• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.2
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• pp.16-30
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• 2021

Objectives: The aim of this study was to establish a clear diagnostic definition of Sanhupung using the Delphi method. Methods: This study used the Delphi technique. A panel consisting of 21 experts of Korean medicine, particularly in of gynecologic medicine, participated in the Delphi examination that included answering the 4th round survey. The Delphi examination was carried out through evaluating and correcting the questionnaire by e-mail. Results: Through the Delphi survey, we have reached on an agreement regarding the basic concepts, time, cause, essential symptoms, and accessory symptoms of Sanhupung. They are as follows: 1) Sanhupung is a culture bound syndrome reflecting Korea's cultural specificity. 2) Sanhupung can be diagnosed even after the miscarriage. 3) For the diagnosis of Sanhupung, the main cause of symptoms should not be classified as other disease. 4) Sanhupung can be diagnosed based on essential symptoms and accessory symptoms. 5) Essential symptoms include local symptoms such as joint pain at specific areas, partial sensory impairment and general symptoms including pain of all the joints, whole body sensory impairment, increased sweating, feeling of wind coming into the body, worsened symptoms with the cold, intolerance to cold, and pain of all the muscles. Conclusions: The basic concepts and diagnostic definition of Sanhupung were suggested based on the Delphi survey among experts in the field. Further research is necessary to improve reliability and validity of diagnostic definition of Sanhupung in clinical trials.

• Archives of Plastic Surgery
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• v.50 no.3
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• pp.279-287
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• 2023

Background Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Methods A total of 14 HTFF for hand defect reconstruction were recorded. The oblique flap was designed in the proximal HT area following relaxed skin tension line along the axis between fourth web space and 10 mm ulnar side of pisiform. A flap pedicle includes one or two perforators with ulnar digital artery and HT branch of basilic vein. In addition, innervated HTFF can be harvested with a branch of ulnar digital nerve. Electronic medical records were reviewed to obtain data on patients' information, operative details, and follow-up period. In addition, surgical outcome score was obtained from the patient, up to 10 points, at the last follow-up. Results Mean harvest time was 46 minutes, and two perforators were included in 10 cases. The mean flap area was 10.84 cm². There were no problems such as donor site depression, scar contracture, keloids, wound dehiscence, numbness or neuroma pain at donor sites, and hypersensitivity or cold intolerance at flap site, either functionally or aesthetically. Conclusion Palmar defect reconstruction is challenging for hand surgeons. However, large HTFF can be harvested without complications using the oblique axis HTFF technique. We believe our surgical tips increase utility of HTFF for palmar defect reconstruction.

• Proceedings of the Korean Society of Crop Science Conference
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• 2022.10a
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• pp.301-301
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• 2022

Dairy products are important diet source for human because of their balanced essential nutrients along with various vitamins and minerals. However, lactose in milk can result in diarrhea to some consumers with lactose intolerance. Soy milk has no lactose and is suitable as a substitute for diary milk in accordance with recent trend of replacing animal food with vegetable food. However, polysaccharides in soy milks are difficult for humans to digest, leading to flatulence. These polysaccharides can be decomposed into monosaccharides by lactic acid bacteria, and fermentation can improve food quality. Because mungbean has higher carbohydrate content than soybean, mung milk can be easily fermented than soy milk, resulting in vege yogurt with higher contents of lactic acid. In this study, fermentation characteristics of vege yogurt were analyzed with different ratio of soy milk and mung milk (0%, 25%, 50%, 75%, 100% and 0%+sucrose) and different fermentation time (0, 8, and 16 hours). In general, pH decreased as fermentation time increased. Overall, pH significantly decreased when the mung milk content in yogurt increased. All samples showed higher titratable acidity after fermentation and soy yogurt (mungbean 0%, 16 hours) with sucrose showed the highest value (6.825%). As fermentation time increase, viscosity increased. In 8 and 16 hours, mung milk yogurt (mungbean 100%) showed the lowest viscosity while soy milk yogurt (soybean 100%) with no sucrose showed the highest viscosity after 16 hours of fermentation. The contents of crude protein, crude fat and ash were measured for nutritional analysis. Soy milk (mungbean 0%, 0 hours) had the values of crude protein 2.9g, crude fat 1.8g, and ash 0.3g, and mung milk (mungbean 100%, 0 hours), showed the values of crude protein 1.7g, crude fat 0g, and ash 0.3g. To analyze the effect of the differences in the contents of nutrition between soy milk and mung milk on fermentation, the changes in sugar contents, and antioxidant capacity will be conducted depending on fermentation time. Our results will provide the information in researching plant beverages.

