Purpose: Individual cancer patients often experience many symptoms that impair their quality of life at the end of life. Identifying symptoms at the terminal stage of cancer patients and possible imminent death prediction by using that assessment can assist physicians and patients in preparing the 'peaceful death'. This study examines symptom experience during the last 48 hours of life of terminal cancer patients, and determines whether symptom experience change with proximal to death. Methods: The medical records of 89 patients who died with terminal cancer at a hospital between July 1, 2003 and March 31, 2006 were reviewed. Symptom prevalence at the last 48 hours was analyzed along with the change of symptom experience at the admission, $48{\sim}24$ hours, and $24{\sim}0$ hours before death. Results: Median age of all patients was 62 years old (range $16{\sim}97$). During the last 48 hours, symptom prevalence was described as follows; unclear consciousness (57%), pain (30%), fever (22%), and dyspnea (19%). According to the primary site, unclear consciousness was notified the most frequent symptom, but fever was relatively high prevalence in patients of biliary origin cancer rather than other site cancer (P=0.012). As death was Impending, the prevalence of poor appetite and general weakness were decreased, while that of unclear consciousness was increased, which were all statistically significant (P < 0.05). Conclusion: The presence of unclear consciousness could be regarded as the symptom indicator as imminent death of terminal canter patients.
The quality changes of hams and sausages in refrigerated storage were investigated. Seven types of hams and six types of sausages produced in Korea were collected from markets and stored at 1$0^{\circ}C$ according to the Food Code of Korea, and then chemical, microbiological, textural and sensory characteristics were evaluated at 30, 40 and 50 days. The proximal analysis showed considerable variation in fat with less variation in moisture and protein. The pH values of hams and sausages slightly changed with no consistent difference. Water activity values of all samples except one type of sausage were consistent over time in refrigerated storage. No purge losses of hams were observed except two types of samples in the intial stage. Several types of sausages showed purge losses with no consistency and one type of sausage showed consistent purge losses (0.44~11.29%) during the storage. The volatile basic nitrogen (VBN) content of hams and sausages was still within 20 mg% (Standard and Specification of Korea) on the 50th day, although the VBN of all samples significantly increased over time (p<0.05). The thiobarbituric acid (TBA) values of hams and sausages were well below 1.0 during the storage, although the TBA values of all samples significantly increased (p<0.05). However it was noticed that one type of ham and two types of sausages showed TBA values of 0.945, 0.928 and 0.978, respectively. All the standard plate counts (SPCs) of hams during the storage period showed a level below 30 CFU/g except one type of sample with 103 CFU/g at 50 days. All the SPCs of sausages showed a level below 50 CFU/g except one type of sample with 102 CFU/g and two types of samples with 104 CFU/g on the 50th day. Coliform groups were not counted in all samples during the storage. Instrumental texture analysis showed that springiness, cohesiveness, chewiness, gumminess and adhesiveness slightly changed with no consistent difference. The hardness of the hams showed a decreasing tendency, and the hardness of the sausages an increasing tendency with no significant difference. Sensory evaluation for color, flavor, taste, texture and overall acceptability showed decreasing tendencies over time (p<0.05). The scores of the five sensory characteristics maintained the medium level of quality at the termination of the experiment. Although the results indicated that the ham and sausage samples were acceptable after the 50 days' storage at 1$0^{\circ}C$, the shelf-life of the samples should be determined considering the rapid growth of bacteria and the high TBA values at 50 days.
Kim, Young Seok;Lee, Chae Su;Yoo, Won Min;Tark, Kwan Chul
Archives of Plastic Surgery
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제35권4호
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pp.360-366
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2008
Purpose: Botulinum toxin type A(BoTA) can block the release of vasoconstriction cotransmitters as well as acetylcholine in nerve terminal. The authors observed that BoTA increases flap survival by preventing sympathetic collapse of peripheral vessels. Methods: 10 Sprague Dawley rats were divided into control(n=5), and BoTA group(n=5). $3{\times}10cm$ sized random pattern cutaneous flaps were elevated on the dorsal side in both groups. In BoTA group, BoTA was injected into the flap via intradermal to subdermal route, 7 days before the flap elevation. Flap survival rates (survival area/total area) were measured 7 days after the elevation. Cutaneous blood flow was measured in proximal, middle and distal compartments of the flap using laser Doppler flowmetry initially, preoperatively, at immediate postoperation, and 7 days after flap elevation, respectively. Histological examination was performed 7 days after the flap elevation. The number and shape of the vessels were evaluated under microscope. Results: Mean flap survival was $53.18{\pm}6.58%$ in control group and $93.79{\pm}6.06%$ in BoTA group, displaying statistically significant difference(p=0.0008, p<0.05). In the control group, blood flow to the middle and distal compartments of the flap decreased significantly immediately after flap elevation. In the BoTA group, blood flow to the middle compartment did not decrease(p=0.002) and slightly decreased in the distal compartment(p=0.001). Cutaneous blood flow was significantly higher in all compartments of the flap in BoTA group than in control group, 7 days after the flap elevation. In histopathologic examination, greater number of vessels were noted in the BoTA group than in the control group. Conclusion: Botulinum toxin A can increase the survival of the random pattern cutaneous flap in rats by preventing the sympathetic collapse of peripheral vessels.
