Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.
The purpose of this study was to investigate the relations between HbA1c level and health risk factor. For analysis, 330 elderly women aged 65 years and over were recruited in Jeonla province, Korea. The subjects were classified into two groups according to their HbA1c level; the diabetic group (HbA1c level${\geq}6.5%$, n=68, 20.6%) and control group (HbA1c level<6.5%, n=262, 79.4%). Demographic characteristics were collected, as well as information on physical measurements, blood tests for biochemical indicators, a health status and health-related life style, dietary behavior, favorite food groups, consumption frequency of food groups and nutrient intake. Educational level of the diabetic group was significantly lower than that of the control group. The height of the diabetic group was shorter, and percentage fat of the diabetic group was higher than those of the control group. In the diabetic group, the higher concentrations of creatinine and activity of alkaline phosphatase were found to be significantly unfavorable factors. Therefore, the diabetic group was assumed to be at risk of decreased liver and renal function. The self-rated health level of the diabetic group has a declining tendency, while the medicine intake was significantly higher than that of the control group, but there are no significant differences in visiting frequency of hospital and community health center. The distribution of physical activity showed a significant difference between the groups. Although there are no significant differences in nutrient intake, the diabetic group had relatively inferior nutrient intake of diet, especially vitamin C, as contrasted with the control group. In conclusion, the weight control and increasing physical activity may be effective in the prevention of the diabetes and continuous education and intervention by specialized nutritionists will be needed for diabetic patients. These results could be useful to plan effective strategies to increase the health-life expectancy and the prevention of the diabetes of Korean elderly people living in rural areas.
Kang, Jun-Koo;Chung, Jae-Wook;Chun, So Young;Ha, Yun-Sok;Choi, Seock Hwan;Lee, Jun Nyung;Kim, Bum Soo;Yoon, Ghil Suk;Kim, Hyun Tae;Kim, Tae-Hwan;Kwon, Tae Gyun
Journal of Yeungnam Medical Science
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v.35
no.2
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pp.171-178
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2018
Background: To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution. Methods: We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated. Results: Based on the D'Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (${\geq}T3a$) and 26.6% (34/128) had high grade disease (Gleason score ${\geq}8$). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ${\geq}8$) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence. Conclusion: Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.
Background: Shift work has been shown to increase the risk of cardiovascular disease (CVD) based on several evidences. The classic risk factors of CVD include age, hypertension, smoking, obesity and diabetes. Recently, the serum homocysteine level has been reported to be a valuable indicator of CVD risk. This study aimed to determine the variation in serum homocysteine level as a cardiovascular risk indicator among female workers according to shift work. Methods: The data of regular health examination of workers at an electronic manufacturing services company in Yeongnam region, South Korea in 2019 were examined in this study. The investigation was based on a cross-sectional study conducted on 697 female workers (199 day workers and 498 shift workers). The sociodemographic and biochemical characteristics were compared between day workers and shift workers. Through a logistic regression analysis, the odds ratio (OR) of the increased serum homocysteine level in relation to shift work was determined. Results: Compared to female day workers, female shift workers showed significantly higher level of serum homocysteine (8.85 ± 2.16 vs. 9.42 ± 2.04 μmol/mL; p = 0.001). The OR of day workers against shift workers was 1.81 (95% confidence interval [CI]: 1.25-2.63). With the adjustment of variables that may influence the level of serum homocysteine, the adjusted OR was 1.68 (95% CI: 1.09-2.60). Conclusions: The serum homocysteine level was significantly higher in shift workers than in day workers. It is thus likely to be a useful predictor of CVD in shift workers.
