Purpose: The quality of kidneys from deceased donors is critical for successful kidney transplantation. Due to donor shortages, expanded criteria donors are increasingly used, raising concerns about posttransplant outcomes. This study evaluated the predictive value of donor aortoiliac calcification on graft outcomes to improve donor assessment and transplant planning. Methods: This retrospective study analyzed pretransplant non-contrast CT scans to classify donor aortoiliac calcification as non-to-mild or moderate-to-severe (MTS). Donor and recipient characteristics, time-zero biopsy findings, and graft outcomes were compared using chi-square tests and logistic regression. Results: MTS donors were significantly older (58.2 ± 5.2 years vs. 49.7 ± 12.8 years, P = 0.002), had more diabetes mellitus (50.0% vs. 10.0%, P = 0.004), and higher Kidney Donor Profile Index (KDPI) scores (79.0 ± 15.2 vs. 59.4 ± 25.1, P = 0.001).Tubular atrophy (TA) was more frequent in the MTS group (81.8% vs. 46.7%, P = 0.022). Logistic regression showed donor diabetes mellitus ( β = 0.496, P = 0.001) and Banff TA (β = 0.431, P = 0.003) were significant predictors of calcification. Conclusion Aortoiliac calcification in deceased donors is associated with older donor age, higher KDPI scores, and increased incidences of diabetes mellitus and TA. Although it correlated with donor-related risk factors known to influence graft outcomes, it did not independently predict graft function or survival. Therefore, its role in donor selection appears limited and warrants further validation through larger prospective studies.

Purpose: To develop a web-based solution for patient need-driven staffing (PNDS) that automatically determines nurses’ staffing requirements. Methods: Activities provided by nurses in four integrated nursing care wards (INCWs) and non-INCWs each in a tertiary hospital were observed over three days. Nursing hours per patient hour (NHPPH) were calculated by dividing nursing hours by patient stay hours per day. Patient needs were evaluated using 19 items. Results: The nurse-patient ratios in INCWs and non-INCWs were 1:4.5 and 1:8.1 (including overtime), respectively. Admitted and transferred-in patients had higher NHPPHs than those with continuing stays. The patients were classified into five groups: Group A for admissions and transfers-in, and Groups 1~4 for the remainder. In INCWs, the nurse-patient ratios ranged from 1:5.3 (Group 1) to 1:2.4 (Group 4), and Group A required 1:3.0, the secondhighest level. In non-INCWs, ratios ranged from 1:9.4 (Group 1) to 1:5.2 (Group 4 and Group A). The PNDS solution was developed to determine staffing requirements by classifying patients into five groups using the entered data on patient needs, assigning the group’s NHPPH to each patient, and calculating the staffing ratio required in the unit. Conclusion The PNDS is expected to support staffing decisions to meet patient needs.

BACKGROUND AND OBJECTIVES: There is a paucity of data regarding the benefit of clopidogrel monotherapy after dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents (DES). This study compared outcome between clopidogrel versus aspirin as monotherapy after DES for acute myocardial infarction (MI).METHODS: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 1,819 patients treated with DES who were switched to monotherapy with clopidogrel (n=534) or aspirin (n=1,285) after uneventful 12-month DAPT were analyzed. The primary endpoint was net adverse clinical events (NACE), defined as a composite of death from any cause, MI, repeat percutaneous coronary intervention (PCI), stent thrombosis, ischemic stroke, or major bleeding during the period from 12 to 24 months.RESULTS: After adjustment using inverse probability of treatment weighting, patients who received clopidogrel, compared with those treated with aspirin, had a similar incidence of NACE (0.7% and 0.7%; hazard ratio, 1.06; 95% confidence interval, 0.31–3.60; p=0.923). The 2 groups had similar rates of death from any cause (0.1% in each group, p=0.789), MI (0.3% and 0.1%, respectively; p=0.226), repeat PCI (0.1% and 0.3%, respectively; p=0.548), stent thrombosis (0.1% and 0%, respectively; p=0.121), major bleeding (0.2% in each group, p=0.974), and major adverse cardiovascular and cerebrovascular events (0.5% in each group, p=0.924).CONCLUSIONS: Monotherapy with clopidogrel, compared to aspirin, after DAPT showed similar clinical outcomes in patients with acute MI treated with DES.
Aspirin ; Drug-Eluting Stents ; Hemorrhage ; Humans ; Incidence ; Korea ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors ; Stents ; Stroke ; Thrombosis

