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Bu Kyung Kim 7 Articles
Postoperative effects of bariatric surgery on heart rate recovery and heart rate variability
Han Su Park, Kyungwon Seo, Hyeon Soo Kim, Sung il Im, Bong Joon Kim, Bu Kyung Kim, Jung Ho Heo
Kosin Med J. 2022;37(2):119-126.   Published online June 27, 2022
DOI: https://doi.org/10.7180/kmj.22.020
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
Several studies have reported associations between obesity and autonomic dysfunction. However, little research has investigated the effect of bariatric surgery on heart rate recovery (HRR) in the treadmill test and heart rate variability (HRV) in 24-hour Holter monitoring. We investigated the effects of bariatric surgery on HRR and HRV, which are parameters related to autonomic dysfunction.
Methods
We retrospectively investigated patients who underwent bariatric surgery in 2019. The treadmill test, 24-hour Holter monitoring, and echocardiography were performed before and 6 months after surgery. We compared the changes in HRR in the treadmill test and HRV parameters such as the time domain and spectral domain in 24-hour Holter monitoring before and after surgery.
Results
Of the 40 patients who underwent bariatric surgery, 25 patients had the treadmill test or 24-hour Holter monitoring both before and after surgery. Body weight and body mass index significantly decreased after surgery (112.86±24.37 kg vs. 89.10±20.26 kg, p<0.001; 39.22±5.69 kg/m2 vs. 31.00±5.09 kg/m2, p<0.001, respectively). HRR significantly increased (n=23; 43.00±20.97 vs. 64.29±18.49, p=0.001). The time domain of HRV parameters increased (n=21; standard deviation of the N-N interval 123.57±28.05 vs. 152.57±39.49, p=0.002 and mean N-N interval 791.57±88.84 vs. 869.05±126.31, p=0.002).
Conclusions
Our data showed that HRR after exercise and HRV during 24-hour Holter monitoring improved after weight reduction with bariatric surgery through improved cardiac autonomic function.
Immediate Changes of Glucose Metabolism After Gastretomy for Early Gastric Cancer in Patients with Type 2 Diabetes
Ki Hyun Kim, Yoon Hong Kim, Kyung Won Seo, Ki Young Yoon, Yeon Myeong Shin, Young Sik Choi, Bu Kyung Kim
Kosin Med J. 2021;36(1):25-33.   Published online June 30, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.1.25
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

It is well known that type 2 diabetes (T2DM) is dramatically improved after bariatric surgery, although the mechanisms have not been clearly identified. The skill required for gastric surgery for gastric cancer is very similar to that needed in bariatric surgery. In this study, we evaluated the immediate improvement of T2DM after gastrectomy for gastric cancer.

Methods

A total of nine patients who were diagnosed with early gastric cancer (EGC) and already had T2DM underwent a 75 g oral glucose tolerance test (OGTT) before surgery and within two weeks after gastrectomy. Glucose, insulin, and c-peptide were measured before, and 30 and 60 minutes after ingesting 75 g of glucose. From these trials, we calculated the HOMA-IR, insulinogenic index, Matsuda index, and area under the curve (AUC).

Results

The mean age of participants was 57.23 ± 11.08 years and eight of them were men. HOMA-IR (4.2 vs. 2.3, P = 0.012) levels were decreased after surgery. There were no significant differences of insulinogenic index, fasting blood sugar before and after surgery. The Matsuda index (3.3 vs. 8.3, P = 0.002) was significantly increased and AUC (512.9 vs. 388.7 mg-hr/dL, P > 0.001) upon 75 g OGTT was significantly decreased after surgery.

Conclusions

Insulin sensitivity was immediately improved after gastrectomy for early gastric cancer in patients with T2DM.

Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines
Young Sik Choi, Kwang-Hyuk Seok, Jong Jin Lee, Gina Jieun Hong, Pablo M. Afidchao, Bu Kyung Kim, Jee-Yeong Jeong
Kosin Med J. 2018;33(1):64-74.   Published online January 21, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.1.64
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Abstract PDFPubReader   CrossRef-TDMCrossref - TDM
Objectives

Iodine deficiency causes multiple health problems. Previously we reported that 96% of high school students in Tuguegarao, Philippines had adequate iodine levels. However, iodine deficiency-associated problems remain among adults in the Philippines. Therefore, we evaluated iodine nutritional status and goiter prevalence among adults, including pregnant women, in Tuguegarao, Philippines.

Methods

A total of 245 adults, including 31 pregnant women, provided samples for urinary iodine analysis, and all pregnant women completed a questionnaire about iodine deficiency.

Results

The median urinary iodine level was 164.0 ± 138.4 g/L; 38.4% of the participants were iodine deficient, according to the International Council for Control of Iodine Deficiency Disorders (ICCIDD) criteria. No severe iodine deficiency was observed. Among the 31 pregnant women, 24 (77.5%) fell into the iodine deficient category defined by a stricter World Health Organization (WHO) guideline, in which iodine deficiency is considered when urinary iodine levels are below 150 g/L. Almost half (42%) of the pregnant women were unaware of the harmful effects of iodine deficiency on the human body and their fetus.

Conclusions

Although iodine nutritional status in the Philippines has improved, iodine deficiency still exists among adults, especially among pregnant women. Therefore, our study strongly suggests that a better strategy should be established to monitor iodine nutritional status among adults continually, and to focus on populations susceptible to iodine deficiency, including pregnant women and women of reproductive age, to achieve the total elimination of iodine deficiency.

