1.Creating a Practical Tool for Predicting Major Amputation Rate in Patients With Diabetic Hindfoot Ulcers: Focus on Ischemia and Infection
Ye-Won CHOI ; Seung-Kyu HAN ; Seong-Ho JEONG ; Eun-Sang DHONG
Journal of Korean Medical Science 2025;40(17):e55-
Background:
Patients with diabetic hindfoot ulcers typically harbor significant concerns regarding their prospects for healing or the potential for major amputation. Nonetheless, a scarcity of data addressing this prevalent and critical query exists. Thus, the aim of this study was to create an initial risk-scoring system to forecast the prognosis of individuals with diabetic hindfoot ulcers, leveraging assessments of ischemia and infection severity, which are recognized as the principal risk factors for amputation.
Methods:
Ischemia severity was categorized as iS0, iS1, or iS2 based on transcutaneous partial oxygen tension values, while infection severity was classified as iN0, iN1, or iN2 according to the results of tissue and bone biopsy cultures. Risk scores were determined by summing the scores for ischemia and infection severity, yielding a range of 0 to 4. Wound healing outcomes were graded as either healed with or without major amputation. Wound healing outcomes were assessed based on the assigned risk scores.
Results:
With ascending risk scores, the proportion of patients subjected to major amputation also increased (P value for trend < 0.001). Univariable logistic regression analysis revealed a significant positive correlation between escalating risk scores and major amputation incidence. Patients with a risk score of 4 exhibited a 41-fold higher likelihood of undergoing major amputation compared to those with a risk score of 0.
Conclusion
Risk scores can serve as a reliable predictor of the major amputation rate in patients with diabetic hindfoot ulcers.
2.A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part I. prescribing enteral nutrition orders
Ye Rim CHANG ; Bo-Eun KIM ; In Seok LEE ; Youn Soo CHO ; Sung-Sik HAN ; Eunjung KIM ; Hyunjung KIM ; Jae Hak KIM ; Jeong Wook KIM ; Sung Shin KIM ; Eunhee KONG ; Ja Kyung MIN ; Chi-Min PARK ; Jeongyun PARK ; Seungwan RYU ; Kyung Won SEO ; Jung Mi SONG ; Minji SEOK ; Eun-Mi SEOL ; Jinhee YOON ; Jeong Meen SEO ;
Annals of Clinical Nutrition and Metabolism 2025;17(1):3-8
Purpose:
This study aimed to develop a comprehensive practical guide for enteral nutrition (EN) designed to enhance patient safety and reduce complications in Korea. Under the leadership of the Korean Society for Parenteral and Enteral Nutrition (KSPEN), the initiative sought to standardize EN procedures, improve decision-making, and promote effective multidisciplinary communication.
Methods:
The KSPEN EN committee identified key questions related to EN practices and organized them into seven sections such as prescribing, delivery route selection, formula preparation, administration, and quality management. Twenty-one experts, selected based on their expertise, conducted a thorough literature review to formulate evidence-based recommendations. Drafts underwent peer review both within and across disciplines, with final revisions completed by the KSPEN Guideline Committee. The guide, which will be published in three installments, addresses critical elements of EN therapy and safety protocols.
Results:
The practical guide recommends that EN orders include detailed elements and advocates the use of electronic medical records for communication. Standardized prescription forms and supplementary safety measures are outlined. Review frequency is adjusted according to patient condition—daily for critically ill or unstable patients and as dictated by institutional protocols for stable patients. Evidence indicates that adherence to these protocols reduces mortality, complications, and prescription errors.
Conclusion
The KSPEN practical guide offers a robust framework for the safe delivery of EN tailored to Korea’s healthcare context. It emphasizes standardized protocols and interdisciplinary collaboration to improve nutritional outcomes, patient safety, and operational efficiency. Rigorous implementation and monitoring of adherence are critical for its success.
