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Park, Soo Hwan,Jeong, Myung Ho,Park, In Hyae,Choi, Jin Soo,Rhee, Jung Ae,Kim, In Soo,Kim, Min Cheol,Cho, Jae Yeong,Sim, Doo Sun,Hong, Young Joon,Park, Hyung Wook,Kim, Ju Han,Ahn, Youngkeun,Cho, Jeong Elsevier 2016 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.212 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute myocardial infarction (AMI) is a risk factor for contrast-induced nephropathy (CIN). We investigated whether pretreatment with statin, N-acetylcysteine (NAC) and sodium bicarbonate (NaHCO<SUB>3</SUB>) reduces the risk of CIN.</P> <P><B>Methods</B></P> <P>We conducted a prospective trial and enrolled a total of 334 ST-segment elevation myocardial infarction (STEMI) patients. Patients were divided into four groups: Group I (statin 40mg), Group II (statin 80mg), Group III (statin 80mg plus NAC 1200mg) and Group IV (regimen of group III plus NaHCO<SUB>3</SUB> 154mEq/L). CIN was defined as ≥25% or ≥0.5mg/dL increase in serum creatinine from the baseline within the 72h after PCI.</P> <P><B>Results</B></P> <P>CIN occurred in 72 (21.6%) patients. The incidence of CIN was the lowest in the group III (14.3%), and multivariate analysis showed the lower incidence of CIN in group III compared to Group I [odds ratio (OR) 0.29, 95% confidence interval (CI) 0.13–0.64, p=0.002]. Admission hyperglycemia [(AHG)>198mg/dL] (OR 2.20, 95% Cl 1.20–3.68, p=0.011) and the use of intra-aortic balloon pump (IABP) (OR 4.20, 95% CI 1.38–12.78, p=0.016) were independent predictors for CIN. The CIN (OR 9.00, 95% CI 1.30–62.06, p=0.026) was an independent predictor for in-hospital mortality.</P> <P><B>Conclusions</B></P> <P>Combination of high-dose statin plus NAC was associated with lower incidence of CIN in patients with STEMI who underwent primary PCI compared to statin only.</P>
화학실험실의 휘발성유기화합물 노출에 대한 정량적 평가전략
변혜정 ( Hyae Jeong Byun ),류경남 ( Kyong Nam Ryu ),윤충식 ( Chung Sik Yoon ),박정임 ( Jeong Im Park ) 한국산업위생학회 2011 한국산업보건학회지 Vol.21 No.1
Working in a research laboratory means exposure to a wide range of hazardous substances. Several studies indicated that laboratory workers, especially working with chemicals, might have an increased risk of certain cancers. However, exposure assessment data in laboratory settings are scarce. This study was performed to examine several approaches for quantitatively assessing the exposure levels to volatile organic compounds (VOCs) among workers in chemistry laboratories. The list of 10 target VOCs, including ethanol, acetone, 2-propanol, dichlormethane, tetrahydrofuran, benzene, toluene, n-hexane, ethyl acetate, chloroform, was determined through selfadministered questionnaire for six chemistry research laboratories in a university, a government-funded research institute, or private labs. From September to December 2008, 84 air samples were collected (15 area samples, 27 personal time weighted samples, 42 personal task-basis short-term samples). Real time monitors with photo ionization detector were placed during the sampling periods. In this study, benzene was observed exceeding the action levels, although all the results were below the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV). From the air sampling results, we concluded that (1) chemicals emitted during experiments could directly affect to neighbor office areas (2) chemical exposures in research laboratories showed a wide range of concentrations depending on research activities (3) area samples tended to underestimate the exposures relative to personal samples. Still, further investigation, is necessary for developing exposure assessment strategies specific to laboratories with unique exposure profiles.