• Korean Circulation Journal
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• v.53 no.6
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• pp.406-417
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• 2023

Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO₂] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO₂ was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.

• Journal of Microbiology and Biotechnology
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• v.34 no.2
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• pp.270-279
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• 2024

Macrophages are versatile immune cells that play crucial roles in tissue repair, immune defense, and the regulation of immune responses. In the context of skeletal muscle, they are vital for maintaining muscle homeostasis but macrophage-induced chronic inflammation can lead to muscle dysfunction, resulting in skeletal muscle atrophy characterized by reduced muscle mass and impaired insulin regulation and glucose uptake. Although the involvement of macrophage-secreted factors in inflammation-induced muscle atrophy is well-established, the precise intracellular signaling pathways and secretion factors affecting skeletal muscle homeostasis require further investigation. This study aimed to explore the regulation of macrophage-secreted factors and their impact on muscle atrophy and glucose metabolism. By employing RNA sequencing (RNA-seq) and proteome array, we uncovered that factors secreted by lipopolysaccharide (LPS)-stimulated macrophages upregulated markers of muscle atrophy and pro-inflammatory cytokines, while concurrently reducing glucose uptake in muscle cells. The RNA-seq analysis identified alterations in gene expression patterns associated with immune system pathways and nutrient metabolism. The utilization of gene ontology (GO) analysis and proteome array with macrophage-conditioned media revealed the involvement of macrophage-secreted cytokines and chemokines associated with muscle atrophy. These findings offer valuable insights into the regulatory mechanisms of macrophage-secreted factors and their contributions to muscle-related diseases.

• Clinical Nutrition Research
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• v.13 no.1
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• pp.1-7
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• 2024

Nutritional support in critically ill patients is an essential aspect of treatment. In particular, the benefits of enteral nutrition (EN) are well recognized, and various guidelines recommend early EN within 48 hours in critically ill patients. However, there is still controversy regarding EN in critically ill patients with septic shock requiring vasopressors. Therefore, this case report aims to provide basic data for the safe and effective nutritional support in septic shock patients who require vasopressors. A 62-year-old male patient was admitted to the intensive care unit with a deep neck infection and mediastinitis that progressed to a septic condition. Mechanical ventilation was initiated after intubation due to progression of respiratory acidosis and deterioration of mental status, and severe hypotension required the initiation of norepinephrine. Due to hemodynamic instability, the patient was kept nil per os. Subsequently, trophic feeding was initiated at the time of norepinephrine dose tapering and was gradually increased to achieve 75% of the energy requirement through EN by the 7th day of enteral feeding initiation. Although there were signs of feeding intolerance during the increasing phase of EN, adjusting the rate of EN resolved the issue. This case report demonstrates the gradual progression and adherence to EN in septic shock patient requiring vasopressors, and the progression observed was relatively consistent with existing studies and guidelines. In the future, further case reports and continuous research will be deemed necessary for safe and effective nutritional support in critically ill patients with septic shock requiring vasopressors.

• Korean Journal of Clinical Pharmacy
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• v.34 no.3
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• pp.184-193
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• 2024

