Amyloid-ß-activated microglia can induce compound proteinopathies.

Neuropathological features of Alzheimer's disease include amyloid plaques, neurofibrillary tangles and Lewy bodies, with the former preceding the latter two. However, it is not fully understood how these compound proteinopathies are interconnected. Here, we show that transplantation of amyloid-ß oligomer-activated microglia into the striatum of naïve mice was sufficient to generate all the features of Alzheimer's disease, including widespread tauopathy and synucleinopathy, gliosis, neuroinflammation, synapse loss, neuronal death, and cognitive and motor deficits. These pathological features were eliminated by microglia depletion and anti-inflammatory drug administration. Our results suggest the crucial roles of microglia-driven inflammation in development of mixed pathology. This study provides not only mechanistic insights into amyloid-ß oligomer-triggered proteinopathies but also a novel animal model recapitulating the salient features of Alzheimer's disease.

Assessing the Feasibility of Biorefineries for a Sustainable Citrus Waste Management in Korea.

Citrus fruits are one of the most widely used fruits around the world and are used as raw fruits, but are also processed into products such as beverages, and large amounts of by-products and waste are generated in this process. Globally, disposal of citrus waste (CW) through simple landfilling or ocean dumping can result in soil and groundwater contamination, which can negatively impact ecosystem health. The case of Korea is not much different in that these wastes are simply buried or recycled wastes are used as livestock feed additives. However, there are many reports that CW, which is a waste, has high potential to produce a variety of products that can minimize environmental load and increase added value through appropriate waste management. In this study, we aim to explore the latest developments in the evaluation and valorization of the growing CW green technologies in an effort to efficiently and environmentally transform these CW for resource recovery, sustainability, and economic benefits. Recent research strategies on integrated biorefinery approaches have confirmed that CW can be converted into various bioproducts such as enzymes, biofuels and biopolymers, further contributing to energy security. It was found that more efforts are needed to scale up green recovery technologies and achieve diverse product profiling to achieve zero waste levels and industrial viability.

Clinical Outcomes of Transarterial Embolization for Chronic Achilles Tendinopathy Refractory to Conservative Treatment: A Pilot Study.

PURPOSE: To evaluate the effectiveness and safety of transarterial embolization (TAE) for chronic Achilles tendinopathy (AT) refractory to conservative treatment. MATERIALS AND METHODS: This retrospective study included 20 patients (12 men and 8 women; mean age, 30.3 years) who received TAE using imipenem/cilastatin sodium for refractory chronic AT from May 2019 to April 2021. Nine patients had bilateral involvement. A total of 29 procedures were performed (8 for nonathletes and 21 for athletes). If feasible, embolization was performed superselectively of the arterial branch demonstrating hypervascularity, early venous drainage, and/or supplying the pain site noted using a radiopaque marker. The visual analog scale (VAS, 0-10) score was used to assess pain symptoms at baseline and during the follow-up period (1 day; 1 week; 1, 3, and 6 months; and open period). Clinical success was defined as a decrease of >50% in the VAS score at 6 months when compared with baseline. RESULTS: In 25 (86.2%) of 29 procedures, clinical success was achieved. Significant decreases in the VAS scores were noted at 1 day, 1 week, 1 month, 3 months, and 6 months (6.86 at the baseline vs 3.48, 3.41, 3.10, 2.55, and 1.62, respectively; all P < .01). For patients available for the 12- and 24-month follow-ups (n = 19 and 6, respectively), the mean VAS scores significantly decreased (6.84 vs 2.00 and 7.33 vs 1.17, respectively; all P < .01). No serious adverse events were observed during follow-up. CONCLUSIONS: TAE may alleviate pain for patients with chronic AT refractory to the conservative treatment with a low risk of adverse events.

Diagnostic performance of rapid antigen tests for SARS-CoV-2 transmission risk based on cycle threshold values in the emergency department.