Park, Hye-Li;Chang, Sei-Kyung;Kim, Ja-Young;Lee, Bo-Mi;Ko, Seong-Young;Kim, Sung-Joon;Shin, Hyun-Soo
Radiation Oncology Journal
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v.29
no.2
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pp.71-82
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2011
Purpose: To evaluate the biochemical control rate and the rate of side effects after performing permanent brachytherapy of localized prostate cancer. Materials and Methods: 67 patients with localized prostate cancer were treated with brachytherapy between April 2007 and December 2008. Of these, 43 patients who were followed up and did not receive external radiotherapy were evaluated for the change in prostate specific antigen (PSA) level and the occurrence of side effects. In total, 18 patients were classified as low risk, 19 patients as intermediate risk, and 6 patients as high risk. The prescription dose was 145 Gy. Results: A PSA increase greater than 2 ng/mL occurred in 2 patients (4.7%). Radiation Therapy Oncology Group (RTOG) grade 1 and 2 acute urologic complications (UC) occurred in 40 and 3 patients, respectively. Further, 5 patients had RTOG grade 1 acute rectal complication (RC). The numbers of RTOG grade 1, 2, and 3 chronic UC were 1, 4, and 1, respectively. The numbers of RTOG grade 1, 2, and 4 chronic RC were 5, 10, and 3, respectively. The statistically significant risk factors (RF) of acute RC were the minimal dose in the most irradiated 0.1 cc volume ($D_{0.1cc}$, p=0.041) and absolute volume receiving 150% of the prescribed dose ($V_{150cc}$, p=0.038) in the entire rectum (ER). The percentage ($V_{100%}$, p=0.019) and absolute volume ($V_{100cc}$, p=0.047) in the involved rectum (IR) were also statistically significant. The RF of chronic RC were $V_{100%}$ (p=0.011) in the ER and the $D_{0.1cc}$ (p=0.049), $V_{100cc}$ (p=0.023) in the IR. The number of used seeds were related with acute UC (p=0.028). Conclusion: Permanent brachytherpy of localized prostate cancer showed a favorable short term biochemical control rate. As such, selective intermediate and high risk patients can be managed with permanent brachytherapy. The effort to reduce rectal complication is also necessary.
Recently interests on raw-food diets are rapidly increasing in relation to chronic diseases prevention in Korea, but studies on raw-food diets have been hardly performed by nutritionists. This study was performed to investigate the effects of low-calorie diets using a raw-food formula in the form of freeze-dried powder on obesity and its complications in the obese women (body mass index (BMI) $\geq$ 25kg/㎡) for eight weeks. Forty premenopausal women (mean BMI 28.04kg/㎡, mean age 28.33years old) participated in this diet intervention, and were controlled by eating 1 regular meal, 1-2 snacks and 2 raw-food formula (140kcal/pack) meals a day within the 1500-1300kcal ranges. Anthropo-mentric measurements, body compositions, physical exercise, and obesity-related risk factors were assessed before (the initial), during (the 4th week) and after (the 8th week) the study. All the data was analyzed by paired t-test, repeated measures ANOVA, and nonparametric rank test at p<0.05 level. Obesity was significantly increased during this study, and it was decreased in weight (-4.59%, p<0.000), BMI (-4.56%, p<0.000), body fat percent (-6.18%, p<0.000), fat mass (-10.19%, p<0.000), waist and hip circumferences(-5.69%, p<0.000 and -2.55%, p<0.000) and WHR (-3.24%, p<0.000). Energy expenditure of physical exercise was increased as much as 70kca1/day during the study (p=0.000), but it did not have any correlations with weight loss and changes of body compositions. Biochemical measurements including blood triglyceride(p <0.006) and leptin(p<0.000) levels were significantly decreased, LDL cholesterol level was increased(p<0.05), but all the blood lipid levels were in the normal ranges. Fatty liver echogenicity and menstrual irregularity were improved after the diet intervention(p<0.000 and p<0.034). In conclusion, this B-week low-calorie diet intervention using raw-food formula was effective for obese premenopausal women in reducing obesity and its risk factors so as not to proceed towards comorbidities. However, the variation of blood lipid levels should be observed for a longer Period.
