1.Thoracic spinal cord damage in rat following cardiac arrest: neuronal loss, blood-spinal cord barrier leakage, and astrocyte endfeet disruption
Myoung Cheol SHIN ; Hyun-Jin TAE ; Joon Ha PARK ; Ji Hyeon AHN ; Dae Won KIM ; Moo-Ho WON ; Jun Hwi CHO ; Tae-Kyeong LEE
Journal of the Korean Society of Emergency Medicine 2025;36(1):1-11
Objective:
Cardiac arrest and cardiopulmonary resuscitation (CA/R) lead to whole-body ischemia and reperfusion (IR) injury, causing multiple organ dysfunction, including ischemic spinal cord injury. The thoracic spinal cord levels are crucial for maintaining the sympathetic functions vital for life. This study examined blood-spinal cord barrier (BSCB) leakage and astrocyte endfeet (AEF) disruption and their effects on survival, physiological variables, and neuronal damage/death in the intermediate zone (IMZ) at the seventh thoracic spinal cord level after asphyxial CA/R in rats.
Methods:
The rats underwent whole-body IR injury by asphyxial CA/R. Kaplan-Meier analysis was conducted to assess the cumulative survival post-CA/R. The histological changes post-CA/R were evaluated using immunohistochemistry, histofluorescence, and double histofluorescence.
Results:
No significant differences in body weight, mean arterial pressure, and heart rate were found between the sham and CA/R groups post-CA/R. The survival rates in the CA/R group at 12, 24, and 48 hours were 62.58%, 36.37%, and 7.8%, respectively. Neuronal loss and BSCB leakage began 12 hours post-CA/R, increasing with time. Reactive astrogliosis appeared at 12 hours and increased, while AEF disruption around blood vessels was evident at 48 hours.
Conclusion
The survival rate declined significantly by 48 hours post-CA/R. Neuronal loss and BSCB leakage in the thoracic spinal cord IMZ was evident at 12 hours and significant by 48 hours, aligning with AEF disruption. Neuronal loss in the thoracic spinal cord IMZ post-CA/R may be related to BSCB leakage and AEF disruption.
2.Thoracic spinal cord damage in rat following cardiac arrest: neuronal loss, blood-spinal cord barrier leakage, and astrocyte endfeet disruption
Myoung Cheol SHIN ; Hyun-Jin TAE ; Joon Ha PARK ; Ji Hyeon AHN ; Dae Won KIM ; Moo-Ho WON ; Jun Hwi CHO ; Tae-Kyeong LEE
Journal of the Korean Society of Emergency Medicine 2025;36(1):1-11
Objective:
Cardiac arrest and cardiopulmonary resuscitation (CA/R) lead to whole-body ischemia and reperfusion (IR) injury, causing multiple organ dysfunction, including ischemic spinal cord injury. The thoracic spinal cord levels are crucial for maintaining the sympathetic functions vital for life. This study examined blood-spinal cord barrier (BSCB) leakage and astrocyte endfeet (AEF) disruption and their effects on survival, physiological variables, and neuronal damage/death in the intermediate zone (IMZ) at the seventh thoracic spinal cord level after asphyxial CA/R in rats.
Methods:
The rats underwent whole-body IR injury by asphyxial CA/R. Kaplan-Meier analysis was conducted to assess the cumulative survival post-CA/R. The histological changes post-CA/R were evaluated using immunohistochemistry, histofluorescence, and double histofluorescence.
Results:
No significant differences in body weight, mean arterial pressure, and heart rate were found between the sham and CA/R groups post-CA/R. The survival rates in the CA/R group at 12, 24, and 48 hours were 62.58%, 36.37%, and 7.8%, respectively. Neuronal loss and BSCB leakage began 12 hours post-CA/R, increasing with time. Reactive astrogliosis appeared at 12 hours and increased, while AEF disruption around blood vessels was evident at 48 hours.
Conclusion
The survival rate declined significantly by 48 hours post-CA/R. Neuronal loss and BSCB leakage in the thoracic spinal cord IMZ was evident at 12 hours and significant by 48 hours, aligning with AEF disruption. Neuronal loss in the thoracic spinal cord IMZ post-CA/R may be related to BSCB leakage and AEF disruption.
3.Thoracic spinal cord damage in rat following cardiac arrest: neuronal loss, blood-spinal cord barrier leakage, and astrocyte endfeet disruption
Myoung Cheol SHIN ; Hyun-Jin TAE ; Joon Ha PARK ; Ji Hyeon AHN ; Dae Won KIM ; Moo-Ho WON ; Jun Hwi CHO ; Tae-Kyeong LEE
Journal of the Korean Society of Emergency Medicine 2025;36(1):1-11
Objective:
Cardiac arrest and cardiopulmonary resuscitation (CA/R) lead to whole-body ischemia and reperfusion (IR) injury, causing multiple organ dysfunction, including ischemic spinal cord injury. The thoracic spinal cord levels are crucial for maintaining the sympathetic functions vital for life. This study examined blood-spinal cord barrier (BSCB) leakage and astrocyte endfeet (AEF) disruption and their effects on survival, physiological variables, and neuronal damage/death in the intermediate zone (IMZ) at the seventh thoracic spinal cord level after asphyxial CA/R in rats.
