Won Hah Park

Sungkyunkwan University, Sŏul, Seoul, South Korea

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Publications (29)77.95 Total impact

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    ABSTRACT: The aim of this study was to test the hypothesis that blood pressure (BP) increase before exercise stress testing is associated with the incidence of hypertension in a prospective study of 3,805 normotensive men without hypertension at baseline. Changes in BP were defined as the difference between seated BP at rest and BP measured immediately before exercise stress testing. Hypertension was defined as systolic and diastolic BP ≥140/90 mm Hg or hypertension diagnosed by a physician at the second examination. During 18,923 patient-years of follow-up, 371 new cases of hypertension developed (incidence rate 19.6 per 1,000 patient-years). Men with systolic BP changes >0 mm Hg and diastolic BP changes >7 mm Hg had 1.70 times (95% confidence interval [CI] 1.37 to 2.12) and 2.23 times (95% CI 1.76 to 2.82) increased relative risk for incident hypertension compared with men whose systolic BP changes were <0 mm Hg and diastolic BP changes were <7 mm Hg after adjustment for confounders. Men in the highest quartile of mean BP change (>10 mm Hg) had a higher incidence of hypertension (relative risk 2.98, 95% CI 2.19 to 4.06) compared with those in the lowest quartile (<0 mm Hg), and each 1 mm Hg increment in mean BP was associated with a 6% (95% CI 1.05 to 1.09) higher incidence of hypertension after adjustment for risk factors. In conclusion, BP increase before exercise stress testing is associated with incident hypertension, independent of risk factors in normotensive men. The assessment of BP immediately before exercise testing may be a useful addition to the standard exercise stress testing procedures.
    The American journal of cardiology. 07/2014;
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    Won Hah Park, Yong Gon Seo, Ji Dong Sung
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    ABSTRACT: A left ventricular assist device (LVAD) is a mechanical circulation support implanted for patients with end-stage heart failure. It may be used either as a bridge to cardiac transplantation or as a destination therapy. The health of a 75-year-old man with a medical history of systolic heart failure worsened. Therefore, he was recommended to have implanted a LVAD (Thoratec Corp.) as a destination therapy. After the surgery, he was enrolled in patient cardiac rehabilitation for the improvement of dyspnea and exercise capacity. In results, there is an improvement on his exercise capacity and quality of life. For the first time in Korea, we reported a benefit of exercise therapy after being implanted with a LVAD.
    Annals of rehabilitation medicine. 06/2014; 38(3):396-400.
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    ABSTRACT: BACKGROUND:One of the goals of rotator cuff repair is to restore the torn tendon to its original insertion anatomically. However, it is sometimes difficult to restore the entire footprint. PURPOSE:This study was undertaken to evaluate the variables affecting this repair coverage and to discern the differences in retear rate and clinical results between complete and incomplete footprint coverage in rotator cuff surgery. STUDY DESIGN:Case series; Level of evidence, 4. METHODS:From 2007 to 2009, a total of 85 consecutive repairs for medium-to-large rotator cuff tears were identified as having complete or incomplete coverage of their original footprints. We defined the complete footprint coverage (CC) group as patients who had >50% of their footprint covered during repair and the incomplete (IC) group as <50% of their footprint. Factors affecting the amount of footprint coverage were evaluated, and multivariable analysis was conducted to identify independent factors. To assess the final outcome according to the amount of footprint coverage, retear and clinical outcomes were compared between the CC and IC groups. RESULTS:Fifty-seven repairs were defined in the CC group and 28 repairs in the IC group. Preoperatively, age, tear size in coronal oblique and sagittal oblique planes, Goutallier fatty infiltration, and atrophy of the supraspinatus affected the amount of footprint coverage in univariate analysis. In multivariable analysis, however, tear size in the coronal plane was the only independent factor affecting footprint coverage in rotator cuff repair. On postoperative MRI, 45.6% of the CC group had an intact tendon, 45.6% had a delaminated partial retear, and 8.8% had a full-thickness retear; in the IC group, 17.9% had an intact tendon, 60.7% had a delaminated partial retear, and 21.4% had a full-thickness retear. There was a statistically significant difference in the proportion of tendon integrity between groups (P = .028). Clinical scores and range of motion at final follow-up showed no difference between the 2 groups. CONCLUSION:Tear size in the coronal plane was the only independent factor affecting the amount of footprint coverage. Repair quality based on retear classification was different between the 2 groups. However, both complete and incomplete footprint coverage in rotator cuff repair showed no differences in clinical scores and range of motion at short-term follow-up.
