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Fatty liver associated with metabolic derangement in patients with chronic kidney disease: A controlled attenuation parameter study

  • Yoon, Chang-Yun;Lee, Misol;Kim, Seung Up;Lim, Hyunsun;Chang, Tae Ik;Kee, Youn Kyung;Han, Seung Gyu;Han, In Mee;Kwon, Young Eun;Park, Kyoung Sook;Lee, Mi Jung;Park, Jung Tak;Han, Seung Hyeok;Ahn, Sang Hoon;Kang, Shin-Wook;Yoo, Tae-Hyun
    • Kidney Research and Clinical Practice
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    • v.36 no.1
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    • pp.48-57
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    • 2017
  • Background: Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients. Methods: CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years). Results: The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%], P < 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr, P = 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L, P < 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m, P < 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (${\beta}=0.742$, P < 0.001), triglyceride levels (${\beta}=2.034$, P < 0.001), estimated glomerular filtration rate (${\beta}=0.316$, P = 0.001), serum albumin (${\beta}=1.386$, P < 0.001), alanine aminotransferase (${\beta}=0.064$, P = 0.029), and total bilirubin (${\beta}=-0.881$, P = 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183; P = 0.029) even after adjusting for multiple confounding factors. Conclusion: Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.

How to Avoid Graft-Tunnel Length Mismatch in Modified Transtibial Technique for Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft

  • Ko, Dukhwan;Kim, Hyeung-June;Oh, Seong-Hak;Kim, Byung-June;Kim, Sung-Jae
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.407-412
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    • 2018
  • Background: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels - the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. Results: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). Conclusions: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.

Analysis of SCI Journals Cited by Korean Journals in the Computer field

  • Kim, Byungkyu;You, Beom-Jong;Kang, Ji-Hoon
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.11
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    • pp.79-86
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    • 2019
  • It is very important to analyze and provide information resources for research output produced in the computer field, the core science of the 4th Industrial Revolution. In this paper, SCI journals cited from domestic journals in the computer field were identified and the citation rankings and their co-citation networks were generated, analyzed, mapped and visualized. For this, the bibliographic and citation index information from 2015 to 2017 in the KSCD were used as the basis data, and the co-citation method and network centrality analysis were used. As a result of this study, the number of citations and the citation ranks of SCI journals and papers cited by korean journals in the computer field were analyzed, and peak time(2 years), half-life(6.6 years), and immediacy citation rate(2.4%) were measured by citation age analysis. As a result of network centrality analysis, Three network centralities(degree, betweenness, closeness) of the cited SCI journals were calculated, and the ranking of journals by each network centrality was measured, and the relationship between the subject classifications of the cited SCI journals was visualized through the mapping of the network.

Analysis of the Characteristics and Treatment of Breast Cancer Patients in a Korean Medicine Hospital (일개 한방병원에 내원한 유방암 환자의 특성 및 치료 분석)

  • Kim, Gyu-Tae;Hwang, Young-Sik;Lee, Jin-Wook;Park, Seung-Hyeok;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.4
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    • pp.132-143
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    • 2019
  • Objectives: The purpose of this study is to provide basic information on Korean medical research and treatment through analysis of breast cancer patients, who visited ${\bigcirc}{\bigcirc}$ university Korean medicine hospital. Methods: To analyze characteristics of breast cancer patients who visited korean medicine hospital, we searched medical records from January 1, 2016 to May 13, 2019, and 86 breast cancer patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $47.65{\pm}9.62years$ and 40's was the most (46.51%). The average height was $159.78{\pm}4.91cm$ and the average weight was $57.29{\pm}9.34kg$. The average body mass index (BMI) of the patients was $22.40{\pm}3.50kg/m^2$. 2. The stage distribution record indicated stage0 (9.72%), stageI (31.94%), stageII (34.72%), stageIII (20.83%) and stageIV (2.78%). 14 patients with unknown stage were excluded. 3. Before coming to the korean medicine hospital, of the 86 patients, 72 (83.72%) patients received surgical therapy, 55 (63.95%) patients received chemotherapy and 44 (51.16%) patients received radiotherapy. 11 (12.79%) patients chose oriental medicine as their primary treatment option. 4. The mean duration from diagnosis to hospital visit was $13.87{\pm}15.53months$. Among the total 86 patients, 46 (53.49%) patients visited for symptom relief during the follow-up period. 5. The most common symptom was general weakness in 29 (33.72%) patients, followed by hot flash, myalgia, insomnia, digestion disorder, numbness, edema, arthralgia, operation site pain, cold sensation and mastalgia. 6. Among 86 patients, 55 (63.95%) patients received acupuncture and moxibustion together. The most prescribed herbal medicine to subjects was Sibjeondaebo-tang-gamibang and Cheonhye-dan (25%). Conclusions: These results could be helpful to provide basic data on the Korean medical approach of breast cancer patients.

