Purpose: Pledget is a PTFE felt that is usually used for suture reinforcement in cardiovascular surgery. In order to minimize the difficulty in intracorporeal continuous gastrointestinal suturing by reducing the number of tied knots, we have used pledget as substitute for a knot (pledget suturing). Materials and Methods: Thirty-two consecutive patients who underwent totally laparoscopic uncut Roux-en-Y gastrojejunostomy after distal gastrectomy in our institution were enrolled in this study, and the patients were divided into three groups according to the method of intracorporeal anastomosis. Basically, intracorporeal anastomosis was performed by several firings of linear staplers; however, the entry holes for the stapler at the jejunojejunostomy and the gastrojejunostomy were closed by pledget suturing in group A (8 patients), the entry hole for the stapler at jejunojejunostomy was closed by conventional suturing in group B (8 patients), and all of the entry holes for the stapler were closed by stapling in group C (16 patients). The surgical outcomes of each group were compared to each other. Results: The anastomotic time in group A was not longer than in group B, although there were more sutures used in group A, but it was longer than in group C. The number of stapler cartridges used in group A was the smallest among the three groups. In group B, there were two cases of a break of suture material during anastomosis, there were no such cases in group A. There was no complication related to anastomosis in all of the groups. Conclusion: Pledget was found to be useful for minimizing the difficulty in intracoproreal continuous gastrointestinal suturing and reducing the number of stapler cartilages used in intracorporeal anastomosis.
The seminiferous epithelium, with its division into 12 spermatogenic stages in the mouse, is a very complex tissue. Glutathione peroxidase (GPx) is a representative antioxidant enzyme that is capable of reducing organic hydroperoxides to their corresponding hydroxyl compounds utilizing glutathione and is related to the mammalian spermatogenesis. In this study, a real-time PCR was performed in the stage-specific seminiferous tubules of mouse testes excised by a laser capture microdissection (LCM) in order to quantitate the expression levels of a series of GPx genes including cytosolic GPx (cGPx), gastrointestinal GPx (GI-GPx), plasma GPx (pGPx), and phospholipid hydroperoxide GPx (PHGPx). Frozen sections (10 ${\mu}m$) were obtained from normal adult mouse testes. LCM was used to capture all the cells that were grouped into stages I-V, VII-VIII, and IX-XI in cross-sections of seminiferous tubules. The expression level of PHGPx mRNA was remarkably higher than those of other GPx mRNAs in mouse testes. During spermatogenesis, the expressions of GI-GPx, pGPx, and PHGPx mRNAs were highest on stages VII-VIII, began to decrease after stage XI, and showed a lowest level on stage I-V. However, the expressions of cGPx mRNA were highest on stages VII-VIII, and showed a lowest level on stage XI-XI. These findings indicate that GPx genes are expressed differentially on mouse spermatogenesis and also LCM can be an useful tool in cellular quantitative analysis of testes.
Kaempferia parviflora, an herbaceous plant in the family Zingiberaceae, is popular in many tropical regions. It is called as black ginger or krachaidum in Thailand and Laos, and its raw or dried root have been used as spices and teas. The rhizomes also have been traditionally used to treat gastrointestinal disorders, ulcers, gout, dysentery, allergies and to improve physical work capacity. Recently, its anti-obesity, anti-oxidant, anti-inflammatory and blood clot-lysis activities were reported. In this study, the anti-thrombosis activity of black ginger was investigated, since improvement in blood fluidity leads to the prevention of various lifestyle-related diseases. The hot water and ethanol extract and their subsequent solvent fractions (hexane, ethylacetate, butanol fractions and water residue) were prepared, and their anti-coagulation and platelet aggregation inhibitory activities were determined, respectively. Among the black ginger extracts and their fractions, the ethylacetate fraction (EAF) of ethanol extract only showed significant extensions of blood coagulation time determined by thrombin time (TT), prothrombin time (PT), and activated partial thromboplastin time (aPTT). At 5 mg/ml concentration, TT, PT and aPTT were extended to 1.22, 1.49 and >15-folds compared to non-treatment. The EAFs of ethanol and hot water extract showed strong inhibitions against collagen-induced platelet aggregations, which are comparable to inhibitions of aspirin. Also the EAFs from black ginger did not show any hemolysis activity against human RBC up to 0.5 mg/ml. Our results suggest that the EAF of black ginger has a potential as novel anti-coagulation and ant-platelet aggregation agent. This report provides the first evidence of anti-coagulation activity of black ginger.
