BACKGROUND: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). METHODS: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O. RESULTS: In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit). CONCLUSIONS: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.
Cardiopulmonary Resuscitation* ; Manikins* ; Models, Theoretical ; Positive-Pressure Respiration ; Thorax ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

PURPOSE: The present study assessed the diagnostic significance of digital infrared thermal imaging (DITI) in determining the inflammatory state of patients with nonspecific orbital inflammation. METHODS: The present study included 11 patients diagnosed with nonspecific orbital inflammation between December 2009 and March 2011 and who were followed-up for more than 6 months. All patients were all diagnosed based on computed tomography (CT), magnetic resonance image (MRI) and tissue biopsy. The grade of eyelid swelling was classified as 5 and severe compared with the temperature of location. The temperature of the upper eyelid, caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid, cornea and lateral orbit were measured with DITI. RESULTS: When comparing the normal eye with the diseased eye in patients with nonspecific orbital inflammation, the temperature of the upper eyelid and cornea were statistically significant (p = 0.003, p = 0.038, respectively, Mann-Whitney test). The correlation between the grade of eyelid swelling and the temperature of location was most highly related in the temperature of the upper eyelid (Spearman's correlation coefficient, r = 0.55, p = 0.008) and cornea (Spearman's correlation coefficient, r = 0.45, p = 0.037). CONCLUSIONS: DITI may aid in evaluating the inflammatory state of nonspecific orbital inflammation. In particular, the temperature of the upper eyelid and cornea can be very useful indicator. Future studies, including larger study population are necessary in order to confirm DITI as a diagnostic tool which can assess the results of medical treatment by comparing temperature before and after treatment.
Biopsy ; Conjunctiva ; Cornea ; Eye ; Eyelids ; Humans ; Inflammation ; Magnetic Resonance Spectroscopy ; Orbit

PURPOSE: To review the radiological findings of retroanastomotic hernia and to derive the useful US and CT criteria to assist in the diagnosis of the condition in patients who had previously undergone gastrojejunostomy. METHODS: During a recent period, 8 consecutive cases of retroanastomotic hernia were encountered. Of the patients involved, seven underwent US and CT imaging. The US and CT scans were reviewed retrospectively to determine the abnormal findings. Surgical confirmation was available in all cases. RESULTS: The efferent loop was herniated through the defect created behind the anastomosis in seven cases, and the afferent loop in one case. Retroanastomotic hernia was suggested prospectively in all cases. Among the seven cases of efferent loop herniation, the US and CT signs of retroanastomotic hernia included whirling of the mesenteric vessels, jejunal loops, and mesentery in the periumbilical abdomen (7/7); mural thickening of the herniated bowel loops (5/7); dilatation of the herniated bowel loops (2/7); and US showed decreased peristalsis of the herniated bowel loops (2/6). In one case, the US and CT signs of retroanastomotic hernia of the afferent loop included dilatation and whirling of a short length of the afferent loop behind the anastomosis. One out of the eight patients had reVersible bowel ischemia, and one had bowel necrosis. CONCLUSION: Retroanastomoic hernia is an important condition, and the US and CT findings might be used for its diagnosis.
Abdomen ; Diagnosis ; Dilatation ; Gastric Bypass* ; Hernia* ; Humans ; Intestines ; Ischemia ; Mesentery ; Necrosis ; Peristalsis ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To evaluate correlations with refractive error, astigmatism and uncorrected visual acuity after Ortho-K LKTM lens wear. METHODS: Sixty-one eyes of 32 patients who had been wearing reverse geometry lenses for over 5 weeks were recruited. Uncorrected visual acuity, subjective refraction on retinoscopy, objective refraction measured by an autorefractometer, and corneal astigmatism were measured by corneal topography before, at 2 days, and 1, 3, and 5 weeks after lenses fitting. RESULTS: Uncorrected visual acuity improved from 0.12+/-0.10 to 0.95+/-0.15 after 5 weeks. Subjective refraction on retinoscopy and objective refraction measures with the autorefractometer were -3.52+/-1.65D and -4.06+/-1.73D, respectively before wearing the lenses. These decreased to -0.08+/-0.40D and -1.98+/-2.04D, respectively after 5 weeks. The astigmatism detected by corneal topography improved from 0.93+/-0.49 to 1.20+/-1.03 after 5 weeks. Uncorrected visual acuity was correlated with the refractive error measured by subjective refraction with retinoscopy rather than that by objective refraction with the autorefractometer. Corneal astigmatism measured by corneal topography correlated with the refraction detected by the autorefractometer. CONCLUSIONS: Subjective refraction by retinoscopy rather than refraction found objectively using the autorefractometer, was highly correlated with uncorrected visual acuity (r=0.77~0.87) which seems to be useful in evaluating myopia patients. The astigmatism determined by autorefractometer examination had high correlation with that determined by corneal topography (r=0.51~0.76). This result appears useful in decisions related to the decentering of lenses.
Astigmatism* ; Corneal Topography ; Humans ; Myopia ; Refractive Errors* ; Retinoscopy ; Visual Acuity*

