Objectives: We investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. Methods: We retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics and various blood test markers were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. Results: Among 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. Conclusions We identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.

Objectives: We investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. Methods: We retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics and various blood test markers were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. Results: Among 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. Conclusions We identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.

Objectives: We investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. Methods: We retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics and various blood test markers were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. Results: Among 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. Conclusions We identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.

Objectives: We investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. Methods: We retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics and various blood test markers were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. Results: Among 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. Conclusions We identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.

Purpose: Notable effectiveness of trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer (BC) has focused pathologists’ attention. We studied the incidence and clinicopathologic characteristics of HER2-low BC, and the effects of immunohistochemistry (IHC) associated factors on HER2 IHC results. Materials and Methods: The Breast Pathology Study Group of the Korean Society of Pathologists conducted a nationwide study using real-world data on HER2 status generated between January 2022 and December 2022. Information on HER2 IHC protocols at each participating institution was also collected. Results: Total 11,416 patients from 25 institutions included in this study. Of these patients, 40.7% (range, 6.0% to 76.3%) were classified as HER2-zero, 41.7% (range, 10.5% to 69.1%) as HER2-low, and 17.5% (range, 6.7% to 34.0%) as HER2-positive. HER2-low tumors were associated with positive estrogen receptor and progesterone receptor statuses (p < 0.001 and p < 0.001, respectively). Antigen retrieval times (≥ 36 minutes vs. < 36 minutes) and antibody incubation times (≥ 12 minutes vs. < 12 minutes) affected on the frequency of HER2 IHC 1+ BC at institutions using the PATHWAY HER2 (4B5) IHC assay and BenchMark XT or Ultra staining instruments. Furthermore, discordant results between core needle biopsy and subsequent resection specimen HER2 statuses were observed in 24.1% (787/3,259) of the patients. Conclusion The overall incidence of HER2-low BC in South Korea concurs with those reported in previously published studies. Significant inter-institutional differences in HER2 IHC protocols were observed, and it may have impact on HER2-low status. Thus, we recommend standardizing HER2 IHC conditions to ensure precise patient selection for targeted therapy.

Clear cell renal cell carcinoma (ccRCC) is a disease with a wide variety of clinical progressions such as the rate of disease progression or the degree of metastasis. About 30% of ccRCC patients suffer from metastatic diseases, and about 30% develop metastasis after diagnosis. In the case of metastatic RCC, early prediction of the disease is important because of the poor prognosis, but ccRCC-specific molecular markers for clinical use are not available yet. As an alternative, liquid biopsy, which can find molecules released from tumor tissues in circulating blood and obtain information on metastatic dissemination and recurrence of ccRCC, is emerging. In this article, we will introduce molecules such as cell free DNA, cell free RNA, protein, and exosomes available as circulating biomarkers for liquid biopsy. We will also introduce some promising technologies that can compensate for the limitations of liquid biopsy.

Background: Neuroinflammation plays an important role in cognitive decline and memory impairment in neurodegenerative disorders. Previously, we demonstrated that Humulus japonicus (HJ) has anti-inflammatory effects in rodent models of Alzheimer’s disease and Parkinson’s disease. The present study aimed to examine the protective potential of HJ extracts against lipopolysaccharide (LPS)-induced cognitive impairment and scopolamine-induced amnesia in mouse models. Cognitive improvement of mice was investigated by novel object recognition test. For analyzing effects on neuroinflammation, immunohistochemistry and quantitative real-time polymerase chain reaction (qRTPCR) assays were performed. Results: We found that the oral administration of HJ significantly improved cognitive dysfunction induced by LPS in a novel object recognition test. The LPS-induced activation of microglia was notably decreased by HJ treatment in the cortex and hippocampus. HJ administration with LPS also significantly increased the mRNA expression of interleukin (IL)-10 and decreased the mRNA expression of IL-12 in the parietal cortex of mice. The increased expression of LPS-induced complement C1q B chain (C1bq) and triggering receptor expressed on myeloid cells 2 (Trem2) genes was significantly suppressed by HJ treatment. In addition, HJ administration significantly improved novel object recognition in a scopolamine-induced amnesia mouse model. Conclusions These findings revealed that HJ has a beneficial effect on cognitive impairment and neuroinflammation induced by systemic inflammation and on amnesia induced by scopolamine in mice.

