소화기 질환과 영양

백현욱 ( Hyun Wook Baik ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.6

Gastrointestinal tract is an organ for digestion, absorption and utilization of nutrients. Also it functions as an immunological organ in the human body. Patients with gastrointestinal disease are at increased risk for nutritional problem due to dietary restriction during the treatment or diagnostic examinations, anorexia or altered nutritional requirement. Clinically, it is important for gastroenterologists to be aware of the principles of nutritional therapy and the relationship between gastrointestinal diseases and the combined nutritional abnormalities. Removal of enteral feeding causes mucosal atrophy and leads to increased mucosal permeability to bacteria and endotoxin. The intestinal endotoxemia results from the translocation of bacteria and endotoxin to systemic circulation, may triggers off systemic inflammatory response syndrome. Therefore, it is crucial in critically ill patients to maintain the gastrointestinal mucosal integrity along with the intestinal flora that enables the host immunity to be maintained or enhanced. Immunonutrition is a therapeutic approach to enhance the gastrointestinal mucosal barrier with various specific nutrients. The intestinal endotoxemia and immunonutrition will also be reviewed briefly. (Korean J Gastroenterol 2004;43:331-340)

노화와 영양

박지은 ( Ji Eun Park ),백현욱 ( Hyun Wook Baik ) 한국정맥경장영양학회 2013 한국정맥경장영양학회지 Vol.5 No.2

Malnutrition is a common health problem in people older than 65 years. In older individuals, malnutrition is associated with poor clinical outcomes and even death. These individuals particularly are characterized by inadequate nutritional intake due to various factors such as medical disease, physical impairment, age-related physiological changes, and psychological and psychosocial issues. Furthermore, as the immune system ages, its function is compromised, and the aged person becomes more vulnerable to harm and disease. Nutrition plays an important role in maintaining the vigor of the immune system, because nutritional deficits and malnutrition can aggravate a diseased condition because of the weakened immune system. It is important to assess older individuals for malnutrition, particularly when weight loss or anorexia is observed. Nutritional status in older individuals is generally assessed with the revised mini-nutritional assessment short form, the malnutrition universal screening tool, and the nutritional risk screening 2002. A structured approach is essential for the management of unintended weight loss or malnutrition in older individuals. Studies have shown that oral nutritional supplementation, a wellestablished approach, can improve nutritional status and quality of life in older individuals. Pharmacological treatments, such as administration of megestrol acetate, dronabinol, testosterone, oxandrolone, and rh-growth hormone, require further investigation to assess whether they are fit for clinical application. (JKSPEN 2013;5(2):42-49)

양파의 알코올 추출물이 코콜레스테롤혈증 환자의 지질 성상에 미치는 영향

남경희(Nam Kyung Hui),백현욱(Baik Hyun Wook),최태윤(Choi Tae Youn),윤순규(Yoon Soon Gyu),박세원(Park Se Won),정효지(Joung Hyojee) 韓國營養學會 2007 Journal of Nutrition and Health Vol.40 No.3

It is known that onion increases anti oxidative and antibiotic capacity, and decreases blood pressure and cholesterol levels. The study was carried out to investigate whether ethanol extract of onion can enhance blood lipid profiles in hypercholesterolemic patients. Fourty three hypercholesterolemic patients were randomly divided into 2 groups; 25 in controls and 18 in experimental group. The control group was offered to take placebo for 4 weeks (200 ㎖/day), and experimental group was offered to consume ethanol extract of onion for 8 weeks (200 ㎖/day that corresponds to 500 g of onion). There were no differences in sex, age, body mass index (BMI) and educational levels between groups before treatment. After 8 weeks of onion extract consumption, plasma triglycerides level was significantly decreased in experimental group compared to control (p<0.05). Total cholesterol level was tended to decrease in experimental group, but there was no significant difference of change between control and experimental group. The levels of plasma glucose and LDL-cholesterol were not changed significantly after onion extract consumption. In summary, alcohol extract of onion may have a positive effect on the lipid profiles of hypercholesterolemia patients through decreasing plasma triglyceride concentration. (Korean J Nutr 2007; 40(3): 242~248)

