Ketogenic diet has been used for more than 80 years as a successful dietary regimen for epilepsy. Recently, dietary modulation by carbohydrate depletion via ketogenic diet has been suggested as an important therapeutic strategy to selectively kill cancer cells and as adjuvant therapy for cancer treatment. However, some researchers insist ketogenic diet to be highly undesirable as ketogenic diet may trigger and/or exacerbate cachexia development and usually result in significant weight loss. This review revisits the meaning of physiological ketosis in the light of this evidence and considers possibility of the use of ketogenic diet for oncology patients. Article search was performed from 1985 through 2017 and finally 10 articles were analyzed. The review focused on the results of human trials for cancer patients and checked the feasibility of using ketogenic diet for cancer patients as adjuvant therapy. The main outcomes showed improvement of body weight changes, anthropometric changes, serum blood profiles, and reduction in novel marker for tumor progression, TKTL1, and increase of ketone body. Lactate concentration was reduced, and no significant changes were reported in the measurements of quality of life. Ketogenic diet may be efficacious in certain cancer subtypes whose outcomes appear to correlate with metabolic status, but the results are not yet supportive and inconsistent. Therefore, it warrants further studies.
Body Weight Changes ; Cachexia ; Diet, High-Fat ; Epilepsy ; Humans ; Ketogenic Diet* ; Ketosis ; Lactic Acid ; Quality of Life ; Weight Loss

BACKGROUND: The aim of this study was to compare the cardiovascular changes followed by laryngoscopy with the McCoy laryngoscope blade with those followed by laryngoscopy with the Macintosh laryngoscope blade. METHODS: Forty eight patients were randomly divided into two groups. Following induction with fentanyl 2 mcg/kg and thiopental 5 mg/kg, and muscle relaxation with vecuronium 0.1 mg/kg, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, then tracheal intubation was performed. Heart rate and arterial blood pressure were measured just before and after laryngoscopy, and 1, 3 and 5 min later. RESULTS: There was a significant increase in both heart rate and arterial blood pressure after tracheal intubation using the Macintosh laryngoscope. Also, use of the McCoy blade resulted in a significant increase in both heart rate and arterial blood pressure. CONCLUSIONS: There was no significant difference on arterial pressure and heart rate to laryngoscopy and tracheal intubation with either the McCoy blade or the Macintosh.
Arterial Pressure ; Blood Pressure* ; Fentanyl ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Laryngoscopy ; Muscle Relaxation ; Thiopental ; Vecuronium Bromide ; Vocal Cords

BACKGROUND: Laryngoscopy and tracheal intubation for general anesthesia are potent stimuli to the cardiovascular system due to sympathetic stimulation. The aim of this study was to compare the hemodynamic responses with different administration routes of lidocaine on blood pressure and heart rate changes associated with tracheal intubation. METHODS: Sixty patients were randomly assigned to spray group (Group 1, n=20) received 10% lidocaine 1.5 mg/kg spray to intratracheally immediately before tracheal intubation, IV group (Group 2, n=20) received 2% lidocaine 1.5 mg/kg intravenously before 90 sec tracheal intubation and control group (Group 3, n=20). Anesthesia was induced with thiopental 5 mg/kg IV, vecuronium 0.1 mg/kg and 50% N2O-O2- 2vol % enflurane. After 5 minutes, tracheal intubation was performed. Mean arterial pressure and heart rate were measured at preintubation and immediately postintubation, 1, 3, 5 mins after tracheal intubation. RESULTS:The differences of mean arterial pressure which were measured at preintubation and immediately postintubation and 1 minute after intubation in group 1 were significantly lower than those in other group (p<0.05). The differences of heart rate which measured at preintubation and 1 minute after intubation were lower than those in group 3 (p<0.05). CONCLUSIONS: For the suppression of sympathetic stimulation following tracheal intubation, 10% lidocaine spray to the laryngotrachea is an effective method to suppress cardiovascular response.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Enflurane ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Laryngoscopy ; Lidocaine* ; Thiopental ; Vecuronium Bromide

The patients with abdominal surgery usually have acute pain. It is important for a patient's quality of life and for good recovery after surgery to control the postoperative pain. The purpose of this study is to identify the relationship between emotional state of preoperative patients and postoperative pain. The participants in this study were the 100 patients receiving abdominal surgery who received Intravenous Patient Controlled Analgesia (IV-PCA) at the end of the operation. The data were collected using questionnaires and the period of the data collection was from March to August, 2001. The instruments used for this study were The State-Trait Anxiety Inventory (STAI) Developed by Spielberger (1972), The Center for Epidemeologic Studies-Depression (CESD) scale and Visual Analog scale (VAS). The data were analyzed using descriptive statistics, t-test, ANOVA and Pearson Correlation coefficient with the SPSS program. The results are as follows. 1.For general characteristics there were significant differences in the degree of trait anxiety according to gender (p= 0.0010), marital status (p=0.0122), religion (p=0.0040), education (p=0.0001), occupation (p=0.0002), monthly income (p=0.0001), diagnosis (p=0.0001), and operation title (p=0.0001). 2.For general characteristics there were significant differences in the degree of state anxiety according to gender (p= 0.0023), education (p=0.0073), monthly income (p=0.0001), diagnosis (p=0.0005), and operation title (p=0.0063). 3.For general characteristics there were significant differences in the degree of depression according to gender (p= 0.0073), occupation (p=0.0469), monthly income (p=0.0001), diagnosis (p=0.012), and operation title (p=0.0033). 4.For general characteristics there were significant differences in the degree of postoperative pain according to gender (p=0.0213), marital status (p=0.0082), education (p=0.0016), occupation (p=0.0128), monthly income (p=0.0008), diagnosis (p=0.0007), and operation title (p=0.0008). 5.The relationship between trait anxiety and postoperative pain revealed a significant positive correlation (r=0.51, p=0.0001), and the relationship between state anxiety and postoperative pain revealed a significant positive correlation (r=0.50, p=0.0001), and the relationship between Depression and pain revealed a significant positive correlation (r=0.49, p=0.0001).
Acute Pain ; Analgesia, Patient-Controlled ; Anxiety ; Data Collection ; Depression ; Diagnosis ; Education ; Humans ; Marital Status ; Occupations ; Pain, Postoperative ; Quality of Life ; Surveys and Questionnaires ; Visual Analog Scale

No abstract available.
Chlamydia trachomatis* ; Chlamydia* ; Female ; Humans ; Infant, Newborn* ; Nasal Cavity* ; Polymers* ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy*

BACKGROUND: Tracheal intubation by direct laryngoscopy induces frequently transient hypertension, tachycardia and arrhythmia. The purpose of this study was to examine the effect of esmolol and clonidine in attenuating the changes of blood pressure and heart rate by tracheal intubation. METHODS: Eighty patients were randomly divided into four groups: Group 1 (control , n=20), Group 2 (esmolol 0.5 mg/kg IV, n=20), Group 3 (clonidine 4 mcg/kg PO, n=20) and Group 4 (clonidine 4 mcg/kg PO and esmolol 0.5 mg/kg IV, n=20). The clonidine premedication were given orally with a sip of water 90 minutes before induction of anesthesia. Anesthesia was induced with thiopental 5 mg/kg, vecuronium 0.1 mg/kg, 50% nitrous oxide in oxygen and 2 vol % enflurane. After 5 minutes, tracheal intubation was performed. Patients in the group 2 and group 4 were given esmolol 0.5 mg/kg 90 seconds prior to tracheal intubation. Blood pressure and heart rate were measured at ward, preinduction, preintubation, immediately after intubation, 1, 3 and 5 minutes after intubation. RESULTS: After tracheal intubation, the increase in systolic blood pressure was supressed significantly in the clonidine-treated patients (Group 3, Group 4) compared with control group (p<0.05). The attenuating effect on increase of mean arterial pressure(MAP) was sustained longer in group 4 than group 3. Heart rate increased after tracheal intubation in all groups, but were markedly increased in the control group (p<0.05). The differences of MAP which measured at preinduction and immediately postintubation were smaller in group 4 than control group (p<0.05). The differences of heart rate which measured at preinduction and immediately postintubation were smaller in group 4 than group 1 or group 3 (p<0.05). CONCLUSIONS: Esmolol 0.5 mg/kg given as bolus, is effective for controlling the increase of heart rate but not in attenuating increase of blood pressure. Oral clonidine is effective for controlling the increase of blood pressure but not in attenuating increase of heart rate. Therefore esmolol combined with oral clonidine results in effective control of both heart rate and blood pressure.
Anesthesia ; Arrhythmias, Cardiac ; Blood Pressure ; Clonidine* ; Enflurane ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation* ; Laryngoscopy ; Nitrous Oxide ; Oxygen ; Premedication* ; Tachycardia ; Thiopental ; Vecuronium Bromide ; Water

