Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

PURPOSE: We conducted a phase II study in previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer to evaluate the response rate and toxicity of the combination chemotherapy regimen of etoposide, ifosfamide and cisplatin. MATERIALS AND METHODS: From September 1993 to December 1996, twenty patients with advanced non-small cell lung cancer (stage IIIB 5 and IV 15) (squamous cell 8, adeno- carcinoma 12), were enrolled in this study. There were 13 (65%) males and 7 (35%) females, and median age of patients were 56 years (range: 34~66). Eighteen patients had performance status (ECOG) 0~1, two patients had performance status 2. Treatment was consisted of cisplatin (20 mg/m2 i.v., day 1~4), VP-16 (etoposide) (75 mg/m2 i.v., day 1~4), ifosfamide (1000 mg/m2 i.v., day 1~4) with mesna. This treatment was repeated every four weeks. RESULTS: The overall response rate was 25%. Complete response rate was 5% (1/20) and partial response rate was 20% (4/20). The median cycle of response was 4 (2~6) cycles. The median overall survival time was 28 weeks (9~98 weeks). The median time to progression was 10 weeks (3~50 weeks). Toxicities were evaluated by WHO criteria. Toxicity > GradeIII included: leukopenia 1.6%, thrombocytopenia 3.2%, nausea and vomiting 15%, alopecia 30%, stomatitis 10%. These toxicities were tolerable and reversible. CONCLUSION: VIP regimen was not superior to previous regimens for advanced non-small all lung cancer, and the toxicities were tolerable.
Alopecia ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide ; Female ; Humans ; Ifosfamide* ; Leukopenia ; Lung Neoplasms ; Male ; Mesna ; Nausea ; Small Cell Lung Carcinoma* ; Stomatitis ; Thrombocytopenia ; Vomiting

Mucoepidermoid carcinoma occurs commonly in salivary gland, but rarely in lacrimal gland. In literature about ten or more cases of mucoepidermoid carcinoma of the lacrimal gland have been described. A 73-year-old woman had noted upper lid swelling and lacrimation of the left eye for 2 months. Computed tomographic scan demonstrated a large homogenous mass on superotemporal portion of the left orbit. The mass extended into the left temporal fossa, middle cranial fossa, and ethmoidal sinus with bone destruction. Histopathologically, the mass was proved to be a intermediate grade mucoepidermoid carcinoma of the lacrimal gland.
Aged ; Carcinoma, Mucoepidermoid* ; Cranial Fossa, Middle ; Female ; Humans ; Lacrimal Apparatus* ; Orbit ; Salivary Glands

BACKGROUND: Since hydroxyethyl starch has colloidal properties closely approximating those of human albumin, it is considered to be a good plasma volume expander. Pentastarch is a hydroxyethyl starch similar to hetastarch, but with lower average molecular weight and molar substitution ratio. These characteristics result in enhanced enzymatic hydrolysis, faster renal elimination and less effect on coagulation. This study was designed to evaluate the safety and clinical efficacy of 10% pentastarch in priming fluid for cardiopulmonary bypass compared with that of 5% albumin. METHODS: Thirty- two adult patients undergoing elective cardiac surgery were randomized into two groups. Sixteen patients received 500 ml of 10% pentastarch and sixteen patients received 100 ml of 20% albumin in a bloodless priming solution for cardiopulmonary bypass. The fluid balance, coagulopathy and organ functions(cardiac, pulmonary and renal) were evaluated at several time intervals. RESULTS: There were no differences between the two groups in operation and bypass time, chest tube drainage and blood usage. The measured prothrombin time, partial thromboplastin time and platelet count of pentastarch group were not significantly different from those of the albumin group at each time interval(p<0.05). We did not find any differences of statistical significance in hemodynamic data, serum osmolarity, pulmonary shunt and BUN between the two groups(p<0.05). CONCLUSIONS: Our study suggests that 10% pentastarch can be used safely and effectively as cardiopulmonary bypass prime in cardiac surgery.
Adult ; Cardiopulmonary Bypass* ; Chest Tubes ; Colloids ; Drainage ; Heart ; Hemodynamics ; Humans ; Hydrolysis ; Hydroxyethyl Starch Derivatives* ; Molar ; Molecular Weight ; Osmolar Concentration ; Partial Thromboplastin Time ; Plasma Volume ; Platelet Count ; Prothrombin Time ; Starch ; Thoracic Surgery ; Water-Electrolyte Balance

PURPOSE: This study was conducted to identify the clinical characteristics and risk factors on the occurrence of variant angina, and to examine the predicting factors on the vascular endothelial dysfunction of the patients with variant angina. METHODS: A total of 134 patients diagnosed with variant angina were recruited from 2006 to 2008. The degrees of endothelial dysfunction were measured and recorded by the researcher using the values of flow-mediated vasodilation of their brachial arteries and Nitroglycerine-mediated dilation. Subjects' demographic data and risk factors were gathered after obtaining informed consent, and their electronic medical records were reviewed to collect laboratory data. RESULTS: The mean age was 54.2 +/- 9.6 years and 52% was male patients. More than 50% of the male patients were cigarette smokers and had hypercholesterolemia. 84% of the male patients and 70% of the female patients had more than one risk factor of cardiovascular disease. A stepwise multiple regression analysis showed that smoking and hypercholesterolemia predicted the decrease of flow-mediated vasodilation (Adjusted R(2) = .204, p < .001). CONCLUSION: Tailored educational interventions for smoking cessation and cholesterol management are needed to prevent recurrence of angina attack for patients with variant angina and to prevent cardiovascular disease for middle-aged workers.
Angina Pectoris, Variant ; Brachial Artery ; Cardiovascular Diseases ; Cholesterol ; Electronic Health Records ; Female ; Humans ; Hypercholesterolemia ; Informed Consent ; Male ; Recurrence ; Risk Factors ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products ; Vasodilation

