Association Between Gut Regulatory Hormones and Post-operative Weight Loss Following Gastrectomy in Patients With Gastric Cancer

Hye-Kyung Jung,Chung Hyun Tae,Hye Ah Lee,Ko Eun Lee,Chang Mo Moon,Seong Eun Kim,Ju Young Seoh,Joo-Ho Lee 대한소화기 기능성질환·운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.3

Background/AimsPost-operative weight loss in patients with gastric cancer lead to a poor quality of life and long-term survival. This study aims to evaluate the effects of gut regulatory hormones on post-operative weight loss in patients with subtotal gastrectomy for gastric cancer. MethodsThis prospective study was conducted for 12 months post-surgery in 14 controls and 13 gastrectomy patients who underwent subtotal gastrectomy for gastric cancer. Serum plasma ghrelin, glucagon-like peptide-1, gastric inhibitory peptide-1, peptide YY, insulin, and homeostatic model assessment for insulin resistance responses to a standardized test meal were recorded at multiple time points before and after gastrectomy at 4 and 12 months. ResultsThe mean weight difference between the pre-operative state and the 4-month period was significantly reduced to 6.6 kg (P = 0.032), but significant weight reduction was not observed from 4 months to 12 months. The plasma levels of glucagon-like peptide-1, gastric inhibitory peptide-1, and peptide YY were significantly increased 4 months postoperatively compared to the pre-operative state (all P = 0.035); however, pre-operative levels and relative changes over a period of 0-4 months of hormones were not correlated with body weight changes. Only the pre-operative ghrelin at peak had a negative correlation with changes in weight reduction in the 4 months after surgery (ρ = −0.8, P = 0.024). ConclusionsSignificant weight reduction was common after subtotal gastrectomy for gastric cancer with a negative correlation pre-operative plasma ghrelin levels. Incretin hormones are modestly but significantly increased after subtotal gastrectomy; however, these changes did not affect the weight changes.

건강신념모델에 근거한 노인 대상 식품안전·영양교육 프로그램 효과 평가

최정화(Jung-Hwa Choi),이은실(Eun-Sil Lee),이윤진(Yoon-Jin Lee),이혜상(Hye-Sang Lee),장혜자(Hye-Ja Chang),이경은(Kyung-Eun Lee),이나영(Na-Young Yi),안윤(Yoon Ahn),곽동경(Tong-Kyung Kwak) 한국식품영양과학회 2016 한국식품영양과학회지 Vol.45 No.9

