No abstract available.
Cholecystectomy*

No abstract available.
Bleomycin* ; Lymphangioma, Cystic*

Chronic diseases are a significant burden on the healthcare system. Nutrition counseling plays a pivotal role in the management and prevention of chronic diseases. Despite its importance, primary healthcare clinicians face practical challenges in providing effective nutritional guidance owing to time limitations, lack of information, and resistance of patients.Current Concepts: This review identifies the main barriers to nutrition counseling that are encountered by primary healthcare clinicians. We propose general strategies to overcome these obstacles, emphasizing the need for simple and easy approaches in clinical settings. In addition, specific one-point counseling methods according to gender and age that can be applied in various situations, techniques related to behavior change for motivating and guiding patients, and practical tips to cope with common conditions such as diabetes, hypertension, and obesity are also discussed. Additionally, utilization of education materials, apps, and websites as convenient resources for patients is highlighted.Discussion and Conclusion: Real-life cases demonstrated successful application of nutrition counseling in clinical practice that benefitted both the patients and clinicians. This review suggests enhancing nutrition education in medical schools and residency programs, along with activating nutrition counseling fees to motivate and support clinicians. In conclusion, this review reaffirms the importance of nutrition counseling and stresses the need for continuous learning and practice by clinicians. In the future, nutrition counseling is envisioned as a more integrated and patient-centered approach, necessitating active engagement and adaptation by primary healthcare providers.

BACKGROUND: Previous randomized controlled trials (RCTs) have reported inconsistent findings regarding the association between vitamin C supplementation and the risk of cancer. METHODS: We performed a meta-analysis of RCTs to investigate the efficacy of vitamin C supplements for prevention of cancer. We searched the PubMed, EMBASE, and Cochrane Library databases in November 2014 using common keywords related to vitamin C supplements and cancer. RESULTS: Among 785 articles, a total of seven trials were identified, which included 62,619 participants; 31,326 and 31,293 were randomized to vitamin C supplementation and control or placebo groups, respectively, which were included in the final analysis. A fixed-effects meta-analysis of all seven RCTs revealed no significant association between vitamin C supplementation and cancer (relative risk, 1.00; 95% confidence intervals, 0.95-1.05). Similarly, subgroup meta-analysis by dose of vitamin C administered singly or in combination with other supplements, follow-up period, methodological quality, cancer mortality, gender, smoking status, country, and type of cancer also showed no efficacy of vitamin C supplementation for cancer prevention. CONCLUSION: This meta-analysis shows that there is no evidence to support the use of vitamin C supplements for prevention of cancer.
Ascorbic Acid* ; Follow-Up Studies ; Mortality ; Smoke ; Smoking ; Vitamins*

A reproducible noninvasive technique for measuring right ventricular ejection fraction (RVEF) was developed using first pass quantitative radionuclide angiocardiography. Tests were carried out in the right anterior oblique position with a computerized multicrystal scintillation camera with high count rate capabilities. RVEF was calculated on beat to beat basis from the high frequency components of the background-corrected right ventricular time-activity curve. The following results were obtained; 1) In 10 normal adults, RVEF averaged 50.9+/-8.2. In 20 patients with chronic obstructive lung diseases (COPD), RVEF was 37.9+/-6.1% and significantly lower than that of normal persons(P<0.005). 2) There was meaningful correlation between RVEF and forced expiratory volume (FEVI) in patients with COPD (r=0.51). And there was significant difference of RVEF between 13 patients with FEVI less than IL/min (6 patients with right ventricular failure, 7 patients with patients without that) and 7 patients with FEVI IL/min or more (35.7+/-6.0%, 42.1+/-3.2% respectively. P<0.005). 3) All 6 patients with clinical manifestation of right heart failure had abnormal RVEF and had FEVI less than IL/min, which was significantly lower than that of 14 patients without clinical manifestation of right heart failure (33.6+/-4.8%, 39.8+/-5.6%, respectively. P<0.005). 4) In 14 patients without clinical manifestation of right heart failure, 11 patients among whom 7 patients had FEVI less than IL/min, had abnormal RVEF.
Adult ; Angiocardiography ; Forced Expiratory Volume ; Gamma Cameras ; Heart Failure ; Humans ; Lung Diseases, Obstructive* ; Pulmonary Disease, Chronic Obstructive ; Radionuclide Ventriculography* ; Stroke Volume ; Ventricular Function, Right*

