• Title/Summary/Keyword: Case D/B

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On-line Image Guided Radiation Therapy using Cone-Beam CT (CBCT) (콘빔CT (CBCT)를 이용한 온라인 영상유도방사선치료 (On-line Image Guided Radiation Therapy))

  • Bak, Jin-O;Jeong, Kyoung-Keun;Keum, Ki-Chang;Park, Suk-Won
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.294-299
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    • 2006
  • $\underline{Purpose}$: Using cone beam CT, we can compare the position of the patients at the simulation and the treatment. In on-line image guided radiation therapy, one can utilize this compared data and correct the patient position before treatments. Using cone beam CT, we investigated the errors induced by setting up the patients when use only the markings on the patients' skin. $\underline{Materials\;and\;Methods}$: We obtained the data of three patients that received radiation therapy at the Department of Radiation Oncology in Chung-Ang University during August 2006 and October 2006. Just as normal radiation therapy, patients were aligned on the treatment couch after the simulation and treatment planning. Patients were aligned with lasers according to the marking on the skin that were marked at the simulation time and then cone beam CTs were obtained. Cone beam CTs were fused and compared with simulation CTs and the displacement vectors were calculated. Treatment couches were adjusted according to the displacement vector before treatments. After the treatment, positions were verified with kV X-ray (OBI system). $\underline{Results}$: In the case of head and neck patients, the average sizes of the setup error vectors, given by the cone beam CT, were 0.19 cm for the patient A and 0.18 cm for the patient B. The standard deviations were 0.15 cm and 0.21 cm, each. On the other hand, in the case of the pelvis patient, the average and the standard deviation were 0.37 cm and 0.1 cm. $\underline{Conclusion}$: Through the on-line IGRT using cone beam CT, we could correct the setup errors that could occur in the conventional radiotherapy. The importance of the on-line IGRT should be emphasized in the case of 3D conformal therapy and intensity-modulated radiotherapy, which have complex target shapes and steep dose gradients.

A Study on the Development of an Instrument for Evaluating the Quality of Nursing Care (간호의 질 평가도구 개발에 관한 일 연구)

  • 유지수
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.11-21
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    • 1977
  • Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

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Growth Characteristics and Ingredient Analysis According to the Transplanting Date and Distance of Dendranthema (L.). (감국 정식시기와 거리에 따른 생육특성과 성분 분석)

  • Jung, J.H.;Park, N.B.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.22 no.1
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    • pp.65-77
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    • 2020
  • In order to industrialize of Dendranthema indicum (L.) DesMoul., which is a lot of commercially available and is synonymous with chrysanthemum tea, in the autumn of 2018, Dendranthema indicum (L.) DesMoul. seeds were collected from its own native region, and the seeds were germinated after refrigerated storage. Young seedlings were subjected to experiments in February, March, and April in the open field to examine the effects on the harvesting of leaves by distance and the growth of leaves and stems. The results of analyzing the components by collecting the leaves+stem after collecting the flower of Dendranthema indicum (L.) DesMoul. are as follows. 1. When D. indicum (L.) DesMoul. seedlings were planted according to the transplanting date, the number of flowers was 17.1 in the transplanting date in April. The diameter of the flower was 2.9cm, 16ea, 6.5~6.6g in the fresh weight, and the dry weight of the case was 1.1~1.2g. The leaves were 46~47ea in March and April in the planted area, 5.2~5.3cm in leaf length and 3.5~3.6cm in leaf width. 2. When planted D. indicum (L.) DesMoul. seedlings according to transplanting distance, the number of flowers was 16.2 when planted at 20×20cm intervals and, 16.8~17.1 at 30×30~50×50cm intervals. The diameter of the flower was 2.7~2.8cm, the number of petals was 8, the length of the petal was 0.8 cm, and fresh weight was 6.5~6.6g per flower. Leaves had the largest number of 47 of 30×30cm and 40×40cm, and leaf length appeared at the longest 6.2cm in the 50×50cm treatment area, but 5.2cm in the other treatment areas. 3. The extraction yield of D. indicum (L.) DesMoul. leaves+stems was 7.93%, and the extraction solvent colors were light green at 50, 60% and green at 70, 80, 90, 100%. The extraction yield of D. indicum (L.) DesMoul. flowers was 7.58%, the color of the extraction solvent was light yellow at 50, 60 and 70%, yellow at 80 and 90%, and dark yellow at 100%. 4. We confirmed 11 kinds of ingredients such as in D. indicum (L.) DesMoul. flowers are gallic acid, 4-hydroxy benzoic acid, methyl gallate, 4-hydroxy-3-methoxy benzoic, caffeic acid, salicylic acid, p-coumaric acid, sinapic acid, naringin, 4-melthoxyben, flavone. The content was 29.200-36.900ppm. 5. The components contained in the D. indicum (L.) DesMoul. leaf+stem, salicylic acid appeared at 6,129.526ppm, and the next 4-methoxyben was 1,966.714ppm. It was methyl gallate 8.197ppm, 4-hydroxy-3-methoxy benzoic 6.994ppm, caffeic acid 5.566ppm, flavone 4.522ppm, p-coumaric acid 3.787ppm, gallic acid 1.893ppm that appeared in the content below 10ppm.

