• Sleep Medicine and Psychophysiology
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• v.18 no.1
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• pp.40-44
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• 2011

Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

• Journal of Nutrition and Health
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• v.43 no.6
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• pp.620-627
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• 2010

The study purpose was to investigate correlations among dietary habits score, life stress score and health-related quality of life (HRQL) score for female college students with functional constipation (FC). The data were collected in 2008 from 265 female college students: 86 with FC and 179 without FC. The diagnosis of FC was based on the Rome II criteria, and life stress and HRQL were assessed using self-administered life stress questionnaire and SF-36, respectively. The correlations among dietary habit score, life stress score, and HRQL score were evaluated. The averages of age, height, weight, body fat percentage and body mass index (BMI) of female college students were 20.8 years, 160.9 cm, 53.7 kg, 27.8%, and $20.7\;kg/m^2$, respectively. The average dietary habit score of "having meals with diverse foods" was significantly lower in the FC group than in the normal group (p < 0.05). The average faculty problem (p < 0.05), grade problem (p < 0.05), economy problem (p < 0.05), value problem (p < 0.05), and total stress (p < 0.01) scores of the FC group were significantly higher than those of the normal group. The average HRQL score was 70.4 in the FC group and 74.3 in the normal group (p < 0.05). There were significantly negative correlations between total stress score and total food habits score (r = -0.221; p < 0.01) and HRQL score (r = -0.539; p < 0.01) in the FC. These results suggest that female students with FC are highly perceptive to stress and have low HRQL. In addition, female students with FC may require nutritional education about eating diversity.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1091-1096
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• 2007

Purpose : The of common carotid artery intima media thickness (IMT) is an acknowledged noninvasive marker for early atherosclerotic changes. We investigate whether common carotid IMT is different between obese and normal-weight children and also evaluate the relationships IMT with cardiovascular risk factors. Methods : We collected the clinical data (age, sex, pubertal stage, body mass index) and measured blood pressure, glucose, insulin, lipid profiles and adiponectin in 49 obese children (mean age, 12 years) and 24 nonobese children as controls. The control group was composed of 24 nonobese children of the same age, sex and pubertal stage. We measured the carotid IMT of all subjects by B-mode ultrasound with a 7.5-MHz linear transducer and analyzed. Results : Obese children demonstrated a significantly thicker intima media (mean, 0.34 mm, peak, 0.42 mm) compared to the control group (mean, 0.31 mm, peak, 0.38 mm, P<0.01). IMT was significantly correlated to the BMI (r=0.431, P<0.01), age (r=0.317, P<0.01), total cholesterol (r=0.377, P< 0.01), triglyceride (r=0.253, P<0.05) and low-density lipoprotein cholesterol (r=0.289, P<0.05). Serum adiponectin was significantly lower in obese children than in controls (11.2 ng/mL vs. 14.7 ng/mL, P<0.05) and negatively related with IMT (r=-0.267, P<0.05). Conclusion : Obesity is associated with increased carotid artery IMT in children. Our results suggest vascular changes in obesity seem to occur already in childhood and vascular ultrasonography may helpful for screening cardiovascular complications in obese children.

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.552-564
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• 2017

Purpose: The purpose of this study was to measure energy expenditure (EE) the metabolic equivalents (METs) of 13 common physical activities by using a portable telemetry gas exchange system ($K4b^2$) and to assess the accuracy of the accelerometer (Actigraph $GT3X^+$) by gender in Korean adults. Methods: A total of 109 adults (54 males, 55 females) with normal BMI (body mass index) participated in this study. EE and METs of 13 selected activities were simultaneously measured by the $K4b^2$ portable indirect calorimeter and predicted by the $GT3X^+$ Actigraph accelerometer. The accuracy of the accelerometer was assessed by comparing the predicted with the measured EE and METs. Results: EE (kcal/kg/hr) and METs of treadmill walking (3.2 km/h, 4.8 km/h and 5.6 km/h) and running (6.4 km/h) were significantly higher in female than in male participants (p < 0.05). On the other hand, the accelerometer significantly underestimated the EE and METs for all activities except descending stairs, moderate walking, and fast walking in males as well as descending stairs in females. Low intensity activities had the highest rate of accurate classifications (88.3% in males and 91.3% females), whereas vigorous intensity activities had the lowest rate of accurate classifications (43.6% in males and 27.7% in females). Across all activities, the rate of accurate classification was significantly higher in males than in females (75.2% and 58.3% respectively, p < 0.01). Error between the accelerometer and $K4b^2$ was smaller in males than in females, and EE and METs were more accurately estimated during treadmill activities than other activities in both males and females. Conclusion: The accelerometer underestimated EE and METs across various activities in Korean adults. In addition, there appears to be a gender difference in the rate of accurate accelerometer classification of activities according to intensity. Our results indicate the need to develop new accelerometer equations for this population, and gender differences should be considered.