    The American journal of sports medicine 02/2014; · 3.61 Impact Factor
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    ABSTRACT: Abstract This study investigated the relationship of cardiorespiratory fitness (CRF) with incident metabolic syndrome in 810 middle aged Korean men. All subjects were free of metabolic syndrome at baseline examination. The metabolic syndrome was defined by NCEP criteria and CRF was directly measured by peak oxygen uptake during a treadmill test. During an average of 3.3 years of follow-up, 155 (19.1%) men developed the metabolic syndrome. The incidence of metabolic syndrome was inversely associated with CRF quartiles (p < 0.05). The relative risk (RR) of incident metabolic syndrome in the lowest CRF quartile vs the highest CRF quartile was 1.67 (95% CI = 1.07-2.60) after adjustment for covariates. Each metabolic equivalent (MET) increment in peak oxygen consumption was associated with a 17% (RR = 0.83, 95% CI = 0.73-0.94) lower incidence of metabolic syndrome. These results demonstrate that cardiorespiratory fitness was associated with the incidence of metabolic syndrome independent of covariates in middle aged Korean men.
    Annals of Human Biology 11/2013; · 1.48 Impact Factor
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    ABSTRACT: The aims of this study were to evaluate the incidence of anchor penetration of the far cortex of the glenoid neck after arthroscopic Bankart repair and to compare the biomechanical properties of anchors in the 4- and 5:30- to 6-o'clock positions on the glenoid. Twelve (6 matched pairs) fresh-frozen human cadaveric shoulders were used to simulate arthroscopic Bankart repair in the lateral decubitus position. The most inferior anchor (5:30 to 6 o'clock) and that above it (4 o'clock) were inserted via the anteroinferior portal on the glenoid using the standard technique. After both anchor insertions, anchor perforation of the glenoid far cortex was identified. Biomechanical properties were measured to determine cyclic displacement of anchors at 100 and 500 cycles, stiffness, yield load, and ultimate failure strength. All 12 suture anchors (100%) at 5:30 to 6 o'clock penetrated throughout the far cortex, whereas only 4 anchors (33%) at 4 o'clock did so (P = .005). The mean distance the anchor tip traveled into far cortex was significantly longer at 5:30 to 6 o'clock than at 4 o'clock (6.8 ± 1.6 mm v 2.0 ± 1.6 mm, P = .001). In terms of mechanical strength, anchors at 5:30 to 6 o'clock had greater 100- and 500-cycle mean displacements than those at 4 o'clock (3.0 ± 0.5 mm v 2.5 ± 0.3 mm, P = .018 for 100 cycles; 3.5 ± 0.7 mm v 2.8 ± 0.3 mm, P = .018 for 500 cycles), although no differences in ultimate failure strength after cyclic loading were found between 2 positions (133.4 ± 40.3 and 133.7 ± 29.2 N, respectively; P = .985). For arthroscopic Bankart repair, insertion of the most inferior anchor via the anteroinferior portal with standard technique, in the lateral decubitus position, carries a high risk of perforating the inferior far cortex of the glenoid (100% in our study). This may result in mechanical weakness of the most inferior repair specifically in the early postoperative period. Perforation of the glenoid far cortex by the most inferior anchor and its mechanical weakness should be taken into consideration. Further study is needed to improve surgical technique to place the most inferior anchor in an optimal position by arthroscopy.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 01/2013; 29(1):31-6. · 3.10 Impact Factor
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    ABSTRACT: Hypothesis Needle lavage is frequently performed before consideration of surgical removal in shoulders with calcific tendinitis because this may avoid surgery. However, its role in nonoperative treatment has not been fully investigated in terms of clinical and radiographic response. We hypothesized that needle decompression and subacromial steroid injection would show good clinical results in chronic calcific tendinitis patients. Materials and methods Thirty-five shoulders in 30 consecutive patients with painful calcific tendinitis were treated by ultrasound-guided needle decompression and subacromial corticosteroid injection. Patients were prospectively evaluated using American Shoulder and Elbow Surgeons (ASES) and Constant scores at 1, 3, and 6 months after the intervention. Size and morphology of the calcific deposits were compared with those in baseline