• Korean Journal of Clinical Pharmacy
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• v.18 no.1
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• pp.45-49
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• 2008

The goal of this research was to identify problems associated with the management of nutrition support team (NST) in hospitals in Korea. Management status of NST in the hospitals was surveyed over the phone or interviewed by visit during August 2007. NST in foreign countries was collected by reference search and websites in the internet. Survey analysis also was performed during March, 2007 with forty-one medical staff in a university hospital located in Jinju, Kyungsangnamdo. Korean Society for Parenteral and Enteral Nutrition (KSPEN) was organized in 2001 and currently has thirty-three member hospitals with on-site NST as of August, 2007. Most of the member hospitals were big hospitals with more than 500 beds and were organized within five years. The most significant problem identified was the shortage of nutrition specialists exclusively involved in the NST. Survey analysis revealed that more than half of medical staff prescribed parenteral nutrition based on their own nutrition requirement calculation rather than consultation with NST. It appears that status of NST management of hospitals in Korea are considered to be at beginner stage and therefore, needs more aggressive advertising activity to increase consultation usage by medical staff.

• Proceedings of the Ginseng society Conference
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• 2002.10a
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• pp.424-455
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• 2002

Diabetes mellitus is reaching epidemic proportions worldwide. The insufficiency of medication to cope with this burden has coincided with a dramatic rise in the prevalence of use of complementary and alternative therapies, especially herbal treatments. This surge in demand presents a challenge to prove the safety and efficacy of these treatments in diabetes. Korean red ginseng (steam treated Panax ginseng C.A. Meyer) is a strong candidate to succeed. It has been shown to possess a multitude of hypoglycemic effects and improve metabolic disturbances related to diabetes in in vitro and animal models. Data in humans is also emerging to support these benefits. Whether these results can be replicated in a rigorous clinical testing program is unclear. We therefore investigated the antidiabetic effects of Korean red ginseng in a series of 2 acute and 1 longterm randomized, double-blinded, placebo-controlled clinical trials. This paper provides the rationale for this program of study, expanding on the problem of diabetes, its management, and the possible role for Korean red ginseng. It then describes the design and expected findings.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.91-98
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• 2023

Adequate nutritional support is crucial in preventing complications and improving outcomes in critically ill patients. Extracorporeal membrane oxygenation (ECMO) is a mode of supportive care for patients with respiratory and/or cardiac failure. ECMO patients frequently exhibit a hypermetabolic state characterized by protein catabolism and insulin resistance, which can lead to malnutrition. Nutritional therapy is a vital component of intensive care, but its optimal administration for ECMO patients is unknown. This case report aims to provide insights into effective nutritional management for critically ill patients undergoing ECMO therapy. The patient was a 72-year-old male with a history of gastric and lung cancer who underwent a lobectomy complicated by bronchopleural fistula, postoperative bleeding, pneumonia, and acute respiratory distress syndrome (ARDS). The patient's nutritional status was assessed indicating a high risk of malnutrition, using the modified Nutrition Risk in the Critically Ill (mNUTRIC) Score. Nutritional support was administered based on the recommendations of European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society for Parenteral and Enteral Nutrition (ASPEN), with energy requirements set at 25-30 kcal/kg/d and protein requirements set at 1.2-2.0 g/kg/day. The patient received parenteral nutrition until the enteral nutrition target amount was reached, with zinc supplements for wound healing. The study highlights the need for further research on proactive and effective nutritional support for ECMO patients to improve compliance and prognosis.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.126-137
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• 2023

Hemodialysis (HD) patients face a common problem of malnutrition due to poor appetite. This study aims to verify the appetite alteration model for malnutrition in HD patients through quantitative data and the International Classification of Functioning, Disability, and Health (ICF) framework. This study uses the Mixed Method-Grounded Theory (MMGT) method to explore various factors and processes affecting malnutrition in HD patients, create a suitable treatment model, and validate it systematically by combining qualitative and quantitative data and procedures. The demographics and medical histories of 14 patients were collected. Based on the theory, the research design is based on expansion and confirmation sequence. The usefulness and cut-off points of the creatinine index (CI) guidelines for malnutrition in HD patients were linked to significant categories of GT and the domain of ICF. The retrospective CIs for 3 months revealed patients with 3 different levels of appetite status at nutrition assessment and 2 levels of uremic removal. In the same way, different levels of dry mouth, functional support, self-efficacy, and self-management were analyzed. Poor appetite, degree of dryness, and degree of taste change negatively affected CI, while self-management, uremic removal, functional support, and self-efficacy positively affected CI. This study identified and validated the essential components of appetite alteration in HD patients. These MM-GT methods can guide the selection of outcome measurements and facilitate the perspective of a holistic approach to self-management and intervention.

• Journal of Community Nutrition
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• v.7 no.3
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• pp.149-155
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• 2005

This exploratory study investigated the software programs utilized by clinical dietitians and their perceptions on the use of information technology. The study focused on the use of specialized software for dietetics, general software for any office use and the Internet. A self-administered survey was used to collect data from clinical dietitians identified in the Kentucky Dietetic Association Directory 2003-2004. The survey was conducted in March through April, 2004. A total of 22 responses were collected, which yielded a response rate of $68\%$. Findings suggest that computer use has become a routine for optimal clinical practice ; major specialized software programs are used for nutrition assessment, nutrition analysis and menu development. Use of specialized software appears to be unassociated with dietitians' age and years of experience ; however, the associations are indicated between use of specialized software and education level as well as their specialty ; word processing and spreadsheet are the major general software used. Internet is used mainly for information search and communication. Respondents perceived that overall work efficiency and productivity significantly increased with computer use. The complexity of software is the major barrier encountered so training is the most needed support by the department. Strategic promotion on the use of specialized software should be targeted to the management team of the hospitals/facilities.

