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A cross-sectional study on prevalence rate and contributing factors of fatty liver diagnosed by ultrasonography (초음파로 진단된 지방간의 유병율 조사 및 그 유발인자에 대한 연구)

  • Ahn, Jae-Eog;Ham, Jung-Oh;Hwang, Kyu-Yoon;Kim, Joo-Ja;Lee, Byung-Kook;Nam, Tack-Sung;Kim, Joung-Soon;Kim, Hun
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.195-210
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    • 1991
  • Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following ; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are $40{\sim}50's$ in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows ; If the odds ratio of below 29 year of age is 1.0 then that of $30{\sim}39$ is 1.74 (p=0.33), $40{\sim}49$ is 2.47 (p=0.10), $50{\sim}59$ is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of $0{\sim}9$ is 5.08 (p<0.01), $10{\sim}19$ is 12.37 (p<0.01), $20{\sim}29$ is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of $100{\sim}120$ is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below $29{\mu}/1{\gamma}-GT$ is 1.0 then that of $30{\sim}s59$ is 2.11 (p<0.01), $60{\sim}90$ is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then $150{\sim}199$ is 1.49 (p=0.05), $200{\sim}250$ is 1.09 (P=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and nm triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.

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The Prognostic Factors Affecting Survival in Muscle Invasive Bladder Cancer Treated with Radiotherapy (방사선치료를 받은 근 침윤성 방광암의 예후 인자)

  • Chung Woong-Ki;Oh Bong-Ryoul;Ahn Sung Ja;Nah Byung Sik;Kwon Dong-Deuk;Park Kwangsung;Ryu Soo-Bang;Park Yang-IL
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.130-138
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    • 2002
  • Purpose : This study analyzed the prognostic factors affecting the survival rate and evaluated the role of radiation therapy in muscle-invading bladder cancer. Materials and Methods : Twenty eight patients with bladder cancer who completed planned definitive radiotherapy in the Departments of Therapeutic Radiology and Urology, Chonnam National University Hospital between Jan. 1986 to Dec. 1998 were retrospectively analyzed. The reviews were peformed based on the patients' medical records. There were 21 males and 7 females in this study. The median of age was 72 years old ranging from 49 to 84 years. All patients were confirmed as having transitional cell carcinoma with histological grade 1 in one patient, grade 2 in 15, grade 3 in 9, and uninformed in 3. Radiation therapy was peformed using a linear accelerator with 6 or 10 MV X-rays. Radiation was delivered daily with a 1.8 or 2.0 Gy fraction size by 4 ports (anterior-posterior, both lateral, alternatively) or 3 ports (Anterior and both lateral). The median radiation dose delivered to the isocenter of the target volume was 61.24 Gy ranging from 59 to 66.6 Gy. The survival rate was calculated by the Kaplan-Meier method. Multivariate analysis was peformed on the prognostic factors affecting the survival rate. Results : The survival rate was $76\%,\;46\%,\;33\%,\;33\%$ at 1, 2, 3, 5 years, respectively, with 19 months of median survival. The potential factors of age (less than 70 years vs above 70), sex, diabetes mellitus, hypertension, hydronephrosis, 1-stage (T3a vs T3b), TUR, chemotherapy, total duration of radiotherapy, radiation dose (less than 60 Gy vs above 60 Gy), and the treatment response were investigated with uniand multivariate analysis. Un univariate analysis, the T-stage (p=0.078) and radiation dose (p=0.051) were marginally significant, and the treatment response (p=0.011) was a statistically significant factor on the survival rate. Multivariate analysis showed there were no significant prognostic factors affecting the survival rate. Conclusion : The treatment response and radiation dose are suggested as th은 statistically significant factors affecting the survival rate of muscle invasive bladder cancer. A Further prospective randomized study is needed to confirm these prognostic factors.

