ABSTRACT
BACKGROUND: This study investigates the potential volume and outcome association of coronary heart disease (CHD) patients who have undergone percutaneous coronary intervention (PCI) using a large and representative sample. METHODS: We used a National Health Insurance Service-Cohort Sample Database from 2002 to 2013 released by the Korean National Health Insurance Service. A total of 8,908 subjects were analyzed. The primary analysis was based on Cox proportional hazards models to examine our hypothesis. RESULTS: After adjusting for confounders, the hazard ratio of thirty-day and 1-year mortality in hospitals with a low volume of CHD patients with PCI was 2.8 and 2.2 times higher (p=0.00) compared to hospitals with a high volume of CHD patients with PCI, respectively. Thirty-day and 1-year mortality of CHD patients with PCI in low-volume hospitals admitted through the emergency room were 3.101 (p=0.00) and 2.8 times higher (p=0.01) than those in high-volume hospitals, respectively. Only 30-day mortality in low-volume hospitals of angina pectoris and myocardial infarction patients with PCI was 5.3 and 2.4 times those in high-volume hospitals with PCI, respectively. CONCLUSION: Mortality was significantly lower when PCI was performed in a high-volume hospital than in a low-volume hospital. Among patients admitted through the emergency room and diagnosed with angina pectoris, total PCI volume (low vs. high) was associated with significantly greater cardiac mortality risk of CHD patients. Thus, There is a need for better strategic approaches from both clinical and health policy standpoints for treatment of CHD patients.
Subject(s)
Humans , Angina Pectoris , Coronary Disease , Emergency Service, Hospital , Health Policy , Hospitals, High-Volume , Hospitals, Low-Volume , Mortality , Myocardial Infarction , National Health Programs , Percutaneous Coronary Intervention , Proportional Hazards ModelsABSTRACT
Healthy and high quality of life has become the main issue with increasing human life span. Many biological treatments for osteoarthritis of the knee have been tried with limited success. We compared data from 7 patients who underwent total knee arthroplasty and 46 patients who underwent autologous bone-marrow mesenchymal cell induced chondrogenesis (MCIC) for osteoarthritis of grade IV of the Kellgren-Lawrence classification and grade IV of modified Outerbridge classification from 50 to 65 years of age. Clinical evaluation of the 2 groups showed significant improvement in the mean telephone Knee Society Scoring system (tKSS)-A (pain) and tKSS-B (function) scores throughout the postoperative follow-up period. There was no difference in the patients' satisfaction between the 2 groups. MCIC is a treatment option at least for delaying disease progression of osteoarthritis of the knee.
Subject(s)
Humans , Arthroplasty, Replacement, Knee , Bone Marrow , Chondrogenesis , Classification , Disease Progression , Follow-Up Studies , Knee , Osteoarthritis , Osteoarthritis, Knee , Quality of Life , TelephoneABSTRACT
Elongated styloid process or ossification of the styloid or stylomandibular ligament is a source of the craniofacial and cervical pain. Most patients with elongated styloid remain asymptomatic but some patients complain of vague facial pain, otalgia, dysphagia and pain along the distribution of internal and external carotid artery. Differential diagnosis from chronic pharyngotonsillitis, trigeminal neuralgia and glossopharyngeal neulagia is difficult. Because that normal length of styloid process was not evaluated and diagnostic criteria was not unclear in Korea, authors measured the length of styloid process in non-symptomatic 60 adults using Fuchs' method. Key words : Styloid process;Fuchs' series