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

BACKGROUND: Most studies on the incidence rate (IR) and post-exposure reporting rate (RR) of needle-stick injuries (NSIs) were performed using retrospective surveillance, which is vulnerable to recall bias. This study aimed to identify the agreement between IRs and RRs obtained from prospective and retrospective surveillance. METHODS: The prospective surveillance was performed with 716 nurses working at 3 hospitals from August to September in 2012. They prospectively reported when they experienced the NSIs, and the investigator retrospectively calculated the RR from records in the infection control unit or health care unit during the same periods when they reported the number of NSIs. The retrospective surveillance was carried out with 312 nurses who participated in the prospective surveillance. They retrospectively answered the question on the number of NSIs and post-exposure reporting after recalling the experienced NSI from August to September in 2012. RESULTS: The IR of NSIs was 9.8 per 100 nurses by the prospective surveillance and 36.4 per 100 nurses by the retrospective surveillance, which was statistically significantly different (P<0.001). The RR of NSIs was 14.3% by the prospective surveillance and 8.5% by the retrospective surveillance, which was not statistically significantly different. CONCLUSION: We recommend using a prospective approach for calculating the IR of NSIs to reduce the risk of recall bias. However, the RR of NSIs can be calculated using both prospective and retrospective approaches.
Bias (Epidemiology) ; Delivery of Health Care ; Humans ; Incidence* ; Infection Control ; Memory ; Needlestick Injuries* ; Prospective Studies* ; Research Personnel ; Retrospective Studies*

Developing Cushing's syndrome during pregnancy is rare because menstruation is irregular and hypercortisolism causes infertility. Developing Cushing's disease during pregnancy is very rare because there is even less ovulation than those with the adrenal adenoma. The clinical manifestations of Cushing's syndrome may easily be missed during pregnancy as the features of weight gain, hypertension, and hyperglycemia overlap with those that occur during a pregnancy. Diagnosing Cushing's syndrome during a pregnancy is complex because the biochemical features are obscured by the natural changes in the hypothalamic-pituitary-adrenal axis that occur during pregnancy. Having Cushing's syndrome during a pregnancy results in increased fetal and maternal complications, so early diagnosis and treatment are critical. We report the clinical and endocrine findings of a pregnant women with Cushing's disease who underwent transsphenoidal surgery after delivery.
Adenoma ; Cushing Syndrome ; Early Diagnosis ; Female ; Humans ; Hyperglycemia ; Hypertension ; Infertility ; Menstruation ; Ovulation ; Pregnancy ; Pregnant Women ; Weight Gain ; Axis, Cervical Vertebra

The authors analysed 39 cases chronic subdural hematoma admitted to the Department of Neurosurgery, Seoul Red Cross Hospital from January 1990 to June 1993. The results were as follows : 1) The ratio of male versus female was 6.8 : 1 and the incidence was predominant in patients whose ages were over 50. 2) Past history of head trauma was found in 28 cases(72%) and head trauma with habitual alcoholism was found in 6 cases(15%). 3) Symptoms and signs at admission were headache(90%), hemiparesis(62%), mental change(46%) and vomiting(36%). 4) The densities of hematoma shown in Brain CT scan were iso, hypo, mixed, and hyperdense and the shapes of hematoma were crescenteric, planoconvex, and biconvex in order of frequency. 5) We have found an association between the neurologic grade at admission and the prognosis, and noted full recovery in 33 cases(84%) and no death as a result of the 2-burr hole trephination.
Alcoholism ; Brain ; Craniocerebral Trauma ; Female ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Male ; Neurosurgery ; Prognosis ; Red Cross ; Seoul ; Tomography, X-Ray Computed ; Trephining

