• Journal of Clinical Nutrition
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• 제10권2호
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• pp.45-50
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• 2018

Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.303-329
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• 2019

Intestinal failure (IF) is the critical reduction of the gut mass or its function below the minimum needed to absorb nutrients and fluids required for adequate growth in children. Severe IF requires parenteral nutrition (PN). Pediatric IF is most commonly due to congenital or neonatal intestinal diseases or malformations divided into 3 groups: 1) reduced intestinal length and consequently reduced absorptive surface, such as in short bowel syndrome (SBS) or extensive aganglionosis; 2) abnormal development of the intestinal mucosa such as congenital diseases of enterocyte development; 3) extensive motility dysfunction such as chronic intestinal pseudo-obstruction syndromes. The leading cause of IF in childhood is the SBS. In clinical practice the degree of IF may be indirectly measured by the level of PN required for normal or catch up growth. Other indicators such as serum citrulline have not proven to be highly reliable prognostic factors in children. The last decades have allowed the development of highly sophisticated nutrient solutions consisting of optimal combinations of macronutrients and micronutrients as well as guidelines, promoting PN as a safe and efficient feeding technique. However, IF that requires long-term PN may be associated with various complications including infections, growth failure, metabolic disorders, and bone disease. IF Associated Liver Disease may be a limiting factor. However, changes in the global management of IF pediatric patients, especially since the setup of intestinal rehabilitation centres did change the prognosis thus limiting "nutritional failure" which is considered as a major indication for intestinal transplantation (ITx) or combined liver-ITx.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup1호
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• pp.111-116
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• 2008

Immunonutrition is the provision of specific nutrients that modulate the activity of the immune system. Several nutrients including arginine, glutamine, nucleotides, omega-3 fatty acids, vitamins, minerals, and prebiotics can be provided to enhance immunity in critically ill patients. Supplying immunonutrition to critically-ill children, better prognosis and shortening of the hospital stay are expected from its immuno-modulating effects. Therefore, immune-enhancing enteral and parenteral formulas can be recommended in children with severe illness.

• Journal of Chest Surgery
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• 제19권4호
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• pp.695-698
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• 1986

Only five instances of chylopericardium following cardiac surgery have been reported in the literature previously. We encounted this complication in a patient who was operated on for secundum atrial septal defect. The patient readmitted one month after discharge because of large amount of chylous pericardial effusion. Conservative treatment of pericardiostomy drainage and parenteral hyperalimentation was continued for 3 weeks without improvement. Partial pericardiectomy and pericardiopleural window was done with success and no recurrence of chylopericardium was observed upto 3 months after surgery. We think this is the first case report of chylopericardium after open heart surgery in Korea.

• 대한한의학회지
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• 제21권2호
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• pp.87-94
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• 2000

Hypokalemic periodic paralysis(HypoPP) is characterized by an abrupt onset of flaccid paralysis with a clear mentality, but muscles of speech and swallowing are usually spared. We report on three patients who suffered attacks of acute paralysis. After exclusion of central nervous system involvement, the patients showing hypokalemia was diagnosed as hypokalemic periodic paralysis, which was completely reversible on parenteral potassium substitution.

• Journal of Digestive Cancer Research
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• 제11권1호
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• pp.41-44
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• 2023

Oral complications, such as mucositis, infection, or xerostomia, are common in patients with cancer receiving chemotherapy or radiotherapy. These complications can cause pain, leading to increased consumption of analgesics, poor oral intake, malnutrition, and even a need for parenteral nutrition. Moreover, they can sometimes interrupt the treatment plan. This review focuses on the proper management and prevention of oral complications that are common in patients with cancer receiving chemotherapy or radiotherapy.

• 기본간호학회지
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• 제7권3호
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• pp.429-440
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• 2000

The purpose of this study was to validate self care outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 103 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not at all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follows : 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Self care: Toileting' attained an OCV score of 0.884 and was the highest OCV score among self care outcomes. 3. 'Self care: Oral Hygiene' attained an OCV score of 0.756 and was the lowest OCV score among self care outcomes. 4. 'Self-care: Activities of Daily Living (ADL)' attained an OCV score of 0.845 and the highest indicator was 'eating'. 5. 'Self-care: Bathing' attained an OCV score of 0.810 and the highest indicator was 'washes body'. 6. 'Self-care: Dressing' attained an OCV score of 0.831 and the highest indicator was 'buttons clothing'. 7. 'Self-care: Eating' attained an OCV score of 0.815 and the highest indicator was 'chews food'. 8. 'Self-care: Grooming' attained an OCV score of 0.833 and the highest indicator was 'combs or brushes hair'. 9. 'Self-care: Hygiene' attained an OCV score of 0.823 and the highest indicator was 'washes hands'. 10. 'Self-care: Insrumental Activities of Daily Living(IADL)' attained an OCV score of 0.776 and the highest indicator was 'uses telephones'. 11. 'Self-care: Non-Parenteral Medication' attained an OCV score of 0.796 and the highest indicator was 'identifies medication'. 12. 'Self-care: Parenteral Medication attained an OCV score of 0.810 and the highest indicator were 'identifies medication' and 'administers medication correctly'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

• 대한지역사회영양학회지
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• 제11권1호
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• pp.124-132
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• 2006

The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

• Clinical and Experimental Pediatrics
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• 제57권11호
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• pp.496-499
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• 2014

Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he showed gait disturbances, nystagmus, and excessive dizziness; his mental state, however, indicated he was alert, which did not fit the classical triad of Wernicke's encephalopathy. A diagnosis of Wernicke's encephalopathy was made only after brain magnetic resonance imaging and serum thiamine level analyses were performed. The patient's symptoms remained after 5 days of treatment with 100-mg thiamine once daily; thus, we increased the dosage to 500 mg 3 times daily, 1,500 mg per day. His symptoms then improved after 20 days of replacement therapy. This case report describes a pediatric patient who was promptly diagnosed with Wernicke's encephalopathy, despite only 2 suspicious symptoms, and who completely recovered after high doses of thiamine were given intravenously.

• Asian-Australasian Journal of Animal Sciences
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• 제28권8호
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• pp.1133-1139
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• 2015

This study aimed to determine the effects of parenteral selenium (Se) and vitamin E supplementation on economic impact, milk yield, and some reproductive parameters in high-yield dairy cows in the dry period and in those at the beginning of lactation. At the beginning of the dry period, cows (n = 323) were randomly divided into three groups as follows: Treatment 1 (T1), Treatment 2 (T2), and Control (C). Cows in group T1 received this preparation 21 days before calving and on calving day, and cows in group T2 received it only on calving day. The cows in the control group did not receive this preparation. Supplementation with Se increased Se serum levels of cows treated at calving day (p<0.05). Differences in milk yield at all weeks and the electrical conductivity values at the 8th and 12th weeks were significant (p<0.05). Supplementation with Se and Vitamin E decreased the incidence of metritis, the number of services per conception and the service period, but had no effects on the incidence of retained fetal membrane. A partial budgeting analysis indicated that Se supplementation was economically profitable; cows in group T1 averaged 240.6$ per cow, those in group T2 averaged 224.6$ per cow. Supplementation with Se and Vitamin E has been found to increase serum Se levels, milk yield, and has positive effects on udder health by decreasing milk conductivity values and incidence of sub-clinical mastitis.