Purpose: Various changes in nutrition, metabolism, immunity, and psychological status occur through multiple mechanisms after gastrectomy. The purpose of this study was to predict disease status after gastrectomy by analyzing diseases pattern that occur or change after gastrectomy. Materials and Methods: A retrospective cohort study was conducted using nationwide claims data. Patients with gastric cancer who underwent gastrectomy or endoscopic resection were included in the study. Eighteen target diseases were selected and categorized based on their underlying mechanism. The incidence of each target disease was compared by dividing the study sample into those who underwent gastrectomy (cases) and those who underwent endoscopic resection for early gastric cancer (controls). The cases were matched with controls using propensity score matching. Thereafter, Cox proportional hazard models were used to evaluate intergroup differences in disease incidence after gastrectomy. Results: A total of 97,634 patients who underwent gastrectomy (84,830) or endoscopic resection (12,804) were included. The incidence of cholecystitis (P<0.0001), pancreatitis (P=0.034), acute kidney injury (P=0.0083), anemia (P<0.0001), and inguinal hernia (P=0.0007) were higher after gastrectomy, while incidence of dyslipidemia (P<0.0001), vascular diseases (ischemic heart disease, stroke, and atherosclerosis; P<0.0001, P<0.0001, and P=0.0005), and Parkinson's disease (P=0.0093) were lower after gastrectomy. Conclusions: This study identifies diseases that may occur after gastrectomy in patients with gastric cancer.
The second telemetry is designed for supplying additional function which the first telemetry system doesn't have and as a part system of the External Management System (EMS). It makes a patient and an animal move more freely with wireless communication at a distance of free activity from the PC and can get most data from the first telemetry to send to the PC. Recently, our laboratory is developing a RF system for the second telemetry.
In systems in which inductive coupling between a pancake-shaped coil on the surface of the body and a similar coil within the body is utilized for the transfort of electromagnetic energy, the minimization of temperature rise in the tissue is intimately related to the achievement of minimum losses in the region of the implanted coil. The new class of amplifiers, named "class E", for inverter is defined and is illustrated by a detailed description and a set of desist equations for one simple member of the class. For TET circuit the authors measured 65 to 76 percent efficiency at 1985kHz at 30 to 50 W output from IRF250 MOSFET transistor.
A new balancing method of atrial pressures balancing for the moving actuator total artificial heart(TAH) without an extra compliance chamber was developed. The asymmetric operation of the pendulous moving actuator have made it possible to compensate the left and right pump output difference by utilizing the interventricular air space as an internal compliance chamber in a pump housing. Furthermore, the balancing performance between left and right pump outputs is increased through the improvement of the flexibility of part of the polyurethane housing. However, the increase of the flexibility of the pump housing causes a little loss of the cardiac output due to the reduction of active filling property. In this paper., a good condition between the balance and pump output performance is evaluated by adjusting the air volume in the interventricular space through a series of in vitro experiments. This new pump was implanted in a sheep weighting 63kg, and it survived for 3 days and the average cardiac output during postoperative days was about 4.2 L/mim with the atrial pressures under 15 mmHg.
Rastelli operation in which right ventricle[RV and pulmonary artery[PA is connected with an artificial graft is effective in increasing the pulmonary blood flow in certain types of congenital heart disease but, in many, it requires a reoperation because of the relative stenosis of graft that develops as the patients become old. The purpose of this study is to evaluate the various factors which many influence the long term outcome of such patients following a Rastelli operation. A total of 47 patients underwent a Rastelli operation during a 15 year period between November, 1978 and October 1993. The mean follow-up period is 76.1 51.3 months.1 Among the 47 patients, a valved conduit was used in 30[63.8% , and non-valved conduit in 17[36.2% patients. In the 8 patients[17.0% who died postoperatively, a valved conduit was used in 5 [16.6% and a non-valved conduit in 3[17.6% . There was no statistical difference in mortality between the 2 groups. There was a good linear correlation between the body surface area[X and the conduit size[Y [Y=3.86X + 14.6, R=0.55, P=0.01 .2 Ten patients underwent replacement of the conduit during the follow-up period. The type of conduit used and the frequency of subsequent replacement were as follows: Ionescu-Shiley, valved-33.3%, Carpentier-Edwards, valved-30.8%, Hancock, valved-80% and non-valved conduit-9.1%. The median period free of reoperation was 110 months for the valved and 79 months for the non-valved group, there being no statistical difference between the 2 groups. 3 The patients who did not require reoperation are all doing well [New York Heart Association Functional Classification: Class I . Pressure gradient between the RV and the PA was 20 mmHg in 10 randomly selected patients who did not require reoperation and 92 9 mmHg in 10 patients who did require reoperation.4 In the 10 patients who underwent a conduit replacement procedure.5 Among patients undergoing reoperation, 2 died from endocarditis.The remaining 8 patients are doing well without limitation in physical activity at a mean follow-up period of 32.7 33.9 months [range 2 to 89 months . 6 At 5, 7, and 10 years, the reoperation-free rates among all patients were 96%, 91% and 29% and the survival rates were 82%, 82% and 71%. In conclusion, Rastelli operation is an effective procedure in ameliorating symptoms in a select group of patients with congenital heart disease. Because of the inherent nature of relative graft stenosis and degeneration, a long-term follow-up is required under the proper selection of the graft material.
