• Title/Summary/Keyword: Complication

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The Effects of Bojungikgi-tang on Streptozotocin-induced Diabetic Gastroparesis Rat Model (보중익기탕(補中益氣湯)이 streptozotocin 유발 당뇨병성 위부전마비 백서에 미치는 영향)

  • Kang, Yun-Mi;Kim, Hyo-Jung;Park, Yun-Beom;Jeong, Chan-Mun;Ham, Seong-Ho;Yang, Woong-Mo;An, Hyo-Jin
    • The Korea Journal of Herbology
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    • v.34 no.6
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    • pp.45-55
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    • 2019
  • Objective : Diabetic gastroparesis is a complication that is defined as delayed gastric emptying and upper gastrointestinal symptoms and often occurs in long-standing diabetic patients. Bojungikgi-tang (BJT) is a traditional oriental herbal formula that has long been used for the treatment of digestive disorders. The purpose of this study was to investigate the effects of BJT on streptozotocin (STZ)-induced diabetic gastroparesis rat model. Methods : Sprague-Dawley (SD) male rats (250-270g) were divided into 13 groups including normal group, STZ-induced diabetic control group, BJT diet (7 various concentrations), and insulin-, glibenclamide-, metformin-treated group were used for the experiments for the comparison. Diabetic gastroparesis was induced by intraperitoneal injection of STZ. The water intake, food intake, body weights and fasting blood glucose levels were measured. After 4 weeks the animals were sacrificed and gastrin, leptin, insulin, hemoglobin A1C (HbA1c), lactate, lactate dehydrogenase (LDH), bilirubin, creatinine, albumin and lipid levels were evaluated. Results : Intraperitoneal injection of BJT for 4 weeks resulted in increased levels of gastrin in blood and decreased leptin and lactate concentration in STZ-induced diabetic gastroparesis rat model. BJT did not affect insulin, fasting glucose, HbA1c, and lipid levels in STZ-induced diabetic gastroparesis rat model. Conclusion : These results indicated that BJT would have protect effect on diabetic gastroparesis through the improvement effect of gastric motility and fatigue syndrome in STZ-induced diabetic rats. This study shows that BJT might be effective for treatment of diabetes and its complications such as gastroparesis.

The Gastroprotective and Antioxidative Effects of Lonicera japonica water extract on HCl/ethanol-induced Gastric Mucosa Damage in Rats (인동(忍冬) 열수 추출물의 항산화 효과 및 HCl-Ethanol로 유도된 위염 동물 모델에서의 위 점막 손상 보호 효과)

  • Sim, Mi-Ok;Lee, Hyun Joo;Jang, Ji Hun;Jung, Ho-Kyung;Yang, Beodul;Woo, Kyeong Wan;Hwang, Taeyeon;Kim, Sunyoung;Nho, Jonghyun;Cho, Hyun-Woo
    • The Korea Journal of Herbology
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    • v.34 no.6
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    • pp.57-62
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    • 2019
  • Objective : Gastritis is a major complication of gastrointestinal disease. Lonicera japonica is used in folk medicine to treat different diseases such as exopathogenic wind-heat, epidemic febrile diseases, sores, carbuncles and some infectious diseases. Therefore, this study examined the effects of Lonicera japonica water extract (LJE) on HCl/ethano-linduced acute gastric ulceration and anti-oxidants properties. Methods : LC-ESI-IT-TOF MS was employed for rapid identification of major compound from LJE. The antioxidant activities were evaluated through total polyphenol and flavonoid contents and radical scavenging assays and superoxide dismutase (SOD)-like activity. SD rats were randomly divided into five different groups including the normal group, ulcer group, positive group (20 kg/mg of omeprazole, ip), and experimental groups (100 kg/mg and 500 kg/mg of LJE, ip). Results : 4,5-Dicaffeoyl quinic acid, loganic acid, secologanic acid, sweroside, loganin, vogeloside were identified based on the detection of the molecular ion with those of literature data. The LJE was possessed free radical scavenging activities such as DPPH (IC50=189.7 ㎍/㎖), ABTS (IC50=164.5 ㎍/㎖), and SOD-like activity (IC50=405.02 ㎍/㎖). Macroscopic and histological analyses showed LJE treated group were significantly reduced to an extent that it allowed leukocytes penetration of the gastric walls compared with the ulcer group. In addition, an ulcer inhibition rate and prostaglandin E2 levels were increased in rats treated with LJE. Conclusion : The present study has demonstrated the antioxidantive and gastroprotective effect of LJE, these findings suggested that LJE has the potential for use in treatment of gastric disorders.

