• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.478-482
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• 2011

Purpose: Free flap reconstruction is performed on defects including benign and malignant tumors as well as trauma in the department of oral and maxillofacial surgery, but there are few reports of free flap reconstruction cases for oral cancer in patients in Korea. Methods: This study was designed to retrospectively analyze surgical outcomes and complications of 164 free-flap reconstructions performed at the Oral Oncology Clinic, National Cancer Center, during 2002~2011. A total of 164 free flaps were performed for reconstruction of oral and maxillofacial defects which were caused by oral cancer and osteoradionecrosis in 155 patients. Results: The present study had 162 successful cases and 2 failed cases for a total of 164 cases. The study had a success rate of 98.8% for free-flap reconstructions. Flap donor sites included radial forearm free flap (n=93), fibula osteocutaneous free flap (n=25), anterolateral thigh flap (n=18), latissimus dorsi myocutaneous flap (n=16) and other locations (n=12). Postoperative medical complications were generally pneumonia and delirium. Postoperative local complications occurred including partial flap necrosis, delayed wound healing of the donor site, infection of the recipient site and salivary fistula. The incidence of postoperative complications and patient-related characteristics including age, sex, smoking, history of radiotherapy, hypertension (HTN) and diabetes Mellitus (DM) were retrospectively analyzed. Patient age ($P$=0.003) and DM ($P$=0.000) and HTN ($P$=0.021) were significant risk factors for complications overall. Conclusion: The present study had no mortality and confirms that free-flap reconstructions are extremely reliable in achieving successful results.

• Journal of Korean Academy of Nursing
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• v.35 no.2
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• pp.283-291
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• 2005

Purpose: The purpose of this study was to explore the levels of depression experienced by clients (N=152) with Type 2 Diabetes Mellitus(DM), and to compare the levels of self care activity, metabolic control and cardiovascular risk factors between depressed and non-depressed clients. Method: Participants aged 50 and above were conveniently recruited in B city. The levels of depression, self-care activity, metabolic control of glucose and lipids, and cardiovascular risk factors of the participants were measured by using questionnaires and blood tests from November, 2003 to June, 2004. Data was analyzed with descriptive statistics, Pearson correlation, Spearman rho and t-test using the SPSS WIN 10.0 program. Result: The prevalence of depression(CES-D=16) among the participants was $44.1\%$. The levels of self-care activities(p=.012), glucose(p=.019), total cholesterol(p=.022), LDL(.007) and cardiovascular risk factors(p=.012) were significantly higher in the depressed group than those in the non-depressed group. Conclusion: Based on the findings, we concluded that many DM patients experience depression and the depression of type 2 DM clients is significantly related with self care activities, diabetic control, and cardiovascular complications. However, this study did not address causality among these variables. Therefore, further research, such as a longitudinal cohort study, is needed to identify causality among these variables.

• Journal of Oral Medicine and Pain
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• v.45 no.1
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• pp.12-16
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• 2020

Chronic otitis media (COM) is a chronic inflammatory disease which affects the middle ear, mastoid cavity. It presents hearing loss, ear pain, dizziness, headache, temporomandibular joint (TMJ) inflammation and intracranial complication. Intracranial complications such as skull base osteomyelitis (SBO) may occur secondary to COM due to transmission of infection by a number of possible routes. SBO is an uncommon condition with a significant morbidity and mortality if not treated in the early stages. We report a-67-year-old male patient with diabetes and untreated COM who presented atypical severe TMJ, periorbital and postmandibular pain. By computerized tomography (CT), magnetic resonance imaging (MRI) and whole body bone scan (WBBS), he was diagnosed with SBO spreading from untreated COM via infective arthritis of TMJ. Through this case, we suggest proper utilization of diagnostic imaging, especially CT or MRI for the early detection of SBO in the case of COM accompanying with the greater risk of infection developments such as diabetes.

• Journal of Korean society of Dental Hygiene
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• v.11 no.1
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• pp.81-94
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• 2011