This study is aimed at providing information on injury prevention and skill improvement by inducing the accurate movements in exercise as well as understanding the principles of badminton drive movements. Movement displacement of racket head showed the similar patterns among those surveyed but, it seemed that slight differences resulted from external factors such as height, length of brachial and forearm and individual trend of swing locus. Regarding upper joint angle per phase, the angles of shoulder joint, elbow joint and wrist joint were closely associated in taking drive movements and they supported the segment order theory that power was conveyed from proximal into distal. It was shown that angular velocity of upper joint became larger in follow through movement after impact among all those surveyed, which meant the importance of follow through in racket sports such as badminton. In conclusion, this follow through movement acts as an important factor in racket sports in terms of pose stability maintenance, pose correction of movements and injury prevention of joints. In summary, when swings are made according to segment order theory, efficient movements can be taken.
To develop the polymerase chain reaction (PCR) for the detection of type D simian retrovirus (SRV) infection, an oligonucleotide primer pair was designed to hybridize to the sequences within env gene of SRV subtype 1 (SRV-1). The 3' proximal env sequences annealing to the primers had been rather conserved among three different subtypes of SRV, SRV-1, SRV-2, and SRV-3 (Mason-Pfizer Monkey Virus: MPMV). The PCR using the primer pair targeting an env region successfully detected and amplified all three subtypes of SRV with excellent specificity after single round of reaction. The tests with peripheral blood mononuclear cells infected either with simian immunodeficiency virus or simian T-Iymphotropic virus type 1, major immunosuppressive viral agents together with SRV in simian, verified the specificity of the PCR by excluding any cross reactivity. Semiquantitative titration PCR, amplifying serially diluted plasmid DNA of each subtype, was performed to evaluate sensitivity limits of the reaction. Based on molecular weight of each cloned SRV genome, the PCR should be able to detect one SRV-infected cell per more than $5-7{\times}10^4$ uninfected cells after simple ethidium bromide staining of resulting products. The PCR must be very efficient screening system with its quickness, certainty, and sensitivity for SRV-infected animals used in human AIDS research model. Second round amplification of the reaction products from the first PCR, or Southern hybridization by radiolabeled probes shall render to compete its efficacy to ELISA which has been the most sensitive technique to screen SRV infection but with frequent ambiguity problem.
Neodiplostomum seoulensis, one of the human intestinal trematodes , was reinfected to albino rats, and worm recovery rates, histopathology and activity changes of the intestinal brush border membrane bound enzymes were observed. The experimental groups were three: uninfected, primary infection and reinfection. The worm recovery rate in the reinfection group was much lower than in the primary infection group 14 days after infection. The duodenal histopathology showed villous atrophy during the first and second week in the primary infection group. In the reinfection group, however. villous changes occurred as early as 3 days after the infection, and the lesion was found healed 7 days after infection. The activities of alkaline phosphatase and sucrase in the duodenum of primary infection rats decreased nearly half of the controls 2 weeks after infection, whereas the activities were unchanged in the reinfection group. However, no changes in the activities were observed in the proximal jejunum between the experimental groups. These findings suggested that a secondary infection of N. seouLensis in rats should make less damage on the intestinal mucosa than a primary infection. Key words: Neoniplostomum seoulensis, albino rats, reinfection, worm recovery, histopathology, brush border membrane bound enxyines.
Long term patency of arterial graft has been better than venous graft and redo coronary artery bypass grafting has been increasing, therefore, there has been an increasing need for alternative arterial grafts except internal thoracic artery(ITA). Material and Method: Right gastroepiploic arteries(RGEA) were harvested from 100 patients who had received gastrectomy for gastric cancer or ulcer. ITAs were obtained from 10 patients undergoing coronary artery bypass grafting. The length of RGEA was measured from the pyloric ring. Items of the morphometric and histologic study at the pyloric ring and sites of the 10cm and 20cm RGEA from the pyloric ring were luminal diameter, intimal thickness, medial thickness, wall thickness, degree of intimal hyperplasia, intimal thickness, medial thickness, wall thickness, degree of intimal hyperplasia, intimal thickness index, medial thickness index, and the number of discontinuities of the internal elastic lamina. Similar items were applied to the proximal site of ITAs. Result: The length of RGEA was 23${\pm}$2.7cm(range 17∼31cm). Comparing the 20cm RGEA with ITA, intimal thickness, medial thickness, wall thickness, and degree of intimal hyperplasia did not show any difference(p>0.05). However, 20cm RGEA was greater than ITA at the luminal diameter, intimal thickness index, and the number thickness and wall thickness in each site of the RGEA(pyloric ring, 10cm, 20cm) decreased from the pyloric ring to the distal sites(p<0.05). The degree of intimal hyperplasia and the number of discontinuities of the internal elastic lamina did not show any difference between the pyloric ring and 10cm, however, those of 20cm were smaller than these sites(p<0.05). RGEA had more number of discontinuities of the internal elastic lamina and rich smooth muscle cells in the media than ITA. Conclusion: The length and diameter of RGEA is good enough to reach most of the coronary arteries. Moreover, long term patency of RGEA may be improved, if anastomosed in the distal site.
