Purpose: We evaluated the socio-personal and clinical factors that can affect preoperative quality of life to determine how to improve preoperative quality of life in patients with gastric cancer. Materials and Methods: The preoperative quality of life data of 200 patients (68 females and 132 males; mean age $58.9{\pm}12.6years$) with gastric cancer were analyzed according to socio-personal and clinical factors. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core (QLQ) 30 and the EORTC QLQ-STO22, a gastric cancer-specific module, were used to assess quality of life. Patients were asked to complete the questionnaire preoperatively by themselves. Results: Patients with a higher academic background and stage I disease tended to have higher global health status scores. Highly educated younger men had better physical functioning scores. Highly educated and well-nourished patients with stage I cancer had higher role functioning scores. Married patients had better emotional scores. The symptom scales were affected by sex, age, education level, nutrition, and cancer stage. Conclusions: Preoperative quality of life in patients with gastric cancer can be improved by nutritional support and treatment of symptoms caused by disease progression. Psychological support may be helpful for patients with a poor quality of life.
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.
Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.
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.
Proceedings of the Korean Nutrition Society Conference
/
2002.11b
/
pp.1171-1177
/
2002
The low molecular weight zinc-binding protein metallothionein (MT) contains 32% cysteine and has been shown to efficiently scavenge hydroxyl radicals in vitro. MT expression is induced by oxidative stress and an antioxidant role for this protein has therefore been proposed. This review mainly focuses on the evidence for this role arising from studies using genetically modified animals and cells which either over-or under-express MT. Despite some considerable disparity of results in the literature, reported studies do generally support an antioxidant role. Nevertheless, oxidant stress at non-physiological treatment levels has been the preferred experimental model and there is little information about the role of MT in physiological oxidative stress Although it is presumed that the mechanism by which MT has an antioxidant effect involves oxidation of cysteinal thiols, it is possible that zinc release from MT is in itself an important signalling factor.
Proceedings of the Korean Nutrition Society Conference
/
2002.11a
/
pp.73-82
/
2002
The low molecular weight zinc-binding protein metallothionein (U) contains 32% cysteine and has been shown to efficiently scavenge hydroxyl radicals in vitro. MT expression is induced by oxidative stress and an antioxidant role for this protein has therefore been proposed. This review mainly focuses on the evidence for this role arising from studies using genetically modified animals and cells which either over- or under-express MT. Despite some considerable disparity of results in the literature, reported studies do generally support an antioxidant role. Nevertheless, oxidant stress at non-physiological treatment levels has been the preferred experimental model and there is little information about the role of MT in physiological oxidative stress. Although it is presumed that the mechanism by which MT has an antioxidant effect involves oxidation of cysteinal thiols, it is possible that zinc release from MT is in itself an important signalling factor.
Cyclic vomiting syndrome(CVS) is a disorder of unknown etiology that is characterized by its clinical pattern of intermittent episodes of severe vomiting, similar in time of onset and duration, with no symptoms during the intervening period. By definition, CVS is an idiopathic disorder that requires exclusionary laboratory testing. Not only can it be mimicked by many specific disorders, eg, surgical, neurologic, endocrine, metabolic, renal, but within idiopathic CVS there may be specific subgroups that have different mechanisms. It has been reported that CVS usually begins in toddlers and resolves during adolescence. Migraine is also self-limiting episodic condition of children and the clinical features of migraine and CVS show considerable similarity. It is proposed that CVS is a condition related to migraine. This paper reports clinical courses of long term follow-up and reversible EEG changes in three patients whose history included CVS. Clinical situations of attack interval, duration and associated symptoms had changed variablely in each patients through long term follow-up period. Cyclic vomiting subsided in two cases. Abnormal delta activity was seen during episodes and resolved at follow-up, when the patient asymptomatic. The brain wave changes support the interpretation of CVS as a migraine variant.
