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Most studies of U.S. cultural diplomacy focus on the ways that the United States has leveraged cultural events to achieve its own political ends. The present article takes a slightly different approach in its analysis of the 1954 Korean Children's Choir (KCC) tour of the United States. Using copious documentary sources and interviews the author has conducted with former child choristers, it traces how Republic of Korea (ROK) President Syngman Rhee used this high-profile cultural event to create a new opening to advance his goals in his complicated diplomatic relations with the United States. At the close of the Korean War, the ROK was a war-ravaged nation with little power in dealing with its patron superpower. Deploying personal connections and propaganda skills that he had cultivated during decades of living in exile in the United States, Rhee orchestrated the KCC's tour of the United States, and the visit helped Rhee gain new footing in negotiating the ROK's unequal partnership with the United States. This detailed socio-historical and musicological account shows how both President Rhee and the choristers were active and effective agents in striving to put the ROK front and center in the imaginations of Americans and impress upon them its cultural gravitas and strategic importance. [ABSTRACT FROM AUTHOR]

In this study, 27 chemicals found in household products, which became an issue in Korea were screened for the agonistoc and antagonistic effects against human estrogen receptor using official Organization for Economic Cooperation and Development (OECD) in vitro assays, STTA assay using ERα-HeLa-9903 cell line and BG1Luc ER TA assay. In the case of human ER agonist screening by two assays, all tested chemicals did not show agonist effect against ER. In ER antagonist test by BG1Luc ER TA assay, five surfactants α-dodecyl-ω-hydroxypoly(oxyethylene), alcohols C16-18 ethoxylated, nonylphenol, ethoxylated, 3,6,9,12,15,18,21-heptaoxatritriacontan-1-ol, and α-dodecyl-ω-hydroxypoly(oxy-1,2-ethanediyl)) were found to exhibit weak antagonistic activities. The agonist/antagonist effects against human estrogen receptor of various chemicals, used in Korea by OECD test guideline are reported in this study. These results indicated that two OECD in vitro assays will can be applied in Korea by screening of agonistic/antagonistic effects against human ER of various chemicals. [ABSTRACT FROM AUTHOR]

ObjectiveThe present study aimed to assess the adequacy of Ca intake and major food sources of Ca in Korean children and adolescents.DesignA cross-sectional study.SettingData from the Korean National Health and Nutrition Examination Survey (KNHANES) 2007–2010. We analysed the daily Ca intake, major food sources of Ca and the prevalence of inadequate Ca intake in the study population. Ca intake was categorized as inadequate when the participant's daily Ca intake was less than the Estimated Average Requirement.SubjectThe study population consisted of 7233 children and adolescents (3973 boys, 3260 girls; aged 1–18 years).ResultsMean Ca intake was 510·2 mg/d in boys and 431·7 mg/d in girls. Overall, 75·0 % of adolescents (boys 71·6 %, girls 79·1 %) had inadequate Ca intake. The prevalence of inadequate Ca intake increased significantly from toddlers (45–55 %) to adolescents (78–86 %) in both genders. The highest ranked food sources for Ca were dairy products (35·0 %), followed by vegetables (17·3 %), grains (11·3 %) and seafood (9·9 %). Ca intake from dairy products decreased significantly from 57 % in toddlers to 30 % in adolescents, while Ca intakes from other foods increased with age.ConclusionsInadequate Ca intake is highly prevalent and increased with age in Korean children and adolescents. It should be emphasized to encourage children and adolescents to eat more Ca-rich products to meet their Ca needs. [ABSTRACT FROM AUTHOR]

Purpose: Medical professionals’ practices and knowledge regarding cancer pain management have often been cited as inadequate. This study aimed to evaluate knowledge, practices and perceived barriers regarding cancer pain management among physicians and nurses in Korea. Methods: A nationwide questionnaire survey was administered to physicians and nurses involved in the care of cancer patients. Questionnaire items covered pain assessment and documentation practices, knowledge regarding cancer pain management, the perceived barriers to cancer pain control, and processes perceived as the major causes of delay in opioid administration. Results: A total of 333 questionnaires (149 physicians and 284 nurses) were analyzed. Nurses performed pain assessment and documentation more regularly than physicians did. Although physicians had better knowledge of pain management than did nurses, both groups lacked knowledge regarding the side effects and pharmacology of opioids. Physicians working in the palliative care ward and nurses who had received pain management education obtained higher scores on knowledge. Physicians perceived patients’ reluctance to take opioids as a barrier to pain control, more so than did nurses, while nurses perceived patients’ tendency to under-report of pain as a barrier, more so than did physicians. Physicians and nurses held different perceptions regarding major cause of delay during opioid administration. Conclusions: There were differences between physicians and nurses in knowledge and practices for cancer pain management. An effective educational strategy for cancer pain management is needed in order to improve medical professionals’ knowledge and clinical practices. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the therapeutic potential of transforming growth factor β (TGF β)–transduced mesenchymal stem cells (MSCs) in experimental autoimmune arthritis, using an accepted animal model of collagen-induced arthritis (CIA). Findings reveal that TGFβ-transduced MSCs suppressed the development of autoimmune arthritis and joint inflammation.