A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours (병원 간호사의 선호근무시간대에 관한 연구)

  • Lee, Gyeong-Sik;Jeong, Geum-Hui
    • The Korean Nurse
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    • v.36 no.1
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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Postprandial hypoglycemic effects of mulberry twig and root bark in vivo and in vitro (In vivo와 in vitro에서 상지 및 상백피 에탄올추출물이 식후 혈당 상승 억제 조절에 미치는 영향)

  • Park, Soo Yeon;Jin, Bo Ra;Lee, Yu Rim;Kim, You Jin;Park, Jeong Bin;Jeon, Young Hee;Choi, Sang Won;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.49 no.1
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    • pp.18-27
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    • 2016
  • Purpose: Our previous study demonstrated the hypoglycemic effects of mulberry (Morus alba L.) leaf and the underlying mechanisms. Here we explored the potency of mulberry twigs (TW) and root barks (RB) in postprandial hypoglycemic effects in vitro and in vivo. Methods: The major components of TW and RB were determined by high performance liquid chromatography (HPLC). Alpha-glucosidase inhibition and glucose/fructose uptake inhibition in Caco-2 cells were determined for TW, RB, and their major components, followed by an oral sugar tolerance test (OSTT) in streptozotocin-induced diabetic rats. Male Wistar rats were fed a high-fat diet for 2 weeks and then a single dose of streptozotocin (35 mg/kg B.W) was administered by intraperitoneal injection. Rats with fasting blood glucose levels above 126 mg/dL were randomly divided into 5 groups (n = 8/group) for the following treatments by gavage for 4 weeks: vehicle (normal control and diabetic control), 200 mg/kg B.W of TW or RB or 100 mg/kg B.W of oxyresveratrol (OXY). Results: OXY and mulberroside A were identified as the major components of TW and OXY, mongolicin, and kuwanon H for RB. A significant inhibitory activity on ${\alpha}-glucosidase$ was found for TW, RB, and OXY (p = 0.0099). There was a dose-dependent inhibition of TW and RB on the intestinal sugar uptakes in Caco-2 cells, showing a greater impact on fructose compared to glucose. The OSTT showed that TW and RB significantly delayed time to maximal concentration (p = 0.0088) and decreased maximal concentration (p = 0.0043) compared to the control group. Conclusion: These results suggest that TW and RB may have a postprandial hypoglycemic effect, particularly in the case of high fructose or sucrose intake. OXY was suggested as a contributor to the hypoglycemic effect of TW and RB. Further studies are needed for the systemic effect of TW and RB in circulation.

Salmonellosis in Children in Daejeon, Korea, 1994~1999 (대전지역 살모넬라증 환아에 대한 임상적 연구(1994~1999년))

