Purpose: Firefighting duties range from field roles such as suppression, rescue, and emergency medical services (EMS) to various administrative tasks. Despite these differences, they face uniform fitness standards in Korea. This study seeks to define distinct fitness needs for each duty and provide data for customized standards. Methods: One hundred seventy-six Korean male firefighters participated, categorized into suppression (n=76), rescue (n=22), administrative (n=27), and EMS (n=51) roles. All underwent maximal oxygen consumption (VO2 max) tests for aerobic capacity, with body composition measured using bioelectrical impedance and height recorded with a stadiometer. Results: The VO2 max (mL/kg/min) among Korean male firefighters varied across different job duties: suppression (39.96±5.84), rescue (44.84±4.85), administration (40.27±7.01), and EMS (40.51±6.75). Rescue had the highest VO2 max, which was significantly higher (p=0.013). The body mass index (BMI, kg/m2 ) values were as follows: suppression (25.07±2.55), rescue (24.95±1.71), EMS (24.33±3.21), and administration (25.10±2.48). There was no statistically significant difference in BMI values (p=0.464). Conclusion This study evaluated the VO2 max and BMI of South Korean male firefighters according to their job duties. It found that 54.5% did not meet the recommended VO2 max standard of 42 mL/kg/min for their activities, and 77.5% had a BMI indicating overweight or higher. However, it is important to note that not every firefighting duty requires high fitness levels. The key is ensuring firefighters possess the fitness necessary for their specific roles to maintain safety and efficiency. The study aims to provide data for creating fitness management guidelines tailored to the diverse duties of firefighters.

Purpose: Although metformin and sildenafil can protect various organs against ischemia/reperfusion (I/R) injuries, their effects and mechanisms of action in bladder I/R injuries remain unknown. This study investigated the effects and mechanisms of action of metformin and sildenafil against bladder I/R insults in rats. Methods: One hundred male Sprague-Dawley rats were randomly divided into 5 groups, each of which contained 20 rats: a sham-operated group, a bladder I/R group, and bladder I/R groups treated with metformin, sildenafil, or both agents. Ischemia was induced by clamping the bilateral common iliac arteries with atraumatic vascular clamps for 2 hours, followed by reperfusion for 7 days. During this period, rats were injected once daily with 4-mg/kg metformin and/or 1-mg/kg sildenafil. Results: I/R injuries induced increased malondialdehyde levels and myeloperoxidase activity and decreased superoxide dismutase activity. These changes were attenuated by treatment with metformin and/or sildenafil. The I/R group had significantly higher Jun N-terminal kinase, p38 mitogen-activated protein kinase (MAPK), Bax, caspase-3, and nuclear factor-kappa B (NF-κB) levels, and lower extracellular signal-regulated kinase, and Bcl-2 levels in the bladder than the sham-operated group; these changes were significantly ameliorated by metformin and/or sildenafil treatment. No differences in the levels of these markers were observed between rats coadministered metformin and sildenafil and those treated with either agent alone. Conclusions Metformin and sildenafil protected the rat bladder against I/R injuries. This effect may have been due to the inhibition of reactive oxygen species production through MAPK, Bax, and Bcl-2 activation, and the restoration of inflammation through NF-κB inhibition. However, the combination of metformin and sildenafil was not more effective than either agent alone.

Accumulated evidence suggests that sporadic cases of Alzheimer's disease (AD) make up more than 95% of total AD patients, and diabetes has been implicated as a strong risk factor for the development of AD. Diabetes shares pathological features of AD, such as impaired insulin signaling, increased oxidative stress, increased amyloid-beta (Aβ) production, tauopathy and cerebrovascular complication. Due to shared pathologies between the two diseases, anti-diabetic drugs may be a suitable therapeutic option for AD treatment. In this article, we will discuss the well-known pathologies of AD, including Aβ plaques and tau tangles, as well as other mechanisms shared in AD and diabetes including reactive glia and the breakdown of blood brain barrier in order to evaluate the presence of any potential, indirect or direct links of pre-diabetic conditions to AD pathology. In addition, clinical evidence of high incidence of diabetic patients to the development of AD are described together with application of anti-diabetic medications to AD patients.
Alzheimer Disease ; Blood-Brain Barrier ; Encephalitis ; Humans ; Incidence ; Insulin ; Neuroglia ; Oxidative Stress ; Pathology ; Risk Factors ; Tauopathies

This correction is being published to correct the corresponding author's name and information in the article.

