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>

초등학교 과학과 에너지영역의 STS 내용 변천

서승조,조태호,백남권,김성규,박강은,정인재 晋州敎育大學校 科學敎育硏究所 2001 科學敎育硏究 Vol.27 No.-

This research compared and analyzed the content ratio of the STS (Science-Technology-Society) Education and subjects and types of learning activities to determine the characteristics of STS education in science classes of elementary schools. In the 5th curriculum, the STS-related content on energy section took up 6.6% , in the 6th curriculum, compared with that of the 5th, the STS content ratio on the energy section increased 7.9% and the STS content on the energy section in the 7th curriculum showed an increased 20.8% proportion. Comparing the main subjects of the STS in the energy section for the science class according to curriculum in the 5th, they obviously have influenced technological development, energy, the development of space studies, and sociology of science, in that order. In the 6th curriculum. compared with that of the 5th, the energy section decreased and the sociology of science increased much. There were no significant changes in other subjects. In the 7th, the STS elements were distributed evenly but the extent of the STS main subjects reduced compared to that of the 6th. The STS education activities represented in science textbooks of elementary schools were mainly executed through discussion, research activities, and actual activities. Other activities such as role-playing, simulation tests, problem solving and decision making, data analysis, research design, case studies, etc. were hardly made.

Optimal Timing of Percutaneous Coronary Intervention in Patients With Non–ST-Segment Elevation Myocardial Infarction Complicated by Acute Decompensated Heart Failure (from the Korea Acute Myocardial Infarction Registry-National Institutes of Healt

Kim, Min Chul,Jeong, Myung Ho,Sim, Doo Sun,Hong, Young Joon,Kim, Ju Han,Ahn, Youngkeun,Ahn, Tae Hoon,Seung, Ki Bae,Choi, Dong-Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, S Elsevier 2018 The American journal of cardiology Vol.121 No.11

<P>The optimal timing of percutaneous coronary intervention (PCI) in patients with non–ST-segment elevation myocardial infarction (NSTEMI), complicated by acute decompensated heart failure (ADHF), is unclear. A total of 1,027 patients with NSTEMI complicated by ADHF who underwent successful PCI were analyzed using a Korean multicenter registry. All patients were divided into 4 groups by the timing of PCI: group 1 (PCI < 2 hour after admission, n = 149), group 2 (2 to 24 hours, n = 577), group 3 (24 to 72 hours, n = 189), and group 4 (≥72 hours, n = 112). We analyzed the incidences of 12-month mortality, nonfatal myocardial infarction (MI), target-vessel revascularization, and rehospitalization because of HF. The prevalence of ADHF in patients with NSTEMI was 15.2% at initial presentation, and in-hospital mortality was higher in group 1 than in the other groups. There were no significant differences in mortality, nonfatal MI, target-vessel revascularization, or rehospitalization for HF during the 12-month follow-up between groups, regardless of initial PCI timing, except for a higher 12-month mortality in patients who received PCI within 24 hours (vs ≥24 hours) (hazard ratio 1.52, 95% confidence interval 1.09 to 2.29, p = 0.046). Early PCI did not reduce adverse clinical outcomes in patients with NSTEMI complicated by ADHF. Delayed PCI after stabilization may be reasonable in such high-risk patients.</P>

Comparison of prasugrel versus clopidogrel in Korean patients with acute myocardial infarction undergoing successful revascularization

Park, Keun-Ho,Jeong, Myung Ho,Kim, Hyun Kuk,Ahn, Tae Hoon,Seung, Ki Bae,Oh, Dong Joo,Choi, Dong-Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, Shung Chull,Kim, Kwon-Bae,Kim, Elsevier 2018 Journal of cardiology Vol.71 No.1

