OBJECTIVES: The purpose of this study was to provide a basic data of nutrition services in home health care by analyzing hospital-based home-visit nutrition education needs of patients at discharge. METHODS: Data was collected from September 11 to October 12, 2012 by administering questionnaires to 289 chronic disease patients to be discharged from a university hospital in Pusan. The home-visit nutrition education instruments used for collecting data were developed by the researcher. RESULTS: Regarding the demands of home-visit nutrition education, 62.3% of subjects were willing to use home-visit nutrition education and 37.7% weren't. The main reason for using the home-visit nutrition education was "the effective nutrient management in consultation with an individual's doctor", 38.9% and 31.2% of patients who did not wish to use the service gave the reason for their decision as, "Just by managing the nutritional requirements of a family's diet and, the patient will be able to fully recover", respectively. As for the demand, classified with the areas of home-visit nutrition education, the demand for the area of basic nutrition (3.75/5.00) was the highest followed by, the area of educational nutrition (3.74/5.00), therapeutic nutrition (3.67/5.00), and dietary nutrition (3.55/5.00). The demand for the area of educational nutrition was high "Considering the state of dietary management, such as disease status and drugs", 73.7%. As for the relation between the characteristics of the study subjects and analysis of demand home-visit nutrition education, the characteristic of subjects, that is, "regular home-visit nutrition education", "practice of diet therapy after discharge" had a significant difference statistically (p < 0.01). As for the relation between the needs for fundamental home-visit nutrition education and the demand of home-visit nutrition education, basic nutrition, educational nutrition, therapeutic nutrition, and dietary nutrition had a significant difference statistically (p < 0.01). CONCLUSIONS: Hospital-based home-visit nutrition education need the access of home nutrition support team.
Busan ; Chronic Disease ; Delivery of Health Care ; Diet ; Diet Therapy ; Education* ; Humans ; Nutritional Requirements ; Surveys and Questionnaires

PURPOSE: To identify predictive factors for recovery time in patients with orbital fracture with diplopia through analysis of preoperative and postoperative computed tomography (CT) images and postoperative recovery time. METHODS: We retrospectively analyzed CT findings-preoperative: fracture size, type of fracture, fracture site, extraocular muscle (EOM) swelling, EOM and soft tissue injury, and the amount of soft tissue herniation; post-operative: degree of enophthalmos, and diplopia recovery period in 379 patients who underwent surgical treatment for orbital fracture between March 2006 and December 2015. RESULTS: The average postoperative follow-up period was 556.2 ± 59.5 days, and the mean duration of recovery was 23.9 ± 42.5 (range, 3–186) days. The recovery time of diplopia was significantly increased with the following preoperative CT findings: fracture size (small and medium < large) (p = 0.049), type of fracture (linear < hinge < comminuted, trap-door) (p < 0.01), fracture site (inferior < medial and both) (p < 0.01), EOM and soft tissue injury (prolapse and torsion, muscle entrapment, kinked muscle) (p < 0.01), and the amount of soft tissue herniation (small and medium < large) (p < 0.001). The mechanism of injury, sex, age, and the degree of enophthalmos were not related to the length of the diplopia recovery period. CONCLUSIONS: The length of diplopia recovery could be predicted by CT findings.
Diplopia ; Enophthalmos ; Follow-Up Studies ; Humans ; Orbit ; Orbital Fractures ; Retrospective Studies ; Soft Tissue Injuries

A case of primary malignant fibrous histiocytoma(MFH) of the lung occurring in a 62-year-old man is presented. After preoperative bronchial brushing and washing cytologic diagnosis of poorly differentiated carcinoma, surgical resection and lymph nodes dissection were performed. Subsequent histologic examination revealed a primary MFH. The diagnosis was confirmed by electron microscopic and immunohistochemical examinations. The review of the bronchial brushing and washing cytologic features disclosed many bipolar and a few unipolar spindle tumor cells with a "comet" configuration, mainly single cells, but also forming loose clusters. The nuclei were elongated and hyperchromatic and contained one or more irregular nucleoli. Scattered bizarre, multinucleated tumor giant cells were also present.
Diagnosis ; Giant Cells ; Histiocytoma, Malignant Fibrous* ; Humans ; Lung* ; Lymph Nodes ; Middle Aged

