• Title/Summary/Keyword: marasmus

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Pharmacokinetic Changes in Drugs during Protein-Calorie Malnutrition: Correlation between Drug Metabolism and Hepatic Microsomal Cytochrome P450 Isozymes

  • Lee, Joo-Hyun;Suh, Ok-Kyung;Lee, Myung-Gull
    • 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.

Marasmus and Kwashiorkor by Nutritional Ignorance Related to Vegetarian Diet and Infants with Atopic Dermatitis in South Korea (아토피피부염 영아의 영양장애 사례보고와 채식주의에 관한 고찰)

  • Chung Sang-Jin;Han Young Shin;Chung Seung Won;Ahn Kang-Mo;Park Hwa Young;Lee Sang Il;Cho Young Yeun;Choi Hye Mi
    • Journal of Nutrition and Health
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    • v.37 no.7
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    • pp.540-549
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    • 2004
  • Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

Marasmus and Kwashiorkor by Nutritional Ignorance Related to Vegetarian Diet and Infants with Atopic Dermatitis in South Korea

  • Chung, Sang-Jin;Han, Young-Shin;Chung, Seung-Won;Cho, Young-Yeun;Ahn, Kang-Mo;Park, Hwa-Young;Lee, Sang-Il;Park, Hye-Mi
    • Proceedings of the KSCN Conference
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    • 2004.05a
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    • pp.415-416
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    • 2004
  • Infants and children with food related Atopic dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea.(omitted)

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A Case of Viral Encephalitis (바이러스성 뇌수막염(Viral Encephalitis) 후유기(後遺期) 환아(患兒) 1례(例)에 대한 증례(症例))

  • Kim, Ki-Hoon;Shin, Dong-Gil;Kim, Deog-Kon
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.1
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    • pp.9-19
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    • 2002
  • Viral Encephalitis are a serious meningeal infection occurred by various chemical substance. Chief symptoms are headache. hyperesthesia in child and fretting. irritation in infant. Adolescence complain of a retrobulbar pain, fever, vomiturition, photophobia. Fever can cause choreic movement, mental disorder and seizure. Most of patients have complete recovery, but if there are brain lesions, it is bad prognosis. Occasionally patients complain of continuous headache, mental disorder, ataxia and marasmus. We report on a 4-year-old male patient with viral encephalitis. It has been 40 days since disease. He had disorientation mentality, dysphagia and fever.

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The Effect of Total Parenteral Nutrition on Hospitalized Patients according to Nutritional Status (입원 환자의 영양상태에 따른 TPN(Total Parenteral Nutrition) 공급 현황 및 TPN 공급 효과 비교)

  • 배제헌;김순경
    • Korean Journal of Community Nutrition
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    • v.8 no.4
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    • pp.574-583
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    • 2003
  • The purpose of this study was to investigate the anthropometry, biochemical parameters and electrolytes concentrations of the Total Parenteral Nutrition (TPN) patients according to their nutritional status at the time of admission. Thirty-three patients in the Intensive Care Unit at S University Hospital were the subjects of this study. Their nutritional status was classified as At-risk I (Mild PCM, n = 13), At - risk II (Moderate PCM, n = 9) and At-risk III (Marasmus + kwashiorkor + severe PCM, n = 11) . Anthropometeric, biochemical and dietary assessments were performed. The Patients intake of calories (75.02%) and protein (53.15%) was insufficient compare with Korean RDA requirements. The body weight and the Body Mass Index (BMI) in the At-risk III group were significantly lower than in the other groups. The percentage of body weight loss and change of body weight (kg) were significantly higher than in the other groups. The subjects were malnourished as indicated by nutritional related parameters such as serum total protein, albumin, total lymphocyte count (TLC), hemoglobin and hematocrit. Serum total protein, albumin and TLC levels were lower at the time of admission before TPN administration. But after TPN administration, they increased. The electrolyte concentrations did not show any differences following TPN administration. The nutritional status of the patients could be affect by the duration of TPN administration and the number of days of the patients hospitalization. The patients who require nutritional support need the continuous follow-up care and monitoring by a nutritional support team. (Korean J Community Nutrition 8(4) : 574-583, 2003)

A Case of Intestinal Tuberculosis with Protein-calorie Malnutrition (단백질-칼로리 영양 실조를 동반한 장결핵 1례)

  • Song, Joon Sup;Park, Ji He;Chung, So Chung;Kim, Kyo Sun
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.222-228
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    • 2001
  • The frequency and severity of intestinal tuberculosis are decreased due to socioeconomic development, pasteurization of milk and more effective anti-tuberculous chemotherapy. But in recent year, HIV-infected patients are known to be at high risk of developing tuberculosis. The pathogenesis of intestinal tuberculosis is dependent on a immune state and nutritional status of the patient, the tuberculosis amount of sputum and tuberculosis toxicity. The diagnosis of intestinal tuberculosis is usually difficult because of non-specific clinical features and radiological signs. Chronic diarrhea in intestinal tuberculosis is able to produce a malnutrition, marasmus, kwashiorkor or the combined form. The treatment is anti-tuberculous chemotherapy for 12~24 months, but operation should be considered to intestinal perforation, obstruction, fistula formation and massive bleeding. The study about kwashiorkor in intestinal tuberculosis is rare in recent years, we should remind that tuberculosis is still prevalent disease in Korea. We report a ten year-old boy with ileocecal tuberculosis who presented with kwashiorkor, severe malnutrition with review of literature.

