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Impact of Gender Differences in Elderly Patients with Acute Myocardial Infarction (고령의 급성 심근경색증 환자에서 성별에 따른 영향)

  • Seol, Soo Young;Jeong, Myung Ho;Lee, Seung Hun;Sohn, Seok-Joon;Cho, Jae Yeong;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Park, Hyung Wook;Kim, Ju Han;Ahn, Youngkeun;Cho, Jeong Gwan;Park, Jong Chun
    • The Korean Journal of Medicine
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    • v.94 no.1
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    • pp.96-106
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    • 2019
  • Background/Aims: It is well known that gender differences are associated with clinical outcomes in patients with acute myocardial infarction (AMI). However, it is not clear whether gender differences affect the prognosis of elderly patients with AMI. Methods: We analyzed the incidence of in-hospital complications and mortality in the Korea Acute Myocardial Infarction Registry-National Institutes of Health from November 2011 to June 2015. This study included elderly patients (≥ 75 years) diagnosed with AMI. Results: A total of 2,953 patients were eligible for this study. Among them, 1,529 (51.8%) patients were female, and the mean age of the female group was older than that of the male group (80.7 ± 4.4 vs. 79.6 ± 4.0 years, respectively, p < 0.001). Elderly females utilized emergency medical services less frequently compared with elderly males (11.5 vs. 15.4%, respectively, p < 0.001). Elderly female AMI patients had a similar rate of in-hospital mortality compared with elderly males (7.1 vs. 8.4%, respectively, p = 0.196). The rate of major cardiac adverse events (MACEs) was lower in elderly females than males during a 12-month follow-up (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.00-1.41, p = 0.045). According to multivariate analysis, the male gender is an independent factor for predicting 1-year MACEs (HR 1.37, 95% CI 1.14-1.65, p < 0.001). Conclusions: No significant differences in peri-procedural complications or in-hospital mortality were observed between male and female elderly patients with AMI. However, elderly female patients had a more favorable prognosis than male patients during a 1-year clinical follow-up.

Clinical Study of Corrosive Injury of the Esophagus (식도부식증의 임상적 고찰)

  • 박철원;송기준;이형석;안경성;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.5.3-6
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    • 1981
  • There are too many kinds of esophageal corrosive agents, such as sodium hydrochloride, acetic acid, hydrochloric acid, etc. Esophageal burn due to above chemical agents are decreasing recently, but still many patients visited to the hospital because of swallowing corrosive agents for the purpose of suicide or accidentally. Among the treatment of corrosive injury of the esophagus, prevention of esophageal stricture is the key point. Recently various methods are using as the treatment of corrosive esophagitis and prevention of esophageal stricture. 51 cases of corrosive injury of the esophagus who had been admitted and treated at the Dept. of Otolaryngology, Han Yang University Hospital during past 9 years (from May 1972 to Dec. 1980) were evaluated and report the result about age distribution, sex incidence, monthly distribution, cause of swallowing, swallowing agents, arriving time at hospital after swallowing, changes on oral and pharyngeal mucosa, laboratory findings, emergency treatment and treatment during admission, treatment follow up results and complications with review of liter ature. Following results were obtained; 1. Female patients 27 cases (52.9%) were more than male patients 24 cases (47.1%) and its ratio was 1.13 : 1. 2. Age distribution showed predilection for age of 21-30 with 20 cases(39.2%), and 11-20 with 11 cases (21.6%), 31-40 with 7 cases(13.7%), over 50 with 7 cases (13.7%) were following. 3. Monthly distribution showed predilection for March with 8 cases(15.7%), and April, July with 7 cases (13.7%), September with 6 cases(l1.8%), October 5 cases(9.8%) were following. 4. For the purpose of suicide was the most cause of swallowing with 40 cases(78.4%), and accidentally swallowing 11 cases(21.6%). 5. Acetic acid was the most swallowing agent with 24 cases (47.0%), and hydrochloric acid 11 cases (21.5%), lye 8 cases(15.7%), iodine 2 cases(3.9%) were following. 6. Arriving time at the hospital after swallowing showed predilection for within 12 hours with 42 cases (82.4%), and from 12 hours to 24 hours with 4 cases(7.8%) was next. 7. Moderate change with injection and swelling was the prevalent change on oral and pharyngeal mucosa with 20 cases(39.2%) and severe cases with ulceration 18 cases (35.3%), mild cases with injection 10 cases (19.6%) were following. 8. Leukocytosis was seen on 40 cases (78.4%), and increased Hct. was seen 31 cases (60.8%). On urine analysis, 14 cases(27.5%) showed over 1.030 S.G., and proteinuria was seen on 25 cases(49.0%), glycosuria was seen on 5 cases(9.8%) and hematuria was seen on 6 cases(11.8). 9. Gastric lavage was done on 30 cases (58.8%) as emergency treatment and on 3 cases(5.9%) tracheostomy was done for the airway keeping. 10. As methods of treatment during admission, L-tube insertion was done on 50 cases (98.0%), antibiotics was given to 49 cases (96.1%), steroid and antacid were given to 46 cases(90.2%). 11. 36 cases(70.6%) were in favorable condition after proper treatment, but 2 cases (3.9%) were expired during admission, 4 cases (7.8%) showed esophageal stricture in-spite of treatment, and 1 case(2.0%) showed pyloric stenosis. 12. Complications were observed in 8 cases (17.7%). Renal failure (4 cases), aspiration pneumonia (2 cases), upper G-I bleeding (1 cases), and diabetic coma (1 cases) were seen in order of frequency.