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Although there have been several reports that prasugrel can improve clinical outcomes, the efficacy and safety of prasugrel is unknown in Korean patients with acute myocardial infarction (AMI) undergoing successful revascularization.</P> <P><B>Methods</B></P> <P>A total of 4421 patients [637 patients were prescribed prasugrel (60/10 or 5mg, loading/maintenance dose) and 3784 patients clopidogrel (600 or 300/75mg)] with AMI undergoing successful revascularization were enrolled from the core clinical cohort of Korea Acute Myocardial Infarction Registry-National Institute of Health.</P> <P><B>Results</B></P> <P>After propensity score matching (637 pairs), there were no significant differences in baseline clinical and procedural characteristics and in-hospital medications between the two groups. The primary efficacy endpoint, defined as the composite of cardiac death, MI, stroke, or target vessel revascularization at 6 months showed no significant difference between prasugrel and clopidogrel (2.4% vs. 2.9%, <I>p</I> =0.593). Also, no difference was observed in the composite of cardiac death, MI, or stroke during hospitalization between two groups (0.8% vs. 0.9%, <I>p</I> =0.762). However, the incidence of in-hospital Thrombolysis in Myocardial Infarction (TIMI) major or minor bleeding was significantly higher in prasugrel compared with clopidogrel (5.3% vs. 2.7%, <I>p</I> =0.015). In multivariate linear regression analysis, trans-femoral intervention, use of glycoprotein IIb/IIIa inhibitors, use of calcium channel blocker, and use of prasugrel were independent predictors of in-hospital TIMI major or minor bleeding [odds ratio (OR)=6.918; 95% confidence interval (CI)=2.453–19.510, OR=2.577; 95% CI=1.406–4.724, OR=4.016; 95% CI=1.382–11.668, OR=2.022; 95% CI=1.101–3.714].</P> <P><B>Conclusions</B></P> <P>Our study shows that the recommended dose of prasugrel had significantly higher in-hospital bleeding complications without reducing ischemic events compared with clopidogrel. However, further large-scale, long-term, randomized clinical trials are required to accurately assess the efficacy and safety of prasgurel and to find out the optimal dose for Korean AMI patients.</P>

이동통신네트워크에서 핸드오프 알고리즘을 이용한 적응형 동적 재라우팅 기법에 관한 연구

김일태,오인권,이진우 건국대학교 1997 학술논문집 : 건국대 대학원 Vol.45 No.1

In consequence of cellular network architecture evolution, a cell size is getting small such as micro/pico cell in new generation communication(FPLMTS). Due to the frequent handoffs in the pico cell, re-connection setup delay and the number of pre-established connections for the seamless handoff might be increased on ATM-based transport network. To reduce handoff processing delay and the number of pre-established connections, this paper proposes a new re-routing scheme. In the scheme, in order to obtain paths for handoff prior to handoff, the new cell architecture and the scheme of searching paths is also suggested. We conclude by comparing the proposed re-routing scheme to the existing schemes in the literature.

급냉응고법에 의한 In-Situ 복합재료로서의 Al-10wt%Ti-4wt%Fe 합금 (II)

김혜성,정재필,권숙인,금동화,Kim, Hye-Seong,Jeong, Jae-Pil,Gwon, Suk-In,Geum, Dong-Hwa 한국재료학회 1998 한국재료학회지 Vol.8 No.12

본 연구에서는 Al-10wt%Ti-4wt%Fe 복합재료를 in-situ공정으로 제조할 수 있는 가능성 및 2 원계 Al-10wt%Ti 복합재료의 낮은 기계적 성질(탄성계수, 상온 고온강도, 내마모특성 등)을 PM SiC/2124 복합재료 수준 흑은 그 이상으로 향상시킬 수 있는 가능성을 조사하였다. 제조된 Al-10wt%Ti-4wt%Fe 합금은 불연속 SiC 강화상으로 보강된 Al-기지 복합재료($SiC{w}$/2124)와 유사한 미세구조를 보여주었으며, 탄성계수 및 인장강도, 내마모성질 등의 기계적 특성이 2원계 Al-10%Ti 합금각 비교해 현저하게 향상되었음이 관찰되었다. 위의 결과는 초정 $Al_3Ti$상 외에도 Fe 원소의 첨가를 통한 추가적인 $Al_{x}Fe$의 분산강화 효과에 기인한 것으로 해석된다. The possibilities of producing Al-10%Ti-4%Fe composites through in-situ processing and thus achieving mechanical property improvements over binary Al-10%Ti to a level or higher exhibited by PM SiC/A12124 composites were explored in this study. The microstructure of in-situ processed Al-10%Ti-4%Fe composites was similar to that of Al matrix composites reinforced with discontinuous SiC particulates(SiC/A12124) and significant enhancements in elastic modulus, tensile strength and wear resistance were observed as compared to Al-10%Ti alloy. These results can be attributed to the in-situ formed Al. Fe by third element addition, leading to additional dispersion strengthening effect over $Al_3Ti$ phase reinforcement in Al-Ti system.

