• Title/Summary/Keyword: risk factor to diabetes

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Non-alcoholic Fatty Liver Disease (NAFLD) and Significant Hepatic Fibrosis Defined by Non-invasive Assessment in Patients with Type 2 Diabetes

  • Sobhonslidsuk, Abhasnee;Pulsombat, Akharawit;Kaewdoung, Piyaporn;Petraksa, Supanna
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1789-1794
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    • 2015
  • Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ${\geq}7$ kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.

Current Treatment and Clinical Outcomes of Community Acquired Pneumonia According to Pneumonia Severity Index (Pneumonia Severity Index에 따른 원외획득폐렴 환자의 치료 현황 및 성과)

  • Park, Hyun-Hee;Ji, Eun-Hee;Lee, Young-Sok
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.170-181
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    • 2011
  • Purpose: There is considerable variability in rates of hospitalization for patients with community-acquired pneumonia (CAP) in part because of physicians' uncertainty in assessing the severity of illness at presentation. The purpose of the study was to examine the current treatment patterns and factors influencing the Pneumonia Severity Index (PSI) and clinical outcomes in the patient with CAP. Method: The retrospective data collection of the patients with CAP was conducted and the data were reviewed. The collected data included demographic, clinical, laboratory and microbiological medical information. All patients were stratified into three risk groups according to PSI: low risk (PSI score I-II), moderate risk (III) and high risk (IV-V) groups. The examined treatment patterns were the appropriateness of admissions, category of antibiotics used. The prognostic factors associated with PSI and clinical outcomes were examined. Results: One hundred and six patients' medical data were reviewed. The overall appropriateness of admissions was low presenting many of patients were admitted or intensely treated in the hospital despite of lower risk of prognosis and treated with intravenous antibiotics instead of oral fluoroquinolones. Primary pneumonia pathogens were Klebsiella pneumoniae (27%) and Streptococcus pneumoniae (21.6%). Mean LOS was 8.5 days and was significantly longer (10.0days) (p<0.001) in high risk group. The patients with age >65 (p<0.001), diabetes mellitus (p<0.001), mental alteration (p<0.001), and/or $PaO_2$ <60 mmHg (p<0.001) had a tendency to have higher PSI. The prognostic factors associated with longer LOS were age >65 years (p=0.008), mental status alteration (p<0.001), dyspnea (p=0.002) and PSI score (p=0.001). The prognostic factors associated with mortality were congestive heart failure (p=0.038), systolic blood pressure <90 mmHg (p=0.002) and arterial pH <7.35 (p=0.013). Conclusion: Most of patients were found to over-utilize medical service according to appropriateness of admissions. The elderly, mentally altered patients with low $PaO_2$ had higher PSI score with increased risk of LOS. The mortality could be increased in the patient with disease state of congestive heart failure, high blood pressure, and/or acidosis.

Association of Coronary Artery Calcium Scores with Cadiovascular Disease Risk Factors in an Asymptomatic Adults (무증상 성인에서 심혈관질환 위험요소와 관상동맥 석회 수치와의 관계)

  • Moon, Il-Bong;Sohn, Seok-Joon
    • The Journal of the Korea Contents Association
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    • v.10 no.7
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    • pp.268-275
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    • 2010
  • Coronary artery calcium scores(CACS) has been used as surrogate marker for coronary atherosclerosis. We evaluated 1042 patients who visited the Department of Health Promotion Center in Chonnam National University Hospital and had a test of the CACS from January 2006, to December 2008. This study was performed to evaluate the relation of the CACS with Cadiovascular disease(CVD) risk factors and FRS. CACS and FRS was a significant difference between the group whose calcium score was 0 and the group whose calcium scores were 1 in case of men 2.38(95% CI, 1.83-3.11), women 2.12(95% CI, 1.03-4.35). The age-and sex-adjusted odds ratios for predictor of CVD risk factors to women with age was 1.10(95% CI, 1.06-1.15), HDL-cholesterol was 2.38(95% CI, 1.04-5.44), Fasting plasma glucose was 2.89(95% CI, 1.16-7.21), to men with age was 1.11(95% CI, 1.08-1.14), LDL-cholesterol was 2.12(95% CI, 1.28-3.50), gamma-GTP was 1.73(95% CI, 1.17-2.55), Diabetes mellitus medication was 3.92(95% CI, 1.73-8.89). The CACS seems to be a siginificant factor to evaluate the CVD risk factors.