• Journal of the Korean Society of Food Science and Nutrition
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• v.42 no.2
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• pp.212-222
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• 2013

We studied the eating habits and sleeping patterns of 682 middle and high school students in their third year in Gwangju. According to the body mass index (BMI) of the subjects, obesity (over weight) was significantly higher in the third graders of high school students ($20.8{\pm}4.0$, 32.9%) than middle school students ($19.4{\pm}3.8$, 14.2%) (p<0.001). In addition, 71.1% of high school students experienced a lack of sleep compared to 48.8% of middle school students (p<0.001). There was a difference between good and bad sleepers in the number of times they ate snacks and the quantity of their snacks. Good sleepers had more fruit and dairy products (e.g. fruit juice 2~4 times (p<0.05), milk 2~4 times (p<0.001), apples 2~4 times, strawberries 2~4 times (p<0.01), and bananas 2~4 times a week), while bad sleepers consumed more beverages, frozen desserts, flour-based foods, fast food, bread, and rice cake. Bad sleepers clearly consumed snacks more frequently. From analyzing the correlations between sleep quality and snack intake, eating fruits 2~4 times a week (30 g~200 g/once) and drinking dairy products 2~4 times a week (120 mL~400 mL/once) appears to promote better sleeping habits.

• The Korean Journal of Food And Nutrition
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• v.16 no.3
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• pp.197-202
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• 2003

The purpose of this study was to investigate basic factors of obesity, nutrient intakes, behaviors of dietary life, daily energy expenditure and emphasize on the necessity of school education. Because the growing prevalence of obesity have required a need for health education in school. The results were as follows. 1. The average height of boys and girls was l59${\pm}$13cm(boys), l54${\pm}$11cm(girls). The average weight of them was 68${\pm}$16kg(boys), 70${\pm}$13kg(girls). BMI(body mass index) of them was 26.9${\pm}$3.4(boys), 29.5${\pm}$2.9(girls). 2. For energy and protein, the average intakes of subjects were higher than recommended dietary allowances for Koreans(7th Ed). The average intakes of vitamin A and ascorbic acid were much lower than the recommended dietary allowances. 3. Most of subjects prefer fast food, rich snacks and overeating, irregular meal amount and these dietary behaviors were severe problems. 4. Total energy expenditure was 1,933kcal in boys and 1,789kcal in girls. To reduce weight and treat obesity, the required energy intake to subjects was 1,546kcal(boys) and 1,431kcal(girls). If we prepared the effective program for obesity, school education should be integrated within the larger community. Parents of students and students may be educated to make good health changes in the home. Nutrition education has a direct impact on their life style of their food intake and nutritional status. The use of multi-component obesity treatments will be effective in a school setting. It is more effective to encourage health habits in school, house and it should be integrated within the larger community.

• 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.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.804-811
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• 2008

Purpose : Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. Methods : A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. Results : There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. Conclusion : Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children.

• Journal of Nutrition and Health
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• v.47 no.1
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• pp.33-44
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• 2014

Purpose: Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium. Methods: This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items. Results: The mean body mass index (BMI) was $22.2{\pm}3.0kg/m^2$, mean serum phosphorus level was $4.50{\pm}1.52mg/dl$, and mean serum potassium level was $4.74{\pm}0.73mEq/l$. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (> 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p < 0.05). Mean duration of HD was $7.9{\pm}7.3$ years and it showed positive correlation with serum potassium levels (p < 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p < 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p < 0.01), potatoes, fish, and high-potassium vegetables (p < 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p < 0.05). Conclusion: The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.

• Journal of Preventive Medicine and Public Health
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• v.35 no.3
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• pp.205-213
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• 2002

Objective : Whether exposure to chronic noise induces an increase in blood pressure, or the development of hypertension, has not been established. A cohort study was performed to identify the effects of chronic noise exposure on blood pressure. Methods : 530 males working at a metal manufacturing factory in Busan, Korea were enrolled for the study. They were monitored for 9 consecutive years, from 1991 to 1999, with an annual health check-up. The subjects were divided into 4 groups, which were determines by noise level categories(NLC) according to noise intensity ; NLC-I: office workers, exposed to noise a level below 60dB(A) ; NLC-II: field technical supporters or supervisors, frequently exposed to workplace noise, wearing no hearing protection device; NLC-III: workers, exposed to workplace noise below 85dB(A), wearing ear plugs or muffs; NLC-IV: workers, exposed to workplace noise over 85 dB(A), wearing both ear plugs and muffs. Results : After controlling possible confoundens, such as baseline age, smoking, alcohol intake, exercise, family history of hypertension, systolic(SBP) of diastolic blood pressure(DBP) and changes in BMI (body mass index), the pooled mean for the systolic blood pressures, over the duration of the study period, were 3.8mmHg, 2.0mmHg and 1.7mmHg higher in NLC-IV, NLC-III NLC-II groups, respectively, than in the NLC-I group. There were no significant differences in the diastolic blood pressures between the groups. Conclusion : This study suggests that chronic noise exposure increases systolic blood pressure independently, among male workers.