A clinical analysis of 249 patients with maxillo-facial trauma, who underwent general anes- thesia from January 1992 to December 1993 at Lee-Rha General Hospital, were made in order to investigate various case characteristics such as sex ratio, age distribution, types of trauma, fracture sites, associated injuries, underlying medical problems, abnormal laboratory findings, intubation, and preoperative physical condition. It was found that males outnumbered females showing the peak age incidence in 20's and 30's. The high velocity motor vehicle accidents was the most common cause of trauma and the mandible was the most frequent fracture sites. Among 96 associated injury cases, 63 cases were neumsurgical problems. Underlying medical problems or abnormal laboratory findings were present in 28.9% of the patients studied and preoperative physical status 1 or 1E (ASA classification) was most common accounting for 54.8% of the patients studied. Of the patients who received endotracheal intubation, 73.5% were done via a nasotracheal route.
Age Distribution ; Anesthesia ; Female ; Hospitals, General ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Male ; Mandible ; Motor Vehicles ; Sex Ratio

BACKGROUND: When the insertion of endotracheal tubes(ETTs) through the nostril, The tubemay be encountered some resistance. Forcing ETT into the nasal cavity develop mucosal and soft tissue injuries and subsequent epistaxis during passage of the tube even when vasoconstrictors and/or a lubricated tube are employed. Therefore, We determined whether balloon dilation technique(BDT) reduces the incidence of epistaxis and increases the ease of the tube advancement in the nasal cavity during nasotracheal intubation. METHODS: Sixty adult patients who scheduled for maxillofacial surgery were divided into two groups, BDT(n=30) and non BDT(n=30). The BDT group received an armored tube, which a 14 Fr-all-silicone Foley catheter insert through the tube, while non BDT group received a plain armored tube. All patients in both groups was inserted ETTs by conventional nasotracheal insertion techniques. RESULTS: The BDT group had a signifieantly lower incidence of epistaxis(0/30 vs 8/30 : p<0.05) and provided a significantly easier passage in the nasal cavity than non BDT group (difficult tube advancement in the nasal cavity, 3/30 vs 17/30 : p<0.05). CONCLUSIONS: The BDT helps to make an easy and smooth passage of the tube and to prevent epistaxis during nasotracheal tube insertion. This study indicates that nasotracheal intubation using BDT is an easily learned, safe, effective and atraumatic method.
Adult ; Catheters ; Epistaxis* ; Humans ; Incidence* ; Intubation ; Nasal Cavity* ; Soft Tissue Injuries ; Surgery, Oral ; Vasoconstrictor Agents

Because nonspecific colonic ulcer is an unusual condition and varies markedly in clinical presentation and course, preoperative clinical diagnosis of nonspecific colonic ulcer is very difficult, But now, preoperative clinical diagnosis can he made by advent of colonofiberscopy. And, it is very important to diagnose this disease early, because late diagnosis make a poor prognosis. We report a case of nonspecific colonic ulcer diagnosed by repeated colonofiberscopy and treated with surgery.
Colon* ; Delayed Diagnosis ; Diagnosis ; Prognosis ; Ulcer*

PURPOSE: To evaluate the exact prevalence of primary glomerular diseases in Korea. METHODS: We analyzed a retrospective cohort of biopsy proven 1,100 patients with primary glomerular disease in OO Hospital from April 1990 to March 2010. RESULTS: Pathologic diagnosises of 1,100 cases were as follows: IgA nephropathy (IgAN), 557 cases (50.6%), was the most common followed by 200 cases (18.1%) of minor glomerular abnormalities (MGA), 168 cases (15.2%) of focal segmental glomerulosclerosis (FSGS), 93 cases (8.0%) of membranous nephropathy (MN), 31 cases (2.8%) of membranoproliferative glomerulonephritis type I (MPGN), 17 cases (1.5%) of focal glomerulonephritis and 7 cases (0.6%) of diffuse mesangial proliferative glomerulonephritis (DMGN) in order. In idiopathic nephrotic syndrome, the most common pathologic diagnosis was minimal change nephrotic syndrome (MCNS) (40.2%), followed by FSGS (27.5%), MN (24.2%), MPGN (8.1%) and DMGN (0.5%). When the incidence rates between 1990-1992 and 2008-2010 were compared, IgAN and FSGS increased from 34.7, 12.5 to 47.8%, 30.4%, but MCNS (from 33.3 to 6.5 %) decreased significantly. CONCLUSION: IgAN was the most common primary glomerulonephritis. During the past 20 years, the prevalence of IgAN and FSGS were increased, while MCNS and MN were decreased.
Biopsy ; Cohort Studies ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Incidence ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Prevalence ; Retrospective Studies

