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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.
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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.
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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.
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Kim Hack-Lyoung,Park Sang Min,Cho In-Jeong,Kim Yu-Mi,Kim Dae-Hee,Sung Hye Kim,김광일,성기철,임상현,Shin Jinho,Yoonjung Kim,Kyungwon Oh,Lee Eun Mi 대한고혈압학회 2023 Clinical Hypertension Vol.29 No.-
Accurate blood pressure (BP) measurement is crucial for hypertension detection and management. The Korea National Health and Nutrition Examination Survey (KNHANES) assesses the health of Koreans using representative cross-sectional data. BP measurements were historically done with mercury sphygmomanometers for participants aged ≥10 years. However, KNHANES transitioned to Greenlight 300TM (mercury-free auscultatory device) in 2020 for participants aged ≥6 years and used dual devices (Microlife WatchBP Office AFIB and Greenlight) in 2021-2022. To ensure consistency, KNHANES will adopt Microlife as the unified BP device with Greenlight for device validation from 2023. Under the new protocol, participants aged ≥6 years will have their BP measured three times at 30-second intervals after a 5-minute rest under ambient temperature (20-25℃) and noise ≤65 dB. The average of the 2nd and 3rd readings will be used as the representative BP value. The quality control (QC) program involves four trained examiners passing the “quality control and assurance of BP measurement program” three times annually, and undergoing “video monitoring of weekly calibration process” once a year. Additionally, the QC team will conduct “on-site evaluations of BP measurement” at mobile examination centers three times a year. A Five-Step QC process for BP devices was also developed. This document outlines the standardized BP measurement protocol and rigorous QC program in KNHANES, aiming to ensure accurate and reliable BP data for epidemiological research and public health policymaking in South Korea.
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Sex differences in coronary atherogenesis: a narrative review
Hack-Lyoung Kim Ewha Womans University School of Medicine 2024 EMJ (Ewha medical journal) Vol.47 No.2
Coronary artery disease (CAD) remains the leading cause of mortality worldwide, driven primarily by atherogenesis. Recent efforts to understand sex differences in CAD have revealed distinct patterns in disease burden, risk factors, and clinical presentations. This review examines these sex differences in CAD, underscoring the importance of customized diagnostic and management strategies. Although men typically have higher rates of CAD prevalence and incidence, women face unique challenges, such as delayed diagnosis, atypical symptoms, and lower rates of medication prescription. Hormonal, genetic, and lifestyle factors all play a role in these disparities, with estrogen notably reducing CAD risk in women. Nontraditional risk factors, including chronic inflammation, psychological stress, socioeconomic status, and reproductive history, also contribute to CAD development and are often neglected in clinical settings. Addressing these differences requires increased awareness, more accurate diagnosis, and equitable healthcare access for both sexes. Furthermore, greater inclusion of women in CAD research is essential to better understand sex-specific mechanisms and optimize treatment outcomes. Personalizing CAD management based on sex-specific knowledge has the potential to improve prognosis and decrease disease incidence for both men and women.
