ABSTRACT
BACKGROUND/AIMS: Although notably common, irritable bowel syndrome (IBS) has no specific cure. Lifestyle modification may be as important as medication; however, few studies support the effectiveness of such modifications. We performed this observational study of IBS patients to explore further the role of lifestyle changes in treatment. METHODS: This study included 831 men who enlisted in 2010 as armed surgeon cadets and 85 women who concurrently entered the Armed Forces Nursing Academy. Of these 916 participants, 89 were diagnosed with IBS using the Rome III criteria. Subjective changes in bowel habits, quality of life, pain, stress, stool frequency and stool consistency were surveyed before and after 9 weeks of army training. We evaluated the lifestyle risk factors that impacted improvement in IBS symptoms by comparing those who responded to lifestyle modification (the responding group) to those who did not respond (the nonresponding group). RESULTS: More than half of the participants (63%) reported that their symptoms improved after training. The quality of life and levels of pain and stress significantly improved after military training. Initial stress levels before military training and smoking history affected IBS symptom improvement. CONCLUSIONS: Lifestyle modification may be effective in managing IBS patients.
Subject(s)
Female , Humans , Male , Arm , Irritable Bowel Syndrome , Life Style , Military Personnel , Prospective Studies , Quality of Life , Risk Factors , Rome , Smoke , SmokingABSTRACT
BACKGROUND: Heterophoria has been considered a disqualifying condition to flying performance because heterophoria, when exposed to high altitude hypoxia, becomes heterotropia causing double vision. However, there has been no actual evidence supporting this assumption. We investigated the binocular fusional ability and symptoms in the subjects having heterophorias upon exposure to acute hypobaric hypoxia. METHODS: 15 subjects having heterophorias and 7 normal controls were included. All the subjects had exophoria and 1 subject had exophoria and hyperphoria. High altitude hypobaric hypoxic condition was simulated in a decompression chamber. Using Worth 4 dot test we measured the binocular fusional ability. To analyze the quality of binocular vision, we measured the stereoscopic visual acuity. By comparing the data between subjects and controls, we evaluated the binocular vision and fusional ability of subjects having heterophorias. RESULTS: All the subjects and controls showed no disruption of binocular fusion on Worth 4 dot test upon exposure to hypoxia. On the whole, 7 of 15 subjects and 3 of 7 controls showed decreased level of stereopsis without significant differences between the two groups. There were no differences in binocular vision including fusional ability and stereopsis between the subjects and the controls in acute hypoxic condition. CONCLUSION: The subjects with heterophorias had stable binocular fusional ability resistant to acute hypobaric hypoxia, which showed no difference from the normal controls. Conclusively, we could not find any disadvantage in heterophoric persons with regard to flying performance. Visual standards for aviation personnel regarding heterophorias also need to be more lenient.
Subject(s)
Humans , Altitude , Hypoxia , Aviation , Decompression , Depth Perception , Diplopia , Diptera , Exotropia , Telescopes , Vision, Binocular , Visual AcuityABSTRACT
BACKGROUND: The physiological change of positive acceleration is primarily focused on the hydrostatic column effects that are associated with acceleration exposures. IOP values during positive acceleration is reduced according to this theory. However, the first trial of IOP measurement during positive acceleration showed that there were no significant changes in IOP values during the +2G phase of parabolic flight. In addition, IOP study during centrifuge exposures showed that there were significant increases in IOP during +2Gz and +3Gz. Therefore, the purpose of this study is to investigate the effect of positive acceleration on IOP. METHODS: The data from 4 normal subjects (2 men and 2 women) were included in this study. The baseline IOPs of subjects were within normal range. The subjects did not wear anti-G suits and use anti-G maneuver during the acceleration exposure. Pressure phosphene tonometer was used to measure IOP. To minimize the difference between the Goldmann tonometer and the pressure phosphene tonometer, IOPs were measured in subjects for 1 week prior to this study. IOP measurements of protocol 1 were obtained with pressure phosphene tonometer at +1Gz (baseline), +2Gz, +3Gz, +4Gz, and again at +1Gz (post). IOP measurements of protocol 2 were obtained at + 1Gz (baseline), +3Gz, and again at +1Gz (post). IOP measurements of protocol 3 were obtained at + 1Gz (baseline), +4Gz, and again at +1Gz (post). A total of 55 IOP measurements for each subject were made. RESULTS: The result showed that there was a significant difference in the means of IOP in protocol 1, 2, and 3 (P<0.05). But, they did not show an increasing or decreasing trend according to increase in acceleration. In particular, subject 1 showed that there was significant decrease of IOP in protocol 1, 2, and 3 compared to the baseline IOP measurements during positive acceleration(P<0.05). Based on symptom questionnaire and VTR review, variable body contractions may affect the IOP measurements during acceleration. There were significant differences in the means of IOP among variable body contractions in subject 1 when compared to the baseline IOP measurements. CONCLUSIONS:Persistent decreases of IOP in subject 1 suggest that the mechanism of IOP changes under positive acceleration could be explained by the hydrostatic column effect. In addition, interpretation for IOP measurements under positive acceleration should be cautious due to variable muscle contraction.
