• Title/Summary/Keyword: diabetes complications

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Effects of Saengjihwangeum-ja Extracts on the Expression of Inflammatory Response in Human Monocyte Cells Induced by Advanced Glycation End Product (생지황음자(生地黃飮子) 추출물이 단핵세포에서 당화종말산물로 유도된 염증반응에 미치는 효과)

  • Lee, Kwang-Gyu;Han, Ung;Jeong, Han-Sol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1305-1313
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    • 2009
  • Saengjihwangeum-ja (SJHEJ) was recorded in DongEuiBoGam as being able to be used for treatment of Sogal whose concept had been applied to Diabetes Mellitus (DM). Modification of proteins by long term circulation of glucose leads to the formation of advanced glycation end product(AGE). Recent immunological studies demonstrated that ligation of AGE play an important role in the development of diabetic complications including atherosclerosis, which includes activation, adhesion, and migration of monocytes. Also, AGE and Maillard reaction product(MRP) could augment monocyte inflammatory responses via ligation of AGE receptor. In this study, the effects of SJHEJ extracts on the expression of inflammatory response-related genes such as tumor necrosis factor-$\alpha$, monocyte chemoattractant protein-1, interferon-g-inducible protein-10, and cyclooxygenase-2 in the human monocyte cell line, THP-1 cells. Reverse transcriptase-polymerase chain reaction revealed that SJHEJ had inhibitory effects on the expression of the TNF-a, MCP-1, IP-10, COX2, IL-1b genes in MRP-induced THP-1 cells. Treatment with SJHEJ had reduced reactive oxygen production in THP-1 cells stimulated by MRP. These inhibitory effects might be exerted via prevention of oxidative stress in activated monocytes. In addition, radical scavenging activity of SJHEJ was increased. These results suggest that SJHEJ has a beneficial effects for improve diabetic vascular complication.

Study on Practical Prescription and It's Drug Composition for the Treatment of Diabetic Nephropathy (당뇨병성신병증(糖尿病性腎病證)의 활용 처방 및 약물에 관한 연구)

  • Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1365-1380
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    • 2007
  • Based on the theories and clinical data of oriental medicine, traditional medicinal prescriptions known to be effective to diabetic nephropathy were collected. The prescriptions were carefully examined and analyzed in order to be used as fundamental material for experiments and in clinicals. More than 40 publications related to diabetes were arranged and analyzed. Of the complications, diabetic nephropathy part of the publications were specifically focused during analysis. Data were analyzed and classified according to the quantity, prescription, differentiation of symptoms, signs and addition and subtraction of each medicine. Frequently used medicines were statistically analyzed. The most frequently used prescription was Yukmigihwang-tang(六味地黃湯) based medicine and prescriptions of its addition and subtraction, which was 15% of the total prescriptions cited. The most frequently used medicine was Astragali Radix, mentioned 192 times in the prescriptions. Hoelen was next with 180 citations, followed by Dioscoreae Rhizoma with 147 times, Rehmanniae Radix with 140, Corni Fructus with 131, Salviae Miltiorrhizae Radix with 106, Angelicae Gigantis Radix with 101, Alismatis Rhizoma with 95, Rhei Rhizoma with 90, Atractylodis Rhizoma Alba with 84, Rehmanniae Radix Preparata with 78, Leonuri Herba with 74, Moutan Cortex Radicis with 66, Aconiti Lateralis Preparata Radix with 66 Cnidii Rhizoma with 65, Pseudostellaria heterophylla with 62, Liriopis Tuber with 55, Lycii Fructus with 52, Rhei Rhizoma with 49, Codonopsis Pilosulae Radix with 44, Paeoniae Radix Rubra with 44, Schisandrae Fructus with 42, Polyporus with 42, Achyranthis Radix with 41 and Euryales Semen with 40. Medicines prescribed more than 30 grams a day included Astragali Radix, Imperatae Rhizoma, Benincasae Pericarpium, Leonuri Herba, Dioscoreae Rhizoma, Plantaginis Semen, Polyporus, Hoelen, Halloysitum Rubrum, Achyranthis Radix, Arecae Pericarpium, Phaseoli Angularis Semen, Coicis Semen, Rhei Rhizoma, Salviae Miltiorrhizae Radix, Sargassum, Ostreae Concha, Pseudostellaria heterophylla, Epimedii Herba, Rehmanniae Radix, Scrophulariae Radix and Polygonati Rhizoma. No scientific reports on the traditional medicinal aspects of diabetic nephropathy was searched. This analysis report would be able to provide the basis of developing new drug candidates for the treatment of diabetic nephropathy, as well as securing the EBM for the traditional medicines already being prescribed to the patients.

