Critically ill trauma patients generally show good nutritional status upon initial hospitalization. However, they have a high risk of malnutrition due to hyper-metabolism during the acute phase. Hence, suitable nutritional support is essential for the optimal recovery of these patients; therefore, outcomes such as preservation of fat-free mass, maintenance of immune functions, reduction in infectious complications, and prevention of malnutrition can be expected. In this report, we present the experience of a patient subjected to 40 days of nutritional interventions during postoperative intensive care unit (ICU) care. Although the patient was no malnutrition at ICU admission, enteral nutrition (EN) was delayed for > 2 weeks because of several postoperative complications. Subsequently, while receiving parenteral nutrition (PN), the patient displayed persistent hypertriglyceridemia. As a result, his prescription of PN were converted to lipid-free PN. On postoperative day (POD) #19, the patient underwent jejunostomy and started standard EN. A week later, the patient was switched to a high-protein, immune-modulating formula for postoperative wound recovery. Thereafter, PN was stopped, while EN was increased. In addition, because of defecation issues, a fiber-containing formula was administered with previous formula alternately. Despite continuous nutritional intervention, the patient experienced a significant weight loss and muscle mass depletion and was diagnosed with severe malnutrition upon discharge from the ICU. To conclude, this case report highlights the importance of nutrition interventions in critically ill trauma patients with an increased risk of malnutrition, indicating the need to promptly secure an appropriate route of feeding access for active nutritional support of patients in the ICU.
Objectives: This study aimed to evaluate the importance and performance of sodium reduction practices among childcare center cooks in the Yongin area before and after a 3-month salinometer support program. Methods: In total, 313 cooks employed in childcare centers in Yongin were surveyed before and after participating in a salinometer support program. The survey included questions on general information, sodium-related dietary habits, and perceived importance and performance levels of sodium reduction approaches in the purchasing, cooking, and serving areas. The centers were divided into childcare centers registered as group-feeding facilities (FS group, n = 68) and those not registered as such (non-FS group, n = 245). The differences between the two groups were analyzed. Results: The overall importance levels increased significantly after the program in both the FS-group (P < 0.001) and non-FS group (P = 0.005). The overall performance levels also increased significantly in both groups (P < 0.001 for all). Consequently, the significant difference between the importance and performance levels disappeared in both groups after the program. However, unlike the FS group, which showed no significant differences between the importance and performance levels after the program in all three areas, the non-FS group still demonstrated lower performance levels than importance levels in the purchasing (P = 0.011) and serving (P = 0.034) areas after the program. Conclusions: The use of salinometers significantly enhanced the performance and importance of low-sodium management practices among cooks in childcare centers, especially in the FS group. The continuous monitoring of salinity measurements and tailored education specialized for the FS and non-FS groups are recommended.
Kim, Je-Sun;Jeong, Soon-Wuk;Kim, Joon-Young;Jeong, Man-Bok;Han, Hyun-Jung
Journal of Veterinary Clinics
/
v.20
no.1
/
pp.12-21
/
2003
In this study, we evaluated effects of three anastomotic techniques of small intestine on adhesions in the dog. Twenty six healthy mixed dogs were randomly assigned to three groups. Group I(n = 8) was sutured with a simple continuous suture, group II(n = 7) was sutured with a simple interrupted approximating suture and group III(n = 11) was sutured with a single layer continuous Connell suture. On completion of any intestinal anastomosis, a pedicle of greater omentum was wrapped around the suture line in all experimental dogs. One percent sodium carboxymeth-ylcellulose (5ml/kg) was administrated into the abdomen by feeding tube prior to closing the last part of peritoneum in all dogs. Postoperative adhesions were evaluated at 14th day after operation. The adhesions consisted primarily in two dogs in group I, three dogs in group II and group III. There were adhesions between intestinal serosal surfaces in eight dogs in all groups, but there were no intestinal serosa-visceral peritoneum adhesion and intestinal serosa-mesentery adhesion. Mean adhesion scores were less than score 2 in all groups. Between anastomotic site and omental graft, there were 13.13$\pm$4.97 mm (mean$\pm$S.D.) adhesion formation in group I and 17.29$\pm$4.68 mm in group II and 14.64$\pm$3.80mm in group III. A simple continuous suture resulted in the least adhesion formation and a simple interrupted approximating suture resulted in the greatest adhesion formation among the groups. However, there were no significant differences among three suture techniques in the severity of adhesions. Intestinal intussusception only encountered in one dog during the 14 days, the dog operated and survived. Daily monitoring of temperature, activity, appetite, defecation and micturition were done. All of those vital signs were within normal values and there were no obvious differences among the groups. In conclusion, even though there were no significant differences among three groups, a simple continous suture pattern is recommended to prevent adhesions when operating intestinal anastomosis in dogs.
