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Nutritional Status of Continuous Ambulatory Peritoneal Dialysis Patients (지속성복막투석 환자의 영양상태에 관한 연구)

  • Park, Jin-Kyung;Son, Sook-Mee
    • Journal of Nutrition and Health
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    • v.39 no.7
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    • pp.624-640
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    • 2006
  • Dialysis patients are at risk of malnutrition not only because of losses of nutrients during peritoneal dialysis but also because of anorexia that results in inadequate nutrient intakes. The aim of this study was to estimate the nutritional status of 154 patients receiving continuous ambulatory peritoneal dialysis (CAPD), especially focused on protein-energy malnutrition and vitamin and mineral status. The mean age of the subjects was $5.12\;{\pm}\;12.4\;y$ with educational years of $12.3\;{\pm}\;0.4\;y$ for male and $9.6\;{\pm}\;0.4\;y$ for female. The mean duration of dialysis was $22.7\;{\pm}\;21.7\;mo$. The causes of renal failure included diabetes (32.7), chronic glomerulonephritis (15.0%), and hypertension (8.5%). The main complications associated with chronic renal failure were hypertension (86.1%), diabetes (35.4%) and liver disease (9.0%). The mean daily energy intake was $1216.8\;{\pm}\;457.3\;kcal$ and increased to $1509.2\;{\pm}\;457.2\;kcal$ when added with the energy from dextrose in dialysate. The latter was still much lower than estimated energy requirement but energy intake per kg of body weight (28.1 kcal/1 g) was within the range of that recommended for CAPD patients' diet therapy (25 - 30 kcal/kg). The average daily intake of protein was $49.2\;{\pm}\;25.1\;g$ with 37.6% of the patients showing their intakes less than Estimated Average Requirement. The average protein intake per kg of weight was 0.9 g/kg, which is less than that recommended for CAPD patients (1.2-1.5g/kg) with mean serum albumin level $3.2\;{\pm}\;0.5\;g/dl$. The proportion of the patients with dietary calcium intake less than EAR was 90.9%, but when added with supplementary calcium (phosphorus binder), most patients showed their total calcium intake between EAR and UL. Fifty percent of the patients were observed with dietary iron intake less than EAR, however most patients revealed their total iron intake with supplementation above UL. The addition of folic acid with supplementation increased mean total folic intake to $1126.0\;{\pm}\;152.4\;{\mu}g$ and ninety eight percent of the subjects showed their total folic acid intake above UL. The prevalence of anemia was 83.1 % assessed with hemoglobin level, even with high intakes of iron with supplementation. Thirty four percent of the patients showed their fasting blood glucose was not under control $(\geq\;126\;mg/dl)$ even with medication or insulin probably due to dextrose from dialysate. The mean blood lipid levels were within the reference levels of hyperlipidemia, but with 72.1 % of the patients showing lower HDL-C. In conclusion, Fairly large proportion of the patients were observed with protein malnutrition with low intake of protein and serum albumin level. Few patients showed their vitamins and minerals intake less than EAR with supplementation. For iron and folic acid, their intakes were increased to above UL for large proportion of he patients. However, more than eighty percent of the patients were still anemic associated with decreased renal function. The serum blood glucose and lipid level were not under control for some patients with medication. It seems that supplementation and medications that patients are taking should be considered for dietary consulting of CAPD patients.

Human Risk Assessment of Polybrominated Diphenyl Ethers by Breast Milk Feeding of Infants (영유아의 모유 섭취에 따른 폴리브롬화디페닐에테르의 위해성 평가)

  • We, Sung-Ug;Cho, Bong-Hui;Cho, Yu-Jin;Yoon, Cho-Hee;Choi, Shi-Nai;Min, Byung-Yun
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.2
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    • pp.109-118
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    • 2012
  • This study achieves results from 22 maternity breast milk samples in total to demonstrate exposure level and risk assessment of PBDEs in Seoul area. PBDEs were detected in all the breast milk samples of the present study, indicating that general population in these Seoul area are widely exposed to these chemicals. Residue levels of total PBDEs (sum PBDEs from tri- to hepta-BDE) ranged of 0.84~13.1 ng/g lipid with an arithmetic mean and median of 3.56 ng/g lipid and 2.6 ng/g lipid, respectively. Global comparison shows that the levels of total PBDEs were relatively similar to those of China, Taiwan and European country (Sweden), and somewhat higher than those in some Asian (Vietnam, Philippines, and Indonesia). In the present study, however, the levels of total PBDEs in human milk are still one to two orders of magnitude lower than those in North America. Contribution rate of each congener appeared to be predominant with BDE-47, followed by BDE-153, BDE-100, BDE-99, BDE-154 and BDE-183. The sum of BDE-47 and BDE-153 accounted for more than 65% of total PBDEs in most samples. From the result of the human risk assessment of infants for total PBDEs and BDE-47 by breast milk feeding, we could find out that the average daily doses and hazard index (95th percentile) were 16.5 ng/kg bw/day and $1.2{\times}10^{-1}$ each other when nursing for 6 months after infants born. However, it was concluded that the infant health hardly had adverse seriously effects under this research condition.