Background: Although international guidelines recommend palliative care approaches for many serious illnesses, the palliative needs of patients with serious illnesses other than cancer are often unmet, mainly due to insufficient prognosis-related discussion. We investigated physicians' and the general public's respective attitudes toward prognostic disclosure for several serious illnesses. Methods: We conducted a cross-sectional survey of 928 physicians, sourced from 12 hospitals and the Korean Medical Association, and 1,005 members of the general public, sourced from all 17 administrative divisions in Korea. Results: For most illnesses, most physicians (adjusted proportions – end-organ failure, 99.0%; incurable genetic or neurologic disease, 98.5%; acquired immune deficiency syndrome [AIDS], 98.4%; stroke or Parkinson's disease, 96.0%; and dementia, 89.6%) and members of the general public (end-organ failure, 92.0%; incurable genetic or neurologic disease, 92.5%; AIDS, 91.5%; stroke or Parkinson's disease, 92.1%; and dementia, 86.9%) wanted to be informed if they had a terminal prognosis. For physicians and the general public, the primary factor to consider when disclosing terminal status was “the patient's right to know his/her condition” (31.0%). Yet, the general public was less likely to prefer prognostic disclosure than physicians. Particularly, when their family members were patients, more than 10% of the general public did not want patients to be informed of their terminal prognosis. For the general public, the main reason for not disclosing prognosis was “psychological burden such as anxiety and depression” (35.8%), while for the physicians it was “disclosure would have no beneficial effect” (42.4%). Conclusion Most Physicians and the general public agreed that disclosure of a terminal prognosis respects patient autonomy for several serious illnesses. The low response rate of physicians might limit the generalizability of the results.

OBJECTIVES: The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. METHODS: A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. RESULTS: Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. CONCLUSIONS: Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.
Adult ; Anxiety Disorders* ; Anxiety* ; Chest Pain ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Headache ; Humans ; Prevalence ; Referral and Consultation ; Suicide ; Syncope

PURPOSE: Inadequate treatment of pain, which has been termed as “oligoanalgesia”, appears to be common phenomenon the emergency department (ED). In order to improve pain recognition and management, a study concerning physician characteristics on pain and pain management is needed. METHODS: This study was based on a survey that targeted emergency medicine doctors from September to November 2015 (the response rate was 7%). Firstly, the survey showed that physicians preferred medicating on five diseases abdominal pain, cancer, simple musculoskeletal disease, trauma, headache in the ED. Secondly, it demonstrated the criteria used to choose the analgesic treatment in accordance with each disease and the level of pain, which is determined using a numerical rating scale (NRS). RESULTS: In the cases of abdominal pain that requires surgery, cancer pain, and multiple trauma, physicians preferred using an opioid as the first medication, while non steroidal anti inflammatory drugs (NSAIDs) are prescribed in most of the other cases. Meperidine was the preferred choice as the opioid. For almost diseases, the NSAIDs are selected in the lower NRS cases over the opioid. Physicians deal with pain of patients who are already diagnosed with specific diseases, such as cancer, while they avoid managing pain from those patients who have not been definitively diagnosed with a specific disease. CONCLUSION: Physicians in the ED prefer the use of NSAIDs as the analgesic treatment, in particular, prescribing meperidine as the preferred opioid. However, it seems that they are hesitant to manage pain without a clear diagnosis.
Abdominal Pain ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Diagnosis ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Headache ; Humans ; Meperidine ; Multiple Trauma ; Musculoskeletal Diseases ; Pain Management