• 제목/요약/키워드: TPN

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Comparison of TPN use with hospital admixtured and industrial manufactured formular TPN in Seoul national university

  • Kim, Kui-Sook;Choi, Mi-Young;Lee, Jin-Ju;Son, In-Ja;Suh, Ok-Kyung
    • 대한약학회:학술대회논문집
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    • 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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    • pp.275.2-275.2
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    • 2002
  • There have been many changes in hospital pharmacy after division of medical practice and dispensing. Many pharmacist leave hospital pharmacy to drugstore. Because reduced number of pharmacist, many of hospital pharmacies are placed in difficulty. Restructuring of hospital pharmacy made us consider substitution hospital admixtured TPN(total parenteral nutrition) with industrial manufactured TPN. But we have no data established to support that, so we have sarried out the comparison of two kinds of TPn formulary. We have divided into groups receiving hospital admixtured TPN and industrial manufactured TPN patients in august. 2002. We have compared with each groups in nutritional related dose, parameters and complication before and after TPN administration and also invertigated the reason of formulary change in each groups. We expect that this study will be good data for selection TPN formulary and substitution hospital admixtured TPN with industrial manufactured TPN.

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신생아 외과환아에서 말초혈관을 통한 전비경구적 영양요법에 대한 고찰 (Total Parenteral Nutrition(TPN) via Peripheral Veins in Neonatal Surgical Patients)

  • 이종인;정풍만
    • Advances in pediatric surgery
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    • 제4권1호
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    • pp.16-26
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    • 1998
  • Parenteral nutrition has been an essential part of postoperative care of neonates requiring major surgery who are unable to tolerate enteral feeding for long periods during the postoperative period. However, TPN via central venous catheters(central TPN), used in increasing trend, still presents significant morbidity. To find out whether TPN via peripheral veins(peripheral TPN) could be used as a viable alternative for postoperative parenteral nutrition in neonates, a clinical study was carried out by a retrospective analysis of 53 neonates subjected to peripheral TPN for more than 7 days after surgery. Operations consisted of procedures for esophageal atresia with tracheoesophageal fistula, gastroschisis and omphalocele. Surgery was performed at the Division of Pediatric Surgery, Department of Surgery, Hanyang University Hospitall, from 1983 to 1994. The mean total duration of TPN was 13.3 days (range; 7-58 days), the average daily total fluid intake was 117.6 ml/kg during TPN and 158.6 ml/kg during subsequent oral feeding. The average daily total calorie intake was 57.7 kcal/kg during full strength TPN and 101.3 kcal/kg during subsequent oral feeding. The mean urine output was maintained at 3.5 ml/kg/ hour during TPN and at 3.6 ml/kg/hour during subsequent oral feeding. The increment of body weight observed during TPN was 132 g in TEF, 53 g in gastroschisis and 3 g in omphalocele patients, while loss of body weight was not observed. The mortality rate was 5.7 %(3/53) and was related to the underlying congenital anomalies, not the TPN. The most common complication of peripheral TPN observed was laboratory findings suggestive of liver dysfunction in 23 cases(43.4 %) with no significant clinical symptom or signs in any case, transient pulmonary edema in one case, and generalized edema in one case. None of the major complications usually expected associated with central TPN were observed. The result of this study suggest that peripheral TPN can be used for adeguate postoperative nutritional support in neonates requiring 2 to 3 weeks of TPN.

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입원초기 영양불량 환자의 TPN 지침에 따른 영양개선 평가 (Evaluation of Nutritional Improvement by Total Parenteral Nutrition Guideline in Early Malnourished Inpatients)

