• 대한지역사회영양학회지
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• 제26권4호
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• pp.280-295
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• 2021

Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Animal Bioscience
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• 제34권1호
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• pp.26-35
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• 2021

Objective: This study was conducted to assess the level of pregnancy-associated glycoprotein (PAG) in whole and skim milk samples, and its suitability for early pregnancy diagnosis in goats. Methods: A two-step sandwich enzyme-linked immunosorbent assay (ELISA) system for estimation of milk PAG was developed and validated, which employed caprine-PAG specific polyclonal antisera. Whole and skim milk samples (n = 210 each) from fifteen multiparous goats were collected on alternate days from d 10 to d 30, and thereafter weekly till d 51 post-mating. PAG levels in milk samples were estimated by ELISA and the pregnancies were confirmed at d40 post-mating by transrectal ultrasonography (TRUS). Results: The level of PAG in whole and skim milk samples of both pregnant and nonpregnant goats remained below the threshold values until d 24 after mating. Thereafter, PAG concentration in whole and skim milk increased steadily in pregnant goats, whereas it continued below the threshold in non-pregnant does. The PAG profiles in whole and skim milk of pregnant goats were almost similar and exhibited strong positive relationship (r = 0.891; p<0.001). Day 26 post-mating was identified as the first time-point for significantly (p<0.05) higher milk PAG concentration in pregnant goats than to non-pregnant goats. When compared to TRUS examination for pregnancy diagnosis, the accuracy and specificity of PAG ELISA using whole and skim milk samples were 94.5% and 95.4%; and 95.3% and 100%, respectively. The high values of area-under-curve (0.904 [whole milk] and 0.922 [skim milk]), demonstrate outstanding discrimination ability of the milk assays. Among the sampling dates chosen, d 37 post-mating was identified as the best suitable time point for collection of milk samples to detect pregnancy in goats. Conclusion: The PAG concentration in whole and skim milk of goats collected between days 26 and 51 post-breeding can be used for the accurate prediction of pregnancy and may be useful for assisting management decisions in goat flocks.

• 한국식품과학회지
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• 제53권1호
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• pp.72-77
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• 2021

숙취를 해결하기 위해서는 숙취를 직접적으로 유발하는 물질인 아세트알데하이드의 조절이 가장 중요한 인자로 작용한다. 숙잠을 함유하는 복합물인 시험식품(CKDHC)의 섭취로 혈중 아세트알데하이드 농도가 대조식품 대비 통계적으로 유의하게 감소하여 숙취개선 효능을 확인하였다. 특히, 30분부터 각 시간별(mg/L), 혈중 아세트알데하이드 농도-시간곡선하 면적(AUC), 최고 혈중 아세트알데하이드 농도(Cmax)의 감소를 통해 30분부터 빠른 숙취개선 효능을 확인하였다. 본 연구의 주원료로 사용된 숙잠은 Ji 등(2016a)에 따르면 18종의 아미노산 및 무기질을 모두 함유하며, 고단백 식용곤충으로 간에 좋은 주요 아미노산인 Alanine, Arginine 등을 많이 함유하여 간의 효소활성에 긍정적인 영향을 줄 수 있음을 알수있다. 본 연구결과를 통해 숙잠을 함유하는 시험식품이 숙취해소제로 작용할 수 있으며, 특히 음주 전 섭취시 아세트알데하이드를 빠르게 분해하여 30분부터 숙취 개선에 효과가 있음을 입증하였다.

• Nutrition Research and Practice
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• 제15권1호
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• pp.54-65
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• 2021

BACKGROUND/OBJECTIVES: This study aimed to develop healthy, appetizing high-protein snacks with enhanced isolated soy protein for diabetic patients and determine the blood glucose and insulin response after being consumed by these patients. MATERIALS/METHODS: Thirty adult patients aged between 30 and 75 years, with a ≤ 10-year history of type 2 diabetes and hemoglobin A1c of < 7.5%, were enrolled in this study. They made 3 clinical visits at one-week intervals. The control group consumed 50 g carbohydrates (white bread), whereas the test groups consumed high-protein grain (HP_G) or high-protein chocolate (HP_C) after an 8-hrs fast. Blood (2 ㎤) was drawn at 15, 30, 45, 60, 90, and 120 min before and after consumption to analyze the blood glucose and insulin concentrations. RESULTS: Compared to the commercial snacks, the developed high-protein snacks had below-average calorie, carbohydrate, and fat content and a 2.5-fold higher protein content. In diabetic patients who consumed these snacks, the postprandial blood glucose increased between 15 min and 2 h after consumption, which was significantly slower than the time taken for the blood glucose to increase in the patients who consumed the control food product (P < 0.001). Insulin secretion was significantly lower at 45 min after consumption (P < 0.05), showing that the high-protein snacks did not increase the blood glucose levels rapidly. The incremental area under the curve (iAUC), which indicated the degree of blood sugar and insulin elevation after food intake, was higher in the control group than the groups given the 2 developed snacks (P < 0.001), and there was no significant difference in insulin secretion. CONCLUSIONS: The results of the postprandial blood glucose and insulin response suggest that high-protein snacks are potential convenient sources of high-quality protein and serve as a healthier alternative for patients with type 2 diabetes, who may have limited snack product choices. Such snacks may also provide balanced nutrition to pre-diabetic and obese individuals.

