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The Relationship between Lifestyle and Metabolic Syndrome in Obese Children and Adolescents (소아청소년 비만에서 생활습관과 대사증후군의 연관성)

  • Cho, Ky-Young;Park, Hye-Sook;Seo, Jeong-Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.150-159
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    • 2008
  • Purpose: To assess the relationship between lifestyle and metabolic syndrome in obese children and adolescents. Methods: We retrospectively reviewed the medical records and laboratory results of 109 subjects (7~15 years of age) who visited our pediatric obesity clinic between January 2004 and December 2007. They completed the parent- and self-report questionnaire developed by the Committee on Nutrition of the Korean Pediatric Society to assess lifestyle. The metabolic syndrome was defined as having 3 or more of the following metabolic risk factors: obesity, hypertension, serum triglycerides ${\geq}$110 mg/dL, HDL-cholesterol ${\leq}$40 mg/dL, fasting glucose ${\geq}$110 mg/dL, and insulin ${\geq}20{\mu}IU/mL$. Results: All subjects had at least 1 risk factor (obesity). Sixty-three percent of subjects had 2 or more risk factors, 32% of subjects had 3 or more risk factors, and 10% had 4 or more metabolic risk factors. Hypertriglyceridemia (36%), hypertension (32%), hyperinsulinemia (24%), and HDL-hypocholesterolemia (20%) were observed. Fasting blood glucose levels were normal in all subjects. Hypertension was significantly associated with an unbalanced diet and hyperinsulinemia was significantly associated with parental obesity (p<0.05). Those who ate after 8 PM were at a risk of hypertension (odds ratio, 2.5; 95% CI, 1.0~6.1). Those who did not have a preference for exercise were at a risk of hyperinsulinemia (odds ratio, 10.4; 95% CI, 2~54.1). Those who watched TV for ${\geq}$3 hours/day were at a risk of metabolic syndrome (odds ratio, 4.8; 95% CI, 1.2∼18.8). Conclusion: Lifestyle, such as eating late, no preference for exercise, and TV watching ${\geq}$3 hours/day, were related to metabolic syndrome in obese children and adolescents.

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The Effect of Gingko Biloba Extract on Energy Metabolic Status in C3H Mouse Fibrosarcoma : Evaluated by in vivo $^{31}P$ Magnetic Resonance Spectroscopy (Gingko biloba extract가 C3H 마우스 섬유육종의 에너지 대사 상태에 미치는 영향 : 생체내 $^{31}P$ 자기공명 분광법을 이용한 분석)

  • Ha Sung Whan;Kim Won Dong;Ahn Yong Chan;Park Chan Il;Lim Tae Hwan;Lee Tae Kuen
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.147-154
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    • 2002
  • Purpose : Gingko biloba extract (GBE), a natural product extracted from Gingko leaves, is known to increase the radiosensitivity of tumors. This radiosensitization probably arises from the increase in the peripheral blood flow by decreasing the blood viscosity and relaxing the vasospasm. The influence of a GBE on the metabolic status in fibrosarcoma II (FSall) of a C3H mouse was investigated using $^{31}P$ magnetic resonance spectroscopy (MRS). Materials and Methods : Eighteen C3H mice with fibrosarcoma II $(from\;100\;mm^3\;to\;130\;mm^3)$ were prepared for this experiment. The mice were divided into 2 groups; one (9 mice) without a priming dose, and the other (9 mice) with a priming dose of GBE. The GBE priming dose (100 mg/kg) was administered by an intraperitoneal (i.p.) injection 24 hours prior to the measurement. First $^{31}P$ MRS spectra were measured in the mice from each group as a baseline and test dose of GBE (100 mg/kg) was then administered to each group. One hour later, the $^{31}P$ MRS spectra were measured again to evaluate the change in the energy metabolic status. Results : In the group without the priming dose, the mean pH, PCr/Pi, PME/ATP, Pi/ATP, PCr/(Pi+PME) values 1 hour after the test dose were not changed significantly compared to the values at the baseline. However, in the group with the priming dose, the mean PCr/Pi, Pi/ATP, PCr/(Pi+PME) values 1 hour after the test dose changed from the baseline values of 0.49, 0.77, 0.17 to 0.74, 0.57, 0.28 respectively. According to the paired t-test, the differences were statistically significant. Conclusion : The above findings suggest that the metabolic status is significantly improved after administering GBE if the priming dose is given 24 hours earlier. This shows that the radiosensitizing effect of GBE is based on the increase of tumor blood flow and the improvement in the metabolic status.