  • 차윤영;김정태;임성실
    • 한국임상약학회지
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    • 제23권4호
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    • pp.365-372
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    • 2013
  • Background: Malnutrition of inpatients has been associated with higher morbidity, mortality, cost, and longer hospital stay. Total parenteral nutrition (TPN) therapy plays an important role in decreasing morbidity and mortality among critical inpatients in hospitals, and has been commonly used to improve clinical outcomes. However, only a few studies were conducted regarding patients' nutritional improvement by TPN. Method: This study therefore evaluated the changes in nutritional parameters by TPN therapy for early malnourished inpatients. Data from early malnourished inpatients who were treated with TPN therapy between January 2012 and June 2013 at the ${\bigcirc}{\bigcirc}$ university Hospital were studied retrospectively. Information regarding sex, age, underlying diseases, division, TPN (peripheral and central), and changes in nutritional parameters were collected by reviewing electronic medical records. The criteria for evaluation of the changes in nutritional parameters were included physical marker, body mass index (BMI), and biochemical markers, including albumin (Alb), total lymphocyte count (TLC), and cholesterol. Nutritional parameters were collected three times: pre-TPN, mid-TPN and end-TPN. A total of 149 patients (peripheral, 97; central, 52) was evaluated. Results: In all patients, the malnutrition number was significantly decreased following the complete TPN therapy (peripheral patients, pre-TPN: $3.33{\pm}0.12$, mid-TPN : $3.06{\pm}0.17$, and end-TPN: $2.85{\pm}0.21$ (p < 0.05); central patients, pre-TPN: $3.38{\pm}0.11$, mid-TPN: $3.06{\pm}0.13$, and end-TPN: $2.75{\pm}0.21$ (p < 0.05). The malnutrition number means number of nutrition parameters below normal range of malnutrition. In addition, all of the four nutritional parameters (BMI, Alb, TLC and cholesterol) were increased with duration of TPN periods for all patients, and the changes in the early stage were larger than in the late stage (p < 0.05). The nutritional parameters of non-cancer patients were increased to a greater extent compared to cancer patients with longer TPN therapy, but it was not significant. The nutritional parameters of younger patients (50-60 years) were also increased more than of older patients (70-80 years), but it was not significant. Conclusion: In conclusion, the TPN therapy decreases malnutritional status and improves nutritional parameters in malnourished patients, thereby decreasing morbidity and mortality. The combined evaluation of all four nutritional parameters is more accurate for nutritional assessment than a single one.

입원환자의 TPN 공급현황에 대한 연구 (A Study on the Provision of TPN for Hospitalized Patients)

  • 강은희;김미경;강신숙
    • 대한영양사협회학술지
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    • 제8권1호
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    • pp.26-32
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    • 2002
  • In Korea, implementation of nutrition support guidelines has been limited due to strict health insurance reimbursement policies as well as the lack of consensus on the best approach to TPN management. We examined the impact of TPN provision to hospitalized patients where NST (nutrition support team ) consultations were not requested by their primary physicians. The study showed the followings : 1. The median dutation of TPN provision was 8 days, but many patients were on TPN for less than 1 week. 2. The intake of energy and protein were less than the patient's requirements 3. Lipid emulsion was not provided to the most TPN patients. In conclusion, the role of NST should be expanded and studies are needed not only on TPN formulations which are suitable to Koreans but also on the cost-effectiveness of NST activities. TPN policies and protocols should be established based on the needs of each hospital.

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토양현탁액중(土壤懸濁液中)에서 Cellulose와 살균제(殺菌濟) Chlorotharonil연용(連用)이 세균(細菌)의 밀도변화(密度變化)에 미치는 영향(影響) (Influence of Repeated Application of Chlorotharonil and Cellulose on the Bacterial Population in Soil Suspension Culture)

  • 이상복;사토 규;소재돈
    • 한국토양비료학회지
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    • 제27권1호
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    • pp.48-53
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    • 1994
  • 토양현탁(土壤懸濁) 배양시(培養時) 셀루로스와 유기염소계(有機鹽素系) 살균제(殺菌劑)인 클로로타로닐(TPN)의 첨가횟수에 따른 총세균(總細菌), TPN분해균(分解菌), 셀루로스분해균(分解菌)의 밀도(密度) 그리고 이들 화학물질(化學物質)의 농도변화(濃度變化) 등(等)에 대한 상호관계(相互關系)를 조사(調査)한 결과(結果)는 다음과 같다. 1. 총세균수(總細菌數)와 그람음성세균수(陰性細菌數)는 TPN과 셀루로스 혼합처리(混合處理)가 TPN 또는 셀구로스 단독처리(單獨處理)에 비(比)하여 많았고, 단독처리(單獨處理)는 배양(培養) 1 또는 2주째까지 증가(增加)한 후 감소(減少)하였으나 혼합처리(混合處理)는 반복시용(反覆施用)할수록 증가(增加) 경향(傾向)이었다. 2. TPN분해수(分解數)는 초기(初期)에 비(比)하여 배양(培養) 5주째 모든 처리(處理)에서 증가(增加)되었고 TPN과 셀루로스를 혼합반복처리(混合反覆處理)할수록 더욱 촉진(促進)되었다. 3. 셀루로스 분해균수(分解菌數)는 배양(培養) 1주째에 모든 처리(處理)에서 가장 많았고, 셀루로스를 첨가(添加)할수록 높았으나 동시 TPN 처리(處理)로 감소(減少)를 촉진(促進)하였다. 4. TPN분해균(分解菌)에 의한 TPN의 분해소실(分解消失) 정도(程度)는 TPN단용(單用)에 비해 셀루로스 첨가(添加)에 의하여 더욱 분해촉진(分解促進)되었으나 반복시용(反覆施用)할수록 소실정도(消失程度)는 지연(遲延)되었다. 5. 셀루로스가 분해(分解)된 환원당(還元糖)의 함량(合量)은 배양(培養) 초기(初期)와 4주 후에 급격한 증가(增加)가 있었고, 셀루로스 단용(單用)보다 셀루로스와 TPN 혼합처리(混合處理)에서 높았으나 반복시용간(反覆施用間)에는 큰 차이(差異)가 없었다.