This report evaluated long-term changes in clinical severity and laboratory parameters in 3 adult patients with severe recalcitrant atopic dermatitis (AD) who were treated with intramuscular injections of 50 mg of autologous immunoglobulin G (IgG) twice a week for 4 weeks (autologous immunoglobulin therapy, AIGT) and followed up for more than 2 years after the treatment. We observed the following 4 major findings in these 3 patients during the long-term follow-up after AIGT. (1) Two of the 3 patients showed a long-term clinical improvement for more than 36 weeks after AIGT with a maximum decrease in clinical severity score greater than 80% from baseline. (2) These 2 patients also showed long-term decreases in serum total IgE concentrations and peripheral blood eosinophil count for more than 36 weeks after AIGT with a maximum decrease in the two laboratory parameters of allergic inflammatory greater than 70% from baseline. (3) No significant side effect was observed during the 2 years of follow-up period after the AIGT in all 3 patients. (4) Serum levels of IgG anti-idiotype antibodies to the F(ab')2 fragment of autologous IgG administered for the treatment were not significantly changed after AIGT in all 3 patients. These findings suggest that AIGT has long-term favorable effects on both clinical severity and laboratory parameters in selected patients with severe recalcitrant AD. Further studies are required to evaluate the clinical usefulness and therapeutic mechanism of AIGT for AD.
Adult ; Antibodies ; Antibodies, Anti-Idiotypic ; Dermatitis, Atopic* ; Eosinophils ; Follow-Up Studies ; Humans ; Immunization, Passive* ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins* ; Immunomodulation ; Injections, Intramuscular

PURPOSE: High frequency oscillatory ventillation (HFOV) is an alternative to conventional ventilation (CV) when oxygenation deteriorates. This study evaluates the efficacy and safety of HFOV in children with respiratory failure. METHODS: Ten cases with respiratory failure (age 8.7+/-7.6 mo, body weight 6.8+/-2.6 kg) that underwent HFOV for more than 3 days because of failure of oxygenation by CV were enrolled. PaO2/FiO2, oxygenation index (OI), (A-a) DO2, mean airway pressure (MAP), blood pressure, heart rate, PEediatric Logistic Organ Dysfunction (PELOD) score and complications were evaluated before and at 6, 12, 24, 48, 72 hours of HFOV. The influencing factors were compared between an HFOV success group and a failure group, and outcomes were evaluated. RESULTS: 1) Lower FiO2 was required for proper oxygenation by HFOV, although MAP was significantly increased. (P< 0.05) 2) PaO2/FiO2 was higher (P=0.002) and (A-a) DO2 was lower than baseline (P< 0.001) during HFOV. However, no significant difference was observed for OI, PaO2, PaCO2 or pH. 3) In the HFOV success group, (A-a) DO2 was significantly lower than failure group at baseline, (P=0.045) and OI was also significantly lower than in the failure group at 6 hours of HFOV. (P=0.032) PaO2/FiO2 was significantly improved in the success group at 6 hours of HFOV. (P=0.045) 4) Complications were air leak, 20% (2/10), and hypotension, 40% (4/10), which was corrected by using inotropics. PELOD scores decreased in all patients compared to at baseline throughout HFOV. (P=0.03) 5) Sixty percent patients survived for 3 months after HFOV were 60% (6/10). The success of HFOV related to survival. (P=0.048) CONCLUSION: HFOV can be used to improve oxygenation effectively and safely in children with respiratory failure who did not improve with CV.
Blood Pressure ; Body Weight ; Child* ; Heart Rate ; High-Frequency Ventilation ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Oxygen ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilation*

PURPOSE: Protein and energy malnutrition are common in patients with stomach cancer. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase morbidity and mortality in stomach cancer. METHODS: The study subject were 88 patients with stomach cancer admitted at Kosin university Gospel Hospital General Surgery Department during August 2001 to December. We assessed the initial nutrition status by anthropometric, biochemical and dietary intake data along with subjective global assessment (SGA) and stomach cancer stage. RESULTS: The mean body index was under weight, body fat mass and body protein mass were decreased with increase cancer stage. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count were decrease with increase cancer stage. Daily energy intake was 1997.8 kcal, energy, cabohyderate and VitB 1 was decrease with cancer stage. The patient were divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss %, 6 month weight loss %, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake CONCLUSION: The author concluded that nutritional assessment should be done in cancer patients preoperatively and that with adequate nutritional support, the morbidity and mortality would be decreased. Our data show that SGA is a clinically adequate method for assessing nutritional status.
Arm ; Body Mass Index ; Body Weight ; Cholesterol ; Energy Intake ; Humans ; Lymphocyte Count ; Malnutrition ; Mortality ; Nutrition Assessment* ; Nutritional Status ; Nutritional Support ; Stomach Neoplasms ; Transferrin ; Triglycerides ; Weight Loss

