• 제목/요약/키워드: Malnutrition

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《상한론(傷寒論)》, 《김궤요략(金匱要略)》의 피부증상(皮膚症狀) 및 질환(疾患)에 대한 연구(硏究) (A Study on the Skin Disease of Sanghanron 《傷寒論》 and Geumgweyoryak 《金匱要略》)

  • 강나루;한정민;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제25권1호
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    • pp.55-74
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    • 2012
  • Objective : The purpose of this study is to investigate the skin disease in Sanghanron"傷寒論" and Geumgweyoryak"金匱要略". Methods : We conducted a study on the original text paragraphs of Sanghanron and Geumgweyoryak containing the skin disease and analysis of Woo, Oh, Sung, Zhang, etc. We drew a parallel between skin disease from Sanghanron and Geumgweyoryak and matching diagnoses from western medicine. Results : The results were as follows. 1. In Sanghanron and Geumgweyoryak pruritus was related to psychogenic pruritus and similar to skin disease caused by decrease of sweating, dry skin in cholinergic urticaria, atopic dermatitis and eczema, etc. in western medicine. 2. In Geumgweyoryak ichthyosis was caused by woman's disease, after menopause, chronic disease and malnutrition and related to winter itch and xerotic eczema in western medicine. 3. In Sanghanron Goose bumps, keratosis follicularis, acute and chronic urticaria and cold urticaria were occurred because of poorly managed fever care and side effect of antibiotic. 4. In Geumgweyoryak red face was similar to face flushing and side effects, which is after drug and laser treatment on face, in western medicine. 5. In Geumgweyoryak urticaria was, in a broad sense, skin disease with pruritus and secondary infection resulted from scratch. Skin diseases with pruritus are similar to urticaria, dermatitis herpetiformis, lichen planus, atopic dermatitis, contact dermatitis, psoriasis, nummular eczema, lichen simplex chronicus, prurigo nodularis, neurodermatitis and internal disease with pruritus in western medicine. 6. In Geumgweyoryak spots in the skin were caused by fever and similar to allergic purpura and SLE symptom in western medicine. 7. In Geumgweyoryak bullous disease with yellowish discharge was similar to eczema, pustule, atopic eczema, etc. in western medicine. 8. In Geumgweyoryak repeated inflammation of oral cavity, genitals, eyes and skin was similar to Behcet's disease in western medicine. 9. In Sanghanron and Geumgweyoryak boil was similar to abscess and acute lymphadenitis in western medicine caused by oily foods and infections. 10. In Geumgweyoryak swelling and boil were occurred in a poor health. Damage from metalic material could cause a convulsion and was similar to tetanus in western medicine. Conclusion : We analyzed the original text paragraphs of Sanghanron and Geumgweyoryak and explanations about skin disease. As a results, we found out etiology, pathogenesis, treatments of the skin disease in Sanghanron and Geumgweyoryak. Further we compared with western medicine to develop better understanding of the skin disease.

소아에서 사봉혈(四縫穴) 활용에 대한 문헌 조사 (A Literature Review of Application of Sifeng Point (EX-UE 10) in Children)

  • 이보람;신혜진;이지홍;장규태
    • 대한한방소아과학회지
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    • 제32권3호
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    • pp.72-89
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    • 2018
  • Objectives The objective of this study is to investigate the application of Sifeng point (EX-UE 10) in children and to make suggestions for domestic research and clinical application by reviewing relevant randomized controlled trials. Methods Eight electronic databases including English, Chinese, Korean databases were comprehensively searched for randomized controlled trials evaluating the effects of Sifeng point in children up to May 2, 2018. We extracted the year of publication, country, target diseases or symptoms, location of Sifeng, acupuncture method; such as acupuncture tool and depth of insertion, and frequency, number, and duration of the treatment. Results Fifty studies were included for analysis. All the included studies were conducted in China, and studies were published from 1962 to 2017. The most frequent target symptom was anorexia (46%). In addition, Sifeng point was used for digestive diseases or symptoms such as diarrhea, constipation, and mesenteric lymphadenitis, as well as respiratory diseases or symptoms such as cough, cold, acute bronchiolitis, recurrent respiratory tract infections, bronchopneumonia, and asthmatic bronchitis. Also, allergic diseases such as chronic urticaria, and other variety of symptoms such as malnutrition, fever, and iron-deficiency anemia were treated with the Sifeng point. The location of Sifeng points was inconsistent, and the most common location of the Sifeng point was the midpoint of transverse creases of the proximal interphalangeal joints of the index, middle, ring and little fingers (84.2%). The most commonly used acupuncture tool was three-edged needle (40.9%). All included studies have the method of squeezing out blood or mucus from the Sifeng points. The treatment was mostly conducted once per week (35.4%), mostly repeated for 4 times (32.6%). The most common treatment duration was 4 weeks (18.6%). Conclusions We could identify acupuncture method and various indications for the Sifeng points treatment. Based on this study, there is a need for the clinical application and related researches on the Sifeng points in children in Korea. In addition, the treatment location of Sifeng point should be standardized.

