• Molecules and Cells
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• 제40권9호
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• pp.685-695
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• 2017

Obesity and the metabolic disorders that constitute metabolic syndrome are a primary cause of morbidity and mortality in the world. Nonetheless, the changes in the proteins and the underlying molecular pathways involved in the relevant pathogenesis are poorly understood. In this study a proteomic analysis of the visceral adipose tissue isolated from metabolically healthy and unhealthy obese patients was used to identify presence of altered pathway(s) leading to metabolic dysfunction. Samples were obtained from 18 obese patients undergoing bariatric surgery and were subdivided into two groups based on the presence or absence of comorbidities as defined by the International Diabetes Federation. Two dimensional difference in-gel electrophoresis coupled with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was carried out. A total of 28 proteins were identified with a statistically significant difference in abundance and a 1.5-fold change (ANOVA, $p{\leq}0.05$) between the groups. 11 proteins showed increased abundance while 17 proteins were decreased in the metabolically unhealthy obese compared to the healthy obese. The differentially expressed proteins belonged broadly to three functional categories: (i) protein and lipid metabolism (ii) cytoskeleton and (iii) regulation of other metabolic processes. Network analysis by Ingenuity pathway analysis identified the $NF{\kappa}B$, IRK/MAPK and PKC as the nodes with the highest connections within the connectivity map. The top network pathway identified in our protein data set related to cellular movement, hematological system development and function, and immune cell trafficking. The VAT proteome between the two groups differed substantially between the groups which could potentially be the reason for metabolic dysfunction.

• 과학기술학연구
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• 제13권2호
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• pp.137-172
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• 2013

전세계적으로 비만에 대한 경각심이 고조되고 있다. 한국에서도 비만은 치료해야 할 질병으로 인식되고 있으며 다양한 해결 방법들이 논의되고 있다. 비만의 문제화 과정은 BMI(체질량지수)라는 표준화된 수치를 통해 지엽적인 행위자 집단에서 개별적으로 이루어진다. 건강감시를 통해 질병의 예방을 강조하는 질병관리체계는 비만의 위험을 증폭시키고 비만과 관련된 행위자 집단이 문제해결과정에 참여하게 만든다. 비만치료법은 행동치료에서 약물치료로, 최근에는 비만수술이 추가되면서 단계화되어 나타난다. 이 과정에 관여하고 있는 행위자 집단은 새로운 비만치료기술인 랩밴드 수술에 관심을 갖고 랩밴드 연결망을 구성하게 된다. 이 논문은 비만 치료법의 표준화 과정을 랩밴드에 관심을 갖고 있는 다양한 행위자들의 연결망이 확장되는 과정으로 보고자 한다. 이 과정에서 다양한 행위자 집단은 랩밴드 수술에 각자의 이해관계를 투영하는 다중 번역을 통해 연결된다. 랩밴드 수술이 각 행위자들에게 해석적 유연성을 제공하는 경계물(boundary object)로서 작동한 것이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.1-27
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

• Clinical and Experimental Pediatrics
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• 제62권1호
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• pp.3-21
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.

• 비만대사연구학술지
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• 제1권2호
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• pp.74-77
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• 2022

Treatment of obesity includes diet therapy, exercise therapy, cognitive behavioral therapy, drug therapy, and bariatric surgery. Most obese patients lose weight by combining diet, exercise, cognitive behavioral therapy or medication. But, in some cases, only one of these treatments is preferred. A 56-year-old male patient had a body mass index (BMI) of 33.1 kg/m² and a waist circumference of 108 cm. He had been treated for hypertension; diabetes and dyslipidemia were diagnosed but not treated. However, at the initial visit to treat obesity, he was diagnosed with type 2 diabetes mellitus and dyslipidemia again. So he decided to treat these two diseases with drugs first and modify his lifestyle. He started walking more than 20,000 steps every day and then he really walked about 15,000 steps every day during 5 months, although diet calorie or alcohol drinking amount was not significantly decreased. After about 6 months, the patient's weight decreased by 10.1 kg, the BMI decreased by 4.1 kg/m², the waist circumference decreased by 10 cm, the glycated hemoglobin (HbA1c) decreased by 4.59%, the visceral fat area decreased by 115 cm², and the subcutaneous fat decreased by 38 cm². As a result of body composition analysis, muscle mass increased by 1.2 kg, and the percentage of body fat decreased by 10.4%. The walking exercise does not have any space restrictions and has high accessibility by using a mobile phone app. Therefore, considering the patient's situation, it would be better to treat obese patients by first recommending walking exercises and increasing the number of steps to lose weight and improve the comorbidities.

• 수면정신생리
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• 제29권1호
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• pp.4-8
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• 2022

Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m²), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.

• Journal of Gastric Cancer
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• 제5권4호
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• pp.295-303
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• 2005

대한복강경위장관연구회가 2004년 전국에서 시행된 복강경 위 수술의 현황을 조사하였다. 모두 36개의 기관으로부터 38명의 외과의가 설문에 응답하였다. 2004년 한 해 동안 시행된 복강경 위 수술은 총 1,089예였고 1995년부터 2004년까지 시행된 복강경 위 수술을 누적하면 모두 2,386예였다. 2004년에 위선암 환자에서 시행된 복강경 위 수술은 2003년보다 약 2배 많은 754예였다. 위선암에 대한 근치적 위절제술인 복강경보조위아전절제술 및 복강경보조위전절제술은 2001년도를 전환점으로 급속히 증가하였다(2001년 55예, 2002년 150예, 2003년 364예, 2004년 738예). 특히 복강경보조위전절제술은 작년에 폭발적 인 증가를 보였다. (2003년 20예, 2004년 112예). 그러나 복강경보조유문부보존위절제술 및 복강경보조근위부위절제술과 같은 복강경보조기능보존위절제술은 작년 각각 1예씩 시행되어 아직 보편화되지 않았다. 위 점막하종양에 시행된 복강경위쐐기절제술은 142예였다. Hand-assisted laparoscopic surgery는 2001년 39예, 2002년 55예, 2003년 49예가 시행되었으나 2004년에는 단 5예만 시행되어 급격한 감소를 보였다. 고도비만수술은 2003년도에 시작되어 2004년에는 49예로 증가하였다. 위선 암에서 복강경위수술의 적응증에 대한 견해로서 19명이 조기위암에서 시행한다고 하였고 7명은 적응증을 T2N0까지 넓히고 있었다. 앞으로 보험문제가 해결이 되고 장기 성적이 나온다면 위선암에 대한 복강경 위 수술은 널리 보편화될 것이다.