The effects of dry roasting whole lupin seeds (lupinus albus, WLS) at 110, 130 or $150{^{\circ}C}$ for 15, 30 or 45 minutes on the in sacco rumen degradation characteristics, optimal heating conditions of time and temperature and in vitro enzyme digestibility were determined. Ruminant degradation characteristics (RDC) of crude protein (CP) of WLS were determined by in sacco technique in dairy cows. Measure ROC were soluble (S), undegradable (U), potentially degradable (D) fractions, lag time (TO) and rate of degradation (Kd) of insoluble but degradable fraction. Based on measured ROC, percentage bypass CP (%BCP) and bypass CP (BCP in g/kg, DM) were calculated. Degradability of CP was significantly reduced by dry roasting (p<0.001). The interaction of dry roasting temperature and time had significant effects on D (p<0.05), Kd (p<0.01), U (p<0.01), %BCP (p<0.001) and BCP (p<0.001) but not on S (p=0.923>0.05). With increasing time and temperature, S, D, Kd and U varied from 31.8%, 67.4%, 10.3%/h and 0.8% in the raw WLS (RWLS) to 27.1 %, 35.8%, 3.6%/h, 38.4% in $150{^{\circ}C}/45\;min$, respectively. All these effects resulted in increasing %BCP from 25.9 in RWLS to 61.0% in the $150{^{\circ}C}/45\;min$. Therefore BCP increased form 111.2 to 261.2 g/kg DM, respectively. Both %BCP and BCP at $150{^{\circ}C}/45\;min$ increased nearly 2.5 times over the RWLS. The effects of dry roasting on %BCP and BCP seemed to be linear up to the highest value tested. Although ROC had been altered by dry roasting, the In vitro perpsin-cellulase digestibility was generally unchanged. It was concluded that dry roasting was effective in shifting CP degradation from rumen to the lower gastrointestinal tract to potential reduce unnecessary N loss in the rumen. It might be of great value in successfully synchronizing the rhythms of release of nitrogen and energy in the rumen, thus achieving a more efficient fermentation of diets with high proportions of lignocellulosic resources. To determine the optimal dry roasting conditions, the digestibility of each treatment in the cows will be measured in the next trial using mobile bags technique.
Lee, Mi Jeong;Hwang, Moon Sook;Lim, Hyun Sook;Park, Mi Ok;Huh, Ji Won;Kang, Ki Joo;Kim, Jae Jun;Cho, Myung Sook
Journal of Korean Clinical Nursing Research
/
v.18
no.2
/
pp.284-295
/
2012
Purpose: This study was done to clarify effects of bispectral index monitoring sedative administration, compared to MOAA/S (Modified Observer's Assessment of Alertness and Sedation), on conscious sedation, physiological stability and recovery time for patients undergoing endoscopic submucosal dissection. Methods: Participants In this study were patients who underwent endoscopic submucosal dissection because of early gastric cancer. Participants were assigned randomly to an experimental group receiving sedatives based on bispectral index monitoring or to a control group with the MOAA/S instrument. Movements, belching, memory, pain, discomfort, physiological stability (MBP, PR, $SpO_2$), and recovery time were measured during the treatment and recovery. Data were analyzed using Spearman partial correlation coefficient analysis, Mixed model and Wilcoxon rank sum test to determine differences in the parameters. Results: There were no statistically significant differences between the two groups for conscious sedation(movement, belching, memory, pain, or discomfort), physiological stability and recovery time. Conclusion: The results of this study indicate that no differences were found between the two types of monitoring. Thus, use of a bispectral index monitor in clinical practice enabling medical staff to readily assess the conscious sedation of for these patients is expected to be increasingly used as an objective assessment tool for conscious sedation for patient safety.