비소세포폐암 환자에서 발생한 지속성 딸꾹질 1예 (A Case of Persistent Hiccup in a Patient with Non-small Cell Lung Cancer)

  • 박혜성;심윤수;임소연;조정연;권성신;노선희;김유리;천은미;이진화;류연주;송동은;문진욱
    • Tuberculosis and Respiratory Diseases
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    • 제64권1호
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    • pp.39-43
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    • 2008
  • 저자 등은 종격동 림프절 비대를 동반한 비소세포폐암환자에서 발생한 지속성 딸꾹질을 경험하였기에 이에 대한 임상적 특성과 치료에 관한 문헌 고찰과 함께 보고하는 바이다.

경장영양과 중시정맥영양을 공급받는 외과계 수술 환자의 과대사 정도에 따른 영양 섭취량 및 생화학적 검사 결과 (The Outcome of Nutrition Support of Surgery Patients with Hypermetabolic Severity by Total Parenteral Nutrition and Enteral Nutrition and Biochemical Data)

  • 라미용;김은미;조영연;서정민;최혜미
    • 대한지역사회영양학회지
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    • 제11권2호
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    • pp.289-297
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    • 2006
  • This study evaluated the nutrition intake and changes in laboratory data of surgery patients with hypermetabolic severity on nutrition support. From January 2002 to September 2002, 66 hospitalized surgery patients who had received enteral nutrition (EN, n=19) and total parenteral nutrition (TPN, n=47) for more than 7 days were prospectively and retrospectively recruited. The laboratory data was examined pre-operatively, and on the post-operative 1, 3, 7 day and at the time of discharge. The characteristics of the patients were examined for the hypermetabolic severity, The hypermetabolic scores were determined by high fever ($>38^{\circ}C$), rapid breathing (>30 breaths/min), rapid pulse rate (>100 beats/min) , leukocytosis ($WBC>12,000/{\mu}l$), leukocytopenia ($WBC>3,000/{\mu}l$), status of infection, inflammatory bowel disease, surgery and trauma. The scores for the hypermetabolic status were divided into three groups (mild 0-10, moderate 11-40, severe>41). According to the results of the study, 38.3% (n=23), 45.4% (n=30) and 19.6% (n=13) were in the mild, moderate, and severe groups, respectively. There was a decrease in the serum albumin level and weight loss according to the hypermetabolic severity. However, the white blood cells (WBC), fasting blood sugar (FBS), c-reactive protein (CRP), total bilirubin, GOT, and GPT increased. The nutritional intake was TPN (32.5 kcal/kg, protein 1.2 g/kg, fat 0.25 g/kg), EN (28.1 kcal/kg, protein 1.0 g/kg, fat 1.01 g/kg). The serum albumin, hemoglobin and cholesterol were higher in the EN group than in the TPN group. But the FBS, total bilirubin, GOT and GPT were higher in the TPN group than the EN group. In conclusion, there was a negative correlation between the changes in the laboratory data and the hypermetabolic severity. There was an increase in the number of metabolic complications in the TPN group.

노인 투석환자의 영양상태 평가 (Assessment of Nutritional Status in Elderly Dialysis Patients)

  • 노유자;하혜정;고혜영;박옥순
    • 대한간호학회지
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    • 제26권2호
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    • pp.304-319
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    • 1996
  • It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calorie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis. which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon-rank sums test, Scheffe test, Kruskal-Wallis test and Pearson correlation coefficients. The results are following : 1. There was no significant difference in the calorie and protein intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea nitrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine increased significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However. each of biochemical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status measured with protein and calorie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

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지역사회중심 재활서비스를 위한 재가 장애인의 요구 사정에 관한 연구 (An Assessment of the Needs of Crippled Persons Staying at Home)