This study was conducted to determine whether dietary factors could be related with serum adiponectin concentrations in 243, year-three female university students living in Seoul. The mean of body mass index (BMI) and adiponectin levels of all subjects were 20.17 kg/m2 and 11.07 microg/ml, respectively. When the subjects were divided into 3 groups based on BMI (underweight: < 18.5, normal: 18.5 < or = < 23, overweight and obesity: > or = 23), serum adiponectin levels in underweight group was significantly higher than that in 'normal' or 'overweight and 'obesity' groups. Also when the subjects were divided into two groups by mean adequacy ratio (MAR), serum adiponectin concentration of the high MAR group (MAR > 75) was slightly higher than that the low MAR group (MAR < or = 75). Serum adiponectin levels showed a negative correlation with body weight (p < 0.01) or BMI (p < 0.001) and a positive correlation with intakes of of animal or total protein (please clarify) or vegetable protein.Among the dietary behaviors, serum adiponectin levels of females who answered 'yes' to the question about 'eating breakfast' was significantly higher than that of those who answered 'sometimes' or 'No' (p < 0.05) and serum adiponectin levels were higher among those who reported higher fruit intakes. Overall, our results suggested that healthy lifestyle including acceptable BMI, eating breakfast and higher fruit consumption might play an important role in the prevention of obesity and enhancement of blood adiponectin levels.
Adiponectin ; Animals ; Body Mass Index ; Body Weight ; Breakfast ; Eating ; Female ; Fruit ; Humans ; Life Style ; Obesity ; Overweight ; Thinness ; Vegetables

The objective of this article is to report improvement of nutritional status by protein supplements in the patient with protein-losing enteropathy. The patient was a female whose age was 25 and underwent medical treatment of Crohn's disease, an inflammatory bowl disease, after diagnosis of cryptogenic multifocal ulcerous enteritis. The weight was 33.3 kg (68% of IBW) in the severe underweight and suffered from ascites and subcutaneous edema with hypoalbuminemia (1.3 g/dL) at the time of hospitalization. The patient consumed food restrictively due to abdominal discomfort. Despite various attempts of oral feeding, the levels of calorie and protein intake fell into 40-50% of the required amount, which was 800-900 kcal/d (24-27 kcal/kg/d) for calorie and 34 g/d (1 g/kg/d) for protein. It was planned to supplement the patient with caloric supplementation (40-50 kcal/kg) and protein supplementation (2.5 g/kg) to increase body weight and improve hypoproteinemia. It was also planned to increase the level of protein intake slowly to target 55 g/d in about 2 weeks starting from 10 g/d and monitored kidney load with high protein supplementation. The weight loss was 1.0 kg when the patient was discharged from the hospital (hospitalization periods of 4 weeks), however, serum albumin was improved from 1.3 g/dL to 2.5 g/dL and there was no abdominal discomfort. She kept supplement of protein at 55 g/d for 5 months after the discharge from the hospital and kept it at 35 g/d for about 2 months and then 25 g/d. The body weight increased gradually from 32.3 kg (65% of IBW) to 44.0 kg (89% of IBW) by 36% for the period of F/u and serum albumin was kept above 2.8 g/dL without intravenous injection of albumin. The performance status was improved from 4 points of 'very tired' to 2 points of 'a little tired' out of 5-point scale measurement and the use of diuretic stopped from the time of 4th month after the discharge from the hospital owing to improvement in edema and ascites. During this period, the results of blood test such as BUN, Cr, and electrolytes were within the normal range. In conclusion, hypoproteinemia and weight loss were improved by increasing protein intake through utilization of protein supplements in protein-losing enteropathy.
Ascites ; Body Weight ; Crohn Disease ; Diagnosis ; Edema ; Electrolytes ; Enteritis ; Female ; Hematologic Tests ; Hospitalization ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Inflammatory Bowel Diseases ; Injections, Intravenous ; Kidney ; Nutritional Status ; Protein-Losing Enteropathies* ; Reference Values ; Serum Albumin ; Thinness ; Ulcer ; Weight Loss

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.

no abstract available.

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.

As the significance of nutrition in intensive care unit grows, large prospective randomized controlled trials on nutrition therapy have been performed and recently published. Each society for Parenteral and Enteral Nutrition designated recommendations for clinical practice based on the best available evidence and the consensus of experts. The European Society for Parenteral and Enteral Nutrition (ESPEN) has released a new guideline that has been updated from the previous ESPEN guidelines on enteral nutrition and parenteral nutrition in adult critically ill patients published in 2006 and 2009, respectively. This study examined the latest trends of nutrition guidelines, and especially those of the ESPEN 2018, for intensive care units as compared to guidelines of other societies and older previous guidelines.