• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.115-124
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• 2024

To compare the outcomes of low central venous pressure (CVP) to standard CVP during laparoscopic liver resection. The study design was a systematic review following the PRISMA statement standards. The available literature was searched to identify all studies comparing low CVP with standard CVP in patients undergoing laparoscopic liver resection. The outcomes included intraoperative blood loss (primary outcome), need for blood transfusion, mean arterial pressure, operative time, Pringle time, and total complications. Random-effects modelling was applied for analyses. Type I and type II errors were assessed by trial sequential analysis (TSA). A total of 8 studies including 682 patients were included (low CVP group, 342; standard CVP group, 340). Low CVP reduced intraoperative blood loss during laparoscopic liver resection (mean difference [MD], -193.49 mL; 95% confidence interval [CI], -339.86 to -47.12; p = 0.01). However, low CVP did not have any effect on blood transfusion requirement (odds ratio [OR], 0.54; 95% CI, 0.28-1.03; p = 0.06), mean arterial pressure (MD, -1.55 mm Hg; 95% CI, -3.85-0.75; p = 0.19), Pringle time (MD, -0.99 minutes; 95% CI, -5.82-3.84; p = 0.69), operative time (MD, -16.38 minutes; 95% CI, -36.68-3.39; p = 0.11), or total complications (OR, 1.92; 95% CI, 0.97-3.80; p = 0.06). TSA suggested that the meta-analysis for the primary outcome was not subject to type I or II errors. Low CVP may reduce intraoperative blood loss during laparoscopic liver resection (moderate certainty); however, this may not translate into shorter operative time, shorter Pringle time, or less need for blood transfusion. Randomized controlled trials with larger sample sizes will provide more robust evidence.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• Korean Journal of Heritage: History & Science
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• v.53 no.2
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• pp.204-221
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• 2020

East Asian countries share a culture of perfuming clothes. The prosperity of the Maritime Silk Road and the incense trade are direct factors that have led to the development of incense culture. Perfuming clothes is a method of applying fragrance by burning incense. The Chinese could make an incense mixture with various types of incense, and records demonstrating use of perfuming clothes tools (熏籠) show that they might have perfumed clothes with incense mixtures. During the Tang dynasty, the incense trade thrived. Examples of ancient literature such as 『千金要方』, 『香譜』, 『香乘』 describe how to make incense for perfuming clothes and how to perfume clothes. 『桂海虞衡志』 and 『諸蕃志』 shows trade partners and goods. Incense was introduced to Korea alongside Buddhist culture. 『買新羅物解』 shows Silla traded incense with Japan. One of the trade goods recorded in 『買新羅物解』 is perfuming cloth incense (熏衣香), which establishes that Silla performed perfuming clothes at that time. During the Goryeo dynasty, Goryeo exported musk as well as ginseng. The royal family burned incense from the Song royal family. Noblewomen preferred sachets. The use of this dress continued into the Joseon dynasty. 『買新羅物解』 showed that Japan imported incense from Silla. 『The tale of Genji』 illustrates Heian nobles' incense culture, perfuming clothes culture, and trade of incense. Perfuming clothes tools became essential articles for marriage purposes and it developed in a practical shape. The Champa had a perfuming clothes culture. It is described on 『諸蕃志』. As Agilawood is found in Tongking, and Tongking was neighbor to the Champa and China, they might have had a perfuming clothes culture as well. Korea, China, Japan, and Vietnam shared a perfuming clothes culture. We can identify universality and commonality in the purpose of perfuming clothes, time of development, the method of making the incense mixture for perfuming clothes, the method of perfuming clothes, the tools, the gender of perfumer, and the type of herbs and spices.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7653-7664
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• 2014

Background: Colorectal ranked first among cancers reported in males and ranked second amongst females in Jordan, accounting for 12.7% and 10.5% of cancers in males and females, respectively. Colorectal cancer patients can suffer several consequences after treatment that include pain and fatigue, constipation, stoma complications, sexual problems, appearance and body-image concerns as well as psychological dysfunction. There is no published quantitative data on the health-related quality of life and psychological wellbeing of Jordanian colorectal cancer survivors. Method: This project was a cross-sectional study of colorectal cancer survivors diagnosed in 2009 and 2010. Assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the colorectal cancer specific module (EORTC QLQ-CR 29) and the Hospital Anxiety and Depression Scale (HADS). Data on potential predictors of scores were also collected. Results: A total of 241 subjects completed the study with mean age of $56.7{\pm}13.6$. Males represented 52.3% of study participants. A majority of participants reported good to high overall health; the mean Global health score was $79.74{\pm}23.31$ with only 6.64% of study participants scoring less than 33.3%. The striking result in this study was that none of the study participants participated in a psychosocial support group; only 4 of them (1.7%) were even offered such support. The mean scores for HADS, depression score, and anxiety score were $8.25{\pm}9$, $4.35{\pm}4.9$ and $3.9{\pm}4.6$, respectively. However, 77.1% of study participants were within the normal category for the depression score and 81.7% were within this category for anxiety score; 5.4% of participants had severe anxiety and 5.4% of them had severe depression. Discussion: Patients with colorectal cancer in Jordan have a good quality of life and psychological wellbeing scores when compared with patients from western countries. None of the colorectal cancer patients managed at the Ministry of Health received any formal counselling, or participated in psychological or social support programmes. This highlights the urgent need for a psychosocial support programme, psychological screening and consultations for patients diagnosed with colorectal cancer at the Ministry of Health Hospitals.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3435-3442
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• 2015