  • 양숙자;김희정
    • 지역사회간호학회지
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    • 제9권2호
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    • pp.280-290
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    • 1998
  • This study was carried out to idenify the health problems and needs of crippled persons in order to develop a community based rehabilitation service program through public health center. Information on health problems and needs were obtained from 120 crippled persons staying at home by questionaire and a measuring ADL. The results were summarized as follows 1. Among 120 subjects, male crippled (70.3%) outnumbered female crippled (29.7%). Many crippled persons belonged to the 40-49 age group (33.6%) while others were over 60 years (17.4%). There were 36.8% crippled persons with an elementary education, 26.5% had completed high school, 14.5% had completed middle school. 31% of the crippled persons were employed but most of them had unskilled jobs. 80% of the respondents replied that their monthly income was under 800,000 won. 2. The major causes of their handicap were due to acquired factors(92%) such as accidents, in fectious & communicable diseases and chronic diseases rather than congenital factors(8%). Crippled persons who belong to the first grade of disabilities were 14.8%, the second grade 35.7%, the third grade 21.7%, the forth grade 12.2%, the fifth grade 12.2% and the sixth grade 3.5%. 3. This study measured the degree of the ADL of crippled persons by a modified Barthel Index including 11 items. 73.5% of them were fully independent, 8.5% required minimal help, 2.7% required moderate help, 6.0% required substantial help and 9.4% were unable to perform task. In response to the 11 items of ADL, crippled persons required more help in stair climbing, ambulation and bathing than in other items. 4. In responding to concerning health problems, 10.3% of the subjects replied with incontinence, 8.5% malnutrition, 7.6% fecal incontinence and bedsores 2.6%. Chronic diseases which needs treatment were chronic pain(61.0 %), hypertension(16.5%) and diabetes(16.5%) 5. To the question of what type of rehabilitation services subjects required, chronic diseases management(52.1%) and physical therapy (41.2%) were the highest. The most important social welfare services subjects required were economics support (51.3%) and introductions to job opportunities(42%).

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당뇨식 잔반 감량을 위한 영양서비스 개선 활동의 효과 (Effects of Nutrition Service Improvement Activities for Reducing Plate Waste of the Diabetic Mellitus Diet in a General Hospital)

  • 손정민;염혜선
    • 대한지역사회영양학회지
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    • 제13권5호
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    • pp.674-681
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    • 2008
  • Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.

인도네시아 아동들의 아침식사하기에 영향을 미치는 요인 분석 -건강신념모델을 이용하여- (Analysis of Factors Affecting Breakfast Eating Behavior of Children in Indonesia: An Application of the Health Belief Model)

  • 강란이;이수진;류호경
    • 대한지역사회영양학회지
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    • 제25권1호
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    • pp.1-12
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    • 2020
  • Objectives: This study investigates the current state of consuming breakfast among elementary school students residing in Malang, East Java, Indonesia, and to identify factors that influence breakfast behavior. Methods: The research model was set up as per the health belief model, and slightly modified by adding the subjective normative factors of the theory of planned behavior. The survey was conducted from July 17 to August 15, 2017 using a questionnaire, after receiving the permission PNU IRB (2017_60_HR). Results: The subjects were 77 boys (49.4%) and 79 girls (50.6%) suffering from malnutrition with anemia (21.2%) and stunting ratio of Height for Age Z Score (HAZ) (11.5%). Furthermore, moderate weakness (14.8%) and overweight and obesity (12.3%) by Body Mass Index for Age Z Score (BMIZ) were coexistent. According to the results obtained for breakfast, 21.8% did not eat breakfast before school, with 18.8% of the reasons for skipping breakfast being attributed to lack of food. Even for subjects partaking breakfast, only about 10% had a good balanced diet. The average score of behavioral intention on eating breakfast was 2.60 ± 0.58. The perceived sensitivity, perceived severity, perceived benefits, and self-efficacy of the health belief model correlated with breakfast behavior. Of these, self-efficacy (β=0.447, R2=0.200) and perceived sensitivity (β=0.373, R2=0.139) had the greatest effect on breakfast behavior. Mother was the largest impact person among children. Conclusions: In order to increase the level of breakfast behavior intention among children surveyed in Indonesia, we determined the effectiveness by focus on education which helps the children recognize to be more likely to get sick when they don't have breakfast, and increase their confidence in ability to have breakfast on their own. We believe there is a necessity to seek ways to provide indirect intervention through mothers, as well as impart direct nutrition education to children.

아토피피부염 영아의 영양장애 사례보고와 채식주의에 관한 고찰 (Marasmus and Kwashiorkor by Nutritional Ignorance Related to Vegetarian Diet and Infants with Atopic Dermatitis in South Korea)

  • 정상진;한영신;정승원;안강모;박화영;이상일;조영연;최혜미
    • Journal of Nutrition and Health
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    • 제37권7호
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    • pp.540-549
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    • 2004
  • Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

재가 복지 봉사 사업의 가정 간호 사업연계 필요 조사 (Study on Effective Utilization Strategies of the Home Health Care Program in the Community Care Service of Welfare Policy)

  • 김성실
    • 지역사회간호학회지
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    • 제7권2호
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    • pp.183-202
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    • 1996
  • This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

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