Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction

( Joon Young Kim ),( Myung Ho Jeong ),( Yong Woo Choi ),( Yong Keun Ahn ),( Shung Chull Chae ),( Seung Ho Hur ),( Taek Jong Hong ),( Young Jo Kim ),( In Whan Seong ),( In Ho Chae ),( Myeong Chan Cho ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.6

Background/Aims: Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. Methods: We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. Results: During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow < 3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p < 0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013). Conclusions: The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow < 3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.

북극 스발바드 군도 스피츠베르겐섬 콩스피요르드에서의 다환 방향족 탄화수소화합물의 분포 특성

김기범,하성용,안인영,최희선 한국환경과학회 2004 한국환경과학회지 Vol.13 No.9

In order to elucidate the polycyclic aromatic hydrocarbon concentration and its origin in arctic area, four arctic brown algae (Laminaria saccharina, L. digita, Alaria esculenta, Desmarestia aculeata), one marine invertebrate (Echinoidea) and sediments were collected from Kongsfjorden in Spitsbergen from the late July to early August. 2003. In case of macroalgae, the young blade part above growth point and the old stipes and blades beneath growth point were separated and analyzed for polycyclic aromatic hydrocarbons (PAHs) in an attempt to check the mechanism of uptake in macroalgae to accumulate PAN. There was no difference in PAH concentrations between sampling sites (Stations B and C), species. and blades beneath and above growth point. PAH concentrations in all samples collected in this study were relatively higher than those reported in other areas of arctic. Especially, station C, which is known as an unpolluted area, showed 10 times higher PAH concentration (8,765 ng/g) in sediment than station A (694 ng/g) around harbor. In addition high PAH concentration, station C had very higher proportion of methylated PAH to parent PAH in sediment than station A. Source analysis using PAH isomer pair ratios as indicators showed that Kongsfjorden area seemed to be relatively contaminated with PAH derived from direct petroleum input.

Decreased Glomerular Filtration Rate is an Independent Predictor of In-Hospital Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Kim, Joon Young,Jeong, Myung Ho,Ahn, Yong Keun,Moon, Jae Hyun,Chae, Shung Chull,Hur, Seung Ho,Hong, Taek Jong,Kim, Young Jo,Seong, In Whan,Chae, In Ho,Cho, Myeong Chan,Kim, Chong Jin,Jang, Yang Soo,Yo The Korean Society of Cardiology 2011 Korean Circulation Journal Vol.41 No.4

<P><B>Background and Objectives</B></P><P>Patients with renal dysfunction (RD) experience worse prognosis after myocardial infarction (MI). The aim of the present study was to investigate the impact of admission estimated glomerular filtration rate (eGFR) on clinical outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation MI (STEMI).</P><P><B>Subjects and Methods</B></P><P>We retrospectively evaluated 4,542 eligible patients from the Korea Acute Myocardial Infarction Registry (KAMIR). Patients were divided into three groups according to eGFR (mL/min/1.73 m<SUP>2</SUP>): normal renal function (RF) group (eGFR ≥60, n=3,515), moderate RD group (eGFR between 30 to 59, n=894) and severe RD group (eGFR <30, n=133). Baseline characteristics, angiographic and procedural results, and in-hospital outcomes between the three groups were compared.</P><P><B>Results</B></P><P>Age, gender, Killip class ≥3, hypertension, diabetes, congestive heart failure, peak creatine kinase-MB, high sensitivity C-reactive protein, B-type natriuretic peptide, left ventricle ejection fraction, multivessel disease, infarct-related artery and rate of successful PCI were significantly different between the 3 groups (p<0.05). With decline in RF, in-hospital complications developed with an increasing frequency (14.1% vs. 31.8% vs. 45.5%, p<0.0001). In-hospital mortality rate was significantly higher in the moderate and severe RD groups as compared to the normal RF group (2.3% vs. 13.9% vs. 25.6%, p<0.0001). Using multivariate logistic regression analysis, adjusted odds ratio for in-hospital mortality was 2.67 {95% confidence interval (CI) 1.44-4.93, p=0.002} in the moderate RD group, and 4.09 (95% CI 1.48-11.28, p=0.006) in the severe RD group as compared to the normal RF group.</P><P><B>Conclusion</B></P><P>Decreased admission eGFR was associated with worse clinical courses and it was an independent predictor of in-hospital mortality in STEMI patients undergoing primary PCI.</P>

