• Archives of Plastic Surgery
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• 제45권5호
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• pp.418-424
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• 2018

Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.85-92
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• 2014

Recently, the incidence and prevalence of obesity and dyslipidemia are increasing. Dyslipidemia is associated with significant comorbidities and complications, and with cardiovascular risk factors (obesity, diabetes mellitus, hypertension and smoking). The main objectives of this article are that describe the prevalence of dyslipidemia in Korean children and adolescents and review the diagnosis and management of dyslipidemia in children and adolescents.

• 한국식품영양과학회지
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• 제33권8호
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• pp.1273-1278
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• 2004

당뇨병의 합병증 중 지질대사성 질환으로 유도되는 대사경로를 규명하고자 6주령의 흰쥐(Sprague-Dawley) 24마리를 3군으로 나누어 4주간 chemical pure diet로 사육하였다. 당뇨병을 유발하고자 alloxan을 20 mg/kg BW 또는 40 mg BW를 매주 1회 투여하였다. 혈당치를 측정하여 당뇨증상을 확인하였으며 혈청 및 간의 지질수준과 각 조직의 지방산 조성을 측정하여 당뇨병에 의한 지질대사의 변화를 비교 검토하였다. Alloxan 40 mg 투여군에서 심한 당뇨병 유발로 체중감소가 크게 나타났으며, 식이섭취량과 간중량/100 g BW도 다른 군에 비하여 유의적으로 높았다. 혈당의 변화는 alloxan 40 mg/kg BW 투여한 군이 다른 군에 비해 약 2배정도로 높게 나타나 당뇨병이 유발되었음을 확실하게 알 수 있었다. 혈청지질에서 cholesterol 함량은 alloxan 40 mg/kg BW 투여한 군에서 다른 군보다 다소 증가된 경향을 보였다. Triglyceride도 역시 alloxan 투여군에서 높은 경향으로 나타났다. 혈청 HDL-cholesterol은 군간의 유의적인 차이가 없었으며 HDL-/total cholesterol 비율도 군간에 유의적인 차이는 없었으나, 다른 군보다 alloxan 40 mg/kg BW을 투여한 군이 다소 높은 경향이었다. 간 지질에서 cholesterol 함량은 alloxan 40 mg/kg BW 투여군이 다른 군에 비해 유의적으로 낮았다. Triglyceride 함량은 군간에 유의적인 차이가 없었다. 각 조직의 인지질 지방산 조성을 보면 alloxan 40 mg/kg BW 투여군에서 lionleic acid는 증가하고 반면 arachidonic acid는 감소되어 그 결과 arachidonic/linoleic acid의 비율이 낮은 경향을 보였으며 특히 혈청과 비장에서는 그 경향이 뚜렷하여 유의적인 차이를 나타냈다. 이상의 결과를 종합하면, 당뇨병이 유도된 흰쥐에서 간의 중량 및 혈청의 지질이 증가되었고, 조직의 인지질에서 desaturation이 억제되었으므로 그로 인하여 지질대사에 관련된 합병증이 유도되는 것으로 판단되었다.

• Journal of Pharmaceutical Investigation
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• 제33권3호
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• pp.171-178
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• 2003

Drug interactions with food, on occasion, lead to serious nutritional and functional changes in the body as well as alterations of pharmacological effect. It, therefore, should be necessary to take drug interactions with food into consideration for effective and safe therapeutics. Diabetes mellitus is a heterogeneous group of disorders characterzed by abnormal glucose homeostasis, resulting in hyperglycemia, and is associated with increased risk of microvascular, macrovascular, and neuropathic complications. However, the precise mechanism of diabetes mellitus remains unclear. Three basic objectives in the care of diabetic patients are maintaining optimal nutrition, avoiding hypo- or hyperglycemia and preventing complications. Laminaria japonica is a brown macroalgae which can be used as a functional diet due to high content of diatery fiber. The purpose of this study was to investigate the effect of Laminaria japonica diet on the pharmacokinetics of metformin which are frequently used in the treatment of diabetes. Diabetic rats induced by streptozotocin were employed in this study. Blood concentrations of oral hypoglycemic agent, metformin, were measured by HPLC and resultant pharmacokinetic parameters were calculated by RSTRIP. The mechanisms of drug interaction with food were evaluated on the basis of pharmacokinetic parameters such as $k_{a},\;t_{1/2},\;C_{max},\;t_{max}$, and AUC. Administration of metformin in normal and diabetic rats treated with Laminaria japonica diet showed significant decrease in AUC, $C_{max},\;and\;k_a$, and increase in $t_{max}$, compared to those with normal diet. This might result from adsortion of metformin on components of Laminaria japonica, causing delayed absorption. The oral glucose test showed that Laminaria japonica diet could lower blood glucose level probably through either inhibiting the activity of disaccharidases, intestinal digestive enzymes, or delaying the absorption of glucose. More studies should be followed to fully understand pharmacokinetic changes of metformin caused by long-term Laminaria japonica diet.

