• 한국컴퓨터정보학회논문지
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• 제17권10호
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• pp.145-154
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• 2012

현대 사회는 서구화된 식생활 패턴과 흡연, 비만 등의 원인으로 인해 심혈관계 질환들이 급증하고 있다. 특히, 급성심근경색은 심혈관계 질환으로 인한 사망의 대부분을 차지하고 있다. 이러한 추세에 따라 해외 선진국에서는 임상생리학적 오류를 줄이기 위해서 자국민의 데이터를 기반으로 급성심근경색의 발병 및 질병에 영향을 미치는 위험인자를 찾는 연구가 활발히 진행되고 있다. 하지만 한국인에 적합한 급성심근경색 예후 진단 예측 시스템이 미비한 실정이다. 따라서 이 논문에서는 KAMIR(Korea Acute Myocardial Infarction Registry) 데이터베이스에서 제공 받은 급성심근경색 환자의 예후 데이터를 기반으로 ST분절 급상승 심근경색 재발 환자들의 단기 사망률 예측모델을 찾고자 한다. 실험을 통해 로지스틱 회귀 분석에 의해 추출된 속성 집합을 적용하였을 때 기존의 원시 데이터 보다 높은 정확도를 얻을 수 있었으며, 인공신경망의 경우 다른 분류기법들보다 높은 성능을 보였다. 이를 통해 ST 분절 급상승 심근경색 재발 환자들의 단기 사망률을 예측함으로써 향후 고위험군 환자들의 관리에 도움을 줄 수 있을 것으로 기대한다.

• 한국응급구조학회지
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• 제17권1호
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• pp.21-39
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• 2013

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

• Journal of Information Processing Systems
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• 제12권1호
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• pp.129-148
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• 2016

Acute myocardial infarction (AMI) is one of the three emergency diseases that require urgent diagnosis and treatment in the golden hour. It is important to identify the status of the coronary artery in AMI due to the nature of disease. Therefore, multi-modal medical images, which can effectively show the status of the coronary artery, have been widely used to diagnose AMI. However, the legacy system has provided multi-modal medical images with flat and unstructured data. It has a lack of semantic information between multi-modal images, which are distributed and stored individually. If we can see the status of the coronary artery all at once by integrating the core information extracted from multi-modal medical images, the time for diagnosis and treatment will be reduced. In this paper, we analyze semantic relations between multi-modal medical images based on coronary anatomy for AMI. First, we selected a coronary arteriogram, coronary angiography, and echocardiography as the representative medical images for AMI and extracted semantic features from them, respectively. We then analyzed the semantic relations between them and defined the convergence data model for AMI. As a result, we show that the data model can present core information from multi-modal medical images and enable to diagnose through the united view of AMI intuitively.

• 한국보건간호학회지
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• 제28권3호
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• pp.565-573
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• 2014

Purpose: Health Insurance Review & Assessment Service (HIRA) launched an Acute Myocardial Infarction(AMI) assessment for the Payment For Performance(Quality Incentives) Pilot Project from July 2007. Assessment measures of AMI were composed of five process measures and one outcome measure, and each measure was incorporated into one composite quality score to Pay for Performance. Method: For calculation of composite quality score, we considered weighting for the measures using the Delphi method. The questionnaire was composed of three measure groups, 'Reperfusion rate'(Fibrolytic therapy received within 60 minutes of hospital arrival, Primary Percutaneous Coronary Intervention within 120 minutes of hospital arrival), 'Medication prescription rate'(Aspirin at arrival, Aspirin prescribed at discharge, Beta-blocker prescribed at discharge) and 'Survival Index'(30-day mortality rate). Result: A panel composed of 18 and completed a questionnaire by allocation of 10 scores to the three above mentioned measure groups. The Delphi was carried out until three rounds of surveys. In conclusion, each measure group was weighted differently and the 10 scores were allocated as 4.5 to 'Reperfusion rate', 2.5 to 'Medication prescription rate', and 3.0 to 'Survival Index'. Conclusion: The results of this study proposed the calculation method for weighting of Acute Myocardial Infarction quality indicators.