• Journal of the Korean Dietetic Association
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• v.19 no.4
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• pp.317-342
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• 2013

The purpose of this study was to evaluate the current state of foodservice and clinical nutrition management in a hospital-based nutrition department. Nutritional guidelines and survey reports of hospital evaluation programs from 2004 to 2009 were analyzed. In total, 275 hospitals in the first period and 288 hospitals in the second period were evaluated. The division of knife and chopping board use decreased from 97.2% in 2005 to 89.7% in 2008, the maintenance of a proper freezer temperature (below $-18^{\circ}C$) increased from 82.1% in 2004 to 97.7% in 2007 (88.9% to 97.4% from large hospitals and 69.8% to 86.5% from small/medium hospitals in 2005 and 2008, respectively). In tube-feeding management, the performance rate of material cold storage and the offer rate of tube-feeding were 65.9% and 94.2% in 2007, respectively. The cold storage of material, proper use within 24 hours after opening or production, and the use of an appropriate label were 47.3%, 71.2% and 67.2% in 2009, respectively. The rate of a management system for undernourished patients was 86.0% in 2007 (56.4% for large hospitals, 18.9% for small/medium hospitals) and 14.3% in 2009. In standards of nutrition support management, the performance rates of constructing a nutrition support team, the nutrition support team activity, and organizing multidisciplinary team were 66.7%, 43.6%, and 64.1% respectively, in 2004. For large hospitals, those rates were 61.1%, 36.1%, and 58.3%, in 2005, 93.0%, 62.8%, and 91.9% in 2007, and 69.2%, 43.6%, and 69.2% in 2008, respectively. The results of this study suggest standards on sanitary foodservice preparation, production, and tube-feeding production need to correspond with HACCP regulations for small/meidium hospitals in standards of a healthcare accreditation system. It will be necessary to understand the operating conditions of nutrition departments in convalescent hospitals, psychiatric hospitals, and geriatrics hospitals. As the application of accreditation is required from 2013, standards will need to be improved and continuously updated for healthcare accreditation.

• Journal of the Korean Dietetic Association
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• v.20 no.4
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• pp.235-246
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• 2014

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

• Journal of Nutrition and Health
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• v.28 no.2
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• pp.162-169
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• 1995

This study was conducted to evaluate the necessity and development of a therapeutic diet manual which contains basic nutritional science concepts that refer to nutritional management of patients in clinical settings. One hundred and fifty-four medical doctors, forty dietitians, and sixty-three students majoring in nutrition participated. The survey included questions about nutritional knowledge, nutrition-related concerns, and nutrition counseling in medical practice. The knowledge score of medical doctors was 47.7%. Lower percentages occurred in the amount of sodium allowed in the sodium restricted diet and the food sources of vitamin B1 were 16.9%, 31.2% respectively. Seventy-four percent of doctors strongly urged nutrition counseling for patients. Seventy one percent of doctors agreed that the present medical-nutrition education was inadequate in medical school curricura. Most doctors (79.2%) agreed that a therapeutic diet manual would be helpful and necessary. The average percentage of nutritional knowledge test scores for dietitians and students majoring in nutrition were 76.0% and 68.3%, respectively. Over ninety percent of dietitians working and their prescriptions. The result of this study strongly suggests that the development of a comprehensive therapeutic diet manual is necessary, especially for medical doctors.

• Nutrition Research and Practice
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• v.10 no.4
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• pp.398-403
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• 2016

BACKGROUND/OBJECTIVES: Atopic dermatitis (AD), a chronic inflammatory skin disease, is accompanied by disruption of the epidermal lipid barrier, of which ceramide (Cer) is the major component. Recently it was reported that vitamin C is essential for de novo synthesis of Cer in the epidermis and that the level of vitamin C in plasma is decreased in AD. The objective of this study was to determine the associations among clinical severity, vitamin C in either plasma or epidermis, and Cer in the epidermis of patients with AD. SUBJECTS/METHODS: A total of 17 patients (11 male and 6 female) aged 20-42 years were enrolled. The clinical severity of AD was assessed according to the SCORAD (SCORing Atopic Dermatitis) system. Levels of vitamin C were determined in plasma and biopsies of lesional epidermis. Levels of epidermal lipids, including Cer, were determined from tape-stripped lesional epidermis. RESULTS: The clinical severity of patients ranged between 0.1 and 45 (mild to severe AD) based on the SCORAD system. As the SCORAD score increased, the level of vitamin C in the plasma, but not in the epidermis, decreased, and levels of total Cer and Cer2, the major Cer species in the epidermis, also decreased. There was also a positive association between level of vitamin C in the plasma and level of total Cer in the epidermis. However, levels of epidermal total lipids including triglyceride, cholesterol, and free fatty acid (FFA) were not associated with either SCORAD score or level of vitamin C in the plasma of all subjects. CONCLUSIONS: As the clinical severity of AD increased, level of vitamin C in the plasma and level of epidermal Cer decreased, and there was a positive association between these two parameters, implying associations among plasma vitamin C, epidermal Cer, and the clinical severity of AD.

• Korean Journal of Community Nutrition
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• v.11 no.1
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• pp.124-132
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• 2006

The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.