• Title/Summary/Keyword: risk reduction

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Serum Lipid Profile and Nutritional Status in 6~7 Year Old Obese Children (6~7세 비만아에서 혈청 지질과 영양 상태에 관한 연구)

  • Rim, Jee-Yeon;Moon, Ji-Young;Lee, Chul-Gab;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.160-168
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    • 2008
  • Purpose: This study was designed to characterize the nutritional status and assess obesity to determine the relationship between obesity and serum lipid profiles in 6~7 year old children. Methods: In 2007, we surveyed 483 children (233 boys and 250 girls) aged 6~7 years. The total cholesterol, triglyceride levels and HDL-cholesterol were measured in the fasting state. Dietary information was obtained by a questionnaire. Results: The prevalence of obesity was 9.9%. There was no significant difference between genders. The mean caloric intake was 1,781 kcal in boys and 1,640 kcal in girls. The prevalence of excessive calories was 33% in boys and 30% in girls. The prevalence of a total cholesterol ${\geq}$200 mg/dL was 8.4%, TG ${\geq}$130 mg/dL was 5.0%, LDL-cholesterol ${\geq}$130 mg/dL was 3.1%, and HDL-cholesterol <35 mg/dL was 4.4%. The prevalence of hypertension was 2.1%. There was no significant difference between genders. The systolic blood pressure, triglyceride levels and LDL-cholesterol were significantly related to an increased obesity index (p<0.05). The mean caloric intake and nutritive component were not related to the obesity index. The obesity group was compared to the control group: for triglycerides ${\geq}$130 mg/dL the odds ratio was 4.08; for LDL-cholesterol ${\geq}$130 mg the odds ratio was 2.85; for a TC/HDL-cholesterol ${\geq}$4.0 the odds ratio was 1.16. The BMI and triglyceride levels in the group with hypertension were higher than control group (p<0.05). There were significant positive correlations between the BMI and blood pressure as well as the LDL-cholesterol and triglycerides (p<0.05). The BMI was not correlated with the mean caloric intake or nutrition. Conclusion: The prevalence of hypertension and hyperlipidemia in 6~7 year old children was significantly related to an increased obesity index. The management of obesity in 6~7 year old children should include a reduction in the risk for hyperlipidemia and hypertension.

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Right-Turn Vehicle Supplementary Signal Improvement at Intersections (교차로 우회전 차량 보조등 개선)

  • LEE, Nam Soo;KIM, Yu Chan;LIM, Joon Beom;KIM, Youngchan
    • Journal of Korean Society of Transportation
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    • v.33 no.5
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    • pp.441-448
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    • 2015
  • This study aims to suggest a reasonable signal operation method for right-turn traffic management. It was found that the right-turn vehicle supplementary signal is currently operated without clear regulations or criteria. It was also analyzed that right-turn supplementary signals are used without consistency, there is a risk of traffic accidents due to the discordance between supplementary signals and traffic signals of forward vehicles, there is a lack of basis for prohibition of a right turn when right-turn vehicle's supplementary signal is red and the flashing red signal is used in a different sense from the law. In order to see the effect of the installed right-turn vehicle supplementary signals on traffic signal violation, a field investigation was conducted. As the result, there was a high proportion of signal violation on the approach lane with right-turn supplementary signals and this means that right-turn supplementary signals hardly influenced the reduction in proportion of signal violation during a right turn. Additionally, a survey was carried out to see if there were differences in driver's interpretation of traffic signals depending on the installation of right-turn supplementary signals. As the result of the survey, there were no differences in interpretation of traffic signals depending on the installation of right-turn supplementary signals or the types of right-turn supplementary signals. A right turn when the signal was red did not lead to serious traffic accidents, so it is thought that there should be a careful consideration of a total ban on a right turn when the signal is red, in order to prevent driver's confusion due to the change of the signal system. Unless there is a disturbance to cars and pedestrians after a temporary stop when the signal is red, there is a need to specify that vehicles must stop temporarily in the Road Traffic Act to facilitate a right turn. What this study finally suggested is to use tri-colored arrow signals for right-turn car supplementary signals to convey a signal to a driver clearly.