경증의 간 기능 이상 소견을 보이는 성인에 대한 동충하초 추출물의 기능 및 안전성

허진영 ( Jin Young Heo ),백현욱 ( Hyun Wook Baik ),김혁중 ( Hyuk Jung Kim ),이재민 ( Jae Min Lee ),김형우 ( Hyung Woo Kim ),최용선 ( Yong Sun Choi ),원정호 ( Jung Ho Won ),김현미 ( Hyun Mi Kim ),박원일 ( Won Il Park ),김철영 ( Chu 한국정맥경장영양학회 2015 한국정맥경장영양학회지 Vol.7 No.3

Purpose: The aim of this study is to determine the efficacy and safety of Cordyceps militaris in Korean adults with mild liver dysfunction. C. militaris is a mushroom traditionally used for several clinical purposes in East Asian territory, including China, and has been found to be effective in improving liver function through animal studies. Methods: The C. militaris group was administered 1.5 g/day of C. militaris (2 capsules per dose, twice per day) and the placebo group was administered the same volume of placebo. Laboratory test (white blood cell, hemoglobin, platelet, aspartate aminotransferase, alanine aminotransferase, gamma glutamyltranspeptidase, lactic dehydrogenase, alkaline phosphatase, total bilirubin, blood urea nitrogen, creatinine), liver computed tomography (CT) were performed, and visual analogue scale score for subjective symptoms and fatigue severity scale were measured. Results: In analysis of the liver CT scan at 8 weeks after administration compared to baseline, the mean ratio of change of Hounsfield unit of 8 segments of liver increased by an average of 21.43%±45.11% in the C. militaris group and 9.64%±11.41% in the placebo group. Others showed no statistically significant inter-group difference. Conclusion: C. militaris extract was used safely as a functional food in patients with mild liver dysfunction, and is expected to protect against progression of fatty liver or cirrhosis caused by suppression of lipid accumulation in hepatocytes.

서울·경기지역 성인의 상용음식에 대한 한식 인식도 조사

박영희(Young Hee Park),강민지(Min Ji Kang),백현욱(Hyun Wook Baik),오상우(Sang Woo Oh),박수진(Su Jin Park),백희영(Hee Young Paik),최정숙(Jeong Sook Choe),이진영(Jin Young Lee),강민숙(Min Sook Kang),정효지(Hyo Jee Joung) 대한지역사회영양학회 2012 대한지역사회영양학회지 Vol.17 No.5

This study was conducted to investigate which food items are perceived as HANSIK (Korean food) in Korea. 562 males and females aged 20-70 were surveyed on 512 most frequently consumed dish items from 4th Korean National Health and Nutrition Survey if they perceive it as HANSIK. Dish items in kimchi, namul·sukchae (cooked and seasoned vegetable) and jeotgal (salt-fermented food) category showed high response rate to be perceived as HANSIK. The response rate of twigim (frying foods) as HANSIK was low showing less than 70%. The response rate as HANSIK for foreign origin foods such as ramen and jjajangmyeon (black bean paste noodle) were lower than 25%. In jang · yangnyum (seasoning) category, doenjang (soybean paste) and gochujang (red pepper paste) showed high response rate as HANSIK more than 90%. Females showed a higher response rate as HANSIK than males for most food items except several items of myen ·mandu (noodle and dumpling). The younger age group had higher HANSIK perception on many items of recently consumed foods, especially budae-jjigae (spicy sausage stew) (p < 0.001) and jwipo-jorim (braised dried filefish) (p < 0.001), implying that they already accept the common foods as HANSIK regardless of the origin. These results provide an information on the foods perceived as HANSIK among currently consumed common foods in Korea and these results can be utilized for establishment of HANSIK concept reflecting transition of dietary life in Korea.