A Comparative Study on the Theory of Lee jaema and Chang ts' ungcheng (이제마(李濟馬)와 장종정(張從正)의 학술사상(學術思想)에 대한 비교(比較) 연구(硏究))

  • Ch’ oi, yeikwen;Kim, kyungyo
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.2
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    • pp.41-68
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    • 1996
  • This thesis is a try for examining the historical characteristics of Constiutional medicine. For this purpose, I have examined their theory, and made a comparison carefully. Through this study, I have obtained several results as following. Both Chang and Lee lived in the time of change, which was unstable and uncertain. Under the condition, they both rejected following the existing trends of learned circles, and developed new thoughts and clinical techniques. They rejected superstitious beliefs and fatalism, and conducted the pursuit of experimental knowledge and rationale idea. Clinical experience was the very base of their study. They both criticized the bad habits of abuse of tonifing medication and health seeking. Especially Lee regarded control of emotion and regulation of a way of life as the best way for preservation of one's health. Chang regarded pathogenic factors as the ultimate factor of diseases, and strived for eliminating pathogenic factors, but L brought to a conclusion that the final factor of diseases was what is called "heart" itself, and emotional changes were the most essential causes of disease. It can be said that the pathogenesis insisted by Chang can be called The insistence that pathologic factors are the very etiology of all the disease (邪氣致病論), or all the diseases result from pathologic factors. And his whole remedy can be summarized as following, A study on the method of eliminating pathogenic factors. But the purpose of Constitutional medicine is to correct imbalance intrinsic to one's internal organs. In this aspect, Constitutional medicine is a "regulatory medicine". Depending on the classification of six vital substances, Chang classified all disease into six categories. These were based on symptoms and sings represented. While classification of diseases made by Lee was likely to rely upon constitutional characteristics. Chang thought that the three remedies made up of perspiration, purgation, vomiting were the most efficient way of eliminating pathogenic factors. Lee, however, thought those weren't methods of eliminating pathogenic factors but the best ways restoring one's self-regulation power. Chang thought that all the febrile disease essentially has a tendency in properties to belong to "heat", but Lee pointed out that pathologic processes are variable in accordance with constitutional features. They both regarded pathogenesis of diabetes as fire. That is to say, fire is the most essential factor of diabetes. And there are many risk factors such as inappropriate foods, drugs, climate, etc., but Lee thought what is most important is heart. Putting all accounts together, medical characteristics of Chang are similar to those of T aiyinjen and Shaoyangjen, and have no relation to those of those of Shaoyinjen. Therefore we can conclude that Chang understood pathologic processes of disease of T aiyinjen and Shaoyangjen, whether he knew about constitutional features or not.

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The Study on Risk Factor of Metabolic Diseases in Pancreatic Steatosis (췌장지방증에서 대사성질환의 위험 요인에 관한 연구)

  • Cho, Jin-Young;Ye, Soo-Young;Kim, Dong-Hyun
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.81-88
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    • 2016
  • The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDL-cholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease.

The Relationship between Pattern Identification and Stroke Risk Factors of Acute Ischemic stroke Patients (급성기 허혈성 뇌경색 환자들의 변증 분형과 위험 요인들간의 관련성 연구)

  • Lee, Ji-Hyun;Doo, Kyeong-Hee;Lu, Hsu-Yuan;Shim, So-Ra;Park, Joo-Young;Cho, Seung-Yeon;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Park, Seong-uk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.43-51
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    • 2012
  • Object : The purpose of this study was to evaluate the relationship between pattern identification (PI) and stroke risk factors, such as hypertension, diabetes mellitus, dyslipidemia, stroke history, obesity, abdominal obesity and metabolic syndrome. Methods : 46 patients with acute ischemic stroke were recruited from May 2012 to November, 2012. We analyzed the data of 32 patients, and pattern identification was identified by resident and specialist of Korean medicine. We analized patient's PI and risk factor by Fisher's exact test. Results : We found that Dampness-phlegm group was more related with patient's metabolic syndrome than non Dampness-Phlegm group. And Yin deficiency group had less relationship with patient's metabolic syndrome, obesity, abdominal obesity and dyslipidemia than non Yin deficiency group. Conclusions : According to the analysis, these results provide evidence for relationship between the Dampness-phlegm group, Yin deficiency and metabolic syndrome.

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Placental histopathology in late preterm infants: clinical implications

  • Ericksen, Kristina;Fogel, Joshua;Verma, Rita P.
    • Clinical and Experimental Pediatrics
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    • v.63 no.2
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    • pp.48-51
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    • 2020
  • Background: The etiopathogenesis of late preterm (LPT) birth is undetermined. Placental histopathology, which reflects an adverse intrauterine environment and is reportedly associated with preterm labor and neonatal morbidities, has not been studied in LPT infants. Purpose: We investigated placental pathological lesion as markers of an adverse intrauterine environment during LPT labor. Methods: This retrospective case-control study compared placental histopathological and clinical variables between LPT and term neonates. Placental variables included chorioamnionitis, funisitis, hemorrhage, abruption, infarction, calcification, and syncytial knots. Maternal variables included age, substance abuse, pregnancyassociated diabetes mellitus and hypertension, duration of rupture of membrane, antibiotic use, and magnesium sulfate, whereas, those of neonates included gestational age, birth weight, race, sex, and Apgar scores. Standard statistical proedures were applied to analyze the data. Results: Chorioamnionitis (50% vs. 17.8%, P<0.001) and funisitis (20% vs. 4.4%, P=0.002) were more common in term infants. Placental infarction rate was insignificantly higher in LPT infants (25.6% vs. 14.3%, P=0.08). The mothers in the LPT group were older (30.4 years vs. 28.1 years, P=0.05; odds ratio [OR], 1.06; 95% confidence interval [CI], 0.998-1.12, P=0.056) and more often suffered from hypertension (28.9 vs. 12.9 %, P=0.02), and received magnesium sulfate (48.9 vs. 20%, P< 0.001; OR, 2.86; 95% CI, 1.12-7.29, P<0.05). Duration of rupture of membrane was higher in term infants (13.6 hours vs. 9.1 hours, P<0.001). Chorioamnionitis (OR, 0.33; 95% CI, 0.13-0.79; P<0.05) was associated with a lower risk of LPT delivery. Conclusion: Placental infection is not a risk factor for LPT births. There is a nonsignificant predominance of vascular anomalies in LPT placentas. Higher maternal age, magnesium sulfate therapy, and maternal hypertension are clinical risk factors for LPT labor.

