• Nuclear Medicine and Molecular Imaging
• /
• v.40 no.6
• /
• pp.327-331
• /
• 2006

Purpose: Aspiration scintigraphy is a procedure of nuclear imaging to evaluate aspiration and of quantifying the amount of aspirate. The ultimate goal of our study is to define the correlation between aspiration and aspiration pneumonia by aspiration scintigraphy and this is a preliminary report of its trial. Materials and methods: Ten patients with positive findings by videofluoroscopy were selected. The patients ingested semi-solid food containing Tc-99m tin colloid 92.5 MBq (2.5 mCi) and images were acquired immediately after the ingestion and 3 hrs later. A fraction of aspiration to the ingested was calculated using an equation with a decay correction. Results: Five patients were interpreted positive by aspiration scintigraphy. Four patients were positive at initial images and the fractions of aspiration were 0.11%, 0.11%, 0.81%, and 0.11%. The one patient who was shown aspirated at both images had initial 5.82% and delayed 2.26%. Conclusion: Aspiration scintigraphy enables us to localize the aspiration at any desired time of the test and to quantify its amount. Follow-up studies are warranted.

• Korean Journal of Community Nutrition
• /
• v.26 no.4
• /
• pp.280-295
• /
• 2021

Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Korean Journal of Community Nutrition
• /
• v.27 no.3
• /
• pp.205-222
• /
• 2022

Objectives: This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated. Results: Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI. Conclusions: NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Journal of Industrial Convergence
• /
• v.21 no.6
• /
• pp.37-42
• /
• 2023

This study aimed to examine the safety of HemoHIM, a dietary supplement containing methoxsalen. HemoHIM is a dietary supplement marketed globally, and a competitor to ginseng. It has been reported to contain methoxsalen, a plant extract for treating psoriasis and vitiligo. Methoxsalen is known to cause hepatotoxicity, but most of the cases has been reported from ingestion as a drug, not a food. There are no reports of hepatotoxicity from the consumption derived from natural products such as Angelica gigas, Cnidium officinale, and Paeonia lactiflora, which are the main ingredients in the HemoHIM. However, a recent case of acute hepatitis was reported in Hong-Kong after ingestion of HemoHIM. It is difficult to conclude that hepatitis was caused by HemoHIM, because there was no check of co-occurring medications with a higher risk of hepatotoxicity, no description of the progress, no quantitative comparison of methoxsalen in HemoHIM to it in common foods such as carrots and celery, and no description of the patient's underlying diseases. On the other hand, there was a study that suggest hemoHIM is safe, and that study had adequate number of subjects even though more studies are needed to ensure safety.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.7 no.3
• /
• pp.429-440
• /
• 2000

The purpose of this study was to validate self care outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 103 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not at all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follows : 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Self care: Toileting' attained an OCV score of 0.884 and was the highest OCV score among self care outcomes. 3. 'Self care: Oral Hygiene' attained an OCV score of 0.756 and was the lowest OCV score among self care outcomes. 4. 'Self-care: Activities of Daily Living (ADL)' attained an OCV score of 0.845 and the highest indicator was 'eating'. 5. 'Self-care: Bathing' attained an OCV score of 0.810 and the highest indicator was 'washes body'. 6. 'Self-care: Dressing' attained an OCV score of 0.831 and the highest indicator was 'buttons clothing'. 7. 'Self-care: Eating' attained an OCV score of 0.815 and the highest indicator was 'chews food'. 8. 'Self-care: Grooming' attained an OCV score of 0.833 and the highest indicator was 'combs or brushes hair'. 9. 'Self-care: Hygiene' attained an OCV score of 0.823 and the highest indicator was 'washes hands'. 10. 'Self-care: Insrumental Activities of Daily Living(IADL)' attained an OCV score of 0.776 and the highest indicator was 'uses telephones'. 11. 'Self-care: Non-Parenteral Medication' attained an OCV score of 0.796 and the highest indicator was 'identifies medication'. 12. 'Self-care: Parenteral Medication attained an OCV score of 0.810 and the highest indicator were 'identifies medication' and 'administers medication correctly'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

• Journal of the Korean Dietetic Association
• /
• v.2 no.2
• /
• pp.112-122
• /
• 1996

This study was designed to provide data useful for the efficiency of dietitians' nutrition care by evaluating medical staffs' perception of nutrition in a hospital. The datas were collected through a questionnaire survey conducted upon 874 medical staffs at 50 general hospitals , each one with more than 100 beds, in Seoul and Pusan. A logistic regression analysis was used to determine the influential factors of medical staffs' perception about nutrition among the selected variables. As a result, most medical staffs(96.9%) had positive perceptions about the importance of nutrition as a medical therapy. However, more than half of the respondents(69.1%) said that the dietary department plays the auxilliary role of producing patients' meals according to diet prescriptions. 271% of the medical staffs perceived that the dietary department as contributor to patient's health care through involvement in medical nutrition therapy, while 4% of the medical staffs misunderstood the dietary department as part of the hospital administration. The results of logistic regression analysis showed that factors related to hospital size and dietitian manpower( Total No. of beds, No. of beds per dietitian) have more influence upon medical staffs' perception about nutrition than their personal and occupational characteristics(P (0.001). In case where medical staffs' perceptions were more positive, the efficiency of dietitians performing nutrition care was higher. Results of this study suggests optimal dietetics staffing as a way to increase the efficiency of nutrition care in a hospital.