A Study on The Relation between Psychological Stress and Stress Hormone, Nutritional Status of Patients with Non-Insulim Dependent Diabetes Mellitus (인슐린 비의존형 당뇨병 환자의 심리적 스트레스와 스트레스호르몬 및 영양상태와의 상관관계에 관한 연구)

  • 문수재
    • Journal of Nutrition and Health
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    • v.29 no.8
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    • pp.889-898
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    • 1996
  • This study estimated the re!ation between psychological stress and stress hormones, nu­t tritional status of patients with non-insulin dependent diabetes mellitus(NIDDM). Psycho­l logical stress such as depr'ession and anxiety in 34 diabetics was analyzedin relation to nutrient intake, blood components such as fasting blood sugar(FBS), hemoglobin AIC, stress hormones a and amino acids. The IeveIs of depression and anxiety were measured by The center for ep­i idemiological studies-depc$pm$111.49pg/ml for total catecholamine ( (norepmephrine and epinephrine) and 233.95 $pm$73.99pg/ml for norepinephrine, 94.03$pm$75. 9 97pg/ml for epinephrine, 13.lS$pm$5.55pl/dl for cortisol and 171.50$pm$62.50pg/ml for gul c cagon respectlveIy. The leveIs of stress hormones in diabetics such as total catecholamine, norep­i mephrine cortisol and glucagon were significantly higher than those in normal control. The lev­el of epmephrine was higher in diabetics but the diffierenee was not significant. The calorie m t take in diabetics was 1762$pm$292keal which is S1.4% lower than Korean recommended dietary a allowances(RDA). Calcium intake was slightly low but other nutrients intakeswere higher than R RDA. The value of fasting blood sugar(FBS), usual fasting blood sugar(usual FBS) which refteet a average FBS during 3 months and hemoglobin Al C in diabetics was 1S4.1S$pm$74.22mg/dl, 177.76$pm$42.77mg/dl and S.S4$pm$2.S2% respec디VeIy. The distribution of plasma amino acids in d diabetics was generally in the normal range. The leveI of anxiety in diabetics was positively cor­related with norepinephrine, concentration and usual FBS. The levels of glucagon, usual FBS a and hemoglobin Aj C were pOSI디veIy correlated with the branched chaimamino acid(BCM : leucme, isoleucme and valine)

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Changes in the Physiological Activities of Four Sweet Potato Varieties by Cooking Condition (고구마 네 가지 품종의 조리방법에 따른 생리활성 변화)

  • Lee, Young-Min;Bae, Ji-Hyun;Kim, Jung-Bong;Kim, So-Young;Chung, Mi-Nam;Park, Mi-Young;Ko, Jeong-Sook;Song, Jin;Kim, Jae-Hyun
    • Journal of Nutrition and Health
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    • v.45 no.1
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    • pp.12-19
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    • 2012
  • The present study was performed to investigate antioxidant, anticancer, and antimicrobial activities of four Korean sweet potato variaties and to identify the changes in these biological activities under different cooking conditions. Total polyphenol content was 3.8-73.6 mg/g in 80% ethanol extracts of sweet potatoes. The polyphenol content was highest Sinjami variety (p < 0.05). Radical scavenging activity against DPPH and $ABTS^{{\cdot}+}$ was high in Sinjami (p < 0.05) and the ethanol extract from Sinjami also showed effective superoxide dismutase (SOD)-like activity, which decreased significantly by steaming and roasting (p < 0.05). Ethanol extracts from the four sweet potato variaties did not inhibit cancer cell growth in MCF-7 or HepG2 cells at concentrations of 1, 10, and $100\;{\mu}g$/mL. Of the investigated sweet potato variaties, only Sinjami exhibited strong antimicrobial activity against Escherichia coli, Staphylococcus aureus, and Salmonella typhimurium. The antimicrobial activity of Sinjami against E. coli, St. aureus, and S. typhimurium decreased following steaming and roasting (p < 0.05). These results indicate that the Sinjami Korean sweet potato had higher polyphenol content, radical scavenging activity, SOD-like activity, and antimicrobial activity than those of the other variaties and consuming raw Sinjami might be beneficial for maintenance of biological activities.

