• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1082-1089
• /
• 2005

Purpose : Abdominal obesity is encountered as a risk factor for cardiovascular diseases. However, the anthropometric cut-off value to estimate the cardiovascular risk, has not been suggested. This study was designed to find the relationship between the abdominal fat and various parameters of obesity to find the cardiovascular risk factors related to abdominal obesity and to establish practical methods to measure them. Methods : Twenty seven obese Korean adolescents of moderate to severe degree and 22 healthy adolescents were enrolled. The body mass index(BMI), arm circumference and skinfold thickness were measured. Furthermore, blood lipid, sugar, insulin and four different cytokines' levels were checked and the distribution of body composition was measured by bioelectrical impedance analysis. The subcutaneous and intra-abdominal fat thickness by abdominal ultrasonography(US) and the total and intra-abdominal fat area by abdominal computerized tomography(CT) were measured in the obese group. Results : The most accurate method to measure abdominal fat in children is abdominal CT and the fat mass measured by bioelectrical impedance was strongly correlated with it(r=0.954). It was also correlated with arm circumference, fat thickness measured by abdominal US, BMI, aspartate aminotransferase(AST), alanine aminotransferase(ALT) and triglyceride level. Conclusion : Abdominal CT is the most accurate method to measure intra-abdominal fat, and it can be replaced by abdominal US for cost effectiveness. The screening methods that can be used at school or in outpatient basis include bioelectrical impedance, waist/hip ratio, and arm circumference. The cardiovascular risk factors include leptin, triglyceride and insulin level.

• Journal of the Korean Society of Physical Medicine
• /
• v.11 no.1
• /
• pp.83-91
• /
• 2016

PURPOSE: There are several methods, such as the abdominal drawing-in maneuver (ADIM), maximal expiration (ME), and Kegel exercise, to strengthen the core muscles. However, to date no study has been conducted to compare the effects of the ADIM, ME, and Kegel exercise on the transverses abdominis (TrA), internal oblique (IO), external oblique (EO), and pelvic floor muscles (PFMs). The purpose of this study was to find out which of the three aforementioned exercises is most effective for contracting the core muscles. METHODS: The thickness of the TrA, IO, EO and PFMs was measured by ultrasonographic imaging during the ADIM, ME and Kegel exercise in 34 healthy participants. RESULTS: There was the significant difference between ADIM and Kegel exercise in the thickness of the TrA (p<0.05). There were the significant differences between ADIM and ME and between ME and Kegel exercise in the thickness of the IO and PFM (p<0.01). There was no significant activation in the thickness of the EO (p>0.05). Measurement reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). An ICC value of >0.77 indicated that reliability measurements was good. CONCLUSION: Kegel exercise was the most effective exercise for the TrA and the PFM, and ME was the most effective exercise for the IO muscles.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.6
• /
• pp.2541-2546
• /
• 2014

Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is rarer than extrahepatic gastrointestinal neuroendocrine carcinoma (NEC). It is difficult to make a correct diagnosis and poses a challenge for management. Materials and Methods: Ten PHNEC patients were admitted to our hospital from June 2006 to June 2011. Laboratory tests and imaging scans were performed for diagnosis and exclusion of extrahepatic NEC. All patients were AFP - and CA199-. Seven patients had solid tumors with cystic changes on ultrasonography, CT and/or MRI. For the initial treatment, four patients received combined-therapy and six monotherapy. Considering overall treatment, six patients received combined-therapy and four patients monotherapy. Staging criteria of primary hepatocellular carcinoma (PHC, AJCC 7th edition) were used to differentiate the stage of all patients: 3 patients were stage I, 2 stageII, 4 patients stageIII and 1 stageIV. All patients were followed up and clinical data were gathered. Results: The median follow-up duration was 38.5 months. The 1-year, 2-year, 3-year and 6-year disease-free survival was 80.0%, 46.2% and 46.2% and 0% respectively. The overall survival rates were 100%, 67.1%, 67.1% and 33.6% respectively. Patients in early-stages (I/II) had similar disease-free and overall survival as those in advanced-stages (III/IV). Patients with monotherapy had significant shorter disease-free and overall survival than the patients with combination-therapy. Conclusions: PHNEC has a unique specificity during its occurrence and development. The staging criteria of PHC might not be suitable for the PHENT. More convenient and effective features need to be found in imaging and laboratory detection. Surgical resection, TACE, chemotherapy and radiofrequency ablation should be performed in combination and actively for patients with PHNEC or recurrence to get the best effectiveness; they might extend the disease-free and overall survival.