• 생명과학회지
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• 제30권12호
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• pp.1054-1062
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• 2020

벼메뚜기는 메뚜기과에 속하는 불완전 변태 곤충으로, 국내에서 오랫동안 식용으로 이용되어 왔다. 현재까지 벼메뚜기의 항산화 및 항염증 효과 등의 기능들이 연구되었으나, 탄수화물 소화 효소나 식후 혈당 수치에 미치는 영향에 관한 연구는 부족한 실정이다. 이에 본 연구는 벼메뚜기 에탄올 추출물(OEE)와 물 추출물(OWE)이 탄수화물 소화 효소를 저해하고, streptozotocin (STZ)으로 유도된 당뇨병 마우스에서 식후 고혈당을 강하시키는 효과에 대해 조사하였다. 그 결과 OEE에 의한 α-glucosidase와 α-amylase 저해 효과가 OWE 보다 더 효과적이었다. 당뇨병 마우스에 전분(2 g/kg)을 투여한 후의 혈당 증가는 15, 30, 60, 120분에 각각 406.50, 431.50, 473.50 and 460.00 mg/dl로 나타났고, 전분(2 g/kg)과 OEE 추출물(300 mg/kg)을 투여한 후 혈당 증가는 15, 30, 60, 120분에 각각 327.00, 361.00, 358.67 and 291.00 mg/dl로 나타나, OEE 추출물 투여군이 대조군에 비해 식후 혈당 강하가 효과적으로 나타남을 알 수 있었다. 이러한 결과는 벼메뚜기 추출물이 α-glucosidase와 α-amylas를 저해함으로써 식후 고혈당을 완화시키고, 특히 벼메뚜기 에탄올 추출물(OEE)이 벼메뚜기 물 추출물(OWE) 보다 식후 고혈당을 완화시키는데 더욱 효과가 있는 것으로 나타났다. 따라서 OEE가 탄수화물 소화 효소 저해 효과로 식후 고혈당을 완화시키는 유용한 천연 기능성 식품이 될 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.575-584
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• 2021

Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.

• 대한영상의학회지
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• 제79권6호
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• pp.340-347
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• 2018

목적: 가도세틱산-조영증강 MRI에서 간세포암 피막 발견에 대한 영상차감기법의 진단적 가치를 알아보고자 하였다. 대상과 방법: 2015년 5월부터 2017년 2월까지 가도세틱산-조영증강 MRI를 시행 받고 수술을 시행한 hepatocellular carcinoma (이하 HCC) 고위험군 108명을 대상으로 하였다. 차감영상의 질 및 간문맥기와 이행기의 일반영상과 차감영상에서 피막 여부에 대해 평가하였고, 차감영상에서의 피막 여부가 Liver Imaging Reporting and Data System에 따른 간세포암 진단에 미치는 영향을 평가하였다. 결과: 수술 전 경동맥화학색전술을 시행 받았거나 차감영상의 질이 불만족스러운 34명의 환자를 제외한 74명의 환자에서 82개의 간 병변(간세포암 73개, 그 외 악성종양 5개, 양성종양 4개)에 대해 분석하였다. 피막의 발견에 대한 차감영상의 민감도, 정확도, 그리고 곡선하면적은 일반영상과 비교하여 통계적으로 유의하게 높았고(각 95.4%, 89.0%, 0.80; p < 0.001), 특이도는 동일하였다(64.7%). HCC의 진단에 대해서도 차감영상이 일반영상과 비교하여 민감도, 정확도, 그리고 곡선하면적이 통계적으로 유의하게 높았으며(각 82.2%, 79.3%, 0.69; p = 0.011), 특이도는 동일하였다(55.6%). 결론: 가도세틱산-조영증강 MRI에서 간문맥기 또는 이행기로부터의 차감영상은 간세포암 피막의 발견에 도움이 된다.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.125-133
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• 2021