Snuffbox Arteriovenous Fistula Formation for Hemodialysis (Snuffbox에 시행한 혈액투석을 위한 동정맥루조성술)

  • 서필원;류재욱;박정옥;장성욱;김미순;박성식;김삼현
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.154-159
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    • 2004
  • The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. Material and Method: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001 The records of the patients except six patients who were lost from follow up were analyzed retrospectively, Mean age and male:female ratio were 52$\pm$15 years (range, 17∼79 years) and 80 : 60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09$\pm$3.68 mg/dL (range, 2.55∼20.09 mg/dL) and 4.7$\pm$0.9 mmol/L (range, 2.3∼8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. Result: Mean follow up period of the patients was 41.8$\pm$31.0 months (range, 0.2∼108,8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8$\pm$10.1 months (range, 0.1∼40.4 months). The patency rates of f month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. Conclusion: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.

The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases (만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성)

  • Kim, Jeong Yi;Ryu, So Yeon;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.41 no.1
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    • pp.13-26
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    • 2016
  • Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.

Relevance of Serum Vitamin D and Indices Related To Cardiovascular Disease Among Korean Adults (한국 성인의 혈청 비타민 D 수준과 심혈관 질환 관련 지표와의 관련성)

  • Kim, Han-Soo;Ryu, So-Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.365-374
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    • 2018
  • This study investigated the relationship between Vitamin D levels and indices related to cardiovascular disease in Korean adults aged ${\geq}19years$. The data for analysis were obtained from the sixth Korea National Health Nutrition Examination Survey in 2013 and 2014. The results showed that the incidence of Vitamin D deficiency was 73.1% among Korean adults and that indices related to cardiovascular disease showed an increasing trend (55.6% of Korean adults). The relationship between Vitamin D levels and indices related to cardiovascular disease with controlled physical activity status was also studied. The odds ratios (ORs) for age were 1.72 for the 4-62 years age group (95% CI, 1.53-1.93) and 2.05 for the ${\geq}65years$ age group (95% CI, 1.71-2.45). For blood pressure, the OR for pre-hypertension was 1.30 (95% CI, 1.15-1.47) and that for hypertension was 1.31 (95% CI, 1.11-1.54). For body mass index (BMI), the OR was 1.36 (95% CI, 1.11-1.66) and that for waist circumference (WC) was 1.36 (95% CI, 1.11-1.66). For fasting blood sugar (FBS), the OR for impaired fasting glucose (IFG) was 1.37 (95% CI, 1.21-1.55) and that for diabetes mellitus (DM) was 1.31 (95% CI, 1.05-1.65). The OR for total cholesterol (TC) was 1.30 (95% CI, 1.11-1.52) and that for triglycerides (TG) was 1.20 (95% CI, 1.04-1.37) in Korean adults. There was a significant relationship between Vitamin D and indices related to cardiovascular disease in Korean adults with respect to age, blood pressure, FBS, BMI, TC and TG. Confirmation of a causal relationship between Vitamin D and indices related to cardiovascular disease may require further research consisting of more systematic cohort studies.

Effects of Benincasa hispida Fractions on Hepatic Lipid Levels and Lipid Peroxidation in Streptozotocin Induced Diabetic Rats (동과 (Benincasa hispida) 분획물의 투여가 Streptozotocin 유발 당뇨 흰쥐의 간장 지질수준 및 지질과산화에 미치는 영향)

  • Lim, Sook-Ja;Lee, Min-Hwan
    • Journal of Nutrition and Health
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    • v.39 no.6
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    • pp.513-519
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    • 2006
  • The effects of fractions of ethanol extract of Benincasa hispida (wax gourd) on lipid levels and lipid peroxidation in streptozotocin (STZ) induced diabetic rats were examined. Sprague-Dawley rats were induced diabetes mellitus by STZ injection (45 mg/kg) into the tail vein and were divided into 5 groups: normal, STZ-control, three experimental diabetic groups [chloroform $(CHCl_3)$ fraction group, butanol (BuOH) fraction group, and water fraction group]. Fractions of ethanol extract of Benincasa hispida were administered orally into the diabetic rats for 14 days. The liver glycogen levels of $CHCl_3$ fraction group and the muscle glycogen levels of BuOH and water fraction groups were significantly higher than that of STZ-control group. Pancreas protein levels of BuOH and water fraction groups were significantly higher than that of STZ-control group. The liver cholesterol level of BuOH and water fraction groups were significantly lower when compared with the STZ-control group. The level of liver triglyceride in BuOH and water fraction groups were significantly higher than that of STZ-control group. Malondialdehyde (MDA) levels in liver of normal and diabetic groups were not significantly different. In the pancreas, the MDA levels of BuOH and water fraction group were significantly lower than that of STZ-control group. The results suggested that the supplementation of the BuOH and water fractions of Benincasa hispida extract could be beneficial for the diabetic complications and damages from the lipid peroxidation.