• Journal of Acupuncture Research
• /
• v.19 no.4
• /
• pp.208-224
• /
• 2002

Objective : Gastic cancer has become major cancers which cause nausea, vomiting. Especially patients with terminal stage of gastric cancer may suffer from nausea, vomiting and other symptoms that can keep patients from taking medicine or food. In those cases, there may be no use of taking herbal medicine to treat or palliate symptoms. So we wanted to know the potential efficiency of Acupuncture and Moxibustion whether they could control the symptoms of terminal stage of Gastric cancer without herbal medicine. Methods : Under the assumption that Acupuncture and Moxibustion may be effective for palliating nausea, vomiting on terminal stage of Gastric cancer, the following points were administrated SaGwan(Hapkok($LI_4$), Taechung($LR_3$)), Chok-Samli($ST_{36}$), Kongson($SP_4$), Naegwan($PC_6$) for Acupuncture, Chungwan($CV_{12}$) for Moxibustion. This observation was carried out on 11 patients with terminal stage of Gastric cancer. We reviewed medical records, specifically intake/output check with vomiting, nausea. Results : After therapy of Acupunture and Moxibustion, there were 22% of complete responses, 46% of major responses and 32% of failures. Therapy resulted in 2 cases of goodness, 4 cases of fairness, 5 cases of badness as satisfaction degree. Unfortunately 2 cases of badness expired. Conclusion : We have concluded that Acupunture and Moxibusiton therapy were effective to palliate the nasea, vomiting of terminal Gastric cancer. So if Gastric cancer develop difficulties of taking medicine with patients, to consider using the methods of Acupunture and Moxibution is worthy to palliate the nausea, vomiting and so on.

• The Korea Journal of Herbology
• /
• v.22 no.4
• /
• pp.1-8
• /
• 2007

Objectives : There are many causes that may affect efficacy of a drug but the time of administration for the Herbal Medicine is among the most important factors. Traditionally, administration of medicine was prohibited during the meal time along with food and the time of administration has been highly regarded in medical practitioners. The rules of administration time are stated in a book titled, "Materia Medica" but it lacked the details and index. Thus, the systemized administration rules for Herbal Medicine were prepared. Methods : The rules were drawn from both ancient teachings and the experiences from modern clinics. Ancient teachings about the administration are focused on treatment of a disease by utilizing biorhythm of the body in accordance of changes in Yin and Yang and Day and Night. Results : It means the medicine should be prepared and administered at the appropriate time of the day and this type of administration method is thought to be superior to the western method such as "once a day" or "twice a day in the morning and evening" that does not take consideration of cold, hot, warm and cool properties of the medicine. If the prescription is assigning appropriate medicine, administration time is an important method of maximizing drug efficacy. Conclusion : With the ancient teaching in mind, it was concluded that, the drug administration time must be determined with regard to properties of the drug and the condition of the patient.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.46.1-46.7
• /
• 2016

Background: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction. Methods: A total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life. Results: Five male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required. Conclusions: Osteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.

• Biomolecules & Therapeutics
• /
• v.13 no.2
• /
• pp.65-77
• /
• 2005

Present article reviews about clinical pharmacology of mycophenolic acid (MPA), the active form of mycophenolate mofetil (MMF), as widely used component of immunosuppressive regimens in the organ transplantation field. MMF, used alone or concomitantly with cyclosporine or tacrolimus, has approved in reducing the incidence of acute rejection and has gained widespread use in solid organ such as kidney, heart and liver transplantation. The application of MPA and development of MMF has shown a considerable impact on immunosuppressive therapy for organ transplantation as a new immunosuppressive agent with different mechanism of action from other drugs after early 1990s. In particular aspect, use of MMF, a morpholinoethyl ester of MPA, represented a significant advance in the prevention of organ allograft rejection as well as allograft and patient survival. In considering MMF clinical data, it is important to note that there is a strong correlation between high MPA area under curve(AUC) values and a low probability of acute allograft rejection. Individual trials have shown that MMF is generally well tolerated and revealed that MMF decreased the relative risk of developing chronic allograft rejection compared with azathioprine. Recent clinical investigations suggested that improved effectiveness and tolerability will results from the incorporation of MPA therapeutic drug monitoring into routine clinical practice, providing effective MMF dose individualization in renal and heart transplant patients. Therefore, MMF has a selective immunosuppressive effect with minimal toxicity and has shown to be more effective that other agents as next step of immunosuppressive agents and regimens that deliver effective graft protection and immunosuppression along with a more favorable side effect.