• Clinical Endoscopy
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• 제57권1호
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• pp.112-121
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• 2024

Background/Aims: Since the usefulness of neoadjuvant chemo(radiation) therapy (NAT) for pancreatic cancer has been demonstrated, recurrent biliary obstruction (RBO) in patients with pancreatic cancer with a fully covered self-expandable metal stent (FCSEMS) during NAT is expected to increase. This study investigated the impact of sarcopenia on RBO in this setting. Methods: Patients were divided into normal and low skeletal muscle index (SMI) groups and retrospectively analyzed. Patient characteristics, overall survival, time to RBO (TRBO), stent-related adverse events, and postoperative complications were compared between the two groups. A Cox proportional hazard model was used to identify the risk factors for short TRBO. Results: A few significant differences were observed in patient characteristics, overall survival, stent-related adverse events, and postoperative complications between 38 patients in the normal SMI group and 17 in the low SMI group. The median TRBO was not reached in the normal SMI group and was 112 days in the low SMI group (p=0.004). In multivariate analysis, low SMI was the only risk factor for short TRBO, with a hazard ratio of 5.707 (95% confidence interval, 1.148-28.381; p=0.033). Conclusions: Sarcopenia was identified as an independent risk factor for RBO in patients with pancreatic cancer with FCSEMS during NAT.

• 한국축산식품학회지
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• 제42권6호
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• pp.915-927
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• 2022

Recently, protein-fortified milk powders are being widely consumed in Korea to prevent sarcopenia, and the demand for high-protein food powders is continuously increasing in the Korean market. However, spray-dried milk proteins have poor flowability and wettability owing to their fine particle sizes and high inter-particle cohesive forces. Fluidized bed agglomeration is widely used to improve the instant properties of food powders. This study investigated the effect of fluidized bed agglomeration on whey protein isolate (WPI)-fortified skim milk powder (SMP) at different SMP/WPI ratios. The fluidized bed process increased the particle size distribution, and agglomerated particles with grape-like structures were observed in the SEM images. As the size increased, the Carr index (CI) and Hausner ratio (HR) values of the agglomerated WPI-fortified SMP particles exhibited excellent flowability (CI: <15) and low cohesiveness (HR: <1.2). In addition, agglomerated WPI-fortified SMP particles exhibited the faster wetting time than the instant criterion (<20 s). As a result, the rheological and physical properties of the WPI-fortified SMP particles were effectively improved by fluidized bed agglomeration. However, the fluidized bed agglomeration process led to a slight change in the color properties. The CIE L^* decreased, and the CIE b^* increased because of the Maillard reaction. The apparent viscosity (η_a,10) and consistency index (K) values of the rehydrated solutions (60 g/180 mL water) increased with the increasing WPI ratio. These results may be useful for formulating protein-fortified milk powder with better instant properties.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1055-1066
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• 2022

Objective: The clinical relevance of myosteatosis has not been well evaluated in patients with pancreatic ductal adenocarcinoma (PDAC), although sarcopenia has been extensively researched. Therefore, we evaluated the prognostic value of muscle quality, including myosteatosis, in patients with resectable PDAC treated surgically. Materials and Methods: We retrospectively evaluated 347 patients with resectable PDAC who underwent curative surgery (mean age ± standard deviation, 63.6 ± 9.6 years; 202 male). Automatic muscle segmentation was performed on preoperative computed tomography (CT) images using an artificial intelligence program. A single axial image of the portal phase at the inferior endplate level of the L3 vertebra was used for analysis in each patient. Sarcopenia was evaluated using the skeletal muscle index, calculated as the skeletal muscle area (SMA) divided by the height squared. The mean SMA attenuation was used to evaluate myosteatosis. Diagnostic cutoff values for sarcopenia and myosteatosis were devised using the Contal and O'Quigley methods, and patients were classified according to normal (nMT), sarcopenic (sMT), myosteatotic (mMT), or combined (cMT) muscle quality types. Multivariable Cox regression analyses were conducted to assess the effects of muscle type on the overall survival (OS) and recurrence-free survival (RFS) after surgery. Results: Eighty-four (24.2%), 73 (21.0%), 75 (21.6%), and 115 (33.1%) patients were classified as having nMT, sMT, mMT, and cMT, respectively. Compared to nMT, mMT and cMT were significantly associated with poorer OS, with hazard ratios (HRs) of 1.49 (95% confidence interval, 1.00-2.22) and 1.68 (1.16-2.43), respectively, while sMT was not (HR of 1.40 [0.94-2.10]). Only mMT was significantly associated with poorer RFS, with an HR of 1.59 (1.07-2.35), while sMT and cMT were not. Conclusion: Myosteatosis was associated with poor OS and RFS in patients with resectable PDAC who underwent curative surgery.