Subject(s)
Humans , Male , Acceleration , Intraocular Pressure , Muscle Contraction , Phosphenes , Reference Values , Surveys and QuestionnairesABSTRACT
BACKGROUND: The present study was done to evaluate the usefulness of SDS-PAGE in measuring glomerular proteins and tubular proteins in patients with type I DM without overt proteinuria. METHODS: The study population consisted of 76 children with type I DM who have been participated in the Taegu Diabetic Camp from 1997 to 2000. We measured urine albumin, NAG, beta2-microglobulin, creatinine level in urine samples collected for 12 hours in 22 children and simultaneously we analyzed urinary proteins by SDS-PAGE. In remainder 54 children, we measured urine albumin, NAG, creatinine level in random morning urines and urinary proteins by SDS-PAGE. RESULTS: In 22 of 76 children, urinary albumin-to-creatinine ratio (mg/mg), NAG (U/g) and beta2-microglobulin (microgram/g) were 0.021, 2.99 and 170.2, respectively. Positive correlation between urine albumin and NAG was statistically significant (r=0.51, p< 0.05). No significant relations between urinary proteins, such as albumin, NAG, beta2-microglobulin, and clinical characteristics, such as age, duration of illness, HbA1c, were observed. In diagnosing `microalbuminuria', sensitivity of SDS-PAGE was 63% and band of tubular proteins was not detected in any children. CONCLUSION: We thought that SDS-PAGE could be one of useful methods in diagnosing early stage of diabetic nephropathy. The more large scale study is necessary.
Subject(s)
Child , Humans , Creatinine , Diabetic Nephropathies , Electrophoresis, Polyacrylamide Gel , ProteinuriaABSTRACT
BACKGROUND: With increasing number of female pilots who fly high-performance aircraft, the gender specific factors have become one of the most important aeromedical considerations. It has been raised that the changes of serum female hormone levels by menstrual cycle may affect vasoregulation and female G-tolerance ultimately. However, the exact relationship between serum female hormone levels and G-tolerance is still unknown. Moreover, well-controlled subjects without taking oral contraceptives are needed to examine the possible effect of menstrual cycle on female G-tolerance. The purpose of this study was to determine how female hormones and menstrual cycle affect female relaxed G-tolerance. METHODS: Eight female subjects were studied to test their relaxed G-tolerance. Seven out of 8 subjects had regular menstrual cycle during the study period. Each subject were exposed to human centrifuge once a week for 4 weeks (one complete menstrual cycle) and blood samplings were performed twice at 2nd and 4th week just before exposure to human centrifuge. The profile of centrifuge training consisted of gradual-onset run (0.1 G/sec) acceleration to the visual endpoint. RESULTS: The changes of 4 different serum female hormone levels failed to show any trend related to relaxed G-tolerance including estrogen. There was no significant difference in relaxed G-tolerance in any menstrual cycle time points. CONCLUSION: We conclude that the changes of female hormone levels and the menstrual cycle have no effect on female relaxed G-tolerance.