Anti-obesity and Anti-hyperlipidemic Activities of Fermented Coffee with Monascus ruber Mycelium by Solid-State Culture of Green Coffee Beans (고지방 식이를 섭취한 마우스에서 홍국균 균사체-고체발효 원두커피의 비만억제 및 지질저하 효과)

  • Sung, Jeehey;Shin, Ji-Young;Kim, Hoon;Baek, Gil-Hun;Yu, Kwang-Won;Yeon, Jeyeong;Lee, Junsoo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.3
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    • pp.341-348
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    • 2014
  • We investigated the anti-obesity and anti-hyperlipidemic effects of extracts of two roasted coffee beans (Vietnam robusta and Ethiopia mocha sidamo G2) and fermented coffee beans with Monascus rubber mycelium (MR) by solid-state culture. C57B/L6 mice were divided into seven groups: normal diet (ND) group, high fat diet (HFD) group, and HFD groups with hot water extracts from Vietnam robusta coffee beans (HFD-VR), MR-fermented Vietnam robusta coffee beans (HFD-VR-MR), MR-fermented Vietnam robusta coffee beans with 10% brown rice (HFD-VR-MR-BR10), Ethiopia mocha sidamo G2 coffee beans (HFD-ES), and MR-fermented Ethiopia mocha sidamo G2 coffee beans (HFD-ES-MR). After 6 weeks, body weight gain and food efficiency ratio were higher in the HFD group, but significantly reduced in the coffee extracts-fed groups. The HFD-ES-MR group showed greater body weight reduction than the HFD-ES group. The serum triglyceride, total cholesterol, and LDL-cholesterol levels as well as the atherogenic index and cardiac risk factor all tended to decrease in groups fed Vietnam robusta coffee extracts compared to the HFD group. These results suggest that Vietnam robusta and Ethiopia mocha sidamo G2 may be used to make functional coffee beverages with anti-obesity and anti-hyperlipidemic activities.

Heart Rate Variability and Autonomic Activity in Patients Affected with Rett Syndrome (Rett 증후군 환자에서의 자율신경 활성도 및 심박수 변이도 측정)

  • Choi, Deok Young;Chang, Jin Ha;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.996-1002
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    • 2003
  • Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

Posttransplantation Lymphoproliferative Disorder after Liver Transplantation in Pediatric Patients: Report from a Single-center Over 21 Years (간 이식 소아에서 발생한 이식 후 림프 증식 질환: 단일 기관에서의 21년 경험)

  • Lee, Jung-Hwa;Ko, Jae-Sung;Seo, Jeong-Kee;Yi, Nam-Joon;Suh, Kyung-Suk;Lee, Kuhn-Uk;Kang, Gyeong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

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Some Factors Affecting Bone Mineral Status of Postmenopausal Women (폐경 후 여성의 골격상태에 영향을 미치는 요인분석)

  • 오세인;이행신;이미숙;김초일;권인순;박상철
    • Korean Journal of Community Nutrition
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    • v.7 no.1
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    • pp.121-129
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    • 2002
  • Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

The Relationship of the Severity of Sleep Apnea Syndrome to the Resting Energy Expenditure and Leptin (수면무호흡증의 중증도와 안정시 에너지 대사 및 혈중 Leptin과의 관계)

  • Lee, Kwan-Ho;Shin, Kyeong-Cheol;Ahn, Jae-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.836-845
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    • 1999
  • Background : Obesity is present in the majority of adult patients with obstructive sleep apnea(OSA) and is considered to be a major risk factor for its development. A reduction in body weight has been associated with substantial improvement in the severity of apnea. However, a variety of treatment strategies for obesity have yielded limited sucess. This study was done to determine resting energy expenditure(REE) in patients with obstructive sleep apnea and the correlation between the severity of sleep apnea and REE, and to investigate whether leptin influences REE and correlated with the severity of sleep apnea in 39 patients with OSA and 45 controls matched for obesity. Method : Overnight polysomnography was performed on all subjects using standard techniques. Measurements of REE were made using a Sensormedic Vmax 229 and a canopy system. Serum leptin concentration was measured by human leptin RIA kit of LINCO Research INC. Results : REE was greater in patients with OSA compared with controls, but there was no difference between the two groups on REE%. And also there was no significant correlation between anthropometric data, polysomnographic data and REE%. Serum leptin was linearly related to body mass index(BMI), apnea index, apnea hypopnea index and lowest arterial oxygen saturation($SaO_2$) but not related to REE%. Conclusion : This study suggests the followings. Firstly patients patients with sleep apnea have a pattern of obesity characterized by energy homeostasis at an elevated body weight set-point. In order to achieve a lower body weight in these patients, it may be necessary to increase energy expenditure by increasing physical activity. Secondly leptin level was not correlated with REE, suggesting that leptin may predominantly regulate body fat by altering eating behavior rather than calorigenesis. Lastly leptin level was significantly correlated with the severity of sleep apnea. These elevated level of leptin in patients of sleep apnea may be related to the obesity, however it needs further studies to determine the relationship between the severity of sleep apnea and serum leptin.

