Jungook Kim;Youngbo Shim;Yoon-Hee Choo; Hye Seon Kim; Young ran Kim; Eun Jin Ha
Journal of Korean Neurosurgical Society
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제67권4호
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pp.451-457
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2024
Objective : Exploring protein requirements for critically ill patients has become prominent. On the other hand, considering the significant impact of coma therapy and targeted temperature management (TTM) on the brain as well as systemic metabolisms, protein requirements may plausibly be changed by treatment application. However, there is currently no research on protein requirements following the application of these treatments. Therefore, the aim of this study is to elucidate changes in patients' protein requirements during the application of TTM and coma therapy. Methods : This study is a retrospective analysis of prospectively collected data from March 2019 to May 2022. Among the patients admitted to the intensive care unit, those receiving coma therapy and TTM were included. The patient's treatment period was divided into two phases (phase 1, application and maintenance of coma therapy and TTM; phase 2, tapering and cessation of treatment). In assessing protein requirements, the urine urea nitrogen (UUN) method was employed to estimate the nitrogen balance, offering insight into protein utilization within the body. The patient's protein requirement for each phase was defined as the amount of protein required to achieve a nitrogen balance within ±5, based on the 24-hour collection of UUN. Changes in protein requirements between phases were analyzed. Results : Out of 195 patients, 107 patients with a total of 214 UUN values were included. The mean protein requirement for the entire treatment period was 1.84±0.62 g/kg/day, which is higher than the generally recommended protein supply of 1.2 g/kg/day. As the treatment was tapered, there was a statistically significant increase in the protein requirement from 1.49±0.42 to 2.18±0.60 in phase 2 (p<0.001). Conclusion : Our study revealed a total average protein requirement of 1.84±0.62 g during the treatment period, which falls within the upper range of the preexisting guidelines. Nevertheless, a notable deviation emerged when analyzing the treatment application period separately. Hence, it is recommended to incorporate considerations for the type and timing of treatment, extending beyond the current guideline, which solely accounts for the severity by disease.
Advancing the estrous cycle of mares is an essential breeding strategy that is routinely conducted by Thoroughbred breeders to improve economic outcomes. For this purpose, Equilume light masks have been developed as an alternative to existing technologies such as artificial lighting or hormonal treatments because they are considered as valid as existing methods with additional animal welfare advantages. For example, with the Equilume light masks, horses can be let out into the pasture, whereas they have to be kept indoors during lighting treatment. Because the function of Equilume light mask on the estrous cycle of mares is influenced by environmental factors such as nutrition condition and temperature, Equilume light mask should be studied in various environments. The objective of the present study was thus to verify the effect of Equilume light masks on the onset of the estrous cycle in Thoroughbred mares in South Korea. Mares were randomly selected and separated into two groups at two Thoroughbred horse breeding farms. The mares in the treatment group were equipped with Equilume light masks from November 18 to February 10 the following year. The body condition, the number and size (> 35 mm) of uterine follicles, and the uterine horn score of the mares were assessed on January 6 and February 10. The body condition scores were not different between the two groups. The treatment with the Equilume light mask had no positive effects on developing follicles and the reproductive tract. In conclusion, the use of Equilume light masks did not influence the seasonal resumption of the estrus cycles in Thoroughbred mares in South Korea.
Objectives : To assess the surgical results for patients with multiple intracranial aneurysms and factors related to prognosis of patients. Materials and Methods : We retrospectively analyzed the clinical characteristics of 47 patients with multiple intracranial aneurysms and assessed the types of surgical treatment and prognosis of 44 patients who received surgical treatment from January 1986 to March 1999. Results : The 47 patients presented altogether 108 aneurysms with male to female ratio of 1 : 3.7, and average age 54.9 years(range 33-81 years). Common locations for multiple aneurysms were P-com(31%), MCA(30%) and Acom( 15%). The postoperative good and poor outcomes were 30 cases(68%) and 11 cases(25%), respectively and there were 3 deaths(7%). The analyzed results for 44 surgically treated patients were as follows ; 1) The size of aneurysm was relevant to frequency of rupture ; the lowest for lesions less than 1cm(21%), rising to 85% for lesions greater than 3cm(p<0.05). 2) The surgical outcome was significantly correlated with preoperative clinical status of the patients(p<0.05). 3) The good outcome was associated with surgery within 7 days(especially 24 hours) after clinical onset of symptoms but not with type of operation and laterality of aneurysms. Conclusion : With regard to the surgical treatment for multiple aneurysm cases, surgeons should consider the salient factors in a good prognosis such as patient's preoperative status, size of aneurysm, timing of surgery, and type of operation.