Subject(s)
Female , Humans , Acceleration , Aircraft , Contraceptives, Oral , Diptera , Estrogens , Menstrual CycleABSTRACT
BACKGROUND: The present study was undertaken to know health-related lifestyles of Republic of Korea Air Force (ROKAF) pilots and to investigate prevalence of obesity of them.METHODS: 1284 KAF pilots were checked their height, weight, and body composition (% body fat). We also tried questionnaires on their health-related lifestyles which included the effort to be healthy, whether they know weight training is beneficial to G-tolerance, exercise habit and smoking history. RESULTS: Pilots' attitude for health promotion was relatively passive. Many of them know that weight training is good for their G-tolerance, but only 8.1% of the pilots carried out that training. They engaged much more in aerobic training, and also fighter pilots are less participated in weight training than transport pilots. The prevalence of obesity (29.4%) determined by bioelectrical impedance analysis was much higher than that assessed on the basis of height and weight (BMI, body mass index). It is suggested that many pilots who were normal in BMI have abdominal or visceral obesity. CONCLUSION: The health promotion program and physical conditioning program related to increasing G tolerance of KAF pilots flying high-performance aircraft are very important. These programs must be organized and progressed with flight surgeon and Aeromedical center in Chung-ju as leaders.
Subject(s)
Aircraft , Body Composition , Diptera , Electric Impedance , Health Promotion , Life Style , Obesity , Obesity, Abdominal , Prevalence , Republic of Korea , Smoke , Smoking , Surveys and QuestionnairesABSTRACT
BACKGROUND: Current studies have focused mainly on the push-pull effect (PPE), the reduction of +Gz tolerance when hypergravity (>+1 Gz) preceded by hypogravity (<+1 Gz). However, the reduced G tolerance could be induced by any G-transition. The frequency and extent of maneuvers to cause G-transition effect (GTEM) have not been studied previously in fighter aircraft. METHODS: 26 HUD (head-up display) videotapes from F-16 aerial combat training missions were reviewed for the presence of GTEM. The frequency and magnitude of the +Gz profiles were analyzed. RESULTS: GTEMs were found in 34 (29.6%) of 115 engagements reviewed. PPEMs (maneuvers found to cause push-pull effect) and rPPEMs (maneuvers found to cause reversed PPE) were found in 7.8%, 11.3% respectively. Combined maneuver that rPPEM followed by PPEM consecutively was found in 10.4% of engagements. There was no difference the frequency of GTEMs between BFM and ACM engagements (28.8% vs. 30.9%). CONCLUSION: GTEMs including PPEMs and rPPEMs are present in aerial combat training missions of F-16 aircraft and represent a significant source for accidents. These findings support the necessity of continued research into the physiologic response to GTE.
Subject(s)
Humans , Aircraft , Hypergravity , Hypogravity , Religious Missions , Videotape RecordingABSTRACT
A patient with chronic cerebral paragonimiasis began to have new motor seizures of the right face clonic contractions that occurred several hundred times a day resulting in the simple partial status epilepticus. The ictal EEG discharge started from the left frontal region and then spread to the left hemisphere. The ictal discharges were limited clearly to the left hemisphere. The brain MRI showed the multiple conglomerated round nodules with encephalomalacia in the left temporo-occipital lobes. Applying the ictal-interictal subtracted SPECT, we were able to localize the focal ictal hyperperfusion on the left precentral cortex adjacent to the lesions that correspond to the anatomical distribution of the left face motor area.
Subject(s)
Humans , Brain , Electroencephalography , Encephalomalacia , Epilepsies, Partial , Magnetic Resonance Imaging , Paragonimiasis , Seizures , Status Epilepticus , Subtraction Technique , Tomography, Emission-Computed, Single-PhotonABSTRACT
PURPOSE: Minimal Change Disease(MCD) is the most common primary nephrotic syndrome in children. Some suggested that tumor necrosis factor-alpha(TNF-alpha) are involved in the pathogenesis of MCD. This study was done to see the changes of plasma and urinary TNF-alpha, and their effects on the permeability of glomerular basement membrane. METHODS: Study patients consisted of 19 biopsy-proven MCD children aged 2-15 years old. Both plasma and urinary TNF-alpha were measured. Employing the Millicell system, TNF-alpha were screened for the permeability factors. RESULTS: Urinary TNF-alpha during relapse was significantly increased(P<0.01). No significant change was seen in the plasma TNF-alpha during relapse when compared to those in remission and the healthy controls. Furthermore, in the in vitro Millicell system, TNF-alpha did not produce a significant change in albumin permeability. CONCLUSION: Therefore, it seems that TNF-alpha may not play a disease-specific role in the pathogenesis of MCD.