Total 400 St.Jude Medical Bileaflet Valves were implanted in 336 pts from January 1983 to June 1993; 64 were aortic, 205 were mitral, 64 were double valve and 3 were tricuspid position. The follow up period extended from 6 months to 10 years[mean 24.3 months]. Male to female ratio was 1:1.7. There were total 27 deaths[cardiac related 20, cardiac non-related 7]. Overall mortality was 2.9%/pt-yr. There were 10 early deaths[3.0%] and 10 late cardiac related deaths [3.0%]. Prosthetic valve related complications occurred in 19 patients[5.7%] and among them, seven died; four died of thromboembolic events, two died of anticoagulants therapy related hemorrhagic complications and one died of bacterial endocarditis. NYHA class improved significantly especially in aortic valve replacement and double valve replacement. In AVR cases, the mean NYHA was 2.8 preoperatively and 1.3 postoperatively. And in DVR cases, 3.3 preoperatively and 2.2 postoperatively. The decision to employ a particular prosthesis was made according to the anticipated or known complications of the valve. The St.Jude Medical Valve retains all the hazards of other mechanical valves, most notably, thromboembolism. But the hemodynamic performance of St.Jude Medical Valve compared most favorably with other substitute valves in many reports. 0ur experience didn`t show any differences compared other authors in terms of valve related complication. So we concluded St. Jude Medical Valve can be primarily considered in the selection of artificial valve except in the patients when the usage of anticoagulant therapy is contraindicated.
Objective : This study is an experimental study which is designed to examine the differences between knowledge and self-confidence before and after theory education(CPR PPT material) based on guidelines of CPR and emergency cardiac treatment of American Heart Association(AHA, 2005) and video self-instruction program for the general public by Korean Association of Cardiopulmonary Resuscitation(KACPR), trace CPR performance ability after CPR and AED education and investigate the accuracy of artificial respiration and chest compression, and know the difference in CPR performance abilities including AED. Methods : Subjects of this study include ground crews and staffs at M airport in G province equipped with emergency equipments for CPR according to Art. 47, Sec. 2 of Emergency Medical Law, airport police, rent-a-cops, security guard, quarantine officer, custom officer, and communication, electricity, civil engineering, facility management staff, airport fire fighting staff, air mechanic, traffic controller, and airport management team among airport facility management staffs. They were given explanation of necessity of research and 147 of 220 subjects who gave consent to this research but 73 who were absent from survey were excluded were used as subjects of this study. of 147 subjects, there were 102 men and 45 women. Results : 1) Knowledge score of CPR was $6.18{\pm}0.87$ before instruction and it was increased to $15.12{\pm}1.78$ after instruction, and there was statistically significant difference. 2) Self-confidence score in CPR was $3.16{\pm}0.96$ before instruction and it was increased to $7.05{\pm}0.75$ after instruction, and there was statistically significant difference. 3) Total average score in CPR performance ability after instruction was 7.46 out of 9, performance ability was highest in confirmation of response as 144(97.95%), follwed by request of help as 140(95.25%) and confirmation of respiration as 135(91.83%), and lowest in performing artificial respiration twice(gross elevation of chest) as 97(65.98%). Accuracy of artificial respiration(%) was $28.60{\pm}16.88$ and that of chest compression(%) was $73.10{\pm}22.16$. 4) Performance ability of AED after instruction showed proper performance in power on by 141(95.91%) and attaching pad by 135(91.83%), hand-off for analyzing rhythm showed 'accuracy' in 115(78.23%) and 'non-performance' in 32(21.77%), delivery of shock and hand-off confirmation showed 'accuracy' in 109(74.14%) and 'inaccuracy' in 38(25.86%), and beginning chest compression immediately after AED was done by 105(71.42%).
