Effectiveness of administration of bronchodilator by spacers, home-made spacers and nebulizers in patients with chronic obstructive pulmonary disease

Background: In chronic obstructive pulmonary disease (COPD), bronchodilator therapy using dry powder inhaler (DPI) or a measured dose inhaler (MDI) is more convenient at a lower cost than nebulizer therapy. Mistakes in the use of MDI often occur due to lack of coordination but with the addition of spacers, drawbacks in the use of this MDI can be overcome so that it does not require coordination. Commercial spacers are relatively expensive and not available anywhere while home-made spacers made from bottles of mineral water are very cheap and can be made alone. Study aimed to evaluate the effectiveness of each device, namely a spacer, a home-made spacer and nebulizer.Methods: This study is an experimental study of 62 COPD patients who received bronchodilators using spacers, home-made spacers, and nebulizers. Spirometry is performed for each sample before and after bronchodilator administration to assess FEV1, KVP and changes in VAS dyspnea. The difference in the effectiveness of bronchodilators for various devices in COPD patients was statistically analyzed using the ANOVA test.Results: There were significant differences in the values of VEP1, KVP and VAS dyspnoea after bronchodilator administration through the spacer, home-made spacer and nebulizer (p<0.001), (p=0.002), (p<0.001). The increase in% VEP1 with a nebulizer device was higher than that of a spacer (p=0.001) and the increase in% VEP1 with the nebulizer device was also significantly significant compared to home-made spacer (p<0.001). The increase in% KVP with the nebulizer device was higher than that of home-made spacer (p<0.001), as well as between spacers and home-made spacers and this was significant (p=0.038). The decrease in VAS dyspnoea in patients using nebulizer device than the spacer (p<0.001). Decreasing VAS dyspnoea with nebulizer devices is higher compared to home-made spacers, also gives significant results (p<0.001). There were no differences in the decrease in VAS dyspnoea between spacers and home-made spacers.Conclusions: The administration of bronchodilators by use of three devices (spacers, home-made spacers and nebulizers) can significantly increase the values of FEV1, KVP and VAS dyspnoea. On the use of spacers and home-made spacers, the increase of pulmonary physiological values is not significantly different.

Development and preliminary clinical application of home-made temporomandibular joint prostheses / 中华口腔医学杂志

Objective@#To explore the clinical application of home-made temporomandibular joint (TMJ) prostheses.@*Methods@#Self-developed TMJ prostheses were applied for end stage osteoarthritis, TMJ ankylosis, condylar tumors after biomechanical examination. The stability of the prostheses toward bone was evaluated during operation. Post-operative CT scans and clinical follow-ups were taken to check changes of mouth opening, position of the prostheses, bone resorption around the screws, and heterotopic bone formation around artificial condyle.@*Results@#There were 6 patients accepted 7 prostheses smoothly without infection and other complications. Post-operative follow-ups were from 6 to 13 months with a mean of 7.6 months. Mouth opening was significantly improved from (16.2±14.4) mm before operation to (31.5±4.8) mm during follow-ups (P=0.01). All prostheses were stable without screw loose and heterotopic bone formation.@*Conclusions@#Home-made TMJ prostheses were stable after primary clinical application, but the long-term results need to be observed.

Dietary quality differs by consumption of meals prepared at home vs. outside in Korean adults

