• Journal of Nutrition and Health
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• v.27 no.8
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• pp.844-855
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• 1994

The purpose of this study is to investigate the nutritional status and dietary intake of gastrectomized cancer patients. For this study, from 1993. 1 to 1993. 8, 50 postoperative gastric cancer patients were selected to examine anthropometric and laboratory data(Body Weight, Body Fat, serum Albumin, Total Lympocyte count), and dietary intake related symptoms. The results were 1) All anthropometric and laboratory data were significantly deteriorated by gastrectomy(s-Albumin, TLC. Body Fat : p<0.001). Weight loss of gastrectomized patients was 8.23$\pm$3.72% from admission to discharge. 2) In many gastrectomized cancer patients, preoperative dietary intake was decreased by abdominal discomfort, indigestion, early satiety, and anorexia. 3) Postoperative energy intake was 602$\pm$158㎉, and it is correspond to 31.18$\pm$.90% of daily energy requirement(1918$\pm$236㎉). The cause of poor oral intake is mostly fear, abdominal distension and fullness, and early satiety. In consideration of the fact that an inadequate energy intake was the main cause of the decreasing nutritional status, a careful nutritional care and dietary education is necessry after gastrectomy.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.31-34
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• 2015

Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.

• Korean Journal of Veterinary Service
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• v.41 no.4
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• pp.221-228
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• 2018

Rumen cannulation is used for nutritional and microbiological research, clinical diagnosis, and rumen component transfaunation. However, the cannulation procedure can affect parameters such as complete blood count findings, serum chemistry, and rumen fluid pH. The objective of this study was to evaluate the health risks related to the rumen cannulation procedure over a 1-month period. We did not identify significant differences in red blood cell numbers or morphologies between pre- and postoperative timepoints. Moreover, no inflammation or infection was detected. Despite the absence of apparent clinical signs after surgery, serum chemistry results revealed changes in blood urea nitrogen levels and the activities of liver enzymes, including aspartate transaminase, lactate dehydrogenase, and creatinine kinase, from postoperative days 1 to 14. Rumen fluid pH, as measured from samples collected via an orogastric tube, was slightly increased after a preoperative fasting period and on postoperative day 1 but decreased thereafter from postoperative day 4, indicating a minor influence of cannulation surgery on ruminal fluid pH. This is the first study to evaluate hematological parameters and rumen pH before and after rumen cannulation surgery in Hanwoo cattle. Further research is required to better elucidate the potential effects of rumen cannulation surgery on animal health.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.6
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• pp.453-460
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• 2022

Purpose: Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is a congenital anomaly that can cause frequent digestive and nutritional problems, even after repair. The most common complication is anastomotic stricture, for which reoperation or balloon dilatation is performed. This study aimed to evaluate the postoperative complications of EA and the role of endoscopic balloon dilatation (EBD) in cases of anastomotic stricture. Methods: We retrospectively analyzed patients diagnosed with EA with or without TEF between January 2000 and February 2021. Patients' baseline characteristics, associated anomalies, and postoperative complications were reviewed. Results: Among 26 patients, 14 (53.8%) were male, 12 (46.2%) had coexisting anomalies, and the median follow-up was 6.1 years (range, 1.2-15.7 years). In univariate analysis, prematurity, low birth weight, and long-gap EA were associated with postoperative complications in 12 (46.2%) patients. Among the 10 (38.5%) patients with anastomotic stricture, nine (90.0%) required EBD. Regarding the first EBD, it was performed at a median of 3.3 months (range, 1.2-7.6 months) post-repair, while the average patient weight was 4.6 kg. The mean diameter ranged from 3.3 to 9.1 mm without major complications. In univariate analysis, long-gap EA alone was significantly associated with EBD. Conclusion: Approximately half of the patients experienced complications after EA repair. In particular, patients with a long-gap EA had a significantly increased risk of complications, such as anastomotic strictures. EBD can be safely used, even in infants.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.79-86
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• 2017

Purpose: Congenital esophageal atresia (CES) is a rare congenital disease. The severity of symptoms is variable; thus, diagnosis is difficult and tends to be delayed. CES is frequently accompanied by esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). We investigated the characteristics of CES by reviewing our experience with CES patients and researched the differences between CES with EA-TEF and isolated CES. Methods: A total of 31 patients underwent operations for CES were reviewed retrospectively. The patients were divided into two groups according to the association with EA-TEF, and compared the differences. Results: Sixteen boys and 15 girls were included. The mean age at symptom onset was 8 months old, and the mean age at diagnosis was 21 months old. Nine patients with EA-TEF were included group A, whereas the other 22 patients were assigned to group B. There were no differences in sex, gestational age, associated anomalies and pathologic results between the groups. In group A, the age at diagnosis and age at surgery were younger than in group B despite the age at symptom occurrence being similar. Postoperative complications occurred only in group A. Conclusion: In this study, symptoms occurred during the weaning period, and vomiting was the most frequent symptom. CES patients with EA-TEF tended to be diagnosed and treated earlier despite the age at symptom occurrence being similar. CES patients with EA-TEF had more postoperative complications; therefore, greater attention should be paid during the postoperative period.

