• Nutrition Research and Practice
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• 제8권1호
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• pp.94-102
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• 2014

Diet attrition and failure of long term treatment are very frequent in obese patients. This study aimed to identify pre-treatment variables determining dropout and to customise the characteristics of those most likely to abandon the program before treatment, thus making it possible to modify the therapy to increase compliance. A total of 146 outpatients were consecutively enrolled; 73 patients followed a prescriptive diet while 73 followed a novel brief group Cognitive Behavioural Treatment (CBT) in addition to prescriptive diet. The two interventions lasted for six months. Anthropometric, demographic, psychological parameters and feeding behaviour were assessed, the last two with the Italian instrument VCAO Ansisa; than, a semi-structured interview was performed on motivation to lose weight. To identify the baseline dropout risk factors among these parameters, univariate and multivariate logistic models were used. Comparison of the results in the two different treatments showed a higher attrition rate in CBT group, despite no statistically significant difference between the two treatment arms (P = 0.127). Dropout patients did not differ significantly from those who did not dropout with regards to sex, age, Body Mass Index (BMI), history of cycling, education, work and marriage. Regardless of weight loss, the most important factor that determines the dropout appears to be a high level of stress revealed by General Health Questionnaire-28 items (GHQ-28) score within VCAO test. The identification of hindering factors during the assessment is fundamental to reduce the dropout risk. For subjects at risk, it would be useful to dedicate a stress management program before beginning a dietary restriction.

• 대한지역사회영양학회지
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• 제13권1호
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• pp.80-90
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• 2008

Atopic dennatitis (AD) is one of the major public health problem. It has been reported that the prevalence of AD in children and adults are 10-20% and 1-3%, respectively. Westernization of food habits, urbanization, and environmental pollution are contributing factors toward the recent rise in prevalence. Excessive dietary restriction leads to chronic malnutrition in atopic dermatitis patients. The purpose of this study was to investigate the effects of medical nutrition therapy (MNT) on quality of diet and blood immune parameters in atopic dermatitis patients. The 19 atopic dermatitis patients (7 men and 12 women) admitted to K University Medical Center were studied. During the 12 weeks of intervention, the subjects were given MNT by a dietitian for 30-45 minutes every other week. MNT was comprised with general dietary therapy, intake of balanced meals, emphasis on n-3 fatty acid contents in foods, and food allergies. Anthropometric and dietary assessment and blood analysis were taken at baseline and after 12 weeks of MNT. After 12 weeks of MNT, the subjects' dietary qualities, including dietary diversity score (DDS), meal balance score (MBS) and dietary variety score (DVS) were significantly increased (p < 0.05). According to significantly increased intake of EPA and DHA, dietary n-6/n-3 fatty acid ratio decreased to the recommended level for the atopic dermatitis patients (p < 0.05). These changes of dietary fatty acid consumption were reflected erythrocyte fatty acid composition. After 12 weeks of MNT, serum levels of IgE and IL-4 levels were significantly decreased, however, the levers of INF-$\{gamma}$, WBC, lymphocyte and TLC were not changed. As a conclusion, the individualized MNT improved the quality of diet in atopic dermatitis patients thereby influenced RBC fatty acid composition and IgE and IL-4 levels.

• Journal of Chest Surgery
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• 제57권2호
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• pp.152-159
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• 2024

Background: Anastomotic leakage (AL) following esophagectomy represents a serious complication that often results in prolonged hospitalization and necessitates repeated interventions, including nothing-by-mouth (NPO) restriction, endoscopic vacuum therapy (EVT), or surgical repair. In this study, we evaluated the patterns and outcomes of AL treatment. Methods: We retrospectively reviewed the medical records of patients who underwent esophagectomy for esophageal cancer at a single center between 2003 and 2020. Of 3,096 examined cases, 181 patients (5.8%) with AL were included in the study: 114 patients (63%) with cervical anastomosis (CA) and 67 (37%) with intrathoracic anastomosis (TA). Results: The incidence of AL was 11.9% in the CA and 3.2% in the TA group (p<0.001). Among patients with CA who developed AL, 87 (76.3%) were managed with NPO, 15 (13.2%) with EVT, and 12 (10.5%) with surgical repair. Over 90% of patients with cervical AL resumed an oral diet by the time of discharge, regardless of treatment method. Among patients with TA and AL, 36 (53.7%) received NPO, 25 (37.7%) underwent EVT, and 6 (9%) required surgery. Of these, 34 patients who were managed with NPO and 19 with EVT could resume an oral diet. However, only 2 patients who underwent surgery resumed an oral diet, and 2 patients required additional EVT. Conclusion: Although patients with CA displayed a higher incidence of AL, their rate of successful oral intake exceeded that of those with TA, regardless of treatment method. Among patients exhibiting AL with TA, EVT was more commonly employed than in CA cases, and it appears effective.

