• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.6
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• pp.546-554
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• 2021

Purpose: Malnutrition is a significant issue for pediatric patients with cancer. We sought to evaluate the effectiveness and complication rate of percutaneous endoscopic gastrostomy (PEG) placement in pediatric oncology patients. Methods: A retrospective chart review was performed on 49 pediatric oncology patients undergoing PEG placement at Johns Hopkins All Children's Hospital between 2000 and 2016. Demographic and clinical characteristics, complications, absolute neutrophil count at time of PEG placement and at time of complications, length of stay, and mortality were identified. Weight-for-age Z-scores were evaluated at time of- and six months post-PEG placement. Results: The overall mean weight-for-age Z-score improved by 0.73 (p<0.0001) from pre- (-1.11) to post- (-0.38) PEG placement. Improvement in Z-score was seen in patients who were malnourished at time of PEG placement (1.14, p<0.0001), but not in those who were not malnourished (0.32, p=0.197). Site infections were seen in 12 (24%), buried bumper syndrome in five (10%), and tube dislodgement in one (2%) patient. One patient (2%) with fever was treated for possible peritonitis. There were no cases of other major complications, including gastric perforation, gastrocolic fistula, clinically significant bleeding, or PEG-related death documented. Conclusion: Consistent with previous studies, our data suggests a relationship between site complications (superficial wound infection, buried bumper syndrome) and neutropenia. Additionally, PEG placement appears to be an effective modality for improving nutritional status in malnourished pediatric oncology patients. However, larger prospective studies with appropriate controls and adjustment for potential confounders are warranted to confirm these findings.

• Journal of Korean Biological Nursing Science
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• v.23 no.3
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• pp.217-226
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• 2021

Purpose: The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. Methods: A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and logistic regression with IBM SPSS/WIN 24.0. Results: Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome (𝛘²=6.01, p=.014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR]=1.14, 95% Confidence interval [CI]=1.06-1.23), aphasia (OR=6.16, CI=1.62-23.40), anosognosia (OR=4.84, CI=1.13-20.79), presence of both aphasia and anosognosia (OR=7.33, CI=1.20-44.60), and time required to achieve targeted blood pressure (OR=1.00, CI=1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation (𝛘²=6.32, p=.012), intensive care unit length of stay (Z=-2.08, p=.038), National Institute of Health Stroke scale score at discharge (Z=-3.14, p=.002), and modified Rankin Scale score at discharge (Z=-2.93, p=.003). Conclusion: This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.5
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• pp.313-321
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• 2024

Purpose: For neonates admitted to the neonatal intensive care unit (NICU), appropriate nutritional assessment and intervention are important for adequate growth. In this study, we aimed to determine whether there were changes in the nutritional supply and growth status of premature infants hospitalized in the NICU after the introduction of the Nutrition support team (NST). Methods: This study retrospectively analyzed premature infants admitted to the NICU for over 14 days. The average daily calorie, protein, and fat supply at 1 and 2 weeks after birth were compared before and after NST, and growth was evaluated by changes in length, weight, and head circumference z-scores at birth and 28 days after birth. Results: A total of 79 neonates were included in the present study, with 32 in the pre-NST group and 47 in the post-NST group. The average daily energy supply during the first (p=0.001) and second (p=0.029) weeks postnatal was significantly higher in the post-NST group than in the pre-NST group. Lipid supply for the first week was significantly higher in the post-NST group than in the pre-NST group (p=0.010). The change in the z-score for length was significantly higher in the post-NST group than in the pre-NST group (p=0.049). Conclusion: Nutrient supply and length z-score change increased significantly at 28 days after birth in the post-NST group. These results suggest that calorie calculators and NST activity can promote adequate growth and development in neonates.

• Korean Journal of Remote Sensing
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• v.33 no.5_1
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• pp.469-480
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• 2017

