• Title/Summary/Keyword: 지표상태인자

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The Metabolic Syndrome in Obese Children (소아 비만에서 대사증후군의 고찰)

  • Yom, Hye Won;Shin, Jee Seon;Lee, Hyun Joo;Park, So Eun;Jo, Su Jin;Seo, Jeong Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.228-238
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    • 2004
  • Purpose: Obesity is rapidly increasing in Korean children. Obesity is a risk factor for cardiovascular morbidity and is frequently associated with hypertension, diabetes mellitus and coronary artery disease. This study was designed to evaluate risk factors of the metabolic syndrome in obese children. Methods: From February 2000 to June 2004, eighty eight obese (body mass index ${\geq}95th$ percentile) children aged 4 to 15 years were included. We measured serum lipid levels (total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol), fasting sugar levels and insulin levels. Insulin resistance was determined by homeostasis model assessment, fasting insulin/glucose ratio and quantitative insulin sensitivity check index. Results: Clustering of risk factors for the metabolic syndrome in obese children demonstrated that 60.2% had more than one risk factors. Hypertension (14.8%), hypertriglyceridemia (14.8%), HDL-hypocholesterolemia (14.8%), LDL-hypercholesterolemia (12.5%) and hyperinsulinemia (12.5%) were observed. As BMI increased, there was statistically significant increase in systolic blood pressure, insulin and insulin resistance values. Insulin resistance was correlated to systolic blood pressure, serum lipid and insulin levels. The more risk factors for the metabolic syndrome obese children had, the higher was their insulin resistance. Conclusion: The increase in insulin resistance and clustering of risk factors for the metabolic syndrome are already apparent in obese children. Monitoring these risk factors for the metabolic syndrome should become a part of routine medical care for obese children.

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Obstructive Ventilatory Impairment as a Risk Factor of Lung Cancer (폐암의 위험인자로서의 폐쇄성 환기장애)

  • Kim, Yeon-Jae;Park, Jae-Yong;Chae, Sang-Cheol;Won, Jun-Hee;Kim, Jeong-Seok;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.746-753
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    • 1998
  • Background : Cigarette smoking is closely related to both lung cancer and chronic obstructive pulmonary disease. The incidence of lung cancer is higher in patients with obstructive ventilatory impairment than in patients without obstructive ventilatory impairment regardless of smoking. So, obstructive ventilatory impairment is suspected as an independent risk factor of lung cancer. Methods: For the evaluation of the role of obstructive ventilatory impairment as a risk factor of lung cancer, a total of 73 cases comprising 47 cases of malignant and 26 benign solitary pulmonary nodule were analyzed retrospectively. A comparative study of analysis of forced expiratory volume curves and frequencies of obstructive ventilatory impairment were made between cases with malignant and benign nodules. Results: In comparison of vital capacity and parameters derived from forced expiratory volume curve between two groups. VC, FVC and $FEV_1$ were not significantly different. whereas $FEV_1/FVC%$ and FEF 25-75% showed a significant decrease in the cases with malignant nodule. The frequency of obstructive ventilatory impairment determined by pulmonary function test was significantly higher in the cases with malignant nodule(23.4%) than in benign nodule(3.8%). When the risk for lung cancer was examined by the presence or absence of obstructive ventilatory impairment using the logistic regression analysis, the unadjusted relative risk for the lung cancer of obstructive ventilatory impairment was 17.17. When the effect of smoking and age were considered, the relative risk was to 8.13. Conclusion: These findings suggest that an obstructive ventilatory impairment is a risk factor of lung cancer.

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B-type Natriuretic Peptide (BNP) as a Predictive Marker after Heart Transplantation (심장이식 후 예측인자로서 B-type Natriuretic Peptide (BNP)의 역할)

