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

BACKGROUND: Bacteriokiller system(BKS) produces disinfectant which is generated by the mixture of active oxygen and hypochlorous acid with tap water. Previous studies showed that BKS disinfectant is highly bacteridal against clinical isolates in in vitro testings and more effective than general soap and water for the disinfecttion of contaminated handa. This study was performed to evaluate ling-trem effects of BKS as a handwasing agent in clinical settings. METHODS: Five BKS were installed for the 9-month period from June 1995 to February 1996 in 16-bed Neurosurgery Intensive Care Unit. Handwashing was frequency was observed after 1, 6, and 8 month of BKS use. Six-month incidences of nosocomial infecrion before and after BKS installation were compared to evaluate the possible effect of handwashings on nosocomial infection rates. A self-administered questionaire was used to collect data on handwashing frequency and their opinions of the BKS disinfectant at 2 and 8 months after the installation. RESULTS: Handwashing frequency of healthcare workers(HCWs) before and after patient contacts was increased from 34.1%(137/402) to 50.3%(193/384) (p<0.00001). At the same time, the 6-month nosocomial infection rate was down to 10.5%(43/411) from the pre-BKS rate of 13.0%( 51/431) and the patient-day rate was also decreased from 18.3(56/3068) to 15.1(43/2,844). Most (80.5%) of HCWs thought that BKS promote handwashing and "convenience" was the main reason for more frequent handwashing. Ninety three percent of HCWs would recommend the replacement of tne existing sinks and handwashing disinfectants with BKS. NO adverse skin reaction were reported after 8 months. Conclusions: BKS appears to promote handwashing because it is easy to use with no skin irritation and may contribute toward the prevention of nosocomial infections.
Cross Infection ; Delivery of Health Care ; Disinfectants ; Hand Disinfection ; Humans ; Hypochlorous Acid ; Incidence ; Intensive Care Units ; Neurosurgery ; Reactive Oxygen Species ; Skin ; Soaps

BACKGROUND: This study aimed to develop feasible and detailed infection control guidelines (ICG) and audit protocols for health care workers and auditors in postpartum care centers (PCC). METHODS: PCC ICG and audit protocols were developed in several steps: 1) review of previous ICG for PCCs; 2) establishment of frameworks for updating guidelines and audit protocols; 3) review of new ICG, regulations, etc.; 4) drafting of PCC ICG and audit protocols and revision based on feedback from the research committee; 5) Delphi survey to solicit opinions from infection control, infant care, and maternal care professionals as well as PCC health care workers; 6) re-revision after discussion with the research committee; and 7) finalization of PCC ICG and audit protocols. RESULTS: We developed ICG with 4 categories and 26 sub-categories, and internal and external audit protocols with 163 and 85 items, respectively. CONCLUSION: The ICG and audit protocols are valid and feasible; we recommend their utilization as auditing tools, baseline data for the development of national infection control policies, and as educational materials for PCC healthcare workers.
Checklist ; Delivery of Health Care ; Humans ; Infant ; Infant Care ; Infection Control* ; Postnatal Care* ; Postpartum Period* ; Social Control, Formal

Traumatic rupture of the major airways may be caused by blunt or penetrating injury. The incidence of blunt trauma has risen dramatically in this century with the increase in modern high-velocity transportation. Clinical presentation of bronchial injuries in blunt trauma is varied, and the initial diagnostic evaluation is often misleading. The emphasis in management of these injuries is on early diagnosis and intervention. We experienced a case of bronchial rupture caused by blunt trauma. A 5-year-old male visited Emergency Room complaining of severe dyspnea and chest pain after traffic accident. Chest X-ray showed left tension pneumothorax. After emergent closed-thoracostomy, persistent air leakage and collapse of the left lung were noted. Chest CT revealed cut-off of left main bronchus and "dropped lung". Bronchoscopic examination confirmed the rupture of left main bronchus including proximal part of upper lobe bronchus. The patient underwent left upper lobectomy and bronchoplasty by using interrupted 4-0 Vicryl sutures. The postoperative course was uneventful.
Accidents, Traffic ; Bronchi ; Chest Pain ; Child, Preschool ; Dyspnea ; Early Diagnosis ; Emergency Service, Hospital ; Humans ; Incidence ; Lung ; Male ; Pneumothorax ; Polyglactin 910 ; Rupture* ; Sutures ; Thorax ; Tomography, X-Ray Computed ; Transportation

PURPOSE: The Purpose of this study was to elucidate the effects of aromatherapy massage on the preoperative anxiety of stomach cancer patients. METHOD: The research design was a nonequivalent control group non synchronized design. The data were collected during the period of October 2 to December 30, 2005 at H Hospital in Seoul. The subjects were 40 patients who were operated under general anesthesia for stomach cancer. State anxiety, systolic and diastolic blood pressure, pulse rate were measured on the day before surgery and the preoperative period. Data were analyzed by chi-square test, independent t-test, paired t-test. RESULTS: Hypothesis 1 that the level of preoperative state anxiety of the experimental group who received aromatherapy massage is lower than that of the control group who did not received aromatherapy was supported(p=.004). Hypothesis 2 the physiological index of the preoperative anxiety of the experimental group who received aroma-therapy is lower than that of the control group who did not received aromatherapy. CONCLUSION: According to these results, aromatherapy hand massage can be regarded as a partially effective nursing intervention that relives anxiety of surgical patients and decreases the blood pressure level.
Anesthesia, General ; Anxiety* ; Aromatherapy* ; Blood Pressure ; Hand* ; Heart Rate ; Humans ; Massage* ; Nursing ; Preoperative Period ; Research Design ; Seoul ; Stomach Neoplasms* ; Stomach*

