• Journal of Industrial Convergence
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• v.21 no.2
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• pp.25-32
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• 2023

Constipation is the most common digestive disorder, and it occurs frequently in the early stages and affects the prognosis on rehabilitation stage in the patients with brain injury. The purpose of this study is to evaluate the bowel habits of brain-injured patients undergoing enteral nutrition immediately after admission to rehabilitation and transmission, and to investigate the effects of abdominal massage and lower extremity exercise. The study design is a quasi-experimental study to investigate the effect of a bowel care intervention (abdominal massage and lower extremity exercise) applicable to patients with brain lesions. As a result of the study, the number of bowel movements was significantly higher in the intervention group (p=.030), and the use of suppositories in the control group was statistically significantly higher than that in the intervention group (p=.004). The time of constipation relief was 1.73 days for the experimental group and 4.61 days for the control group, indicating that there was a difference in the time of constipation relief between the two groups (p<.001). Abdominal massage and lower extremity exercise were effective as nursing interventions to relieve constipation and prevent constipation in patients with brain injury from the early stage of rehabilitation.

• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.8
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• pp.1200-1205
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• 2015

Medical foods are enteral nutrition for patients, but they cause maladaptation symptoms like diarrhea. Although the cause of diarrhea remains unknown, some studies have indicated that the cause of diarrhea is fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP). This is a consideration for medical foods since they are easily fermented by intestinal bacterial. In this study, we estimated the FODMAP contents of commercial medical foods and carbohydrate ingredients. We measured the concentrations of FODMAP in 13 types of different medical foods and five types of carbohydrate ingredients by using high performance liquid chromatography with an evaporative light scattering detector (HPLC-ELSD). The limits of detection of FODMAP were fructose, 0.002; lactose, 0.010; raffinose, 0.003; stachyose, 0.032; 1-kestose, 0.005; nystose, 0.012; and 1-fructofuranosylnystose, 0.003 mg/kg. Limits of quantitation of FODMAP were fructose, 0.008; lactose, 0.033; raffinose, 0.009; stachyose, 0.107; 1-kestose, 0.015; nystose, 0.042; and 1-fructofuranosylnystose, 0.011 mg/kg, respectively. Concentration of FODMAP ranged from 0.428~2.968 g/200 mL. Concentrations of carbohydrate ingredients in FODMAP were chicory fiber, 278.423; soy fiber, 27.467; indigestible maltodextrin, 52.384; maltodextrin (DE10~15), 32.973; and maltodextrin (DE15~20), 50.043 g/kg. Contents of carbohydrates were 19.0~41.0 g/200 mL in commercial medical foods. We expected a correlation between contents of carbohydrates and FODMAP, as carbohydrates included FODMAP. However, we detected a low correlation (r=0.55). Since most commercial medical foods have a similar carbohydrate ingredients and nutritional values, the difference between products was determined by FODMAP contents of carbohydrate ingredients. In this study, we analyzed FODMAP contents of commercial medical foods and carbohydrate ingredients. These results are expected to be utilized as basic data for product development and minimizing maladaptation of medical foods.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.953-959
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• 2005

Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1065-1070
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• 2008

Purpose : This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d). Methods : Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively. Results : The mean gestational age (GA) was $26{\pm}2weeks$ (range, 23-32 wk), and the birth weight was $782{\pm}146g$ (range, 430-990 g). The delayed closure group was associated with early GA ($25.7{\pm}1.7wk$ vs $27.1{\pm}2.0wk$, P=0.013), in vitro fertilization (IVF) (55% vs 24%, P=0.017), and the absence of preeclampsia (5% vs. 34%, P=0.013). There was no difference in ductal size between the early closure and delayed closure groups. The incidence of bronchopulmonary dysplasia (95% vs 65%, P=0.012) and intraventricular hemorrhage (70% vs. 39%, P=0.027) increased in the delayed closure group. Using regression analysis adjusted for gestational age, delayed closure correlated positively with the duration of ventilator support (P=0.008), hospitalization (P=0.020), time to full enteral feeding (P<0.001), and total parenteral nutrition (P=0.010). Conclusion : Delayed closure of the hemodynamically significant patent ductus arteriosus in extremely-low-birth-weight infants is significantly related to the development of various morbidities. Thus, early closure of PDA is needed within the first week of life.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.18-25
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• 2009

Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.