PURPOSE: Conventional intravenous nutrition has been given as a solution of amino acids combined with dextrose and a separate line delivering a lipid emulsion. This technique was unsatisfactory, however, because of difficulties in managing technical and metabolic complications. Since the first clinical use of a single solution containing all the necessary nutrients was introduced in 1976, the total nutrient admixture (TNA) system has been used. However, despite the numerous advantages of this TNA system, it has not been used worldwide because of an assumption about unstability of this admixture. This study was conducted to compare the physical stability of TNA systems using two different 2 commercially available amino acid solutions and fat emulsions. METHODS: Each group contained 600 ml of 20% dextrose, 250 ml of 10% amino acid solution, 250 ml of 10% fat emulsion, 0.2 ml of heparin, and 20 ml of electrolyte solution was investigated for 7 days while being stored 4oC and at ambient temperature. The stabilities of these admixtures were compared by noting changes in macroscopic appearance, pH, osmolarity, Zeta-potential, peroxide value, particle size and distribution, and fat composition. RESULTS: When an amino acid solution containing P 2 was used, a supernatant yellow band was observed from the 3rd day at ambient temperature. The pH and peroxide value also showed significant changes, but these changes did not exceed the product-specifications. When an amino acid solution without P 2 was used, no significant change was observed. CONCLUSION: TNA systems are physically stable at 4oC temperature for at least 7 days, but TNA systems prepared with amino acid solution containing P 2 are not stable at ambient temperature from the 3rd day. On the other hand, TNA systems prepared with an amino acid solution without P 2 are stable at ambient temperature for 7 days. Various commercially available fat emulsions containing 10% soybean oil did not affect the stability of TNA systems.
Amino Acids ; Emulsions ; Glucose ; Hand ; Heparin ; Hydrogen-Ion Concentration ; Osmolar Concentration ; Parenteral Nutrition ; Particle Size ; Soybean Oil

We reviewed the records of 23 patients who underwent repeat operation after initial vitreoretinal surgery in Chungnam National University Hospital between January 1993 and December 1993. Of 193 eyes who underwent vitreoretinal surgery in that period, 23(12%) had undergone reoperation. The most common cause of initial anatomic failure and reoperation was either new or recurrent proliferative vitreoretinopathy(10 eyes). Other causes included iatrogenic retinal tears(5 eyes), hidden retinal breaks(4 eyes), vitreous traction(1 eye), inappropriate chorioretinal adhesion(1 eye), and new break(1 eye). We performed vitreous base dissection on all 9 eyes with anterior proliferative vitreoretinopathy. With additional surgery and after a mean follow-up period of 10.4 months, 21(91%) of 23 retinas were reattached. The final cause of anatomic failure was anterior proliferative vitreoretinopathy. Of the 23 reoperated eyes, 20(87%) had postoperative visual acuity of 0.05 or better.
Chungcheongnam-do ; Follow-Up Studies ; Humans ; Reoperation ; Retina ; Retinaldehyde ; Visual Acuity ; Vitreoretinal Surgery* ; Vitreoretinopathy, Proliferative

No abstract available.
Multiple Organ Failure* ; Sepsis*

BACKGROUND: This study was conducted to investigate the knowledge, anxiety and compliance with preventive behavior of Middle East respiratory syndrome (MERS) in liver transplant patients. METHODS: The participants in the study were 100 liver transplant patients at an outpatient clinic. The data were collected from May 20, 2016, to June 20, 2016. RESULTS: The knowledge score was 6.37±1.73 (range; 1~10) and the correct answer rate was 63.7%. The state anxiety score was 41.35±10.08 (range; 20~68) and the trait anxiety score was 39.60±8.85 (range; 22~59). The compliance with preventive behavior score was 35.70±5.23 (range; 21~45). Anxiety differed significantly according to education level (P=0.040) and occupation status (P=0.047). Compliance with preventive behavior differed significantly according to period after surgery (P=0.035). Compliance with preventive behavior and state anxiety (P=0.007) and trait anxiety (P<0.001) were negatively related. The factor that had the greatest effect on compliance with preventive behavior was trait anxiety (P=0.003). CONCLUSIONS: The epidemic of the MERS has already been completed and none of the subjects of this study has been infected with the MERS; however, patients with liver transplantation always have a risk of various opportunistic infections. If new infectious diseases such as MERS occur in the future, increased anxiety may decrease the practice of prevention. Therefore, anxiety experienced by liver transplant patients should be managed.
Ambulatory Care Facilities ; Anxiety* ; Communicable Diseases ; Compliance* ; Coronavirus Infections* ; Education ; Humans ; Liver Transplantation ; Liver* ; Middle East* ; Occupations ; Opportunistic Infections

