• Nutrition Research and Practice
• /
• v.9 no.6
• /
• pp.637-643
• /
• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• Journal of Nutrition and Health
• /
• v.6 no.2
• /
• pp.17-24
• /
• 1973

The function of the liver is so complicated and important that various Hepatic diseases are occured due to functional retardation of liver. Above all, the incidence of Hepatitis and liver cirrhosis among Koreans has shown an increasing tendency recently. 113 cases of Hepatitis and 125 cases of liver cirrhosis which had been admitted, more than 10 days, to KOREA Hospital between November, 1968 and July,1972, were studied through clinic charts. (A) Hepatitis 1) of the 113 cases; 54 cases (47.7%) were Infectious hepatitis; 40 cases (35.4%) were chronic hepatitis 2) of the 113 cases ; 80 cases (70.8%) were male and 33 cases (29.2%) were female; the sex ratio was 2.4 : 1 The ages of the onset of the disease was as follows; 34 cases (30.1%) were among $30{\sim}40$. 3) Patients had abdominal pain (77.9%) anorexia (66.4 %) and general weakness(82.3%) as symptom and jaundice (94.7%) hepatomegaly (76.1%) as sign 4) 57 cases of all had complication 26 cases (45.6%) were parasite, 12 cases (21.1%) were diabeties mellitus. 5) 99 casea (87.6%) of all were improved and recovered. (B) Liver Cirrhosis 1) Etiologic factors are hepatitis (56cases) and alcoholics (28 cases). 2) of the 125 cases, 84 cases (67.2%) were male and 41 cases (32.8%) were female; the sex ratio was 2 : 1 The age of the onset of the disease was as follows; 47 cases (37.6%) were among 41-50. 3) Patients had symptoms: indigestion (64.8%), Abdominal pain (60%), general wenkness (35.2%) and signs; Hepatomegaly (61.6%) Ascites (59.2%), Jaundice(56.8%). 4) 107 cases of all had complications; Hepatic coma was 20 cases (18.7 %), Ascites was 16 cases (15.0%). 5) 69 cases (55.2%) were improved. (c) Treatment of Hepatitis and cirrhosis. 1) Absolutely (bed) rest. 2) A well-balanced diet adequate in calorie value, showed be given (High Carbohydrate, High Protein, High vitamin diet) if the patient's appetite is good and easily digested. 3) Drugs; (1) Vitamins (2) Digestants (3) Tranquize

• Journal of Nutrition and Health
• /
• v.39 no.7
• /
• pp.641-648
• /
• 2006

This study was designed to evaluate the effect of the individual nutrition education for type 2 diabetes who participate the diabetes buffet. The subjects were 66 patients and divided into education (n=34) and control groups (n=32). The mean age of education and control groups were 59.8 and 56.6 years old, respectively. There were no differences in age and body mass index (BMI) between two groups. Initial glycosylated hemoglobin (HbA1c), post prandial plasma glucose (PP2), total plasma cholesterol, and blood pressure were not different between two groups. But fasting blood sugar (FBS) was higher in education group than in control group. On completion of the study, the education group showed significant decreases in body weight, BMI, FBS and PP2, however, the control group showed no changes in body weight, BMI and PP2, and showed a significant increase in FBS. Initial calorie and protein intakes of the education group did not meet the prescribed amount, however, mineral and vitamin intakes were higher than estimated average requirement (EAR). By the end of study, calorie and protein intakes were significantly increased to meet the prescription. In order to evaluate the effect of diet education, awareness of calorie requirement was used as an index of understanding diet prescription. The degree of awareness of calorie requirement was dependent on age: younger patients showed higher awareness than older subjects. The subject who showed better understanding of diet prescription showed lower levels of HbA1c, FBS, and PP2 at the end of the experiment period. The results of this study clearly show that individual diabetes diet education is effective to make the patient understand their diet prescription, and is effective to control body weight and blood sugar level. Awareness of calorie requirement could be used as an index of understanding of prescribed diet. Since age is an important variable to determine the awareness of calorie requirement, different strategies of nutrition education should be developed for different age groups, especially patients over 70 years old.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.8 no.1
• /
• pp.133-138
• /
• 1997

Prader Willi Syndrome(PWS) was first recognized and reported by Prader-Willi. The etiology of the syndrome is not fully understood, but 50-70% of the patients show small deletion in chromosome 15. Manifested symtoms vary according to developmental age. In early life, hypotonia, areflexia, feeding difficulties, hypothermia, microgenitalia, hypoplastic scrotum, cryptochordism were observed. But in several years, hypotonia disappears, and polyphagia, decreased satiety, psychomotor retardation, obesity, hypogonadism and short stature become main problems. Behavioural problems including temper and aggressive outbursts, stealing food, hoarding food, and self excoriating skin picking, trichotillomania are more prominent during adolescence and young adulthood. Also, irritable, depressed mood are described. Lots of psychological and behavioural problems explain the reason why psychiatrists have managed and reported this syndrome. However, there has been no official report of PWS in our country. So authors report the clinical characteristics and issues in management of a patient with PWS.

