• Title/Summary/Keyword: acute myocardial infarction

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Weighting of Acute Myocardial Infarction Quality Indicators using Delphi Method (델파이기법을 이용한 급성심근경색증 질 평가지표 가중치 부여)

  • Kim, Hyung Seon;Cho, Yeon Hee
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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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.

Morroniside on anti-inflammation activities in rats following acute myocardial infarction

  • Yu, Bangxing;Zhang, Guoxing;An, Yi;Wang, Wen
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.1
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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.

Fabrication and evaluation of label-free protein sensor for diagnosing acute myocardial infarction (급성 심근경색 검지를 위한 비표지식 단백질 센서 제작 및 검증에 관한 연구)

  • Cho, Younggeol;Kang, Ki-Won;Kim, Hyo-Kyum;Cho, Eikhyun;Kang, Shinill
    • Transactions of the Society of Information Storage Systems
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    • v.9 no.1
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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.

골수단핵세포 이식에 의한 심장근육 조직 재생

  • Ryu, Ju-Hui;Kim, Il-Gwon;Jo, Seung-U;Im, Sang-Hyeon;Yu, Gyeong-Jong;Hong, Yu-Seon;Choe, Cha-Yong;Kim, Byeong-Su
    • 한국생물공학회:학술대회논문집
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    • 2003.04a
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    • pp.95-97
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    • 2003
  • Despite recent advances in the treatment of acute myocardial infarction, the ability to repair extensive myocardial damage is limited. To develop a new therapy for myocardial infarction, we examined the possibility of regenerating myocardium by implanting bone marrow-derived mononuclear cells(BM-MNC) . Histological and immunohistochemical examination showed myocardium regeneration and angiogenesis in the cell transplantation site. Isolated perfused (Langendorff) heart experiments revealed enhanced functions of heart. These results suggest that BM-MNC transplantation induce cardiac muscle regeneration and that this approach could be applied as a possible treatment for myocardial infarction.

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Quantitative Assessment of Myocardial Infarction by In-111 Antimyosin Antibody (In-111-Antimyosin 항체를 이용한 심근경색의 정량적 평가)

  • Lee, Myung-Chul;Lee, Kyung-Han;Choi, Yoon-Ho;Chung, June-Key;Park, Young-Bae;Koh, Chang-Soon;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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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.

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The Situational, Clinical and Psychosocial Factors Related to Treatment-Seeking Behavior Among Those with Acute Myocardial Infarction (심근경색증 환자의 상황적, 임상적 요인 및 사회심리적 요인과 치료추구행위에 관한 연구)

  • Kim, Cho Ja;Kim, Gi Yon;Jang, Yeon Soo
    • Korean Journal of Adult Nursing
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    • v.12 no.3
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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.

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Repair of Left Ventricular Free Wall Rupture after Acute Myocardial Infarction: Application of Pericardial Patch Covering and Fibrin Glue Compression A case report (급성심근경색 후 발생한 좌심실벽 파열에서 소심낭과 Fibrin Glue 압박을 이용한 치험 - 1예 보고 -)

  • 김상익;금동윤;원경준;오상준
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.363-366
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    • 2003
  • Background: Left ventricular rupture after acute myocardial infarction is a serious complication with high mortality. Emergency operation is usually the only available treatment. A 76-year-old female with persistent chest pain and syncopal attacks was admitted. Transthoracic echocardiography showed the pericardial effusion and generalized hypokinesia of the inferolateral wall of left ventricle. Coronary angiography revealed a total occlusion of the first diagonal branch. After percutaneous transluminal coronary angioplasty with coronary stent and insertion of intraaortic balloon pump, emergency operation was performed. Under cardiopulmonary bypass and cardiac arrest with cold blood cardioplegia, coronary artery bypass graft with saphenous vein, pericardial patch covering on the rupture area with 6-0 polypropylene running sutures, and fibrin glue compression under the patch were performed. We present a case of left ventricular (free wall) rupture after acute myocardial infarction.

