• 한국방사선학회논문지
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• 제13권3호
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• pp.489-493
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• 2019

산업의 발달로 인한 생활습관과 신체활동 부족 등으로 한국인의 비만인구가 급증하고 있다. 전산화단층영상을 이용한 기존의 지방량 계산 프로그램에서 반자동방식의 프로그램이 사용되고 있다. 관련 문제를 해결하기 위한 방법들이 제시되고 있으나 본 연구에서는 모폴로지 연산을 이용한 알고리즘을 제시하고 절차가 간단하고 비교적 계산량이 적은 새로운 방법으로 문제를 해결하고자 한다. 모폴로지 연산을 통해 침식과 팽창을 반복한 결과 영상으로부터 문제점이 해결된 것을 알 수 있어 결과로부터 각 조직 간의 경계를 더욱 정교하게 얻을 수 있었다. LoG (Laplace of Gaussian) 함수를 이용해서 각 조직간 경계 부분을 분할하였다. 각 경계는 명확하게 구분이 되었으며, 피하지방을 계산하기 위해 충분한 정보를 제공하였다. 개발된 분할결과를 사용하여 향후 자동 지방량 계산을 할 수 있다. 정확한 분할 도구를 제공함으로써 의사에게 편리함을 주고 재검사로 인한 피폭과 검사비용을 줄이는데 도움이 될 것으로 판단한다.

• 한국방사선학회논문지
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• 제13권5호
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• pp.691-698
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• 2019

건강증진센터를 방문한 환자를 대상으로 CT 지방측정 위치에 따른 내장지방 면적과 Inbody로 측정한 내장지방 면적의 차이를 비교하여 보았다. CT 지방측정에서 L4-5와 CT Umbilicus 위치에서 측정한 내장지방 면적은 남 여 성별에 다른 차이는 없었다. 또한, CT 지방측정 위치에 따른 내장지방 면적과 Inbody로 측정한 내장지방 면적과의 상관관계에서 CT 내장지방 면적과 Inbody로 측정한 내장지방 면적 간의 차이가 없었다. CT 내장지방 측정 위치는 남자 L4-5, L5-S1 위치, 여자 L3-4, L4-5, L5-S1, Umbilicus 위치에서 높은 상관관계를 보였다. Inbody 내장지방 면적과 CT 내장지방 면적 관계 간의 연구를 할 때 CT L4-5 위치의 내장지방 면적과 비교하는 것을 제안한다.

• Journal of Gastric Cancer
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• 제22권2호
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• pp.145-155
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• 2022

Purpose: Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy. Materials and Methods: In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data. Results: A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03). Conclusions: Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.

• Korean Journal of Radiology
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• 제22권2호
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• pp.189-197
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• 2021

Objective: Muscle depletion in patients undergoing liver transplantation affects the recipients' prognosis and therefore cannot be overlooked. We aimed to evaluate whether changes in muscle and fat mass during the preoperative period are associated with prognosis after deceased donor liver transplantation (DDLT). Materials and Methods: This study included 72 patients who underwent DDLT and serial computed tomography (CT) scans. Skeletal muscle index (SMI) and fat mass index (FMI) were calculated using the muscle and fat area in CT performed 1 year prior to surgery (1 yr Pre-LT), just before surgery (Pre-LT), and after transplantation (Post-LT). Simple aspects of serial changes in muscle and fat mass were analyzed during three measurement time points. The rate of preoperative changes in body composition parameters were calculated (preoperative ΔSMI [%] = [SMI at Pre-LT - SMI at 1 yr Pre-LT] / SMI at Pre-LT x 100; preoperative ΔFMI [%] = [FMI at Pre-LT - FMI at 1 yr Pre-LT] / FMI at Pre-LT x 100) and assessed for correlation with patient survival. Results: SMI significantly decreased during the preoperative period (mean preoperative ΔSMI, -13.04%, p < 0.001). In the multivariable analysis, preoperative ΔSMI (p = 0.016) and model for end-stage liver disease score (p = 0.011) were independent prognostic factors for overall survival. The mean survival time for patients with a threshold decrease in the preoperative ΔSMI (≤ -30%) was significantly shorter than for other patients (p = 0.007). Preoperative ΔFMI was not a prognostic factor but FMI increased during the postoperative period (p = 0.009) in all patients. Conclusion: A large reduction in preoperative SMI was significantly associated with reduced survival after DDLT. Therefore, changes in muscle mass during the preoperative period can be considered as a prognostic factor for survival after DDLT.