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Strategies of Large Park Development and Management through Governance - Case Studies of The Presidio and Sydney Harbour National Park - (거버넌스를 통한 대형 도시공원의 조성 및 운영관리 전략 - 프레시디오 공원과 시드니 하버 국립공원 사례를 중심으로 -)

  • Sim, Joo-Young;Zoh, Kyung-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.6
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    • pp.60-72
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    • 2016
  • This study aims to suggest strategies of development and management for large parks by examining experimental cases of park governance models related to a shift away from public administration. The shifts towards governance as well as public-private partnership in city parks have involved the need for new public management. This study has analyzed two exemplary cases of Presidio Park and Sydney Harbour National Park in the aspects of planning process and management strategies, as the results derived the meaning and effect of park governance management and is also an essential prerequisite for the achievement of the model. There are six dimensions of research frames--namely policy, governance, partnership, finances and funds, design and maintenance-management, and evaluation-monitoring-taken as the basis for this study. Through the analysis, several key characteristics of these cases were elicited. First, the park planning process must be consistent in carrying a policy from planning to implementation, and furthermore, an independent operation body which can properly authorize an execution and uphold its responsibility from the public could serve in adaptable park services. Second, it has been suggested to build various partnerships with PAs and NGOs, private corporations, community groups, and academic institutes that allow it to expand the diversity of the park activities. Third, there has been experimental exploration to achieve a financially self-sufficient model by establishing internal revenue models and hence allow the reduction of reliance on public finances. The result of this type of park management would allow for improving park quality and make the park space a vital part of the local economy. Fourth, the strategies for a local community's participation are needed to allow the community to become a producer as well as a consumer. This study shows that the direction and significance of the park governance model regarding the fact that the plans sought by the two parks are extending the layout of public-centered discussion to the private sector and the third non-governmental sector including to the local community group. This shows both implications and limitations, such as the risk of privatization through non-governmental activities at the park or the violation of essential functions as a public good due to a profit-generating management policy for securing financial self-sufficiency. At the current point in which plans are under way for the development and management of large parks, a park governance model requires continuous study and expansion of discussion in the future.

PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

Effect Assessment and Derivation of Ecological Effect Guideline on CO2-Induced Acidification for Marine Organisms (이산화탄소 증가로 인한 해수 산성화가 해양생물에 미치는 영향평가 및 생태영향기준 도출)

  • Gim, Byeong-Mo;Choi, Tae Seob;Lee, Jung-Suk;Park, Young-Gyu;Kang, Seong-Gil;Jeon, Ei-Chan
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.17 no.2
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    • pp.153-165
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    • 2014
  • Carbon dioxide capture and storage (CCS) technology is recognizing one of method responding the climate change with reduction of carbon dioxide in atmosphere. In Korea, due to its geological characteristics, sub-seabed geological $CO_2$ storage is regarded as more practical approach than on-land storage under the goal of its deployment. However, concerns on potential $CO_2$ leakage and relevant acidification issue in the marine environment can be an important subject in recently increasing sub-seabed geological $CO_2$ storage sites. In the present study effect data from literatures were collected in order to conduct an effect assessment of elevated $CO_2$ levels in marine environments using a species sensitivity distribution (SSD) various marine organisms such as microbe, crustacean, echinoderm, mollusc and fish. Results from literatures using domestic species were compared to those from foreign literatures to evaluate the reliability of the effect levels of each biological group and end-point. Ecological effect guidelines through estimating level of pH variation (${\delta}pH$) to adversely affect 5 and 50% of tested organisms, HC5 and HC50, were determined using SSD of marine organisms exposed to the $CO_2$-induced acidification. Estimated HC5 as ${\delta}pH$ of 0.137 can be used as only interim quality guideline possibly with adequate assessment factor. In the future, the current interim guideline as HC5 of ${\delta}pH$ in this study will look forward to compensate with supplement of ecotoxicological data reflecting various trophic levels and indigenous species.