BACKGROUND: Compliance with self-care and lifestyle modification is recommended for all patients with acute coronary syndrome to prevent a secondary attack. Data is limited regarding the association between compliance with self-care and restenosis. This study was conducted to examine the association between compliance with self-care and restenosis and to determine the predicting factors for restenosis and low compliance with self-care. METHODS: A total of 166 acute coronary syndrome patients (64.2+/-10.8 years) hospitalized for an angiogram during routine follow-up or symptom management were conveniently recruited from a university hospital cardiovascular care unit. Self-administered questionnaires were used to evaluate the level of compliance with self-care and symptom-related satisfaction. RESULTS: In-stent restenosis was found in 40.4% of the subjects and 36.1% were persistently smoking. There was no significant relationship between low compliance with self-care and restensosis. A lower symptom-related satisfaction significantly predicted restenosis and low compliance with self-care. A longer period after initial diagnosis predicted restenosis and a shorter period after initial diagnosis predicted low compliance with self-care. Persistent smoking was independently associated with low compliance with self-care. CONCLUSIONS: Patients who continued to smoke and had lower symptom-related satisfaction with daily living showed a stronger tendency for lower compliance with self-care and lifestyle modification. Effective educational strategy focusing on smoking cessation is needed to increase compliance with self-care in patients with ACS, especially during admission with a first heart attack.
Acute Coronary Syndrome ; Compliance ; Coronary Artery Disease ; Follow-Up Studies ; Heart ; Humans ; Life Style ; Patient Compliance ; Self Care ; Smoke ; Smoking ; Smoking Cessation ; Surveys and Questionnaires

The 447 cases of skin tumors were studied at the departments of dermatology and surgical pathology, National Medical Center in Seoul during the period of 18 years and 8 months from January, 1959 to August, 1977. The results were as follows: 1) the total number of specimens surveyed in the study was 447, among which benign tumors accoungted for 234 cases and malignant tumors for 213. 2) Male to female ratio for benign tumors was 1.2:1 and for malignant tumors 2.2:1. 3) Among the 234 cases of benign tumors, 67 cases were epidermal cyst. 53 cases of hemangioma and 34 cases of pigmented neni. 4) Among the 2 cases of malignant melanoma. 5) The peak age incidence for benign tumors were below the 2nd decade, The peak ago incidence for malignant tumors were 50th decade. 6) the sites of predilection of the epidermal cysts were trunk, face and neck. The sites of predilection of the hemangiomas and pigmented nevi were face. 7) The sites of peredilection of the squamaous cell carcinomas were penis(27.1%), lower extremities(25.7%) and face(21.5%) The sites of predilection of the basal cell carcinomas were face(83.3%) 8) The ratio of squamous cell carcinoma ws basal cell careinoma was 4:1. 9) The accuracy of clinical dianosis were 42.7% for benign tumors and 79.3% for malignant tumors.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidermal Cyst ; Female ; Hemangioma ; Humans ; Incidence ; Male ; Melanoma ; Neck ; Nevus, Pigmented ; Pathology, Surgical ; Seoul ; Skin*

PURPOSE: This study was conducted to identify the clinical characteristics and risk factors on the occurrence of variant angina, and to examine the predicting factors on the vascular endothelial dysfunction of the patients with variant angina. METHODS: A total of 134 patients diagnosed with variant angina were recruited from 2006 to 2008. The degrees of endothelial dysfunction were measured and recorded by the researcher using the values of flow-mediated vasodilation of their brachial arteries and Nitroglycerine-mediated dilation. Subjects' demographic data and risk factors were gathered after obtaining informed consent, and their electronic medical records were reviewed to collect laboratory data. RESULTS: The mean age was 54.2 +/- 9.6 years and 52% was male patients. More than 50% of the male patients were cigarette smokers and had hypercholesterolemia. 84% of the male patients and 70% of the female patients had more than one risk factor of cardiovascular disease. A stepwise multiple regression analysis showed that smoking and hypercholesterolemia predicted the decrease of flow-mediated vasodilation (Adjusted R(2) = .204, p < .001). CONCLUSION: Tailored educational interventions for smoking cessation and cholesterol management are needed to prevent recurrence of angina attack for patients with variant angina and to prevent cardiovascular disease for middle-aged workers.
Angina Pectoris, Variant ; Brachial Artery ; Cardiovascular Diseases ; Cholesterol ; Electronic Health Records ; Female ; Humans ; Hypercholesterolemia ; Informed Consent ; Male ; Recurrence ; Risk Factors ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products ; Vasodilation

