PURPOSE: The aim of this study was to examine the effects of long-term endurance exercise and natural fermented vinegar on body composition and cardiopulmonary function of 50-aged postmenopausal women. METHODS: Subjects were divided into four groups (sedentary group, aerobic exercise group, natural fermented vinegar group, and aerobic exercise plus natural fermented vinegar group) to perform natural fermented vinegar intake or aerobic exercise for 8 weeks. Body weight, body composition, cardio-pulmonary function test, and blood concentration of glucose, lipid profiles, aspartate aminotransferase, and alanine aminotransferase were measured. RESULTS: The results showed that natural fermented vinegar or aerobic exercise training for 8 weeks no significantly improved body weight control and body composition. However, natural fermented vinegar plus aerobic exercise training for 8 weeks significantly improved cardiopulmonary function. CONCLUSION: These results suggest that natural fermented vinegar plus aerobic exercise training has a significant effect on anti-fatigue.
Acetic Acid* ; Alanine Transaminase ; Aspartate Aminotransferases ; Body Composition* ; Body Weight ; Exercise* ; Fatigue ; Female ; Glucose ; Humans ; Middle Aged* ; Obesity

This study analyzed the differences in aerobic and anaerobic exercise ability and growth-related indicators, depending on the polymorphism of the ACE and the ACTN3 genes, to understand the genetic influence of exercise ability in the growth process of children. The subjects of the study consisted of elementary school students (n=856, age 10.32+/-0.07 yr). The anthropometric parameters, physical fitness and growth factors were compared among groups of the ACE I/D or the ACTN3 R577X polymorphisms. There were no significant differences between the anthropometric parameters, physical fitness and growth factors for the ACE gene ID or the ACTN3 gene R577X polymorphism. However, the DD type of ACE gene was highest in the side step test (p<0.05), and the DD type was significantly higher than the II+ID type (p<0.05) in the early bone age. The combined group of the ACE gene II+ID and the ACTN3 gene XX type significantly showed lower early bone age (p< 0.05). This study did not find any individual or compounding effects of the polymorphism in the ACE I/D or the ACTN3 R577X polymorphisms on the anthropometric parameters, physical fitness and growth factors of Korean children. However, the exercise experience and the DD type of the ACE gene may affect the early maturity of the bones.
Child* ; Exercise ; Exercise Test ; Genotype* ; Humans ; Intercellular Signaling Peptides and Proteins* ; Peptidyl-Dipeptidase A* ; Physical Fitness*

The aim of this study is to investigate the effects of intermittent ladder-climbing exercise training on mitochondrial biogenesis and ER stress of the cardiac muscle in high fat diet-induced obese middle-aged rats. We induced obesity over 6 weeks of period in 40 male Sprague-Dawley rats around 50 weeks old, and were randomly divided into four experimental groups: chow, HFD, exercise+HFD, and exercise+chow. The exercising groups underwent high-intensity intermittent training using a ladder-climbing and weight exercise 3 days/week for a total of 8 weeks. High-fat diet and concurrent exercise resulted in no significant reduction in body weight but caused a significant reduction in visceral fat weight (p<0.05). Expression of PPARδ increased in the exercise groups and was significantly increased in the high-fat diet+exercise group (p<0.05). Among the ER stress-related proteins, the expression levels of p-PERK and CHOP, related to cardiac muscle damage, were significantly higher in the cardiac muscle of the high-fat diet group (p<0.05), and were significantly reduced by intermittent ladder-climbing exercise training (p<0.05). Specifically, this reduction was greater when the rats underwent exercise after switching back to the chow diet with a reduced caloric intake. Collectively, these results suggest that the combination of intermittent ladder-climbing exercise training and a reduced caloric intake can decrease the levels of ER stress-related proteins that contribute to cardiac muscle damage in obesity and aging. However, additional validation is required to understand the effects of these changes on mitochondrial biogenesis during exercise.
Aging ; Animals ; Body Weight ; Diet ; Diet, High-Fat ; Endoplasmic Reticulum Stress* ; Endoplasmic Reticulum* ; Energy Intake ; Humans ; Intra-Abdominal Fat ; Male ; Myocardium* ; Obesity ; Organelle Biogenesis* ; Rats* ; Rats, Sprague-Dawley