The Effect of the Integrated Therapy of Neurofeedback, Brain Gymnastics, and Oriental Herbal Tea on the Improvement of Brain Functions and the Quality of Life of Elders living alone (뉴로피드백·뇌체조·한방차를 병행한 통합요법이 독거노인의 뇌기능 향상 및 삶의 질에 미치는 영향)

  • Jeong, Eun-sil;Lee, Jung-eun;Jung, Hyun-mo;Kim, Soo-Kyung;Youn, Mee-Kyung;Lee, Eun-han
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.569-581
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    • 2016
  • This experimental study employs a pretest -posttest method concerning the integrated therapy of neurofeedback training, brain gymnastics, and oriental herbal tea effects on seniors living alone. The purpose of the study is to identify effects on brain functions and quality of life. The study participants included 23 seniors living alone (male 10, female 13), ranging in age from 65~90. The experiment lasted 8 weeks, from December 22, 2014, to February 28, 2015. The neurofeedback training utilized the 2 Channel neurofeedback system by Braintech Corporation and was conducted a total of 16 times over 8 weeks, having two sessions per week lasting for 30 minutes focusing on relaxation, concentration and memory. Brain gymnastics, developed by the Korean Science Institute of Psychiatry, ran for 30 minutes, twice a week for a total of 16 sessions administered over 8 weeks. Participants were required to drink 3 cups of oriental herbal tea developed according to Donguibogam for 8 weeks. The results of applying integrated therapy found positive effects on brain function resulting from changes in level of tension and anti-stress quotient. Quality of life, daily life basic measurements, and depression symptoms were significantly influenced by decreases in blood pressure and blood sugar. Results of this study find the integrated therapy of neurofeedback training, brain gymnastics, and oriental herbal tea can significantly enhance brain functions and quality of life within seniors living alone. Therefore integrated therapy involving neurofeedback, brain gymnastics, and oriental herbal tea is a necessary intervention to improve the quality of life of seniors living alone, and will improve the quality of life through healing both mind and body in a more practical and systematical manner.

Pre- and post-paturition rumen volatile fatty acid composition and blood chemistry in ketotic and non-ketotic dairy cows (케톤증(症) 및 비(非)케톤증(症) 빈유우간(牝乳牛間)의 출산전후시(出産前後時) 제1위내(第1胃內) 휘발성지방산(揮發性脂肪酸)과 혈액화학치(血液化學値)의 변화(變化) 비교관찰(比較觀察))

  • Hamakawa, Masaaki;Shohji, Hiroshisa;Sakai, Takeo;Lee, Won-chang
    • Korean Journal of Veterinary Research
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    • v.35 no.4
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    • pp.823-831
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    • 1995
  • The composition of rumen volatile fatty acids(VFA) and the blood chemistry were investigated in 5 clinically health dairy cows(Group I) reared on dairy farms and in 5 cows with post-parturition(POP) primary ketosis(Group II). The determinations were performed on days 5 to 7 pre-parturition(PRP), immediately POP, and on days 5, 10, 15, 20 and 25 POP. In both groups, the total VFA levels gradually increased starting from day 5 POP, but the levels were lower in Group II than in Group I. With regard to POP. changes in the composition of VFA, Group II occasionally showed lower levels of acetic acid and caproic acid than did Group I. Blood glucose levels decreased POP in both groups. In contrast, blood levels of ketone bodies and 3-hydroxybutyric acid were increased POP, but there was no statistically by significant difference between the groups. The aspartate aminotransferase level was transiently increased immediately POP in both groups, and the increase was more marked in Group II than in Group I. Both groups showed a tendency for total cholesterol, free cholesterol, ester cholesterol, phospholipid, and total bile acid to be increased POP, but there was no statistically significant difference between the groups. Clinically healthy dairy cows also showed POP changes in the composition of VFA and blood similar to those in dairy cows with ketosis, suggesting that even apparently healthy cows are at risk of subclinical ketosis POP.