This study aims to understand the relationship between lineaments and epicenters in Geochang region, Gyungsangnam-do, South Korea. An instrumental observation of earthquakes has been started by Korea Meteorological Administration (KMA) since 1978 and there were 6 earthquakes with magnitude ranging 2 to 2.5 in Geochang region from 1978 to 2016. Lineaments were extracted from LANDSAT 8 satellite image and shaded relief map displayed in 3-dimension using Digital Elevation Model (DEM). Then, lineament density was statistically examined by hotspot analysis. Hexagonal grids were generated to perform the analysis because hexagonal pattern expresses lineaments with less discontinuity than square girds, and the size of the grid was selected to minimize a variance of lineament density. Since hotspot analysis measures the extent of clustering with Z score, Z scores computed with lineaments' frequency ($L_f$), length ($L_d$), and intersection ($L_t$) were used to find lineament clusters in the density map. Furthermore, the Z scores were extracted from the epicenters and examined to see the relevance of each density elements to epicenters. As a result, 15 among 18 densities,recorded as 3 elements in 6 epicenters, were higher than 1.65 which is 95% of the standard normal distribution. This indicates that epicenters coincide with high density area. Especially, $L_f$ and $L_t$ had a significant relationship with epicenter, being located in upper 95% of the standard normal distribution, except for one epicenter in $L_t$. This study can be used to identify potential seismic zones by improving the accuracy of expressing lineaments' spatial distribution and analyzing relationship between lineament density and epicenter. However, additional studies in wider study area with more epicenters are recommended to promote the results.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.254-260
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• 2013

Purpose: Recently, vitamin D insufficiency has increased and has been correlated to growth and puberty in children. This study was conducted to find the prevalence of subclinical vitamin D insufficiency and its influence on school-aged children in Korea. Methods: The subjects of this study were 397 children aged 7 to 15 years who had been tested for 25-OH vitamin D3 among the outpatients of the Department of Pediatrics in Eulji General Hospital from March 2007 to February 2011. Data for age, sex, comorbidities, serum 25-OH vitamin D3, height, weight, body mass index (BMI), and sunlight exposure time were collected before and after 3 months of vitamin D administration, retrospectively. Results: Vitamin D insufficiency was present in 343 (86%) of the subjects. In the vitamin D insufficient group, chronological age was $8.96{\pm}1.72$ years, mean height (z-score [z]) was $0.51{\pm}1.26$, mean BMI (z) was $0.81{\pm}2.20$, and bone age was $10.26{\pm}1.75$ years. In the vitamin D sufficient group, chronological age was $9.61{\pm}1.77$ years, mean height (z) was -$0.66{\pm}0.98$, mean BMI (z) was -$0.01{\pm}1.16$, and bone age was $9.44{\pm}2.12$ years. A paired t-test showed that three months after vitamin D administration, the mean 25-OH vitamin D3 level in the insufficient group increased to $24.38{\pm}10.03$ ng/mL and mean BMI (z) decreased to $0.67{\pm}1.06$. Conclusion: In Korean school-aged children, vitamin D insufficiency were relatively higher and may be closely related with higher BMI. Insufficient rise of the level of vitamin D after supplementation suggest the new supplementation guidelines, especially for Korean children.

• Korean Journal of Biological Psychiatry
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• v.16 no.3
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• pp.170-180
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• 2009

Objectives : To assess clinical improvement and change in plasma brain-derived neurotrophic factor(BDNF) level after repetitive transcranial magnetic stimulation(rTMS) in patients with treatment-resistant schizophrenia. Methods : Seven patients with DSM-IV schizophrenia, who were proven to be treatment-resistant, were treated with 15 sessions of rTMS for three weeks as an adjuvant therapy to antipsychotic treatment. Clinical improvement and change in plasma BDNF level were measured after the treatment period. The symptom severity was assessed with the Positive and Negative Syndrome Scale(PANSS) and the Korean Version of Calgary Depression Scale for Schizophrenia(K-CDSS) at baseline and 7 days after the treatment. Plasma BDNF level was measured by enzyme-linked immunosorbent assay(ELISA) at baseline and 7 days after the treatment. Results : After the rTMS treatment, there was no significant improvement in PANSS total score(Z=-1.693, p=0.090) and no significant change in plasma BDNF was found(Z=-1.183, p=0.237). Negative correlations were found between percentage change in PANSS positive subscale score and duration of illness(rho=-0.991, N=7, p<0.0005, two-tailed), and PANSS negative subscale score at baseline and percentage change in plasma BDNF level(rho=-0.821, N=7, p=0.023, two-tailed). Conclusion : This preliminary study suggests that rTMS didn't make a significant change in clinical symptoms nor in plasma BDNF level in treatment-resistant schizophrenia. Percentage change in plasma BDNF, however, might be correlated with treatment resistance in schizophrenic patients. This is a pilot study with a small sample size, therefore, a further study with a larger sample size is needed.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.131-139
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• 2017

Purpose: Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center. Methods: During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015). Results: Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. -0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group. Conclusions: The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.

