• Title/Summary/Keyword: Total lymphocyte count

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Development of Nutrition Screening Index for Hospitalized Patients (입원 환자 영양검색 지표 개발)

  • Kim, Su-An;Kim, So-Yeon;Sohn, Cheong-Min
    • Korean Journal of Community Nutrition
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    • v.11 no.6
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    • pp.779-784
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    • 2006
  • Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

A Study on Nutritional Status after Gastrectomy of Gastric Cancer Patients in Jeonbuk Province (전북지역 위암환자의 위절제술 전.후 영양상태 평가)

  • Jeong, Mi-Jin;Kim, Chan-Young;Kim, Sook-Bae
    • Korean Journal of Community Nutrition
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    • v.11 no.6
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    • pp.785-792
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    • 2006
  • The purpose of this study was to investigate the nutritional status before and after gastrectomy of gastric cancer patients in Jeonbuk Province. The subjects were 136 patients with gastrectomy of gastric cancer. We assessed the nutritional status before and after an operation by general characteristics (age, clinicopathological stage, type of operation, method of reconstruction), anthropometric characteristics (height, weight, skeletal muscle mass, body fat mass, body mass index (BMI), percent body fat, arm muscle circumference AMC, arm circumference AC) and biochemical characteristics (hemoglobin Hb, hematocrit Hct, mein corpuscular volume MCV, mean corpuscular hemoglobin MCH, total lymphocyte count TLC, serum albumin, serum transferrin). Mean ages were 60.0 yrs in males and 58.8 yrs in females. Age, clinicopathological stage, types of operation and reconstruction methods were not significantly different between males and females. Weight, skeletal muscle mass, body fat mass, BMI, percent body fat, AMC and AC significantly deteriorated by gastrectomy. There were severe weight losses in males and females after gastrectomy. Hemoglobin, Hct, MCV, MCH, TLC, albumin and transferrin significantly deteriorated by gastrectomy. After gastrectomy, subjects who were assessed as malnounrished in Hb and Hct were increased in male and those who were assessed as malnounrished in Hb were increased in females. These results suggest that a nutrition intervention, specially for energy, protein and iron, is necessary to improve the nutritional status of gastric cancer patients with gastrectomy.

2-Week repeated oral dose toxicity study of 1,4-dichlorobutane in rats (1,4-Dichlorobutane의 랫드 2주 반복경구투여독성시험)

  • Kim, Jong-Kyu;Lee, In-Chul;Kim, Sung-Hwan;Baek, Hyung-Seon;Bae, Jin-Sook;Song, Si-Whan;Kim, Jong-Choon;Chung, Yong-Hyun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.23 no.1
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    • pp.1-10
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    • 2013
  • Objectives: The present study investigated the potential subacute toxicity of 1,4-dichlorobutane (1,4-DCB) by a 2-week repeated oral dose in male Sprague-Dawley rats. Materials and Methods: The test chemical was administered once daily by gavage to male rats at dose levels of 0, 74, 222, 667, and 2000 mg/kg/day for 2 weeks. All rats were sacrificed at the end of treatment period. During the test period, clinical signs, mortality, body weights, food and water consumption, urinalysis, hematology, serum biochemistry, gross findings, and organ weights were examined. Results: At 2000 mg/kg/day, treatment-related clinical signs, as evidenced by hypothermia, decreased locomotor activity, piloerection, lying on side, and prone position were observed. All the rats were found dead on test day 2. At 667 mg/kg/day, polyuria, suppressed body weight gain, food consumption, and spleen and thymus weights, and increased adrenal gland and liver weights were observed.Hematological and serum biochemical investigations revealed increases in the alanine aminotransferase, alkaline phosphataseand total bilirubinand decreases in the serum $Na^+$ level, white blood cell count and lymphocyte ratio. There were no treatment-related adverse effects in the 74 and 222 mg/kg/day groups. Conclusions: In the present experimental conditions, target organs were determined to be spleen, thymus,and liver. The no-observed-adverse-effect level was considered to be 222 mg/kg/day in male rats.