Cardiac Complications Associated with Eating Disorders in Children: A Multicenter Retrospective Study

  • Choi, So Yoon;Lee, Kyung Jae;Kim, Soon Chul;Lee, Eun Hye;Lee, Yoo Min;Kim, Yu-Bin;Yi, Dae Yong;Kim, Ju Young;Kang, Ben;Jang, Hyo-Jeong;Hong, Suk Jin;Choi, You Jin;Kim, Hyun Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.5
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    • pp.432-440
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    • 2022
  • Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m2. Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m2 vs. 16.06± 4.55 kg/m2, p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

A Nationwide Analysis Evaluating the Safety of Using Acellular Dermal Matrix with Tissue Expander-Based Breast Reconstruction

  • Jessica Luo;Whitney D. Moss;Giovanna R. Pires;Irfan A. Rhemtulla;Megan Rosales;Gregory J. Stoddard;Jayant P. Agarwal;Alvin C. Kwok
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.716-723
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    • 2022
  • Background In March 2021, the United States Food and Drug Administration (FDA) safety communication cautioned against the use of acellular dermal matrix (ADM) products in breast reconstruction and reiterated that the FDA does not approve ADM use in breast surgery. This study aims to assess the safety of ADM use in breast reconstruction. Methods Women who underwent ADM and non-ADM assisted tissue expander (TE)-based breast reconstruction were identified using the National Surgical Quality Improvement Program database (2012-2019). Trends of ADM use over time, and 30-day outcomes of surgical site infection (SSI), dehiscence, and unplanned reoperation were assessed. Results Of the 49,049 TE-based breast reconstructive cases, 42.4% were ADM assisted and 57.6% non-ADM assisted. From 2012 to 2019, the use of ADM increased from 26.1 to 55.6% (relative risk [RR] =1.10; p < 0.01). Higher rates of SSI (3.9 vs. 3.4%; p = 0.003) and reoperation (7.4 vs. 6.0%; p < 0.001) were seen in the ADM cohort. There was no significant difference seen in dehiscence rates (0.7 vs. 0.7%; p = 0.73). The most common reoperation within 30 days for the ADM group (17.6%) was removal of TE without insertion of implant (current procedural terminology: 11,971). ADM-assisted breast reconstruction was associated with increased relative risk of SSI by 10% (RR = 1.10, confidence interval [CI]: 1.01-1.21; p = 0.03) and reoperation by 15% (RR = 1.15, CI: 1.08-1.23; p < 0.001). Conclusions ADM-assisted breast reconstruction more than doubled from 2012 to 2019. There are statistically higher complication rates of SSI (0.5%) and reoperation (1.4%) with ADM use in TE-based breast reconstruction, suggesting that reconstruction without ADM is safe when comparing immediate postoperative outcomes.

Acute Appendicitis: A Rare But Probable Manifestation of Kawasaki Disease

  • Wonshik Choi;Sin Weon Yun;Mineui Hong;Suk-Won Suh;Dae Yong Yi;Ji Young Park
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.97-103
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    • 2023
  • Kawasaki disease (KD) is an acute, systemic inflammatory disorder that often targets coronary arteries. Being the common cause of acquired heart disease in children, timely diagnosis and intravenous immunoglobulin treatment are crucial. However, it is challenging for physicians to diagnose KD if it presents with atypical manifestations. We report the case of a 5-year-old boy who initially presented with appendicitis; after an appendectomy, he had a prolonged fever. He was finally diagnosed with atypical KD and successfully recovered after intravenous immunoglobulin treatment. Through a literature review, we found 21 cases of appendicitis associated with KD. In most cases, the patients were male with a mean age of 5.3 years. Most had higher proportions of incomplete KD and coronary artery complications than expected for typical KD. In conclusion, appendicitis could be a rare complication of KD; therefore, multidisciplinary cooperation and early recognition of atypical KD are essential for timely diagnosis.

Effectiveness of Short-Course Antibiotic Treatment in Uncomplicated, Non-Bacteremic Pediatric Urinary Tract Infections: A Rapid Systematic Review

  • Han Ho Kim;Young June Choe
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.55-61
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    • 2023
  • Purpose: Urinary tract infections (UTIs) pose a significant disease burden in children. This study aims to determine whether a short-course regimen is non-inferior to a standard-course regimen in children with UTIs without complication and presence of bacteremia, and to define, in the optimal way possible, the term "short-course" in this context. Methods: We conducted a rapid systematic review of research up to April 2021 in PubMed, Embase, and Cochrane databases. We included studies that compared clinical outcomes in pediatric UTIs treated with short-course(≤4 days) or standard (≥5-7 days) courses. Results: Our analysis suggests that short-course regimes have equivalent efficacy to standard-course regimens, with similar clinical cure rates and recurrence rates. All 10 studies comparing the clinical cure rates of short- and standard-course regimens reported comparable outcomes. The study evaluating renal scarring indicated no inferiority of short-course regimens compared to standard-course ones. Regarding UTI relapse, 8 out of 10 studies reported no significant difference in outcomes between short- and standard-course regimens. Conclusions: Our results purpose that short-course UTI regimens of 6 days or less are just as effective as standard-term regimens of 7 days or more in terms of infection cure and prevention of recurrence. Considering the equivalent rates of clinical cure and relapse between short- and standard-course regimens, it could be inferred that short-course regimens might be a more optimal strategy for managing pediatric UTIs without increasing the risk of complications.

