PURPOSE: Tetanus vaccine or immunoglobulin is given routinely to patients with wounds according to immunization history. Our aim is to identify prediction factors that affect tetanus antibody titer, which lead to proper application of an antibody screening test according to the factors. METHODS: Subjects who visited the emergency department after injury from October 2008 to February 2010 were enrolled. The Tetanus Immunoglobulin G ELISA (Enzyme-linked immunosorbent assay) method was used for analysis of serum samples. Using multivariate analysis, we identified statistically significant variables affecting the tetanus antibody titer. And we developed the Boramae Tetanus Score as a screening model. RESULTS: A total of 1218 samples were analyzed. Significant factors affecting tetanus antibody titer were as follows: Age in the twenties, thirties, and fifties, male sex, and experience of military service. We assigned proper scores to each variable using the beta-coefficients. The area under the Receiver Operating Characteristic (ROC) curve of the scoring system was 0.807. Patients were categorized as high risk and low risk groups; 18.0% of the high risk group and 67.7% of the low risk group had serum tetanus antibody titer higher than safe antibody level (0.1 IU/mL). CONCLUSION: The antibody titer of the high risk group was low enough for performance of routine immunization. "In order to prevent unnecessary immunization, patients in the low risk group should undergo screening using proper tools".
Emergencies ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunization ; Immunoglobulin G ; Immunoglobulins ; Male ; Mass Screening ; Military Personnel ; Multivariate Analysis ; ROC Curve ; Tetanus ; Tetanus Toxoid

OBJECTIVE: This study aimed to verify the intra-individual reproducibility of the natural head position (NHP) in adult Korean patients in the centric relation (CR) position and to prove the inter-individual variability of the Frankfurt horizontal (FH) plane and sella-nasion (SN) line compared to the true horizontal line (THL). In addition, the study aimed to investigate the correlations between linear measurements from A-point and B-point to the nasion true vertical line (NTVL) and angular measurements from A-point and B-point to the SN line. METHODS: Two lateral cephalograms were taken of 116 subjects (23 males, 93 females) with CR wax bites in a NHP at a one-week interval. RESULTS: Method errors of three variables and intraclass correlation coefficients of six parameters proved the intra-individual reproducibility of NHP (p < 0.001). The angle of the FH to the THL was not significantly different from 0degrees (p > 0.05), but it was clinically variable (SD 3.89degrees) on the inter-individual level. Conversely, the angle of the SN line to the THL was significantly different from 7degrees (p < 0.05). Very low correlation was found between the linear measurements and angular measurements of A-point and B-point (p < 0.01). CONCLUSIONS: The NTVL could be a useful reference line for assessing the antero-posterior position of the maxilla and mandibleof Korean adult patients in NHP and CR.
Adult ; Bites and Stings ; Centric Relation ; Head ; Humans ; Male ; Maxilla