Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients

Kim, Eun Jung,Jeong, Myung Ho,Kim, Ju Han,Ahn, Tae Hoon,Seung, Ki Bae,Oh, Dong Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, Shung Chull,Kim, Kwon-Bae,Kim, Young Jo,Cha, Kwa Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.236 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate.</P> <P><B>Methods</B></P> <P>A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status.</P> <P><B>Results</B></P> <P>In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA<SUB>1</SUB>C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, <I>p</I> <0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, <I>p</I> <0.001). Comorbidity including cardiogenic shock (<I>p</I> <0.001), cerebral hemorrhage (<I>p</I> =0.012), decreased Hb≥5g/dL (<I>p</I> =0.013), atrioventricular block (<I>p</I> <0.001) and ventricular tachycardia (<I>p</I> =0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients.</P> <P><B>Conclusions</B></P> <P>These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients.</P>

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

Kim, Jong Hun,Baik, Seung Hee,Chun, Byung Chul,Song, Joon Young,Bae, In-Gyu,Kim, Hyo Youl,Kim, Dong-Min,Choi, Young Hwa,Choi, Won Suk,Jo, Yu Mi,Kwon, Hyun Hee,Jeong, Hye Won,Kim, Yeon-Sook,Kim, Jeong Elsevier 2018 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.74 No.-

<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK).</P> <P><B>Methods</B></P> <P>Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015.</P> <P><B>Results</B></P> <P>A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (<I>p<</I> 0.001). In particular, early death within 7days of hospitalization accounted for 60.6% (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped.</P> <P><B>Conclusions</B></P> <P>This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization of the elderly with the 23-valent polysaccharide vaccine (PPSV23) was implemented in Korea in 2013. </LI> <LI> Overall in-hospital mortality was 34.2% for adult invasive pneumococcal disease (IPD) and 51.0% for patients ≥75 years of age. </LI> <LI> Mortality risks were older age, higher bacteremia score, and immunocompromised status. </LI> <LI> An effective vaccination strategy for those at higher risk of IPD is needed. </LI> </UL> </P>

In-vitro and In-vivo Anti-hyperglycemic Effects of Nipa palm (Nypa fruticans Wurmb) Extract

Kyung-Tae Kwon,Gi Jung Kim,Tae Yang Kim,Jin-A Yu,Su-Young Lee,Ji-Yoon Hong,Ye Lim Jang,Tessema Haimanot Miticu,Young-In Kwon 한국식품영양과학회 2021 한국식품영양과학회 학술대회발표집 Vol.2021 No.10

In this study, Nipa palm extract by solvent were investigated for their anti-hyperglycemic and using in-vitro, in-vivo animal models. In-vitro study, we investigated the inhibitory activities of Nipa palm stems and flower extracts by solvent against various digestive enzymes such as α-glucosidase, sucrase, maltase, and glucoamylase. In addition, α-amylase inhibitory activity, oxygen radical absorbance capacity, total phenolic and flavonoid content were measured. Among solvent extract, stem water extract (SWE) had the highest α-glucosidase inhibitory activity (3.6 mg/ml of IC50) and high sucrase inhibitory activity (0.28 mg/ml IC50). Furthermore, the extracts were investigated for in-vivo post-prandial blood anti-hyperglycemic effect using Sprague-Dawley(SD) rat model. The maximum blood glucose concentration(Cmax) in SWE-treated SD-rat (0.5 g-ΚBE/kg-bw) was significantly lower than in untreated SD-rats (199.9±10.4 vs. 222.0±15.4 hr·mg/dL, p<0.05). These results indicate that SWE may improve exaggerated post-prandial spikes in blood glucose via inhibition of intestinal α-glucosidase and thus delays carbohydrate absorption in colon.

The level of urinary aflatoxin M1 in Korean adults

Yong-Dae Kim1, Hyojin Kwon, Sun-In Moon, Sang-Yong Eom, Jung-Duk Park, Byung-Sun Choi, Seok-Joon Sohn, Young-Seoub Hong, Ho Kim, Ho-Jang Kwon, Ji-Ae Lim, Hae-Jung Yoon, Gwang-Jin Kim, Heon Kim 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.3

Competitive ELISA methods were used to measure the level of aflatoxin M1 (AFM1) from urine in 1008 Korean adults. Subjects were selected by random sampling in all areas of Korea, except Cheju-do. The recovery rate of AFM1 using this method was 105% (73-124%). The geometric mean of urinary AFM1 in all subjects was 3.43 pg/mL (3.67 ng/g creatinine). The level of AFM1 in males was statistically higher, compared with female subjects. However, the levels of AFM1 did not differ according to age. Subjects in Chungbuk-do showed the highest urinary AFM1 concentration, whereas subjects in Kyeongnam-do showed the lowest concentration. Assuming an excretion rate of 5%, this AFM1 excretion corresponds to approximately 0.1 microgram/day in Korean adults.

