• Radiation Oncology Journal
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• v.28 no.3
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• pp.177-183
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• 2010

Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.256-261
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• 2008

Purpose: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. Materials and Methods: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. Results: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, $kg/m^2$) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. Conclusion: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.

• Journal of the Korean Applied Science and Technology
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• v.36 no.3
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• pp.758-765
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• 2019

The purpose of the this study was to determine the comparative analysis of body muscle activities in plank exercise with and without thera-band. Twelve healthy adult males(age, $21.75{\pm}.57$ years; height, $173.33{\pm}1.34cm$; body mass, $65.92{\pm}1.64kg$; and BMI, $21.93{\pm}.46kg/m^2$) participated in this study as subjects. Plank exercises(full, elbow, side, and reverse plank) were performed with four different thera-band in without(WT), red color(RT), blue color(BT), and siver color(ST). We measured the muscle activities of the erector spinae(ES), deltoideus p. acromialis(DA), external oblique(EO), rectus abdominis(RA), rectus femoris(RF), latissimus dorsi(LD), pectoralis major(PM), and biceps femoris(BF). The research findings were as follows. ES and DA muscle activities were greatest during full plank performed with the WT(p<.05). EO, RA, RF, and PM muscle activities were greatest during full plank performed with the ST(p<.05). ES and DA muscle activities were greatest during elbow plank performed with the WT(p<.05). RF and PM muscle activities were greatest during elbow plank performed with the ST(p<.05). ES, EO, RA, RF, LD, PM, and BF muscle activities were greatest during side plank performed with the ST(p<.05). DA, EO, RA, RF, LD, PM, and BF muscle activities were greatest during reverse plank performed with the ST(p<.05). These results are expected to serve as reference materials for plank exercise applications in training programs for body muscle strengthening.

• Journal of Nutrition and Health
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• v.52 no.1
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• pp.73-89
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• 2019

Purpose: This study was conducted to identify the dietary life and nutritional status of Korean elementary school students according to breakfast frequency and to clarify the relationship between breakfast frequency of elementary school students and parental dietary and social environmental factors. Methods: This study used data from the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES VI). The subjects were 1,325 elementary school students aged 6 to 11 years old. Subjects were categorized into two groups: a skipping breakfast group (ate breakfast 0 ~ 4 times per week), eating breakfast group (ate breakfast 5 ~ 7 times per week) by sex and grade (lower grade: 1st ~ 3rd/upper grade: 4 th ~ 6 th). Results: Among upper grade boys and girls, the skipping breakfast group had a higher rate of childhood obesity than the eating breakfast group. In lower grade boys, the mothers of the skipping breakfast group had higher rates of economic activity and eating breakfast alone without family members than the mothers of the eating breakfast group. For lower grade boys and girls and upper grade boys, the skipping breakfast group had a higher rate of parents who did not eat breakfast than the eating breakfast group. The energy intake of the breakfast consumed by all subjects was less than 25% of the Estimated Energy Requirements (EER). Moreover, for upper grade boys and girls, the skipping breakfast group had a higher rate of subjects whose daily intake was below the Estimated Average Requirement (EAR) for iron than the eating breakfast group. Conclusion: Breakfast frequency of elementary school students was related to childhood obesity. The frequency of eating breakfast among elementary school students was related to the dietary life factors of parents such as breakfast frequency and dietary condition. Intake for breakfast was less than 25% of the EER, while the skipping breakfast group had a higher rate of subjects whose daily intake was below the EAR for iron than the eating breakfast group. Therefore, it is necessary to consider diverse forms of policy support such as opening nutrition education programs for parents and practicing morning meals at school for elementary school students to provide regular and balanced breakfasts.

• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.12
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• pp.1856-1864
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• 2015

The purpose of this study was to investigate the nutrient intake status of university students in Chuncheon area (175 males and 131 females). This study was conducted by employing a self-administered questionnaire. Dietary assessment was measured by a 24-h recall method. The average height and weight of male students were $175.2{\pm}6.2cm$ and $68.2{\pm}9.9kg$, respectively. For female students, average values were $161.7{\pm}5.2cm$ and $55.1{\pm}6.5kg$, respectively. The mean BMIs for both male and female students were 22.2 and 21.1, respectively. In both male and female students, the rate of skipping breakfast was high. Daily averages for energy, carbohydrates, protein, and fat intakes in male students were significantly higher than those of female students (P<0.001). For male students, protein, vitamin B1, P, Fe, and Na were above recommended nutrient intake and adequate intake, whereas for female students, they were protein, vitamin A, P, and Na. For male students, nutrient intakes for Ca, vitamin $B_2$, vitamin C, and vitamin $B_6$ were below the estimated average requirement (EAR) by at least 50% or more, whereas for female students, they were vitamin C, Fe, vitamin $B_6$, vitamin $B_2$, niacin, folate, and Ca. Ca was alarmingly low, with more than 75% of both male and female students showing levels below the EAR. Therefore, it is important that nutritional education be facilitated for college students to take responsibility of their own health through learning about nutrient intake as well as developing positive eating habits.

• Journal of Nutrition and Health
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• v.48 no.1
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• pp.46-57
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• 2015

Purpose: The aim of this study was to determine an appropriate energy level of breakfast with less risk of chronic disease for Korean adults. Methods: Using data from the 2007~2009 Korean National Health & Nutrition Examination Survey, from a total of 12,238 adults aged 19~64, the final 7,769 subjects were analyzed except subjects who were undergoing treatment for cancer or metabolic disorder. According to the percent of breakfast energy intake versus their estimated energy requirement (EER), the subjects were divided into four groups: < 10% (very low, VL), 10~20% (low, L), 20~30% (moderate, M), ${\geq}30%$ (sufficient, S). All data were analyzed on the metabolic risk and nutritional state after application of weighted value and adjustment of sex, age, residential area, income, education, job or jobless, and energy intake using a general linear model or logistic regression. Results: The subjects of group S were 16.9% of total subjects, group M 39.2%, group L 37.6%, and group VL 6.3%. The VL group included more male subjects, younger-aged (19 to 40 years), urban residents, higher income, higher education, and fewer breakfasts eaters together with family members. Among the 4 groups, the VL group showed the highest waist circumference, while the S group showed the lowest waist circumference, body mass index, and serum total cholesterol. The groups of VL and L with lower intake of breakfast energy showed high percent of energy from protein and fat, and low percent of energy from carbohydrate. With the increase of breakfast energy level, intake of energy, most nutrients and food groups increased, and the percentage of subjects consuming nutrients below EAR decreased. The VL group showed relatively higher intake of snacks, sugar, meat and eggs, oil, and seasonings, and the lowest intake of vegetable. Risk of obesity by waist circumference was highest in the VL group by 1.90 times of the S group and the same trend was shown in obesity by BMI. Risk of dyslipidemia by serum total cholesterol was 1.84 times higher in the VL group compared to the S group. Risk of diabetes by Glu-FBS (fasting blood sugar) was 1.57 times higher in the VL group compared to the S group. Conclusion: The results indicate that higher breakfast energy level is positively related to lower metabolic risk and more desirable nutritional state in Korean adults. Therefore, breakfast energy intake more than 30% of their own EER would be highly recommended for Korean adults.

• Journal of Nutrition and Health
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• v.49 no.3
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• pp.165-178
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• 2016