This study was conducted to obtain basic data for reinforcing and developing course programs in department of Food Science and Nutrition. For this purpose, data was collected from dietitians and professors who work at 2-and 4-year colleges. Results are as follows. 1. Many respondents (95.7%) support that It Is desirable to separate dietitian license into two types. Reasons are (1) specific knowledge required by job type is different(29.5%), and (2) to increse job performance (29.3%). 2. Most respondents(95.4%) agree that course programs are needed to be revised. Because (1) current programs are inadequate to provide specific knowledge required at field work (67.8%), and (2) the programs are not helpful to increase job performance of dietitians (54.1%). 3. Respondents of dietitians want to extend applied science area(37.7%) and reinforce lab training (63.1%), as principles of program revision. 4. Course titles which need to be reinforced are Internship(95.8%) and Lap training(67.8%). 5. Specialized areas which need to be reinforced are Food Service Managemant and Practical Training(90.9%), Nutrition Education and Guide(88.9%), Public Health Nutrition(79.0%), Basic Area for Clinics(85.6%), Basic area for Education and Counselling(87.1%), and Cooking Science(77.5%) 6. Courses which are needed to be reinforced by respondents(over 75% agree) are Computer Management for Food Service, Counselling, Nutrition and Disease, Diet Therapy, Quantity Cooking, Internship, Public Health (Health Care), Community Nutrition(Environment and Nutrition), Clinical Nutrition, Psychology, and Communication.
There is no any reports on nation-wide nutrition survey since 1947 in Korea, During the period only the small scaled nutrition surveys have been reported by several investigators. Authors, under the financial support from the Ministry of Health and Social Affairs, Republic of Korea, had conducted a nation-wide nutrition survey, including dietary, clinical, and socio-economical aspects, during the period from 29th of July to 15th of August, 1969. Number of households surveyed and population distribution are shown in Table II-2 and age and sex distribution of the population surveyed are also in Table II-3 in this report. Average food and nutrient intakes are shown in Tables II-6, II-7 and II-8 respectively. For the detailed discussions on food and nutrient intakes, see the Tables II-9 through II-11 and Figures II-1 through II-10 in this report. Anthropometric data are shown in Tables III-1 through III-4 and in Figures III-1 through III-4. Data of deficiency diseases are shown in Table III-5 and in Figure III-5 in this report. Socio-economical data are shown in Tables IV-1 through IV-26 and in Figures IV-1 through IV-3 in this report.
Wilson disease (WD) is an autosomal recessive disorder of copper metabolism that results in accumulation of copper primarily in the liver, the brain and the cornea. Mutations in the WD gene, ATP7B cause failure of copper excretion from hepatocyte into bile and a defective synthesis of ceruloplasmin. More than 370 mutations are now recognized, scattering throughout the ATP7B gene. Since WD has protean clinical presentations, awareness of WD in clinical practice is important for the early diagnosis and prevention of accumulated copper toxicity. None of the laboratory parameters alone allows a definite diagnosis of WD. There are numerous pitfalls in the diagnosis of WD. Low serum ceruloplasmin concentrations, increased 24 hour urinary copper excretion, increased hepatic copper concentrations and the presence of Kayser-Fleischer rings in the cornea are major diagnostic points. A combination of any two of these 4 laboratory findings is strong support for a diagnosis of WD. Molecular methods are now being used to aid diagnosis. Molecular genetic testing has confirmed the diagnosis in individuals in whom the diagnosis is not clearly established biochemically and clinically. Siblings should be screened for WD once an index case has been diagnosed. Discrimination of heterozygotes from asymptomatic patients is essential to avoid inappropriate lifelong therapy for heterozygotes. Genetic testing, either by haplotype analysis or by mutation analysis, is the only reliable tool for differentiating heterozygote carriers from affected asymptomatic patients. Currently, genetic testing is of limited value in the primary diagnosis. However, genetic testing will soon play an essential role in diagnosing WD as rapid advancement of biomedical technology will allow more rapid, easier and less expensive mutation detection.
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