PURPOSE: The purpose is to evaluate the CT or MRI findings to help in the differentiation between benign and malignant meningiomas. MATERIAL AND METHODS: The CT and MRI findings of 8 patients with surgically proven malignant meningioma were reviewed. Four cases of 8 malignant meningiomas and 18 cases of 27 benign lesions were studied with a 1.5T or 0.5T MRI. Radiologic analysis was focused on the heterogeneity of tumor, grade of peritumoral edema, presence of cystic degeneration and calcification, tumoral enhancement pattern, dural enhancement, and tumoral border. RESULT: Histologic types of malignant meningioma were meningotheliomatous (n=4), papillary(n=1), fibroblastic(n=l), angioblastic(n=l), and sarcomatous(n=l). Tumoral Heterogeneity was seen in 8 of 8 malignant lesions(100%) and 8 of 27 benign ones(30%). (p<0.01) Marked peritumoral edema was seen in 8 of 8 malignant lesions(100%) and 2 of 27 benign ones. (7.3%)(p<0.01) Most of malignant lesions(6 of 8 cases, 75%) showed ill defined border. Calcification was not present in malignant lesions in contrast with benign ones (14 of 27 cases, 52%). (p<0.05) No statistical significance was noted in cystic degeneration, dural tail like enhancement or tumoral enhancement pattern between malignant and benign meningiomas. MRI signal intensity of malignant meningiomas was homogeneously or heterogeneously hypointense on T1WI, heterogeneously isointense or hypointense on T2WI and heterogeneous or mixed on Gd-DTPA enhancement study. CONCLUSION: The CT or MRI findings such as heterogeneity, ill defined tumoral border, marked peritumoral edema, and absence of calcification may suggest the possibility of malignancy in meningioma.
Edema ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging* ; Meningioma* ; Population Characteristics

OBJECTIVES: The purpose of this study was to compare the microshear bond strength (uSBS) to enamel prepared with different burs and to determine what type of bur were chosen when a self-etching primer adhesive was used. MATERIALS AND METHODS: Enamel of forty-two human molars were used. They were divided into one of six groups (n = 7), Group 1, coarse (125 - 150 microm) diamond bur; Group 2, standard (106 - 125 microm) diamond bur; Group 3, fine (53 - 63 microm) diamond bur; Group 4, extrafine (20 - 30 microm) diamond bur; Group 5, plain-cut carbide bur (no. 245); Group 6, cross-cut carbide bur (no. 557). Clearfil SE Bond and Clearfil AP-X (Kuraray Medical Inc.) was bonded to enamel surface. The bonded specimens were subjected to uSBS testing. RESULTS: The uSBS of Group 4 was the highest among groups and it was significantly higher than that of Groups 1, 2, 3, and 6 (p < 0.05), but it was not significantly different from that of Group 5. CONCLUSIONS: Different burs used on enamel surface affected the microshear bond strengths of a self-etching primer adhesive to the enamel surface. In the case of Clearfil SE Bond, extrafine diamond and plain-cut carbide bur are recommended for bonding to enamel.
Adhesives ; Dental Enamel ; Diamond ; Humans ; Methacrylates ; Molar ; Resin Cements

