Esophageal Calibration with Soft Orogasrtric Tube During Laparoscopic Nissen Fundoplication may Reduce Postoperative Transient Dysphagia

Gastroesophageal reflux is the most common benign disorder of the esophagus and laparoscopic Nissen fundoplication has become the standard surgical treatment for its treatment. In our area, where the use of bougie calibration is debatable, postoperative dysphagia is encountered often after this surgery although it is usually not permanent. The aim of this study was to investigate the effect of using a soft silicone tube 39 F in diameter for esophageal calibration during laparoscopic Nissen fundoplication on the incidence of postoperative dysphagia. We divided cases scheduled to undergo laparoscopic Nissen fundoplication between January 2009 and November 2010 into two groups, each consisting 25 patients. Esophageal calibration with a 39 F silicone orogastric tube was used for the first group while there was no operative calibration in the second group. The surgical duration was recorded; the presence and severity of the postoperative dysphagia was calculated by using a dysphagia severity scoring system during the 1-year postoperative follow-up. The dysphagia severity scores were significantly lower in group 1 than group 2 on the postoperative second day and at the end of the first week and first month. We did not find a significant difference at the end of the 6-month and first year. There was also no significant difference regarding surgery duration. The use of a soft orogastric tube 39 F in diameter for esophagus calibration during laparoscopic Nissen fundoplication has significantly decreased the incidence of postoperative transient dysphagia without affecting the duration of surgery. Although dysphagia gradually resolves in the majority of patients, a safe and easy calibration method for its prevention is worth developing, and we believe that the use of our method in larger series could be beneficial.     

大学生健康概念认知的调查研究

随着教育改革的深化,健康教育日益成为高校素质教育的热点课题。现代健康理念建立在“生物-心理-社会医学模式”之上,1978年WHO在《阿拉木图宣言》中指出:“健康不仅是没有疾病或不虚弱,而且是身体的、精神的健康和社会适应的完美状态。”[1]依据这一健康观的指导,笔者认为高校健康教育机构应该从机体健康、心理健康、行为与社会适应性健康几方面对学生的健康观和保健能力进行培养。为了解目前大学生对“健康”的理解和认识水平,进一步为高校有针对性的健康教育实践提供依据,笔者在广州市两所综合大学对学生的健康概念认知情况进行调查。1…     

Spatial dispersion modeling of 90Sr by point cumulative semivariogram at Keban Dam Lake, Turkey.

Spatial analysis of (90)Sr artificial radionuclide in consequence of global fallout and Chernobyl nuclear accident has been carried out by using the point cumulative semivariogram (PCSV) technique based on 40 surface water station measurements in Keban Dam Lake during March, April, and May 2006. This technique is a convenient tool in obtaining the regional variability features around each sampling point, which yields the structural effects also in the vicinity of the same point. It presents the regional effect of all the other sites within the study area on the site concerned. In order to see to change of (90)Sr, the five models are constituted. Additionally, it provides a measure of cumulative similarity of the regional variable, (90)Sr, around any measurement site and hence it is possible to draw regional similarity maps at any desired distance around each station. In this paper, such similarity maps are also drawn for a set of distances. (90)Sr activities in lake that distance approximately 4.5 km from stations show the maximum similarity.     

Preliminary findings for preemptive analgesia with inhaled morphine: efficacy in septoplasty and septorhinoplasty cases.

OBJECTIVE: The aim of this study was to assess the efficacy of inhaled morphine for preemptive analgesia in patients who undergo septoplasty or septorhinoplasty. STUDY PLAN AND METHODS: Eighty ASA I-II patients scheduled for septoplasty or septorhinoplasty were recruited and randomly divided into 2 groups that received different treatments 10 minutes prior to induction. The preemptive analgesia group (Group P, n = 40) received 65 mug kg(-1) morphine sulphate (a 3-mL volume) via an oral nebulizer, and the control group (Group C, n = 40) received 3 mL 0.9% sodium chloride (physiological saline) via the same type of nebulizer. Blood pressure, oxygen saturation, heart rate, time to first requirement for analgesia, and occurrence of nausea/vomiting were recorded. RESULTS: There were no significant differences between Groups P and C with respect to age, body weight, sex distribution, or duration of surgery. There was also no significant difference between the group frequencies of postoperative nausea/vomiting. The time to first requirement for analgesia was significantly longer in Group P than Group C. CONCLUSION: The results of this preliminary study suggest that a single dose of inhaled morphine administered preemptively prior to septoplasty or septorhinoplasty provides effective postoperative analgesia. EBM rating: B-3b.     

Effect of N-acetylcysteine on blood and tissue lipid peroxidation in lipopolysaccharide-induced obstructive jaundice.

In obstructive jaundice, free radical production is increased and antioxidative activity is reduced. N-Acetylcysteine (NAC) has a beneficial effect with anti-inflammatory and antioxidant activity, acting as a free radical scavenger. NAC inhibits inducible nitric oxide synthase, suppresses cytokine expression/release, and inhibits adhesion molecule expression and nuclear factor kappa B. The aim of this study was to investigate the effects of NAC on liver/renal tissue and serum lipid peroxidation in lipopolysaccharide (LPS)-induced obstructive jaundice. We randomized 60 rats into 6 groups: group 1, Sham; group 2, obstructive jaundice (OJ) induced after bile-duct ligation; group 3, OJ + NAC (100 mg kg- 1 subcutaneously); group 4, OJ + LPS (10 mg kg-1); group 5, OJ + NAC + LPS; and group 6, OJ + LPS + NAC. For each group, the biochemical markers of lipid peroxidation and the antioxidant products were measured in serum and liver/renal tissue after sacrifice. Almost all lipid peroxidation products levels were increased and antioxidant products levels were decreased in groups who received LPS (groups 4, 5, and 6), but the effect was less remarkable when NAC was administered before LPS (group 5). The same trend was seen for groups with OJ +/- LPS who did not received NAC or received it after induced toxemia (groups 2, 4, and 6) as compared to groups 1 and 3. Moreover, in the case of OJ + LPS, rats treated with NAC before LPS (group 5) had lower lipid peroxidation products levels and higher antioxidant products levels as compared to those who did not received NAC (group 4). This phenomenon was not reproducible with NAC administered after LPS (group 6). Thus, results of this study showed that NAC prevents the deleterious effects of LPS in obstructive jaundice by reducing lipid peroxidation in serum and liver/renal tissue if administered before LPS. Nonetheless, NAC failed to prevent the lipid peroxidation in the case of established endotoxemia in obstructive jaundice.     

An analysis of edentulous maxillary arch width and palatal height.

This study involving 500 edentulous patients (250 males, 250 females) was undertaken to introduce a dimensionless factor termed the "palatal height ratio," defined as the ratio of the width of the edentulous maxillary arch to the height of the palate. The authors categorized the height, width, and anteroposterior dimensions of the edentulous maxillae. Measurements were made on diagnostic casts at five defined points. The difference between males and females was statistically analyzed and the variables were categorized. The results of this study may be helpful for a better standardization of the same variables in future studies.