PURPOSE: The 2005 resuscitation guidelines stipulate the need for monitoring CPR (cardiopulmonary resuscitation) quality. Recently, several clinical investigations have shown that a real time monitoring and feedback system is effective for improving the quality of chest compressions during resuscitation. However little data exists regarding the accuracy of the monitoring system using an accelerometer sensor and a pressure sensor for the measuring of compression rate and depth. Our goal for this study was to investigate how well chest compression rate and depth can be estimated using the monitoring system. METHODS: Thirty seconds of continuous chest compressions were delivered on a standard skillmeter manikin lying on the floor with the monitoring system. The chest compressions were delivered with variations in compression rate (67~142 /min) and with variations in compression depth (22~61 mm). A total of 120 sets of compressions were delivered for validation of rate and depth. RESULTS: The correlation coefficient for compression rate between the monitoring system and the standard method was 0.999 (p<0.001), and Bland-Altman analysis showed a mean bias of -0.10+/-0.77/min, with limits of agreement ranging from -1.60 to 1.40 /min. The correlation coefficient for compression depth between two methods was 0.983 (p<0.001), and Bland-Altman analysis showed a mean bias of 4.2+/-2.0 mm, with limits of agreement ranging from 0.24 to 8.10 mm. CONCLUSION: Compared with a skillmeter manikin, a monitoring system for the quality of CPR estimates chest compression rate precisely, but overestimates chest compression depth by an average of 10.3%.
Bias (Epidemiology) ; Cardiopulmonary Resuscitation ; Deception ; Delivery of Health Care ; Floors and Floorcoverings ; Manikins ; Monitoring, Physiologic ; Resuscitation ; Thorax

Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, seven years after an uterine myomectomy. A 6.9x5.8 cm-sized intrapelvic mass suspected of uterine origin was discovered while searching for potential extrathoracic primary origin. A pelviscopy and simultaneous thoracoscopic lung biopsy were conducted for pathologic diagnosis. Finally, the diagnosis was confirmed as low-grade ESS with lung metastasis based on the histopathologic examination with immunohistochemical stain, which was showed positive for CD10 and hormone receptor markers (estrogen and progesterone receptors) in both pelvic and lung specimens.
Adult ; Biopsy ; Diagnosis ; Diagnostic Errors ; Female ; Humans ; Leiomyoma ; Lung* ; Mesoderm ; Multiple Pulmonary Nodules* ; Neoplasm Metastasis ; Progesterone ; Sarcoma, Endometrial Stromal* ; Uterine Myomectomy ; Uterine Neoplasms

OBJECTIVE: To evaluate maintained effectiveness and tolerability when treated with long-acting risperidone compared to the previous antipsychotics in patients with schizophrenia or other psychotic disorders and to compare maintained effectiveness between oral risperidone and non-risperidone subgroups. METHODS: Subjects aged at least 18 years who required long-term antipsychotic therapy and who have been symptomatically stable on a stable dose of antipsychotics during the last month were enrolled in the non-randomized, single-arm, multi-center, 12 weeks duration study. Antipsychotic medications were switched from oral antipsychotics to long-acting risperidone. Injections were administered every 2 weeks. Most patients were started on 25mg long-acting risperidone injection or 37.5mg in some patients. The dosage were adjusted according to the patients' symptoms and responses to treatment at the discretion of investigators. Oral antipsychotics were continued at the same dose as before for 2 weeks and then were stopped or tapered off within next 7days. RESULTS: A total of 204 patients with schizophernia (N=192) and other psychotic disorder (N=12) from 20 sites in Korea were enrolled. The drop-out rate was 22.5% at 12 weeks. LOCF analysis has been performed. At 12 weeks after switching from oral antipsychotics to long-acting risperidone, statistically significant improvement was observed from baseline across all symptom domains including PANSS total, positive, negative, general subscale, CGI-S (Clinical Global Impression-Severity) scores and GAF (Global Assessment of Functioning) scores. The proportion of responders was 36.8% where response was defined as > or =20% reduction from baseline PANSS total score. The proportion of symptom worsening at 12 weeks was 7.4% (N=15) where symptom worsening was defined as > or =20% increase from baseline in PANSS total score or drop-out due to insufficient response or any 2 points change on any of 4 PANSS psychotic items (delusion, conceptual disorganization, hallucinatory behavior, suspiciousness/persecution) excluding changes in which the ratings remained at nonpsychotic levels (i.e >3). Significant improvement from baseline was also observed in the measure of parkinsonism assessed using Extrapyramidal Symptom Rating Scale (ESRS). In addition, overall, patients were satisfied with long-acting risperidone injection on a single item measure of satisfaction. When subgroup analysis was performed on the basis of previous antipsychotics before switching to long-acting risperidone, no statistically significant differences were detected between oral risperidone (N=139) and non-risperidone subgroup (N=65) on all measures of effectiveness and tolerability including baseline demographic and clinical characteristics, symptom improvements, proportion of symptom improvement or worsening and ESRS score changes. CONCLUSION: Our study results demonstrated maintained effectiveness and tolerability of long-acting risperidone microsphere and also could confirm successful switching from not only oral risperidone but also non-risperidone to long-acting risperidone injection.
Antipsychotic Agents* ; Humans ; Korea ; Microspheres ; Parkinsonian Disorders ; Psychotic Disorders ; Research Personnel ; Risperidone* ; Schizophrenia