occupational accident and sickness absence, and that the pattern of risks for the three outcomes differs according to the occupational type. Some limitations of this study and considerations for future study were also discussed.

젊은 성인에서 신체 만족도에 따른 문제해결양식, 대인관계문제와 우울증상과 자살사고와의 관련성

차승민,김태성,강문희,권명진,김정란,왕성근,지익성 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:The aim of this study was to evaluate that problem solving styles, interpersonal problems, depression and suicidal ideation according to body image satisfaction. Methods:One hundred and nineteen young healthy normal subjects filled out administered the Body Dysmorphic Disorder Examination-Self Report (Korean version of BDDE-SR K-BDDE-SR), Problem Solving Style Scale(Korean version PSS), Korean Inventory of Interpersonal Problem(KIIP), Korean version of the Depression Anxiety Stress Scale(KDASS-21), Korean version of Beck Scale for Suicidal Ideation(Korean version SSI) and Korean version of Reynolds Suicidal Ideation Questionnaire(Korean version SIQ) for a month. Results:Out of the 119 subjects, 39%(N=46) was male and 61%(N=73) was female. In high K-BDDE-SR group (higher than 67), helplessness was significantly higher than low K-BDDE-SR group(lower than 67), and problem-solving confidence, creative style, approach style were significantly lower than low K-BDDE-SR group. Also, Higher level of all KIIP factors in High K-BDDE-SR group was significantly differ than low K-BDDE-SR group. In High K-BDDE-SR group, K-DASS-21, SSI, and SIQ were significantly higher than low K-BDDE-SR group. Using multiple regression analysis contributing variance toward the total factor score of K-BDDE-SR of participants were K-DASS-21 and SIQ. Conclusion:Our results indicates that high tendency of dissatisfied body images have differences in helplessness, problem-solving confidence, approach style, interpersonal problems, depression and suicidal ideation compared to low tendency of dissatisfied body images. It is necessary to study body dysmorphic disorder patients group in the future.

일부 생산직 근로자의 소음과 사회심리적 요인이 혈압에 미치는 영향

박종구,강명근,차봉석,고상열,장세진,고상백 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.2

This study was conducted to assess the effects of noise exposure and psychosocial factor on blood pressure in manufacturing workers. The study subjects are 414 workers(243 males, 171 females) employed at the noisy department. The mean age of low exposed group(<85dB) was 34.65±9.53 years, and that of high exposed group(≥85dB) was 36.37±11.15 years. The difference in mean age was not significant. The mean and distribution of working duration, smoking status, drinking status were not significantly different between two groups. The mean systolic blood pressure of the low exposed group was 120.01±12.06 mmHg, and that of high exposed group was 126.27±13.84mmHg. The mean diastolic blood pressure of the low exposed and the high exposed group were 77.18±10.83 mmHg, and 83.46±11.22mmHg respectively. These differences of blood pressure were statistically significant(p<0.05). The workers in noisy department have significantly less work environmental satisfaction, higher job demand, and higher social support. The mean values of psychosocial distress were higher in the workers of the noisy department, but the difference was not statistically significant. This study was to speculate whether the work environmental satisfaction and social support modify the association between the noise exposure level and the blood pressure. The result showed that work environmental satisfaction could not modify the association between the blood pressure and the noise exposure. Social support at work did not modify the association. Furthermore, we evaluated the high job strain from a combination of ratio of the high job strain group for hypertension in diastolic blood pressure were statistically significant, but not in systolic blood pressure. Hierarchical multiple regression analysis was used to determine whither the independent variables contributed to explaining the blood pressure. After controlling for possible confounders, we found that the noise exposure level was a correlated of the diastolic blood pressure. But no association between the noise exposure level and the systolic blood pressure. No significant result was found for psychosocial factor.