Sung Eun Kim

Effects of audio tone guidance on performance of CPR in simulated cardiac arrest with an advanced airway

THE AIM OF THE STUDYnDespite the emphasis of cardiopulmonary resuscitation (CPR) quality, the performance of on-site CPR is reported to be frequently unsuccessful. In order to improve CPR quality, various feedback systems have been developed, but they have not yet been widely used on site due to low economic efficiency. The present study was attempted to determine whether CPR quality can be improved using audio tone guidance.nnnTHE METHODSnA total of 80 seniors at our medical school and college of nursing participated in the study. After they were trained in CPR according to the 2005 guidelines, they performed CPR using a cardiac arrest model with an advanced airway. The participants were organized into 40 groups. After they took Test 1 without any feedback for 2 min, they were randomly assigned to the feedback and control groups and took Test 2 for 2 min. In the feedback group, a low-pitched sound was delivered every 0.6 s for the guidance of chest compression and a high-pitched sound was simultaneously delivered every 10 deliveries of a low-pitched sound for the guidance of ventilation at 6s intervals.nnnTHE RESULTSnIn the feedback group the mean compression rate significantly improved in accuracy from 111.5+/-13.7/min to 100.1+/-3.2/min (P<0.01), and ventilation counts significantly improved in accuracy from 7.4+/-1.8/min to 9.9+/-0.3/min (P<0.01). However, the mean compression depth significantly decreased from 39.3+/-9.5 mm to 35.8+/-8.2 mm (P<0.01).nnnTHE CONCLUSIONnAudio tone guidance ensures better chest compression rate and ventilation rate but this does not necessarily result in a better CPR quality.

Omental Infarction: Case Series and Review of the Literature

BACKGROUNDnOmental infarction is a rare disease entity that can cause acute or subacute abdominal pain. In the past, it was thought that omental infarction mainly occurred on the right side because it was detected when surgery was performed on patients who complained of abdominal pain on the right side.nnnOBJECTIVEnWe present this case to demonstrate that omental infarction can occur at any site, including the epigastric area and the lower abdomen, and even on the left side where the greater omentum is located.nnnCASE REPORTnFour patients with omental infarction presented to the Emergency Department with various clinical symptoms. All of them were diagnosed by computed tomography scan. Omental infarction occurred on the right side in 2 patients, at the epigastric area in 1 patient, and on the left side in 1 patient. Three were improved with supportive care. Laparoscopy was performed in 1 patient because his abdominal pain persisted despite conservative treatment.nnnCONCLUSIONnOmental infarction should be included in the differential diagnosis list of acute abdominal pain because it can occur at any site. In addition, because this disease runs a self-limited course, conservative care is recommended. Thus, unnecessary operations can be avoided in cases where omental infarction is diagnosed by imaging studies.

Treatment of Striae Distensae Using Needling Therapy: A Pilot Study

BACKGROUND Striae distensae are dermal scars characterized by flattening and atrophy of the epidermis. Although many treatment modalities have been attempted with variable results, there is no criterion standard treatment modality for striae distensae. OBJECTIVES To evaluate the effectiveness and safety of a disk microneedle therapy system (DTS) in the treatment of striae distensae. MATERIALS AND METHODS Sixteen Korean volunteers with striae distensae alba or rubra were enrolled. Patients received three treatments using a DTS at 4‐week intervals. Clinical response to treatment was assessed by comparing pre‐ and post‐treatment clinical photographs, skin biopsies, and patient satisfaction scores. Clinical improvement was assessed using the quartile grading scale. RESULTS Marked to excellent improvement was noted in seven (43.8%) patients, with minimal to moderate improvement in the remaining nine. Patient satisfaction scores showed that six (37.5%) patients were highly satisfied, eight (50.0%) were somewhat satisfied, and two (12.5%) were unsatisfied. There were no significant side effects except mild pain, erythema, and spotty bleeding. CONCLUSION Disk microneedle therapy system (DTS) can be effectively and safely used in the treatment of striae distensae.

Efficacy of intradermal radiofrequency combined with autologous platelet‐rich plasma in striae distensae: a pilot study

Backgroundu2002 Different types of laser have recently been reported as effective tools of treatment in striae distensae. Although fractional photothermolysis is effective for striae distensae, post‐inflammatory hyperpigmentation is a major concern and common complication. There are no reports of the effects of using an intradermal radiofrequency (RF) device in striae distensae. Autologous platelet‐rich plasma (PRP) is an effective treatment known for its wound‐healing effects.

Distribution of Malassezia Species on the Scalp in Korean Seborrheic Dermatitis Patients

BACKGROUNDnMalassezia species play an important role in the pathogenesis of seborrheic dermatitis. In particular, M. restricta and M. globosa are considered to be the predominant organisms in seborrheic dermatitis of Western countries. However, species distribution of Malassezia in seborrheic dermatitis has not been clearly determined yet in Asia.nnnOBJECTIVEnTo identify the distribution of Malassezia species on the scalp of seborrheic dermatitis patients in Korea using 26S rDNA PCR-RFLP analysis.nnnMETHODSnA total of 40 seborrheic dermatitis patients and 100 normal healthy volunteers were included in this study. For the identification of Malassezia species, the scalp scales of the subjects were analyzed by 26S rDNA PCR-RFLP analysis.nnnRESULTSnThe most commonly identified Malassezia species were M. restricta in the seborrheic dermatitis patients, and M. globosa in the normal controls. In the seborrheic dermatitis group, M. restricta was identified in 47.5%, M. globosa in 27.5%, M. furfur in 7.5%, and M. sympodialis in 2.5% of patients. In the healthy control group, M. globosa was identified in 32.0%, M. restricta in 25.0%, M. furfur in 8.0%, M. obtusa in 6.0%, M. slooffiae in 6.0%, and M. sympodialis in 4.0% of subjects.nnnCONCLUSIONnM. restricta is considered to be the most important Malassezia species in Korean seborrheic dermatitis patients.