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Effect of fermented Hovenia dulcis Thunb fruit water extract on biomarker for liver injury and body weight changes in rats given oral administration of ethanol (헛개열매추출액발효물이 흰쥐의 에탄올 경구투여에 의한 간손상 지표와 체중 감량 완화에 미치는 영향)

  • Choi, Ji-Young;Kim, Jun-Han;Kim, Gho;Kim, Choon-Kyung;Choi, Myung-Sook
    • Food Science and Preservation
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    • v.21 no.3
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    • pp.412-420
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    • 2014
  • This study was performed to investigate the effect of fermented Hovenia dulcis Thunb fruit water extract on biomarkers for acute (a) ethanol-induced hangover and chronic (c) ethanol-induced liver injury in rats. For acute ethanol-induced hangover, the rats were administered distilled water (D.W., 10 mL/kg body wt.), Hovenia dulcis Thunb fruit water extract (HWE, 400 mg/10 mL/kg body wt.) and fermented HWE (FHWE, 400 mg/10 mL/kg body wt.), respectively, before 40% ethanol (5 g/kg body wt.) was administered. For chronic ethanol-induced liver injury, the rats were randomly divided into the normal control (cNC), ethanol (cET), cET-HWE and cET-FHWE groups. The cNC and cET groups were administered D.W. (10 mL/kg body wt.) before 40% alcohol (5 g/kg body wt.) was administrered for 21 days. The cET-HWE and cET-FHWE groups were administered HWE (400 mg/10 mL/kg body wt.) and FHWE (400 mg/10 mL/kg body wt.), respectively before 40% ethanol (5 g/kg body wt.) administration for 21 days. For acute ethanol-induced hangover, the serum alcohol and acetaldehyde concentrations were more significantly reduced in the aHWE and aFHWE groups than in the aET group. Moreover, the effect of FHWE was greater than that of HWE. For chronic ethanol-induced liver injury, the serum ethanol, acetaldehyde, ${\gamma}$-glutamyl transpeptidase (${\gamma}$-GTP) levels and the hepatic lipids concentration more significantly dropped in the cET-HWE and cET-FHWE groups than in the cET group. The FHWE administration showed faster recovery of the serum glucose concentration than in the cET and cET-HWE groups. The body weight reduction tended to normalize in the cET-HWE and cET-FHWE groups, which is ideal for chronic ethanol administration. These results suggest that FHWE has a protective effect against ethanol-induced liver damage, as evidenced by its ability to lower the serum ethanol and acetaldehyde concentrations after alcohol administration, and by its ability to decrease the level of ${\gamma}$-GTP and hepatic lipids. FHWE also elevated serum glucose concentration. Therefore, FHWE is effective in reducing ethanol-induced hangover and can play a beneficial role in the treatment of ethanol-induced liver damage as well as body weight reduction.

A Study of the Effect, Safety and Saving Expense by Reusing Hemodialyzer (재사용(再使用) 투석기(透析器)의 효과(效果) ${\cdot}$ 안정성(安定性) 및 비용절감(費用節減)에 관한 연구(硏究))

