• Title/Summary/Keyword: TPN

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고령위암 환자에서 술 후 처치 및 영양지원

  • 김인호
    • 대한위암학회:학술대회논문집
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    • 2002.04a
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    • pp.53-60
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    • 2002
  • 1. 병원에 입원하는 환자들 중 상당수에서 어느정도의 영양실조가 있는 것으로 보고되므로 수술하기 위해 입원하는 환자에서 영양과 관계있는 측면에서 병력청취 및 이학적 검사상 약 6개월간 평소체중의 $10\%$ 이상 감소, 혈장단백(알부민, 트란스페린 등) 저하, 총임파 구수감소 등이 있으면 철저한 영양평가를 시행하여 중등도 이상의 위험군에서는 술 전 약 $7\~10$일간 영양지원을 하는 것이 약 $10\%$의 술 후 합병증을 줄이는 것으로 보고되나 이는 수술의 스트레스 정도, 술 후 영양 섭취 지연의 기간 및 정도 및 수술의 응급여부에의 해 결 정한다. 2. 영양지원이 결정되면 그 경로는 경장이 좋으며 그것이 안될 때 정맥영양을 시행한다. 3. 술 전 영양지원을 받지않은 중등도 이상의 영양실조 환자에서 술 후 조기 영양지원에 대한 연구에서는 TPN군에서 대조군보다 오히려 약 $10\%$의 합병증 발생률이 높다. 4. 영양실조가 없는 환자에서도 술 후 약 7일 이상의 금식이 예상되면 TPN을 시행하는 것이 좋다.

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Application of Fuzzy Transition Timed Petri Net for Discrete Event Dynamic Systems (퍼지 트랜지션 시간 페트리 네트의 이산 사건 시스템에 응용)

  • 모영승;김진권;김정철;탁상아;황형수
    • 제어로봇시스템학회:학술대회논문집
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    • 2000.10a
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    • pp.364-364
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    • 2000
  • Timed Petri Net(TPN) is one of methods to model and to analyze Discrete Event Dynamic Systems(DEDSs) with real time values. It has two time values, earliest firing time ($\alpha$$_{i}$) and latest firing time ($\beta$$_{I}$) for the each transition. A transition of TPN is fired at arbitrary time of time interval ($\alpha$$_{I}$, $\beta$$_{i}$). Uncertainty of firing time gives difficulty to analyze and estimate a modeled system. In this paper, we proposed the Fuzzy Transition Timed Petri Net(FTTPN) with fuzzy theory to determine the optimal transition time (${\gamma}$$_{i}$). The transition firing time (${\gamma}$$_{i}$) of FTTPN is determined from fuzzy controller which is modeled with information of state transition. Each of the traffic signal controllers are modeled using the proposed method and timed petri net. And its Performance is evaluated by simulation of traffic signal controller. controller.

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Oral Insulin-like Growth Factor-I Combined Alters Intestinal Protein Synthesis in Parenterally-fed Piglets

  • Park, Yoo-Kyoung;Sharon M. Donovan
    • Nutritional Sciences
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    • v.3 no.2
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    • pp.57-65
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    • 2000
  • Partial enteral nutrition (PEN) supplemented with insulin-like growth factor-I (IGF-I) to neonatal piglets receiving parenteral nutrition increases lactase-phlorizin hydrolase (LPH) activity, but not LPH mRNA. The goal of the current study was to investigate the mechanism by which IGF-I up-regulates LPH activity. We hypothesized that IGF-I regulates LPH synthesis post-transcriptionally. Methods: Newborn piglets (n=15) received 100% parenteral nutrition (TPN), 80% parenteral nutrition + 20% PEN (PEN), or PEN + IGF-I (1.0mg/kg/d). On day 7, two stable isotopes of leucine, [$^2 H_3$]-leucine and [$^{13}C_1$]-L-leucine were intravenously administered to measure mucosal protein and brush LPH (BB LPH) synthesis. Results: Weight gain, nutrient intake and jejunal weight and length were similar among the treatment groups. PEN increased mucosal weight, villus width and cross-sectional area, LPH activity, mRNA expression and the abundance of proLPHh compared to 100% TPN (p<0.05). IGF-I further increased mucosal weight, LPH activity and LPH activity per unit BB LPH ~2-fold over PEN alone (p<0.05), but did not affect LPH mRNA or the abundance of proLPHh or mature LPH. Isotopic enrichment of [$^2 H_3$]-leucine and [$^{13}C_1$]-L-leucine in plasma, mucosal protein and LPH precursors, and the fractional and absolute synthesis rates of mucosal protein and LPH were similar among the treatment groups. Total mucosal protein synthesis was increased 60% (p<0.05) and LPH synthesis tended (p=0.14) to be greater in the IGF-I treated animals compared to the other two groups. Conclusions: The primary mechanism by which IGF-I up-regulates LPH may be post-translational, either via reducing LPH turnover, or by specifically altering LPH activity.

