BACKGROUND: The prognostic significance of change in red cell distribution width (RDW) during hospital stays in patients treated with therapeutic hypothermia (TH) after out-of-hospital cardiac arrest (OHCA) was investigated. METHODS: Patients treated with TH after OHCA between January 2009 and August 2013 were reviewed. Patients with return of spontaneous circulation (ROSC) were assessed according to Utstein Style. Hematologic variables including RDW, hematocrit, white blood cell count, and platelets were also obtained. RDW changes during the 72 hours after ROSC were categorized into five groups as follows: Group 1 (-0.8-0.1%), Group 2 (0.2-0.3%), Group 3 (0.4-0.5%), Group 4 (0.6-0.8%), and Group 5 (>0.8%). RESULTS: A total of 218 patients were enrolled in the study. RDW changes during the 72 hours after ROSC in Group 4 (HR 3.56, 95% CI 1.25-10.20) and Group 5 (HR 5.07, 95% CI 1.73-14.89) were associated with a statistically significant difference in one-month mortality. RDW changes were associated with statistically significant differences in neurologic outcome at 6 months after ROSC (Group 3 [HR 2.45, 95% CI 1.17-5.14], Group 4 [HR 2.79, 95% CI 1.33-5.84], Group 5 [HR 3.50, 95% CI 1.35-7.41]). Other significant variables were location of arrest, cause of arrest, serum albumin, and advanced cardiac life support time. CONCLUSIONS: RDW change during the 72 hours after ROSC is a predictor of mortality and neurologic outcome in patients treated with TH after OHCA.
Advanced Cardiac Life Support ; Erythrocyte Indices* ; Hematocrit ; Humans ; Hypothermia* ; Length of Stay ; Leukocyte Count ; Mortality ; Out-of-Hospital Cardiac Arrest* ; Prognosis ; Serum Albumin

OBJECTIVES: The present study is to investigate inflammatory markers and associated clinical factors between treatment resistant schizophrenia and non-treatment resistant schizophrenia.METHODS: Of the 116 schizophrenia subjects who were hospitalized for ac ute symptomatic treatment, 19 patients (16%) were treated with clozapine as a treatment resistant schizophrenia(TRS) and 97 patients(84%) were treated with other atypical antipsychotics as a non-treatment resistant schizophrenia(Non-TRS). Various inflammatory markers including C-reactive protein(CRP) and clinical factors were retrospectively evaluated with electrical medical records.RESULTS: There were significant differences between two groups in disease duration(p =0.015), number of admission (p =0.003), Clinical Global Impression(p <0.001) but other demographic and clinical variables including previous antipsychotics use did not show significant differences. In terms of hematologic profiles, TRS group demonstrated higher CRP level(p =0.006), lower neutrophil count(p =0.012), and lower hemoglobin level(p =0.003) compared with non-TRS group. Body mass index was significantly correlated with CRP(r=0.318, p =0.001).CONCLUSION: The elevated level of serum CRP in TRS suggests that treatment resistance in schizophrenia may be associated with inflammatory response. However, retrospective study design and small number of subjects could limit this interpretation.
Antipsychotic Agents ; Body Mass Index ; C-Reactive Protein ; Clozapine ; Humans ; Medical Records ; Neutrophils ; Retrospective Studies ; Schizophrenia

