• Anatomy & Biological Anthropology
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• v.31 no.4
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• pp.133-142
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• 2018

3D histology is a imaging system for the 3D structural information of cells or tissues. The synchrotron radiation propagation phase contrast micro-CT has been used in 3D imaging methods. However, the simple phase contrast micro-CT did not give sufficient micro-structural information when the specimen contains soft elements, as is the case with many biomedical tissue samples. The purpose of this study is to develop a new technique to enhance the phase contrast effect for soft tissue imaging. Experiments were performed at the imaging beam lines of Pohang Accelerator Laboratory (PAL). The biomedical tissue samples under frozen state was mounted on a computer-controlled precision stage and rotated in $0.18^{\circ}$ increments through $180^{\circ}$. An X-ray shadow of a specimen was converted into a visual image on the surface of a CdWO4 scintillator that was magnified using a microscopic objective lens(X5 or X20) before being captured with a digital CCD camera. 3-dimensional volume images of the specimen were obtained by applying a filtered back-projection algorithm to the projection images using a software package OCTOPUS. Surface reconstruction and volume segmentation and rendering were performed were performed using Amira software. In this study, We found that synchrotron phase contrast imaging of frozen tissue samples has higher contrast power for soft tissue than that of non-frozen samples. In conclusion, synchrotron radiation propagation phase contrast cryo-microCT imaging offers a promising tool for non-destructive high resolution 3D histology.

• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Anatomy & Biological Anthropology
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• v.31 no.4
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• pp.121-131
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• 2018

Stature is one of the unique biological properties of a person, which can be used for identification of the individual. In this regard, statures are estimated for the unknown victims from crimes and disasters. However, the accuracy of estimates may be compromised by inappropriate methodologies and/or practices of stature estimation. Discussed in this study are the methodological issues related to the current practices of forensic anthropological stature estimation in Korea, followed by suggestions to enhance the accuracy of the stature estimates. Summaries of forensic anthropological examinations for 560 skeletal remains, which were conducted at the National Forensic Service (NFS), were reviewed. Mr. Yoo Byung-eun's case is utilized as an example of the NFS's practices. To estimate Mr. Yoo's stature, Trotter's (1970) femur equation was applied even though the fibula equation of a lower standard error was available. In his case report, the standard error associated with the equation (${\pm}3.8cm$) was interpreted as an 'error range', which gave a hasty impression that the prediction interval is that narrow. Also, stature shrinkage by aging was not considered, so the estimated stature in Mr. Yoo's case report should be regarded as his maximum living stature, rather than his stature-at-death. Lastly, applying Trotter's (1970) White female equations to Korean female remains is likely to underestimate their statures. The anatomical method will enhance the accuracy of stature estimates. However, in cases that the anatomical method is not feasible, the mathematical method based on Korean samples should be considered. Since 1980's, effort has been made to generate stature estimation equations using Korean samples. Applying the equations based on Korean samples to Korean skeletal remains will enhance the accuracy of the stature estimates, which will eventually increase the likelihood of successful identification of the unknowns.

• Korean Public Health Research
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• v.44 no.4
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• pp.87-97
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• 2018

Background: Recently, the prevalence of obesity (body mass index [BMI] ${\geq}25kg/m^2$) has been increasing rapidly worldwide over a short period. In Korea, the prevalence of obesity has also increased rapidly due to the rapid socio-economic development and lifestyle changes, with differing patterns according to gender. This study aimed to compare the change in obesity prevalence according to gender among the adult population in Korea using representative data, the National Health Check-up Database (NHCD), to follow-up individuals who had undergone checkups during both years in Korea (2011~2013). Methods: To analyze the changes in obesity prevalence in the recent two years, data regarding men and women who had undergone health check-ups in both two years (2011, 2013) were extracted. The final study population comprised 144,934 persons: 83,604 (58%) males and 61,330 (42%) females. Chi-square test within a univariate analysis, and the level of factor difference was verified with t-test, one-way ANOVA and multiple comparison. Results: In 2011, one out of three participants was obese (BMI ${\geq}25kg/m^2$; male, 37.7%; female, 27.3%) and more than half of the subjects were overweight (BMI ${\geq}23kg/m^2$; male, 65.6%; female, 50.4%) requiring obesity management. For the two years, the BMI of the participants significantly increased (p < .0001) and the prevalence of obesity increased among both males and females. The prevalence of obesity was higher among both genders with a longer duration of smoking, more smoking, family history of hypertension, and family history of diabetes. However, residence, income level, drinking status, psychiatric disorder, disability status and severity of disability were the opposite gender. Conclusion: In the analysis of data, the prevalence of obesity among both men and women was increasing. The degree of change in the prevalence of obesity among men and women was different in each variable. Thus, it will need to consider gender in developing health policies for obesity mediation and to provide integrated healthcare and management for those people.

• Journal of Nutrition and Health
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• v.52 no.2
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• pp.217-226
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• 2019

Purpose: This study examined the nutrient intake and dietary habits based on breakfast consumption in Korean adolescents. Methods: The data of the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES) were used in this study. The analysis included 1,281 adolescents aged 12 to 18 years. The subjects were divided into two groups (EBF: eating breakfast, n = 911; SBF: skipping breakfast, n = 370). Results: The EBF group was significantly younger than the SBF group. In addition, the EBF group had a significantly lower frequency of skipping dinner than the SBF group. The EBF group consumed significantly higher levels of most nutrients except for vitamin A than the SBF group. The percent of nutrient intake under the EAR (estimated average requirements) in the EBF group were also significantly lower than that in the SBF group. Moreover, the NAR (nutrient adequacy ratio) and MAR (mean adequacy ratio) of the EBF group were significantly higher than those of the SBP group. The intake of cereal, sugars and sweeteners, vegetables, and eggs in the EBF group was significantly higher than that in the SBF group. Conclusion: The habit of skipping breakfast in adolescents leads to a decrease in the total nutrient intake and imbalanced dietary habits. Breakfast consumption in adolescence is very important. Therefore, more studies will be needed to develop nutrition education systematically in Korean adolescents.

