• Title/Summary/Keyword: hospital nutrition department

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Esophagogastirc Anastomosis: Analysis of Postoperative Morbidity and Mortality (위장을 이용한 식도재건술의 합병증)

  • 신화균;이두연;강정신;윤용한;김도형
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.573-578
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    • 1999
  • Background: After an esophageal resection for an esophageal disease, the stomach becomes the most common organ for a substitute. The stomach has the advantages of being simple with fewer complications when used properly. The complications of an esophageal reconstruction using the stomach as the substitute are assessed and discussed. Material and Method: Between 1990 and 1998, 44 patients who underwent esophagogastric anastomosis were treated in the department of Thoracic and Cardiovascular Surgery of Yongdong Severance Hospital, Seoul, Korea. Result: The rate of postoperative complications and mortality in these 44 patients were 70.5% and 13.6%, respectively. The major complications in our series involved the stricture of anastomosis(13.6%), pneumonia(11.4%), and wound infection(9.1%). The most frequent causes of postoperative deaths were pulmonary complications and sepsis(6.8%). Conclusion: Anastomotic leakage is no longer a major complication of an esophagogastrostomy. Most postoperative stricture can be overcome with frequent esophageal dilations. Postoperative pulmonary infection, nutrition, and physiotherapy are very important in reducing the rate of pulmonary morbidity and mortality.

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Posterior Vertical Approach for Sacrococcygeal Teratomas in Children (소아의 천미추부 기형종 수술시 후방종단식 술식의 이용)

  • Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.102-109
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    • 1996
  • Pediatric surgeons are familiar with the posterior sagittal approach to the rectum at sacrococcygeal area and well oriented with the anatomy because of the Penal procedure for imperforate anus. The author utilized the posterior vertical elliptical incisions in 12 cases of sacrococcygeal teratoma since 1987. For presacral tumor(type IV)$^2$, the incision was exactly same as the posterior sagittal procedure for imperforate anus. But the out-growing(type I) or dumbbell-shaped(type II & III) tumors, a vertical elliptical incision was required. For the laterally deviated tumors, a vertical and half-chevron incision was utilized in one case, but an unbalanced vertical elliptical incision was acceptable for the remaining two cases, with shrinkage of the overlying skin. In dumbbell-shaped tumors(type II & III), the narrow waist of the tumor was at the level of the levator muscle, which formed a muscle-belt on the tumor waist. A careful dissection to save the muscle-belt seemed to be the most important point during this procedure, utilizing the nerve-stimulator. After complete removal of the tumor and the coccyx, the levator muscles and the skin were closed in vertical fashion along the midline. For the caudally extending tumors in 3 cases, the muscle complex was divided in midline. Nothing by mouth and total parenteral nutrition was maintained for 1 week and then laxatives were given for 2 weeks in order to give the sphincters rest. Operative scars were acceptable resembling natural vertical midline folds, and the sphincter function was continent in all cases. In conclusion, vertical elliptical incision in sacrococcygeal teratoma is recommended because of the acceptable scar, functional restoration, and because it is a familiar procedure particularly for the pediatric surgeons who are accustomed performing posterior sagittal approach for imperforate anus.

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Clinical Study of Congenital Duodenal Obstruction (선천성 십이지장 폐쇄증의 임상적 연구)

  • Huh, Young-Soo;Lim, Myeung-Kook;Park, Sung-Kyu
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.67-74
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    • 1998
  • Successful management of duodenal obstruction in newborn infant implies not only satisfactory nutrition but also achievement of normal growth. To aid early diagnosis and management, we evaluated the diagnostic methods, operative interventions and clinical characteristics of thirty-nine infants with congenital duodenal obstructions. In the 11-year period from July 1986 through June 1997, thirty-nine patients with congenital duodenal obstruction (23 males and 16 females) were treated and reviewed at the Department of Pediatric Surgery, Yeungnam University Hospital. The ratio of male to female was 1.4:1, and 29 cases(74.1%) among total 39 patients were newborn. There were 5 premature patients and 16 patients of small for gestational age. The most common causes of the congenital duodenal obstruction was malrotation (26 cases, 66.7%) and followed by annular pancreas (9 cases, 23.1 %), type 1 atresia (3 cases, 7.7%) and wind-sock anomaly (1 case, 2.6%). Common symptoms were vomiting, abdominal distention, jaundice. Plain abdominal X-ray study combined with upper gastrointestinal series was the most commonly used diagnostic method. The operative procedures were performed by same pediatric surgeon utilizing Ladd's procedure in 26, duodenoduodenostomy in 8, duodenojejunostomy in 4, excision of wind-sock membrane in 1. A total of 15 associated congenital anomalies were found in 9 patients. Postoperative complications occurred in 13(33.3%). Overall mortality was 2.6%(1/39). Bilious vomiting and plain abdominal radiologic study were most useful for the diagnosis of congenital duodenal obstruction. Early diagnosis and operative intervention were important to prevent complications such as sepsis and peritonitis.