  • Shin, Hong-Ju;Kim, Hee-Jung;Choo, Suk-Jung;Kim, Jae-Joong;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.552-557
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    • 2007
  • Background: B-type natriuretic peptide (BNP) is a cardiac hormone that is primarily synthesized by the ventricular cardiac myocytes. Increased plasma BNP levels have been observed in patients suffering with congestive heart failure, ventricular hypertrophy and myocaridits and also during heart transplantation rejection. We investigated the serum BNP level as a predictive marker for rejection after heart transplantation. Material and Method: To test the usefulness of measuring the BNP level in cardiac transplant patients, consecutive blood samplings for BNP, right ventricular endomyocardial biopsies, hemodynamic measurements and transthoracic echocardiogram were all done in 10 such patients between January 2004 and August 2005 at the Department of Thoracic and Cardiovascular Surgery in Asan Medical Center. Two groups were identified with using the median value: the low BNP group (n=28, BNP: ${\le}290$ pg/mL) and the high BNP group (n=29, BNP: >290 pg/mL). We retrospectively analyzed rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy, the pulmonary capillary wedge pressure and the right atrial pressure between the 2 groups. Result: There were no differences in age, gender, rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy and the right atrial pressure between the 2 groups (p>0.05). However, a higher pulmonary capillary wedge pressure and a higher mean pulmonary atrial pressure were observed in the high BNP group (p<0.05). Further, BNP has linear correlation with the pulmonary capillary wedge pressure (r=0.590, p<0.001). Using the cut-off value of 620 pg/mL, the BNP predicted a high PCWP (>12 mmHg) with a sensitivity of 83.3% and a specificity of 91.1% (AUC: $0.900{\pm}0.045$, p<0.001). Conclusion: The BNP level after heart transplantation does not show any significant correlation with rejection, yet it might be a predictive marker of ventricular diastolic dysfunction.

Correlations of Leptin, Adiponectin and Leptin/Adiponectin Ratio with Metabolic Disorders in the Childhood Obesity (소아 비만에서 Leptin, Adiponectin 및 Leptin/Adiponectin Ratio와 대사 장애의 연관성에 관한 연구)

  • Cho, Sung Jong;Kim, Eun Young;Moon, Kyung Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.48-57
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    • 2006
  • Purpose: To investigate the correlation of the serum leptin, adiponectin, and leptin/adiponectin ratio with metabolic disorders in the childhood obesity. Methods: Fifty children (25 obese and 25 non-obese) were recruited in the pediatric outpatient clinic of Chosun University Hospital from January 1st to June 30th 2005. Adiponectin, leptin, anthropometric parameters, glucose, LDL-cholesterol, HDL-cholesterol, total cholesterol, triglyceride, and insulin levels were measured. The correlations of leptin and adiponectin levels with anthropometric parameters, glucose, insulin and lipids were analyzed by Pearson's correlation coefficients. Results: Insulin and leptin levels of the obese group were significantly higher than those of the non-obese group (p<0.05, p<0.001 respectively). HDL-cholesterol and adiponectin levels of the obese group were significantly lower than those of the non-obese group (p<0.005, p<0.05 respectively). In the obese group, leptin level was positively correlated with BMI and the percentage of body fat, but negatively correlated with adiponectin level. Moreover, adiponectin level of the obese group was negatively correlated with BMI and the percentage of body fat, but positively correlated with leptin level. In the non-obese group, only insulin level was positively correlated with adiponectin. In the obese group, leptin/adiponectin ratio was positively correlated with the percentage of body fat and leptin level. Also, leptin/adiponectin ratio was positively correlated with BMI and the percentage of body fat in the non-obese group. Conclusion: Leptin, adiponectin, and leptin/adiponectin ratio did not appear to have a major role linking various metabolic disorders in the childhood obesity, even though they were strongly associated with obesity indices. Also, leptin/adiponectin ratio was associated with obesity indices even in non-obese children.

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Regulatory Mechanism of Insulin-Like Growth Factor Binding Protein-3 in Non-Small Cell Lung Cancer (비소세포성 폐암에서 인슐린 양 성장 인자 결합 단백질-3의 발현 조절 기전)

