Myocarditis and/or pericarditis have been reported as adverse events following coronavirus disease 2019 (COVID-19) messenger RNA vaccination, with most cases occurring within 1 week after the second dose. We report a rare case of myocarditis after the first dose of the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine in a 17-year-old boy. Here, we describe the laboratory, electrocardiographic, and imaging findings of myocarditis.

No abstract available.
Acupuncture* ; Mycobacterium*

BACKGROUND: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. METHODS: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. RESULTS: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). CONCLUSION: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.
Brain Injuries ; Cardiopulmonary Bypass ; Cardiopulmonary Resuscitation* ; Catheterization ; Cause of Death ; Child* ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Medical Records ; Myocarditis ; Neck ; Respiratory Insufficiency ; Resuscitation ; Retrospective Studies ; Sepsis ; Shock, Septic ; Thorax ; Weaning

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.
Emergencies ; Nails ; Sutures ; Tissue Adhesives

An algific talus slope is composed of broken rocks with vents connected to an ice cave, releasing cool air in summer and relatively warmer air in winter to maintain a more stable microclimate all year round. Such geological features create a very unusual and delicate ecosystem. Although there are around 25 major algific talus slopes in Korea, lichen ecology of these areas had not been investigated to date. In this study, we report the first exploration of lichen diversity and ecology at an algific talus slope, Jangyeol-ri, in Korea. A total of 37 specimens were collected over 2017–2018. Morphological and sequencing analysis revealed 27 species belonging to 18 genera present in the area. Of particular interest among these species was Solorina saccata, as it has previously not been reported in Korea and most members of genus Solorina are known to inhabit alpine regions of the Northern Hemisphere. We provide here a taxonomic key for S. saccata alongside molecular phylogenetic analyses and prediction of potential habitats in South Korea. Furthermore, regions in South Korea potentially suitable for Solorina spp. were predicted based on climatic features of known habitats around the globe. Our results showed that the suitable areas are mostly at high altitudes in mountainous areas where the annual temperature range does not exceed 26.6 °C. Further survey of other environmental conditions determining the suitability of Solorina spp. should lead to a more precise prediction of suitable habitats and trace the origin of Solorina spp. in Korea.

Type 2 diabetes mellitus is a multifactorial condition characterized by high level of sugar in the blood. To control hyperglycemia, combination therapy is recommended if monotherapy fails to achieve glycemic control. The combination of a dipeptidyl peptidase-4 (DPP-4) inhibitor and a sodium-glucose cotransporter type 2 (SGLT2) inhibitor is a promising option of the combination therapies in terms of safety as well as efficacy. Despite of the value of combination therapy of these two agents, the pharmacokinetic drug interactions between these two classes of agents have been evaluated in a few drugs. Thus, we reviewed the potential pharmacokinetic drug interaction based on the in vitro metabolism- and transporter-mediated drug interaction information as well as drug interaction studies in human, between a DPP-4 inhibitor and a SGLT2 inhibitor which are marketed in South Korea.

Background: Unlike the Mycoplasma IST2 kit (bioMérieux), the Mycoplasma IST3 kit has been updated to comply with the standardized antimicrobial susceptibility test (AST) method for Ureaplasma spp. (Up) and Mycoplasma hominis (Mh). We aimed to verify the use of the Mycoplasma IST3 kit for genital mycoplasma cultures. Methods: From September 2023 to January 2024, the R1 medium remaining after inoculation with IST2 was refrigerated until the next day. For IST2-positive samples, 300 μL of residual R1 medium was inoculated into the IST3. Species identification, enumeration, and AST results obtained using IST3 were compared with those obtained using IST2. Results: A total of 48 IST2-positive samples were inoculated into IST3, including 35, 1, and 12 Up-only, Mh-only, and both Up- and Mh-positive samples, respectively. Among Up-only samples, 2.8%, 91.4%, and 100.0% were susceptible to ciprofloxacin, tetracycline, and erythromycin, respectively. With IST3, 45 (93.8%) samples grew genital mycoplasmas; 42 (89.4%) of the 47 Up-positive samples and 6 (46.2%) of the 13 Mh-positive samples showed growth of the same organisms. All seven samples that failed to grow Mh were from mixed cultures, of which four Mh concentrations of < 104 /mL. Up was susceptible to levofloxacin, tetracycline, and erythromycin at the rates of 64.3 %, 88.1 %, and 95.2 %, respectively. Conclusion IST3 showed good performance in detecting genital Mycoplasma except for its tendency to not detect Mh of low concentrations in mixed cultures. IST3 is preferable to IST2 because it can accurately screen for erythromycin resistance in Up and reduce falseresistances for fluoroquinolone.

