Background: Although the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery. Methods: We searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery. Results: Twelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation. Conclusions: Erector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.
Oh, Hyunjoo;Yoo, Jeong Rae;Heo, SangTaek;Oh, Jung-Hwan;Lee, Ho Kyu
Journal of Medicine and Life Science
/
v.16
no.1
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pp.17-22
/
2019
Epstein-Barr virus(EBV) infection is common and usually asymptomatic in young infants and children. However, EBV infections in transplant recipients and other immunosuppressed patients can be fatal. EBV-related neurological complications in immunocompetent adults are extremely rare and self-limited. Acute disseminated encephalomyelitis(ADEM) may also follow EBV infection; ADEM is characterized by abrupt onset and rapid progression. We report an immunocompetent adult patient who developed diffuse meningoencephalitis with ADEM-like features caused by EBV infection. A 35-year-old Vietnamese woman was admitted presenting with urinary retention, altered mental status, and paraplegia. PCR of the patient's cerebrospinal fluid showed positive results for EBV. Brain and spine magnetic resonance imaging showed ADEM-like features. She was treated with acyclovir, steroid, and immunoglobulins. We report the case of an immunocompetent adult Vietnamese woman who presented with rapidly progressive diffuse meningoencephalitis associated with EBV infection and was treated with antivirals, corticosteroids, and immunoglobulins.
Forty-eight barrows with an average initial body weight of $25.5{\pm}0.3kg$ were assigned to 6 dietary treatments arranged in a $3{\times}2$ factorial of 3 graded levels of P at 1.42, 2.07, or 2.72 g/kg, and 2 levels of casein at 0 or 50 g/kg to compare the estimates of true total tract digestibility (TTTD) of P in soybean meal (SBM) for pigs fed diets with or without casein supplementation. The SBM is the only source of P in diets without casein, and in the diet with added casein, 1.0 to 2.4 g/kg of total dietary P was supplied by SBM as dietary level of SBM increased. The experiment consisted of a 5-d adjustment period and a 5-d total collection period with ferric oxide as a maker to indicate the initiation and termination of fecal collection. There were interactive effects of casein supplementation and total dietary P level on the apparent total tract digestibility (ATTD) and retention of P (p<0.05). Dietary P intake, fecal P output, digested P and retained P were increased linearly with graded increasing levels of SBM in diets regardless of casein addition (p<0.01). Compared with diets without casein, there was a reduction in fecal P in the casein-supplemented diets, which led to increases in digested P, retained P, ATTD, and retention of P (p<0.01). Digested N, ATTD of N, retained N, and N retention were affected by the interaction of casein supplementation and dietary P level (p<0.05). Fecal N output, urinary N output, digested N, and retained N increased linearly with graded increasing levels of SBM for each type of diet (p<0.01). The estimates of TTTD of P in SBM, derived from the regression of daily digested P against daily P intake, for pigs fed diets without casein and with casein were calculated to be 37.3% and 38.6%, respectively. Regressing daily digested N against daily N intake, the TTTD of N in SBM were determined at 94.3% and 94.4% for diets without casein and with added casein, respectively. There was no difference in determined values of TTTD of P or N in SBM for pigs fed diets with or without casein (p>0.05). In summary, our results demonstrate that the estimates of TTTD of P in SBM for pigs were not affected by constant casein inclusion in the basal diets.
This study was conducted to determine effects of probiotics on performance, nutrient digestibility and nitrogen retention in Korean black goats fed two diets differing in forage to concentrate (F:C) ratio (30:70 and 70:30), for the establishment of their more efficient feeding management system. The probiotics employed in this trial were mixtures of different microbial species, which consisted of Lactobacillus casei, Bacillus subtilis, Saccharomyces cerevisiae, Aspergillus oryzae and Streptomyces griseus. Additional levels of probiotics to each F:C ratio (70:30 or 30:70) were 0 and 0.2%, respectively. Thus, twelve Korean black male goats were allotted to treatments in four groups of three goats per treatment and then they were housed in individual metabolism cages with a randomized complete block design for 21 days. Dry matter (DM) intakes were not affected by dietary F:C ratio and probiotics. Digestible DM amounts were significantly (p<0.05) decreased with increasing levels of dietary forage, but they were not affected by probiotics addition. Dry matter intakes per metabolic body weight and their ratio per body weight had a similar trend to DM intakes with no significant difference by F:C ratio and probiotics addition. The nutrient digestibility was significantly (p<0.05) increased with decreasing levels of forage in the diet, but it was not affected by probiotics addition. Urinary nitrogen loss was significantly (p<0.05) decreased with decreasing levels of dietary forage, but there was no significant difference between probiotics-supplemented and unsupplemented groups within the same F:C ratio. On the contrary, nitrogen retention was decreased with increasing levels of dietary forage, and probiotics supplementation to two diets differing in F:C ratio showed slightly increasing trends in the nitrogen retention. From the above results, probiotics supplementation to two diets differing in F:C ratio did not have the significant influence on feed intakes, nutrient digestibility and nitrogen retention. Consequently, these parameters of Korean black goats were dominated rather by F:C ratio than by dietary probiotics.