• 지역사회간호학회지
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• 제27권3호
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• pp.231-241
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• 2016

Purpose: This study was conducted to examine effects of sarcopenic obesity on metabolic syndrome in Korean elders. Methods: This study is based on the analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) with 1,155 subjects (524 men, and 631 women) aged 60 or older, from 2008 to 2011. Sarcopenia was defined as an appendicular skeletal muscle (ASM), divided by weight (%) of <1 SD (standard deviation) below the sex-specific mean for young adults. Obesity was defined as a total body fat percent (men${\geq}$25%, women${\geq}$35%). Results: The prevalence of SO (sarcopenic obesity) was 13.3% among men and 22.5% among women. Both sexes showed a higher total body fat percent, and the SMI (skeletal muscle index) was the lowest in the SO group. Metabolic syndrome was highly prevalent in the SO group (52.5% men, 60.4% women). The SO group showed a higher risk for metabolic syndrome (odds ratio men 6.57 [95% CI 5.19~7.27], women 3.89 [95% CI 2.41~6.29]) than the obese group (men 3.14 [95% CI 1.76~4.14], women 2.54 [95% CI 1.38~4.65]). Conclusion: SO is a major risk factor for metabolic syndrome in Korean elders. Therefore, a nursing program should be given to the Korean elderly SO group to prevent metabolic syndrome.

• 지역사회간호학회지
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• 제29권4호
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• pp.429-439
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• 2018

Purpose: The aim of this study is to identify core keyword of frailty research in the past 35 years to understand the structure of knowledge of frailty. Methods: 10,367 frailty articles published between 1981 and April 2016 were retrieved from Web of Science. Keywords from these articles were extracted using Bibexcel and social network analysis was conducted with the occurrence network using NetMiner program. Results: The top five keywords with a high frequency of occurrence include 'disability', 'nursing home', 'sarcopenia', 'exercise', and 'dementia'. Keywords were classified by subheadings of MeSH and the majority of them were included under the healthcare and physical dimensions. The degree centralities of the keywords were arranged in the order of 'long term care' (0.55), 'gait' (0.42), 'physical activity' (0.42), 'quality of life' (0.42), and 'physical performance' (0.38). The betweenness centralities of the keywords were listed in the order of depression' (0.32), 'quality of life' (0.28), 'home care' (0.28), 'geriatric assessment' (0.28), and 'fall' (0.27). The cluster analysis shows that the frailty research field is divided into seven clusters: aging, sarcopenia, inflammation, mortality, frailty index, older people, and physical activity. Conclusion: After reviewing previous research in the 35 years, it has been found that only physical frailty and frailty related to medicine have been emphasized. Further research in psychological, cognitive, social, and environmental frailty is needed to understand frailty in a multifaceted and integrative manner.

• 한국응용과학기술학회지
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• 제36권4호
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• pp.1349-1357
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• 2019

이 연구의 목적은 코어 저항 운동이 농업 여성노인들의 근감소증 지표에 미치는 영향을 보고자 하였다. 이 연구에 참여한 피검자는 65세 이상의 천안시 거주 농업 여성노인 15명과 통제군 여성 15명으로 하였다. 코어 운동군은 주 2회 60분간 코어 강화 운동을 실시하였고, 종속변인인 근감소증 지표로는 악력, 의자 앉았다 일어서기, 근육의 면적과 단기운동수행력으로 4m 보행, 2.44m 걷기 및 400m 걷기를 실시하였다. 코어 저항 운동 결과 의자 앉았다 일어서기의 유의한 개선을 보였으나 근단면적에서는 집단 간에 유의한 차이를 보였다. 또한 단기운동수행 능력 중 4m 보행속도에서 유의한 상호 작용과 2.44m 왕복걷기와 400m 걷기에서는 유의한 개선을 보이는 것으로 나타났다. 이상과 같이 코어 저항 운동은 근육의 활성화로 인해 하체근육 및 단기 운동수행능력을 개선을 가져오는 것으로 판명되었다.

• 한국응용과학기술학회지
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• 제36권1호
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• pp.189-199
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• 2019

이 연구의 목적은 복합운동이 노인여성의 낙상관련 지표 및 마이오카인에 미치는 효과를 보는데 있다. 근감소증은 근력의 손실로 인해 발생하고, 기능적 상태의 감소, 활동력의 저하에 따른 낙상의 위험성이 높아지고 끝내 사망의 위험성이 높아지게 된다. 유산소운동은 대근을 이용한 리듬과 반복적인 동작으로 특징 지워지고 주로 유산소성 대사를 통한 산소를 에너지 이용으로 심폐체력, 체성분 및 심장과 호흡계 건강에 기여한다. 한편 저항운동은 근육에 스트레스를 가해 노인들의 근력관련 체력과 기능적 수행 개선에 기여한다. 근기능 및 심폐지구력 향상을 꾀하는 복합운동은 노년들의 효과적인 건강증진에 기여하는 것으로 나타내고 있다. 근육에서 분비되는 마이오카인은 운동에 중요한 요인으로 간주되고 있는데 지방세포 감소, 골격, 근육 및 인체 전반에 걸쳐 유익한 효과를 보인다.

