Familial hypercholesterolemia (FH) is a genetic disease that is not well known or diagnosed in Korea. This disease is associated with persistently high levels of low-density lipoprotein cholesterol (LDL-C), which increase the risk of coronary artery disease at a young age. Therefore, early diagnosis and treatment are important; however, there are no global consensus diagnostic criteria. In Korea, the Dutch Lipid Clinic Network diagnostic criteria, and the Simon Broome diagnostic criteria were used for diagnosis of FH according to the agreement announced at the Korean Society of Lipid and Atherosclerosis (KSoLA) in 2022. Recently, the absence of coronary artery calcification has been considered a good prognostic factor, even among patients with very high LDL-C levels who are considered to be at high risk for atherosclerotic cardiovascular disease. We describe throughout this paper the diagnosis and treatment of FH in a young male without coronary artery calcification.
Objective : As part of the Korean Medicine Official Development Assistance(ODA) and Public Health Project, we implemented a obesity management program(OMP) using Korean medicine in Uzbekistan and its follow-up study was conducted to evaluate the effectiveness of the program. Method : We recruited the participants of whose Body Mass Index(BMI) were over $25kg/m^2$ and who agreed to participate in the program at the South Korea-Uzbekistan Friendship Korean Medical Hospital in Uzbekistan. The program consisted of auricular acupuncture, functional food, and education program on diet and exercise. It was provided once a week during 7-week period. Anthropometric measurements and blood test measuring total cholesterol, triglyceride, and glucose were performed at the baseline, the end of the program, and 10-month follow-up. At the end of the program and the follow-up, survey on satisfaction and self-evaluation of the effectiveness of the program was additionally conducted. Results : 43 out of 78 participants completed the program and were included in the analysis. The analysis of the main outcomes showed that there were significant decreases in anthropometric measurements such as body weight, waist circumference, body mass index (BMI) and body fat content as well as blood test including triglycerides, total cholesterol and blood glucose levels. In the follow-up study, 24 subjects participated and 19 subjects (79.1%) reported that they succeeded in weight control. Furthermore, many participants reported that they maintained healthy lifestyles like healthy diet and regular exercise. The satisfaction with the program was also relatively high, and the education program was selected as the most motivating intervention for weight control. The outcomes such as body weight, BMI, body fat content, and blood glucose level were maintained to be at the decreased level; however, waist circumference, total cholesterol and triglycerides levels either returned back to the baseline level or were elevated to the level higher than the baseline. Conclusion : This study suggests that the OMP using Korean medicine may contribute to weight control of obese population in Uzbekistan. It is meaningful in that the study shows the possibility of implementing health promotion programs using Korean medicine in other countries with different cultures. In the future, more efforts to evaluate the effectiveness of the programs using rigorous methodologies and utilize the effective programs in ODA project will be needed.
Recently the hospitals or clinics tend to get out of the functional and technological aspect so as to gradually emphasize service for patients. While qualitative rather than quantitative alteration is noticeable, the scale of clinics is getting larger. Especially, the opulence resulted from economic, social and cultural development has enabled more people to visit dermatology or plastic surgery besides treatment for disease. Responding to this tendency, dermatology is focusing on skin beauty, plastic operation, controlling obesity, etc. for women rather than ordinary treatment. Thus, dermatology is in need of space for skin control as well as ordinary treatment, which raises the immediate necessity of new plan for space and interior environment. In order to meet such necessity of dermatology, it is required to fully study and consider the plan for interior space. First, the purpose, scope and method of research will be defined in the introduction. Second, the concept of clinic as well at the characteristic of dermatology will be studied by theoretical investigation. Third, the general concept of dermatology will be analyzed by examining the characteristic of each room in dermatology, the moving line of nurses and patients, the color of dermatology and the design factor of finishing materials through general investigation on dermatology. Fourth, in order to look into the general case of dermatology, the object of examination will be selected for examination through literature and visiting. After examining data, the result will be analyzed and evaluated to prepare the ground for interior plan of dermatology.
Objective : "Dochangbup" is one of the therapies that remove pathogenic qi[邪氣] from the Emetic Method in the Miscellaneous Disorders part of Dongeuibogam東醫寶鑑. It is, in particular, the method of treatment that removes phlegm[痰], the cause of various disorders. Method : Application of "Dochangbup" had a long history in Korea as well. The meaning and application of "Dochangbup" are mentioned in various texts from early Chosun dynasty to the post liberation. Result : In China, there are a lot of medical texts by physicians throughout Ming and Qing Dynasty, with GeZhiYuLun格致餘論 at the top of the list, dealing with the meaning and applicable scope of "Dochang" method and pharmacy of "Hacheongo霞天膏". Most of the physicians are affiliated with Dan Xi School, regarding ZhudanXi朱丹溪 as a suzerain. In "Dongeuibogam", it is mentioned that "Dochangbup" can treat various disorders caused by phlegm. Though, when there is a possibility of harming original qi[元氣] during the treatment or grave deficiency in patients, it is requested to consider tonifying while purging. Conclusion : "Dochangbup" can be applied not only to the disorders mentioned in classical medical texts, like heart pain[心痛], leg disease[脚氣], urine turbidity[小便濁], involuntary discharge of semen[遺精], cough[咳嗽], blood spitting[喀血], but also to metabolic syndrome such as obesity, hypertention and diabetes, commonly found in the modern era.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제30권2호
/
pp.150-156
/
2004
The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree & site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.
