Objective: To compare and analyze the differences in the sociodemographic and clinical characteristics of suicide attempters who visited an emergency department (ED) before and during the coronavirus disease (COVID-19) pandemic. Methods: This single center, retrospective study was conducted by reviewing the medical records of patients in the “self-injury/suicide” category of the National Emergency Department Information System who visited an ED between January 2019 and December 2020. We obtained information on baseline characteristics, suicide attempt, and disposition. Data were analyzed using the chi-squared test. Results: A total of 456 patients were included. The number of patients visiting the ED for suicide attempts increased by 18.2% (from 209 to 247 cases) during the COVID-19 pandemic, and the ratio of suicide attempters to the total number of ED visits increased by 48.8% (from 0.43% to 0.64%, P<0.001). There were significant differences in methods of suicide attempt, endotracheal intubation, ED disposition, and the presence of mental illness. Drug overdose (42.1% vs. 53.4%) and gas inhalation (5.7% vs. 8.5%) increased, and hanging decreased (6.0% vs. 2.0%) during the pandemic. Endotracheal intubation (13.9% vs. 5.7%) and intensive care unit admission (29.7% vs. 14.6%) decreased. More patients with the history of mental illness visited during the pandemic (54.0% vs. 70.1%). Conclusion Since the COVID-19 pandemic began, suicide attempts have increased in this single ED although the lethality of those attempts is low.

Purpose: The optimal time for home safety intervention for children’s injury prevention is during the injury-related visits to emergency departments. The authors investigated the effect of home safety equipment provision on the guardians’ perception of injury prevention and attitude toward it, and the use of home safety equipment. Methods: We conducted a double blind randomized controlled study on guardians of children aged 7 years or younger who visited the emergency department with accidental injuries. After completing the structured, pre-intervention survey on home safety, the guardians were randomly assigned to receive either home safety equipment (the intervention group) or stationery (the control group) in the same opaque boxes enclosing pamphlets about home safety education. After 4 weeks, the guardians were contacted for the post-intervention survey. The questionnaires for the latter survey consisted of the same contents with 2 added questions regarding the use of new home safety equipment after intervention. Logistic regressions were conducted to identify factors associated with the outcome (i.e., behavioral change). Results: From April through October 2019, we approached 972 guardians. Of these, 59 guardians answered both pre- and post-intervention surveys. No differences were found in the perception and attitude, and use of home safety equipment between the intervention and control groups at the pre- and post-intervention surveys. No variables were associated with the primary outcome. Conclusion Provision of home safety equipment may be inadequate to improve guardians’ behaviors about prevention of domestic injuries.

Purpose: The optimal time for home safety intervention for children’s injury prevention is during the injury-related visits to emergency departments. The authors investigated the effect of home safety equipment provision on the guardians’ perception of injury prevention and attitude toward it, and the use of home safety equipment. Methods: We conducted a double blind randomized controlled study on guardians of children aged 7 years or younger who visited the emergency department with accidental injuries. After completing the structured, pre-intervention survey on home safety, the guardians were randomly assigned to receive either home safety equipment (the intervention group) or stationery (the control group) in the same opaque boxes enclosing pamphlets about home safety education. After 4 weeks, the guardians were contacted for the post-intervention survey. The questionnaires for the latter survey consisted of the same contents with 2 added questions regarding the use of new home safety equipment after intervention. Logistic regressions were conducted to identify factors associated with the outcome (i.e., behavioral change). Results: From April through October 2019, we approached 972 guardians. Of these, 59 guardians answered both pre- and post-intervention surveys. No differences were found in the perception and attitude, and use of home safety equipment between the intervention and control groups at the pre- and post-intervention surveys. No variables were associated with the primary outcome. Conclusion Provision of home safety equipment may be inadequate to improve guardians’ behaviors about prevention of domestic injuries.

Objective: The purpose of this study is to report the activities of Disaster Medical Assistance Team and national emergency medical center in the fire at a women’s hospital on December 14, 2019, and to suggest an improvement plan for the special disastrous situation. Methods: We reviewed the transfer records of national emergency medical center, medical records of regional emergency medical center, and records of each patient’s prognosis of the women’s hospital, retrospectively. Triage of casualties was conducted according to SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) method. Results: The fire was extinguished early and there was no victim with significant carbon monoxide intoxication. Among 228 casualties, there were 143 patients of the women’s hospital. Two patients were classified as immediate, 55 patients including pregnant women, newborns, and mothers were classified as delayed, and 171 casualties including newborns and mothers were classified as minimal. Among 66 newborns, 40 newborns were transferred to the regional Emergency Medical Center, and a second triage was conducted by doctors there. Conclusion Although there was no significant victim, physically and socially susceptible people such as pregnant women, newborns, and mothers were included in this accident. We recommend establishing a standard of disaster response for special population and improving our capability at a national level.

