Objective: This study aimed to investigate the biochemical, histologic, and immunologic effects of post-treatment administration of fluvastatin in a hemorrhagic shock (HS) rat model. Methods: Experimental rats were randomly divided into four groups: control group: no drugs and did not undergo HS; control statin group: fluvastatin 1 mg/kg (no HS); HS group: normal saline after HS; HS+statin group: fluvastatin 1 mg/kg+normal saline after HS. Briefly, HS was induced by femoral arterial catheter blood extraction of 30% of the total blood volume. The mean arterial pressure and heart rate were monitored for 2 hours after starting blood withdrawal. Arterial blood gas, complete blood count, and serum cytokine levels were measured at baseline, 2 hours after HS, and 48 hours after resuscitation. The kidneys, lungs, and small intestines were removed for pathological examination 48 hours after HS. Results: At the end of the resuscitation period, the HS and HS+statin groups showed reduced bicarbonate, base excess, and platelet counts, all of which differed significantly from values in the control and control+statin groups. Compared to the control group, the HS+statin group exhibited significantly elevated serum interleukin-10 (IL-10) at 2 hours after resuscitation (P<0.05). Except for IL-10, the group-time interaction was not significant for other cytokine profiles. Conclusion This study demonstrates that post-treatment with fluvastatin after HS increases the production of the anti-inflammatory cytokine IL-10 and affects the cytokine profiles in rats.

HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.

HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.

Objectives: ：The purpose of this study was to identify the change in the reasons for referrals before and after the COVID-19 outbreak among students who were referred to the one hospital-linked Wee center in Dalseo-gu, Daegu. Methods: ：324 students who were referred to one hospital-linked Wee center for personal counseling from January 1, 2019 to December 31 were included. In the initial session of individual counseling, 3 of the chief reasons among 27 emotional and/or behavioral problems were indicated. This reason was divided into before and after COVID-19 to determine whether there is a difference, and whether there is a difference between before and after COVID-19 depending on the school level. Results: ：The most frequent emotional and/or behavioral problem was ‘interpersonal problems’ in both pre- COVID-19 and post- COVID-19 groups. In post- COVID-19 group, ‘anxiety’ was significantly increased, whereas ‘conduct problems,’ ‘impulsivity’ and ‘inattention’ were significantly decreased. In elementary students group, only ‘conduct problems’ was significantly decreased after COVID-19 and the same result was shown in middle and high school students group. Conclusions ：The study showed that after COVID-19 pandemics in Daegu the difference of students’ problems was noted, and internalizing problems seem to increase rather than externalizing problems. This result calls upon schools to plan for students’ further mental health care measures.

BACKGROUND: Tuberculosis (TB) causes substantial health burden to the Korean military. This study aims to assess the impact of infectious TB cases on close and casual contacts in the Korean Army settings based on contact investigation data. METHODS: Six Army units with infectious TB cases from September 2012 to May 2013 were enrolled in the study. We analyzed the clinical data from close and casual contacts screened using the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube to identify latent tuberculosis infection (LTBI) cases. For the control group, 286 military conscripts with no reported TB exposure were tested by TST only. RESULTS: Of the 667 contacts of index cases, LTBI cases identified were as follows: 21.8% of close contacts of smear-positive cases (71/326), 8.5% of casual contacts of smear-positive cases (26/305), and 2.8% of close contacts of smear-negative cases (1/36). In the control group, 16.8% showed positivity in TST. In a multivariate analysis, having stayed in the same room or next room with TB patients was identified as a risk factor of LTBI. CONCLUSION: Using the data from TB contact investigations in the Korean Army units, we found an overall LTBI rate of 14.7% among the contacts screened. This study demonstrates that contacts living in the same building, especially the same room or next room, with TB patients are at a high risk of acquiring LTBI, serving as additional evidence for defining close and casual contacts of a TB patient with regard to Army barrack settings.
Asian Continental Ancestry Group ; Disease Outbreaks ; Humans ; Korea ; Latent Tuberculosis ; Military Personnel ; Multivariate Analysis ; Risk Factors ; Skin Tests ; Tuberculin ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Tuberculosis (TB) causes substantial health burden to the Korean military. This study aims to assess the impact of infectious TB cases on close and casual contacts in the Korean Army settings based on contact investigation data. METHODS: Six Army units with infectious TB cases from September 2012 to May 2013 were enrolled in the study. We analyzed the clinical data from close and casual contacts screened using the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube to identify latent tuberculosis infection (LTBI) cases. For the control group, 286 military conscripts with no reported TB exposure were tested by TST only. RESULTS: Of the 667 contacts of index cases, LTBI cases identified were as follows: 21.8% of close contacts of smear-positive cases (71/326), 8.5% of casual contacts of smear-positive cases (26/305), and 2.8% of close contacts of smear-negative cases (1/36). In the control group, 16.8% showed positivity in TST. In a multivariate analysis, having stayed in the same room or next room with TB patients was identified as a risk factor of LTBI. CONCLUSION Using the data from TB contact investigations in the Korean Army units, we found an overall LTBI rate of 14.7% among the contacts screened. This study demonstrates that contacts living in the same building, especially the same room or next room, with TB patients are at a high risk of acquiring LTBI, serving as additional evidence for defining close and casual contacts of a TB patient with regard to Army barrack settings.