• Journal of Trauma and Injury
• /
• v.25 no.4
• /
• pp.203-208
• /
• 2012

Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty- nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.

• Journal of Veterinary Clinics
• /
• v.18 no.4
• /
• pp.442-447
• /
• 2001

A 2-year-old 4.0-kg female Shih Tzu with history of hematemesis and melena was referred to Veterinary Medical Teaching Hospital, Seoul national University for further evaluation and treatment. During physical examination, the dog revealed mild depression, dry mucous membrane and abdominal pain. Hematologic values were normal and serum chemical values showed increased serum bile acid (53.47 umol/l, preprandial), fasting serum ammonia concentration (184 g/dl), alanine transferase (98 U/L), alkaline phosphatase (871 U/L) and gamma glutamyl transpeptidase (21 U/L), and decreased blood urea nitrogen (4 mg/dl), total protein (4.1 g/dl) and albumin (1.2 g/dl). Microhepatica was shown in abdominal radiography. During the ultrasound examination, dilated tortuous vein communicating with caudal vena cava ws observed near the stomach. Intraoperative jejunal vein portography was performed during laparotomy to confirm the location and size of shunt vessel. According to history taking, physical examination, hematologic and serum chemical examination and radiographic study, it was diagnosed as single extrahepatic portosystemic shunt. The anomalous vessel (7 mm, o.d.) that enter the caudal vena cava from the left gastric vein, near the level of the diaphragm, was identified. A Ameroid constrictor (5 mm, i.d.) was applied to the shunting vessel near the caudal vena cava. Hematologic and serum chemical values recovered gradually and were revealed normal values 4 months after surgery. Four month after surgery serum bile acids concentrations were 0.56 $\mu$mol/l (preprandial) and 18.45 umol/l (postprandial). Abdominal radiograph showed normal gastric axis and it revealed normal size of the liver. Fine texture and increased echogenecity of liver and enlargement of portal vein were shown in ultrasonography. Single extrahepatic portosystemic shunt might be treated surgically using Ameroid constrictor.

• Physical Therapy Rehabilitation Science
• /
• v.9 no.3
• /
• pp.184-190
• /
• 2020

Objective: Patients with low back pain can possibly have impaired core muscle function, which is the common cause of low back pain. Spinal stabilization exercises are recommended for prevention and reinforcement. This study aimed to compare the effects of different types of feedback on abdominal and lumbar multifidus (LM) muscle recruitment during spinal stabilization exercises. Design: Cross-sectional study. Methods: Fifty-seven healthy subjects (sex=male 21/female 36, age=21.28±1.60 years) were divided into three different groups: the control group (n=19), the auditory feedback (AF) group (n=19), and the visual and auditory feedback (VAF) group (n=19). The control group received no feedback, whereas the AF group only received AF during exercises and the VAF group received the AF and visual feedback through the real-time ultrasound images. The main outcome measure was the assessment of the thickness of the abdominal muscles and LM measured by a dual ultrasound. Results: When VAF was applied, the thickness of the transverse abdominis significantly increased rather than when feedback was not applied or with AF only (p<0.05). The VAF group showed significant differences in both the control group and the AF group in the post-hoc test (p<0.05), and there was no significant difference between the control group and the AF group. Conclusions: With spinal stabilization exercises, VAF should be applied in standing posture for healthy adults to further promote the production of effective contractions.

• Safety and Health at Work
• /
• v.3 no.4
• /
• pp.287-293
• /
• 2012

Objectives: Metabolic syndrome has received attention as a risk factor for cardiovascular disease, with particular importance attached to visceral fat accumulation, which is associated with lifestyle-related diseases and is strongly correlated with waist circumference. In this study, our aim is to propose waist circumference cut-off values that can be used as a marker for fatty liver based on a sample of workers receiving health checkups in Japan. Methods: This study was conducted in a total of 21,866 workers who underwent periodic health checkups between January 2007 and December 2007. The mean age of the subjects was 47.4 years for men (standard deviation [SD]: 8.0) and 44.7 years for women (SD: 6.9). Evaluation included abdominal ultrasound and measurement of waist circumference, body mass index, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure. Results: Based on receiver operating characteristic curve analysis, the optimal waist circumference cut-off values were shown as 85.0 cm (sensitivity 0.72, specificity 0.69) for men and 80.0 cm (sensitivity 0.75, specificity 0.78) for women. Conclusion: Abdominal ultrasound is the most efficient means of diagnosing fatty liver, but this examination seldom occurs because the test is not routinely performed at workers' health checkups. In people found to have a high risk of fatty liver, recommendations can be made for abdominal ultrasound based on the waist circumference cut-off values obtained in this study. That is, waist circumference can be used in high risk individuals as an effective marker for early detection of fatty liver.

