Background: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. Methods: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. Results: Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). Conclusion Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

BACKGROUND AND OBJECTIVES: Prehypertension according to JNC7 is common and is associated with increased vascular mortality. The importance of management in high-normal blood pressure (BP) is underemphasized. SUBJECTS AND METHODS: We analyzed major adverse cardiac events (MACEs) in the Korea Acute Myocardial Infarction Registry in normal BP (group I) and high-normal BP (group II) patients. RESULTS: Among 14871 patients, 159 (61+/-12.3 years, 122 males) satisfied the study indication. Six-month and one-year clinical follow-up rate was 88.9% and 85.8%, respectively. Group I had 78 patients (60.9+/-12.4 years). Group II had 81 patients (61.6+/-12.5 years). Demographics of patients were not different between groups. Treatment strategy was not different. Initial Thrombolysis in Myocardial Infarction flow grade 0 was less frequent in group II (n=32, 47.1%) than in group I (n=16, 21.9%) (p=0.001). Successful intervention rate was not different between group II (93.8%) and group I (97.1%) (p=0.590). Six-month MACE occurred in 3 patients in group I (4.4%) and 10 in group II (15.6%) (p=0.031). Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE. CONCLUSION: Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP. Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.
Blood Pressure ; Demography ; Emergencies ; Follow-Up Studies ; Humans ; Korea ; Myocardial Infarction ; Odds Ratio ; Prehypertension ; Prognosis

Mushrooms collected from Deogyu mountain, Korea, in 2011, were identified as four classes, four orders, 13 families, 22 genera, and 33 species. In particular, agaricales was most abundant and comprised more than 70%. Their antioxidant activities were estimated using three different bioassay methods, the 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonate) (ABTS) radical scavenging assay, 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assay, and reducing power assay. As a result, the methanol extracts of Stereum ostrea, Laetiporus sulphureus var. miniatus, and Tyromyces sambuceus exhibited potent antioxidant activity in all bioassays tested.
Agaricales ; Biological Assay ; Biphenyl Compounds ; Humans ; Korea ; Methanol ; Ostrea ; Picrates

