• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.608-618
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• 2021

Objective : The endoscopic endonasal transsphenoidal approach is a widely-used method for the surgical treatment of pituitary adenomas. We aimed to evaluate the results of endoscopic surgery by comparing preoperative classification methods and investigating their relationship with postoperative resection and remission rates and complications. Methods : We retrospectively reviewed the medical records of 236 patients (118 males) who underwent surgery for pituitary adenomas. Preoperative Knosp classification, tumor size (TS), suprasellar extension (SSE), postoperative resection and remission rates, and complications were evaluated. Results : The follow-up period was 3 months to 6 years. The patients' ages ranged between 16 and 84 years. Endocrinologically, 114 patients (48.3%) had functional adenoma (FA), and 122 patients (51.7%) had non-functional adenoma (NFA). Among the FA group, 92 (80.7%) showed remission. A statistically significant difference was found between patients with and without remission in terms of the Knosp, TS, and SSE classifications (p<0.01). Knosp, TS, and SSE classification grades were found to be correlated with the resection rates (p<0.01). Meningitis was seen in seven patients (3.0%), diabetes insipidus in 16 (6.9%; permanently in two [0.9%]), and rhinorrhea in 19 (8.1%). Thirty-six patients (15.3%) developed pituitary insufficiency and received hormone replacement therapy. Conclusion : The resection categories and remission rates of FAs were directly proportional to the adenoma sizes and Knosp grades, while the degree of suprasellar growth further complicated resection and remission rates. Adenoma sizes less than 2 cm and SSEs less than 1 cm are associated with favorable remission and resection rates.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.351-356
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• 2023

Background: Total elbow arthroplasty (TEA) is uncommon, but growing in incidence. Traditionally an inpatient operation, a growing number are performed outpatient, consistent with general trends in orthopedic surgery. The aim of this study was to compare TEA outcomes between inpatient and outpatient surgical settings. Secondarily, we sought to identify patient characteristics that predict the operative setting. Methods: Patient data were collected from the American College of Surgeons National Quality Improvement Program. Preoperative variables, including patient demographics and comorbidities, were recorded, and baseline differences were assessed via multivariate regression to predict operative setting. Multivariate regression was also used to compare postoperative complications within 30 days. Results: A total of 468 patients, 303 inpatient and 165 outpatient procedures, were identified for inclusion. Hypoalbuminemia (odds ratio [OR], 2.5; P=0.029), history of chronic obstructive pulmonary disorder or pneumonia (OR, 2.4; P=0.029), and diabetes mellitus (OR, 2.5; P=0.001) were significantly associated with inpatient TEA, as were greater odds of any complication (OR, 4.1; P<0.001) or adverse discharge (OR, 4.5; P<0.001) and decreased odds of reoperation (OR, 0.4; P=0.037). Conclusions: Patients undergoing inpatient TEA are generally more comorbid, and inpatient surgery is associated with greater odds of complications and adverse discharge. However, we found higher rates of reoperation in outpatient TEA. Our findings suggest outpatient TEA is safe, although patients with a higher comorbidity burden may require inpatient surgery. Level of evidence: III.

• Journal of Korean Foot and Ankle Society
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• v.28 no.3
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• pp.96-101
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• 2024

Purpose: Diabetic foot ulcers and gangrene are major complications of diabetes, often accompanied by peripheral vascular occlusion. Revascularization is performed to restore blood flow and reduce complications such as amputation surgery. Nevertheless, reocclusion, a frequently reported complication after revascularization, often necessitates further lower limb amputations to facilitate rehabilitation and ambulation. This study examined the factors influencing the performance of secondary revascularization procedures in patients with diabetic foot gangrene who even underwent transtibial amputation (TTA) following revascularization. Materials and Methods: A retrospective study was conducted on 36 patients with diabetic foot gangrene who underwent TTA after revascularization from March 2005 to March 2022. The factors influencing restenosis were classified into three categories: revascularization factors, preoperative factors, and intraoperative factors. The revascularization factors were categorized based on whether percutaneous transluminal angioplasty (PTA) or bypass surgery had been performed. Preoperative factors included the patient's age, gender, body mass index (BMI), hypertension, and other relevant factors. Intraoperative factors included surgery duration, blood loss, and transfusion. The study examined the factors influencing secondary revascularization in these three categories. Results: Among the 36 patients in the study, 27.8% (11 patients) underwent secondary revascularization procedures. There was no significant correlation between the performance of secondary revascularization and the type of revascularization procedure, whether PTA or bypass surgery (p>0.05). Similarly, no significant differences were observed in preoperative factors (including age, BMI, smoking status, HbA1c, and underlying diseases) and intraoperative factors (surgery duration, blood loss, and transfusion). On the other hand, regarding gender, all patients who underwent revascularization procedures were male, indicating a statistically significant result (p=0.039). Conclusion: This study suggests that while most clinical variables showed no association with reocclusion, the fact that all patients who underwent secondary revascularization procedures were male indicates that gender may be a significant predictive factor of revascularization.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.2
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• pp.160-174
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• 2023