BACKGROUND/AIMS: Bronchiectasis is aggravated by gastroesophageal reflux disease (GERD) owing to micro aspiration. Some researchers note the effect of antireflux surgery in bronchiectasis with GERD. However, few have investigated the effects of medical antireflux therapy. We investigated the effect of proton pump inhibitors (PPIs) in bronchiectasis with GERD. METHODS: From March 2003 to May 2015, the clinical records of patients who had bronchiectasis with GERD were reviewed. Patients underwent an initial pulmonary function test (PFT) and chest computed tomography when diagnosed with bronchiectasis. One group with typical GERD symptoms was treated with PPIs, while the other group was not. Both groups underwent PFTs within six months after completing PPI therapy. Population characteristics and associations were compared between the groups. RESULTS: Two hundred and fifty-seven patients (124 male, 133 female; mean age 67.6±10.0 years) were included. There were no significant differences between the groups in terms of forced vital capacity (FVC; p=0.239), forced expiratory volume in one second (FEV1; p=0.555), or FEV1/FVC (p=0.374) after PPI therapy. However, there were significant improvements in FVC (p=0.002) and FEV1 (p=0.006) in patients with high BMI in the PPI treatment group. CONCLUSIONS: PPIs have no effect on the pulmonary function in patients with bronchiectasis and GERD. However, PPIs were noted to produce improvements in lung function in patients with bronchiectasis and high BMI.
Bronchiectasis ; Female ; Forced Expiratory Volume ; Gastroesophageal Reflux* ; Humans ; Lung ; Male ; Population Characteristics ; Proton Pump Inhibitors* ; Proton Pumps* ; Protons* ; Respiratory Function Tests ; Thorax ; Vital Capacity

BACKGROUND/AIMS: The prevalence of gastroesophageal reflux disease (GERD) is high in patients with idiopathic pulmonary fibrosis (IPF). GERD may cause chronic microaspiration that leads to repeated subclinical lung injury, which leads to pulmonary fibrosis. Although some studies have suggested that proton pump inhibitors (PPI) were associated with a good prognosis in IPF, their effects remain unclear. METHODS: We retrospectively reviewed 786 consecutive adult patients with IPF at Seoul National University Bundang Hospital between April 2003 and March 2015. RESULTS: Mean duration of follow-up was 2.6 ± 2.8 years. Of the 786 patients with IPF, 107 (13.6%) were given diagnoses of GERD, and 103 (13.1%) died due to IPF-related pneumonia or respiratory failure. The prevalence of GERD and the cumulative incidence of de novo GERD increased depending on the period of follow-up in patients with IPF. Patients administered PPI for more than four months had a lower IPF-related mortality rate than patients on PPI less than 4 months (Log-rank P-value = 0.024 in Kaplan-Meier curve). In a univariate and multivariate Cox regression hazard model, younger age (hazard ratio [HR], 1.06; 95% CI, 1.03-1.10; P = 0.001), higher initial forced vital capacity (HR, 0.98; 95% CI, 0.96-0.99; P = 0.004), and longer duration of PPI use (HR, 0.97; 95% CI, 0.95-1.00; P = 0.022), but not a diagnosis of GERD, were significantly associated with lower IPF-related mortality. CONCLUSIONS: In Korean patients with IPF, the prevalence of GERD was lower than in other countries. PPI use for at least 4 months may have a protective effect against IPF-related mortality.
Adult ; Diagnosis ; Follow-Up Studies ; Gastroesophageal Reflux* ; Humans ; Idiopathic Pulmonary Fibrosis* ; Incidence ; Korea ; Lung Injury ; Mortality ; Pneumonia ; Prevalence ; Prognosis ; Proportional Hazards Models ; Proton Pump Inhibitors ; Proton Pumps* ; Protons* ; Pulmonary Fibrosis ; Respiratory Insufficiency ; Retrospective Studies ; Risk Factors ; Seoul ; Vital Capacity