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JOB-SHOP SCHEDULING ANALYSIS IN FLEXIBLE MANUFACTURING SYSTEM USING UNFOLDING (UNFOLDING을 이용한 유연생산시스템의 JOB-SHOP스케쥴링 분석)

  • 김정원
    • Proceedings of the Korea Society for Simulation Conference
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    • 1998.10a
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    • pp.137-141
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    • 1998
  • 본 연구는 TPN unfolding을 이용하여 WIP의 FMS(Flexible Manufacturing System)를 분석하는 방법을 제시한다. PN의 unfolding은 상태폭발이 발생하지 않는 concurrent system의 검증에 사용되는 순서기반방법이다. 본 연구는 일반적으로 발생하는 순환상태스케쥴문제에서 가장 그 작업과정 시간을 최적화함을 위하여 원래의 net을 동일한 비순환 net으로 바꾸어 줄 수 있는 unfolding 개념을 기반으로 한 것이다.

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Clinical Use and Complications of Percutaneous Central Venous Catheterization in Very Low Birth Weight Infants (극소 저출생 체중아에서 경피 중심정맥 도관의 유용성과 합병증)

  • Kim, Hyang;Kim, Sun Hui;Byun, Hyung Suck;Choi, Young Youn
    • 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.

Change of Clinical Effect upon Use of Glutamine to Critically Ill Patients over Age 60 Receiving TPN (정맥영양 투여 받는 60세 이상 중환자에서 glutamine 사용에 따른 임상 효과의 변화)

  • Lee, Hye Seung;Kim, Sungtae;Min, Young Sil;Sohn, Uy Dong
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.9-14
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    • 2014
  • Background: It is known to reduce the mortality when glutamine is supplied to patients during the surgery or in intensive care unit through intravenous nutrition supply. The purpose of this study is to establish the appropriate basis for use of glutamine and guidelines of nutrition supply for critically ill patients in the hospital by examining the clinical effects of administration of glutamine with subjects of elderly critically ill patients receiving intravenous nutrition in one hospital in Korea. Method: Among elderly patients with age of 60 or more hospitalized in Yeuido St. Mary's Hospital from August 2012 to July 2013, those who stayed in the intensive care unit for more than a week and received TPN (Total Parenteral Nutrition) for more than 3 days during staying in the intensive care unit were classified to a test group using glutamine and a control group without glutamine. Duration of use of mechanical ventilator, duration of hospitalization, occurrence of infectious disease and death were compared between two groups. We would like to identify the clinical test figures affected by the use of glutamine by examining changes in SCr, Total Protein, Albumin, AST, ALT, TB, DB and GFR at the time of admission and discharge. Results: At the time of admission to intensive care unit, gender, physical measurement information and clinical test figures did not show any significant difference between 72 subjects in a test group and 24 subjects in a control group. Thus, two groups began in the same condition. There were no significant difference in duration of hospitalization, duration of intensive care unit, use of mechanical ventilator, occurrence of infectious disease and death. As the results of statistical analysis of the average changes of clinical test figures at the time of admission and discharge of intensive care unit, SCr and GFR were significantly changed in the test group. GFR was significantly changed in a control group. As the result of analysis of the clinical test figures at the time of discharge with reflection of average changes after clinical test figures were corrected at the time of admission of intensive care unit, TB and GFR were significantly increased in a test group compared with those in a control group. Other clinical test figures were not significantly changed. Conclusion: If glutamine is administered to critically ill patients over age 60 receiving TPN and careful monitoring for total bilirubin is made in the future, it is expected to give the positive effect on renal function andminimize the side effect of arise in total bilirubin.

A Study on Controls System of FMS Using Petri net Modelling (페트리네트 모델링을 이용한 FMS 통제 시스템에 관한 연구)

  • 김만균;함효준
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.20 no.42
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    • pp.9-19
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    • 1997
  • 최근 제조업체들은 고객의 다양한 요구와 제품의 Life Cycle 단축에 따른 제조환경의 변화 에 직면하고 있다. 이러한 변화에 능동적으로 대처하기 위한 수단으로 효율성과 유연성이 크게 부각된 유연생산시스템(FMS)의 역할은 대단히 크다. 따라서, 본 연구에서는 유연생산시스템을 평가하고 모델링하는 도구인 Petri net 모델링 기법을 이용하여 효율성이 뛰어난 흐름생산방식을 적용한 복잡한 유연생산 시스템의 통제시스템 모델 설정과 시스템정지(deadlock) 예방에 대한 분석을 하였으며, AGVs의 셀이동 생산시스템을 제어할수 있는 FMS의 계층적 TPN 모델링을 구축하였다.

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Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition (경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향)

  • Rha Mi yong;Kim Eun mi;Cho Young Y.;Seo Jeong Meen;Choi Hay mie
    • Korean Journal of Community Nutrition
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    • v.11 no.1
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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.