• Title/Summary/Keyword: obese patients

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Effects of Obesity on Presentation of Breast Cancer, Lymph Node Metastasis and Patient Survival: A Retrospective Review

  • Kaviani, Ahmad;Neishaboury, MohamadReza;Mohammadzadeh, Narjes;Ansari-Damavandi, Maryam;Jamei, Khatereh
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2225-2229
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    • 2013
  • Background: As data on the relation between obesity and lymph node ratio are missing in the literature, we here aimed to assess the impact of obesity on this parameter and other clinicopathological features of breast cancer cases and patient survival. Materials and Methods: Medical data of 646 patients, all referred to two centers in Tehran, Iran, were reviewed. Factors that showed significant association on univariate analysis were entered in a regression model. Kaplan-Meier and Cox-regression were employed for survival analysis. Results: Obesity was correlated with the expression of estrogen and progesterone receptor (p=0.004 and p=0.039, respectively), metastasis to axillary lymph nodes (p=0.017), higher lymph node rate (p<0.001) and larger tumor size (p<0.001). The effect of obesity was stronger in premenopausal women. There was no association between obesity and expression of human epidermal growth factor receptor. Three factors showed independent association with BMI on multivariate analysis; tumor size, estrogen receptor and lymph node ratio. Obesity was predictive of shorter disease-free survival with a hazard ratio of 3.324 (95%CI: 1.225-9.017) after controlling for the above-mentioned variables. Conclusions: The findings of this study support the idea that obese women experience more advanced disease with higher axillary lymph node ratio, and therefore higher stage at the time of diagnosis. Furthermore, obesity was associated with poorer survival independent of lymph node rate.

Diabetes, Overweight and Risk of Postmenopausal Breast Cancer: A Case-Control Study in Uruguay

  • Ronco, Alvaro L.;Stefani, Eduardo De;Deneo-Pellegrini, Hugo;Quarneti, Aldo
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.139-146
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    • 2012
  • Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni- and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

Differential Expression of Metabolism-related Genes in Liver of Diabetic Obese Rats

  • Seo, Eun-Hui;Park, Eun-Jin;Park, Mi-Kyoung;Kim, Duk-Kyu;Lee, Hye-Jeong;Hong, Sook-Hee
    • The Korean Journal of Physiology and Pharmacology
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    • v.14 no.2
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    • pp.99-103
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    • 2010
  • The Otsuka Long-Evans Tokushima Fatty (OLETF) rat, a model of spontaneous type 2 diabetes (T2D), develops hyperglycemic obesity with hyperinsulinemia and insulin resistance after the age of 25 weeks, similar to patients with noninsulin-dependent diabetes mellitus (DM). In the present study, we determined whether there are differences in the pattern of gene expression related to glucose and lipid metabolism between OLETF rats and their control counterparts, Long-Evans Tokushima (LETO) rats. The experiment was done using 35-week-old OLETF and LETO rats. At week 35 male OLETF rats showed overt T2D and increases in blood glucose, plasma insulin, plasma triglycerides (TG) and plasma total cholesterol (TC). Livers of diabetic OLETF and LETO rats also showed differences in expression of mRNA for glucose and lipid metabolism related genes. Among glucose metabolism related genes, GAPDH mRNA was significantly higher and FBPase and G6Pase mRNA were significantly lower in OLETF rats. For lipid metabolism related genes, HMGCR, SCD1 and HL mRNA were substantially higher in OLETF rats. These results indicate that gluconeogenesis in OLETF rats is lower and glycolysis is higher, which means that glucose metabolism might be compensated for by a lowering of the blood glucose level. However, lipid synthesis is increased in OLETF rats so diabetes may be aggravated. These differences between OLETF and LETO rats suggest mechanisms that could be targeted during the development of therapeutic agents for diabetes.