Objectives : This study conducted to investigate oral care abilities in diabetic patients to find a good dental method which may efficiently control diabetes. Methods : The diabetic group consisted of 40 patients with type 2 diabetics, while the non-diabetes were 34 persons with no signs of diabetics, who had visited a Public Health Center and dental clinic of a general hospital in Gwangju city from Dec. 2008 to Sep. 2009. Periodontal disease, gingivitis, dental caries, tongue plaque and halitosis between diabetic group and non-diabetic group were examined and at the same time a questionnaire survey was conducted. The data were analyzed with chi-square, t-test, pearson correlation coefficients using the SPSS WIN 15.0 program. Results : The mean values of both the community periodontal index and the gingival index of diabetic group were 2.18 and 1.75, respectively, and those were higher than those (1.79 and 1.50) of non-diabetic group with no statistical significance. The mean saliva secretion of non-diabetics was 16.74 mL, which was higher than 13.90 mL of diabetic patients(p<0.05). The oral care ability(mean 3.10) acquired from plague index in diabetic group was worse than in non-diabetic(mean 2.33). Conclusions : The high blood sugar concentration in diabetic patients causes low saliva secretion and high saliva viscosity, with the results halitosis and periodontal disease take place. This study suggested that good oral care ability of diabetic patients was very helpful to prevent periodontal disease and halitosis. In addition to this, it may reduce complications of diabetic patients.

• Journal of Korean society of Dental Hygiene
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• v.12 no.6
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• pp.1203-1211
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• 2012

Objectives : The aim of this study was to investigate the factor-related oral care self-efficacy among the type 2 diabetic patients. Methods : Questionnaire was conducted with 174 Type 2 diabetic patients from 9th January to 9th March in 2012. The following conclusion was obtained as a result of carrying out t-test and one-way ANOVA analysis and multiple linear regression analysis. Results : 1. Analysis of the level of each item concerning oral care self-efficacy showed tooth brushing self-efficacy was $13.3{\pm}2.9$, the highest of all. 2. The factor that was most highly related with oral care self-efficacy was oral health behaviors(${\beta}=0.474$). The other factors were found to be expected duration of diabetes(${\beta}=-0.205$), self-assessed physical health(${\beta}=0.177$) and oral health(${\beta}=0.111$) in such order (p<0.05). Conclusions : Diabetes causes a variety of complications in the mouth, and therefore it is very important to practice oral care activity in order to oral health promotion. This study showed oral care self-efficacy appeared to be the greatest factor of relevance in practicing oral care activity. So, dental hygienist is obliged to keep on motivating so that the patient may maintain the oral care activity for him/herself. Also, a study on various intervention methods to improve oral care self-efficacy should be continued.

• The Korean Journal of Physiology and Pharmacology
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• v.9 no.5
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• pp.305-314
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• 2005

Diabetes mellitus is associated with vascular complications, including an impairment of vascular function and alterations in the reactivity of blood vessels to vasoactive substances in various vasculature. In the present study, the authors have observed endothelin-B ($ET_B$) receptor agonist-induced relaxation in precontracted mesenteric arterial segments from streptozotocin (STZ)-induced diabetic rats, which was not shown from control rats or in other arterial segments from diabetic rats. Accordingly, the goal of this study was to investigate in what way STZ-induced diabetes altered reactivity of the mesenteric arterial bed and to examine the causal relaxation, if any, between this $ET_B$ receptor-mediated relaxation and endothelial paracrine function, especially nitric oxide (NO) production. The relaxation induced by $ET_B$ agonists was not observed in mesenteric arteries without endothelium. The relaxation to $ET_B$ agonists was completely abolished by pretreatment with BQ788, but not by BQ610. $N_{\omega}-nitro-L-arginine$ methyl ester and soluble guanylate cyclase inhibitors, methylene blue or LY83583 significantly attenuated the relaxant responses to $ET_B$ agonists, respectively. When the expression of eNOS and iNOS was evaluated on agarose gel stained with ethidium bromide, the expression of eNOS mRNA in diabetic rats was significantly decreased, but the expression of iNOS was increased compared with control rats. Furthermore, the iNOS-like immunostaining was densely detected in the endothelium and slightly in the arterial smooth muscle of diabetic rats, but not in control rats. These observations suggest that $ET_B$ receptor may not play a role in maintaining mesenteric vascular tone in normal situation. However, the alterations in $ET_B$ receptor sensitivity were found in diabetic rats and lead to the $ET_B$ agonist-induced vasorelaxation, which is closely related to NO production. In the state of increased vascular resistance of diabetic mesenteric vascular bed, enhanced NO production by activation of iNOS could lead to compensatory vasorelaxation to modulate adequate perfusion pressure to splanchnic area.