BACKGROUND AND OBJECTIVES: There is a paucity of data regarding the benefit of clopidogrel monotherapy after dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents (DES). This study compared outcome between clopidogrel versus aspirin as monotherapy after DES for acute myocardial infarction (MI). METHODS: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 1,819 patients treated with DES who were switched to monotherapy with clopidogrel (n=534) or aspirin (n=1,285) after uneventful 12-month DAPT were analyzed. The primary endpoint was net adverse clinical events (NACE), defined as a composite of death from any cause, MI, repeat percutaneous coronary intervention (PCI), stent thrombosis, ischemic stroke, or major bleeding during the period from 12 to 24 months. RESULTS: After adjustment using inverse probability of treatment weighting, patients who received clopidogrel, compared with those treated with aspirin, had a similar incidence of NACE (0.7% and 0.7%; hazard ratio, 1.06; 95% confidence interval, 0.31–3.60; p=0.923). The 2 groups had similar rates of death from any cause (0.1% in each group, p=0.789), MI (0.3% and 0.1%, respectively; p=0.226), repeat PCI (0.1% and 0.3%, respectively; p=0.548), stent thrombosis (0.1% and 0%, respectively; p=0.121), major bleeding (0.2% in each group, p=0.974), and major adverse cardiovascular and cerebrovascular events (0.5% in each group, p=0.924). CONCLUSIONS Monotherapy with clopidogrel, compared to aspirin, after DAPT showed similar clinical outcomes in patients with acute MI treated with DES.

Background/Aims: Left ventricular hypertrophy (LVH) on clinical outcomes in patients with acute myocardial infarction (AMI) is not clear. This study was performed to investigate the effect of abnormal left ventricular geometry on clinical outcomes in Korean patients with AMI. Methods: A total of 852 consecutive patients with AMI were divided into two groups: normal left ventricular geometry (n = 470; 389 males) and LVH (n = 382; 214 males) groups. Major adverse cardiac events (MACEs) were defined as cardiac death, recurrent myocardial infarction, and rehospitalization. Results: During the clinical follow-up period of 21 ± 7.8 months, MACEs developed in 173 patients (20.0%), and the rate was higher in the LVH than normal left ventricular geometry groups (25.5% vs. 16.0%, respectively, p = 0.001). According to Kaplan-Meier survival curves, the MACE-free survival rate was significantly lower in the LVH group than in the left ventricular geometry group (p = 0.008). The rates of MACEs and all-cause mortality differed among the AMI with concentric remodeling, concentric hypertrophy, and eccentric hypertrophy subgroups (11.2% vs. 15.5% vs. 22.1%, respectively, p = 0.046). Eccentric hypertrophy was a predictive factor of MACE according to Cox proportional hazards analysis (hazard ratio 1.804, confidence interval 1.034-3.148, p = 0.038). Conclusions LVH is a predictor of poor outcomes in patients with AMI, and eccentric hypertrophy is associated with a worse prognosis compared with concentric remodeling and concentric hypertrophy. Therefore, Korean patients with AMI and LVH, especially eccentric hypertrophy, require more careful observation and intensive treatment.

Background/Aims: Left ventricular hypertrophy (LVH) on clinical outcomes in patients with acute myocardial infarction (AMI) is not clear. This study was performed to investigate the effect of abnormal left ventricular geometry on clinical outcomes in Korean patients with AMI. Methods: A total of 852 consecutive patients with AMI were divided into two groups: normal left ventricular geometry (n = 470; 389 males) and LVH (n = 382; 214 males) groups. Major adverse cardiac events (MACEs) were defined as cardiac death, recurrent myocardial infarction, and rehospitalization. Results: During the clinical follow-up period of 21 ± 7.8 months, MACEs developed in 173 patients (20.0%), and the rate was higher in the LVH than normal left ventricular geometry groups (25.5% vs. 16.0%, respectively, p = 0.001). According to Kaplan-Meier survival curves, the MACE-free survival rate was significantly lower in the LVH group than in the left ventricular geometry group (p = 0.008). The rates of MACEs and all-cause mortality differed among the AMI with concentric remodeling, concentric hypertrophy, and eccentric hypertrophy subgroups (11.2% vs. 15.5% vs. 22.1%, respectively, p = 0.046). Eccentric hypertrophy was a predictive factor of MACE according to Cox proportional hazards analysis (hazard ratio 1.804, confidence interval 1.034-3.148, p = 0.038). Conclusions LVH is a predictor of poor outcomes in patients with AMI, and eccentric hypertrophy is associated with a worse prognosis compared with concentric remodeling and concentric hypertrophy. Therefore, Korean patients with AMI and LVH, especially eccentric hypertrophy, require more careful observation and intensive treatment.