PURPOSE: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. MATERIALS AND METHODS: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0~100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. RESULTS: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p < 0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch. CONCLUSION: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.
Accidental Falls ; Ankle* ; Foot* ; Hand ; Humans ; Knee* ; Orthotic Devices ; Retreatment ; Retrospective Studies ; Self-Help Devices ; Walkers* ; Walking ; Wrist

PURPOSE: Prediction of neurologic outcome in survivors after cardiac arrest is difficult. In particular, since therapeutic hypothermia has emerged as the standard treatment for post cardiac arrest syndrome, the prediction has been more difficult. Methods for prediction of neurologic prognosis include the general neurologic examination, SSEPs, EEG, serum biomarkers, and so on. Among these, EEG was recommended for detection of non-convulsive seizure since early phase of post cardiac arrest syndrome. However, the relationship between EEG finding and neurologic outcome is not yet clear. METHODS: We conducted a retrospective observational study using a prospectively collected hypothermia database. We collected EEG findings during hypothermia and other data from January 2010 to December 2012. The EEG findings were classified according to five patterns as extremely low voltage, continuous slow wave, burst suppression, status epilepticus, and other. We analyzed the relationship between EEG pattern and one-month CPC score after cardiac arrest. RESULTS: During the study period, 121 patients were enrolled in the hypothermia database. Among these patients, 84 patients underwent EEG during hypothermia and were enrolled. The EEG patterns of enrolled patients were 20 extremely low voltage, 39 generalized slow wave, 15 burst suppression, 8 status epilepticus, and 2 alpha coma. None of the periodic, status eplilepticus, and alpha coma pattern patients showed a good neurologic outcome (CPC 1 or 2). Two of 20 extremely low voltage and 28 of 39 continuous slow wave pattern patients recovered to good neurologic outcome. CONCLUSION: Burst suppression and status epilepticus EEG pattern during hypothermia treatment showed an association with poor neurologic outcome.
Biomarkers ; Coma ; Electroencephalography* ; Heart Arrest ; Humans ; Hypothermia* ; Hypothermia, Induced ; Neurologic Examination ; Observational Study ; Out-of-Hospital Cardiac Arrest* ; Prognosis* ; Prospective Studies ; Retrospective Studies ; Seizures ; Status Epilepticus ; Survivors

PURPOSE: Prediction of neurologic outcome in survivors after cardiac arrest is difficult. In particular, since therapeutic hypothermia has emerged as the standard treatment for post cardiac arrest syndrome, the prediction has been more difficult. Methods for prediction of neurologic prognosis include the general neurologic examination, SSEPs, EEG, serum biomarkers, and so on. Among these, EEG was recommended for detection of non-convulsive seizure since early phase of post cardiac arrest syndrome. However, the relationship between EEG finding and neurologic outcome is not yet clear. METHODS: We conducted a retrospective observational study using a prospectively collected hypothermia database. We collected EEG findings during hypothermia and other data from January 2010 to December 2012. The EEG findings were classified according to five patterns as extremely low voltage, continuous slow wave, burst suppression, status epilepticus, and other. We analyzed the relationship between EEG pattern and one-month CPC score after cardiac arrest. RESULTS: During the study period, 121 patients were enrolled in the hypothermia database. Among these patients, 84 patients underwent EEG during hypothermia and were enrolled. The EEG patterns of enrolled patients were 20 extremely low voltage, 39 generalized slow wave, 15 burst suppression, 8 status epilepticus, and 2 alpha coma. None of the periodic, status eplilepticus, and alpha coma pattern patients showed a good neurologic outcome (CPC 1 or 2). Two of 20 extremely low voltage and 28 of 39 continuous slow wave pattern patients recovered to good neurologic outcome. CONCLUSION: Burst suppression and status epilepticus EEG pattern during hypothermia treatment showed an association with poor neurologic outcome.
Biomarkers ; Coma ; Electroencephalography* ; Heart Arrest ; Humans ; Hypothermia* ; Hypothermia, Induced ; Neurologic Examination ; Observational Study ; Out-of-Hospital Cardiac Arrest* ; Prognosis* ; Prospective Studies ; Retrospective Studies ; Seizures ; Status Epilepticus ; Survivors