BACKGROUND AND OBJECTIVES: Acute myocardial infarction (AMI) occurring in patients at a young age (40 years or younger) is an uncommon condition and is characterized by multiple cardiovascular risk factors. We analyzed the risk factors of young-aged Korean AMI patients (age of 40 years or younger) and other AMI patients, who were registered in the Korea Acute Myocardial Infarction Registry (KAMIR) for one year. SUBJECTS AND METHODS: In 2006, 8,565 patients (mean age 64.4+/-12.7 years; 5,591 males) were registered in the KAMIR. The patients were divided into two groups: Group I (younger patients < or =40 years; n=261; mean age 35.9+/-4.5 years; 245 males) and Group II (older patients >40 years; n=8,304, mean age 65.4+/-11.8 years; 5,330 males). The clinical and angiographic characteristics and major adverse cardiac events (MACE) were compared for the two groups of patients. RESULTS: The baseline clinical characteristics of gender, age, risk factors (hypertension, smoking, diabetes, familial history) and body weight were different between the two groups (p<0.001). The baseline echocardiographic and laboratory findings of the initial ejection fraction, and the glomerular filtration rate, level of creatine kinase (CK), level of CK-MB isoenzyme, total cholesterol level, triglyceride level, and N-terminal prohormone brain natriuretic peptide (NT-proBNP) level were different between the two groups (p< or =0.001). According to the use of multiple logistic regression analysis, use of thrombolysis [p=0.009, adjusted hazard ratio (aHR)=9.140, 95% confidence interval (CI): 1.727-48.383], a high blood glucose level (p=0.029, aHR=1.008, 95% CI: 1.001-1.016), a low body mass index (<25 kg/m(2), p=0.031, aHR=6.236, 95% CI: 1.183-32.857), and a high CK-MB level and high Thrombolysis in Myocardial Infarction (TIMI) risk score were independent predictors of MACE at 1 year after an AMI in young age patients. Early clinical outcomes were better in Group I than in Group II patients, but one-, six- and twelve-month MACE were not different between the two groups. CONCLUSION: The independent predictors of MACE at 1 year in young age AMI patients were the use of thrombolysis, a high blood glucose level, a low body mass index, a high CK-MB level and a high TIMI risk score. Patients that have had an acute myocardial infarction at a young age have a better early clinical outcome, but the long-term clinical outcomes were not different compared with older patients, and thus long-term intensive medical therapy will be required, even in young AMI patients.
Age of Onset ; Blood Glucose ; Body Mass Index ; Body Weight ; Cholesterol ; Creatine Kinase ; Glomerular Filtration Rate ; Humans ; Korea ; Logistic Models ; Myocardial Infarction ; Natriuretic Peptide, Brain ; Prognosis ; Risk Factors ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: We performed this study to evaluate the common carotid artery intima-media thickness (CCA IMT), and its correlation with several clinical variables, including the 10 year coronary heart disease (10 Yr CHD) risk in both healthy and hyperlipidemic hypertensive (HH) Koreans. SUBJECTS AND METHODS: This was a multi-centered prospective epidemiological study. The study population consisted of 227 healthy subjects without risk factors, with the exception of age (mean 49 years old, 114 males), and 243 HH subjects (mean 51 years old, 120 males). The carotid IMT and presence of plaques were semi automatically measured in both carotid arteries at a central reading facility. RESULTS: Linear regression analysis of all the subjects revealed that the independent factors of both CCA IMT were age, pulse pressure (PP) and HDL-cholesterol, and that of the right CCA IMT were sex and 10 Yr CHD risk. In healthy subjects, the independent factor of both CCA IMTs was age, and that of the right CCA IMT was body weight. In the HH subjects, age, sex, total cholesterol, HDL-cholesterol and PP were independent factors of both CCA IMTs, but 10 Yr CHD risk was an independent factor of only the right CCA IMT. Carotid plaques were seen in 17% of the healthy subjects and 35% of the HH subjects. An ROC curve analysis showed a right CCA IMT of 0.646 mm and left CCA IMT of 0.656 mm demonstrated 60% sensitivity and specificity in differentiating healthy from HH subjects. CONCLUSION: This result reliably demonstrates the Korean CCA IMT, as well as several other significant pieces of information.
Blood Pressure ; Body Weight ; Carotid Arteries ; Carotid Artery, Common ; Carotid Intima-Media Thickness* ; Cholesterol ; Coronary Disease ; Epidemiologic Studies* ; Humans ; Korea* ; Linear Models ; Middle Aged ; Prospective Studies ; Risk Factors* ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: To avoid the adverse effects of cardiopulmonary bypass and to overcome late vein graft failure, we routinely performed off-pump total arterial coronary revascularization. MATERIAL AND METHOD: From July 2000 to August 2001, 104 consecutive patients underwent first elective off-pump total arterial coronary revascularization. Both internal mammary, radial and gastroepiploic arteries were used. Sequential and composite grafts were used to achieve complete revascularization. Perioperative adverse events and postoperative angiograms were analyzed. RESULT: A total of 252 arterial conduits were used with an average of 2.47 grafts per patient. A total of 326 distal anastomosis were performed with a mean of 3.13 distal anastomosis per patient. Cross over to on-pump occurred in seven patients (6.7%). Of these 4 were due to unstable hemodynamics during lateral or posterior wall stabilization as a result of cardiomegaly and 3 were due to uncontrolled bleeding during dissection of diffusely dimunitive deeply placed intramyocardial coronary arteries. There were no opeartive deaths. Two cases of perioperative myocardial infarction and transient neurologic complications occurred, respectively. Of the 312 distal anastomoses, 308 (98.7%) were compatible with Fitz-Gibbon A or B patency grading. CONCLUSION: Off-pump total arterial coronary revascularization was technically feasible in most elective cases with satisfactory early results. However, on-pump coronary bypass surgery should be considered in difficult circumstances, such as cardiomegaly or unfavorable anatomy of the target coronary artery.
Cardiomegaly ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Vessels ; Gastroepiploic Artery ; Hemodynamics ; Hemorrhage ; Humans ; Myocardial Infarction ; Transplants ; Veins

BACKGROUND AND ackground and Objectives: Smoking has been reported as an important risk factor of laryngeal cancer. Cytochrome P450 1A1 (CYP1A1) and glutathione S-transferase P1 (GSTP1) are genes that encode enzymes which are involved in the metabolism of carcinogens in cigarette smoke. In this study, we statistically tested the significances of smoking and genotypes of CYP1A1 and GSTP1 as risk factors of laryngeal cancer. MATERIALS AND METHOD: In this case-control study, 84 pathologically proven laryngeal cancer patients and 168 age- and sex-matched controls were included as the study subjects. Information on smoking habit was collected using a self-administered questionnaire, and CYP1A1 and GSTP1 genotypes were analyzed using PCR-RFLP method. Chi-square test, Student's t-test and conditional logistic analysis were used to test statistical significance. RESULTS: Smoking was turned out to be a significant risk factor of laryngeal cancer both in univariate and multivariate analyses. The CYP1A1 Ile/Ile genotype was significant in the univariate test, but the statistical significance disappeared in the multivariate conditional logistic model including smoking. The odds ratio (95% confidence interval) of GSTP1 A/A genotype for laryngeal cancer was 0.71 (0.38, 1.33), which was not statistically significant. CONCLUSION: Smoking is the most potent risk factor among the three factors, and the genotypes of CYP1A1 and GSTP1 would not be major risk factors for laryngeal cancer in Koreans.
Carcinogens ; Case-Control Studies ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 Enzyme System ; Genotype ; Glutathione Transferase ; Humans ; Laryngeal Neoplasms* ; Logistic Models ; Metabolism ; Multivariate Analysis ; Odds Ratio ; Polymorphism, Genetic* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Tobacco Products

