Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients

Kim, Eun Jung,Jeong, Myung Ho,Kim, Ju Han,Ahn, Tae Hoon,Seung, Ki Bae,Oh, Dong Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, Shung Chull,Kim, Kwon-Bae,Kim, Young Jo,Cha, Kwa Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.236 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate.</P> <P><B>Methods</B></P> <P>A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status.</P> <P><B>Results</B></P> <P>In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA<SUB>1</SUB>C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, <I>p</I> <0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, <I>p</I> <0.001). Comorbidity including cardiogenic shock (<I>p</I> <0.001), cerebral hemorrhage (<I>p</I> =0.012), decreased Hb≥5g/dL (<I>p</I> =0.013), atrioventricular block (<I>p</I> <0.001) and ventricular tachycardia (<I>p</I> =0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients.</P> <P><B>Conclusions</B></P> <P>These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients.</P>

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

중재 시술용 기능성 기관-기관지 팬텀의 유용성

김태형(Tae-Hyung Kim),임청환(Cheong-Hwan Lim),김정구(Jeong-Koo Kim),김명수(Myeong-Soo Kim),최원찬(Won-Chan Choi),임진오(Jin-Oh Lim),이광종(Kwang-Jong Lee),박인애(In-Ae Park),김미옥(Mi-Ok Kim),정은미(Eun-Mi Jung),신령미(Ryung-Mi Shin) 대한방사선과학회(구 대한방사선기술학회) 2003 방사선기술과학 Vol.26 No.4

중재 시술용 기능성 기관-기관지 팬텀을 제작하고, 스텐트 삽입술을 시행하여 그 유용성을 평가하고자 한다. 중재 시술용 기능성 기관-기관지 팬텀은 실리콘으로 제작하였으며, 기관을 통하여 스텐트 삽입술이 가능하도록 삽입구를 제작하였다. 팬텀은 지점토를 이용하여 인체와 동일한 형태로 기관, 기관지 분지부와 양쪽 상부 기관지를 재현하였고, 사각형의 틀에 지점토를 고정시킨 후 액상의 실리콘을 채워 건조시킨 후 지점토를 제거하여 제작하였다. 인체, 동물, 팬텀에서 기관지스텐트 삽입 후 흉부 촬영 필름의 농도와 기관지 분지부의 각도를 측정하여 비교하였다. 기관지스텐트는 세선의 교차가 다른 2가지(X-type, Y-type) 형태를 삽입하였으며, 스텐트 삽입술 후 기관 상부, 기관 분지부, 좌기관지, 우기관지, 스텐트 삽입부의 필름농도를 측정하였다. 필름농도는 기관 상부의 경우, 인체 0.76(±0.011), 동물 0.97(±0.015), 팬텀 0.45(±0.016)이었고, 기관 분지부의 경우는 인체 0.51(±0.006), 동물 0.65(±0.005), 팬텀 0.65(±0.OO8)이었고, 우기관지의 경우는 인체 0.14(±0.OO8), 동물 0.59(±0.014), 팬텀 0.04(±0.007)이었고, 좌기관지의 경우는 인체 0.54(±0.004), 동물 0.54(±O.008)로 팬텀 0.08(±0.OO8)이었고, 스텐트 삽입부의 경우는 인체 0.54(±0.004), 동물 0.59(±0.011), 팬텀 0.04(±0.007)이었다. 기관 분지부가 이루는 각도는 인체의 좌기관지에서 42.6(±2.07)˚, 우기관지에시 32.8(±2.77)˚이었으며, 동물에서 각각 43.4(±2.40)˚, 34.6(±1.94)˚, 팬텀에서 각각 35(±2.00)˚, 50.2(±1.30)˚이었다. 본 연구팀이 제작한 기관-기관지 팬텀은 기관지 스텐트 삽입술의 재현이 가능하여 중재시술의 술기연습용이나 스텐트를 평가하기 위한 체외실험에 사용이 가능할 것으로 사료된다. To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom, respectively. The film density of trachea part were O.76(±O.O11) in human, O.97(±O.015) in animal, O.45(±O.O16) in phantom. The tracheobronchial bifurcation part measured O.51(±O.OO6) in human, O.65(±O.OO5) in animal, O.65(±O.008) in phantom. The right bronchus part measured O.14(±0.008) in human, O.59(±0.014) in animal and O.O4(±O.OO7) in phantom. The left bronchus were O.54(±O.004) in human, O.54 (±0.008) in animal and O.08(±0.008) in phantom. At the stent part were O.54(±O.004) in human, O.59(±0.011) in animal and O.04(±0.007) in phantom, respectively. The tracheobronchial angle of the left bronchus site were 42.6(± 2.07)˚ in human, 43.4(±2.4O)˚ in animal and 35(±2.00)˚ in phantom, respectively. The right bronchus site were 32.8(±2.77)˚ in human, 34.6(±1.94)˚ in animal and 50.2(±1.30)˚ in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce.