The Characteristics of Taeyangin on Body Shape, Face, Voice and Temperament (태양인 체형, 안면, 음성, 성격 특성)

  • Jang, Eun-Su;Do, Jun-Hyeong;Jang, Jun-Su;Ku, Bon-Cho;Yoo, Jong-Hyang;Choi, Hee-Seok;Lee, Si-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.3
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    • pp.145-157
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    • 2013
  • Objectives This study was aimed to reveal the characteristics of the body shape, face, voice and temperament in Taeyangin. Methods The subjects were recruited from November 2005 to August 2012. Sasang constitutional specialist in each clinics confirmed the Sasang Constitution. Taeyangin (TY) became a standard guidance to be compared with each other Sasang type. Anova test was used in analyzing continuous variables and factor analysis was conducted in temperament questionnaire in advance. Generalized propensity score with age and body mass index (BMI) was used in adjusted model. Significant level was .05 Results 1. The TY body shape were generally smaller than Taeeumin (TE) (p<0.001) and Soyangin (SY) (p<0.05) in crude. The TY body shape were still smaller than TE (p<0.05) and there was no significant difference between TY and SY except rib circumference in males and forehead circumference (p<0.05) in females in adjusted model. 2. The size of face and nose in TY was smaller than in TE and there was different between males and females' TY and others in the characteristics of eye, nose and forehead variables in crude (p<0.05). Most of differences between TY and TE were disappeared in adjusted model. 3. The vocal height and speed of TY was different other types and there was different between males and females' TY in some of frequency change rate in crude (p<0.05). Most of differences between TY and other types were similar before and after adjusted model. 4. The temperament of TY was different with SE before and after adjusted mode 1 (p<0.05). TY males showed difference in expression factor and TY females showed difference in behavior factor compared with TE respectively (p<0.05). Conclusions This study reveals characteristics of body shape, face, voice and character in the TY males females compared with each other type respectively.

Association of Sasang Constitutional Type with Bone Mineral Density, Osteopenia, and Osteoporosis (사상체질과 골밀도, 골감소증, 골다공증과의 연관성)

  • Lee, Seung Ku;Yoon, Dae Wui;Kim, Jong Yeol;Kim, Jin Kwan;Yi, Hyeryeon;Lee, Sunghee;Abbott, Robert D.;Shin, Chol
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.3
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    • pp.33-45
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    • 2020
  • Object Although Taeeum and Soyang constitutional types have bigger body shapes and higher body mass index values than those with the Soeum, the relationship between the Sasang constitutional type and bone mass density is controversial and the association of osteopenia and osteoporosis remains unknown. Therefore, we investigated the relationship between bone mineral density, osteopenia, and osteoporosis according to Sasang constitutional type. Methods A total of 2,508 participants were included in this study. Among the study participants, 1,396 had Taeeum type, 276 had Soeum type, and 836 had Soyang type, respectively. The relationships to bone mass density, osteopenia, and osteoporosis in those with Sasang constitutional type were estimated using logistic and linear regression models. Results Bone mass density was significantly higher in the order of Taeeum, Soyang, and Soeum group (p < 0.01). Soeum group in comparison with Taeeum or Soyang group was significantly associated with a high odds ratio for osteopenia and osteoporosis except in the hip and femoral neck in the comparison of Taeeum and Soeum group (p < 0.01). Moreover, the bone mass density of Soeum group decreased more rapidly as the age increased when compared with Taeeum and Soyang group. Conclusions Our findings may contribute to the early prevention and management of high-risk individuals with poor bone mass density, osteopenia, and osteoporosis using Sasang constitution medicine.

Study on the Characteristics of Ordinary Symptoms in Overweight and Obesity Patients according to Sasang Constitution (사상체질에 따른 과체중 및 비만 환자의 소증(素證) 특성 비교)

  • Shin, Seung Won;Lee, Junhee
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.1
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    • pp.33-45
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    • 2013
  • Objectives: This study was aimed to find out the characteristics of ordinary symptoms between the control and patient groups, diagnosed as overweight or obesity, in Soyang, Taeeum, and Soeum Constitutions and among those 3 groups. Methods: As a prospective cross-sectional study based on medical records, 9213 patients, who visited Kyung Hee University Medical Center from May in 2007 to June in 2010, were included. To diagnose the constitution, Revised Questionnaire for the Sasang Constitution Classification II and examinations by oriental medical doctors who majored in Sasang Constitution Medicine were performed. Based on the World Health Organization criteria for Asian obesity assessment, body mass index (BMI) was classified into 3 groups; more than 25 as obesity, 23 to 25 as overweight, and less than 23 as normal. Ordinary symptoms questionnaire, which consists of 46 questions in 8 categories, were given to the subjects. One-way ANOVA test in continuous variables and chi-square test in categorical variables were carried out to analyze statistical significance. Results and Conclusions: 1) In general characteristics, we could find out the significant differences in age, sex, height, weight, BMI, waist circumference, blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood sugar, and hemoglobin A1c among the 3 Constitutional groups. 2) Soyang Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 3) Taeeum Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 4) Soeum Constitution of overweight and obesity has tendency to have higher appetite and less fatigue in the ordinary symptoms, compared with the control group. 5) Soeum Constitution showed the slightest increase in appetite, preference about room temperature water, less number of feces, and feeling of chill and warmer extremities in ordinary symptoms, compared with Soyang and Taeeum Constitutions. Taeeum Constitution showed the distinct increase in appetite and sweating in ordinary symptoms, compared with Soyang and Soeum Constitutions.

