[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[AIM]
We investigated the predictive factors of oral intake on discharge in the patients of pneumonia.
[Method]
The patients who admitted to our hospital from January 1 to July 31, 2009 were subjected in this study. We categorized the pneumonia patients into two groups, aspiration pneumonia (AP) group and non-aspiration pneumonia (NAP) group. We compared the backyard, and the swallowing functions, the abilities of oral intake between two groups.
[Results]
The patients of AP group had more frequent incidence of cerebral vascular diseases and neurological diseases than those of NAP group. The patients of AP group also showed lower average of physical activities, and higher proportion of the residence in nursing homes than the patients of NAP group. The recurrent patients who had histories of previous AP had younger ages than those who experienced the first AP. After medical treatments, the patients in AP group were more difficult to intake foods orally than in NAP group. However, By the dysphagia rehabilitation and modified food formulation, more than half of AP patients could take foods orally on discharge. No patients who were judged unable to intake orally (Grade c) by ST (speech-language-hearing therapists) on admission took foods orally on discharge.
[Conclusion]
We could conclude the assessment of swallowing function by ST had a predictive value for the possibility of oral intake on discharge.

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[Purpose] The usefulness of PEG for very old patients aged 90 years or older was investigated.
[Patients and Methods] Preoperative background, perioperative management, and prognosis were investigated in 34 very old patients aged 90 years and older who underwent PEG between January 2001 and December 2007.
[Results] The mean age was 92.9 years, and there were 7 men and 27 women. The most frequent main underlying disease was cerebrovascular disorder in 19 patients. The most frequent reason for applying PEG was dysphasia with a past medical history of aspiration pneumonia in 19 patients. Postoperative complications occurred in 88.2% within 30 days and 58.8% thereafter, and the frequency of pneumonia was high. The 2-year survival rate was 38.6%. Regarding prognostic factors, a past history of aspiration pneumonia and a nutrition index, a total lymphocyte count lower than 1200/mm3, were factors significantly related to poor outcomes on univariate analysis (p<0.05), but no independent prognostic factor was extracted on the multivariate analysis.
[Conclusion] The incidence of postoperative complications was high. Respiratory infection control and preoperative intervention through nutrition therapy may improve the outcome.

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Aim: We investigated the influence of using semi-solid diet to the burden of nursing care for family- caregiver of PEG patients at home.
Subject and Methods: The questionnaire was sent to family- caregiver of PEG patients at home. The questionnaire asked about time for nursing care and the change of care giving environment comparing liquid diets and semi-solid diets feeding method. Thirty-four caregivers answered the questionnaire.
Results: Time for care, administration time of diets, time for clean up and time for keeping on eye patients were all shorten in semi-solid diets compare to liquid diets. Due to these time reduction, time for family-caregivers themselves increased. Clinical conditions of patients were improved and 88.2% of caregiver commented that semi-solid food was a better feeding method for their patients and themselves.
Conclusion: These results suggest that using semi-solid diet would improve the quality of life for family -caregiver of PEG patients at home.

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[Aim] Our previous study reported that taste was restrained in patients with gastrointestinal malignant disease, and taste was restrained more in patients who underwent gastric resection as compared to in patients who underwent large bowel resection. Based on our previous study results, influences of surgical stress, nitrogen balance and anthropometric measurements were explored.
[Materials and Methods] Taste threshold, score of surgical stress, nitrogen balance and anthropometric measurements were evaluated after surgery in 20 patients [11 underwent gastric resection (group 1) and 9 underwent large bowel resection (group 2)].
[Results] Reduction of anthropometric measurements and catabolic effects were larger, and score of surgical stress was greater in group 1 than in group 2. Postoperative taste was restrained relevantly to reduction of anthropometric measurements, nitrogen loss and high surgical stress score.
[Conclusion] Prolonged and larger deterioration of taste in patients who underwent gastric resection was linked to a long catabolic period caused by greater surgical aggression.

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