Pediculus humanus capitis is an ectoparasite, which causes scalp pruritus particularly among children. A total of 15,373 children including 8,018 boys and 7,355 girls from 26 primary schools and 15 kindergartens attached to the primary schools and a total of 33 children from an orphanage were examined for head lice infestation (HLI). The overall prevalence of HLI in this study was 4.1% including 3.7% of the urban areas and 4.7% of the rural areas. Head lice were found more frequently in girls than in boys with prevalence of 6.5% and 1.9%, respectively. The infestation rate by school grade was 3.2%, 4.7%, 4.2%, 5.0%, 4.9%, 3.8%, and 2.1% for kindergarten, first, second, third, fourth, fifth, and sixth grades, respectively. The infestation rate of the children in an orphanage was 66.7%. The prevalence of HLI has decreased especially in the rural areas. However, HLI is a still health problem of kindergarteners and primary schoolchildren in Korea. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of exercise programs on physical fitness, depression, and self-efficacy in low-income elderly women (age≥75). Design and Sample: A pretest-posttest experimental research design with a control group was used. The sample consisted of 26 women in the exercise group and 22 women in the wait-list control group in Seoul, Korea. Measures: The measures of physical fitness included body mass index, cardiopulmonary endurance (blood pressure and heart rate), muscle strength (hand grip strength), flexibility (degree of bending of the upper body), and balance (duration of time for which the subject could stand on one foot). Depression and self-efficacy were measured by the Center for Epidemiological Studies Depression scale and a modified form of Lee's scale, respectively. All measures were obtained twice: at baseline and at the completion of the exercise program. Intervention: The exercise program consisted of 4 weeks of education along with 8 weeks of physical exercise. Results: After the intervention, significant improvements were found in depression, self-efficacy, and all measures of physical fitness, except heart rate and flexibility, in the experimental group. Conclusion: The exercise program may be recommended as a method to maintain and promote the health of low-income elderly women. [ABSTRACT FROM AUTHOR]

In expanding their market to the global level with clear and consistent global brand images across nations, marketers are ever confronting the issue of how to deal with different cultural values. Cultural value is identified as an influential factor on brand image and is widely accepted as one of the crucial concepts in understanding consumer consumption value, which determines choices of consuming everyday products and services. Most firms endeavoring to establish and maintain consistent global brand images, however, adopt a standardized brand image strategy that usually does not consider individual target markets” characteristics, including the concepts of cultural value and consumption value. This study developed a conceptual framework which incorporated cultural value not only as a direct antecedent of brand image, but also as an indirect antecedent of brand image through consumption value, and empirically tested it using the category of apparel. Following this framework, this study hypothesized the differences in brand image, cultural value, and consumption value between the U.S. and South Korea. Data were gathered through surveying university students residing in the San Francisco and Seoul metropolitan areas using a convenience sampling method. A total of 329 completed questionnaires were used in factor analysis, discriminant analysis, and structural equation modeling. The results provide insights into standardized brand image strategies and suggest some implementable tools that might prove effective in both countries. © 2009 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Purpose: Socioeconomic status may influence the risk of the metabolic syndrome. We investigated the association between socioeconomic status and the metabolic syndrome in Korean adults. Methods: We analyzed a total of 8,541 subjects ages 20 to 79 years who participated in the Korean National Health and Nutrition Examination Survey, 2001. Socioeconomic status was measured by education and income level. Results: The prevalence of the metabolic syndrome among this population was 29%. Relative to women with educational level <7 years, those with educational levels of 7 to 9 years, 10 to 12 years, and >13 years had odds ratios for the metabolic syndrome of 0.92 (95% confidence interval [CI]: 0.73 to 1.16), 0.55 (95% CI: 0.44 to 0.70), and 0.31 (95% CI: 0.22 to 0.43), respectively (p for trend <0.05). Relative to women with lower income, those with middle and upper income had odds ratios for the metabolic syndrome of 0.90 (95% CI: 0.75 to 1.08) and 0.80 (95% CI: 0.66 to 0.97), respectively (p for trend <0.05). A significant association between the metabolic syndrome and socioeconomic status was not observed in men. Conclusions: Lower socioeconomic status was associated with a higher risk of the metabolic syndrome in Korean women but not in Korean men. [Copyright &y& Elsevier]