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.

급성 중독 환자에 대한 역학적 고찰 : 서울과 지방의 비교

김성중,김인병,최성욱,김경수,이영수,Choi, Jong Moo 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study objective: To compare patients with acute poisoning between urban and rural areas Design: Retrospective chart review of 217 patients with acute poisoning Setting: Two University Hospital EDs Methods: patients were divided into two groups according to hospital. The group A was 109 patients who came to ED of Asan Medical Center and the group B was patients who came to ED of Ajou University Hospital from June 1994 to February 1995. We analysed the age and sex distributions, poisoning substances. causes of poisoning and the past history of psychiatric problems in patients of the two groups. Results: Total number of patients with acute poisoning were 109 in the group A and 108 in the group B. Female was more prevalent than male in the group A and male was more than female in the group B. There was a significant difference in sex distribution between two groups. The mean age of the group A was 27.7 years which was significantly different from the mean age of the group B, 33.7 years. The age incidences in both group were highest in 2nd decade. The accidental poisoning cases were 37% in the group A and 31% in the group B. The rates of committed suicide were 7% in the group A and 22% in the group B. The most common agent of poisoning was therapeutic drug in the group A and agricultural or industrial chemical in the group B. The overall mortality was 5% in the group A and 15% in the group B. Conclusion: There were significant differences in age and sex distributions. poisoning substances, causes of poisoning and the past history of psychiatric problems between two groups.

총력전기 식민지 조선의 사회과학 비판

김인수(Kim, In-Soo) 고려대학교 아세아문제연구소 2013 亞細亞硏究 Vol.56 No.4

Since the mid-1930s, intellectuals of colonial Korea had become professionals of social science academics. In this paper, I tracked the whereabouts of this professional knowledge in total war period. After political conversion(1938), In Jeongsik(印貞植) obtained and produced by himself the data which were more detailed and accurate than before for the society of colonial Korea. Using these indexes, In defined the historical status of it. At the same time, he compared colonial Korea with Southeast Asia, China, and Manchuria. Firstly, In argued that capitalistic industrialization was advanced in colonial Korea under Japanese imperialism, on the contrary, feudalism had been exacerbated in Southeast Asia since colonization by Western imperialism. Secondly, he represented China as a stagnant society based on the theory of "Asiatic mode of production"(K. Wittfogel), excepting colonial Korea from the range of that theory. Finally, In argued that Korean society was modernized based on the fact that the system of nuclear family was overwhelming, in contrast to Manchuria which had been evaluated as a large family system society. However, In"s claims were the answers to the questions suggested from Japanese resident intellectuals in Korea. These questions, produced in the asymmetry of power between empire and colony, were to serve the purpose of Japanese imperialism to mobilize colonial Korean society. In, without denying these questions, only looked to the others, neighboring Asian states, which were evaluated inferior than Korea by himself. After all, In neither could recognize accurately the "colonial Korea", nor fairly neighboring others. Disregarding the violence of questions he tried to answer, In distorted the history and reality of others. The way that In Jeongsik walked on as a social scientist of colonial Korea, needs to be remembered as the typical case that clearly says why colonial intellectuals fail to know their society and others accurately.