BACKGROUND/AIMS: Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease, with eosinophilic infiltration limited to the esophagus. A minority of EoE patients respond well to proton pump inhibitor (PPI) therapy alone, and that condition is labelled PPI-responsive esophageal eosinophilia (PPI-REE). The prevalence of PPI-REE among EoE cases is unknown. We aimed to identify clinical manifestations of PPI-REE, and the proportion of PPI-REE among all EoE cases. METHODS: We reviewed pathology of the 4,075 patients who underwent esophageal biopsy at an institution from March 2003 to July 2015. EoE was diagnosed based on esophageal symptoms and eosinophilic infiltration limited to the esophagus, with ≥15 eosinophils per high-power field. We collected endoscopic and pathologic findings, and clinical features for these patients. RESULTS: Thirteen (0.3%) patients were diagnosed with EoE. Clinical manifestations were dysphagia (30.8%), foreign body sensation (23.1%), regurgitation (23.1%), cough (15.4%), heartburn (15.4%), nausea (7.7%), dyspepsia (7.7%). The endoscopic findings noted were polypoid lesion (23.1%), whitish plaque or exudate (23.1%), linear furrow (7.7%), concentric ring (7.7%), nodularity (7.7%), erosion (7.7%), and normal (30.8%). Of these patients, five had a favorable course with PPI as monotherapy. CONCLUSIONS: The proportion of EoE among all patients undergoing endoscopic biopsy was 0.3%. Of those, PPI-REE comprised 38%. Most of the endoscopic findings were atypical or normal when compared to the typical findings in EoE. In conclusion, patients who present with symptoms related to esophageal dysfunction need esophageal biopsy, regardless of the endoscopic findings. Moreover, patients diagnosed with EoE need to be treated first with PPI alone.
Adult ; Aged ; Endoscopy, Gastrointestinal ; Eosinophilic Esophagitis/*diagnosis/etiology ; Esophagus/pathology ; Female ; Gastroesophageal Reflux/drug therapy ; Hospitals, University ; Humans ; Male ; Middle Aged ; Proton Pump Inhibitors/*adverse effects/therapeutic use ; Retrospective Studies

Background/Aims: Less invasive surgical treatment is performed in East Asia to preserve postoperative digestive function and reduce complications such as postgastrectomy syndromes, but there is an issue of metachronous gastric cancer (GC) in the remaining stomach. This study aimed to analyze the incidence of metachronous GC and its risk factors in patients who had undergone partial gastrectomy. Methods: A total of 3,045 GC patients who had undergone curative gastric partial resection at Seoul National University Bundang Hospital were enrolled and analyzed retrospectively for risk factors, including age, sex, smoking, alcohol, Helicobacter pylori status, family history of GC, histological type, and surgical method. Results: Metachronous GC in the remaining stomach occurred in 35 of the 3,045 patients (1.1%): 23 in the distal gastrectomy group (18 with Billroth-I anastomosis, five with Billroth-II anastomosis), seven in the proximal gastrectomy (PG) group, and five in the pylorus-preserving gastrectomy (PPG) group. Univariate and multivariate Cox regression analyses showed that age ≥60 years (p=0.005) and surgical method used (PG or PPG, p<0.001) were related risk factors for metachronous GC, while male sex and intestinal type histology were potential risk factors. Conclusions Metachronous GC was shown to be related to older age and the surgical method used (PG or PPG). Regular and careful follow-up with endoscopy should be performed in the case of gastric partial resection, especially in patients with male sex and intestinal type histology as well as those aged ≥60 years undergoing the PG or PPG surgical method.