• The Korean Journal of Rehabilitation Nursing
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• v.8 no.1
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• pp.59-67
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• 2005

Purpose: The purpose of this study is to investigate the effect of Self-Efficacy Promoting Program on Self-Efficacy, Metabolic Control and Self-Care Behaviors in Patients with NIDDM. Method: Data was collected from March 15th to July 15th, 2001. The subjects of the study consisted of 23 NIDDM patients who had visited regularly the endocrinology out-patient department of Gwangju Christian Hospital. The instrument used in the study Paek's self-efficacy measurement scale, was modified by the researcher, self-care behaviors were created by health care teams, and HbA1c for the sugar metabolic control were measured from the patients blood. The Interventions of the self efficacy promoting program were applied 4 hours a week for 6weeks. Data were analyzed with SPSS/PC+, using T-test and Wilcoxon rank sum test. Result: The mean score for self-efficacy was $70.61{\pm}15.48$ of a 140 point scale, the mean score for $HbA_{1c}$ level was $8.07{\pm}1.86%$. The self efficacy promoting program significantly increased the score of self efficacy(Z=-4.198, P=.000). And the self efficacy promoting program was significantly decreased in metabolic control(Z=-2.585, p=.010). Taking medicine and controlling alcohol were the best self care behaviors of this program. Conclusion: It was established that the self efficacy promoting program was effective for improving self efficacy, metabolic level and self care behaviors in patients with NIDDM.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.2
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• pp.104-109
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• 2016

Purpose: Regurgitation is a common physiological phenomenon in infants. The aim of the present study was to evaluate the efficacy of a new anti-regurgitation (AR) formula (Novalac), thickened with an innovative complex including fibres, on the daily number of regurgitations and to assess its impact on stool consistency and frequency. Methods: Infants younger than five months, presenting at least 5 regurgitations per day were recruited in this trial. The efficacy of the new formula on regurgitation (daily number and Vandenplas score), stool frequency and consistency were assessed at day 14 and 90. Growth data were recorded at each study visit. Results: Ninety babies (mean age $9.6{\pm}5.8weeks$) were included in the full analysis data set. The mean number of regurgitation episodes at inclusion was $7.3{\pm}3.4$. In all infants, regurgitations improved after 2 weeks. The daily number of regurgitations decreased significantly ($-6.3{\pm}3.3$, p<0.001) including in those previously fed a thickened formula ($-6.2{\pm}3.0$, p<0.001). There was no significant change in stool consistency at day 14. After 3 months, 97.5% of infants had formed or soft stools. Growth was appropriate with a slight increase of weight-for-age z-score (from $-0.5{\pm}1.0$ to $-0.1{\pm}0.9$) and no change of weight-for length z-score ($-0.1{\pm}1.1$ to $-0.1{\pm}-1.1$). Conclusion: The new AR formula thickened with an innovative complex is very effective in reducing the daily number of regurgitations without having a negative impact on stools consistency.

• Journal of the East Asian Society of Dietary Life
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• v.15 no.6
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• pp.655-662
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• 2005

Body content bone mined density and nutrient intake status of 129 college women in Daegu area are analyze4 The mean age was 23.1 years. Bone mineral density was measured in their right heel by SONOST-2000 ultrasound bone densitometer, and nutrient intake was assessed by a Questionnaire. Diet intake data were obtained by using a 24 hours recall method to evaluate the subject's usual diet. The average energy, Ca, Ee, Zn and folate intakes were 64.2, 47.5, 54.7, 62.9 and $57.4\%$ of RDA, respectively. Ca/P and Ca/Protein ratio were 0.46 and 6.7, respectively. The mean adequacy ratio(MAR), an index of overall dietary quality wag 0.6. The index of nutritional quality was under 1.0 for protein(0.7), vitamin A(0.9), E(0.7), $B_1(0.8)$, niacin(0.8), $B_6(0.6)$ and phosphorus(0.6). The less the protein and energy intake, the less the bone mineral density(p<0.05). The intakes of protein(p<0.05) and that of phosphorus(p<0.001) were positively correlated with bone quality index(BQI). The calcium intake was positively correlated with Z-score(p<0.05). The phosphorus intake was positively correlated with T-score(p<0.001) and Z-score(p<0.0001). In conclusion, this study indicates that nutrient intake of the college women is considerably lower than the RDA. Also the BQI is lower than standard.