• 한국콘텐츠학회논문지
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• 제18권12호
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• pp.208-217
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• 2018

당뇨병 유병기간에 따른 심혈관 질환의 혈청학적, 합병증의 양상을 국민건강영양조사 6기(2013-2015)의 모든 가용 데이터를 사용하여 당뇨병 환자의 치료뿐 아니라 향후 관리에 대한 정보를 제공함에 목적을 두고 있다. 국민건강영양조사는 건강 설문, 검진, 영양조사로 이루어져 있으며, 18~80세 미만으로 나이를 제한하였고, 당뇨병 유병기간을 응답한 1,316명을 조사 대상으로 하였다. 당뇨병 유병기간에 따라 0-5, 6-10, 11-15, 16-20, 20년 이상으로 구분하였다. 당뇨병 유병기간이 길어질수록 나이는 많아지고, BMI는 낮고, 흡연자의 비율은 떨어지며, HbA1c는 상승하고 사구체 여과율은 낮아졌다. 총 콜레스테롤, LDL-C, 중성 지방 수치는 낮고, HDL-C 수치는 비슷하였다. 인슐린 및 경구용 항고혈당제제를 치료 받는 환자의 비율은 증가하였다. 당뇨병 기간이 길수록 혈당 조절이 악화되었고, 미세혈관 및 대혈관합병증의 위험도는 상승하였다. 이러한 합병증을 예방하기 위해 집중적인 치료와 모니터링으로 위험요인을 통제해야 할 것이다.

• Journal of Nutrition and Health
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• 제49권4호
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• pp.233-240
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• 2016

항산화, 항암 및 항염증 효능 등의 생리 활성이 보고된 우엉 뿌리의 열수 추출물을 제조하여 advanced glycation end products (AGEs) 형성 저해 효과를 확인하였다. AGEs는 bovine serum albumin (BSA)과 단당류인 glucose, fructose, galactose를 혼합하여 $37^{\circ}C$에서 3주간 배양하여 생성하였고 매주 형광도 측정, fructosamine 분석, ${\alpha}$-dicarbonyl compounds 함량 분석을 통해 AGEs의 생성량을 확인하였다. 우엉 뿌리 추출물의 AGEs 생성 저해능을 AGEs 생성 억제제로 알려져 있는 aminoguanidine (AG)의 저해능과 비교하였다. 우엉 뿌리 추출물은 BSA와 단당류인 glucose, fructose, galactose 각각의 당화반응을 억제하였으며 특히 배양 3주차에서 BSA와 glucose의 당화반응 결과물인 AGEs 생성을 유의적으로 저해하였다. 농도 2 mg/mL 이상의 우엉 뿌리 추출물은 1 mM AG보다 AGEs 생성 저해능이 우수하였으며 농도 4 mg/mL의 우엉 뿌리 추출물은 배양 3주차에서 AGEs 생성을 약 80% 이상 억제하는 효능을 나타냈다. 체내 혈당은 당뇨병과 같은 질환과 식이의 영향을 받으므로 다양한 glucose 농도에서 우엉 뿌리 추출물의 AGEs 생성 억제능을 조사하였다. 그 결과 AGEs 생성은 glucose의 농도에 비례하여 증가하였으며 우엉 뿌리 추출물은 당뇨환자의 식후에 관찰되는 혈당인 25 mM glucose 군에서 1 mM의 AG보다 높은 우수한 저해 효과를 확인하였다. 본 연구 결과는 우엉 뿌리 추출물의 AGEs 생성 억제라는 새로운 기능성을 밝히며 향후 당뇨 합병증 예방 효능을 가진 기능성 식품으로의 개발 가능성을 제시한다.

• Journal of Nutrition and Health
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• 제44권6호
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• pp.577-591
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• 2011

A food exchange system for diabetes is a useful tool for meal planning and nutritional education. The first edition of the Korean food exchange lists was developed in 1988 and the second edition was revised in 1995. With recent changes in the food marketplace and eating patterns of Koreans, the third edition of food exchange lists was revised in 2010 by the Korean Diabetes Association, the Korean Nutrition Society, the Korean Society of Community Nutrition, the Korean Dietetic Association and the Korean Association of Diabetes Dietetic Educators through a joint research effort. The third edition is based on nutritional recommendations for people with diabetes and focuses on adding foods to implement personalized nutrition therapy considering individual preferences in diverse dietary environment. Foods were selected based on scientific evidence including the 2007 Korea National Health and Nutrition Examination Survey data analysis and survey responses from 53 diabetes dietetic educators. While a few foods were deleted, a number of foods were added, with 313 food items in food group lists and 339 food items in the appendix. Consistent with previous editions, the third edition of the food exchange lists included six food categories (grains, meat, vegetables, fats and oils, milk, and fruits). The milk group was subdivided into whole milk group and low fat milk. The standard nutrient content in one exchange from each food group was almost the same as the previous edition. Korea Food & Drug Administration's FANTASY (Food And Nutrient daTA SYstem) database was used to obtain nutrient values for each individual food and to determine the serving size most appropriate for matching reference nutrients values by each food group. The revised food exchange lists were subjected to a public hearing by experts. The third edition of the food exchange lists will be a helpful tool for educating people with diabetes to select the kinds and amounts of foods for glycemic control, which will eventually lead to preventing complications while maintaining the pleasure of eating.