  • Chun, Jung-Soo;Lee, Kyung-Yil;Lee, Hyung-Shin;Kim, Sang-Yong;Han, Ji-Whan;Her, Jae-Kyun;Whang, Tyung-Tai
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.211-217
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    • 2000
  • Purpose : Salmonellosis including typhoid fever is still prevalent in Korea. Recently it has been reported that the incidence of salmonella gastroenteritis is increasing with a reduction of typhoid fever. We studied the clinical and laboratory features of salmonellosis. Methods : We evaluated the clinical records of 83 patients with salmonellosis who had been confirmed by stool culture from 1994 to 1999. Results : Annual incidence of salmonellosis showed an increasing tendency during recent 4 years. Seasonally, summer(45.8%) was the most prevalent, followed by fall(32.5%). Male to female ratio was 1.4 : 1. In age distribution, 64 cases(77.1%) were under 5 year-old, and 18 cases(21.7%) were younger than 1 year-old. Clinical features included diarrhea(96.4%), fever(91.6%), vomiting(49.4%), bloody stool(42.1%), abdominal pain(40.1%) and tenesmus(12.0%). In serogroups, there was no group A and group B, group C, group D(including 2 cases of S.typhi) and group E were in 41.0%(34 cases), 3.6%(3 csaes), 51.8%(43cases) and 3.6%(3 cases), respectively. In Widal test, 5 cases(13.5%) and 1 case(2.7%) of group B, C and E(total 37 cases) were observed the O titer above 1 : 80 and 1 : 320, respectively. However, in 36 cases of group D, 19 cases(52.7%) and 9 cases(25.0%) were above the O titer 1 : 80 and 1 : 320, respectively. Antibiotics resistant rates to ampicillin, trimethoprim/sulfamethoxazole and chloramphenicol were 23.2%, 10.1% and 51.4%, respectively. Conclusion : Salmonellosis has become a common cause of gastroenteritis in children, especially under the pre-school age. Isolation of salmonella is neccessary for accurate diagnosis of gastroenteritis and typhoid fever. A careful attention of the use of antibiotics is needed to reduce the muilti-drug resistant strains.

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Growth and Physiological Responses of 1-Year-Old Containerized Seedlings of Quercus myrsinaefolia by Shading Treatment (피음처리에 따른 가시나무 1년생 용기묘의 생장과 생리적 반응)

  • Song, Ki-Sun;Sung, Hwan-In;Cha, Young-Geun;Kim, Jong-Jin
    • Journal of Bio-Environment Control
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    • v.20 no.4
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    • pp.373-381
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    • 2011
  • This study was carried out to investigate the growth and physiological responses to shading treatment of 1-year-old containerized seedling of Quercus myrsinaefolia. Experimental process was conducted in a facility that consisted of compartments under the lighting control with full sunlight and shading (35%, 55% and 75% of full sunlight). Height and root collar diameter growth were high in the seedlings under both 35% and 55% shading. Regardless of shading level, root collar diameter growth lasted for more than 4 weeks compared to height growth. Highest H/D ratio was observed in the seedlings under 35% shading as 4.31, and the lowest ratio was 3.63 under 75% shading. It was found that seedlings under 55% shading showed highest dry mass production, which was followed in seedlings under 35% shading. In case of leaf dry weight ratio (LWR) after shading treatment, the highest value was 0.53 under 55% shading, and followed in seedlings under 35% shading as 0.52. But root dry weight ratio (RWR) was highest as 0.36 under 75% shading (highest level of shading). In terms of shading treatment, it was found that the higher level of shading had a tendency toward the higher content of chlorophyll a and the higher total chlorophyll content in the leaves of Quercus myrsinaefolia, but there was no significant difference in the content of chlorophyll b depending on the level of shading. It was found that high photosynthesis and transpiration rate were more correlated with high level of shading than full sunlight, but the rates of seedlings had a tendency to be higher under 35% and 55% shading than under 75% shading. The results on growth and physiological responses to different shading levels of 1-year-old containerized seedlings of Quercus myrsinaefolia could be useful in setting up the optimum light intensity for growth, and in estimating the shade tolerance of the species.

Quality Factor Determination and Shelf-Life Prediction of Powdered-Model Food (분말 제품의 품질 인자 규명 및 저장 수명 예측)

  • Baik, Eun-Kyung;Park, Seok-Jun;Lee, Kang-Pyo;Choi, Sung-Won;Hur, Nam-Yun;Baik, Moo-Yeol
    • Journal of Marine Bioscience and Biotechnology
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    • v.2 no.3
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    • pp.160-167
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    • 2007
  • Shelf-stability of powdered model food was determined during storage at various temperatures ($25^{\circ}C$, $35^{\circ}C$) and various moisture contents (3.5%, 6.0%, 8.0%). Moisture content, peroxide value, pH, color, microbial counting and sensory evaluation were conducted during storage. Moisture content, peroxide value, pH and color were not significantly changed during storage in all samples indicating that this powdered model food was relatively stable at given conditions. Pathogenic microorganisms, such as Bacillus cereus, Listeria spp., Clostridium perfrigens, Salmonella spp. and Staphylococcus aureus, were not found during storage suggesting that there was no problem in safety in this case. On the other hand, the number of artificially added Lactic acid bacteria was decreased with increasing both storage temperature and moisture content. Therefore, powdered model food was very shelf-stable and it was impossible to predict the shelf-life using above quality factors.

