Objective: We investigated the distribution of AI viruses in fecal samples from wild bird habitats (and nearby poultry-farm areas) surveyed between September and March from 2019 to 2025 and identified associated epidemiological risk factors. Methods: Samples were screened for influenza A (M, H5, H7) genes using real-time reverse transcription polymerase chain reaction (PCR), subjected to virus isolation in embryonated chicken eggs, and subtyped by PCR and sequencing. Host species were identified through DNA barcoding. Relative risks (RRs) with 95% confidence intervals were estimated for province, month, and waterfowl density. Results: Overall prevalence of HPAI and low pathogenic AI (LPAI) virus was 0.10% and 3.21%, respectively. HPAI virus was continuously isolated since 2020–2021, except 2019– 2020, while LPAI prevalence steadily increased (3.01%–4.35%). Twelve hemagglutinin (H1–H12) subtypes were identified in 1,722 isolates, and H3 (16.5%) was the most prevalent, followed by H5 (11.1%) and H7 (5.2%). LPAI H5N3 (55.7%) and H7N7 (75.5%) were the predominant H5 and H7 subtypes, respectively. Detection was higher in western coastal provinces, and higher mallard/spot-billed duck density and sampling in September– December were associated with increased risk. Conclusions and Relevance: Continued surveillance of migratory-bird habitats can provide early warning of HPAIV incursions and support targeted biosecurity measures in high-risk regions and seasons.

OBJECTIVES: Individuals with disabilities are at greater risk of hospitalization than the general population. We examined 10-year trends in potentially preventable hospitalizations (PPH) in Korea, comparing individuals with and without disabilities and assessing age-specific patterns. METHODS: Using National Health Information Database claims data (2010–2019), we established a fixed cohort of newly registered individuals with disabilities and control subjects statistically matched (1:1.5) at baseline. Annual PPH rates among patients with each condition were calculated and age- and sex-standardized according to Organization for Economic Cooperation and Development Health Care Quality Indicators definitions. Trends and annual percent changes (APCs) were analyzed by disability status and age group (non-older: 30–64; older adults: ≥65 years). RESULTS: Between 2010 and 2019, PPH rates declined significantly in both groups. Among individuals with disabilities, the steepest decline was observed for hypertension (APC, −15.7%; 95% confidence interval [CI], −17.7 to −13.7), whereas congestive heart failure showed the largest reduction among individuals without disabilities (APC, −7.8%; 95% CI, −10.8 to −4.7). Declines were generally greater among non-older adults aged 30–64 years, regardless of disability status. The disparity between disability and non-disability groups narrowed over the decade, primarily due to larger improvements among non-older adults. Older adults with disabilities consistently exhibited the highest PPH rates for most conditions, whereas younger individuals with disabilities had the highest rates for diabetes. CONCLUSIONS PPH rates declined over the decade among both individuals with and without disabilities, particularly for hypertension and among non-older adults. However, older adults with disabilities remain at elevated risk, underscoring the need for targeted strategies to improve access to community-based primary care.

Objective: In this study, we compared differences based on the gender of Korean emergency physicians to provide basic data for future emergency medicine development plans. Methods: We used data from the emergency physician survey (2020) conducted by the Korean Society of Emergency Medicine. A total of 1,303 emergency physicians responded to the survey. We adjusted demographic data relating to age, position, and work duration as an emergency physician, which could affect the differences based on gender. After propensity score matching, we compared working hours, work burden, income, motives for applying for emergency medicine, and future plans of the emergency physicians by sex. Results: The total working hours per month and night shifts per month were higher in men compared to the women. The women felt more pressure in the following areas: number of emergency patients, relationships with administrative agencies, insufficient emergency medical technician manpower, patients’ compliance, and relationships with other emergency physicians. Monthly income was higher in men. Women placed a higher value on ‘Acquiring a range of knowledge’ and ‘Degree of interest in working in the emergency room’ than men as motivation for applying for positions in emergency medicine. Regarding future plans, women placed less value on income and more on having enough free time and avoiding burnout. The retirement age was about 3 years lower for women than for men. Conclusion This study revealed gender differences in working hours, income, motivation for applying for emergency medicine, work burden, and future plans. It is expected that these differences are caused by physical limitations and socio-cultural backgrounds. It is recommended that more detailed investigations be carried out through qualitative research. These results could help in gender considerations while hiring emergency physicians.

