Although current preoperative fasting guidelines apply restrictions to drinks containing milk because of delayed gastric emptying, the safe volume of milk that can be consumed up to 2 h before ...surgery on a theoretical basis has not yet been defined. We aimed to determine whether delayed gastric emptying depended mainly on the total amount of calories irrespective of compositional differences between milk and clear fluids.
We prepared five beverages with a uniform volume (500 ml) and step-wise increments in calories (0, 220, and 330 kcal), comprised mainly of non-human milk, pulpless orange juice, water, and gum syrup. The gastric emptying rate of each beverage was determined by ultrasound measurements of the gastric antral cross-sectional area after their ingestion by eight healthy fasting volunteers.
The emptying rates of 500 ml of orange juice and 330 ml of non-human milk with 170 ml of water (both were 220 kcal) from the stomach were similar. Furthermore, 450 ml of orange juice with 50 ml of gum syrup and 500 ml of non-human milk (both were 330 kcal) left the stomach at similar rates. The 220 kcal beverages emptied faster than the 330 kcal beverages.
There were no significant differences in liquid gastric emptying after drinking equal volumes of either orange juice or milk as long as both had the same amount of calories. Liquid gastric emptying depends chiefly on the total caloric content.
UMIN000012537.
The acclimation of a plant to a constantly changing environment involves the accumulation of certain organic compounds of low molecular mass, known collectively as compatible solutes, in the ...cytoplasm. The evidence from numerous investigations of the physiology, genetics, biophysics and biochemistry of plants strongly suggests that glycine betaine (GB), an amphoteric quaternary amine, plays an important role as a compatible solute in plants under various types of environmental stress, such as high levels of salts and low temperature. Plant species vary in their capacity to synthesize GB and some plants, such as spinach and barley, accumulate relatively high levels of GB in their chloroplasts while others, such as Arabidopsis and tobacco, do not synthesize this compound. Genetic engineering has allowed the introduction into GB‐deficient species of biosynthetic pathways to GB from both micro‐organisms and higher plants; this approach has facilitated investigations of the importance of GB in stress protection. In this review, we summarize recent progress in the genetic manipulation of the synthesis of GB, with special emphasis on the relationship between the protective effects of GB in vivo and those documented in vitro.
Luminescence characteristics of Ce:Y 3 Al 5 O 12 (YAG) glass-ceramic (GC) phosphor for a white LED were investigated. The GC phosphor was obtained by a heat treatment of a Ce-doped SiO 2 -Al 2 O 3 -Y ...2 O 3 mother glass between 1300degC and 1500degC for the prescribed time period. The quantum efficiency (QE) of Ce 3+ fluorescence in the GC materials, the color coordinate, and the luminous flux of electroluminescence of LED composite were evaluated with a blue LED (465 nm) set in an integrating sphere. The QE increased with increasing ceramming temperature of the as-made glass. The color coordinates ( x , y ) of the composite were increased with increasing thickness of the GC mounted on a blue LED chip. The effect of Gd 2 O 3 substitution on the optical properties of the GC materials was also investigated. The excitation and emission wavelengths shifted to longer side up to Gd/(Y + Gd) = 0.40 in molar composition. As a result, the color coordinate of the LED with GdYAG-GC of various thickness shifted to closer to the Planckian locus for the blackbody radiation. These results were explained by partial substitution of Gd 3+ ions in the precipitated YAG microcrystals, leading to the increase of lattice constant of unit cell, which was confirmed by XRD.
Summary
We previously demonstrated that the gastric emptying time of different liquids with the same volume mainly depended on their energy content, regardless of differences in composition. In this ...crossover study, we investigated whether the same applies when soluble solid foods are ingested with water. Ten healthy volunteers ingested one of five test diets consisting of two test meals (Calorie Mate® 100 and 200 kcal) and three test solutions (water and glucose solutions of 100 and 200 kcal), each given in a volume of 400 ml, and then underwent ultrasonography to measure the gastric antral cross‐sectional area every 10 min for 120 min. The gastric emptying time was defined as the time for the antral cross‐sectional area to revert to its initial value. When test diets with the same energy content were ingested, the gastric emptying curves were nearly identical, regardless of whether the original form was solid or liquid. The median (IQRrange) gastric emptying times of Calorie Mate® of 100 kcal with water vs. isocaloric glucose solution were 65 (60–78 50–80) vs. 65 (60–70 50–80) min (p = 0.58), and for Calorie Mate® of 200 kcal with water vs. isocaloric glucose solution they were 100 (93–108 90–120) vs. 105 (90–110 90–120) min (p = 0.54). The median (IQR range) for water was 40 (30–40 30–50) min. Energy content may be a critical determinant of the gastric emptying time when ingesting soluble solid diets with water.