• Tuberculosis and Respiratory Diseases
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• 제86권4호
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• pp.272-283
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• 2023

Background: In patients with chronic obstructive pulmonary disease (COPD), decreased muscle mass is a frequently encountered comorbidity in clinical practice. However, the evaluation of muscle mass in patients with COPD in real-world practice is rare. Methods: We retrospectively reviewed the electronic medical records of all patients with COPD who underwent bioelectrical impedance analysis at least once between January 2011 and December 2021 in three hospitals. Then, we analyzed the performance rate of muscle mass measurement in the patients and the correlation between muscle mass, clinical parameters, and COPD prognosis. Results: Among the 24,502 patients with COPD, only 270 (1.1%) underwent muscle mass measurements. The total skeletal muscle mass index was significantly correlated with albumin, alanine transaminase, and creatinine to cystatin C ratio in patients with COPD (r=0.1614, p=0.011; r=0.2112, p=0.001; and r=0.3671, p=0.001, respectively). Acute exacerbation of COPD (AE COPD) was significantly correlated with muscle mass, especially the truncal skeletal muscle mass index (TSMI) in males (r=-0.196, p=0.007). In the multivariate analysis, TSMI and cystatin C were significant risk factors for AE COPD (hazard ratio, 0.200 [95% confidence interval, CI, 0.048 to 0.838] and 4.990 [95% CI, 1.070 to 23.278], respectively). Conclusion: Low muscle mass negatively affects the clinical outcomes in patients with COPD. Despite its clinical significance, muscle mass measurement is performed in a small proportion of patients with COPD. Therefore, protocols and guidelines for the screening of sarcopenia in patients with COPD should be established.

• 대한물리의학회지
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• 제19권3호
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• pp.47-54
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• 2024

PURPOSE: This study aimed to identify the potential clinically predictive indicators of the age-related loss of skeletal muscle mass (ALSMM) in middle-aged women. METHODS: The data from a cross-sectional study involving 2,066 community-dwelling female participants aged 40 to 49 years were analyzed. Complex sampling analyses were used to ensure a nationally representative analysis, incorporating the individual weights provided by KNHANES. This approach accounted for the stratified, clustered, and multistage probability sampling design of the survey. The participants were screened for ALSMM, and various potential predictive indicators were assessed, including age, height, weight, body mass index, waist circumference, skeletal muscle mass index, smoking and drinking status, systolic and diastolic blood pressure, fasting glucose levels, triglyceride levels, and cholesterol levels. RESULTS: Significant potential predictive indicators for ALSMM included height, weight, body mass index, waist circumference, skeletal muscle mass index, and fasting glucose (p < .05). The systolic blood pressure, diastolic blood pressure, triglyceride levels triglyceride, and drinking and smoking status were found to be non-significant variables (p > .05). CONCLUSION: The study identified the potential predictive indicators for ALSMM among community-dwelling middle-aged women. These findings enhance the current understanding of ALSMM and highlight the potential predictive indicators associated with its development in middle-aged women.

• 한국조리학회지
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• 제22권1호
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• pp.52-60
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• 2016

As Korea is expected to become super high aged society in 2026, nutrition is important elements of health in the elderly and affects their life. In epidemiological surveys, anthropometric and biochemical measurements represent important components of nutritional assessment in elderly. In the present study, we investigated anthropometric index, biochemical markers, and nutrient intake for elderly aged over 85 by using data on 71 elderly (24 men, 47 women) over 85 years which was obtained from Korea National Health and Nutrition Examination Survey in 2009. According to BMI values, the prevalence of underweight and obesity was 9.7% and 34.5% in men, and 7.9% and 26.4% in women. The prevalence of sarcopenia was 70.7% in men and 25.0% in women. However, plasma biochemical data are normal range in the older population. In nutrients intake, daily Intake of energy, protein, dietary fiber, water, thiamin, riboflavin, niacin, calcium, and potassium was inadequate considering the Dietary Reference Intakes for Koreans(KDRIs). In conclusion, elderly need to be educated nutrition and their health dietary life to prevent malnutrition, and standard of nutrition intake should be rearranged in elderly aged 85 over considering their antrhopometric index.