Objective: The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments. Methods: A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison. Results: The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups. Conclusion The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Objective: The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments. Methods: A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison. Results: The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups. Conclusion The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Objective: The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments. Methods: A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison. Results: The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups. Conclusion The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Purpose: To evaluate recurrence patterns of and survival outcomes in glioblastoma treated with intensity-modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3D-CRT). Materials and Methods: We retrospectively examined 91 patients with glioblastoma treated with either IMRT (n = 60) or 3D-CRT (n = 31) between January 2013 and December 2019. Magnetic resonance imaging showing tumor recurrence and planning computed tomography scans were fused for analyzing recurrence patterns categorized as in-field, marginal, and out-of-field based on their relation to the initial radiation field. Results: The median overall survival (OS) was 18.9 months, with no significant difference between the groups. The median progression-free survival (PFS) was 9.4 months, with no significant difference between the groups. Patients who underwent gross total resection (GTR) had higher OS and PFS than those who underwent less extensive surgery. Among 78 relapse cases, 67 were of in-field; 5, marginal; and 19, out-of-field recurrence. Among 3D-CRT-treated cases, 24 were of in-field; 1, marginal; and 9, out-of-field recurrence. Among IMRT-treated cases, 43 were of in-field; 4, marginal; and 10, out-of-field recurrence. In partial tumor removal or biopsy cases, out-of-field recurrence was less frequent in the IMRT (16.2%) than in the 3D-CRT (36.3%) group, with marginal significance (p = 0.079). Conclusion IMRT and 3D-CRT effectively managed glioblastoma with no significant differences in OS and PFS. The survival benefit with GTR underscored the importance of maximal surgical resection. The reduced rate of out-of-field recurrence in IMRT-treated patients with partial resection highlights its potential utility in cases with unfeasible complete tumor removal.

Although glycopeptides remain the preferred treatment for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, the treatment of persistent MRSA bacteremia has been challenging. We investigated real-world treatment strategies for persistent MRSA bacteremia, with a specific emphasis on the use of antimicrobial agents and the frequency of changes during the treatment course. We retrospectively identified patients with persistent MRSA bacteremia in four university-affiliated hospitals between 2017 and 2021. The primary objective of this study was to investigate the patterns of antimicrobial uses for MRSA bacteremia. The secondary objectives were evaluating the associated factors with 1) overall 30-day mortality and 2) changing agents during the treatment course. Time-dependent Cox regression analysis was used to adjust for immortal time bias. Among 116 patients, 37.1% underwent antimicrobials switching, primarily prompted by persistent bacteremia. The 30-day mortality rates of groups with and without antimicrobial switching were 21.4% and 44.2%, respectively (p=0.010 by log-rank test); however, after adjustment for immortal time bias, there was no statistical significance between the two groups (adjusted hazard ratio 0.24, 95% confidence interval 0.03–2.17, p=0.238). Only the Pitt bacteremia score on day 4 and pneumonia were associated with 30-day mortality. Meanwhile, the factors associated with antimicrobial switching were the duration of bacteremia, the initial use of teicoplanin, echocardiogram, and Charlson comorbidity index. This study showed that while over one-third of persistent MRSA bacteremia patients experience changes in antimicrobial agents during treatment, this practice does not significantly improve the 30-day mortality. Our study suggests the need for more effective treatment strategies in managing persistent MRSA bacteremia.

This research group (forensic research via omics markers in environmental health vulnerable areas: FROM) aimed to develop biomarkers for exposure to environmental hazards and diseases, assess environmental diseases, and apply and verify these biomarkers in environmentally vulnerable areas. Environmentally vulnerable areas—including refineries, abandoned metal mines, coal-fired power plants, waste incinerators, cement factories, and areas with high exposure to particulate matter—along with control areas, were selected for epidemiological investigations. A total of 1,157 adults, who had resided in these areas for over 10 years, were recruited between June 2021 and September 2023. Personal characteristics of the study participants were gathered through a survey. Biological samples, specifically blood and urine, were collected during the field investigations, separated under refrigerated conditions, and then transported to the laboratory for biomarker analysis. Analyses of heavy metals, environmental hazards, and adducts were conducted on these blood and urine samples. Additionally, omics analyses of epigenomes, proteomes, and metabolomes were performed using the blood samples. The biomarkers identified in this study will be utilized to assess the risk of environmental disease occurrence and to evaluate the impact on the health of residents in environmentally vulnerable areas, following the validation of diagnostic accuracy for these diseases.

Purpose: To evaluate recurrence patterns of and survival outcomes in glioblastoma treated with intensity-modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3D-CRT). Materials and Methods: We retrospectively examined 91 patients with glioblastoma treated with either IMRT (n = 60) or 3D-CRT (n = 31) between January 2013 and December 2019. Magnetic resonance imaging showing tumor recurrence and planning computed tomography scans were fused for analyzing recurrence patterns categorized as in-field, marginal, and out-of-field based on their relation to the initial radiation field. Results: The median overall survival (OS) was 18.9 months, with no significant difference between the groups. The median progression-free survival (PFS) was 9.4 months, with no significant difference between the groups. Patients who underwent gross total resection (GTR) had higher OS and PFS than those who underwent less extensive surgery. Among 78 relapse cases, 67 were of in-field; 5, marginal; and 19, out-of-field recurrence. Among 3D-CRT-treated cases, 24 were of in-field; 1, marginal; and 9, out-of-field recurrence. Among IMRT-treated cases, 43 were of in-field; 4, marginal; and 10, out-of-field recurrence. In partial tumor removal or biopsy cases, out-of-field recurrence was less frequent in the IMRT (16.2%) than in the 3D-CRT (36.3%) group, with marginal significance (p = 0.079). Conclusion IMRT and 3D-CRT effectively managed glioblastoma with no significant differences in OS and PFS. The survival benefit with GTR underscored the importance of maximal surgical resection. The reduced rate of out-of-field recurrence in IMRT-treated patients with partial resection highlights its potential utility in cases with unfeasible complete tumor removal.

