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

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

PURPOSE: To compare the efficacies and side effects of intravenous hydromorphone and pethidine in the emergency department (ED) treatment of ureteral colic. METHODS: A prospective, controlled, randomized clinical trial was conducted in a university-affiliated tertiary referral center. All adult patients who presented to the ED with severe ureteral colic were included. The patients received either 1 mg of hydromorphone (n=26) or 50 mg of pethidine (n=26) intravenously. Pain intensity was determined using a 10 cm visual analogue scale 0, 15, 30, and 120 minutes after injection. RESULTS: Dermographic characteristics and baseline pain scores of both groups were comparable (p>0.05). The pain intensity level for the hydromorphone group was lower than for the pethidine group at 15, 30, and 120 minutes. Pain relief was better with hydromorphone at 15 minutes (p<0.05). Side effects of the two groups were not statistically significant. CONCLUSION: The ureteral colic patients receiving hydromorphone achieved more pain relief. The side effects were similar for either treatment. Hydromorphone should be the preferred agent in suspected ureteral colic, when an opioid analgesic is to be used.
Adult ; Benzeneacetamides ; Emergencies ; Humans ; Hydromorphone ; Meperidine ; Piperidones ; Prospective Studies ; Renal Colic ; Tertiary Care Centers ; Ureter

BACKGROUND: The injection of rocuronium causes pain and withdrawal responses.This study was designed to determine an optimal dose of alfentanil to prevent the withdrawal responses associated with injection of rocuronium in children. METHODS: One hundred and ten ASA physical status I and II pediatric patients were randomly allocated into four groups; Group C (control; normal saline 3 ml, n = 28), Group A5 (alfentanil 5microgram/kg, n = 28), Group A10 (alfentanil 10microgram/kg, n = 27) and Group A15 (alfentanil 15microgram/kg, n = 27). After the induction of anesthesia with 5 mg/kg of thiopental sodium, the test drug was injected over 20 seconds, respectively. After one minute, rocuronium 0.6 mg/kg was injected over 5 seconds. The patient's response after injection was graded using a four-point scale. Additionally, the mean arterial pressure and heart rate were recorded upon arrival in the operating room, as well as 1 min before and 1 min after tracheal intubation. RESULTS: The incidence of withdrawal responses was 96%, 61%, 19% and 19% in groups C, A5, A10 and A15, respectively. The incidence and severity of withdrawal responses in group A10 and A15 were lower than group C and A5. CONCLUSIONS: After thiopental injection, alfentanil 10microgram/kg prevent the withdrawal responses on injecting rocuronium in pediatric patients.
Alfentanil ; Androstanols ; Anesthesia ; Arterial Pressure ; Benzeneacetamides ; Child ; Heart Rate ; Humans ; Incidence ; Intubation ; Operating Rooms ; Piperidones ; Thiopental

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: 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

OBJECTIVE: This study assessed the efficacy of anterior cervical discectomy and fusion (ACDF) with cage alone compared with ACDF with plate instrumentation for radiologic and clinical outcomes in two-level cervical degenerative disease. METHODS: Patients with cervical degenerative disc disease from September 2004 to December 2009 were assessed retrospectively. A total of 42 patients received all ACDF at two-level cervical lesion. Twenty-two patients who underwent ACDF with cage alone were compared with 20 patients who underwent ACDF with plate fixation in consideration of radiologic and clinical outcomes. Clinical outcomes were assessed using Robinson's criteria and posterior neck pain, arm pain described by a 10 point-visual analog scale. Fusion rate, subsidence, kyphotic angle, instrument failure and the degenerative changes in adjacent segments were examined during each follow-up examination. RESULTS: VAS was checked during each follow-up and Robinson's criteria were compared in both groups. Both groups showed no significant difference. Fusion rates were 90.9% (20/22) in ACDF with the cage alone group, 95% (19/20) in ACDF with the plate fixation group (p = 0.966). Subsidence rates of ACDF with cage alone were 31.81% (7/22) and ACDF with plate fixation were 30% (6/20) (p = 0.928). Local and regional kyphotic angle difference showed no significant difference. At the final follow-up, adjacent level disease developed in 4.54% (1/22) of ACDF with cage alone and 10% (2/20) of ACDF with plate fixation (p = 0.654). CONCLUSION: In two-level ACDF, ACDF with cage alone would be comparable with ACDF with plate fixation with regard to clinical outcome and radiologic result with no significant difference. We suggest that the routine use of plate and screw in 2-level surgery may not be beneficial.
Arm ; Benzeneacetamides ; Diskectomy ; Follow-Up Studies ; Humans ; Neck Pain ; Piperidones ; Retrospective Studies