Objective: Carotid artery stenting (CAS) is currently widely used for the treatment of carotid artery stenosis. The objective of this study was to analyze the outcomes of CAS performed in a single institution. Methods: We retrospectively analyzed 313 CAS cases from January 2007 to December 2020, including 206 (66%) symptomatic and 107 (34%) asymptomatic cases. Procedure-related morbidity and mortality were assessed. Rates of periprocedural (≤30 days after CAS) and postprocedural ipsilateral strokes (>30 days after CAS) were also assessed. Logistic regression analysis was used to identify risk factors for the periprocedural complication, in-stent restenosis (ISR), and ipsilateral stroke. Results: The success rate of CAS was 98%. Among 313 cases, 1 patient died due to hyperperfusion-related intracerebral hemorrhage (ICH). The CAS-related mortality rate was 0.31%. The overall incidence of periprocedural complications is 5.1%. A risk factor for periprocedural complication was a symptomatic carotid artery stenosis (7.3% vs. 0.9%, p=0.016). Twenty cases of ISR occurred during 63.7±42.1 months of follow-up. The overall incidence of ISR was 10.2% (20/196). A risk factors for ISR were diabetes mellitus (17.6% vs. 5.7%, p=0.008) and patients who used Open-cell stents (19.6% vs. 6.9%, p=0.010). The overall incidence of ipsilateral stroke is 5.6%. A risk factors for ipsilateral stroke was ISR (95% CI, p=0.002). Conclusions: CAS is a safe and effective procedure for carotid artery stenosis. Although the incidence of complications is low, fatal complication such as hyperperfusion-related ICH can occur. To prevent hyperperfusion-related ICH, several methods such as strict blood pressure (BP) control, intentional less widening of stenotic segment should be used. To prevent ISR or stroke occurrence, special attention should be paid to patients who have ISR or ipsilateral stroke risk factors.

• Journal of Life Science
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• v.13 no.3
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• pp.333-342
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• 2003

The pathogenic effort of high glucose, possibly in concert with fatty acids, is mediated to vascular complications of diabetes via increased production of reactive oxygen species(ROS), reactive nitrogen species(RNS), and subsequent oxidative stress. This study was carried out to investigate the suppressive effect of buchu(Allium tuberosum) on oxidative stress in streptozotocin(STZ)-induced diabetes in Sprague Dawley male rats. The effect of buchu supplementation (10%) on lipid peroxidation, and antioxidative defense system in blood and liver was compared among normal rats fed basal diet(normal) and diabetic rats fed basal diet(DM-control) or 10% buchu-supplemented diet(DM-buchu). Diabetes was experimentally induced by the femoral muscle injection of 50 mg STZ per kg of body weight. Animals were sacrificed after 4 wks of experimental diets feeding. The induction of diabetes by STZ elevated the level of lipid peroxidation represented by thiobarbituric acid-reactive substances(TBARS) and conjugated dienes in plasma, LDL, liver, and erythrocytes. 10% buchu-supplemented diet significantly reduced the levels of conjugated dienes in erythrocytes(p<0.05) and lowered TBARS in liver and LDL to the levels of control. Induction of diabetes by STZ elevated Mn-superoxide dismutase(Mn-SOD) activity and lowered activities of glutathionine reductase(GSH-red) and glutathionine peroxidase(GSH-px). Catalase activity was not affected by the induction of diabetes by STZ. However, buchu supplementation to diabetic rats significantly elevated catalase activity(p<0.05) and slightly elevated GSH-px and GSH-red activities in liver. GSH levels of blood and liver were lowered or not changed by induction of diabetes by STZ, respectively, while buchu supplementation to diabetic rats significantly elevated hepatic GSH level (p<0.05). In conclusion, it can be concluded that buchu might be a food source to attenuate oxidative stress in diabetic patients by inhibiting lipid peroxidation, by increasing hepatic GSH level, and by inducing anti-oxidative enzyme systems.

• KSBB Journal
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• v.23 no.5
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• pp.419-424
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• 2008

In this study, we examined the anti-diabetic activity in vitro by the crude extracts of Tetragonia tetragonioides which has been known to superior plants for the traditional prevention and treatment of stomach-related diseases. $\alpha$-Amylase and $\alpha$-glucosidase, the principal enzymes involved in the metabolism of carbohydrates, and aldose reductase, the key enzyme of the polyol pathway, have been shown to play the important roles in the complications associated with diabetes. A hexane (HX) fraction of T. tetragonioides were shown to inhibit more than 50% of salivary and pancreatin $\alpha$-amylase activity at concentration of 2.882 mg/mL and 2.043 mg/mL, respectively. In addition, the HX and ethylacetate (EA) fraction showed the highest inhibitory activity on yeast $\alpha$-glucosidase at values of $IC_{50}$ of 0.723 mg/mL and 1.356 mg/mL respectively. The HX, dichloromethane (DCM) and EA fraction showed more higher inhibitory activity on yeast $\alpha$-glucosidase than commercial agent such as 1-deoxynorjirimycin and acarbose. Also, the aldose reductase from human muscle cell had been inhibited strongly by the DCM fraction and HX fraction at 51.95% and 47.22% at a concentration of 1 mg/mL, respectively. Our study, for the first time, revealed the anti-diabetic potential of T. tetragonioides and this study could be used to develop medicinal preparations or nutraceutical and functional foods for diabetes and related symptoms.