포스터 전시 : 위장관 ; 공장에 발생한 gastrointestinal autonomic nerve tumor 1예

이우진 ( Woo Jin Lee ),이준성 ( June Sung Lee ),백현욱 ( Hyun Wook Baik ),전영빈 ( Young Bin Jeon ),이정환 ( Jung Whan Lee ),김유선 ( You Sun Kim ),우광훈 ( Gwang Hoon Woo ),문정섭 ( Jeong Seop Moon ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

gastrointestinal automomic nerve tumor (GANT)는 1984년 Herrera 등에 의해 plexosarcoma로 처음 기술된 신경총에서 유래한 종양이다. Gastrointestinal stromal tumor(GIST) 등의 다른 간엽계세포에서 유래한 종양과 감별이 어려우며, 전자현미경상 dense core granule 등의 소견이 진단에 필수적이다. GANT는 소화관의 근간신경총을 발생모지로 하는 의견이 유력한데, 최

대사증후군 환자 및 위험군의 식사 내 총 항산화능과 산화스트레스 및 대사 지표의 연관성

함동우(Ham, Dongwoo),전신영(Jun, Shinyoung),강민지(Kang, Minji),신상아(Shin, Sangah),위경애(Wie, Gyung-Ah),백현욱(Baik, Hyun Wook),정효지(Joung, Hyojee) 한국영양학회 2017 Journal of Nutrition and Health Vol.50 No.3

본 연구에서는 수도권에 위치한 일개 종합병원의 건강검진 수검자 중 대사증후군 위험요인을 두 가지 이상 보유한 346명을 대상으로 건강검진과 설문조사 자료, 한국인 상용식품의 총 항산화능 데이터베이스와 연계한 식사 자료를 분석하여 성별에 따라 대사증후군 환자 및 위험군의 식사 내 총 항산화능과 그에 따른 산화스트레스 및 대사 지표의 특성을 파악하였다. 대상자들의 식사 내 평균 총 항산화능은 여성이 196.4 mg VCE/d/1,000 kcal, 남성이 132.0mg VCE/d/1,000 kcal로 남성은 총 항산화능 수준이 높을수록 GGT로 추정한 산화스트레스 수준과 수축기·이완기혈압, 혈중 중성지질 농도의 이상자 비율이 유의하게 낮았던 반면 여성은 그렇지 않았다. 또한 남성은 플라바논, 안토시아니딘을 비롯한 플라보노이드의 섭취밀도가 GGT와, α-카로틴, β-카로틴, 루테인/제아잔틴을 비롯한 카로티노이드의 섭취밀도가 d-ROMs과 유의한 음의 상관관계를 보인 반면 여성에서는 α-토코페롤과 γ-토코페롤만이 BAP와 양의 상관관계를 보였다. 식사 내 총 항산화능 수준에 따른 높은 산화스트레스 수준과 대사 지표 이상자의 유병률 차이는 남녀 모두 유의하지 않았다. 추후 식사 내 총 항산화능과 대사증후군을 비롯한 만성질환의 관련성을 규명하기 위하여 대규모의 표본으로 전향적 연구를 진행할 필요가 있을 것이라 사료된다. Purpose: This study aimed to investigate the association of total dietary antioxidant capacity (TAC) with oxidative stress and metabolic markers among patients with metabolic syndrome according to gender. Methods: A total of 346 subjects aged 30~59 years with two or more risk factors of metabolic syndrome were recruited from a general hospital near Seoul in South Korea between 2010 and 2012 based on data from the medical checkup. Biochemical indices for oxidative stress and metabolic markers were measured. Food consumption data from 3-day food records were linked with the antioxidant capacity database for commonly consumed Korean foods to estimate individual"s TAC. Results: Average dietary TAC of the study subjects was 132.0 mg VCE/d/1,000 kcal in men and 196.4 mg VCE/d/1,000 kcal in women. Levels of γ-glutamyltransferase (GGT), systolic blood pressure, diastolic blood pressure, and blood triglycerides were reduced significantly according to increasing TAC in men, but there was no significant trend in women. Intakes of total flavonoids and carotenoids were significantly negatively correlated with GGT (p < 0.05) and d-ROMs (p < 0.01) in men, whereas those of α-tocopherol (p < 0.05) and γ-tocopherol (p < 0.05) were positively correlated with biological antioxidant potential (BAP) in women. The odds ratio of high oxidative stress indices and abnormal metabolic markers according to TAC level were not significant in either men or women. Conclusion: The results show that dietary TAC was partially associated with oxidative stress and metabolic markers among patients with metabolic syndrome. Further research is required for elucidating the association between dietary TAC and incidence of metabolic syndrome and chronic diseases within a large population in prospective studies.