This study aimed to investigate dietary concentrate:forage ratios (C:F) and undegraded dietary protein (UDP) on nitrogen balance and urinary excretion of purine derivatives (PD) in lambs. Four Dorper${\times}$thin-tailed Han crossbred castrated lambs with $62.3{\pm}1.9$ kg body weight at 10 months of age were randomly assigned to four dietary treatments in a $2{\times}2$ factorial arrangement of two levels of C:F (40:60 and 60:40) and two levels of UDP (35% and 50% of CP), according to a complete $4{\times}4$ Latin-square design. Each experimental period lasted for 19 d. After a 7-d adaptation period, lambs were moved into individual metabolism crates for 12 d including 7 d of adaption and 5 d of metabolism trial. During the metabolism trial, total urine was collected for 24 h and spot urine samples were also collected at different times. Urinary PD was measured using a colorimetric method and creatinine was measured using an automated analyzer. Intake of dry matter (DM) (p<0.01) and organic matter (OM) (p<0.01) increased as the level of UDP decreased. Fecal N was not affected by dietary treatment (p>0.05) while urinary N increased as the level of UDP decreased (p<0.05), but decreased as dietary C:F increased (p<0.05). Nitrogen retention increased as dietary C:F increased (p<0.05). As dietary C:F increased, urinary excretion of PD increased (p<0.05), but was not affected by dietary UDP (p>0.05) or interaction between dietary treatments (p>0.05). Daily excretion of creatinine was not affected by dietary treatments (p<0.05), with an average value of $0.334{\times}0.005$ mmol/kg $BW^{0.75}$. A linear correlation was found between total PD excretion and PDC index ($R^2$ = 0.93). Concentrations of creatinine and PDC index in spot urine were unaffected by sampling time (p>0.05) and a good correlation was found between the PDC index (average value of three times) of spot urine and daily excretion of PD ($R^2$ = 0.88). These results suggest that for animals fed ad libitum, the PDC index in spot urine is effective to predict daily excretion of PD. In order to improve the accuracy of the spot sampling technique, an appropriate lag phase between the time of feeding and sampling should be determined so that the sampling time can coincide with the peak concentration of PD in the urine.
Journal of the Korean Society of Food Science and Nutrition
/
v.30
no.5
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pp.894-899
/
2001
Intakes and excretions of zinc and copper were determined for 8 female adolescents (aged 16.4$\pm$0.5 y; body mass index 20.4$\pm$1.3kg/$m^2$; body fat 33.3$\pm$2.5%; bone mineral density of lumbar spine in L2-L4; 0.96$\pm$0.08g/$\textrm{cm}^2$) when they consumed diets basal and high in calcium for 6 days each. All subjects consumed a basal Ca diet containing 800 mg, Korean RDA level of the subjects, and a high Ca diet containing 1200mg, RDA plus 2 SDs of calcium intake. The diets provided 58% of energy intake as carbohydrate, 25% as fat, and 17% as protein. Food, urine and fecal samples were collected during the last 3 days of each feeding period and were assayed. Mean daily intakes on the basal and high calcium diets, respectively, were 6.57 and 6.37 mg for zinc and 910 and 812 $\mu\textrm{g}$for copper. Fecal excretion of copper and zinc in relation to intake was significantly greater on the high calcium than on the basal calcium diet. Hence, apparent absorption rate was significantly lowered from 98.7% on the basal calcium diet to 97.9% on the high calcium diet for zinc from 66.3% to 56.4% for copper, respectively. Urinary loss of copper was not detectable but that of zinc was 0.38mg on the basal diet and 0.47mg on the high calcium diet. Copper retention was 899$\pm$105$\mu\textrm{g}$/day on the basal calcium diet and 792$\pm$20.8$\mu\textrm{g}$/day on the high calcium diet, and zinc retention was 3.95$\pm$0.91mg/day and 3.11$\pm$0.89mg/day. Thus, copper and zinc retention was significantly decreased on the high calcium diet (p<0.05). Summarizing the results, apparent absorption and retention of zinc and copper were significantly decreased by calcium supplementation. Therefore, it is suggested that interactions among minerals should be considered in determining RDA.