• 한국정보과학회:학술대회논문집
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• 한국정보과학회 1998년도 가을 학술발표논문집 Vol.25 No.2 (2)
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• pp.438-440
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• 1998

본 논문에서는 복부의 전산화 단층촬영 영상으로부터 체지방의 양을 측정하기 위한 영상처리에서 사용되는 문턱치의 자동 설정 방법을 제안한다. 체지방의 정량적 측정은 비만과 관련된 진단 및 치료에 있어서 중요하다. 기존의 비만도 측정은 체중과 신장의 비, 허리와 둔부 둘레의 비, 손으로 잡히는 복부의 두께 등 단순한 측정방법을 사용하여 실제 지방의 양을 제대로 반영하지 못하는 단점이 있다. 이러한 단점을 보완하기 위하여 최근에 전산화 단층촬영 영상으로부터 영상처리를 통하여 직접 지방의 양을 측정하려는 시도가 있다. 전산화 단층촬영 영상을 이용하면 지방의 양을 정량적으로 측정할 수 있고 피하지방과 복강내지방 등 특정부위의 체지방의 양을 측정할 수 있다. 전산화 단층촬영은 밀도에 비례하는 하운스필드 단위 값으로 구성된 영상을 제공한다. 일반적으로 체지방은 하운스필드 단위 값이 -150에서 -50사이인 것으로 알려져 있다. 그러나, 체지방의 문턱치는 사람에 따라 다르고, 또한 같은 사람에 대해서도 촬영 부위에 따라 다르다. 본 논문에서는 이러한 차이를 히스토그램을 통하여 보이고 히스토그램의 가우시안 함수 근사로부터 체지방의 문턱치를 자동으로 설정하는 방법을 제안한다.

• Journal of Nutrition and Health
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• 제43권4호
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• pp.374-381
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• 2010

본 연구는 체질량지수가 $23\;kg/m^2$ 이상 또는 체지방률이 27% 이상인 과체중 혹은 비만인 여성을 대상으로 무작위 배정, 이중 맹검, 위약-대조 연구 디자인을 통해 8주간의 생커피두 엑기스 섭취가 체지방 개선에 미치는 영향을 평가하기 위하여 실시되었다. 시험군 또는 대조군으로 배정된 대상자는 시험제제 또는 placebo제제를 하루 2번 2캡슐씩 식전에 물과 함께 섭취하게 하였으며, 연구에 참여하는 동안 평상시 식습관 및 커피 섭취량을 그대로 유지하도록 하였다. 본 연구에서 사용된 시험제제에는 1캡슐 당 생커피두 엑기스 50 mg와 덱스트린 150 mg을 함유하였고, placebo제제에는 200 mg의 덱스트린을 함유하였다. 생커피두 엑기스에는 28.4%의 클로로겐산과, 49.3%의 클로로겐산 류 (ferulic acid, coumalic acid, neochlorogenic acid 등), 그리고 12.6%의 카페인을 함유하도록 하였다. 총 48명이 시험을 완료하였으며, 이 중 섭취율 미달로 유효성 평가가 불가능한 5명을 제외한 43명을 대상으로 결과분석을 실시하였으며, 시험군 23명 대조군 20명이었다. 컴퓨터 단층촬영을 통한 복부지방면적 측정결과, 상복부에서는 생커피두 엑기스 섭취군에서 총 지방 면적은 섭취 전 $231.2\;{\pm}\;12.2\;cm^2$에서 8주 후 $220.1\;{\pm}\;11.2\;cm^2$으로 4.8%가 유의적으로 감소하였고 (p < 0.05), 내장지방 면적은 섭취 전 $86.4\;{\pm}\;6.08\;cm^2$에서 8주 후 $82.4\;{\pm}\;5.84\;cm^2$으로 4.6%가 감소하는 경향을 나타냈다 (p = 0.062). 하복부에서는 생커피두 엑기스 섭취군에서 내장지방 면적은 섭취 전 $71.8\;{\pm}\;4.81\;cm^2$에서 8주 후 $68.4\;{\pm}\;4.72\;cm^2$으로 4.7%가 유의적으로 감소하였다 (p<0.05). 또한 상복부의 총 지방 면적 (p < 0.05)과 내장지방 면적 (p < 0.05)의 변화량은 군간 비교에서도 유의하였다. 본 연구 결과 생커피두 엑기스를 섭취하는 기간 동안 식사 섭취량 조절 없이 평상시 식습관을 유지하였음에도 불구하고 복부 내장지방의 유의적인 감소로 체지방 분포의 개선 효과를 보여주었다. 따라서 생커피두 엑기스의 섭취와 병행하여 식사조절과 운동이 실시 될 경우 체지방 감소에 더욱 효과적일 것으로 사료되며, 추후 대상자 수의 확대 및 복용기간의 연장 등을 통한 생커피두 엑기스의 체지방 분포 개선 효과 및 대사 관련 지표 개선을 평가하는 후속 연구도 필요할 것이다.