Assessment of Carotid Geometry by Using the Contrast-enhanced MR Angiography (조영증강 MR 혈관 조영술을 이용한 경동맥 기하학의 평가)

  • Lee, Chung-Min;Ryu, Chang-Woo;Kim, Keun-Woo
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.1
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    • pp.47-55
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    • 2010
  • Purpose : To evaluate the geometry of carotid artery by assessing the images of contrast-enhanced MR angiography (CE-MRA) and interrelationships between the geometry of carotid artery and clinical factors. Materials and Methods : 216 consecutive patients who performed supraaortic CE-MRA with fast spoiled gradient-echo imaging were included. Their medical records were reviewed for variable information including risk factors predictive of generalized atherosclerotic disease (age, hypertension (HTN), diabetes mellitus, hyperlipidema, and smoking), sex, body weight, height, and body mass index (BMI). We reviewed the CE-MRA with carotid origin (3 types), carotid artery tortuosity, angle of internal carotid artery bifurcation, the type of aortic arch branching, and the presence of the coiling of carotid artery. Results : Multinomial logistic regression analysis showed that significantly contributed clinical backgrounds for carotid origin were the age and the BMI. With an increase of age at 1, the probability that the type of carotid origin become from type 1 to type 2 was 0.9 times (p=0.004) in right carotid artery (RCA), 0.9 times (p = 0.031) in left carotid artery (LCA), 0.9 times that are likely to be type3 from type 2 (p<0.001) in RCA and 0.9 times in LCA (p=0.009). Increase in BMI at 1 increased odds of becoming type 2 as 1.1 times (p = 0.067) in RCA, 1.1 times (p=0.009) in LCA and increased chance of becoming type 3 as 1.2 times (p = 0.001) in RCA, 1.2 times (p=0.003) in LCA. Mean value of right and left carotid tortuosity were $240.9{\pm}69.0^{\circ}$and $154.4{\pm}55.0^{\circ}$, respectively. Conclusion : The BMI, age, sex and presence of HTN affects the geometry of carotid arteries, the site of origin and tortuosity of carotid artery specifically.

Anti-diabetic Activity of Germinated Ilpum Rough Rice Extract Supplement in Mice (C57BL/KsJ-db/db 제2형 당뇨병 마우스에서 발아일품벼 추출물의 항당뇨효과)

  • Lee, Youn-Ri;Woo, Koan-Sik;Hwang, In-Guk;Kim, Hyun-Young;Lee, Sang-Hoon;Kim, Yun-Bae;Lee, Jun-Soo;Jeong, Heon-Sang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.3
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    • pp.339-344
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    • 2012
  • This study was performed to investigate the effect of germinated Ilpum rough rice extract on blood glucose in C57BL/KsJ-db/db mice. The mice were divided into several groups: normal control (NC), diabetic control (DC), those fed with 0.25% germinated Ilpum rough rice extract (DM-0.25%GIRRE), those fed with 0.5% germinated Ilpum roughrice extract (DM-0.5%GIRRE) and those fed with 1% germinated Ilpum rough rice extract (DM-1%GIRRE). After 8 weeks of treatment, body weight, water intake, and diet intake of the DM-1%GIRRE group were significantly lower than the other DM groups. Blood glucose levels of the DM-1%GIRRE group were significantly lower compared to the DC group. Fasting blood glucose HbA1c level and total glucose tolerance test were significantly lower in the DM-1%GIRRE groups compared to the DC group. There was no significant difference in serum insulin level among each group. Therefore, the results of this study demonstrate that germinated Ilpum rough rice extract alleviates many of the symptoms of diabetes in genetically obese mice and may offer a possibility as a therapeutic supplement for the normalization of blood glucose levels in humans with hyperglycemia. It may also have beneficial effects in patients with non-insulin-dependent diabetes mellitus.

