The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels. Percutaneous coronary intervention (PCI) rates were high for both STEMI and non-ST-elevation myocardial infarction (NSTEMI) with higher use of drug-eluting stents (DESs). DES were effective and safe without increased risk of stent thrombosis in Korean AMI patients. Triple antiplatelet therapy, consisting of aspirin, clopidogrel, and cilostazol, was effective in preventing adverse clinical outcomes after PCI. Statin therapy was effective in Korean AMI patients, including those with very low levels of low-density lipoprotein cholesterol and those with cardiogenic shock. The KAMIR score had a greater predictive value than Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores for long-term mortality in AMI patients. Based on these results, the KAMIR will be instrumental for establishing new therapeutic strategies and effective methods for secondary prevention of AMI and guidelines for Asian patients.
Asian Continental Ancestry Group ; Aspirin ; Cholesterol ; Drug-Eluting Stents ; Dyslipidemias ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Korea* ; Lipoproteins ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prevalence ; Registries* ; Risk Factors ; Secondary Prevention ; Shock, Cardiogenic ; Stents ; Thrombosis ; Triglycerides

Sick sinus syndrome comprises a variety of conditions involving sinus node dysfunction and commonly affects elderly persons. Though sudden cardiac death accounts for as much as 15% of all cause mortality in uremia, requiring permanent cardiac pacing in end-stage renal disease hemodialysed patients are very few. Most cases of sick sinus syndrome are idiopathic, and the cause can be multifac- torial. A-V conducton defects were attributed to extensive metastatic calcifications, involving the cardiac skeleton, conservative to severe hyperparathyroidism and inadvertent use of calcitriol and calcium carbonate as phosphate binders. If optimal hemodialysis is provided, benefits of permanent pacing are equal in uremic or non uremic patients and pacemaker implantation should be instituted. We report a case of sick sinus syndrome derived in elderly patient on hemodialysis.
Aged* ; Calcitriol ; Calcium Carbonate ; Death, Sudden, Cardiac ; Humans ; Hyperparathyroidism ; Kidney Failure, Chronic ; Mortality ; Renal Dialysis* ; Sick Sinus Syndrome* ; Skeleton ; Uremia

In Korea, the incidence of acute myocardial infarction has been increasing rapidly. Twelve-month clinical outcomes for 13,133 patients with acute myocardial infarction enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry study were analyzed according to the presence or absence of ST-segment elevation. Patients with ST-segment elevation myocardial infarction (STEMI) were younger, more likely to be men and smokers, and had poorer left ventricular function with a higher incidence of cardiac death compared to patients with non-ST-segment elevation myocardial infarction (NSTEMI). NSTEMI patients had a higher prevalence of 3-vessel and left main coronary artery disease with complex lesions, and were more likely to have co-morbidities. The in-hospital and 1-month survival rates were higher in NSTEMI patients than in STEMI patients. However, 12-month survival rates was not different between the two groups. In conclusion, NSTEMI patients have worse clinical outcomes than STEMI patients, and therefore should be treated more intensively during clinical follow-up.
Coronary Artery Disease ; Death ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Male ; Myocardial Infarction ; Prevalence ; Prognosis ; Survival Rate ; Ventricular Function, Left

Delayed arterial healing at culprit sites after drug-eluting stent (DES) placement for acute myocardial infarction (AMI) is associated with increased risk of late stent thrombosis. The Korea Acute Myocardial Infarction Registry was established in commemoration of the 50(th) anniversary of Korea Circulation Society. Between November 2005 and December 2016, more than 62,000 patients were registered from 50 primary percutaneous coronary intervention (PCI) centers in Korea. DES in AMI may be safe and effective, however, there is concern about increased stent thrombosis after DES implantation in AMI patients, requiring longer-term dual anti-platelet therapy to reduce the risk of late stent thrombosis. Device innovation is needed to overcome issues such as stent thrombosis and restenosis by using new coating materials with biocompatible polymers, different coating methods using non-polymer techniques, bioabsorbable stents and pro-healing stents. In this review article, we describe the current usage of DES in AMI in Korea and introduce novel DES uses in development for patients with AMI. We have developed many types of DES in our research laboratory. Abciximab-coated stents inhibited platelet thrombi and restenosis. Furthermore, anti-oxidants (carvedilol, probucol and alpha-lipoic acid) were used for stent coating. Currently we are developing novel DESs using polymer-free and natural binding techniques, peptide coating stents, gene-and-drug delivery, bioabsorbable stents using 3D printing, endothelial progenitor cell capturing stents to promote reendothelialization and reduce stent thrombosis. New DESs in development may be safe and effective in preventing late stent thrombosis and restenosis in patients with AMI.
Anniversaries and Special Events ; Blood Platelets ; Drug-Eluting Stents ; Endothelial Progenitor Cells ; Humans ; Korea ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Polymers ; Printing, Three-Dimensional ; Probucol ; Stents ; Thrombosis