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Inter-regional Transport Accident Mode Comparison Using National Hospital Discharge Patients Injury Survey (퇴원손상환자조사를 이용한 지역간 운수사고 양상 비교)

  • Lim, Nam-Gu;Lee, Jin-Yong;Na, Baeg-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.2
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    • pp.747-754
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    • 2012
  • The purpose of this study was to compare inter-regional accident modes using the National Hospital Discharge Patient Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized as 5 groups according to their financial self-reliance ratio. The main results are as follows. First, transport accidents had increased by the age group of 25 to 44 but decreased thereafter. Second, the frequency of car accidents was the highest among several types of transport accidents. Most common site of transport accidents was roads and highways. Third, there was significant difference in the modes of transport accident among regions. Fourth, emergency admission rate was quite different according to regional groups but it was no significant difference by economic status. Lastly, there was significant difference in injury patterns by region groups. In regions which were high economic status, there were relatively less serious injury patterns such as sprain, strain, dislocation while regions which were in low economic status had experienced serious injury including fracture, stab wound, and open fracture. We could find the difference in accident modes by regional economic status. Therefore, health authority should consider different accident prevention strategies by regional groups.

Assessing Disaster Response Capability and Feature Analysis for Coastal Residents of Korea using Sampling Process (표본추출법을 이용한 연안주민의 재해대응능력 평가 및 특성 분석)

  • Kang, Tae-Soon;Oh, Hyeong-Min;Kim, Jong-Kyu;Jeong, Kwang-Young;Hwang, Soon-mi;Kim, Soo-Min
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.20 no.1
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    • pp.55-61
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    • 2017
  • This study conducted a survey to evaluate the disaster response capability of coastal residents and analyzed the characteristics. For the sampling process, nonrandom sampling method was used. Sample size is 4,520 and sample error is ${\pm}1.5%p$ at 95% confidence level. As a result of the survey, 72% and 68% of the respondents said that they recognized the emergency contact network and listened to the disaster broadcast. On the other hand, 17% and 18% said that they organized the local voluntary disaster prevention teams and participated in disaster preparedness training. In addition, male's disaster response capability was higher than female's, and first aid techniques and participation in disaster preparedness training were higher in teens and twenties. By occupation, public official possess the highest response capability. By region, it was high in the East coast and low in the South coast. It is necessary that the authorities improve the national disaster preparedness training and publicity to enhance the coastal disaster response capability of coastal residents.