3.A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part I. prescribing enteral nutrition orders
Ye Rim CHANG ; Bo-Eun KIM ; In Seok LEE ; Youn Soo CHO ; Sung-Sik HAN ; Eunjung KIM ; Hyunjung KIM ; Jae Hak KIM ; Jeong Wook KIM ; Sung Shin KIM ; Eunhee KONG ; Ja Kyung MIN ; Chi-Min PARK ; Jeongyun PARK ; Seungwan RYU ; Kyung Won SEO ; Jung Mi SONG ; Minji SEOK ; Eun-Mi SEOL ; Jinhee YOON ; Jeong Meen SEO ;
Annals of Clinical Nutrition and Metabolism 2025;17(1):3-8
Purpose:
This study aimed to develop a comprehensive practical guide for enteral nutrition (EN) designed to enhance patient safety and reduce complications in Korea. Under the leadership of the Korean Society for Parenteral and Enteral Nutrition (KSPEN), the initiative sought to standardize EN procedures, improve decision-making, and promote effective multidisciplinary communication.
Methods:
The KSPEN EN committee identified key questions related to EN practices and organized them into seven sections such as prescribing, delivery route selection, formula preparation, administration, and quality management. Twenty-one experts, selected based on their expertise, conducted a thorough literature review to formulate evidence-based recommendations. Drafts underwent peer review both within and across disciplines, with final revisions completed by the KSPEN Guideline Committee. The guide, which will be published in three installments, addresses critical elements of EN therapy and safety protocols.
Results:
The practical guide recommends that EN orders include detailed elements and advocates the use of electronic medical records for communication. Standardized prescription forms and supplementary safety measures are outlined. Review frequency is adjusted according to patient condition—daily for critically ill or unstable patients and as dictated by institutional protocols for stable patients. Evidence indicates that adherence to these protocols reduces mortality, complications, and prescription errors.
Conclusion
The KSPEN practical guide offers a robust framework for the safe delivery of EN tailored to Korea’s healthcare context. It emphasizes standardized protocols and interdisciplinary collaboration to improve nutritional outcomes, patient safety, and operational efficiency. Rigorous implementation and monitoring of adherence are critical for its success.
4.Creating a Practical Tool for Predicting Major Amputation Rate in Patients With Diabetic Hindfoot Ulcers: Focus on Ischemia and Infection
Ye-Won CHOI ; Seung-Kyu HAN ; Seong-Ho JEONG ; Eun-Sang DHONG
Journal of Korean Medical Science 2025;40(17):e55-
Background:
Patients with diabetic hindfoot ulcers typically harbor significant concerns regarding their prospects for healing or the potential for major amputation. Nonetheless, a scarcity of data addressing this prevalent and critical query exists. Thus, the aim of this study was to create an initial risk-scoring system to forecast the prognosis of individuals with diabetic hindfoot ulcers, leveraging assessments of ischemia and infection severity, which are recognized as the principal risk factors for amputation.
Methods:
Ischemia severity was categorized as iS0, iS1, or iS2 based on transcutaneous partial oxygen tension values, while infection severity was classified as iN0, iN1, or iN2 according to the results of tissue and bone biopsy cultures. Risk scores were determined by summing the scores for ischemia and infection severity, yielding a range of 0 to 4. Wound healing outcomes were graded as either healed with or without major amputation. Wound healing outcomes were assessed based on the assigned risk scores.
Results:
With ascending risk scores, the proportion of patients subjected to major amputation also increased (P value for trend < 0.001). Univariable logistic regression analysis revealed a significant positive correlation between escalating risk scores and major amputation incidence. Patients with a risk score of 4 exhibited a 41-fold higher likelihood of undergoing major amputation compared to those with a risk score of 0.
Conclusion
Risk scores can serve as a reliable predictor of the major amputation rate in patients with diabetic hindfoot ulcers.