The purpose of this study was to investigate the seasonal distribution of phytoplankton as prey for oysters and to characterize the environmental factors controlling their abundance from June 2016 to May 2017, in the northeast coast between Tongyeong and Saryang Island, particularly for the oyster farming area. During the survey period, water temperature changed from $7.54^{\circ}C$ in February to $29.5^{\circ}C$ in August. The abnormal high temperature persisted during one month in August. Salinity was low due to summer rainfall and typhoon. The lowest level was 30.68 psu in September, and it peaked at 34.24 psu in May. The dissolved oxygen (DO) concentration ranged from $6.0-9.45mg\;L^{-1}$, and the DO concentration in the surface layer was like that in the bottom layers. The seasonal trends of pH were also like those of DO. The pH ranged from 7.91 to 8.50. Nitrate with nitrite, phosphate, and silicate concentrations ranged from $0.14{\mu}M$ to $7.66{\mu}M$, from $0.01{\mu}M$ to $4.16{\mu}M$, and from $0.27{\mu}M$ to $20.33{\mu}M$, respectively. The concentration of chlorophyll a (Chl. a) ranged from $0.37{\mu}g\;L^{-1}$ to $2.44{\mu}g\;L^{-1}$ in the surface layer. The annual average concentration was $1.26{\mu}g\;L^{-1}$. The annual mean phytoplankton community comprised Bacillariophyta (69%), Dinophyta (17%), and Cryptophyta (10%), respectively. Dinoflagellate Prorocentrum donghaiense in June was the most dominant at 90%. In the summer, diatom Chaetoceros decipiens, Rhizosolenia setigera and Pseudo-nitzschia delicatissima were dominant. These species shifted to diatom Chaetoceros spp. and Crytophyta species in autumn. In the winter, high densities of Skeletonema spp. and Eucampia zodiacus were maintained. Therefore, the researchers thought that the annual mean Chl. a concentration was relatively lower to sustain oyster feeding, implying that the prey organism (i.e., phytoplankton) was greatly controlled by continuous filter feeding behavior of oyster in the vicinity area of the oyster culture farm.
A study was conducted to compare growth performance of six female commercial Korean native chicken (KNC) crossbreeds from hatching to twelve weeks of age. Three hundred and twelve, 1-day-old female commercial KNC were used within 1 paternal line and 6 maternal lines. The chickens were allocated to 24 battery cages to give 4 replicates per strain with 13 chickens per cage. The chickens were reared under continuous lighting (24 h) and water was available at all times. Ad-libitum feeding was practiced throughout the experimental period. Among the six different strains, 2A had the greatest bodyweight (BW) at 42 days after hatching (p < 0.05). No BW difference between six crossbreed strains (p > 0.05) was found thereafter. Crossbreed 1A had the higher average daily gain (ADG) than crossbreed 2A and 3A chickens (p < 0.05), whereas crossbreed 4A, 5A, and 6A had similar ADGs to that of crossbreed 1A (p > 0.05) at 84 days after hatching. Furthermore, crossbreed 4A had a great average daily feed intake (ADFI) from hatching to 84 days (p < 0.05). Nonetheless, there was no difference in the feed conversion ratio (FCR) and uniformity between six crossbreed strains for the experimental period (p > 0.05). Despite that 1A, 4A, and 6A had the higher viability (p < 0.05) than crossbreed 2A and 5A, they had a similar viability than crossbreed 3A (p > 0.05). With this in mind, crossbreed 2A had greater BW, ADG, and FCR than other chicken crossbreeds from hatching to 84 days, although they had a lower viability than others.
