Purpose: The liver is one of the most commonly injured organs in abdominal trauma. Surgery has played a major role in treating traumatic liver injury. Recently, it was reported that conservative treatment could be the first-line management for hemodynamically stable patients without combined intraabdominal surgical problems. The aim of this study was to examine the prognostic factors in traumatic liver injury. Methods: The medical records of 41 patients who were treated for traumatic liver injury at Seoul National University Bundang Hospital from March 2003 to October 2007 were retrospectively reviewed. Results: Among the 41 patients, 34 cases (82.9%) were managed nonsurgically, and 7 cases (17.1%) were managed surgically. Out of the 5 (12.2%) mortalities, 2 were encountered in those who underwent surgery, and 3 were encountered in those who were treated nonsurgically. Univariate analysis showed that the initial systolic blood pressure, the initial hemoglobin level, and the grade of liver injury were significant prognostic factors for survival. Multivariate analysis indicated that initial low systolic blood pressure was the only independent risk factor. Conclusion: Patients with unstable vital signs initially have a poor prognosis. Aggressive management might be helpful for improving the survival rate in these patients.
Background: Survival rates after resection of advanced gastric cancer are extremely poor. An increasing number of patients with gastric carcinomas (GC) are therefore being treated with preoperative chemotherapy. We evaluated 36 month survival rate of GC patients that were treated by adding a neoadjuvant chemoradiotherapy before gastrostomy.Materials and Methods: Patients with stage II or III gastric adenocarcinomas were enrolled. The patients divided into two groups: (A) Neoadjuvant group that received concurrent chemoradiation before surgery (4500cGy of radiation at 180cGy per day plus chemotherapy with cisplatin and 5-fluorouracil, in the first and the end four days of radiotherapy). Resection was attempted 5 to 6 weeks after end of chemoradiotherapy. (B) Adjuvant group that received concurrent chemo-radiation after surgical resection. Results: Two (16.7%) patients out of 12 patients treated with neoadjuvant chemo-radiotherapy and 5 (38.5%) out of 13 in the surgery group survived after 36 months. These rates were not significantly different with per protocol and intention-to-treat analysis. The median survival time of patients in group A and B were 13.4 and 21.6 months, respectively, again not significantly different. Survival was significantly greater in patients with well differentiated adenocarcinoma in group B than in group A (p<0.004). Conclusions: According to this study we suggest surgery then chemoradiotherapy for patients with well differentiated gastric adenocarcinoma rather than other approaches. Additional studies with greater sample size and accurate matching relying on cancer molecular behavior are recommended.
Barse, A.V.;Jadhao, S.B.;Sahu, N.P.;Srivastava, P.P.;Jain, K.K.;Pal, A.K.
Asian-Australasian Journal of Animal Sciences
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제17권1호
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pp.127-130
/
2004
Lathyrus sativus, locally known as Khesari, is a leguminous pulse crop grown in many parts of the world for food (used by poor people) and animal feed/fodder. Its seeds are rich in protein and energy but contains anti-nutritional factors prominent among which is ${\beta}$-N-Oxalylamino-L-Alanine (BOAA), a neurotoxin causing lathyrism in humans due to prolong consumption. Keeping in view the chemical characteristics of this toxin and literary facts on L. sativus feeding in terrestrial animals, it was hypothesized that aquatic species may better utilise this ingredient in mixed extruded diets. Diets were prepared with varying levels (0, 10, 18, 26 and 34%) of L. sativus seeds and fed for 60 days to study growth, body composition and digestibility of nutrients. Final body weight, specific growth rate and feed and protein conversion ratio did not differ (p>0.05) between treatments. Crude protein digestibility was reduced (p<0.01) beyond 26% inclusion level of L. sativus. Final carcass composition with regard to protein, lipid and ash did not differ (p>0.05) among the treatments. Comparable craniosomatic, viscerosomatic, renosomatic and hepatic indices and no mortality implies no apparent adverse effect on the vital organs and fish health. It was concluded that L. sativus can be a promising feed ingredient that can be used up to 34% or possibly higher level in fingerlings diet. To our knowledge, it appears to be the first report of its kind under laboratory conditions.
Noreen, Mamoona;Murad, Sheeba;Furqan, Muhammad;Sultan, Aneesa;Bloodsworth, Peter
Asian Pacific Journal of Cancer Prevention
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제16권3호
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pp.979-984
/
2015
Breast cancer is the leading cause of morbidity and mortality globally but has an even more significant impact in developing countries. Pakistan has the highest prevalence among Asian countries. A general lack of public awareness regarding the disease often results in late diagnosis and poor treatment outcomes. The literacy rate of the Southern Punjab (Pakistan) is low compared to its Northern part. It is therefore vital that university students and especially medical students develop a sound knowledge about the disease so that they can spread awareness to others who may be less educated. This study therefore considers current knowledge and understanding about the early signs of breast cancer amongst a study group of medical and non-medical university students of the Southern Punjab, Pakistan. A cross-sectional descriptive analysis of the university students was carried out using a self-administered questionnaire to assess their awareness of breast cancer from March to May 2014. A total of 566 students participated in this study, out of which 326 were non-medical and 240 were from a medical discipline. Statistical analysis was carried out using Graph Pad Prism Version 5 with a significance level set at p<0.05. The mean age of the non medical and medical participants was 23 (SD 2.1) and 22 (SD 1.3) years, respectively. Less than 35% students were aware of the early warning signs of the breast cancer development. Knowledge of medical students about risk factors was significantly better than the non medical ones, but on the whole was insufficient. Our study indicated that knowledge regarding breast cancer was generally insufficient amongst the majority of the university students (75% non-medical and 55% medical) of Southern Punjab, Pakistan. This study highlights the need to formulate an awareness campaign and to organize conferences to promote breast cancer awareness among students in this region.