Purpose: Diuretic renography (DR) can be false negative in patients with upper urinary tract obstruction due to low compliance of the renal pelvis. Delayed parenchymal transit (DPT) may be a valuable sign in case of false negative DR. We compared the diagnostic values of DR and DPT during Tc-99m MAG3 diuretic scan in adults with suspected unilateral obstructive uropathy. Materials and Methods: Fifty-four patients(male:female=30:24, age: $40.7{\pm}15.5$ yrs) who underwent Tc-99m MAG3 diuretic scan due to suspicious unilateral obstructive uropathy were analyzed. DR with a $T_{1/2}\;of\;>\;15min$ was considered as positive for obstruction. DPT was considered to be present when there was delayed appearance of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal parenchyma. The renal area ratio was defined as the ratio of pixel number of hydronephrotic kidney over that of normal contralateral at $1{\sim}2min$ images. Definition of obstruction was improved hydronephrosis after intervention, or aggravated hydronephrosis without intervention. Non-obstruction was defined as unchanged hydronephrosis over 6 months. Results: Twenty-six renal units had obstruction and 28 no obstruction. The sensitivities of DR and DPT were 69% (18/26) and 50% (13/26) respectively. Two renal units with DPT but negative DR showed the renal area ratio of <1.1. Among the 20 obstructive renal units with DPT or positive DR, 13 with DPT had lower renal area ratio than 7 renal units without DPT ($0.97{\pm}0.20\;vs\;1.30{\pm}0.41,\;p<0.05$). Differential renal function was not significantly different between these groups. DPT correctly diagnosed all renal units with non-obstruction (specificity 100%), while the specificity of DR was 89% (25/28). Conclusion: DPT during Tc-99m MAG3 diuretic scan may be a valuable sign in diagnosing urinary obstruction especially in patients with false negative DR and early HN.
55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients(36 male and 19 female) ranged in age from 3 to 72years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases(9.4%), atelectasis in 4(7.5%), transient urine leak in 2(3.8%), delayed bleeding in 2(3.8%) and urinary retention in 2(3.8%), Postoperative residual stones were identified in 15(27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases(87.3%) became stone free, The recurrence of stone was noted in 2 out of 48 patients during the short followup period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.
No, Jung-Ran;Park, Sun-Young;Kim, Mi-Kyoung;Jo, Han-Young;Lee, In-Young;Ly, Sun-Yung
Journal of the Korean Society of Food Science and Nutrition
/
v.36
no.1
/
pp.51-57
/
2007
Levan, the fructose polymer is an indigestible carbohydrate regularly consumed by humans. Its physiological functions, in terms of hypocholesterolemic effect and calcium metabolism, have not been well documented. The objective of this study was to investigate the effects of levan on blood lipids and the calcium absorption ratio in rats fed a 0.1% low calcium diet. Thirty rats were divided into three groups and fed a 0.1% low calcium diet (control) or low calcium diets containing either 2.5% levan or 5% levan for eight weeks. The blood lipid and biomarkers relevant to Ca metabolism (urinary Ca and hydroxyproline), the femoral weight and the Ca contents were determined. The body weight gains were lower in the 5% levan group than the control group. Plasma concentrations of triacylglycerol and LDL-cholesterol decreased in the 5% levan group, compared to the control group, but the atherogenic indice were not affected. Blood alkaline phosphatase activity, Ca and urinary hydroxyproline excretion levels were not different in the three groups. The net calcium absorption in rats fed a 5% levan diet was greater than rats fed the control diet, while the femoral weights and Ca contents were not significantly different in the three groups. We concluded that a 5% levan diet could both enhance the calcium absorption and improve the lipid profiles in rats fed a low calcium diet.
Kim, Yong Ju;Kim, Tae Heon;Song, Min Ho;An, Ji Seon;Yun, Won;Lee, Ji Hwan;Oh, Han Jin;Lee, Jun Soeng;Kim, Gok Mi;Kim, Hyeun Bum;Cho, Jin Ho
Journal of Animal Science and Technology
/
v.62
no.5
/
pp.659-667
/
2020
This study was conducted to evaluate the effects of different levels of crude protein (CP) and protease on nitrogen (N) utilization, nutrient digestibility, and growth performance in growing pigs. A total of six crossbred ([Landrace × Yorkshire] × Duroc) barrows were individually accepted in 1.2 m × 0.7 m × 0.96 m stainless steel metabolism cages. The pigs (average initial body weight of 27.91 ± 1.84 kg) randomly assigned to six diets with six weeks (6 × 6 Latin square design). The experiment was carried out in an environment with a temperature of 23 ± 1.5℃, a relative humidity of 83 ± 2.3% and a wind speed of 0.25 ± 0.03 m/s. The dietary treatments were arranged in a 2 × 3 factorial design with two levels of CP (15.3% or 17.1%) and three levels of protease (0 ppm, 150 ppm, or 300 ppm). The average daily gain and gain to feed ratio (G:F) tended to increase (p = 0.074) with increasing amounts of protease. The low CP level diet reduced (p < 0.050) urinary and fecal N concentrations, the total N excretion in feces, and increased (p < 0.050) N retention. Different protease levels in the diet did not affect (p > 0.05) at N intake, but supplementation of the diets with 300 ppm protease decreased (p < 0.050) the N concentration in urine and feces and tended to increase (p = 0.061) the percentage of N retention retained of the total N intake. The dietary CP level did not affect (p > 0.050) the apparent total tract digestibility (ATTD) of dry matter, digestible energy (DE), and metabolic energy (ME), but diet supplementation with 300 ppm protease showed higher (p < 0.050) ATTD of DE and ME than in the protease-free diet. Therefore, a low protein diet with protease could improve the utilization of nitrogen, thereby reducing the negative effect of N excretion into the environment while maintaining or increasing growth performance compared to a high protein diet.
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