No Abstract Available.
Arthroplasty* ; Knee Joint* ; Knee*

No abstract available.

BACKGROUND: Although current dietary guidelines recommend to increase the consumption of whole grain, these recommendations are mainly derived from the belief that replacing fats with carbohydrate may reduce risk of coronary artery disease (CAD) by improving serum lipids. Our objective was to evaluate whether the isocalorical replacement of refined rice with whole grain reduce CAD risk factors such as insulin demand and lipid peroxidation in CAD patients. METHODS: Thirty-eight male patients with CAD were provided with 70 g powder of whole grain (220 kcal) for 16 weeks, replacing cooked refined rice as a carbohydrate source of breakfast. An oral glucose tolerance test (OGTT) was performed in all subjects to determine the effect of whole grain consumption on serum concentrations of insulin and glucose in CAD patients with different degree of glucose tolerance. RESULTS: With the substitution of whole grain for refined rice, serum glucose concentrations decreased by 24% without altering body weight and energy intake. Estimates of daily fiber and vitamin E intakes increased by 24% and 50%, respectively. Whole grain consumption in CAD patients without diabetes decreased fasting glucose (22%) and the area under the curve (AUC) for insulin (26%) and glucose (19%) during an OGTT. CAD patients with diabetes also showed reductions in fasting glucose (27%) and AUC for glucose (25%) during the OGTT, compared with baseline values. Whole grain consumption reduced plasma malondialdehyde and homocysteine and urinary 8-epi-prostaglandin F 2alpha concentrations by about 30%. Lipid-corrected concentrations of alpha-carotene, retinol, alpha- and gamma-tocopherol and lycopene increased by 22-46%, compared with baseline values. Whole grain consumption decreased the percentage composition of w6 fatty acids of serum phospholipid increased by 14%. CONCLUSION: The replacement of refined rice with whole grain as a carbohydrate source of a meal showed significant beneficial effects on glucose, insulin and homocysteine concentrations and lipid peroxidation in CAD patients. These effects are likely to substantially reduce the risk factors of CAD and diabetes in CAD patients.
Area Under Curve ; Blood Glucose ; Body Weight ; Breakfast ; Edible Grain* ; Coronary Artery Disease* ; Coronary Vessels* ; Energy Intake ; Fasting ; Fats ; Fatty Acids ; gamma-Tocopherol ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Insulin* ; Lipid Peroxidation* ; Male ; Malondialdehyde ; Meals ; Nutrition Policy ; Plasma* ; Risk Factors ; Vitamin A ; Vitamin E ; Vitamins

No abstract available.
Colonic Neoplasms* ; Humans ; Hydromorphone* ; Intercellular Adhesion Molecule-1*

OBJECTIVES: The aim of this study was to compare the osteogenic effects of demineralized dentin matrix (DDM) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) in rabbit calvarial defects with DDM and anorganic bovine bone (ABB) combined with rhBMP-2. MATERIALS AND METHODS: Four round defects with 8-mm diameters were created in each rabbit calvaria. Each defect was treated with one of the following: 1) DDM, 2) ABB/rhBMP-2, or 3) DDM/rhBMP-2. The rhBMP-2 was combined with DDM and ABB according to a stepwise dry and dip lyophilizing protocol. Histological and microcomputed tomography (µCT) analyses were performed to measure the amount of bone formation and bone volume after 2- and 8-week healing intervals. RESULTS: Upon histological observation at two weeks, the DDM and ABB/rhBMP-2 groups showed osteoconductive bone formation, while the DDM/rhBMP-2 group showed osteoconductive and osteoinductive bone formation. New bone formation was higher in DDM/rhBMP-2, DDM and ABB decreasing order. The amounts of bone formation were very similar at two weeks; however, at eight weeks, the DDM/rhBMP-2 group showed a two-fold greater amount of bone formation compared to the DDM and ABB/rhBMP-2 groups. The µCT analysis showed markedly increased bone volume in the DDM/rhBMP-2 group at eight weeks compared with that of the DDM group. Notably, there was a slight decrease in bone volume in the ABB/rhBMP-2 group at eight weeks. There were no significant differences among the DDM, ABB/rhBMP-2, and DDM/rhBMP-2 groups at two or eight weeks. CONCLUSION: Within the limitations of this study, DDM appears to be a suitable carrier for rhBMP-2 in orthotopic sites.
Dentin* ; Humans* ; Osteogenesis ; Skull ; X-Ray Microtomography

BACKGROUND: Both remifentanil and sevoflurane are known for their rapid recovery characteristics, and the bispectral index (BIS) has been used as an indicator of the sedative state during anesthesia. Therefore, it is expected that if they are used together, the anesthetic-sparing effect of remifentanil and titration of the sevoflurane concentration using the BIS monitor will contribute to a faster recovery. This study examined the effect of a remifentanil infusion on the hemodynamics, the decrease in the sevoflurane concentration, and the recovery from BIS-guided sevoflurane anesthesia. METHODS: Thirty patients undergoing laparoscopic gynecologic surgery were assigned to receive a remifentanil (0.1microng/kg/min)(Group I) or saline infusion (Group II) with sevoflurane. The sevoflurane concentration was adjusted to maintain a BIS value between 40 and 60. The mean arterial pressure, heart rate, BIS, and end-tidal sevoflurane concentration were recorded during anesthesia. The eye opening time and the incidence of postoperative nausea, vomiting and shivering were checked. RESULTS: During anesthesia, the hemodynamics were more stable in Group I than in Group II with the reduced use of cardiovascular drugs. The BIS value was lower and the end tidal sevoflurane concentration was higher in group II than in group I. Group I had a shorter eye opening time and there was a similar incidence of postoperative nausea, vomiting and shivering in both groups. CONCLUSIONS: A remifentanil infusion with BIS-guided sevoflurane anesthesia produces more stable hemodynamics, reduced sevoflurane concentration, and a more rapid recovery without side effects than in BIS-guided sevoflurane anesthesia alone.
Anesthesia* ; Arterial Pressure ; Cardiovascular Agents ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Postoperative Nausea and Vomiting ; Shivering ; Vomiting

