http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Thomas B. Russell,Peter L. Labib,Paula Murphy,Fabio Ausania,Elizabeth Pando,Keith J. Roberts,Ambareen Kausar,Vasileios K. Mavroeidis,Gabriele Marangoni,Sarah C. Thomasset,Adam E. Frampton,Pavlos Lykou 한국간담췌외과학회 2024 Annals of hepato-biliary-pancreatic surgery Vol.28 No.1
Backgrounds/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods: Data were extracted from the Recurrence After Whipple’s study, a retrospective multicenter study of PD outcomes. Results: In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was “enteral only,” “parenteral only,” and “enteral and parenteral” in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions: A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.
Thomas B. Russell,Peter L. Labib,Jemimah Denson,Fabio Ausania,Elizabeth Pando,Keith J. Roberts,Ambareen Kausar,Vasileios K. Mavroeidis,Gabriele Marangoni,Sarah C. Thomasset,Adam E. Frampton,Pavlos Lyk 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.4
Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple’s (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6–21), group B (49 days, 39–64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-todeath (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.
Regional Structure of the Indian Summer Monsoon in Observations, Reanalysis, and Simulation
Cash, Benjamin A.,Kinter III, James L.,Adams, Jennifer,Altshuler, Eric,Huang, Bohua,Jin, Emilia K.,Manganello, Julia,Marx, Larry,Jung, Thomas American Meteorological Society 2015 Journal of climate Vol.28 No.5
Lee, Hang-Jae,Lee, Yuong-Nam,Adams, Thomas L.,Currie, Philip J.,Kobayashi, Yoshitsugu,Jacobs, Louis L.,Koppelhus, Eva B. Elsevier 2018 Palaeogeography, palaeoclimatology, palaeoecology Vol.494 No.-
<P><B>Abstract</B></P> <P>A theropod tracksite was discovered in the Nemegt Formation (Maastrichtian) at Bügiin Tsav, Mongolia by the Korea-Mongolia International Dinosaur Project in 2009. A total of 67 tracks (14 trackways [one didactylous, 13 tridactylous] and 12 isolated tracks) belonging to four ichnomorphotypes were mapped on a single horizon. This indicates at least four different theropod trackmakers lived in the same area at the same time. This tracksite consists of laminated gray mudstone-yellowish brown siltstone couplets interbedded with eolian yellowish brown sandstone deposited on a distal floodplain. Abundant footprints with V-shaped profiles (cross-section) within in the vertical section indicate that dinosaurs repeatedly walked across in this area. Before the discovery of the tracks, the site was illegally excavated by fossil poachers, a widespread problem in the Gobi Desert. During excavation of the track horizon, a clenched, inclined <I>Gallimimus</I> foot skeleton was found in the mudstone, extended down 20cm below the track-bearing sandstone layer. The occurrence of tracks closely associated with body fossils is unusual and taphonomically intriguing. It is possible that the foot skeleton represents an animal that died in its tracks. However, the depth of the foot in mud is probably too shallow for the animal to have been mired. Sedimentological and taphonomic evidence also suggests that the pes of <I>Gallimimus</I> may have passed straight through the track-bearing sandstone layer. The inclined right pes indicates that the body lay on its left side on the substrate. During decomposition in the mud, all digits were flexed but the distal phalanges were stuck and anchored in the stiff lower mud. Consequently, as more proximal phalanges were able to accommodate flexing, they were pulled away and dislocated from the anchored distal phalanges. Subsequent trampling by dinosaurs in the track-bearing sandstone would have further distorted the underlying foot.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The first report of theropod trackways from the Nemegt Formation in Bügiin Tsav, Mongolia </LI> <LI> Taphonomic interpretation of a <I>Gallimimus</I> foot skeleton associated with theropod tracks </LI> <LI> An interpretation of disarticulation and distortion of the foot skeleton is proposed. </LI> </UL> </P>