The Comparative Study of on Pump CABG during Pulsatile $(T-PLS^{TM})$ and Nonpulsatile $(Bio-pump^{TM})$ Perfusion (관상동맥우회술 시 사용된 박동성펌프$(T-PLS^{TM})$와 비박동성펌프$(Bio-pump^{TM})$의 비교연구)

  • Park Young-Woo;Her Keun;Lim Jae-Ung;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.354-358
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    • 2006
  • Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.

Pulse wave velocity and ankle brachial index in obese adolescents (비만 청소년에서 맥파 속도와 발목 상완 동맥압 지수에 대한 연구)

  • Kim, Ji Hye;Koo, Hee Sun;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1078-1084
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    • 2007
  • Purpose : The prevalence of childhood obesity has doubled over the last 30 years. Obesity-associated sequelae in the vasculature begins in the early stages of life. The purpose of this study was to investigate how pulse wave velocity (PWV) and ankle brachial index (ABI) change with height, weight and body mass index (BMI) in obese adolescents. Methods : Seventy-nine obese adolescents (group 1: $85th{\leq}BMI<95th$ percentile, n=40; group 2 ($BMI{\geq}95th$ percentile, n=39) were included. The control group(group 3) included 99 healthy adolescents. Brachial- ankle (ba) PWV and ABI were estimated with blood pressure from four extremities. Heart rate (HR), and pre-ejection period/ejection time (PEP/ET) were also estimated. BMI was calculated from individual height and weight. Linear regression analysis was performed to evaluate the correlations between BMI and PWV. Results : Blood pressure and baPWV were significantly higher in group 2, compared to either group 1 or group 3. However, there was no significant difference in ABI, HR and PEP/ET between the groups. PWV showed linear correlation with both BMI and body weight. Conclusion : Obesity was associated with higher arterial stiffness in adolescents, which was demonstrated by an increase in PWV. There was no significant correlation between obesity and ABI.

A Study on Health Condition and Nutritional Status of Female University Students in Masan Area (마산시 일부 여대생의 건강상태 및 영양섭취 실태 조사)

  • Park, Eun-Ju;Cheong, Hyo-Sook;Shin, Dong-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.9
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    • pp.1501-1514
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    • 2004
  • The purpose of this study was to evaluate the health condition and nutritional status in female university students in Masan. The 285 subjects aged 20.1 years (18~26 years) were assessed with a set of questionnaire composed of general information, food, smoking, drinking and exercise habits, anthropometric measurements, blood pressure measurements, 24-hour recall and food frequency questionnaire. The rates of smoking and alcohol drinking habits were 1.8% and 82.5%, respectively. All the subjects had the experience of passive smoking. The 11% of the students exercised regularly and 11.6% ate meal regularly. The average height and weight of subjects were 161.0 ㎝ and 53.9 ㎏, respectively and the BMI was calculated as 20.8${\pm}$2.6 ㎏/$m^2$:The 13.3% of subjects were underweight, while 6.7% of them were overweight. The mean value for body fat was 26.4% and subscapular and tricep skinfolds thickness were 14.2 ㎜ and 16.9 ㎜, and waist-hip ratio was 0.72. The systolic/diastolic blood pressure of the subjects was 115.9 ㎜Hg/70.9 ㎜Hg. Except protein, phosphorous, vitamin E, B_6 and C, the average intakes of energy and nutrients were below the Korea recom-mended dietary allowance (RDA). Especially, intakes of calcium, iron and zinc were the lowest, as <70% of RDA. The proportion of energy derived from carbohydrates : protein : fat was 58.0 : 15.8 : 26.2. The 10 frequently consumed food were ssalbap (47.2/mon), kimchi (35.6/mon), onion (16.8/mon), japgokbap (15.1/mon), sesame oil (14.1/mon), carbonated drink (13.3/mon), grapes (12.7/mon), ice cream (12.4/mon), milk (11.9/mon) and water-melon (10.6/mon). Results of this study could be useful for planning nutrition education programs for female university students in this area to improve their dietary habit and health status.