한국 성인의 항산화 비타민 섭취와 대사증후군 위험 간의 관련성

안서은(Ahn, Seoeun),전신영(Jun, Shinyoung),강민지(Kang, Minji),신상아(Shin, Sangah),위경애(Wie, Gyung-Ah),백현욱(Baik, Hyun Wook),정효지(Joung, Hyojee) 한국영양학회 2017 Journal of Nutrition and Health Vol.50 No.4

Purpose: The purpose of this study was to examine the association between intake of antioxidant vitamins and prevalence of metabolic syndrome (MetS) among Korean adults. Methods: A total of 614 subjects aged 30~60 years were recruited from those who received a medical checkup at a general hospital in South Korea between 2009 and 2012. Presence of MetS was determined based on criteria issued by the NCEP ATP III. Intakes of antioxidant vitamins (vitamin A, retinol, carotenoids, vitamin C, and vitamin E) were estimated by combining 3-day diet records with an antioxidant vitamin database for common Korean foods. We used multiple logistic regression analysis to assess the association between dietary intakes of antioxidant vitamins and MetS. Results: Men in the highest tertile for retinol (OR = 0.40, 95% CI = 0.23~0.71, P for trend = 0.0009), carotenoids (OR = 0.57, 95% CI = 0.32~1.00, P for trend = 0.0470), and vitamin E (OR = 0.52, 95% CI = 0.30~0.92, P for trend = 0.0190) intakes had a lower likelihood of having Mets than those in the lowest tertile. The OR of high fasting blood glucose among men in the highest tertile for vitamin A (μg RE: OR = 0.55, 95% CI = 0.32~0.97, P for trend = 0.0417, μg RAE: OR = 0.52, 95% CI = 0.29~0.92, P for trend = 0.0211), carotenoids (OR = 0.41, 95% CI = 0.23~0.73, P for trend = 0.0036), and vitamin E (OR = 0.47, 95% CI = 0.26~0.82, P for trend = 0.0080) intakes was lower than those in the lowest tertile. In women, subjects in the highest tertile of retinol intakes had a lower prevalence of MetS than those in the lowest tertile group (OR = 0.55, 95% CI = 0.30~0.98). The OR for abdominal obesity was lower among women with the highest vitamin A (μg RE) intakes compared to those in the lowest tertile (OR = 0.51, 95% CI = 0.28~0.93, P for trend = 0.0293). Conclusion: These results suggest that dietary intakes of antioxidant vitamins might be associated with reduced risk of having MetS among Korean adults.

재발 기복증을 동반한 재발 장관포상기종 1예

박주이 ( Ju Yee Park ),윤재영 ( Jae Young Yoon ),민선양 ( Sun Yang Min ),홍승권 ( Seung Kwon Hong ),박주상 ( Ju Sang Park ),장은정 ( Eun Jeong Jang ),백현욱 ( Hyun Wook Baik ),박상종 ( Sang Jong Park ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.3

Pneumatosis cystoides intestinalis is an uncommon condition of unknown etiology, characterized by the presence of multiple gas filled cysts in the gastrointestinal tract. Many different causes of pneumatosis cystoides intestinalis have been proposed, including mechanical, pulmonary, and bacterial causes. Approximately 85% of cases are thought to be secondary to coexisting disorders of the gastrointestinal tract or the respiratory system. The condition has been associated with the therapeutic uses of lactulose, steroids, and various cancer chemotherapeutic regimens. Lactitol is a disaccharide analogue of lactulose which is available as a pure crystalline powder. There are three previous case reports suggestive of lactulose causing pnumatosis intestinalis. We report a case of recurrent pneumatosis cystoides intestinalis associated with benign recurrent pneumoperitoneum developed probably secondary to lactitol therapy. (Korean J Gastroenterol 2007;50:188-192)

스테로이드에 조기 호전을 보인 Ticlopidine 유발성 담즙정체성간염 1 예

김은순(Eun Soon Kim),우광훈(Gwang Hoon Woo),김유선(You Sun Kim),이정환(Jung Whan Lee),문정섭(Jeong Seop Moon),강윤경(Yun Kyung Kang),이우진(Woo Jin Lee),이준성(June Sung Lee),정영빈(Young Bin Jeon),백현욱(Hyun Wook Baik) 대한소화기학회 2002 대한소화기학회지 Vol.40 No.3

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