Cardiac tamponade is a life-threatening predicament which demands early recognition and immediate treatment. We report a case of iatrogenic intraoperative cardiac tamponade during an orthotopic liver transplantation. A 55 year-old man was scheduled for an orthotopic liver transplantation due to hepatocellular carcinoma. During the anhepatic period, the patient's vital signs remained stable, but the central venous pressure and pulmonary artery diastolic pressure were increased. However, immediately after reperfusion, sudden hypotension and tachycardia developed. Fluid volume resuscitation and epinephrine injection led only to a transient improvement of the blood pressure. It took approximately 30 minutes to realize the possibility of the cause of hypotension might be due to cardiac tamponade rather than post-reperfusion syndrome. After an emergent transdiaphragmatic pericardiocentesis, we found that the cause of the cardiac tamponade was tearing of an epicardial coronary vein. Evacuation of a massive hematoma resulted in a rapid improvement in the patient's cardiovascular status. The patient has made an uneventful recovery.
Blood Pressure ; Carcinoma, Hepatocellular ; Cardiac Tamponade* ; Central Venous Pressure ; Coronary Vessels ; Epinephrine ; Hematoma ; Humans ; Hypotension ; Liver Transplantation* ; Liver* ; Middle Aged ; Pericardiocentesis ; Pulmonary Artery ; Reperfusion* ; Resuscitation ; Tachycardia ; Vital Signs

PURPOSE: The clinical usefulness of subcutaneous allergen immunotherapy (SCIT) in the treatment of atopic dermatitis (AD) is still controversial. We analyzed the clinical efficacy of SCIT in patients with AD and the clinical characteristics of patients showing a favorable clinical response to the treatment. MATERIALS AND METHODS: Two hundred and fifty one patients with AD sensitized to house dust mite (HDM) were treated by SCIT using HDM extract. The clinical severity of AD was measured using the standardized clinical severity scoring system for AD (SCORAD) at baseline and 12 months. A favorable clinical response to SCIT was defined as a decrease in SCORAD value at 12 months greater than 50% compared to baseline value. Severe AD was defined as a baseline SCORAD value above 50. RESULTS: A favorable clinical response to SCIT was observed in 73.6% of patients. The proportion of patients showing a favorable clinical response to SCIT was significantly higher in patients with severe AD (90.6%) than patients with mild to moderated AD (63.7%) (p<0.001). Patients with severe AD showing a favorable clinical response had a significantly shorter duration of AD (12.3±8.5 years; mean±SD) than patients with severe AD showing no significant clinical response (20.6±10.9 years) (p<0.05) at baseline. CONCLUSION: SCIT could be a clinically useful therapeutic option for patients with severe AD sensitized to HDM. Early initiation of SCIT might provide a favorable clinical outcome in patients with severe AD sensitized to HDM.
Allergens ; Dermatitis, Atopic* ; Desensitization, Immunologic* ; Humans ; Pyroglyphidae ; Treatment Outcome*

PURPOSE: The clinical usefulness of subcutaneous allergen immunotherapy (SCIT) in the treatment of atopic dermatitis (AD) is still controversial. We analyzed the clinical efficacy of SCIT in patients with AD and the clinical characteristics of patients showing a favorable clinical response to the treatment. MATERIALS AND METHODS: Two hundred and fifty one patients with AD sensitized to house dust mite (HDM) were treated by SCIT using HDM extract. The clinical severity of AD was measured using the standardized clinical severity scoring system for AD (SCORAD) at baseline and 12 months. A favorable clinical response to SCIT was defined as a decrease in SCORAD value at 12 months greater than 50% compared to baseline value. Severe AD was defined as a baseline SCORAD value above 50. RESULTS: A favorable clinical response to SCIT was observed in 73.6% of patients. The proportion of patients showing a favorable clinical response to SCIT was significantly higher in patients with severe AD (90.6%) than patients with mild to moderated AD (63.7%) (p<0.001). Patients with severe AD showing a favorable clinical response had a significantly shorter duration of AD (12.3±8.5 years; mean±SD) than patients with severe AD showing no significant clinical response (20.6±10.9 years) (p<0.05) at baseline. CONCLUSION: SCIT could be a clinically useful therapeutic option for patients with severe AD sensitized to HDM. Early initiation of SCIT might provide a favorable clinical outcome in patients with severe AD sensitized to HDM.
Allergens ; Dermatitis, Atopic* ; Desensitization, Immunologic* ; Humans ; Pyroglyphidae ; Treatment Outcome*