• The Journal of the Korea Contents Association
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• v.14 no.10
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• pp.198-209
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• 2014

Diabetes Mellitus (DM) is well known for increasing morbidity and mortality, especially related to their complications. The purpose of this study was to investigate the factors affecting the prevalence rate of DM and provide a fundamental material to develop an intervention strategy to reduce the prevalence rate of DM. The study subjects were adults aged over 19 on the basis of the primitive data of "The Fifth Korean National Health and Nutrition Examination Survey, 2012". Therefore, the data of 5995 participants were analyzed. For data process, the complex sample analysis module of SPSS 18.0 program was employed to add weighting before analysis. According to the analysis, the prevalence rate of DM of the study subjects was 10.5%. Regarding the odds ratio of DM prevalence, the subjects who graduated from middle school had the odds ratio 2.51 times higher than those who graduated from college and more; those in subjective bad health condition 4.77 times higher than those in subjective good health condition; those in obesity 1.44 times higher; those with high blood pressure 2.57 times higher; those with hyperlipidemia 2.63 times higher; those who fail to control their weight 1.31 times higher; those going on a diet 2.75 times higher. This study revealed that a level of education, perceived health status, obesity, high blood pressure, hyperlipidemia, weight control, and dietary therapy were the predictable variables of the prevalence rate of DM, and thereby suggested the nursing direction and research direction to reduce the prevalence rate of DM.

• Journal of Preventive Medicine and Public Health
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• v.42 no.5
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• pp.315-322
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• 2009

Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

• Korean Journal of Medicinal Crop Science
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• v.26 no.5
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• pp.382-390
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• 2018

Background: The plant Aster koraiensis has long been used as an ingredient in folk medicine. It has been reported that Aster koraiensis extract (AKE) prevents the progression of diabetes-induced retinopathy and nephropathy. However, although these beneficial effects of AKE on diabetes complications have been identified, the antidiabetic effects of AKE have not yet been completely investigated and quantified. In the present study, the glucose-lowering and antioxidant effects of aqueous and ethanolic AKEs were evaluated. Methods and Results: The glucose-lowering effects of aqueous and ethanolic (30%-, 50%-, and 80%-ethanol) AKEs were investigated via ${\alpha}$-glucosidase inhibitory assays. The mode of inhibition by AKEs on ${\alpha}$-glucosidase was identified through kinetic analysis. The total antioxidant capacity of each of the 4 AKEs was evaluated by assessing their conversion rate of $Cu^{2+}$ to $Cu^+$. The content of chlorogenic acid and 3,5-di-O-caffeoylquinic acid, the bioactive compounds in AKE, in each extract were analyzed by high performance liquid chromatography (HPLC). The AKEs showed potent ${\alpha}$-glucosidase inhibitory activity with mixed inhibition mode, and significant antioxidant capacity. Conclusions: These results of this study suggested that the AKEs tested had ${\alpha}$-glucosidase inhibitory and antioxidant effects. Among the extracts, the 80% ethanol extract showed the most significant ${\alpha}$-glucosidase inhibitory activity, with a half maximal inhibitory concentration ($IC_{50}$ value) of $1.65{\pm}0.36mg/m{\ell}$ and a half maximal effective concentration ($EC_{50}$ value) for its antioxidant activity of $0.42{\pm}0.10mg/m{\ell}$. It can therefore be used as a source of therapeutic agents to treat diabetes patients.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.8
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• pp.1337-1343
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• 2003

Diabetes mellitus has been known to be a state of increased oxidative stress. Free radical formation and lipid peroxidation are accelerated in this metabolic disorder. Buchu (Allium tuberosum Rottler) contains lots of antioxidative nutrients such as chlorophyll, vitamin C, $\beta$-carotene, phenolic compounds and sulfur compounds. To investigate the protective effects of buchu, 10% lyophilized buchu diet was fed to streptozotocin (STZ)-induced diabetic rats for 14 weeks and lipid peroxidation, protein oxidation, contents of reactive oxygen species, activities of antioxidative enzymes and contents of accumulated lipofuscin were measured as indicators of oxidative stress. Hepatic MDA and carbonyl contents tended to decrease in 10% buchu diet group compared with control group. Dietary buchu significantly suppressed lipid and protein oxidation in the skin of rats (p<0.05). Contents of hepatic hydroxyl radicals, which exert the highest toxicity among the reactive oxygen species, were significantly decreased in rats fed 10% buchu diet (P<0.05). Activities of antioxidative enzyme, such as superoxide dismutase, catalase, and glutathione peroxidase, tended to increase in liver and skin of rats fed 10% buchu diet, while hepatic catalase activity was significantly increased in buchu group compared with control group. Buchu supplementation significantly inhibited the accumulation of lipofuscin, an end-product of lipid peroxidation reactions induced by reactive oxygen radicals, in eye tissues compared with control diet (p<0.001). In conclusion, buchu supplementation diminished the oxidative stress, so dietary buchu could help to attenuate diabetes complications.