BACKGROUND: This study aimed to investigate the diagnostic performance of the rapid antigen test (RAT) for screening patients with cycle threshold (Ct) values of SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) in the emergency department. Previous studies have shown that Ct values could be used as indicators of infectiousness. Therefore, we considered the Ct value an indicator of potential infectiousness. METHODS: This single-center retrospective observational study was conducted between January 1, 2020, and March 31, 2022. Patients who underwent both RT-PCR and RAT for the diagnosis of COVID-19 were included. Patients with negative RT-PCR results were excluded. Patients with Ct values lower than 26 and 30 were considered potentially infectious for COVID-19. RESULT: A total of 386 patients were analyzed. At Ct value cutoffs of 26 and 30, the result of the RAT showed a sensitivity of 82% and 74%, specificity of 84% and 89%, and area under the curve (AUC) of 0.829 and 0.813, respectively, in the receiver operating characteristic curve. However, the NPV was relatively low at 55% and 25%. CONCLUSION: The RAT might be a rapid screening tool for detecting patients with the infectiousness of SARS-CoV-2. However, considering the low NPV, it is challenging to depend only on a negative test result from an antigen test to terminate quarantine. Clinicians should consider additional factors, such as the duration of symptoms and the immunocompromised state, for SARS-CoV-2 transmission.

Phytochemistry and Applications of Cinnamomum camphora Essential Oils.

Camphor tree (Cinnamomum camphora) is an ornamental plant that has been cultivated for a long time to obtain wood or camphor. Furthermore, its essential oil can be used as an alternative medicine and is an important source of perfume. Camphor obtained from camphor trees has long been used as a treatment for various symptoms such as inflammation, infection, congestion, muscle pain, and irritation in various regions. The purpose of this literature review is to provide knowledge of the well-established, wide, and extensive applications of camphor both in traditional and modern applications. Despite many studies focused on the essential oil of the camphor tree, there is a lack of systematic studies of its extraction or separation. Besides, various components of camphor are not fully understood, and further research is needed on the medicinal effects of individual components of C. camphor. The genus Cinnamomum has crucial economic value and theoretical significance. However, further systematic reviews and investigative studies based on existing research are needed to promote the modernization process of traditional applications of camphor. For proper use of the essential oil of C. camphora, it is imperative to consider its possible effects on humans and the environment.

RF Transceiver for the Multi-Mode Radar Applications.

In this work, a multi-mode radar transceiver supporting pulse, FMCW and CW modes was designed as an integrated circuit. The radars mainly detect the targets move by using the Doppler frequency which is significantly affected by flicker noise of the receiver from several Hz to several kHz. Due to this flicker noise, the long-range detection performance of the radars is greatly reduced, and the accuracy of range to the target and velocity is also deteriorated. Therefore, we propose a transmitter that suppresses LO leakage in consideration of long-range detection, target distance, velocity, and noise figure. We also propose a receiver structure that suppresses DC offset due to image signal and LO leakage. The design was conducted with TSMC 65 nm CMOS process, and the designed and fabricated circuit consumes a current of 265 mA at 1.2 V supply voltage. The proposed transmitter confirms the LO leakage suppression of 37 dB at 24 GHz. The proposed receiver improves the noise figure by about 20 dB at 100 Hz by applying a double conversion architecture and an image rejection, and it illustrates a DC rejection of 30 dB. Afterwards, the operation of the pulse, FMCW, and CW modes of the designed radar in integrated circuit was confirmed through experiment using a test PCB.

Intramuscular delivery of HGF-expressing recombinant AAV improves muscle integrity and alleviates neurological symptoms in the nerve crush and SOD1-G93A transgenic mouse models.

Hepatocyte growth factor (HGF) is a versatile neurotrophic factor that mediates a variety of cellular activities. In this study, we investigated the effects of intramuscularly injected recombinant AAV vectors expressing HGF in two pathologic conditions: the sciatic nerve crush and the SOD1-G93A transgenic mouse models. AAV serotype 6 (rAAV6) was chosen based on its expression levels in, and capability of moving to, the spinal cord from the injected muscle area. In the nerve crush model, rAAV6-HGF was shown to reduce the degree of mechanical allodynia, increase the cross-sectional area of muscle fibers, promote regrowth of peripheral axons, and improve motor functions. In the SOD1-G93A TG mouse model, rAAV6-HGF increased the mass of the tibialis anterior and gastrocnemius, alleviated disease symptoms, and prolonged survival. Improvements in integrity and functions of muscle in these models seemed to have come from the ability of HGF produced from rAAV6-HGF to regulate the expression of various atrogenes through the control of the FOXO signaling pathway. Our findings suggested that intramuscular injection of rAAV6-HGF might be used to relieve various symptoms associated with muscle atrophy and/or nerve damages observed in a majority of neuromuscular diseases.

Disproportionately high levels of HGF induce the degradation of the c-met receptor through the proteasomal degradation pathway.