Prognostic impact of chromogranin A in patients with acute heart failure

  • Kim, Hong Nyun;Yang, Dong Heon;Park, Bo Eun;Park, Yoon Jung;Kim, Hyeon Jeong;Jang, Se Yong;Bae, Myung Hwan;Lee, Jang Hoon;Park, Hun Sik;Cho, Yongkeun;Chae, Shung Chull
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.337-343
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    • 2021
  • Background: Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods: We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results: In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion: The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

Association between periodontal bacteria and degenerative aortic stenosis: a pilot study

  • Kataoka, Akihisa;Katagiri, Sayaka;Kawashima, Hideyuki;Nagura, Fukuko;Nara, Yugo;Hioki, Hirofumi;Nakashima, Makoto;Sasaki, Naoki;Hatasa, Masahiro;Maekawa, Shogo;Ohsugi, Yujin;Shiba, Takahiko;Watanabe, Yusuke;Shimokawa, Tomoki;Iwata, Takanori;Kozuma, Ken
    • Journal of Periodontal and Implant Science
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    • v.51 no.4
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    • pp.226-238
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    • 2021
  • Purpose: Although several reports have described the relationship between periodontal disease and cardiovascular disease, information about the association between periodontal disease and the progression of degenerative aortic stenosis (AS) is lacking. Therefore, we performed a retrospective, single-center, pilot study to provide insight into this potential association. Methods: Data from 45 consecutive patients (19 men; median age, 83 years) with mild or moderate degenerative aortic stenosis were analyzed for a mean observation period of 3.3±1.9 years. The total amount of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis and titers of serum immunoglobulin G (IgG) against periodontal bacteria and high-sensitivity C-reactive protein (hs-CRP) were evaluated. Aortic valve area (AVA), maximal velocity (Vmax), mean pressure gradient (mean PG), and the Doppler velocity index (DVI) were evaluated. The change in each parameter per year ([ParameterLATEST-ParameterBASELINE]/Follow-up Years) was calculated from the retrospective follow-up echocardiographic data (baseline vs. the most recently collected data [latest]). Results: No correlation was found between the concentration of periodontopathic bacteria in the saliva and AS status/progression. The anti-P. gingivalis antibody titer in the serum showed a significant positive correlation with AVA and DVI. Additionally, there was a negative correlation between the anti-P. gingivalis IgG antibody titer and mean PG. The hs-CRP concentration showed positive correlations with Vmax and mean PG. Meanwhile, a negative correlation was observed between the anti-P. gingivalis IgG antibody titer and ΔAVA/year and Δmean PG/year. The hs-CRP concentration showed positive correlations with Vmax and mean PG, and it was significantly higher in patients with rapid aortic stenosis progression (ΔAVA/year <-0.1) than in their counterparts. Conclusions: Our results suggest that periodontopathic bacteria such as A. actinomycetemcomitans and P. gingivalis are not directly related to the status/progression of degenerative AS. However, inflammation and a lower immune response may be associated with disease progression.

The association of dietary patterns with insulin resistance in Korean adults: based on the 2015 Korea National Health and Nutrition Examination Survey (한국 성인의 식사 패턴과 인슐린 저항성 간의 상관성: 2015년도 국민건강영양조사를 이용하여)

  • Kim, I Seul;Yang, Yoon Jung
    • Journal of Nutrition and Health
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    • v.54 no.3
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    • pp.247-261
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    • 2021
  • Purpose: This study was conducted to identify the association between insulin resistance and the major dietary patterns of Korean adults. Methods: This study used data from the 2015 Korea National Health and Nutrition Examination Survey. The subjects were 2,276 adults aged 19 to 64 years old. Based on the food frequency questionnaire data, 112 food items were reclassified into 30 food groups. The principal component analysis method was applied to identify major dietary patterns. We used homeostatic model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) value as indicators of insulin resistance. The association between major dietary patterns and insulin resistance was investigated using logistic regression analysis. Results: Three major dietary patterns were identified and assigned descriptive names based on the food items with high loadings: 'healthy Korean meal pattern', 'western meal pattern', and 'white rice, alcohol, meat pattern'. As the 'white rice, alcohol, meat pattern' score increased, significant increasing trends for fasting glucose concentration and HOMA-IR and a significant decreasing trend for QUICKI were observed after adjusting for age and sex. The odds ratio of insulin resistance according to the 'healthy Korean meal pattern' and the 'western meal pattern' were not statistically significant. the 'white rice, alcohol, meat pattern' showed a significant positive association with the risk of insulin resistance after adjusting for covariates. Conclusion: These results suggest that the 'white rice, alcohol, meat pattern' is positively associated with the risk of insulin resistance. The white rice, alcohol, meat pattern was related to the high consumption of alcohol together with rice or meat. This pattern was also associated with the high intake of sodium and low intakes of vitamin C, calcium, potassium, and dietary fiber. To confirm the association, further longitudinal studies are required.