노인은 면역취약집단으로 다른 인구 집단보다 만성질환과 식품매개 질병에 걸릴 위험이 크며 식행동은 오랜 세월 굳어져 왔기 때문에 변화하기가 쉽지 않다. 노인을 대상으로 건강신념모델을 적용하여 식품안전・영양교육 프로그램을 시범 적용하고 그 효과를 평가하였다. 식품안전·영양 시범 교육은 서울 마포, 충북 청주, 경북 의성, 충북 진천의 노인복지관을 이용하는 65세 이상 노인을 대상으로 2011년 7월 28일부터 9월 9일까지 총 5주간 매주 1회, 35~40분씩 교육을 시행하였다. 교육 전후 조사가 완료된 최종 연구대상은 교육군이 5회 교육 중 3회 이상 교육에 참여하고 교육 전후 평가를 마친 대상자로 137명, 대조군은 사후 설문조사를 하지 않거나 불성실한 응답자를 제외한 83명으로 총 220명이었다. 교육은 건강신념모델을 적용하여 노인들이 식습관을 변화하지 않을 경우 질병 가능성을 알려 심각성을 인지하도록 하였으며 노인들이 식행동 수정 시 얻게 되는 이들을 알려주고 행동을 실행할 수 있도록 자아효능감을 제공해주고자 하였다. 교육 후 식품안전·영양지식은 모든 항목에서 향상을 보였으며, 식품안전 영역 5문항 중 4문항, 영양 영역 3문항 중 2문항에서는 유의적인 향상을 보였다. 식행동은 교육군에서 ‘고기, 생선류는 조리 시 속까지 완전히 익힌다’를 제외한 모든 항목에서 유의적인 향상을 보였다. 건강신념은 식품안전의 영역에서는 인지된 심각성과 자아효능감, 영양 영역에서는 인지된 민감성, 인지된 장애, 자아효능감에서 유의적인 향상을 보였다. 지식, 식행동, 건강신념 변화량의 상관관계를 분석한 결과 건강신념의 변화량과 식행동의 변화 가능성 간의 유의적인 상관관계를 보였다(P<0.001). 본 연구의 참여 대상자들이 일반 재가 노인보다 복지관에서 봉사하거나 활동하는 노인이었기 때문에 표본의 대표성이 떨어져 결과를 일반화하기에 어려움이 있다. 또한, 교육기간이 5주로 비교적 짧았기 때문에 오랜 기간에 걸쳐 형성된 식행동이 쉽게 변화하거나 개선되기 어려우므로 장기간에 걸친 반복교육이 필요할 것으로 생각한다. 본 연구에서 개발된 교육 프로그램을 향후 보건소나 복지관 등을 통해 지속해서 시행된다면 노인의 식품안전・영양에 대한 인식을 높이고 바람직한 식행동 변화에 긍정적인 기여를 할 수 있을 것으로 생각된다. Most elderly have difficulties in managing food safety and nutrition by themselves. Various nutrition educations for the elderly have been developed, but food safety and nutrition education program and educational tools for the elderly are very limited. The aim of the study was to evaluate a food safety and nutrition education program based on the Health Belief Model (HBM) for the elderly. Education program was implemented for 220 seniors (137 educated group and 83 control group) aged over 65 years at senior welfare community centers. The intervention study was carried out on a weekly basis during each of 5 weeks, and each session lasted about 35 or 40 minutes. The effectiveness of the program was assessed with a questionnaire before and after education. Education program consisted of a 5 week program, and topics were ‘Dietary changes for the elderly"s healthy life’, ‘Prevention of food poisoning in everyday life’, ‘Safe food handling for my health’, ‘Healthy dietary life to prevent chronic disease’, and ‘Safety! nutrition! healthy dietary life’. Education program materials such as slides, handouts, videos, leaflet, and booklets were developed. As a result, there were score improvements in knowledge, dietary behaviors, and health belief after intervention in the intervention group, which were higher than those of the control group. In particular, there was a meaningful interrelation between dietary behavior and health belief (r=0.520, P<0.001). This finding suggests that changing beliefs is very important to make desirable dietary behavioral changes. For this reason, we can conclude HBM theory is an effective model to educate nutrition and food safety for the elderly. Furthermore, food safety and nutrition education programs are implemented and delivered continuously at various settings such as a health center or community welfare center, and those will contribute significantly to enhance perception and change their desirable dietary behaviors for the elderly.

Changes of Sugar Composition and Related Enzyme Activities during Fruit Development of Asian Pear Cultivars ‘Niitaka’ and ‘Whangkeumbae’

Jin-Ho Choi,Jang-Jeon Choi,Chang-Seok Bang,Jung-Sup Lee,Dong-Woog Choi,Hye-Sun Cho,Jun Cheul Ahn 한국원예학회 2009 Horticulture, Environment, and Biotechnology Vol.50 No.6

We report on the seasonal changes of soluble sugar accumulation and several enzyme activities related to sugar metabolism, in two Asian pear cultivars (Pyrus pyrifolia) cultivars ‘Niitaka’ and ‘Whangkeumbae’. Soluble sugar content increased as the fruit developed and its total contents in matured fruits were 104.6 and 95.1 ㎎ㆍg?¹ fresh weight for ‘Niitaka’ and ‘Whangkeumbae’, respectively. However, the fructose-glucose-sucrose-sorbitol ratio was not significantly changed. Sorbitol-6-phosphate dehydrogenase activity was maintained at high level in leaves and low in fruits throughout the fruit development, although the enzyme activity highly fluctuated in young and mature fruits. NAD-dependent sorbitol dehydrogenase activity increased sigmoidally in both leaves and fruits during fruit development, and correlated with accumulation of total sugar in fruits. Sucrose synthase and sucrose phosphate synthase (SPS) activities remained low in leaves, but higher with two peak fluctuations in fruits. The change of soluble sugar contents positively correlated with SPS activity, based on the seasonal fluctuation of SPS activity and soluble sugar accumulation.