Subject(s)
Child , Humans , Glomerular Basement Membrane , Necrosis , Nephrosis, Lipoid , Nephrotic Syndrome , Permeability , Plasma , Recurrence , Tumor Necrosis Factor-alphaABSTRACT
BACKGROUND: The hostile environment experienced in flying high performance aircraft, including changes in acceleration, atmospheric pressure, vibration, and temperature, may affect cardiac function of the pilot. It is not known, however, whether different mission scenarios with different workloads and emotional stress would differentially affect the heart. To evaluate the effects of four different types of light missions on cardiac function, we analyzed echocardiograms of pilots that were recorded baseline and within 30 min. after flight. METHODS: 78 healthy male pilots (mean age 29 years, range 22-43) who fly high performance aircraft in F-4D fighter squadrons (SQs) were included in this study. Their mean F-4D flight time was 452 h (range 1 1690). These subjects were divided into four groups based on the type of mission they flew: combat air patrol mission (N=20, Group I), air to ground mission (N=19, Group II), air to air mission including combat maneuver (N=22, Group III) and night flight mission (N=17, Group IV). Baseline echocardiograms and questionnaire were recorded at some previous day before actual flight. Echocardiograms and individual questionnaire were repeated within 30 min. after actual flight. Each subject served as his own control. We compared baseline and post-flight measurements and also compared the magnitude of changes among four groups from 18 echocardiographic variables. RESULTS: No echocardiographic variables differed significantly between baseline and post-flight measurements in any of the variables (at paired-t test) at each group. There were no significant differences among four groups for any changes in echocardiographic variables (Change=baseline data-post-flight data). CONCLUSION: We conclude that there were no significant differences in changes in cardiac functions among groups from before to after their missions.
Subject(s)
Humans , Male , Acceleration , Aircraft , Atmospheric Pressure , Diptera , Echocardiography , Heart , Religious Missions , Stress, Psychological , Vibration , Surveys and QuestionnairesABSTRACT
BACKGROUND: This study was designed to examine how glutathione, one of the nucleophilic sulfur compounds, effects the cisplatin cellular toxicity in the non-small cell lung cancer cell lines and normal lung epithel ial cell line. METHODS: Three cultured cell lines, the lung adenocarcinoma cell(NCL-H23), the lung squamous carcinoma cell (SK-MES-1) and the normal lung epithelial cell(L-132) line were exposed to various concentrations of cisplation with or without glutathione. The relative viability was estimated as a means of measuring the cisplatin cellular toxicity using the MTT method. RESULTS: In NCL-23, the response to cisplatin was sensitive but glutathione markedly increased the relative survival of the tumor cells by removing the antitumor effect of cisplatin. In both SK-MES-1 and L-132, the responses to cisplatin were less sensitive, and the chemoprotective effect of glutathione compared to an equal cisplatin dose was signigicantly higher in L-132 than in SK-MES-1(p<0.05). CONCLUSION: The protective effects of glutathione on cisplatin-induced cellular toxicity is more signigicant in normal lung epithelial cells than in squamous carcinoma cells.
Subject(s)
Adenocarcinoma , Carcinoma, Non-Small-Cell Lung , Carcinoma, Squamous Cell , Cell Line , Cells, Cultured , Cisplatin , Epithelial Cells , Glutathione , Lung , Sulfur CompoundsABSTRACT
PURPOSE: Exposure to hostile environment as experienced in flying high performance aircraft, such as changes in acceleration, atmospheric pressure, hypoxia, vibration, and temperature, has been attributed to cardiac function of pilot. The inflight aerial combat environment is one where multistressors with various factors occurs simul-taneously. Accordingly, to evaluate the effects of actual flight with aerial combat mission on cardiac function, we analyzed echocardiograms of 22 pilots before and immediate after actual flight. METHODS: 22 healthy male pilots (mean age 31.00 years) who fly high performance aircraft in F-4D fighter squadrons were included in this study. Baseline echocardiograms with questionnaire were performed before flight. Echocardiograms including individual questionnaire were repeated within 30 min. after flight. Each subject served his own control. We analyzed the different echocardiographic parameters (LVEDD, LVESD, Ao. Root Diam., LA Diam., IVST, LVPWT, EPSS, EF slope, LVEDV, LVESV, E/A Ratio, EF, FS, LV Mass, D-Ao. Flow, D-Pulm. Flow). RESULTS: Mean F-4 flying time of 22 pilots was 663.59 h. By paired-t test, no significant differences were founded between pre-baseline and repeated echocardiographic parameters. One pilot was found to have minimal mitral regurgitation without mitral leaflet thickening or redundancy on color doppler echocardiography. CONCLUSION: We found no significant dif-ferences in cardiac functions after actual flight when compared to pre-baseline cardiac functions.
