Review of the 3-Chamber Bag Preparations for Total Parenteral Nutrition

Total parenteral nutrition (TPN) therapy has advanced significantly during the recent half a century, from single bottle therapy to the combined therapy including macronutrients and micronutrients. The purposes of 3-chamber bag development are to reduce the restriction of total nutrient admixture, and increase the accessibility of therapy. This is also based on trial and errors during R&D activities, and the clinical experiences at the hospital compounding centers. The 3-chamber bag started with concerns regarding the mixture of fat and glucose and amino acids, but up to the present, it is used widely with clinical experience of more than 15 years. Therefore, it might be reasonable to ensure that its efficacy and safety is confirmed. The physicians have reported that it contributes to the convenient and efficient nutrition therapy, allowing enhanced patient compliance and convenience at hospital. In addition, depending on the further R&D works, 3-chamber bags are expected to advance further, opening a new landscape for advanced nutrition therapy.

High levels of carcinoembryonic antigen and smoking might be markers of colorectal adenoma in Korean males aged 40-49 years / 영남의대학술지

BACKGROUND: Prevalence of adenoma in males aged 40-49 years in Korea was higher than expected. The aim of this study was to investigate the prevalence and risk factors of colorectal adenoma in males aged 40-49 years. METHODS: Total 1,902 asymptomatic subjects with a mean age of 47.9±6.7 years, who underwent a screening colonoscopy in a health promotion center of Myongji Hospital from 2010 to 2013 were enrolled in this study. We conducted a case-control study to determine the risk factors for adenoma. The subjects were classified into two groups (adenoma vs. controls). To validate the diagnostic value of carcinoembryonic antigen (CEA) for adenoma, area under the receiver operating characteristic curve (AUROC) was calculated. RESULTS: At least one colorectal adenoma was identified in 385 subjects (20.2%). Among these 385 subjects, 372 subjects were found to have a non-advanced adenoma, 13 subjects had an invasive adenoma. One subject had cancer. Male sex, age, smoking, metabolic syndrome, and elevated CEA level were significantly associated with a colorectal adenoma in univariate analysis. However, metabolic syndrome was not significant in multivariate analysis. In the male group, the AUROC of CEA for colorectal adenoma was 0.600 (0.543 to 0.656) in non-smokers under 50 years of age, and 0.615 (0.540 to 0.690) in smokers under 50 years of age. CONCLUSION: Male sex, smoking, and high levels of CEA seem to be associated with colorectal adenoma. High levels of CEA and smoking may be diagnostic markers for any colorectal adenoma in Korean males aged 40-49 years.