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : Changing Pattern Of Digestive And Liver Disease In Korea, 1990-2006 Year; A Single Center Study

( Jung Hyun Kwon ),( Sang Woo Kim ),( In Sik Chung ),( Myung Gyu Choi ),( Kwan Woo Nam ),( Jung Pil Suh ),( Jae Hyuck Chang ),( Won Haing Hur ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: Westernization in many Asian countries have changed lifestyles and diets, so once rare diseases have now become prevalent. The aim of this study is to investigate the changing pattern of digestive and liver disease in Korea, from 1990 to 2006. Methods: We extracted data specific gastrointestina (GI) disease based on the International Classification of Diseases code from the in-patients records at the Kangnam St. Mary`s Hospital in 1990, 1996 and 2006. This hospital is a tertiary-care hospital in Seoul, Korea, which has a capacity of 800 beds. Results: The admission rate for GI disease increased between 1990 and 2006. Overall in-patients were 1,623 persons in 1990, 2,368 persons in 1996 and 4,166 persons in 2006. The mean age of in-patients increased as time went by. A stomach cancer was the most common diagnosis during all periods, but its prevalence has decreased. Colon cancer ranked the 7th in 1990, but markedly increased and now ranks the second. The third was a hepatocellular carcinoma. The bile duct and gallbladder cancer, pancreas and esophageal cancer ranking followed with little interval change. In cases of cancer patients, a regular admission dramatically increased for chemotherapy. The number of patients admitted with pre-malignant neoplasm of stomach and colon increased remarkably with the development of endoscopy. The liver transplant, inflammatory bowel discase, and reflux esophagitis emerged form mid-1990s with greater frequencies, yet much below the levels found in the West. The admission rate for peptic ulcer, especially ulcer bleeding remained relatively stable, despite a decreased rate for ulcer perforation. Liver cirrhosis, hepatitis, cholelithiasis with cholecystitis-cholangitis, appendicitis, hemorrhoid and gastritis all decreased. Conclusions: The stomach cancer is the leading cause of admission, despite a recent decline. Colon cancer showed a marked rise. The liver transplant, inflammatory bowel disease and reflux esophagitis were new diagnosis with an increased tendency.

Effects of Indium Composition Ratio on Electrical Stability of Top-gate Self-aligned Coplanar IGZO TFTs under Self-heating Stress Conditions

Yeong-Gil Kim,Chae-Eun Oh,Ye-Lim Han,Dong-Ho Lee,Joon-Young Lee,Kyoung-Seok Son,Jun Hyung Lim,Ick-Joon Park,Sang-Hun Song,Hyuck-In Kwon 대한전자공학회 2024 Journal of semiconductor technology and science Vol.24 No.4

We demonstrated that the indium composition ratio in the channel layer significantly affects the electrical stability of top-gate self-aligned (TG SA) coplanar structure indium-gallium-zinc oxide (IGZO) thin-film transistors (TFTs) under self-heating stress (SHS) conditions. The transfer curves of the In-poor IGZO TFT continuously shifted in the positive direction with extended stress time, without a significant change in the subthreshold swing (SS) and field-effect mobility (μFE) values during SHS application. In contrast, the transfer curve of the In-rich IGZO TFT shifted in the negative direction until the SHS time reaches 1200 s, after which it shifted in the positive direction with extended stress time. Besides, SS and μFE values continuously increased as the SHS time increased in the In-rich IGZO TFTs. The unusual behavior of the TG SA coplanar In-rich IGZO TFT during SHS is mainly attributed to the more pronounced diffusion of hydrogen (H) atoms from the n+-IGZO source/drain extension region to the IGZO channel region in the In-rich IGZO than in the In-poor IGZO. The H atoms diffused into the IGZO channel layer act as either shallow donors or deep acceptors, depending on their concentration and environmental conditions, thus causing the abnormal behavior of IGZO TFTs during SHS.