BACKGROUND/OBJECTIVES: Eating out has been reported to have negative effects on nutritional status. However, eating out can include meals prepared at home and eaten outside. Conversely, meals eaten at home can be brought from outside, as take-out and home deliveries have become common in Korea. Thus, we tested whether or not meal preparation location influences daily diet quality. SUBJECTS/METHODS: From the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2009, 4,915 Korean adults (20-64 years) were classified into two groups: home-made meal group (HMG), who ate ≥ 2 meals per day prepared at home (n = 4,146), and non-home-made meal group (NHMG), who ate ≥ 2 meals per day prepared outside home (n = 769). Daily diet quality was determined by energy intake, nutrient intake, Dietary Variety Score (DVS), and Diet Diversity Score (DDS). RESULTS: Compared to the HMG, the NHMG was more likely to consist of men, single, employed, educated and of a higher economic status (all, P < 0.01). The NHMG showed higher energy intakes (1,776 vs. 2,116 kcal/day) with higher percentages of energy from protein (15 vs. 23%) and fat (14 vs. 16%) and lower intakes of dietary fiber, phosphorus, potassium, niacin, and vitamin C (all, P < 0.01) than the HMG, with some variations among age groups. The NHMG tended to consume foods prepared by frying and grilling and had more one-dish meals such as bibimbap, noodles, and dumplings but also showed higher dietary diversity. CONCLUSIONS: It should be noted that home-made meals do not necessarily guarantee a healthy diet, and the effects of meal preparation location on nutritional status might vary depending on socio-demographic characteristics.

Dietary quality differs by consumption of meals prepared at home vs. outside in Korean adults

BACKGROUND/OBJECTIVES: Eating out has been reported to have negative effects on nutritional status. However, eating out can include meals prepared at home and eaten outside. Conversely, meals eaten at home can be brought from outside, as take-out and home deliveries have become common in Korea. Thus, we tested whether or not meal preparation location influences daily diet quality. SUBJECTS/METHODS: From the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2009, 4,915 Korean adults (20-64 years) were classified into two groups: home-made meal group (HMG), who ate ≥ 2 meals per day prepared at home (n = 4,146), and non-home-made meal group (NHMG), who ate ≥ 2 meals per day prepared outside home (n = 769). Daily diet quality was determined by energy intake, nutrient intake, Dietary Variety Score (DVS), and Diet Diversity Score (DDS). RESULTS: Compared to the HMG, the NHMG was more likely to consist of men, single, employed, educated and of a higher economic status (all, P < 0.01). The NHMG showed higher energy intakes (1,776 vs. 2,116 kcal/day) with higher percentages of energy from protein (15 vs. 23%) and fat (14 vs. 16%) and lower intakes of dietary fiber, phosphorus, potassium, niacin, and vitamin C (all, P < 0.01) than the HMG, with some variations among age groups. The NHMG tended to consume foods prepared by frying and grilling and had more one-dish meals such as bibimbap, noodles, and dumplings but also showed higher dietary diversity. CONCLUSIONS: It should be noted that home-made meals do not necessarily guarantee a healthy diet, and the effects of meal preparation location on nutritional status might vary depending on socio-demographic characteristics.

Retroperitoneal laparoendoscopic single-site donor nephrectomy using home-made single-port device:report of 11 cases / 中华器官移植杂志

Objective To investigate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) donor nephrectomy using home-made single-port device.Methods From January 2011 to June 2012,11 consecutive LESS left donor nephrectomies using home-made single-port device with conventional laparoscopic instrument were performed through retroperitoneal access in our center.Results The procedures were completed and no complications occurred in all donors.Mean operative time was 149.5 min.Estimated blood loss was 30-350 ml.Warm ischemia time was 2-4 min.The urine output was prompt in all cases.Recipient graft function was normal within 2 weeks.Donor hospital stay was 5-6 days after operation.Conclusion LESS donor nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-effective and minimally invasive with conventional laparoscopic donor nephrectomy.This technique is a good option for living donor nephrectomy.