A 79-year-old woman with a known history of hypertrophic cardiomyopathy presented with severe anemia of unknown origin. She had also suffered from repeated episodes of upper gastrointestinal bleeding for the previous 2-3 years. Despite small bowel series and panendoscopic and angiographic studies, the origin of anemia remained undefined until a small multiple bleeding site was found during capsule endoscopy. The lesion proved to be angiodysplasia in jejunum. We report a case of jejunal angiodysplasia is diagnosed by capsule endoscopy in a patient with hypertrophic cardiomyopathy.
Aged ; Anemia ; Angiodysplasia* ; Capsule Endoscopy* ; Cardiomyopathy, Hypertrophic* ; Endoscopy ; Female ; Hemorrhage ; Humans ; Jejunum

Gastric cancer occurs with high frequency and is a significant cause of cancer motality in Korea. The most common metastatic sites of gastric cancer are liver, lung, bone and adrenal gland. Intramuscular metastasis from gastric cancer is an rare case. Skeletal muscle is one of the most unusual sites of metastasis from any malignancy. We report an elderly patient with gastric cancer developing multiple metastasis in skeletal musle.
Adenocarcinoma* ; Adrenal Glands ; Aged* ; Humans ; Korea ; Liver ; Lung ; Muscle, Skeletal* ; Neoplasm Metastasis* ; Stomach Neoplasms

Bronchioloalveolar carcinoma may present with a variety of clinical and radiographic findings. It is originated from the periphery of the lung and can be mistaken for lobar pneumonia or atypical pneumonia. The most frequent symptoms and signs are cough, sputum, shortness of breath, weight loss, hemoptysis, and fever. Brochorrhea is unusual and a late manifestation. We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.We report two cases of brochioloalveolar carcinoma presenting as proper clinical and radiological findings.
Adenocarcinoma, Bronchiolo-Alveolar* ; Cough ; Dyspnea ; Early Diagnosis ; Fever ; Hemoptysis ; Lung ; Pneumonia* ; Sputum ; Weight Loss

Spontaneous renal rupture with diversion of blood into the subcapsular and/or perinephric spaces in a patient on chronic hemodialysis is a rare clinical entity. The underlying causes found by various authors were tumours, vascular diseases, inflammatory process and cysts. Rupture of renal cysts is another complication that can be life-threatening when it gives rise to subcapsular and/or perinephric hematomas. Screening has been recommended with ultrasound for hemodialysis patients of longer than 3years'duration. We are report a case of spontaneous renal rupture associated with right renal cyst in a patient receiving chronic hemodialysis.
Hematoma ; Humans ; Mass Screening ; Renal Dialysis* ; Rupture* ; Ultrasonography ; Vascular Diseases

Spontaneous renal rupture with diversion of blood into the subcapsular and/or perinephric spaces in a patient on chronic hemodialysis is a rare clinical entity. The underlying causes found by various authors were tumours, vascular diseases, inflammatory process and cysts. Rupture of renal cysts is another complication that can be life-threatening when it gives rise to subcapsular and/or perinephric hematomas. Screening has been recommended with ultrasound for hemodialysis patients of longer than 3years'duration. We are report a case of spontaneous renal rupture associated with right renal cyst in a patient receiving chronic hemodialysis.
Hematoma ; Humans ; Mass Screening ; Renal Dialysis* ; Rupture* ; Ultrasonography ; Vascular Diseases

No abstract available.
Angina, Unstable/*enzymology/*immunology ; Female ; Humans ; Inflammation Mediators/*blood ; Interleukins/*blood ; Male ; Matrix Metalloproteinase 9/*blood ; Myocardial Infarction/*enzymology/*immunology ; Tissue Inhibitor of Metalloproteinase-1/*blood