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A Study on the Knowledge-Based T.P.N. System (1) (지식 구조화 경정맥 완전 영양공급 시스템의 개발에 관한 연구 (I))

  • Jeon, Gye-Rok;Choe, Sam-Gil;Byeon, Geon-Sik
    • Journal of Biomedical Engineering Research
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    • v.11 no.2
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    • pp.305-314
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    • 1990
  • In this paper we have implemented and tested TPN which is system to supply sufficent nutrition to nutritionally deficient patient by means of ES (expert system) a kind of A.1 (artificial intelligence) . This system affords to evaluation of nutritional state of patient which is essential to physi- cian. who performs TPN, decision of performing TPN and management of patient-data & calculation of information needing to making TPN fluid. The features were as follolv 1. we input data, take ideal weight of patient and 24hr's creatlnln In urine according to chart in system compare TSF (triceps skin fold), MAC (mid-arm circumference), AMC (arm muscle circumference) to 5th, 15th, 50th percentile and evaluate the nutritional state of patient. 2. Calculation of protein & nonprotein calorie needing to treament of patient can be made exactly by stress factor, activity factor and body temperature. 3. patient's personal recording needing to management of patient date name of chief doc- tor, name of department of admission, chart number, history can by taken very easily. 4. The way of system operating is pull-down Menu one, It can be processing very efficiently. 5. Date processing in system, we can manage memory volume of computer verlr efficiently using of dynamic allocation variables. 6. We can make it very easy to edit & revise the input data, processed data is saved to diskette in 2 files (TDF, THF) , these are semipermanent preservation.

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Analysis of Perceived Levels on Health in Paraguay (파라과이 보건의료분야에 대한 인식수준 실태분석)

  • Lee, Myung-Sun
    • The Journal of Korean Society for School & Community Health Education
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    • v.14 no.3
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    • pp.67-76
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    • 2013
  • Objectives: This study was intended to provide the base of developing countries' Health Partnership Strategy by investigating the Paraguay's awareness level of health and analyzing the actual state. Methods: The data was collected from 11 government employees, 20 hospital staffs, 26 local residents on Asunci$\acute{o} $n, Paraguay in February, 2012. The method of the study was the questionnaires consisting of 62 questions including 7 questions of general features, 3 questions of awareness on maternal health care, child health care, planned parenthood program, 52 questions of awareness on health. The questionnaires was translated into Spanish which is local language in Paraguay. Results: The results of this study are summarized as follows; 1) The most important awareness on maternal healthcare, child healthcare, planned parenthood program was providing child health care. 2) The most important awareness to prevent non-health behavior was sufficient nutrition. The most important awareness to reduce the rate of chronic disease was diabetes. The most important awareness to eradicate communicable disease was HIV/AIDS. 3) The most important awareness to provide healthcare service was vaccination. 4) The most important awareness on healthcare delivery system was policy. The most important awareness on health education was student's health education. 5) The most important awareness to strength healthcare capacity was developing domestic economy. Conclusion: The results of this study suggest that awareness levels on health are high against low health behavior status in Paraguay. But awareness on health can lead to health behavior by healthcare system. Therefore, it has to induce the healthcare network and system by injecting public health funds, infrastructure, human resources on prevention of disease and healthcare management.

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Recent Advance in Pathogenesis and Treatment of Precocious Precocity (사춘기 조숙증의 기전 및 치료의 최신 지견)

  • Park, Mi-Jung
    • Development and Reproduction
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    • v.10 no.4
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    • pp.215-225
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    • 2006
  • Precocious puberty is defined as the appearance of secondary sex characteristics before age 8 years in girls (or menarche before age 9 years) and before 9 years in boys. The age of onset of puberty is progressing to younger age. The pubertal activation of gonadotrophin releasing hormone(GnRH) release requires coordinated changes in excitatory or inhibitory amino acids, growth factors, and a group of transcriptional regulators. A number of factors affecting precocious puberty were explored, including the role of genetic factors, nutrition(body fat) and exposure to endocrine disrupting chemicals. In addition to the psychosocial disturbances associated with precocious puberty, the premature pubertal growth spurt and the accelerated bone maturation result in reduced adult height. Precocious puberty may be gonadotrophin-dependent premature activation of the GnRH pulse generator or gonadotrophin-independent. In rapidly progressing central precocious puberty, GnRH agonists appear to increase final height. However more data on the effect and long-term safety of GnRHa are needed.