BACKGROUND: The adequate management of mild to moderate dilatation of the ascending aorta during cardiac operations remains controversial. In this study, we present the short-term outcomes of 90 patients undergoing ascending aortic wrapping with a Dacron graft during other cardiac operations. MATERIALS AND METHODS: From March 2008 to January 2011, 90 consecutive patients underwent treatment for ascending aortic aneurysm using the external wrapping technique during the concomitant procedure. The study group consisted of 49 male and 41 female patients with a mean age of 58.7+/-13 years. The primary cardiac surgical procedures were coronary artery bypass grafting (CABG) in 3, aortic valve replacement in 2, and aortic valvuloplasty in 85 patients (isolated in 62 and combined with CABG or mitral valvuloplasty in 23). The ascending aorta diameter was measured using a computed tomography scan within 4 weeks after surgery, and was compared with the preoperative value. RESULTS: The diameters of the ascending aorta wrapped with the Dacron graft were significantly reduced within a month after surgery from 46.4+/-4.3 mm to 33.0+/-3.5 mm (p<0.05). There was no early mortality or major surgical complication. During the mean follow-up period of 15.4+/-5.2 months, there was only one late death caused by septic multiorgan failure. CONCLUSION: Dacron wrapping of the ascending aorta offers excellent results with very low mortality and morbidity, and it can be regarded as a safe and effective method for the treatment of moderately dilated ascending aorta in selected patients.
Aorta ; Aortic Aneurysm ; Aortic Valve ; Cardiac Surgical Procedures ; Coronary Artery Bypass ; Dilatation ; Female ; Follow-Up Studies ; Humans ; Male ; Polyethylene Terephthalates ; Thoracic Surgery ; Transplants

Granulomatous hypophysitis is a rare pituitary condition that commonly presents with enlargement of the pituitary gland. A 31-year-old woman was admitted to the hospital with a severe headache and bitemporal hemianopsia. Magnetic resonance imaging (MRI) showed an 18 x 10-mm sellar mass with suprasellar extension and compression of the optic chiasm. Interestingly, brain MRI had shown no abnormal finding 4 months previously. On hormonal examination, hypopituitarism with mild hyperprolactinemia was noted. The biopsy revealed granulomatous changes with multinucleated giant cells. We herein report this rare case and discuss the relevant literature.
Adult ; Biopsy ; Female ; Giant Cells/pathology ; Granuloma/complications/*diagnosis/therapy ; Headache/etiology ; Hemianopsia/etiology ; Humans ; Hyperprolactinemia/etiology ; Hypopituitarism/etiology ; Inflammation/complications/*diagnosis/therapy ; Magnetic Resonance Imaging ; Optic Chiasm/pathology ; Pituitary Diseases/complications/*diagnosis/therapy ; Pituitary Function Tests ; Pituitary Gland/*pathology/surgery ; Predictive Value of Tests ; Severity of Illness Index ; Treatment Outcome

BACKGROUND: Therapeutic hypothermia has been recommended as a standard treatment of cardiac arrest patients after return of spontaneous circulation. There are various methods to drop patient's core body temperature below 33.5degrees C. We compared the cooling rate of the conventional cooling method using cold saline bladder irrigation with the commercial hydrogel pad in out-of-hospital cardiac arrest (OHCA) patients. METHODS: We collected data retrospectively from the Samsung Medical Center hypothermia database. The conventional method group was cooled with IV infusion of 2,000 ml of 4degrees C cold saline and cold saline bladder irrigation. Patients in the hydrogel pad group had their body temperature lowered with the Artic Sun(R) after receiving 2,000 ml of 4degrees C cold saline intravenously. The induction time was defined as time from cold saline infusion to the esophageal core temperature below 33.5degrees C. The esophageal temperature probe insertion to the target temperature time (ET to target BT time) was defined as the time from the esophageal probe insertion to the core temperature below 33.5degrees C. We compared these times and cooling rates between the two groups. RESULTS: Eighty one patients were enrolled. Fifty seven patients were included in the hydrogel pad group and 24 patients were in the conventional group. There were no statistical differences of baseline characteristics between the two groups. The induction time of the conventional group (138 min., IQR 98-295) was shorter than that of the hydrogel pad group (190 min., IQR 140-250). The ET to target BT time of the conventional group (106 min., IQR 68-249) was shorter than that of the hydrogel pad group (163 min., IQR 108-222). The cooling rate of the conventional group (0.93degrees C/hr., IQR 0.58-2.08) was lower than that of the hydrogel pad group (1.05degrees C/hr., IQR 0.74-1.96). However, there were no statistical differences in the induction time, the ET to target BT time and the cooling rate between the two groups. CONCLUSIONS: There was no significant statistical difference of the cooling rate of the hydrogel pad and conventional method on the induction time of therapeutic hypothermia in Patients with OHCA. The conventional cooling method can be used as an effective and efficient way to lower OHCA patient's core body temperature during the induction phase of therapeutic hypothermia.
Body Temperature ; Cold Temperature ; Heart Arrest ; Humans ; Hydrogel ; Hypothermia ; Out-of-Hospital Cardiac Arrest ; Retrospective Studies ; Urinary Bladder