Objective: The purpose of this study was to compare the physical work intensity of emergency medicine (EM) and non-EM residents during a 24-hour work duty cycle using a smartwatch. Methods: This study was conducted for a month from 7 May to 4 June 2021. A total of 27 residents submitted their consent to be recruited as subjects for the study. We distributed a smartwatch to each of the participants and measured their physical work intensity. Twenty non-EM residents wore a smartwatch for a week. Also, seven EM residents wore a watch during the time they were on 24-hour duty for the whole research period. After finishing their 24-hour duty, participants took off the smartwatch and stopped recording their physical activities. Sixty-five samples were matched for comparison between the non-EM and EM residents. Each of the samples comprised a pair of 24-hour records of EM and non-EM residents. The data were matched to ensure the same date and grade and thus control the variables. Results: The results of this study showed that the maximum heart rate of the EM residents was 129.7±3.8 beats/min, which was higher than that of the non-EM residents. A comparison of the sleep hours during the 24-hour duty showed that the average sleep time of the EM residents was 156.9±84.8 minutes, which was significantly lower than that of the non-EM residents. However, calorie consumption, moving distance, and step count during the 24-hour duty cycle showed no significant difference between the EM and non-EM residents. Conclusion The maximum heart rate was higher among EM residents during their 24-hour work duty compared to the non-EM residents. In addition, the sleep time of the EM residents was significantly lower than that of the non-EM residents.

Purpose: The purpose of this study is to find out the current status of toxicology laboratory operated by six locations nationwide and to investigate the satisfaction of emergency medical professionals who working at local and regional emergency medical centers. Methods: This survey was conducted prospective. It was conducted on 665 emergency medical professionals working at regional and regional emergency medical centers across the South Korea. Among them, the analysis was conducted with data that 510 emergency medical professionals who respond to this survey. The questionnaire was conducted on an online basis for a month. To ensure statistical significance, consider a dropout rate of 10% based on a minimum response recovery rate of 70%. 506 people were selected for the survey. Results: According to a survey on the status of addiction analysis room usage, the average monthly usage of addiction test rooms among respondents were 406 cases.71.0 cases (17.4%) of toxicology laboratory in Seoul and 71 cases (17.4%) in Gwangju. 32 cases (7.8%), 118 cases (29.0%) requested by toxicology laboratory in Busan, and the toxicology laboratory in Daegu. Eighty two cases (20.1%), Daejeon area 25 cases (6.1%), Wonju area toxicology laboratory was 78 (19.6%). According to a survey on the satisfaction of the addiction analysis room,Seoul (4.9±2.71) and Gwangju (4.8±2.52) showed high satisfaction. Conclusion Due to the limited operation time of the four addiction analysis rooms currently in operation, the satisfaction level of addiction analysis by emergency medical professionals in the area is low due to the delay until the result is notified.

BACKGROUND AND OBJECTIVES: Impaired recovery from left ventricular (LV) dysfunction is a major prognostic factor after myocardial infarction (MI). Because P2Y12 receptor blockade inhibits myocardial injury, ticagrelor with off-target properties may have myocardial protection over clopidogrel. In animal models, ticagrelor vs. clopidogrel protects myocardium against reperfusion injury and improves remodeling after MI. We aimed to investigate the effect of ticagrelor on sequential myocardial remodeling process after MI. METHODS: High platelet inhibition with ticagrelor to improve LV remodeling in patients with ST-segment elevation MI (HEALING-AMI) is an investigator-initiated, randomized, open-label, assessor-blinded, multi-center trial done at 10 sites in Korea. Patients will be enrolled if they have ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention and a planned duration of dual antiplatelet treatment of at least 6 months. Screened patients will be randomly assigned (1:1) using an internet-based randomization with a computer-generated blocking with stratification across study sites to either ticagrelor or clopidogrel treatment. The co-primary primary endpoints are LV remodeling index with three-dimensional echocardiography and the level of N-terminal prohormone B-type natriuretic peptide (NT-proBNP) at 6 months representing post-MI remodeling processes. Changes of LV end-systolic/diastolic volume indices and LV ejection fraction between baseline and 6-month follow-up will be also evaluated. Analysis is per protocol. CONCLUSIONS: HEALING-AMI is testing the effect of ticagrelor in reducing adverse LV remodeling following STEMI. Our trial would show the benefit of ticagrelor vs. clopidogrel related to the recovery of post-MI LV dysfunction beyond potent platelet inhibition. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02224534
Blood Platelets ; Echocardiography, Three-Dimensional ; Follow-Up Studies ; Humans ; Korea ; Models, Animal ; Myocardial Infarction ; Myocardium ; Natriuretic Peptide, Brain ; Percutaneous Coronary Intervention ; Random Allocation ; Reperfusion Injury ; Ventricular Remodeling

