• Journal of the Korean Dietetic Association
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• v.4 no.1
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• pp.65-75
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• 1998

Recently, the number of patients who received Bone Marrow Transplantation(BMT) has been increased dramatically and the diseases for which BMT if efficacious are increasing. Adequate nutritional card for BMT patients is crucial for the success of BMT because nutritional deficiency could provoke deteriorative effects. However, little is known about nutritional status among BMT patients in Korea. This study was conducted to assess oral and parenteral intake of BMT patients and compare the change of nutritional status before and after BMT. Twenty-two BMT patients who were admitted to the Severance hospital from December in 1995 to September in 1997 participated in the study. Total calorie requirements were calculated for each patients individually and nutritional support for each patients consisted of oral and parenteral feeding. To assess oral intake of BMT patients, each patients recorded the amount of food they have eaten from 6 days before BMT to 28 days after BMT. The medical records of each patients were used to assess parenteral intake. To compare the nutritional status before and after BMT, the results of anthropometric and biochemical test from 14 days before BMT to 28 days after BMT were used. At the time of admission, the patients were in allowable nutritional status and their total calorie intake was 93% of total calorie requirement. When the preparative regimen for BMT was started, the patients' oral intake was dramatically decreased below 400kcal/day. Even though their oral intake was increased after BMT, their oral intake at the 4th week after BMT was only 752kcal/d, which is only 35.8% of total calorie requirement. The patients' mean oral intake during BMT period (from 6 days before BMT to 28 days after BMT) was only 439kcal/d. Although Total Parenteral Nutrition(TPN) was added when the preparative regimen was started, the patients' mean total caloric intake during BMT period was 111% of basal energy expenditure and 83% of total calorie requirement. The mean total protein intake was only 58% of total protein requirement. In the comparison of nutritional status between pretransplant phase and posttransplant phase in BMT patients, their body weight and serum albumin level were significantly decreased(p<0.001). These results show inadequacies in nutritional intake among BMT patients, and indicate the need of TPN during BMT period.

• Journal of Nutrition and Health
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• v.25 no.6
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• pp.461-467
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• 1992

Although intravenous fat emulsions are well accepted as a consituent of a total parenteral nutrition regimen it is still controversial how much it can be used and who to use it in consideration of physical situation of useres. In this study the effect of two marketed lipid formulas on serum lipids change was investigated. Each lipid formula was injected to twelve normal adult volunteers and a set of blood samples was drawn at 5 minute interval during the experiment. Changes of triglycerides. free fatty acids free glycerol total cholesterol and phospolipids in the serum wre determined. To calculate serum lipids clearance the phar-macokinetics of serum triglyceride fractional removal rate(k) and half-life time(t/2) were calculated using intravenous fat tolerance-test(IVFTT) None of the parameters determined in this experiment was statistically different between two marketed formulas. In summary the bolus injection of the lipid formulas did not produce any adverse effects and their elimination kinetics from the blood stream were similar.

• Neonatal Medicine
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• v.15 no.2
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• pp.190-195
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• 2008

Cholelithiasis is rarely recognized in children, especially in infants. Hemolytic disorders, long-term total parenteral nutrition (TPN), congenital anomalies of the biliary tree leading to stasis of bile flow, congenital IgA-deficiency, furosemide treatment, and prolonged fasting have been reported as predisposing factors for cholelithiasis in childhood. Hemolytic disease of the newborn due to anti-E has rarely been reported as a risk factor for cholelithiasis. We report a case of gallbladder stones in a neonate associated with anti-E antibody hemolytic disease.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.953-959
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• 2005

Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.972-976
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• 2006

