Journal of The Korean Society of Clinical Toxicology
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v.11
no.1
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pp.1-8
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2013
Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.
Lee, Won Hee;Choi, Seo Hee;Kim, Se-Heon;Choi, Eun Chang;Lee, Chang Geol;Keum, Ki Chang
Radiation Oncology Journal
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v.36
no.4
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pp.304-316
/
2018
Purpose: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. Materials and Methods: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. Results: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. Conclusion: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.
The UK Government's approach to how to deliver regeneration in its towns and cities has changed considerably in recent years. Traditionally, urban regeneration policy focused on reversing physical, economic and social decline in an area where market forces would not do this without intervention. Since 2010 urban regeneration has become a vital part of the Government's approach to increasing local growth and competitiveness and building a strong and balanced economy. The current emphasis is on a place-based approach to regeneration that builds on the particular strengths of different places to drive growth and addresses the factors that hold them back. This paper outlines the key features of current UK urban regeneration policy and how interventions to support regeneration and growth are being pursued at different spatial scales to ensure all parts of the country benefit. They include pan regional initiatives like the Northern Powerhouse and Midlands Way, to groups of local authorities operating at a sub regional level (combined authorities/city regions), Local Enterprise Partnerships, and a variety of smaller scale programmes delivering regeneration in areas of economic and social decline. The paper explains some of the policy instruments and funding programmes available to support regeneration, and provides case studies of some major urban regeneration projects that illustrate the new approach including housing and infrastructure improvements like the planned High Speed Rail 2 line. These are supporting regeneration through the creation of strategic partnerships involving government, places and investors. The paper concludes with some lessons from past and future regeneration schemes to improve their effectiveness and impact on places and enhance local growth potential.
Purpose: The aim of this study was to evaluate the clinical efficiency of the subepithelial connective tissue graft (SCTG) with and without plasma rich in growth factor (PRGF) in the treatment of gingival recessions. Methods: Twenty bilateral buccal gingival Miller's Class I and II recessions were selected. Ten of the recessions were treated with SCTG and PRGF (test group). The rest ten of the recessions were treated with SCTG (control group). The clinical parameters including recession depth (RD), percentage of root coverage (RC), mucogingival junction (MGJ) position, clinical attachment level (CAL), and probing depth (PD) were measured at the baseline, and 1 and 3 months later. The data were analyzed using the Wilcoxon signed rank and Mann-Whitney U tests. Results: After 3 months, both groups showed a significant improvement in all of the mentioned criteria except PD. Although the amount of improvement was better in the SCTG+PRGF group than the SCTG only group, this difference was not statistically significant. The mean RC was $70.85{\pm}12.57$ in the test group and $75.83{\pm}24.68$ in the control group. Conclusions: Both SCTG+PRGF and SCTG only result in favorable clinical outcomes, but the added benefit of PRGF is not evident.
Purpose: Laparoscopic gastrectomy is accepted as a standard treatment for patients with early gastric cancer in Korea, Japan, and China. However, duodenal stump leakage remains a fatal complication after gastrectomy. We conducted a prospective phase II study to evaluate the safety of the new technique of laparoscopic reinforcement suture (LARS) on the duodenal stump. Materials and Methods: The estimated number of patients required for this study was 100 for a period of 18 months. Inclusion criteria were histologically proven gastric adenocarcinoma treated with laparoscopic distal or total gastrectomy and Billroth II or Roux-en-Y reconstruction. The primary endpoint was the incidence of duodenal stump leakage within the first 30 postoperative days. The secondary endpoints were early postoperative outcomes until discharge. Results: One hundred patients were enrolled between February 2016 and March 2017. The study groups consisted of 65 male and 35 female patients with a mean age (years) of 62.3. Of these, 63 (63%) patients had comorbidities. The mean number of retrieved lymph nodes was 38. The mean operation time was 145 minutes including 7.8 minutes of mean LARS time. There was no occurrence of duodenal stump leakage. Thirteen complications occurred, with one case of reoperation for splenic artery rupture and one case of mortality. Conclusions: Based on the results of this prospective phase II study, LARS can be safely performed in a short operation period without development of duodenal stump leakage. A future randomized prospective controlled trial is required to confirm the surgical benefit of LARS compared to non-LARS.
${\cdot}$ Recent social policy and labour markets debates in Europe, responding to the difficulties faced by the traditional neo-Keynesian welfare state settlement, stress the value of positive investment alongside de-regulation and greater flexibility as a way of achieving both economic and social goals. ${\cdot}$ Patterns of policy reform are complex and reflect differing national circumstances. A general move towards deregulation, constraints on entitlement to passive benefits, programmes to enhance employment, particularly among high-risk groups such as single parents and young people, targeted subsidies for low earners and casemanagement may be identified. ${\cdot}$ In relation to investment in education, research and development and combined training and benefit programmes to enhance mobility between jobs the picture is less clear. Education standards continue to rise, but research and development spending stagnates and few countries have developed substantial ‘flexi-curity’ programmes to support job mobility. ${\cdot}$ The labour market tradition in much of Europe has been one of conflict between labour and employers. As labour grows weaker, new approaches develop. These tend to stress productivity agreements and greater flexibility in work practices within firms and reforms to passive social security systems more broadly, but movement to support the more challenging investment and flexi-curity policies is slow. ${\cdot}$ In general, social and labour market policies in Europe stress deregulation and negative activation more strongly than social investment and ‘flexi-curity’. The countries with high growth and employment achieve that goal by different routes: Sweden has a closely integrated social democratic corporatism with high spending on benefits and training programmes and the UK a more liberal market-oriented system, with lower spending, highly targeted benefits and less mobility support. ${\cdot}$ Europe has something to learn from Korea in achieving high investment in human capital and R and D, while Korea may have something to learn from Europe in social investment, particularly flexi-curity and equal opportunity policies.