Raw cow manure was treated by a 4-step integrated system with phase separation anaerobic digestion and algal culture. When the first methane fermentation was performed by the effluent from the acid fermenter with retention time of 4 days, the elrerage blogas production rate was 977m1/1 culture/day Gas productivity compared to conventional single-stage anaerobic digestion increased up to 31.4%. As the 2nd methane fermenter was fed by the effluent from the first methane fermenter with 4 days of retention time, average amount of 428m1/1 culture/day of biogas was produced. The reduction rate of COD in the effluent from the acid fermenter, the 1st and the 2nd methane fermenter were 71.8%, 42.6% and 24.0% respectively. Finally, we examined algal treatment process for the effluent from the 2nd methane fermenter. A semi-continuous culture of Chlorella sp. PSH3 was conducted by feeding the effluent with retention time of 10days. In this process, the production rate of algal biomass and COD reduction rate were averaged 1.8g/1 culture/day(2.8$\times$106 cells/ml) and 73%, respectively. Through the 4-setp treatments, the total chemical oxygen demand was reduced from 51,300ppm to 85ppm. Therefore, the reduction rate of total chemical oxygen demand reached about 99.8%. The results indicate that the integrated system could be applicable for treatment of organic wastes, concurrently producing biogas and algal biomass.
Kim, Seung Hyun;Yoon, Gil Sung;Cho, Yong Jin;Shin, Kyoo-Ho;Suh, Jin-Suck;Yang, Woo-Ick
The Journal of the Korean bone and joint tumor society
/
v.19
no.2
/
pp.50-55
/
2013
Purpose: The purpose of this study is to determine the usefulness of arterial embolization on sacral and pelvic giant cell tumor (GCT). Materials and Methods: We retrospectively reviewed the medical records of 9 patients who had undergone serial arterial embolization between December 1996 and May 2008. We analyzed the clinical outcomes and therapeutic responsiveness of arterial embolization on sacral and pelvic GCT. Results: Six of 9 cases showed progression of disease (PD) status, even if 5 cases showed PD status despite of additional treatments including surgery and radiation, implying that serial arterial embolization on sacral and pelvic GCT is not effective. Three of 9 cases showed stable disease (SD) or continuous disease free (CDF) status and we analyzed associated factors with these good responses for embolization by ${\chi}^2$ test. The number of feeding vessels under six (p=0.048) and the number of collateral arterial supply under three (p=0.048) in the first angiogram showed significant relationships with good response for embolization, while remaining tumor staining by contrast after the first embolization and repeated embolization times were not significant. Conclusion: Although serial arterial embolization is not an effective modality on sacral and pelvic giant cell tumors, it may be a pilot modality under narrow indication of tumors with poor vascularity at first angiogram.