Subject(s)
Humans , Male , Acceleration , Aircraft , Hypoxia , Atmospheric Pressure , Diptera , Echocardiography , Echocardiography, Doppler, Color , Heart , Religious Missions , Mitral Valve Insufficiency , Vibration , Surveys and QuestionnairesABSTRACT
BACKGROUND: Pilots of tactical aircraft are exposed to sustained accelerations ranging from -1Gz to +9Gz. Pilots are routinely exposed to +2 and +3Gz. It has been known that chronic elevations in intraocular pressure (IOP) are associated with the development of visual impairments, which could lead to a damage of optic nerve fibers with subsequent visual field defects. This IOP alteration may be caused by body fluid shifts resulting from acceleration forces. The IOP, theoretically, will be increased under negative Gz acceleration resulting from cephalad shift of body fluid and should not be increased under positive Gz accelerations according to hydrostatic column effects. However, there is little research regarding intraocular pressure changes during acceleration forces. Therefore, this study was designed to evaluate IOP effects of exposure to +2 Gz, +3 Gz, and -1Gz environments. METHODS: Intraocular pressures were measured on 3 subjects (2 men and 1 woman) during +2Gz, +3Gz, and -1Gz centrifuge exposures on the Dynamic Environment Simulator (DES) centrifuge. Two IOP measurements were obtained with the Ocuton S self-tonometer at +1Gz (Pre-baseline), +2Gz, +3Gz, -1Gz, and again at +1Gz (Post-baseline). A total 60 measures were obtained under +1Gz, + 2Gz, + 3Gz, and -1Gz. RESULTS: The result showed that there was a significant difference in the means for percent change of IOP from pre-baseline to +2Gz, +3Gz, and -1Gz. The mean IOP increased by 19.5% during +2Gz acceleration when compared to pre-baseline (16.3 vs. 19.5 mmHg, P=0.0001). The mean IOP of +3Gz level was 30.2% higher than that of pre-baseline level (16.3 vs. 21.2 mmHg, P=0.0001). The mean of IOP increased 127.9% during -1Gz when compared to baseline values (16.3 vs. 37.1 mmHg, P=0.0001). However, there was no significant difference in IOP between pre-baseline and post-baseline (16.3 vs. 16.0 mmHg, P=0.4261). There were significant differences, in percent change from pre-baseline, among the +2Gz, +3Gz, and -1Gz conditions {F (2,18)=152.05, P=0.0001}. There was a significant difference in the means of IOP at +2Gz and -1Gz (19.5 vs. 37.1 mmHg, P=0.0001). There was a significant difference in the means of IOP at +3Gz and -1Gz (21.2 vs. 37.1 mmHg, P=0.0001). There was a marginal significance in the means of IOP at +2Gz and +3Gz (P=0.0321). CONCLUSION: The conclusion of this study was that significant increases in IOP were found during +2Gz and +3Gz as well as -1Gz when compared to pre-baseline IOP values. These findings suggest that a rise of IOP during +2Gz and +3Gz cannot be explained by the hydrostatic column effects that are associated with acceleration exposure.
