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      • SCOPUSKCI등재

        Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database

        Hyung seon Yeom,Dae Ryong Kang,Seong Kyung Cho,Seung Won Lee,Dong Ho Shin,Hyeon Chang Kim 한국역학회 2015 Epidemiology and Health Vol.37 No.-

        OBJECTIVES: The goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea. METHODS: The National Health Insurance (NHI) claims database between 2007 and 2011 was used. We iden­tified all admission claims that included codes from the tenth revision of the International Classification of Dis­eases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, ad­mission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database. RESULTS: Of the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, ad­missions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%). CONCLUSIONS: The reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has in­creased. These findings suggest that simply counting the number of admission claims cannot provide valid in­formation on trends in AMI occurrence.

      • KCI우수등재

        커피전문점에서 흡연 및 금연구역의 분리형태에 따른 PM<sub>2.5</sub> 농도 비교

        염지선,황윤형,서수연,김태현,이기영,Yeom, Ji-Seon,Hwang, Yun-Hyung,Seo, Soo-Yun,Kim, Tae-Hyun,Lee, Ki-Young 한국환경보건학회 2011 한국환경보건학회지 Vol.37 No.1

        Under the Enforcement Rules of the National Health Promotion Act, smoking areas in coffee shops in Korea should be divided off from other areas. The effect on indoor air quality of different division types for smoking areas was evaluated. Using real-time monitors, fine particulate matter <2.5 ${\mu}m$ in diameter ($PM_{2.5}$) concentrations were measured simultaneously in the smoking and non-smoking areas of 30 coffee shops in Seoul. Average $PM_{2.5}$ concentrations in smoking and non-smoking areas were 132 ${\mu}g/m^3$ and 52 ${\mu}g/m^3$, respectively; significantly different. Average $PM_{2.5}$ concentrations in non-smoking areas were 39 ${\mu}g/m^3$ in the glass-wall type and 64 ${\mu}g/m^3$ in the separate-floor type. These $PM_{2.5}$ levels were above the US national ambient air quality standard of 35 ${\mu}g/m^3$. Although indoor $PM_{2.5}$ levels in non-smoking areas were reduced by the division, the rates of reduction were not significantly different by division type. Our results demonstrated that $PM_{2.5}$ from smoking areas can infiltrate into non-smoking areas. Therefore, a complete indoor smoking ban in coffee shops is the only way to protect customers and workers in non-smoking areas.

      • KCI등재

        말기암환자에서 혈청 비타민 C 농도와 연관된 인자들

        김형준,황인철,염창환,안홍엽,최윤선,이재준,임수혁,Kim, Hyung Jun,Hwang, In Cheol,Yeom, Chang Hwan,Ahn, Hong Yup,Choi, Youn Seon,Lee, Jae Jun,Lim, Su Hyuk 한국호스피스완화의료학회 2014 한국호스피스.완화의료학회지 Vol.17 No.4

        목적: 혈청 비타민 C 수치는 체내 항산화상태를 나타내는 지표로서, 암환자에서는 정상인에 비해 감소되어 있다. 하지만, 이 지표가 말기암환자에서 어느 정도 감소되어 있고, 그 감소에 어떤 요인들이 관련되는지에 대한 연구는 매우 드물다. 방법: 두 개 기관의 완화의료병동에 입원했던 암환자 65명을 대상으로 하였다. 환자의 나이, 성별, 암의 종류, 기능상태, 임상증상, 완치 목적의 암 치료력, 그리고 혈청 비타민 C를 포함한 혈액검사 자료를 수집하였다. 혈청 비타민 C 수치의 사분위수를 기준으로 두 군(3사분위수 이하 vs. 4 사분위수)으로 분류한 후 각 군의 차이를 비교하였고, 단계적 다중 로지스틱 회귀분석을 통해 혈청 비타민 C 수치와 관련된 인자를 확인하였다. 결과: 대상자의 혈청 비타민 C의 평균은 $0.44{\mu}g/mL$이었으며, 대상자 전체가 비타민 C 결핍에 해당되었다. 단변량 분석에서는, 비폐암 환자이거나(P=0.041) 발열이 있는 환자(P=0.034)에서 낮은 혈청 비타민 C 수치를 보였다. 폐암, 발열, 삼킴곤란, 호흡곤란, C 반응단백, 그리고 항암화학요법 등의 잠재적인 인자들을 보정한 다변량 분석에서, 낮은 혈청 비타민 C 수치를 나타낼 가능성은 항암화학요법을 받은 군에서 그렇지 않은 군에 비해 3.7배 높았고(P=0.046), 발열이 있는 군에서 그렇지 않은 군에 비해 7.22배 높았다(P=0.020). 결론: 말기암환자에서 비타민 C 부족은 매우 심각하였고, 항암화학요법 치료력과 발열이 관련 있었다. Purpose: Serum vitamin C is one of the indicators for antioxidant levels in the body and it is lower in cancer patients compared with the healthy population. However, there have been few studies on the levels of serum vitamin C in terminally ill cancer patients and related factors. Methods: We followed 65 terminal cancer patients who were hospitalized in two palliative care units. We collected data of age, sex, cancer type, functional status, clinical symptoms, history of cancer therapy, and various laboratory findings including serum vitamin C level. Patients were categorized into two groups according to the quartile of serum vitamin C level (Q1-3 vs. Q4), which were compared each other. Stepwise multiple logistic regression analysis was used to identify factors related to serum vitamin C levels. Results: The mean serum vitamin C level was $0.44{\mu}g/mL$, and all patients fell into the category of vitamin C deficiency. Univariate analysis showed that The serum vitamin C level was lower in non-lung cancer patients (P=0.041) and febrile patients (P=0.034). Multivariate analysis adjusted for potential confounders such as lung cancer, fever, dysphagia, dyspnea, C reactive protein, and history of chemotherapy demonstrated that odds for low serum vitamin C level was 3.7 for patients receiving chemotherapy (P=0.046) and 7.22 for febrile patients (P=0.02). Conclusion: Vitamin C deficiency was very severe in terminally ill cancer patients, and it was associated with history of chemotherapy and fever.

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