Neurofibromatosis type I is one of the most common neurocutaneous syndrome which is inherited by autosomal dominant manner, characterized by cafe au-lait spots, axillary freckling, Lisch nodules in iris, multiple neurofibromas and bone involvement with pseudoarthrosis, bowing of the long bone. And Moyamoya disease is a specific disease characterized by progressive idiopathic stenosis and eventual occlusion of the large cerebral arteries at the circle of Willis. In response to the stenosis, an abnormal network of small collateral vessels develops, creating the "puff of smoke". Intracranial lesions associated with Neurofibromatosis type I include optic glioma, sphenoid wing dysplasia, "unidentified bright objects" and cerebrovascular lesions such as Moyamoya syndrome and aneurysm. Moyamoya syndrome is an uncommon association of neurofibromatosis type 1 and lung mass has not frequently been found with neurofibromatosis and moyamoya syndrome. We report a case with Neurofibromatosis type I with Moyamoya syndrome and ganglioneuroma in lung with reviewing literatures.
Aneurysm ; Cerebral Arteries ; Circle of Willis ; Constriction, Pathologic ; Ganglioneuroma ; Iris ; Lung ; Moyamoya Disease ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Optic Nerve Glioma ; Pseudarthrosis

An increased placental ratio has known to be associated with the occurrence of cardiovascular complications in adulthood among the intrauterine fetal growth restriction. A retrospective study on 202 singleton growth-restricted infants without major congenital anomalies born from Jan. 1995 to Feb. 2001 was performed to determine the relationship between placental ratio and neonatal morbidity. The cases were categorized into three groups according to the placental ratio (<1SD below the mean, within 1SD of the mean, >1SD above the mean). There were no differences in the maternal characteristics and antenatal complications except pregnancy induced hypertension between high placental ratio group and the other groups. It presented the trend that was toward the increase of placental weight and the decrease of birth weight in high placental ratio group. The infants with a high placental ratio had increasing tendencies of meconium stained amnionic fluid, hypocalcemia, phototherapy, asphyxia.
Amnion ; Asphyxia ; Birth Weight ; Female ; Fetal Development ; Humans ; Hypertension, Pregnancy-Induced ; Hypocalcemia ; Infant* ; Meconium ; Phototherapy ; Pregnancy ; Retrospective Studies

An increased placental ratio has known to be associated with the occurrence of cardiovascular complications in adulthood among the intrauterine fetal growth restriction. A retrospective study on 202 singleton growth-restricted infants without major congenital anomalies born from Jan. 1995 to Feb. 2001 was performed to determine the relationship between placental ratio and neonatal morbidity. The cases were categorized into three groups according to the placental ratio (<1SD below the mean, within 1SD of the mean, >1SD above the mean). There were no differences in the maternal characteristics and antenatal complications except pregnancy induced hypertension between high placental ratio group and the other groups. It presented the trend that was toward the increase of placental weight and the decrease of birth weight in high placental ratio group. The infants with a high placental ratio had increasing tendencies of meconium stained amnionic fluid, hypocalcemia, phototherapy, asphyxia.
Amnion ; Asphyxia ; Birth Weight ; Female ; Fetal Development ; Humans ; Hypertension, Pregnancy-Induced ; Hypocalcemia ; Infant* ; Meconium ; Phototherapy ; Pregnancy ; Retrospective Studies

