Medicine
-
The anterolateral thigh free flap is one of the most preferred options for reconstructing soft tissues of the extremities and vascular anastomosis is one of the most important factors for flaps survival. T-anastomosis and double venous anastomosis have been widely used for increasing flap survival. This report shows both application of T-shape pedicle and multiple venous anastomosis to each 43 cases for extremity reconstruction that have not been described so far in the literature and it showed the necessity of multiple anastomosis. ⋯ We classified multiple venous anastomosis according to flow direction and the vascular connections between the superficial and deep veins. In result, 37 cases survived completely but 2 flaps developed severe necrosis (>50%) because of infection and hematoma and 4 flaps developed partial necrosis due to wound infection. In conclusion, T-shaped pedicle and multiple venous anastomosis is a method to improve free flap survival and useful in cases where sacrificing a dominant vessel is inevitable or those in which only 1 vessel remains.
-
This study sought to validate the applicability of the mandarin Tinnitus Evaluation Questionnaire (TEQ), a brief score method administered by clinicians to quantify the tinnitus severity. A descriptive observational questionnaire study in regard to psychometric properties and practicability was conducted with a total of 414 primary tinnitus outpatients, in which 173 of 414 patients completed the follow-up after receiving an intervention based on the tinnitus educational counseling and the life-style adjustment guidance. For quantifying the tinnitus severity, the TEQ and other 2 self-report questionnaires, Tinnitus Handicap Inventory and visual analog scale, were administered on patients' first-visit and follow-up. ⋯ After estimating the test-error, a 2-point reduction (2/21) of the TEQ was recommend to be considered a reference outcome indicator for the effective intervention. Even though the TEQ is scored by clinician, it can reflect the clinical features of tinnitus patient. Flexible and simple assessing process makes it a practical tool for patient intake, intervention selection, and outcome measurement.
-
Expression and prognostic analyses of HDACs in human gastric cancer based on bioinformatic analysis.
Gastric cancer (GC) is a common cancerous tumor, and is the third leading cause of cancer mortality worldwide. Although comprehensive therapies of GC have been widely used in clinical set ups, advanced gastric cancer carries is characterized by poor prognosis, probably due to lack of effective prognostic biomarkers. Mammalian histone deacetylase family, histone deacetylases (HDACs), play significant roles in initiation and progression of tumors. ⋯ In addition, expression levels of HDACs were correlated with different Lauren classifications, and clinical stages, lymph node status, treatment, and human epidermal growth factor receptor 2 status in GC. The findings of this study showed that HDAC members are potential biomarkers for diagnosis or prognosis of gastric cancer. However, further studies should be conducted to validate these findings.
-
This study examined the association between physical activity (PA) and quality of life (QOL) in Korean patients with inflammatory bowel disease (IBD). We enrolled 158 patients with IBD (81 men and 47 women). PA levels were assessed using the International PA questionnaire. ⋯ The frequency of sweat-inducing exercise showed an inverse correlation with IBDQ (κ = -0.228, P = .011), physical function of SF36v2 (κ = -0.245, P = .006), EQ5D (κ = -0.225, P = .007), and EQ-VAS (κ = -0.246, P = .004) scores. Increased PA levels were associated with improved QOL in patients with IBD. More leisure activity and non-sweat-inducing exercise were associated with improved QOL in patients with IBD.
-
Observational Study
Hip fractures in elderly patients with non-dialysis dependent chronic kidney disease: Outcomes in a Southeast Asian population.
Chronic kidney disease (CKD) causes bone and mineral disorders and alterations in vitamin D metabolism that contribute to greater skeletal fragility. Hip fracture in elderly is associated with significant morbidity and mortality. The aim of this study was to investigate the outcome of elderly patients with non-dialysis dependent CKD and hip fracture undergoing surgery. ⋯ In summary, in elderly, non-dialysis dependent CKD patient with hip fracture we found that male gender, age ≥80 years, low serum albumin and eGFR < 30 mL/min/1.73 m2 were associated with higher risk of death. The hospital stay in the CKD group was also longer. Additional studies are needed to validate our findings.