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Kim Hack-Lyoung,김명아,Oh Sohee,Choi Dong-Ju,Han Seongwoo,전은석,조명찬,김재중,Yoo Byung-Su,신미승,Kang Seok Min,채성철,유규형 대한심부전학회 2020 International Journal of Heart Failure Vol.2 No.1
Background and Objectives Although an inverse correlation between the level of amino (N)-terminal pro-brain natriuretic peptide (NT-proBNP) and body mass index (BMI) has been reported, the impact of BMI on the prognostic value of NT-proBNP has not been well addressed. Methods A total of 1,877 patients (67-year-old and 49.9% females) hospitalized for acute heart failure (HF) with documented NT-proBNP levels at baseline were included. Patients were classified into 2 groups by BMI (nonobese: BMI<23 kg/m2 and overweight or obese: BMI≥23 kg/m2). Clinical events during the follow-up including all-cause mortality and HF readmission were assessed. Results During the median follow-up of 828 days (interquartile range, 111–1,514 days), there were 595 cases of total mortality (31.7%), 600 cases of HF readmission (32.0%), and 934 cases of composite events (49.8%). In unadjusted analyses, higher NT-proBNP level was associated with all-cause mortality and composite events (all-cause mortality and HF readmission) in both patients with BMI<23 kg/m2 and those with BMI≥23 kg/m2. In adjusted analyses controlling for potential confounders, however, a higher NT-proBNP level was associated with all-cause mortality and composite events in patients with BMI<23 kg/m2, but not in those with BMI≥23 kg/m2. Conclusions The prognostic value of NT-proBNP was more significant in nonobese patients than in overweight and obese patients in this HF population. BMI should be considered when NT-proBNP is used for risk estimation in HF patients. Background and Objectives Although an inverse correlation between the level of amino (N)-terminal pro-brain natriuretic peptide (NT-proBNP) and body mass index (BMI) has been reported, the impact of BMI on the prognostic value of NT-proBNP has not been well addressed. Methods A total of 1,877 patients (67-year-old and 49.9% females) hospitalized for acute heart failure (HF) with documented NT-proBNP levels at baseline were included. Patients were classified into 2 groups by BMI (nonobese: BMI<23 kg/m2 and overweight or obese: BMI≥23 kg/m2). Clinical events during the follow-up including all-cause mortality and HF readmission were assessed. Results During the median follow-up of 828 days (interquartile range, 111–1,514 days), there were 595 cases of total mortality (31.7%), 600 cases of HF readmission (32.0%), and 934 cases of composite events (49.8%). In unadjusted analyses, higher NT-proBNP level was associated with all-cause mortality and composite events (all-cause mortality and HF readmission) in both patients with BMI<23 kg/m2 and those with BMI≥23 kg/m2. In adjusted analyses controlling for potential confounders, however, a higher NT-proBNP level was associated with all-cause mortality and composite events in patients with BMI<23 kg/m2, but not in those with BMI≥23 kg/m2. Conclusions The prognostic value of NT-proBNP was more significant in nonobese patients than in overweight and obese patients in this HF population. BMI should be considered when NT-proBNP is used for risk estimation in HF patients.
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Kim Ue-Hwan,Kim Moon Young,Park Eun-Ah,Lee Whal,Lim Woo-Hyun,Kim Hack-Lyoung,Oh Sohee,Jin Kwang Nam 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.11
Objective: With the recent development of various MRI-conditional cardiac implantable electronic devices (CIEDs), the accurate identification and characterization of CIEDs have become critical when performing MRI in patients with CIEDs. We aimed to develop and evaluate a deep learning-based algorithm (DLA) that performs the detection and characterization of parameters, including MRI safety, of CIEDs on chest radiograph (CR) in a single step and compare its performance with other related algorithms that were recently developed. Materials and Methods: We developed a DLA (X-ray CIED identification [XCID]) using 9912 CRs of 958 patients with 968 CIEDs comprising 26 model groups from 4 manufacturers obtained between 2014 and 2019 from one hospital. The performance of XCID was tested with an external dataset consisting of 2122 CRs obtained from a different hospital and compared with the performance of two other related algorithms recently reported, including PacemakerID (PID) and Pacemaker identification with neural networks (PPMnn). Results: The overall accuracies of XCID for the manufacturer classification, model group identification, and MRI safety characterization using the internal test dataset were 99.7% (992/995), 97.2% (967/995), and 98.9% (984/995), respectively. These were 95.8% (2033/2122), 85.4% (1813/2122), and 92.2% (1956/2122), respectively, with the external test dataset. In the comparative study, the accuracy for the manufacturer classification was 95.0% (152/160) for XCID and 91.3% for PPMnn (146/160), which was significantly higher than that for PID (80.0%,128/160; p < 0.001 for both). XCID demonstrated a higher accuracy (88.1%; 141/160) than PPMnn (80.0%; 128/160) in identifying model groups (p < 0.001). Conclusion: The remarkable and consistent performance of XCID suggests its applicability for detection, manufacturer and model identification, as well as MRI safety characterization of CIED on CRs. Further studies are warranted to guarantee the safe use of XCID in clinical practice.
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Kim Hack-Lyoung,Park So-Jeong,Bae Yoon-Jong,Ihm Sang Hyun,Shin Jinho,Kim Kwang-il 대한고혈압학회 2024 Clinical Hypertension Vol.30 No.-
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.
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