• Nutrition Research and Practice
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• v.11 no.2
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• pp.139-146
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• 2017

BACKGROUND/OBJECTIVES: Chewing difficulty is a factor contributing to a poor nutritional status in the elderly. The aim of this study was to examine disparities in food and nutrition intakes among Korean elderly people with and without chewing difficulty. SUBJECTS/METHODS: This study utilized data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013. The study subjects included males and females over 65 years of age who were not required to adhere to a special diet due to disease or sickness. They were divided into groups according to their chewing ability. Those who found chewing "very difficult" or "difficult", were combined to form the chewing difficulty group. Similarly, those who found chewing "moderately difficult", "easy", and "very easy" were combined to form the normal chewing group. RESULTS: Of the 999 subjects, 47.7% had chewing difficulties and the prevalence of chewing difficulty was higher in females than in males (P = 0.03) and higher in those 75 years of age and over than in younger individuals (P < 0.001). The chewing difficulty group had a significantly lower intake of fruits and vegetables (P < 0.05) and lower vitamin C and potassium intake than those in the normal group. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) in the two groups indicated that the intake of most nutrients (energy, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, sodium, potassium, and iron) were significantly lower in the chewing difficulty group than in the normal group. In particular, calcium intake was inadequate (51% of KDRIs) in the chewing difficulty group. CONCLUSIONS: The results indicate that chewing difficulty is closely related to food and nutrient intake in the elderly and can result in vitamin and mineral intake deficiencies. It is evident that the care of elderly subjects with chewing difficulty is essential for maintaining a healthy lifestyle.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.429-433
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• 2009

Burning mouth syndrome (BMS) is defined as burning pain in the tongue or other oral mucous membrane associated with normal sign and laboratory findings at least 4 to 6 months. There are many factors that affect this condition and the pain characters are various among the sufferers, so it is difficult to diagnose exactly and treat properly. The cause of BMS is currently unknown. The etiology is presumed to be that it is related with local, systemic and psychogenic factor. The BMS is related with local factor such as allergic reaction, oral fungal infection(candidiasis), parafunctional oral habits and systemic factors such as diabetes mellitus, hypothyroidism, nutritional deficiencies(vitamin $B_{12}$, folic acid), hyposalivation and psychogenic factor such as depression, anxiety, cancerphobia. So clinicians must be aware of these factors and can give proper treatment options to patients. The management of BMS are pharmacologic management, cognitive behavioral therapy and psychotherapy treatment. Clonazepam, gabapentin, amitriptyline, alpha-lipoic acid and capsaicin are used to manage the BMS. Among these, topical clonazepam is reported that the effect is higher than systemic medication and the complications are rare. This case report is about some cases of the effect of topical clonazepam on BMS.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.58-64
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• 2006

In the clinical state of vitamin D deficiency, it is possible that associated phosphate depletion, parathyroid hormone excess, and hypocalcemia may all depress the proximal tubular reabsorption of bicarbonate, in addition to abnormal skeletal modeling or remodeling, Although nutritional rickets is considered a rare disease in developed countries nowadays, cases of vitamin D deficient rickets caused by various unhealthy lifestyles such as insufficient exposure to sunlight, breast feeding infants without giving vitamin D supplements, unbalanced vegetarian diets of breast feeding mothers, low-birth weight, and maternal deficiency of vitamin D or calcium are increasing. Here, we present the case of an 8 month old girl, who was completely breastfed without any weaning diet or infant vitamin supplements. She visited our emergency room with hypocalcemic seizure and subsequently was diagnosed with vitamin D deficient rickets accompanied by overt bone changes and proximal renal lobular acidosis. After intravenous(IV) and oral calcium replacement therapy(IV calcium gluconate injection 1 mEq/kg/day for 6 days, 2 mEq/kg/day for 4 days followed by oral calcium gluconate administration 4 g/day for 3 days) with vitamin D supplement(Alfacalcidol 0.5 mcg/day) during admission, serum calcium level was normalized with clinical improvement. Oral sodium bicarbonate(0.6 g/day) was administered from the $2^{nd}$ hospital day for 2 weeks, which normalized the serum bicarbonate(measured by $tCO_2$) level. Calcium and vitamin D replacement were continued for 2 weeks and 3 months each. After discontinuing medications, follow up laboratory findings showed good maintenance of serum calcium, alkaline phosphate and bicarbonate levels with complete improvement of bone X-ray findings.