5.Creating a Practical Tool for Predicting Major Amputation Rate in Patients With Diabetic Hindfoot Ulcers: Focus on Ischemia and Infection
Ye-Won CHOI ; Seung-Kyu HAN ; Seong-Ho JEONG ; Eun-Sang DHONG
Journal of Korean Medical Science 2025;40(17):e55-
Background:
Patients with diabetic hindfoot ulcers typically harbor significant concerns regarding their prospects for healing or the potential for major amputation. Nonetheless, a scarcity of data addressing this prevalent and critical query exists. Thus, the aim of this study was to create an initial risk-scoring system to forecast the prognosis of individuals with diabetic hindfoot ulcers, leveraging assessments of ischemia and infection severity, which are recognized as the principal risk factors for amputation.
Methods:
Ischemia severity was categorized as iS0, iS1, or iS2 based on transcutaneous partial oxygen tension values, while infection severity was classified as iN0, iN1, or iN2 according to the results of tissue and bone biopsy cultures. Risk scores were determined by summing the scores for ischemia and infection severity, yielding a range of 0 to 4. Wound healing outcomes were graded as either healed with or without major amputation. Wound healing outcomes were assessed based on the assigned risk scores.
Results:
With ascending risk scores, the proportion of patients subjected to major amputation also increased (P value for trend < 0.001). Univariable logistic regression analysis revealed a significant positive correlation between escalating risk scores and major amputation incidence. Patients with a risk score of 4 exhibited a 41-fold higher likelihood of undergoing major amputation compared to those with a risk score of 0.
Conclusion
Risk scores can serve as a reliable predictor of the major amputation rate in patients with diabetic hindfoot ulcers.
6.A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part I. prescribing enteral nutrition orders
Ye Rim CHANG ; Bo-Eun KIM ; In Seok LEE ; Youn Soo CHO ; Sung-Sik HAN ; Eunjung KIM ; Hyunjung KIM ; Jae Hak KIM ; Jeong Wook KIM ; Sung Shin KIM ; Eunhee KONG ; Ja Kyung MIN ; Chi-Min PARK ; Jeongyun PARK ; Seungwan RYU ; Kyung Won SEO ; Jung Mi SONG ; Minji SEOK ; Eun-Mi SEOL ; Jinhee YOON ; Jeong Meen SEO ;
Annals of Clinical Nutrition and Metabolism 2025;17(1):3-8
Purpose:
This study aimed to develop a comprehensive practical guide for enteral nutrition (EN) designed to enhance patient safety and reduce complications in Korea. Under the leadership of the Korean Society for Parenteral and Enteral Nutrition (KSPEN), the initiative sought to standardize EN procedures, improve decision-making, and promote effective multidisciplinary communication.
Methods:
The KSPEN EN committee identified key questions related to EN practices and organized them into seven sections such as prescribing, delivery route selection, formula preparation, administration, and quality management. Twenty-one experts, selected based on their expertise, conducted a thorough literature review to formulate evidence-based recommendations. Drafts underwent peer review both within and across disciplines, with final revisions completed by the KSPEN Guideline Committee. The guide, which will be published in three installments, addresses critical elements of EN therapy and safety protocols.
Results:
The practical guide recommends that EN orders include detailed elements and advocates the use of electronic medical records for communication. Standardized prescription forms and supplementary safety measures are outlined. Review frequency is adjusted according to patient condition—daily for critically ill or unstable patients and as dictated by institutional protocols for stable patients. Evidence indicates that adherence to these protocols reduces mortality, complications, and prescription errors.
Conclusion
The KSPEN practical guide offers a robust framework for the safe delivery of EN tailored to Korea’s healthcare context. It emphasizes standardized protocols and interdisciplinary collaboration to improve nutritional outcomes, patient safety, and operational efficiency. Rigorous implementation and monitoring of adherence are critical for its success.