• 비만대사연구학술지
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• 제2권1호
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• pp.6-10
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• 2023

Compensatory changes in energy consumption and neuro-hormonal changes following weight loss make it difficult to maintain the reduced weight and may cause weight regain. Therefore, establishing a long-term weight control plan and strategy starting from the initial weight loss period is necessary. Both the patient and doctor should know that weight loss cannot occur continuously, and that maintaining weight after the weight loss period is the basic course of obesity treatment. No single dietary pattern is effective for weight maintenance, and a variety of dietary control methods - such as calorie restriction and healthy proportions of carbohydrates, proteins, fats, and meal replacements - should be used to target an integrated and healthy dietary habit. An increase in physical activity is needed for weight loss and maintenance; however, rather than recommending an excessive amount of exercise, it is better to set realistic and long-term achievable goals. It is necessary to reset the goal according to the patient's weight maintenance stage and continuously apply behavioral therapies, such as self-monitoring and stress management. In previous studies, since the degree of weight loss and changes in behavioral patterns over the course of one year were important factors in maintaining long-term weight loss, obesity therapists should closely examine patient data and behavioral patterns across a period of one year and actively intervene when needed.

• 대한유전성대사질환학회지
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• 제13권1호
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• pp.48-53
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• 2013

Tyrosinemia I (fumarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that produces liver failure in infancy or a more chronic course of liver disease with cirrhosis, often complicated by hepatocellular carcinoma in childhood or early adolescence. We studied a 37-year-old woman with tyrosinemia I whose severe liver disease in infancy and rickets during childhood were resolved with dietary therapy. From 14 years of age, she resumed unrestricted diet with the continued presence of the biochemical features of tyrosinemia, yet maintained normal liver function. In adult years, she accumulated only a small amount of succinylacetone. Despite this evolution to a mild biochemical and clinical phenotype, she eventually developed hepatocellular carcinoma. Her fumarylacetoacetate hydrolase genotype consists of a splice mutation, IVS6-1G>T, and a novel missense mutation, p.Q279R. Studies of resected liver revealed the absence of hydrolytic activity and immunological expression of fumarylacetoacetate hydrolase in tumour. In the non-tumoral areas, however, 53% of normal hydrolytic activity and immunologically present fumarylacetoacetate hydrolase were found. This case demonstrates the high risk of liver cancer in tyrosinemia I even in a seemingly favorable biological environment. In this study of tyrosinemia I, Case 2 with negative succinylacetone accumulation and the recovery of acute liver failure was compared with Case 1. Diet restriction and NTBC treatment are crucial to prevent hepatocellular carcinoma until liver transplant can take place and cure the condition. Further studies are needed to examine cases where liver cancer did not result despite clinical symptoms/signs of tyrosinemia type I.