• Journal of Veterinary Clinics
• /
• v.24 no.2
• /
• pp.251-254
• /
• 2007

A 10-year-old intact female Yorkshire terrier dog was referred for evaluation of marked abdominal distension and hemorrhagic effusion. Abdominal radiography and ultrasonography demonstrated abdominal effusion and intraabdominal mass with anechoic cystic components. On ascites cytology, neoplastic epithelial cells with vacuolated cytoplasm and prominent nucleoli were identified. Magnetic resonance imaging (MRI) showed the well-defined, heterogeneous, and large mass filled the intraabdominal cavity. At necropsy, a large mass arising from the right ovary was observed. Histopathologically, the mass was composed of papillary structures lined by neoplastic epithelial cells. The dog was definitively diagnosed as malignant ovarian adenocarcinoma with papillary pattern based on clinical and histopathological findings.

• Clinical and Experimental Pediatrics
• /
• v.62 no.1
• /
• pp.30-35
• /
• 2019

Purpose: Obesity is risk factor for nonalcoholic fatty liver disease (NAFLD). However, nonobese patients are also increasingly susceptible to NAFLD. The aim of this study was to compare the clinical characteristics of obese and nonobese pediatric patients with NAFLD. Methods: We retrospectively studied 68 patients who were diagnosed with NAFLD between January 2010 and October 2016 at 10-18 years of age. Body mass index ${\geq}95th$ percentile for age and sex was defined as obesity. Abdominal ultrasonography and laboratory, anthropometrics measurements were evaluated. Results: Among the 68, 26 (38.2%) were nonobese patients. The ratio of male to female was 5.8:1, and the median age at diagnosis was 13 years (range, 10-17 years). Significant higher triglyceride (223.0 mg/dL vs. 145.9 mg/dL, P=0.047) and total cholesterol levels (211.6 mg/dL vs. 173.2 mg/dL, P=0.011) were shown in nonobese than obese patients. High-density lipoprotein cholesterol level <40 mg/dL (hazard ratio [HR], 6.5; 95% confidence interval [CI], 2.13-7.10; P=0.048), total cholesterol level >200 mg/dL (HR, 5.6; 95% CI, 1.23-15.31; P=0.038) and abdominal obesity (HR, 2.53; 95% CI, 1.22-4.68; P=0.013) were significant risk factors for NAFLD in nonobese patients. Conclusion: Nonobese patients present a substantial proportion of pediatric NAFLD cases. Significant abnormal lipid concentrations were found in nonobese and abdominal obesity was important risk factor for nonobese NAFLD.

• Physical Therapy Korea
• /
• v.28 no.3
• /
• pp.186-193
• /
• 2021

Background: While the formal test has been used to provide a quantitative measurement of core stability, studies have reported inconsistent results regarding its test-retest and intraobserver reliabilities. Furthermore, the validity of the formal test has never been established. Objects: This study aimed to establish the concurrent validity and test-retest reliability of the formal test. Methods: Twenty-two young adults with and without core instability (23.1 ± 2.0 years) were recruited. Concurrent validity was determined by comparing the muscle thickness changes of the external oblique, internal oblique, and transverse abdominal muscle to changes in core stability pressure during the formal test using ultrasound (US) imaging and pressure biofeedback, respectively. For the test-retest reliability, muscle thickness and pressure changes were repeatedly measured approximately 24 hours apart. Electromyography (EMG) was used to monitor trunk muscle activity during the formal test. Results: The Pearson's correlation analysis showed an excellent correlation between transverse abdominal thickness and pressure biofeedback unit (PBU) pressure as well as internal oblique thickness and PBU pressure, ranging from r = 0.856-0.980, p < 0.05. The test-retest reliability was good, intraclass correlation coefficient (ICC1,2) = 0.876 for the core stability pressure measure and ICC1,2 = 0.939 to 0.989 for the abdominal muscle thickness measure. Conclusion: Our results provide clinical evidence that the formal test is valid and reliable, when concurrently incorporated into EMG and US measurements.