• Journal of Nutrition and Health
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• v.36 no.7
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• pp.675-683
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• 2003

This study investigated the effect of dietary $\beta$-carotene supplementation on lipid peroxidation and anti oxidative enzyme activity as indices of oxidative stress in diabetic rats. Fifty Sprague-Dawley male rats aging 7 weeks were used as experimental animals, which were divided into the non-diabetic control group and the diabetic group. The diabetic group received an intraperitoneal injection with streptozotocin to induce diabetes. Then the diabetic rats were divided into four dietary groups which contained different amounts of $\beta$-carotene; 0%, 0.002%, 0.02%, or 0.2% of the diet. The diabetic rats were fed the experimental diets and the non-diabetic rats were fed the basal diet without $\beta$-carotene supplementation for 2 weeks and then sacrificed. The diabetic group had a significantly higher blood glucose level than the non-diabetic group. However, blood glucose level were not significantly changed by the level of dietary $\beta$-carotene supplementation. Compared to the non-diabetic control group, the diabetic control group indicated a significant increase of plasma thiobarbituric acid reactive substance (TBARS). Liver TBARS level also tended to be higher in diabetic control group, although it was not significant. The $\beta$-carotene supplementation did not reduce plasma TBARS level. However, Liver TBARS level was significantly decreased when 0.02% or more $\beta$-carotene was supplemented in the diet. The liver lipofuscin level in the diabetic control group was higher than in the non-diabetic control group, but the effect of $\beta$-carotene supplementation did not show any differences. Superoxide dismutase activity was significantly lower in the diabetic group, but it was increased in groups receiving 0.02% or more $\beta$-carotene. Compared to the non-diabetic control group, lower activities of catalase and glutathione peroxidase were observed in the diabetic control group, although it was not significant. Catalase and glutathione peroxidase activities tended to increase as the levels of $\beta$-carotene supplementation increased, although it was not statistically significant. Therefore, it seems that dietary $\beta$-carotene supplementation might reduce diabetic complications by partly decreasing the lipid peroxidation and increasing the activity of antioxidative enzyme in diabetes.

• Nutrition Research and Practice
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• v.1 no.4
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• pp.363-370
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• 2007

Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G${\rightarrow}$T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G${\rightarrow}$T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.

• Preventive Nutrition and Food Science
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• v.7 no.4
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• pp.454-460
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• 2002

While atherosclerosis is a major killer, there is now concern that mortality from the disease will increase due to the rising incidence of type II diabetes. Because diet can potentially influence both diseases, it is important to elucidate the role of diet in the progression of atherosclerosis. In addition, the mechanisms involved in dietary-related alterations of the disease need to be defined to guide public health recommendations to reduce athero-sclerosis incidence and limiting unwanted side effects. Since diet is thought to play a role in atherosclerosis even without added complications due to type II diabetes, reducing the incidence of that metabolic disease will not be enough. While evidence is increasing that high intake of carbohydrate can lead to type II diabetes and atherosclerosis, the preponderance of existing evidence indicates that intake of specific fats as a major dietary causal factor. It has recently been hypothesized that a dietary fat link to atherosclerosis may depend partly on the activity of a transcriptional regulator, the peroxisome proliferator activated receptors (PPAR). Thusfar, PPAR $\alpha$, $\beta$/$\delta$ and ${\gamma}$, have been shown to play a major role in metabolism, inflammation, and cancer. Furthermore, PPAR may regulate specific processes associated with atherosclerosis such as triglyceride and low density lipoprotein (LDL) metabolism; the reverse cholesterol transport pathway; lipid accumulation within plaques; the local inflammatory response and plaque stability. Synthetic ligands for PPAR have been developed; however, natural ligands include specific fatty acids and their metabolites. Though the role of PPAR in atherosclerosis has been reported with respect to synthetic ligands, additional studies need to be done with established and possible natural ligands. In this review, we will focus on the relation of dietary fat to PPAR alteration of atherosclerosis.

• Herbal Formula Science
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• v.21 no.1
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• pp.119-130
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• 2013

Objectives : Diabetes mellitus is the leading cause for vascular complications such as atherosclerosis. The present study is to investigate whether Doinseunggi-tang (DST) improves diabetic vascular dysfunction in type II diabetes. Methods : The db/db mice were treated with high fat/high cholesterol diet and DST (200 mg/kg/day) for 8 weeks. Results : DST significantly lowered blood glucose and systolic blood pressure. In addition, DST also markedly decreased total plasma cholesterol, triglyceride, and LDL-cholesterol, whereas increased the HDL-cholesterol. Vascular relaxation of aortic rings by acetylcholine or SNP was ameliorated by DST in a dose-dependent manner. Damage of vascular intima and hypertrophic of media was improved by DST. Immunohistological study revealed that DST attenuated the increase of ICAM-1, VCAM-1, and ET-1 expression in thoracic aorta. Conclusions : Taken together, DST suppressed hyperglycemia and diabetic vascular dysfunction in type II db/db mice. The present data suggests that Doinseunggi-tang may be prevent a development of diabetic atherosclerosis.