This double blind, randomized clinical trial compared the postoperative sensitivity of the placement technique (incremental and bulk fill) in posterior composite resin restorations bonded with two ...different adhesive strategies (self-etch and etch-and-rinse).
Posterior dental cavities of 72 participants (n=236), with a cavity depth of at least 3 mm, were randomly divided into four groups. The restorations were bonded using either the etch-and-rinse Tetric N-Bond (Ivoclar Vivadent) or the self-etch Tetric N-Bond SE (Ivoclar Vivadent). The composite resin Tetric N-Ceram Bulk Fill (Ivoclar Vivadent) was placed either incrementally or using the bulk-fill technique. Two experienced and calibrated examiners evaluated the restorations using World Dental Federation criteria after one week of clinical service. Spontaneous postoperative sensitivity was assessed using a 0-4 numerical rating scale and a 0-10 and 0-100 visual analog scale up to 48 h after the restorative procedure and after one week.
The risk (p>0.49) and intensity of spontaneous postoperative sensitivity (p>0.38) was not affected by the adhesive strategy or the filling technique. The overall risk of postoperative sensitivity was 20.3% (95% confidence interval 15.7-25.9) and typically occurred within 48 hours after the restorative procedure.
The overall risk of immediate postoperative sensitivity was 20.3% and was not affected by either the adhesive strategy (etch-and-rinse/self-etch) or the filling technique (incremental/ bulk).
Background and Purpose
The locus coeruleus (LC) is the principal nucleus containing the noradrenergic neurons and is a major endogenous source of pain modulation in the brain. Glial cell line‐derived ...neurotrophic factor (GDNF), a well‐established neurotrophic factor for noradrenergic neurons, is a major pain modulator in the spinal cord and primary sensory neurons. However, it is unknown whether GDNF is involved in pain modulation in the LC.
Experimental Approach
Rats with chronic constriction injury (CCI) of the left sciatic nerve were used as a model of neuropathic pain. GDNF was injected into the left LC of rats with CCI for 3 consecutive days and changes in mechanical allodynia and thermal hyperalgesia were assessed. The α2‐adrenoceptor antagonist yohimbine was injected intrathecally to assess the involvement of descending inhibition in GDNF‐mediated analgesia. The MEK inhibitor U0126 was used to investigate whether the ERK signalling pathway plays a role in the analgesic effects of GDNF.
Key Results
Both mechanical allodynia and thermal hyperalgesia were attenuated 24 h after the first GDNF injection. GDNF increased the noradrenaline content in the dorsal spinal cord. The analgesic effects continued for at least 3 days after the last injection. Yohimbine abolished these effects of GDNF. The analgesic effects of GDNF were partly, but significantly, inhibited by prior injection of U0126 into the LC.
Conclusions and Implications
GDNF injection into the LC exerts prolonged analgesic effects on neuropathic pain in rats by enhancing descending noradrenergic inhibition.
Background
Diverting colostomy followed by neoadjuvant treatment is a treatment of choice for obstructive rectal cancer. Such patients may be treated via a robotic approach with several advantages ...over conventional laparoscopic surgery. Conversely, the existing stoma may interfere with the optimal trocar position and thus affect the quality of robotic surgery. Moreover, the console surgeon does not face the patient, which may endanger the stoma.
Methods
Patients with rectal cancer who underwent sphincter-preserving surgery were retrospectively investigated using a robotic platform after neoadjuvant treatment at our hospital. Based on pretreatment stoma creation, patients were divided into the NS (those without a stoma) and S groups (patients with a stoma). Baseline characteristics, types of neoadjuvant treatment, short-term surgical outcomes, postoperative anorectal manometric data, and survival were compared between the groups.
Results
The NS and S groups comprised 65 and 9 patients, respectively. Conversion to laparotomy was required in three patients in the NS group. The S group required a longer console time than the NS group (median: 367 vs. 253 min, respectively,
p
= 0.038); however, no difference was observed in the total operative time (
p
= 0.15) and blood loss (
p
= 0.70). Postoperative complication rates, anorectal function, and oncological outcomes were similar between the groups.
Conclusions
Although console time was longer in patients with a stoma, robotic surgery could be performed safely like in those without a stoma after neoadjuvant treatment.
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