BACKGROUND: Bacterial contamination of platelets represents the highest infectious risk for a transfusion. In this study, we evaluated 2 culture-based systems that have been approved by the US FDA for bacterial screening. METHODS: Platelet concentrates were inoculated with 5 bacterial species to give a final concentration of 10(0), 10(1) and 10(2) CFU/mL. Samples for culture were taken immediately after inoculation (0 hr sample) and after 24 hrs (24 hr sample). For the BacT/ALERT 3D system, a 10 mL sample was inoculated into an aerobic culture bottle and incubated for 7 days. For the Pall eBDS system, 3 mL samples were taken from the 0 hr and 24 hr samples, respectively. The samples were incubated for 24 hrs and 30 hrs. RESULTS: Both systems detected all inoculated units both in the 0 hr and 24 hr samples, except for units inoculated with K. pneumoniae. Eleven units out of 30 units inoculated with K. pneumoniae were detected by the BacT/ALERT 3D system in the 24 hr samples. The Pall eBDS system detected 8 of 30 units in the 24 hr samples. CONCLUSION: Implementation of either system will decrease the risk of transfusing bacterially contaminated platelets. However, testing for bacterial contamination will not completely prevent septic transfusion reactions; pathogen inactivation that is now available should also be considered as an alternative method to reduce the risk of bacterial contamination.
Benzeneacetamides ; Blood Platelets ; Piperidones ; Pneumonia

PURPOSE: Most of postoperative patients experience pain, state anxiety and sleep disturbance. These problems negatively influence the recovery of postoperative patients. So alleviating these problems has been one of the nurses' central roles. The purpose of this study was to examine the effects of back massage on pain, state anxiety and quality of sleep of postoperative gastrectomy patients. METHODS: A non-synchronized non-equivalent control group pre and post-test design was used. The research instruments used in this study were the Numerical Rating Scale (NRS) for pain, the State-Anxiety Inventory (STAI) for anxiety and the Verran and Synder-Halpern scale for quality of sleep. The subjects were patients admitted to a university hospital located in D city. Twenty-nine patients in the experimental group had a 10 min manual back massage stimulation for 5 days from the 1st day to the 5th day after their operation, and 25 patients in the control group did not. RESULTS: The degree of pain was significantly reduced according to post operation day and quality of sleep was significantly increased. However state anxiety was not significantly reduced. CONCLUSION: Back massage is a partially effective nursing intervention for postoperative patients with gastrectomy who experience pain and sleep disturbance.
Anxiety ; Benzeneacetamides ; Gastrectomy ; Humans ; Massage ; Piperidones

BACKGROUND: We evaluated the analgesic efficacy of a 5% eutectic mixture of lidocaine and prilocaine (EMLA(R)) topically applied before performing skin puncture for spinal or epidural anesthesia. METHODS: The patient population consisted of 75 ASA physical status 1 and 2 adults scheduled for operations of the lower abdominal region, the perineal region or the lower extremities. The patients were randomly allocated to one of five groups of equal size: group A - topical application of EMLA(R) cream 120 min before spinal block; group B - subcutaneous infiltrationof 2 ml of 2% lidocaine immediately before spinal block; group C - no pretreatment before spinal block; group D - topical application of EMLA(R) cream 120 min before epidural block; and group E - subcutaneous infiltration of 2 ml of 2% lidocaine immediatelybefore epidural block. Pain experienced during the whole procedure was rated using a 10 cm visual analogue scale. RESULTS: Patients in group A experienced less pain compared with those in groups B and C (2.0 +/- 1.9 cm vs 4.1 +/- 1.9 cm and 3.9 +/- 2.2 cm, respectively; P < 0.05). However there was no significant difference between group D and group E (3.6 +/- 2.4 cm vs 4.1 +/- 2.5 cm). The patients in group A and group D were highly satisfied with the method of analgesia (P < 0.05). CONCLUSIONS: EMLA(R) cream is an effective alternative to subcutaneous infiltration of local anesthetic for analgesia during skin puncture using a 25 G spinal needle. It provides insufficient analgesia however for epidural anesthesia.
Adult ; Analgesia ; Anesthesia, Epidural ; Anesthesia, Spinal ; Benzeneacetamides ; Humans ; Lidocaine ; Lower Extremity ; Needles ; Piperidones ; Prilocaine ; Punctures ; Skin