7.A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part I. prescribing enteral nutrition orders
Ye Rim CHANG ; Bo-Eun KIM ; In Seok LEE ; Youn Soo CHO ; Sung-Sik HAN ; Eunjung KIM ; Hyunjung KIM ; Jae Hak KIM ; Jeong Wook KIM ; Sung Shin KIM ; Eunhee KONG ; Ja Kyung MIN ; Chi-Min PARK ; Jeongyun PARK ; Seungwan RYU ; Kyung Won SEO ; Jung Mi SONG ; Minji SEOK ; Eun-Mi SEOL ; Jinhee YOON ; Jeong Meen SEO ;
Annals of Clinical Nutrition and Metabolism 2025;17(1):3-8
Purpose:
This study aimed to develop a comprehensive practical guide for enteral nutrition (EN) designed to enhance patient safety and reduce complications in Korea. Under the leadership of the Korean Society for Parenteral and Enteral Nutrition (KSPEN), the initiative sought to standardize EN procedures, improve decision-making, and promote effective multidisciplinary communication.
Methods:
The KSPEN EN committee identified key questions related to EN practices and organized them into seven sections such as prescribing, delivery route selection, formula preparation, administration, and quality management. Twenty-one experts, selected based on their expertise, conducted a thorough literature review to formulate evidence-based recommendations. Drafts underwent peer review both within and across disciplines, with final revisions completed by the KSPEN Guideline Committee. The guide, which will be published in three installments, addresses critical elements of EN therapy and safety protocols.
Results:
The practical guide recommends that EN orders include detailed elements and advocates the use of electronic medical records for communication. Standardized prescription forms and supplementary safety measures are outlined. Review frequency is adjusted according to patient condition—daily for critically ill or unstable patients and as dictated by institutional protocols for stable patients. Evidence indicates that adherence to these protocols reduces mortality, complications, and prescription errors.
Conclusion
The KSPEN practical guide offers a robust framework for the safe delivery of EN tailored to Korea’s healthcare context. It emphasizes standardized protocols and interdisciplinary collaboration to improve nutritional outcomes, patient safety, and operational efficiency. Rigorous implementation and monitoring of adherence are critical for its success.
8.A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part I. prescribing enteral nutrition orders
Ye Rim CHANG ; Bo-Eun KIM ; In Seok LEE ; Youn Soo CHO ; Sung-Sik HAN ; Eunjung KIM ; Hyunjung KIM ; Jae Hak KIM ; Jeong Wook KIM ; Sung Shin KIM ; Eunhee KONG ; Ja Kyung MIN ; Chi-Min PARK ; Jeongyun PARK ; Seungwan RYU ; Kyung Won SEO ; Jung Mi SONG ; Minji SEOK ; Eun-Mi SEOL ; Jinhee YOON ; Jeong Meen SEO ;
Annals of Clinical Nutrition and Metabolism 2025;17(1):3-8
Purpose:
This study aimed to develop a comprehensive practical guide for enteral nutrition (EN) designed to enhance patient safety and reduce complications in Korea. Under the leadership of the Korean Society for Parenteral and Enteral Nutrition (KSPEN), the initiative sought to standardize EN procedures, improve decision-making, and promote effective multidisciplinary communication.
Methods:
The KSPEN EN committee identified key questions related to EN practices and organized them into seven sections such as prescribing, delivery route selection, formula preparation, administration, and quality management. Twenty-one experts, selected based on their expertise, conducted a thorough literature review to formulate evidence-based recommendations. Drafts underwent peer review both within and across disciplines, with final revisions completed by the KSPEN Guideline Committee. The guide, which will be published in three installments, addresses critical elements of EN therapy and safety protocols.
Results:
The practical guide recommends that EN orders include detailed elements and advocates the use of electronic medical records for communication. Standardized prescription forms and supplementary safety measures are outlined. Review frequency is adjusted according to patient condition—daily for critically ill or unstable patients and as dictated by institutional protocols for stable patients. Evidence indicates that adherence to these protocols reduces mortality, complications, and prescription errors.