  • Jung, Ha-Chung
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.93-106
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    • 1997
  • By the increase of the rate of existence of the hemodialyzing patients, they were required the long run treatment. Regardless of medical insurance expansion, hemodialyzing cost much expenses so that hospital has been considering the reuse of hemodialyzer and flowing euqipments along with the diverse study and progress of the ways of hemodialyzing and medical instruments. This study was aimed to provide the basic materials regarding the reuse of hemodialyzer which is used for the patients of chronic renal disease. The reusing program in the artificial kidney center of K hospital has been used for this study from 50 patients aften one year result from Sep. 1995 through Aug. 1996. Automatic equipment of DRS-4 made by Seratronic Co., was used as the equipment and it was retreated with the function test simultaneously. Compliaction and confirmation of the infection were by the records of the hemodialysis of the patients. SPSS was used for the analysis of the materials by computerization. The character of the patients and the rate of removal was by mistake and percentage, function test and rate of complication by Ftest(ANOVA) and the rate of complication per items by ${\chi}^2$ and Ftest. As the post test the Duncan's test was used for the statistically significant different variables in the standard of p<.05 after Ftest. The followings are the summary of the result : 1) In the function test of the new hemodialyzer and the reused one, and in all of CA110 and CF15.11, the dialyzer ultrafiltration coeffient(KUf) was appeared to have been higher in the reusing groups than the first use ones. This has been the normal limit showing no troubles with them. 2) In the function test of the new and reused hemodialyzer, in all of CA110 and CF15.11, the total blood volume was appeared to have been the less value in the reuse groups than the new ones. This was the price within 80% of the first price that both showed possible for use. 3) The result of reuse hemodialyzer of CA110 was $29.48{\pm}7.83$ in average in the test of leak test while $17.3{\pm}7.96$ in reuse of CF15.11. The normal limit of <60 was the leak test result. So both of the hemodialyzer was normal for reuse. 4) The rate of removal of Blood Urea Nitrogen(BUN) was 72.25% in CA110 hemodialyzer by reusing 16-20 times as the highest rate showing the better result in the reuse hemodialyzer, while in CF15.11 hemodialyzer showed 71.16% by highest rate in the first use by the highest rate with no difference from the reuse. 5) The rate of removal of serum creatinine of CA110 was 64.08% by highest rate in reuse of 1-5 times by showing better result in reuse hemodialyzer. While in CF15.11 66.47% the highest by reuse of 16-20 times showing no difference from each other. 6) No patients were admitted or precribed by antibiotics in relation with reuse dialyzer and no reports were shown about hepatitis $B{\cdot}C$. AIDS in fection. 7) Of the total 248 episods of complication due to the hemodialyzing, 86 by first use, 73 by 1-5 times, 35 by 6-10 times, 35 by 11-15 times and 19 by 16-20 times have been shown which have had no significant difference between the groups. 8) In the comparison of the expense for the hemodialyzer, there was the effect of saving 11,597.6 Won between the first and reuse hemodialyzer. And by decreasing the extracted materials, they did the great role of disposing the waste matters.

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Skeletal relapse and dental change during intermaxillary fixation after mandibular setback (외과적 하악 후퇴술 후 악간고정기간 중의 골격성 재발과 치열의 변화)

  • Chang, Chong-On
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.457-466
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    • 1999
  • It has been reported that skeletal relapse and dental change after mandibular setback do occur not only after intermaxillary fixation(IMF) removal but also during IMF The side effects of skeletal relapse during IMF have clinical importance because they can cause many Postoperative orthodontic Problems. Generally, the Prevention of solid union between segments, compensatory tooth movement, anterior openbite, etc. have been cited as the side effects of jaw displacement. The purpose of this study was to evaluate the skeletal relapse and dental change during IMF. The material consisted of 28 patients who were treated by BSSRO(bilateral sagittal split ramus osteotomy), wire osteosynthesis, IMF for correction of mandibular prognathism. Through cephalometric analysis, the amount and direction of surgical movement, skeletal relapse and dental change during IMF were measured. The correlation between surgical movement and skeletal relapse, between skeletal relapse and dental changes were evaluated. The following conclusions were obtained; 1. Distal segment was repositioned backward and upward, proximal segment showed clockwise rotation during surgery. 2. During ]m, anterior portion of distal segment was displaced backward and posterior portion was displaced upward. Proximal segment was displaced upward with forward movement of p-Go(gonion of proximal segment). Backward surgical movement of p-GO was significantly correlated with forward displacement of p-Go. 3. Overjet and overbite were not changed during IMF. The compensatory tooth movements during IMF were characterized by retroclination of upper incisors md retroclination, extrusion of lower incisors. These compensatory tooth movements had statistically significant correlation with upward displacement of d-Go (gonion of distal segment).

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Quality Assurance of Volumetric Modulated Arc Therapy for Elekta Synergy (Elekta Synergy 선형가속기를 이용한 입체적세기조절회전방사선치료(VMAT) 정도관리)

  • Shim, Su-Jung;Shim, Jang-Bo;Lee, Sang-Hoon;Min, Chul-Kee;Cho, Kwang-Hwan;Shin, Dong-Oh;Choi, Jin-Ho;Park, Sung-Ill;Cho, Sam-Ju
    • Progress in Medical Physics
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    • v.23 no.1
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    • pp.33-41
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    • 2012
  • For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, $360^{\circ}$. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of $360^{\circ}$ directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.