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

No abstract available.
Endometriosis* ; Female

No abstract available.

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

Usually the histologic response of muscle to the ischemia range from mild, reversible change to extensive necrosis and fibrosis in the case of anterior tibial compartment syndrome. But dystmphic calcification in the late stages is very rare condition.Only three cases were previously reported by Gallie and Broder et al in the literature. We are reporting six cases of dystrophic calcification following anterior tibial compartment syndrome in late stages. Onsets of dystrophic calcifications after original injuries ranged from twelve years to thirty-two years. Two out of six cases revealed painless maas in the anterior tibial compartment and remaining four cases revealed painful aases. At surgery, tooth-paste like, calcified material was evacuated in one of five operated cases and yellowish grey, brittle materials were evacuated in the remaining four cases.
Compartment Syndromes ; Fibrosis ; Ischemia ; Leg ; Necrosis

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*

A 18 year old male with myesthenia gravis. Osserman Adult B type, underwent thymectany under general anesthesia combining the use of the new competitive muscle relaxant. Vecuronium, with initial dose of 0.08mg/kg. Neuromuscular blockade of Vecuronium in this myasthenic patient was monitored carefully from induction to postanesthetic period and it was compared with neuromuscular blockade of vecuronium(0.08mg/kg) and pancuronium(0.08mg/kg) in non-myasthenic patient. In this dose of Vecuronium in myasthenic patient, easy to achive endotracheal intubation, it's duration action and recovery were makedly prolonged and delayed than those of non-myasthenic patient and weakly approximated to those of pancuronium in non-myasthenic patients. Conclusively, the reduced dosage of vecuronium with careful neuromuscular monitering in myasthenic patient should be more effective and safe without any difficulties of anesthetic management and ventilatory support on post-operative period.
Adolescent ; Adult ; Anesthesia, General ; Humans ; Intubation, Intratracheal ; Male ; Myasthenia Gravis* ; Neuromuscular Blockade ; Pancuronium ; Thymectomy* ; Vecuronium Bromide*

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

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

About a third of the patients with decompensated liver cirrhosis have reduced arterial oxygen saturation and are sometimes cyanosed in the absence of any apparent lung or heart disease; There is a reduction of diffusing capacity without a restrictive ventilatory defect. The aim of this study was to determine diffusing capacities in patients with chronic liver- diseases. The diffusing capacities and arterial oxygen saturations were measured in 25 patients with chronic active hepatitis(CAH), 9 early cirrhotics (early LC), 36 cirrhotics(Child's class A) and 11 cirrhotics(Child's class B). The anterior tibial area was observed for pitting edema, and Thallium-201 test per rectum(shunt index) was done. Hypoxemia was not observed in all subjects. The number of cases with decreased pulmonary diffusing capacity (DLco) is 3/25(12.0%) for CAH, 3/9(33.3%) for CAH with early liver cirrhosis(LC), 17/36(47.2%) for LC(Child's class A) and 6/11(54.5%) for LC(Child's class B). The mean+/-standard deviation of Dlco(% predicred) are 93.1+/-12.1 for CAH, 85.7+/-12.3 for CAH with early LC, 82.2+/-14.7 for LC(Child's class A) and 80.4+/-6.9 for LC(Child's class B), There is a significant difference between DLco in CAH and that in LC(Child's class A)(p<0.01). Patients with higher shunt index(>0.3) had significantly lower DLco than these with lower shunt index(<0.3)(76.4+/-9.7% vs. 89.3+/-13.3%)(p<0.01). The DLco was also lower in patients with pitting edema(77.3+/-10.2%) than in those without pitting edema(85.5+/-13.8%) (p<0.01). These results summarized that the DLco was low in patients with cirrhosis and with higher shunt index(>0.3) or pitting edema. This may be due to an increased systemic blood flow shunt and an increased generalized interstitial edema. Pulmonary function tests including diffusing capacity may be useful as prognostic parameters in patients with chronic liver disease, especially in those with CAH or early LC.
Anoxia ; Edema ; Fibrosis ; Heart Diseases ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Lung ; Oxygen ; Pulmonary Diffusing Capacity* ; Respiratory Function Tests