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Atrophic Gastritis Concurrent with Helicobacter Infection in Two Dogs

  • An, Su-Jin;Eom, Na-Young;Lee, Hee-Chun;Sur, Jung-Hyang;Park, Chul;So, Kyung-Min;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.33 no.5
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    • pp.286-289
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    • 2016
  • Two dogs (Case 1: Poodle, 4 years old, spayed female; Case 2: Bulldog, 3 years old, intact female) were referred to us for treatment of vomiting; Case 1 had a history of acute vomiting that started 1 day prior to presentation, and Case 2 had a history of chronic vomiting that started 2 years prior to presentation. The vomiting did not respond to medication in the local animal hospital. Results from abdominal ultrasound examinations showed that case 1 had gastric wall thickening, and case 2 had no remarkable findings. For both cases, we performed gastrointestinal endoscopic examinations, and several biopsy samples were obtained from different gastric areas. On the basis of the results of histopathological examinations, both dogs were diagnosed with atrophic gastritis concurrent with a Helicobacter infection. Clinical signs improved after antibiotic therapy. This case report describes the clinical, endoscopic, and histopathological findings of atrophic gastritis concurrent with a Helicobacter infection.

Analysis of the Occurrence of Diseases Following Gastrectomy for Early Gastric Cancer: a Nationwide Claims Study

  • Seo, Ho Seok;Na, Yewon;Jung, Jaehun
    • Journal of Gastric Cancer
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    • v.21 no.3
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    • pp.279-297
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    • 2021
  • Purpose: Various changes in nutrition, metabolism, immunity, and psychological status occur through multiple mechanisms after gastrectomy. The purpose of this study was to predict disease status after gastrectomy by analyzing diseases pattern that occur or change after gastrectomy. Materials and Methods: A retrospective cohort study was conducted using nationwide claims data. Patients with gastric cancer who underwent gastrectomy or endoscopic resection were included in the study. Eighteen target diseases were selected and categorized based on their underlying mechanism. The incidence of each target disease was compared by dividing the study sample into those who underwent gastrectomy (cases) and those who underwent endoscopic resection for early gastric cancer (controls). The cases were matched with controls using propensity score matching. Thereafter, Cox proportional hazard models were used to evaluate intergroup differences in disease incidence after gastrectomy. Results: A total of 97,634 patients who underwent gastrectomy (84,830) or endoscopic resection (12,804) were included. The incidence of cholecystitis (P<0.0001), pancreatitis (P=0.034), acute kidney injury (P=0.0083), anemia (P<0.0001), and inguinal hernia (P=0.0007) were higher after gastrectomy, while incidence of dyslipidemia (P<0.0001), vascular diseases (ischemic heart disease, stroke, and atherosclerosis; P<0.0001, P<0.0001, and P=0.0005), and Parkinson's disease (P=0.0093) were lower after gastrectomy. Conclusions: This study identifies diseases that may occur after gastrectomy in patients with gastric cancer.

The Usefulness of the Evaluation of Gastric Residuals in Premature Infants (미숙아의 장관영양 시 위 잔류 확인의 유용성 평가)

  • Lee, Kyung Min;Choi, Su Jung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.3
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    • pp.74-83
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    • 2019
  • Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI ($X^2=0.38$, p=.540), and NEC ($X^2=1.42$, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.

The Correlation Between Adult Hypercholesterolemia, Abdominal Obesity, Hyperuricemia, and High-Sensitivity C-Reactive Protein (성인의 고콜레스테롤혈증과 복부비만에 대한 고요산혈증과 고감도 C-반응단백의 관련성)

  • Jae-Jung Kim
    • Journal of the Health Care and Life Science
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    • v.11 no.2
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    • pp.417-424
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    • 2023
  • This study aimed to analyze the association between hyperuricemia and hs-CRP in adults with hypercholesterolemia and abdominal obesity, utilizing data from the 7th Korea National Health and Nutrition Examination Survey. The subjects were classified into fourgroups based on hypercholesterolemia and abdominal obesity, and binary logistic regression analysis was conducted. The association between hyperuricemia and hs-CRP wasevident in the abdominal obesity group, with an OR 2.22 (95% CI 2.070-2.395). In thegroup with both conditions, the OR was 2.31 (95% CI 2.032-2.626). Stratified by gender, both conditions showed a higher OR in males 2.29 (95% CI 1.911-2.748), while in females, the abdominal obesity group exhibited a higher OR of 2.44 (95% CI 2.146-2.775), indicating a gender-specific difference. In conclusion, hyperuricemia and hs-CRP in adults with hypercholesterolemia and abdominal obesity demonstrated a significant association, suggesting their role as predictive factors for inflammatory responses.