• Journal of Gastric Cancer
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• v.17 no.2
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• pp.99-109
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• 2017

Purpose: In this study, we aimed to evaluate the rarely reported long-term nutritional results of patients with gastric cancer after curative gastrectomy. Materials and Methods: We retrospectively reviewed the prospectively collected medical records of 658 patients who underwent radical gastrectomy with curative intent for gastric cancer from January 2008 to December 2009 and had no recurrences. All patients were followed for 5 years. Nutritional statuses were assessed using measurements of body weight, serum hemoglobin, total lymphocyte count (TLC), protein, albumin, cholesterol, and nutritional risk index (NRI). Results: Patients who underwent total gastrectomy had lower body weights, hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI values after the first postoperative year (P<0.05), and lower hemoglobin and NRI values during the fifth postoperative year than patients who underwent distal gastrectomy (P<0.05). Patients who received adjuvant chemotherapy after gastrectomy had lower hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI values during the first postoperative year, than those who underwent gastrectomy only (P<0.05). Regarding post-distal gastrectomy reconstruction, those who underwent Roux-en-Y had lower cholesterol levels than did those who underwent Billroth-I and Billroth-II reconstruction at the first and fifth years after gastrectomy, respectively (P<0.05). Conclusions: Patients undergoing total or distal gastrectomy with Roux-en-Y anastomosis or adjuvant chemotherapy after surgery should be monitored carefully for malnutrition during the first postoperative year, and patients undergoing total gastrectomy should be monitored for malnutrition and anemia for 5 years.

• Korean Journal of Community Nutrition
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• v.17 no.1
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• pp.101-108
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• 2012

The purpose of this survey is to investigate the nutritional status and dietary intake of gastrectomized cancer patients in Asan Medical Center. The subjects were 98 patients, who underwent a gastrectomy due to gastric cancer and were admitted to the General Surgery Department during March 2007 to December 2007. We examined general characteristics (sex, age, clinicopathological stage, type of operation), anthropometric data (height, weight change), biochemical data (red blood cell RBC, hemoglobin HGB, hematocrit HCT, mean corpuscular volume MCV, total lymphocyte count TLC, albumin, total cholesterol), dietary intake and dietary intake related symptoms. Weight loss of gastrectomized patients was $9.0{\pm}4.3$% from preillness weight to visiting out-patient department (OPD) weight. Biochemical data (RBC, HGB, HCT, MCV, TLC, albumin, total cholesterol) significantly deteriorated after gastrectomy. However, outpatient visits were all restored to the normal range. Postoperative energy intake was $785.0{\pm}164.2$ kcal, which corresponds to $41.6{\pm}9.6$% of daily energy requirement. The cause of poor oral intake is mostly fear, abdominal pain and abdominal discomfort. Therefore, to control pre-or post-operative weight change in the future requires, focusing on the body weight to maintain a normal or usual nutrition by interventions and increased caloric intake during hospitalization for the development of nutrient-dense meals. In addition, as the main reason of the lack of intake of meals after the gastrectomy was fear, the patients should be actively encouraged to consider the importance of eating proper meals.

• Nutrition Research and Practice
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• v.6 no.3
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• pp.213-220
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• 2012

This study was conducted to identify dietary factors that may affect the occurrence of gastric cancer in Koreans. Preoperative daily nutrition intake and diet quality of patients diagnosed with gastric cancer were evaluated. Collected data were comparatively analyzed by gender. The results were then used to prepare basic materials to aid in the creation of a desirable postoperative nutrition management program. The subjects of this study were 812 patients (562 men and 250 women) who were diagnosed with gastric cancer and admitted for surgery at Soonchunhyang University Hospital between January 2003 and December 2010. Nutrition intake and diet quality were evaluated by the 24-hr recall method, the nutrient adequacy ratio, mean adequacy ratio (MAR), nutrient density (ND), index of nutritional quality (INQ), dietary variety score (DVS), and dietary diversity score (DDS). The rate of skipping meals and eating fast, alcohol consumption, and smoking were significantly higher in males than those in females. The levels of energy, protein, fat, carbohydrate, phosphorous, sodium, potassium, vitamin $B_1$, vitamin $B_2$, niacin, and cholesterol consumption were significantly higher in males than those in females. Intake of fiber, zinc, vitamin A, retinol, carotene, folic acid were significantly higher in females than those in males. MAR in males was significantly higher (0.83) than that in females (0.79). INQ values were higher in females for zinc, vitamin A, vitamin $B_2$, vitamin $B_6$, and folic acid than those in males. The average DVS was 17.63 for females and 13.19 for males. The average DDS was 3.68 and the male's average score was 3.44, whereas the female's average score was 3.92. In conclusion, males had more dietary habit problems and poor nutritional balance than those of females. Our findings suggest that proper nutritional management and adequate dietary education for the primary prevention of gastric cancer should be emphasized in men.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.71-76
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• 2024

Recurrence of progressive familial intrahepatic cholestasis (PFIC) type II poses challenges during postoperative liver transplant care. Posttransplant patients with PFIC type II risk developing recurrent cholestasis with normal gamma-glutamyl transferase activity, which mimics the original bile salt export pump (BSEP) protein deficiency and is related to a form of immunoglobulin G antibody (anti-BSEP)-mediated rejection. Bortezomib effectively induces apoptosis of actively antibody-producing plasma cells that may have a role in antibodymediated rejection. In this case, we used bortezomib to treat PFIC type II recurrence after liver transplantation in a child.