ABSTRACT
OBJECTIVES: Enhanced Recovery After Surgery (ERAS) protocols promote recovery after various invasive surgeries. Likewise, preoperative glucocorticoid administration can reduce complications after some surgeries. However, the effects of ERAS protocols and glucocorticoid administration in patients undergoing major surgery for head and neck cancer have not been well described. The aim of this study was to evaluate the effect of an ERAS protocol with preoperative glucocorticoid administration in major surgery for head and neck cancer. METHODS: This retrospective study included 28 patients who underwent major head and neck surgery with free tissue transfer reconstruction at our institution from September 2016 to May 2017, after implementation of an ERAS protocol with preoperative glucocorticoid administration. Outcomes in that group were compared with those in a control group that underwent surgery from January 2015 to September 2016, before implementation of the protocol. RESULTS: Analysis revealed significantly less body weight fluctuation, lower C-reactive protein levels, higher albumin levels, and lower body temperature in the ERAS group than in the control group postoperatively. CONCLUSIONS: Patients undergoing major surgery for head and neck cancer who were treated with the ERAS protocol and preoperative glucocorticoid administration had evidence of better hemodynamic stability and less inflammatory response than control patients.
Subject(s)
Dexamethasone/administration & dosage , Glucocorticoids/administration & dosage , Head and Neck Neoplasms/surgery , Perioperative Care/methods , Postoperative Complications/prevention & control , Aged , Female , Free Tissue Flaps , Hemodynamics/drug effects , Humans , Inflammation/prevention & control , Length of Stay , Male , Middle Aged , Retrospective Studies , Tissue TransplantationABSTRACT
OBJECTIVES: The life of biobatteries remains an issue due to loss of enzyme activity over time. In this study, we sought to develop a biobattery with a long life using a hyperthermophilic enzyme. RESULTS: We hypothesized that use of such hyperthermophilic enzymes would allow for the biofuel cells to have a long battery life. Using pyrroloquinoline quinone-glucose dehydrogenase and the multicopper oxidase from Pyrobaculum aerophilum, we constructed an anode and cathode. The maximum output was 11 µW at 0.2 V, and the stability of the both electrode was maintained at 70 % after 14 days. CONCLUSION: The biofuel cells that use hyperthermophilic enzymes may prolong their life.
Subject(s)
Archaeal Proteins/metabolism , Bioelectric Energy Sources , Electrochemical Techniques/instrumentation , Enzymes, Immobilized/metabolism , Oxidoreductases/metabolism , Pyrobaculum/enzymology , Electrochemical Techniques/methods , Electrodes , Enzyme Stability , Equipment Design , Glucose 1-Dehydrogenase/metabolism , Nanotubes, Carbon , PQQ CofactorABSTRACT
STUDY OBJECTIVE: To evaluate the thermal ablative effects of magnetic resonance-(MR) guided focused ultrasound surgery (MRgFUS) on adenomyosis and to assess improvement in clinical parameters. DESIGN: Twenty patients with adenomyosis were treated with MRgFUS. Extensive adenomyosis (6 cases) was treated with 2 applications. Uterine volume was evaluated by MR imaging before and immediately after MRgFUS. Ablation of adenomyosis and the architecture of nonperfused areas were evaluated immediately after MRgFUS. Improvement in patient symptoms was assessed through the symptom severity score questionnaire (Canadian Task Force classification II-3). SETTING: Department of gynecology at a Japanese general hospital. PATIENTS: Premenopausal women at least 18 years of age with symptomatic adenomyosis. INTERVENTIONS: Thermal ablation by MRgFUS. MEASUREMENTS AND MAIN RESULTS: We classified the nonperfused lesions on contrast-enhanced MR images immediately after MRgFUS into 3 types: lesions with round margins (type R), serrated margins (type S), and honeycomb architecture (type H). Type R was the most common (16/20 patients). Most adenomyosis lesions could be sufficiently ablated close to the serosal surface or to the endometrium by MRgFUS. The mean uterine volume 6 months after therapy was decreased by 12.7%. Symptom severity score improved significantly during 6 months of follow-up. No serious complications were observed. CONCLUSION: These early results indicate the safe and effective ablation of adenomyosis tissue by MRgFUS. The procedure also resulted in the improvement in clinical symptoms during the 6 months of follow-up.