Kwi Suk Kim

Acute necrotic stomatitis (noma) associated with methicillin-resistant Staphylococcus aureus infection in a newly acquired rhesus macaque (Macaca mulatta)

Backgroud  A newly acquired rhesus macaque was suffering from rapid destruction of the left cheek caused by necrotizing stomatitis.

Higher plasma bilirubin predicts veno-occlusive disease in early childhood undergoing hematopoietic stem cell transplantation with cyclosporine

AIM To analyze the association between plasma bilirubin levels and veno-occlusive disease (VOD) in non-adult patients undergoing hematopoietic stem cell transplantation (HSCT) during cyclosporine therapy. METHODS A total of 123 patients taking cyclosporine were evaluated using an electronic medical system at the Seoul National University Childrens Hospital from the years 2004 through 2011. Patients were grouped by age and analyzed for incidence and type of adverse drug reactions (ADRs) including VOD. RESULTS The HSCT patients were divided into three age groups: G#1 ≥ 18; 9 ≤ G#2 ≤ 17; and G#3 ≤ 8 years of age). The majority of transplant donor types were cord blood transplantations. Most prevalent ADRs represented acute graft-vs-host disease (aGVHD) and VOD. Although the incidences of aGVHD did not vary among the groups, the higher frequency ratios of VOD in G#3 suggested that an age of 8 or younger is a risk factor for developing VOD in HSCT patients. After cyclosporine therapy, the trough plasma concentrations of cyclosporine were lower in G#3 than in G#1, indicative of its increased clearance. Moreover, in G#3 only, a maximal total bilirubin level (BILmax) of ≥ 1.4 mg/dL correlated with VOD incidence after cyclosporine therapy. CONCLUSION HSCT patients 8 years of age or younger are more at risk for developing VOD, diagnosed as hyperbilirubinemia, tender hepatomegaly, and ascites/weight gain after cyclosporine therapy, which may be represented by a criterion of plasma BILmax being ≥ 1.4 mg/dL, suggestive of more sensitive VOD indication in this age group.

Six-hour central venous oxygen saturation has no prognostic value in patients with septic shock

Methods We have retrospectively identified septic shock patients who received protocolized treatment in two tertiary academic EDs. All patients were treated using the early goaldirected protocol. The data with respect to demographics, predisposing factors, site of infection, and the admission APACHE II score were collected. Hemodynamic (mean arterial pressure and central venous pressure) and laboratory (arterial blood gas analysis, Scv02, and lactate level) parameters at baseline and 6-hour were also recorded. To test the prognostic value of 6-hour Scv02, the area under receiver operating characteristics curve (AUROC) to predict 1-month mortality was calculated and compared with that of 6-hour lactate level. Pearson correlation coefficient between 6-hour Scv02 or lactate level and the admission APACHE II score were also analyzed.

Transcultural adaptation and validation of familial satisfaction in the intensive care unit in Korea: preliminary study

Lately, in North America, questionnaires have been developed and validated, which were to assess family needs and satisfaction with care in the intensive care unit. One of the most widely used one is FS-ICU-24 survey.

Diagnostic performance of ct angiography for gastrointestinal haemorrhage according to the clinical severity

Acute gastrointestinal haemorrhage (GIH) is a common medical emergency with a significant morbidity and mortality. Although endoscopy is considered as a primary diagnostic modality, computed tomography (CT) angiography is recently introduced as an alternative diagnostic tool because of its advantages such as readiness, wide anatomic coverage, and minimal invasiveness. However, no studies have evaluated the diagnostic performance of CT angiography according to the clinical severity of GIH.