• IMMUNE NETWORK
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• 제1권2호
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• pp.104-108
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• 2001

Aging is a senescence and defined as a normal physiologic and structural alterations in almost all organ systems with age. As Leonard Hayflick, one of the first gerontologists to propose a theory of biologic aging, indicated that a theory of aging or longevity satisfies the changes of above conditions to be universal, progressive, intrinsic and deleterious. Although a number of theories have been proposed, it is now clear that cell aging (cell senescence) is multifactorial. No single mechanism can account for the many varied manifestations of biological aging. Many theories have been proposed in attempt to understand and explain the process of aging. Aging is effected in individual by genetic factors, diet, social conditions, and the occurrence of age-related diseases as diabetes, hypertension, and arthritis. It involves an endogenous molecular program of cellular senescence as well as continuous exposure throughout life to adverse exogenous influences, leading to progressive infringement on the cell's survivability so called wear and tear. So we could say the basic mechanism of aging depends on the irreversible and universal processes at cellular and molecular level. The immediate cause of these changes is probably an interference in the function of cell's macromolecules-DNA, RNA, and cell proteins-and in the flow of information between these macromolecules. The crucial questions, unanswered at present, concerns what causes these changes in truth. Common theories of aging are able to classify as followings for the easy comprehension. 1. Biological, 1) molecular theories - a. error theory, b. programmed aging theory, c. somatic mutation theory, d. transcription theory, e. run-out-of program theory, 2) cellular theories - a. wear and tear theory, b. cross-link theory, c. clinker theory, d. free radical theory, e. waste product theory, 3) system level theory-a. immunologic/autoimmune theory, 4) others - a. telomere theory, b. rate of living theory, c. stress theory, etc. Prevention of aging is theoretically depending on the cause or theory of aging. However no single theory is available and no definite method of delaying the aging process is possible by this moment. The most popular action is anti-oxidant therapy using vitamin E and C, melatonin and DHEA, etc. Another proposal for the reverse of life-span is TCP-17 and IL-16 administration from the mouse bone marrow B cell line study for the immunoglobulin VDJ rearrangement with RAG-1 and RAG-2. Recently conclusional suggestion for the extending of maximum life-span thought to be the calory restriction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권3호
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• pp.288-294
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• 2021

Purpose: Despite aggressive medical and nutritional management, patients with methylmalonic acidemia (MMA) often suffer from multi-organ damage. Early deceased donor liver transplantation (DDLT) has emerged as an intervention to prevent disease progression. We investigated the efficacy of living donor LT (LDLT) with a potential carrier of MMA and a small volume of graft in patients with MMA as an alternative to DDLT. Methods: Of five patients (three male, two female; median age 5.7 years; range, 1.3-13.7 years), four underwent carrier LDLT, while one underwent non-carrier auxiliary LDLT. All patients received pre- and post-LT continuous renal replacement therapy and were provided with minimal restriction diet according to serum MMA level after LT. MMA levels in the serum and urine, the incidence of metabolic crisis, and clinical findings before and after LT were compared. Results: The survival rate was 100% during 2.2 years of follow up period after LT. In all five cases, MMA titer in the serum after transplantation decreased with less restrictive diet. Metabolic crisis was not observed during the follow-up period. In addition, no patient showed progression of severe renal impairment requiring hemodialysis. Progression of delayed cognitive development was not observed. Social functioning with improved neuropsychiatric development was observed. Conclusion: This study showed that LDLT achieved improved quality of life with less restrictive diet, therefore it could be a feasible alternative option to DDLT for the treatment of patients with MMA, even with an auxiliary LT.

• Archives of Pharmacal Research
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• 제14권3호
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• pp.242-248
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• 1991

Antihypertensive effect of YH 334 was examined in various experimental hypertension rat models and the systemic and regional hymohynamic profiles of the compound were investigated in conscious spontaneously hypertensive rats (SHR). The antiypertensive potensive potency of YH 334 is found to be more than 10 times stronger than that of nitrendipine in the all hypertensive models. The effective doses to lower the initial blood pressure by 20% $(ED_{20})$ of YH334 were 1.4 mg/kg in normotensive rats (NR), 0.7 mglkg in SHR. 0.1 mg/kg in DOCA salt hypertensive rats (DHR) and 0.4 mg/kg in renal hypertensive rats (RHR), and the $ED_{20}$ values of nitrendipine were 15.8 mg/kg in NR, 7.1 mg/kg in SHR, 1.7 mg/kg in DHR and 4.8 mg/kg in RHR. The primary hemodynamic effect hemodynamic profile is similar to that of nitrendipine. Both compounds seem to produce potent antihypertensive effects by lowering peripheral resistance in the skeletal muscles. In the organ bath study using isolated rabbit aorta, YH 334 was found to be a potent voltage dependent calcium channel blocker without significant inhibitory effect on the receptor operated calcium channels like the most of other dihydropyridine type calcium antagonists. Furthermore, YH334 showed acute diuretic and natriuretic effects in conscious SHR, which may render the unnecessary restriction of sodium in the diet of those patients on long term hypertension therapy. This effect would provide an additional benefit to its potent antihypertensive activity.