Purpose: This study evaluated the prevalence of the metabolic syndrome (MetS) and risk factors for metabolic derangement in young adults with childhood-onset hypopituitary growth hormone deficiency (ACOHGHD). Methods: Thirty patients with ACOHGHD who were treated with hormone-replacement therapy, aged 18 to 29 years, who visited the Seoul National University Children's Hospital between September 2009 and February 2010 were enrolled. Height, weight, waist circumference, hip circumference, and blood pressure were measured, and the clinical and hormonal features were reviewed retrospectively. We evaluated measures of metabolic derangement in the enrolled patients and in the data of healthy adults aged 20 to 29 years taken from the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) as part of the National Cholesterol Education Program-the Adult Treatment Panel III. Results: Compared with the KNHANES participants, patients with ACOHGHD had significantly large waist circumference (men and women), high systolic blood pressure (BP) (women) and diastolic BP (men), and high serum triglyceride levels (women). The duration of illness correlated significantly with central obesity ($r^2$=0.546, $P$=0.003). The prevalence of MetS was 10% in patients with ACOHGHD and 2.3% in KNHANES participants. The prevalence of central obesity and MetS was higher in patients with ACOHGHD than in KNHANES participants ($P$<0.001 and $P$=0.042, respectively). Conclusion: Abdominal obesity correlated with the duration of illness in patients with ACOHGHD. Waist circumference should be measured in the clinic to prevent MetS, particularly in patients with a long history of ACOHGHD, regardless of age or sex.
During last few decades dietary guidelines for the weight management mainly have focused on a low-fat, high carbohydrate diet. Carbohydrate was supposed to be low-dense, highly satiating as well as it affects little on the lipogenesis. Although low-fat diet has significant weight-reducing effect, the loss was modest and usually regained after cessation of the diet. Furthermore, low-fat, modest-carbohydrate diet did not impact on the ever increasing rates of overweight and obesity. Alternative approaches include low-carbohydrate diet, high-carbohydrate diet and low-glycemic index diet. Although none of above mentioned diet have sufficient evidence for standard weight management diet, short-term efficacy and safety are being approved continuously. Low-carbohydrate diet contains less than 45% of carbohydrate in daily energy consumption, it is claimed to have more satiating effect and to improve metabolism. However, low compliance due to the limitation of food choice should be considered on prescribing the diet. High-carbohydrate which contains 90% of carbohydrate in total daily energy consumption, is effective in providing satiety and lowering total calorie intake and cholesterol. On the other hand, nutritional unbalance should be took into account. Low-glycemic index diet is based on the theory that contemporary diet contains significantly less fiber and unrefined carbohydrate, therefore insulin secretion is disturbed. Because low glycemic index food slowly increase blood glucose and insulin level, it induces much satiating effect and may decrease calorie ultimate intake. However, poor standardization of glycemic index is one of the main obstacle for the diet to be applied in the clinic. Meanwhile, high fructose food and beverage should be discouraged because it has little satiating effect and may cause insulin resistance. High fiber food is another recommendation for healthy, lean diet.
Purpose: The ${\beta}3-adrenergic$ receptor (ADRB3) is expressed in visceral adipose tissue and has been speculated to contribute to lipolysis, energy metabolism, and regulation of the metabolic rate. In this study, we aimed to investigate the association of polymorphism of the ADRB3 gene with the sex of children with obesity and related pathologies. Methods: ADRB3 gene trp64arg genotyping was conducted in 441 children aged 6-18 years. Among these subjects, 264 were obese (103 boys; 161 girls) and 179 were of normal weight (81 boys; 98 girls). In the obese group, fasting lipids, glucose and insulin levels, and blood pressure were measured. Metabolic syndrome (MS) was defined according to the modified World Health Organization criteria adapted for children. Results: The frequency of trp64arg genotype was similar in obese and normal weight children. In obese children, serum lipid, glucose, and insulin levels; homeostasis model assessment of insulin resistance (HOMA-IR) scores; and MS were not different between arg allele carriers (trp64arg) and noncarriers (trp64trp). In 264 obese children, genetic analysis results revealed that the arg allele carriers were significantly higher in girls than in boys (p=0.001). In the normal weight group, no statistically significant difference was found between genotypes of boys and girls (p=0.771). Conclusion: Trp64arg polymorphism of the ADRB3 gene was not associated with obesity and MS in Turkish children and adolescents. Although no relationships were observed between the genotypes and lipids, glucose/insulin levels, or HOMA-IR, the presence of trp64arg variant was frequent in obese girls, which can lead to weight gain as well as difficulty in losing weight in women.
Objectives: Ephedra sinica and Wolbigachul-tang which contains Ephedra sinica are used to treat obesity in Korean medicine. The aim of this study was to analyze the quantities of ephedrine alkaloids by high-performance liquid chromatography. Methods: The analysis was performed using a YMC-Triat C18 column with operating at 25℃, and UV detection at 210 nm. The mobile phase used a gradient flow with 0.1% H3PO4 in water and acetonitrile. Specificity, linearity, precision, accuracy, limit of detection, and limit of quantification were measured for validation anaylsis. This method was applied to analyze the quantities of ephedrine alkaloids in Ephedra sinica and Wolbigachul-tang. Results: The concentration per Ephedra sinica (gram) of ephedrine and pseudoephedrine in Ephedra sinica decoction are 4.74±0.22 mg and 2.19±0.10 mg, respectively and in Wolbigachul-tang decoction are 6.39±0.34 mg and 2.97±0.21 mg, respectively. The retention time of ephedrine was 23.6 min and that of pseudoephedrine was 25.8 min, and norephedrine and methylephedrine were not detected. Conclusions: In conclusion, analyzed the concentration of ephedrine alkaloids in Ephedra sinica and Wolbigachul-tang by the developed validation method.
Background/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea. Methods: We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed. Results: In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain. Conclusions: IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.
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