Objective: Ischemia-modified albumin (IMA) is a marker of oxidative stress and hypoperfusion that is usually used for acute coronary syndrome. Patients with sepsis undergo hypoperfusion and multi-organ failure that results in death. This study evaluated the efficacy of the albumin-adjusted IMA (AAIMA) level in the emergency department (ED) to predict the 30-day mortality of patients with sepsis Methods: A retrospective analysis study of patients with sepsis was conducted from June 2018 to April 2019 in ED. The data were obtained from the medical records of the patients, and the blood test results were taken from the initial blood tests at the ED. The data and blood test results of the 30-day survival and non-survival groups were compared. Results: Two hundred thirty-three patients were included. The mean age was 75 years, and the overall mortality was 20.6%. The non-survival group had higher AAIMA levels than the survival group (75.1 U/mL vs. 68.4 U/mL). The area under the receiver operating characteristic curve of AAIMA to predict the 30-day mortality was 0.789 (95% confidence interval, 0.730-0.840; P<0.001), and the sensitivity and specificity of predicting mortality was 68.8% and 78.2%, respectively, after setting the AAIMA cutoff value to 72.9 U/mL. Conclusion The initial albumin-adjusted IMA on ED admission has potential as a predictor of the 30-day mortality in patients with sepsis.

Objective: Ischemia-modified albumin (IMA) is a marker of oxidative stress and hypoperfusion that is usually used for acute coronary syndrome. Patients with sepsis undergo hypoperfusion and multi-organ failure that results in death. This study evaluated the efficacy of the albumin-adjusted IMA (AAIMA) level in the emergency department (ED) to predict the 30-day mortality of patients with sepsis Methods: A retrospective analysis study of patients with sepsis was conducted from June 2018 to April 2019 in ED. The data were obtained from the medical records of the patients, and the blood test results were taken from the initial blood tests at the ED. The data and blood test results of the 30-day survival and non-survival groups were compared. Results: Two hundred thirty-three patients were included. The mean age was 75 years, and the overall mortality was 20.6%. The non-survival group had higher AAIMA levels than the survival group (75.1 U/mL vs. 68.4 U/mL). The area under the receiver operating characteristic curve of AAIMA to predict the 30-day mortality was 0.789 (95% confidence interval, 0.730-0.840; P<0.001), and the sensitivity and specificity of predicting mortality was 68.8% and 78.2%, respectively, after setting the AAIMA cutoff value to 72.9 U/mL. Conclusion The initial albumin-adjusted IMA on ED admission has potential as a predictor of the 30-day mortality in patients with sepsis.

Ischemic colitis is the consequence of a sudden reduction in colon blood supply, which in turn results in ischemic injury. The splenic flexure and rectosigmoid junction are the areas most often affected. Ischemic colitis occurs with greater frequency in the elderly and is caused by various medications and procedures. Pseudoephedrine acts as a vasoconstrictor directly affecting adrenal receptors of nasal mucous membrane. Pseudoephedrine occasionally causes vascular insufficiency due to intense vasoconstriction, even at standard doses. Ischemic colitis associated with pseudoephedrine has been reported in other countries,, but it has never been reported in Korea. In this paper, we describe 3 cases of ischemic colitis that occurred after taking pseudoephedrine for nasal congestion.
Aged ; Colitis, Ischemic* ; Colon ; Colon, Transverse ; Estrogens, Conjugated (USP) ; Gastrointestinal Hemorrhage ; Humans ; Korea ; Mucous Membrane ; Pseudoephedrine* ; Vasoconstriction

