This study was conducted to investigate the effect of an energy restriction program on the weight loss and changes of the biochemical nutritional status for 35 obese women. The energy restriction program took place over a 3-week period that was devided into two parts. The first part consisted of 750-800kcal diet and the second part of 800-1000kcal. Subjects were provided a low energy formula and a menu for the recommended diet. Anthropometric and biochemical measurement before and after the energy restriction program were estimated. Mean weight loss was 3.0kg, accordingly the obestiy rate was lowered from 40.2 to 34.4, BMI from 29.2 to 28.9 and fat weight from 23.3kg to 21.0kg( <0.01. <0.05). Waist circumference loss was most prominent(4.4%) compared to triceps(21% loss)and hip circumference(2.2%loss). Mean RBC count, hemoglobin and hematocrit were significantly lowered( <0.01) but they were in the normal range. Systolic blood pressure was significantly decreased from 124.1mmHg to 113.1mmHg . Mean SGOT and SGPT were lowered from 29.3u/L to 20.0u/L and from 28.7u/L to 16.6u/L, respectively. It seems that the 3 weeks of energy restriction program used in this study was effective in improving anthropometric measurements without producing deficiency of iron or other susceptible nutrients.(Korean J community Nutrition 2(5) : 695-700,1997)
Objective : C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count are inflammatory markers used to evaluate postoperative infections. Although these markers are non-specific, understanding their normal kinetics after surgery may be helpful in the early detection of postoperative infections. To compliment the recent trend of reducing the duration of antibiotic use, this retrospective study investigated the inflammatory markers of patients who had received antibiotics within 24 hours after surgery according to the Health Insurance Review & Assessment Service guidelines and compared them with those of patients who had received antibiotics for 5 days, which was proven to be non-infectious. Methods : We enrolled 74 patients, divided into two groups. Patients underwent posterior lumbar interbody fusion (PLIF) at a single institution between 2019 and 2020. Group A included 37 patients who received antibiotics within 24 hours after the PLIF procedure, and group B comprised 37 patients who had used antibiotics for 5 days. A 1 : 1 nearest-neighbor propensity-matched analysis was used. The clinical variables included age, sex, medical history, body mass index, estimated blood loss, and operation time. Laboratory data included CRP, ESR, and WBC, which were measured preoperatively and on postoperative days (POD) 1, 3, 5, and 7. Results : CRP dynamics tended to decrease after peaking on POD 3, with a similar trend in both groups. The average CRP level in group B was slightly higher than that in group A; however, the difference was not statistically significant. Multiple linear regression analysis revealed operation time, number of fused levels, and estimated blood loss as significant predictors of a greater CRP peak value (r2=0.473, p<0.001) in patients. No trend (a tendency to decrease from the peak value) could be determined for ESR and WBC count on POD 7. Conclusion : Although slight differences were observed in numerical values and kinetics, sequential changes in inflammatory markers according to the duration of antibiotic administration showed similar patterns. Knowledge of CRP kinetics allows the assessment of the degree of difference between the clinical and expected values.
This study was performed to investigate correlation between total body weight loss and local sweat rate and to find out any possible method that can estimate total body weight loss judging from local sweat rate. Twelve adult females were kept at 44 $\pm1^{\circ}C$, 50 ${\pm}5\%$ R.H. (1) Physiological responses such as total body weight loss, local sweat rate, rectal temperature, skin temperature, blood pressure and pulse, (2) micro climate inside garment and (3) subjective sensation were examined. Two types of garment such as long-sleeves with long pants (Type I) and half·sleeves with short pants (Type II) were used to observe the effect of garment types on sweating response. Both clothing weight was equal (132$\pm$3 g/$m^{2}$). The results were as follows: 1. Regardless of the different types, total body weight loss was more interrelated with the sweat rate on forehead than any other parts of the body. Except the forehead, different parts of body with different types of garment influenced on body weight loss quite differently. 2. Total body weight loss was more interrelated with the weight gain of garment than the local sweat rate. 3. Under the environment of 44$\pm1^{\circ}C,\;50{\pm}5\%$R.H., body weight loss during 1 hour of subject clothed and silted was 275.2 g/hr and weight loss per body surface area was 178.9 g/$m^{2}/hr$ Garment types have no influences on total body weight loss. 4. Local sweat rate (mg/7.07 $cm^{2}/hr$) was 208.0,191.0, 133.0, 115.0,81 0, 75.1 and 66.3 on scruff, breast, forehead, forearm, thigh, upper arm, leg respectively No evidence has been found that garment types influenced on local sweat rate (p<0.1). 5. No interrelationships between rectal temperature and total body weight loss, local skin temperature and total body weight loss, and local skin temperature and local sweat rate were found. From this study, some possible method that we can estimate total body' weight loss judging from weight loss of garment. But considering the fact that clothing design factor, the physical characteristics of fabric and environmental factor such as humidity and wind velocity should be concerned in weight loss of garment, it should be studied further whether the total body weight loss can be estimated properly from the weight loss of garment. This experiment suggest that different parts of body with different types of garment can influence on body weight loss quite differently. Therefore, in order to get more precise results, more studies under the diversity of garment types should be done in the near future.
Leukemia is a blood disease that occurs in the abnormal process of leukocyte maturation. Its main medical treatment is chemical therapy and bone medical transplant. But its treatments give rise to ill effects and sequela. At present, the cause of leukemia is not fully understood. But oriental concept of curing leukemia is the holistic thinking that emphasizes the unity, wholeness, and the relationship between the human organs, including western medical concept of blood cause. So it is estimated that holistic medical treatment in oriental medicine could present new medical way of curing leukemia. I read over the diary on struggles against leukemia, survey on the leukemia patients, and, medical charts in the oriental clinics that treated in the holistic way, and I interviewed the leukemia patients. With these materials, I classified the early main attacking symptoms according to the chief complaints of one hundred leukemia patients. With these results collected, I present new alternative treatment by oriental medical diagnosis. The chief early complaints that leukemia patients give are fatigue, enervation, cold, contusion, fever, high fever, sweating at sleep, myalgia, arthralgia, and dizziness, in order of main symptoms. Fatigue occurs mainly by spleen and stomach weakness and marrow shortage. So it is estimated that It is important to treat the spleen that is responsible for supplementing the marrow. Because the leukemia patients have anemia and hemorrhage, to treat the spleen is important for hematopoiesis and controlling blood. In case of cold, it penetrates into the body when the body is weak. So its treatment is to increase body's health. But the cause of fever is difficult to classify into outer cause and inner cause. But in case of children under 14 years old, fever is the main sypmptom. I think this is because children have the body with pure vital energy. Hemorrhage is thought to be the result of yin-lack and heat-miasma of spleen and stomach channels. Contusion occurs from the qi-weakness and the not-controlling-blood. Sweating at sleep is from the yin-weakness. It is found with all weak symptoms. Dizziness is from the yin-blood impairment. Weight-loss is from the marrow shortage. Myalgia and arthralgia is mainly from inner weakness, not outer maisma. Most leukemia patients have the idea that holistic treatment of leukemia could be of assistance and give help to the low immunity. So it is expected that holistic medical treatment could contribute to knowing the cause and treatment of leukemia, and give people reliability on oriental medical treatment, through the profound diagnosis of leukemia.
Lim, Jaekwan;Won, Jong Yun;Ahn, Chi Bum;Kim, Jieon;Kim, Hee Jung;Jung, Jae Seung
Journal of Chest Surgery
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제54권2호
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pp.81-87
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2021
Background: Artificial grafts such as polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) are used for various cardiovascular surgical procedures. The compliance properties of prosthetic grafts could affect hemodynamic energy, which can be measured using the energy-equivalent pressure (EEP) and surplus hemodynamic energy (SHE). We investigated changes in the hemodynamic energy of prosthetic grafts. Methods: In a simulation test, the changes in EEP for these grafts were estimated using COMSOL MULTIPHYSICS. The Young modulus, Poisson ratio, and density were used to analyze the grafts' material properties, and pre- and post-graft EEP values were obtained by computing the product of the pressure and velocity. In an in vivo study, Dacron and ePTFE grafts were anastomosed in an end-to-side fashion on the descending thoracic aorta of swine. The pulsatile pump flow was fixed at 2 L/min. Real-time flow and pressure were measured at the distal part of each graft, while clamping the other graft and the descending thoracic aorta. EEP and SHE were calculated and compared. Results: In the simulation test, the mean arterial pressure decreased by 39% for all simulations. EEP decreased by 42% for both grafts, and by around 55% for the native blood vessels after grafting. The in vivo test showed no significant difference between both grafts in terms of EEP and SHE. Conclusion: The post-graft hemodynamic energy was not different between the Dacron and ePTFE grafts. Artificial grafts are less compliant than native blood vessels; however, they can deliver pulsatile blood flow and hemodynamic energy without any significant energy loss.