Although glycopeptides remain the preferred treatment for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, the treatment of persistent MRSA bacteremia has been challenging. We investigated real-world treatment strategies for persistent MRSA bacteremia, with a specific emphasis on the use of antimicrobial agents and the frequency of changes during the treatment course. We retrospectively identified patients with persistent MRSA bacteremia in four university-affiliated hospitals between 2017 and 2021. The primary objective of this study was to investigate the patterns of antimicrobial uses for MRSA bacteremia. The secondary objectives were evaluating the associated factors with 1) overall 30-day mortality and 2) changing agents during the treatment course. Time-dependent Cox regression analysis was used to adjust for immortal time bias. Among 116 patients, 37.1% underwent antimicrobials switching, primarily prompted by persistent bacteremia. The 30-day mortality rates of groups with and without antimicrobial switching were 21.4% and 44.2%, respectively (p=0.010 by log-rank test); however, after adjustment for immortal time bias, there was no statistical significance between the two groups (adjusted hazard ratio 0.24, 95% confidence interval 0.03–2.17, p=0.238). Only the Pitt bacteremia score on day 4 and pneumonia were associated with 30-day mortality. Meanwhile, the factors associated with antimicrobial switching were the duration of bacteremia, the initial use of teicoplanin, echocardiogram, and Charlson comorbidity index. This study showed that while over one-third of persistent MRSA bacteremia patients experience changes in antimicrobial agents during treatment, this practice does not significantly improve the 30-day mortality. Our study suggests the need for more effective treatment strategies in managing persistent MRSA bacteremia.

Purpose: To evaluate recurrence patterns of and survival outcomes in glioblastoma treated with intensity-modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3D-CRT). Materials and Methods: We retrospectively examined 91 patients with glioblastoma treated with either IMRT (n = 60) or 3D-CRT (n = 31) between January 2013 and December 2019. Magnetic resonance imaging showing tumor recurrence and planning computed tomography scans were fused for analyzing recurrence patterns categorized as in-field, marginal, and out-of-field based on their relation to the initial radiation field. Results: The median overall survival (OS) was 18.9 months, with no significant difference between the groups. The median progression-free survival (PFS) was 9.4 months, with no significant difference between the groups. Patients who underwent gross total resection (GTR) had higher OS and PFS than those who underwent less extensive surgery. Among 78 relapse cases, 67 were of in-field; 5, marginal; and 19, out-of-field recurrence. Among 3D-CRT-treated cases, 24 were of in-field; 1, marginal; and 9, out-of-field recurrence. Among IMRT-treated cases, 43 were of in-field; 4, marginal; and 10, out-of-field recurrence. In partial tumor removal or biopsy cases, out-of-field recurrence was less frequent in the IMRT (16.2%) than in the 3D-CRT (36.3%) group, with marginal significance (p = 0.079). Conclusion IMRT and 3D-CRT effectively managed glioblastoma with no significant differences in OS and PFS. The survival benefit with GTR underscored the importance of maximal surgical resection. The reduced rate of out-of-field recurrence in IMRT-treated patients with partial resection highlights its potential utility in cases with unfeasible complete tumor removal.

Although glycopeptides remain the preferred treatment for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, the treatment of persistent MRSA bacteremia has been challenging. We investigated real-world treatment strategies for persistent MRSA bacteremia, with a specific emphasis on the use of antimicrobial agents and the frequency of changes during the treatment course. We retrospectively identified patients with persistent MRSA bacteremia in four university-affiliated hospitals between 2017 and 2021. The primary objective of this study was to investigate the patterns of antimicrobial uses for MRSA bacteremia. The secondary objectives were evaluating the associated factors with 1) overall 30-day mortality and 2) changing agents during the treatment course. Time-dependent Cox regression analysis was used to adjust for immortal time bias. Among 116 patients, 37.1% underwent antimicrobials switching, primarily prompted by persistent bacteremia. The 30-day mortality rates of groups with and without antimicrobial switching were 21.4% and 44.2%, respectively (p=0.010 by log-rank test); however, after adjustment for immortal time bias, there was no statistical significance between the two groups (adjusted hazard ratio 0.24, 95% confidence interval 0.03–2.17, p=0.238). Only the Pitt bacteremia score on day 4 and pneumonia were associated with 30-day mortality. Meanwhile, the factors associated with antimicrobial switching were the duration of bacteremia, the initial use of teicoplanin, echocardiogram, and Charlson comorbidity index. This study showed that while over one-third of persistent MRSA bacteremia patients experience changes in antimicrobial agents during treatment, this practice does not significantly improve the 30-day mortality. Our study suggests the need for more effective treatment strategies in managing persistent MRSA bacteremia.