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Improved Region-Based TCTL Model Checking of Time Petri Nets

  • Esmaili, Mohammad Esmail;Entezari-Maleki, Reza;Movaghar, Ali
    • Journal of Computing Science and Engineering
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    • 제9권1호
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    • pp.9-19
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    • 2015
  • The most important challenge in the region-based abstraction method as an approach to compute the state space of time Petri Nets (TPNs) for model checking is that the method results in a huge number of regions, causing a state explosion problem. Thus, region-based abstraction methods are not appropriate for use in developing practical tools. To address this limitation, this paper applies a modification to the basic region abstraction method to be used specially for computing the state space of TPN models, so that the number of regions becomes smaller than that of the situations in which the current methods are applied. The proposed approach is based on the special features of TPN that helps us to construct suitable and small region graphs that preserve the time properties of TPN. To achieve this, we use TPN-TCTL as a timed extension of CTL for specifying a subset of properties in TPN models. Then, for model checking TPN-TCTL properties on TPN models, CTL model checking is used on TPN models by translating TPN-TCTL to the equivalent CTL. Finally, we compare our proposed method with the current region-based abstraction methods proposed for TPN models in terms of the size of the resulting region graph.

컴퓨터 통신 프로토콜의 모델링과 시뮬레이션에 관한 연구 (A study on modelling and simulation of computer communication protocols)

  • 손진곤;백두권
    • 한국경영과학회:학술대회논문집
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    • 대한산업공학회/한국경영과학회 1990년도 춘계공동학술대회논문집; 한국과학기술원; 28 Apr. 1990
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    • pp.22-31
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    • 1990
  • 본 논문에서는 컴퓨터 통신 프로토콜의 모델링과 시뮬레이션에 관한 이론적 인 연구를 하였다. 먼저 통신 프로토콜의 정의와 기능을 설명하였고 통신 프 로토콜을 위한 모델을 분류하였다. 또한, 통신 프로토콜의 모델 중에 Timed Petri Net(TPN) 모델에 시간함수 .tau.를 부여함으로써 TPN을 구조적으로 정의하였으며 TPN Based 모델의 문제점을 보완하기 위하여 시스템 시뮬레 이션 분야의 이산사건 시스템 명세(DEVS:Discrete Event Simulation) 개념 을 도입하였다. 중요한 연구 결과로서 TPN모델이 DEVS모델이라는 정리를 제시하고 증명하였다. 이 정리에 따르면, TPN모델을 시뮬레이션 할 때 시뮬 레이션을 위해 모델을 설계할 필요없이 DEVS모델로 변환하여 사용함으로써 시뮬레이션을 수행할수 있다.

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유연생산시스템 모듈라 구축을 위한 확장 세이프/시간형 PN 접속행렬 설계 (Design of Incidence Matrix on SE&TPN for Construction of Modular on the Flexible Manufacturing System)

  • 김만균;함효준
    • 산업경영시스템학회지
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    • 제21권47호
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    • pp.193-209
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    • 1998
  • The objective of this paper is to present a methodology for design of the FMS by using a new modeling tool which is called SE&TPN(Safe Extended & Timed Petri Net). A FMS, which consists of various machine groups, may produce machine parts in different physical dimensions and lot size. The approach involves the SE&TPN modeling by Petri-nets. The proposed algorithm can handle determining of firing count vector by incidence matrix and adjustment of conflict using the marking of SE&TPN. The SE&TPN is defined as nets that can have at most one token in one place and can have elements such as permissive arcs and inhibitor arcs in addition to elements. The SE&TPN with permissive arcs and inhibitor arcs are intuitively direct approach to increase the modeling power of the SE&TPN. Finally, this paper is to develop a modulation to optimize the system problems of FMS using SE&TPN which describes exactly features of Petri Nets.