Background: Since 2003, the H5 highly pathogenic avian influenza (HPAI) subtype has caused massive economic losses in the poultry industry in South Korea. The role of inland water bodies in avian influenza (AI) outbreaks has not been investigated. Identifying water bodies that facilitate risk pathways leading to the incursion of the HPAI virus (HPAIV) into poultry farms is essential for implementing specific precautionary measures to prevent viral transmission. Objectives: This matched case-control study (1:4) examined whether inland waters were associated with a higher risk of AI outbreaks in the neighboring poultry farms. Methods: Rivers, irrigation canals, lakes, and ponds were considered inland water bodies.The cases and controls were chosen based on the matching criteria. The nearest possible farms located within a radius of 3 km of the case farms were chosen as the control farms.The poultry farms were selected randomly, and two HPAI epidemics (H5N8 [2014–2016] and H5N6 [2016–2017]) were studied. Conditional logistic regression analysis was applied. Results: Statistical analysis revealed that inland waters near poultry farms were significant risk factors for AI outbreaks. The study speculated that freely wandering wild waterfowl and small animals contaminate areas surrounding poultry farms. Conclusions Pet birds and animals raised alongside poultry birds on farm premises may wander easily to nearby waters, potentially increasing the risk of AI infection in poultry farms. Mechanical transmission of the AI virus occurs when poultry farm workers or visitors come into contact with infected water bodies or their surroundings. To prevent AI outbreaks in the future, poultry farms should adopt strict precautions to avoid contact with nearby water bodies and their surroundings.

Fat embolism syndrome is a rare disease associated with long bone fractures and plastic surgery. In previous studies of cerebral fat embolism, no reports of cardiac arrest occurred by cerebral fat embolism. Therefore, we aimed to report the first case of cardiac arrest by cerebral fat embolism after scalp lipoma removal.

OBJECTIVE: Radiation is used extensively in emergency centers. Computed tomography and X-ray imaging are used frequently. Portable X-rays, in particular, cause a significant amount of indirect radiation exposure to medical personnel. The authors' emergency center was remodeled, and a comparative study of radiation exposure was carried out in certain places that had experienced radiation for a long time. METHODS: The cumulative radiation dose was measured 20 times in the 24 hours prior to remodeling, and the cumulative radiation dose was measured again 20 times across the 24-hour period. The measurement points were fixed at the emergency doctor's seat (Zone A), charge nurse's seat (Zone B), and section nurse's seat (Zone C). During the 24-hour cumulative radiation measurement period, the number of portable X-ray shots was recorded in the emergency center. RESULTS: The mean of the 24-hour cumulative radiation measurements in zone A was 3.36±0.07 µSV and 4.54±0.07 µSV before and after remodeling, respectively (P<0.001). Regarding the number of portable X-rays performed during the measurement, a higher number of trials in the Pearson correction correlated with a higher radiation measurement. CONCLUSION: In an emergency medical center, there is a higher level of low-dose radiation exposure compared to that experienced from natural radioactivity. Regarding the number of portable X-rays, the cumulative radiation dose measured 24 hours after remodeling increased and can be assumed to be related to the environment.
Emergencies ; Radiation Exposure ; Radioactivity

The aim of this study was to measure and compare polyphenol content, antioxidant, and anti-inflammatory activity of six halophytes (Limonium tetragonum, Suaeda glauca, Suaeda japonica, Salicornia europaea, Triglochin maritimum, and Sonchus brachyotus). Depending on the total polyphenol content, the plants were categorized into two groups: (1) a high total polyphenol content group that included L. tetragonum, S. brachyotus, and S. europaea, and, (2) a low total polyphenol content group consisting of S. glauca, T. maritima, and S. japonica. Antioxidant activity was evaluated using DPPH and hydroxyl radical scavenging assays, and by measuring ROS. Anti-inflammatory activity was evaluated by measuring NO and PGE₂. L. tetragonum and S. brachyotus, that have high polyphenol content, also showed strong antioxidant activity. In addition, L. tetragonum, S. brachyotus, and S. europaea showed good anti-inflammatory activity. Consequently, the total polyphenol content was thought to be related to antioxidant and anti-inflammatory activity. Therefore, S. brachyotus and L. tetragonum are good candidates for use in pharmaceuticals and functional foods.
Chenopodiaceae ; Functional Food ; Hydroxyl Radical ; Korea ; Salt-Tolerant Plants ; Sonchus

