Objective: To compare and analyze the differences in the sociodemographic and clinical characteristics of suicide attempters who visited an emergency department (ED) before and during the coronavirus disease (COVID-19) pandemic. Methods: This single center, retrospective study was conducted by reviewing the medical records of patients in the “self-injury/suicide” category of the National Emergency Department Information System who visited an ED between January 2019 and December 2020. We obtained information on baseline characteristics, suicide attempt, and disposition. Data were analyzed using the chi-squared test. Results: A total of 456 patients were included. The number of patients visiting the ED for suicide attempts increased by 18.2% (from 209 to 247 cases) during the COVID-19 pandemic, and the ratio of suicide attempters to the total number of ED visits increased by 48.8% (from 0.43% to 0.64%, P<0.001). There were significant differences in methods of suicide attempt, endotracheal intubation, ED disposition, and the presence of mental illness. Drug overdose (42.1% vs. 53.4%) and gas inhalation (5.7% vs. 8.5%) increased, and hanging decreased (6.0% vs. 2.0%) during the pandemic. Endotracheal intubation (13.9% vs. 5.7%) and intensive care unit admission (29.7% vs. 14.6%) decreased. More patients with the history of mental illness visited during the pandemic (54.0% vs. 70.1%). Conclusion Since the COVID-19 pandemic began, suicide attempts have increased in this single ED although the lethality of those attempts is low.

Objective: The purpose of this study is to report the activities of Disaster Medical Assistance Team and national emergency medical center in the fire at a women’s hospital on December 14, 2019, and to suggest an improvement plan for the special disastrous situation. Methods: We reviewed the transfer records of national emergency medical center, medical records of regional emergency medical center, and records of each patient’s prognosis of the women’s hospital, retrospectively. Triage of casualties was conducted according to SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) method. Results: The fire was extinguished early and there was no victim with significant carbon monoxide intoxication. Among 228 casualties, there were 143 patients of the women’s hospital. Two patients were classified as immediate, 55 patients including pregnant women, newborns, and mothers were classified as delayed, and 171 casualties including newborns and mothers were classified as minimal. Among 66 newborns, 40 newborns were transferred to the regional Emergency Medical Center, and a second triage was conducted by doctors there. Conclusion Although there was no significant victim, physically and socially susceptible people such as pregnant women, newborns, and mothers were included in this accident. We recommend establishing a standard of disaster response for special population and improving our capability at a national level.

Purpose: The optimal time for home safety intervention for children’s injury prevention is during the injury-related visits to emergency departments. The authors investigated the effect of home safety equipment provision on the guardians’ perception of injury prevention and attitude toward it, and the use of home safety equipment. Methods: We conducted a double blind randomized controlled study on guardians of children aged 7 years or younger who visited the emergency department with accidental injuries. After completing the structured, pre-intervention survey on home safety, the guardians were randomly assigned to receive either home safety equipment (the intervention group) or stationery (the control group) in the same opaque boxes enclosing pamphlets about home safety education. After 4 weeks, the guardians were contacted for the post-intervention survey. The questionnaires for the latter survey consisted of the same contents with 2 added questions regarding the use of new home safety equipment after intervention. Logistic regressions were conducted to identify factors associated with the outcome (i.e., behavioral change). Results: From April through October 2019, we approached 972 guardians. Of these, 59 guardians answered both pre- and post-intervention surveys. No differences were found in the perception and attitude, and use of home safety equipment between the intervention and control groups at the pre- and post-intervention surveys. No variables were associated with the primary outcome. Conclusion Provision of home safety equipment may be inadequate to improve guardians’ behaviors about prevention of domestic injuries.

Purpose: The optimal time for home safety intervention for children’s injury prevention is during the injury-related visits to emergency departments. The authors investigated the effect of home safety equipment provision on the guardians’ perception of injury prevention and attitude toward it, and the use of home safety equipment. Methods: We conducted a double blind randomized controlled study on guardians of children aged 7 years or younger who visited the emergency department with accidental injuries. After completing the structured, pre-intervention survey on home safety, the guardians were randomly assigned to receive either home safety equipment (the intervention group) or stationery (the control group) in the same opaque boxes enclosing pamphlets about home safety education. After 4 weeks, the guardians were contacted for the post-intervention survey. The questionnaires for the latter survey consisted of the same contents with 2 added questions regarding the use of new home safety equipment after intervention. Logistic regressions were conducted to identify factors associated with the outcome (i.e., behavioral change). Results: From April through October 2019, we approached 972 guardians. Of these, 59 guardians answered both pre- and post-intervention surveys. No differences were found in the perception and attitude, and use of home safety equipment between the intervention and control groups at the pre- and post-intervention surveys. No variables were associated with the primary outcome. Conclusion Provision of home safety equipment may be inadequate to improve guardians’ behaviors about prevention of domestic injuries.