Kim, Hack-Sun;Choi, Kyung-Sook;Kim, Jung-Sook;Lee, Joo-Hyun
The Journal of Korean Academic Society of Nursing Education
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v.17
no.2
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pp.257-266
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2011
Purpose: The aim of this study was to elucidate the themes involved in a nursing experience of caring for extremely low birth weight infants (ELBWIs) in a neonatal intensive care unit (NICU). Methods: Interviews with 6 nurses in various positions and observations in a level III NICU were conducted. The transcribed interview contents and observational notes were reviewed to analyze the data and conceptualize major themes. Results: Three major themes were identified: the fears expressed by the nurses regarding taking care of ELBWIs, reasons for persistent fears, and overcoming fears and gaining intuition. Nurses were afraid of the following factors: the physical fragility of the infants; the possibility of developing disabilities in the future; and the rapid changes in infants' physical condition. These fears were reduced when nurses had developed intuition and confidence in taking care of ELBWIs through various situational experiences. Conclusion: NICU nurses may benefit from obtaining more opportunities to participate in various learning experiences with simulated nursing situations in a variety of patient groups. Applying knowledge and skills into various nursing situations in an integrative way may contribute to enhancing nurses' confidence in nursing practice.
Journal of Fisheries and Marine Sciences Education
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v.27
no.3
/
pp.718-724
/
2015
To survey the most feeding frequence of formulated diet as food for cultured puffer in winter season, we performed a rearing test using juveniles of river puffer, Takifugu obscurus (body weight 15.0 g) for 120 days. The feeding frequencies were set up as 2times/1day, 2times/2days, 2times/3days and 2times/4days. We tested triplicately the experiment and investigated survival rate, daily food intake (DFI), feed efficiency (FE), condition factor (CF), daily growth rate (DGR). Consequently, growth was increased following to an increasing of feeding frequency, was the fast in 2times/1day of feeding frequency, and was the slowest in 2times/4days (p<0.05). DFI and CF were increased following to an decreasing of feeding frequency and was the highest in 2times/4days of feeding frequency. FE was decreased following to an decreasing of feeding frequency, and was the highest in 2times/1day of feeding frequency. In a proximate carcass composition at the final day, moisture and crude lipid contents were the lowest in 2times/4days, and in survival, there was not any significant difference among experimental groups. Therefore, we concluded that the 2times/2days are the best of feeding frequency for economical benefit of river puffer culture in winter season.
BACKGROUD/OBJECTIVES: The objective of this study was to investigate the effects of vitamin C on inflammation, tumor development, and dysbiosis of intestinal microbiota in an azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced inflammation-associated early colon cancer mouse model. MATERIALS/METHODS: Male BALB/c mice were injected intraperitoneally with AOM [10 mg/kg body weight (b.w)] and given two 7-d cycles of 2% DSS drinking water with a 14 d inter-cycle interval. Vitamin C (60 mg/kg b.w. and 120 mg/kg b.w.) was supplemented by gavage for 5 weeks starting 2 d after the AOM injection. RESULTS: The vitamin C treatment suppressed inflammatory morbidity, as reflected by disease activity index (DAI) in recovery phase and inhibited shortening of the colon, and reduced histological damage. In addition, vitamin C supplementation suppressed mRNA levels of pro-inflammatory mediators and cytokines, including cyclooxygenase-2, microsomal prostaglandin E synthase-2, tumor necrosis $factor-{\alpha}$, Interleukin $(IL)-1{\beta}$, and IL-6, and reduced expression of the proliferation marker, proliferating cell nuclear antigen, compared to observations of AOM/DSS animals. Although the microbial composition did not differ significantly between the groups, administration of vitamin C improved the level of inflammation-related Lactococcus and JQ084893 to control levels. CONCLUSION: Vitamin C treatment provided moderate suppression of inflammation, proliferation, and certain inflammation-related dysbiosis in a murine model of colitis associated-early colon cancer. These findings support that vitamin C supplementation can benefit colonic health. Long-term clinical studies with various doses of vitamin C are warranted.
Gill, Diane L.;Hammond, Cara C.;Reifsteck, Erin J.;Jehu, Christine M.;Williams, Rennae A.;Adams, Melanie M.;Lange, Elizabeth H.;Becofsky, Katie;Rodriguez, Enid;Shang, Ya-Ting
Journal of Preventive Medicine and Public Health
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v.46
no.sup1
/
pp.28-34
/
2013
Physical activity (PA) professionals and participants recognize enhanced quality of life (QoL) as a benefit of and motivator for PA. However, QoL measures are often problematic and rarely consider the participants' perspective. This paper focuses on recent findings from a larger project on the role of QoL in PA and health promotion. More specifically, we focus on the views of participants and potential participants to better understand the relationship of PA and QoL. In earlier stages of the project we began with a conceptual model of QoL and developed a survey. We now focus on participants' views and ask two questions: 1) what is QoL? and 2) how does PA relate to QoL? We first asked those questions of a large sample of university students and community participants as open-ended survey items, and then asked focus groups of community participants. Overall, participants' responses reflected the multidimensional, integrative QoL model, but the responses and patterns provided information that may not be picked up with typical survey measures. Findings suggest that PA contributes to multiple aspects of QoL, that social and emotional benefits are primary motivators and outcomes for participants, and that the meaning of QoL and PA benefits is subjective and contextualized, varying across individuals and settings. Programs that directly target and highlight the multiple dimensions and integrative QoL, while considering the individual participants and contexts, may enhance both PA motivation and participants' health and QoL.
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