A Survey on the Delay Time Before Seeking Treatment and Clinical Symptoms in Patients with Acute Myocardial Infarction (급성 심근경색증환자의 임상적 증상과 치료추구시간의 지연)

  • 박오장;김조자;이향련;이해옥
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.659-669
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    • 2000
  • Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. Center, USA The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment. 4. The differences of time sought for treatment between perceptions about the seriousness of the symptoms were significant (F= 6.5, p< .01). The more serious the heart symptoms they felt, the shorter the seeking time for treatment. 5. The differences of the time delay before treatment between the degree of the symptoms were significant (F= 2.9, p< .05). The patients with the typical chest pain and discomfort spent shorter the seeking time for treatment than those with the atypical symptoms of acute myocardial infarction. 6. The differences of transportation time to the first hospital between the types of cars that the patients used, were significant (F= 4.3, p< .01). When the patients used 119 or 129 they spent the least time (5.3 minutes) for transportation, and followed by way of an ambulance (15.6 minutes), private car (20.6 minutes), and taxi (24.8 minutes).

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Early hypothermia improves outcomes of cardiopulmonary resuscitation after cardiac arrest in acute myocardial infarction rat models (급성심근경색 쥐 모델의 심정지 후 조기 저체온 치료가 심폐소생술 결과에 미치는 효과)

  • Park, Jeong-Hyun;Im, Hee-Kyung;Kim, Jee-Hee;Lee, Young-Il
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.2
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    • pp.7-19
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    • 2016
  • Purpose: To investigate the effect of early hypothermia on post-resuscitation myocardial recovery and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction(MI). Methods: Thoracotomies were performed in 10 male Sprague Dawley rats weighing 450-455g. Myocardial infarction was induced by ligation of the left anterior descending coronary artery. Ninety minutes after arterial ligation, ventricular fibrillation was induced, cardiopulmonary resuscitation was subsequently performed before defibrillation was attempted. Animals were randomized to control group and experimental group(acute MI-normothermia)($32^{\circ}C$ for 4 hours). Duration of survival was recorded. Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured using echocardiography. Results: Myocardial function was significantly better in hypothermia group than the control group during the first 4 hours post-resuscitation. The survival time of the experimental group was greater than that of the control group(p<.050). Conclusion: This study suggests that early hypothermia can attenuate post-resuscitation myocardial dysfunction after acute myocardial function, and may be a useful strategy in post-resuscitation care.

Progression of Korean Herbal Medicine and Conventional Medicine Administration for Cough in Patients with Myocardial Infraction Relapse Suspected of Developing Acute Respiratory Infection: Case Report (호흡기감염 후 심근경색이 재발한 것으로 의심되는 환자의 기침에 대한 한양방 약물 병용투여 경과 : 증례보고)

  • Kim, Bo-min;Jo, Hee-geun
    • The Journal of Internal Korean Medicine
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    • v.40 no.1
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    • pp.145-153
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    • 2019
  • Objectives: This case is significant as a rare observational record at the Korean medical practice field. This case reports progression of co-administration of Korean herbal medicines and conventional medicines for cough in patients with myocardial infarction relapse suspected of developing acute respiratory infection. Methods: First, the chest radiography, CBC count and urinalysis were performed to estimate patient's systematic condition. After the estimated diagnosis, the patient was treated with modified Dingchuan decoction, antibiotics, and complex syrup for cough. We used the Cough-Specific Quality-of-Life Questionnaire (CQLQ) to assess patient's respiratory symptoms. Results: Co-administration of Korean herbal medicines and conventional medicines resulted improving of cough and sputum symptoms. Laboratory analysis items and total score of CQLQ also showed significantly improved results. Adverse effects were not observed. Conclusions: In this case, we concluded that co-administration of Korean herbal medicine and conventional medicine may be an effective therapy for the treatment of cough in patients with myocardial relapse of developing acute respiratory infection.