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Higher dextrose delivety via TPN related to the development of hyperglycemia in non-diabetic critically ill patients

  • Lee, Ho-Sun;Koh, Shin-Ok;Park, Moo-Suk
    • Nutrition Research and Practice
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    • 제5권5호
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    • pp.450-454
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    • 2011
  • The beneficial effects of total parenteral nutrition (TPN) in improving the nutritional status of malnourished patients during hospital stays have been well established. However, recent randomized trials and meta-analyses have reported an increased rate of TPN-associated complications and mortality in critically ill patients. The increased risk of complications during TPN therapy has been linked to the development of hyperglycemia, especially during the first few days of TPN therapy. This retrospective study was conducted to determine whether the amount of dextrose from TPN in the 1st week in the intensive care unit (ICU) was related to the development of hyperglycemia and the clinical outcome. We included 88 non-diabetic critically ill patients who stayed in the medical ICU for more than two days. The subjects were 65 ${\pm}$ 16 years old, and the mean APACHE (Acute Physiology and Chronic Health Evaluation) II score upon admission was 20.9${\pm}$7.1. The subjects received 2.3${\pm}$1.4 g/kg/day of dextrose intravenously. We divided the subjects into two groups according to the mean blood glucose (BG) level during the 1st week of ICU stay: <140 mg/dl vs ${\geq}$ 140 mg/dl. Baseline BG and the amount of dextrose delivered via TPN were significantly higher in the hyperglycemia group than those in the normoglycemia group. Mortality was higher in the hyperglycemia group than in the normoglycemia group (42.4% vs 12.8%, P=0.008). The amount of dextrose from TPN was the only significant variable in the multiple linear regression analysis, which included age, APACHE II score, baseline blood glucose concentration and dextrose delivery via TPN as independent variables. We concluded that the amount of dextrose delivered via TPN might be associated with the development of hyperglycemia in critically ill patients without a history of diabetes mellitus. The amount of dextrose in TPN should be decided and adapted carefully to maintain blood glucose within the target range.

2-Bromo-3-(3,5-tert-butyl-4-hydroxylphenyl)-1,4-naphthalenedione (TPN2)의 항혈소판 작용 (Antiplatelet Actions of 2-Bromo-3-(.3,5-tert-butyl-4-hydroxylphenyl)-1,4-naphthaleneflione (TPN2))

  • 최소연;김민화;이수환;정이숙;백은주;유충규;문창현
    • Biomolecules & Therapeutics
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    • 제7권3호
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    • pp.227-233
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    • 1999
  • The effects of 2-bromo-3-(3,5-tert-butyl-4-hydroxylphenyl)-1,4-naphthalenedione(TPN2), a synthetic vitamin K derivative, on platelet aggregation and its action mechanisms were investigated in rat platelet. TPN2 inhibited the platelet aggregation induced by collagen($10\mu\textrm{g}$/ml), thrombin(0.1 U/ml), A23187($10\mu\textrm{M}$) and arachidonic acid($100\mu\textrm{M}$) in concentration-dependent manner with $IC_{50}$ values of 6.5$\pm$1.3, 59.3$\pm$4.5, 13.0$\pm$2.37 and 2.9$\pm$$1.0\mu\textrm{M}$, respectively. Collagen-induced serotonin release was significantly reduced by TPN2. The elevation of intracellular free $Ca^{2+}$ concentration ([$Ca^{2+}$]i) by collagen stimulation was greatly decreased by the pretreatment of TPN2, which was due to the inhibition of calcium release from intracellular store and influx from outside of the cell. TPN2 also significantly reduced the thromboxane $A_2$($TXA_2$) formation in a concentration-dependent manner. The collagen-induced arachidonic acid (AA) release in [$^3H$]-AA incorporated platelet, an indicative of the phospholipase $A_2$ activity, was decreased by TPN2 pretreatment. TPN2 significantly inhibited the activity of thromboxane synthase, but did not affect the cyclooxygenase activity. From these results. it is suggested that TPN2 exert its antiplatelet activity through the inhibition of the intra-cellular $Ca^{2+}$ mobilization and the decrease of the $TXA_2$ synthesis.

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