Background/Objectives: To investigate the association of antioxidant nutritional status with the risk of atopic dermatitis (AD) in young children in a case-control, population-based study. Subjects/Methods: Identified from preschools by using the Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC). Final analysis included 180 AD (mean age 5.3 ± 0.9 years) and 242 non-AD (mean age 5.2 ± 1.0 years) children. Diet was assessed using a validated semi-quantitative food frequency questionnaire. Fasting blood samples were used for analyses of fat-soluble vitamins (retinol, a-tocopherol, and b-carotene) and vitamin C. . There was no relationship of AD risk with dietary and plasma vitamin C as well as nutrient supplement intake regardless of nutrient type. AD was predicted better by the intake measure than the corresponding blood biomarker regarding vitamin E and b-carotene. Conclusions: These findings suggest that higher antioxidant nutritional status reduces the risk of AD and that such risk-reduction effects depend on nutrient type.
Postoperative bleeding is the most frequent surgical complication after tonsillectomy and may be associated with increased mortality rate. We have, therefore, analyzed factors associated with and prognostic for bleeding after tonsillectomy. The 2,254 patients who underwent tonsillectomy under general anesthesia at our institution from January 2005 to December 2009 were divided into bleeding and non-bleeding groups, and their demographic and clinical characteristics were compared. Age, administration of steroid immediately after general anesthesia, absence of administration of non-steroidal anti-inflammatory drugs, and the surgeon's experience were significantly associated with bleeding. In contrast, gender, chief complaints, performance of associated surgery, and type of anesthetic were not associated with postoperative bleeding. Hemorrhage after tonsillectomy was associated with the administration of steroids and with the non-administration of non-steroidal anti-inflammatory drugs.
The interleukin 1 receptor, type I (IL1R1) is important in the pathogenesis of cancer. We investigated whether single nucleotide polymorphisms (SNPs) of IL1R1 contribute to the development of papillary thyroid carcinoma (PTC), in addition to the clinicopathological features such as the size, number, location, extrathyroidal invasion and metastasis of PTC. Three promoter SNPs (rs949963 -615G/A, rs2192752 -1028A/C and rs3917225 -1099A/G) in IL1R1 were genotyped using direct sequencing in 118 patients with PTC and 347 controls. The odds ratio (OR), 95% confidence interval (CI) and P value were analysed using SNPStats and SNPAnalyzer Pro. For the exact results, Fisher's exact test and Bonferroni correction (P(c)) were performed. The three promoter SNPs of IL1R1 were not associated with PTC development. For the clinicopathological features of PTC, rs2192752 was associated with location (one lobe versus both lobes): dominant model, OR = 3.11, 95% CI = 1.39-6.96, P(c) = 0.015; log-additive model, OR = 2.79, 95% CI = 1.38-5.66, P(c) = 0.0087. The C allele frequency of rs2192752 was higher in the both lobes group (28.0%) than the one lobe group (12.3%) (OR = 2.77, 95% CI = 1.40-5.48, P(c) = 0.009). However, rs949963 and rs3917225 were not correlated with clinicopathological features including location of PTC. The IL1R1 promoter SNP rs2192752 may contribute to the location of PTC, and the C allele of rs2192752 may be a risk factor for the development of PTC in both lobes.
SummaryThis study investigated the effect of intrathecal fentanyl on the dose of propofol during sedation guided by Cerebral State Index monitoring. Seventy patients were randomly assigned to receive either fentanyl 25 lg (n = 35) or normal saline (n = 35) with hyperbaric bupivacaine 12.5 mg for spinal anaesthesia. Propofol was infused to maintain a Cerebral State Index value of 65-75 for 30 min. The propofol infusion time and dose required to reach a Cerebral State Index value of 75 were recorded together with the time required to reach a Cerebral State Index value higher than 90 after cessation of sedation. The onset time for sedation was faster and the recovery time was slower in the fentanyl group compared to those in the saline group (p = 0.018 and 0.027, respectively). The propofol doses required for onset and maintenance of sedation were significantly lower in the fentanyl group compared to those in the control group (p = 0.018 and < 0.001, respectively). In conclusion, adding intrathecal fentanyl 25 lg during spinal anaesthesia significantly reduced the dose of propofol required for sedation and prolonged the subsequent recovery time. During spinal anaesthesia, conscious sedation can be provided for patient comfort. A minimal dose of intravenous sedative agents such as midazolam and propofol is often used to reduce patients' anxiety with minimal influence on haemodynamic variables. Neuraxial anaesthesia with local anaesthetics alone has been reported to reduce sedative requirements but with significant sedation achieved only with a high sensory block level, which may result in haemodynamic instability [1][2][3][4][5][6]. Intrathecal fentanyl is often combined with a local anaesthetic agent to enhance and prolong the sensory block produced by spinal anaesthesia [7,8], and a recent study reported the sedative effect of intrathecal fentanyl as monitored using Bispectral Index (BIS) [9]. The level of sedation can be monitored using the Observer's Assessment of Alertness ⁄ Sedation scale (OAA ⁄ S) and other commercially available monitors such as BIS, entropy and the Cerebral State Index (CSI), which uses the spontaneous EEG to calculate a numerical index between 100 and 0. The CSI has been reported to distinguish between graduated levels of propofol anaesthesia [1,10].The purpose of this study was to investigate the effect of intrathecal fentanyl on the dose of propofol required for sedation guided by CSI monitoring and the OAA ⁄ S scale in patients undergoing lower extremity surgery. We hypothesised that the addition of intrathecal fentanyl would decrease the propofol dose for an adequate level of sedation during spinal anaesthesia. MethodsThis study was approved by our Institutional Review Board and informed consent was obtained from all patients. Seventy patients of ASA physical status 1 or 2, undergoing lower extremity surgery, were assigned by random number in sealed envelopes to either a fentanyl group (n = 35) or the saline group (n = 35). Exclusion criteria included age kg.m )2 over 65 years,
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