Sunagawa, Katsunori;Weisinger, Richard S.;McKinley, Michael J.;Purcell, Brett S.;Thomson, Craig;Burns, Peta L.
Asian-Australasian Journal of Animal Sciences
/
v.14
no.7
/
pp.929-934
/
2001
The physiological role of brain somatostatin in the central regulation of feed intake in sheep was investigated through a continuous intracerebroventricular (ICV) infusion of somatostastin 1-28 (SRIF) at a small dose of $5{\mu}g/0.2ml/hr$ for 98.5 hours from day 1 to day 5. Sheep (n=5) were fed for 2 hours once a day, and water and 0.5 M NaCI solution were given ad libitum. Feed, water and salt intake were measured during ICV infusion of artificial cerebrospinal fluid (CSF) and SRIF. The feed intake during SRIF infusion on days 2 to 5 increased significantly compared to that during CSF infusion. Water intake, when compared to that during CSF infusion, only increased significantly on day 4. NaCI intake during SRIF infusion was not different from that during CSF infusion. Mean arterial blood pressure (MAP) and heart rate during SRIF infusion were not different from those during CSF infusion. The plasma concentrations of Na, K, Cl, osmolality and total protein during SRIF infusion were also not different from those values during CSF infusion.There are two possible mechanisms, that is, the suppression of brain SRIF on feed suppressing hormones and the direct actions on brain mechanisms controlling feed intake, explaining how SRIF works in the brain to bring about increases in feed intake in sheep fed on hay. The results indicate that brain SRIF increases feed intake in sheep fed on hay.
Plasma protein adsorption is the first event in the blood-material interaction and influenc- es subsequent platelet adhesion towards thlㅈombus formation. Thiㅈomboembolic events are strongly influenced by surface characteristics of materials and fluid dynamics inside the blood pump. In vitro flow visualizaion and an amimal experiment with the moving actuator type TAH were Performed in order to investigate fluid dynamic effects on the protein adsorption. The diffel'encl level, j of shear rate inside the ventricle Lvere determined by consid- ering the direction of the major opening of four healt valves in the implanted TAH and the visualized flow patterns as well. Each ventricle of the explanted TAH was sectionalized into 12 segments according to the shear rate level. The adsorbed protein on each segment was quantified using the ELISA method after soaking in 2% (wye)SDS/PBS for two days. Adsorbed protein layer thicknesses Itvere measured by the Immunogotd method under TEM. The SEM observation show that right ventricle (RV) , immobilized with albumin, displayed different degrees of platelet adhesion on each segment, whereas the left ventricle (LV), grafted by PEO-sulronate, indicated nearly , iame platelet adhesion behavior, regardless of shear rates. The surface concentrations of adsorbed proteins in the low shear rate region are hlghel'than those in the high region, which was confirmed statistically. A modified adsorption model of plasma protein onto polyurethane surface was suggested by considering the effect of the fluid dynamic characteristics.
Oriental medicine thinks life and death as the following. 1. The universe seems to be a kind of organism which is divided into 3 branches, as Heaven, Earth and Man. Man is not created from nihil by the Creator. Heaven and Earth by their interaction operate to produce man. This is similiar that zygote is not created from nihil, and that sperm and ovum are transformed into zygote by their interaction. The symbolic meaning of sperm is Heaven, and that of ovum is Earth. Mind and body, as well as spirit and body, are not the real, but artificial words for the purpose of observing and expressing one man. So there is not spiritual substance as distinct from body. The expected life span of man is subjected to change, and is always becoming through life. Fate, the Creator and the world to come cannot be said to be. 2. After one's death, man is transformend into Heaven and Earth. Dying is this process of transformation. Although man comes into existence and closes one's life, the total life of the universe does not change. The criteria of determination of death is not in cell death, but in somatic death. Somatic death divided into 2 branches, one is heart-lung death, the other is brain death. For the standard of health changes ceaselessly as time goes by, aging and dying is not the process of losing health. Because of mind cannot be seperated from body, we'll feel at ease bodily and mentally in healthy dying. The completion of lifetimes is the value of healthy dying. 3. From the viewpoint of these, we must think to let a person die healthily is the right medical ethics. The way to let a person die healthily is divided into 3 branches, one is treatment, another is prevention and the other is promotion of health. We should treat and prevent death of sickness, but take care of healthy dying.
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