성인병에 대한 한방치료법(증치의학과 사상의학)에 관한 연구 : 고혈압에 대한 한방치료법(중치의학과 사상의학)에 관한 연구

박동일,김영균,안창범,이인선,김종원,권정남,장경전,이인선,이성근,장용우,신영민 동의대학교 한의학연구소 1999 동의한의연구 Vol.3 No.-

We had a result of the treatment as below when is devided Korean medicine Tx.. Western medical Tx., Cooperative Tx.. 1) At the improvement of BP control, an average in Korean medicine Tx. (from 170㎜Hg/100㎜Hg to 150㎜Hg/90㎜Hg), an average in Western medical Tr. (from 170㎜Hg/100㎜Hg to 130㎜Hg/80㎜Hg), an average in Cooperative Tx.(from 180㎜Hg/110㎜Hg to 130㎜Hg/90㎜Hg), generally all pars had improvements of BP control. But it is not significant of each case. 2) At the improvement of symptoms by the apologetics, Cooperative Tx. is profitable in cases of 'GanHwa',' DamEum', 'EumYangYangHer', 'EumHer'. Korean medicine Tx. is superior in case of 'GiChe'. 3) At the improvement of symptoms by a questionnaire, Korean medical Tx., Western medical Tx., Cooperative Tx. groups had improvements, but each practice group didn't have specific significance. Only it was somewhat profitable to Korean medical Tx. in the 210㎜Hg/110㎜Hg, Western medical Tx. in the 180㎜Hg/110㎜Hg, Cooperative Tx, in the 170㎜Hg/90㎜ Hg. 4) There are the apparent improvements in patients whose BP are over 200㎜Hg of Korean medical Tx. group, whose BP are over 190㎜Hg of Western medical Tx. group and whose BP are over 170㎜Mg of Cooperative Tx. group. There are the improvement of diastolic BP in 110㎜Mg(Korean medical Tx., Western medical Tx.) and 90㎜Hg(Cooperative Tx.). 5) At the improvement of Pulse pressure, generally Pulse pressure are decreased. There are similar improvements in all of Korean medical Tx., Western medical Tx., and Cooperative Tx.. 6) At the Symptomatic approvement according to ages, Korean medical Tx., Cooperative Tx. are somewhat good for his twentieth, and Western medical Tx. is somewhat good for his forties. 7) the correlation of Obesity-grade and BP, as Obesity-grade is higher as BP is higher, but there are no similarity in the improvement. 8) At the EAV improvements, as examination into correlation with the point of 1~3th, we could get results as below. There are high improvements of DRHTM, DRALM, DLLYM, DLLIM in Cooperative Tx. There are high improvements of DRPASI, DLLARI in the Korean medical Tx. group. There are high improvements of DRFADM in Western medical Tx. group.

내원시 저혈당이 당뇨병을 동반한 심근경색증 환자의 예후에 미치는 영향

김은정 ( Eun Jung Kim ),정명호 ( Myung Ho Jeong ),정인석 ( In Seok Jeong ),오상기 ( Sang Gi Oh ),김상형 ( Sang Hyung Kim ),안영근 ( Young Keun Ahn ),김주한 ( Ju Han Kim ),김영조 ( Young Jo Kim ),채성철 ( Shung Chull Chae ),홍택종 대한내과학회 2014 대한내과학회지 Vol.87 No.5