Platelet count and mean platelet volume in low birth weight infants (≤2,000 g) with sepsis (패혈증에 이환된 저출생체중아(≤2,000 g)에서 혈소판수치와 평균혈소판용적의 변화)

  • Lee, Wan-soo;Cho, Jin-young;Yoo, Seung-taek;Lee, Chang-woo;Choi, Doo-young;Kim, Jong-duck;Oh, Yeon-kyun
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.643-648
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    • 2007
  • Purpose : Sepsis is a common complication in Neonatal Intensive Care Units (NICU), seen especially in low birth weight (LBW) infants. A recent study showed that fungal or gram-negative sepsis is associated with a greater degree of thrombocytopenia than is seen with gram-positive sepsis. So, this study was undertaken to examine the platelet counts and platelet indices in LBW infants during episodes of sepsis. Methods : We analyzed 36 cases with culture-proven sepsis on chart review in LBW infants admitted to the NICU at Wonkwang University Hospital from January 2001 to June 2006. Results : Patients were grouped by organism type: gram-positive bacteria ($1,521{\pm}309g$, $31.3{\pm}2.9wk$, 15/36), gram-negative bacteria ($1,467{\pm}290g,\;30.6{\pm}3.6wk$, 17/36), and fungi ($1,287{\pm}205g,\;30.0{\pm}3.9wk$, 4/36). The most common organism was Staphylococcus epidermis and the incidence of thrombocytopenia was 88.9%. When compared with infants with gram-positive sepsis, those with gram-negative sepsis had significantly higher incidences of thrombocytopenia, lower initial platelet count, lower platelet nadir, and greater mean percentage decrease in platelet count from before the onset of sepsis. Those with fungal infections were similar to gram-negative sepsis, but they were not significant because of the small number of patients. And mean platelet volume (MPV) in sepsis was increased more significantly in time of platelet nadir than before the onset of sepsis. Conclusion : We conclude that decrease in platelet count was significantly greater in gram-negative sepsis than gram-positive sepsis, and also greater than fungal sepsis-which was insignificant because of the small number of patients-in LBW infants. And elevation in MPV will be helpful in the diagnosis and treatment of sepsis in LBW infants.

The Effect of Ginkgo Biloba Extract on Radiosensitivity of Mouse Skin and Jejunal Crypt (Ginkgo Biloba Extract가 마우스 피부 및 공장 소낭선의 방사선감수성에 미치는 영향)

  • Shin, Kyung-Hwan;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.107-114
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    • 1998
  • Purpose : Ginkgo biloba extract(GBE) is known to increase the peripheral blood circulation. This study was designed to evaluate the effect of GBE on the acute normal tissue radiation reaction. Materials and Methods : mice were divided into two groups, radiation alone and two doses GBE plus radiation, for both acute skin reaction and jejunal crypt assay. GBE was given i.p. one hour before irradiation with priming dose given one day earlier. Thirty to Fifty Gy for acute skin reaction and 11 to 14 Gy for jejunal crypt were irradiated to right hind leg and whole body, respectively. Results : Radiation doses($RD_{50}$) for Peak skin score of 2.0 were 44.2Gy (40.6-48.2Gy) for radiation alone and 44.4Gy(41.6-47.4Gy) for two doses GBE plus radiation, showing no effect of GBE on acute radiation skin damage. The numbers of regenerating jejunal crypts per circumference were also almost the same for each radiation dose level(p=0.57-0.94), and the mean lethal doses($D_o$) were 1.800y(1.57-2.09Gy) for radiation alone and 1.88Gy(1.65-2.18Gy) for two doses GBE plus radiation, indicating no effect of GBE on jejunal crypt cell survival after radiation. Conclusion : GBE doesn't increase acute normal tissue radiation reaction in this model system. As GBE was verified to enhance radiation effect on tumor, high therapeutic gain is expected when GBE is combined with radiation therapy.