PURPOSE: The anticancer property and cytoprotective role of selenium in chemotherapy have been reported. However, the combination effects of selenium on chemotherapy for advanced breast cancer have not yet been clearly defined. The purpose of this study was to investigate the combined effects of selenium on chemotherapy using docetaxel on breast cancer cell lines. METHODS: Under adherent culture conditions, two breast cancer cell lines, MDA-MB-231 and MCF-7, were treated with docetaxel at 500pM and selenium at 100nM, 1microM, or 10microM. Changes in cell growth, cell cycle duration, and degree of apoptosis after 72 hours in each treated group were evaluated. RESULTS: In the MDA-MB-231 cells, the combination therapy group (docetaxel at 500pM plus selenium at 10microM) showed a significantly decreased percentage of cell growth (15% vs. 28%; P = 0.004), a significantly increased percentage of late apoptosis (63% vs. 26%; P = 0.001), and an increased cell cycle arrest in the G2/M phase (P = 0.001) compared with the solitary docetaxel therapy group. Isobologram analysis demonstrated the synergistic effect of the combination therapy in the MDA-MB-231 cells. However, in the MCF-7 cells, no significant differences in the percentage of cell growth apoptosis, the percentage of apoptosis, and the pattern of cell cycle arrest were noted between the combination therapy groups and the solitary docetaxel therapy group. CONCLUSION: Our in vitro study indicated that the combination of selenium with docetaxel inhibits cell proliferation through apoptosis and cell arrest in the G2/M phase in MDA-MB-231 breast cancer cells.
Apoptosis ; Breast Neoplasms* ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line* ; Cell Proliferation ; Drug Therapy ; Drug Therapy, Combination ; Humans ; MCF-7 Cells ; Selenium*

PURPOSE: To determine the clinical features of urolithiasis-patients; specifically negative hematuriapatients (NHP) versus positive hematuria patients (PHP) in an emergency department (ED). METHODS: Patients with urolithiasis who had visited an ED over the past two years were retrospectively analyzed. Only patients analyzed through both urinalysis and computed tomography were included (1005 patients). NHP was present in 125(12.4%) of these patients. The clinical features of NHP and PHP were assessed in regard to several factors: sex, age, onset to ED visit time, associated symptoms, costovertebral angle tenderness (CVAT), stone size, stone location, length of stay in the ED, repeated drug rate, admission rate, and revisit rate within 72 hours. RESULTS: There were no significant differences in sex, age, onset to ED visit time, associated symptom, CVAT, and stone size between NHP and PHP. However, in NHP there was a slight dominance in renal and ureterovesical junction (UVJ) according to stone location. Compared with PHP, NHP increased the length of stay in the ED (150.0+/-52.3 min vs. 132.7+/-48.6 min; p=0.001), repeated drug rate (80% vs. 69.4%; p=0.015) and admission rate (12.8% vs. 6.4%; p=0.015). There was no significant difference in revisit rate within 72 hours between NHP and PHP (8.3% vs. 4.7%; p=0.161). CONCLUSION: Compared with the conventional PHP, NHP increased the length of stay in an ED, increased the repeated drug rate, and was associated with a high admission rate in an ED setting.
Emergencies* ; Hematuria* ; Humans ; Length of Stay ; Retrospective Studies ; Urinalysis ; Urolithiasis*

PURPOSE: To determine the clinical features of urolithiasis-patients; specifically negative hematuriapatients (NHP) versus positive hematuria patients (PHP) in an emergency department (ED). METHODS: Patients with urolithiasis who had visited an ED over the past two years were retrospectively analyzed. Only patients analyzed through both urinalysis and computed tomography were included (1005 patients). NHP was present in 125(12.4%) of these patients. The clinical features of NHP and PHP were assessed in regard to several factors: sex, age, onset to ED visit time, associated symptoms, costovertebral angle tenderness (CVAT), stone size, stone location, length of stay in the ED, repeated drug rate, admission rate, and revisit rate within 72 hours. RESULTS: There were no significant differences in sex, age, onset to ED visit time, associated symptom, CVAT, and stone size between NHP and PHP. However, in NHP there was a slight dominance in renal and ureterovesical junction (UVJ) according to stone location. Compared with PHP, NHP increased the length of stay in the ED (150.0+/-52.3 min vs. 132.7+/-48.6 min; p=0.001), repeated drug rate (80% vs. 69.4%; p=0.015) and admission rate (12.8% vs. 6.4%; p=0.015). There was no significant difference in revisit rate within 72 hours between NHP and PHP (8.3% vs. 4.7%; p=0.161). CONCLUSION: Compared with the conventional PHP, NHP increased the length of stay in an ED, increased the repeated drug rate, and was associated with a high admission rate in an ED setting.
Emergencies* ; Hematuria* ; Humans ; Length of Stay ; Retrospective Studies ; Urinalysis ; Urolithiasis*