Perinatal Factors Affecting Thyroid Stimulating Hormone(TSH) and Thyroid Hormone Levels in Cord Blood (제대혈 갑상선 자극호르몬과 갑상선 호르몬 농도에 영향을 주는 주산기 인자들)

  • Kim, Eun Young;Park, Sang Kee;Song, Chang Hun;LIm, Sung-Chul
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.143-147
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    • 2005
  • Purpose : The aim of the this study was to evaluate the effect of various perinatal conditions on TSH and thyroid hormone levels in cord blood. Methods : Cord blood samples were collected from 130 neonates immediately after birth. TSH, $T_3$, and free $T_4$ levels were measured by the radioimmunoassay(RIA) method. The effects of gestational age, sex, birth weight, delivery method, perinatal asphyxia, maternal diabetes mellitus(DM), and preeclampsia on TSH and thyroid hormone levels were assessed by ANOVA test, Student t-test, and multiple regression analysis. Results : Birth weight and sex did not affect TSH and thyroid hormone levels. TSH level increased according to gestational age(P<0.05). TSH level was $4.42{\pm}0.66{\mu}IU/mL$ in infants born vaginally, which was higher than that of cesarian section delivery($3.31{\pm}0.33{\mu}IU/mL$)(P<0.05). TSH level was $5.18{\pm}0.93{\mu}IU/mL$ in asphyxiated newborns and $2.97{\pm}0.84{\mu}IU/mL$ in non-asphyxiated newborns(P<0.05). TSH level in infants with maternal DM($8.911{\pm}1.25{\mu}IU/mL$) was higher than that of infants without maternal DM($4.32{\pm}0.42{\mu}IU/mL$)(P<0.05). TSH level was $5.28{\pm}0.42{\mu}IU/mL$ in infants with maternal preeclampsia and $3.65{\pm}0.46{\mu}IU/mL$ in infants without maternal preeclampsia(P<0.05). Thyroid hormones were lower in infants with perinatal asphyxia(P<0.05). In asphyxiated infants, $T_3$ level was $75.33{\pm}55.65ng/mL$ and free $T_4$ was $0.54{\pm}0.21ng/mL$. $T_3$ and free $T_4$ level was $109.85{\pm}41.77ng/mL$ and $0.76{\pm}0.22ng/mL$ each in infants without perinatal asphyxia. Among the perinatal factors, gestational age, 1 min Apgar score and maternal DM influenced TSH level independently. Conclusion : In our study, cord blood TSH and thyroid hormone levels were affected by perinatal stress events.

A Study on the Serum Concentrations of Glucose, Insulin and Lipid in Elementary School Children by Body Weight (체중에 따른 일부 초등학교 아동의 혈청 중 포도당, 인슐린 및 지질농도에 관한 연구)

  • Han, Gi-Hyung;Kim, Gyeong-Eup;Yoon, Gi-Young;Cheong, Hyo-Sook;Kim, Sung-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.9
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    • pp.1375-1380
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    • 2005
  • The purpose of this study was to investigate anthropometric values, serum biochemical levels and their correlation in elementary school children. The subjects were 98 boys and girls in the $4{\~}6$ grade and divided into three groups by body size. The mean height of under-weight group (boys: $14.9\pm7.8\;cm$, girls: $144.9\pm9.6\;cm$) was the highest of the groups. The systolic and diastolic blood pressure of all the groups ranged from $111.56\pm13.51\;mmHg/72.86\pm7.26\;mmHg\;to\;117.50\pm10.00\;mmHg/75.31\pm9.51\;mmHg$, all within the normal levels. As subject was fatter, serum concentrations of triglyceride, total cholesterol, LDL-cholesterol insulin and atherogenic index (AI) in the boys, and serum concentrations of triglyceride, insulin and AI in the girls were significantly higher The concentrations of serum glucose, insulin, triglyceride, total cholesterol and LDL- cholesterol were significantly positively correlated with BMI and WHR. No significant correlation was found with blood pressure and serum lipid concentrations. Serum insulin levels was significantly positively correlated with serum glucose and triglyceride concentrations. Thus, this study implicates that obesity in childhood may be relevant to hyperlipidemia, atherosclerosis and diabetes mellitus.