Single Oral Dose Toxicity Evaluation of Leejung-tang, a Korean Traditional Herbal Formula, in Crl:CD (SD) rats

Hye-Sun Lim,Mee-Young Lee,Chang-Seob Seo,In-Sik Shin,Hye-Kyung Ha,Jung-Im Huh,Hyeun-Kyoo Shin 대한한의학회 2011 대한한의학회지 Vol.32 No.3

제왕절개술을 위한 경막외 마취시 술전 투여 수액이 신생아 혈당치에 미치는 영향

이혜원,김선희,신정순,장성호,임혜자,채병국 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.4

It is common for patient undergoing cesarean section under epidural anesthesia to have lower blood pressure because of not only supine hypotension syndrome but vasodilation due to sympathetic blockade. So it is necessary to give large volume of fluid before perfarming epidural anesthesia to prevent hypotension. When we use the dextrose containing fluid for that purpose, newborn baby could have a high blood glucose at delivery and low blood glucose level due to high insulin level after birth. The authors examined the blood glucose level at delivery and two hours after birth following use of 5% dextrose in lactated Ringers solution(HD group, n=24) or lactated Ringers solution (HS group, n=24) for prevention of hypotension during epidural anesthesia for cesarean section. The results were as follows; 1) The total amount of fluid was 789.6±264.2 ml in HD group and 741.1±253.5 ml in HS group. 2) The glucose level of mother at delivery was 300.9±76.3 mg/dl in HD group and 98.7±24.6 mg/dl in HS group and there wastistical significance(p$lt;0.01). 3) In HD group, the glucose level of newborn baby was 212.2±57.2 mg/dl at delivery and 465.±20.3 mg/dl at 2 hours after birth. The change of amount during 2 hours after birth was highly related to the glucose level at birth. Higher level of glucose at birth, larger amount of change during 2 hours after birth. 4) In HS group, the glucose level of newborn baby was 66.8±10.2 mg/dl at birth and 67.0±12.1 mg/dl at 2 hours after birth. There was no significant change.

강릉수력발전소 발전수 방류 전후의 남대천 수질과 미생물 분포

심혜숙,김규중,김형섭,최창근,전방욱 江陵大學校東海岸地域硏究所 1993 東海岸硏究 Vol.4 No.1

강릉수력발전소의 발전수 방류가 강릉 남대천의 수질 및 미생물 분포에 미치는 영향을 조사하였다. 정점 3 상류지역의 발전수 방류는 수질에 상당한 영향을 끼쳐 정점 3 및 정점 4의 수질은 악화되고 정점 5, 정점 6 및 정점 7의 수질은 개선되었다. 미생물 분포도 이와 유사하여 정점 3 및 정점 4의 세포수는 상당히 증가한 반면 정점 5, 정점 6 및 정점 7에서는 대체적으로 감소하였다. 이 결과로 미루어보아 강릉수력발전소의 발전수는 희석효과에 의해 수질 및 미생물 분포를 변화시키는 것으로 사료된다. The effects of water discharged from Kangnung hydropower plant on the water quality and some bacterial population of Namdaecheon Stream, Kangnung were investigated. The water discharged above station 3 affected the water quality significantly; the water quality of station 3 and station 4 took a turn for the worse, however those of station 5, station 6 and station 7 changed for the better. It was also true with the bacterial population; The number of cells of bacteria increased in station 3 and 4, but the number significantly decreased in station 5, station 6, and station 7. The data suggested the idea that the water discharged from Kangnung hydropower plant changed the water quality and some bacterial population by dilution effect.