Hepatocyte growth factor (HGF) receptor is a member of the receptor tyrosine kinases (RTKs) and has been reported to perform diverse functions in various cell types during both the developmental and adult stages. Among different roles, HGF is best known for its angiogenic effects of inducing the migration of endothelial cells. Because angiogenesis is one of the prerequisite steps for tumor metastasis, HGF-dependent cell migration has to be tightly controlled. However, the underlying mechanisms regulating the optimum level of HGF/c-met signaling have been poorly understood. In this study, we tested whether the migration of endothelial cells is regulated by a negative feedback mechanism under disproportionately large amounts of HGF. Data from endothelial cell migration assays showed that HGF activity increased as its concentration increased, but declined beyond a certain point. Under limiting conditions, amounts of phosphorylated Erk and Akt surged, reaching a plateau in which the enhanced level was more or less maintained. The c-met receptor was degraded when unnecessarily large amounts of HGF were present. Under these conditions, HGF could no longer activate downstream signaling pathways even if cells were re-treated with optimal amounts of HGF. Excessive doses of HGF increased the phosphorylation of tyrosine residue 1003 involved in the ubiquitination of c-met, and phosphorylated c-met was diverted toward the proteasomal degradation pathway. Taken together, HGF/c-met signaling is tightly regulated by a negative feedback loop through an ubiquitin-proteasomal degradation pathway.

Feasibility of intraperitoneal placental-derived mesenchymal stem cell injection in stomachs of diabetic mice.

BACKGROUND AND AIM: Diabetic gastropathy is associated with loss of interstitial cells of Cajal and autonomic neuropathy. Effective management for diabetic gastropathy is still unavailable. This study was aimed to confirm the pathogenetic changes in diabetic gastropathy and to examine the effect of treatment with placental-derived mesenchymal stem cells (PDMSCs) in stomachs of animal models. METHODS: Fourteen non-obese diabetic/ShiLtJ mice of 8 weeks were bled until week 30. Diabetes mellitus developed in 10 out of 14 mice, which all survived with insulin. The mice were grouped into three groups: nondiabetic group (n = 4), diabetic sham group (n = 5), and diabetic PDMSC group (n = 5) all of which were treated with intraperitoneal PDMSCs injection at week 30. All mice were killed at week 34, and the stomachs were examined by immunohistochemical stain with c-kit and neuronal nitric oxide synthase antibodies. RESULTS: The number of c-kit positive cells in stomach decreased significantly in the diabetic sham group compared with that in the nondiabetic group (21.2 ± 6.7 vs 88.0 ± 29.3, P = 0.006) but increased with PDMSC treatment (21.2 ± 6.7 vs 64.0 ± 15.1, P = 0.02). The positive rate of neuronal nitric oxide synthase in neural plexus was also significantly lower in the diabetic sham group than in the nondiabetic group (22.3% ± 18.5% vs 48.0% ± 22.7%, P = 0.003) but increased with PDMSC treatment (22.3% ± 18.5% vs 43.3% ± 20.5%, P = 0.03). CONCLUSIONS: Interstitial cells of Cajal and neural plexus decreased in stomachs of mice with diabetes mellitus but were significantly repaired with intraperitoneal injection of PDMSC.

Low-Temperature Burn on Replanted Fingers and Free Flaps in Hand.

BACKGROUND: Patients who have undergone microsurgery for reconstruction with a free flap or finger replantation are vulnerable to heat injury. Moreover, some of these injuries can occur at low temperatures. Although the temperature does not reach the threshold to cause burns in the adjacent normal tissues, burns can occur in the areas that underwent microsurgery. On the other hand, this type of burn is not completely understood and there are few reports of the clinical prognosis. METHODS: The medical records of patients who received warm therapy using an infrared heat lamp with the appropriate temperature after hand surgery from January 2009 to December 2016 were reviewed. The patients were classified into 2 groups. Group A comprised patients who underwent free flap or replantation surgery of the hand. Group B comprised patients who underwent other hand surgeries without microsurgery, such as tenorrhaphy, tenolysis, or joint surgery. Through the medical records, all patients with second- or third-degree thermal burns were selected. The relationship between the 2 types of surgery and thermal injury and the timing of the burn after microsurgery were analyzed. RESULTS: Groups A and B were composed of 370 (mean age, 48.2 years) and 7010 patients (mean age, 44.5 years), respectively. Burns requiring treatment occurred in 4 patients in group A and in 1 patient in group B. The proportion of low-temperature burns was 4 of 370 in group A and 1 of 7010 in group B. The occurrence of low-temperature burns was more associated with patients who had undergone microsurgery for a hand reconstruction with free flap or finger replantation (P < 0.05). In the patients who underwent microsurgery, all 4 patients had thermal burns within 1 year after surgery. CONCLUSIONS: Low-temperature thermal burns can occur in patients who have undergone microsurgery for a hand reconstruction. This is believed to be related to a disruption of the thermoregulatory function of the skin and poor nerve regeneration, as well as more heat accumulation in the surgical area after microsurgery.