Comparison of clinical characteristics and prognosis of pneumocystis jirovecii pneumonia in patients with immunocompromised and non-immunocompromised conditions

( Hong-joon Shin ),( Min-seok Kim ),( Bo Gun Kho ),( Ha Young Park ),( Tae-ok Kim ),( Cheol-kyu Park ),( Yong-soo Kwon ),( In-jae Oh ),( Yu-il Kim ),( Sung-chul Lim ),( Young- Chul Kim ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Pneumocystis jirovecii pneumonia (PCP) is a fatal respiratory infection frequently associated with immunocompromised (IC) conditions. Although PCP has been reported in non-immunocompromised (non-IC) patients, however, few studies have been conducted. This study was aimed to compare the clinical characteristics and prognosis of PCP in IC and non-IC patients. Methods: We retrospectively analyzed patients who were suspected of having PCP with polymerase chain reaction (PCR) test positive for Pneumocystis jirovecii from January 2013 to May 2019. IC group was classified into human immunodeficiency virus (HIV), hematologic, solid organ tumor, rheumatologic and immunosuppressive agent group. Results: A total 192 PCP cases including 176 IC cases and 16 non-IC cases were analyzed. Patients were older in the non-IC group compared with the IC group (72.5 vs. 62.0, P=0.002). Hematologic malignancy was the most common (47.2%), followed by HIV (14.8%) in the IC group. The interval between test for PCP-PCR and PCP treatment was shorter in the IC group compared with non-IC group (0 [0-3] vs. 4.0 [2.2-7.7] days, P=0.001). In-hospital mortality was not significantly different between IC and non-IC groups (43.2% vs. 62.5%, P=0.189). Age (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.02-1.09; P=0.002) and PaO₂/FiO₂ (OR 0.99; 95% CI 0.98-1.00; P=0.039) were the prognostic factors for in-hospital mortality in the multivariate logistic regression analysis. There was no significant difference between IC and non-IC group in 6-month survival. However, HIV group had better 6-month survival compared with non- IC group in the subgroup analysis (Hazard ratio 0.16; 95% CI 0.05-0.53; P=0.003]. Conclusion: Patients with PCP in non-IC group were older than IC group, and had similar prognosis as other IC group except HIV group.

혈액투석시 Double Lumen Silicone Rubber Catheter ( = Permcath ) 사용의 임상적 경험

차대룡(Dae Ryong Cha),김선숙(Sun Sook Kim),이영호(Young Ho Lee),권영주(Young Joo Kwon),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim),선경(Kung Sun),김정숙(Jung Sook Kim),함인귀(In Gui Ham),김미경(Mi Kyung Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.4

Background: Repeated, long-term access of the vascular system is a prerequisite for successful extended care of the patients with end stage renal disease (=ESRD) treated with hemodialysis. Despite recent technical advances in percutaneous venous cannulation, vascular access remains a major problem in patients requiring acute Hemodialysis. Although the subclavian cannula has gained a large clinical acceptance in recent years, it carries specific risks such as hemothorax, pneumothorax, venus stenosis, thrombus formation and infection. Recently, a double-lumen, central venous catheter made of Silicone Rubber (=Perm cath) has developed for use as a vascular access device, This device is particularly useful in patients who have exhausted other vascular access sites or who have severe cardiovascular disease. Methods: A total of 23 dual-lumen silicone rubber catheters were placed through the internal jugular vein in 23 patients as a vascular access at our institution during the period of April, 1992 through November, 1992. The perm-cath (Hemocath, Quinton, Seattle) is 36 Cm long and each lumen has an internal diameter of 2 mm. Implantation of the catheters occurred in the operating room and under strict aseptic conditions through the right internal jugular vein. A 10 cm subcutaneous tunnel was then created, which extended from the in-cison to a point 2 cm above the ipsilateral clavicle. The catheter was passed out through the upper portion of the subcutaneous tunnel with the Dacron cuff placed 2 cm from the lower end of the tunnel, acting as both an anchor and a barrier to infection. The tip of the catheter was inserted through an internal jngular vein terminating in the right atrium under EKG monitoring. Each lumen of the catheter was filled with 1000 units of heparin sodium (1.5 ml in venous line, 1.5 ml in arterial line) and capped. Results : The mean duration of catheter use was 24±16 days (8 to 119 days), and the complication of perm-cath occurred in 3 cases such as venous thrombosis in 1 case, catheter exit site infection in 1 case, and exit site hematoma in 1 case. During hemodialysis, blood flow rate ranged from 190 to 313ml/min (mean:235±26ml/ min), and venous retrun pressure ranged from 20 to 150 mmHg(mean:65±16mmHg). Total 14 catheters were removed during treatment and the causes of catheter removal were patient death in 8 cases, venous thrombosis 1, recovery from acute rena1 failure 2, fistula maturation 2, infection 1. Conclusion: Internal jugular vein cannulation with silastic catheter which offers a new percutaneous method was provided safe and reliable as the temporary central vein access. The catheters are well tolerated by the patients and have the advantages of immediate use after placement, high blood flow rates, no repetitive venipuncture, and no cardiac dysfunction. Permcath is particulary useful in patients who have exhausted other vascular access site, severe cardiovascular disease, and terrified by repetitive venipuncture. Though our initial experience has been favorable, there will be needed to evaluate the outcome of permcath over longer period of time.

