Abstract Background Adequate nutritional support for patients undergoing major surgery significantly affects postoperative recovery. Data on enteral feeding after liver transplantation (LT) are ...scarce. The aim of this work was to determine the efficacy and complications of feeding tubes inserted with the use of fluoroscopic assistance, endoscopic assistance, or transperitoneal jejunostomy in patients who underwent LT. Methods From January 2008 to August 2013, 2,058 LTs were performed at Asan Medical Center, Seoul, Korea. Enteral feeding tubes were inserted in 155 patients (7.5%) after LT: with the use of fluoroscopic placement in 81 (52%), endoscopic placement in 49 (32%), and transperitoneal jejunostomy in 25 (16%). We retrospectively analyzed the efficacy and complications of enteral feeding tubes. Results The median age was 55 years (interquartile range IQR 49–60). Enteral feeding indications were a high risk of gastric aspiration ( n = 90), gastric stasis ( n = 27), pneumonia ( n = 23), gastrointestinal bleeding ( n = 12), and bowel rest ( n = 3). Median enteral feeding durations were 14.5 days (IQR 8.0–30.7) for fluoroscopic placement, 20.0 days (IQR 8.0–40.0) for endoscopic placement, and 37.5 days (IQR 18.2–86.2) for transperitoneal jejunostomy. Times to establishment of oral feeding were 13.0 days (IQR 6.2–25.7) for fluoroscopic placement, 24.0 days (IQR 10.5–43.5) for endoscopic placement, and 37.0 days (IQR 17.0–64.2) for transperitoneal jejunostomy. After tube insertion, tube dislocation and blockage occurred in 34 patients (22%) and 16 patients (25%), respectively. Conclusions Enteral feeding tube insertion in patients who can not maintain a nasogastric tube or start oral intake for a long time is important for nutritional support after LT. Proper feeding method selection according to patient condition can help patients by improving nutritional support after major operations such as LT.
We report two microlensing events, KMT-2017-BLG-1038 and KMT-2017-BLG-1146, that are caused by planetary systems. These events were discovered by Korea Microlensing Telescope Network survey ...observations from the 2017 bulge season. The discovered systems consist of a planet and host star with mass ratios of and , respectively. Based on a Bayesian analysis assuming a Galactic model without stellar remnant hosts, we find that the planet KMT-2017-BLG-1038Lb is a super-Jupiter-mass planet ( ) orbiting a mid-M dwarf host ( ) that is located at kpc toward the Galactic bulge. The other planet, KMT-2017-BLG-1146Lb, is a sub-Jupiter-mass planet ( ) orbiting a mid-M dwarf host ( ) at a distance of kpc toward the Galactic bulge. Both are potentially gaseous planets that are beyond their hosts' snow lines. These typical microlensing planets will be routinely discovered by second-generation microlensing surveys, rapidly increasing the number of detections.
Background and purpose
Hearing loss (HL) is one of the most influential risk factors of dementia in older adults. However, its potential association with neurodegeneration is not well established. ...The association between HL and cortical thickness in cognitively normal older adults was evaluated.
Methods
In all, 982 cognitively normal older adults (age ≥65 years) were identified from the Health Promotion Center at the Samsung Medical Center from September 2008 to December 2014. The participants underwent pure‐tone audiometry and brain magnetic resonance imaging. HL was evaluated according to a four‐frequency (0.5, 1, 2, 4 kHz) pure‐tone average. Participants were divided into three groups according to pure‐tone average (normal hearing ≤15 dB, minimal HL 16–25 dB, mild‐to‐severe HL >25 dB). Cortical thickness in the HL groups was compared with that of the normal hearing group.
Results
In women, right ear HL was associated with cortical thinning: the minimal HL group showed cortical thinning in the left frontal and bilateral occipital areas and the mild‐to‐severe HL group showed cortical thinning in the bilateral frontal, right temporal and bilateral occipital areas compared to the normal hearing group. In men, there was no significant association between HL on either side and cortical thickness.
Conclusion
In older women, right ear HL is associated with neurodegeneration even in a cognitively normal state. Therefore, managing HL especially in older women may be an effective strategy for dementia prevention.
The KMTNet/K2-C9 (Kepler) Data Release Kim, H.-W.; Hwang, K.-H.; Kim, D.-J. ...
The Astronomical journal,
05/2018, Letnik:
155, Številka:
5
Journal Article
Recenzirano
Odprti dostop
We present Korea Microlensing Telescope Network (KMTNet) light curves for microlensing-event candidates in the Kepler K2 C9 field having peaks within three effective timescales of the Kepler ...observations. These include 181 "clear microlensing" and 84 "possible microlensing" events found by the KMTNet event finder, plus 56 other events found by OGLE and/or MOA that were not found by KMTNet. All data for the first two classes are immediately available for public use without restriction.