Intrawound Vancomycin Powder Application for Preventing Surgical Site Infection Following Cranioplasty

  • Seong Bin Youn;Gyojun Hwang;Hyun-Gon Kim;Jae Seong Kang;Hyung Cheol Kim;Sung Han Oh;Mi-Kyung Kim;Bong Sub Chung;Jong Kook Rhim;Seung Hun Sheen
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.536-542
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    • 2023
  • Objective : Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics. Methods : This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1 g) was applied on the dura mater and bone flap in 105 patients (18.1%; vancomycin powder group). Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within 1-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated. Results : Surgical site infection occurred in 31 patients (5.3%) and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4-333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105, 0.0%) was significantly lower than that in the conventional group (31/475, 6.5%; crude odds ratio [OR], 0.067; 95% confidence interval [CI], 0.006-0.762; adjusted OR, 0.068; 95% CI, 0.006-0.731; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. Conclusion : Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

Mortality rate undergoing anesthesia in Thoroughbred racehorses at Busan Race Park (부산경남경마공원 Thoroughbred 경주마의 마취중 치사율)

  • Yang, Jaehyuk;Park, Yong-Soo
    • Journal of Practical Agriculture & Fisheries Research
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    • v.17 no.1
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    • pp.125-132
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    • 2015
  • The report about equine anesthesias in Korea are very rare. This paper aimed at the mortality rate during anesthesia in Thoroughbred horses at Equine Hospital of Busan Race Park, KRA in South Korea from 2005 to 2010. Drugs used in anesthesia was IV injection of detomidine hydrochloride (0.01 mg/kg) or xylazine(0.5mg/kg) for sedation and premedication, Guaifenesin(50-100 mg/kg) for muscle relaxation, ketamine hydrochloride(2 mg/kg) for induction of anaesthesia and Inhalational isoflurane(1.3-1.5 %) to maintain anesthesia. Total number of anesthetic cases was 190, 150 of inhalational anesthesia and 40 of general anesthesia, repectively. The purpose of anesthesia was highest in the disorder of musculoskeletal system, followed by urogenital system and respiratory system Mortality case due to anesthesia was one during arthroscopic surgery for removal of osteochondral chip fragments. The time of anesthesia was 150 min, fatal sign was hypoxemia and the reason was improper machine operation of the anesthetist. In conclusion, the perianesthetic mortality rate during anesthesia in Thoroughbred horses at Busan Race Park was 0.52%(1 death per 190 anesthetics).

Ginsenoside Rg1 treatment protects against cognitive dysfunction via inhibiting PLC-CN-NFAT1 signaling in T2DM mice

  • Xianan Dong ;Liangliang Kong ;Lei Huang ;Yong Su ;Xuewang Li;Liu Yang;Pengmin Ji ;Weiping Li ;Weizu Li
    • Journal of Ginseng Research
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    • v.47 no.3
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    • pp.458-468
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    • 2023
  • Background: As a complication of Type II Diabetes Mellitus (T2DM), the etiology, pathogenesis, and treatment of cognitive dysfunction are still undefined. Recent studies demonstrated that Ginsenoside Rg1 (Rg1) has promising neuroprotective properties, but the effect and mechanism in diabetes-associated cognitive dysfunction (DACD) deserve further investigation. Methods: After establishing the T2DM model with a high-fat diet and STZ intraperitoneal injection, Rg1 was given for 8 weeks. The behavior alterations and neuronal lesions were judged using the open field test (OFT) and Morris water maze (MWM), as well as HE and Nissl staining. The protein or mRNA changes of NOX2, p-PLC, TRPC6, CN, NFAT1, APP, BACE1, NCSTN, and Ab1-42 were investigated by immunoblot, immunofluorescence or qPCR. Commercial kits were used to evaluate the levels of IP3, DAG, and calcium ion (Ca2+) in brain tissues. Results: Rg1 therapy improved memory impairment and neuronal injury, decreased ROS, IP3, and DAG levels to revert Ca2+ overload, downregulated the expressions of p-PLC, TRPC6, CN, and NFAT1 nuclear translocation, and alleviated Aβ deposition in T2DM mice. In addition, Rg1 therapy elevated the expression of PSD95 and SYN in T2DM mice, which in turn improved synaptic dysfunction. Conclusions: Rg1 therapy may improve neuronal injury and DACD via mediating PLC-CN-NFAT1 signal pathway to reduce Aβ generation in T2DM mice.

Case Report: Lower Extremity Paresthesia and Pain with Diabetic Polyneuropathy Combated with Complex Korean Medical Treatment (하지 감각이상 및 통증을 호소하는 당뇨병성 다발신경병증 환자에 대한 복합 한의치험 1례)

  • Seong-Hoon Jeong;Young-Seon Lee;Si-Yun Sung;Han-Gyul Lee;Ki-Ho Cho;Sang-Kwan Moon;Woo-Sang Jung;Seungwon Kwon
    • The Journal of Internal Korean Medicine
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    • v.44 no.2
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    • pp.231-243
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    • 2023
  • Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.