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Comparison of nutritional status by energy level of night snack in Korean adults: using the data from 2005 Korean National Health and Nutrition Examination Survey (한국 성인의 야식의 에너지 수준에 따른 영양상태 비교: 2005년 국민건강영양조사 자료 이용)

  • Suh, Yoonsuk;Lee, Eun-Kyoung;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.45 no.5
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    • pp.479-488
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    • 2012
  • This study aims to investigate the nutritional status of night eaters using the data from 2005 Korean National Health and Nutrition Examination Survey. A total of 3,903 subjects aged 20 and above were divided into 3 groups by using 24-hr recall data according to the night snack calorie intake: non-night snack, night snack less than 500 kcal and 500 kcal and more. Their data were analyzed to find out the difference on the socio-demographic, anthropometric, blood pressure, blood parameters and dietary characteristics. Among the subjects, non-night eaters were 66.0%, night eaters of less than 500 kcal were 28.4% and 500 kcal and above were 5.6%. Male adults, young-aged, higher educated, higher income earner, breakfast skipper and frequent dine-outer (3 times and more a day) were found more in the night eaters with 500 kcal and above. Night eaters above 500 kcal showed higher waist circumference, Glu-FBS, Glu-PP120 and also showed higher daily intake of fat and alcohol per 1,000 kcal and food groups of meat & eggs, beverages and alcohol drinks (p < 0.05), while they showed the lowest carbohydrate energy ratio of $58.3{\pm}13.7$ among the three groups. These results suggest that habitual night snack intake above 500 kcal could lead to abdominal obesity and diabetes due to higher intake of meat, fat and alcohol.

Usefulness of Pulsatile Flow Aortic Aneurysm Phantoms for Stent-graft Placement (스텐트그라프트 장치술을 위한 대동맥류 혈류 팬텀의 유용성)

  • Kim, Tae-Hyung;Ko, Gi-Young;Song, Ho-Young;Park, In-Kook;Shin, Ji-Hoon;Lim, Jin-Oh;Kim, Jin-Hyoung;Choi, Eu-Gene K.
    • Journal of radiological science and technology
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    • v.30 no.3
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    • pp.205-212
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    • 2007
  • To evaluate the feasibility and efficacy of a pulsatile aortic aneurysm phantoms for in-vitro study. The phantoms consisted of a pulsating motor part(heart part) and an aortic aneurysm part, which mimicked true physiologic conditions. The heart part was created from a high-pressured water pump and a pulsatile flow solenoid valve for the simulation of aortic flow. The aortic aneurysm part was manufactured from paper clay, which was placed inside a acrylic plastic square box, where liquid silicone was poured. After the silicone was formed, the clay was removed, and a silicone tube was used to connect the heart and aneurysm part. We measured the change in pressure as related to the opening time(pulse rate, Kruskal-Wallis method) and pressure before and after the stent-graft implantation(n = 5, Wilcoxon's signed ranks test). The changes in blood pressures according to pulse rate were all statistically significant(p<0.05). The systolic/diastolic pressures at the proximal aorta, the aortic aneurysm, and the distal aorta of the model were $157.80{\pm}1.92/130.20{\pm}1.92$, $159.40{\pm}1.14/134.00{\pm}2.92$, and $147.20{\pm}1.480/129.60{\pm}2.70\;mmHg$, respectively, when the pulse rate was 0.5 beat/second. The pressures changed to $161.40{\pm}1.34/90.20{\pm}1.64$, $175.00{\pm}1.58/93.00{\pm}1.58$, and $176.80{\pm}1.48/90.80{\pm}1.92\;mmHg$, respectively, when the pulse rate was 1.0 beat/second, and $159.40{\pm}1.82/127.20{\pm}1.48$, $166.60{\pm}1.67/138.00{\pm}1.87$, and $161.00{\pm}1.22/135.40{\pm}1.67\;mmHg$, respectively, when it was 1.5 beat/second. When pulse rate was set at 1.0 beat/second, the pressures were $143.60{\pm}1.67/90.20{\pm}1.64$, $147.20{\pm}1.92/84.60{\pm}1.82$, and $137.40{\pm}1.52/88.80{\pm}1.64\;mmHg$ after stent-graft implantation. The changes of pressure before and after stent-graft implantation were statistically significant(p<0.05) except the diastolic pressures at the proximal(p =1.00) and distal aorta(p=0.157). The aortic aneurysm phantoms seems to be useful for the evaluation of the efficacy of stent-graft before animal or clinical studies because of its easy reproducibility and ability to display a wide range of pressures.

