BACKGROUND: Postoperative ileus and pain are concerns among surgical patients. Epidural anesthesia and analgesia with local anesthetics can decrease the duration of postoperative ileus and pain. Significant systemic absorption of local anesthetics occurs during epidural use. The object of the study was to define the effect of intravenous (iv) lidocaine on postoperative ileus and pain. METHODS: In a double-blind prospective study, 24 patients undergoing foot surgery were studied with one half of the patients receiving a lidocaine bolus (1.5 mg/kg) and infusion (2 mg/min) (n=12 Lidocaine group); the other half received a saline infusion (n=12 Control group). IV lidocaine initiated before general anesthesia and continued 1h postoperatively. We compared faces pain rating scale (at recovery room, op. day 7 PM, postop. 1 day 7 PM, postop. 2 day 7 PM), the total amount of analgesic use, the return of bowel function (first passage of flatus), hospital stay, side effects, patient satisfaction. RESULT: Perioperative IV lidocaine infusion reduced the pain scale at recovery room, op.day 7 PM, postop. 1 day 7 PM but not postop. 2 day 7 PM. No significant difference was found in return of bowel function, additional analgesics use, hospital stay, subjective satisfaction between 2 groups. No specific side effect due to lidocaine was found. CONCLUSION: IV lidocaine-treated patients has less pain postoperatively, but no faster return of bowel function in patients undergoing foot surgery.
Absorption ; Analgesia ; Analgesics ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics, Local ; Foot ; Humans ; Ileus ; Length of Stay ; Lidocaine* ; Patient Satisfaction ; Prospective Studies ; Recovery Room

BACKGROUND: Postoperative ileus and pain are concerns among surgical patients. Epidural anesthesia and analgesia with local anesthetics can decrease the duration of postoperative ileus and pain. Significant systemic absorption of local anesthetics occurs during epidural use. The object of the study was to define the effect of intravenous (iv) lidocaine on postoperative ileus and pain. METHODS: In a double-blind prospective study, 24 patients undergoing foot surgery were studied with one half of the patients receiving a lidocaine bolus (1.5 mg/kg) and infusion (2 mg/min) (n=12 Lidocaine group); the other half received a saline infusion (n=12 Control group). IV lidocaine initiated before general anesthesia and continued 1h postoperatively. We compared faces pain rating scale (at recovery room, op. day 7 PM, postop. 1 day 7 PM, postop. 2 day 7 PM), the total amount of analgesic use, the return of bowel function (first passage of flatus), hospital stay, side effects, patient satisfaction. RESULT: Perioperative IV lidocaine infusion reduced the pain scale at recovery room, op.day 7 PM, postop. 1 day 7 PM but not postop. 2 day 7 PM. No significant difference was found in return of bowel function, additional analgesics use, hospital stay, subjective satisfaction between 2 groups. No specific side effect due to lidocaine was found. CONCLUSION: IV lidocaine-treated patients has less pain postoperatively, but no faster return of bowel function in patients undergoing foot surgery.
Absorption ; Analgesia ; Analgesics ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics, Local ; Foot ; Humans ; Ileus ; Length of Stay ; Lidocaine* ; Patient Satisfaction ; Prospective Studies ; Recovery Room