PURPOSE: HEMS is expected to shorten transportation time to an advanced facility and to enable administration of advanced treatment at the scene. In Korea, HEMS was launched in September 2011. The aim of this study is to provide an overview of HEMS in South Korea during the first year and to provide information for use in improvement. METHODS: Data were collected from September 23. 2011 to September 22. 2012; emergency patients on islands and in vulnerable areas were transported by helicopter. During the one-year study period, a prospective cohort study was conducted. Target diseases were acute coronary syndrome, stroke, and severe trauma. We classified patients according to two groups (severe group vs. mild group), whether they had been admitted to the intensive care unit (included death in the emergency room) or not. RESULTS: During this period, the total request mission number was 555 and the number of patients transported to base hospitals was 322. Differences between severe group and minor group were as follows: (1) final diagnosis; severe trauma (27.7% vs. 3.5%), cerebrovascular accident (CVA) (24.3% vs. 4.2%), and acute coronary syndrome (7.3% vs. 2.1%), p<0.001. (2) classification of transport area; islands (45.8% vs. 77.2%), bridge islands (26.0% vs. 15.9%), and inland area (28.3% vs. 6.9%), p<0.001. (3) the median time of call to hospital time was 52 vs. 55 minutes (p=0.289). and the median time of on scene time was 9 vs. 8 minutes (p=0.046). CONCLUSION: During the 12-month period, air ambulance played an important role in medically vulnerable areas (inclusion islands). However, the number of transport missions was still relatively low, and has shown a gradual increase.
Acute Coronary Syndrome ; Air Ambulances ; Aircraft* ; Classification ; Cohort Studies ; Diagnosis ; Emergencies* ; Emergency Medical Services* ; Humans ; Intensive Care Units ; Islands ; Korea ; Missions and Missionaries ; Prospective Studies ; Rural Health Services ; Stroke ; Transportation

PURPOSE: HEMS is expected to shorten transportation time to an advanced facility and to enable administration of advanced treatment at the scene. In Korea, HEMS was launched in September 2011. The aim of this study is to provide an overview of HEMS in South Korea during the first year and to provide information for use in improvement. METHODS: Data were collected from September 23. 2011 to September 22. 2012; emergency patients on islands and in vulnerable areas were transported by helicopter. During the one-year study period, a prospective cohort study was conducted. Target diseases were acute coronary syndrome, stroke, and severe trauma. We classified patients according to two groups (severe group vs. mild group), whether they had been admitted to the intensive care unit (included death in the emergency room) or not. RESULTS: During this period, the total request mission number was 555 and the number of patients transported to base hospitals was 322. Differences between severe group and minor group were as follows: (1) final diagnosis; severe trauma (27.7% vs. 3.5%), cerebrovascular accident (CVA) (24.3% vs. 4.2%), and acute coronary syndrome (7.3% vs. 2.1%), p<0.001. (2) classification of transport area; islands (45.8% vs. 77.2%), bridge islands (26.0% vs. 15.9%), and inland area (28.3% vs. 6.9%), p<0.001. (3) the median time of call to hospital time was 52 vs. 55 minutes (p=0.289). and the median time of on scene time was 9 vs. 8 minutes (p=0.046). CONCLUSION: During the 12-month period, air ambulance played an important role in medically vulnerable areas (inclusion islands). However, the number of transport missions was still relatively low, and has shown a gradual increase.
Acute Coronary Syndrome ; Air Ambulances ; Aircraft* ; Classification ; Cohort Studies ; Diagnosis ; Emergencies* ; Emergency Medical Services* ; Humans ; Intensive Care Units ; Islands ; Korea ; Missions and Missionaries ; Prospective Studies ; Rural Health Services ; Stroke ; Transportation

PURPOSE: On November 23, 2010, Yeonpyeong Island was under artillery fire and mass civilian casualties developed. Incheon West-sea regional emergency medical center, dispatched a disaster team to deal with the casualties. The purpose of this study was to review the regional disaster response of this team to improve the operations of the National Disaster Medical System, Disaster Medical Assistance Team, and the Mobile Emergency Support Unit in case of future emergencies. METHODS: We retrospectively reviewed the disaster response upon bombardment of the Yeonpyeong Island and analyzed medical records of patients who treated by the disaster team at Yeonpyeong island. RESULTS: The disaster team and EMS were activated after the bombardment. Disaster team included two doctors, three emergency medical technicians, and one ambulance driver. The bombardment occurred at 14:34, and lasted for 30 minutes. The disaster team was dispatched at 16:40, and arrived in Incheon port at 17:07 and departed for Yeonpyeong Island with a fire engine and ambulance at 21:48. Our team reached the island the next morning and started to treat a patient. A total of 30 patients were participated in this study. The mean age of the patients was 49.4(+/-14.2) yrs old. Most of he patients are a mild case. Diagnosis was multiple contusion, acute stress reaction, cerebral concussion, rupture of tympanic membrane. Also: It may help to include data/analyses showing that there were inadequacies and problems with the system (time lag, insufficient medical training or supplies, etc.) CONCLUSION: This article is the first to report on the efficacy of the National Disaster Medical System after bombardment. From our analysis, the National Disaster Medical System contains many problems including access to the island, the equipment of communication, and the security of disaster team. This report shows that a review of our National Disaster Medical System is necessary to plan for future disaster scenarios.
Ambulances ; Brain Concussion ; Contusions ; Disasters ; Emergencies ; Emergency Medical Technicians ; Equipment and Supplies ; Fires ; Humans ; Medical Assistance ; Medical Records ; Retrospective Studies ; Rupture ; Tympanic Membrane