Purpose: Most terminally ill cancer patients die from cancer anorexia-cachexia syndrome. This study evaluated a prognostic role of plasma leptin levels in terminally ill cancer patients. Methods: This study enrolled 69 terminally ill cancer patients who were aged above 20 years old from July 2009 to July 2010. For univariate analysis, an association between leptin levels and patient's characteristics or other variables was examined using Spearman's correlation analysis, Wilcoxon's rank-sum test or Kruskal-Wallis test, as appropriately. For multivariable analysis, Cox's proportional hazard regression model was used to evaluate a clinical significance of plasma leptin levels as a prognostic factor and to determine factors which affect the risk of death in terminally ill cancer patients. Results: A statistically significant positive correlation between plasma leptin levels and survival time was found. Univariate Cox's proportional hazard regression analyses also showed a moderately significant association between plasma leptin levels and survival time. However, after adjusting variables for sex, white blood cell counts, total bilirubin, AST, ALT, albumin and CRP levels, plasma leptin levels were not significantly associated with survival time. Conclusion: No significant association was found between plasma leptin levels and survival time in terminally ill cancer patients. However, this study suggested a prognostic value of plasma leptin levels in gastrointestinal cancer patients.
Exercise-induced anaphylaxis (EIA) is defined as the onset of allergic symptoms during, or immediately after, exercise, the clinical signs being various degrees of urticaria, angioedema, respiratory and gastrointestinal signs, and even anaphylactic shock. Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of exercise-induced anaphylaxis that requires both vigorous physical activity and the ingestion of specific foods within the preceding several hours. To describe the physiopathologic mechanism, etiologic factors, and clinical manifestations, we evaluated the supplementation of vitamin C and catalase on spleen index, proliferation assay, ROS, and ASAS in sensitized and exercise trained mice. The results were as follows: Spleen index showed the highest level in the ST12 group compared to other groups; this level increased in a time dependent manner and in significant amounts. In proliferation assay of Med and OVA, the ST12 group showed the highest level compared to other groups; this level also increased in a time dependent manner. On the other hand, spleen ROS did not show a statistically significant difference, and peritoneal ROS showed the highest level in the ST12 group. ASAS showed the highest level in the ST12 compared to the S; this was also in a time dependent manner and in significant amounts. From the results, we chose the ST9 and ST12 groups to evaluate allergy anaphylaxis with supplementation of Vitamin C and catalase. In both the ST9 and ST12 groups, peritoneal ROS and ASAS were lower in vitamin C treatment group than in the catalase treatment group. This was a statistically significant difference. From the results, allergy anaphylaxis showed a higher level in the long trained group than in the short trained group. Also, treatment with vitamin C was more effective in lowering allergy anaphylaxis than catalase treatment.
Background: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. Methods: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl $700{\mu}g$ was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. Results: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were $4.4{\pm}2.0$ and $3.7{\pm}1.9$ in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was $10.7{\pm}13.7$ and $8.6{\pm}8.5$, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. Conclusion: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.
The Journal of the Korean Society for Microbiology
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v.20
no.1
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pp.35-44
/
1985
Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.
Nesfatin-1/NUCB2, which is associated with the control of appetite and energy metabolism, was reported for the first time to be expressed in the hypothalamus. However, recent studies have shown that nesfatin-1/NUCB2 was expressed not only in the hypothalamus, but also in various tissues including digestive and reproductive organs. We also demonstrated that nesfatin-1/NUCB2 was expressed in the reproductive organs, pituitary gland, heart, lung, and gastrointestinal tract of the adult mouse. However, little is known about nesfatin-1/NUCB2 expression in fetal and neonatal mice. Therefore, we examined here the distribution of nesfatin-1/NUCB2 in various organs of fetal and neonatal mice and compared them with the distribution in adult mice. As a result of immunohistochemical staining, nesfatin-1/NUCB2 protein was expressed relatively higher in the lung, kidney, heart, and liver compared to other organs in the fetus. Western blot results also showed that nesfatin-1/NUCB2 protein was detected in the lung, kidney, heart, and stomach. Next, we compared the expression levels of nesfatin-1/NUCB2 mRNA in the fetus and neonate with the expression levels in both male and female adult mice. The expression levels in heart, lung, stomach, and kidney were higher compared with other organs in fetal and neonatal mice and in both male and female adult mice. Interestingly, the expression of nesfatin-1/NUCB2 mRNA in the kidney was dramatically increased in male and female adult mice compared to fetal and neonatal mice. These results indicate that nesfatin-1/NUCB2 may regulate the development and physiological function of mouse organs. In the future, we need more study on the function of nesfatin-1/NUCB2, which is highly expressed in the heart, lung, and kidney during mouse development.
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