• Korean Journal of Radiology
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• 제24권5호
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• pp.434-443
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• 2023

Objective: To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. Materials and Methods: We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. Results: A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. Conclusion: In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.

• Nutrition Research and Practice
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• 제15권3호
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• pp.279-293
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• 2021

BACKGROUND/OBJECTIVES: The steamed ginger has been shown to have antioxidative effects and a protective effect against obesity. In the present study, we investigated the effects of ethanolic extract of steamed ginger (SGE) on adipogenesis in 3T3-L1 preadipocytes and diet-induced obesity (DIO) mouse model. MATERIALS/METHODS: The protective effects of SGE on adipogenesis were examined in 3T3-L1 adipocytes by measuring lipid accumulations and genes involved in adipogenesis. Male C57BL/6J mice were fed a normal diet (ND, 10% fat w/w), a high-fat diet (HFD, 60% fat w/w), and HFD supplemented with either 40 mg/kg or 80 mg/kg of SGE for 12 weeks. Serum chemistry was measured, and the expression of genes involved in lipid metabolism was determined in the adipose tissue. Histological analysis and micro-computed tomography were performed to identify lipid accumulations in epididymal fat pads. RESULTS: In 3T3-L1 cells, SGE significantly decreased lipid accumulation, with concomitant decreases in the expression of adipogenesis-related genes. SGE significantly attenuated the increase in body, liver, and epididymal adipose tissue weights by HFD. Serum total cholesterol and triglyceride levels were significantly lower in SGE fed groups compared to HFD. In adipose tissue, SGE significantly decreased adipocyte size than that of HFD and altered adipogenesis-related genes. CONCLUSIONS: In conclusion, steamed ginger exerted anti-obesity effects by regulating genes involved in adipogenesis and lipogenesis in 3T3-L1 cell and epididymal adipose tissue of DIO mice.

• 대한의용생체공학회:의공학회지
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• 제38권1호
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• pp.49-55
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• 2017

The prevalence of obesity has noticeably increased worldwide over several decades with various complication. Even though anti-obesity drug treatments have been spotlighted by resulting in effective mean weight losses, its adverse effects cannot be overlooked. Thus, this study aimed to evaluate the effects of multi-frequency whole body vibration, one of the mechanical stimulus, as a countermeasure against obesity. Thirty-two-6-week-old C57BL/6J male mice were equally assigned to four groups: the Control group (CON, n = 8), the Sham group (Sham, n = 8), the sham with single frequency whole body vibration (S+V, n = 8), and the sham with multi frequency whole body vibration (S+MV, n = 8). After 4 weeks, morphologic changes in the adipose tissue were evaluated from three-dimensional images using in vivo micro-computed tomography. At 4 weeks, the volume of the abdominal adipose tissue, which had the highest value in Sham group, noticeably reduced in S+MV group compared to it in S+V group. These results implied that the accumulation of abdominal adipose tissue can be effectively reduced through applying multi-frequency whole body vibration.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.488-495
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• 2018

Background: Skeletal muscle plays a major role in glucose metabolism. We investigated the association between thigh muscle mass, insulin resistance, and incident type 2 diabetes mellitus (T2DM) risk. In addition, we examined the role of body mass index (BMI) as a potential effect modifier in this association. Methods: This prospective study included 399 Japanese Americans without diabetes (mean age 51.6 years) who at baseline had an estimation of thigh muscle mass by computed tomography and at baseline and after 10 years of follow-up a 75-g oral glucose tolerance test and determination of homeostasis model assessment of insulin resistance (HOMA-IR). We fit regression models to examine the association between thigh muscle area and incidence of T2DM and change in HOMA-IR, both measured over 10 years. Results: Thigh muscle area was inversely associated with future HOMA-IR after adjustment for age, sex, BMI, HOMA-IR, fasting plasma glucose, total abdominal fat area, and thigh subcutaneous fat area at baseline (P=0.033). The 10-year cumulative incidence of T2DM was 22.1%. A statistically significant interaction between thigh muscle area and BMI was observed, i.e., greater thigh muscle area was associated with lower risk of incident T2DM for subjects at lower levels of BMI, but this association diminished at higher BMI levels. Conclusion: Thigh muscle mass area was inversely associated with future insulin resistance. Greater thigh muscle area predicts a lower risk of incident T2DM for leaner Japanese Americans.