PURPOSE: Lung Cancer Subcommittee of Korean Radiation Oncology Group (KROG) has recently launched a prospective clinical trial (KROG 17-06) of hippocampus-sparing whole brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in treating multiple brain metastases from non-small cell lung cancer. In order to improve trial quality, dummy run studies among the participating institutions were designed. This work reported the results of two-step dummy run procedures of the KROG 17-06 study. MATERIALS AND METHODS: Two steps tested hippocampus contouring variability and radiation therapy planning compliance. In the first step, the variation of the hippocampus delineation was investigated for two representative cases using the Dice similarity coefficients. In the second step, the participating institutions were requested to generate a HS-WBRT with SIB treatment plan for another representative case. The compliance of the treatment plans to the planning protocol was evaluated. RESULTS: In the first step, the median Dice similarity coefficients of the hippocampus contours for two other dummy run cases changed from 0.669 (range, 0.073 to 0.712) to 0.690 (range, 0.522 to 0.750) and from 0.291 (range, 0.219 to 0.522) to 0.412 (range, 0.264 to 0.598) after providing the hippocampus contouring feedback. In the second step, with providing additional plan priority and extended dose constraints to the target volumes and normal structures, we observed the improved compliance of the treatment plans to the planning protocol. CONCLUSION: The dummy run studies demonstrated the notable inter-institutional variability in delineating the hippocampus and treatment plan generation, which could be decreased through feedback from the trial center.
Brain ; Carcinoma, Non-Small-Cell Lung ; Compliance ; Hippocampus ; Lung Neoplasms ; Neoplasm Metastasis ; Prospective Studies ; Radiation Oncology ; Radiotherapy

BACKGROUND AND OBJECTIVES: Impaired recovery from left ventricular (LV) dysfunction is a major prognostic factor after myocardial infarction (MI). Because P2Y12 receptor blockade inhibits myocardial injury, ticagrelor with off-target properties may have myocardial protection over clopidogrel. In animal models, ticagrelor vs. clopidogrel protects myocardium against reperfusion injury and improves remodeling after MI. We aimed to investigate the effect of ticagrelor on sequential myocardial remodeling process after MI. METHODS: High platelet inhibition with ticagrelor to improve LV remodeling in patients with ST-segment elevation MI (HEALING-AMI) is an investigator-initiated, randomized, open-label, assessor-blinded, multi-center trial done at 10 sites in Korea. Patients will be enrolled if they have ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention and a planned duration of dual antiplatelet treatment of at least 6 months. Screened patients will be randomly assigned (1:1) using an internet-based randomization with a computer-generated blocking with stratification across study sites to either ticagrelor or clopidogrel treatment. The co-primary primary endpoints are LV remodeling index with three-dimensional echocardiography and the level of N-terminal prohormone B-type natriuretic peptide (NT-proBNP) at 6 months representing post-MI remodeling processes. Changes of LV end-systolic/diastolic volume indices and LV ejection fraction between baseline and 6-month follow-up will be also evaluated. Analysis is per protocol. CONCLUSIONS HEALING-AMI is testing the effect of ticagrelor in reducing adverse LV remodeling following STEMI. Our trial would show the benefit of ticagrelor vs. clopidogrel related to the recovery of post-MI LV dysfunction beyond potent platelet inhibition.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02224534

BACKGROUND: Healthy skin is an important determinant of the quality of life and physical and mental well-being. The demand for dermatological information is increasing not only in patients with skin diseases, but also in the general population with normal/healthy skin. However, public perception and behavior with regard to skin health among Koreans are not known. OBJECTIVE: To examine public perception and behaviors with regard to skin health in Koreans visiting the Skin Health Expo 2017. METHODS: A total of 597 participants completed a questionnaire that assessed demographics, status, and behavior for skin health and Expo satisfaction. RESULTS: Respondents with higher stress levels and a history of skin diseases showed lower satisfaction with self-skin health. Most participants considered adequate sleep and water intake to be important factors associated with healthy skin. One-on-one consultation with dermatologists was the most satisfactory among participants at the Expo. CONCLUSION: Educational tools using mass media and informative activities such as the Expo planned by dermatologists and the government are necessary to spread awareness and provide proper information to improve skin health in the general population and to emphasize the key role of dermatologists in skin disorders with a social burden.
Demography ; Drinking ; Humans ; Korea* ; Mass Media ; Quality of Life ; Research Report* ; Skin Diseases ; Skin* ; Surveys and Questionnaires