Effects of Egg Yolk Antibody Powder (IgY) Supplementation on Growth Performance, Blood Component Profile, Intestinal Microflora, and Immunoglobulin G in Meat Ducks (난황항체제제(IgY) 첨가가 육용오리의 생산성, 혈액성상, 장내 미생물 및 면역글로불린 함량에 미치는 영향)

  • Jeon, Ik Soo;Kang, Hwan Ku;Kim, Chan Ho;Hwangbo, Jong;Park, Seong Bok
    • Korean Journal of Poultry Science
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    • v.43 no.3
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    • pp.143-148
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    • 2016
  • This study was conducted to investigate the effect of dietary egg yolk antibody (IgY) powder supplementation on the growth performance, blood component profile, intestinal microflora, and immunoglobulin G in ducks. A total of 300 1-day-old ducks (Cherry Valley) were randomly divided into 5 groups, with 3 replicates of 20 birds. The treatment groups were the negative (NC), positive (PC), egg yolk antibody powder 0.1% (T1), egg yolk antibody powder 0.5% (T2), and egg yolk antibody powder 1.0% (T3) groups. In the growth performance of ducks during the entire experimental period, the IgY groups and positive control group (PC) showed significantly higher (P<0.05) body weights and body weight gains compared to the negative control group (NC). However, no significant differences were observed in the feed intake and feed conversion ratio. The blood component profiles showed that the IgY 0.1 and 1.0% groups decreased in total cholesterol content compared to the NC group. The aspartate aminotransferase (AST) and alanine aminotranferease (ALT) contents were lower in the IgY 1.0% group, but there were no significant differences. Regrading the leukocyte content after feeding IgY, the heterophil: lymphocyte ratio decreased in the IgY groups, especially in the IgY 0.1% group, which had a lower content than the other groups. However, these results showed no significant differences. The Lactobacillus count in the intestines significantly increased (P<0.05) in the IgY 0.1 and 0.5% groups, the level of IgY increased, and the Escherichia coli count decreased. However, no significant difference was observed in the total plate count. The immunoglobulin G content was lower in the IgY groups than in the NC group, and compared with the IgY groups, the IgY 0.5% had a lower content, which was not a significant difference.

Changes of the Preoperative and Postoperative Nutritional Statuses in Patients with Gastric Cancer and Assessment of the Nutritional Factors That Are Correlated with Short-Term Postoperative Complications (위암 환자에서 수술 전후의 영양지표의 변화와 수술 후 단기간 합병증과의 연관성)

  • Oh, Cheong-Ah;Kim, Dae-Hoon;Oh, Seung-Jong;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung;Bae, Jae-Moon
    • Journal of Gastric Cancer
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    • v.10 no.1
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    • pp.5-12
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    • 2010
  • Purpose: The aim of this study was to evaluate the preoperative and postoperative nutritional statuses of patients with gastric cancer and to investigate the nutritional factors that are correlated with perioperative complications. Materials and Methods: From January 2008 to Jun 2008, 669 patients who underwent curative gastrectomy were enrolled in a retrospective study. To evaluate the changes of their nutritional status preoperatively and postoperatively, we measured the total lymphocyte count, the serum albumin, the body weight change and the BMI. The nutritional factors correlated with short-term postoperative complications were analyzed. Results: The total lymphocyte count and serum albumin decreased from the first preoperative day to the $5^{th}$ day after operation, but they tended to increase and approach the normal range 6 months after operation. The only factor correlated with the short-term postoperative complications (defined as the ones that occurred for 30 days) was the serum albumin checked on the $5^{th}$ day after operation. Conclusion: Low serum albumin on the $5^{th}$ day after operation was correlated with postoperative short-term complications. Serum albumin can be the preoperative statistical parameter that can predict the occurrence of postoperative complications.