Reconstruction of Abdominal Wall Defects Using Periumbilical Perforator-Based Island Skin Flap (제대주변부 천공분지에 기저를 둔 도서형 피부피판을 이용한 복벽결손의 재건)

  • Kim, Johng-Jin;Moon, Ji-Hyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.163-168
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    • 2001
  • The defects of the abdominal wall could be brought about either congenitally, for instances in such cases as omphalocele or gastroschisis, or by various acquired causes-trauma, excision of tumors, excision of burn scar, tissue necrosis caused by infection, hematoma after abdominal surgery, tissue necrosis after radiation therapy and so on. As for the techniques of the reconstruction of the abdominal wall defects, many authors have developed and reported diverse methods. To summarize, primary closure, skin graft, local skin flaps, various myocutaneous flaps, free flap, fascia graft, artificial mesh, tissue expansion, etc could be used in the reconstruction of the abdominal wall defects. The periumbilical perforator-based island skin flap has a many advantages such as no significant sacrifice of the rectus abdominis muscle, wide rotation arc, reliable blood flow of the perforator, short elevation time for flap, and for middle-aged, obese patients, the donor site may be the best from the cosmetic point of view. We used perforator-based island skin flap in 5 cases with reasonable result from March 1999 to May 2001. There were no significant complications and donor sites could be repaired primarily.

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A Study on Diagnostic Pattern Questionnaire Associated with Body Mass Index in 20-40's Women (20-40대 여성의 체질량지수에 따른 한방변증지표의 특성 연구)

  • Park, Kyoung-Sun;Yoo, Seung-Yeon;Park, Young-Jae;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub;Lee, Jin-Moo
    • Journal of Korean Medicine for Obesity Research
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    • v.11 no.1
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    • pp.25-34
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    • 2011
  • Objectives The purpose of this study was to examine the characteristics of diagnostic pattern questionnaire associated with Body Mass Index in premenopausal women. Methods We studied 41 patients visiting Gangdong Kyung Hee University Hospital from 1st April 2011 to 25th May 2011. The subjects were categorized in two groups, overweight & obesity group (n=12) and low weight & normal group (n=29). We studied the difference of diagnostic pattern questionnaire scores between two groups by Independent samples T-test and correlation between diagnostic pattern questionnaire scores of overweight & obesity group by Pearson's correlation coefficient test using SPSS for windows (version 13.0). Results Blood stasis, retention of undigested food, cold pattern scores of overweight & obesity group were non-significantly higher than low weight & normal group. Heat pattern score of overweight & obesity group was significantly higher than low weight & normal group. Cold-heat, phlegm-cold, blood stasis-cold, phlegm-blood stasis, phlegm-retention of undigested food significantly showed positive correlation coefficient in overweight & obesity group. Conclusions The results suggest that obese women tend to show heat pattern. It seems to be that multiple factors such as phlegm, blood stasis, retention of undigested food are causative of obesity.

An Aerodynamic study used aerophone II for snoring patients (코콜이 환자의 sleep splint 착용 전후의 음향학적 및 공기역학적 연구)

  • Jung, Se-Jin;Kim, Hyun-Gi;Shin, Hyo-Keun
    • The Journal of the Korean dental association
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    • v.49 no.4
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    • pp.219-226
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    • 2011
  • Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.

The Study of Mechanical Simulation for Human Respiratory System (인체 호흡 모사를 위한 기계적 장치 연구)

  • Chi, S.H.;Lee, M.K.;Lee, T.S.;Choi, Y.S.;Oh, S.K.
    • Journal of Biomedical Engineering Research
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    • v.29 no.4
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    • pp.323-328
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    • 2008
  • A patient with respiratory disorders such as a sleep apnea is increasing as the obese patient increase on the modern society. Positive Airway Pressure (PAP) devices are used in curing patient with respiratory disorders and turn out to be efficacious for patients of 75%. However, these devices are required for evaluating their performance to improve their performance by the mechanical breathing simulator. Recently, the mechanical breathing simulator was studied by the real time feedback control. However, the mechanical breathing simulator by an open loop control was specially required in order to analyze the effect of flow rate and pressure after operating the breathing auxiliary devices. Therefore the aims of this study were to make the mechanical breathing simulator by a piston motion and a valve function from the characteristic test of valve and motor, and to duplicate the flow rate and pressure profiles of some breathing patterns: normal and three disorder patterns. The mechanical simulator is composed cylinder, valve, ball screw and the motor. Also, the characteristic test of the motor and the valve were accomplished in order to define the relationship between the characteristics of simulator and the breathing profiles. Then, the flow rate and pressure profile of human breathing patterns were duplicated by the control of motor and valve. The result showed that the simulator reasonably duplicated the characteristics of human patterns: normal, obstructive sleep apnea (OSA), mild hypopnea with snore and mouth expiration patterns. However, we need to improve this simulator in detail and to validate this method for other patterns.