The Angioplasty Summit TCTAP is an international conference held annually at the end of April in Seoul, Korea that focuses on interventional cardiology. Over the past two decades, this meeting has played an integral part in the Asia-Pacific region on educating physicians and other healthcare professionals who are interested in this field. It has become a very useful opportunity for them to catch up with cutting-edge techniques, overviews and clinical investigations from all over the world. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Few data are available on sinus tachycardia among medical intensive care unit (ICU) patients. We investigated new critical illnesses related to new-onset prolonged sinus tachycardia (NOPST) and the relationship of NOPST with ICU mortality. Methods: The heart rate (HR) of all enrolled patients was monitored hourly over a 12-month period, and NOPST was defined as sinus tachycardia (>100 beats/min) with an increase in HR of more than 20% from the baseline value lasting longer than 6 hours. Results: Among the 522 patients enrolled, the average mean HR was 96.1 ± 18.4 beats/min. Fifty-two (10.0%) patients met the criteria for NOPST; pneumonia, delirium, septic shock, acute respiratory distress syndrome, catheter-related infections, and mechanical ventilator–related problems were related to the occurrence of NOPST. The ICU mortality rate in patients with a NOPST duration of more than 72 hours was higher compared with other patients with NOPST (60.0% vs 18.5%; P = .002). A high daily mean HR rather than NOPST was a significant predictor of ICU mortality (odds ratio, 1.415; 95% confidence interval, 1.177-1.700). Conclusions: Although NOPST was not associated with ICU mortality, it indicates the presence of new critical events in the medical ICU setting. [Copyright &y& Elsevier]

Ethnopharmacological relevance: CGX is a traditional Korean herbal medicine used to treat chronic liver diseases. Aim of study: The purpose of this study was to evaluate the pharmaceutical safety of hepatoprotective herbal medicine, CGX via systemic 6-month repeated dose toxicity study in SD rats. Materials and methods: Male and female SD rats were administered CGX for 6 months (0, 100, 200, or 400mgkg−1, respectively). The rats were visually inspected for changes in behavior, body weight, food and water consumption, and appearance during the experiment period. At the end of the experiment, urine, hematological, biochemical analysis, and histopathological examination were carried out. Results: No drug-induced abnormalities were found as clinical signs or in the histopathology, hematology, blood biochemistry, and urinalysis results for any administered doses of CGX. Conclusion: The results suggest that CGX is safe and could be considered as an effective and prospective herbal formulation in clinical applications with a wide therapeutic index. [Copyright &y& Elsevier]

Abstract: This study investigates a construction-induced sea level rise and tide characteristics change, using a regression analysis to separate the local construction effect such as sea-dike/seawalls and global warming from total sea level change. The study also makes it clear why and how the extreme high water level has risen just after constructions at Mokpo harbor in Korea. As a result of the regression analysis, it is found that the high water level rise for the period of 1960–2006 is ∼60cm, which is summation of four components: ∼23cm for Youngsan River sea-dike (1981), ∼15cm for Youngam seawall (1991), ∼8cm for Geumho seawall (1994), and ∼14cm for gradual rise (due mainly to global warming). Then, a numerical simulation at Mokpo coastal zone is performed to identify each component, and the results support the premise that the tidal amplification caused by constructions is due mainly to the extinguishment of the tidal choking effect at outer Mokpogu. The tidal flat effect makes the amplification greater at spring tide or extraordinary high tide, which would result in the increase of inundation risk at the Mokpo coastal zone. Frequency distribution of observed high water level data shows increasing trend for both maximum value of astronomical tide component (simulated high water level) and meteorological tide component (surge height) after the coastal constructions. A frequency analysis presents that the high water level for 50 year return period, which is often used for design in practice, is 474cm before the construction, and while that is 553cm after the construction. Furthermore, design height might steadily be elevated considering future global sea level rise. [Copyright &y& Elsevier]