Objective : To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods: A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results: Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion: Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5927-5936
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• 2014

Introduction: Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores. Methods: In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected. Results: The number of patients interviewed was 236 (mean age=$50.7{\pm}10.7$ years). The mean Global Health score for the QLQ-C30 was $63.7{\pm}20.2$ SD. Among functional scales, "social functioning" scored the highest ($mean=78.1{\pm}28.6$ SD), whereas "emotional functioning" scored the lowest ($mean=59.0{\pm}SD\;33.5$). For the QLQ-BR23, the worst scores within the functional scales were for "body image" ($mean=52.1{\pm}36.8$ SD) and "future perspective" ($mean=52.9{\pm}38.5$ SD). The worst symptom was "upset by hair loss" ($mean=69.8{\pm}43.0$). The mean HADS scores was $18.{\pm}9.0$ SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status. Conclusions and Recommendations: Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.

• Journal of Gastric Cancer
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• v.17 no.2
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• pp.132-144
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• 2017

Purpose: To identify baseline prognostic factors for survival in patients with disease progression, during or after chemotherapy for the treatment of advanced gastric or gastroesophageal junction (GEJ) cancer. Materials and Methods: We pooled data from patients randomized between 2009 and 2012 in 2 phase III, global double-blind studies of ramucirumab for the treatment of advanced gastric or GEJ adenocarcinoma following disease progression on first-line platinum- and/or fluoropyrimidine-containing therapy (REGARD and RAINBOW). Forty-one key baseline clinical and laboratory factors common in both studies were examined. Model building started with covariate screening using univariate Cox models (significance level=0.05). A stepwise multivariable Cox model identified the final prognostic factors (entry+exit significance level=0.01). Cox models were stratified by treatment and geographic region. The process was repeated to identify baseline prognostic quality of life (QoL) parameters. Results: Of 1,020 randomized patients, 953 (93%) patients without any missing covariates were included in the analysis. We identified 12 independent prognostic factors of poor survival: 1) peritoneal metastases; 2) Eastern Cooperative Oncology Group (ECOG) performance score 1; 3) the presence of a primary tumor; 4) time to progression since prior therapy <6 months; 5) poor/unknown tumor differentiation; abnormally low blood levels of 6) albumin, 7) sodium, and/or 8) lymphocytes; and abnormally high blood levels of 9) neutrophils, 10) aspartate aminotransferase (AST), 11) alkaline phosphatase (ALP), and/or 12) lactate dehydrogenase (LDH). Factors were used to devise a 4-tier prognostic index (median overall survival [OS] by risk [months]: high=3.4, moderate=6.4, medium=9.9, and low=14.5; Harrell's C-index=0.66; 95% confidence interval [CI], 0.64-0.68). Addition of QoL to the model identified patient-reported appetite loss as an independent prognostic factor. Conclusions: The identified prognostic factors and the reported prognostic index may help clinical decision-making, patient stratification, and planning of future clinical studies.

• Journal of Ginseng Culture
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• v.1
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• pp.28-42
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• 2019

What is unknown about Leibniz (Gottfried Wilhelm Leibniz, 1646~1716), a great philosopher and mathematician, is that he inquired about ginseng. Why Leibniz, one of the leading figures of the Enlightenment, became interested in ginseng? This paper excavates Leibniz's references on ginseng in his vast amount of correspondences and traces the path of his personal life and cultural context where the question about ginseng arose. From the sixteenth century, Europe saw a notable growth of medical botany, due to the rediscovery of such Greek-texts as Materia Medica and the introduction of a variety of new plants from the New World. In the same context, ginseng, the renowned panacea of the Old World began to appear in a number of European travelogues. As an important part of mercantilistic projects, major scientific academies in Europe embarked on the researches of valuable foreign plants including ginseng. Leibniz visited such scientific academies as the Royal Society in London and $Acad{\acute{e}}mie$ royale des sciences in Paris, and envisioned to establish such scientific society in Germany. When Leibniz visited Rome, he began to form a close relationship with Jesuit missionaries. That opportunity amplified his intellectual curiosity about China and China's famous medicine, ginseng. He inquired about the properties of ginseng to Grimaldi and Bouvet who were the main figures in Jesuit China mission. This article demonstrates ginseng, the unnoticed subject in the Enlightenment, could be an important clue that interweaves the academic landscape, the interactions among the intellectuals, and the mercantilistic expansion of Europe in the late 17th century.