No abstract available.
Multiple Organ Failure* ; Sepsis*

Four patients with intraocular foreign bodies and traumatic cataracts underwent combined pars plana lensectomy, vitrectomy, and intraocular foreign body removal. During pars plana lensectomy, anterior lens capsule and zonules were left intact. At the end of surgery, a posterior chamber intraocular lens was placed in the sulcus in front of the anterior capsule through a 7-mm limbal incision. This procedure was performed in selected cases of combined anterior and posterior segment trauma. Combining pars plana lensectomy and posterior chamber intraocular lens implantation with posteior segment procedures allows rapid visual rehabilitation and functional unaided vision. We therefore suggest that this technique is effective in treating selected patients with both cataract and vitreoretinal diseases.
Cataract ; Foreign Bodies* ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Rehabilitation ; Vitrectomy

No abstract available.
Evoked Potentials* ; Intercostal Nerves* ; Neural Conduction*

OBJECTIVE: To study the effect of pregnancy on knee joint contracture in the rat, because the laxity of peripheral joint increases during pregnacy. METHOD: We evaluated the difference of contracture between the pregnant and non-pregnant female rats after 3 week of knee immobilization using a wire. The femorotibial angle at immobilization status was 30o. After immobilization, the femorotibial angle were measured using X-ray after removal of wire at 50 g and 100 g weighted state on the tibia. To study the change of fibroblast in immobilized knee joint ligament, immunohistochemical staining for actin was performed using alpha-smooth muscle actin antibody (DAKO, Denmark). RESULTS: The femorotibial angles were 116.7+/-9.2o and 97.3+/-18.0o after wire removal, in the immobilized pregnant and nonpregnant rats respectively. The femorotibial angles at 50 g and 100 g weighted state were 136.8+/-7.2o and 144.7+/-3.8o, respectively in the immobilized pregnant rats and 129.4+/-12.7o and 136.3+/-8.9o in the immobilized non-pregnant rats. The angles of pregnant group were significantly larger than those of non-pregnant group (p<0.05). In immobilized pregnant and non-pregnant rats, the alpha-smooth muscle actin was moderately expressed in fibroblast of anterior and posterior cruciate ligaments of the knee by immunohistochemistry, while there was no expression of alpha-smooth muscle actin in fibroblast of the ligaments in the non-immobilized knee. CONCLUSION: Joint contracture develops to a lesser degree in pregnant rats than in non-pregnant rats and alpha-smooth muscle actin is expressed in fibroblast of contractured knee ligaments.
Actins ; Animals ; Contracture* ; Female ; Fibroblasts ; Humans ; Immobilization ; Immunohistochemistry ; Joints ; Knee Joint* ; Knee* ; Ligaments ; Posterior Cruciate Ligament ; Pregnancy* ; Rats* ; Tibia

Phantom limb pain is a painful sensation that is perceived in a body part that no longer exists. To control this pain, many methods have been used such as medication, physical treatment, nerve block, neuromodulation, surgical treatment and mirror therapy. However, until now, there effects have been uncertain. We report the successful reduction of phantom limb pain using mirror therapy when other treatments initially failed to control the pain.
Amputation ; Mirror Neurons ; Nerve Block ; Phantom Limb ; Sensation

A cilioretinal artery occlusion associated with a central retinal vein occlusion is a rare condition and has been reported to have a good visual prognosis. We report a young patient with this condition who also demonstrated prolonged filling of the branch retinal arteries with fluorescein angiography. Her initial visual acuity was 0.03 in the affected eye. Two months later, normal central retinal artery inflow resumed. Her visual acuity has improved to 0.5 over the three years' follow-up.
Arteries* ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Prognosis ; Retinal Artery ; Retinal Vein* ; Visual Acuity