PURPOSE: The Purpose of this study was to elucidate the effects of aromatherapy massage on the preoperative anxiety of stomach cancer patients. METHOD: The research design was a nonequivalent control group non synchronized design. The data were collected during the period of October 2 to December 30, 2005 at H Hospital in Seoul. The subjects were 40 patients who were operated under general anesthesia for stomach cancer. State anxiety, systolic and diastolic blood pressure, pulse rate were measured on the day before surgery and the preoperative period. Data were analyzed by chi-square test, independent t-test, paired t-test. RESULTS: Hypothesis 1 that the level of preoperative state anxiety of the experimental group who received aromatherapy massage is lower than that of the control group who did not received aromatherapy was supported(p=.004). Hypothesis 2 the physiological index of the preoperative anxiety of the experimental group who received aroma-therapy is lower than that of the control group who did not received aromatherapy. CONCLUSION: According to these results, aromatherapy hand massage can be regarded as a partially effective nursing intervention that relives anxiety of surgical patients and decreases the blood pressure level.
Anesthesia, General ; Anxiety* ; Aromatherapy* ; Blood Pressure ; Hand* ; Heart Rate ; Humans ; Massage* ; Nursing ; Preoperative Period ; Research Design ; Seoul ; Stomach Neoplasms* ; Stomach*

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

BACKGROUND: The proper use of disinfectants has been a major issue in infection control programs. We performed a survey to evaluate the current usage of disinfectants in Korea. METHODS: A questionnaire was e-mailed to 95 hospitals that had infection control programs and data were collected between 10 and 28 October 2005. The questionnaire included questions about whether the hospital had official procedures for selection and use of disinfectants and an education program for proper use; also included were questions about the general characteristics of the hospitals. The types of disinfectants consisted of antiseptics and disinfectants for medical devices, endoscopes, and environments. The questionnaire was analyzed using SPSS 12.0 program. RESULTS: Thirty-nine (41.1%) of the 95 hospitals responded to the questionnaire. Thirty-six hospitals (84.6%) had an official decision making process in selecting disinfectants in their hospitals. Ten percent povidone iodine (PVI) (94.9% for central line) and alcohol (92.3% for peripheral line) were commonly used for skin preparation for intravenous catheterization. Most hospitals used 10% PVI for clean wound (97.4%), dirty/infected wound (94.8%) and sore wound (61.5%); 3% H2O2 (43.6%) for dirty/infected wound; and saline (25.6%) for sore wound. Waterless alcohol handrubs were used in general ward (92.3%), ICU (97.4%), and OR (43.6%). Over the 60% of the hospitals used sodium hypochlorites for cleansing the floors and bathrooms of patients' rooms. As a disinfectant for endoscopes, peracetic acid (40-60%) was used the most frequently, followed by orth-pthalaldehyde (25-36%), and superoxidized water (8-23%). Most hospital followed the manufactures' guidelines on the exposure time of gastroscopes to disinfectants such as orth-pthalaldehyde (100%) and peracetic acid (96%). But, some hospitals re-used peracetic acid (12.0%) and superoxidized water (28.6%) for a longer duration than was recommended by the manufacturers. Fifty to eighty percents of the hospitals used tap water for rinsing endoscopes after disinfection, and only about 80% of these dried with alcohol after rinsing. Most hospitals (84.6%) had teaching sessions for the proper use of disinfectants more than once a year. CONCLUSION: The current use of disinfectants has been improved since 1999 in its suitability and appropriateness Proper use of disinfectants ensures the safety of invasive and non-invasive medical processes; therefore, the current guidelines for disinfection should be strictly followed by the hospital. And continuous staff education will facilitate the correct use of disinfectants.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Decision Making ; Disinfectants* ; Disinfection ; Education ; Electronic Mail ; Endoscopes ; Gastroscopes ; Infection Control ; Korea* ; Patients' Rooms ; Peracetic Acid ; Povidone-Iodine ; Skin ; Sodium ; Water ; Wounds and Injuries ; Surveys and Questionnaires

Local alignment is an important task in molecular biology to see if two sequences contain regions that are similar. The most popular approach to local alignment is the use of dynamic programming due to Smith and Waterman, but the alignment reported by the Smith-Waterman algorithm has some undesirable properties. The recent approach to fix these problems is to use the notion of normalized scores for local alignments by Arslan, Egecioglu and Pevzner. In this paper we consider the problem of finding all local alignments whose normalized scores are above a given threshold, and present a fast heuristic algorithm. Our algorithm is 180-330 times faster than Arslan et al.''s for sequences of length about 120 kbp and about 40-50 times faster for sequences of length about 30 kbp.
Molecular Biology