관상동맥 중재술을 시행 받은 40세 이하의 ST 분절 상승과
박종춘 ( Jong Chun Park ),조정관 ( Jeong Gwan Cho ),김주한 ( Ju Han Kim ),홍영준 ( Young Joon Hong ),안영근 ( Youngkeun Ahn ),강정채 ( Jung Chaee Kang ),김남윤 ( Nam Yoon Kim ),박인혜 ( In Hyae Park ),정명호 ( Myung Ho Jeong ) 대한내과학회 2012 대한내과학회지 Vol.82 No.2
Background/Aims: The prevalence of coronary artery disease has increased in young adults. We evaluated the differences in clinical characteristics and clinical outcomes in young patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Methods: A total of 164 patients with acute myocardial infarction who underwent percutaneous coronary intervention were divided into two groups: the STEMI group (120 patients; mean age, 35.7±3.8 years; 118 males) and the NSTEMII group (44 patients; mean age, 35.7±4.3 years; 43 males). We analyzed clinical and angiographic characteristics and major adverse cardiac events (MACE), including death from any cause, non-fatal myocardial infarction, target lesion revascularization, and coronary artery bypass graft surgery, during a 1-year clinical follow-up of the two groups. Results: During hospitalization, Killip class II acute myocardial infarction (5.8% vs. 15.9%, p=0.041) was observed more frequently in the NSTEMI group. The levels of troponin-I (66.9±103.6 vs. 26.6±38.5 ng/mL, p=0.014) and N-terminal pro-brain natriuretic peptide (733.0±1,018.1 vs. 476.2±374.5 pg/mL, p=0.012) were significantly higher in the STEMI group. One-year MACE did not differ between the two groups. By multiple logistic regression analysis, bare metal stents (odds ratio, 3.360; 95% confidence interval, 1.105-10.217; p=0.033) and high lipoprotein (a) levels (odds ratio, 1.047; 95% confidence interval, 1.020-1.075; p=0.001) were independent predictors of 1-year MACE. Conclusions: Young patients with STEMI and NSTEMI have similar clinical outcomes. Bare metal stents and high serum lipoprotein (a) levels are independent predictors of MACE during 1-year clinical follow-ups in young patients with acute myocardial infarction. (Korean J Med 2012;82:175-184)
급성 ST분절 비상승 환자의 1년 사망률 예측을 위한 새로운 위험 도구
박진희 ( Jin Hee Park ),박인혜 ( In Hyae Park ),정명호 ( Myung Ho Jeong ),이숙자 ( Sook Ja Lee ),장수영 ( Soo Yong Jang ),조재영 ( Jae Young Cho ),정해창 ( Hae Chang Jeong ),이기홍 ( Ki Hong Lee ),박근호 ( Keun Ho Park ),심두선 ( 대한내과학회 2015 대한내과학회지 Vol.88 No.2
Background/Aims: Accurate risk stratification is important in the management of patients with acute myocardial infarction (AMI). This study aimed to develop a new assessment tool for the prediction of 1-year mortality in patients with AMI, including biochemical markers. The author developed a new assessment tool (new risk score) that takes biochemical markers into account for 1-year mortality in patients with non-ST elevation myocardial infarction (NSTEMI) and identifies the risk factors related to 1-year mortality. Methods: A total of 1,427 patients (65 ± 11.8 years of age, 985 males) who were admitted to the Chonnam National University Hospital with NSTEMI from November 2005 to March 2012 were retrospectively analyzed for score derivation. Multivariable Cox-regression analysis was used to select correlates of 1-year mortality that were subsequently weighted and integrated into an integer scoring system.Results: Seven variables selected from the initial multivariate model were weighted proportionally to their respective hazard ratiofor 1-year mortality; age ≥ 65 years (2 points), N-terminal pro-brain natriuretic peptide (NT pro-BNP) > 991 pg/mL (1 point), baseline left ventricular ejection fraction < 40% (1 point), high sensitivity C-reactive protein (hs-CRP) > 3 mg/dL (1 point), glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 (1 point), heart rate > 82 beats/min (2 points), and final thrombolysis In myocardial infarction flow < 3 (2 points). Conclusions: In NSTEMI patients, our new score that incorporates seven risk factors accurately predicts the 1-year mortality. Additionally, the biochemical markers hs-CRP, NT pro-BNP, and GFR are reliable predictors of 1-year mortality. (Korean J Med 2015;88:168-176)
