In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea-hypopnea syndrome（OSAHS） patients with nasal obstruction. The airflow distribution and movement of the soft pal...In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea-hypopnea syndrome（OSAHS） patients with nasal obstruction. The airflow distribution and movement of the soft palate before and after surgery were described by a numerical simulation method. The curative effect of nasal surgery was evaluated for the three patients with OSAHS. The degree of nasal obstruction in the 3 patients was improved after surgery. For 2 patients with mild OSAHS, the upper airway resistance and soft palate displacement were reduced after surgery. These changes contributed to the mitigation of respiratory airflow limitation. For the patient with severe OSAHS, the upper airway resistance and soft palate displacement increased after surgery, which aggravated the airway obstruction. The effcacy of nasal surgery for patients with OSAHS is determined by the degree of improvement in nasal obstruction and whether the effects on the pharynx are beneficial. Numerical simulation results are consistent with the polysomnogram（PSG） test results, chief complaints, and clinical findings, and can indirectly reflect the degree of nasal patency and improvement of snoring symptoms, and further,provide a theoretical basis to solve relevant clinical problems.展开更多
AIM:To present our experience with refeeding syndrome in southeastern Taiwan.METHODS:We conducted a retrospective study during a 2-year period at the Mackay Memorial Hospital,Taitung Branch.We enrolled patients with v...AIM:To present our experience with refeeding syndrome in southeastern Taiwan.METHODS:We conducted a retrospective study during a 2-year period at the Mackay Memorial Hospital,Taitung Branch.We enrolled patients with very little or no nutrition intake for more than 10 d,a high risk group of refeeding syndrome,including those suffering from alcohol abuse,cancerous cachexia,chronic malnutrition,and prolonged starvation.RESULTS:A total of 11 patients(7 males,4 females)with nasogastric feeding were included as having refeeding syndrome.Most of them had the symptoms of diarrhea,lethargy,and leg edema.The initial nutritional supplement was found to be relatively high in calories(1355.1±296.2 kcal/d),high in protein(47.3±10.4 gm/d),low in vitamin B1(2.0±0.5 mg/d),low in potassium(1260.4±297.7 mg/d),and low in phosphorus(660.1±151.8 mg/d).Furthermore,hypophosphatemia(2.4±0.9 mg/dL)was noted during follow-up.Based on the suggestions of a dietician and a gastroenterologist,the clinical disorders of diarrhea,malaise and leg edema were significantly improved.The level of phosphate was also increased(3.3±0.6mg/dL).CONCLUSION:Refeeding syndrome is an overlooked and risky disorder that has some potentially fatal complications.Nasogastric feeding in nursing homes is an important risk factor for patients and deserves greater attention based on the initial results of this study.展开更多
基金supported by the National Natural Science Foundation of China(10902022,11072055,and 11032008)the Fundamental Research Funds for the Central Universities(DUT13LK49)
文摘In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea-hypopnea syndrome（OSAHS） patients with nasal obstruction. The airflow distribution and movement of the soft palate before and after surgery were described by a numerical simulation method. The curative effect of nasal surgery was evaluated for the three patients with OSAHS. The degree of nasal obstruction in the 3 patients was improved after surgery. For 2 patients with mild OSAHS, the upper airway resistance and soft palate displacement were reduced after surgery. These changes contributed to the mitigation of respiratory airflow limitation. For the patient with severe OSAHS, the upper airway resistance and soft palate displacement increased after surgery, which aggravated the airway obstruction. The effcacy of nasal surgery for patients with OSAHS is determined by the degree of improvement in nasal obstruction and whether the effects on the pharynx are beneficial. Numerical simulation results are consistent with the polysomnogram（PSG） test results, chief complaints, and clinical findings, and can indirectly reflect the degree of nasal patency and improvement of snoring symptoms, and further,provide a theoretical basis to solve relevant clinical problems.
文摘AIM:To present our experience with refeeding syndrome in southeastern Taiwan.METHODS:We conducted a retrospective study during a 2-year period at the Mackay Memorial Hospital,Taitung Branch.We enrolled patients with very little or no nutrition intake for more than 10 d,a high risk group of refeeding syndrome,including those suffering from alcohol abuse,cancerous cachexia,chronic malnutrition,and prolonged starvation.RESULTS:A total of 11 patients(7 males,4 females)with nasogastric feeding were included as having refeeding syndrome.Most of them had the symptoms of diarrhea,lethargy,and leg edema.The initial nutritional supplement was found to be relatively high in calories(1355.1±296.2 kcal/d),high in protein(47.3±10.4 gm/d),low in vitamin B1(2.0±0.5 mg/d),low in potassium(1260.4±297.7 mg/d),and low in phosphorus(660.1±151.8 mg/d).Furthermore,hypophosphatemia(2.4±0.9 mg/dL)was noted during follow-up.Based on the suggestions of a dietician and a gastroenterologist,the clinical disorders of diarrhea,malaise and leg edema were significantly improved.The level of phosphate was also increased(3.3±0.6mg/dL).CONCLUSION:Refeeding syndrome is an overlooked and risky disorder that has some potentially fatal complications.Nasogastric feeding in nursing homes is an important risk factor for patients and deserves greater attention based on the initial results of this study.