Pigmented villonodular synovitis is a benign proliferative disorder affecting the synovium. In 1941, Jaffe assembled under the common term of pigmented villonodular synovitis dissimilar lesions described by different names, that issuch as giant cell tumors of synovial tendon sheaths, actual pigmented villonodular synovitis, and villonodular bursitis. (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, or diffuse, usually arising in the vicinity of large joints.) Involvement of the temporomandibular joint is very rare. (We report a rare case of pigmented villonodular synovitis of the temporomandibular joint that invaded the mandibular condyle. A 34-year-old man had a large left preauricular (parotid) mass for two years that he had focal facial nerve paralysis, temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. At surgical exploration, a tumor was found to be severely adhered sion to the facial nerve and involving the temporomandibular joint. Histologically, Tthe resected specimen histologically was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.) The appearance was typical of the family of lesions that includes pigmented villonodular synovitis, bursitis, and tenosynovitis . rewritten as follows: (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, and spread to other parts after arising in the vicinity of large joints.) rewritten as follows: (A 34-year-old man had a large left preauricular (parotid) mass for two years and showed focal facial nerve paralysis in the temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. Surgical exploration revealed a tumor that was severely connected to the facial nerve involving the temporomandibular joint. Histologically, the resected specimen was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.)
Adult ; Bursitis ; Facial Nerve ; Fingers ; Giant Cell Tumors ; Histiocytes ; Humans ; Joints ; Mandibular Condyle ; Paralysis ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Temporomandibular Joint* ; Tendons ; Tenosynovitis

BACKGROUND AND OBJECTIVES: Although it is well known that mitral valve repair provides a better postoperative outcome than valve replacement for mitral valve prolapse with mitral regurgitation, there haven't been much studied the nature of remnant regurgitation and the change of heart function and structure by remnant regurgitation after mitral valve repair surgery. We tried to research for it. METHODS AND RESULTS: Retrospective analysis of echocardiographic data and medical records was done in patients who underwent repair surgery for mitral valve prolapse with significant mitral regurgitation at the Keimyung University Dong-san Medical Center from February 1996 to February 2000. Patients who underwent echocardiography before and after the surgery were selected for the analysis. Of patients who underwent mitral valve repair surgery for mitral valve prolapse with mitral regurgitation during that period, 30 patients (male 15, female 15) were included in this study. The average age of them was 44.30+/-14.30 year old. After surgery, heart chamber size was decreased significantly in all patients (e. g. LVDd 6.25+/-1.06 cm vs. 5.14+/-0.62 cm, LV mass 272.46+/-107.36 gm vs. 197.30+/-75.16 gm). Remnant mitral regurgitation after repair surgery was found in 22 patients (73.3%). Remnant mitral regurgitation above trivial flow was found in 10 patients. Such case as involving ant. leaflet was found in 5 patients (16.7%), as involving post. leaflet, in 2 patients (6.7%), as involving both leaflet, in 3 patients (10%) among 10 ones. Eccentric flow among remnant regurgitation, was observed in 2 patients who underwent repair surgery for ant. leaflet, 1 patient who underwent repair surgery for both leaflet. CONCLUSION: Mitral valve repair surgery reduce the left ventricular chamber size and left ventricular mass. Postoperatively, patients who involve ant. leaflet were much remnant regurgitation above trivial flow more than others.
Ants ; Echocardiography ; Female ; Heart ; Humans ; Medical Records ; Mitral Valve Insufficiency* ; Mitral Valve Prolapse* ; Mitral Valve* ; Retrospective Studies ; Thoracic Surgery

BACKGROUND AND OBJECTIVES: Parathyroid gland tumor is a relatively rare disease in Korea. The purpose of our study is to assess the clinical features, diagnostic tools and therapeutic results. MATERIALS AND METHOD: Seven patients with parathyroid gland tumor were analyzed retrospectively. They were diagnosed and received surgical therapy in our hospital from 1995 to 1999. The patients were all female with mean age of 45.3 years (in the range of 21-64 years old). We used ultrasonography, computed tomography, magnetic resonance imaging, parathyroid scan and 18F-FDG positron emission tomograph (PET) to identify the location of parathyroid gland neoplasm. RESULTS: All patients received proper surgical management. Three patients were diagnosed as parathyroid carcinoma, three as parathyroid adenoma and one patient as cavernous hemangioma. Two patients were found as recurrent tumor, Parathyroid carcinoma recurred in one patient, and parathyroid hyperplasia occurred in patient who was previously diagnosed as parathyroid adenoma. CONCLUSION: The results would he a useful guideline for better diagnostic strategies, proper surgical management and follow-up study for recurrence in the parathyroid gland tumor.
Electrons ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Hyperplasia ; Korea ; Magnetic Resonance Imaging ; Parathyroid Glands* ; Parathyroid Neoplasms ; Rare Diseases ; Recurrence ; Retrospective Studies ; Ultrasonography