Laparoendoscopic Single-Site Nephrectomy Using a Modified Umbilical Incision and a Home-Made Transumbilical Port

PURPOSE: To assess the clinical utility of laparoendoscopic single-site surgery (LESS) nephrectomy using a modified umbilical incision and home-made transumbilical port in cases requiring extirpative surgery. MATERIALS AND METHODS: Initial consecutive 18 patients underwent LESS nephrectomies that were performed by a single surgeon. A home-made port was placed through a modified umbilical incision, the length of which had preoperatively been determined. The laparoscopic transperitoneal nephrectomy procedures were performed with various combinations of standard and articulating laparoscopic instruments. Patient characteristics and perioperative outcomes, including pathologic results, were recorded prospectively. RESULTS: All 18 extirpative surgeries, including simple nephrectomy (eight cases), radical nephrectomy (nine cases), and nephroureterectomy (one case), were completed successfully. The median operation time was 167 min (range 82-220), and the median blood loss was 250 mL (range 0-1050). All specimens were extracted intact through a modified umbilical incision (median length 2.5 cm, range 1.5-6.0). Final pathological analysis revealed a nonfunctioning kidney in five cases, a dysplastic kidney in three cases, a mixed epithelial and stromal tumor in one case, renal cell carcinoma in eight cases (T1: five cases, T3: three cases), and Ta ureter transitional cell carcinoma in one case. CONCLUSION: LESS nephrectomy using a home-made port and modified umbilical incision is feasible with both minimal incision and cost-effective. Our technique may be more useful for extirpative procedures in which a specimen needs to be removed intact, because incision length can be freely adjusted. Prospective comparisons are warranted to more clearly elucidate the utility of this surgical technique.

The treatment of VSD with home-made occluder and its mid-term and long-term results / 介入放射学杂志

Objective To evaluate the home-made occluder in the treatment of VSD and its mid-term and long-term results. Methods From Jan. 2004 to May 2007, percutaneous VSD closure therapy under X-ray monitoring was performed in 78 consecutive VSDpatients, including 43 males and 35 females with an average age of (16.5±8.6) years (ranged 3-37 years). TTE, ECG and Holter examinations were performed in 1 week, 3 months, 1 year and 2 years after the procedure. Results Seventy-three home-made occluder devices with a diameter of 5-16 mm (10.3±3.2 mm) were implanted successfully, with a technical successful rate of 93.6% (73/78). The whole course follow-up were carried out in all 73 successful cases (100%). One week after the procedure ITE detected residual shunt in 8 cases, and three months later the residual shunt was observed in 5 cases. Follow-up check at one and two years after the treatment the residual shunt disappeared completely. For the observation of arrhythmia, occasional atrial premature beats or ventricular premature beats occurred in 28 cases (38.4%) within one week after the procedure, and two patients developed grade Ⅲ complete atrioventricular block at the third day after the surgery. The arrhythmia disappeared after medication of prednisone and nutrient drugs for 4-10 days. Bundle branch blocks were observed in 8 cases (10.1%) at one-year and two-year follow-up. Conclusion For the treatment of VSD, the home-made Amplatzer occluder device is reliable and effective, although a close foUow-up is required after the surgery.

A Retrospective Review of Endovascular Aneurysm Repair (EVAR) for Abdominal Aortic Aneurysm (AAA) with Home-made Devices

PURPOSE: This study was performed to assess the safety and efficacy of Endovascular Aneurysm Repair (EVAR) with a home-made stent graft. METHOD: The medical records of 17 patients who underwent EVAR at Seoul National University Hospital between January 1995 and December 2003 were analyzed retrospectively. The outcomes were measured with respect to efficacy (deployment success rate, technical success rate, conversion rate, and reintervention rates) and safety (30-day mortality rate, complication rate, endoleaks, graft thrombosis, stenosis, and migration). RESULT: The median follow-up of the patients was 42.8 months (range, 2.7~72.67 months). The male to female ratio was 7.5 (15:2). The deployment success rate was 100% and the technical success rate was 70.6% at discharge. Early complications were present in five patients (29%). Late complications occurred in 47% of the cases. Secondary intervention to treat complications was required in 29% of patients. Open repairs were performed in two patients (12%), one with an immediate type Ia endoleak and the other for migrations. The cumulative patient survival rate was 94.1%, 76.0% and 57.0% at 1, 3 and 5 years follow up. The overall clinical success rate during follow-up was 38.5%. CONCLUSION: Although EVAR with a home-made device in high-risk patients showed good early technical outcomes, there were complications. Continued device innovation, good compliance and close surveillance are required for these patients.

