• Journal of Gastric Cancer
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• v.18 no.3
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• pp.242-252
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• 2018

Purpose: Surgical resection for gastric adenocarcinoma is associated with significant post-operative morbidity and mortality. The aim of this study was to assess the prognostic significance of sarcopenia in patients undergoing resection for gastric adenocarcinoma with respect to post-operative morbidity and survival. Materials and Methods: A retrospective analysis was conducted on a cohort of consecutive patients who underwent surgical resection for gastric adenocarcinoma between 2008 and 2014. Patient demographics, radiological parameters, and pathological data were collected. OsiriX software (Pixmeo) was used to measure skeletal muscle area, which was normalized for height to calculate skeletal muscle index. Results: A total of 56 patients (41 male, 15 female; mean age, $68.4{\pm}11.9years$) met the inclusion criteria. Of these, 36% (20 of 56) of the patients were sarcopenic pre-operatively. Both sarcopenic and non-sarcopenic patient groups were equally matched with the exception of weight and body mass index (P=0.036 and 0.001, respectively). Sarcopenia was associated with a decreased overall survival (log-rank P=0.003) and was an adverse prognostic predictor of overall survival in multivariate analysis (hazard ratio, 10.915; P=0.001). Sarcopenia was a predictor of serious in-hospital complications in multivariate analysis (odds ratio, 3.508; P=0.042). Conclusions: In patients undergoing curative resection for gastric cancer, there was a statistically significant association between sarcopenia and both decreased overall survival and serious post-operative complications. The measurement and reporting of skeletal muscle index on pre-operative computed tomography should be considered.

• Journal of the Optical Society of Korea
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• v.18 no.1
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• pp.55-59
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• 2014

Sarcopenia, or reduced muscle mass and volume, is due to various factors such as senile change, neuronal degeneration, drug, malignancy, and sepsis. Sarcopenia with the aging process has been evidenced by the decline in muscle mass by 0.5 to 1% per year with 3-5% reduction in muscle strength for 10 years between the ages of 40 and 50, and a 1-2% of decline of mass every year in people aged 60-70. Therefore, early diagnosis and understanding the mechanism of sarcopenia are crucial in the prevention of muscle loss. However, it is still difficult to image changes of muscle microstructure due to a lack of techniques. In this study, we developed an animal model using denervated rats to induce a rapid atrophy in the tibialis anterior (TA) and imaged its structural changes using optical coherence tomography (OCT) along with histologic and ultrasound analyses. Ultrasound showed changes of overall muscle size. Histology revealed that the atrophic TA muscle displayed an increased size variability of muscle fiber and inflammatory changes. Three dimensional OCT imaged the changes of perimysial grid and muscle fiber structure in real time without sacrifice. These observed advantages of multimodal imaging using OCT and ultrasound would provide clinical benefits in the diagnosis of sarcopenia.

• Journal of Korean Medical Science
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• v.33 no.50
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• pp.299.1-299.13
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• 2018

Background: Sarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis. Methods: We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements. Results: A total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (${\Delta}SMA/y$) were -0.89%. During a median follow-up period of 46.2 months (range, 3.4-87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ${\Delta}SMA/y$ were independently associated with mortality. Cumulative mortality was significantly higher in patients with ${\Delta}SMA/y$ < -2.4% than those with ${\Delta}SMA/y{\geq}-2.4%$ (log-rank test, P < 0.001). Conclusion: Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

• Nutrition Research and Practice
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• v.13 no.1
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• pp.47-57
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• 2019

BACKGROUND/OBJECTIVES: The aim of this study was to analyze the factors related to sarcopenic obesity among the elderly in South Korea. SUBJECTS/METHODS: A total of 3,367 elderly (${\geq}65years$) from the Korea National Health and Nutrition Examination Survey (2008-2011) were included in this analysis. The subjects were assessed to determine their sarcopenia and obesity status. Sarcopenia was assessed by determining their appendicular skeletal muscle mass (ASM). Obesity was defined by the waist circumference. An association of sarcopenic obesity and the related factors was analyzed using multiple logistic regression models. RESULTS: The risk of sarcopenic obesity of the subjects was decreased by active physical activity. After adjusting for age, smoking, and alcohol consumption, the risk of sarcopenic obesity in men of the highest level group (Q4) decreased by 45% (OR = 0.550, 95% CI = 0.334-0.905, P trend 0.018) compared to that in the reference group (Q1). Among the women, the risk of sarcopenic obesity in the Q3 and Q4 groups decreased by 29.0% (OR = 0.710, 95% CI = 0.512-0,984) and 56.7% (OR = 0.433, 95% CI = 0.281-0.668), respectively, compared to that in the Q1 group (P trend < 0.001). The mean daily energy intake was higher in the non-sarcopenia group than in the sarcopenia group. The risk of sarcopenic obesity in subjects not meeting the recommended intakes of energy, riboflavin, and vitamin C increased significantly by 25.4%, and 36.6%, and 32.6%, respectively, compared to that in the subjects meeting the recommended nutrient intake. CONCLUSION: Active physical activity as well as an adequate intake of energy and some vitamins might be negatively associated with the development of sarcopenia and sarcopenic obesity in the elderly.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1168-1180
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• 2018

