BACKGROUND/AIMS: Platelet counts and characteristics can influence platelet reactivity during antiplatelet therapy. We compared the effects of both platelet count and indices on platelet reactivity between patients who were treated with either clopodogrel or ticagrelor. METHODS: Patients with coronary artery disease who underwent percutaneous coronary intervention were randomly assigned to either the clopidogrel (n = 63) or ticagrelor (n = 65) groups. Platelet count, platelet indices (including mean platelet volume, platelet distribution width, platelet large cell ratio, and immature platelet fraction), and platelet reactivity were measured before intervention, and 48 hours and 30 days post-intervention. High on-treatment platelet reactivity (HPR) was defined as ≥ 47 unit as assessed by multiple electrode platelet aggregometry. RESULTS: Baseline platelet reactivity was similar between the two groups; however, at 48 hours and 30 days, platelet reactivity was significantly lower in the ticagrelor group than in the clopidogrel group. Platelet count, mean platelet volume, platelet distribution width, platelet large cell ratio, and immature platelet fraction were significantly correlated with platelet reactivity in the clopidogrel group; however, these correlations were attenuated in the ticagrelor group. The use of clopodogrel (hazard ratio [HR] 4.1, 95% confidence interval [CI] 1.4–11.9; p = 0.010) and platelet count (HR 9.7, 95% CI 2.9–32.7; p = 0.001) were independent predictors for 30 day HPR. Platelet count was an independent predictor of HPR in the clopidogrel group but not in the ticagrelor group. CONCLUSIONS: Platelet count and indices are significantly correlated with platelet reactivity. However, antiplatelet treatment with ticagrelor could overcome these associations.
Blood Platelets* ; Coronary Artery Disease ; Electrodes ; Humans ; Mean Platelet Volume ; Percutaneous Coronary Intervention ; Platelet Count* ; Platelet Function Tests ; Purinergic P2Y Receptor Antagonists

PURPOSE: The aim of this study was to understand factors that influence post-traumatic stress (PTS) in Korean forensic science investigators. METHODS: A total of 111 forensic science investigators were recruited in Korea. PTS was measured using the tool modified by Choi (2001) from the original developed by Foa, Riggs, Dancu, and Rothbaum (1993) based on DSM-IV. Factors influencing PTS included demographic and job-related characteristics, emotional intelligence, and death anxiety. RESULTS: PTS scores were positively correlated with personality type, fatigue from work, and death anxiety. PTS scores were negatively correlated with length of career as a forensic science investigator and emotional intelligence. The factors that had the greatest influence on PTS were death anxiety, years spent as a forensic science investigator, personality type, emotional intelligence, fatigue, and homicide experience. The explanatory power of these six factors was 44.0%. CONCLUSION: Therefore, it is necessary to regularly evaluate the mental health of those who are vulnerable to PTS. Based on these results, various interventions could be implemented for promoting overall health of the forensic science investigators.
Anxiety ; Attitude to Death ; Diagnostic and Statistical Manual of Mental Disorders ; Emotional Intelligence ; Fatigue ; Forensic Sciences* ; Homicide ; Humans ; Korea ; Mental Health ; Research Personnel* ; Stress Disorders, Post-Traumatic

The significant morbidity and mortality associated with coronary artery disease has spurred the development of intravascular imaging devices to optimize the detection and assessment of coronary lesions and percutaneous coronary interventions. Intravascular ultrasound (IVUS) uses reflected ultrasound waves to quantitatively and qualitatively assess lesions; integrated backscatter and virtual histology IVUS more precisely characterizes plaque composition; angioscopy directly visualize thrombus and plaque; optical coherence tomography using near-infrared (NIR) light with very high spatial resolution provides more accurate images; and the recently introduced NIR spectroscopy identifies chemical components in coronary artery plaques based on differential light absorption in the NIR spectrum. This article reviews usefulness of these devices and hybrids thereof.
Absorption ; Angioscopy ; Coronary Artery Disease ; Coronary Vessels ; Diagnostic Imaging ; Mortality ; Percutaneous Coronary Intervention ; Spectroscopy, Near-Infrared ; Thrombosis ; Tomography, Optical Coherence ; Ultrasonography