干拓地의 農業開發을 위한 綜合硏究 : IV.界火島 干拓地의 土壤微小動物相에 관한 연구 -

金泰興,蘇仁永,郭晙洙,金俊範 전북대학교 농업과학기술연구소 1987 農大論文集 Vol.18 No.-

This study was carried out to investigate the soil arthropods and nematodes fauna, population density, biomass, vertical distribution, seasonal fluctuation , and the relationship between the density of soil inhabiting animals and some edaphic factors such as organic matter , pH, temperature, moisture, and salt concentration at reclaimed paddies Samples were taken on January 25, April 5, July 9, and October 4 in1986 from three sites of Gyehwado reclaimed land and one paddy field of Ch?nmidong ,n Ch?n Buk province, southern part of Korea. The results were as follows : 1. Soil arthropods consisted of Diptera (41 .2% ), Collembola(36%), Acarina(21.1%). and etc .. but the proportion in biomass of Diptera(90.5%) showed the highest of all, Nematodes fauna was composed of free living type(55.7 %), p.edato.5(33.') %), and plant parasites(11 .1 %). 2. Density and biomass of arthropods were highest In Ch?nmldong site(35.4 %), and of nematodes highest in the Gyehwa Ⅲ slte. 3. Arthropods(83.4%) and nematodes(65%) were found the most In the first layer. subsoil, i.e., 0-5in and 0-10 in, respectively but the density of arthropods was higher than that of nematodes 4. The population density of arthropods showed highest in April lowest In July, slightly increasing in October. And of the nematodes showed highest in October, lowest in January. 5. Density of arthropods In the first layer decreased gradually from January to July, and slightly increased in October. Of the nematodes. the highest In July and the lowest in April. 6. The correlations between arthropods and organic matter, pH, and temperature were significant , respectively but those of nematodes were significant In case of temperature only.

산업재해 환자의 삶의 질, 자살사고 및 우울증상

김수인,연규월,하은희,우행원,김영철 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 최근 산업재해(이하 산재) 및 교통사고 발생이 증가하면서 사고 후유증으로 치료받는 환자들이 늘어나고 있다. 산재를 포함한 각종 사고들은 환자의 신체적 상태를 변화시킬 뿐 아니라 이로 인한 사회적, 직업적, 경제적 문제들을 초래하게 되고 환자의 삶 전체를 변화시킬수 있다. 본 연구에서는 산재가 환자들에게 미치는 정신적 영향을 알아보기 위해 산재 환자들과 대조군에서 삶의 질, 자살사고 및 우울증상을 비교하였다. 방 법 : 연구대상은 1999년 12월 21일부터 12월 30일 사이에 경상남도 울산 마산·창원지역의 입원한 산재환자 169명이었고 정상 대조군은 울산의 공업단지 내 일반근로자 166명이었다. 평가군과 대조군 모두 남성이었고, 19세에서 60세였다. 모든 대상에서 일반 인구학적 특성, 삶의 질, 자살사고, 우울 증상을 평가하였고, 산재 환자군의 경우 사고일시, 사고원인, 치료기간, 손상부위를 추가로 조사하였다. 주관적 삶의 질은 한국판 스미스클라인 비챰 삶의 질척도로 평가하였고, 자살사고는 Beck의 자살사고(思考)척도로 평가하였으며, 우울증상은 PRIME-MD를 개선한 Patient Problem Questionaire의 우울증 척도로 평가하였다. 결 과 : 산재환자군과 대조군간 일반 인구학적 요인에서 통계적으로 유의한 차이 없었다. 산재환자군이 대조군에 비해 유의하게 낮은 삶의 질 척도 점수를 나타냈고, 유의하게 높은 자살사고와 우울증상을 나타냈다(p<.05). 산재환자군에서 연령, 결혼상태, 치료기간과 삶의 질 점수는 관련이 있었다. 30대 이상의 연령에서 유의하게 낮았고 10∼20대 연령에서 유의하게 높았으며, 미혼이거나 이혼, 별거중인 경우 유의하게 삶의 질 점수가 낮았고, 치료기간이 길수록 낮았다. 치료기간과 자살사고가 관련있었으며, 치료기간이 길수록 자살사고가 많았다. 산재환자군에서 손상부위에 따라 삶의 질 점수, 자살사고 점수와 우울증상이 유의한 관련이 있었다. 삶의 질 점수는 요추부 손상군에서 높았고, 경추부 손상군과 다발성 좌상환자군에서 낮았다(p<0.01). 자살사고 점수는 경추부손상군과 다발성 좌상 환자군에서 높았고, 요추부 손상군에서 낮았다(p<0.01). 연구 대상군에서 삶의 질 점수, 자살사고 점수, 우울증상간 유의한 상관관계가 있었다. 결 론 : 본 연구 결과 산재환자들은 일반 근로자들과 비교하였을 때 삶의 질이 낮다고 느끼고 있었으며, 주관적으로 우울감과 자살사고를 많이 나타냈다. 따라서 산재로 인한 우울 및 자살등의 증상을 예방하기 위해서는 조기 정신과적 치료 중재가 반드시 필요하다고 생각된다. Objective : As the occupational and traffic accidents are increased, patients who are treated for complications of accidents have been increased in recent years. Accidents including industrial injury affect the physical state of the patients and make social, vocational, and economic problems, so that they can affect the whole life of the patients. We performed this study to compare subjective evaluation of quality of life, depressive symptoms, and suicide ideation in both industrial injury patients and control subjects in order to know how industrial injury affect patients in psychiatric aspect. Method : The subjects were 169 inpatients who met the inclusion criteria of industrial injury patients and 166 healthy control subjects. All subjects were male and their age is from 19 to 60 years old. Demographic variables, quality of life, depressive symptom, suicide ideation were assessed in subjects. The types of injury and duration of treatment were assessed in patients. The quality of life was measured using the Korean version of SmithKline Beecham 'Quality of Life' Scale(KvSBQOL), and the suicide ideation was measured using the Scale for Suicide Ideation(SSI), and the depressive symptom was measured using the Dpression scale of Patient Problem Questionaire(PPQ) which were devised from Primary Care Evaluation of Mental Disorder(PRIME-MD). Results : 1) There were no significant differences in the general demographic variables between industrial injury patients and control subjects. 2)Scores of KvSBQOL were significantly lower, and SSI and Depression scale of PPQ were significantly higher in the industrial injury patients than control subjects(p<0.05). 3) In industrial injury patients, there was a correlation between the age and the scores of KvSBQOL(p<0.01). The scores of KvSQOL were lowest in older than 30's, highest in 10's-20's. No significant correlation was recognized between the age and the suicide ideation, the depressive symptoms. Threre was a correlation between the marital status and the scores of KvSBQOL(p<0.01). In unmarried, divorced or separated state, the scores of KvSBQOL were significantly lower than married state. There was a correlation between the the duration of treatment and the scores of KvSBQOL, the suicide ideation. As the duration of treatment was longer, the scores of KvSBQOL were significantly lower(p<0.01), and the scores of SSI were significantly higher(p<0.01). 4) In industrial injury patients, there was a significant correlation between the type of injury nd the scores of KvSBQOL, the suicide ideation, and the depressive symptoms. The scores of KvSBQOL were highest in the L-spine injury patients, lowest in the C-spine injury and multiple contusion patients(p<0.01). The scores of SSI were higher in the C-spine injury and multiple contusion patients, lowest in the L-spine injury patients(p<0.01). 5) In subjects, there was significant correlation between the scores of KvSBQOL, the scores of SSI, and the Depression scale of PPQ. Conclusion : Industrial injury patients feel bad about the quality of life and have more depression and suicide ideation. As a results, psychiatric intervention is needed for prevention of depression and suicide due to industrial injury.