Purpose: To assess the effect of medically-attended injury (MAI) on the use of home safety equipment, we analyzed the differences in parents’ perception and attitude about injury prevention, and use of home safety equipment depending on the children’s MAI experiences. Methods: From March 2018 through February 2019, we surveyed parents of children aged 5 years or younger via a mobile phone. The parents were divided into the MAI and non-MAI groups. The mobile survey focused on the perception and attitude about injury prevention, and use of home safety equipment (if not used, barriers). Results: Of the 204 parents, 75 (36.8%) reported their children’s MAI, comprising the MAI group. This group used the safety equipment more frequently than the non-MAI group (odds ratio, 7.03; 95% confidence interval, 3.39-14.59; P < 0.001). No significant differences between the 2 groups were found in the perception and attitude about injury prevention, barriers to the use of the equipment, and the type of the equipment in use. Conclusion Parents’ experience in their children’s MAIs was associated with the use of home safety equipment, but it did not affect their perception and attitude about injury prevention. A visit to the emergency department with MAI is an opportunity for education on injury prevention and changes of the attitude.

Purpose: To assess the effect of medically-attended injury (MAI) on the use of home safety equipment, we analyzed the differences in parents’ perception and attitude about injury prevention, and use of home safety equipment depending on the children’s MAI experiences. Methods: From March 2018 through February 2019, we surveyed parents of children aged 5 years or younger via a mobile phone. The parents were divided into the MAI and non-MAI groups. The mobile survey focused on the perception and attitude about injury prevention, and use of home safety equipment (if not used, barriers). Results: Of the 204 parents, 75 (36.8%) reported their children’s MAI, comprising the MAI group. This group used the safety equipment more frequently than the non-MAI group (odds ratio, 7.03; 95% confidence interval, 3.39-14.59; P < 0.001). No significant differences between the 2 groups were found in the perception and attitude about injury prevention, barriers to the use of the equipment, and the type of the equipment in use. Conclusion Parents’ experience in their children’s MAIs was associated with the use of home safety equipment, but it did not affect their perception and attitude about injury prevention. A visit to the emergency department with MAI is an opportunity for education on injury prevention and changes of the attitude.

PURPOSE: Multidrug resistance-associated protein (MRP) 2 is a glutathione conjugate in the canalicular membrane of hepatocytes. Early graft damage after liver transplantation (LT) can result in alteration of MRP2 expression. The purpose of this study was to evaluate the relationship between the pattern of MRP2 alteration and graft outcome. METHODS: Forty-one paraffin-embedded liver graft tissues obtained by protocol biopsy within 2 months after LT; these were stained using monoclonal antibodies of MRP2. We selected 15 live donor biopsy samples as a control, that showed homogenous canalicular staining for MRP2. The pattern of canalicular MRP2 staining of graft was classified into 3 types: homogenous (type C0), focal (type C1), and no (type C2,) staining of the canaliculi. RESULTS: In total, 17.1% graft tissues were type C0, 36.6% were type C1, and 46.3% were type C2. The median operation time was longer in patients with type C2 (562.6 minutes) than in patients with type C0 (393.8 minutes) (P = 0.038). The rates of posttransplant complications were higher in patients with type C2 (100%) than in patients with type C0 (42.9%) and C1 (73.3%) (P < 0.001). CONCLUSION: MRP2 expression pattern was altered in 82.9% after LT. The pattern of MRP2 alteration was associated with longer operation time and higher rates of post-LT complications.
Antibodies, Monoclonal ; Biopsy ; Glutathione ; Hepatocytes ; Humans ; Liver Transplantation* ; Liver* ; Membranes ; Multidrug Resistance-Associated Proteins ; Tissue Donors ; Transplants*

PURPOSE: Accidental out-of-hospital deliveries are generally associated with high rates of perinatal morbidity and mortality. To determine the status of accidental out-of-hospital deliveries transferred by emergency medical services (EMS), we analyzed the records of EMS runsheets in two South Korean provinces, Gyeonggi and Gangwon. METHODS: The EMS runsheets of patients who were more than 20 weeks pregnant and had delivery-related symptoms between January 2012 and December 2013 in Gyeonggi and Gangwon province were reviewed retrospectively. We analyzed the characteristics of accidental out-of-hospital deliveries by comparing these with those non out-of-hospital deliveries. RESULTS: There were 1,426 urgent dispatches during the study period. In 137 (9.6%) out-of-hospital deliveries, which took place prior to arriving at the hospital, and 48 of these were attended by EMS providers. The accidental out-of-hospital deliveries were more frequent during night time and more common among multiparous and younger age women; however, these observation was without any significance with respect to premature birth. The rate of the accidental out-of-hospital deliveries was not significantly different between rural and urban areas. Twenty cases of complication, including 10 arrests of neonates and EMS providers managed them by the following intervention: reduction of nuchal cord, umbilical cord clamping and cut, warming-up of and stimulating the neonates warms, using oropharyngeal suction, O₂ supplication, and neonatal cardiopulmonary resuscitation. CONCLUSION: As the rate of accidental out-of-hospital deliveries in patients who were transferred by EMS is higher than the rate of out-of-hospital deliveries in general, EMS providers should be fully trained. Moreover, there is the need for more completive records and continuous education.
Cardiopulmonary Resuscitation ; Constriction ; Education ; Emergencies* ; Emergency Medical Services* ; Female ; Gangwon-do ; Gyeonggi-do ; Humans ; Infant, Newborn ; Mortality ; Nuchal Cord ; Obstetric Labor Complications ; Pregnancy ; Premature Birth ; Retrospective Studies ; Suction ; Umbilical Cord