BACKGROUND: Nipple reconstruction following breast mound reconstruction is the final step in breast reconstruction. Although nipple reconstruction is a simple surgery, the psychological aspects of nipple reconstruction are thought to be important. Nipple projection is a key factor in determining patient satisfaction with the surgery. In the present study, the Hammond flap technique was introduced for nipple reconstruction. METHODS: Twenty-six patients who had undergone breast reconstruction from February 2008 to March 2012 were enrolled in this prospective study. All patients were evaluated based on preoperative photos, and their nipple diameters and heights were measured. Postoperative evaluation was conducted 3, 6, 9, and 12 months following nipple reconstruction. A questionnaire on patient satisfaction with the nipple reconstruction was administered 12 months after nipple reconstruction. Moreover, the same plastic surgeon scored nipple projection and overall cosmetic result of the new nipple. RESULTS: The mean projection was 4.4 mm (range, 3-6 mm), and it well matched the contralateral nipple. Twelve months following nipple reconstruction, the mean reduction rate in the nipple projection was 43.6%. Patients were satisfied or very satisfied with the nipple projection and the overall cosmetic result in 80.7% cases. CONCLUSIONS: In the present study, compared with other techniques, the use of the Hammond flap technique in nipple reconstruction showed competitive results with regard to nipple projection and patient satisfaction.
Breast ; Female ; Humans ; Mammaplasty ; Nipples* ; Patient Satisfaction ; Prospective Studies ; Surveys and Questionnaires

BACKGROUND: Mesenteric infarction is a significant cause of death in elderly patients, and is being reported with increasing frequency. The diagnosis seldom is made prior to the onset of gangrene, despite an increased awareness of the lethality of mesenteric ischemia. The outcome for patients with mesenteric ischemia depends on the age of the patient, the extent and the severity of the ischemia and the effectiveness of the collateral blood supply. METHODS: We retrospectively reviewed the cases of 23 patient with mesenteric infarction who had been treated at the Department of Surgery, Hallym University, Chunchon Sacred Heart Hospital, between September 1988 and August 1977. RESULTS: The mean age was 52.3 years and the ratio of males to females was 1:1.6. The most frequent underlying diseases were hypertension, congestive heart failure, atrial fibrillation, and myocardial infarction. The radiologic study of a simple plain abdomen revealed a paralytic ileus in 87% of the cases; a partial vascular occlusion was shown under angiogram. The mean time lapse from onset of symptom to operation was 38.3 hours. Eight (34.8%) patients died when renal failure, ARDS or peritonitis developed. CONCLUSIONS: The cause of the persistently high mortality in patients with mesenteric in farction and to define a more effective form of management based on our results and recent clinical or laboratory findings. This study was concluded that early detection of the mesenteric infarction was reduced postoperative complications.
Abdomen ; Aged ; Atrial Fibrillation ; Cause of Death ; Diagnosis ; Female ; Gangrene ; Gangwon-do ; Heart ; Heart Failure ; Humans ; Hypertension ; Infarction* ; Intestinal Pseudo-Obstruction ; Ischemia ; Male ; Mortality ; Myocardial Infarction ; Peritonitis ; Postoperative Complications ; Renal Insufficiency ; Retrospective Studies

PURPOSE: To evaluate the clinical results of a case of subretinal neovascularization (SRN) in bilateral acquired parafoveal telangiectasis, performed combination therapy of intravitreal bevacizumab (1.25 mg/0.05ml) and photodynamic therapy (PDT). CASE SUMMARY: A 46-year-old female presented with a decrease invisual acuity. Her best-corrected visual acuity (BCVA) was 1.0 in the right eye and 0.1 in the left eye. On ophthalmic examination, she was diagnosed with bilateral acquired parafoveal telangiectasis combined with SRN in the left eye. Intravitreal bevacizumab was injected, and then photodynamic therapy was performed 4 days later. Three months after the combination therapy, her BCVA improved to 0.5, a regression of SRN was observed and vascular leakage was markedly decreased. However, her BCVA decreased to 0.1 and SRN recurred 9 months later. CONCLUSIONS: The combined treatment of intravitreal bevacizumab and photodynamic therapy may be used as a selective alternative treatment modality for SRN in bilateral acquired parafoveal telangiectasis, although its effect is short-term.
Antibodies, Monoclonal, Humanized ; Eye ; Female ; Humans ; Middle Aged ; Photochemotherapy ; Telangiectasis ; Visual Acuity ; Bevacizumab