Obesity and Insulin Resistance According to Age in Newly Diagnosed Type 2 Diabetes Patients in Korea
Ju Won Lee, Nam Kyu Kim, Hyun Joon Park, Jun Yeob Lee, Seon Yoon Choi, Eun Mi Lee, So Young Ock, Su Kyoung Kwon, Young Sik Choi, Bu Kyung Kim
Kosin Med J. 2016;31(2):157-166.   Published online January 20, 2016
DOI: https://doi.org/10.7180/kmj.2016.31.2.157
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Abstract Objectives

With the rapid increase in the prevalence of diabetes, the age groups of diabetic patients are becoming diversified. This study will examine the degree of obesity, insulin resistance, and insulin secretion ability among patients first diagnosed with diabetes according to age and gender.

Methods

The subjects of this study included 616 patients who were first diagnosed with diabetes during a routine physical examination. This sample was obtained from a total of 28,075 adults aged 19 years and older who received the examination among 33,829 participants in the Korea National Health & Nutrition Examination Survey (KNHANES) from 2007–2010. The subjects were categorized by age into young age (age: 19 – 39 years), middle age (age: 40 – 59 years), and old age (age: 60 years and older). The degree of obesity was categorized according to body mass index (BMI) into normal weight (BMI: 18.5 ∼ 22.9), overweight (BMI: 23 ∼ 24.9), and obesity (BMI: 25 or above). Insulin resistance was evaluated by homeostatic model assessment of insulin resistance (HOMA-IR).

Results

It was found that 14.1% (n = 87) of a total of 616 subjects (324 men, 292 women) were in the young age group, 43.8% (n = 270) were in the middle age group, and 42.1% (n = 259) were in the old age group. In addition, 83.3% of men that were overweight or obesity were in the young age group, while 79.2% and 60.5% were in the middle age and old age groups, respectively. A total of 82.2% of women that were overweight or obesity were in the young age group, while 79.5% and 77% were in the middle age and old age groups, respectively. For men, the more obesity they were in all age groups, the higher their HOMA-IR. For women, the more obesity they were in the young age and middle age groups, the higher their HOMA-IR; however, women in the old age group showed the highest HOMA-IR when they were of normal weight.

Conclusion

Among diabetic patients first diagnosed with the disease in Korea, the youth population had the highest obesity rate. Insulin resistance increases as an individual's weight increases among those patients who are first diagnosed with diabetes; the only exception noted is for elderly women.

Diagnostic Value of Preoperative Serum Thyroglobulin Measurement for the Diagnosis of Malignancy in Follicular or Hürthle Cell Neoplasms of the Thyroid Gland
Nam Kyu Kim, Seong Joo Kang, Weon Hyoung Lee, Go Eun Yeo, You Jin Han, Bu Kyung Kim, Su Kyoung Kwon, Yo-Han Park, Young Sik Choi
Kosin Med J. 2014;29(1):17-22.   Published online December 17, 2014
DOI: https://doi.org/10.7180/kmj.2014.29.1.17
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Abstract PDFPubReader   CrossRef-TDMCrossref - TDM
Abstract Objectives

The aim of this retrospective study was whether serum Tg predicts malignancy in follicular or Hürthle-cell neoplasms on fine needle aspiration.

Methods

A chart review of 111 patients (90 females, 21 males; mean age 46.8 ± 11.9 years) with follicular or Hürthle-cell neoplasms on fine needle aspiration, who were surgically treated between Sep. 2001 and Sep. 2011, was performed. Predictive factors for malignancy were identified by the chi-squared test and multivariate logistic regression.

Results

There were no differences between 41 malignant and 70 benign lesions in serum Tg or any of the normalized indexes. Receiver-operator characteristic analysis revealed no cutoff value. Lesions with serum Tg levels greater than 500 g/L had no significant difference. And also there were no independent predictors of malignancy by multivariate logistic regression.

Conclusions

In this study, the author found that serum Tg has poor accuracy for predicting malignancy in follicular or Hürthle cell neoplasms on fine needle aspiration.

A Case of Type III Autoimmune Polyglandular Syndrome
Sangeon Gwoo, Young Sik Choi, Bu Kyung Kim, Yo Han Park, Keun Tae Kim, Jun Seop Lee
Kosin Med J. 2013;28(2):167-170.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.2.167
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

The autoimmune polyglandular syndromes (APS) are groups of syndromes comprising a combination of endocrine and nonendocrine autoimmune diseases. Among of those four types of APS, the main characteristics of the 3 APS are autoimmune thyroid diseases associated to other autoimmune diseases, excluding Addison’s disease. Type 3 APS are also subdivided into 3A, 3B, 3C, and 3D. Recently, we experience a case of APS manifesting 3A, 3C, and 3D subtype. A 28-year-old woman developed type I diabetes. According to her medical history, she had Graves’ disease, vitiligo, auimmune hemolytic anemia and systemic lupus erythematosus (SLE). The antoantibodies associated with Graves’ disease, SLE, and type I diabetes showed positive findings. We report this case with literatures review.

A Case of Diffuse Sclerosing Variant of Papillary Carcinoma
Jung Min Choi, Song Ju Lee, Bu Kyung Kim, young Sik Choi, Yo Han Park, Jun Hun Kim, Bang Hur
Kosin Med J. 2009;24(1):157-160.   Published online June 30, 2009
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KMJ : Kosin Medical Journal