PURPOSE: To maintain high quality cardiopulmonary resuscitation (CPR), optimal alternating rescuers is important. Stronger and faster chest compression has recently been emphasized in the 2010 guidelines. Therefore, this study compared and evaluated changes in the quality of chest compression in a 2-min scenario group and a 1-min scenario group. METHODS: Among the 88 participants, two-rescuer pairs were randomly allocated. After the training and a one-day break, participants were asked to perform continuous chest compressions for 2 min on a manikin and to take a one-day break, followed by continuous chest compression for 1 min. In all simulated CPRs, the total number of chest compressions and those with appropriate depth were counted. Chest compression quality index was calculated as the proportion of chest compressions with appropriate depth. RESULTS: The mean overall chest compression depth was lower in the 2-min scenario group, compared with the 1-min scenario group. In particular, compression rate (p=0.110), abnormal hand position (p=0.181), and chest recoil (p=0.892) showed no significant difference between the two groups. However, the quality index, mean depth (p=0.018) and too shallow compression depth (p=0.020) 1-min scenario was better than that of the 2-min scenario group. The difference in the CPR quality index reached statistical significance. CONCLUSION: Switching compressors at an interval of 2 min is reasonable for performance of CPR by a lay-bystander. However, alternating rescuers every 1 min may be an alternative method during continuous chest compression.
Cardiopulmonary Resuscitation ; Fatigue ; Hand ; Manikins ; Thorax

BACKGROUND: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. RESULTS: In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (+/-1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/105 and 17.4/105 person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. CONCLUSION: There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea.
Diagnosis ; Humans ; Incidence ; Korea* ; Medical Records ; Police* ; Recurrence ; Retrospective Studies ; Tuberculosis*

BACKGROUND: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. RESULTS: In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (+/-1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/105 and 17.4/105 person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. CONCLUSION: There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea.
Diagnosis ; Humans ; Incidence ; Korea* ; Medical Records ; Police* ; Recurrence ; Retrospective Studies ; Tuberculosis*

Secretory leukocyte protease inhibitor (SLPI) is a serine protease inhibitor with anti-microbial properties found in mucosal fluids. At the tissue level, the ability of this 12kDa protein is to counteract the excessive degradation of functional and structural proteins such as collagen and fibronectin. Impaired healing states are characterized by excessive proteolysis and often bacterial infection, leading to the hypothesis that SLPI may have a role in this process. To investigate the role of SLPI in skin how it contributes to tissue repair, we have generated mice null for the gene encoding SLPI (Slpi), which show impaired cutaneous wound healing with increased inflammation. For the purpose of this, we have performed wound experiment in skin tissue with morphometrical analyses, immunohistochemistry, and Rnase protection assay. From these analyses, the results were that delayed healing in KO mice wounds compared to that of WT, prolonged inflammatory phase and increased TGF-beta1 in KO wounds, and lower mechanical properties in KO wounds. Taken together, SLPI may play a cruical role in cutaneous wounds healing especially in matrix reorganization that suggests the development as a clinical drug for wound healing.
Animals ; Bacterial Infections ; Collagen ; Fibronectins ; Immunohistochemistry ; Inflammation ; Mice ; Mice, Knockout* ; Proteolysis ; Ribonucleases ; Secretory Leukocyte Peptidase Inhibitor* ; Serine Proteases ; Skin ; Transforming Growth Factor beta1 ; Wound Healing* ; Wounds and Injuries*