Respiratory syncytial virus (RSV) is common cause of acute respiratory infection in infants and young children. Group life in postpartum care centers is easily exposed to infectious diseases in neonates and puerperds immediately after giving birth, and the harm caused by exposure to them is much greater. In particular, respiratory diseases are highly infectious and infections occur in a short period of time. among them, RSV infections are very serious in children under 5 years of age, leading to death. This paper studied an infection of RSV in outbreaks at postpartum care center in Busan. In 4 postpartum care centers, a total of 877 people (390 neonates, 386 puerperds, 106 others) were exposed to RSV outbreak. Of these, there were 73 RSV-positive patients; most of them had cough and runny nose and no fever. We were collected from neonates and puerperds with acute respiratory tract a total of 146 samples (throat swabs). In 51 samples, RSV (43 cases), human rhinovirus (6 cases), human coronavirus NL63 (1 case), and human coronavirus 229E (1 case) were found to be positive and the rest were negative. All 43 RSV positive samples were identified as RSV B. Sequence analysis of the detected strains was performed to confirm the molecular genetic information of RSV. Out of 43 RSV positive samples, 38 samples were successfully sequenced using the G gene, resulting in all of the same genotype BA9. This study provides a better understanding of RSV prevalence patterns and genetic characteristics. It also contributes to the accumulation of epidemiological data and the development of public health and hygiene.

Avian trematodes, Urogonimus turdi (Digenea: Leucochloridiidae), were collected from the intestine of wild birds, Zoothera aurea, 2013–2017 in the Daejeon Metropolitan City, Korea. The body was ellipsoidal, attenuated and/or round ends, 1,987–2,120 long and 819–831 μm wide. The oral sucker was subterminal, rounded anteriorly, and 308–425×351–432 μm in size; the prepharynx and esophagus were almost lacking; pharynx was well-developed, 142–179×78–170 μm in size; intestine narrow, bifurcating just after pharynx, ascending to the oral sucker before looping posteriorly and terminating near the posterior end; ventral sucker larger, in almost median, 536–673×447–605 μm and approximately 1.5 times larger than oral sucker. A phylogenetic tree constructed with 18S ribosomal RNA showed inter- and intraspecific relationships. Based on these morphological and molecular findings, we report here a U. turdi from White’s thrushes in Korea.
Birds ; Candidiasis, Oral ; Esophagus ; Intestines ; Korea ; Pharynx ; Republic of Korea ; RNA, Ribosomal, 18S ; Songbirds ; Trees

OBJECTIVE: Data on the intensity of statin therapy for patients with acute myocardial infarction (MI) and very low baseline low-density lipoprotein (LDL) cholesterol level are lacking. We sought to assess the impact of statin intensity in patients with acute MI and LDL cholesterol <70 mg/dL. METHODS: A total of 1,086 patients with acute MI and baseline LDL cholesterol <70 mg/dL from the Korea Acute Myocardial Infarction Registry-National Institute of Health database were divided into less intensive statin (expected LDL reduction <40%, n=302) and more intensive statin (expected LDL reduction ≥40%, n=784) groups. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs), a composite of cardiac death, MI, revascularization occurring at least 30 days after admission, and stroke, at 12 months. RESULTS: After 1:2 propensity matching, differences were not observed between less intensive (n=302) and more intensive statin (n=604) groups in incidence of cardiac death (0.3% vs. 0.3%) and hemorrhagic stroke (0.3% vs. 0.5%, p=0.727) at 12 months. Compared with the less intensive statin group, the more intensive statin group showed lower target-vessel revascularization (4.6% vs. 1.8%, p=0.027) and MACCE (11.6% vs. 7.0%, p=0.021). Major bleeding was not different between less intensive and more intensive statin groups (1.0% vs. 2.6%, p=0.118). CONCLUSION: More intensive statin therapy was associated with significantly lower major adverse cardiovascular events in patients with acute MI and very low LDL cholesterol compared with less intensive statin therapy.
Cholesterol ; Cholesterol, LDL ; Death ; Hemorrhage ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Korea ; Lipoproteins ; Myocardial Infarction ; Stroke

To survey the prevalence of Sarcocystis infections, 210 heart samples were collected from Korean native cattle (Bos taurus coreanae) at an abattoir in Daejeon Metropolitan City, Republic of Korea. Sarcocysts were detected form 31 specimens (14.8%) and identified as Sarcocystis cruzi via transmission electron microscopy. The wall of S. cruzi has flattened protrusions that did not contain fibrils or microfilaments. The protrusions arose irregularly from the base, contained a fine granular substance, lacked internal microfilaments, and measured approximately 0.21–1.25 μm in length and 0.05–0.07 μm in width. Sequence analysis revealed 99.5% homology to S. cruzi. This is the first report on the prevalence of S. cruzi in native cattle from the Republic of Korea.
Abattoirs ; Actin Cytoskeleton ; Animals ; Cattle ; Heart ; Korea ; Microscopy, Electron, Transmission ; Prevalence ; Republic of Korea ; Sarcocystis ; Sequence Analysis