• Journal of Preventive Medicine and Public Health
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• v.35 no.1
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• pp.1-12
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• 2002

Objective : To estimate the socioeconomic costs of obesity in Korea,1998. Methods : The 1998 National Health and Nutrition Examination Survey(1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM(non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF(Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. Results : The direct costs of obesity were 2,126 billion${\sim}965$ billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion${\sim}1,086$ billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4.225 billion${\sim}2,050$ billion Won, which corresponded to about $0.094%{\sim}0.046%$ of GDP and $1.88%{\sim}0.91$ of total health care costs in Korea. Conclusions : Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. further studies are needed to caculate socioeconomic costs of obesity more exactly.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.516-522
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• 2017

Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.

• Journal of Life Science
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• v.22 no.12
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• pp.1729-1739
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• 2012

The aim of this study was to evaluate the clinical efficacy and safety of fermented medicinal herbs. A search of the China National Knowledge Infrastructure (CNKI), PubMed databases and Korean Journal of Oriental Medicine in 2000-2011 located 11 randomized controlled trials (RCTs) that investigated the clinical efficacy of fermented medicinal herbs. Domestic RCTs reported clinical efficacy on improvement of immune responses and clinical safety on usage of fermented medicinal herbs in subjects suffering from cerebral hemodynamics. Countries other than Chinareported studies on the cause of esophageal cancer and on local inflammatory reactions. In China, studies were reported on the effectiveness of fermented medicinal herbs on scapulohumeral periarthritis of the stasis type, chronic superficial gastritis, dysuria induced by benign prostatic hyperplasia of deficiency of kidney yang, diabetic nephropathy, essential hypertension, and benign prostate hyperplasia. These results indicate that fermented medicinal herbs have obvious clinical effects in some diseases and no adverse reactions. Therefore, we need to initiate more fermentation research with useful bacteria, fungi, and mushrooms to produce fermented medicinal herbs. Both governments and research authorities should focus on research involving fermentation of medicinal herbs.

• Journal of Life Science
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• v.29 no.4
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• pp.447-454
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• 2019

Fat accumulation in adipocytes occurs through the process of adipogenesis in which preadipocytes differentiate into adipocytes. Obesity is a metabolic disorder caused by excessive accumulation of fat in the body, which increases the incidence of cardiovascular diseases, hypertension, type 2 diabetes, hyperlipidemia, and various cancers. Recently, inhibition of adipocyte differentiation was shown to be a potential antiobesity strategy. In this study, the inhibitory effect of dichloromethane fractions from Illicium verum Hooker fil. water extract on the differentiation of 3T3-L1 preadipocytes to adipocytes was investigated. Dichloromethane fractions from I. verum Hooker fil. significantly inhibited adipocyte differentiation when applied during the adipocyte differentiation process, as assessed by measuring fat accumulation using Oil-red O staining. In addition, dichloromethane fractions from I. verum Hooker fil. reduced important adipogenic transcription factors, such as CCAAT/enhancer binding protein ${\alpha}$ ($C/EBP{\alpha}$), $C/EBP{\beta}$, and peroxisome proliferator activated receptor ${\gamma}$ ($PPAR{\gamma}$). The expression of FAS and LPL, which are terminal differentiation markers of mature adipocytes, was also reduced in the 3T3-L1 adipocytes treated with dichloromethane fractions from I. verum Hooker fil. In addition, the treatment significantly inhibited mitotic clonal expansion, which is essential for adipocyte differentiation, by arresting the G1 phase of the cell cycle. Taken together, these results suggest that dichloromethane fractions from I. verum Hooker fil. may be a natural material with antiobesity effects.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.94-100
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• 2020

Objectives Amyloid β positron emission tomography (Aβ PET) is widely used as a diagnostic tool in patients who have symptoms of cognitive impairment, however, this diagnostic examination is too expensive. Thus, predicting the positivity of Aβ PET before patients undergo the examination is essential. We aimed to analyze clinical predictors of patients who underwent Aβ PET retrospectively, and to develop a predicting model of Aβ PET positivity. Methods 468 patients who underwent Aβ PET with cognitive impairment were recruited and their clinical indicators were analyzed retrospectively. We specified the primary outcome as Aβ PET positivity, and included variables such as age, sex, body mass index, diastolic blood pressure, systolic blood pressure, education, dementia family history, Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Box (CDR-SB), hypertension (HTN), diabetes mellitus (DM) and presence of apolipoprotein E (ApoE) E4 as potential predictors. We developed three final models of amyloid positivity prediction for total subjects, mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using a multivariate stepwise logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) value was calculated for the ROC curve. Results Aβ PET negative patients were 49.6% (n = 232), and Aβ PET positive patients were 50.4% (n = 236). In the final model of all subjects, older age, female sex, presence of ApoE E4 and lower MMSE are associated with Aβ PET positivity. The AUC value was 0.296. In the final model of MCI subjects (n = 244), older age and presence of ApoE E4 are associated with Aβ PET positivity. The AUC value was 0.725. In the final model of AD subjects (n = 173), lower MMSE scores, the presence of ApoE E4 and history of HTN are associated with Aβ PET positivity. The AUC value was 0.681. Conclusions The cerebral amyloid positivity model, which was based on commonly available clinical indicators, can be useful for prediction of amyloid PET positivity in MCI or AD patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.34 no.6
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• pp.326-333
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• 2020