정보사회 지체로 인한 학교붕괴 해소책 연구 I ( 정보 ) 주도적 학습체제와 N ( 네트워크 ) 문화 학교풍토개발을 중심으로

이미나(Mi Na Lee),이건만(Kohn Man Lee),박부권(Bu Kwon Park),권숙인(Sook In Kwon),김대일(Dae Il Kim) 한국사회과교육학회 2002 시민교육연구 Vol.34 No.1

Currently, we are experiencing a rapid societal change due to information technology (IT). The perceived rapidity of this change presents major challenges to societal adaptation. Schools, like any other aspect of society, need to adapt to this societal change, originating from the IT revolution. We need to figure out what kinds of educational change need to take place. Therefore, this study explores what are I-directed Learning System and School Environments for Students in Net Culture. This issue is examined through the following three questions: 1. How can an information-oriented learning system play a role in helping students use and produce knowledge on their own? 2. How should education be changed to prepare students to survive in this knowledge-based labor market? 3. How should teachers interact with students in digital code? This study surveys people`s perceptions about the gap between the present state of education and IT society. Separate questionnaires on the suject were given to teachers (n = 206), students (n=474), and parents (n=429) in Seoul. The data were analyzed with x2 tests. Besides, we also adopted qualitative methods such as participant observation in PC room, in-depth interviews with teachers and students about N-generations` culture, and so on. The findings and conclusions are summarized as following. This study found that presently education does not play a good role in offering information-knowlege appropriate to an IT society. Students are also not ready to use internet for gathering information. Most of them tend to use internet for entertainment tools (except for home assignments). School graduates are not able to meet the needs of companies or labor markets in this IT society. In other words, schools neither educate students with high-tech knowledges nor sufficiently nurture their creativity. Students and parents do not perceive the necessity of new concept of knowledge in the knowledge-based society, either. Students in digital code seem to have difficulty in interacting with schools who have stayed in analogue code. However, even students do not interact with others in the original way of digital code. They make virtual human relations not with outsiders of the third group but with intimate school friends. Based upon these findings, this study suggests how an information-oriented learning system should be built. This study analyzes three aspects of schooling regrarding these issues: teachers, curriculum and educational interaction. Regarding the issue of teachers, this study examines what the teachers` role as facilitators should be to help students produce their own knowledge with raw information. In addition, it redefines the concept of the teachers` authority and explores a labor cooperation system of teachers to increase the performance of their own teaching using internet. This study will also suggest various types of curricula which will complement the labour markets in an IT society. For example, the study suggests curricula which allow students diversified tracks; individualized curriculum ordered by each student, who is an educated prosumer and knows what they need; curriculum in fusion style where no borders exists between academic disciplines; and curriculum to enhance the students` practical intelligence as well as critical intelligence. Thirdly, the study investigates how digitalized interaction could be used in an educational setting at school. Proposed in the study are two-way-e-conversations between students within and beyond classrooms, between students and teachers, or between students and e-textbooks. In addition, several ideas to achieve educational goals more successfully are demonstrated using digital technology. This study promotes these kinds of educational reforms as result of the IT revolution. School is not an exception; it should also be flexible in a changing and evolving society.