Effects of Inonotus Obliqua Extract on Blood Glucose Levels in Genetically Diabetic Mice (차가버섯 추출물이 당뇨생쥐 $(C57BL/KsJ^-m^{+/+}Lepr^{db})$의 혈당수준에 미치는 영향)

  • Hong, Hee-Ok
    • Journal of Nutrition and Health
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    • v.40 no.7
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    • pp.601-605
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    • 2007
  • This study investigated the therapeutic effects of Inonotus obliqua extract on blood glucose, insulin, and other biochemical parameters in genetically diabetic mice $(C57BL/KsJ^-m^{+/+}Lepr^{db})$. The mice were divided into four groups-control, Chaga 1 (dose of 0.09 mg/kg of body weight), Chaga 5 (5 times of Chaga 1), and Chaga 10 (10 times of Chaga 1) - according to supplemented dose. Inonotus obliqua extract was orally administered to the animals for 6 weeks. The body and organ (liver and kidney) weights were not different among groups. Fasting blood glucose level was significantly lower in the Chaga 5 group compared with the control (p < 0.05). Hemoglobin A1c content was significantly lower in the Chaga 5 group compared with either the control and Chaga 1 group (p < 0.05). There was no significant difference in serum insulin level among groups. The glucose-6-phosphatase activity in liver was significantly the lowest in Chaga 10 group and was significantly lower in Chaga 5 group as compared with those of control and Chaga 1 groups. Therefore, the results of this study demonstrate that Inonotus obliqua extract alleviates many of the symptoms of diabetes in genetically obese mice and may offer a possibility as a therapeutic supplement for the normalization of blood glucose levels in human with hyperglycemia and have beneficial effects in patients with non-insulin-dependent diabetes mellitus.

Ultrasonographic Findings of Normal Hip Joint and Painful Hip due to Soft Tissue Problem (고관절 초음파의 정상 소견 및 고관절 주위 질환의 초음파 소견)

  • Nam, Woo-Dong;Nam, Shin Woo;Han, Kye Young
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.38-46
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    • 2010
  • The lesions around hip joint including bone, joint and soft tissue can cause the pain. For diagnosis of these lesions, physical examination and simple X-ray were accomplished primarily. Some special cases, CT or MRI was a useful tool. However ultrasonography could provide non-invasive and dynamic images for the lesions of tendon and bursa, and it could be a useful tool for follow up after hip surgery. Due to the deep location of hip joint, ultrasonography is not easy for physician to examine and its application was impossible in some obese patients. This article deals with the normal and pathologic ultrasonographic findings of the hip joint and various applications using ultrasonography.

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Association of Demographic and Socioeconomic Factors With Risk Factors for Chronic Kidney Disease

  • Kim, Tae Hyun;Lee, Min-Jee;Yoo, Ki-Bong;Han, Euna;Choi, Jae-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.3
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    • pp.170-177
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    • 2015
  • Objectives: The goal of this study was to examine the association of various demographic and socioeconomic factors with risk factors for chronic kidney disease (CKD). Methods: We used nationally representative pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2007-2013. We estimated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease equation. We defined CKD as a GFR <60 mL/min/$1.73m^2$, and 1304 of the 45 208 individuals included in the KNHANES were found to have CKD by this definition. The outcome variable was whether individual subjects adhered to the CKD prevention and management guidelines recommended by the Korea Centers for Disease Control and Prevention. The guidelines suggest that individuals maintain a normal weight, abstain from alcohol consumption and smoking, manage diabetes and hypertension, and engage in regular exercise in order to prevent and manage CKD. Results: This study found that individuals with CKD were more likely to be obese and have hypertension or diabetes than individuals without CKD. In particular, male and less-educated CKD patients were less likely to adhere to the guidelines. Conclusions: Although the prevalence of CKD, as indicated by the KNHANES data, decreased from 2007 to 2013, the prevalence of most risk factors associated with CKD fluctuated over the same time period. Since a variety of demographic and socioeconomic factors are related to the successful implementation of guidelines for preventing and managing CKD, individually tailored prevention activities should be developed.