Background: Sunitinib, commonly used for metastatic renal cell carcinoma (mRCC), often induces hypothyroidism, affecting 27 to 85% of patients. There are clues suggesting an association between sunitinib-induced hypothyroidism and improved survival outcomes. This study aims to identify the predictive factors of sunitinib-induced hypothyroidism and evaluate whether the occurrence of overt or subclinical hypothyroidism predicts tumor outcome in patients with mRCC. Methods: Patients administered to sunitinib for mRCC was included in this retrospective study. Log-rank test and Cox proportional hazards model were conducted to identify predictive factors of hypothyroidism and prognostic factors of progression-free survival (PFS) and overall survival (OS). Results: A total of 156 patients with mRCC treated with sunitinib were included. Predictive factors of sunitinib-induced hypothyroidism were female (odds ratio (OR), 2.77), sunitinib-induced hypertension (OR, 2.99) and dose reduction of sunitinib due to intolerance (OR, 3.57). Sunitinib-induced overt hypothyroidism was a significant prognostic factor in predicting PFS and OS (hazard ratio, 0.38 and 0.23, respectively). Thyroid hormone replacement did not have an influence on PFS and OS. Conclusions: Female patients, patients who experienced sunitinib-induced hypertension and sunitinib dose reduction are at higher risk of hypothyroidism and need close monitoring. Overt hypothyroidism is a strong prognostic factor of sunitinib treatment outcome in mRCC patients and thyroid hormone replacement does not have a negative effect on tumor outcome.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.626-632
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• 2006

Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.1
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• pp.39-46
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• 2009

This study investigated the beneficial effects of crude saponins from soybean cake on body weight and glucose tolerance in high-fat (37% calories from fat) diet fed C57BL/6 mice. The mice were supplemented with three doses of saponins (0.5%, 1.0%, and 1.5%, wt/wt) and 1.0% Garcinia cambogia (wt/wt), positive control for 9 weeks. The body weight, visceral fat weight and epididymal adipocyte area were significantly reduced in the saponin supplemented groups in a dose dependent manner compared to the high-fat group. Saponins did not significantly affect food intake; however, cambogia significantly lowered food intake compared to the high-fat fed control group. The crude saponins from soybean cake supplement significantly lowered plasma leptin, triglyceride and total cholesterol levels, whereas they significantly elevated the fecal excretion of triglyceide in a dose dependent manner compared to the high-fat group. Cambogia did not affect the fecal excretion of lipid in the diet-induced obese mice. Supplementation of 1.5% saponin reduced the hepatic triglyceride content compared to the high-fat group. High-fat induced glucose intolerance with the elevation of blood glucose levels compared to the normal group; however, the saponins supplement significantly improved postprandial glucose levels. After 9 weeks of being fed a high-fat diet, the mice presented with significantly increased activities of hepatic fatty acid synthase and fatty acid ${\beta}$-oxidation; however, saponins and cambogia normalized these activities. These results indicate that saponins from soybean cake exhibit a potential anti-obesity effect and may prevent glucose intolerance by reducing body weight and plasma lipids, increasing fecal lipid excretion and regulating hepatic lipid metabolism in high-fat fed mice.

• Proceedings of the Ginseng society Conference
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• 1984.09a
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• pp.83-88
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• 1984

It is now well established that the rodenticide Vacor (N-3-pyridyl-mehtyl-N'-p-nitropheny-lurea) causes a hyperglycemia in human and rats. It is also reported that there are some components (DPG-3) in ginseng radix which cause hypoglycemic effect on alloxan diabetic mice. In the present study, attempts were made to demonstrate in Vacor-poisoned rats the hypo-glycemic activity of red ginseng component(RGC), which was extracted by Kimura's DPG-3 extraction procedure and found to be effective for lowering a hyperglycemia in alloxan-diabetic rats. Vacor in a dose of $LD_{50}$ (10mg/kg) produced a glucose intolerance with a paradoxical moderate increase in blood immunoreactive insulin and derangement in glucose metabolism of epididymal adipocytes in rats. Although RGC (20mg/kg, i.p.) did not exert any significant influence on a hyperglycemia induced by large lethal doses (25mg/kg) of Vacor ingestion, it improved the LDso Vacor-induced glucose intolerance and caused a further increase in blood insulin levels in Vacor-poisoned rats. The administration of RGC (20mg/kg, i.p.) normalized Vacor-induced depression of glucose metabolism and lipogenesis in the epididymal adipocytes with an improvement of reduced responses to insulin of adipocytes from Vacor-poisoned rats. These results suggest that some red ginsneng components contained in RGC fraction normalize the depressed peripheral glucose unitlization and insulin response and eventually lead to an improvement of abnormal glucose tolerance developed in rats poisoned with small doses of Vacor.