Blood Picture of Army Pack Horses(Jeju Horses) (군용타마(軍用馱馬)(제주마(濟州馬))의 혈액상(血液像))

  • Mun, Gyeong Gi;Lee, Do Pil;Chung, Soon Tong
    • Korean Journal of Veterinary Research
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    • v.15 no.2
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    • pp.147-152
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    • 1975
  • Although considerable research has been done on the blood picture of the horse, hot-blooded and cold-blooded, little work has been made of the blood picture of the army pack horse, Jeju horse. The object of the present investigation was to make good this deficiency, and to suggest standard for the blood picture of army pack horses kept under the regular military training and the ideal feeding in the heart of a mountain. Blood samples were drawn from the jugular vein through a 15-gauge bleeding needle from 41 males and 28 females, aging 3 to 9 years old. It was taken between seven and nine o'clock in the morning. Animals were handled as quietly as possible to avoid any excitation. No restraint other than a halter was used. Enumeration of erythrocyte, total and differential leukocyte count, determination of hemoglobin in blood, and the value of packed cell volume were male in the usual manner, and erythrocytic constant was calculated by the method of Wintrobe. Erythrocyte count was $7.83{\pm}0.20(4.95{\sim}11.05){\times}10^6/mm^3$(SE). This value was much lower than hot-horses, but slightly higer than the values of cold-horse reported from foreign country. Concentration of hemoglobin in blood was $13.0{\pm}0.33(9.5{\sim}17.8)g/100ml$. This value was much higher than that of cold-horses observed by the other authors, approaching to the values of hot-horses. Packed cell volume was $32.1{\pm}0.92(22{\sim}42)ml/100ml$. This vague was a little higher than that of the other cold-horses. Mean corpuscular volume was $41.5{\pm}1.20(26.6{\sim}59.3){\mu}m^3$. This value matched so well with the other results recorded by various investigators. Mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration were $16.9{\pm}0.43(12.3{\sim}25)$ pg and $41.0{\pm}0.45(29.1{\sim}51.1)g/100ml$, respectively. These values were significantly higher than the values found by the other investigations. Total leukocyte enumeration was $10.5{\pm}0.41(5.6{\sim}17.9){\times}10^3/mm^3$, being considered as normal. And differential leukocyte count of neutrophil was $44.5{\pm}2.23(15{\sim}76)%$, $5,527{\pm}234(2,231{\sim}9,144)/mm^3$, of lymphocyte $50.5{\pm}1.19(19{\sim}77)%$, $4,307{\pm}125(1,456{\sim}11,098)/mm^3$, of monocytel (0~4)%, $105(0{\sim}352)/mm^3$, of eosiophil 3.2(0~14)%, $340(0{\sim}1,232)/mm^3$ and of basophil 0.25(0~3)%, $23(0{\sim}236)/mm^3$. The percentage of the differential count obtained from the present work showed a good agreement with the results of various authors. Of the horses examined monocyte was found from 42 horses, eosinophil from 62 horses and basophil from 10 horses. No significant differences recognized between male and female horses, and the effect of age was not observed between three to nine years old. Judging from the blood picture of the present investigation, it could be stated that the army pack horses on training were kept better than the average farming conditions.

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EFFECTS OF ACTIVATED CARBON ON GROWTH, RUMINAL CHARACTERISTICS, BLOOD PROFILES AND FEED DIGESTIBILITY IN SHEEP