This study examined how achievement of session goals contributes to outcomes of subjects after participation in a 12-week lifestyle intervention program in men with metabolic syndrome (MetS). Thirty office workers with MetS, aged $47.2{\pm}6.6$ years, participated in this study, from March to July, 2011. The intervention program included face-to-face counseling five times during the 12-week period. Counselors and subjects designed session goals for each round. The average of the goal achievement rate was calculated based on compliance for each round. The subjects were divided into three groups according to their tertiles of achievement rate: Low-compliance group (LC, < 59%), medium-compliance group (MC, 59-70%), and high-compliance group (HC, > 70%). Anthropometry, biochemical index, and nutrient intake were examined at baseline and at the end of the 12-week intervention program. After the intervention, diastolic blood pressure (DBP) showed a significant decrease in the LC group, and waist circumference (WC) showed a significant decrease in the MC group. Systolic blood pressure (SBP), DBP, and low-density lipoprotein cholesterol (LDL) showed a significant decrease in the HI group. Changes in SBP and DBP were significantly lower in the HC group than in the MC group (p < 0.05, p < 0.01). Changes in LDL were significantly lower in the HC group than in the MC group (p < 0.05). Results for intake of total energy, protein, fat, and sodium, as well as rates of carbohydrate and fat intake, showed a significant decrease in all participants (p < 0.05). The change in fiber was significantly higher in the HC group than in the MC group (p < 0.05). The change of fruit serving size showed a significant increase in the HC group (p < 0.01). The number of risk factors for MetS showed a significant decrease in the LC and HC groups (p < 0.05), however, no significant mean differences were observed among the three groups. In conclusion, participation in this intervention program resulted in positive effects on risk factors for MetS, nutrient intake, and dietary habits, especially in the High-compliance group.
Journal of the Korean Society of Food Science and Nutrition
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v.38
no.11
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pp.1551-1558
/
2009
The management of skeletal health in the twenties is the number one priority for preventing fracture or osteoporosis occurrence in later life cycle. Therefore, the factors influencing bone mineral density were examined by anthropometric measurements, food intakes, bone mineral density and biochemical nutritional indexes in blood among college students. Among the students who received health examinations from May to December, 2007, 532 male and 507 female students who agreed to participate in the study were selected. Nutritional intakes were estimated with 3-day 24-hour recall method. Bone mineral density was measured by ultrasonic attenuation passing through right calcaneus bone and expressed as broadband ultrasound attenuation and t-score was calculated by WHO criteria. Red blood cell count, hemoglobin, hematocrit values were measured by whole blood analysis, and alkaline phosphatase, serum calcium and serum iron were used as indexes for biochemical nutritional status. Data analysis was conducted using SPSS 14.0 program, and protecting and risk factors on bone health status were analyzed by logistic regression analysis between normal bone health group (t-score$\underline{\geq}$ -1.0) and osteopenia group (t-score<-1.0). The results showed that more people belong to the normal bone health group probably because this study was conducted among those with their peak bone density. Biochemical nutritional status and nutrition intakes of both groups for normal and osteopenia did not show statistically significant difference except MCHC, animal protein and animal iron intakes in female. According to the results of logistic regression analyses, dietary intakes of animal protein, animal iron and zinc showed protecting effects against osteopenia. Therefore, dietary nutritional intakes of micronutrients, especially iron and zinc are important for bone health of young people.
In Suh Choi;Won-Suk Sung;Min-gi Jo;Jung-Hyun Kim;Yeon-Cheol Park;Eun-Jung Kim;Yong-Hyeon Baek;Geun-Woo Kim;Byung-Kwan Seo
Journal of Convergence Korean Medicine
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v.3
no.1
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pp.5-13
/
2022
Objectives: Smoking had a long negative impact on public health. The ingredients of a cigarette are major risk factors for several diseases. Owing to the problems about economic and quality of life, we need to ensure smoking cessation (SC). There are several approaches for SC including pharmacological therapy, nicotine replacement therapy, education, and behavioral intervention. However, due to some limitations, other alternative approaches are gaining popularity. Acupuncture has been reported to have few side effects and be more effective than some conventional treatments in several articles. However, there are no systematic reviews on the comparison of acupuncture combination treatment with other conventional monotherapies. Methods: Randomized controlled trials that used acupuncture as an adjunct treatment for SC will be searched and data will be summarized according to the predefined criteria. The primary outcome will be the abstinence rate, and secondary outcomes will be adverse events and biochemical indicators. We will use Review Manager to perform a meta-analysis, Cochrane Collaboration Risk of Bias tool for the risk of bias assessment, and the Grades of Recommendation, Assessment, Development and Evaluation approach to determine the quality of evidence. We will investigate the efficacy and safety of acupuncture combination treatment for SC with this study. Ethics and dissemination: This study will provide reliable clinical evidence on additional effect of acupuncture on smoking cessation. We will publish our results in a peer-review journal.
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