Abstract: Dextromethorphan (DMP), an antitussive, is one of the most popular drugs among the younger generation in Korea. It usually is taken for its hallucinogenic properties and overdoses have been responsible for the fatalities that have been reported frequently. To control the abuse of DMP, the authorities restricted its use through classifying it as a controlled drug on October 2003. The purpose of this study is to provide a standard method for the analysis of DMP and its main metabolite, dextrorphan (DTP) in biological specimens. At first we established a standard operating procedure (SOP) for DMP/DTP in urine, and a method validation was performed. We also quantified DMP from 16 drug abuser''s urine samples all of which were positive in the screening test for DMP. For the detection of DMP/DTP, urine samples were adjusted with 6N NaOH (pH 11) and extracted with ethylacetate. Thin layer chromatography was used as the screening test, and the final identification for DMP/DTP was used by GC/MS. The ions (m/z 271 for DMP, m/z 257 for DTP and m/z 86 for lidocaine as internal standard) were extracted from the full scan mass spectrum and were used for quantification. The selectivity, linearity of calibration, accuracy, within- and between day precision, limit of detection and quantification, recovery and stability were examined as parts of the method validation. Extracted calibration curves were linear from 100 to 2000ng/mL for DMP and DTP with correlation coefficients better than 0.999. Limit detection was 50ng/mL for DMP and DTP. Within-run precision (%CV) for DMP and DTP at three different concentrations (100, 500 and 1000ng/mL) was 6.10–18.85%, and between-run precision was 1.70–7.86% for DMP and DTP. Absolute recovery for DMP and DTP was 57–74%, and relative recovery (extraction efficiency) was 80–89%. For 16 drug abuser''s urine samples, the concentrations of DMP and DTP were 0.16–52.63 and 0.41–23.75μg/mL, respectively. Method validation is an important requirement in the practice of chemical analysis, and it will be particularly useful in verifying the reliability of analytical results in the field of forensic science. [Copyright &y& Elsevier]

Abstract: Background: Anastrozole is an aromatase inhibitor used to treat advanced breast cancer in postmenopausal women. A generic 1-mg tablet of anastrozole was recently developed. Objective: The study was designed to provide data to submit to Korean regulatory authorities to allow marketing of the test formulation. We evaluated the comparative bioavailability and tolerability of the test and reference formulations in healthy male adult volunteers. Methods: This single-dose, randomized, double-blind, 2-way crossover trial was conducted in the Clinical Trial Center at the Asan Medical Center (Seoul, Korea). A total of 24 healthy male Korean volunteers were enrolled. Subjects were randomized to receive 1 mg of the test or reference formulation, and pharmacokinetic (PK) parameters were measured. After a 3-week washout period, the other formulation was administered, and PK parameters were measured again. Cmax and AUClast were determined from blood samples obtained at 0.33, 0.67, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96, 120, 168, and 216 hours after drug administration. The formulations were considered bioequivalent if the 90% CIs of the geometric mean ratios of test-to-reference formulations for AUClast and Cmax were within the bioequivalence limits of 0.8 to 1.25. Nonlinear mixed-effect modeling and Monte Carlo simulations for both formulations were also conducted, and the results were used to characterize and compare the PK properties. Safety profile and tolerability were assessed using measurements of vital signs, clinical chemistry tests, and interviews. Results: All enrolled subjects completed the study. A total of 8 adverse events (AEs) were reported (2 on test formulation, 6 on reference formulation) in 7 of 24 participants. These AEs were headache (n = 1), hordeolum (n = 1), and abnormal laboratory test values (n = 6). Both formulations were well tolerated, and there were no serious AEs. Both formulations were best described by a 2-compartment disposition model with lag phase. The 90% CIs of the geometric mean ratios of test formulation to reference formulation were 0.96 to 1.08 for Cmax and 0.93 to 1.0 for AUClast. Conclusion: The test and reference formulations had similar PK parameters and similar plasma concentration-time profiles. The test formulation of anastrozole met the Korean regulatory criteria (AUC and Cmax) for assuming bioequivalence. ClinicalTrials.gov identifier: NCT01105299. [Copyright &y& Elsevier]