• Korean Journal of Clinical Pharmacy
• /
• v.25 no.3
• /
• pp.171-177
• /
• 2015

Background: Androgenetic alopecia (AGA), one of alopecias, requires continuous treatment in order to prevent or stop it, and patient's compliance is very important. Currently, only two drugs (finasteride, minoxidil) have been approved for AGA by Food and Drug Administration of United States (US FDA). However, another ${\alpha}-2$ reductase inhibitor, dutasteride, is approved by Korea Ministry of Food and Drug Safety (MFDS) through a phase III trial. For treatment, pharmacotherapy of AGA usually combines topical minoxidil 7% with one of oral <${\alpha}-2$ reductase inhibitor. Objectives: We evaluated the comparative efficacy and adverse effect between topical minoxidil 7%/finasteride 1 mg and topical minoxidil 7%/dutasteride 0.5 mg pharmacotherapy for outpatients with AGA. Also we evaluated the relationship between therapeutic effect and regular hospital visit. Method: This study was performed retrospectively based on electronic medical record (EMR) data of total 98 patients (topical minoxidil 7% with dutasteride 0.5 mg ($Avodart^{(R)}$) or finasteride 1 mg ($Alopecia^{(R)}$, $Propecia^{(R)}$) with diagnosis of AGA from department of dermatology at a secondary hospital from January $1^{st}$, to May $31^{st}$, 2014. Results: The efficacy and adverse event of topical minoxidil 7%/dutasteride 0.5 mg (DUTA group) were 100% and 45.7%, and of topical minoxidil 7%/finasteride 1 mg (FINA group) were 92.1% and 33.3%, respectively. The mean onset time of responses and adverse events in the FINA group were 3.86 months and 4.43 months. Those in the DUTA group were 3.97 months and 5.06 months. Conclusion: Both FINA and DUTA group were highly effective, but the DUTA group showed higher efficacy and adverse effects than those in the FINA group. Dutasteride may be another alternative in AGA treatment.

• Journal of the East Asian Society of Dietary Life
• /
• v.5 no.1
• /
• pp.7-19
• /
• 1995

This study was conducted to evaluate the nutritional status and diabetes management of diabetic patients in the Health Center. General characteristics, food habits, food intakes and the knowledge about diet therapy were investigated from ninety one diabetes subjects. Anthropometric assessment such as weight, hight, triceps skinfold thickness, and biochemical measurement of fasting blood glucose(FBG), post prandial 2 hours blood glucose(PP2), and hemoglobin A1c(HbA1c) were obtained form the subjects. The results were summarized as following : 1. The average of age was 60.9 years old and 83.5% of subjects was illiterate and primary school graduated. 2. Relative Body Weight(RBW) and % body muscle were 96.18${\pm}$13.6 and 33.56${\pm}$7.01%, respectively. Obese subjects whose body weight exceeded 120% of the ideal values were 3.3%. 3. The 86.8% of subjects were managed by oral hyperglycemic agents. 4. The mean of FBG, PP2, HbA1c were 140.75${\pm}$44.43mg/㎗, 7.60${\pm}$1.88%, respectively. 5. The mean daily intake of calorie was 1407㎉, and 73.6% of subjects lower caloric intake than prescribed calorie. when the degree of dietary compliance was expressed as Tunbridge score, 18.7% of total subjects was grouped as satisfactory, where as 20.9% and 60.4% could be considered as tolerable and hopeless, respectively. The nutrients intake were lower than RDA except for Vitamin A and Vitamin C and the ratio of carbohydrate : protein : fat was 72 : 14 : 14. 6. The mean score of knowledge test about diet therapy was 3.52${\pm}$2.19 out of possible 14.00 points. The above results suggested that the most of diabetic patient showed the poor nutritional status and they faced the lack of knowledge about diabetes management.