"Off-pump" Coronary Artery Bypass Graft in the Chronic Renal Failure Patients -3 Cases Report- (만성 신부전증을 동반한 협심증 환자에서 심폐바이패스를 사용하지 않는 관상동맥우회술 -3예 보고-)

  • 김태헌;김기봉
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.835-839
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    • 1999
  • Since the first report of coronary artery bypass grafting (CABG) in patients with end-stage renal disease in 1974, numerous reports have documented the feasibility of CABG in patients with chronic renal diseases. Patients with chronic renal failure often have comorbid disorders such as hypertension, and diabetes mellitus, each with their own complications and associated impact on both short and long-term survivals. In addition, infection and sepsis have been identified as significant causes of morbidity and mortality in most series of patients with end-stage renal disease undergoing cardiac surgical procedure. As a result of these and other factors such as perioperative volume and electrolyte disturbances, patients with chronic renal failures are at an increased risk of complication and mortality after CABG. We report 3 cases of "Off-pump" CABG in the chronic renal failure patients. patients.

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Surgical Outcomes of Pituitary Apoplexy

  • Kim, Jin-Kyung;Park, Bong-Jin;Cho, Keun-Tae;Lee, Sang-Koo;Cho, Maeng-Ki;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.450-455
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    • 2005
  • Objective : Pituitary apoplexy is a rare clinical syndrome caused by pituitary hemorrhage, hemorrhagic infarction, or ischemic infarction within a pituitary tumor or surrounding structure. We analyzed surgical outcomes of pituitary apoplexy. Methods : From 1995 to 2004, we reviewed our experience of 29 cases with pituitary apoplexy. In all patients, pre- and postoperative clinical presentation were checked and endocrine study were performed. Results : The most frequent symptoms were visual disturbance [24 cases, 82.8%] and headache [22 cases, 75.9%]. After surgery, headache improved in 86.4%, 88.9% among 18cases who had preoperative reduction in visual acuity and 75.0% among 12 cases who had preoperative reduction in visual field improved. In endocrine study, long-term steroid and thyroid hormone replacement therapy was necessary in 42.9% of 14 cases presenting preoperative hypopituitarism. Postoperative transient hypopituitarism developed in 5 cases [33.3%] and they all recovered in follow up study. Postoperative endocrinological recovery were in 77.9% of 9 cases with preoperative prolactinoma, 1 case in 2 cases with acromegaly and one case with Cushing disease. Postoperative complications were diabetes inspidus[DI] in 1 case [3.4%]. cerebrospinal fluid[CSF] leakage in 2 cases [6.8%] and death in 1 case [3.4%] due to sepsis, Conclusion : We report good results through surgery of pituitary apoplexy in a clinical and endocrine outcomes. The surgery should be performed as soon as possible to be a suitable method for treating pituitary apoplexy.

Factors Influencing Postoperative Urinary Retention Following Elective Posterior Lumbar Spine Surgery: A Prospective Study

  • Aiyer, Siddharth Narasimhan;Kumar, Ajit;Shetty, Ajoy Prasad;Kanna, Rishi Mugesh;Rajasekaran, Shanmuganath
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1100-1105
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    • 2018
  • Study Design: Prospective observational study. Purpose: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. Overview of Literature: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. Methods: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. Results: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/decompression, and higher postoperative pain scores (p<0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. Conclusions: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.

Anti-diabetic effects of blue honeyberry on high-fed-diet-induced type II diabetic mouse

  • Sharma, Anshul;Kim, Joo Wan;Ku, Sae-Kwang;Choi, Jae-Suk;Lee, Hae-Jeung
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.367-376
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    • 2019
  • BACKGROUND/OBJECTIVE: The blue honeysuckle berry (Lonicera caerulea var. edulis L.) is a small deciduous shrub belonging to the Caprifoliaceae family that is native to Russia, China, Japan, and Korea. The berry of this shrub is edible, sweet and juicy and is commonly known as the blue honeyberry (BHB). This study examined the anti-diabetic potential of BHB on high-fat-diet-induced mild diabetic mice. The hypoglycemic, and nephroprotective effects of the 12-week oral administration of blue honeyberry extract were analyzed. MATERIALS/METHODS: The hypoglycemic effects were based on the observed changes in insulin, blood glucose, and glycated hemoglobin (HbA1c). Furthermore, the changes in the weight of the pancreas, including its histopathology and immunohistochemical investigation were also performed. Moreover, the nephroprotective effects were analyzed by observing the changes in kidney weight, its histopathology, blood urea nitrogen (BUN), and serum creatinine levels. RESULTS: The results showed that the high-fat diet (HFD)-induced control mice showed a noticeable increase in blood glucose, insulin, HbA1c, BUN, and creatinine levels. Furthermore, growth was observed in lipid droplet deposition related to the degenerative lesions in the vacuolated renal tubules with the evident enlargement and hyperplasia of the pancreatic islets. In addition, in the endocrine pancreas, there was an increase in the insulin-and glucagon-producing cells, as well as in the insulin/glucagon cell ratios. On the other hand, compared to the HFD-treated mice group, all these diabetic and related complications were ameliorated significantly in a dose-dependent manner after 84 days of the continuous oral administration of BHBe at 400, 200 and 100 mg/kg, and a dramatic resettlement in the hepatic glucose-regulating enzyme activities was observed. CONCLUSIONS: By assessing the key parameters for T2DM, the present study showed that the BHBe could act as a potential herbal agent to cure diabetes (type II) and associated ailments in HFD-induced mice.

Medication Adherence for Hypertensive Patients in Korea (우리나라 고혈압 환자의 투약 순응도 연구)

  • Hong, Jae-Seok
    • Health Policy and Management
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    • v.31 no.3
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    • pp.292-300
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    • 2021
  • Background: Medication adherence in hypertension is the most important to control blood pressure and prevent major complications. The purpose of this study was to identify factors affecting medication adherence and to examine the relationship between medication adherence and blood pressure control in Korea. Methods: This study used data from the 7th Korea national health and nutrition examination survey (2016-2018) of the Korea Disease Control and Prevention Agency. We selected 4,063 hypertensive patients from the data. And we choose socio-demographic, health behavior, healthcare utilization, and severity characteristics as hypertensive patient characteristics. Results: Of the patients with hypertension, 92.3% had shown adherence to medication as of 2016-2018 and shows variation according to the characteristic of patients. The cases with male, under 50 years old, urban area, single household, unmet medical services, less than 5 years of hypertension duration, no comorbidities (diabetes mellitus, myocardial infarction) showed significantly low medication adherence. After adjusting for confounders, adherent patients tended to have lower current systolic blood pressure (β=-10.846, p<0.001) and diastolic blood pressure (β=-5.018, p<0.001) than nonadherent patients. And, adherent patients increased the control odds of blood pressure compared with nonadherent patients (odds ratio, 3.02; 95% confidence interval, 2.21-4.12). Conclusion: This study confirmed that adherence to antihypertensive drugs was effective in controlling blood pressure. In order to more actively manage hypertensive patients at the national level, it is necessary to make an effort to improve the medication compliance of nonadherent groups, such as early-diagnosis patients, young patients under 50 years of age, and patients living alone.

Anterolateral thigh free flaps and radial forearm free flaps in head and neck reconstruction: A 20-year analysis from a single institution

  • Yang, Simon;Hong, Jong Won;Yoon, In Sik;Lew, Dae Hyun;Roh, Tai Suk;Lee, Won Jai
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.49-54
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    • 2021
  • Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer. Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients' age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated. Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups. Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

Development of Insole for AI-Based Diagnosis of Diabetic Foot Ulcers in IoT Environment (IoT 환경에서 AI 기반의 당뇨발 진단을 위한 깔창 개발)

  • Choi, Won Hoo;Chung, Tai Myoung;Park, Ji Ung;Lee, Seo Hu
    • KIPS Transactions on Computer and Communication Systems
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    • v.11 no.3
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    • pp.83-90
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    • 2022
  • Diabetes is a common disease today, and there are also many cases of developing into serious complications called Diabetic Foot Ulcers(DFU). Diagnosis and prevention of DFU in advance is an important task, and this paper proposes the method. Based on existing studies introduced in the paper, it can be seen that foot pressure and temperature information are deeply correlated with DFU. Introduce the process and architecture of SmarTinsole, an IoT device that measures these indicators. Also, the paper describes the preprocessing process for AI-based diagnosis of DFU. Through the comparison of the measured pressure graph and the actual human step distribution, it presents the results that multiple information collected in real-time from SmarTinsole are more efficient and reliable than the previous study.

Clinical Outcome of Patients Over 90 Years of Age Treated for Chronic Subdural Hematoma

  • Dobran, Mauro;Marini, Alessandra;Nasi, Davide;Liverotti, Valentina;Benigni, Roberta;Costanza, Martina Della;Mancini, Fabrizio;Scerrati, Massimo
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.123-129
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    • 2022
  • Objective : Chronic subdural hematoma (CSDH) is one of the most common pathology in daily neurosurgical practice and incidence increases with age. The aim of this study was to evaluate the prognostic factors and surgical outcome of CSDH in patients aging over 90 years compared with a control group of patients aging under 90 years. Methods : This study reviewed 25 patients with CSDH aged over 90 years of age treated in our department. This group was compared with a younger group of 25 patients aged below their eighties. At admission past medical history was recorded concerning comorbidities (hypertension, dementia, ictus cerebri, diabetes, and heart failure or attack). History of alcohol abuse, anticoagulant and antiplatelet therapy, head trauma and seizures were analyzed. Standard neurological examination and Markwalder score at admission, 48 hours after surgery and 1-6 months follow-up, radiologic data including location and CSDH maximum thickness were also evaluated. Results : Their mean age was 92.8 years and the median was 92.4 years (range, 90-100 years). In older group, the Markwalder evaluation at one month documented the complete recovery of 24 patients out of 25 without statistical difference with the younger group. This data was confirmed at 6-month follow-up. One patient died from cardiovascular failure 20 days after surgery. The presence of comorbidities, risk factors (antiplatelet therapy, anticoagulant therapy, history of alcohol abuse, and head trauma), preoperative symptoms, mono or bilateral CSDH, maximum thickness of hematoma, surgical time and recurrence were similar and statistically not significant in both groups. Conclusion : In this study, we demonstrate that surgery for very old patients above 90 years of age affected by CSDH is safe and allows complete recovery. Comparing two groups of patients above and under 90 years old we found that complication rate and recovery were similar in both groups.