BACKGROUND/AIMS: The relationship between halitosis and gastroesophageal reflux disease (GERD) remains controversial. The aim of this study was to investigate an association between subjective and objective halitosis and GERD. METHODS: The subjects were enrolled from participants who visited a health promotion center at Seoul National University Bundang Hospital. For diagnosis of halitosis, a questionnaire was requested, and volatile sulfur compounds (VSCs) were measured by Halimeter. Self-conscious halitosis was defined as halitosis perceived by himself or herself. Informed halitosis was defined as halitosis perceived by others. Objective halitosis was defined when mean VSCs values were > 100 parts per billion. GERD was defined based on a questionnaire and endoscopy, including erosive esophagitis and non-erosive reflux disease (NERD). RESULTS: A total of 54 subjects (male:female = 33:21) with mean age of 46.0 +/- 11.4 years were analyzed. The mean VSCs values were not significantly different between presence and absence of self-conscious halitosis (P = 0.322), but significantly different between presence and absence of informed halitosis (P = 0.021). Informed halitosis was associated with objective halitosis (P = 0.039). GERD, erosive esophagitis and NERD did not correlate with objective halitosis (P = 0.556, 0.206 and 0.902, respectively). In multivariable analysis, the relationship between objective halitosis and GERD symptoms including chest pain, heart burn, acid regurgitation, epigastric pain, hoarseness, globus sensation and coughing was not significant. Besides, GERD was not associated with self-conscious halitosis, informed halitosis and objective halitosis, respectively. CONCLUSIONS: GERD might not be associated with self-conscious, informed halitosis and objective halitosis indicated by Halimeter results. Informed halitosis could be correlated with objective halitosis determined by the Halimeter.
Burns ; Chest Pain ; Cough ; Diagnosis ; Endoscopy ; Esophagitis ; Gastroesophageal Reflux* ; Halitosis* ; Health Promotion ; Heart ; Hoarseness ; Surveys and Questionnaires* ; Sensation ; Seoul ; Sulfur Compounds

BACKGROUNDS/AIMS: We evaluated the clinical usability of immune cell monitoring in adult liver transplantation (LT) recipients. METHODS: This study was composed of two parts as using calcineurin phosphatase (CNP) activity assay and ImmuKnow assay independently as in vitro monitoring tools of immune cell function in adult LT recipients. RESULTS: There was a rough correlation between CNP activity and tacrolimus concentration in 33 patients. This association was evident in patients who were only administered tacrolimus, but disappeared after the co-administration of mycophenolate. In 118 healthy individuals, the mean proportion of helper T-cells was 37.4+/-8.1%. According to ImmuKnow assay, their immune responses were strong in 12 patients (10.2%), moderate in 92 patients (78.0%), and low in 14 patients (11.9%). In 85 patients waiting for LT, there was a rough correlation between the ImmuKnow ATP level and age. Their immune responses were strong in 0 patients (0%), moderate in 8 patients (9.4%), and low in 77 patients (90.6%). There was a difference in the ImmuKnow ATP levels between healthy individuals and patients with liver disease. In 137 LT recipients, there was no correlation between the ImmuKnow ATP levels and tacrolimus concentration. This trend did not change after grouping the patients according to co-administration with mycophenolate. Eight recipients experienced acute rejection, but none showed strong immune response. CONCLUSIONS: We think that both CNP activity assay and ImmuKnow assay are too limited to objectively determine the level of immunosuppression. Further studies should be performed to identify other methods for immune function monitoring.
Adenosine Triphosphate ; Adult* ; Calcineurin ; Humans ; Immunosuppression* ; Liver Diseases ; Liver Transplantation ; Liver* ; T-Lymphocytes, Helper-Inducer ; Tacrolimus ; Transplantation*

BACKGROUND/AIMS: In gastric mucosa-associated lymphoid tissue (MALT) lymphoma, the clinical significance of various endoscopic findings has not yet been determined. This study aimed to compare the time to complete remission (CR) and relapse-free survival (RFS) in gastric MALT lymphoma based on endoscopic findings. METHODS: In this single-center retrospective cohort study, the medical records of 122 consecutive adult patients with gastric MALT lymphoma were collected over a period of 12 years. CR was defined by the absence of macroscopic or microscopic features of lymphoma on two subsequent follow-ups. Relapse was clinically defined by a positive endoscopic biopsy after CR. RESULTS: The median time to CR did not differ significantly between treatment methods. However, it was significantly longer in the group with polypoid endoscopic appearance than in the groups with diffuse infiltration or ulceration (7.83, 3.43, and 3.10 months, respectively; p=0.003). Six patients relapsed after CR. Kaplan-Meier analysis showed that RFS differed significantly between groups based on Ann Arbor staging, treatment methods, and initial endoscopic findings. CONCLUSIONS: In gastric MALT lymphoma, the endoscopically defined polypoid type was characterized by a longer duration to CR, with a higher likelihood of recurrence, compared to the endoscopically defined diffuse infiltration or ulceration types.
Adult ; Biopsy ; Cohort Studies ; Endoscopy ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Medical Records ; Recurrence* ; Retrospective Studies ; Ulcer