There have been many reports regarding complications associated with cardiopulmonary resuscitation(CPR) and it may be true that there are many unrevealed complications. Although it is used to say that 'any CPR is better than no CPR', inadvertent or inadequate CPR may insult in serious organ injury. This report describes a 64-year-old woman who suffered Mallory-Weiss tear resulting from inadvertent cardiopulmonary resuscitation by a bystander who had never been trained. Possible mechanisms of gastric injuries caused by CPR are suggested, and importance of adequate CPR training are emphasized in this report.
Cardiopulmonary Resuscitation* ; Female ; Humans ; Mallory-Weiss Syndrome* ; Middle Aged

PURPOSE: We wanted to clinically evaluate the antibiotic therapy used from pre- to postlaparoscopic cholecystectomy along with the improved surgical techniques and instruments and the patient nutrition. METHODS: We prospective studied 105 patients who were treated with laparoscopic cholecystectomy for acute and chronic cholecystitis at Busan St. Mary Hospital from March 2007 to January 2008. The two groups were divided as follows: (A) the group was not injected with antibiotics, and the other group (B) was injected with antibiotics. We did not used antibiotics when the patient had no acute aggravating symptoms, and we exclude the patients with old age (<70 years), a past history of diabetes mellitus (DM) or hypertension (HTN), and a past operation history. RESULTS: Between the two group, there was no difference when they were compared for age, BMI (Body Mass Index), the operation time (minute) and the length of the hospital stay: (A) Group 49.3+/-13.0 years, 24.4+/-3.2 kg/m2, 37.9 +/- 10.0 minute and 4.6 +/- 1.3 days, respectively, and (B) Group 55.9+/-15.6 years, 23.5+/-3.5 kg/m2, 43.2 +/- 23.8 minute and 5.5 +/- 2.5 days, respectively. There was a significant different in the leukocyte count and the % of neutrophils: (A) Group 6396microliter(-1) and 53.4%, respectively and (B) Group 9354microliter(-1) and 66.6%, respectively. In (B) group, there were 2 cases of atrial fibrillation, 1 case of diarrhea and 1 case of wound seroma. There were no surgical related complications in group (A). CONCLUSION: For the well nourished chronic cholecystitis patients, the use of the prophylatic antibiotics may be less effective because of the many drug-induced side effects. More studies about the use of prophylactic antibiotics are needed.
Anti-Bacterial Agents ; Atrial Fibrillation ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Diabetes Mellitus ; Diarrhea ; Humans ; Hypertension ; Leukocyte Count ; Prospective Studies ; Seroma

Inversion of nipple is a common condition occurring with an incidence of 2% in women. It not only causes irritation and inflammation, but also causes aesthetic problems, affecting sexual relationships and psychological well-being of the patients. Several methods have been introduced to treat this condition in the past century, but the major principle of correction is based on the concept suggested by Schwager, that inverted nipple develops because of the lack of connective tissue located directly beneath the nipple. Based on this concept, many surgeons including Broadbent, Teimourian, and Elshy etc. have proposed that adding bulk of connective tissue and scarifing the ductal system is the principle of the treatment. Author`s method is also based on such a concept, and we have modified the Teimourian method. First, an intraglandular section in the shape of an inverted cone was performed. The crator-like glandular section was closed using horizontal mattress suture, leading to circumglandular V-Y advancement. Second, the donor sites on the areolar area were closed with V-Y advancement. Third, purse-string suture was performed to achieve neck tightening and to compensate for the lack of connective tissue beneath the nipple. Dermal flap suture was done by Foot-plate manner. We operated on 52 cases using this method, 28 patients during past 2 years. After 1 year following the operation, there were just two cases of relapse and virtually no complications. We obtained satisfactory projection of the nipples in all patients except in 2 cases. The resulting shapes and scars were acceptable to all patients.
Cicatrix ; Connective Tissue ; Female ; Humans ; Incidence ; Inflammation ; Neck ; Nipples* ; Recurrence ; Sutures ; Tissue Donors

In this study we evaluated the influence of both the thickness of residual enamel and the color of the composite resins applied to lingual surface on the labial surface color. Background plates were made by randomly (A1, A2, A6D, B1, B2, B3, C1, C2, C6D) selected colors of Filtek Supreme (3M ESPE, St. Paul, U.S.A.) composite resin. Crown portion of 9 maxillary central incisors were cut off and embedded with acrylic resin except labial surface. Samples of average thickness of 2.2 mm were obtained after cutting it in a thickness of 2.5 mm from the labial surface and sandpaper polish. The shade of composite resin background was measured using Spectrophotometer (Spectrolino(R) GretagMacbeth, Regensdorf, Switzerland). And CIE L*a*b* value of 2.2 mm thickness tooth samples were measured on the 9 composite resin backgrounds. And then, the cutting side of tooth samples was ground to the extent of 1.9 mm, 1.6 mm, 1.3 mm, 1.0 mm and placed on composite resin backgrounds and measured L*a*b* values with the same method. In all samples, L* value and b* value seemed to have a tendency of decreasing as thickness of tooth sample becomes thinner regardless of background colors (p < 0.05). But, a* value didn't show the significant differences depending on the thickness.
Composite Resins ; Crowns ; Dental Enamel ; Incisor ; Tooth