목적: 당뇨병 환자에게 철저한 혈당 조절은 논란의 여지가 있으며, 이에 당뇨병을 동반한 급성 심근경색증 환자의 내원 시 저혈당과 병원 내 주요 임상 사건 및 사망률 그리고 추적관찰 1년간 사망률과의 관계를 알아보고자 하였다. 방법: 2005년 11월부터 2012년 3월까지 KAMIR에 등록된 당뇨병이 동반된 급성 심근경색증 환자 5,249명을 혈당 수치에 따라서 저혈당을 보인 환자(≤ 70 mg/dL)를 I군(93명, 72.6± 11.0세, 여성 46.2%), 정상혈당을 보인 환자(> 70 and < 140)를 II군(1,262명, 71.3 ± 10.7, 여성 34.3%), 고혈당을 보인 환자(≥ 140)를 III군(3,894명, 70.3 ± 11.1, 여성 36.0%)으로 분류하여, 병원 내 주요 임상사건 및 1년 후 사망률과의 관계를 비교하였다. 결과: 각 군의 평균 연령은 I군(72.6 ± 11.0세), II군(71.3 ±10.7세), III군(70.3 ± 11.1세)으로 I군에서 연령이 높았다(p =0.006). I군에서 내원 시 비전형적인 증상 양상(p = 0.002), Killip class III-IV (p = 0.003), 심초음파을 이용한 좌심실 구혈률 40% 미만의 환자(p = 0.002), NSTEMI가 많았다(p = 0.001). 전체 대상 환자 5,249명 중 344명(6.6%)이 입원 중 사망하였으며, 이 중에서 I군 12명(12.9%), II군 66명(5.2%), III군 266명(6.8%)으로 I군에서 사망률이 유의하게 높았다(p = 0.006).다변량 회귀분석에서 나이(p = 0.001), Killip class III-IV (p =0.001), 뇌혈관 질환(p = 0.002), 만성 신부전증(p = 0.001), 급성 신부전증(p = 0.001), 심인성 쇼크(p = 0.001), 심실성 빈맥증(p = 0.005), 좌심실 구혈률 40% 미만(p = 0.001), 내원시 혈당 70 mg/dL 미만(p = 0.005)은 추적관찰 한 달간 사망률에 독립적인 예측인자이었다. 정상 혈당군에 비하여 저혈당 군에서 사망률이 유의하게 증가하였고(OR 3.571, 95% CI1.465-8.705, p = 0.005). 고혈당군에 비해 저혈당군에서 사망률이 유의하게 증가하였다(OR 4.088, 95% CI 1.757-9.511, p= 0.001). 그러나 추적관찰 1년간에서 내원시 혈당은 사망률의 유의한 예측인자가 아니었다(p = 0.428). 결론: 당뇨병을 동반한 심근경색증 환자의 내원 시 저혈당은 입원중과 추적관찰 한 달간의 사망률을 예측할 수 있는 예후인자였다. Methods: We analyzed 5,249 diabetic patients who enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to March 2013. The patients were divided into three groups according to their blood glucose level at admission; Group I:hypoglycemia (≤ 70 mg/dL), Group II: normoglycemia (70-140 mg/dL) and Group III: hyperglycemia (≥ 140 mg/dL). We assessed in-hospital mortality and the major adverse cardiac events based on blood glucose levels at admission. Results: The mean age was older in group I at 72.6 ± 11.0 years compared to 71.3 ± 10.7 in group II and 70.3 ± 11.1 in group III (p < 0.006). A total of 344 patients died during hospitalization. In-hospital mortality was higher in group I at 12.9%, compared to 5.2% in group II and 6.8% in group III (p < 0.006). Multivariable logistic regression analysis determined that the independent predictors of 1-month mortality were age, Killip class III-IV, cerebrovascular disease, chronic renal failure, acute renal failure, cardiogenic shock, ventricular tachycardia, ejection fraction < 40% and hypoglycemia in admission. The mortality rate at 1 month was significantly higher in group I compared to group II (odds ratio [OR] 3.571; 95% confidence interval [CI] 1.465-8.705, p = 0.005) compared to group II and group III (OR 4.088; 95% CI 1.757-9.511, p = 0.001). Conclusions: Hypoglycemia on admission was an important predictor of in-hospital and one-month mortality in AMI patients with diabetes mellitus. (Korean J Med 2014;87:565-573)