Patients with acute coronary syndromes (ACS) who are accompanied by atypical symptoms are frequently misdiagnosed and under-treated. This study was conducted to examine and compare the factors associated with atypical symptoms other than chest pain in younger (<70 yr) and older (> or =70 yr) patients with first-time ACS. Data were obtained from the electronic medical records of the patients (n=931) who were newly diagnosed as ACS and hospitalized from 2005 to 2006. The 7.8% (n=49) of the younger patients and 13.4% (n=41) of the older patients were found to have atypical symptoms. Older patients were more likely to complain of indigestion or abdominal discomfort (P=0.019), nausea and/or vomiting (P=0.040), and dyspnea (P<0.001), and less likely to have chest pain (P=0.007) and pains in the arm and shoulder (P=0.018). A logistic regression analysis showed that after adjustment made for the gender and ACS type, diabetes and hyperlipidemia significantly predicted atypical symptoms in the younger patients. In the older patients, the co-morbid conditions such as stroke or chronic obstructive pulmonary disease were positive predictors. Health care providers need to have an increased awareness of possible presence of ACS in younger persons with diabetes and older persons with chronic concomitant diseases when evaluating patients with no chest pain.
Abdominal Pain/etiology ; Acute Coronary Syndrome/complications/*diagnosis ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Diabetes Mellitus/etiology ; Dyspnea/etiology ; Female ; Humans ; Hyperlipidemias/etiology ; Male ; Middle Aged ; Nausea/etiology ; Odds Ratio ; Predictive Value of Tests ; Pulmonary Disease, Chronic Obstructive/etiology ; Regression Analysis ; Risk Factors ; Stroke/etiology ; Vomiting/etiology

BACKGROUND AND OBJECTIVES: Identifying symptom clusters of acute myocardial infarction (AMI) and their clinical significance may be useful in guiding treatment seeking behaviors and in planning treatment strategy. The aim of this study was to identify clusters of acute symptoms and their associated factors that manifested in patients with first-time AMI, and to compare clinical outcomes among cluster groups within 1-year of follow-up. SUBJECTS AND METHODS: A total of 391 AMI patients were interviewed individually using a structured questionnaire for acute and associated symptoms between March 2008 and June 2009 in Korea. RESULTS: Among 14 acute symptoms, three distinct clusters were identified by Latent Class Cluster Analysis: typical chest symptom (57.0%), multiple symptom (27.9%), and atypical symptom (15.1%) clusters. The cluster with atypical symptoms was characterized by the least chest pain (3.4%) and moderate frequencies (31-61%) of gastrointestinal symptoms, weakness or fatigue, and shortness of breath; they were more likely to be older, diabetic and to have worse clinical markers at hospital presentation compared with those with other clusters. Cox proportional hazards regression analysis showed that, when age and gender were adjusted for, the atypical symptom cluster significantly predicted a higher risk of 1-year mortality compared to the typical chest pain cluster (hazard ratio 3.288, 95% confidence interval 1.087-9.943, p=0.035). CONCLUSION: Clusters of symptoms can be utilized in guiding a rapid identification of symptom patterns and in detecting higher risk patients. Intensive treatment should be considered for older and diabetic patients with atypical presentation.
Acute Coronary Syndrome ; Biomarkers ; Chest Pain ; Cluster Analysis ; Fatigue ; Humans ; Myocardial Infarction ; Regression Analysis ; Thorax ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: This examined the association of cognitive function with self-care and major adverse cardiac events (MACE) among heart failure (HF) patients. SUBJECTS AND METHODS: In this prospective study, 86 outpatients with HF completed face-to-face interviews including neuropsychological testing to evaluate cognitive function and the use of the Self-Care of Heart Failure Index to measure self-care. Functional status was assessed with the New York Heart Association (NYHA) classification. Follow-up data on MACE were obtained at 24 months after enrollment. RESULTS: Compared with the Korean norm values, more than half of the HF patients had cognitive deficits in global function (33.0%), immediate recall (65.1%), delayed recall memory (65.1%), and executive function (60.5%). Patients with symptomatic HF (> or =NYHA class II) had the higher risk for substantially poor cognitive function in all areas of cognitive function than asymptomatic HF patients (NYHA class I, p<0.05). Most patients demonstrated poor self-care adequacy in maintenance (84.9%), management of symptoms (100%), and confidence (86.0%). After adjustment for age and gender, memory function was significantly associated with self-care confidence (odds ratio 1.41, 95% confidence interval 1.03-1.92, p=0.033). No relationship was found between cognition and self-care maintenance. There were 19 MACE's during the 24-month follow-up. Patients without MACE had a significantly higher global cognitive function (p=0.024), while no cognitive domains were significant predictors of MACE when adjusted for age and gender. CONCLUSION: HF patients with memory loss have poorer self-care confidence. Studies are warranted to examine the functional implication of cognitive deficits and adverse outcomes in a larger sample.
Classification ; Cognition ; Executive Function ; Follow-Up Studies ; Heart ; Heart Failure* ; Humans ; Memory ; Memory Disorders ; Memory, Short-Term ; Neuropsychological Tests ; Outpatients ; Prospective Studies ; Self Care*