PURPOSE: To report the surgical results of unilateral pediatric cataracts from uncertain causes in relatively older children and to identify factors related to better visual outcomes. METHODS: We retrospectively evaluated the medical records of 39 patients who underwent surgery between the ages of 3 and 10 years for unilateral pediatric cataracts of no known cause. All patients underwent primary intraocular lens implantation and postoperative amblyopia treatment. A postoperative final visual acuity better than 20 / 30 was considered to be a good visual outcome. RESULTS: The mean age of patients was 6.0 ± 1.8 years at the time of surgery. The mean preoperative visual acuity was 1.07 ± 0.71 logarithm of the minimum angle of resolution (range, 0.15 to 3.00), while the mean final postoperative visual acuity was 0.47 ± 0.54 logarithm of the minimum angle of resolution (range, 0.00 to 2.00). Of 39 patients, 18 (46.2%) achieved a good visual outcome. Only the preoperative visual acuity maintained a significant association with a good visual outcome according to our multivariate analysis (p = 0.040). A preoperative visual acuity of 20 / 100 or better was found to increase the chance of achieving a good visual outcome by 13.79-fold (95% confidence interval, 1.13 to 167.58). CONCLUSIONS: The visual outcome of unilateral pediatric cataract surgery for cataracts with no specific cause identified in patients after three years of age could be satisfactory, especially with a preoperative visual acuity of 20 / 100 or better.
Amblyopia ; Cataract* ; Child ; Humans ; Lens Implantation, Intraocular ; Medical Records ; Multivariate Analysis ; Phacoemulsification ; Prognosis ; Retrospective Studies ; Visual Acuity

PURPOSE: Intravenous lipid emulsion (ILE) has been shown to have significant therapeutic effects on calcium channel blocker overdose in animal studies and clinical cases. In this preliminary experiment, we investigated the hemodynamic changes and survival in a rat model of verapamil intoxication. METHODS: Fourteen male Sprague-Dawley rats were sedated and treated with ILE or normal saline (control), followed by continuous intravenous infusion of verapamil (20 mg/kg/h). Mean arterial pressure and heart rate of rats were monitored during the infusion. In addition, the total dose of infused verapamil and the duration of survival were measured. RESULTS: Survival was prolonged in the ILE group (32.43±5.8 min) relative to the control group (24.14±4.3 min) (p=0.01). The cumulative mean lethal dose of verapamil was higher in the ILE group (4.3±0.7 mg/kg) than in the control group (3.2±0.5 mg/kg; p=0.017). CONCLUSION: ILE pretreatment prolonged survival and increased the lethal dose in a rat model of verapamil poisoning.
Animals ; Arterial Pressure ; Calcium Channels ; Heart Rate ; Hemodynamics ; Humans ; Infusions, Intravenous ; Male ; Models, Animal* ; Poisoning ; Rats* ; Rats, Sprague-Dawley ; Therapeutic Uses ; Verapamil*

A perfusion deficit of the aortic branch vessels in a patient with a type B aortic dissection is a challenging complication, as it leads to hemodynamic instability and doubles the mortality rate; however, the optimal management strategy in these cases remains controversial. Although surgical repair is still performed as the standard, endovascular approaches have been used recently as alternatives because of the high rate of perioperative complications. Herein, we report a patient with a type B aortic dissection and compromised renal and iliac arteries who was successfully treated by thoracic endovascular repair and insertion of a percutaneous stent. In addition, we adopted the chimney technique to preserve blood flow to the left subclavian artery due to the short proximal landing zone.
Aorta ; Aortic Diseases ; Hemodynamics ; Humans ; Iliac Artery ; Mortality ; Perfusion ; Stents ; Subclavian Artery