어깨 근막통 증후군에서 어깨 관절운동범위에 대한 분석

김정수,김인아,이수진,김용규,박시복,고재우,송재철 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objective: This study was carried out to investigate if the measurement of range of motion(ROM) could be applied in the diagnosis of Myofascial Pain Syndrome(MPS) and to determine the severity by analyzing ROM in MPS patients. Methods: The study subjects were 476 female telephone number information service workers. Southampton Protocol and Pittsburgh Protocol were used to diagnose MPS and to measure ROM. ROMs were measured by 2 inclinometers exercising each shoulder passively and actively in 5 directions ; abduction, forward flexion, extension, external rotation, and internal rotation. Results: Compared to the normal group (n=147), the mean of right side ROM in the subjects (n=270) with same side MPS was 2.1˚ (SD=11.5) lesser in active extension and 1.7˚ (SD=10.4) lesser in passive extension. Compared to the mild group (n=210), the mean of right side ROM in the patients with same side severe MPS (N=58) was lesser in all directions. Especially in active forward flexion, passive forward flexion, active extension, passive extension and active external rotation, ROM in the subjects with severe MPS was lesser by 6.5˚ (SD=13.1), 5.1˚ (SD=12.8), 5.9˚ (SD=11.8), 5.0˚ (SD=10.6) and 3.9˚ (SD=9.8), respectively, than those of the subjects with mild MPS. Compared to the subjects with left side mild MPS(n=172), ROM in the subjects with left side severe MPS (n=59) was 5.3˚ (SD=13.3) lesser in active forward flexion. Conclusions: In this study, ROMs in the subjects with severe MPS tended to be lesser than those in mild patients. This tendency was more prominent in the right side than the left, active range of motion than passive and forward flexion and extension than others. The results of this study are expected to help diagnose shoulder MPS and determine severity.