Abstract Background Sufficient arterial flow after living donor liver transplantation (LDLT) is closely related to graft survival and prevention of postoperative complications. However, some ...unfavorable hepatic arterial conditions in recipients preclude reconstruction, requiring alternative stumps. We have used the right gastroepiploic artery (RGEA) as a first alternative for hepatic inflow. Methods From January 2006 to December 2008, we performed 754 LDLTs including 28 cases of RGEA among hepatic arterial anastomoses. The arterial anastomosis was performed by an single surgeon under 859 a microscope using an end-to-end interrupted suture technique. RGEA was mobilized over 15 cm from the greater curvature of stomach and greater omentum. Results The indications for RGEA use included severe hepatic arterial injury from previous transarterial chemoembolization ( n = 14), need for additional arterial flow in dual-grafts LDLT ( n = 13), poor blood flow from the recipient hepatic artery ( n = 3), and arterial injury during hilar dissection ( n = 3). The mean diameter of the isolated RGEA was 2.0 ± 0.2 mm (range: 1.0–2.5). Most hepatic arterial anastomoses were performed with a significant size discrepancy of more than twofold. All reconstructed hepatic arterial flowes showed good; no complication was identified during the mean follow-up period of 56 months to date. Conclusions Using RGEA as an alternative arterial inflow is a simple, reliable procedure for situations of inadequate recipient hepatic or multiple graft arteries.
Selective blockade of nociceptive neurons can be achieved by the delivery of permanently charged sodium channel blockers through the pores of nociceptive ion channels. To assess the feasibility of ...this application in the dental area, we investigated the electrophysiological and neurochemical characteristics of nociceptive dental primary afferent (DPA) neurons. DPA neurons were identified within trigeminal ganglia labeling with a retrograde fluorescent dye applied to the upper molars of adult rats. Electrophysiological studies revealed that the majority of dental primary afferent neurons showed characteristics of nociceptive neurons, such as sensitivity to capsaicin and the presence of a hump in action potential. Immunohistochemical analysis revealed a large proportion of DPA neurons to be IB4-positive and to express TRPV1 and P2X3. Single-cell RT-PCR revealed mRNA expression of various nociceptive channels, including the temperature-sensitive TRPV1, TRPA1, TRPM8 channels, the extracellular ATP receptor channels P2X2 and P2X3, as well as the nociceptor-specific sodium channel, NaV1.8. In conclusion, DPA neurons have the electrophysiological characteristics of nociceptors and express several nociceptor-specific ion channels. Analysis of these data may assist in the search for a new route of entry for the delivery of membrane-impermeant local anesthetics. Abbreviations: AP, action potential; DiI, 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate; DPA, dental primary afferent; FITC, fluorescein 5(6)-isothiocyanate; IB4, isolectin-B4; RT-PCR, reverse-transcription polymerase chain-reaction; TRP, transient receptor potential.
We combine Spitzer and ground-based Korea Microlensing Telescope Network microlensing observations to identify and precisely measure an Earth-mass ( ) planet OGLE-2016-BLG-1195Lb at orbiting a ...ultracool dwarf. This is the lowest-mass microlensing planet to date. At kpc, it is the third consecutive case among the Spitzer "Galactic distribution" planets toward the Galactic bulge that lies in the Galactic disk as opposed to the bulge itself, hinting at a skewed distribution of planets. Together with previous microlensing discoveries, the seven Earth-size planets orbiting the ultracool dwarf TRAPPIST-1, and the detection of disks around young brown dwarfs, OGLE-2016-BLG-1195Lb suggests that such planets might be common around ultracool dwarfs. It therefore sheds light on the formation of both ultracool dwarfs and planetary systems at the limit of low-mass protoplanetary disks.
Curcumin has diverse therapeutic effects, such as anti-inflammatory, anti-oxidant, anti-cancer, and antimicrobial activities. The vanilloid moiety of curcumin is considered important for activation ...of the transient receptor potential vanilloid 1 (TRPV1), which plays an important role in nociception. However, very little is known about the effects of curcumin on nociception. In the present study, we investigated whether the anti-nociceptive effects of curcumin are mediated via TRPV1 by using nociceptive behavioral studies and in vitro whole-cell patch-clamp recordings in the trigeminal system. Subcutaneous injection of capsaicin in the vibrissa pad area of rats induced thermal hyperalgesia. Intraperitoneally administered curcumin blocked capsaicin-induced thermal hyperalgesia in a dose-dependent manner. Whereas curcumin reduced capsaicin-induced currents in a dose-dependent manner in both trigeminal ganglion neurons and TRPV1-expressing HEK 293 cells, curcumin did not affect heat-induced TRPV1 currents. Taken together, our results indicate that curcumin blocks capsaicin-induced TRPV1 activation and thereby inhibits TRPV1-mediated pain hypersensitivity.