Background: The coronavirus disease (COVID-19) can manifest in a range of symptoms, including both asymptomatic systems which appear nearly non-existent to the patient, all the way to the development of acute respiratory distress syndrome (ARDS). Specifically, COVID-19-associated pneumonia develops into ARDS due to the rapid progression of hypoxia, and although arterial blood gas analysis can assist in halting this deterioration, the current environment provided by the COVID-19 pandemic, which has led to an overall lack of medical resources or equipment, has made it difficult to administer such tests in a widespread manner. As a result, this study was conducted in order to determine whether the levels of oxygen saturation (SpO₂) and the fraction of inhaled oxygen (FiO₂) (SF ratio) can also serve as predictors of ARDS and the patient's risk of mortality. Methods: This was a retrospective cohort study conducted from February 2020 to Mary 2020, with the study's subjects consisting of COVID-19 pneumonia patients who had reached a state of deterioration that required the use of oxygen therapy. Of the 100 COVID-19 pneumonia cases, we compared 59 pneumonia patients who required oxygen therapy, divided into ARDS and non-ARDS pneumonia patients who required oxygen, and then investigated the different factors which affected their mortality. Results: At the time of admission, the ratios of SpO₂, FiO₂, and SF for the ARDS group differed significantly from those of the non-ARDS pneumonia support group who required oxygen (p<0.001). With respect to the predicting of the occurrence of ARDS, the SF ratio on admission and the SF ratio at exacerbation had an area under the curve which measured to be around 85.7% and 88.8% (p<0.001). Multivariate Cox regression analysis identified that the SF ratio at exacerbation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.846-0.991; p=0.029) and National Early Warning Score (NEWS) (HR, 1.277; 95% CI, 1.010-1.615; p=0.041) were significant predictors of mortality. Conclusion: The SF ratio on admission and the SF ratio at exacerbation were strong predictors of the occurrence of ARDS, and the SF ratio at exacerbation and NEWS held a significant effect on mortality.

• Journal of Nutrition and Health
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• 제54권6호
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• pp.594-602
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• 2021

본 연구는 고지방식이로 유도한 비만 동물모델에서 아연의 식이를 통한 보충 급여가 혈당 조절과 골격 근육의 ZIP7의 작용에 미치는 영향에 대해 살펴보았다. 고지방식이를 공급한 HF군은 정상 대조군에 비하여 단위 체중당 골격 근육 무게가 유의하게 감소하였으며, 혈당은 유의적으로 증가하였다. 고지방식이와 함께 아연을 보충 공급한 HF+Zn군은 아연을 보충하지 않은 HF군과 비교하여, 공복 혈당과 경구 포도당 부하 후 혈당 증가 면적이 유의하게 감소하였다. 또한, HF+Zn군은 HF군에 비해 골격 근육의 ZIP7 단백질 수준이 유의하게 증가하였으며, AKT 활성과 GLUT4 단백질 수준도 유의하게 증가하는 것으로 나타났다. 이상의 결과를 종합해 볼 때, 아연 보충은 비만으로 인한 고혈당 증세를 완화하는 효과를 나타내며, 이는 골격 근육에서의 ZIP7 아연 수송체에 의한 당 대사 조절과 관련이 있을 것으로 생각된다.

• Journal of Gastric Cancer
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• 제21권4호
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• pp.368-378
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• 2021

Purpose: When patients with early gastric cancer (EGC) undergo non-curative endoscopic submucosal dissection requiring gastrectomy (NC-ESD-RG), additional medical resources and expenses are required for surgery. To reduce this burden, predictive model for NC-ESD-RG is required. Materials and Methods: Data from 2,997 patients undergoing ESD for 3,127 forceps biopsy-proven differentiated-type EGCs (2,345 and 782 in training and validation sets, respectively) were reviewed. Using the training set, the logistic stepwise regression analysis determined the independent predictors of NC-ESD-RG (NC-ESD other than cases with lateral resection margin involvement or piecemeal resection as the only non-curative factor). Using these predictors, a risk-scoring system for predicting NC-ESD-RG was developed. Performance of the predictive model was examined internally with the validation set. Results: Rate of NC-ESD-RG was 17.3%. Independent pre-ESD predictors for NC-ESD-RG included moderately differentiated or papillary EGC, large tumor size, proximal tumor location, lesion at greater curvature, elevated or depressed morphology, and presence of ulcers. A risk-score was assigned to each predictor of NC-ESD-RG. The area under the receiver operating characteristic curve for predicting NC-ESD-RG was 0.672 in both training and validation sets. A risk-score of 5 points was the optimal cut-off value for predicting NC-ESD-RG, and the overall accuracy was 72.7%. As the total risk score increased, the predicted risk for NC-ESD-RG increased from 3.8% to 72.6%. Conclusions: We developed and validated a risk-scoring system for predicting NC-ESD-RG based on pre-ESD variables. Our risk-scoring system can facilitate informed consent and decision-making for preoperative treatment selection between ESD and surgery in patients with EGC.