Nitrate-nitrite-nitric oxide (NO) pathway is a major alternative source of NO and is essential for NO - dependent physiological functions in body. Food supplements having nitrate/nitrite can improve metabolic syndromes including hypertension through antioxidant activity or vasodilation. The purpose of this study was to observe the effects of fermented garlic (F. garlic) having high concentration of NO2- on changes in blood flow and nitric oxide synthesis in the cerebral cortex of rodents. The generation of nitric oxide detected by a chemi-luminescence detector was higher in F. Garlic compared with NaNO2 solution under artificial gastric juice with pH 2.0. Ether F. garlic or NaNO2 diluted with artificial cerebrospinal fluid was directly applied into around the needle probe of laser Doppler flow meter that was located on epidural surface of the cortex. Direct application of F. garlic resulted in increase of cerebral blood flow detected by a laser Doppler flow meter with a dose-dependent manner. Compared with NaNO2 solution, F. garlic produced changes in cerebral blood flow at lower concentration of NO2-. Pretreatment of methylene blue, a guanylyl cyclase inhibitor prevented upregulation of cerebral blood flow by the treatment of F. garlic. In addition, the application of F. garlic with 250, 500ppm of NO2- caused significantly the production of NO in the cortical tissue but NaNO2 solution with 500ppm of NO2- did not. In summary, these results suggested that F. garlic with high content of NO2- induce increase in cerebral blood flow through nitric oxide-dependent signal pathway.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.67 no.4
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• pp.305-318
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• 2022

To minimize the effects of aging-related comorbidities and to maintain a good quality of life and physical independence for a longer period, the improvement of lifestyle and dietary habits is essential, and healthy foods can be helpful. Among them, medicinal plant such as ginseng (Panax ginseng) and bellflower (Platycodon grandiflorum) contain natural functional substances and have been used for disease treatment and prevention since ancient times. This review summarizes the scientific of these treatments basis by investigating the pharmacological and pharmacokinetic effects of major functional substances on the aging-related health effects of Panax ginseng and Platycodon grandiflorum. The main functional substances of Panax ginseng and Platycodon grandiflorum are saponins, which have a similar molecular structure and confirmed anti-inflammatory, antioxidant, neuroprotective, anticancer, and anti-metabolic syndrome effects (improvement of hypertension, dyslipidemia, diabetes, and obesity). Both types of saponins in Panax ginseng (Ginseonside) and Platycodon grandiflorum (Platycoside) have very low absorption profiles in their purified state, but methods to increase absorption in the body through extraction or fermentation have been studied.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.1
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• pp.85-91
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• 2010

Sodium is a major component that maintains homeostasis and physiological state in body. It is an essential mineral that the body cannot produce for itself, so it must be supplied from food. On the other hand, overindulgence is one cause of hypertension, stroke, stomach cancer, osteoporosis and kidney disease. The purpose of this study was to monitor sodium content in meals of school foodservice. In this study, 801 samples (main/side dishes) were collected from 8 school foodservice in Busan and Gyeongsangbuk-do, Korea. Samples were classified into 21 food items, which were cooked rices, cooked rice with seasoning, noodles, cooked gruels, soups, stews, tang and chon-gol, stir-fried foods, fried foods, pan-fried foods, hard-boiled foods, roasted foods, steamed foods, seasoned vegetables, preserved foods, kimchis, sauces, fruits, breads and snacks, beverages, and dairy products. The samples were analyzed by AAS (atomic absorption spectrometry) after microwave digestion. The sodium content of sauces (1459 mg/100 g) and preserved foods (1165 mg/100 g) was higher than those of other dishes. Aside from them, sodium contents of roasted foods (894 mg/100 g), hard-boiled foods (786 mg/100 g) and kimchis (737 mg/100 g) were relatively higher than the others. Sodium intakes from meals of school foodservice were calculated by multiplying food intakes by sodium contents. The average sodium intakes from one serving of school foodservice were 605 mg for younger boys, 572 mg for younger girls, 774 mg for older boys, 730 mg for older girls in elementary school. Boys in middle school took in 1423 mg Na whereas girls consumed 1063 mg Na in middle school. Results from this study can be useful for establishing database of sodium contents and intake in meals of school foodservice. The database will be helpful for providing information on managing food for children.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1075-1082
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• 2002

Purpose : Obesity is known to be associated with hypertension, dyslipidemia, and fatty liver and is thought to be associated with increased levels of free fatty acids. One of the strategies for decreasing free fatty acid levels is stimulation of hepatic lipid oxidation with L-carnitine. Carnitine is an essential cofactor for transport of long-chain fatty acid into mitochondria for oxidation. This study was designed to evaluate the changes of serum fatty acids and carnitine levels after exogenous injection of L-carnitine. Methods : Sprague Dawley rats were divided into two groups. Group A was control. Group B was given intraperitoneal injection with L-carnitine(200 mg/kg) daily for two weeks. Serum lipid (total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol) and fatty acid levels were analyzed on the first day of the first and second weeks after injection of L-carnitine. Total, free, and acyl carnitine levels also were performed by a enzymatic cycling techniques at the same day intervals. Results : There was no significant difference between the two groups in total cholesterol, HDL-cholesterol, LDL-cholesterol levels before and after the administration of L-carnitine. But triglyceride levels were significantly decreased at the first week in group B compared with group A. Among free fatty acids, linoleic acid showed significant decrement(A group : $131.3{\pm}31.3mg/dL$ vs B group : $90.0{\pm}7.0mg/dL$) at the first week. Total, free, and acyl carnitine levels showed significant increments at all days intervals, but only free carnitine showed significant increments according to cumulative doses of carnitine. Conclusion : Plasma linoleic acid, a long-chain fatty acid, showed significant decrement after administration of L-carnitine in the first week. This may suggest that L-carnitine can be used as an antilipidemic agent for obese patients. A prospective study will investigate obese children in the future.