BACKGROUND: Post-CPB bleeding diathesis remains one of main causes of morbidity in open heart operation since it requires significant amount of homologous transfusion. Many approaches have been studied to reduce the amount of postoperative blood loss and blood use. Aprotinin is known to reduce postoperative bleeding. Therefore, hemostatic effects of aprotinin have been searched in open heart surgery. METHODS: Adult patients for open heart opeartion were randomly allocated to two groups, control group and study group. All anesthetic, surgical and bypass techniques were standardized. After induction, 10,000 KIU given for testing and then 2,000,000 KIU of aprotinin was infused for 20~30 minutes before sternotomy, and followed by at rate of 500,000 KIU/hr. Additional 2,000,000 KIU of aprotinin was mixed to pump prime of heart-lung machine. Aprotinin infusion was ended by the time of skin closure. Amount of postoperative bleeding as well as homologous blood requirement were measured. Urine output and serum creatinine were also documented during postoperative period. RESULTS: Postoperative-36hr summation of blood loss differed significantly(1858.4 1182.9 ml vs. 1256.7 688.4 ml, p<0.1). Postoperative homologous blood requirements were also reduced in the requirement of packed RBCs use(3.0 2.5 units vs. 1.0 0.8 units, p<0.01) and of fresh frozen plasma use(6.6 4.4 units vs. 3.9 2.6 units, p<0.05). Postoperative measurement of urine output and serum creatinine showed insignificant difference between groups while remained within normal range. CONCLUSIONS: High-dose aprotinin seems to have beneficial effect in reducing postoperative blood loss and blood use without renal complication.
Adult* ; Aprotinin* ; Blood Platelets ; Cardiopulmonary Bypass ; Control Groups ; Creatinine ; Disease Susceptibility ; Heart ; Heart-Lung Machine ; Hemorrhage ; Humans ; Pharmacology ; Plasma ; Postoperative Hemorrhage ; Postoperative Period ; Reference Values ; Skin ; Sternotomy ; Thoracic Surgery*

Dilutional hyponatremia as one of the postoperative complications shows around 0.34% in pediatric patients, of which iatrogenic administration of salt-free water is the major cause. Aggressive management should be performed if neurologic symptoms and signs coexist. He/she may be expired of respiratory arrest in severe cases, or permanent neurologic sequelae might persist. We report a case of female pediatric surgical patient who received general anesthesia for Salter innominate osteotomy and had generalized convulsions following 5% dextrose administration. Sodium concentration at immediate postconvulsive period revealed 122 mEq/L, appropriate fluid & electrolyte therapy was performed, then sodium level was successfully restored without any sequelae found. We emphasize that it should be checked out prudently whether postoperative free water is administered in the case of postoperative convulsion, while surgical stimuli and anesthesia itself elevate serum antidiuretic hormone level.
Anesthesia ; Anesthesia, General ; Female ; Glucose ; Humans ; Hyponatremia ; Neurologic Manifestations ; Osteotomy ; Postoperative Complications ; Seizures* ; Sodium ; Water ; Water Intoxication

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

No Abstract Available.
Mass Screening*