Conclusion
The KSPEN practical guide offers a robust framework for the safe delivery of EN tailored to Korea’s healthcare context. It emphasizes standardized protocols and interdisciplinary collaboration to improve nutritional outcomes, patient safety, and operational efficiency. Rigorous implementation and monitoring of adherence are critical for its success.
9.Creating a Practical Tool for Predicting Major Amputation Rate in Patients With Diabetic Hindfoot Ulcers: Focus on Ischemia and Infection
Ye-Won CHOI ; Seung-Kyu HAN ; Seong-Ho JEONG ; Eun-Sang DHONG
Journal of Korean Medical Science 2025;40(17):e55-
Background:
Patients with diabetic hindfoot ulcers typically harbor significant concerns regarding their prospects for healing or the potential for major amputation. Nonetheless, a scarcity of data addressing this prevalent and critical query exists. Thus, the aim of this study was to create an initial risk-scoring system to forecast the prognosis of individuals with diabetic hindfoot ulcers, leveraging assessments of ischemia and infection severity, which are recognized as the principal risk factors for amputation.
Methods:
Ischemia severity was categorized as iS0, iS1, or iS2 based on transcutaneous partial oxygen tension values, while infection severity was classified as iN0, iN1, or iN2 according to the results of tissue and bone biopsy cultures. Risk scores were determined by summing the scores for ischemia and infection severity, yielding a range of 0 to 4. Wound healing outcomes were graded as either healed with or without major amputation. Wound healing outcomes were assessed based on the assigned risk scores.
Results:
With ascending risk scores, the proportion of patients subjected to major amputation also increased (P value for trend < 0.001). Univariable logistic regression analysis revealed a significant positive correlation between escalating risk scores and major amputation incidence. Patients with a risk score of 4 exhibited a 41-fold higher likelihood of undergoing major amputation compared to those with a risk score of 0.
Conclusion
Risk scores can serve as a reliable predictor of the major amputation rate in patients with diabetic hindfoot ulcers.
10.Normative Parameters of Olfactory Bulbs Based on Magnetic Resonance Imaging and Olfactory Function
Minju KIM ; Ji Ye LEE ; Yong Hwy KIM ; Seung Hong CHOI ; Tae-Bin WON ; Doo Hee HAN
Journal of Korean Medical Science 2024;39(45):e321-
Background:
Olfactory dysfunction is a frequently encountered sensory disorder that increases with aging, assessed magnetic resonance imaging (MRI); however, reference quantitative values for associated anatomical structures have rarely been suggested. The aim of this study was to assess the parameters of the olfactory bulbs (OBs) and olfactory sulcus (OS) in Korean adults according to age, along with their olfactory function.
Methods:
We retrospectively evaluated 217 consecutive patients (104 men, 113 women;mean age, 52.4 ± 15.6 years) who underwent sellar MRI and olfactory function testing before transsphenoidal approach at a single tertiary center from March 2022 to December 2023. Based on the T2-weighted MRI, we evaluated the quantitative size parameters and morphological features of patients’ OB and OS, along with their olfactory function test scores. We assessed the relationship between OB volume and age in pairwise correlations.
Results:
The mean OB volume was 45.6 ± 15.3 mm 3 in all patients. The patients’ mean Korean version of the Sniffin’ Sticks (KVSS) test II score was 26.8 ± 4.1. OB volume (P < 0.001), height (P < 0.001), and anteroposterior diameter (APD) (P < 0.001) differed significantly among the different age groups. Reduced OB volume was significantly associated with aging (r = –0.58, P < 0.001) and a decline in olfactory function scores (r = 0.34, P < 0.001).
Conclusion
Based on MRI, we proposed reference OB and OS values in adults of different age groups, highlighting the reduction in OB parameters, especially height and APD along with volume associated with aging and olfactory decline. These values can be useful for evaluating adult patients undergoing MRI for olfactory dysfunction.

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