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Difference of Short Term Survival in Patients with ARDS According to Responsiveness to Alveolar Recruitment (급성호흡곤란증후군 환자에서 폐포모집술의 반응에 따른 초기 예후의 차이)

  • Kim, Ho Cheol;Cho, Dae Hyun;Kang, Gyoung Woo;Park, Dong Jun;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.280-288
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    • 2004
  • Background : Lung protective strategies, using low tidal volume in ARDS, improve survival rate in ARDS. However, low tidal volume ventilation may promote alveolar de-recruitment. Therefore, alveolar recruitment is necessary to maintain arterial oxygenation and to prevent repetitive opening and closure of collapsed alveoli in lung protective strategies. There has been a recent report describing improvement in arterial oxygenation with use of recruitment maneuver. However, impact of recruitment on outcome of ARDS is unknown. We evaluated whether short-term survival difference existed in patients with ARDS, who were performed alveolar recruitment maneuver(ARM) and prone position, according to response of alveolar recruitment or not. Methods : All patients who were diagnosed with ADRS and received mechanical ventilation were included. ARM were sustained inflation($35-45cmH_2O$ CPAP for 30-40 sec.) or increasing level of PEEP. If these methods were ineffective, alveolar recruitment with prone position was done for at least 10 hours. $P_aO_2/FiO_2$(P/F) ratio was determined before and at 0.5 and 2 hours after ARM. We defined a responder if the P/F ratio was increased over 50% of baseline value. We compared 10-days and 30-days survival rate between responders and non-responders. Results : 20 patients(M:F=12:8, $63{\pm}14age$) were included. Among them, 12 patients were responders and 8 patients were non-responders. In responders, P/F ratio was increased from $92{\pm}25mmHg$ to $244{\pm}85mmHg$. In non-responders, P/F ratio increased from $138{\pm}37mmHg$ to $163{\pm}60mmHg$. Among non-responders, P/F ratio was improved over 50% in 2 patients after prone position. Overall, 14 patients were responders after ARM and prone position. The 10-days and 30-days survival rate in responders was significantly higher than in non-responders(86%, 57% in responders and 33%, 0% in non-responders)(p<0.05). There was no significant difference between responders and non-responders in age($71{\pm}11$, $60{\pm}14$), lung injury score($2.8{\pm}0.2$, $2.9{\pm}0.45$), simplified acute physiology score(SAPS) II ($35{\pm}4.6$, $34{\pm}5.7$), positive end-positive pressure level($15.6{\pm}1.9cmH_2O$, $14.5{\pm}2.1cmH_2O$). Conclusion : ARM may improve arterial oxygenation in some patients with ARDS. These responders in patients with ARDS showed significant higher 10-days and 30-days survival rate than non-responders patients with alveolar recruitment.