Topical immunomodulators are effective for treatment of vitiligo

Vitiligo is a common, acquired, depigmenting disease of the skin. Although the pathogenesis of vitiligo is still unclear, it is postulated that topical immunomodulators exert therapeutic effects on treatment of vitiligo. We reviewed the treatment of vitiligo with topical immunomodulators and topical steroids to evaluate the efficacy of immunomodulators in treatment of vitiligo. We reviewed 52 patients treated with topical immunomodulators and 27 patients with topical steroids. To evaluate the efficacy, repigmentation of vitiligo was reviewed. Between the two treatments, the duration from the start of treatment to onset of repigmentation was significantly shorter in the topical immunomodulator group (P = 0.002). However, no statistically significant differences were found in sex, age, mean disease duration, sites of vitiligo lesion and ratio of patients who showed response. We may suggest topical immunomodulator as an alternative to topical steroids for treatment of vitiligo.

Isolated cricoid fracture associated with blunt neck trauma

A 32-year-old woman without a remarkable history presented at the emergency department with strangulation of the neck. CT scans of the neck revealed a displaced cricoid fracture. Six days after admission to hospital, hoarseness and dyspnoea disappeared. On the 10th day, the patient was discharged without complications. The traditional treatment guidelines for laryngeal trauma have recommended an early surgical intervention after immediate tracheotomy in cases of displaced fractures of the cricoid cartilage. The patient could be treated successfully through continuous monitoring of airway obstruction without surgical management.

Safety Evaluation of Stamp Type Digital Microneedle Devices in Hairless Mice

Background Microneedles provide a minimally invasive means to transport molecules into the skin. A number of specific strategies have been employed to use microneedles for transdermal delivery. Objective The purpose of this study was to investigate the safety of two new digital microneedle devices (Digital Hand® and Digital Pro®; Bomtech Electronics Co., Ltd., Seoul, Korea) for the perforation of skin in skin-hairless-1 mice. This device replaces conventional needles and is designed specifically for intradermal delivery. Methods We used two newly developed digital microneedle devices to perforate the skin of skin-hairless-1 mice. We conducted a comparative study of the two digital microneedle devices and DTS® (Disk type-microneedle Therapy System; DTS lab., Seoul, Korea). To evaluate skin stability, we performed visual and dermatoscopic inspections, measurements of transepidermal water loss, and biopsies. Results The two novel digital microneedle devices did not induce significant abnormalities of the skin on visual or dermatoscopic inspection, regardless of needle size (0.25~2.0 mm). No significant histopathological changes, such as inflammatory cell infiltration, desquamation of the stratum corneum, or disruption of the basal layer, were observed. The digital microneedle devices and microneedle therapy system produced similar results on measures of skin stability. Conclusion These two novel digital microneedle devices are safe transdermal drug delivery systems.

Use of step stool during resuscitation improved the quality of chest compression in simulated resuscitation.

Objectives: Resuscitation on a medical bed is difficult because of the need to match the height of the bed to the height of the rescuer, which is impossible on a fixed‐height medical bed. This study investigated the effect of using a step stool on chest compressions performed on a manikin in a fixed‐height medical bed.

Elevated serum S100B levels in acute spinal fracture without head injury

Background S100B is a biomarker that reflects injury to the central nervous system. As the spine is an integral part of the spinal cord, a study was undertaken to investigate whether serum S100B levels are associated with acute spinal fracture without head injury. Methods The study population consisted of 32 consecutive patients aged ≥18u2005years in whom the emergency physicians suspected spinal fractures. All the patients underwent CT scans to establish the diagnosis of spinal fracture. MRI was then performed on all the patients to determine the presence of spinal cord injury. Results Serum S100B levels were higher in the spinal fracture group than in the non-spinal fracture group, and 19 of the 20 patients in the spinal fracture group (95%) had an S100B level >0.12u2005μg/l, whereas all 12 of the non-spinal fracture group had an S100B level ≤0.12u2005μg/l. The S100B level in patients with epidural encroachment of the spinal cord was significantly higher (0.22–4.58u2005μg/l; mean 2.45u2005μg/l; 95% CI 0.95 to 3.94) than in those without epidural encroachment (0.114–2.87u2005μg/l; mean 0.80u2005μg/l; 95% CI 0.24 to 1.37) (p=0.037). Plain radiography revealed no definite abnormal findings in half of the patients with spinal fracture. Conclusions Serum S100B levels are raised in all patients with acute spinal fracture without head injury. Spinal fracture may therefore be one of the extracerebral sources of S100B. Serum S100B levels may be an effective tool for excluding subtle spinal fractures with no clear radiographic findings.