PURPOSE: The aim of this study is to evaluate the incidence of synchronous colonic lesions and to identify the impact of an incomplete preoperative colonoscopy in colorectal cancer patients. METHODS: We studied 187 patients with colorectal cancer who received colonoscopic examinations pre or postoperatively in our hospital from January 2000 to March 2002. The pre and postoperative colonoscopic findings were reviewed. Most post-operative colonoscopies were performed 12 months after the operation, but in cases of incomplete pre-operative examination, they were performed at 6 months. We analyzed the incidence of synchronous lesions of the colon and the rectum and then compared the findings for complete and incomplete pre-operative examinations. RESULTS: Complete pre-operative colonoscopic examinations were performed in 152 patients, but in 35 patients, the colonoscopy was performed incompletely. Twenty-two of these 35 patients had obstructive colorectal cancer. In the complete examination group, 23 patients had synchronous lesions preoperatively; 20 cases were benign, and 3 cases were malignant. By postoperative colonoscopic examination, 27 patients had synchronous polyps. In 19 of the 27, the polyps had not been detected preoperatively. The incidence of synchronous lesions in the complete examination group was 27.6% (42/152), and the incidence of synchronous cancer was 2.0% (3/152). In the incomplete examination group, the incidence of synchronous lesions was 37.1% (13/35), and the incidence of malignancy was 2.9% (1/35). The incidence of synchronous lesions in the preoperative incomplete examination group was higher than it was in the complete examination group, but the difference was not statistically significant (P=0.161). CONCLUSIONS: In our study, the incidence of synchronous lesions with colorectal cancer patients was 29.4%, and the incidence of malignancy was 2.1%, these are similar to figures in others reports. Patients with an incomplete preoperative entire-colon examinations should have immediate postoperative colonoscopy.
Colon* ; Colonoscopy ; Colorectal Neoplasms* ; Humans ; Incidence ; Polyps ; Rectum

PURPOSE: The purpose of this study is to analyze the mode of recurrence and it's relating factors in gastric adenocarcinoma. MATERIALS AND METHODS: 1,446 patients who had been undergone gastrectomy for gastric adeno carcinoma from September 1983 to December 1996 (Department of Surgery, Korea University) were studied (median follow-up was 2.9 years). Of them, 243 patients who had been proven recurrence were studied on recurrence mode and clinicopathological factors. RESULTS: The mean duration to recurrence was 22 months. The modes of recurrence were locore gional (30.0%), peritoneal (23.0%), hematogenous (19.3%) and distant lymph node metastasis (4.1%) in order. In 23.5%, more than 2 recurrent pattern were combined. Age, gross type, tumor size and stage were statistically significant to the mode of recurrence. The disease free survival was calculated: regional lymph node, number of lymph node, stage, and tumor emboli had statistical significance in all types of recurrence and in locoregional recurrence, tumor size was significant. Multivariate analysis showed that regional lymph node influenced the disease free survival period in all cases and tumor size in locoregional recurrence. CONCLUSION: The number of positive regional lymph node and tumor size are important factors predicting the timing of recurrence after curative resection for gastric adenocarcinoma.
Adenocarcinoma* ; Disease-Free Survival ; Follow-Up Studies ; Gastrectomy ; Humans ; Korea ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Stomach Neoplasms

OBJECTIVE: The time to positivity (TTP) of blood culture reflects bacterial load and has been reported to be associated with outcome in bloodstream infections. This study was performed to evaluate the relationship between the TTP of blood culture and the mortality rates associated with sepsis and septic shock according to the site of infection. METHODS: We performed a retrospective cohort study on patients with sepsis and septic shock. The rates of blood culture positivity and mortality as well as the relationship between the TTP and 28-day mortality rate were compared among patients with different sites of infection, such as the lungs, abdomen, urogenital tract, and other sites. RESULTS: A total of 2,668 patients were included, and the overall mortality rate was 21.6%. The rates of blood culture positivity and mortality were different among the different infection sites. There was no relationship between the TTP and mortality rates of total, lung, and urogenital infections. Patients with abdominal infections showed a negative correlation between the TTP and 28-day mortality rate. In patients with abdominal infections, a TTP < 20 hours was independently associated with 28-day mortality compared with patients with negative blood culture (hazard ratio, 1.73; 95% confidence interval, 1.16–2.58). However, there was no difference in mortality rates of patients with a TTP≥20 hours and a negative blood culture. CONCLUSION: The shorter TTP in patients with abdominal infections in sepsis and septic shock was associated with a higher 28-day mortality rate.
Abdomen ; Bacterial Load ; Cohort Studies ; Humans ; Lung ; Mortality* ; Retrospective Studies ; Sepsis* ; Shock, Septic

As the proportion of elderly individuals within the population grows, the incidence of hip fractures increases.Traditionally, orthopedic surgeons used to focus on surgical treatment of hip fractures; however, the field’s appreciation for the importance of postoperative rehabilitation has been increasing recently. Many studies have shown that proper rehabilitation after hip fracture surgery can shorten hospital stays and improve clinical outcomes.However, such studies use different methods and published rehabilitation protocols address varying aspects that do not always overlap. Here, we review and summarize the latest guidelines and studies on postoperative rehabilitation of elderly patients with hip fractures.