고감도 Ames test(microsuspension assay)와 임파구 소핵시험법을 이용한 변이원성에 관한 조사 연구

안지영,김해준,윤인재,성영자,김영환,장영철 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.3

In order to evaluate the mutagenic effects of extractable indoor air pollutants (organic matters), we measured the mutagenic activities by sensitive microsuspension Ames test using new tester strains (YG 1024 and YG 1029). And additionally to evaluate the mutagenic effects on vital cell, we examined the frequencies of micronucleus appearing in lymphocytes from dye handling workers and controls. This study was conducted from Jan. to May, 1995. The extractable indoor air pollutants were collected by low volume air sampler in a general office room and 3 of dye handling factories. And the environment of general office room divided into 3 different groups according to the type of room heaters. To determine the frequencies of micronucleus appearing in lymphocytes, we sampled peripheral venous blood from 20 of dye handling workers and 20 of controls, and cultured, and then examined the lymphocytes. The results obtained were as follows: 1. The indirect mutagenic activities of extractable organic matters from suspended particulates collected in a general office room were higher than the direct one. 2. The strain YG 1024 was the most sensitive, and the increasing order of test strains that showed higher number of revertant were YG 1024, YG 1029, TA 100, TA 98. 3. In the general office room, the room using kerosene heater showed the highest mutagenecity, and the next was buthan gas heater, and non-heating room in order. 4. The mutagenic effects of suspended particulates in dye handling factories on the strain YG 1024 was 1.2 times higher than YG 1029. 5. The frequencies of micronucleus appearing in lymphocyte of the circulating blood of dye handling workers and the control were 5.65±2.97‰ and 4.65±0.97‰, respectively. And the difference was statistically significant.

Reconstruction of Rabbit Corneal Epithelium on Lyophilized Amniotic Membrane Using the Tilting Dynamic Culture Method

Ahn, Jae-Il,Lee, Doo-Hoon,Ryu, Yang-Hwan,Jang, In-Keun,Yoon, Mun-Young,Shin, Youn Ho,Seo, Young-Kwon,Yoon, Hee-Hoon,Kim, Jae-Chan,Song, Kye-Yong,Yang, Eun-Kyung,Kim, Ki-Ho,Park, Jung-Keug Blackwell Publishing Inc 2007 Artificial Organs Vol.31 No.9

<P>Abstract: </P><P>Rabbit corneal epithelium was reconstructed using tilting dynamic culture with a self-manufactured, amniotic membrane (AM) supporter and a lyophilized amniotic membrane (LAM). Rabbit corneal epithelial (RCE) cells were cultured and cryopreserved after isolation from the limbus. The second- and third-passage RCE cells were plated onto the epithelial side of the LAM of Ahn's AM supporter. Two days later, the air–liquid interface culture was maintained with third-passage RCE cells for 6 days and second-passage corneal epithelial cells for 9 days. The average viability of thawed RCE cells, assessed using trypan blue dye exclusion, was 77.42%. The reconstructed corneal epithelium was characterized by histological (hematoxylin and eosin) and immunohistochemical staining (proliferating cell nuclear antigen) for light microscopy, and by reverse transcriptase-polymerase chain reaction, glucose assay, and transmission electron microscopy. The basal layer of the reconstructed corneal epithelium was well formed, and the epithelium was tightly constructed due to the increase in cell proliferation and differentiation caused by the tilting dynamic culture, as opposed to static culture. Tilting dynamic culture was useful for the reconstruction of the epithelium using easily damaged epithelial cells and resulted in more stratum cell layers. Moreover, cytokeratin (CK3) mRNA expression in tilting dynamic cultured third-passage RCE cells seeded onto AM was greater than in static cultured third-passage RCE cells. The morphology of the reconstructed corneal epithelium on LAM by tilting dynamic culture for 9 days resembled that of the skin epidermis. This was thought to be because the tilting dynamic culture not only accelerated the proliferation and differentiation of cells by physical or mechanical stimulation, but also ensured that the supply of medium was delivered to the basal cells more efficiently. Thus, the reconstruction of the corneal epithelium using LAM and tilting dynamic culture was considered to be a good in vitro model for autologous or allogeneic transplantation of corneal epithelium and skin epidermis in patients with damaged epithelia. </P>