• The Korean Journal of Food And Nutrition
• /
• v.10 no.2
• /
• pp.186-192
• /
• 1997

Endoscopic diagnosis and medical management from K43 and C45 patients, whose sex, occupation, character and life patterns are quite different each other, were discussed. The K43 was patient with erosive gastritis, which may caused by maldietary habits and life stresses. Although the effective drugs such as H2-receptor antagonists with atacids, H+/K+-pump inhibitors, prokinetics, colloidal bismuth, and sucralfates, were administrated for long time, symptomatic relief of abdominal pain was not improved. The tests of clinical phathology and abdominal sonogram were normal, visceral hypersensitivity was appeared from barostat test of stomach. However C45 had taken headache during every day life, and endoscopically confirmed as a gastric·duodenal ulcer patiant, which may caused by chronic use of NSAIDs. The her ulceric symptoms were suppressed from active stage to healing stage by using combination therapy for H. pylori with traditional antipeptic ulcer drugs, where as amitriptyline was administrated to the K43 but not effective. Nonulcer dyspepsia and irritable bowel syndrome is pooly defined, and affect about 15% of the population annually in U. S. A. but don't seek medical care. Author would like to point out that statistics for visceral pains are absent in Korea.

• Korean Journal of Community Nutrition
• /
• v.16 no.4
• /
• pp.488-496
• /
• 2011

The purpose of this study was to investigate the perception and utilization of Complementary and Alternative Medicine (CAM) for diabetic patients in Busan. The subjects were 227 patients at two general hospitals (over 400 bed). This study was performed through the interviewing process using questionnaires conducted from January to April, 2010. Of a total of subjects, 109 patients (48.0%) had taken CAM at least one time. The patients used CAM recognized that they were 'auxiliary medicines' (39.4%), 'supplementary health foods' (32.1%) and 'medicines' (19.3%), but inexperienced patients perceived them as 'supplementary health foods' (29.6%), 'unscientific treatment' (22.6%) and 'medicines' (20.2%), It was significantly different between two groups of patients (p < 0.001). The number of CAM types used for the patients was 51. The CAM types were plant foods (64.3%), dietary supplement (23.6%) and animal diets (12.1%). The patients used an average of 5.9 different kinds of CAM and an average of 3.8 years them and paid \93,345 per month. The patients with diabetic complications and for longer morbidity periods used CAM for significantly (p < 0.05) longer periods. The mean effectiveness scores of the patients used CAM were 3.31/5.00 for efficacy satisfaction, 3.58/5.00 for fewer side effects compared to those of oral drugs, 3.60/5.00 for psychological stability, 3.81/5.00 for easiness to use, and 3.06/5.00 for economic satisfaction. Of the patients that used CAM, 55.9% did not consult with doctors about CAM. More than two-thirds of the patients (77.1%) did not feel the need to consult with doctors.

• The Korean Society of Law and Medicine
• /
• v.15 no.2
• /
• pp.63-89
• /
• 2014

In 1976, the Dalkon Shield-intrauterine device injured several thousand women in U.S.A. which caused the changes of medical deivce regulation. The Medical Device Regulation Act or Medical Device Amendments of 1976 (MDA) was introduce. As part of the process of regulating medical devices, the MDA divides medical devices into three categories. The class II, and III devices which have moderate harm or more can use the section 510 (k), premarket notification process if the manufacturer can establish that its device is "substantially equivalent" to a device that was marketed before 1976. In 21 U.S.C. ${\S}$ 360k(a), MDA introduced a provision which expressly preempts competing state laws or regulations. After that, the judicial debates had began over the proper interpretation and application of Section 360(k) In February 2008, the U.S. Supreme Court ruled in Riegel v. Medtronic that manufacturer approved by the Food and Drug Administration (FDA)'s pre-market approval process are preempted from liability, even when the devices have defective design or lack of labeling. But the Supreme Court ruled in Medtronic Inc. v. Lora Lohr that the manufactures which use the section 510 (k) process cannot be preempted and in Bausch v. Stryker Corp. that manufactures which violated the CGMP standard are also liable to the damage of patient at the state courts. In 2009, the Supreme Court ruled in Wyeth v. Levine that patients harmed by prescription drugs can claim damages in state courts. This may cause a double standard between prescription drugs and medical devices. FDA Preemption is the legal theory in the United States that exempts product manufacturers from tort claims regarding Food and Drug Administration approved products. FDA Preemption has been a highly contentious issue. In general, consumer groups are against it while the FDA and pharmaceutical manufacturers are in favor of it. This issues also influences the theory of product liability of U.S.A. Complete immunity preemption is an issue need to be more declared.

• The Korean Journal of Food And Nutrition
• /
• v.11 no.2
• /
• pp.165-170
• /
• 1998

Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.