radiographs at each visit. Results At 6 months after the index procedure, 25 shoulders (71.4%) showed ASES and Constant score improvements from 48.0 and 53.7 to 84.6 and 87.9, respectively (P < .01). Ten shoulders (28.6%) showed no symptom relief at the last follow-up. In shoulders with pain improvement, the mean size of calcific deposits reduced from 13.6 to 5.6 mm (P < .01), and in shoulders with no pain improvement or that underwent operation, mean size was 13.1 mm at initial visits and 12.7 mm at final visits (P = .75). Discussion Shoulders showing little evidence of deposit size reduction at 6 months after needle decompression are less likely to achieve symptomatic improvement and may be considered as candidates for surgical removal. Conclusion Needle decompression with subacromial steroid injection is effective in 71.4% of calcific tendinitis within 6 months. The size of calcific deposits in patients that achieved symptom relief was reduced.
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    ABSTRACT: Low-cardiorespiratory fitness (CRF) has been associated with incident hypertension, but whether temporal changes in CRF are associated with incident hypertension in initially normotensive subjects are not known. We investigated the relationship of baseline CRF and longitudinal changes in CRF with incident hypertension in initially normotensive subjects. Subjects were 3,831 men who participated in two health examinations during 1998-2009. All subjects were free of cardiovascular diseases and hypertension at baseline. CRF was directly measured by peak oxygen uptake using expired gas analysis during a standard treadmill test. During an average of 5 years of follow-up, 373 (9.7%) subjects developed hypertension. The incidence of hypertension was inversely associated with baseline CRF quartiles [Q1 (lowest) 11.8%, Q2 10.4%, Q3 9.1%, and Q4 (highest) 7.5%; P < 0.05 for trend]. The relative risk (RR) of incident hypertension in the lowest CRF quartile versus the highest CRF quartile was 1.69 (95% CI: 1.22-2.34) after adjustment for risk factors. Each metabolic equivalent increment higher peak oxygen uptake at baseline examination was associated with 10% (RR 0.90, 95% CI: 0.83-0.98) lower incidence of hypertension in multivariate adjusted model. Subjects whose CRF decreased (<-1.18 ml/kg/min per year) over time had a 72% increased risk in developing hypertension (RR 1.72, 95% CI: 1.20-2.49) compared to subjects with increased CRF (>0.13 ml/kg/min per year) after adjustment for risk factors. These results demonstrate that both baseline CRF levels and changes in CRF over time were associated with the incidence of hypertension independent of risk factors. Am. J. Hum. Biol. 2012. © 2012 Wiley Periodicals, Inc.
    American Journal of Human Biology 09/2012; 24(6):763-7. · 2.34 Impact Factor
  • Journal of Musculoskeletal Pain 05/2012; 20(2). · 0.33 Impact Factor
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    ABSTRACT: Arterial stiffness is increased in hypertension, even at an earlier stage. The blood pressure (BP) response to exercise reflects the future risk of developing hypertension. We investigated the relationship between the pulse wave velocity (PWV) and the BP response to exercise to evaluate whether arterial stiffness is increased in normotensive persons with higher exercise BPs. The participants of the study were adults with normal BP (SBP < 120 mmHg and DBP < 80 mmHg) without history of clinical cardiovascular diseases, who had undergone health screening. Treadmill exercise tests were done by modified Bruce protocol, and brachial-ankle PWV (baPWV) was measured. The participants were 2156 men and women (69 : 31%) with mean age of 52 ± 5 years. The baPWV correlated significantly to variables such as age, sex, baseline SBP and DBP, pulse pressure, maximal oxygen consumption (VO(2max)), SBP at stage 1, at stage 2 and peak exercise and hemoglobin A1c (HbA1c). In multiple regression model, SBP at stage 1 had a significant association with baPWV after an adjustment with age, sex, VO(2max) and SBP at rest, current smoking and HbA1c. For every 10 mmHg increase in exercise SBP, baPWV increased by 18 ± 0.3 cm/s (P < 0.001). In normotensive individuals, increased arterial stiffness, as reflected by baPWV, is accompanied by higher SBP at the early stage of treadmill exercise test. This finding suggests that arterial stiffening processes are present even in the normotensive setting and are correlated with BP changes during exercise.