Clinical study of home-made coronary artery stent / 中国实用内科杂志

Objective To access the clinical effectiveness and safety of the home-made coronary artery stent - Jin Xin stent. Methods Ten patients with coronary heart disease,from 39 to 70 years old (averaged 55 2yrs),male 7,female 3,were performed PTCA .Jin Xin stents were implanted in to left anterior descending arteries(2),left circumflex(3)and right coronary arteries (5). Results The stenosis was 80～100% before the stents implantation, and 0 after the implantation. There were no abrupt occlusion and thrombosis during the procedure,and no cardiac events during the 6～8 months follow-up. Conclusion Jin Xin Stent is very good at releasing and standing-support. And it can dilate completely. It is safe and effective as an interventional therapy for coronary heart disease.

The experience of gasless laparoscopic surgery using Home-made Abdominal-wall-take-up / 临床外科杂志

Objectives To sum up the experience of the gasless laparoscopic surgery using home-made abdominal-wall-take-up.Methods Using home-made abdominal-wall-take-up application on 15 patients,including 12 cholecystectmy,3 appendectomy.Every patients was used epidural block.Results All the surgery were successed and every patients had no complication.The hospitalization was 4～40 days (average 13.6 days),the time of operation was 50 to 215 minutes (average 89 minutes), fee of hospitalization was 5487 yuan.Conclusions It conclude that the gasless laparoscopic surgery using home-made abdominal-wall-take-up application is a safe,economic,useful method,which adapts to the situation of China.It reinforces the gas laparoscopic surgery.

Evaluation of home-made ELISA's for protein C and protein S antigenic assays.

Home-made enzyme-linked immunosorbent assays (ELISA) for protein C (PC) and protein S (PS) antigenic assays, using commercial antibodies, were set up in our laboratory. The latter can be used for the measurement of total PS and also free PS, after the precipitation of bound form. Here we describe the procedure for both PC and PS ELISA's, and their quality evaluation and cost. Intra- and inter-assay variation (n = 20) were calculated to be 7.3% and 8.1% for the PC ELISA and 10.2% and 10.1% for free PS ELISA. The accuracy of the tests assessed by external quality assurance of WHO International External Quality Assessment Scheme in Blood Coagulation (IEQAS) was satisfactory. The level of PC antigen in 50 healthy volunteers was 89 ฑ 18% and that of free protein S was 94 ฑ 16%. In conclusion the quality of the home-made ELISA's was acceptable while the cost was much cheaper than that of commercial ELISA kits.

Home-made Rapid Urease Test for Detection of Helicobacter pylori Infection / 대한임상미생물학회지

BACKGROUND: The rapid urease test has been widely used for detection of Helicobacter pylori infection because it is easy, simple and rapid result. The CLO test and PyloriTek test observe color changes after the gastric biopsy specimens are inerted into the test kits. Because H. pylori is not evenly distributed in the gastric mucosa, grinding or mincing of gastric specimens prior to culture enhances isolation rate of H. pylori. Therefore, we evaluated the effects of rubbing the gastric biopsy specimens onto the urea soaked filter paper in this home-made rapid urease test. METHODS: Forty-three patients referred for upper gastrointestinal tract endoscopy were evaluated for H. pylori infection. The home-made rapid urease test was prepared by soaking a piece of Whatman No. 2 filter paper in 2% urea agar. We compared the results of the home -made rapid urease test with histologic examination, gram stain, CLO test and culture. RESULTS: Of forty-three patients, 28 were found to be H. pylori-positive either by gram stain or by culture. The sensitivity and specificity of CLO test, based on the results of gram stain and culture were 85.7% and 92.9%. The sensitivity and specificity of home -made rapid urease test, based on the results of gram stain and culture were 92.9% and 92.9%. CONCLUSIONS: The home-made rapid urease test is faster and shows a high sensitivity and specificity.