• 한국식생활문화학회지
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• 제24권6호
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• pp.784-792
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• 2009

This study was conducted to investigate the effects of weight control programs on BMI, serum profiles, nutrition knowledge and eating behaviors of adult obese women. The subjects of this study were 33 adult obese women aged 30-65 years residing in Seoul. The weight control program for obese women included nutritional education, cognitive behavioral therapy and exercise for 12 weeks. The weight control experience of the subjects was 60.6%. They preferred physical exercise and diet restriction to weight control and 72.7% of subjects answered that the reasons for wanting to control their weight was health. The BMI of test subjects significantly decreased (p<0.001) from 28.3 to 27.1 after the 12 weeks of the weight control program. In addition, the % body fat significantly decreased (p<0.001) from 36.4% to 34.5% after completion of the weight control program. SGPT levels in the serum were also significantly decreased (p<0.05) after the program. Triglyceride levels significantly decreased from 194.9 mg/dL to 98.1 mg/dL (p<0.01) and the HDL cholesterol level significantly increased (p<0.01) from 55.8 mg/dL to 60.0 mg/dL after completion of the weight control program. Nutritional knowledge and eating behavior scores were significantly increased (p<0.001). In addition, the eating self-efficacy of the subjects was significantly increased (p<0.01); however, the food diversity scores were not changed after the program. These results suggest that the weight control program for adult obese women may be effectively used to promote weight reduction and improve nutritional knowledge and eating behavior.

• 대한한의학회지
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• 제16권2호
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• pp.79-99
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• 1995

The survey was done on 30 cases of obese patients who were treated by fasting therapy in the Dept. of Oriental Rehabilitation Medicine, oriental medical hospital in Won Kwang University from May 1995 to August 1995. The results are as follows: 1. The ratio of females to males was 1:14. The distribution was 20th decades (63%), 30th decade(13%), 10th decade(6.7%), and 40th decade(6.7%). 2. In the age of obese-prevalence, the middle to high school years was the highest number as 12 persons(40%). The 20th decade(23.3%) and 30th decade(13.3%) were the second and third highest frequency of subjects. 3. In the obesity index, 150% of ideal weight was the highest percentage with persons(40%). 120-129%(30%), 130-139%(23.3%) and 140-149%(6.7%) were in order of frequency. 4. In the family histories of obese patients, it was found that hypertension had a high incidence of 8 persons. Other evidences of family histories were DM (7), cancer (3) and CVD (2). In hereditary tendency of obese parents, it was known that hereditary tendency of obese mothers was high at 14 persons, that of obese fathers was 5 persons, and that of obese parents was 2 persons. 5. In identifying the cause of obesity, it was found that changes of diet patterns was high at 24 persons(80%). Pregnancy, birth and diseases were in order of cause. 6. The review of consumption showed that obese patients ate the same amount as non-obese persons in the case of 21 patients(70%), 8 patients(26.7%) ate more than non-obese persons and 1 person(3.3%) ate less than persons of the same ages. 7. Obese patients consumption of daily snacks was 10 persons(33%). 17 person(57%) of the obese patients ate midnight snacks every 3-4 days. 11 persons(37%) of the obese patients ate out every 3 - 4 days. 8. For the purpose of weight reduction, 15 patients(50%) used exercise. Fasting therapy(36.7%) and food restriction(33.3%) were the second and third methods used by obese patients. 9. In the relation of constitution medicine usage with obese patients, TAE-EUM-IN was 14 persons(46.7%), SO-EUM-IN was 11 persons(36.7%), and SO-YANG-IN was 5 persons(l6.7%).