Utility Comparison of Chest Lateral Decubitus Projection with AP and PA Position (흉부 측와위 촬영 시 전후방향과 후전방향 검사의 유용성 비교)

  • Choi, Guirack
    • Journal of the Korean Society of Radiology
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    • v.7 no.3
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    • pp.233-238
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    • 2013
  • Chest lateral decubitus radiation exposure PA be carried out in general, but emergency patient or the patient's discomfort in the body examination had a lot of inconvenience. In this study, we compared AP and PA image quality, patient safety, and analysis of the examination effectiveness between the two tests was to evaluate the usefulness. Pleurisy or pneumothorax in patients with suspected or diagnosed chest lateral decubitus radiation exposure 30 consecutive patients (male 20 patients, 10 females) were included in the study. Image quality evaluation method microstructure of lung, wide areas of diagnosis, a clear air-fluid interface, the patient rotate, cardiac shadow and sharp diaphragmatic was based on Department of Radiology specialist, division of pulmonology resident blind test was evaluated by four people. Chest decubitus by radiation exposure the AP and PA position examination the usefulness of comparative analysis Image quality in the AP and PA, whereas there was no significant difference in attitude, Stability of the patient and Radiation's examination efficiency AP position compared to the position of PA scores were higher. PA position does not require a examination may be of AP position in a position to suggest that.

Risk Factors of Coronary Artery Bypass Grafting According to Ventricular Function (좌심실기능에 따른 관상동맥우회술의 위험인자)

  • 이헌재;현성렬
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.885-890
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    • 1997
  • Patients with coronary artery disease and depressed ventricular function have better longterm benefits after coronary artery bypass grafting compared with medical therapy. But operative mortality remains high. This study was designed to identify the risk factors for coronary artery bypass grafting according to ventricular function. The records of 103 patients who underwent coronary artery bypass grafting from truly 1994 to June 1996 were analysed. The patients were divided into two groups based on preoperative ejection fraction: Low EF group(Ejection fraction < 40%, n=24) and Normal EF group(Ejection fraction $\geq$ 40%, n=79). The indication of operation was significantly different between the two groups (p=0.00003). Postinfarction angina was frequent in Low EF group but unstable angina was frequent in Normal EF group. The frequency of cardiomegaly(p=0.0012), serum creatinine abnormality(p=0.0473) and preoperative use of IABP(Intra Aortic Balloon Pump, p=0.0095) were higher in Low EP group. The left internal thoracic artery was used less frequently in Low EP group(p=0.00416). The operative mortality was 8.3% in Low EF group and 5.1% in Normal EF group, but without statistical difference(p=0.5492). In Normal EF group, age (p=0.041) was identified as a significant risk factor for operative mortality. In Low EF group, age(p=0.018), preopertive use of IABP(p=0.0036), hypercholesterolemia(p=0.0007), and emergency of operation(p=0.0037) were identified as significant risk factors. Postoperative morbidity was 50% in Low EF group and 33olo in Normal EP group, but without s atistical significance(p=0.1007). These results suggest that in patients with coronary artery disease and depressed ventricular function, more aggresive coronary artery bypass grafting is needed to improve the symptom and long-term benefit.

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Effects of Simulation-based Education focusing on Cardiopulmonary Resuscitation on Attitude, Self-efficacy and Satisfaction of the Elderly in Rural Community (시뮬레이션 기반 심폐소생술교육이 노인의 태도, 자기 효능감, 만족도에 미치는 효과)

  • Yoo, Je-Bog;Jeong, Jeong-Hee;Bang, Sul-Yeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.460-468
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    • 2017
  • The purpose of this study was to compare the effects of class-based and simulation-based CPR education for the rural elderly on their attitudes toward CPR, self-efficacy, and satisfaction. Using a quasi-experimental design with a nonequivalent control group, this study used a pretest-posttest method with a sample of 43 elderly people aged 65 or older in rural areas. The twenty-two elderly people in the control group received class-based CPR education, while the experimental group underwent both class-based and simulation-based education. Both groups were given surveys to complete before and after the education. The statistical analysis was based on the $X^2$-test, Fisher's exact test, paired t-test, and ANCOVA. The study found no significant differences between the two groups in terms of their attitudes (F=0.89, p=.353). However, statistical differences were found in the self-efficacy (F=5.54, p=.025) and satisfaction (F=4.66, p=.039) between the two groups. This study provides the baseline data indicating that the education methods implemented in this study were effective for the elderly living in rural areas. Thus, it is necessary to make efforts to ensure that the elderly are able to manage emergency situations by boosting their CPR self-efficacy and educational satisfaction through simulation-based education.