Objective: As the number of sarcopenic patients worldwide is increasing, the need for the treatment of sarcopenia is increasing. Ginseng has been reported to be a major herbal supplement. We tested whether red ginseng would be effective for sarcopenia using red ginseng preparation which can be easily obtained locally in Korea. Methods: 30 rats were randomly divided into three groups: the control group (n=10) (Group C), the group with Dexamethasone -induced sarcopenia (n=10) (Group D), and the group to which red ginseng was administered group after induced sarcopenia with Dexamethasone (n=10) (Group DH). Dexamethasone was intraperitoneally administered to group D and group DH for 7 days to make sarcopenic model. After that, the red ginseng tablets prepared by Korea Ginseng Corporation were diluted in distilled water and administered orally to the DH group for 2 weeks. Body weight and grip strength were measured 8 times during the experiment. At the end of the experiment, blood was collected by cardiac puncture. In addition, the tibialis muscle was extracted, a myofibril cross section was measured by immunohistochemical staining and MyHC (myosin heavy chain) was quantified by Western blotting. Results: The ratio of the area on myofibril cross-section showed significant differences after administration of the red ginseng tablet. Conclusions: Red ginseng has a significant effect on the recovery of myofibril cross-section on sarcopenia. This experiment will be helpful for future clinical studies on drug effects in sarcopennia.

• Journal of Ginseng Research
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• v.45 no.6
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• pp.744-753
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• 2021

Background: Gintonin-enriched fraction (GEF) is a new non-saponin component glycolipoprotein isolated from ginseng root. This study examined the effect of GEF on age-related sarcopenia in old C57BL/6J mice. Methods: Young (3-6 months) and old (20-24 months) C57BL/6J mice received oral GEF (50 mg/kg/day or 150 mg/kg/day) daily for 5 weeks. During the oral administration period, body weight and grip strength were measured weekly. After sacrifice, muscles from the hindlimb were excised and used for hematoxylin and eosin staining and western blotting to determine the effects of GEF on sarcopenia. The thymus was photographed to compare size, and flow cytometry was performed to examine the effect of GEF on immune homeostasis in the thymus and spleen. Blood samples were collected, and the concentrations of pro-inflammatory cytokines and IGF-1 were measured. Results: GEF caused a significant increase in muscle strength, mass, and fiber size in old mice. GEF restored age-related disruption of immune homeostasis by maintaining T cell compartments and regulating inflammatory biomarkers. Thus, GEF reduced common low-grade chronic inflammatory parameters, which are the main cause of muscle loss. Conclusion: GEF maintained immune homeostasis and inhibited markers of chronic inflammation, resulting in anti-sarcopenia effects in aged C57BL/6J mice. Thus, GEF is a potential therapeutic agent that slows sarcopenia in the elderly.

• International Journal of Internet, Broadcasting and Communication
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• v.15 no.2
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• pp.187-195
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• 2023

Sarcopenia is a phenomenon in which muscle function, including muscle strength, deteriorates as muscle mass decreases in the process of increasing age. The diagnosis of sarcopenia utilizes total muscle mass and limb muscle mass, and limb muscle mass is expressed as height squared, body weight, and BMI. Each divided value is used as an index, mainly less than 7.23 kg/m2 for men and less than 5.67 kg/m2 for women. Grip strength, standing up from a chair, and walking speed were mainly used as physical function factors, and grip strength less than 27 kg for men and less than 16 kg for women were used as indicators. The limb muscle mass showed a decreasing trend after peaking in the mid-20s in men, and maintaining a gradual peak in women from the mid-20s to the mid-40s, showing a more rapid decline in men. The rate of decrease in muscle mass and strength continues to increase after the age of 20, and muscle strength rapidly decreases after the age of 80. In Korean men, total muscle mass and limb muscle mass show a decreasing trend from the mid-30s, and a more markedly rapid decrease from the age of 60. For women, it remains constant from the age of 30 to the age of 50, then gradually decreases after the mid-50s, and shows a rather rapid decrease after the mid-70s, showing a more gradual decrease than that of men. Men show a sharp decrease from the mid-40s when limb muscle mass is divided by height squared, and women show a marked decrease after 70 years old when limb muscle mass is divided by height squared. Exercise for the prevention and treatment of sarcopenia results in an increase in protein assimilation hormone, an increase in antioxidant activity, a decrease in inflammation, an increase in muscle insulin sensitivity, and an increase in protein synthesis. Resistance exercise is basically used, and aerobic exercise and equilibrium A combination of exercises is effective. In addition, for a more efficient effect of sarcopenia through resistance exercise, it is necessary to supplement nutrition including protein.