OBJECTIVES: This study investigated associations between symptom severity and neurocognitive functions in patients with major depressive disorder using comprehensive neuropsychological tests. METHODS: Ten patients with low depression (LD) and 22 patients with high depression (HD) participated. Symptom severity was determined by both the Beck Depression Inventory and the Hamilton Depression Rating Scale. Additionally, anxiety was measured by the Korean version of the State-Trait Anxiety Inventory (STAI-KYZ). Ten subtests of the Korean-Wechsler Adult Intelligence scale (K-WAIS), Stroop test, the word/design fluency tests were administered to assess cognition. RESULTS: The LD and HD groups did not differ in any of cognitive measures but anxiety level. Namely, the HD group obtained significantly higher scores on the state (U = 29.50, p < 0.01) and trait (U = 28.50, p < 0.001) anxiety scales than the LD group. A significant interaction effect between trait anxiety and depression severity was observed on the picture arrangement subtest of the K-WAIS [F (1, 27) = 5.09, p < 0.05]. CONCLUSIONS: Cognitive deficits observed in patients with major depressive disorder may be related to other factors rather than current symptom severity. Trait anxiety possibly moderates the effect of current symptom severity on social judgment in these patients.
Adult ; Anxiety ; Cognition ; Cognition Disorders ; Depression* ; Depressive Disorder, Major* ; Humans ; Intelligence ; Judgment ; Neuropsychological Tests ; Stroop Test ; Weights and Measures

PURPOSE: To compare the effects of IVTA with focal laser photocoagulation, for cystoid macular edema and sponge-like macular edema categorized by findings of optical coherence tomography (OCT). METHODS: This study comprised 104 eyes of diabetic macular edema. OCT findings were used to divide the eyes into one group with sponge-like macular edema, and one group with cystoid macular edema. Each group was then divided into two subgroups, one with eyes treated with IVTA, and the other with eyes treated with laser photocoagulation. Visual acuity and macular thickness were compared between the subgroups at 1, 2, and 3 months after therapy. RESULTS: Regardless of the type of macular edema, the group treated with IVTA showed a more rapid improvement of visual acuity (P<0.05), and the group with cystoid macular edema showed better improvement of visual acuity (P<0.05) and macular thickness. The group with sponge-like macular edema showed a similar improvement regardless of the method of treatment (P>0.05), but patients who definetely had focal leakage showed better improvement and consistency of visual acuity when treated with focal laser photocoagulation. CONCLUSIONS: The correct therapeutic method, depending on the type of macular edema, grouped by OCT and FAG, should result in better improvement of visual acuity. Further study is needed to determine the optimal combination therapy depending on the type of macular edema.
Humans ; Light Coagulation* ; Macular Edema* ; Tomography, Optical Coherence ; Triamcinolone Acetonide ; Visual Acuity