A Case of Coronary Artery Dissection after Blunt Chest Trauma Resulting in ST-Segment Elevation Myocardial Infarction / 대한내과학회지

Coronary artery injury after thoracic injury is very rare, but can result in serious acute myocardial infarction (MI). It can be easily mistaken for chest wall pain or cardiac contusion if relying solely on a history and physical examination. We herein report a rare case of a 60-year-old female patient who presented with inferior wall ST-segment elevation MI due to right coronary artery dissection following blunt chest trauma after a traffic accident. Successful primary percutaneous coronary intervention was performed without complications.

Adaptation of Evidence-based Surgical Wound Care Algorithm

PURPOSE: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. METHODS: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. RESULTS: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were > or =.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. CONCLUSION: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

A case of sarcoidosis associated with acute tubular necrosis and pulmonary hemorrhage / 대한내과학회지

Sarcoidosis is a multisystemic granulomatous disorder that commonly involves the lungs, skin, and eyes. The coexistence of sarcoidosis with a kidney disorder and pulmonary hemorrhage is extremely rare. Hypercalciuria and hypercalcemia are the most common manifestations of renal involvement, although granulomatous interstitial nephritis, glomerular disease, and obstructive uropathy also occur in sarcoidosis. Acute tubular necrosis associated with acute renal failure generally shows early remission. In Korea, no cases of sarcoidosis associated with acute tubular necrosis and pulmonary hemorrhage have been reported. Here, we describe the case of a 65-year-old man with stage 3 sarcoidosis associated with acute tubular necrosis and pulmonary hemorrhage. The patient was treated with steroid and hydroxychloroquine for approximately 1 month. Most of his symptoms improved gradually, and he has been symptom-free since then.

A case of peripheral T-cell lymphoma presenting with a necrotizing gingival ulcer / 대한내과학회지

Peripheral T-cell lymphoma (PTCL) is a heterogenous group of generally aggressive neoplasms constituting less than 15% of all non-Hodgkin's lymphomas in adults. PTCL unspecified (PTCL-U) comprises 6% of lymphomas in the United States and Europe. Most patients with PTCL-U present with generalized lymphadenopathy and hemophagocytosis, eosinophilia, and pruritus involving the skin, liver, spleen, and other viscera. Gingival and genital ulcers are a very uncommon manifestation. The diagnosis of PTCL-U is based on the results of a tissue biopsy that shows evidence of T-cell lymphoma that does not meet the criteria for other subtypes of T-cell lymphoma. Here, we describe an 85-year-old man with intermittent fever and necrotizing gingival and genital ulcers who was diagnosed with PTCL-U after a gingival biopsy.