Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted various aspects of daily living and has influenced the life of every individual in a unique way.Acute myocardial infarction (AMI) is associated with high morbidity and mortality; thus, timely treatment is crucial to prevent poor prognosis. Therefore, an immediate emergency department (ED) visit is required; however, no domestic studies have reported the effect of COVID-19 on ED visits by patients with AMI. Therefore, this study aimed to assess the changes in the pattern of ED visits by patients with AMI by comparing visits during the COVID-19 outbreak period to those during two control periods. Methods: This nationwide, retrospective study used registry data of the National Emergency Department Information System. The ‘outbreak period’ was defined as the period between February 21, 2020 and April 1, 2020, while the ‘control period’ was defined as the same time period in the preceding two years (2018 and 2019). The primary outcome of our study was the number of patients admitted to the ED owing to AMI during the outbreak and control periods. Secondary outcomes were time from symptom onset to ED visit, length of ED stay, and 30-day mortality following admission. Results: During the outbreak period, 401,378 patients visited the ED; this number was lower than that during the control periods (2018: 577,548; 2019: 598,514). The number of patients with AMI visiting the ED was lower during the outbreak period (2,221) than during 2018 (2,437) and 2019 (2,591). Conclusion The COVID-19 pandemic has caused a reduction in ED visits by patients with AMI. We assume that this could likely be caused by misinterpretation of AMI symptoms as symptoms of respiratory infection, fear of contracting severe acute respiratory syndrome coronavirus 2, and restrictions in accessing emergency medical care owing to overburdened healthcare facilities. This study sheds light on the fact that healthcare and emergency medical staff members must work towards eliminating hurdles due to this pandemic for patients to receive timely emergency care, which in turn will help curb the growing burden of mortality.

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted various aspects of daily living and has influenced the life of every individual in a unique way.Acute myocardial infarction (AMI) is associated with high morbidity and mortality; thus, timely treatment is crucial to prevent poor prognosis. Therefore, an immediate emergency department (ED) visit is required; however, no domestic studies have reported the effect of COVID-19 on ED visits by patients with AMI. Therefore, this study aimed to assess the changes in the pattern of ED visits by patients with AMI by comparing visits during the COVID-19 outbreak period to those during two control periods. Methods: This nationwide, retrospective study used registry data of the National Emergency Department Information System. The ‘outbreak period’ was defined as the period between February 21, 2020 and April 1, 2020, while the ‘control period’ was defined as the same time period in the preceding two years (2018 and 2019). The primary outcome of our study was the number of patients admitted to the ED owing to AMI during the outbreak and control periods. Secondary outcomes were time from symptom onset to ED visit, length of ED stay, and 30-day mortality following admission. Results: During the outbreak period, 401,378 patients visited the ED; this number was lower than that during the control periods (2018: 577,548; 2019: 598,514). The number of patients with AMI visiting the ED was lower during the outbreak period (2,221) than during 2018 (2,437) and 2019 (2,591). Conclusion The COVID-19 pandemic has caused a reduction in ED visits by patients with AMI. We assume that this could likely be caused by misinterpretation of AMI symptoms as symptoms of respiratory infection, fear of contracting severe acute respiratory syndrome coronavirus 2, and restrictions in accessing emergency medical care owing to overburdened healthcare facilities. This study sheds light on the fact that healthcare and emergency medical staff members must work towards eliminating hurdles due to this pandemic for patients to receive timely emergency care, which in turn will help curb the growing burden of mortality.

Since the economic crisis in 1997, the number of low income families has increased and the turmoil is likely to affect nutritional and health status of the children in low-income families. The purpose of this study was to investigate dietary behaviors and physical development of low income family children in the Seoul area. The subjects were 44 boys and 56 girls, between the ages of 7 and 12 years, from the beneficiary families of the governmental assistant program and enrolled in after school-care centers. A self-reported questionnaire, including general characteristics and dietary behaviors, was applied to the children and their parents. Skipping meal rate was higher in breakfast than in lunch or dinner, and was less frequent in parents and children families compared to that of the other types of families (p<0.05). Most students are shown that they usually keep the dietary guideline for Korean children. There were significant differences in keeping the dietary guidelines between the parents and children family group and other groups in several items. The results imply that the nutrition education program should be more focused on the families which are not composed of parents and children.
Breakfast ; Child* ; Education ; Female ; Humans ; Lunch ; Meals ; Nutrition Policy ; Parents ; Seoul*