Methods:
The rats underwent whole-body IR injury by asphyxial CA/R. Kaplan-Meier analysis was conducted to assess the cumulative survival post-CA/R. The histological changes post-CA/R were evaluated using immunohistochemistry, histofluorescence, and double histofluorescence.
Results:
No significant differences in body weight, mean arterial pressure, and heart rate were found between the sham and CA/R groups post-CA/R. The survival rates in the CA/R group at 12, 24, and 48 hours were 62.58%, 36.37%, and 7.8%, respectively. Neuronal loss and BSCB leakage began 12 hours post-CA/R, increasing with time. Reactive astrogliosis appeared at 12 hours and increased, while AEF disruption around blood vessels was evident at 48 hours.
Conclusion
The survival rate declined significantly by 48 hours post-CA/R. Neuronal loss and BSCB leakage in the thoracic spinal cord IMZ was evident at 12 hours and significant by 48 hours, aligning with AEF disruption. Neuronal loss in the thoracic spinal cord IMZ post-CA/R may be related to BSCB leakage and AEF disruption.
4.Presenteeism in Agricultural, Forestry and Fishing Workers:Based on the 6th Korean Working Conditions Survey
Sang-Hee HONG ; Eun-Chul JANG ; Soon-Chan KWON ; Hwa-Young LEE ; Myoung-Je SONG ; Jong-Sun KIM ; Mid-Eum MOON ; Sang-Hyeon KIM ; Ji-Suk YUN ; Young-Sun MIN
Journal of Agricultural Medicine & Community Health 2024;49(1):1-12
Objectives:
Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey.
Methods:
From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status.
Results:
As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups.
Conclusion
This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.
5.Presenteeism in Agricultural, Forestry and Fishing Workers:Based on the 6th Korean Working Conditions Survey
Sang-Hee HONG ; Eun-Chul JANG ; Soon-Chan KWON ; Hwa-Young LEE ; Myoung-Je SONG ; Jong-Sun KIM ; Mid-Eum MOON ; Sang-Hyeon KIM ; Ji-Suk YUN ; Young-Sun MIN
Journal of Agricultural Medicine & Community Health 2024;49(1):1-12
Objectives:
Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey.
Methods:
From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status.
Results:
As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups.
Conclusion
This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.
6.Presenteeism in Agricultural, Forestry and Fishing Workers:Based on the 6th Korean Working Conditions Survey
Sang-Hee HONG ; Eun-Chul JANG ; Soon-Chan KWON ; Hwa-Young LEE ; Myoung-Je SONG ; Jong-Sun KIM ; Mid-Eum MOON ; Sang-Hyeon KIM ; Ji-Suk YUN ; Young-Sun MIN
Journal of Agricultural Medicine & Community Health 2024;49(1):1-12
Objectives:
Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey.
Methods:
From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status.
Results:
As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups.
Conclusion
This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.
7.Impact of T-Cell Engagers on COVID-19–Related Mortality in B-Cell Lymphoma Patients Receiving B-Cell Depleting Therapy
Chan Mi LEE ; Pyoeng Gyun CHOE ; Chang Kyung KANG ; Hyeon Jae JO ; Nam Joong KIM ; Sung-Soo YOON ; Tae Min KIM ; Wan Beom PARK ; Myoung-don OH
Cancer Research and Treatment 2024;56(1):324-333
Purpose:
B-cell depleting therapies, including T-cell engager (TCE), are increasingly used for patients with hematologic malignancies, including during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the relationship between TCE therapy and COVID-19–related outcomes among patients with COVID-19 and B-cell lymphomas receiving B-cell depleting therapy.
Materials and Methods:
This retrospective cohort study included patients with B-cell lymphoma, who were admitted to Seoul Natio-nal University Hospital with COVID-19 between September 2021 and February 2023, and received B-cell depleting therapy before COVID-19 diagnosis. Multivariable logistic regression was used to identify factors associated with severe to critical COVID-19 and COVID-19–related mortality.
