A Multicenter Study on the Tetanus Antibody Titers of Elderly Koreans

BACKGROUND: Although tetanus infections have diminished dramatically since the advent of tetanus vaccination, this disease has not disappeared. Those 60 years and older are still very much at risk for this infection. Thus, we investigated the tetanus antibody titers in people 60 years and older in Korea. METHODS: Our subjects included those visiting eight emergency departments from March 2009 to February 2010 after an injury with stable vital signs and without acute disease. Samples obtained were tested using the tetanus immunoglobulin enzyme-linked immunosorbent assay method. The resultant tetanus antibody titers were analyzed. RESULTS: The number of subjects enrolled was 462. The mean titer was 0.09+/-0.14 IU/mL. Twenty-two percent of the subjects had a safe titer level (>0.1 IU/mL). Males and urban subjects had higher tetanus antibody titers than did females and suburban subjects. Subjects living in Incheon, Gangwon-do, Chungcheong-do, and Jeju-do had lower titers. CONCLUSION: The results of this study showed that Koreans 60 years and older did not have a protective mean level of tetanus antibody titer and that 78% of the subjects did not have a seroprotective level after tetanus exposure. Therefore, a national effort to administer tetanus vaccination to elderly Koreans is needed.

Approximation of the Size of Pneumothorax by Ultrasound for Patients with a Possibility of Pneumothorax

PURPOSE: This study was designed to evaluate the accuracy of ultrasound in detecting and estimating the size of pneumothorax METHODS: This was a prospective study with convenience sampling, based on researcher availability. Inclusion criteria were chest pain, sudden dyspnea, and chest trauma. Bedside ultrasound examination was performed to determine the presence of "lung sliding" and "comet tail" artifacts in order to rule out pneumothorax and the location of "lung point" when pneumothorax was detected. RESULTS: There were 97 patients enrolled; The cause of pneumothorax was spontaneous in 64 cases and traumatic in 33 cases. The Pearson correlation coefficient between ultrasound estimates and pneumothorax size by Collins method on erect chest X-ray was 0.874 (p<0.000), and the coefficient between ultrasound estimates and pneumothorax size on computed tomography was 0.820 (p<0.000). CONCLUSION: Ultrasound is more sensitive and specific than supine chest X-ray and even erect chest PA for the diagnosis of pneumothorax. Ultrasound allowed skilled physicians to approximate the size of pneumothorax accurately with good correlation with results obtained by both computed tomography and erect chest X-ray.