  • Chang, Yoon Soo;Lee, Ho-Young;Kim, Young Sam;Kim, Hyung Jung;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Kim, Se Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.465-484
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    • 2004
  • Background : Insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3) inhibits the proliferation of non-small cell lung cancer (NSCLC) cells by inducing apoptosis. Methods : In this study, we investigated whether hypermethylation of IGFBP-3 promoter play an important role in the loss of IGFBP-3 expression in NSCLC. We also studied the mechanisms that mediate the silencing of IGFBP-3 expression in the cell lines which have hypermethylated IGFBP-3 promoter. Results : The IGFBP-3 promoter has hypermethylation in 7 of 15 (46.7%) NSCLC cell lines and 16 (69.7%) of 23, 7 (77.8%) of 9, 4 (80%) of 5, 4 (66.7 %) of 6, and 6 (100%) of 6 tumor specimens from patients with stage I, II, IIIA, IIIB, and IV NSCLC, respectively. The methylation status correlated with the level of protein and mRNA in NSCLC cell lines. Expression of IGFBP-3 was restored by the demethylating agent 5'-aza-2'-deoxycytidine (5'-aza-dC) in a subset of NSCLC cell lines. The Sp-1/ Sp-3 binding element in the IGFBP-3 promoter, important for promoter activity, was methylated in the NSCLC cell lines which have reduced IGFBP-3 expression and the methylation of this element suppressed the binding of the Sp-1 transcription factor. A ChIP assay showed that the methylation status of the IGFBP-3 promoter influenced the binding of Sp-1, methyl-CpG binding protein-2 (MeCP2), and histone deacetylase (HDAC) to Sp-1/Sp-3 binding element, which were reversed by by 5'-aza-dC. In vitro methylation of the IGFBP-3 promoter containing the Sp-1/Sp-3 binding element significantly reduced promoter activity, which was further suppressed by the overexpression of MeCP2. This reduction in activity was rescued by 5'-aza-dC. Conclusion : These findings indicate that hypermethylation of the IGFBP-3 promoter is one mechanism by which IGFBP-3 expression is silenced and MeCP2, with recruitment of HDAC, may play a role in silencing of IGFBP-3 expression. The frequency of this abnormality is also associated with advanced stages among the patients with NSCLC, suggesting that IGFBP-3 plays an important role in lung carcinogenesis/progression and that the promoter methylation status of IGFBP-3 may be a marker for early molecular detection and/or for monitoring chemoprevention efforts.

Iron Status According to Serum Selenium Concentration and Physique in Young Female Adults (젊은 여성의 혈청 셀레늄 농도 및 체격에 따른 체내 철 수준)

  • Lee, Ok-Hee;Chung, Yong-Sam;Moon, Jong-Wha
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.114-122
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    • 2010
  • Se and Fe are trace minerals acting as antioxidant scavenging free radicals. Iron deficiency is the most frequently reported nutritional deficiency in females. Body iron status are known to be dependent not only upon dietary iron intake, but also upon micro-mineral nutrition and obesity. Antioxidants such as selenium are reported to play an important role on the regulation of erythropoiesis by protecting RBC membrane from antioxidative damage. In this study, iron status in young females and its relationships with selenium status and physique were examined. Serum selenium and iron concentrations were measured by HANARO research reactor using neutron activation analysis method (NAA-method). The proportion with iron deficiency and anemia were 27.1% and 8.6%, respectively in young females, but the proportion with iron deficient anemia was 1.4%. The mean serum selenium level was $12.0\;{\mu}g/dL$ and in normal range in the young women. The study participants were tertiled according to BMI and serum selenium levels. Serum ferritin and iron levels inclined with increasing BMI tertiles. Serum iron and RBC count were higher in middle selenium group than low selenium group. Individuals had significantly lower hematocrit level in the lowest tertile for their serum selenium levels compared with the highest tertile. The serum ferritin level was predicted 25% by BMI and RBC count 26.2% by the serum selenium level and body fat%. In conclusion, this study shows that body iron status in young adult females are influenced by obesity and body selenium status.

Autonomic Nervous Response of Female College Students with Type D Personality during an Acute Stress Task: Heart Rate Variability (Type D 성격 여대생의 급성 스트레스에 따른 자율신경계 반응 : 심박률 변동성을 중심으로)

  • Ko, Seon-Young;Kim, Myung-Sun
    • Korean Journal of Health Psychology
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    • v.14 no.2
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    • pp.277-292
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    • 2009
  • This study investigated the responses of the autonomic nervous system of individuals with Type D personality during an acute stressful situation. Twenty-three female students of Type D personality and 23 female students with non-Type D personality. Stroop Color-Word Task was used to induce a stressful situation, heart rate variability (HRV) was used to measure the responses of the autonomic nervous system during the baseline, acute stress, recovery periods. To analyze the data, the repeated measures analysis of variance was used to compare the autonomic nervous system of the Type D group to that of the non-Type D group. Regression analysis is used to determine if the Type D scale and stress vulnerability predicted the activities of the autonomic nervous system during the baseline period. The results of this study demonstrated that the Type D group's normalized low frequency (LF norm) and ratio of low frequency to high frequency (LF/HF ratio) were higher than those for the non-Type D group, while its normalized high frequency (HF norm) was lower than that for the non-Type D group in all three periods. There were no statistically significant differences among the three periods in terms of LF norm, HF norm, and LF/HF ratio in the Type D group. The study demonstrated that the total scores of the Type DS-14 and scores of social inhibition and negative affect were independent predictors of LF norm and HF norm during the baseline. The Type D group showed increased activation of the sympathetic nervous system and/or decreased activation of the parasympathetic nervous system. These results support the hypothesis that the Type D personality is vulnerable to the stress. Also, the highly activated sympathetic and/or lowly activated parasympathetic nervous systems, which were observed in the Type D group during the baseline, indicated that the Type D individual is susceptible to psychosomatic disorders.

Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

Changes of Stress Response and Physiological Metabolic Activity of Flounder, Paralichthys olivaceus Following to Food Deprivation and Slow Temperature Descending (먹이제한과 단기 수온하강 조건에서 넙치의 스트레스 반응과 생리학적 대사활성 변화)

  • Myeong, Jeong-In;Kang, Duk-Young;Kim, Hyo-Chan;Lee, Jeong-Ho;Noh, Jae-Koo;Kim, Hyun-Chul
    • Korean Journal of Ichthyology
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    • v.23 no.2
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    • pp.87-94
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    • 2011
  • To find the preliminary environmental conditions for a short-time transport of living olive flounder, Paralichthys olivaceus, the stress response and physiological metabolic activity of the cultured fish to feed deprivation and slow temperature descending ($15.8^{\circ}C{\rightarrow}13.3^{\circ}C$) were monitored for 8 days. The monitored variables were the plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose (GLU), total protein (TP), electrolytes ($Na^+$, $K^+$, $Cl^-$) and thyroid hormones ($TT_4$, $TT_3$, $FT_4$ and $FT_3$). In food deprivation experiment for 8 days, we did not find any statistical change of level in AST, ALT and electrolytes ($Na^+$, $K^+$, $Cl^-$), but found a significant decrease in TP and GLU. In thyroid hormones, the levels of four hormones in plasma were all showing a tendency to decrease. Especially, $FT_4$ and $TT_3$ were significantly decreased, indicating a withering of physiologic activity. In the temperature test, although no any significant change in AST, TP and electrolytes ($Na^+$, $K^+$, $Cl^-$), we observed a significant decrease of ALT and GLU following to temperature descending from $15.8^{\circ}C$ to $13.3^{\circ}C$ (P<0.05). In the levels of thyroid hormones, any significant change was not observed for experimental period. We conclude that the stress response and physiological activity of olive flounder were more influenced by feed deprivation than slow temperature descending at a transport of living fish, and plasma GLU appears to be sensitive factor to physiological metabolic activity, indicating that it could be used as a monitering mark or index for a health inspection of the fish.

A Study on Damage factor Analysis of Slope Anchor based on 3D Numerical Model Combining UAS Image and Terrestrial LiDAR (UAS 영상 및 지상 LiDAR 조합한 3D 수치모형 기반 비탈면 앵커의 손상인자 분석에 관한 연구)

  • Lee, Chul-Hee;Lee, Jong-Hyun;Kim, Dal-Joo;Kang, Joon-Oh;Kwon, Young-Hun
    • Journal of the Korean Geotechnical Society
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    • v.38 no.7
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    • pp.5-24
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    • 2022
  • The current performance evaluation of slope anchors qualitatively determines the physical bonding between the anchor head and ground as well as cracks or breakage of the anchor head. However, such performance evaluation does not measure these primary factors quantitatively. Therefore, the time-dependent management of the anchors is almost impossible. This study is an evaluation of the 3D numerical model by SfM which combines UAS images with terrestrial LiDAR to collect numerical data on the damage factors. It also utilizes the data for the quantitative maintenance of the anchor system once it is installed on slopes. The UAS 3D model, which often shows relatively low precision in the z-coordinate for vertical objects such as slopes, is combined with terrestrial LiDAR scan data to improve the accuracy of the z-coordinate measurement. After validating the system, a field test is conducted with ten anchors installed on a slope with arbitrarily damaged heads. The damages (such as cracks, breakages, and rotational displacements) are detected and numerically evaluated through the orthogonal projection of the measurement system. The results show that the introduced system at the resolution of 8K can detect cracks less than 0.3 mm in any aperture with an error range of 0.05 mm. Also, the system can successfully detect the volume of the damaged part, showing that the maximum damage area of the anchor head was within 3% of the original design guideline. Originally, the ground adhesion to the anchor head, where the z-coordinate is highly relevant, was almost impossible to measure with the UAS 3D numerical model alone because of its blind spots. However, by applying the combined system, elevation differences between the anchor bottom and the irregular ground surface was identified so that the average value at 20 various locations was calculated for the ground adhesion. Additionally, rotation angle and displacement of the anchor head less than 1" were detected. From the observations, the validity of the 3D numerical model can obtain quantitative data on anchor damage. Such data collection can potentially create a database that could be used as a fundamental resource for quantitative anchor damage evaluation in the future.