Purpose: To assess the effect of medically-attended injury (MAI) on the use of home safety equipment, we analyzed the differences in parents’ perception and attitude about injury prevention, and use of home safety equipment depending on the children’s MAI experiences. Methods: From March 2018 through February 2019, we surveyed parents of children aged 5 years or younger via a mobile phone. The parents were divided into the MAI and non-MAI groups. The mobile survey focused on the perception and attitude about injury prevention, and use of home safety equipment (if not used, barriers). Results: Of the 204 parents, 75 (36.8%) reported their children’s MAI, comprising the MAI group. This group used the safety equipment more frequently than the non-MAI group (odds ratio, 7.03; 95% confidence interval, 3.39-14.59; P < 0.001). No significant differences between the 2 groups were found in the perception and attitude about injury prevention, barriers to the use of the equipment, and the type of the equipment in use. Conclusion Parents’ experience in their children’s MAIs was associated with the use of home safety equipment, but it did not affect their perception and attitude about injury prevention. A visit to the emergency department with MAI is an opportunity for education on injury prevention and changes of the attitude.

Purpose: To assess the effect of medically-attended injury (MAI) on the use of home safety equipment, we analyzed the differences in parents’ perception and attitude about injury prevention, and use of home safety equipment depending on the children’s MAI experiences. Methods: From March 2018 through February 2019, we surveyed parents of children aged 5 years or younger via a mobile phone. The parents were divided into the MAI and non-MAI groups. The mobile survey focused on the perception and attitude about injury prevention, and use of home safety equipment (if not used, barriers). Results: Of the 204 parents, 75 (36.8%) reported their children’s MAI, comprising the MAI group. This group used the safety equipment more frequently than the non-MAI group (odds ratio, 7.03; 95% confidence interval, 3.39-14.59; P < 0.001). No significant differences between the 2 groups were found in the perception and attitude about injury prevention, barriers to the use of the equipment, and the type of the equipment in use. Conclusion Parents’ experience in their children’s MAIs was associated with the use of home safety equipment, but it did not affect their perception and attitude about injury prevention. A visit to the emergency department with MAI is an opportunity for education on injury prevention and changes of the attitude.

PURPOSE: Multidrug resistance-associated protein (MRP) 2 is a glutathione conjugate in the canalicular membrane of hepatocytes. Early graft damage after liver transplantation (LT) can result in alteration of MRP2 expression. The purpose of this study was to evaluate the relationship between the pattern of MRP2 alteration and graft outcome. METHODS: Forty-one paraffin-embedded liver graft tissues obtained by protocol biopsy within 2 months after LT; these were stained using monoclonal antibodies of MRP2. We selected 15 live donor biopsy samples as a control, that showed homogenous canalicular staining for MRP2. The pattern of canalicular MRP2 staining of graft was classified into 3 types: homogenous (type C0), focal (type C1), and no (type C2,) staining of the canaliculi. RESULTS: In total, 17.1% graft tissues were type C0, 36.6% were type C1, and 46.3% were type C2. The median operation time was longer in patients with type C2 (562.6 minutes) than in patients with type C0 (393.8 minutes) (P = 0.038). The rates of posttransplant complications were higher in patients with type C2 (100%) than in patients with type C0 (42.9%) and C1 (73.3%) (P < 0.001). CONCLUSION: MRP2 expression pattern was altered in 82.9% after LT. The pattern of MRP2 alteration was associated with longer operation time and higher rates of post-LT complications.
Antibodies, Monoclonal ; Biopsy ; Glutathione ; Hepatocytes ; Humans ; Liver Transplantation* ; Liver* ; Membranes ; Multidrug Resistance-Associated Proteins ; Tissue Donors ; Transplants*

PURPOSE: We aimed to investigate the triage results and the degree of agreement between prehospital and hospital stages of pediatric patients who visited the emergency department (ED) via emergency medical service providers (EMSP) in comparison with adult patients. METHODS: We retrospectively reviewed 8,152 pediatric patients who visited a regional emergency medical center ED via EMSP from January 2015 to December 2015. Pediatric patients were defined as younger than 15 years according to the Korean Triage and Acuity Scale (KTAS). Given the difference of the triage tools of the prehospital (EMSP) and hospital (KTAS) stages, we performed the re-triage into “critical” and “non-critical” Comparisons of characteristics between pediatric and adult patients were made using chi-square tests. The degree of agreement between the tools was analyzed using κ analysis. RESULTS: Of 8,152 patients, 654 (8.0%) were pediatric patients. Direct medical control was more frequently performed to adult patients (P < 0.001). Critical patients were more common among adults (12.2% by KTAS, 24.8% by EMSP) than children (3.5% by KTAS, 14.1% by EMSP). The κ value of pediatric patients was lower than that of adult patients (0.09 [poor]; 95% confidence interval [CI], 0.01–0.18 vs. 0.38 [fair]; 95% CI, 0.35–0.40). CONCLUSIONS: Pediatric patients transferred by EMSP showed lower severity and degree of agreements of the triage results between prehospital and hospital stages than adult patients. It is necessary to pay particular attention to pediatric triage in a pre-hospital setting.
Adult ; Child* ; Critical Illness ; Emergencies* ; Emergency Medical Services* ; Emergency Service, Hospital* ; Humans ; Observational Study* ; Pediatrics ; Reproducibility of Results ; Retrospective Studies ; Triage*