The restricted resources on healthcare highlights the importance of clinical and cost effectiveness. The social and economic costs of chronic diseases are increasing. Home total parenteral nutrition (home TPN) for the patients with intestinal failure is a life-sustaining therapy until intestinal transplantation. An economic evaluation of home TPN has not been conducted in Korea. Three types of economic evaluations for home TPN are cost benefit analysis, cost effectiveness analysis, and cost utility analysis. Korea's medical market is competitive due to the limited health care resources. A health care delivery system from hospital to home needs to be established under the supervision of professional Nutrition Support Team staff including the systematic policies and social recognition.
Chronic Disease ; Cost-Benefit Analysis ; Delivery of Health Care ; Humans ; Korea ; Organization and Administration ; Parenteral Nutrition, Home Total* ; Quality-Adjusted Life Years

No abstract available.
Parenteral Nutrition, Total

No abstract available.
Humans ; Infant, Newborn* ; Parenteral Nutrition, Total* ; Sepsis*

No abstract available.
Incidence* ; Nurseries* ; Parenteral Nutrition, Total* ; Pharmacy* ; Sepsis*

Symptomatic Zinc Deficiency occurs due to decreased supplimentation, increased consumption, and decreased bowel absorption of the zinc. We report the typical case of symptomatic zinc deficiency in a patient who received total parenteral nutrition for about 4 weeks due to chronic diarrhea. And after supplementation with oral zinc sulfate, the diarrhea stopped in a day and skin lesions disappeared completely within a week.
Absorption ; Diarrhea ; Humans ; Parenteral Nutrition, Total* ; Skin ; Zinc Sulfate ; Zinc*

Chylous ascites is a rare complication following treatment for gynecologic malignancies. Conservative management is usually effective for the treatment of postoperative chylous ascites. If conservative management fails, surgical management should be considered. This is the first domestic case reported in which retroperitoneal lymph node dissection for primary fallopian tubal cancer resulted in persistent chylous ascites. The patient was treated with total parenteral nutrition (TPN) and a medium-chain triglyceride diet for about 8 weeks. So we present the case with a brief review of literature.
Chylous Ascites ; Diet ; Humans ; Lymph Node Excision ; Parenteral Nutrition, Total

Chylous ascites is a rare complication following treatment for gynecologic malignancies. Conservative management is usually effective for the treatment of postoperative chylous ascites. If conservative management fails, surgical management should be considered. This is the first domestic case reported in which retroperitoneal lymph node dissection for primary fallopian tubal cancer resulted in persistent chylous ascites. The patient was treated with total parenteral nutrition (TPN) and a medium-chain triglyceride diet for about 8 weeks. So we present the case with a brief review of literature.
Chylous Ascites ; Diet ; Humans ; Lymph Node Excision ; Parenteral Nutrition, Total

Traditional treatments of gastrointestinal fistula include early drainage, maintaining nutrition and then resection of fistula at the proper time,which usually take three to four months or even longer. Rapid treatments of gastrointestinal fistula mean promoting rapid spontaneous closure of tract fistula and early primary resection of fistula within two weeks after fistula occurrence. Early diagnosis is the premise of early management, and fistulography and abdominal CT scan are important early diagnostic methods. Most of fistula could close spontaneously in the maintaining stage. To promote the rapid closure, however, special measures including sufficient drainage, somatostatin and total parenteral nutrition in the early stage should be implemented to avoid intra-abdominal collection of intestinal fluid and infection, control further leakage of intestinal fluid and improve nutritional status. In the late stage,when leakage of intestinal fluid could be controlled, recombine human growth hormone (rhGH) and enteral nutrition should be administered in place of somatostatin and total parenteral nutrition respectively. The fistula can reach rapid spontaneous closure in both stages. Fibrin glue and rhGH used at the same time can improve the curative rate and shorten the treatment time even more. In the 1960s and 1970s, early primary resection of the fistula and re-anastomosis often resulted in anastomosis failure. The reasons for this included poor nutritional status, uncontrolled secretion of intestinal fluid, severe intra-abdominal infection and multiorgan dysfunction syndrome. Such stage management policy has been proposed, developed and persisted since late 1960s. Nowadays, the advance of medical science provided the possibility to change or improve the current policy. Our research proved that early resection of the primary fistula and re-anastomosis of the small bowel could be performed successfully in some selected patients whose general conditions are good and intestinal adhesion were not severe within ten to fourteen days after fistula occurrence. More studies are still needed to define the indications and contradictions for early resection of the primary gastrointestinal fistula, and prove the feasibility and rationality of rapid treatments of gastrointestinal fistula.
Early Diagnosis ; Humans ; Intestinal Fistula ; diagnosis ; therapy ; Parenteral Nutrition, Total