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The antidiabetic effects of an herbal formula composed of Alnus hirsuta, Rosa davurica, Acanthopanax senticosus and Panax schinseng in the streptozotocin-induced diabetic rats

  • Hu, Weicheng;Yeo, Jin-Hee;Jiang, Yunyao;Heo, Seong-Il;Wang, Myeong-Hyeon
    • Nutrition Research and Practice
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    • v.7 no.2
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    • pp.103-108
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    • 2013
  • A folk prescription consisting of Alnus hirsuta, Rosa davurica, Acanthopanax senticosus and Panax schinseng has been used in the treatment of diabetes mellitus. The aim of the present investigation was to evaluate the antidiabetic effects of the herb formula extract (HFE) composed of Alnus hirsuta, Rosa davurica, Acanthopanax senticosus and Panax schinseng in the streptozotocin (STZ)-induced diabetic rats. The HFE was mixed in the food supply of the healthy and STZ-induced diabetic male Sprague-Dawley rats, and its effects on the body weight, water and food intake, hyperglycemia, hypolipidemic and islet structure were studied. The treatment of the rats with STZ for 6 weeks resulted in marasmus, polydipsia, polyphagia, hyperglycemia and hypoinsulinemia. In addition, the diabetic rats showed an apparent decrease in the insulin immunoreactivity and the number of ${\beta}$-cells in the pancreas. The addition of the HFE to the rats' food supply significantly lowered the serum glucose and the serum triglycerides level and preserved the normal histological appearance of the pancreatic islets. These results indicate that the HEF have a strong antidiabetic potential along with the significant hypoglycemic and hypolipidemic effects, which may be applicable in the pharmaceutical industry.

Investigation of the Transforming Theories of Diseases and the Need of Teaching Them in the Pathology Class (동의병리학에서의 병리전변이론(病理傳變理論) 고찰 및 교육의 필요성)

  • Chi Gyoo-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.5
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    • pp.1105-1111
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    • 2005
  • In order to investigate the meanings and bases of transforming theories of diseases(病傳論), several relevant theories were collected from medical books since . The outside-to-inside changing process(pyoree jeon) was the fundamental pattern in febrile diseases regardless of slang han and wen bing after Han dynasty. But in case of numb disease the three exogenous pathogenic factors of wind, cold and dampness got into each viscera through five tissues like skin, vessesl, flesh, tendons, bones respectively. It was called corresponding changing process(sanghap jeon) here. The pathogenic changing process(byungsa jeon) had complicated details to explain pathologic processes, but could give useful informations on evaluating relative strength of pathogens and tendency ahead. The changing process of diseases of internal injuries were explained in case of emotional distress which is outbroken abruptly didn't follow regular order of viscera-emotion relations. So it was named random changing process(bulcha jeon) after 's usage. And marasmus and asthenic disease followed top-to-down or down-to-top changing process(sangha jeon) based on . There are many types of changing process of diseases between viscera and viscera or viscera and bowels like generation changing process, restriction changing process, changing process between couple, changing process of mutual transmission based on attributions of each element by the theory of 5 phases(五行論). And changing process to a neighbor doesn't have any special relations within two organs but has anatomical contiguity and physiological continuity between them. The transforming theories of diseases bring forth useful understanding on comings and goings of pathogenic factors and tendency and prognosis of disease, so they are needed to be taught in the course of pathology class.

Current Status of Symptom and Pain Control in Cancer Patients Treated with Chemotherapy (화학요법을 받는 암환자의 증상 및 통증조절 현황)

  • Chung, Young;Na, Duck-Mi;Kim, Jin-Sun;Yang, Kyung-Mi
    • Journal of Hospice and Palliative Care
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    • v.6 no.2
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    • pp.144-151
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    • 2003
  • Purpose : The purpose of this study was to identify the current status of symptom and pain control in cancer patients treated with chemotherapy. Methods : The study population consisted of 66 cancer patients treated with chemotherapy and the data was collected by chart audit and using questionnaire from 19 clinicians in an university hospital during the period of August 7 to 24, 2001. The degree of symptom, analgesics type, dose, administration route, and pain control method of cancer patients treated with chemotherapy was investigated. The collected data were analyzed by frequency, percent, mean, and SD using SPSS $PC^+$ program. Results : The number of cancer patients treated with chemotherapy was 66, male 35 (53.0%), female was 31 (47.0%). The largest of age group was $61{\sim}69$(34.8%) years old. Most frequent cancer site was stomach 19 case (28.8%), cole-rectal 17 case (25.8%), urinary 11 case (16.7%) in the respective order. The most common stage of cancer was stage 3, 14 case (29.2%). The most frequent duration of diagnosis was under 3 month, 25 (37.9%). The frequent symptom of cancer patients treated with chemotherapy was marasmus ($2.4193{\pm}1.2220$), pain ($1.9333{\pm}1.2194$), sleep disorders ($1.7142{\pm}1.0384$), personality change ($1.5806{\pm}0.8971$) in the respective order. 3) The analgesics used for pai control were narcotic analgesics 66.2% and nonnarcotic analgesics 33.8%. Pain control method were regular basis+as needed 47.4%, as needed 31.6%, regular basis 21.0% in order. Administration route were oral 50.7%, injection 41.8%, patch 7.5% in order. Conclusion : The most frequent symptom of cancer patients treated with chemotherapy were marasmus and pain. The frequent analgesics was narcotic analgesics but 21% of the clinician regularly prescribed analgesics for pain control. Thus this prescription was insufficient for pain control. Administration route that were used more oral or injection than patch. Based on this evidence, it seemed that more active practice and education about evaluation and pain control of cancer patients treated with chemotherapy are needed.

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