Abstract: Health effects of the Asian Dust Storm (ADS) have not been evaluated adequately, even though it may affect health of people in East Asia. This study was conducted to evaluate whether the ADS affects particulate air pollution and pulmonary function of children. We studied 110 school children in Seoul, Korea with daily measurement of peak expiratory flow rate (PEFR) from May 13 to June 15, 2007. PM2.5, PM10 and metals bound to the particles were also determined daily during the study period in Ala Shan and Beijing (China) as well as in Seoul (Korea). Three-day back trajectories showed that air parcels arrived at Seoul mostly from the desert areas in China and Mongolia through eastern China during ADS event affecting levels of particulate pollutants in the areas. Analysis of metals bound to the particulates showed that natural metal levels were much higher than the anthropogenic metal levels. We found that ambient concentrations of PM2.5 and PM10 were not significantly associated with PEFR in school children except asthmatics during the study period (P >0.05). However, most of the metal concentrations bound to the particulates were significantly associated with decrease of the children''s PEFR (P <0.05). The effect of anthropogenic metals was not different from natural components of metals for reduction of PEFR. This result indicates that exposure to the metals bound to particles during the ADS period reduces children''s pulmonary function, but there was no difference of potency for reduction of the pulmonary function between natural and anthropogenic metal components. [Copyright &y& Elsevier]

The aim of this study was to assess the safety and benefits of early elective percutaneous coronary intervention (PCI) after successful thrombolytic therapy for acute myocardial infarction. Early elective PCI after successful thrombolysis is controversial, and the optimal time for PCI is elusive. Using data from the Korea Acute Myocardial Infarction Registry from November 2005 to June 2007, a total of 383 patients with acute myocardial infarction who underwent elective PCI within 2 weeks of successful thrombolytic therapy were grouped based on time between thrombolysis and PCI as group 1, <24 hours (n = 81, age 59.5 ± 10.5 years, 10.9 ± 7.2 hours); group 2, ≥24 and <48 hours (n = 79, 59.5 ± 11.6 years, 36.4 ± 6.8 hours); group 3, ≥48 hours and <72 hours (n = 79, 61.0 ± 10.9 years, 59.8 ± 6.8 hours); and group 4, >72 hours (n = 144, 61.7 ± 12.9 years, 117.8 ± 48.5 hours). Primary study outcomes included major bleeding, in-hospital death, and major adverse cardiac events (MACEs; cardiac death, myocardial infarction, repeated PCI, and coronary artery bypass surgery) at 1, 6, and 12 months. There were no differences among the 4 groups in baseline clinical characteristics and angiographic findings. There were no differences in the incidences of major bleeding, in-hospital mortality, and 1-month outcomes among groups. Rates of composite MACEs and repeated PCI at 6 and 12 months were significantly lower in patients who underwent PCI within 48 hours of thrombolytic therapy compared with those who underwent PCI later (6-month MACEs: 1.0% vs 9.5%, p = 0.014; 6-month repeated PCI: 0% vs 6.8%, p = 0.028; 12-month MACEs: 4.1% vs 14.9%, p = 0.026; 12-month repeated PCI: 1.4% vs 9.6%, p = 0.034). In conclusion, early elective PCI within 48 hours of successful thrombolytic therapy for AMI appeared safe and more beneficial compared with PCI performed later. [Copyright &y& Elsevier]

Abstract: Background and objectives: The first on-line prospective, open and observational registration, Korea Acute Myocardial Infarction Registry (KAMIR), has been carried out throughout 41 primary percutaneous coronary intervention (PCI) centers by the support of the Korean Circulation Society (KCS) in the memorandum of the 50th Anniversary of the KCS. Subjects and methods: Between Nov 2005 and Aug 2006, 5624 enrolled patients (3925 male, 1699 female; age=64.0±13.0 years) were analyzed. The treatment strategy of acute myocardial infarction (AMI) was analyzed according to the sex differences in the field of acute ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Results: In the initial selection of treatment strategy, invasive treatment was more commonly performed in males than females with both STEMI and NSTEMI (82.0% vs. 78.7%, p =0.001; 50.4% vs. 43.7%, p =0.004). Severe heart failure was the most important predictor of invasive treatment after multivariate adjustment. During hospital stay, PCI regardless of its subtype was more frequently performed in males than in females with both STEMI and NSTEMI (STEMI: 89.5% vs. 84.7%, p <0.001; NSTEMI: 77.0% vs. 66.7%, p <0.001). Success rate of PCI in STEMI was not different between the sexes (95.8% vs. 93.8%, p =0.075), but that of NSTEMI was higher in males than females (96.8% vs. 95.6%, p =0.005). Major adverse cardiac events (MACE) developed more frequently in women than men with both STEMI (9.2% vs. 17.0%, p <0.001) and NSTEMI (7.3% vs. 12.0%, p <0.001) during 1 month clinical follow-up. Conclusions: In the initial treatment of AMI in Korea, there is no gender difference for invasive treatment. However, success rate of PCI in NSTEMI was lower and 1 month MACE was higher in females than males in Korea. [Copyright &y& Elsevier]