    Journal of Hypertension 03/2012; 30(3):587-91. · 4.22 Impact Factor
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    ABSTRACT: We tested the hypothesis that high cardiorespiratory fitness (fitness) is associated with lower levels of arterial stiffness in 1035 (age 52 ± 6 years) men with and without the metabolic syndrome. Arterial stiffness was derived from brachial-ankle pulse wave velocity (baPWV). Fitness was directly measured by peak oxygen uptake during a standard treadmill test. Men with the metabolic syndrome (n = 168) had significantly higher baPWV than men without the metabolic syndrome (1424 ± 175 cm/s vs. 1333 ± 150 cm/s, p < 0.05). When separated according to quartiles of fitness, men with and without the metabolic syndrome in the highest quartile of fitness had significantly lower baPWV compared to men in the lowest quartile of fitness (p < 0.05). Fitness was inversely correlated with baPWV in men with (p = -0.29, p < 0.05) and without the metabolic syndrome (p = -0.22, p < 0.05). There was no differences in baPWV levels between fit men with the metabolic syndrome and unfit men without the metabolic syndrome (fit/MetS; 1366 ± 140 vs. unfit/no MetS; 1401 ± 194 cm/s, p = 0.81). These results demonstrate that high fitness is inversely associated with arterial stiffness in men with and without the metabolic syndrome. Increased arterial stiffness in the metabolic syndrome is attenuated by high fitness.
    Diabetes research and clinical practice 10/2010; 90(3):326-32. · 2.74 Impact Factor
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    ABSTRACT: Although suprascapular nerve injury after SLAP (superior labrum anterior to posterior) repair has rarely been reported, the direction of anchor insertion is toward the suprascapular nerve. The purpose of this study was to evaluate the risk of suprascapular nerve injury during the drilling and anchor insertion for anterior SLAP repair. Twelve cadaveric shoulders were mounted in a lateral decubitus position (to mimic actual surgery) and 1 suture anchor for anterior SLAP repair was inserted arthroscopically from the anterior portal at 00:30-1:00 o'clock in right shoulders (11-11:30 in left). Then, cadaveric shoulders were dissected to determine the pathway of suprascapular nerve, the location of suture anchor, and anchor perforation of the glenoid wall. Distances from suprascapular nerve to suture anchor tips (which perforated medial cortex of glenoid)-that is, nerve-anchor interval (NAI)--were measured. Glenoid widths and heights were also measured to evaluate the correlation between glenoid areas and NAI. Depth of drilling was also determined. All suture anchors perforated the glenoid wall. Mean drill depth was 14.2 (±2.8) mm and mean NAI was 3.1 (±2.7) mm. In 4 shoulders, suture anchor tips contacted the suprascapular nerve. The mean height of the glenoid surface was 30.0 mm (±2.5), its mean width was 22.9 mm (±1.9), and its mean area was 2164.3 mm(2) (±334.1). No correlation was found between glenoid areas and NAI (P = .277). Suprascapular nerve lies very close to drilling sites and suture anchors during arthroscopic anterior SLAP repair. The present study cautions that care should be taken when anterior anchors are being inserted.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 10/2010; 20(2):245-50. · 1.93 Impact Factor
  • Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 04/2010; 19(4):e19-23. · 1.93 Impact Factor
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    ABSTRACT: Relatively large calcific materials on radiographs of shoulders with persistent symptoms after extended periods of conservative treatment are candidates for operative treatment. But complete removal of calcific materials sometimes leaves a large defect in the rotator cuff tendon, and tendon repair might be essential if defects are large. We evaluated the clinical results of complete removal of calcific deposits with or without repair of the rotator cuff tendon in 35 consecutive patients. Eighteen patients underwent calcific material removal, which resulted in a complete tear in the rotator cuff tendon, and suture anchor repair. And the other 17 patients received either side-to-side repair or simple debridement. Clinical outcomes improved at a median 31 (range 24-45) months after surgery, and pain relief was achieved within 6 months of surgery in 30 of 35. However, ten patients developed a secondary stiff shoulder. Repair with or without suture anchor after complete removal of calcific material provides good clinical results and earlier pain relief when it was compared to previous literatures of minimal removal technique.