20~30대 직장인의 음주 이유와 의미 -근거이론적 분석을 중심으로-

윤홍권 ( Yoon Hong-gwon ),권혁인 ( Kwon Hyeog-in ) 커뮤니케이션디자인학회(구 시각디자인학회) 2021 커뮤니케이션 디자인학연구 Vol.74 No.-

본 연구는 근거이론적 분석을 통해 20~30대 직장인의 음주 이유와 의미를 분석하고자 했다. 이를 위해 음주에 적극적으로 참여하는 20~30대 직장인 10명을 대상으로 심층 면접을 진행했다. 심층 면접 분석결과 89개의 개념과 48개의 하위범주, 18개의 상위범주를 도출했으며, 이를 바탕으로 패러다임 모형을 형성했다. 인과적 조건은 즐거움 강화, 보상 및 도피, 유대관계 형성 및 유지, 업무에 의한 필요, 맥락적 조건은 가족 구성원으로서 역할, 직장인으로서 역할, 중재적 조건은 음주에 대한 인식 및 태도, 함께 하는 사람과의 유대, 술의 특징 인식, 장소의 특징 인식, 중심현상은 적극적 음주 참여로 나타났다. 작용/상호작용 전략은 동질성 인식, 본능적으로 변화, 통제 불능 상태로 나타났으며, 이에 따른 결과는 유대 강화, 정서적 쾌락, 아쉬움, 과함에 대한 반성으로 분석됐다. 대부분의 선행연구가 음주 참여와 음주 문제와 관련된 선택적 속성의 인과 관계를 연구한 반면, 본 연구는 20~30 직장인의 음주 인식에 대한 가설적 이론을 도출했다는 점에서 의의가 있다. This study attempted to analyze the reasons and meanings of drinking alcoholic beverages of office workers in their 20s and 30s through grounded theoretical analysis. To this end, an in-depth interview was conducted with 10 adults act ively participating in drinking. As a result of in-depth interview analysis, 89 concepts, 48 sub-categories, and 18 high-category categories were derived, and based on this, a paradigm model was formed. Result showed that causal conditions included enhance enjoyment, reward and escape, build and maintain ties, work needs, contextual conditions consisted act as a family member, role as a worker, and intervening conditions included aware of and attitude toward drinking, ties with people, the recognition of the characteristics of alcohol, the recognition of the characteristics of places, and the phenomenon appeared to be active drinking participation. Results also indicated that the action/interaction strategy included homogeneous awareness, instinctive change, and out of control, and the results were analyzed by strengthening bonds, emotional pleasure, regret, and reflection on excess. While most previous studies have studied causality of selective attributes related to drinking participation and drinking problems, this study is significant in that it draws a comprehensive hypothetical theory of overall drinking enjoyment.

부신피질 호산성 과립세포종 1예

이성진,이호권,박철영,정인경,홍은경,오기원,김현규,김두만,유재명,임성희,최문기,유형준,박성우 대한내분비학회 2004 Endocrinology and metabolism Vol.19 No.1

저자들은 건강검진에서 시행한 복부 초음파검사상 우연히 좌측 부신 종괴가 발견되어 복부 전산화 단층 촬영검사와 호르몬검사를 시행한 후 부신피질 악성종양과의 감별 진단을 위해 부신절제술과 전자현미경검사를 포함한 병리조직학적 검사를 시행하여 부신피질호산성 과립세포종으로 진단한 증례를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. Oncocytomas are neoplasms, histologically are composed of epithelial cells, with abundant, acidophilic and granular cytoplasm. Electron microscopic studies of oncocytomas have shown that the cytoplasm of oncocytes is packed with mitochondria. The adrenal gland is a very rare anatomical site for oncocytomas, and to the best of our knowledge, only thirty-six cases of adrenal oncocytomas have been described. Herein, a case of a large adrenal mass in a forty-year-old man, which was incidentally detected by abdominal ultrasonography, is presented. This patient demonstrated no clinical manifestation associated with adrenal hyperfunction. Hormonal studies showed no abnormal findings, except for a mild elevation of the 24-hour urinary VMA level. Abdominal computed tomography with enhancement revealed a large, well-defined left adrenal mass, measuring 5.0×4.2 ×3.0 cm. The patient underwent a left adrenalectomy, and a light microscopic examination confirmed an adrenocortical oncocytoma, with characteristic oncocytes and polygonal, abundant, eosinophilic and granular cytoplasm. The tumor cells were positive for cytokeratin and vimentin as well as S-100, but negative for chromogranin on immunohistochemical staining. An electron microscopic examination demonstrated closely packed mitochondria, containing intramitochondrial inclusions. After surgery, there was no evidence of a recurrent or distant metastatic disease at the 5 month follow-up. In summary, an extremely rare case of a man with an adrenocortical oncocytoma is reported, which was confirmed by histological examinations, including electron microscopy (J Kor Soc Endocrinol 19:82∼89, 2004).

호장근 추출물의 Helicobacter pylori에 대한 생육억제 및 인간 위암세포주에 대한 유전적 손상 유도

박정현,김현정,이지원,임효권,이인선 대한암예방학회 2003 Journal of cancer prevention Vol.8 No.2

都市環境美化를 위한 看板디자인에 관한 硏究

金寅權 경성대학교 1985 부산수산대학 논문집 Vol.6 No.2