Purpose : The purpose of this study was to evaluate the effect of amino acid mixtures on incidence and severity of total parenteral nutrition associated-cholestasis(PNAC) in very low birth weight infants. Methods : Retrospective review of 63 very low birth weight infants(birth weight ${\leq}1,500g$) who received total parenteral nutrition(TPN) in our neonatal intensive care unit from January 2000 to December 2004 was performed. Patients were divided into 2 groups : Group I(n=32, Jan 2000-Jun 2002) and Group II(n=31, Jul 2002-Dec 2004), where infants in Group II received taurine and glutamic acid-rich amino acid mixtures. PNAC was defined as serum direct bilirubin(DB) level greater than 2.0 mg/dL. The incidence and severity of PNAC were compared between these groups. Results : The incidence of PNAC was significantly lower in Group II than in Group I(21.9% vs 6.5%, P<0.148). Maximum and mean DB levels were also significantly lower in Group II(P<0.05). Conclusion : The incidence and severity of PNAC in very low birth weight infants may be reduced with different composition of amino acid mixtures in TPN. Further prospective randomized controlled studies are needed to determine an ideal composition of acid mixtures to prevent the development of PNAC.

• Journal of Gastric Cancer
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• v.2 no.1
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• pp.20-25
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• 2002

Purpose: Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity due to trauma or to an obstruction on the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. It is frequently reported after retroperitoneal dissections and results in high morbidity and mortality. However, there have been few report of such a complication following a radical gastrectomy. Therefore, we review the clinical analysis and treatment of chylous ascites based on our experience. Materials and Methods: From July 1992 to June 2001, we treated 13 cases of chylous ascites after operations for gastric cancer. We reviewed medical charts of those patients retrospectively. Results: The incidence of chylous ascites after operations for gastric cancer was $0.83\%$ (13/1552). The mean time from ingestion of a meal after the operation to the development of symptoms was 2 days (range: $1\∼6$ days). Conservative treatment by fasting, total parenteral nutrition (TPN), and repeated paracentesis was successful in all patients. The mean time from diagnosis to complete resolution was 25 days (range: $2\∼105$ days). Conclusion: Chylous ascites should be considered in any patient with a typical milky color of drainage who has recently undergone radical gastrectomy. Treatment with fasting, TPN, and repeated paracentesis usually is successful.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.586-595
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• 2023

An umbilical venous catheter (UVC) is commonly placed for central venous access in preterm or critically ill full-term neonates to provide total parenteral nutrition (TPN) and medication. However, UVCs can result in complications, including infection, portal vein thrombosis, and hepatic tissue injury. The inadvertent administration of hypertonic fluid through a malpositioned UVC can also cause hepatic parenchymal damage with mass-like fluid collection that simulates a tumorous condition during imaging. Ultrasonography and radiographic examinations play an essential role in detecting UVC-related complications. This pictorial essay aims to present the imaging findings of UVC-related hepatic complications in neonates.

• Clinical and Experimental Pediatrics
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• v.45 no.7
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• pp.847-854
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• 2002

Purpose : Long term hospitalized infants in neonatal intensive care units(NICUs) are prone to systemic infection. It is important to differentiate systemic candidiasis from systemic bacterial infection early in the course. Thus, in this study, we have compared clinical characteristics of systemic candidiasis and systemic bacterial infection, in premature low birth weight infants. Methods : Retrospective chart review of the medical records of 20 patients with systemic candidiasis and 23 patients with systemic bacterial infection was performed. Results : Among the risk factors of systemic candidiasis, total parenteral nutrition(TPN), the use of broad spectrum antibiotics, central catheter insertion, endotracheal intubation and the use of H2 blockers were more frequent in neonates with systemic candidiasis than neonates with systemic bacterial infection. Apnea with bradycardia developed more frequently in neonates with systemic candidiasis compared with systemic bacterial infection(75% vs 39%). In laboratory findings at symptom onset, seven cases(35%) of systemic candidal infections and two cases(9%) of systemic bacterial infections showed leukopenia and thrombocytopenia(P=0.03). Blood was the most frequent isolation site of candida and bacteria. Conclusion : In neonates with systemic candidiasis, apnea with bradycardia, pneumonia and thrombocytopenia were prone to develop more frequently. The use of TPN, antibiotics and central catheters was strongly associated with systemic candidiasis. Empirical treatment with antifungal agent should be considered in critically ill neonates with above findings.