    Knee Surgery Sports Traumatology Arthroscopy 02/2010; 18(12):1694-9. · 2.68 Impact Factor
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    ABSTRACT: Needle lavage is frequently performed before consideration of surgical removal in shoulders with calcific tendinitis because this may avoid surgery. However, its role in nonoperative treatment has not been fully investigated in terms of clinical and radiographic response. We hypothesized that needle decompression and subacromial steroid injection would show good clinical results in chronic calcific tendinitis patients. Thirty-five shoulders in 30 consecutive patients with painful calcific tendinitis were treated by ultrasound-guided needle decompression and subacromial corticosteroid injection. Patients were prospectively evaluated using American Shoulder and Elbow Surgeons (ASES) and Constant scores at 1, 3, and 6 months after the intervention. Size and morphology of the calcific deposits were compared with those in baseline radiographs at each visit. At 6 months after the index procedure, 25 shoulders (71.4%) showed ASES and Constant score improvements from 48.0 and 53.7 to 84.6 and 87.9, respectively (P < .01). Ten shoulders (28.6%) showed no symptom relief at the last follow-up. In shoulders with pain improvement, the mean size of calcific deposits reduced from 13.6 to 5.6 mm (P < .01), and in shoulders with no pain improvement or that underwent operation, mean size was 13.1 mm at initial visits and 12.7 mm at final visits (P = .75). Shoulders showing little evidence of deposit size reduction at 6 months after needle decompression are less likely to achieve symptomatic improvement and may be considered as candidates for surgical removal. Needle decompression with subacromial steroid injection is effective in 71.4% of calcific tendinitis within 6 months. The size of calcific deposits in patients that achieved symptom relief was reduced.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 12/2009; 19(4):596-600. · 1.93 Impact Factor
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    ABSTRACT: Although studies have shown an inverse association between cardiorespiratory fitness (CRF) and C-reactive protein (CRP) levels, the underlying mechanisms are not fully understood. There is emerging evidence that autonomic nervous system function is related to CRP levels. Because high CRF is related to improved autonomic function, we hypothesized that the association between high CRF and low CRP levels would be affected by autonomic nervous system function. Cross-sectional analyses were conducted on 2,456 asymptomatic men who participated in a medical screening program. Fasting blood samples for cardiovascular disease risk factors were analyzed, and CRF was measured by maximal exercise treadmill test with expired gas analysis. We used an index of cardiac autonomic imbalance defined as the ratio of resting heart rate to 1 min of heart rate recovery after exercise (RHR/HRR). CRF was significantly correlated with CRP (r = -0.16, P < 0.05), and RHR/HRR (r = -0.48, P < 0.05), while RHR/HRR was significantly correlated with CRP (r = 0.25, P < 0.05). In multivariable linear regression models that adjusted for age, body mass index, smoking, disease status, medications, lipid profiles, glucose, and systolic blood pressure, CRF was inversely associated with CRP (beta = -0.09, P < 0.05). However, this relationship was no longer significant after adjusting for RHR/HRR in a multivariable linear regression model (beta = -0.03, P = 0.29). These results suggest that autonomic nervous system function significantly affects the relationship between CRF and inflammation in middle-aged men. Thus, physical activity or exercise training may favorably affect the cholinergic antiinflammatory pathway, but additional research is needed to confirm this finding.
