Trends in Avoidable Death over 20 Years in Korea

To evaluate the achievement of health care services in Korea independent of other socioeconomic factors, we observed the time trend of avoidable death between 1983 and 2004. A list of avoidable causes of death was constructed based on the European Community Atlas of "Avoidable Death". We calculated sex- and age-standardized mortality rates of Korean aged 1-64 yr using data of the Korea National Statistical Office. The avoidable mortality rate (per 100,000 persons) decreased from 225 to 84 in men and from 122 to 41 in women. Accordingly, the proportion of avoidable deaths among all classifiable deaths was reduced by 8.1% in men and 6.4% in women. However, mortality rates from some preventable causes such as ischemic heart disease and malignant neoplasms of lung, breast, cervix, and colorectum have been on the rise. Mortality preventable by appropriate medical care showed the greatest reduction (by 77.8%), while the mortality preventable by primary prevention showed the least reduction (by 50.0%). These findings suggest that health care service has significantly contributed to the improvement of health in Korea. However, more effective intervention programs would be needed given the less reduction in mortality avoidable by primary or secondary prevention than expected and unexpectedly increasing mortality from several preventable causes

Effect of young exosomes injected in aged mice

Introduction: Exosomes, nano-sized extracellular vesicles, are known to circulate through the blood stream to transfer molecular signals from tissue to tissue. Methods: To determine whether exosomes affect aging in animals, we primarily identified the changes in exosomal miRNA contents during the aging process. In exosomes from 12-month-old mice, mmu-miR-126-5p and mmu-miR-466c-5p levels were decreased and mmu-miR-184-3p and mmu-miR-200b-5p levels were increased significantly compared with those of 3-month-old mice. Their levels in exosomes were partially correlated with those in tissues: levels of only mmu-miR-126-5p and mmu-miR-466c-5p in lungs and/or liver were decreased, but those of mmu-miR-184-3p and mmu-miR-200b-5p in tissues did not coincide with those of exosomes. Results and discussion: In the aged tissues injected with young exosomes isolated from serum, mmu-miR-126b-5p levels were reversed in the lungs and liver. Expression changes in aging-associated molecules in young exosome-injected mice were obvious: p16(Ink4A), MTOR, and IGF1R were significantly downregulated in the lungs and/or liver of old mice. In addition, telomerase-related genes such as Men1, Mre11a, Tep1, Terf2, Tert, and Tnks were significantly upregulated in the liver of old mice after injection of young exosomes. Conclusion: These results indicate that exosomes from young mice could reverse the expression pattern of aging-associated molecules in aged mice. Eventually, exosomes may be used as a novel approach for the treatment and diagnosis of aging animals.1

Low-density lipoprotein cholesterol goal attainment rates in high-risk patients with cardiovascular diseases and diabetes mellitus in Korea: a retrospective cohort study

Background Real-world evidence of low-density lipoprotein cholesterol (LDL-C) goal attainment rates for Asian patients is deficient. The objective of this study was to assess the status of dyslipidemia management, especially in high-risk patients with cardiovascular disease (CVD) including stroke and acute coronary syndrome (ACS). Methods This was a retrospective cohort study of 514,866 subjects from the National Health Insurance Service-National Health Screening Cohort database in Korea. Participants were followed up from 2002 to 2015. Subjects with a high-risk of CVD prior to LDL-C measurement and subjects who were newly-diagnosed for high-risk of CVD following LDL-C measurement were defined as known high-risk patients (n = 224,837) and newly defined high-risk patients (n = 127,559), respectively. Data were analyzed by disease status: stroke, ACS, coronary heart disease (CHD), peripheral artery disease (PAD), diabetes mellitus (DM) and atherosclerotic artery disease (AAD). Results Overall, less than 50% of patients in each disease category achieved LDL-C goals (LDL-C < 70 mg/dL in patients with stroke, ACS, CHD and PAD; and LDL-C < 100 mg/dL in patients with DM and AAD). Statin use was observed in relatively low proportions of subjects (21.5% [known high-risk], 34.4% [newly defined high-risk]). LDL-C goal attainment from 2009 to 2015 steadily increased but the goal-achiever proportion of newly defined high-risk patients with ACS remained reasonably constant (38.7% in 2009; 38.1% in 2015). Conclusions LDL-C goal attainment rates in high-risk patients with CVD and DM in Korea demonstrate unmet medical needs. Proactive management is necessary to bridge the gap between the recommendations of clinical guidelines and actual clinical practice.This study was supported by a research grant from Amgen, Inc

Establishment of Passive Energy Conservation Measure and Economic Evaluation of Fenestration System in Nonresidential Building of Korea

ECO2 (building energy efficiency rating program) and passive energy conservation measures (ECMs) were established as a basic study for targeted methodologies and decision support systems development in Korea to meet national regulations. The primary energy consumption and economic evaluation of nonresidential buildings was performed. Passive ECMs were classified as planning and performance elements. The planning elements are the window-to-wall ratio (WWR) and horizontal shading angle. The performance elements are the thermal transmittance (U-value) of the walls, roof, and floor and the U-value and solar heat gain coefficient (SHGC) of windows. This study focused on the window-to-wall ratio and the U-value and solar heat gain coefficient of windows. An economic efficiency database for the constructed alternatives was built; the target building was set and the Passive ECM List for the target building was derived. The energy consumption evaluation and economic evaluation were performed for each of the constructed alternatives, and a methodology for guiding energy efficiency decisions was proposed based on the performance evaluation results, and the optimal Passive ECM List for the target building was derived

Incidental Diagnosis of the Unicuspid Aortic Valve with Ascending Aortic Aneurysm in an Asymptomatic Adult

The unicuspid aortic valve is an extremely rare congenital anomaly. It usually presents with aortic stenosis and/or aortic regurgitation. Other cardiovascular complications, such as aortic dilatation and left ventricular hypertrophy can accompany it. Herein, we present a case report of a 50-year-old asymptomatic male patient with unicuspid aortic valve, complicated by ascending aortic aneurysm

Preliminary Experience of Amnioinfusion

Oligohydramnios is considered as one of the major obstetrical dilemmas for the multiple serious complications associated with the condition. The condition hampers an appropriate ultrasonographic evaluation of the fetal anatomy and frequently causes variable fetal heart rate decelerations by compressing the fetal cord, often to incur irreversible damage to the fetus. Based on precedent reports regarding the effect of amnioinfusion in managing oligohydramnios-complicated pregnancies, we report here our experience of amnioinfusion in 8 cases complicated by oligohydramnios which we have experienced from November of 1990 to May of 1993 at Seoul National University Hospital(SNUH). The procedure was applied largely for three purposes, viz., diagnostic(3cases), therapeutic (4cases), and prophylactic(lcase) with favorable results. We concluded that amnioinfusion can be of important use in the detection of fetal anomalies, relief of abnormal fetal heart rate pattern, and prevention of intrapartum fetal complications