Results:
Of 54 patients with B-cell lymphomas and COVID-19 who received B-cell depleting therapy, 14 were treated with TCE (TCE group) and 40 with rituximab (RTX group). COVID-19–related mortality was higher in the TCE group than in the RTX group (57.1% vs. 12.5%, p=0.002). In multivariable analyses, TCE therapy (adjusted odds ratio [aOR], 7.08; 95% confidence interval [CI], 1.29 to 38.76; p=0.024) and older age (aOR, 1.06; 95% CI, 1.00 to 1.13; p=0.035) were associated with severe to critical COVID-19. TCE therapy (aOR, 8.98; 95% CI, 1.48 to 54.40; p=0.017), older age (aOR, 1.13; 95% CI, 1.02 to 1.26; p=0.022), and prior bendamustine therapy (aOR, 7.78; 95% CI, 1.17 to 51.65; p=0.034) were independent risk factors for COVID-19–related mortality.
Conclusion
B-cell lymphoma patients treated with TCE had significantly worse outcomes from COVID-19 than those treated with RTX. TCE therapy should be used with caution in B-cell lymphoma patients during the COVID-19 epidemic.
8.Impact of Infection Prevention Programs on Catheter-Associated Urinary Tract Infections Analyzed in Multicenter Study
Sun Hee NA ; Joong Sik EOM ; Yu Bin SEO ; Sun Hee PARK ; Young Keun KIM ; Wonkeun SONG ; Eunjung LEE ; Sung Ran KIM ; Hyeon Mi YOO ; Heekyung CHUN ; Myoung Jin SHIN ; Su Hyun KIM ; Ji Youn CHOI ; Nan hyoung CHO ; Jin Hwa KIM ; Hee-jung SON ; Su ha HAN ; Jacob LEE
Journal of Korean Medical Science 2024;39(18):e151-
Background:
Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes.
Methods:
Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals.
Results:
Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals.
Conclusion
We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.
9.Clinical and Radiological Outcomes of Unstable Intertrochanteric Fractures Treated with Trochanteric Fixation Nail-Advanced and Proximal Femoral Nail Antirotation-II: Correlation between Lateral Sliding of the Helical Blade and Lateral Trochanteric Pain
Sung Yoon JUNG ; Myoung Jin LEE ; Lih WANG ; Hyeon Jun KIM ; Dong Hoon SUNG ; Jun Ha PARK
The Journal of the Korean Orthopaedic Association 2024;59(3):208-218
Purpose:
This study examined the clinical and radiological outcomes of TFNA (Trochanteric Fixation Nail-Advanced) and PFNA-II (Proximal Femoral Nail Antirotation-II) used in the treatment of unstable intertrochanteric femur fractures. The association between lateral screw sliding and lateral trochanteric pain was analyzed.
Materials and Methods:
The study included 116 patients diagnosed with unstable intertrochanteric femur fractures who underwent intramedullary nailing surgery at the author’s hospital. The patients were divided into two groups: 72 who received PFNA-II and 44 who received TFNA. Ten patients with positive greater trochanter tenderness and 106 patients with negative tenderness were assessed for the factors associated with lateral trochanteric pain. The radiological outcomes included an evaluation of fracture union, screw position, tipapex distance, proximal femoral nail protrusion, and lateral sliding length of the helical blade. The clinical outcomes were assessed using the Harris Hip Score, visual analogue scale (VAS) score, greater trochanter tenderness, and pre- and postoperative ambulation ability.
Results:
Thirty-three patients (45.8%) of the PFNA-II group and 18 (40.9%) of the TFNA group had lateral sliding of the helical blade, with no significant difference between the two groups (p=0.604). The VAS score was significantly higher in the TFNA group (3.77±1.71) than the PFNA-II group (3.10±1.57, p=0.032). Furthermore, the prevalence of a positive greater trochanter tenderness was significantly higher in the TFNA group (seven patients) than in the PFNA-II group (3 patients, p=0.04). Eight patients had lateral sliding in the positive greater trochanter tenderness group, whereas 43 had lateral sliding in the negative greater trochanter tenderness group (p=0.030). The lateral sliding length was 8.87±5.22 and 2.68±4.47 in the positive and negative groups, respectively (p<0.001).
Conclusion
The PFNA-II and TFNA groups showed favorable clinical and radiological outcomes, suggesting that both devices are suitable for treating unstable intertrochanteric femur fractures. A comparison of the two devices showed that TFNA induces more lateral trochanteric pain than PFNA-II, and the presence and extent of lateral sliding were associated with lateral trochanteric pain.
10.Korean National Healthcare-associated Infections SurveillanceSystem for Hand Hygiene Report: Data Summary from July 2019to December 2022
Sung Ran KIM ; Kyung-Sook CHA ; Oh Mee KWEON ; Mi Na KIM ; Og Son KIM ; Ji-Hee KIM ; Soyeon PARK ; Myoung Jin SHIN ; Eun-Sung YOU ; Sung Eun LEE ; Sun Ju JUNG ; Jongsuk JEOUNG ; In-Soon CHOI ; Jong Rim CHOI ; Ji-Youn CHOI ; Si-Hyeon HAN ; Hae Kyung HONG
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(1):40-47
Background:
Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022.
Methods:
Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022.
Results:
Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did.
Conclusion
This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.

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