    Molecular Medicine 07/2009; 15(9-10):291-6. · 4.47 Impact Factor
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    ABSTRACT: We tested that slow heart rate recovery (HRR) after exercise testing, indicative of decreased parasympathetic nervous system activity, is associated with the development of type 2 diabetes in 1,813 healthy men. Heart rate recovery was calculated as the difference between maximum heart rate during the exercise test and heart rate 1 min after cessation of the exercise test. During an average of 6.4 years of follow-up, 64 (3.5%) subjects developed type 2 diabetes. The unadjusted relative risk (RR) of developing incident diabetes in the slowest versus the fastest HRR quartile was 3.13 (95% CI, 1.28-7.65). However, the association was no longer significant after adjustment for diabetes risk factors and baseline glucose (RR = 2.28, 95% CI, 0.87-5.95). Slow HRR is associated with the development of type 2 diabetes, but these relationships were largely explained by baseline fasting glucose in healthy men.
    Clinical Autonomic Research 05/2009; 19(3):189-92. · 1.48 Impact Factor
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    ABSTRACT: Increased inflammation, fibrinolytic factors, and lipoprotein(a) (LP[a]) were associated with increased cardiovascular events in patients with type 2 diabetes, whereas higher levels of cardiorespiratory fitness (CRF) were associated with a lower incidence of cardiovascular mortality. Whether CRF is associated with inflammatory markers, fibrinolytic factors, and LP(a) in patients with type 2 diabetes was investigated. A total of 425 men with type 2 diabetes (mean age 55 +/- 8 years) who participated in a medical screening program were studied. CRF was measured using peak oxygen uptake with expired gas analysis during a symptom-limited exercise test. CRF inversely correlated with C-reactive protein (CRP; r = -0.27, p <0.05), white blood cell count (r = -0.13, p <0.05), fibrinogen (r = -0.28, p <0.05), LP(a) (r = -0.53, p <0.05), tissue plasminogen activator (t-PA) antigen (r = -0.65, p <0.05), and plasminogen activator inhibitor-1 activity (r = -0.17, p <0.05). Men in the highest tertile of CRF had significantly lower CRP, white blood cell count, fibrinogen, LP(a), and t-PA than men in the lowest tertile of CRF (all p <0.05). In separate multivariable linear regression models that adjusted for age, body mass index, smoking, lipid profiles, glucose, and systolic blood pressure, CRP (beta = -0.23, p <0.05), white blood cell count (beta = -0.16, p <0.05), fibrinogen (beta = -0.24, p <0.05), LP(a) (beta = -0.28, p <0.05), and t-PA (beta = -0.69, p <0.05) were each inversely associated with CRF. Each MET increment higher peak oxygen uptake was associated with a lower odds ratio of having abnormal LP(a) (odds ratio 0.43, 95% confidence interval 0.20 to 0.91) in a multivariate logistic regression model. In conclusion, CRF was inversely associated with inflammatory markers, fibrinolytic factors, and LP(a) in men with type 2 diabetes.
    The American Journal of Cardiology 09/2008; 102(6):700-3. · 3.21 Impact Factor
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    ABSTRACT: Postoperative radiotherapy for breast cancer has a number of associated complications. This study examined whether supervised moderate-intensity exercise could mitigate the complications that occur during radiotherapy. Forty women were randomized before radiotherapy after various operations for breast cancer. Seventeen patients who were assigned to the exercise group performed supervised moderate-intensity exercise therapy for 50 min 3 times per week for 5 weeks. Twenty-three patients in the control group were asked to perform self-shoulder stretching exercise. The World Health Organization Quality of Life-BREF (WHOQOL-BREF), brief fatigue inventory (BFI), range of motion (ROM) of the shoulder, and pain score were assessed before and after radiotherapy. There were no significant differences noted at baseline between groups. In the exercise group, there was an increase in the WHOQOL-BREF and shoulder ROM and decrease in BFI and pain score after radiotherapy. On the other hand, patients in the control group showed decrease in the WHOQOL-BREF and shoulder ROM and increase in BFI and pain score after radiotherapy. There were statistically significant differences in the changes in the WHOQOL, BFI, shoulder ROM, and pain score between the groups. Patients receiving radiotherapy for breast cancer may benefit in physical and psychological aspects from supervised moderate-intensity exercise therapy.