Vaporizador artesanal de éter para cirurgia experimental em pequenos roedores

This paper described a homemade ether vaporizer, changed from WAYNFORTH & FLECKNELL model for small animals. The device is build with hospital material and products bought in aquarium’s shops. Their advantages are maintenance of anesthetic level without successive "inductions" by inhalatory nasal ether ; ether consumption of 5 ml per hour in animals with 300 g ; smaller ambient pollution and small cost. The disadvantages are a hardness and reduction of the plastic tubes after approximately 150 hour in use, by ether action and the necessity of experience acquisition in anesthetic manipulation with the device

O presente trabalho descreve modelo experimental de vaporizador artesanal de éter, modificado a partir do modelo de WAYNFORTH & FLECKNELL, a fim de manter fluxo contínuo e homogêneo do anestésico em cirurgias onde se utiliza roedores de pequeno porte como animais de experimentação. O sistema é construído a partir de material encontrado em casas de materiais para aquários, sonda e tubo de ensaio de uso hospitalar, base de madeira e campânula de vidro confeccionada em vidraçaria. Como vantagens do sistema pode-se citar a manutenção do animal em plano anestésico sem que haja necessidade de contínuas "induções" com algodão embebido em éter e ofertado por via nasal, com perda do excesso para o meio ambiente e inalação do mesmo por quem conduz o experimento. Diminui-se assim quantidade de anestésico total gasto, devido manter-se níveis de oferta mais homogêneas por um fluxo contínuo de acordo com o plano anestésico do animal. Consegue-se também através do consumo aferido no tubo de ensaio, calcular aproximadamente o volume / minuto inalado, consumindo-se em média 5 ml de éter em uma hora de anestesia para ratos com 300g, obtendo com isto economia da substância, melhor controle da quantidade inalada pelo animal e redução da poluição do meio ambiente pelo mesmo.

Clinical study of selective salpingography and fallopian tube recanalization by home made coaxial catheter / 介入放射学杂志

Objective To evaluate the clinical value of selective salpingography (SSG) and fallopian tube recanalization (FTR) by home made coaxial catheter. Methods 116 cases of tube obstruction were diagnosed by hysterosalpingogram (HSG). SSG was performed with home made coaxial catheter. If proximal tube complete obstruction was still present, then followed by FTR. Results 116 cases of follow up showed 55 intrauterine pregnancies (IUPS) and 6 ectopic pregnancies. IUP rate was 47.4%. 28 of 116 cases were performed by HSG again, 25 of 28 cases were improved, effective rate was 89.3%.Conclusions SSG and FTR were a safe and effective procedure for the diagnosis and treatment of tube obstruction with home made coaxial catheter.

Percutaneous Intravascular Home-Made Port-Catheter System Implantation / 介入放射学杂志

Purpose: To investigate the security and clinical value of percutaneous intravascular home-made port-catheter-system(PCS) implatation. Materials and Methods: This technique was used to treat thoracic, abdominal and pecvic malignant tuwcors in 63 patients. Intra-arterial injection of anticancerous agents and lipiodol were regularly carried out Via PCS. Results: All PCS implatation were successful. The PCS catheter tips were all retained within target vessels. The related complications in- cluded local hemorrhage (5 cases, 7.9%), wound delaged healing or wound dehiscence (4 cases, 6. 3%), indwelling catheter blockage (4 cases, 6. 3%), migrating of catheter tip (1case, 1.5%), local infection (2cases, 3.1%). Most of these cases were recovered after appropriate management without any fatal and pevae sequelae. Conclusion: Percutaneous Intravascular home-made port-eatheter system implantation is safe and reliable. Home-made PCS is cheaper and more suitable for chinese than im- ported products.