The change of compressing personnel will inevitably accompany hands off time when cardiopulmonary resuscitation (CPR) is performed by two or more rescuers. The present study assessed whether changing compression by a second rescuer located on the opposite side (OS) of the first rescuer can reduce hands-off time compared to CPR on the same side (SS) when CPR is performed by two rescuers. The scenario of this randomized, controlled, parallel simulation study was compression-only CPR by two laypersons in a pre-hospital situation. Considering sex ratio, 64 participants were matched up in 32 teams equally divided into two gender groups, i.e. , homogenous or heterogeneous. Each team was finally allocated to one of two study groups according to the position of changing compression (SS or OS). Every team performed chest compression for 8 min and 10 sec, with chest compression changed every 2 min. The primary endpoint was cumulative hands-off time. Cumulative hands-off time of the SS group was about 2 sec longer than the OS group, and was significant (6.6 +/- 2.6 sec vs. 4.5 +/- 1.5 sec, P = 0.005). The range of hands off time of the SS group was wider than for the OS group. The mean hands-off times of each rescuer turn significantly shortened with increasing number of turns (P = 0.005). A subgroup analysis in which cumulative hands-off time was divided into three subgroups in 5-sec intervals revealed that about 70% of the SS group was included in subgroups with delayed hands-off time > or = 5 sec, with only 25% of the OS group included in these subgroups (P = 0.033). Changing compression at the OS of each rescuer reduced hands-off time compared to the SS in prehospital hands-only CPR provided by two bystanders.
Cardiopulmonary Resuscitation/methods/*statistics & numerical data ; Clinical Competence/*statistics & numerical data ; Emergency Medical Services/*statistics & numerical data ; Female ; Heart Arrest/epidemiology/*prevention & control ; Heart Massage/methods/*statistics & numerical data ; Humans ; Male ; Republic of Korea/epidemiology ; Treatment Outcome ; Workload/*statistics & numerical data ; Young Adult

Cytomegalovirus(CMV) infections are common in immune compromised situations such as human immunodeficiency virus infection and organ transplantation. However CMV colitis had been rarely found in immunocompetent individuals. We experienced a case of an 83-year-old female patient, initially immune competent, who developed a massive lower gastrointestinal bleeding caused by CMV colitis. Previously, multiple antibiotics were used for nontuberculous Myco- bacterium and other bacterial infections after total knee arthroplasty. Colonoscopy revealed multiple ulcerations and mucosal congestion with hemorrhage. In spite of ganciclovir therapy, our patient did not recover.
Aged, 80 and over ; Anti-Bacterial Agents ; Arthroplasty ; Bacterial Infections ; Colitis ; Colonoscopy ; Cytomegalovirus ; Estrogens, Conjugated (USP) ; Female ; Ganciclovir ; Hemorrhage ; HIV ; Humans ; Knee ; Mycobacterium Infections, Nontuberculous ; Nontuberculous Mycobacteria ; Organ Transplantation ; Transplants ; Ulcer

PURPOSE: We reviewed the clinical result of two techniques of anterior fixation method for unstable pelvic ring injuries, which are external and internal fixation. MATERIALS AND METHODS: A retrospective clinical analysis was performed on 33 cases which had been operated from September 1998 to February 2003.Mean follow-up period is 29 months (range, 12-54 months).Previous to anterior fixation percutaneous iliosacral screw fixation was applied on iliosacral joint in Type C injury. After then plate and screw fixation were done in 17 cases and external fixation in 16 cases as an anterior fixation method. The patient' functional outcome was evaluated by Postel score and comparison between two groups was performed. RESULTS: In external fixator group the complaints are long duration of application of external fixator, excessive scar formation due to pin tract infection, pain and discomfort (Postel score 9.9;range, 8-11) due to malunion. In internal fixation group all of them showed more than good result and satisfactory to the postoperative condition and clinically (Postel score 11.6;range, 10-12). CONCLUSION: An open reduction and internal fixation technique is better than external fixation for the treatment of injured anterior pelvic ring in unstable pelvis fracture.
Cicatrix ; External Fixators ; Follow-Up Studies ; Joints ; Pelvis ; Retrospective Studies

A medullary carcinoma of the breast is an uncommon breast cancer subtype, but has a fair prognosis. The histopathological criteria for a medullary carcinoma were delineated by Ridolfi et al. in 1977, and most pathologists use these criteria. The authors experienced a huge carcinoma of the breast, which was diagnosed as an atypical medullary carcinoma. A 47-year old female visited our clinic due to a breast mass of six months duration. The mass was 16 cm in size and exophytic in the left lower breast. There had been necrosis, with a foul odor in most of the mass. A large fixed axillary lymph node was noted, but there was no evidence of distant metastasis. A radical mastectomy was performed due to invasion of the pectoralis major. On pathological examination, the tumor was diagnosed as an atypical medullary carcinoma.
Breast ; Breast Neoplasms* ; Carcinoma, Medullary ; Female ; Humans ; Lymph Nodes ; Mastectomy, Radical ; Necrosis ; Neoplasm Metastasis ; Odors ; Prognosis