Abstract: Background: Cases of stent strut fractures (SSFs) after DES implantation have been reported, but the clinical significance is uncertain. Then we sought to define the incidence and clinical implications of SSFs developed after drug-eluting stent (DES) implantation. Methods: We gathered SSF cases from 13 centers in Korea retrospectively. SSF was defined as angiographically visible interrupted connection of stent struts or fewer visible stent struts at the suspected site than normally looking stented area on intravascular ultrasound (IVUS). Furthermore, we classified the SSFs cases into three patterns (disruption, avulsion, and displacement) according to the interruption site and absence or presence of displacement. Results: Thirty-seven SSFs (2 disruption, 7 avulsion, 28 displacement) were detected in 35 lesions in 35 patients. All fractured stents were sirolimus-eluting stents (SESs). The incidence of SSFs was 0.84% and the proportion of restenosis related with SSF was 6.3% after SES implantation driven from the data of 8 centers. The average length of stent used was 49 mm, overlapping stenting was performed in 19 lesions (54%), and the average maximal angulation in the initial coronary angiography was 67°. Twenty-four fractures (65%) were associated with focal in stent restenosis and 11 fractures (30%) with target lesion revascularization. No acute coronary syndrome developed. Conclusions: SSF after DES implantation might be a considerable complication after DES implantation especially after SES implantation. [Copyright &y& Elsevier]

A predominance of total or partial chromosomal losses and the rarity of translocations are characteristics of myelodysplastic syndrome (MDS), and 5q,−5, −7 and +8 are known to be the most predominant chromosomal changes. To investigate whether the incidence and the pattern of chromosomal changes in MDS varies by location in Korea, we reviewed the cytogenetic results of 205 MDS cases from three medical centers. Distribution of MDS subtypes and the incidence of chromosomal aberration (44.8%) of MDS in Korea were similar to those found in other countries, however, their patterns were different. Translocations (40.4%) predominated over partial or total deletions (36.3%) in Korea. The most common abnormalities in MDS were trisomy 8, trisomy 1q, −5/5q−, and −7/7q−, which occurred in 18(19.5%), 14(15.2%), 12(13.0%), and 11(11.9%) patients, respectively. It is of note that trisomy 1q, which is rarely reported in hematologic malignancies, was the second most common change associated with MDS in Korea, and that structural anomalies of chromosomes 1(19.6%) exceeded that of chromosome 5(15.2%). The most common sole anomalies were trisomy 8(7.6%) and 14(78%) of 18 cases with chromosome 1 anomalies accompanied by other chromosomal abnormalities, suggesting that the changes of chromosome 1 may be evolutionary events rather than sporadic events. In conclusion, trisomy 1q and trisomy 8 predominate in Korean MDS, suggesting the likelihood of ethnic differences. [Copyright &y& Elsevier]

Assessment of risk at time of discharge could be a useful tool for guiding postdischarge management. The aim of this study was to develop a novel and simple assessment tool for better hospital discharge risk stratification. The study included 3,997 hospital-discharged patients with acute myocardial infarction who were enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry-1 (KAMIR-1) from November 2005 through December 2006. The new risk score system was tested in 1,461 hospital-discharged patients who were admitted from January 2007 through January 2008 (KAMIR-2). The new risk score system was compared to the Global Registry of Acute Coronary Events (GRACE) postdischarge risk model during a 12-month clinical follow-up. During 1-year follow-up, all-cause death occurred in 228 patients (5.7%) and 81 patients (5.5%) in the development and validation cohorts, respectively. The new risk score (KAMIR score) was constructed using 6 independent variables related to the primary end point using a multivariable Cox regression analysis: age, Killip class, serum creatinine, no in-hospital percutaneous coronary intervention, left ventricular ejection fraction, and admission glucose based on multivariate-adjusted risk relation. The KAMIR score demonstrated significant differences in its predictive accuracy for 1-year mortality compared to the GRACE score for the developmental and validation cohorts. In conclusion, the KAMIR score for patients with acute myocardial infarction is a simpler and better risk scoring system than the GRACE hospital discharge risk model in prediction of 1-year mortality. [ABSTRACT FROM AUTHOR]