Multi-vessel coronary artery disease (MVD) frequently features ambiguous or intermediate lesions that may be both serial and complex, suggesting that multiple regions require revascularization. Percutaneous coronary intervention (PCI) is associated with various challenges such as appropriate identification of lesions that should be treated, the choice of an optimum revascularization method, and limitations of long-term outcomes. Optimal patient selection and careful targeting of lesions are key when planning treatment. Physiology-guided decision-making (based on the fractional flow reserve) can overcome the current limitations of PCI used to treat MVD regardless of clinical presentation or disease subtype, as confirmed in recent clinical trials. Here, we review the use of physiology-guided PCI for patients with MVD, and their early and late outcomes.
Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Methods ; Patient Selection ; Percutaneous Coronary Intervention* ; Physiology* ; Prognosis

BACKGROUND: It is well known that Korea is one of the endemic areas for viral hepatitis B and those who are positive for HBsAg has been reported to be about 5-10% in Korea. Since the 1980s, research and population education for prevention and vaccination for hepatitis B were implemented in Korea. Therefore, we predicted that the positive rates of HBsAg and Anti-HBs have changed since then. Young adults are considered to be the main candidates for hepatitis B vaccination, and the change in the rate of prevalence of HBsAg and Anti-HBs has been investigated in this study. METHODS: We surveyed 3760 freshmen who were positive for HBsAg and Anti-HBs who were in 1998. HBsAg and Anti-HBs was tested by RPHA/PHA. RESULTS: 3760 students included 2780 males and 980 females(mean age 19.44 years). Among them, 128(3.4%) was positive for HBsAg and 2488(66.2%) was positive for Anti-HBs. The positive rate of HBsAg was 105(3.8%) and that of Anti-HBs was 179(64.7%) among 2780 male students. The positive rate of HBsAg was 23(2.3%) and that of Anti-HBs was 691(70.5%) among 980 female students. CONCLUSIONS: As compared with previous prevalence studies of HBsAg and Anti-HBs, the positive rate of HBsAg was decreased and that of Anti-HBs was increased. The researchers hope that farther study is necessary using wider range of subjects.
Cross-Sectional Studies ; Education ; Female ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hope ; Humans ; Korea ; Male ; Prevalence ; Vaccination ; Young Adult*

The surgical approach to the lower cervical lesions, especially in traumatic injuries, has been controversial. Some authors advocated posterior fusion for such lesions, while others disagreed and reported good operative results with anterior approach using several types of cervical plates. We analysed 28 patients with lower cervical spine traumatic as well as pathological lesions who underwent 32 anterior surgical interventions with cervical plates during the period of August, 1991 and December, 1993. A successful postoperative vertebral stability was obtained in 5 patients(89.3%) and in 19 patients(87.5%) who had predominent posterior ligamentous injuries. Serious complications such as esophageal perforation and postoperative angulation were seen in 5 patients(17.3%) that were related to the process of reduction. With our clinical experiences, we support anterior fusion with cervical plates particularly for lower cervical lesions even though posterior fusion has ben preferred for traumatic posterior ligamentous complex injuries.
Esophageal Perforation ; Humans ; Ligaments ; Spine

No abstract available.
Tomography, Optical Coherence*

A series of 89 patients diagnosed between 1988 and 1993 with computerized tomography(CT) as having subdural hematoma was studied retrospectively in order to evaluate the age of the subdural hematomas according to its appearance on CT scans. In all the patients, the interval from onset of injury to performance of CT scans was more than 2 days. The patients were divided into 4 groups based on the difference in density of the hematoma as seen on the CT scans;hyperdensity(16.9%), isodensity(30.3%), hypodensity(19.1%), and mixed-density(33.7%) groups. The mean interval from onset of injury to diagnosis in hyperdensity, hypodensity, mixed density, and isodensity groups was 15.7+/-18.3 days, 18.8+/-27.9 days, 35.6+/-62.1 days, and 47.6+/-52.1 days, respectively. The configuration of the hematomas on CT scans was crescentic in 74.2%, planoconvex in 12.4%, and biconvex in 13.5%. As the interval became longer, the hematomas tended to take on a planoconvex or biconvex shape rather than the crescentic shape;when the interval from onset of injury to diagnosis was within 7 days, crescentic shape was observed in 91%, within 8 to 21 days, 69%, and over 21 days, 58%. It is concluded from these findings that subdural hematomas undergo a progressive change in their attenuation as the hematomas age, changing from the initial hyperdense stage, go through a hypodense stage, and eventually to an isodense stage. These changes of attenuation values correlates fairly well with the rebleeding theory. The appearance of the hematomas as seen on CT scans also tended to change from the initial crescentic shape to the planoconvex or biconvex shape with time. However, given the possible variations of attenuation values and shapes of subdural hematomas, assumption of the age of the hematomas based on CT findings alone should be made with caution.
Diagnosis ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Chronic ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed