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Correlation between Peripheral Neuropathy and Cognitive Factors in Type 2 Diabetic Patients (제2형 당뇨병환자에서 말초신경병증과 인지기능항목의 상관관계)

  • Yang, Wonyul;Kim, Jong Kuk;Park, Kyung Won;Suh, Sunghwan;Lee, Hye-Jeong;Park, Mi-Kyoung
    • Journal of Life Science
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    • v.30 no.3
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    • pp.250-259
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    • 2020
  • Diabetes is a well-known risk factor for dementia and cognitive impairment. Diabetic polyneuropathy (DPN) is the most prevalent microvascular complication in type 2 diabetes mellitus (T2DM) patients. The purpose of this study was to evaluate the relation between diabetic peripheral polyneuropathy and cognitive factors in T2DM patients. Retrospective chart review of type 2 diabetic patients with results of a nerve conduction study (NCS) and a neurocognitive study. A total of 19 patients were included. DPN was defined using data from a nerve conduction study: a score of less than 24 in the Korean version of the Mini-Mental State Examination (K-MMSE) was considered as an indicator of cognitive impairment (CI). The mean age of the 19 patients was 71.6±5.0 years. The mean duration of diabetes was 8.4±9.1 years, and the mean HbA1c level was 8.1±1.8%. DPN was present in 7 of the 19 patients. Based on the K-MMSE score, CI was diagnosed in eight patients. The mean K-MMSE scores and the prevalence of CI was not different between the groups with and without DPN. There was no significant difference in DPN prevalence between the groups with and without CI. Education was significantly correlated with cognitive factors. Only the digit span-forward among the cognitive factors showed a significant negative correlation with nerve conduction velocity. In conclusion, the longer education period was associated with higher cognitive function and no significant correlation was observed between diabetic peripheral neuropathy and cognitive dysfunction in type 2 diabetic patients. Further prospective research is needed in the future.

Effects of Green Tea Polyphenol and Vitamin C on Type 2 Diabetic Rats Induced by Low Dose Streptozotocin Following High Fat Diet (고지방식이와 저용량 스트렙토조토신으로 유도된 2형 당뇨병 흰쥐에서 녹차 폴리페놀과 비타민 C 병합 투여 효과)

  • Lee, Byoung-Rai;Yang, Hoon;Park, Pyoung-Sim
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.2
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    • pp.167-173
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    • 2016
  • This study investigated the effects of green tea polyphenol and vitamin C on type 2 diabetes mellitus by administering polyphenon 60 (P60) and sodium ascorbate (SA) to diabetic rats induced by high fat diet/low-dose streptozotocin. The experimental group was divided into five different groups: non-diabetic control group (NC), diabetes control group (DC), diabetes+P60 group (DM+P60), diabetes+SA group (DM+SA), and diabetes+P60+SA group (DM+P60+SA). P60 and SA were dissolved in 0.1% drinking water. After P60 and SA were administered for 16 weeks, fasting blood glucose, plasma insulin, serum triglyceride, blood urea nitrogen (BUN), and creatinine levels as well as kidney alkaline phosphatase (AP) and ${\gamma}$-glutamyltranspeptidase (GGT) activities were measured. Fasting blood glucose level increased 5-fold in the DC group compared to the NC group. In the DM+P60 group, fasting blood glucose level decreased by 14%. In the DM+P60+SA group, fasting blood glucose level decreased by 28% compared to the DC group, whereas the DM+SA group did not show any significant difference. The homeostasis model assessment for insulin resistance index increased in the DC group and decreased in the DM+P60+SA group compared to the DC group. Serum creatinine level increased in the DC group, but decreased by 17% in the DM+P60 group and by 43% in the DM+P60+SA group compared to the DC group. The serum BUN level increased in the DC group, but decreased by 41% in the DM+P60+SA group compared to the DC group. Kidney GGT and AP activities decreased in the DC group compared to the NC group; however, they were reversed by DM+P60+SA group. These results show that combined administration of both green tea polyphenol and vitamin C had better effects on improving blood glucose level, insulin resistance, serum triglyceride level, and protecting kidneys than administration of either green tea polyphenol or vitamin C alone in the context of type 2 diabetes.

Anthropometry, Blood Pressure, Serum Lipid Levels and Nutrient Intakes in People with Impaired Fasting Glucose and with Diabetes (공복혈당장애군 및 당뇨군의 비만도, 혈압, 혈청 지질 농도 및 영양소 섭취 상태)

  • 김은경;권숙정
    • Journal of Nutrition and Health
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    • v.35 no.3
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    • pp.303-313
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    • 2002
  • The purpose of this study was to compare the anthropometry, blood pressure, blood lipid levels, and nutrient intakes in three groups: a group with an impaired fasting blood glucose (IFG) condition (62 males and 30 females); a group with normal blood glucose (73 males and 50 females); and a group with diabetes mellitus (DM) (79 males and 49 females). In male subjects, body mass index (BMI) and obesity index values were significantly higher in the IFG group than in normal and DM groups, but waist/hip ratio (WHR), systolic blood pressure, and diastolic blood pressure were not significantly different from those of the DM group. In female subjects, there was no difference in body weight, BMI, obesity index and WHR values between the IFG and the DM groups. The prevalence of obesity in the IFG group (males 43.6%, females 76.7%) was the highest among the three groups. The percentage of high SBP (40.0%) and high DBP (52.0%) in male subjects of the IFG group was significantly greater than in the DM group or the normal group. In the male subjects, the serum triglyceride concentration was significantly higher in the DM group than in the normal and IFG groups. There was no difference in various nutrient intakes(energy, carbohydrate, protein, fat, calcium, iron, vitamin A and cholesterol) among the three groups. In male subjects, the percentage of energy intake from alcohol was higher in the IFG group (7.0%) than that of the normal (4.5%) and the DM (5.6%) groups. The fasting blood glucose level had a positive correlation with WHR, TG, the athrogenic index and LDL-cholesterol/HDL-cholesterol. This study suggested that the IFG group had a higher obesity index, BMI, blood pressure and serum lipid levels (TG, cholesterol) than the normal or the DM group; furthermore, the IFG group had higher levels of alcohol intake and habits of taking unbalanced diets. Therefore, guidelines for IFG group should emphasize weight control, diet therapy, physical activities and regular balanced diets, in order to prevent diabetes in this group.

Pretreatment prognostic Factors in Early Stage Caricinoma of the Uterine Cervix (초기 자궁 경부암에서 치료전 예후 인자)

  • Kim, Mi-Sook;Hua, Sung-Whan
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.59-67
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    • 1992
  • From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.

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Risk Factors for Nosocomial Pneumonia in Patients at NS ICU (신경외과 중환자실의 병원성 폐렴 발생 위험요인)

  • Kim Nam Cho;Kim So Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.239-248
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    • 2001
  • The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

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Effects of YK-209 Mulberry Leaves on HMG-CoA Reductase and Lipid Composition of Liver in Streptozotocin-Induced Diabetic Rats (YK-209 뽕잎이 Streptozotocin 유발 당뇨쥐 간조직에서의 HMG-Coa Reductase 활성과 지질조성에 미치는 영향)

  • 홍정희;이순재;박모라
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.5
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    • pp.826-833
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    • 2002
  • This study was conducted to investigate the effects of YK-209 mulberry leaves on HMG-CoA reductase activity and lipid composition of liver in streptozotocin-induced diabetic rats. Sprague-Dawley male rats weighing 100 $\pm$ 10 B were randomly assigned as a normal group and four STZ-induced diabetic groups according to the level of dietary mulberry leaves supplement. The experimental diets were fed ad libidum, so that diabetes was experimentally induced by intravenous injection of STZ 55 mg/kg of body weight after feeding for 3 weeks. Animals were sacrificed on the 9th day of diabetic states. The levels of serum triglyceride, total-cholesterol and LDL-cholesterol in DM group were higher than mulberry leaves supplemented groups and normal group, but those of the mulberry leaves supplemented groups were significantly decreased to normal level. In contrast, the leavels of serum HDL-cholesterol in DM group was significantly reduced than that of normal group, but mulberry leaves supplemented groups were increased to normal level. Atherogenic index in DM group was higher about 3 fold than the normal group but the DM-0.1Y and DM-0.2Y groups were maintained the normal level. Contents of total lipid and triglyceride of liver in DM group were significantly lower than that of normal group, but the mulberry Leaves supplemented groups increased than that of DM group. The contents of hepatic cholesterol in DM group was 160% higher than that of normal group, but the mulberry leaves supplementation groups maintained the normal level. The activity of hepatic 3-hydroxy -3-methylglutaryl Coenzyme A (HMG-CoA) reductase in DM group was 43% lower than that of normal group, but had no significant difference between DM-0.1Y, DM-0.2Y and normal groups. In conclusion, YK-209 mulberry loaves has improving effect of the lipid metabolism in STZ-induced diabetic rats through hepatic HMG-CoA reductase activity, and the change of lipids contents in serum and liver.

Effect of Self-care Education at a Diabetes Camp on Diabetes Management Behaviors, Knowledge and Self-efficacy in Children with Type 1 Diabetes (당뇨병 캠프의 자가간호 교육이 제1형 당뇨병 아동의 당뇨관리행위, 당뇨지식 및 당뇨관리 자아효능감에 미치는 영향)

  • Kang, Narae;Ahn, Youngmee;Lee, Ji Eun;Sohn, Min
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.168-175
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    • 2014
  • Purpose: Study purposes were to exam effects of self-care education for children with type 1 diabetes on their diabetes management behaviors and to explore the relationship among diabetes management behaviors, knowledge, self-efficacy and clinical variables. Methods: This study was a one group quasi-experimental study. Study participants were children with type 1 diabetes and attended a four hour self-care education of a diabetes camp. Data were collected using structured questionnaires including Diabetes Management Behavior Scale (DMBS), Michigan Diabetes Research and Training Center's Brief Diabetes Knowledge Test and Self-Efficacy for Diabetes Self-Management. Results: The mean age of the participants was 12 (${\pm}2.3$) years. After the education, their DMBS and knowledge improved, but the improvement was not statistically significant (t=1.758, p=.101; t=0.528, p=.606). Two areas of DMBS, daily prevention behaviors and modification of care plan, were associated with study variables. Daily prevention behaviors were associated with duration of diabetes (r=.653, p=.008), HbA1c (r=.563, p=.038) and having a complication (r=-2.788, p=.015). Modification of care plan was associated with age at diagnosis (r=-.552, p=.033). Conclusion: Children with type 1 diabetes could improve some parts of their diabetes management behaviors even after a short diabetes camp.

Clinical Characteristics of Pulmonary Cryptococcosis (국내 폐효모균증의 임상적 특징)

  • Moon, Doo-Seop;Yoo, Jeong-Soo;Kim, Chung-Mi;Kim, Yeon-Soo;Kim, Seung-Min;Oh, Kwang-Taek;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Hahm, Shee-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1083-1093
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    • 1997
  • Background : So far, there have been numerous reports on organ damage due to cryptococcosis, however, cases of lung localization have been infrequently reported. Recently pulmonary cryptococcosis has been reported more frequently than before due to enhanced diagnostic techniques and increased underlying diseases. Method : The author, therefore, analyzed the clinical manifestations of 5 cryptococcosis cases that we experienced at Hanyang University Hospital from 1985 to 1996 and 9 cases reported in Korea from 1984 and 1996 retrospectively. The following results were obtained. Results : Cryptococcosis occurred frequently over sixth decade and the male to female ratio was 3.6 : 1. Underlying diseases included acute rejection after kidney transplantation, rheumatoid arthritis, autoimmune hepatitis, diabetes mellitus and state of bilateral adrenalectomy. Remaining 8 cases had no evidence of an underlying disease. Because the symptoms were subacute & nonspecific, and not improved by conventional antibiotics, 6 patients of 14 pulmonary cryptococcosis patients were treated as pulmonary tuberculosis before correct diagnosis was made. There were three asymptomatic cases. According to the results of CXR, solitary alveolar consolidation was the most common finding(8 cases) followed by diffuse infiltration(5 cases). It also showed pleural effusion, hilar lymphadenopathy and cavity formation that was rarely reported in world literature. The diagnasis was made through fine needle aspiration biopsy in 10 cases, open thoracotomy in 2 cases, transbronchial lung biopsy in 1 case. and thoracentesis with pleural biopsy in 1 case. Only one case showed positive result in sputum stain and culture, serum latex agglutination test for cryptococcus neoformans. Treatment modalities were various such as fluconazole, amphotericin B, flucytosine, ketoconazole, surgery and it's combination. After 1990 year, there was a trend that fluconazole or ketoconazole are more used than other therapeutic modalities. Conclusion : Because the symptoms are subacute & nonspecific and not improved by conventional antibiotics, pulmonary cryptococcosis is likely to misdiagnosis as pulmonary tuberculosis in Korea. Because the diagnosic yield of sputum stain, culture and serologic test for pulmonary cryptococcosis is low, histologic diagnosis is need in most pulmonary cryptococcosis.

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Clinical Characteristics and Prognostic Factors of Severe Community-Acquired Pneumonia (중증 지역사회획득 폐렴의 임상상 및 예후 예측인자에 관한 연구)

  • Oh, Heung-Kook;Seo, Ji-Young;Kim, Dong-Kyu;Choi, Jeong-Eun;Mo, Eun-Kyung;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1072-1082
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    • 1997
  • Background : To characterize the clinical features and determine the prognostic factors of severe community-acquired pneumonia. This study is the first of its kind in Korea. Methods : Recruited were 40 patients diagnosed as severe community-acquired pneumonia in Hallym University Hospital from January 1, 1989 through July 31, 1996. Patients were analysed retrospectively for age, sex, underlying disease, respiration rate, hypoxemia, requirement of mechanical ventilation, involvement on chest radiograph, shock, and the serum concentration of BUN and albumin. All parameters were compared between survived and dead group. Results : Male to female ratio was 2.07 : 1. The mean age was $63.1{\pm}17.5$years(range 25~90years) with 65% of patients aged equal to or more than 60. The major underlying diseases were old pulmonary tuberculosis(12.5%), chronic obstructive pulmonary disease(7.5%), bronchial asthma(5%), bronchiectasis(2.5%), and diabetes mellitus(22.5%). Microbiologic diagnosis was made in 26 out of 40 patients(65%). The most common causative organism was S. pneumoniae(17.5%, 7/40) followed by S. aureus(15.0%, 6/40), K. Pneumoniae(12.5%, 5/40), M. tuberculosis(7.5%, 3/40), H. influenzae(2.5%, 1/40), coagulase negative staphylococcus(2.5%, 1/40), P. aeruginosa(2.5%. 1/40), E. cloaceae(2.5%, 1/40), and E. coli(2.5%, 1/40). M. pneumoniae was detected in no patient. The most frequent drugs administered in single or combination therapy were aminoglycosides(75%, 30/40), second- and third-generation cephalosporin(40%, 16/40 and 27.5%, 11/40), macrolides(27.5%, 11/40), and amoxicillin/clavulanic acid(22.5%, 9/40). Of the 40 patients, 14 died of severe community-acquired pneumonia(37.5%). Among them, seven patients (50%) expired within 72h of hospital arrival. According to multivariate analysis, mortality was significantly associated with requirement of mechanical ventilation, bilateral pulmonary involvement, and serum albumins$\leq$3.0g/dl. Conclusion : An understanding of the clinical characteristics and prognostic factors in severe community-acquired pneumonia identified in this study will optimize therapeutic approach in this disease and help decreasing its notorious mortality rate.

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Antihyperglycemia Effect of Medicinal Plants Mixture in Streptozotocin-Induced Diabetic Rats (Streptozotocin 유발 당뇨쥐에서 항당뇨 생약 복합물의 혈당강하 효과)

  • Park, Keum-Ju;Jin, Hwi-Seung;Park, Seung-Hee;Kim, Eun-Ho;Kim, Jae-Ki
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.12
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    • pp.1554-1559
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    • 2008
  • This study was performed to investigate the hypoglycemic effect of single and repeated oral administration of medicinal herbal mixture (AD) in streptozotocin (STZ) induced diabetic rats. Angelica decursiva, Lycium chinense and Adenophora triphylla var. japonica Hara were selected by oral glucose tolerance test (OGTT) and mixed for AD mixture. In an oral glucose tolerance test, the AD inhibited the increase in blood glucose levels at 1 hr and 2 hr and decreased incremental glycemic response area under the curve. In a single administration of AD1 (100 mg/kg) and AD2 (500 mg/kg), significant reductions by 5.3% and 12.3% were observed in fasting blood glucose level for 4 hours. During the 1 month of the experimental period, AD1 and AD2 was given to the STZ induced diabetic rats. At 4th week, the fasting blood glucose levels of AD1 and AD2 caused a fall of 25.5% and 37.9%, respectively. In addition, the body weights were decreased by 7.7% (AD1) and 1.7% (AD2), respectively, compared with diabetic control (DC, decreasing of 10.2%). This study suggests that AD could be potentially useful for fasting and post-prandial hyperglycemia treatment and all these effects concluded to the use of this plant extract to manage diabetes mellitus.