There is a marked increase in geriatric disease, especially liver disease, due to the continuous increase in alcohol and fat consumption. Since the fatty liver, induced by alcohol or fat, is basically from abnormalities in the lipid metabolism, it is possible that fatty acid binding protein(FABP) which is related to the fatty acid metabolism may also be abnormal in these livers. FABP is a small molecular weight protein family present in cytosol in high concentration. It has been proposed as a fatty acid transfer protein and as a binding protein responsible for controlling intracellular free fatty acid concentration. In this research, we have examined the relationship between liver FABP and fatty liver induced by alcohol or high cholesterol diet. Rats were fed one of either semipurified liquid diets; control diet containing 65% carbohydrate, 20% protein, and 15% fat or high cholesterol diet containing 1%(w/w) cholesterol or alcohol diet containing 37% of alcohol instead of carbohydrate. After 5 weeks of feeding period, all rats received commercial chow diet for 5 weeks to examine recovery effect. Liver and blood samples were collected at 0, 1, 3, 5 and 10 weeks to analyze lipid compositions. FABP was purified from liver cytosol and injected to rabbit to obtain antiserum. Liver FABP amount was determined by SDS-PAGE and western blotting methods. Fatty acid binding capacity was determined by binding of 14Cpalmitate with the delipidated liver cytosol. Consumption of alcohol increased serum cholesterol, triglyceride concentration and decreased HDL-cholesterol concentration after 5 weeks. Serum apolipoprotein B concentration increased after 3 weeks and LDL-cholesterol and apolipoprotein A concentration changed after 1 week. Liver cholesterol and triglyceride concentration increased after 3 weeks. Consumption of high cholesterol diet changed liver and serum lipid composition after 3 weeks. Swiching to normal diet for 5 weeks did not normalize most of lipid composition in serum and liver except serum and liver except serum cholesterol, triglyceride and liver cholesterol. Liver cytosol FABP content and the fatty acid binding capacity decreased dramatically after 1 week with alcohol consumption. This results indicate that FABP content changes before the changes before the changes of blood or liver lipid composition, suggesting changes of FABP may cause development of the fatty liver induced by alcohol and can be used as an index of detecting a early development of fatty liver.
Journal of the Korea Organic Resources Recycling Association
/
v.11
no.3
/
pp.35-41
/
2003
The on-site sewage sludge vermicomposting equipment was designed and evaluated on the batch and continuous tests. The vermicomposting equipment was designed to consider the mechanization as well as automation. Especially, the automatic controls of water content and temperature and the mechanization of the sludge feeding and cast separating were the important factors. In terms of changes in chemical characteristics when the equipments for experiments are operated continuously, the ORP, EC, $NH_3-N$ and $NO_3-N$ were found to be higher before and after treatment. In addition, it was found that changes in properties were low. Furthermore, the $NO_3-N$ concentration of the humus produced after treatment was found to be higher than the $NH_3-N$ concentration showing that it was appropriate based on the recycling criteria.
Low Electromagnetic Field (EMF) intensity in the range of $1{\mu}T\;to\;10{\mu}T$(Tesla) was found to enhance the growth of CHO cells and the production of tPA in batch and perfusion cultivations. At $1{\mu}T\;intensity,\;1.3{\times}10^7$ viable cells/ml of maximum cell density and 80 mg/l of maximum tPA production were obtained in batch cultivation, compared to $2.8{\times}10^6$ viable cells/ml and 59 mg tPA/1 in unexposed case (control). A similar trend was observed in the perfusion process, where it was possible to obtain $1.2{\times}10^7$ viable cells/ml of maximum cell density and 81 mg tPA/l of maximum tPA production by more than 80 days of cultivation. However, there was not much difference between $1{\mu}T\;and\;10{\mu}T$ in perfusion cultivation, possibly due to better environmental growth conditions being maintained by continuous feeding of fresh medium into the reactor. On the contrary, both cell growth and tPA production were severely inhibited at higher than 1 mT intensity, showing no growth at 10 mT exposure. Specific growth rate was linearly correlated to specific tPA production rate at $1{\mu}T$EMF intensity, which represents a partially growth-related relationship. It was also found that a large amount of $Ca^2+$ was released at low EMF intensity, even though the cell growth was not much affected. Low EMF intensity significantly improved both cell growth and tPA production, and tPA production seemed to be more affected than the cell growth, possibly due to the changes of cell membrane characteristics. It can be concluded that the elaboration of EMF intensity less than $10{\mu}T$ could improve cell growth and tPA production, but mainly tPA secretion through batch or perfusion process in a bioreactor.
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