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Influence of Bubble Sheet Applying Methods on Temperature of Exposed Joint Rebar at Wall Surface of Load-Bearing Wall Structure Building During Winter (동절기 벽식구조 건축물 벽부분의 버블시트 포설방법 변화가 이음부 노출철근의 온도에 미치는 영향)

  • Han, Cheon-Goo;Lee, Jea-Hyeon;Kim, Min-Sang
    • Journal of the Korea Institute of Building Construction
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    • v.17 no.2
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    • pp.149-155
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    • 2017
  • In this research, the surface covered curing method using the double-layered bubble sheet was evaluated. This double-layered bubble sheet has outstanding insulating performance with its low heat conductivity and high economic feasibility with its high durability. However, in the case of wall-typed building construction, the area of exposed rebar is curious on curing performance with the double-layered bubble sheet in spite of the double-layered bubble sheet showed favorable performance for slab. Therefore, in this research, regarding the actually constructed wall-typed apartment building, the most efficient curing method was suggested based on the evaluation of curing performance depending on temperature distribution depending on various location of covered or exposed rebar. As a result, the D method was determined as the most efficient curing method without any concern of early-age frost damage. However, by considering easiness of construction, the B method of covering the pieced double-layered bubble sheet on gap between rebars can be another option of desired result.

Anemia and Iron Deficiency according to Feeding Practices in Infants Aged 6 to 24 Months

  • 김순기
    • Journal of Nutrition and Health
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    • v.31 no.1
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    • pp.96-101
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    • 1998
  • The prevalence of iron deficiency in later infancy and the toddler years(25% to 40% at 1 year of age) has not decreased remarkably , except in Western countries. The purpose of this study was to 1) determine the relationship between current feeding practices and iron status, and 2) assess compliance to infant feeding instructions. Two groupsof infants were examined. The first group of 302 infants aged 6 to 24months was seen at a well baby clinic while the second group of 135 infants of the same age group was assessed by venipuncture. Cutoff values for laboratory tests were as follows ; hemoglobin<11g/dL, mean corpuscular volume (MCV) <72fl ; red cell distribution width(RDW)>15% ; serum ferritin level<10ng/ml ; and transferrin saturation (serum iron(TIBC)<10%. The diagnosis of iron deficiency anemia (IDA) was made when a low hemoglobin level was associated with either low ferritin orlow transferrin saturation . Of the 302 children brought to the well baby clinic , 12.3%(n=37) were found to have anemia (hemoglobin<11.0/dL). In terms of children grouped according to feeding practices, it was found that children with anemial comprised 32.0% (24/75) of the prolonged breast-fed group (Group A), significantly more than the 4.0%(7/176) of the artificial milk feeding group(Group B). and 3.9%(2/51) of the switched from breast milk to iron -fortified weaning foods group(Group C).Among the 107 children with IDA , iron deficiency in 105 children(98.1%) was suggested by their dietary histories ; exclusive or prolonged breast-feeding for more than 6 months without iron fortification in 98 infants ; cow's milk consumption> 500ml/day without iron fortification during infancy(n=12), or >800ml without iron-fortified foods after infancy(n=15) ; and the use of unfortified forumula or unbalanced diets, mainly limited to rice gruel. Despite the relatively high (79.6%) motivation on the part of the infants mothers and supervison by professional personnel, the poor results in the infants receiving iron fortified foods were due to poor compliance(85.75). Among the mothers of 98 IDA patients who were contacted by telephone , it was revealed that 29% did not give the oral iron preparation for more than 2 months. Furthermore, negligence or disregard by the parents occurred in 14% of the case , discontinuance of the oral iron preparation by the parents due to side effects occurred in 6%, and the children's refusal or poor oral intake and no further trial occurred in 6%. The dietary history of a large group of infants was highly predictive of their risk for anemia . Continued consumption of breast milk until the age of 1 year is not warranted unless iron-fortified foods are given concomitantly. Because there is a problem with compliance, more successful and safe strategies for preventing iron deficiency woold included dual coverage in the from of therapeutic iron supplementation as well use of iron-fortified foods for teddlers who are at risk of iron deficiency.

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