PURPOSE: ST-elevation myocardial infarction (STEMI) patients may visit the emergency department (ED) complaining of sensations of pain other than the chest. We investigated our performance of reperfusion therapy for STEMI patients presenting with non-chest pains. MATERIALS AND METHODS: This was a retrospective observational cohort study. STEMI patients who underwent primary percutaneous coronary intervention (PCI) were divided into a chest pain group and a non-chest pain group. Clinical differences between the two groups and the influence of presenting with non-chest pains on door-to-electrocardiograms (ECG) time, door-to-balloon time, and hospital mortality were evaluated. RESULTS: Of the 513 patients diagnosed with STEMI, 93 patients presented with non-chest pains. Patients in the non-chest pain group were older, more often female, and had a longer symptom onset to ED arrival time and higher Killip class than patients in the chest pain group. There was a statistically significant delay in door-to-ECG time (median, 2.0 min vs. 5.0 min; p<0.001) and door-to-balloon time (median, 57.5 min vs. 65.0 min; p<0.001) in patients without chest pain. In multivariate analysis, presenting with non-chest pains was an independent predictor for hospital mortality (odds ratio, 2.3; 95% confidence interval, 1.1-4.7). However, door-to-ECG time and door-to-balloon time were not factors related to hospital mortality. CONCLUSION: STEMI patients presenting without chest pain showed higher baseline risk and hospital mortality than patients presenting with chest pain. ECG acquisition and primary PCI was delayed for patients presenting with non-chest pains, but not influencing hospital mortality. Efforts to reduce pre-hospital time delay for these patients are necessary.
Aged ; Aged, 80 and over ; Chest Pain/*diagnosis ; Electrocardiography ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Myocardial Infarction/mortality/*surgery ; Retrospective Studies

PURPOSE: Appropriate aortocaval compression during cardiopulmonary resuscitation (CPR) plays a significant role in outcomes following cardiac arrest during pregnancy. The existing aortocaval compression women may have due to pregnancy conditions can be relieved by either manual displacement of the gravid uterus or by placing the patient in an inclined lateral position. Hence, the objective of this study was to compare the quality of chest compression in two different positions, supine versus 30degrees inclined lateral, to ascertain whether or not high quality CPR is feasible in an inclined position for treating cardiac arrest during pregnancy. METHODS: A prospective, crossover, randomized study was performed with thirty emergency medicine residents and emergency medical technicians. Each participant performed hands-only CPR for 2 minutes in both supine and 30degrees inclined lateral positions on a manikin. Compression rate, depth, compression depth rate, recoil rate, and hand positioning were evaluated using the Laerdal PC SkillReporting System(R). Participants were scored on the subjective difficulty of chest compression using a visual analogue scale (VAS). RESULTS: There were no significant differences in compression rates, correct recoil rates and correct hand position ratings between the two positions. The compression depth in the supine position was 56.1+/-4.5 mm, and 52.6+/-6.5 mm (p<0.001) in the 30degrees inclined lateral position. However, the latter result met the current guideline recommendation. There was no reported difference in the difficulty of chest compression between the two positions. CONCLUSION: In the 30degrees inclined lateral position, high-quality chest compression is feasible to achieve in simulated cardiac arrest associated with pregnancy.
Cardiopulmonary Resuscitation ; Displacement (Psychology) ; Emergency Medical Technicians ; Emergency Medicine ; Female ; Hand ; Heart Arrest ; Humans ; Manikins ; Pregnancy ; Prospective Studies ; Supine Position ; Thorax ; Uterus

A 38-year-old female patient with a history of tetralogy of Fallot repair at 10 years of age underwent pulmonary valve replacement with a mechanical prosthesis, tricuspid annuloplasty, and right ventricular outflow tract cryoablation due to pulmonary regurgitation, tricuspid regurgitation, and multiple premature ventricular contractions with sustained ventricular tachycardia. After surgery, she had an uneventful postoperative course with arrhythmia monitoring. She was discharged without incident, and a follow-up Holter examination showed a decrease in the number of ventricular ectopic beats from 702 to 41.
Adult ; Arrhythmias, Cardiac ; Cryosurgery* ; Female ; Follow-Up Studies ; Humans ; Prostheses and Implants ; Pulmonary Valve Insufficiency ; Pulmonary Valve* ; Tachycardia, Ventricular ; Tetralogy of Fallot* ; Tricuspid Valve Insufficiency ; Ventricular Premature Complexes