PURPOSE: There have been reported that preoperative chemotherapy for treating noncurative gastric cancer could increase the R0 resection rate by downstaging the gastric cancer. Yet there have been only rare reports about the effect of preoperative chemotherapy on performing surgery for noncurative gastric cancer. Our study was designed to analyze our experiences with these effects. MATERIALS AND METHODS: We retrospectively analyzed 46 patients who had undergone gastrectomy after chemotherapy between December 2001 and January 2009. The patients' preoperative condition, the operative findings and the postoperative clinical coursed were analyzed. RESULTS: Preoperative chemotherapy was performed for a mean of 4.4 cycles. Four patients showed a level of ANC below 1,500 (micron/L) and above a 10 percentile weight loss, respectively. For an operation, we found fibrosis or fixation between the tumor and the adjacent organs in 29 patients, and 4 of the 13 patients who underwent resection with another organ were documented to have invasion by tumor. Forty one patients underwent curative resection. Ten patients developed postoperative complications. There was no mortality at postoperative 60 days. CONCLUSION: We assumed that preoperative chemotherapy had little effect on the patient preoperatively, and it had some effect on down-staging pathologically. Preoperative chemotherapy didn't increase the postoperative complication rate.
Benzeneacetamides ; Fibrosis ; Gastrectomy ; Humans ; Piperidones ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms ; Weight Loss

PURPOSE: To evaluate the efficacy of ultrasound for the detection of a partial tendon injury of the dorsum of the hand by emergency doctors using a swine model. METHODS: Fifteen swine feet were used for the study. Two tendons from each foot were examined using a 10 MHz hocky stick scan head. A 0%, 10%, 50% and 90% incision was made in each extensor tendon at the proximal site of the skin incision. Four emergency physicians and five senior emergency residents were blinded to the injuries and evaluated the samples for a partial tendon rupture. RESULTS: The difference between the results for the emergency physicians and the emergency senior residents were not statistically significant.The diagnostic sensitivity for all participants was more than 10%; more than a 50% tendon injury was identified in 69.2% and 77.0%, respectively. The specificity was 51.4% and 53.5% for each case. The sensitivity and specificity showed no significant differences. (sensitivity p=0.243, specificity p=0.992) CONCLUSION: The results of this study confirm that ultrasound was useful in the detection of a partial tendon rupture by emergency doctors. The findings of this study have implications for the training of emergency room doctors.
Benzeneacetamides ; Emergencies ; Foot ; Hand ; Head ; Piperidones ; Rupture ; Sensitivity and Specificity ; Skin ; Swine ; Tendon Injuries ; Tendons

OBJECTIVE: Medpor porous polyethylene was used to reconstruct small bone defects (gaps and burr holes) along a craniotomy bone flap. The feasibility and cosmetic results were evaluated. METHODS: Medpor Craniotomy Gap Wedges, V and T, were designed. The V implant is a 10 cm-long wedge strip, the cross section of which is an isosceles triangle with a 4 mm-long base, making it suitable for gaps less than 4 mm after trimming. Meanwhile, the Medpor T wedge includes a 10 mm-wide thin plate on the top surface of the Medpor V Wedge, making it suitable for gaps wider than 4 mm and burr holes. Sixty-eight pterional craniotomies and 39 superciliary approaches were performed using the implants, and the operative results were evaluated with respect to the cosmetic results and pain or tenderness related to the cranial flap. RESULTS: The small bone defects were eliminated with less than 10 minutes additional operative time. In a physical examination, there were no considerable cosmetic problems regarding to the cranial bone defects, such as a linear depression or dimple in the forehead, anterior temporal hollow, preauricular depression, and parietal burr hole defect. Plus, no patient suffered from any infectious complications. CONCLUSION: The Medpor Craniotomy Gap Wedge is technically easy to work with for reconstructing small bone defects, such as the bone gaps and burr holes created by a craniotomy, and produces excellent cosmetic results.
Benzeneacetamides ; Cosmetics ; Craniotomy ; Depression ; Forehead ; Humans ; Operative Time ; Physical Examination ; Piperidones ; Polyethylene ; Polyethylenes

PURPOSE: We hypothesized that a new scoring system that included emergency ultrasound (EUS) and clinical or laboratory predictors for diagnosing acute appendicitis (AA) in patients with right lower quadrant (RLQ) pain could decrease the false negative rate when EUS is performed alone. METHODS: During a 10 month period, patients with RLQ pain were evaluated with EUS just after history taking and physical examination. We also checked the 17 well-known predictors of AA. Univariate analyses for each predictor including EUS findings identified 11 predictors. We then tested those predictors with logistic regression analysis. RESULTS: A total 397 patients (mean age=31.13+/-18.25 years: 196 males, 201 females) were enrolled in this study. Among the 397, 247 underwent an operation, but 14 turned out to have normal appendices. Among 233 patients with appendicitis, 75 had a perforated appendix. Four independent correlates of AA (constant pain, aggravated pain, male sex, and positive EUS findings) were identified with logistic regression analysis. We developed a novel scoring system using regression coefficients as follows: 6 points for a positive EUS, 3 points for aggravated pain, 2 points for constant pain, and 2 points for being male. We named the new scoring system "CAMUS" for "Constant or Aggravated pain, Male sex, and UltraSound score". The area under the receiver-operating characteristic curve (ROC) for the CAMUS score for AA was 0.93(95% confidence interval: 0.871 to 0.959). CONCLUSION: Our new CAMUS scoring system can help emergency physicians diagnose AA accurately and rapidly.
Appendicitis ; Appendix ; Benzeneacetamides ; Diagnosis, Differential ; Emergencies ; Humans ; Logistic Models ; Male ; Physical Examination ; Piperidones