• Journal of Nutrition and Health
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• v.52 no.1
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• pp.47-57
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• 2019

Purpose: This study was conducted to investigate the relationship between atopic dermatitis and dietary fat and fatty acid (FA) intakes in 9 ~ 11 year old children. Methods: We analyzed data from the combined 2013 ~ 2015 KNHANES (Korean National Health and Nutrition Examination Survey). Subjects were divided into two groups according to atopic dermatitis (AD); with AD and without AD. Data pertaining to macronutrients and FA intakes were obtained by a single 24-h dietary recall. Food sources were identified based on the amounts of total fat and FA consumption according to each food. The associations between each FA intake and atopic dermatitis were analyzed using simple and multiple logistic regression analyses. Age, sex, body mass index (BMI) and income levels were adjusted as covariates. Results: Of the participants, 17.69% suffered from atopic dermatitis. Children with AD had significantly lower fat percentages of total energy and higher carbohydrate percentages of total energy than normal children. Percentages of energy and intakes of polyunsaturated fatty acid (PUFA), n-3 FA and n-6 FA in children with AD were significantly lower than those in normal children. In the FA, linoleic acid, ${\gamma}$-linoleic acid and ${\alpha}$-linolenic acid levels of children with AD were significantly lower than those of normal children. However, the P/S ratio and n-6/n-3 ratio did not differ significantly between children with AD and normal children. Soybean oil was the main contributor to PUFA, n-3 FA and n-6 FA in both groups, while perilla seed oil and mackerel were the major food sources of n-3 FA in children with atopic dermatitis. Atopic dermatitis was significantly correlated with low-fat and high-carbohydrate diets. The adjusted odds ratios were 0.966, 0.776 and 0.963 for PUFA, n-3 FA, and n-6 FA intakes, respectively. Conclusion: The present study provides reliable evidence regarding the relationship between fat and FA intakes and AD in Korean children 9 ~ 11 years of age.

• Journal of Nutrition and Health
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• v.52 no.3
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• pp.297-309
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• 2019

Purpose: This study examined the relationship among the use of food-related content (FRC), dietary behaviors, and dietary self-efficacy to demonstrate the need for nutrition education to help adolescents build healthy eating habits and provide evidence for developing nutrition education programs for adolescents. Methods: Three hundred and eighty-one high school students in Seoul and Gyeonggi areas participated in the study. The subjects were divided into three groups (low, medium, and high) according to the level of use of the FRC, and their general characteristics, dietary behaviors, and dietary self-efficacy were analyzed. Correlation analysis was performed between FRC usage, dietary behaviors, and dietary self-efficacy, and the mediating effects of dietary self-efficacy on the relationship between the level of the use of FRC and dietary behaviors were estimated. Results: A higher level of FRC usage was associated with an increased daily cost of eating out and snacking, but no difference was observed in the BMI range. The subjects in a group with a high level of FRC usage ate convenience store or instant foods instead of homemade meals (p = 0.033), had a late-night meal or snack (p = 0.024), and turned to emotional eating under stress (p < 0.001) more than those in the low level group. In addition, the high level group checked the nutrition facts label more carefully when purchasing processed foods (p = 0.016) and exercised at least 30 minutes daily, not considering physical education classes (p = 0.057). The higher level of FRC use, the lower the dietary self-efficacy, whereby the subscales 'environmental stimulus control efficacy' and 'affective factor control efficacy' showed complete mediating effects. Conclusion: Given that FRC has been increased recently, adolescents are in need of support to help them control and enhance their dietary self-efficacy as well as develop healthy dietary behaviors through proper nutrition education programs.

• Journal of Nutrition and Health
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• v.51 no.6
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• pp.556-566
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• 2018

Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.

• Journal of the Korean Applied Science and Technology
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• v.36 no.2
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• pp.371-382
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• 2019

The aim of this study was to evaluate the physiological responses following acute and chronic Nurida-ball exercise to measure the relative exercise intensity and health-related fitness in middle-aged men. In study 1, eight middle-aged men carried out acute Nurida-ball exercise for 30 min. The physiological responses were normalized and compared with a graded treadmill exercise test (GXT) to evaluate the relative exercise intensity. In study 2, twelve middle-aged men were divided into two groups: Nurida-ball exercise group (NB, n=6) and control group (CON, n=6). NB group performed the Nurida-ball exercise for 8 weeks (30min/day, 3 days/week). And then, we measured the body composition, cardiovascular factors, blood lipid factors, and muscle damage markers to confirm the exercise efficiency. In study 1, the related exercise intensity of acute Nurida-ball is the range of GXT-HRpeak (55~85%) and $GXT-VO_2peak$(23~61%). The change in body fat-related factors was significantly lower in the NB compared to the CON group. Moreover, TC and LDL were decreased whereas BMC was increased in the NB group after Nurida-ball exercise. The change in VEpeak and performance time of GXT were significantly greater in the NB compared to the CON group. The performance time of GXT was increased in the NB group after Nurida-ball exercise. Our results indicated that Nurida-ball exercise would be effective equipment for the improvement of health-related fitness. Especially, Nurida-ball exercise can affect body composition and cardiovascular function, which might alleviate metabolic syndrome-related diseases in middle-aged men.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.339-348
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• 2019

The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.