STATEMENT OF PROBLEM: The aims of the study were to evaluate the effect of current surface conditioning methods on the bond strength of a resin composite luting cement bonded to ceramic surfaces and to identify the optimum cement type. MATERIAL AND METHODS: The sixty zirconia ceramic specimens(10 per group) with EVEREST milling machine and 60 tooth block were made. The zirconia ceramic surface was divided into two groups according to surface treatment: (1) airborne abrasion with 110micrometeraluminum oxide particles; (2) Rocatec system, tribochemical silica coating. The zirconia ceramic specimens were cemented to tooth block using resin cements. The tested resin cements were Rely X ARC, Panavia F and Superbond C and B. Each specimen was mounted in a jig of the universal testing machine for shear strength. The results were subjected to 2-way ANOVA and Post hoc tests was performed using Tukey, Scheffe, and Bonferroni test. RESULTS: The mean value of shear bond strength(MPa) were as follows: RelyXARC(+Al2O3),5.35+/-1.69; RelyXARC(+Rocatec),8.50+/-2.13; PanaviaF(+Al2O3),9.58+/-1.13; PanaviaF(+Rocatec),12.98+/-1.71; Superbond C and B(+Al2O3),8.27+/-2.04; Superbond C and B(+Rocatec),14.46+/-2.39. There was a significant increase in the shear bond strength when the ceramic surface was subjected to the tribochemical treatment(Rocatec 3M) in all cement groups(P<0.05). Bonding strengths of cements applied to samples treated with Al2O3 were compared; Rely X ARC showed the lowest values, whereas Panavia F cement showed higher value than that of Superbond C and B group with no statistical significance. When the bond strength of cements with Rocatec treatment was compared, Rely X ARC showed lowest values. Overall, it was apparent that tribochemical treated Super-Bond possessed higher mean bond strength.(14.46MPa; P<0.05) than that of Panavia F cement group with no significance. CONCLUSIONS: Silica coating followed silanization(Rocatec treatment) increase the bond strength between resin cement and zirconia ceramic. Panavia F containing phosphate monomer and Superbond C and B comprised of 4-META tend to bond chemically with zirconia ceramic, thus demonstrating higher bond strength compared to BisGMA resin cement. Superbond C and B has shown to have highest value of bonding strength to zirconia ceramic after Rocatec treatment compared to other cement.
Ceramics* ; Resin Cements* ; Shear Strength ; Silicon Dioxide ; Tooth

PURPOSE: The object of the present study was to evaluate the shear bonding strength of composite to PEKK by applying several methods of surface treatment associated with various bonding materials. MATERIALS AND METHODS: One hundred and fifty PEKK specimens were assigned randomly to fifteen groups (n = 10) with the combination of three different surface treatments (95% sulfuric acid etching, airborne abrasion with 50 µm alumina, and airborne abrasion with 110 µm silica-coating alumina) and five different bonding materials (Luxatemp Glaze & Bond, Visio.link, All-Bond Universal, Single Bond Universal, and Monobond Plus with Heliobond). After surface treatment, surface roughness and contact angles were examined. Topography modifications after surface treatment were assessed with scanning electron microscopy. Resin composite was mounted on each specimen and then subjected to shear bond strength (SBS) test. SBS data were analyzed statistically using two-way ANOVA, and post-hoc Tukey's test (P<.05). RESULTS: Regardless of bonding materials, mechanical surface treatment groups yielded significantly higher shear bonding strength values than chemical surface treatment groups. Unlike other adhesives, MDP and silane containing self-etching universal adhesive (Single Bond Universal) showed an effective shear bonding strength regardless of surface treatment method. CONCLUSION: Mechanical surface treatment behaves better in terms of PEKK bonding. In addition, self-etching universal adhesive (Single Bond Universal) can be an alternative bonding material to PEKK irrespective of surface treatment method.
Adhesives ; Aluminum Oxide ; Dental Bonding ; Methods ; Microscopy, Electron, Scanning ; Polymers* ; Sulfur

PURPOSE: The aim of this study was to evaluate tolerance to adjuvant chemotherapy, and to compare survival between treatments using only surgery and using surgery with adjuvant chemotherapy, in elderly patients with advanced gastric cancer who were ≥75 years of age. MATERIALS AND METHODS: Patients ≥75 years of age who were diagnosed with pathological stage II or III gastric cancer were identified retrospectively and categorized into the surgery only and surgery with adjuvant chemotherapy groups. Clinicopathological and survival data were compared between these two groups. RESULTS: Among the 130 patients studied, 67 patients underwent curative surgery only, and 63 patients received adjuvant chemotherapy after curative surgery. In the latter group, adverse events were reported in 24 patients (38.1%). The treatments were discontinued in 19 patients (30.2%) owing to any reason. The overall 5-year survival rates of the surgery only and the surgery with adjuvant chemotherapy groups did not differ significantly (44.1% vs. 30.7%, respectively; P=0.804). Among 90 death events, deaths from recurrences of gastric cancer occurred in 42 patients. Multivariate analyses revealed that the American Society of Anesthesiologists score and the depths of tumor invasions were related to survival, and the addition of adjuvant chemotherapy after surgery did not influence survival. CONCLUSIONS: The decision for the addition of adjuvant chemotherapy for elderly patients should be taken after considering the condition of individual patients and their life expectancies.
Aged* ; Chemotherapy, Adjuvant* ; Drug Therapy ; Gastrectomy ; Humans ; Life Expectancy ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate