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: Lumbar plexus block by posterior approach has been used for thigh and hip surgery and unilateral low back pain and/or low extremity pain control. We measured the needle depth from the skin to the lumbar plexus and its relation with body indices in Korean. METHODS: Forty-eight (male 35, female 13) patients with unilateral low back pain and/or low extremity pain received lumbar plexus block by the posterior approach known as "psoas compartment block". We measured the distance from the skin to the lumbar plexus with the aid of a nerve stimulator and evaluated its relation to body mass indices such as weight, height, abdominal circumference and body mass index (BMI; kg/m2). RESULTS: The distance described above was 7.42 +/- 0.82 cm (range 6.0-9.5 cm) in males and 7.18 +/- 1.24 cm (range 5.3-10.0 cm) in females. Its relation to body weight was greater than with other body indices. The Pearson's coefficient between the distance and body weight was 0.745 in males and 0.842 in females. The predicted distance (cm) was 4.23 + 0.0471 x weight (kg) in males (adjusted R2 = 0.532) and 1.25 + 0.0975 x weight in females (adjusted R2 = 0.682). CONCLUSIONS: Body weight is the most important factor for prediction of the distance from the skin to the lumbar plexus. The distance was about 6-10 cm in korean patients.
Body Mass Index ; Body Weight ; Extremities ; Female ; Hip ; Humans ; Low Back Pain ; Lumbosacral Plexus* ; Male ; Needles* ; Sagittal Abdominal Diameter ; Skin ; Thigh

Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

Clear cell chondrosarcoma, first described by Unni in 1976, is distinguished from classical chondrosarcoma by a typical histological picture, mostly an epiphyseal site of origin, and relatively a benign clinical course. We present a case of clear cell chondrosarcoma arising from hyoid bone in a 70-year-old male. Histologically, large areas of closely packed cells with characteristic clear cytoplasm were seen in addition to the usual elements of a conventional chondrosarcoma. Our search and review of the literature did not reveal any reported case of clear cell chondrosarcoma arising from hyoid bone.
Aged ; Chondrosarcoma* ; Cytoplasm ; Humans ; Hyoid Bone* ; Male

The authors reviewed 3145 pediatric patients who visited the emergecy room in this hospital during 3yrs period from Jan. 1989 to Dec. 1991. 1) Among the patients visiting the emergency room, the patients under 15 years of age were 26.4% (3145) of total emergency patients (11930). 2) yearly distribution of patients were decreased 17% between 1989 and 1991. 3) Monthly distribution of visits showed higher incidence in June and July. The male to female ratio was 1.5:1. 4) Weekly distribution of visits showed higher incidence on Sunday and Saturday, relatively. 5) Most popular time of visiting the emergency room was between 8:00 PM to 12:00 PM during which time 29.5% of all pediatric patient were seen. 6) Distribution of age showed peak incidence between 6 and 12 years of age (30.9%). 7) 65.18% of total emergency room isits were pediatric patients. 8) Distribution of cases was as follows: Respiratory disease 37%, accident, GI disease in turn listed respectively in ecreasing order of freqency. 9) The admission rate through emergency was 8.5% of total pediatric emergency patients. 10) 82.3% of total emergency visits had medical insurance coverage, 7% had no insurance and 10.7% were on medical aid program.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Incidence ; Insurance ; Insurance Coverage ; Male

BACKGROUND: The level of physical adaptation through active lifestyle can result in changes in appetite; and caused by physical activity and exercise, physical adaptation may change carbohydrate and fat metabolism during exercise. This study investigated the differences in carbohydrate and fat metabolism after moderate treadmill running and the difference in appetite response before and after exercise in active, regularly exercising individuals and those inactive. METHODS: We analyzed the effects of moderate physical activity (70% of oxygen uptake reserve, 30 minutes on the treadmill) on free fatty acids, glucose, growth hormone, insulin and an appetite visual analogue scale (VAS). Our subjects included 28 healthy males who were divided into two groups, the activity group (n=14) and the inactivity group (n=14) according to the International Physical Activity Questionnaire (IPAQ). The serum samples and VAS were collected at pre, post and 30 min post-exercise. RESULTS: The results of the serum analysis showed no significant effects on free fatty acids, glucose, growth hormone and insulin between the groups, but showed significant changes in free fatty acids and growth hormone between points of measurement. Significant increases in VAS were seen with moderate exercise in both groups, with the inactivity group expressing greater hunger than the activity group. CONCLUSIONS: This study found that inactive persons were hungrier than active persons after moderate exercise. This information might be useful to staff and participants of weight loss programs.
Appetite ; Energy Metabolism ; Exercise ; Fatty Acids, Nonesterified ; Glucose ; Growth Hormone ; Humans ; Hunger ; Insulin ; Life Style ; Male ; Motor Activity ; Oxygen ; Running ; Weight Reduction Programs ; Surveys and Questionnaires