BACKGROUND: The prognostic significance of change in red cell distribution width (RDW) during hospital stays in patients treated with therapeutic hypothermia (TH) after out-of-hospital cardiac arrest (OHCA) was investigated. METHODS: Patients treated with TH after OHCA between January 2009 and August 2013 were reviewed. Patients with return of spontaneous circulation (ROSC) were assessed according to Utstein Style. Hematologic variables including RDW, hematocrit, white blood cell count, and platelets were also obtained. RDW changes during the 72 hours after ROSC were categorized into five groups as follows: Group 1 (-0.8-0.1%), Group 2 (0.2-0.3%), Group 3 (0.4-0.5%), Group 4 (0.6-0.8%), and Group 5 (>0.8%). RESULTS: A total of 218 patients were enrolled in the study. RDW changes during the 72 hours after ROSC in Group 4 (HR 3.56, 95% CI 1.25-10.20) and Group 5 (HR 5.07, 95% CI 1.73-14.89) were associated with a statistically significant difference in one-month mortality. RDW changes were associated with statistically significant differences in neurologic outcome at 6 months after ROSC (Group 3 [HR 2.45, 95% CI 1.17-5.14], Group 4 [HR 2.79, 95% CI 1.33-5.84], Group 5 [HR 3.50, 95% CI 1.35-7.41]). Other significant variables were location of arrest, cause of arrest, serum albumin, and advanced cardiac life support time. CONCLUSIONS: RDW change during the 72 hours after ROSC is a predictor of mortality and neurologic outcome in patients treated with TH after OHCA.
Advanced Cardiac Life Support ; Erythrocyte Indices ; Hematocrit ; Humans ; Hypothermia ; Length of Stay ; Leukocyte Count ; Mortality ; Out-of-Hospital Cardiac Arrest ; Prognosis ; Serum Albumin

Objective: Interpersonal sensitivity, characterized by a heightened awareness of others’ behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. Methods: The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. Results: Network analysis detected five communities. Item 10 (“I worry about being criticized for things that I have said or done”) showed the highest value in strength. Multiple items on “Interpersonal Worry/Dependency” and “Low Self-Esteem” showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. Conclusion Our findings emphasize the importance of addressing “Interpersonal Worry/Dependency” and “Low Self-Esteem” in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.

Objective: Interpersonal sensitivity, characterized by a heightened awareness of others’ behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. Methods: The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. Results: Network analysis detected five communities. Item 10 (“I worry about being criticized for things that I have said or done”) showed the highest value in strength. Multiple items on “Interpersonal Worry/Dependency” and “Low Self-Esteem” showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. Conclusion Our findings emphasize the importance of addressing “Interpersonal Worry/Dependency” and “Low Self-Esteem” in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.

Objective: Interpersonal sensitivity, characterized by a heightened awareness of others’ behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. Methods: The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. Results: Network analysis detected five communities. Item 10 (“I worry about being criticized for things that I have said or done”) showed the highest value in strength. Multiple items on “Interpersonal Worry/Dependency” and “Low Self-Esteem” showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. Conclusion Our findings emphasize the importance of addressing “Interpersonal Worry/Dependency” and “Low Self-Esteem” in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.

Objective: Interpersonal sensitivity, characterized by a heightened awareness of others’ behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. Methods: The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. Results: Network analysis detected five communities. Item 10 (“I worry about being criticized for things that I have said or done”) showed the highest value in strength. Multiple items on “Interpersonal Worry/Dependency” and “Low Self-Esteem” showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. Conclusion Our findings emphasize the importance of addressing “Interpersonal Worry/Dependency” and “Low Self-Esteem” in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.