Subject(s)
Humans , Male , Acceleration , Aircraft , Body Fluids , Intraocular Pressure , Optic Nerve , Vision Disorders , Visual FieldsABSTRACT
BACKGROUND AND METHOD: For decades, the presence of aortic insufficiency (AI) has been considered a potential hazard in military aviation and has generally excluded aircrew from high performance flight. The cardiovascular effect of repeated exposure of high +Gz forces associated with AI is largely unknown. To evaluate whether the flying of High Performance Aircraft (HPA) was detrimental to subjects with AI, we performed a retrospective review. we studied 32 asymptomatic patients in whom 16 of them had flying time with AI in HPA(Group I), others(GroupII, Control Gr.) in Low-G Aircraft(LGA). Among them, the data of 24 patients were available, 12 in group I., and 12 in group II. The two groups were matched for age, severity of AI, and flying time. RESULTS: Interval echocardiographic, and cineangiographic studies were obtained over a mean period of 4.6+/-2.6 years in group I and 5.9+/-4.2 years in group II (range, 0.9 to 12.7 years) and mean flying time with AI of 528.1+/-435.0 hours in group I and 865.0+/-816.1 hours in group II (range, 50 to 2290 hours). By paired-t test, there were no significant differences between both groups in left ventricular end-diastolic dimension (LVEDD), end-systolic dimension (LVESD), aortic dimension (Ao.D) and fractional shortening (FS) by echocardiography (p>0.05) and by multiple linear regression, there were no significant interval changes of above values in Gr. I according to increasing of flying time with AI (p>0.05). Visual grade by doppler echocardiography or aortic cineangiography increased 1 patient in Gr.I and 2 patients in Gr.II within no more than one grade. CONCLUSION: Thus, this study demonstrated that : 1) Quantitative echocardiographic measurements such as LEVDD, LVESD, Ao.D and FS didn't show significant interval change in Gr.I.2) A single subject with a minor increase in AI severity together with no difference between the HPA and LPA groups argue for a relatively chronic effect of high G exposure in aircrew with mild AI.
Subject(s)
Humans , Aircraft , Aviation , Cineangiography , Diptera , Echocardiography , Echocardiography, Doppler , Linear Models , Military Personnel , Retrospective StudiesABSTRACT
The ROKAF(Republic of Korea Air Force ) has been conducting high G-training with new centrifuge training equipment at Aeromedical Research and Training Center(AMRTC) to enhance G-tolerance since July 1995. All trainees routinely have received ECG monitoring during High G training, both for safety and medical evaluation. The purpose of this study was to estimate the incidence of cardiac dysrhythmia among the fighter pilots of ROKAF and other countries and to investigate the relationship between G-induced loss of consciousness (G-LOC) and the presence of dysrhythmia during High-G training. The electrocardiographic responses of 417 fighter pilots exposed to the standard centrifuge high-G training profile were analysed. Dysrhythmias were observed in 204(42.7%) of the sessions, Ventricular ectopy occurred In 143(29.9% ) and supraventricular ectopy showed in 56(11.7%) of the sessions. G-induced loss of consciousness(G-LOC) occurred in 15%(62 pilots) of the trainees. Dysrhythmias associated with G-LOC were recorded In 23(37%), however, aeromedically serious arrhythmias were not observed. 41%(25/61) of dysrhythmias appeared in ROR(Rapid Onset Rate), whereas 27.9%(17/61) of them in GOR (Gradual Onset Rate). Although riding the centrifuge is a stressful experience in aircrews, the presence of the serious arrhythmias could potentially result in sudden incapacitation during flight. Therefore, ECG monitoring of aircrews during centrifuge training is hlghly recommended for their safety as well as aeromedical policy.
Subject(s)
Arrhythmias, Cardiac , Electrocardiography , Incidence , Korea , UnconsciousnessABSTRACT
To identify the long-term survival rate and prognostic factors of AMI in Korea, total 404 patients who presented between Jan 1984 and mar 1989 at Seoul National University Hospotal were followed for and average of 24.9+/-18.2 months(range 1 to 69 months). 50 patients(12.4%) died during the in-hospital period and 25 patients(6.2%) died after discharge. Among the survivors reinfarction developled in 11 patients(3.3%). Overall survival rates were 0.87, 0.85, 0.83, 0.81, 0.79, 0.77 and event-free survival rates were 0.87, 0.84, 0.83, 0.79, 0.77, 0.72 at 1, 6, 12, 24, 36, 48 months respectively. During the in-hospital period sex, age, peak creatine kinase level, Killip class, Q wave in ECG, heart failure, and AV block in anterior infarction were of prognostic value. After discharge age, exercise duration on pre-discharge treadmill test, cardiac index, ejection fraction, and presence of heart failure were significant prognostic factors. Pre-discharge coronary angiographies were performed in 217 cases. There was no statistically significant difference in survival rate between multiple vessel disease and single vessel disease. But the more the number of involved vessels was, the higher the incidence of reinfarction was. In the group with jeopardy score less than 8, event-free survival rate was signigicantly higher. Overall survival rate was higher and reinfarction rate was lower in the group, but both were not statistically significant. On discriminant analysis of in-hospital prognostic factors, Killip class, heart failure and age were independent prognostic factors, but other factors had no additional prognostic value.