No abstract available.
Humans ; Surgery, Plastic*

A nipple can be reconstructed either by nipple sharing or local flap. But donor site scar is inevitable when nipple is reconstructed with local flap method. The scar which remains inside the nipple areolar complex can be hidden by medical tattooing, but elongated scar, which cross over the areolar border leads to poor esthetic result. So as to solve this problem, we used purse string suture method. We reconstructed nipple with C-V flap for 9 patients who previously reconstructed breast with extended latissimus dorsi flap. Purse string suture with 3-0 nylon was used for donor site closure. We minimize 10.7% of the scar length with this method. Enhancement of nipple projection due to the flattening of V limb was attained in addition. We expect the reduction of V-limb of C-V flap and amount of absorption of the reconstructed nipple with purse string suture method.
Absorption ; Breast ; Cicatrix ; Extremities ; Humans ; Nipples* ; Nylons ; Superficial Back Muscles ; Sutures ; Tattooing ; Tissue Donors

BACKGROUND: This study evaluates the effectiveness of immunochemotherapy and radiation therapy in the treatment of patients with primary bone lymphoma (PBL). METHODS: We retrospectively reviewed the medical records of 33 patients with PBL who were treated at 6 medical centers in Korea from 1992 to 2010. Clinicopathological features and treatment outcomes were analyzed. RESULTS: The median age of the patients participating in our study was 40 years. The most common sites of involvement were the pelvis (12.36%) and femur (11.33%). CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) or CHOP-like regimens were administered to 20 patients (61%), and R-CHOP (rituximab plus CHOP) was administered to the remaining 13 patients (39%). The overall response rate was 89% (complete response, 76%; partial response, 12%). The overall survival (OS) of patients with solitary bone lesions was longer than that of patients with multiple bone lesions (median OS: not reached vs. 166 months, respectively; P=0.089). Addition of rituximab to CHOP did not significantly affect either OS or progression-free survival (P=0.53 and P=0.23, respectively). Combining radiation therapy with chemotherapy also did not improve the OS or progression-free survival of patients with solitary bone lesions. CONCLUSION: Conventional cytotoxic chemotherapy remains an effective treatment option for patients with PBL. Additional benefits of supplementing chemotherapy with either rituximab or radiation therapy were not observed in this study. Further investigation is needed to characterize the role of immunochemotherapy in treating patients with PBL.
Antibodies, Monoclonal, Murine-Derived ; Disease-Free Survival ; Doxorubicin ; Femur ; Humans ; Korea ; Lymphoma ; Medical Records ; Pelvis ; Retrospective Studies ; Vincristine ; Rituximab

Purpose: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard management for relapsed or high-risk non-Hodgkin’s lymphoma (NHL). We reported the busulfan, melphalan, and etoposide (BuME) conditioning regimen was effective in patients with relapsed or high-risk NHL. Moreover, the busulfan, cyclophosphamide, and etoposide (BuCE) conditioning regimen has been used widely in ASCT for NHL. Therefore, based on these encouraging results, this randomized phase II multicenter trial compared the outcomes of BuME and BuCE as conditioning therapies for ASCT in patients with NHL. Materials and Methods: Patients were randomly assigned to receive either BuME (n=36) or BuCE (n=39). The BuME regimen was comprised of busulfan (3.2 mg/kg/day, intravenously) administered on days –7, –6, and –5, etoposide (400 mg/m2 intravenously) on days –5 and –4, and melphalan (50 mg/m2/day intravenously) on days –3 and –2. The BuCE regimen was comprised of busulfan (3.2 mg/kg/day intravenously) on days –7, –6, and –5, etoposide (400 mg/m2/day intravenously) on days –5 and –4, and cyclophosphamide (50 mg/kg/day intravenously) on days –3 and –2. The primary endpoint was 2-year progression-free survival (PFS). Results: Seventy-five patients were enrolled. Eleven patients (30.5%) in the BuME group and 13 patients (33.3%) in the BuCE group had disease progression or died. The 2-year PFS rate was 65.4% in the BuME group and 60.6% in the BuCE group (p=0.746). There were no non-relapse mortalities within 100 days after transplantation. Conclusion There were no significant differences in PFS between the two groups. Therefore, busulfan-based conditioning regimens, BuME and BuCE, may be important treatment substitutes for the BCNU-containing regimens.

We assessed the success rate of empirical antifungal therapy with itraconazole and evaluated risk factors for predicting the failure of empirical antifungal therapy. A multicenter, prospective, observational study was performed in patients with hematological malignancies who had neutropenic fever and received empirical antifungal therapy with itraconazole at 22 centers. A total of 391 patients who had abnormal findings on chest imaging tests (31.0%) or a positive result of enzyme immunoassay for serum galactomannan (17.6%) showed a 56.5% overall success rate. Positive galactomannan tests before the initiation of the empirical antifungal therapy (P=0.026, hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.10-4.69) and abnormal findings on the chest imaging tests before initiation of the empirical antifungal therapy (P=0.022, HR, 2.03; 95% CI, 1.11-3.71) were significantly associated with poor outcomes for the empirical antifungal therapy. Eight patients (2.0%) had premature discontinuation of itraconazole therapy due to toxicity. It is suggested that positive galactomannan tests and abnormal findings on the chest imaging tests at the time of initiation of the empirical antifungal therapy are risk factors for predicting the failure of the empirical antifungal therapy with itraconazole. (Clinical Trial Registration on National Cancer Institute website, NCT01060462)
14-alpha Demethylase Inhibitors/adverse effects/therapeutic use ; Adolescent ; Adult ; Aged ; Antifungal Agents/adverse effects/*therapeutic use ; Aspergillosis/complications/*drug therapy ; Candidiasis/complications/*drug therapy ; Coccidioidomycosis/complications/drug therapy ; Febrile Neutropenia/complications/drug therapy ; Female ; Hematologic Neoplasms/complications/drug therapy/*microbiology ; Humans ; Itraconazole/adverse effects/*therapeutic use ; Male ; Mannans/blood ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult