• Clinical Nutrition Research
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• v.12 no.2
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• pp.91-98
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• 2023

Adequate nutritional support is crucial in preventing complications and improving outcomes in critically ill patients. Extracorporeal membrane oxygenation (ECMO) is a mode of supportive care for patients with respiratory and/or cardiac failure. ECMO patients frequently exhibit a hypermetabolic state characterized by protein catabolism and insulin resistance, which can lead to malnutrition. Nutritional therapy is a vital component of intensive care, but its optimal administration for ECMO patients is unknown. This case report aims to provide insights into effective nutritional management for critically ill patients undergoing ECMO therapy. The patient was a 72-year-old male with a history of gastric and lung cancer who underwent a lobectomy complicated by bronchopleural fistula, postoperative bleeding, pneumonia, and acute respiratory distress syndrome (ARDS). The patient's nutritional status was assessed indicating a high risk of malnutrition, using the modified Nutrition Risk in the Critically Ill (mNUTRIC) Score. Nutritional support was administered based on the recommendations of European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society for Parenteral and Enteral Nutrition (ASPEN), with energy requirements set at 25-30 kcal/kg/d and protein requirements set at 1.2-2.0 g/kg/day. The patient received parenteral nutrition until the enteral nutrition target amount was reached, with zinc supplements for wound healing. The study highlights the need for further research on proactive and effective nutritional support for ECMO patients to improve compliance and prognosis.

• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.693-699
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• 2005

Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes $(3.45\pm0.43g/dL)$ than in non-diabetic patients $(3.64\pm0.36 g/dL)$ (p<0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes $(1.42\pm1.8mg/dL)$ (p<0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r=-0.553, p<0.01) and non-diabetic (r=-0.579, p<0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r=0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) $(153.1\pm80.1mg/dL\;vs\;101.6\pm62.4mg/dL)$ and decreased serum HDL cholesterol $(36.89\pm13.48mg/dL\;vs\;47.00\pm14.02mg/dL,\;P<0.05)$. There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r=0.438, p< 0.05) and non-diabetic (r=0.527, p<0.05) patients. Serum CRP level was negatively correlated with calorie (r= -0.468, p < 0.05), protein (r=-0.520, p < 0.01) and fat intakes (r=-0.403, p < 0.05) in diabetic patients and calorie (r=-0.534, p<0.05) and protein intakes (r=-0.559, p<0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.

• The Journal of the Korean dental association
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• v.12 no.7
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• pp.477-480
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• 1974

This case of acute necorotizing ulcerative gingivitis was presented pseudomembrane, necrosis, ulceration, gingival bleeding and pain. The etiology of this case seemed malhygiene and malnutrition. Patient was managed by local treatment with subgingival curettage and systemic antibiotic therapy.

• Proceedings of the PSK Conference
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• 2001.10a
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• pp.299.2-300
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• 2001

• Proceedings of the PSK Conference
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• 2000.10a
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• pp.273.2-274
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• 2000

• Journal of Nutrition and Health
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• v.31 no.8
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• pp.1338-1346
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• 1998

North Korea has been experiencing a serious food shortage. However, the extent and magnitude of malnutrition and health problems are virturally unknown because a nationwide food and nutritional survey has never been conducted. To get a better udnerstanding of the situation., an exhaustive literature search on the health and nutritiona conditions of North Koreans was performed. We also obtained anthropometric data on 274 North Korean Defectors who are recently resettlers in the South. Some(137) measurements were taken at the time of entry to the South, and the remaining data was from the health and nutrition mail survey conducted by us on North Korean refugeee re-settlers. Health and inutritional status of North Koreans was found to be less than desirable as shown in high infant mortality rates, high mortality and morbidity rates of malnutriton-related infectious deseases, and smaller body sizes. Striking differences were noted in all of the above health and nutrition indicators between north and South Koreans. Considering the fact that North and South Koreans are homogeneous in their genetic back-ground, ours study results clearly demonstrate that the health and nutrition of North Koreas has deteriorated with the dhronic food shortage, which might have sorsened with a recent food crissi. The smaller and thinner adult stature proevailing in North Korea could play a significant negative role in the country's economy, since lower lean body mass has been associated with reduced work productivity that could hinder economic growth and development.

• Journal of Nutrition and Health
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• v.36 no.7
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• pp.749-758
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• 2003

Malnutrition is a common problem in patients undergoing maintenance hemodialysis (HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in these patients. This study was conducted to evaluate the effectiveness of nutrition education at improving nutritional status of 23 Korean HD patients (mean : 48.6 $\pm$ 10.4 years, men : 8, women : 15). Anthropometric indices, nutrient intakes, and biochemical blood indices were measured before and after a 6-month nutrition education intervention. Anthropometric indices such as percent ideal body weight [PIBW (%)], body fat, body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and calculated arm muscle area (CAMA) of subjects were within the normal range and not changed by nutrition education. Subjective global assessment (SGA) was significantly increased (p < 0.05) after nutrition education. Intake of total energy, carbohydrate, lipid, Ca, and vitamin B1 was increased significantly (p < 0.05) but intake of phosphorus, potassium, and sodium was decreased (p < 0.05). The serum concentrations of albumin, total protein, and Ca were significantly increased (p < 0.05), but levels of P and K were decreased (p < 0.05) after the intervention. These findings suggest that nutrition education for HD patients can be effective for positively changing nutrient intakes, leading to improvements in blood indices and nutritional status.

• Journal of Nutrition and Health
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• v.33 no.5
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• pp.540-547
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• 2000

The present study was conducted to document North Korea's long standing food shortage situation and to evaluate the devastating effects of its recent food crisis on the already poor health and nutritional state of the people in North Korea. We analyzed the mail survey data on food consumption patterns and anthropometry of 109 North Korean defectors, male, aged 20 years and older, who resettled in the South during the period of 1988-1999. The result of our survey data indicated that during 1988-1993 when North Korea's food supply was not yet emerged as a serious problem, food and nutrient intake of North Korean defectors was estimated to be significantly lower that the recommended intake levels for maintenance. Energy and protein intake of subjects who defected further with the recent food crisis. For subjects who defected after 1994, the total and animal food intakes were reduced to 67% and 25%, respectively, of the amounts consumed by those who defected in the period of 1988-1993, and their energy and protein intake was decreased by 27% and 30% to the level of 1,181kcal and 40g. Regardless of the time of defection, the mean height and body weight of defectors was significantly lower than that of South Korean reference men. The prevalence of infectious diseases and malnutrition signs was higher among defectors who resettled in the South after 1994 compared to those who resettled during 1988-1993.

• Archives of Pharmacal Research
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• v.27 no.7
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• pp.693-712
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• 2004

The rats with protein-calorie malnutrition (PCM, 5％ casein diet for a period of 4-week) were reported to exhibit 60 and 80％ suppression in the hepatic microsomal cytochrome P450 (CYP) 1 A2 and CYP2C11 levels, respectively, and 40-50％ decreases in CYP2E1 and CYP3A 1/2 levels compared to control (23％ casein diet for a period of 4-week) based on Western blot analysis. In addition, Northern blot analysis showed that CYP1 A2, CYP2E1, CYP2C11, and CYP3A1/2 mRNAs decreased in the state of PCM as well. Hence, pharmacokinetic changes of the drugs in rats with PCM [especially the area under the plasma concentration-time curve from time zero to time infinity (AUC) changes of metabolite(s)] reported from literatures were tried to explain in terms of CYP isozyme changes in the rats. Otherwise, the time-averaged nonrenal clearance ($CL_{NR}$) of parent drug was compared. Pharmacokinetic changes of the drugs in other types of malnutritional state, such as kwashiorkor and marasmus, in both human and animal models were also compared. The drugs reviewed are as follows： diuretics, antibiotics, anticancer agents, antiepileptics, antiarrythmics, analgesics, xanthines, antimalarials, and miscellaneous.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.90-99
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• 2021

Purpose: Nutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool. Methods: Retrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool. Results: There was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital. Conclusion: The moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.