원 저급성 심근경색증 환자에서 Everolimus-eluting Stent와 Biolimus-eluting Stent 시술 후 임상 경과
박인철 ( In Cheol Park ),정명호 ( Myung Ho Jeong ),김인수 ( In Soo Kim ),이정애 ( Jung Ae Rhee ),최진수 ( Jin Su Choi ),박인혜 ( In Hyae Park ),채임순 ( Leem Soon Chai ),정윤아 ( Yun Ah Jeong ),현대용 ( Dae Yong Hyun ),정해창 ( Ha 대한내과학회 2015 대한내과학회지 Vol.89 No.4
Background/Aims: We compared the efficacy and safety of the second-generation everolimus-eluting stent (EES) and the third generation biolimus-eluting stent (BES) in patients with acute myocardial infarction (AMI). Methods: We analyzed 629 consecutive patients (mean age 65.1 ± 11.2 years, 426 males) with AMI undergoing percutaneous coronary intervention from February 2008 to April 2012. They were divided into two groups according to stent type (EES group, n = 426; BES group, n = 203). The primary end-point was 2-year major adverse cardiac events (MACEs), defined as the composite of all-cause death, myocardial infarction, target vessel revascularization, non-target vessel revascularization and target lesion revascularization. The secondary end-point was 2-year target lesion failure (TLF). Results: There were no significant differences in baseline characteristics, except that the patients with EES had a significantly higher prevalence of diabetes mellitus (34.7 vs. 22.7%, p = 0.002) and were older (67.1 ± 11.3 vs. 64 ± 12.9 years, p = 0.039) com-pared with the patients with BES. After propensity score matching, 2-year clinical outcomes showed no differences in composite MACEs or TLF between the two groups. Multivariate Cox regression analysis showed that stent type was not a predictor of 2-year mortality or MACEs. However, older age (hazard ratio [HR] 1.037, 95% confidence interval [CI] 1.014-1.060, p = 0.001), diabetes mellitus (HR 2.247, 95% CI 1.426-3.539, p = 0.001) and a left ventricular ejection fraction ≤ 45% (HR 3.007, 95% CI 1.978-4.573, p = 0.001) were independent predictors for 2-year MACEs in patients undergoing EES or BES. Conclusions: Patients with BES had similar clinical 2-year outcomes compared with EES patients with AMI. (Korean J Med 2015;89:418-427)
Choi, Yun Ha,Hong, Young Joon,Park, In Hyae,Jeong, Myung Ho,Ahmed, Khurshid,Hwang, Seung Hwan,Lee, Min Goo,Park, Keun-Ho,Sim, Doo Sun,Kim, Ju Han,Ahn, Youngkeun,Cho, Jeong Gwan,Park, Jong Chun,Kang, J The Korean Academy of Medical Sciences 2011 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.26 No.8
<P>The aim of this study was to evaluate the relationship between coronary artery calcium score (CACS) assessed by multidetector computed tomography (MDCT) and plaque components assessed by virtual histology-intravascular ultrasound (VH-IVUS) in 172 coronary artery disease (CAD) patients with 250 coronary lesions. CACS was assessed according to Agatston scoring method by MDCT and patients were divided into four groups: Group I (CACS = 0 [n = 52]); Group II (CACS = 1-100 [n = 99]); Group III (CACS = 101-400 [n = 84]); and Group IV (CACS > 400 [n = 15]). Total atheroma volume was greatest in Group IV (152 ± 132 µL vs 171 ± 114 µL vs 195 ± 149 µL vs 321±182 µL, <I>P</I> < 0.001). The absolute dense calcium (DC) and necrotic core (NC) volumes were greatest, and relative DC volume was greatest in Group IV (5.5 ± 6.6 µL vs 11.0 ± 10.3 µL vs 15.6 ± 13.6 µL vs 36.6 ± 18.2 µL, <I>P</I> < 0.001, and 14.8 ± 18.2 µL vs 19.5 ± 18.9 µL vs 22.5 ± 19.1 µL vs 41.7 ± 27.9 µL, <I>P</I> < 0.001, and 6.4 ± 5.3% vs 11.0 ± 6.2% vs 14.0 ± 6.5% vs 20.0 ± 7.8%, <I>P</I> < 0.001, respectively). The absolute plaque and DC and NC volumes and the relative DC volume correlated positively with calcium score. CAD patients with high calcium score have more vulnerable plaque components (greater DC and NC-containing plaques) than those with low calcium score.</P>