• The Korean Journal of Physiology and Pharmacology
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• 제22권1호
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• pp.17-21
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• 2018

Our previous studies have confirmed that morroniside has neuroprotective effects. However, the effects of morroniside on cardiac myocardium remain unknown. Rats were anaesthetized with 10% chloral hydrate (0.35~0.4 mL/kg) and an acute myocardial infarction (AMI) was induced by ligating the anterior descending coronary artery (LAD). Following AMI, morroniside was administered intragastrically for 3 consecutive days at doses of 45, 90 and 180 mg/kg, respectively. Lactate dehydrogenase (LDH) and cardiac troponin T (cTnT) activities in AMI rats in the serum were detected with commercial kits. The expression of IL-6, $IL-1{\beta}$ and $TNF-{\alpha}$ in myocardium was detected by Western blotting analysis. We observed a significant decline in the Q(q) wave amplitude in morroniside-treated rats after 72 h. Additionally, treatment of morroniside decreased the levels of LDH and cTnT in AMI rats. We also observed that morroniside reduced the expression of IL-6, $IL-1{\beta}$ and $TNF-{\alpha}$ in myocardium. Taken together, our findings demonstrate that morroniside had effective anti-inflammatory properties in AMI rats.

• 정보저장시스템학회논문집
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• 제9권1호
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• pp.28-31
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• 2013

We proposed a method to fabricate label-free protein sensor with sub-wavelength nanograting structures to be used for diagnosing acute myocardial infarction. A nickel stamp for the injection molding of nanograting integrated protein sensor was fabricated by electroforming process with high fidelity. By using metallic stamp, we replicated label-free protein sensor via injection molding, which is an outstanding method for low-cost and mass production of polymer products. Finally, we performed a feasibility test, examining cardiac troponin T (cTnT) and anti-cTnT interactions. From the results, we demonstrated that the fabricated protein sensor can provide information for the early and accurate detection of cardiac diseases such as acute myocardial infarction.

• Korean Circulation Journal
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• 제53권9호
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XII)
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• pp.95-97
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• 2003

본 연구에서는 손상된 심근의 재생을 위하여 골수단핵세포를 SD 래트에 이식하였고 5주 후에 심근의 재생, 신생혈관의 형성과 더불어 심장의 기능이 향상되었음을 확인할 수 있었다. 골수단핵세포를 손상된 심근경색 부위에 넣어주는 것은 추가 보완 실험을 통하여 심근경색의 치료법으로서 이용될 수 있을 것이다.

• 대한핵의학회지
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• 제25권1호
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• pp.37-45
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• 1991

Infarct size is a major determinant of prognosis after acute myocardial infarction. Up to date, however, clinically available tests to estimate this size have not been sufficiently accurate. Twelve lead electrocardiogram and wall motion abnormality measurement are not quantitative, and creatine phophokinase (CPK) measurement is inaccurate in the presence of reperfusion or right ventricular infarction. Methods have been developed to localize and size acute myocardial infarcts with agents that are selectively sequestered in areas of myocardial damage, but previously used agents have lacked sufficient specificity. Antibodies that bind specifically only to damaged myocardial cells may resolve this problem and provide an accurate method for noninvasively measuring infarct size. We determined the accuracy with which infarcted myocardial mass can be measured using single photon emission computed tomography (SPECT) and radiolabeled antimyosin antibodies. Seven patients with acute myocardial infarction and one stable angina patient were injected with 2 mCi of Indium-111 labeled antimyosin antibodies. Planar image and SPECT was performed 24 hours later. None of the patients had history of prior infarcts, and none had undergone reperfusion techniques prior to the study, which was done within 4 days of the attack. Planar image showed all infarct patients to have postive uptakes in the cardiac region. The location of this uptake correlated to the infarct site as indicated by electrocardiography in most of the cases. The angina patient, however, showed no such abnormal uptake. Infarct size was determined from transverse slices of the SPECT image using a 45% threshold value obtained from a phantom study. Measured infarct size ranged from 40 to 192 gr. There was significant correlation between the infarct size measured by SPECT and that estimated from serial measurements of CPK (r=0.73, p<0.05). These date suggest that acute myocardial infarct size can be accurately measured from SPECT Indium-111 antimyosin imaging. This method may be especially valuable in situations where other methods are unreliable, such as early reperfusion technique, right ventricular infarct or presence of prior infarcts.

• 성인간호학회지
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• 제12권3호
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• pp.323-333
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• 2000

The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows ; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was $12.09{\pm}11.44$ hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.