사회인지이론 기반 중산층 노인 식품안전 교육 프로그램의 효과 평가

최정화(Jung-Hwa Choi),유효이(Hyo-E Yoo),정하림(Harim Chung),이혜상(Hye-Sang Lee),이민준(Min-June Lee),장혜자(Hye-Ja Chang),이경은(Kyung-Eun Lee),이나영(Na-Young Yi),곽동경(Tong-Kyung Kwak) 한국식품영양과학회 2018 한국식품영양과학회지 Vol.47 No.8

현대의학의 발달은 인간의 수명을 연장시키고 그 결과 노인인구 증가를 가져와 노인 의료비 문제가 사회적으로 대두되고 있다. 이에 적절한 방안으로는 노인들의 건강한 노화(healthy aging)를 도모하는 것이며, 이는 사회의 의료비용을 감소시킴으로써 사회 전체의 효율성을 제고시킬 수 있다. 본 연구는 중산계층 노인을 대상으로 사회인지이론 기반의 식품안전 관리 교육 프로그램을 적용하여 시범실시를 하여 교육 효과 평가를 실시하였다. 본 연구에서는 교육군 212명, 대조군 42명의 자료가 분석되었으며, 사전 사후 지식 총점의 변화는 교육군이 2.80점에서 3.80점으로 유의적으로 상승하였다(P<0.001). 교육군의 식품안전 식태도/건강신념의 교육 전과 후의 총점은 20점 만점에 15.28점에서 16.50점으로 유의적인 상승을 보였다(P<0.001). 대조군은 사전 15.21점에서 사후 15.29점으로 상승하였으나 유의적인 차이를 보이지 않았다. 노인의 식품안전 식행동은 교육군의 교육 전과 후의 총점이 28점 만점에 20.07점에서 22.50점으로 2.43점 상승하여 유의적인 향상을 보였다(P<0.001). 가정 내 식품 취급실태를 살펴보면 식품을 직접 구매한다고 한 응답자가 교육군의 87.3%, 대조군의 95.2%로 나타났으며, 식품 조리 여부 항목에 대해서는 교육군의 87.7%, 대조군의 95.2%가 직접 가정에서 조리한다고 응답하였다. 식태도/건강신념 변화와 식행동 변화값 간에 상관관계가 가장 높으며(r=0.447, P<0.001), 식행동 변화값과 지식의 변화 값과의 상관관계가 높은 것으로 나타났다(r=0.152, P<0.05). 경로별 교육 효과를 보기 위하여 사전, 사후 점수와 점수변화량을 비교 분석한 결과 지식, 식태도/건강신념, 식행동의 모든 경로에서 유의적인 향상을 보였다. 개발된 교육 프로그램의 효과 평가는 2차 시 교육의 사전, 사후 평가를 대조군의 평가 결과와 비교 분석하였는데, 교육의 기간이 2차시로 제한되어 있고 교육 후 행동 변화의 유지를 평가하지 못하였다. 또한, 교육경로와 대상자의 수가 적어 연구 결과를 일반화하기에는 무리가 있으며, 향후 교육의 확대를 통한 후속연구들이 진행되어야 할 것으로 사료된다. This study assessed the educational effectiveness of a developed food safety management education program based on social cognitive theory for elderly in the middle class. The subjects participated in the food safety education program two times at a public health center, community welfare center, senior citizens’ center, and center for children’s foodservice management. For food safety intervention education, data from the intervention group (212 subjects) and control group (42 subjects) were analyzed. Significant (P<0.001) differences in the scores for food safety knowledge, food attitude, and food behavior were observed in the intervention group before and after the study, but no significant difference was observed in the control group. A significant positive correlation also detected between knowledge, food attitude/health belief, and food behavior in the intervention group, which indicates that the study contributed to perception changes in the intervention group and eventually behavioral changes. Accordingly, this program can induce cognitive and behavioral changes by conducting food safety training for the elderly.