First, mice were dosed with 50mg/kg of streptozotocin(STZ) twice every 24 hours to cause high blood-sugar. Then, after three days, mice were injected with 100mg/kg of STZ again. Two different dosages of Saengjihwangeumja-gami were given to the experiment groups: SA group, 15mg/kg/day, and SB group, 90mg/kg/day, in order to determine the effects of Saengjihwangeumja-gami, which has been known to be good for DM(Diabetes Mellitus). By observing weight and blood-sugar level changes, blood tolerance, the numerical value of BUN(Blood Urea Nitrogen) and creatinine in blood, and through light-electronicmicroscopic and immunohistologic investigations of pancreas and kidneys, the following results were obtained: 1. The experiment groups showed a high suppressive effect of weight-loss. 2. The experiment groups' blood-sugar and blood tolerance showed an effective lowering of blood-sugar levels. 3. The experiment groups did not show any noticeable change in the numerical value of BUN and creatinine in blood compared with that of the control groups. 4. The experiment groups showed a higher Insulin positive reaction of pancreatic islets ${/beta}-cell$ than the control groups. 5. The experiment groups showed a higher immuno-reaction against IGF- II than the control groups. 6. Observation of apoptosis of the pancreatic islets showed that the cells of experiment groups were less injured compared with those of the control groups, and fewer apoptag-positive reaction cells were seen in experiment groups than in the control groups. 7. Uunder electron-microscopy, the insulin-containing granules in pancreatic islets ${/beta}-cells$ had increased more in the experiment groups than in the control groups. 8. Under light microscopy, the injury on the inner & outer membrane of the glomerulus and epithelial cells of capillaries and cells among vessels were fewer in the experiment groups than in the control groups. 9. More apoptag-positive reaction cells in the kidney were seen in the control groups than in the experiment groups. 10. PAS-positive reaction substances had increased more in the substrate among the vessels of a glomerulus belonging to the control group than those of the experiment group. 11. Uunder electron-microscopy, the nucleonic membrane, nucleoplasm and mitochondria of proximal and distal renal tubular were more injured in the control groups than in the experiment groups. In conclusion, strong evidence for the efficacy of Saengjihwangeumja-gami in lowering blood-sugar, and in recovery and generation of pancreatic tissues injured by DM was observed. Results suggest Saengjihwangeumja-gami is an effective treatment for DM. Further study of the principles of blood-sugar dropping effects of Saengjihwangeumja-gami are needed, as well as further study of recovery and regeneration of pancreatic tissues injured by DM.
Kim, Yun Seok;Kim, Jeong Heon;Kim, Joon Bum;Yang, Dong Hyun;Kang, Joon-Won;Hwang, Su Kyung;Choo, Suk Jung;Chung, Cheol Hyun
Journal of Chest Surgery
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제47권1호
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pp.6-12
/
2014
Background: Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities. Methods: This study enrolled 41 patients (age, $55.2{\pm}11.9$ years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr). Results: On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint. Conclusion: The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.
Na, Kwon Joong;Lee, Kyung-Hak;Oh, Se Jin;Hwang, Ho Young;Kim, Ki-Bong
Journal of Chest Surgery
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제46권4호
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pp.274-278
/
2013
Background: Coronary involvement in Takayasu's arteritis is a rare but fatal disease. The aim of this study was to evaluate the early and mid-term results of Takayasu's arteritis patients who underwent coronary artery bypass grafting (CABG). Materials and Methods: Of 2,280 patients who underwent isolated CABG from January 1998 to June 2012, Takayasu's arteritis was identified in 5 patients. There were 3 female patients, and the mean age was $58{\pm}9$ years. Takayasu's arteritis was diagnosed during preoperative evaluation for coronary artery disease in 4 patients, and the initial manifestation was angina pectoris in 4 patients. All of the patients underwent anaortic off-pump CABG (OPCAB) using the in situ left or right internal thoracic arteries (ITA); 3 patients had severe stenosis of the proximal left subclavian artery and the in situ right ITA was used instead. Medical treatment for inflammatory arteritis during the perioperative and follow-up period was performed if indicated. Early, 1-year, and 5-year angiographic results and clinical outcomes were analyzed. Results: There was no surgical mortality, and all of the patients were discharged without complications on postoperative $8{\pm}2$ days. Early postoperative (postoperative $2{\pm}1$ days) angiography demonstrated a graft patency of 100% (12 of 12 distal anastomoses). One-year ($13{\pm}3$ months) angiography was performed in 4 patients, and all of the grafts were patent (100%, 9 of 9 distal anastomoses). Conclusion: By performing anaortic OPCAB in patients with Takayasu's arteritis, we were able to avoid complications associated with manipulating an atherosclerotic and severely calcified ascending aorta. The early and mid-term graft patency of OPCAB in Takayasu's arteritis was maintained when concomitant with medical treatment.
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