    Yonsei Medical Journal 07/2008; 49(3):443-50. · 1.31 Impact Factor
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    ABSTRACT: Slow heart rate recovery (HRR) after exercise is an estimate of impaired parasympathetic tone and predictor of all-cause and cardiovascular mortality. Carotid atherosclerosis is associated with high risk of developing coronary heart disease (CHD) and stroke. We tested the hypothesis that slow HRR is associated with carotid atherosclerosis in a cross-sectional study of 12,712 middle-aged men (age 49.1+/-8.9 years). Carotid atherosclerosis was measured using B-mode ultrasonography and defined as stenosis >25% and/or intima-media thickness >1.2mm. HRR was calculated as the difference between peak heart rate during a graded exercise treadmill test and heart rate 2 min after cessation of exercise. The prevalence of carotid atherosclerosis was 8.4%. The prevalence of atherosclerosis was significantly higher among subjects in the lowest (<44 bpm) versus the highest (>61 bpm) quartile of HRR (14.4% versus 4.1%, p<0.001). In multivariable logistic regression models adjusted for established CHD risk factors, inflammatory markers, and exercise capacity, subjects in the lowest quartile of HRR (<44 bpm) were 1.50 times (95% CI: 1.13-2.00) more likely to have carotid atherosclerosis than subjects in the highest quartile (HRR>61 bpm). Slow heart rate recovery after exercise, an index of decreased parasympathetic activity, is associated with carotid atherosclerosis independent of established risk factors in middle-age men.
    Atherosclerosis 01/2008; 196(1):256-61. · 3.71 Impact Factor
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    ABSTRACT: This study was conducted to test the hypothesis that slow and abnormal heart rate recovery (HRR), an indicator of decreased autonomic nervous system activity, after exercise is associated with inflammatory markers. Subjects who underwent exercise treadmill testing (n = 5,527, mean age 50.4 +/- 8.5 years) were studied in a cross-sectional design. HRR was calculated as the difference between maximum heart rate during the test and heart rate 1 minute after the cessation of exercise. Abnormal HRR was defined as < or =12 beats/min. Subjects with abnormal HRR had higher levels of log C-reactive protein (CRP; 1.38 +/- 0.6 vs 1.11 +/- 0.4 mg/dl, p <0.001) and higher white blood cell counts (6.9 +/- 2.1 vs 6.2 +/- 1.7 x 10(9) cells/L, p <0.001) than those with normal HRR. HRR was associated with CRP (r = -0.21, p <0.001) and white blood cell count (r = -0.19, p <0.001). HRR was independently associated with CRP (beta = -0.13, p = 0.001) in a stepwise multiple regression. In a logistic multivariate model, the group within the highest quartile of CRP (odds ratio 1.54, 95% confidence interval 1.05 to 2.27) was more likely to have abnormal HRR than those within the lowest quartile. In conclusion, slow and abnormal HRR after exercise testing is associated with inflammatory markers, which could contribute to the high incidence of cardiovascular disease in these subjects.
    The American Journal of Cardiology 03/2007; 99(5):707-10. · 3.21 Impact Factor

Publication Stats

223 Citations
77.95 Total Impact Points

Institutions

  • 2007–2014
    • Sungkyunkwan University
      • • Department of Physical Medicine and Rehabilitaion
      • • Department of Internal Medicine
      • • Samsung Medical Center
      Sŏul, Seoul, South Korea
  • 2008–2012
    • University of Seoul
      Sŏul, Seoul, South Korea
  • 2006
    • University of Illinois, Urbana-Champaign
      • Department of Kinesiology and Community Health
      Urbana, IL, United States