PURPOSE: To evaluate the outcome of a second intravitreal injection of triamcinolone acetonide for the treatment of diabetic macular edema. METHODS: This clinical series study was carried out on 12 eyes with diabetic macular edema. All patients had shown VA (visual acuity) improvement after the first intravitreal injection of triamcinolone acetonide (4 mg). Following the exhibition of decreased VA and increased foveal thickness, the eyes received a second intravitreal injection. We analyzed the visual acuity and foveal thickness at post-treatment 1, 3, and 6 months by ETDRS (LogMar) and optical coherence tomography (OCT). RESULTS: The mean improvement of visual acuity was 0.24, 0.11, and 0.00 at the 1-, 3-, and 6-month follow-up after the first injection, and was 0.09, 0.00, and -0.20 at the 1-, 3-, 6-month follow-up after the second injection. The mean decrease of foveal thickness was 400, 243, and 109 micrometer at the 1-, 3-, 6-month follow-up after the first injection and 298, 78, and -53 micrometer at the 1-, 3-, and 6-month follow-up after the second injection. The differences of change in foveal thickness after the first and second injections were significant (P=0.02, 0.04, 0.02) but the differences of change in visual acuity were not significant (P=0.14, 0.41, 0.28). CONCLUSIONS: Intravitreal injection of 4 mg of triamcinolone acetonide may increase the visual acuity and may decrease the foveal thickness in the short term, postoperative period, but the second intravitreal injection was less effective than the first injection.
Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema* ; Postoperative Period ; Tomography, Optical Coherence ; Triamcinolone Acetonide* ; Triamcinolone* ; Visual Acuity

PURPOSE: Diabetic foot wound (DFW) is known as a major contributor of nontraumatic lower extremity amputation. We aimed to evaluate overall amputation rates and risk factors for amputation in patients with DFW. MATERIALS AND METHODS: From January 2014 to December 2017, 141 patients with DFW were enrolled. We determined rates and risk factors of major amputation in DFW and in DFW with peripheral arterial occlusive disease (PAOD). In addition, we investigated rates and predictors for amputation in diabetic foot ulcer (DFU). RESULTS: The overall rate of major amputation was 26.2% in patients with DFW. Among 141 DFWs, 76 patients (53.9%) had PAOD and 29 patients (38.2%) of 76 DFWs with PAOD underwent major amputation. Wound state according to Wagner classification, congestive heart failure, leukocytosis, dementia, and PAOD were the significant risk factors for major amputation. In DFW with PAOD, Wagner classification grades and leukocytosis were the predictors for major amputation. In addition, amputation was performed for 28 patients (38.4%) while major amputation was performed for 5 patients (6.8%) of 73 DFUs. Only the presence of osteomyelitis (OM) showed significant difference for amputation in DFU. CONCLUSION: This study represented that approximately a quarter of DFWs underwent major amputation. Moreover, over half of DFW patients had PAOD and about 38.2% of them underwent major amputation. Wound state and PAOD was major predictors for major amputation in DFW. Systemic factors, such as CHF, leukocytosis, and dementia were identified as risk factors for major amputation. In terms of DFU, 38.4% underwent amputation and the presence of OM was a determinant for amputation.
Amputation ; Arterial Occlusive Diseases ; Classification ; Dementia ; Diabetic Foot ; Heart Failure ; Humans ; Leukocytosis ; Lower Extremity ; Osteomyelitis ; Risk Factors ; Ulcer ; Wounds and Injuries

PURPOSE: The purpose of this study is to analyze college sudents' attitudes toward people with disabilities, and factors affecting the attitudes, and further to examine possible ways to improve the attitudes. and to furnish guideline of curriculum and practice in rehabilitation nursing on the basis of this analysis. METHOD: A descriptive. relational study design was used. The subjects of this study were 448 college students. A convenient sampling is used. Data were collected through 4 types of previous questionnaires used to examine attitude from May 1 to May 30, 2003. RESULT: 1. The attitude toward people with disabilities whose mean is 3.762 was responded somewhat negatively. Especially, a contact tension whose mean was 4.00 is high. 2. As a result of analyzing the attitudes of college students toward people with disabilities. some factors were statistically significant. They were experience of contact with the disabled. concern toward the disabled, voluntary work related to the disabled, and disability experience education. 3. The more negative experience of people with disabilities and the lower stereotype of disability and the higher effects of parents, teachers, and mass media, then the more positive response of peoples attitude with disabilities. 4. The main factors of determining the attitude of people with disabilities were the stereotype of disability. contact experience concern about disability, voluntary work experience. CONCLUSION: These results suggested that an appropriate educational intervention and strategy is needed in order to change the attitudes of college students toward people with disabilities. Also experimental researches are needed to do it.
Curriculum ; Disabled Persons ; Education ; Humans ; Mass Media ; Parents ; Surveys and Questionnaires ; Rehabilitation Nursing

Race and ethnicity are influential in estimating glomerular filtration rate (GFR). We aimed to find the Korean coefficients for the Modification of Diet in Renal Disease (MDRD) study equations and to obtain novel proper estimation equations. Reference GFR was measured by systemic inulin clearance. Serum creatinine (SCr) values were measured by the alkaline picrate Jaffe kinetic method, then, recalibrated to CX3 analyzer and to isotope dilution mass spectrometry (IDMS). The Korean coefficients for the 4 and 6 variable MDRD and IDMS MDRD study equations based on the SCr recalibrated to CX3 and to IDMS were 0.73989/0.74254 and 0.99096/0.9554, respectively. Coefficients for the 4 and 6 variable MDRD equations based on the SCr measured by Jaffe method were 1.09825 and 1.04334, respectively. The modified equations showed better performances than the original equations. The novel 4 variable equations for Korean based on the SCr measured and recalibrated to IDMS were 107.904xSCr-1.009xage-0.02 (x0.667, if woman) and 87.832xSCr-0.882xage0.01 (x0.653, if woman), respectively. Modified estimations of the MDRD and IDMS MDRD study equations with ethnic coefficients and the novel equations improve the performance of GFR estimation for the overall renal function.
Adult ; Aged ; Aged, 80 and over ; Algorithms ; Creatinine/blood ; *Diet ; Female ; *Glomerular Filtration Rate ; Humans ; Inulin/metabolism ; Kidney Diseases/*ethnology/physiopathology ; Male ; Mass Spectrometry ; Middle Aged ; Republic of Korea/ethnology