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.133-141
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• 2009

We reviewed retrospectively the medical records of 600 elderly patients, over 65 years old who visited oral medicine. The ratio of the age group was composed of 65${\sim}$74 years old group was 63.7%, 75${\sim}$84 years old group was 32.2%, over 85years old group was 4.2%, and the patients were mostly females. The main chief complaint was composed of oral soft tissue problem(44.1%) and oromaxillofacial pain(39.0%). The majority of systemic diseases was composed of diseases of the circulatory system(30.1%), diseases of the musculoskeletal system and connective tissue(16.8%), endocrine, nutritional and metabolic diseases, and diseases of the digestive system(10.1%). The numerous pateints were diagnosed as soft tissue disease(32.0%), arthrogenous disease(24.1%), and myogenous disease(18.1%) of temporomandibular disease.Principally medication(43.9%), physical therapy(24.2%) were performed. 14.2% of all patients visited oral medicine with a letter of request written by other medical departments or local dental clinics, or referred from other departments in Chosun university dental hospital. These findings indicate epidemiologic characteristics on the elderly patients visited oral medicine. We hope that this study will play a basis in the future research about the elderly patients.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.110-118
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• 2018

Background: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. Methods: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. Results: The monthly mean number of interventions increased from 8.0 (${\pm}5.7$) to 31.7 (${\pm}12.8$) (P<0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. Conclusion: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.3
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• pp.288-294
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• 2021

Purpose: Despite aggressive medical and nutritional management, patients with methylmalonic acidemia (MMA) often suffer from multi-organ damage. Early deceased donor liver transplantation (DDLT) has emerged as an intervention to prevent disease progression. We investigated the efficacy of living donor LT (LDLT) with a potential carrier of MMA and a small volume of graft in patients with MMA as an alternative to DDLT. Methods: Of five patients (three male, two female; median age 5.7 years; range, 1.3-13.7 years), four underwent carrier LDLT, while one underwent non-carrier auxiliary LDLT. All patients received pre- and post-LT continuous renal replacement therapy and were provided with minimal restriction diet according to serum MMA level after LT. MMA levels in the serum and urine, the incidence of metabolic crisis, and clinical findings before and after LT were compared. Results: The survival rate was 100% during 2.2 years of follow up period after LT. In all five cases, MMA titer in the serum after transplantation decreased with less restrictive diet. Metabolic crisis was not observed during the follow-up period. In addition, no patient showed progression of severe renal impairment requiring hemodialysis. Progression of delayed cognitive development was not observed. Social functioning with improved neuropsychiatric development was observed. Conclusion: This study showed that LDLT achieved improved quality of life with less restrictive diet, therefore it could be a feasible alternative option to DDLT for the treatment of patients with MMA, even with an auxiliary LT.

• Journal of Life Science
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• v.33 no.3
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• pp.287-294
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• 2023