It is unclear whether edoxaban shows better risk reduction of ischemic stroke, bleeding, and all-cause mortality than warfarin in Asian patients with nonvalvular atrial fibrillation (AF).
This study ...compared the effectiveness and safety of edoxaban with those of warfarin in a Korean population with AF.
Using the Korean National Health Insurance Service database, we included new users of edoxaban and warfarin in patients with AF from January 2014 to December 2016 (n = 4,200 on edoxaban, and n = 31,565 on warfarin) and analyzed the risk of ischemic stroke, intracranial hemorrhage (ICH), hospitalization for gastrointestinal (GI) bleeding, hospitalization for major bleeding, and all-cause death. The propensity score matching method was used to balance covariates across edoxaban and warfarin users.
We compared a 1:3 propensity score-matched cohort of patients with AF who were new users of edoxaban and warfarin (n = 4,061 and n = 12,183, respectively). Baseline characteristics were balanced between the 2 groups (median age 72 years; median CHA
DS
-VASc congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke, transient ischemic attack, or thromboembolism, vascular disease, age 65-74 years, sex category (female) score 3). Edoxaban users had a significantly lower risk of ischemic stroke (hazard ratio HR: 0.693; 95% confidence interval CI: 0.487 to 0.959), ICH (HR: 0.407; 95% CI: 0.182 to 0.785), hospitalization for GI bleeding (HR: 0.597; 95% CI: 0.363 to 0.930), hospitalization for major bleeding (HR: 0.532; 95% CI: 0.352 to 0.773), and all-cause death (HR: 0.716; 95% CI: 0.549 to 0.918) than warfarin users. All subgroups (age, sex, CHA
DS
-VASc score, renal function, edoxaban dose) showed better clinical outcomes with edoxaban than with warfarin.
In this real-world Asian population with AF, edoxaban might be associated with reduced risk of ischemic stroke, major bleeding, and all-cause death compared with warfarin. These benefits were consistent across various high-risk subgroups.
There is a paucity of information about cardiovascular outcomes related to exercise habit change after a new diagnosis of atrial fibrillation (AF). We investigated the association between exercise ...habits after a new AF diagnosis and ischemic stroke, heart failure (HF), and all-cause death. This is a nationwide population-based cohort study using data from the Korea National Health Insurance Service. A retrospective analysis was performed for 66,692 patients with newly diagnosed AF between 2010 and 2016 who underwent 2 serial health examinations within 2 years before and after their AF diagnosis. Individuals were divided into 4 categories according to performance of regular exercise, which was investigated by a self-reported questionnaire in each health examination, before and after their AF diagnosis: persistent non-exercisers (30.5%), new exercisers (17.8%), exercise dropouts (17.4%), and exercise maintainers (34.2%). The primary outcomes were incidence of ischemic stroke, HF, and all-cause death. Differences in baseline characteristics among groups were balanced considering demographics, comorbidities, medications, lifestyle behaviors, and income status. The risks of the outcomes were computed by weighted Cox proportional hazards models with inverse probability of treatment weighting (IPTW) during a mean follow-up of 3.4 ± 2.0 years. The new exerciser and exercise maintainer groups were associated with a lower risk of HF compared to the persistent non-exerciser group: the hazard ratios (HRs) (95% CIs) were 0.95 (0.90-0.99) and 0.92 (0.88-0.96), respectively (p < 0.001). Also, performing exercise any time before or after AF diagnosis was associated with a lower risk of mortality compared to persistent non-exercising: the HR (95% CI) was 0.82 (0.73-0.91) for new exercisers, 0.83 (0.74-0.93) for exercise dropouts, and 0.61 (0.55-0.67) for exercise maintainers (p < 0.001). For ischemic stroke, the estimates of HRs were 10%-14% lower in patients of the exercise groups, yet differences were statistically insignificant (p = 0.057). Energy expenditure of 1,000-1,499 MET-min/wk (regular moderate exercise 170-240 min/wk) was consistently associated with a lower risk of each outcome based on a subgroup analysis of the new exerciser group. Study limitations include recall bias introduced due to the nature of the self-reported questionnaire and restricted external generalizability to other ethnic groups. Initiating or continuing regular exercise after AF diagnosis was associated with lower risks of HF and mortality. The promotion of exercise might reduce the future risk of adverse outcomes in patients with AF.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
PDF