Purpose: The advantages of totally laparoscopic surgery in early gastric cancer (EGC) are unproven, and some concerns remain regarding the oncologic safety and technical difficulty. This study aimed to evaluate the technical feasibility and clinical benefits of totally laparoscopic distal gastrectomy (TLDG) for the treatment of gastric cancer compared with laparoscopy-assisted distal gastrectomy (LADG). Materials and Methods: A retrospective review of 211 patients who underwent either TLDG (n=134; 63.5%) or LADG (n=77; 36.5%) for EGC between April 2005 and October 2013 was performed. Clinicopathologic features and surgical outcomes were analyzed and compared between the groups. Results: The operative time in the TLDG group was significantly shorter than that in the LADG group (193 [range, 160~230] vs. 215 minutes [range, 170~255]) (P=0.021). The amount of blood loss during TLDG was estimated at 200 ml (range, 100~350 ml), which was significantly less than that during LADG, which was estimated at 400 ml (range, 400~700 ml) (P<0.001). The hospital stay in the TLDG group was shorter than that in the LADG group (7 vs. 8 days, P<0.001). One patient from each group underwent laparotomic conversion. Two patients in the TLDG group required reoperation: one for hemostasis after intraabdominal bleeding and 1 for repair of wound dehiscence at the umbilical port site. Conclusions: TLDG for distal EGC is a technically feasible and safe procedure when performed by a surgeon with sufficient experience in laparoscopic gastrectomy and might provide the benefits of reduced operating time and intraoperative blood lossand shorter convalescence compared with LADG.
Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.
Background: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). In this study, the efficacy and side effects of PCEA and PCIA after LARP were compared. Methods: Forty patients undergoing LARP were randomly divided into two groups: 1) a PCEA group, treated with 0.2% ropivacaine 3 ml and 0.1 mg morphine in the bolus; and 2) a PCIA group, treated with oxycodone 1 mg and nefopam 1 mg in the bolus. After the operation, a blinded observer assessed estimated blood loss (EBL), added a dose of rocuronium, performed transfusion, and added analgesics. The numeric rating scale (NRS), infused PCA dose, and side effects were assessed at 1, 6, 24, and 48 h. Results: EBL, added rocuronium, and added analgesics in the PCEA group were less than those in the PCIA group. There were no significant differences in side-effects after the operation between the two groups. Patients were more satisfied with PCEA than with PCIA. The NRS and accumulated PCA count were lower in PCEA group. Conclusions: Combined thoracic epidural anesthesia could induce less blood loss during operations. PCEA showed better postoperative analgesia and greater patient satisfaction than PCIA. Thus, PCEA may be a more useful analgesic method than PICA after LARP.
This study was performed to determine the subacute toxicities of SKI306X, an antiinflammatory herbal extract, in rats. SKI306X was administered orally to rats once a day for 4 weeks at doses of 0.3, 1.0, and 3.0 g/kg/ day. Each group consisted of 20 male and 20 female rats, including 5 male and 5 female rats per group for an interim study at the end of 2-week administration and for a 2-week recovery study, respectively. Throughout the study, all rats survived and no adverse clinical signs were observed. Although male rats treated with high dose (3.0 g/kg/day) of SKI306X showed slight loss of body weight (approximately 5%) in comparison with control animals during the administration period, their body weight loss was normally restored during the recovery period. No significant change was found in all hematological parameters of SKI306X-treated groups except for the decreased number of red blood cells in all female groups at the interim study. Statistically significant changes were observed in several blood enzyme levels of SKI306X-treated groups; however, most of these significant changes were within normal range and statistically significant values did not show dose-related responses. In SKI306X-treated groups, the absolute and relative weights of liver, heart, and stomach were statistically different from those of control group, but these differences disappeared at the end of recovery period and also drug-related gross and histopathological findings in these organs were not found. No other drug-related gross and histopathological findings were observed. It is concluded from the results of this study that non-toxic dose of SKI306X was estimated to be between 0.3 and 1.0 g/kg/day and the maximum tolerated dose of SKI306X was assumed to be higher than 3.0 g/kg/day.
Purpose: To compare perioperative outcomes and oncologic outcomes in endometrial cancer patients treated with laparotomy, and laparoscopic or robotic surgery. Materials and Methods: Endometrial cancer patients who underwent primary surgery from January 2011 to December 2014 were retrospectively reviewed. Perioperative outcomes, including estimated blood loss (EBL), operation time, number of lymph nodes retrieved, and intra and postoperative complications, were reviewed. Recovery time, disease free survival (DFS) and overall survival (OS) were compared. Results: Of the total of 218 patients, 143 underwent laparotomy, 47 laparoscopy, and 28 robotic surgery. The laparotomy group had the highest EBL (300, 200, 200 ml, p<0.05) while the robotic group had the longest operative time (302 min) as compared with laparoscopy (180 min) and laparotomy (125 min) (p<0.05). Intra and postoperative complications were not different with any of the surgical approaches. No significant difference in number of lymph nodes retrieved was identified. The longest hospital stay was reported in the laparotomy group (four days) but there was no difference between the laparoscopy (three days) and robotic (three days) groups. Recovery was significantly faster in robotic group than laparotomy group (14 and 28 days, p =0.003). No significant difference in DFS and OS at 21 months of median follow up time was observed among the three groups. Conclusions: Minimally invasive surgery has more favorable outcomes, including lower blood loss, shorter hospital stay, and faster recovery time than laparotomy. It also has equivalent perioperative complications and short term oncologic outcomes. MIS is feasible as an alternative option to surgery of endometrial cancer.
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