• The Journal of the Convergence on Culture Technology
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• v.9 no.3
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• pp.737-744
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• 2023

Sarcopenia is an increasingly common disease among the elder that has recently received attention. Although the causes of sarcopenia are diverse, aging, dietary habits, lack of exercise are the one of the major factors. As the causes of sarcopenia are diverse, it is important to develop strategies for prevention and treatment. However, predicting sarcopnia accuartely is difficult due to the variety of factors involved. Here, machine learning can significantly improve the accuracy and convenience of predicting sarcopenia. However, since lifestyle habits and biological data are vast, using data without preprocessing may be inappropriate in terms of time complexity and accuracy. This paper reviews recent literature on sarcopnia and its causes, focusing on preprocessing the data to be used in sarcopnia prediction machine learning accrodingly.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.3
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• pp.97-113
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• 2023

Objectives This study examined the trends in domestic and international research on the treatment of sarcopenia and analyzed the effectiveness of the treatment. Based on the results, we suggest directions for future Korean medicine research on sarcopenia. Methods The study was conducted using Arksey and O'Malley's scoping review methodology. It included three international databases (PubMed, EMBASE, Cochrane Library) and five domestic databases (Korean studies Information Service System, Korean Medical database, Oriental Medicine Advanced Search Integrated System, Research Information Sharing Service, ScienceON) were used. Literatures published until April 30, 2023, including the contents of 'sarcopenia' and Korean Medicine treatment', were searched. Results A total of 45 studies were included in the analysis. The number of studies on Korean medicine treatments for sarcopenia is steadily increasing, with the majority of studies coming from Asian countries. Of the 45 studies, 30 were conducted in the field of medicine, and the study design was analyzed into 10 clinical studies and 35 non-clinical studies. Among the 10 clinical studies, the most common treatment interventions were herbs (n=4), followed by Daoist exercises (n=3). The most common diagnostic criteria used in clinical studies were those published by the Asian working group for sarcopenia, and various physical examinations and laboratory tests were used as outcome measures. Conclusions The future direction of Korean medicine research on sarcopenia should be to expand the number of clinical studies applying Korean medicine treatment interventions.

• Journal of Gastric Cancer
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• v.17 no.1
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• pp.74-87
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• 2017

Purpose: Neoadjuvant chemotherapy has been shown to improve survival in locally advanced gastric cancer, but it is associated with significant toxicity. Sarcopenia and sarcopenic obesity have been studied in several types of cancers and have been reported to be associated with higher chemotherapy toxicity and morbi-mortality. The aim of this study was to assess the prevalence of sarcopenia/sarcopenic obesity in patients with gastric cancer, as well as its association with chemotherapy toxicity and long-term outcomes. Materials and Methods: A retrospective analysis was performed using an academic cancer center patient cohort diagnosed with locally advanced gastric cancer between January 2012 and December 2014 and treated with neoadjuvant chemotherapy. We analyzed body composition (skeletal muscle and visceral fat index) in axial computed tomography images. Results: A total of 48 patients met the inclusion criteria. The mean age was $68{\pm}10years$, and 33 patients (69%) were men. Dose-limiting toxicity was observed in 22 patients (46%), and treatment was terminated early owing to toxicity in 17 patients (35%). Median follow-up was 17 months. Sarcopenia and sarcopenic obesity were found at diagnosis in 23% and 10% of patients, respectively. We observed an association between termination of chemotherapy and both sarcopenia (P=0.069) and sarcopenic obesity (P=0.004). On multivariate analysis, the odds of treatment termination were higher in patients with sarcopenia (odds ratio=4.23; P=0.050). Patients with sarcopenic obesity showed lower overall survival (median survival of 6 months [95% confidence interval {CI}=3.9-8.5] vs. 25 months [95% CI=20.2-38.2]; log-rank test P=0.000). Conclusions: Sarcopenia and sarcopenic obesity were associated with early termination of neoadjuvant chemotherapy in patients with gastric cancer; additionally, sarcopenic obesity was associated with poor survival.