Healthy adipose tissue is critical for preventing obesity by maintaining metabolic homeostasis. Adipose tissue plays an important role in energy homeostasis through glucose and lipid metabolism. Depending on nutritional status, adipose tissue expands to store lipids or can be consumed by lipolysis. The role of adipose tissue as an endocrine organ is emerging, and many studies have reported that there are various adipose tissue hormones that communicate with other organs and tissues through metabolic signaling. For example, leptin, a representative peptide hormone secreted from adipose tissues (adipokine), circulates and targets the central nervous system of the brain for appetite regression. Furthermore, adipocytes secrete inflammatory cytokines to target immune cells in adipose tissues. Not surprisingly, adipocytes can secrete fatty acid-derived hormones (lipokine) that bind to their specific receptors for paracrine and endocrine action. To understand organ crosstalk by adipose tissue hor- mones, specific metabolic signaling in adipocytes and other communicating cells should be defined. The dysfunction of metabolic signaling in adipocytes occurs in unhealthy adipose tissue in overweight and obese conditions. Therapy targeting novel adipose metabolic signaling could potentially lead to the development of an effective anti-obesity drug. This review summarizes the latest updates on adipose tissue hormone and metabolic signaling in terms of obesity and metabolic diseases.

• 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.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.8
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• pp.1079-1085
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• 2012

Obesity is an important issue worldwide as it may associated with increased prevalence of metabolic diseases. Mung bean is known as a functional food for decreasing the glycemic index and lipid profile of plasma. The purpose of this study was to investigate the anti-obesity effects of vitexin from mung bean on the regulation of adipocyte differentiation and adipocytokine secretion. When 3T3-L1 adipocytes were treated with vitexin from days 0 to 14 at various levels of 25, 50, 100, and $200{\mu}M$, there was no change in cell viability. Vitexin treatment at 50, 100, and $200{\mu}M$ decreased triacylglycerol levels in cells, but only $100{\mu}M$ vitexin induced lipolysis. At $200{\mu}M$ of vitexin, phosphorylation of p38 and ERK, which causes secretion of inflammatory adipocytokines, was depressed, whereas there was an increase in expression of $PPAR{\gamma}$, the key regulator of adipocyte differentiation. Phosphorylation of AMPK increased at $100{\mu}M$ vitexin. TNF-${\alpha}$ and aP2 mRNA expression increased at $25{\mu}M$ vitexin, whereas only TNF-${\alpha}$ mRNA expression increased at $200{\mu}M$ vitexin. Further, the mRNA levels of TNF-${\alpha}$ and aP2 decreased at other concentrations in a dose-dependent manner. Since we observed that mRNA expression of C/EBP, SREBP1, and $PPAR{\gamma}$ did not change upon vitexin treatment, our future studies will investigate other genes such as mTOR, which is related with apoptosis signaling, or SIRT1, which is associated with inhibition of adipogenesis. Our results indicate that vitexin at concentrations between 100 and $200{\mu}M$ is suitable in vivo for the development of mung bean as an anti-obesity therapy or functional food.

• The Korean Journal of Food And Nutrition
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• v.19 no.1
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• pp.70-78
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• 2006

This study was performed to investigate the effect of 12-week weight control program including nutrition education, diet therapy and regular exercise on body weight, obesity degree, BMI and blood lipid levels among middle aged obese women. The 31 middle aged obese women participated in the weight control program for 12-week. The body weight, body composition, blood lipid levels and food habit were measured before and after the weight control program. Changes in body weight after 12 week weight control program showed the slight reduction from $67.4{\pm}10.8kg\;to\;65.1{\pm}9.2kg$. Obesity degree and BMI were decreased from $128.4{\pm}19.1%,\;27.8{\pm}3.9\;to\;123.4{\pm}15.7%,\;26.8{\pm}3.0$, respectively. Waist-hip ratio was also decreased from $0.98{\pm}10.16\;to\;0.94{\pm}0.04$. LBM was also slightly reduced from $39.9{\pm}5.6kg\;to\;37.0{\pm}8.5kg$ with the reduction of body fat. The levels of systolic blood pressure, total cholesterol and triglyceride were slightly decreased, HDL-chol level was significantly increased from $43.1{\pm}14.1mg/dL\;to\;50.4{\pm}16.5mg/dL$. Waist-hip ratio was also slightly decreased after 12 weeks. Food habit score was significantly increased after nutriton education and personal counseling about their eating behaviors and nutritional status.