PURPOSE: To analyze the clinical features of patients who successfully discontinued correction with hyperopic glasses for refractive accommodative esotropia during a 10 year follow-up. METHODS: The authors of the present study analyzed 29 patients followed-up for a minimum of 10 years after diagnosis of accommodative esotropia. The patients were divided into 2 groups: patients who successfully discontinued correction with hyperopic glasses (10 patients, Group A), and patients who required constant use of hyperopic glasses (19 patients, Group B). The age at first visit, refractive error, deviated angle without correction, stereopsis, and follow-up duration were compared between the 2 groups. RESULTS: The mean age at first visit for all patients was 3.03 +/- 1.46 years, and the follow-up duration was 11.3 +/- 1.51 years. Patients in Group A discontinued the use of hyperopic glasses after 10.26 +/- 2.08 years. There were no statistical differences in mean age at first visit, deviated angle without correction, stereopsis, follow-up duration, or the amount of change in hyperopia. The initial amount of hyperopia in Group A was 3.81 +/- 1.54 D, significantly lower than the 5.12 +/- 1.37 D in Group B. CONCLUSIONS: After a 10 year follow-up of accommodative esotropia, 34% of the patients discontinued the use of hyperopic glasses, and the hyperopic amount at initial visit was statistically lower than that of patients who required constant use of hyperopic glasses.
Benzeneacetamides ; Depth Perception ; Esotropia ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Hyperopia ; Piperidones ; Refractive Errors

OBJECTIVE: We applied chest radiographs to scoliosis screening for conscription. Prevalence, types of scoliosis, and insight of examinees with scoliosis were investigated. METHODS: In this study, chest radiographs of 2417 males, who had been given an examination for conscription at the Seoul Regional Military Manpower Administration from April 2009 to May 2009, were analyzed. The prevalence of scoliosis more than a 10 degrees Cobb angle was calculated. The insight of scoliosis was investigated in every examinee and thoracolumbar radiographs were checked in those examinees with more than a 20 degree Cobb angle. RESULTS: Among 1904 males, 477 (19.7%) exhibited scoliosis involving more than a 5 degrees Cobb angle were and 131 (5.4%) exhibitedmore than a 10 degree Cobb angle. In those 131 cases, 18 (13.7%) had a known history of problems with scoliosis. Among the group measuring less than a 10 degree Cobb angle, 1.7% of them misunderstood scoliosis. Insight of scoliosis increased according to the severity of spinal curvature; however, nearly half of the cases with a 20 degree or greater Cobb angle had no insight with respect to their scoliosis. CONCLUSION: In male adolescents, the prevalence of scoliosis with a greater than 10 degree Cobb angle was 5.4% and there was a low insight with respect to scoliosis.
Adolescent ; Benzeneacetamides ; Humans ; Male ; Mass Screening ; Military Personnel ; Piperidones ; Prevalence ; Scoliosis ; Thorax

PURPOSE: The aim of the present study was to evaluate if a smaller morse taper abutment has a negative effect on the fracture resistance of implant-abutment connections under oblique compressive loads compared to a conventional abutment. MATERIALS AND METHODS: Twenty morse taper conventional abutments (4.8 mm diameter) and smaller abutments (3.8 mm diameter) were tightened (20 Ncm) to their respective implants (3.5 x 11 mm) and after a 10 minute interval, implant/abutment assemblies were subjected to static compressive test, performed in a universal test machine with 1 mm/min displacement, at 45degrees inclination. The maximum deformation force was determined. Data were statistically analyzed by student t test. RESULTS: Maximum deformation force of 4.8 mm and 3.8 mm abutments was approximately 95.33 kgf and 95.25 kgf, respectively, but no fractures were noted after mechanical test. Statistical analysis demonstrated that the evaluated abutments were statistically similar (P=.230). CONCLUSION: Abutment measuring 3.8 mm in diameter (reduced) presented mechanical properties similar to 4.8 mm (conventional) abutments, enabling its clinical use as indicated.
Benzeneacetamides ; Collodion ; Compressive Strength ; Dental Implant-Abutment Design ; Dental Implants ; Displacement (Psychology) ; Humans ; Piperidones