Angiosarcoma is a rare primary malignancy occurring anywhere in the body, but most often in the skin, liver or breast. The radiological findings of angiosarcoma of the breast have rarely been reported. We encountered a case in which the condition involved a 32-year-old woman in whom mammography revealed a obscuved-marginated and lobular-shaped high-density lesion, and ultrasonography demonstrated an ovalshaped, microlobular-marginated, inhomogenous hypoechoic mass which metastasized to the whole body after surgery. We report the radiological findings of this case of angiosarcoma of the breast, and review the literature.
Adult ; Breast Neoplasms ; Breast* ; Female ; Hemangiosarcoma* ; Humans ; Liver ; Mammography ; Sarcoma ; Skin ; Ultrasonography

BACKGROUND: Several reports have indicated that there are fewer postoperative complications after using a smaller spinal needle in young patients. However, no comparative report has been issued on the incidences of postoperative complications after using differently sized spinal needles for spinal anesthesia in elderly patients. Here, we compared a 22 G Quincke needle with a 25 G Quincke needle in elderly patients and investigated postoperative complications. METHODS: Fifty patients, aged over 60 years presented for an elective urological operation. Patients were randomized into two groups to receive spinal anesthetics using a 22 G Quincke needle (group L) or a 25 G Quincke needle (group S). The incidences of postdural puncture headache (PDPH), backaches, and the outcomes of spinal anesthesia were compared between the two groups. RESULTS: Two patients in group L and one in group S developed PDPH postoperatively with no significant statistical difference between the two groups. Four patients suffered backache in group L and two in group S again without significance. But the number of puncture attempts was significantly higher in group S. CONCLUSION: In conclusion, postoperative complications were similar for both groups. However, spinal anesthesia was performed more easily when using a larger spinal needle. Therefore, we recommend that a larger spinal needle be used when difficult spinal anesthesia is anticipated in elderly patients.
Aged* ; Anesthesia, Spinal* ; Anesthetics ; Back Pain ; Humans ; Incidence ; Needles* ; Post-Dural Puncture Headache ; Postoperative Complications* ; Punctures

Simultaneous perioperative measurements of cradiac output were obtained in 16 patients for coronary artery bypass graft with transthoracic impedance and pulmonary artery thermodilution techniques to evaluate the utility of the noninvasive methods. Correlation coefficient of average pairs of the two methods was 0.81 (heart rate<60) 1.00 (60< or =heart rate<70) 0.82 (70< or =heart rate<80) 0.52 (80< or =heart rate<90) 0.65 (heart rate> or =90). Correlation coefficient of individual pairs of the two methods was 0.73 (heart rate<60) 0.99 (60< or =heart rate<70) 0.72 (70< or =heart rate<80) 0.60 (80< or =heart rate<90) 0.57 (heart rate> or =90). Each value has a significance with 95% confidence except average pairs below 60 of heart rate. In a scattergram with +/-20% confidence bands, 100% of data points fall inside this confidence bands when the heart rate is below 70. Each value has a significance with 95% confidence except average pairs below 60 of heart rate. In a scattergram with +/-20% confidence bands, 100% of data points fall inside this confidence bands when the heart rate is below 70, Two methods are in good agreement when the heart rate is below 70. It is concluded that transthoracic impedance can replace thermodilution method for coronary artery bypass graft, at least, in operating room and intensive care unit because heart rate should be managed at relatively low range.
Cardiac Output* ; Cardiography, Impedance ; Coronary Artery Bypass* ; Coronary Vessels* ; Electric Impedance* ; Heart Rate ; Humans ; Intensive Care Units ; Operating Rooms ; Pulmonary Artery ; Thermodilution* ; Transplants

No Abstract Available.
Mass Screening*