공단지역 및 청정지역 식물 잎권의 잎표면세균 및 내산성세균의 분포

안종훈,방숙진,한남정,송왕영,황소영,이인수,박성주 대전대학교 이과대학 기초과학연구소 1997 自然科學 Vol.- No.-

산성강하물의 영향을 받는 대천공단지역과 영향을 받지 않는 청정지역인 대전 계족산 자연휴양림에서 자라는 밤나무(Castanea crenat)의 잎표면에서 서식하는 총세균수, 생존세균수, 종속영양세균수, 내산성세균수를 1996년 8월부터 1997년 8월까지 5회에 걸쳐 조사하였다. 공단지역 잎표면 평균 총세균수, 생존세균수 및 종속영양세균수는 각각 9.9×10^(5) cell/㎠, 1.6×10⁴cell/㎠, 7.1×10³cell/㎠,로서 청정지역에 비하여 각각 1.5배, 2배, 2.6배 정도로 관찰되었다. MPN법으로 측정한 pH 5.6애서의 잎표면 내산성세를수는 공단지역 3.3×10⁴, 청정지역 3.4×10⁴MON/㎠로 거의 같았고, pH 4.0에서의 내산성세균수는 공단지역애서 1.9×10^-(-1)MPN/㎠인 반면 청정지역에서는 전혀 검출되지 않았다. pH 3.0에서의 내산성 잎표면세균수는 공단지역과 청정지역의 잎권 어느 곳에서도 검출되지 않았다. 한편 계절별 잎표면세균수의 분포는 대체로 잎이 나기 시작하여 크기가 가장 작은 5월에 최대를, 그리고 낙엽이 지는 11월에 최소를 나타내었다. 이런 결과는 공단지역의 대기오염물질의 침적이 주변의 식물 잎표면 세균수를 감소시키지는 않으며, 특히 산성강하물의 영향으로 내산성세균수가 증가함을 보여주고 있다. Total, direct viable count, and acid-tolerant epiphytic bacterial population sizes were quantified on leaves of chestnut tree (Castanea crenata S. et Z.) near Taejon Industrial Estate affected by acid precipitation and deposition as well as in the clean natural forest area, Mt. Kyejok, in Taejon city from August 1996 to August 1997. Geometric mean numbers of total, direct viable count, and acid-tolerant epiphytic bacteria were 9.9×10^(5) cell/㎠, 1.6×10^(6)cell/㎠, and 7.1×10³cfu/㎠ respecfvely, being 1.5, 2, and 2.6 times those in the clean area. Acid-to-lerant epiphytic bfcterial numbers at pH 5.6 by MPN method were 3.3×10" in the industrial area, about the same as the number,3.4×104 MPNicni, of the clean area. Acid-tolerant bacterial number at pH 4.0 was 1.9×10^(-1)MPN/㎠ in the industrial area, whereas none was detected in the clean area. Acid-tolerant bacteria at pH 3.0 were not detected at all in the industrial area as well as in the clean area. Epiphytic bacterial population sizes were generally the greatest in May when leaves are emerged and grew but the lowest in November when defoliation occurs. These results showed that air pollutant deposition on leaves did not cause a deuease of epiphytic bacteria at least and acid deposition on leaves did cause an increase of acid-tolerant bacteria.