PURPOSE: Peripheral neuropathy (PN) is known as a major contributor of the worsening of ischemic symptoms and the foot ulceration in patients with peripheral arterial occlusive disease (PAOD). However, there are few studies reporting the prevalence and risk factors for PN in PAOD. This study aimed to evaluate these issues for PN and to establish the importance of screening as additional treatment target for PN in PAOD. MATERIALS AND METHODS: A total of 52 limbs with PAOD were enrolled from January 2011 to December 2012. PN was divided into radiculopathy, ischemic PN (IPN), and diabetic PN (DPN), based on electromyographic findings. We investigated the prevalence of overall PN and subtypes of PN and then analyzed the risk factors. RESULTS: The prevalence of overall PN in PAOD was 43 of 52 limbs (82.7%). In terms of subtypes of PN, the prevalence rate of radiculopathy and IPN was 30.8% and 23.1%, respectively. DPN showed in 22 limbs (73.3%) among 30 diabetic limbs. There was no significant correlation between each type of PN and ischemic symptoms. Our analysis showed that coronary artery disease (CAD) was a significant risk factor (P=0.01) for IPN, however, did not identify any significant risk factors for DPN. CONCLUSION: This present study indicated that most patients with PAOD had PN and CAD was a risk factor for IPN. In particular, PAOD with diabetes represented a higher prevalence for DPN. Our study suggests that PN should be evaluated and considered as another treatment target in patients with PAOD.
Arterial Occlusive Diseases* ; Coronary Artery Disease ; Extremities ; Foot Ulcer ; Humans ; Mass Screening ; Peripheral Nervous System Diseases* ; Prevalence* ; Radiculopathy ; Risk Factors*

BACKGROUND/AIMS: Race and ethnicity are important determinants when estimatingglomerular filtration rate (GFR). The Korean coefficients for the isotope dilution mass spectrometry (IDMS) Modification of Diet in Renal Disease (MDRD) Study equations were developed in 2010. However, the coefficients have not been validated. The aim of this study was to validate the performance of the Korean coefficients for the IDMS MDRD Study equations. METHODS: Equation development and validation were performed in separate groups (development group, n = 147 from 2008 to 2009; validation group, n = 125 from 2010 to 2012). We compared the performance of the original IDMS MDRD equations and modified equations with Korean coefficients. Performance was assessed by comparing correlation coefficients, bias, and accuracy between estimated GFR and measured GFR, with systemic inulin clearance using a single injection method. RESULTS: The Korean coefficients for the IDMS MDRD equations developed previously showed good performance in the validation group. The new Korean coefficients for the four- and six-variable IDMS MDRD equations using both the development and validation cohorts were 1.02046 and 0.97300, respectively. No significant difference was detected for the new Korean coefficients, in terms of estimating GFR, between the original and modified IDMS MDRD Study equations. CONCLUSIONS: The modified equations with Korean coefficients for the IDMS MDRD Study equations were not superior to the original equations for estimating GFR. Therefore, we recommend using the original IDMS MDRD Study equation without ethnic adjustment in the Korean population.
Adult ; Aged ; *Asian Continental Ancestry Group ; Biomarkers/blood ; Case-Control Studies ; Chromatography, High Pressure Liquid ; Creatinine/blood ; Female ; *Glomerular Filtration Rate ; Humans ; Indicator Dilution Techniques ; Inulin/administration & dosage/blood ; Kidney/*physiopathology ; Male ; Mass Spectrometry ; Middle Aged ; *Models, Biological ; Oligosaccharides/administration & dosage/blood ; Predictive Value of Tests ; Renal Insufficiency, Chronic/blood/*diagnosis/ethnology/physiopathology ; Reproducibility of Results ; Republic of Korea

Cushing's syndrome is produced by the hypersecretion of adrenal glucocorticoids and is characterized by moon face, central obesity, disappearance of diurnal variation of plasma cortisol and unsuppressibility of plasma cortisol by low-dose dexamethasone. On the other hand, hyperaldosteronism is produced by the hypersecretion of aldosterone and is characterized by hypertension and hypokalemia. We report a rare case of adrenal adenoma with concurrent hypercortisolism and hyperaldosteronism manifestated with hypertension, cushingoid appearance, left adrenal mass with low-normal plasma potassium. Laparoscopic unilateral tumor excision was performed and hypertension disappeared after the operation.
Adenoma* ; Aldosterone ; Cushing Syndrome* ; Dexamethasone ; Glucocorticoids ; Hand ; Hydrocortisone ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Obesity, Abdominal ; Plasma ; Potassium