Successful Transplantation of Organs from a Donor with Bacterial Meningitis Caused by Streptococcus pneumonia: A Case Report / 대한구급학회지

The number of organs transplanted worldwide is increasing annually. As a result, there is a shortage of available donor organs. This scarcity has led to the progressive broadening of donor organ criteria. The expanded criteria include infections such as bacterial meningitis. A 55-year old male visited our emergency room with cardiac arrest and recovered after cardiopulmonary resuscitation. The cause of the cardiac arrest was bacterial meningitis caused by Streptococcus pneumoniae. While proper antibiotics were applied, the patient met the clinical criteria for brain death. Prophylactic antibiotics were administered to the recipients, and liver and kidney transplantations were done successfully.

A Comparative Study Between Newly Developed Wave-form and Traditional Straight-form Splints

PURPOSE: Widely used fiberglass splints are made from straight-form material. These prove difficult to mold at joints and form wrinkles, causing complications such as pain, pressure sores, and peripheral nerve palsy. We compared the usefulness of wave-form splints with straight-form splints and the level of satisfaction of these designs from care providers and wearers. METHODS: Eighty-nine (n=89) emergency physicians and orthopedic surgeons participated in this study. The subjects (acting as care providers and mock patients) used wave-form and straight-form material to construct and wear short leg splints, long arm splints, and sugar tong splints. The clinicians were surveyed on their satisfaction as providers and wearers. All questions were measured on scores from 0 and 10(10=maximum score). After splints were removed, subjects were surveyed on the extent of splint wrinkling with scores from 1 to 3(3=maximum wrinkling). RESULTS: Provider satisfaction scores for wave-form splints versus straight-form splints in short leg splint applications were 7.76+/-1.30 vs 6.74+/-1.25 (p=0.000). Provider satisfaction scores for wave-form splints versus straight-form splints in long arm splint applications were 7.73+/-1.33 and 6.73+/-1.59 (p=0.004), respectively. The subjects felt more comfortable wearing wave-form splints, compared to straight-form splints (7.79+/-1.49 vs. 6.79+/-1.58, respectively; p=0.004) and more satisfied (8.03+/-1.35 vs. 7.18+/-1.33, respectively; p=0.003). The frequencies of wrinkle occurrence in wave-form and straight-form splints were 29.7% and 42.2%, respectively (p=0.02). CONCLUSION: Wave-form splints may be more practical for molding and wearing than traditional straight-form splints.

A Successful Repair of Nail Bed Injury with 2-N-butylcyanoacrylate (Histoacryl(TM)): A Case Report

Injury of the nail bed is commonly encountered in the emergency department. Despite the importance of initial management, difficulties such as long duration of operation and need of skill hinder the practice. Tissue repair with tissue adhesives, like 2-N-butylcyanoacrylate (Histoacryl(TM)), is a common replacement for suture repair. Here we describe a case of nail bed injury, which was repaired with Histoacryl(TM), and the method of repair.

Prediction of Mortality in Patients with Acute Paraquat Intoxication Using Simplified Acute Physiology Score II / 대한구급학회지

BACKGROUND: The prognosis of paraquat intoxication patients is poor and this makes the prediction of mortality important in administering aggressive treatment and admission. This article investigates the usefulness of simplified acute physiology score II (SAPS II), as a predictor of the mortality in paraquat intoxication. METHODS: We retrospectively reviewed 65 patients who were admitted in one hospital between January in 2005 and December in 2010. We calculated their SAPS II, serum paraquat level, and severity index of paraquat poisoning (SIPP) at the time of intensive care unit (ICU) admission. We investigated the relationship between each systems and the mortality. RESULTS: Overall mortality was 73.8%: 48 out of 65 patients died. Non-survived group (n = 48) had a higher SAPS II score (30.44 +/- 15.99) than survived group (n = 17 [15.7 +/- 6.26], p < 0.001). Serum paraquat level and SIPP were significantly higher in non-survived group than in survived group (p < 0.05, in all comparisons). By using the area under receiver operating characteristic curves (AUC), the SAPS II system yielded equal discriminative power (AUC = 0.82) with serum paraquat level (AUC = 0.896) and SIPP (AUC = 0.865). Hosmer-Lemeshow goodness-of-fit test C indicated SAPS II score validated well in paraquat intoxication group (p = 0.33). CONCLUSIONS: Serum paraquat level is the best way for prediction of mortality in patients with acute paraquat intoxication. If checking serum paraquat level is impossible or delayed, SAPS II score can be an alternative tool for evaluating the prognosis in paraquat intoxication.