In-hospital mortality in patients with STEMI admitted during off hours

( Sung-Soo Kim ),( Myung Ho Jeong ),( Jeong Gwan Cho ),( Young Keun Ahn ),( Jong Hyun Kim ),( Shung Chull Chae ),( Young Jo Kim ),( Seung Ho Hur ),( In Whan Seong ),( Taek Jong Hong ),( Dong-hoon Choi 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Conflicting results exist on the outcome of off hours PCI in ST elevation myocardial infarction (STEMI). However, there were only a few studies that have focused on the clinical characteristics and outcomes of off hours PCI in STEMI. So, we studied the clinical characteristics and hospital mortality in STEMI patients treated with primary PCI during regular hours (weekdays 9:00 AM to 6:00 PM) versus off hours Weekdays 6:01 PM to 8:59 AM, weekends, and holidays) in Korea Acute Myocardial Infarction Registry. We analyzed in hospital and one year mortality among 5,665 consecutive ST segment elevation myocardial infarction patients treated with primary PCI between November 2005 to January 2008. Total 2,848 (50.2%) patients were treated during off hours. Baseline finding were similar, although regular hours patients were older. Median symptom to balloon time (304 min, IQR 175 to 750 vs. 270 min, IQR 145 to 551, p=0.001) were longer for regular hours primary PCI. Median door to balloon time (71min, IQR: 48 to 132 vs. 59 min, IQR 39 to 110 min, p=0.001) were longer for off hours pPCI. Also, Cardiac enzyme such as Max CK-MB (212.1±299.3 vs 194.7±303.4, p=0.031) and max TnI (72.6±239.5 vs. 58.9±94.4, p=0.013) were increased in off hours pPCI. However, unadjusted in hospital (6.0% off hours vs. 6.0% regular hours, p=0.946) and one year cardiac mortality (11.3% off hours vs. 11.7% regular hours, p=0.661) were comparable. In multivariate analysis, off hours primary PCI did not predict an adverse outcome. In conclusion, when primary PCI was performed within an appropriate reperfusion strategy, the clinical effectiveness of either off hours or regular hours pPCI is comparable.

흰쥐 뇌에서 Tyrosine Hydroxylase분비세포의 출현시기 및 분포에 관한 면역조직화학적 연구

정윤영,선희매,김영택,김남훈,안계훈,장인엽,김종중,문정석,강양수 조선대학교 부설 의학연구소 1999 The Medical Journal of Chosun University Vol.24 No.1

The immunohistochemical (ABC method) studies on the ontogeny and localization of the catecholamine-synthesizing enzyme tyrosine hydroxylase (TH) were examined in rat brain from the 12th fetal day until the 9th postnatal day. The results obtained were as follows : 1. Tyrosine hydroxylase was first detected immunohistochemically at embryonic day 13(E13). At this stage, the TH-containing neurons were still migrating and cytologically immature. 2. The changes occuring from the early to the late prenatal stages of development appeared to be the result of an increase in the number and size of the TH-containing cells and in the length of nerve fibers. 3. The distribution of the TH-containing neurons at embryonic day 19(E19) more closely resembled catecholaminergic neurons in the adult rat brain : 1) a rhombencephalic group became the A1-7 ; 2) a ventral mesencephalic group became A8-10 ; 3) a ventral prosencephalic group and a few neurons ventral to the striatum became A11-14 ; and 4) the cells of the olfactory bulb corresponded to the A15. 4. The cytodifferentiation of the TH-immunoreactive neurons was accompanied by continued migration to form the collective catecholaminergic groups during ontogenesis. In addition, the morphology of the TH-immunoreactive neurons in the late prenatal stage resembled in the adult rat brain.