Association Analysis between Genes' Variants for Regulating Mitochondrial Dynamics and Fasting Blood Glucose Level

  • Jung, Dongju;Jin, Hyun-Seok
    • Biomedical Science Letters
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    • v.22 no.3
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    • pp.107-114
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    • 2016
  • Maintenance of fasting blood glucose levels is important for glucose homeostasis. Disruption of feedback mechanisms are a major reason for elevations of glucose level in blood, which is a risk factor for type 2 diabetes mellitus that is mainly caused by malfunction of pancreatic beta-cell and insulin. The fasting blood glucose level has been known to be influenced by genetic and environmental factors. Mitochondria have many functions for cell survival and death: glucose metabolism, fatty acid oxidation, ATP generation, reactive oxygen species (ROS) metabolism, calcium handling, and apoptosis regulation. In addition to these functions, mitochondria change their morphology dynamically in response to multiple signals resulting in fusion and fission. In this study, we aimed to examine association between fasting blood glucose levels and variants of the genes that are reported to have functions in mitochondrial dynamics, fusion and fission, using a cohort study. A total 416 SNPs from 36 mitochondrial dynamics genes were selected to analyze the quantitative association with fasting glucose level. Among the 416 SNPs, 4 SNPs of PRKACB, 13 SNPs of PPP3CA, 6 SNPs of PARK2, and 3 SNPs of GDAP1 were significantly associated. In this study, we were able to confirm an association of mitochondrial dynamics genes with glucose levels. To our knowledge our study is the first to identify specific SNPs related to fasting blood glucose level.

Glucosamine increases vascular contraction through activation of RhoA/Rho kinase pathway in isolated rat aorta

  • Kim, Do-Hyung;Seok, Young-Mi;Kim, In-Kyeom;Lee, In-Kyu;Jeong, Seong-Yun;Jeoung, Nam-Ho
    • BMB Reports
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    • v.44 no.6
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    • pp.415-420
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    • 2011
  • Diabetes is a well-known independent risk factor for vascular disease. However, its underlying mechanism remains unclear. It has been reported that increased influx of the hexosamine biosynthesis pathway (HBP) induces O-GlcNAcylation of proteins, leading to insulin resistance. In this study, we determined whether or not O-GlcNAc modification of proteins could increase vessel contraction. Using an endothelium-denuded aortic ring, we observed that glucosamine induced OGlcNAcylation of proteins and augmented vessel contraction stimulated by U46619, a thromboxane $A_2$ agonist, via augmentation of the phosphorylation of MLC20$MLC_{20}$, MYPT1(Thr855), and CPI17, but not phenylephrine. Pretreatment with OGT inhibitor significantly ameliorated glucosamine-induced vessel constriction. Glucosamine treatment also increased RhoA activity, which was also attenuated by OGT inhibitor. In conclusion, glucosamine, a product of glucose influx via the HBP in a diabetic state, increases vascular contraction, at least in part, through activation of the RhoA/Rho kinase pathway, which may be due to O-GlcNAcylation.

Enhancement for competencies of health education specialists to prevent chronic diseases in public health organizations (공공부문 보건의료조직의 만성질환 예방사업에서 요구하는 필요능력과 보건교육사의 직무 강화 방안)

  • Kim, Young-Bok
    • Korean Journal of Health Education and Promotion
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    • v.31 no.5
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    • pp.135-146
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    • 2014
  • Objectives: This study performed to enhance the competency of health education specialist on population-based program to prevent chronic disease in public health organizations. In addition, it will provide the basic data to enhance specialized competency for health education specialist. Method: The current operating strategy and demanded competency related to chronic disease programs were analyzed by reviewing the Korean Health Plan 2020, the guideline of integrated health promotion programs, and the job description of health education specialist. Results: Preventive programs for chronic disease provide with healthy lifestyle programs in integrated health promotion service. First, health education specialist should learn to professional knowledge on health risk factor and chronic disease. Second, they should cultivate the integrated competency to manage operations on obesity, hypertension, diabetes, cardiovascular disease, and cancer prevention programs. Third, they get strengthened the-job training to implement health education, public relations, campaigns, media advocacy, and utilization of multi-media. Conclusion: It should implement the preventive programs for chronic disease in various health promotion services through coordination with multiple sectors. To identify of the job in preventive program for that, it would be required empowerment of health education specialists on disease prevention science and practical life skill.