Analysis of Exposure Dose According to Chest and Abdomen Combine CT Exam Method (CT 흉·복부 통합검사 시 선량분석)

  • Mo, KyeongHwan;Han, DongKyoon;Lim, HyunSoo;Jeon, WooJin
    • Journal of the Korean Society of Radiology
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    • v.8 no.7
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    • pp.401-408
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    • 2014
  • The purpose of this study is confirmed to usefulness between division exam and combine exam of chest and abdomen according to comparing chest and abdomen radiation dose of division exam and combine exam in CT exam method. This study was conducted on patients who were admitted to the E hospital from July 2013 to March 2014 underwent CT studies for the diagnosis of chest and abdomen disease. In study result, male dose were more higher than female dose according to gender analysis of exposure dose that combine exam effective dose were male $33.10{\pm}2.75mSv$, female $31.66{\pm}3.12mSv$ and chest exam effective dose were male $9.07{\pm}2.62mSv$, female $8.30{\pm}2.18mSv$(p<0.05). And, division exam dose and combine exam dose were similar in gender comparison (p>0.05). And, combine exam effective dose, only chest exam effective dose, only abdomen exam effective dose were more higher than DRL(Diagnostic Reference Level) in comparison of patient exposure dose with DRL (p<0.05). In conclusion, chest-abdomen combine exam dose and division exam dose were similar. The chest-abdomen combine study can be used as follow-up and emergency trauma patients. That study will be reduce exam time and the occurrence risk of side effect of the contrast medium.

Congenital Ileal Atresia in Newborn (신생아 선천성 회장 폐쇄증)

  • Huh, Young-Soo;Kim, Chang-Sig;Shin, Son-Moon
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.35-41
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    • 1994
  • Newborns with ileal atresia freqently present with abdominal distension, bilious vomiting. and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprised of 4 males and 4 females, the ratio of male and female was 1 : 1. 2. Six patients(75%) had been admittted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases : Type I in two(25%), Type II in two(25%), Type IIIa in three(37.5%), Type IIIb in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).

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Impact Assessment of Climate Change on Drought Risk (기후변화가 가뭄 위험성에 미치는 영향 평가)

  • Kim, Byung-Sik;Kwon, Hyun-Han;Kim, Hung-Soo
    • Journal of Wetlands Research
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    • v.13 no.1
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    • pp.1-11
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    • 2011
  • A chronic drought stress has been imposed during non-rainy season(from winter to spring) since 1990s. We faced the most significant water crisis in 2001, and the drought was characterized by sultry weather and severe drought on a national scale. It has been widely acknowledged that the drought related damage is 2-3 times serious than floods. In the list of the world's largest natural disaster compiled by NOAA, 4 of the top 5 disasters are droughts. And according to the analysis from the NDMC report, the drought has the highest annual average damage among all the disasters. There was a very serious impact on the economic such as rising consumer price during the 2001 spring drought in Korea. There has been flood prevention measures implemented at national-level but for mitigation of droughts, there are only plans aimed at emergency (short-term) restoration rather than the comprehensive preventive measures. In addition, there is a lack of a clear set of indicators to express drought situation objectively, and therefore it is important and urgent to begin a systematic study. In this study, a nonstationary downscaling model using RCM based climate change scenario was first applied to simulate precipitation, and the simulated precipitation data was used to derive Standardized Precipitation Index (SPI). The SPI under climate change was used to evaluate the spatio-temporal variability of drought through principal component analysis at three different time scales which are 2015, 2045 and 2075. It was found that spatio-temporal variability is likely to modulate with climate change.