The intrauterine fetal death(IUFD) is the death of the fetus prior to complete expulsion or extraction from its mother when the fetus is over 20 weeks gestation or weights more than 500 gm. This is a clinical study of 262 cases of IUFD and 262 control cases among 18542 deli-veries at Chung Goo Sung Sim Hospital during 10 years from 1987 to 1996. The results obtain-ed were as follows: 1. The incidence of IUFD was 1.41%. 2. The risk of IUFD was high in women older. 3. The risk of IUFD was high in women with parity of three or more, there was a previous history of IUFD in 11.2% of the IUFD cases and in 6.3% of the control cases, but there was no difference between the two groups of women in history of spontaneous abortion. 4. The sex ratio of male versus female was 1.24:1 in the IUFD cases, 1.11:1 in the control cases. 5. The low birth weight and preterm infants were much more frequent in the IUFD cases. 6. The mode of delivery IUFD was induced labor(77.5%), laparotomy(12.2%), spontaneo- us delivery(10.3%). The indications for laparotomy were placental abruption, placenta previa, transverse lie, previous cesarean section status, cephalopelvic disproportion and uterine rupture. 7. The most common cause of IUFD was unexplained causes(45.1%). 8. There were 67 cases(25.6%) of maternal complication, and the most common complica- tion was fever(35.8%). 9. In the incidence of abnormal coagulation test, the low platelet count(<100,000/mm3) was 8.0%, the prolonged prothrombin time(>14 seconds) was 7.2%, the prolonged partial thr- omboplastin time was 1.0%, the hypofibrinogenemia(<150mg/dl) was 7.2% and the elevated fibrinogen degradation products(>40 ug/ml) was 8.4%. 10. The risk of IUFD was lowered as the number of antenatal care was increased.
Abortion, Spontaneous ; Abruptio Placentae ; Blood Platelets ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Death* ; Fetus ; Fibrinogen ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Laparotomy ; Male ; Mothers ; Parity ; Placenta Previa ; Pregnancy ; Prothrombin ; Sex Ratio ; Uterine Rupture ; Weights and Measures

PURPOSE: The present study examines the current influenza immunization rate among kidney transplant patients in an effort to identify the factors influencing their decisions pertaining to the immunization. METHODS: Participants in the study included 150 adults over the age of 64 years who visited a General Surgery Department in Korea on April 2015, who had had a kidney transplant at least two years prior to the visit. We compared the characteristics of transplant patients who were immunized against those of the patients who had not been immunized. RESULTS: The average age of the participants was 48.5±9.6 years, consisting of 87 males (58.0%) and 63 females (42.0%). The average post-surgery period was 91.0±59.0 months. Between September and December 2014, the immunization rate among these participants was 61.3%. Factors which influenced the participant's decision to get immunized in 2014 and drove up the immunization rate were: previous immunization in 2013 (OR=24.57, CI= 8.79-68.70, p<.001), marital status (OR=3.33, CI 1.05-10.56, p=.041), and awareness (OR=1.58, CI=0.99-2.52, p=.056). CONCLUSION: The current study found that the previous year's immunization record, marital status, and awareness increased the rate of immunization among the participants.
Adult ; Female ; Humans ; Immunization* ; Influenza, Human* ; Kidney* ; Korea ; Male ; Marital Status ; Vaccination*

OBJECTIVE: To identify the differences in the movement of the hyoid bone and the vocal cord with and without electrical stimulation in normal subjects. METHODS: Two-dimensional motion analysis using a videofluoroscopic swallowing study with and without electrical stimulation was performed. Surface electrical stimulation was applied during swallowing using electrodes placed at three different locations on each subject. All subjects were analyzed three times using the following electrode placements: with one pair of electrodes on the suprahyoid muscles and a second pair on the infrahyoid muscles (SI); with placement of the electrode pairs on only the infrahyoid muscles (IO); and with the electrode pairs placed vertically on the suprahyoid and infrahyoid muscles (SIV). RESULTS: The main outcomes of this study demonstrated an initial downward displacement as well as different movements of the hyoid bone with the three electrode placements used for electrical stimulation. The initial positions of the hyoid bone with the SI and IO placements resulted in an inferior and anterior displaced position. During swallowing, the hyoid bone moved in a more superior and less anterior direction, resulting in almost the same peak position compared with no electrical stimulation. CONCLUSION: These results demonstrate that electrical stimulation caused an initial depression of the hyoid bone, which had nearly the same peak position during swallowing. Electrical stimulation during swallowing was not dependent on the position of the electrode on the neck, such as on the infrahyoid or on both the suprahyoid and infrahyoid muscles.
Deglutition ; Deglutition Disorders ; Depression ; Electric Stimulation* ; Electrodes ; Hyoid Bone ; Jupiter ; Muscles ; Neck ; Neck Muscles ; Vocal Cords