• 대한한방내과학회지
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• 제22권3호
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• pp.285-290
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• 2001

Purpose : Impaired glucose tolerance (IGT) was standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes, replacing groups such as 'borderline' and 'chemical' diabetes. The main clinical significance of IGT is as a risk factor for type 2 diabetes and as a risk factor for cardiovascular disease and as a component of the metabolic syndrome. In 1997 the American Diabetes Association(ADA) was proposed the new classification and diagnostic criteria for diabetes, which is strict with the diagnostic baseline of Diabetes from 140mg/dl to 126mg/dl. And it's main purpose is to prevent chronic complications by early diagnosis and treatments. In the oriental medicine, Supungsunkihwan has been used in treatments of Diabetes including IGT & NIDDM, however there is not enough studies about the its objective hypoglycemic effect. so in order to investigate whether there is hypoglycemic effect of Supungsunkihwan, clinical studies were performed with IGT and mild NIDDM patients. Methods : Prior to the study, fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. In addition, ECG, cholesterol, TG, HbA1c levels were measured, and the dinical characteristics of patients that can be influence to the blood sugar level such as age, gender, rest type, diet type were surveyed. Supungsukihwan was administered for 7 days, and FBS & PP2hrs were measured again after the therapy. Result : PP2hrs glucose levels were decreased by the administration of Supungsunkihwan. And It's hypoglycemic effects has the correlation with age. That is, the more age increase, the more hypoglycemic effect decrease. Conclusion : Supungsukihwan has hypoglycmic effects on IGT & mild NIDDM patients and it is more effective when administrated to young patients relatively.

• 대한한방내과학회지
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• 제32권1호
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• pp.56-67
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• 2011

Objectives : Recent etiological studies show that oxidative stress might play a major role in the diabetes and its complications. Mori Ramulus (MR) has been known to have antioxidative, anti-inflammatory and antidiabetic effects. The methanol extract of MR was tested for its effectiveness in LLC-PK1 cells exposed to high glucose. Methods : The cytoprotective effect of MR was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The antioxidative effect was measured in terms of generation amount of ${\cdot}O_2^-$ by 2',7'-dichlorodihydrofluorescein diacetate (DCFDA), NO by 4,5-diaminofluorescein (DAF-2), $ONOO^-$ by dihydrorhodamine 123 (DHR 123) in the high glucose -treated LLC-$PK_1$ cells. Western blotting was performed using anti-AGE, anti-RAGE, anti-MAPKs(ERK1/2, JNK, p38), anti-PI3K, anti-Akt, and anti-NF-${\kappa}$B (p50, p65) respectively. Results : MR extract reduced cell death and inhibited the generation of ${\cdot}O_2^-$, NO, $ONOO^-$ in the high glucose-treated LLC-$PK_1$ cells. MR inhibited the expression of AGE, RAGE, MAPKs, PI3K, and Akt by means of decreasing NF-${\kappa}$B activation. MR also inhibited NF-${\kappa}$B activation itself. Conclusions : These results indicate MR has cytoprotective, antioxidative, and anti-inflammatory effects. Therefore it is suggested that MR might prevent and cure diabetes and its complications.

• 한국한의학연구원논문집
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• 제13권2호통권20호
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• pp.1-14
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• 2007

To overcome the limits of prevention and treatment against Diabetes Mellitus(DM) in Western medicine, there have been tendency finding solutions in traditional medicine based on Sogal. But Sogal had been so various concepts, classification and names. As a result there has been confusion in applying Sogal treatment to DM. So in order to clarify, it is necessary to study Sogal concepts and classification historically. The results of studying changes of Sogal concepts and classification are following : Untill AD 8 century, Sogal had not been only syndrome but also disease with throat and urinating difficulties. From 10c to 13c, Sogal had been divided three types in addition to the theories of internal organs, Samcho and complications. From 13c to 14c, the three types of Sogal theory was improved by various medical theory. But still Sogal covered the concepts of syndrome and disease. After 16c, in Chosun Dynasty. concepts of syndrome was eliminated and concepts of disease was strengthend by accounts on pathology, prognosis. complications and malignities. This tendeny was showed well in ${\ulcorner}DongEuiBoGam{\lrcorner}$ and connected to post doctors in Chosun. It was distiction with Chinese Traditional Medicine's view regarding Sogal as syndrome and disease as well, up to the present.