"Internet of Things" Real-Time Free Flap Monitoring.

BACKGROUND: Free flaps are a common treatment option for head and neck reconstruction in plastic reconstructive surgery, and monitoring of the free flap is the most important factor for flap survival. In this study, the authors performed real-time free flap monitoring based on an implanted Doppler system and "internet of things" (IoT)/wireless Wi-Fi, which is a convenient, accurate, and efficient approach for surgeons to monitor a free flap. METHODS: Implanted Doppler signals were checked continuously until the patient was discharged by the surgeon and residents using their own cellular phone or personal computer. If the surgeon decided that a revision procedure or exploration was required, the authors checked the consumed time (positive signal-to-operating room time) from the first notification when the flap's status was questioned to the determination for revision surgery according to a chart review. To compare the efficacy of real-time monitoring, the authors paired the same number of free flaps performed by the same surgeon and monitored the flaps using conventional methods such as a physical examination. RESULTS: The total survival rate was greater in the real-time monitoring group (94.7% versus 89.5%). The average time for the real-time monitoring group was shorter than that for the conventional group (65 minutes versus 86 minutes). CONCLUSIONS: Based on this study, real-time free flap monitoring using IoT technology is a method that surgeon and reconstruction team can monitor simultaneously at any time in any situation.

Delayed hepatobiliary injury in a decompression sickness patient after scuba diving: case report.

We report here the first case of liver injury in a 51-year-old man following a dive to a depth of 40 meters. He presented with typical neurological symptoms affecting the lower limbs. Five days later, he experienced delayed abdominal pain, followed by rapidly progressive liver and adjacent organ injury due to air emboli in the intrahepatic portal vein. He received supportive care and hyperbaric therapy with a U.S. Navy Treatment Table 6 and recovered. Decompression sickness is a disease of protean manifestations. More information about venous gas emboli may be useful for better assessing decompression sickness. In this case, radiologic evaluation of the abdomen and the presentation of air bubbles in the portal vein in computed tomography played an essential role in diagnosing induced venous gas emboli in the liver and adjacent organs.

Ossifying renal tumor of infancy: findings at ultrasound, CT and MRI.

A 4-month-old boy presented with persistent gross hematuria. At ultrasonography, a 3.5-cm echogenic mass with posterior shadowing and tumor vascularity was detected within the right renal pelvis. Precontrast CT showed a slightly hyperattenuating mass in the renal pelvis. At MRI the mass was heterogeneously hypointense on T2-weighted images and isointense on T1-weighted images. Contrast-enhanced CT and MRI both revealed peripheral enhancement of the mass. A histological diagnosis of ossifying renal tumor of infancy was made after open pyelostomy and tumor enucleation. We suggest that ossifying renal tumor of infancy should be considered when a mass with posterior acoustic shadowing and tumor vascularity on US, hyperattenuation on precontrast CT and hypointensity on T2-weighted MRI is seen within the renal pelvis of an infant with hematuria.

Influence of amendments and aided phytostabilization on metal availability and mobility in Pb/Zn mine tailings.

A greenhouse experiment was conducted to evaluate the effect of four different amendments, bone mill, bottom ash, furnace slag, and red mud, as immobilizing agents and the plant species Miscanthus sinensis and Pteridium aquilinum in aided phytostabilization of Pb/Zn mine tailings. The effects of amendments and plants on the availability and mobility of heavy metals were evaluated using single extraction, sequential extraction, pore-water analysis, and determination of heavy metal concentrations in plants. The application of Fe-rich amendments significantly reduced the amount of soluble and extractable heavy metals in the tailings (p < 0.05). Furnace slag and M. sinensis reduced CaCl2-extractable heavy metals by 56-91%, red mud and P. aquilinum treatment was the most effective at decreasing bioaccessible Pb, reducing it to 34% of the total Pb. Compared to control, water soluble Cd, Cu, Pb, and Zn were reduced by 99, 99, 98, and 99%, respectively, in the red mud and P. aquilinum tailings. M. sinensis accumulated heavy metals mainly in the root, and had lower translocation factors compared with P. aquilinum. The results of this study suggest that M. sinensis can be used in aided phytostabilization for these types of mine tailings and Fe-rich amendments are effective for the in situ immobilization of metals.

The effectiveness of spent coffee grounds and its biochar on the amelioration of heavy metals-contaminated water and soil using chemical and biological assessments.

Spent coffee grounds (SCG) and charred spent coffee grounds (SCG-char) have been widely used to adsorb or to amend heavy metals that contaminate water or soil and their success is usually assessed by chemical analysis. In this work, the effects of SCG and SCG-char on metal-contaminated water and soil were evaluated using chemical and biological assessments; a phytotoxicity test using bok choy (Brassica campestris L. ssp. chinensis Jusl.) was conducted for the biological assessment. When SCG and SCG-char were applied to acid mine drainage, the heavy metal concentrations were decreased and the pH was increased. However, for SCG, the phytotoxicity increased because a massive amount of dissolved organic carbon was released from SCG. In contrast, SCG-char did not exhibit this phenomenon because any easily released organic matter was removed during pyrolysis. While the bioavailable heavy metal content decreased in soils treated with SCG or SCG-char, the phytotoxicity only rose after SCG treatment. According to our statistical methodology, bioavailable Pb, Cu and As, as well as the electrical conductivity representing an increase in organic content, affected the phytotoxicity of soil. Therefore, applying SCG during environment remediation requires careful biological assessments and evaluations of the efficiency of this remediation technology.

Synergistic Effect of SARS-CoV-2 Infection and COVID-19 Vaccination on the Risk of Venous Thromboembolism.

BACKGROUND: Previous studies have reported a greater risk of venous thromboembolism among patients infected with SARS-CoV-2 and those who received COVID-19 vaccination. Nevertheless, there is a lack of understanding regarding the interaction effect on the risk of venous thromboembolism occurrence between SARS-CoV-2 infection and COVID-19 vaccination. METHODS: This was a retrospective cohort study including adult patients with confirmed SARS-CoV-2 infection between October 2020 and September 2021. Patients with confirmed SARS-CoV-2 infection were selected and matched 1:1 by age and sex with individuals who were not infected during the same period. A Cox proportional hazards model was used to analyze the venous thromboembolism risk. RESULTS: The study included 422546 individuals who were divided into 4 groups; the interaction group defined by having SARS-CoV-2 infection within 90 days following COVID-19 vaccination, the infection group defined by no vaccination before 90 days of SARS-CoV-2 infection, the vaccination group defined by COVID-19 vaccination without SARS-CoV-2 infection, and the reference group defined by neither COVID-19 vaccination nor SARS-CoV-2 infection. The results showed that the adjusted hazard ratio (aHR) of the interaction group was 29.71 (95% confidence interval [CI], 22.95-38.47), while the aHRs of the infection group and the vaccination group were 6.66 (95% CI, 5.18-8.58) and 2.31 (95% CI, 1.78-3.00), respectively. CONCLUSIONS: A synergistic effect on the risk of venous thromboembolism was suggested when individuals were infected with SARS-CoV-2 within 90 days following COVID-19 vaccination.

The impact of pulmonary tuberculosis on SARS-CoV-2 infection: a nationwide cohort study.

Background: The interaction between COVID-19 and tuberculosis (TB) is not yet fully understood, and large-scale research on the mortality outcome of such dual infection has been limited. This study aimed to investigate the impact of PTB on mortality among patients with COVID-19 within a Korean population by conducting an extensive analysis of a nationwide large dataset. Method: We investigated the mortality and disease severity among COVID-19 patients who had PTB in South Korea. This study analyzed 462,444 out of 566,494 COVID-19 patients identified between January 2020 and December 2021. Result: A total of 203 COVID-19 with PTB patients and 812 matched COVID-19 without PTB were analyzed using 1:4 propensity score matching. COVID-19 patients with PTB exhibited higher in-hospital mortality (odds ratio (OR) 3.02, 95% confidence interval (CI) 1.45-6.27, p-value = 0.003) and were at increased risk of requiring conventional oxygen therapy (OR 1.57, 95% CI 1.10-2.25, p-value = 0.013) as well as high flow nasal cannula (HFNC) or noninvasive ventilation (NIV) oxygen therapy (OR 1.91, 95 CI 1.10-3.32, p-value = 0.022) compared to those without PTB. Compared to matched COVID-19 without PTB, co-infected patients showed increased mortality rates across various timeframes, including during hospitalization, and at 30 day and 90 day intervals. In-hospital mortality rates were particularly elevated among women, individuals with malignancy, and those with lower incomes. Furthermore, the increased in-hospital mortality among PTB patients persisted irrespective of the timing of TB diagnosis or vaccination status against COVID-19. Conclusion: We suggest that physicians be aware of the risk of mortality and severity among COVID-19 patients with PTB; coinfection with COVID-19 is a critical situation that remains to be further explored and needs more attention in countries with an intermediate to high PTB burden.