Background This study aimed to identify the initial diagnostic characteristics and treatment status of children with submucous cleft palate (SMCP) and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement. Methods This retrospective study included 72 children diagnosed with SMCP between 2008 and 2016. The evaluation criteria were the age of the initial visit, total number of visits, age at the end of treatment, speech problems, resonance problems, and speech therapy. Results Children with SMCP first visited the hospital at an average age of 34.32 months, and speech problems were identified at an average age of 48.53 months. Out of 72 children, 46 underwent surgery at an average age of 49.74 months. Four of these children required secondary surgery at an average age of 83.5 months. Among the children who underwent surgery before 3 years of age, 70% exhibited articulation improvements, with mild-to-moderate hypernasality. Articulation improvements showed no statistically significant differences according to age at the time of surgery. However, children who underwent surgery before 4 years had a better hypernasality rating than those who underwent surgery after 4 years of age. Conclusions Children with SMCP tend to undergo delayed treatment because the anatomical symptoms in some children with SMCP are unclear, and surgical interventions are considered only after speech problems are clarified. Starting interventions as early as possible reduces the likelihood of receiving secondary surgery and speech therapy, while increasing expectations for positive speech function at the end.
Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta-synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.
Objective : Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA. Methods : Patients treated for SEA in the authors' department between 2007 and 2016 were included for analysis and retrospectively analyzed for basic clinical parameters and outcome. Pre- and postoperative neurological status were assessed using the American Spinal Injury Association Impairment Scale (AIS). The self-reported quality of life (QOL) based on the Short-Form Health Survey 36 (SF-36) was assessed prospectively. Surgery was defined as "early", when performed within 12 hours after admission and "late" when performed thereafter. Conservative therapy was preferred and recommend in patients without neurological deficits and in patients denying surgical intervention. Results : One hundred and twenty-three patients were included in this study. Forty-nine patients (39.8%) underwent early, 47 patients (38.2%) delayed surgery and 27 (21.9%) conservative therapy. No significant differences were observed regarding mean age, sex, diabetes, prior history of spinal infection, and bony destruction. Patients undergoing early surgery revealed a significant better clinical outcome before discharge than patients undergoing late surgery (p=0.001) and conservative therapy. QOL based on SF-36 were significantly better in the early surgery cohort in two of four physical items (physical functioning and bodily pain) and in one of four psychological items (role limitation) after a mean follow-up period of 58 months. Readmission to the hospital and failure of conservative therapy were observed more often in patients undergoing conservative therapy. Conclusion : Our data on both clinical outcome and QOL provide evidence for early surgery within 12 hours after admission in patients with SEA.
The influences of dietary supplement of citron tea on the hepatocellular chemical carcinogenesis have been studied by examining placental glutathione S-transferase(GST-P) positive foci area in a liver tissue, contents of total cytochrome P450, thiobarbituric acid reactive substances(TBARS) and glucose 6-phosphatase(G6Pase) in hepatic microsome and glutathione S-transferase(GST) activity. Weaning Sprague-Dawley male rats were fed AIN76 diet with or without citron tea supplement. Rats of CTR and CTR+ groups were fed diet without citron tea supplement while CDI and CDI+ groups were fed diet with citron tea supplement for the entire experimental period(13 weeks). Rats of CDP and CDP+ groups were fed diet without citron tea supplement for the first 7 weeks and swiched to citron tea containing diet for the last 6 weeks of experimental period. CTR+, CDI+ and CDP+ groups were carcinogen treated group. Diethylnitrosamine(DEN) was used as a carcinogen initiator and injected to the rats of carcinogen treated groups as a single dose of 200 mg/kg body weight intraperitoneally after 4 weeks of feeding. 2-Acethylaminofiuorene(AAF) was used as a carcinogen promoter and supplied in the diets of carcinogen treated rats as 0.02% content for the last 6 weeks starting from 2 weeks after DEN injection. Rats were sacrificed after 13 weeks of feeding. Liver/body weight ratio and GST activities were increased by carcinogen treatment. However, they were not changed by citron tea supplement. Total cytochrome P450 contents were not changed by carcinogen treatment or citron tea supplement. TBARS contents of carcinogen treated rats showed tendency to decrease by citron tea supplement. G6Pase activity decreased by carcinogen treatment and citron tea supplement. The area of GST-P positive foci detected in carcinogen treated rats were decreased by citron tea supplement and not affected by the timing and the duration of citron tea supplement. These results suggest that citron tea has suppressive effects on hepatocellular chemical carcinogenesis probably through antioxidant compounds by decreasing TBARS contents.