Although breastfeeding is recognized to be vital to the health and well-being of children and women, the rate of breastsfeeding among Korean women has continuously decreased. One barrier to breastfeeding has been identified to be associated with health care providers. Health care professionals do not give sufficient advice and encouragement, next do hospitals provide supportive environments for breastfeeding by separating infants from mothers or providing formula. The purpose of this study was to investigate prenatal breastfeeding education and infant feeding practices in public health centers and baby-friendly hospitals. A telephone survey was carried out on 57 public health centers located in the Seoul and Chungcheong areas and 13 baby-freindly hospitals from February to April in 2000. Among the public health centers, 43.8% offered periodic prenatal education for pregnant women who visited the centers. Most of them used leaflets or pamphlets developed by the Ministry of Health and Welfare or UNICEF. Twenty six percent of the public health centers developed their own educational materials. All of the 13 baby-friendly hospitals gave additional fluids to infants, did not allow mothers and infants to stay together 24 hours a day, and did not foster the establishment of breatfeeding support groups among the mothers. Most of the baby-friendly hospitals gave artificial teats, did not help mothers initiate breastfeeding within a half-hour of birth. Findings indicate that current practices even in the baby-friendly hospitals are not consistent with the '10 steps to success breastfeeding'. Therefore, deliberate efforts should be made to incorporate adequate breastfeeding education into prenatal program in both public health centers and hospitals, and create environments to support breastfeeding in hospitals, even in baby-friendly hospitals.
Purpose: It is important to begin a transfusion safely and appropriately as soon as possible in a hemorrhagic shock patient. A group $O^+$ unmatched pack red blood cell (universal $O^+$) transfusion may satisfy that requirement. We report our experiences with universal $O^+$ to compare its usefulness for hemorrhagic shock patients with that of a matched pack red blood cell transfusion in the emergency department (ED). Methods: This is a retrospective study. Patients who had systolic blood pressure of less than 90 mmHg or a pulse rate of more than 120 beats per minute in the ED were included, and their medical records were reviewed. The collected data were demographic data, vital signs, blood test results, time to transfusion, the amount of transfusion, complications, and diagnoses. We calculated the emergency transfusion score (ETS) based on the patients' medical records. Results: Two hundred thirty-five patients were included. Forty-eight patients (36 trauma and 12 non-trauma patients) were transfused with a universal $O^+$. These patients had less time to transfusion compared with the cross-matched transfusion groups (35${\pm}$42 versus $170{\pm}187$ minutes, p<0.001). There were no differences in complications between groups (p=0.076). Of the patients who were transfused with universal $O^+$, 94.4% got more than 3 ETS. Conclusion: The universal $O^+$ transfusion, compared with matched pack red blood cell transfusion, should be a useful treatment for ED hemorrhagic shock patient due to its having a shorter time to transfusion without an increase in complications.
Objectives : The purpose of this research is to examine the efficacy of Gamisoyosan on anxiety of generalized anxiety disorder according to dosage form. Methods : In this randomized, double blinded, placebo-controlled study, we planned to give Gamisoyosan simple extract mixture or Gamisoyosan compound extract or controlled medication for major symptoms of generalized anxiety disorder. As preparatory research, Hamilton rating Scale for Anxiety(HAM-A) was measured as the 1st evaluative instrument, and Korean State-Trait Anxiety Inventory(STAI-K), Penn State Worry Questionnaire(PSWQ) Korean Beck's Depression Inventory (BDI-K), Symptom Checklist-90-Revised(SCL-90R), WHO Quality of Life Abbreviated(WHOQOL-BREF) and Heart Rate Variability(HRV) were also measured as the 2nd evaluative instrument at the before treatment. Results : Demographic characteristics showed that there are Clinical characteristics-vital signs are within the normal range. The characteristics of disease-chief complaint, pattern Identification and etiological factor of the highest frequency number were worry, heart deficiency with timidity(心膽虛怯), family matters. The average period of disease in subjects is 6.31years. The results of Chest PA, EKG and clinicopathologic examination are within the reference range. The Scores of HAM-A, STAI-K, PSWQ were measured above the cutoff point. There are significant positive correlations among HAM-A, STAI-K, BDI-K and among HAM-A, STAI-K, PSWQ. There are no significant correlations between PSWQ and BDI-K. Conclusions : We considered that selection of subjects in this research is appropriately accomplished And this methodology is expected to be applied to the subsequent research. And also, we hope to make up for this study through various study and discussion.