• Journal of the Korean Institute of Landscape Architecture
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• v.45 no.5
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• pp.60-70
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• 2017

This study traces the development of physic gardens in Korea and explores their significance in the history of landscape architecture. For this purpose, records related to physic gardens from medical sources from the period of the Three States to the Joseon dynasty, when herbal medicine was systematized as a field, were searched. Physic gardens had been developed by the time of the late Goryeo and early Joseon dynasties, in the 13th and the 15th centuries. Yakpo(kitchen gardens for medicinal herbs) were cultivated by a group of new high-level officials in the late Goryeo dynasty, when an increasing interest in hyangyak(native herbs) emerged under the influence of the Neo-Confucian perspective on nature, which emphasized locality. The sources analyzed in this study confirm that physic gardens called jong-yakjeon(royal medicinal herb gardens) were in operation in the early Joseon dynasty when policies to investigate, discover, cultivate, and research native herbs were put into place. It is likely that the jong-yakjeon were established at the beginning of the Joseon dynasty as subsidiary facilities under its central medical institutions, the Naeuiwon and Hyeminseo, and then declined in the late Joseon dynasty. Jong-yakjeon can be confirmed to have existed in the mid-15th century. Physic gardens were located in several places outside the Fortress Wall of Hanyang, such as Yakhyeon, Yuldo, Yeoudo, and Saari. The total area encompassed by physic gardens was about 160,000 square meters in the early 18th century. In jong-yakjeon, dozens of medicinal herbs were cultivated, including Schizonepeta tenuifolia var. japonica, Rehmannia glutinosa, and Glycyrrhiza uralensis Fischer, and these gardens were operated by physicians dispatched from the Naeuiwon and dozens of provincial slaves. In conclusion, the jong-yakjeon were similar to the physic gardens of Renaissance medical universities in that they reflected the interest in and development of theories about new herbs, and were similar to the physic gardens of medieval castles and monasteries in terms of species types, location, and function. This paper has limitations in that it does not present the specific spatial forms of the yakpo or the jong-yakjeon. Nevertheless, this paper is significant for the field of garden history because it shows that physic gardens in Korea appeared in the late Goryeo and early Joseon dynasties concomitantly with the development of medicine towards native herbs and functioned as utilitarian gardens to cultivate community remedies.

• Journal of the Korean Society of Food Culture
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• v.11 no.4
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• pp.487-495
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• 1996

The consumer perception on health and food habit, the experience of health food use and the discrimination between health food and drug of Korean consumer were surveyed by using a questionnaire containing 20 items in order to obtain the basic data for the assessment of the benefit and risk of health foods in Korea. A total of 1,000 people over 20 years of age living in Seoul and the vicinities were interviewed and asked to fill out the questionnaire during the period from the October 1995 to the February 1996. Among the 882 answers collected 23 was incomplete data, and 859 answers were used for the statistical analysis by using SAS program. The survey revealed a strong interest of the consumer on health food by showing that more than a half of the subjects (58.8%) had the experience of actual use of health food, and 68.2% believed the effectiveness. What the consumer expect most from health food was to have beneficial effect to maintain overall health condition (59.8%), and the most negative aspect of health food was the overstatement on the effectiveness by the producers (52.1%). The most important source of information for the purchase of health food was the suggestion of friends and relatives (30.6%). Among the health foods registered and regulated by the food law, royal jelly (22.7%), squalene (16.0%), refined fish oil (15.1%), lactic acid bacteria (10.6%) and aloe (8.8%) were relatively well aware. Although 84% of the subjects perceived that health food is different from drug or traditional medicine, the largest percentage of the subject selected ginseng as the most well known type of health food (22.7%) as well as the most well known drug (or traditional medicine) (41.7%). Ginseng was also chosen as the most frequently used health food (17.0%), and vitamin tablets the third (13.0%). The vague definition of health food and unambiguous discrimination of it from medicine by the consumers were problematic for the correct use and reasonable purchasing behavior. The clear definition and proper regulation on the manufacture and distribution of health food, more strict control of labelling and advertisement, and a wide consumer education on health food were recommended.