  • Garillo, E.P.;Pradhan, R.;Tobioka, H.
    • Asian-Australasian Journal of Animal Sciences
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    • v.8 no.1
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    • pp.43-50
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    • 1995
  • This study was carried out to investigate the effects of activated carbon (AC) on growth, ruminal charateristics, blood profiles and feed digestibility in sheep, using roughage-based or concentrate-based diets. Twelve Suffolk breed of sheep of similar age and weight were distributed into 4 groups in a $2{\times}2$ factorial design. Two groups were fed a roughage-based diet with (R + AC) and without AC (R - AC), while the other two were fed a concentrate-based diet with (C + AC) and without AC (C - AC), respectively. The addition of 0.3% AC was based on dry matter of feed offered to animals. The incorporation of AC in roughage and concentrate based diets had no marked effects on feed intake, daily gain and feed conversion of the animals within experimental diets. The results obtained might be due to the low level of AC added in the diet. The animal on both concentrate-based diets were higher than the roughage-based diets in terms of daily gain and feed conversion ratio. However, it was observed that the animals provided with AC in the concentrate-based diet did not suffer from diarrhea and easily adjusted to high concentrate feeding. Further, the pH value for all diets before feeding was noted to be similar. After feeding, however, pH was shown to be higher in R + AC (p < 0.05) than in C + AC diet. Rumen protozoa number was decreased after feeding for both + AC diets, but in C - AC diet it was higher than in the roughage-based diets. For ammonia-nitrogen, C - AC was found to be higher than C + AC diet and the roughage-based diets before feeding. Total volatile fatty acid concentration, propionate and valerate molar ratios for both diets and time of collection were not affected. However, acetate, butyrate and valerate molar ratios were observed to be affected by diets and time of collections. The diets with AC increased (p < 0.05) before feeding for acetate molar ratio, but not different within diet, however, the roughage diets were found to be higher (p < 0.05) in acetate than the concentrate diet. In the blood parameters, the glutamic pyruvic transaminase (GPT), red and white blood cell (RBC, WBC) counts and packed cell volume (PCV) did not differ within and among the diets. Likewise, the WBC differential count in both diets with either - AC or + AC were similar in trend. However, lymphocyte count was noted to be increased in R + AC than the R - AC diet. The addition of AC in both diets did not affect nutrient digestibilities within diets.

Prognostic Evaluation of Categorical Platelet-based Indices Using Clustering Methods Based on the Monte Carlo Comparison for Hepatocellular Carcinoma

  • Guo, Pi;Shen, Shun-Li;Zhang, Qin;Zeng, Fang-Fang;Zhang, Wang-Jian;Hu, Xiao-Min;Zhang, Ding-Mei;Peng, Bao-Gang;Hao, Yuan-Tao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5721-5727
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    • 2014
  • Objectives: To evaluate the performance of clustering methods used in the prognostic assessment of categorical clinical data for hepatocellular carcinoma (HCC) patients in China, and establish a predictable prognostic nomogram for clinical decisions. Materials and Methods: A total of 332 newly diagnosed HCC patients treated with hepatic resection during 2006-2009 were enrolled. Patients were regularly followed up at outpatient clinics. Clustering methods including the Average linkage, k-modes, fuzzy k-modes, PAM, CLARA, protocluster, and ROCK were compared by Monte Carlo simulation, and the optimal method was applied to investigate the clustering pattern of the indices including platelet count, platelet/lymphocyte ratio (PLR) and serum aspartate aminotransferase activity/platelet count ratio index (APRI). Then the clustering variable, age group, tumor size, number of tumor and vascular invasion were studied in a multivariable Cox regression model. A prognostic nomogram was constructed for clinical decisions. Results: The ROCK was best in both the overlapping and non-overlapping cases performed to assess the prognostic value of platelet-based indices. Patients with categorical platelet-based indices significantly split across two clusters, and those with high values, had a high risk of HCC recurrence (hazard ratio [HR] 1.42, 95% CI 1.09-1.86; p<0.01). Tumor size, number of tumor and blood vessel invasion were also associated with high risk of HCC recurrence (all p< 0.01). The nomogram well predicted HCC patient survival at 3 and 5 years. Conclusions: A cluster of platelet-based indices combined with other clinical covariates could be used for prognosis evaluation in HCC.

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

  • Cha, Yun Young;Kim, Jung Tae;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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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.

[Retracted]Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools ([논문철회]위암 수술 후 외래환자의 영양상태 평가: 5가지 영양검색도구의 비교연구)

  • Cho, Jae Won;Youn, Jiyoung;Choi, Min-Gew;Rha, Mi Young;Lee, Jung Eun
    • Korean Journal of Community Nutrition
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    • v.26 no.4
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    • pp.280-295
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    • 2021
  • Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.