No abstract available.
Fistula* ; Perilymph*

BACKGROUND: Serologic testing is considered a standard method for syphilis diagnosis. We compared Auto RPR Plus and Auto TPIM Plus with previously developed assays. METHODS: The precision around the cut-off, linearity, and recovery rate of Auto RPR Plus and Auto TPIM Plus was evaluated using their positive/negative control materials. The results of these two tests were compared with those of Mediace RPR and Abbott Syphilis TP using 431 remnant serum samples collected from people who underwent medical examinations. RESULTS: The within-run precisions (coefficient of variation, CV values) of negative/positive control materials of Auto RPR Plus, Mediace RPR, Auto TPIM Plus and Abbott Syphilis TP were 15.7/2.3%, 20.4/2.3%, -/2.7%, and 8.5/2.3%, respectively; between-run precisions were 67.7/3.3%, 39.1/3.4%, -/4.0%, and 7.0/1.5%, respectively. Auto RPR Plus showed better precision around the cutoff level (1.0 U) compared to Mediace RPR (7.2–7.3% vs. 12.2–14.3%). The CVs of Auto TPIM Plus around the cutoff (10.0 U) were 13.5% at 10.5 U and 6.6% at 12.5 U. Agreement rates between Auto RPR Plus and Mediace RPR and between Auto TPIM Plus and Abbott Syphilis TP were 97.2% and 98.4%, respectively. However, twelve samples showed discrepant results for Auto RPR Plus (−)/Mediace RPR (+) and false-positive Mediace RPR results could not be excluded around the cutoff of 1.0 U. CONCLUSIONS: Auto RPR Plus showing good precision near the cutoff can be used for syphilis screening in health checkups. However, Auto TPIM Plus needs improvement in precision and adjusting the cutoff to be used for syphilis screening.
Diagnosis* ; Mass Screening ; Methods ; Serologic Tests ; Syphilis*

OBJECTIVES: The purpose of this study was to compare the microshear bond strength (uSBS) to enamel prepared with different burs and to determine what type of bur were chosen when a self-etching primer adhesive was used. MATERIALS AND METHODS: Enamel of forty-two human molars were used. They were divided into one of six groups (n = 7), Group 1, coarse (125 - 150 microm) diamond bur; Group 2, standard (106 - 125 microm) diamond bur; Group 3, fine (53 - 63 microm) diamond bur; Group 4, extrafine (20 - 30 microm) diamond bur; Group 5, plain-cut carbide bur (no. 245); Group 6, cross-cut carbide bur (no. 557). Clearfil SE Bond and Clearfil AP-X (Kuraray Medical Inc.) was bonded to enamel surface. The bonded specimens were subjected to uSBS testing. RESULTS: The uSBS of Group 4 was the highest among groups and it was significantly higher than that of Groups 1, 2, 3, and 6 (p < 0.05), but it was not significantly different from that of Group 5. CONCLUSIONS: Different burs used on enamel surface affected the microshear bond strengths of a self-etching primer adhesive to the enamel surface. In the case of Clearfil SE Bond, extrafine diamond and plain-cut carbide bur are recommended for bonding to enamel.
Adhesives ; Dental Enamel ; Diamond ; Humans ; Methacrylates ; Molar ; Resin Cements

A 17 year-old female patient with chief complaints of pneumaturia and fecaluria was found to have s vesicocolonic fistula. A transurethral attempt to catheterize the suspect tract, which was on the left posterior wall of the bladder, and radiography, following injection of dye through the catheter, proved that the fistu1ous tract was communicating with the sigmoid colon. Excision of the fistulous tract corrected successfully the pathology. Histopathologic findings were of chronic non-specific colitis.
Adolescent ; Catheters ; Colitis ; Colon, Sigmoid ; Female ; Fistula* ; Humans ; Pathology ; Radiography ; Urinary Bladder

PURPOSE: This study was aimed to investigate the frequency of different classes of partial edentulism and the most frequently used design components of conventional removable partial dentures. MATERIALS AND METHODS: 63 patients who were treated with removable partial denture in Kyungpook National University hospital for 2003 - 2006 were selected. A total of 76 removable partial denture frameworks were investigated. Kennedy classification was used to identify the class of partial edentulism. RESULTS: Results indicated that Kennedy class I removable partial dentures were the most frequently constructed. Most patients'cases were designed without modification areas. CONCLUSION: The most common type of direct retainer were the RPI clasp and RPA clasp in both maxilla and mandible. Lingual bar, linguoplate and anterior posterior palatal straps were the more frequently used mandibular and maxillary major connectors respectively. We did not have any case about Kennedy class IV patients.
Denture, Partial, Removable ; Humans ; Mandible ; Maxilla