Arterial Blood Gas Analysis for Survival Prediction in Pediatric Patients with Out-of-Hospital Cardiac Arrest.

Arterial blood gas analysis (ABGA) is one of the few tests performed during cardiopulmonary resuscitation (CPR). There have been some studies on the prediction of survival outcomes in adult out-of-hospital cardiac arrest (OHCA) patients during CPR using ABGA results. However, in pediatric OHCA patients, the prognosis of survival outcome based on ABGA results during CPR remains unclear. We retrospectively analyzed prospectively collected data from the Korean Cardiac Arrest Resuscitation Consortium (KoCARC) registry, a multicenter OHCA registry of Republic of Korea. We analyzed 108 pediatric (age < 19 years) OHCA patients between October 2015 and June 2022. Using multivariable logistic regression, an adjusted odds ratio (aOR) was obtained to validate the ABGA results of survival to hospital admission and survival to discharge. The variables associated with survival to hospital admission were non-comorbidities (aOR 3.03, 95% confidence interval (CI) 1.22-7.53, p = 0.017) and PaO2 > 45.750 mmHg (aOR 2.69, 95% CI 1.13-6.42, p = 0.026). There was no variable that was statistically significant association with survival to discharge. PaO2 > 47.750 mmHg and non-comorbidities may serve as an independent prognostic factor for survival to hospital admission in pediatric OHCA patients. However, the number of cases analyzed in our study was relatively small, and there have been few studies investigating the association between ABGA results during CPR and the survival outcome of pediatric OHCA patients. Therefore, further large-scale studies are needed.

Association of Socioeconomic Status With Long-Term Outcome in Survivors After Out-of-Hospital Cardiac Arrest: Nationwide Population-Based Longitudinal Study.

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major public health problem and a leading cause of death worldwide. Previous studies have focused on improving the survival of people who have had OHCA by analyzing short-term survival outcomes, such as the return of spontaneous circulation, 30-day survival, and survival to discharge. Research has been conducted on prehospital prognostic factors to improve the survival of patients with OHCA, among which the association between socioeconomic status (SES) and survival has been reported. SES could affect bystander cardiopulmonary resuscitation rates and whether OHCA is witnessed, and low cardiopulmonary resuscitation education rates are associated with low SES. It has been reported that areas with high SES have shorter hospital transfer times and more public defibrillators per person. Previous studies have shown the impact of SES disparities on the short-term survival of patients with OHCA. However, understanding the impact of SES on the long-term prognosis of OHCA survivors remains limited. As long-term outcomes are more indicative of a patient's ongoing health care needs and the burden on public health than short-term outcomes, understanding the long-term prognosis of OHCA survivors is important. OBJECTIVE: This study aimed to identify whether SES influenced the long-term outcomes of OHCA. METHODS: Using health claims data obtained from the National Health Insurance (NHI) service in Korea, we included OHCA survivors who were hospitalized between January 2005 and December 2015. The patients were divided into 2 groups: NHI and Medical Aid (MA) groups, with the MA group defined as having a low SES. Cumulative mortality was estimated using the Kaplan-Meier method, and a Cox proportional hazards model was used to evaluate the impact of SES on long-term mortality. A subgroup analysis was performed based on whether cardiac procedures were performed. RESULTS: We followed 4873 OHCA survivors for up to 14 years (median of 3.3 years). The Kaplan-Meier survival curve showed that the MA group had a significantly decreased long-term survival rate compared to the NHI group. With an adjusted hazard ratio (aHR) of 1.52 (95% CI 1.35-1.72), low SES was associated with increased long-term mortality. The overall mortality rate of the patients who underwent cardiac procedures in the MA group was significantly higher than that of the NHI group (aHR 1.72, 95% CI 1.05-2.82). The overall mortality rate of patients without cardiac procedures was also increased in the MA group compared to the NHI group (aHR 1.39, 95% CI 1.23-1.58). CONCLUSIONS: OHCA survivors with low SES had an increased risk of poor long-term outcomes compared with those with higher SES. OHCA survivors with low SES who have undergone cardiac procedures need considerable care for long-term survival.