BACKGROUND: Intrathecal neostigmine produces antinociceptive effects in many pain tests. Comparisons of pre- versus postinjury drug interventions have been made using the formalin test as a model for central sensitization. The purpose of this study was to compare behavioral antinociceptive responses with spinal fos-like immunoreactivity (FLI) in an intrathecal neostigmine injection between pre- versus post-formalin administration in a rat pain model. METHODS: Sprague-Dawley rats (250 300 g) were prepared with a PE 10 indwelling intrathecal catheter to receive either saline or neostigmine. The formalin test was performed on the second day after surgery with 5% 100microl. All rats were randomly divided into one of five groups; Sham, basal, control, pretreatment or posttreatment group. The Sham group (n = 4) received a dry needle at the hindpaw and the basal group (n = 6) received saline 100microl at the hindpaw. Saline 20microl was injected intrathecally after the formalin test in the control group (n = 8). Neostigmine (7.5microgram/10microl in volume) was administered intrathecally 7 minutes before the formalin test in the pretreatment group (n = 8) and 7 minutes after the formalin injection in the posttreatment group (n = 8). Pain related behavior was quantified by counting the incidence of flinches of the injected hindpaw for 60 minutes. Two hours after injection of formalin, animals were perfused with PBS and the spinal cords were removed immediately. The effect of pre- versus posttreatment with the neostigmine on c-Fos protein in the cord was examined by immunohistochemistry using specific antibodies. Immuno-positive cells in laminae I-II and III-V in the lumbar enlargement were calculated. RESULTS: Intraplantar formalin injection produced a biphasic appearance of the flinch behavior (phase 1 = 0 5 minutes, phase 2 = 20 60 minutes) in the control, pretreatment and postreatment groups. In the pretreatment group, rats showed less remarkable phase 1 and 2 responses than other groups. Flinches of phase 1 were 2.3 2.1, 33.2 7.6 (P< 0.05 vs. basal), 10.0 6.6 and 33.0 13.4(P< 0.05 vs. basal) in basal, control, pre- and posttreatment groups respectively. Flinches of phase 2 were 0.3 0.5, 224.5 66.4 (P< 0.05 vs. basal), 120.6 151.3 and 187.5 76.8 (P< 0.05 vs. basal) in basal, control, pre- and posttreatment groups respectively. Similarly, the pretreatment group virtually inhibited formalin-induced expression of FLI (P< 0.05 vs. control, posttreatment) in the laminae I-II ipsilateral to injection. The posttreatment group inhibited formalin-indeced expression of FLI (P< 0.05 vs. control) in the laminae III-V ipsilateral to injection. CONCLUSIONS: Pretreatment of intrathecal neostigmine inhibits nociceptive behaviors and FLI in the laminae I-II following formalin injection in rats, suggesting that pretreatment plays an important role in the development of plasticity in this model.
Analgesics ; Animals ; Antibodies ; Catheters ; Central Nervous System Sensitization ; Formaldehyde* ; Immunohistochemistry ; Incidence ; Needles ; Neostigmine* ; Pain Measurement* ; Plastics ; Rats ; Rats, Sprague-Dawley ; Spinal Cord

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

Thirty cases of gastric adenocarcinoma were examined immunohistochemically for expression of transforming growth factor-beta(TGF-beta) in order to analyze significant correlation with clinical stage and pathologic grade of gastric adenocarcinoma. Specific immunostaining was clearly detected in the cytoplasm of the neoplastic cells. The TGF-,6 expression in the gastric adenocarcinoma is closely related to the depth of invasion, the degree of invasiveness and the presence of metastasis. Thus, we observed the stronger immunohistochemical. expression of TGF-beta in the deeper portion of invasion and in the invasive gastric adenocarcinomas with the lymph nodal metastasis than in the superficial portion of invasion and in those without the lymph nodal metastasis. There results suggest that the transforming growth factors expression in carcinoma cells may play an important role in the carcinomatous invasion resulting in metastasis.
Adenocarcinoma ; Neoplasm Metastasis

The temporomandibular joint (TMJ) is unique among joints in the human body, since it can be dislocated without external force. Manipulation of the upper airway other than laryngoscopy is a risk factor in patients who have a history of habitual dislocation of the TMJ. The case report illustrates that severe limitation of the jaw opening ("closed lock") requiring manipulation for restoration may occur during induction of general anesthesia.
Anesthesia* ; Anesthesia, General ; Dislocations ; Human Body ; Humans ; Jaw* ; Joints ; Laryngoscopy ; Risk Factors ; Temporomandibular Joint

PURPOSE: The study aimed to explore the health consequences that women experienced after miscarriage and the factors related to them. METHODS: A convenience sample consisting of 102 women who had miscarried within 2 years was used. Women were recruited from hospitals and enterprises in Seoul and Gyeong-Gi Province. Participants completed a self-administered questionnaire containing a physical and psychological symptoms checklist developed for this study. RESULTS: More than 40% of the miscarriages occurred after 9 weeks of pregnancy and 35% of women were found to have had a previous miscarriage prior to this study. Psychological symptoms were more prevalent and prolonged than the physical symptoms, furthermore, the frequencies of the symptoms experiencedwere not consistent with the duration of symptoms. Employed women and women with early miscarriages complained of more physical symptoms; however, psychological symptoms were not different according to women's characteristics. Employment was a significant factor affecting physical symptoms. CONCLUSION: Health care professionals need to inform and educate women and the family of the potential health changes during the recovery after the miscarriage. Health consequences due to miscarriages also need to be incorporated in women's reproductive health care. Nursing care should consider factors of maternal age, employment status, and obstetrical conditions upon the apparent social changes.
Abortion, Spontaneous ; Checklist ; Delivery of Health Care ; Employment ; Female ; Humans ; Maternal Age ; Nursing Care ; Pregnancy ; Surveys and Questionnaires ; Reproductive Health ; Social Change