Purpose: This study was performed to examine associations of intakes of milk and dairy products, pulses, and soy foods with bone health in Koreans aged 50 yr and older. Methods: A total of 3,201 men and 3,581 women aged 50 yr and older who participated in the 2008~2011 Korea National Health and Nutrition Examination Survey were grouped by sex and age groups of 50~64 yr and 65 yr and older. Subjects within each sex and age group were divided into three bone health groups: normal, osteopenia, and osteoporosis groups based on bone mineral density. Intakes of nutrients and foods derived from 24-hour recall data were compared among three bone health groups. Associations between intake frequencies of foods, including milk, yogurt, tofu, or soy milk, and osteoporosis risk were evaluated based on confounding risk factor-adjusted logistic regression. Results: Calcium intake was in the order of normal, osteopenia, and osteoporosis in men (p < 0.01) and women (p < 0.05) aged 50~64 yr as well as in men aged 65 yr and older (p < 0.001). In women aged 50~64 yr, intake of milk and dairy products was lower in the osteoporosis group (p < 0.01) as compared with the osteopenia group. Intake of pulses or tofu was not significantly different among bone health groups. Odds ratio (OR) for milk intake frequency (${\geq}2$ times/week) compared to intake frequency less than 1 time/month was 0.45 (95% CI 0.24~0.85, p for trend = 0.022) in men aged 65 yr and older. The OR for yogurt intake frequency (1 time/month~1 time/week) was 0.47 (95% CI 0.30~0.73, p for trend = 0.019) in women aged 50~64 yr. Intake frequency of tofu or soy milk was not associated with reduced risk of osteoporosis in all groups. Conclusion: Dairy food intake was significantly associated with bone health, and its effect was sex- and age group-specific, whereas soy food intake was not. Dietary intervention to prevent osteoporosis would be effective for women aged 50~64 yr old and for men aged 65 yr and older.

• Journal of Nutrition and Health
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• v.42 no.6
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• pp.536-546
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• 2009

This study was done to investigate the effect of stress on appetite and eating habits, and other health-related behaviors. The subjects of this study consisted of 188 males and 224 females in Ulsan area. The results were as follows: When stressed, 56% (n = 231) of the subjects experienced a change in appetite and of these, 32% (n = 132) experienced an increased appetite. Stress-induced eating may be one factor contributing to the development of obesity. There was a gender-specific response to stress in which women are more likely to use food to deal with stress, whereas men are more likely to use alcohol consumption or smoking. It was found that types of stressors were individual (52.9%), social (50.7%), family relations (34.5%), work demands (34.2%) and physical environment (32.3%). Stress-induced symptoms of the subjects were anxiety (38.3%), headache (36.7%) and neck or shoulder aches (36.2%), and females experienced those symptoms more than males. Those older than 50 years had a higher eating habit score and lower stress score compared with younger subjects. There were significant differences between sex, age, occupation, family type, BMI, exercise, sleeping hours and eating habits or stress level. This study may be helpful in advancing findings in this area to better provide health professionals with appropriate counseling tools to improve the health of all individuals.

• Sleep Medicine and Psychophysiology
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• v.19 no.2
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• pp.68-76
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• 2012

Objectives: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. Methods: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=$41.50{\pm}13.16$ yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=$43.67{\pm}12.11$ yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age $44.93{\pm}12.38$ yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=$45.87{\pm}12.44$ yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. Results: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were $991.1{\pm}27.1$ and $875.8{\pm}22.0$ ms (p=0.016), standard deviation of NN interval (SDNN) was $85.4{\pm}6.6$ and $112.8{\pm}5.4$ ms (p=0.022), SDNN index was $57.5{\pm}5.2$ and $87.6{\pm}4.2$ (p<0.001), total power was $11,893.5{\pm}1,359.9$ and $18,097.0{\pm}1,107.2ms^2$(p=0.008), very low frequency (VLF) was $7,534.8{\pm}1,120.1$ and $11,883.8{\pm}912.0ms^2$ (p=0.035), low frequency (LF) was $2,724.2{\pm}327.8$ and $4,351.6{\pm}266.9ms^2$(p=0.003). Conclusions: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.135-143
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• 2009

Objectives : Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods : 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results : The amount of fat in the symptomatic side was $7.6{\pm}4.51%$, asymptomatic side was $6.7{\pm}4.29%$. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men $8.5{\pm}5.1%$, women $6.5{\pm}3.6%$). Conclusions : The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.