기존의 쌀겨농법 기술을 보완하여 잡초방제효과를 증진하기 위해 쌀겨의 분시방법 및 대두박과의 혼용, 중경제초와의 병행을 통한 잡초방제효과 및 쌀 수량의 변화를 조사하였다. 쌀겨 및 대두박 투입시기 조절에 따른 잡초방제효과 시험에서는 쌀겨관행구에서 잡초억제율이 가장 높아 대두박을 쌀겨와 같이 투입하는 것은 부적절하였다. 그러나 이앙 후 5일의 대두박 처리에서 피 발생이 적어 대두박 내 초기 피 발생 억제물질 존재 여부에 대한 추후 연구가 필요한 것으로 생각된다. 관행에 비해 잡초발생이 많은 쌀겨 및 대두박 시용의 경우 중경제초 병행 효과가 있었고 이에 대한 정밀한 중경제초 시기 및 방법에 대한 시험이 필요할 것이다.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제28권2호
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pp.103-113
/
2002
Distraction osteogenesis is a biologic process of new bone formation between the surfaces of bone segments that are gradually separated by incremental traction. Distraction osteogenesis is clinically applied as a new treatment modality of mandibular hypoplasia or bony defect area in maxillofacial area by many studies of distraction devices and method. But, disadvantages of distraction osteogenesis shows unfavorably long consolidation period and relapse tendency. Therefore, this experiment was designed to investigate the effectiveness of combined application of distraction and compression force for improving of bone quality and shortening of treatment period during distraction osteogenesis. Twenty-five Sprague-Dawley rats with $300{\sim}350gm$ were used. These were divided into two group as distraction group and combination group. The distraction group was added with conventional method during distraction osteogenesis, but the combination group was applied with compression force in the consolidation period. The rats were sacrificed for gross finding, radiographic and histologic findings at 3, 6 weeks after distraction. The results were as follow: 1. On radiographic finding, all combination of distraction and compression force group appeared more radiopacity than distraction group both at 3 weeks and 6 weeks after distraction group. 2. On histologic finding, the formation of mature lamellar bone were showed increasingly in combined group at 6weeks after distraction group. From this study, we may suggest that compression force application in consolidation period during distraction osteogenesis can be useful method to improve bone quality and to shorten the treatment period. But more experimental and clinical studies is necessitated on ideal application timing and method of compression force application during distraction osteogenesis.
Patients with unilateral cleft lip and palate (UCLP) generally demonstrate the asymmetries in the lip, nose and the naso-maxillary complex. And their skeletal asymmetries are known to be derived from the displacement of nasal septum, anterior nasal spine (ANS) and the pre-maxilla toward the non-affected side during the developmental and growth period. Due to the interruption of the important facial muscles, which are critical for the symmetric growth of premaxilla, functional matrix system fails to develop and results in the displacement of the ANS toward the non-affected side and nasal asymmetry. Therefore the rhinoplasty for CLP patients is required to have inter-skeletal and muscular rearrangement in the naso-maxillary complex in order to let them recover from esthetic and physiologic imbalances. And functional cheilorhinoplasty (FCR) has been a representative treatment of choice for this concept of treatment modality. The outcome and prognosis of primary or repair FCR have been known to be definitely affected by timing of the operation as well as adequate reconstruction of naso-labial muscles. However, sometimes FCR has an ineffective treatment results for patients after the facial growth period, and the limited rhinoplasty around the nose often fails to bring satisfying results. In order to circumvent this limitation, we performed ANS osteotomy for patients with unilateral CLP showing asymmetric nose, as an alternative way for corrective rhinoplasty. We could observe that the nose was rearranged along the facial mid-line by this osteotomy design and asymmetries were evidently improved postoperatively. Here we present this osteotomy method in CLP patients.
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