기관내 삽관을 위한 Atracurium 의 적정량에 대한 임상적 고찰

이혜원,신정순,장성호,임혜자,김종욱,정형근 대한마취과학회 1990 Korean Journal of Anesthesiology Vol.23 No.6

The usefulness of a nondepolarizing muscle relaxant for endotracheal intubation is limited by its relatively slow onset of neuromuscular block compared to that achieved with succinylcholine. Several attempts have been made to produce a more rapid onset of muscle relaxation for endotracheal intubation. A large dose of nondepoarizing muscle relaxant may produce rapid onset but cauae undesirable side effects and a prolonged duration of neuromuscular block. The authors observed the degree of vocal cord relaxation and intubation condition 2 minutes after administration of atracurium and measured changes in mean arterial blood pressure and heart rate at the time of arrival in the operating room, just before abministration of atracurium, 2minutes after administration, and 5mins after intubation. The 40 of patients in this observation were divided into four groups. Group 1; 10patients, received 0.3 mg/kg of atracurium Group 2; 10patients, received 0.4 mg/kg of atracurium Group 3; 10patients, received 0.5 mg/kg of atracurium Group 4; 10patients, received 0.6 mg/kg of atracurium The results were as follows; 1) There were better intubating conditions in Group 3 and 4 than in Group 1 and 2(p$lt;0.001). 2) Mean arterial blood pressure and heart rate did not change significantly after administration of atracurium in all four groups. From the above results we conclude that 0.5~0.6 mg/kg of atracurium provides satisfactory intubation condition 2 minutes after administration without hemodynamic changes.

Single Oral Dose Toxicity Evaluation of Leejung-tang, a Korean Traditional Herbal Formula, in Crl:CD (SD) rats

Lim, Hye-Sun,Lee, Mee-Young,Seo, Chang-Seob,Shin, In-Sik,Ha, Hye-Kyung,Huh, Jung-Im,Shin, Hyeun-Kyoo The Society of Korean Medicine 2011 대한한의학회지 Vol.32 No.3

Objective: Leejung-tang (Rechu-to in Japanese) is a traditional Korean herbal formula used for treatment of gastrointestinal disorders such as vomiting, stomach pain, chronic gastritis and gastrointestinal ulceration. The present study was carried out to investigate the potential acute toxicity of Leejung-tang water extract (LJT) by a single oral dose in Crl:CD (SD) rats in compliance with current guidelines. Methods: In the preliminary study, there were no adverse effects such as death, clinical signs, and body weight changes at dose levels of 500, 1000, and 2000 mg/kg/day body weight. Based on the results, a dose of 2000 mg/kg was selected as the toxicological limited dose. LJT was administered once by gavage to male and female rats at dose levels of 0 and 2000 mg/kg bodyweight. During the study period, mortalities, clinical findings, and body weight changes were observed for 14 days following the administration. On day 14 after the treatment, the animals were sacrificed by carbon dioxide overdose and complete gross postmortem examinations were performed. Results: In present study, no treatment-related deaths were observed. There were no adverse effects on clinical signs and body weight changes. In addition, there were no observed gross findings in all groups except for a kidney cyst in the 2000 mg/kg/day female group. Conclusion: The results indicated that LJT did not induce toxic effects at a dose level up to 2000 mg/kg in rats and its median lethal dose ($LD_{50}$) was considered to be over 2000 mg/kg/day body weight for both genders.

The Return of an Old Worm: Cerebral Paragonimiasis Presenting with Intracerebral Hemorrhage

Koh, Eun Jung,Kim, Seung-Ki,Wang, Kyu-Chang,Chai, Jong-Yil,Chong, Sangjoon,Park, Sung-Hye,Cheon, Jung-Eun,Phi, Ji Hoon The Korean Academy of Medical Sciences 2012 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.27 No.11

<P>Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of <I>Paragonimus</I>. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.</P>