Effect of a Single Tetanus Toxoid in Korean Adults with Low Tetanus Antibody Titers

PURPOSE: The determination of tetanus prophylaxis according to patients' memories of past immunization is inaccurate. However, by using the Tetanos Quick Stick(R) test, it is possible to select Korean adults with low tetanus antibody titers and to perform tetanus prophylaxis in the emergency department. In 1996, Ha reported that tetanus toxoid injection into healthy Korean adults revealed significant differences between the tetanus antibody titers at the beginning and the tetanus antibody titers after 1 week. Our purpose is to determine the effect of a single tetanus toxoid in Korean adults with low tetanus antibody titers. METHODS: Blood samples were taken from 44 volunteers for a period of 6 weeks. All samples were analyzed using the Tetanus IgG ELISA (enzyme-linked immunosorbent assay) method. RESULTS: The results for tetanus antibody titers at the beginning and after 1 week, 2 weeks, 4 weeks, and 6 weeks were 0.04+/-0.05 IU/mL, 1.22+/-3.63 IU/mL, 4.99+/-7.3 6 IU/mL, 8.36+/-11.10 IU/mL and 6.59+/-9.21 IU/mL respectively. There was a statistically significant defference between the tetanus antibody titers at the beginning and the tetanus antibody titers after 2 weeks. There was no statistically significant defference between the tetanus antibody titers after 2 weeks and 6 weeks. After 4 weeks, all subjects' tetanus antibody titers were at the protective level. CONCLUSIONS: A single tetanus toxoid injection is effective in Korean adults with low tetanus antibody titers.

Utility of Tetanos Quick Stick(R) Test for Selective Tetanus Prophylaxis

PURPOSE: Tetanus is still one kind of major health problem in many countries, so tetanus prophylaxis is very important. However medical interview and wound description are not always enough to determine the tetanus prophylaxis. Thus, we assessed the utility of Tetanos Quick Stick(R) test for selective tetanus prophylaxis in the emergency department. METHODS: From September 17, 2003 to October 4, 2003, 180 patients were studied for 14 days. Tetanos Quick Stick (R) and ELISA (enzyme-linked immunosorbent assay) were performed with 180 samples from 180 patients. RESULTS: The Tetanos Quick Stick(R) had a sensitivity of 79.6%, a specificity of 99.2%, a positive predictive value of 97.7 %, a negative predictive value of 91.9%, and an accuracy of 93.3%. CONCILUSION: The results of our study revealed that the Tetanos Quick Stick(R) test is useful for selective tetanus prophylaxis in the emergency department.

Effect of imipramine on calcium utilization of single cells isolated from canine detruso

This study is to investigate the mechanism of inhibitory effect of imipramine on the calcium utilization in single cells isolated from canine detrusor. 2 mm thick smooth muscle chops were incubated in 0.12% collagenase solution at 36degreeC, and aerated with 95% O2/5% CO2, and then cell suspension was examined Acetylcholine (ACh) evoked a concentration-dependent contraction of the isolated detrusor cells in normal physiologic salt solution (PSS), and the ACh-induced contraction was significantly inhibited by imipramine. In Ca2+-free PSS, ACh-induced contraction was less than those in normal PSS and it was not affected by the pretreatment with imipramine. Ca2+-induced contraction in Ca2+-free PSS was supressed by imipramine, but addition of A 23187, a calcium ionophore, overcomed the inhibitory effect of imipramine. High potassium-depolarization (40 mM KCl) evoked cell contraction, which was inhibited by imipramine. Caffeine, a releasing agent of the stored Ca2+ from sarcoplasmic reticulum, evoked a contraction of the cells that was not blocked by the pretreatment with imipramine. These results suggest that imipramine inhibits the influx of calcium in the detrusor cells through both the receptor-operated- and voltage-gated-calcium channels, but does not affect the release of calcium from intracellular storage site.

Early Prognostic factors and New Approach to Organophosphate Poisoning

BACKGROUND: Definite criteria for determining severity of organophosphate poisoning have not been made. Discovery of the third neuromuscular syndrome, the intermediate syndrome, have made it more complicating then ever. Objectives of this study is to determine early prognostic factors of outcome and development of a new treatment algorithm. METHOD: 74 patients admitted to Severance hospital with acute organophosphate poisoning during 5 years were included. We made a protocol concerning the initial consciousness level, QTc interval, PVC, serum cholinesterase, the intermediate syndrome, total hospital, ICU day, length of ventilator support, disposition and have done a study retrospectively. Multiple regression and Chi-square was used as statistical analysis. Significant statistical P-value was 0.05. RESULTS: The total hospital days were prolonged as serum cholinesterase levels were lower, the age was older and mental status graver.(p<.05) The length of ventilatory support was prolonged when patient's serum cholinesterase level was very low, they were unconscious and serum cholinesterase level not recovered to 500 IU/ml within initial 3 days. The intermediate syndrome was significantly related to the prolonged cholinesterase inhibition. CONCLUSION: As an early prognostic factor for the length of ventilatory support in organophosphate poisoning, 1) level of concsiousness and 2) serum cholinesterase level at admission, 3) recovery to more than 500 IU/ml within initial 3 days are useful. Especially when the serum cholinesterase level is not recovered to more than 500 IU/ml within initial 3 days, it is essential to observe closely for the possibility of an intermediate syndrome.