OBJECTIVE: To study the clinical effect of alanyl-glutamine-enriched nutritional support in the treatment of children with abdominal Henoch-Schönlein purpura. METHODS: Children with abdominal Henoch-Schönlein purpura who needed nutritional support were enrolled and stratified according to age, sex and the severity of disease, and were randomly divided into a control group (n=118) and an enriched nutritional support group (n=107). The control group was given nutritional support without using alanyl-glutamine, while the enriched nutritional support group was given alanyl-glutamine-enriched nutritional support. Intravenous steroids were used according to the severity of disease in both groups. Other therapies were the same in the two groups. The two groups were compared in terms of the length of hospital stay, the rate and duration of use of intravenous steroids, the recurrence rate of symptoms during hospitalization, the rate of total parenteral nutrition (TPN), the rate of weight loss and the rate of fasting for more than 5 days. All patients were followed up for 3 months after discharge to monitor the recurrence of symptoms. RESULTS: There were no significant differences in the length of hospital stay, the rate of TPN and the rate of fasting for more than 5 days between the two groups (P>0.05). Compared with the enriched nutritional support group, the control group showed significant increases in the rate and duration of use of intravenous steroids, the recurrence rate of symptoms and the rate of weight loss (P<0.05). After the 3-month follow-up, all the children resumed normal diet, and the recurrence rate of digestive symptoms was less than 20% in each group. Abdominal pain was the most common symptom (83.33%, 30/36), followed by vomiting and abdominal distention. No digestive hemorrhage was observed. All the symptoms were relieved after symptomatic treatment. No significant difference was found between the two groups in the recurrence rate of digestive symptoms (P=0.693). CONCLUSIONS Alanyl-glutamine-enriched nutritional support in the treatment of children with abdominal Henoch-Schönlein purpura can reduce the use of intravenous steroids and weight loss, but without impact on the length of hospital stay and post-discharge recurrence.
Child ; Dipeptides ; Humans ; Parenteral Nutrition, Total ; Purpura, Schoenlein-Henoch ; Recurrence

PURPOSE: Liver function test abnormalities have been reported frequently in patients receiving total parenteral nutrition (TPN). In adults, it is known that liver complications decrease with the use of cyclic parenteral nutrition (CPN), especially if the shift to cycling was not too late. However, there are few studies about the effects of cycling on liver injury in children beyond the neonatal period. The aim of this study is to evaluate the effect of the early use of CPN on total parenteral nutrition induced hepatic dysfunction. METHODS: Twelve sets of CPN in 11 children (2 months to 17 years) were included in this study. Data on underlying diseases, age, length of time on TPN, macronutrient intake, complications, and biochemical parameters were collected from clinical records. All children had received CPN in the early period of persistent transaminase elevation or cholestasis complicated by previous continuous PN. The duration of infusion off-time in CPN was 2 hours in patients less than 3 months of age and 4 hours in the older children. RESULTS: All 12 cases showed elevated aminotransferase and 5 of them also showed cholestasis. Serum total bilirubin concentration was normalized in all 5 cases with median periods of 8 days (p<0.05) after initiation of CPN. ALT either decreased significantly or was normalized in all cases with median periods of 30 days (p<0.05) on CPN. The CPN was well tolerated without significant complication except for one case of hyperglycemia. CONCLUSION: The early use of cyclic parenteral nutrition had a beneficial effect in improving hepatic dysfunction complicated by TPN in children.
Adult ; Bilirubin ; Child ; Cholestasis ; Humans ; Hyperglycemia ; Liver ; Liver Function Tests ; Parenteral Nutrition* ; Parenteral Nutrition, Total*