Background: Although patients with a ruptured abdominal aortic aneurysm (RAAA) often reach the hospital alive, the perioperative mortality is still very high. We retrospectively reviewed thirty patients who underwent repair of RAAA to identify the factors affecting postoperative mortality in a single hospital. Materials and Methods: Between September 2007 and May 2011, thirty patients with RAAA underwent emergent surgery (n=27) or endovascular aneurysm repair (n=3). Their medical records were retrospectively reviewed regarding three categories: 1) preoperative patient status: age, gender, vital signs, serum creatinine, blood urea nitrogen, hematocrit, and hemoglobin level: 2) aneurysmal status: size, type, and rupture status; and 3) operative factors: interval time to operating room, operative duration, and amount of perioperative transfusion. Results: The 30-day postoperative mortality rate was 13.3% (4/30); later mortality was 3.3% (1/30). On multivariate analysis, the initial diastolic blood pressure (BP), interval time to operating room and amount of preoperative packed cell transfusion were statistically significantly linked with postoperative mortality (p<0.05). Conclusion: In this study, preoperative diastolic BP, preoperative packed cell transfusion amount and interval time between arrival and entry to operating room were significantly associated with postoperative mortality. It is important to prevent hemorrhage as quickly as possible.
Background: The aim of this study was to examine the seasonal variation of death from intentional self-harm by hanging, strangulation and suffocation (HSS: Korean Standard Classification of Diseases-6 code: X70) using the 2011 death registry data. Methods: The analysis was based on data of 8,359 HSS deaths from 2011 national vital statistics in Korea. Daily, weekly, and monthly death pattern on HSS were used to examine the relationship seasonal variation and HSS deaths. Results: A total of 8,359 HSS deaths occurred in 2011, with a mean age of 50.6 years. The HSS death rate (per 100,000) was 25.5 in male and 10.8 in female. In one day 17.6 males and 8.0 females occurred HSS death on average. The number of HSS death per day was the highest on 8th June (45 deaths), and lowest on 1st February (7 deaths) during the period. The variations of daily HSS death showed wide fluctuation from a peak of 34 to 45 deaths (29th May to 9th June) to a trough of 17-26 deaths (10th-13th September: the Korean thank-giving consecutive holidays), 13-20 deaths (2nd-5th February: the new year's day by the lunar calendar) and 8-9 deaths (24th-25th December: Christmas holidays). There were no significant difference between gender and seasonal variation (month, season, and week). Conclusion: The mean number of HSS death per day was highest in June (30.6 deaths), and months with the lowest number of deaths was January and December (range, 19.4 to 19.6 deaths). HSS death were more prevalent during summer and spring and were less likely to occur during winter. On Saturdays (21.0 deaths), the number of HSS death per day was the lowest, and Monday (27.9 deaths) was the highest. HSS death was less likely to occur on holidays (21.4 deaths). There was significant seasonal variation in HSS death by weekly and monthly (p<0.01).
Park, Tae Yun;Jung, Jae-Woo;Jang, Ju Young;Choi, Jae Chol;Shin, Jong Wook;Park, In Won;Choi, Byoung Whui;Kim, Jae Yeol
Tuberculosis and Respiratory Diseases
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제81권2호
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pp.156-162
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2018
Background: Eosinophilia is well recognized in specific conditions. The objective of the present study was to determine clinico-radiologic characteristics of eosinophilia and changes in prevalence over 10 years in recipients of private health screening program at a tertiary hospital in Korea. Methods: Data of private health screening program recipients at the health promotion center of Chung-Ang University Hospital from 2004 to 2013 were collected. Health-related questionnaires and laboratory findings of private health screening program with possible relation with eosinophilia were reviewed. Results of enzyme-linked immunosorbent assay (ELISA) for parasite, chest computed tomography, and pulmonary function test were also reviewed. Results: The cumulative prevalence of eosinophilia was 4.0% (1,963 of 48,928). Prevalence of eosinophilia showed a decreased trend from 2004 to 2013. Most cases (96.6%) had mild degree of eosinophilia. Eosinophilic subjects were older and male-predominant. They showed lower levels of forced expiratory volume in 1 second ($FEV_1%$), forced vital capacity (FVC%), and $FEV_1/FVC$ than those without eosinophilia. Eosinophilic subjects showed higher positive rate for common parasite in ELISA than those without eosinophilia. On radiologic findings, consolidation and ground glass opacities were positively associated with the degree of eosinophilia. When eosinophil was classified based on severity, statistically significant correlation between the severity of eosinophil and radiologic abnormalities was found. Conclusion: Eosinophilia is uncommon in healthy population. It usually occurs at a mild degree. Eosinophilic patients have more radiologic abnormalities compared to those without eosinophilia. Such radiologic abnormalities are associated with the severity of eosinophilia.
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