BACKGROUND/AIMS: As the prevalence of diabetes mellitus and its complications increase rapidly, diabetic foot ulcers (DFUs), which are a major diabetic complication, are expected to increase. For prevention and effective treatment, it is important to understand the clinical course of DFUs. The aim of this study was to investigate the natural course and predictors of amputation in patients with DFUs who required hospitalization. METHODS: A total of 209 patients with type 2 diabetes, aged 30 to 85 years, who visited emergency department or needed hospitalization due to DFUs were consecutively enrolled from May 2012 to January 2016, by retrospective medical record review. The main outcome was lower extremity amputation (LEA). RESULTS: Among 192 patients who completed follow-up, 113 patients (58.9%) required LEAs. Compared to patients without amputation, baseline levels of white blood cell counts and C-reactive protein were higher in patients with amputation. In addition, bone and joint involvement was more frequently observed in patients with amputation. Multivariable regression analysis revealed that combined infection (odds ratio [OR], 11.39; 95% confidence interval [CI], 2.55 to 50.93; p = 0.001) and bone or joint involvement (OR, 3.74; 95% CI, 1.10 to 12.70; p = 0.035) were significantly associated with an increased risk of LEA. CONCLUSIONS: The depth of the wound and combined infection of DFU, rather than the extent of the wound, were significant prognostic factors of LEAs in patients with type 2 diabetes.
Amputation* ; C-Reactive Protein ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Foot* ; Emergency Service, Hospital ; Follow-Up Studies ; Hospitalization ; Humans ; Joints ; Leukocyte Count ; Lower Extremity* ; Medical Records ; Prevalence ; Prognosis ; Retrospective Studies ; Ulcer* ; Wounds and Injuries

BACKGROUND: This retrospective study analyzed the causes of failure in the management process from the identification of brain-dead potential organ donors to actual donation in Korea over the past 5 years. METHODS: Data of 8,120 potential brain deaths reported to the Korea Organ Donation Agency were used, including information received at the time of reporting, donation suitability evaluation performed by the coordinator after the report, and data obtained from interviews of hospital medical staff and the donor's family. RESULTS: From January 2012 to December 2016, the total number of brain-dead potential organ donors in Korea was 8,120, of which 2,348 (28.9%) underwent organ procurement surgery with designated recipients. While the number of transplant donors has increased over time, the ratio of transplant donors to medically suitable brain-dead donors has decreased. The common causes of donation failure included donation refusal (27.6%), non-brain death (15.5%), and incompatible donation (11.6%); 104 potential donors (7.8%) were unable to donate their organs because they were not pronounced brain dead. CONCLUSION: The rate of successful organ donation may be increased by analyzing the major causes of failure in the brain-dead organ donation management process and engaging in various efforts to prevent such failures.
Brain Death ; Humans ; Korea* ; Medical Staff, Hospital ; Retrospective Studies ; Statistics as Topic* ; Tissue and Organ Procurement ; Tissue Donors* ; Transplantation

OBJECTIVE: This study was designed to report on the progress of the fire at Jecheon sports complex and to assess the adequacy of Disaster Medical Assistant Team (DMAT)'s activities in response to the fire disaster. METHODS: We conducted a retrospective review based on camera recordings and medical records that were recorded at the disaster site for assessment of activities. We cooperated with firefighters, police officers, local hospital medical staffs and public health personnel in Jecheon in order to classify patients in the disaster field and to understand the patients' progress. RESULTS: At 15:53, the first request for emergency rescue came to the 119 general emergency call center, and a request for DMAT activation came at 16:28. DMAT arrived at the site at 17:04 and remained active until the following day at 00:43. The total number of casualties was 60, including 27 minimal (Green) patients, 29 expectant (Black) patients, three delayed (Yellow) patients, and one immediate (Red) patient. There were 32 patients who received on-site care by DMAT. Two patients were transferred from a local hospital to Wonju Severance Christian Hospital for hyperbaric oxygen therapy. CONCLUSION: Twenty-nine victims were found in the sports complex building, and there were 31 mildly to moderately injured patients in this fire disaster. The main cause of death was thought to be smoke suffocation. Although DMAT was activated relatively quickly, it was not able to provide effective activity due to the late rescue and difficulty with fire suppression.
Asphyxia ; Cause of Death ; Chungcheongbuk-do* ; Disasters* ; Emergencies ; Firefighters ; Fires* ; Gangwon-do ; Humans ; Hyperbaric Oxygenation ; Medical Assistance ; Medical Records ; Medical Staff, Hospital ; Police ; Public Health ; Retrospective Studies ; Smoke ; Sports*

This study analyzed the seeds of Zizyphus jujuba var. inermis commonly used as a remedy in traditional Chinese medicine, in order to determine its various biologically active compounds. Through process 3-pentadecylcatechol, ρ-menth-8-ene, and γ-bisabolene were isolated and identified for the first time which are urushiol, monoterpenoidal, and sesquiterpenoidal compounds, respectively. Also, found were another sesquiterpenoidal compounds, vomifoliol, and four steroidal compounds, β-sitosterol, stigmasterol, stigmasta-5,23-dien-3β-ol, and stigmast-4-en-3-one. In addition, fourteen triterpenoidal compounds were isolated and identified. These were lupeol, betulinic acid, betulinaldehyde, alphitolic acid, 3-O-cis-ρ-coumaroyl-alphitolic acid, 3-O-trans-ρ-coumaroylalphitolic acid, 2-O-cis-ρ-coumaroyl-alphitolic acid, 2-O-trans-ρ-coumaroyl-alphitolic acid, zizyberanalic acid, ceanothic acid, oleanolic acid, maslinic acid, 3-O-cis-ρ-coumaroyl-maslinic acid, and 3-O-trans-ρ-coumaroylmaslinic acid. The structures were identified by comparing of the spectroscopic experiments, NMR and MS, and then compared that reported data, respectively. Three extracts of water, methanol, and chloroform from the seeds showed a weak anti-proliferative effect, anti-microbial activity, and anti-oxidant effect, respectively.
Antioxidants ; Chloroform ; Medicine, Chinese Traditional ; Methanol ; Oleanolic Acid ; Stigmasterol ; Water ; Ziziphus*