The purpose of this randomized, prospective study was to compare the intubation time, hemodynamic effect and complication rates of orotracheal intubation performed by direct laryngoscopic or lighted stylet (lightwand) methods in the controlled settings of the operating room. After approval of clinical investigation committee and informed consent from patients, healthy ASA class 1 and 2 elective surgical patients were studied. On arrival to operating room, EKG, radial arterial cannulation to monitor blood pressure continously and neuromuscular monitoring device were applied to patients. Anesthesia was induced with fentanyl 3 ug/kg, thiopental 4 mg/kg and vecuronium 0.15 mg/kg to facilliate relaxation. Ventilation was controlled for 5 min by facemask with oxygen-isoflurane (1.2 vol%) or enflurane(1.7 vol%) before intubation. The patients were intubated randomly using either direct curved laryngoscope (DL, 37 patients) or lightwand (LW, 36 patients). The time to intubation (TTI) was recorded. The mean arterial pressure(MAP) and heart rate(HR) were recoreded every 30 sec after intubation for 5 min. The changes of MAP and HR after intubation were compared with pre-intubation value. After extubation, complications such as mucosal trauma and postoperative sore throat were recorded. The data were analyzed using either unpaired t-test or Chi-square analysis, where appropriate. There were no failed intuhation in either groups. There was no significant differences between the groups with respect to sex, age, weight, height, existence of nasogastric tube. The TTI was similar between groups(14.5+/-8.1 sec for LW, 16.8+/-9.5 sec for DL). There was no differences in incidence of trauma(19.4% for LW, 16.2% for DL) between groups. There were no statistically significant difference in the maximal increase in MAP(44% for LW, 55% for DL at 30 sec) and HR(25.6% for LW, 24.1% for DL at 30 sec) and during 5 min following intubation. In canclusion, even though the hemadynamic effect after intubation was not influenced by using LW, the results of this study indicate that the use of the LW is as useful, effective and safe method as using DL for oro-endotracheal intubation. Further study may prove that using the LW to be an effective alternative technique of intubation in patients with difficult airway.
Anesthesia ; Blood Pressure ; Catheterization ; Electrocardiography ; Fentanyl ; Heart ; Hemodynamics* ; Humans ; Incidence ; Informed Consent ; Intubation* ; Laryngoscopes ; Neuromuscular Monitoring ; Operating Rooms ; Pharyngitis ; Prospective Studies ; Relaxation ; Thiopental ; Vecuronium Bromide ; Ventilation

The treatment of supracondylar fracture of the femur remains a difficult problem because of the wide range of portential complications. In the past, authors thought conservative treatment was superior to operative treatment of supracondylar fracture of the femur. In addition, the advent of the Cast-Brace introduced the change in concept of the conservative treatment. Recently, however, the advances in the techniques and in the devices used in intemal fixation have encouraged the operative treatment. Tibiofemoral angle, gap or stepping of the articular surface of the distal femur, range of motion of the knee, and pains in the knee were used to evaluate the following results investigated by statistical study(T-test). These clinical results were shown by analyzing 49 cases of supracondylar fracture of the femur trea ted in the Department of Orthopedic Surgery, Hallym College of Medicine, from Jan. 1980 to Dec. 1983 1. We end result of each patient was evaluated by scaled score value calculated from above mentioned criteria. 2. The mean value of the operative treatment(35 cases) was 31.03±5.52, while that of the conservative treatment(14 cases) was 27.71±4.56. 3. The mean value of the group which began the exercise of the knee joint within 2 weeks (33 cases) was 32.24±4.43. The mean value of the other group which began the exercise of the knee joint after 2 weeks(16 cases) was 25.78±4.56. This difference of means between two groups was statistically significant. Beginning the knee joint exercise within 2 weeks has large effect on the result of the treatment. 4.The results of treatment in patient over age of 50 were graded as fair irrespective of methods of treatment. 5. Various devices were used in intemal fixation but there was no difference in the results. 6. We mean value of the Tibiofemoral angle(difference from normal angle) in the operative treatment was 2.37±6.25 and that of the conservative treatment was 8.04±4.62. Both of the above method of treatment showed a varus trend, especially in the conservative treatment. In statistical study, through, there was no significance in two methods.
Adult ; Femur ; Humans ; Knee ; Knee Joint ; Methods ; Orthopedics ; Range of Motion, Articular ; Statistics as Topic

No abstract available.
Vitamin D* ; Vitamins*

No abstract available.
Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa*

PURPOSE: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. RESULTS: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). CONCLUSION: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
Biopsy ; Carcinosarcoma ; Follow-Up Studies ; Humans ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors