• Title/Summary/Keyword: Complication of Diabetes Mellitus

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Thromboembolectomy in Acute Arterial Occlusion (급성 동맥폐색증에서 혈전색전 제거술 -48례 경험-)

  • 김진희
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.792-797
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    • 2000
  • Background : Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. Meterial and methods: This study recruited 48 patients(42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. Result: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7%(8/48) and the amputation rate was 25% Conclusion : This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.

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Stroke after the Procedure of Lumbar Facet Joint block and Lumbar Epidural Block -Case reports- (요부 추간관절차단 및 요부 경막외차단 후 발생한 뇌졸증 -증례 보고-)

  • Lee, Hyo-Keun;Kim, Sung-Mo;Han, Kyung-Ream;Lee, Jong-Moo;Ko, Seok-Shin;Kim, Chan
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.131-133
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    • 1997
  • Number of elderly patients requiring nerve blocks have been increasing in recent years. We had two elderly patients who suffered stroke one day and three days after lumbar facet joint block and lumbar single epidural block respectively. Both patients due to their advanced age had potential risk factor to suffer one or more of the following; stroke, hypertension, and diabetes mellitus. Due to our experience with these patients, we suggested the following: (1) Nerve blocks should be reconsidered for elderly patient who posesses a potential risk factor to suffer a stroke. (2) Prior to invasive block administration of mild sedatives or analgesics may provide beneficial effects for patients with hypertension. (3) Adequately informed consent must be fully discussed time of consultation with patient scheduled for nerve block especially for elderly and risky patient.

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Short-term Glycemic Control and the Related Factors in Association with Compliance in Diabetic Patients (당뇨병 환자의 치료순응도에 따른 단기간 혈당조절정도와 관련 요인)

  • Kim, Gui-Young;Kim, Bo-Wan;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.349-363
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    • 2000
  • Objectives : Generally, it seemed that the therapeutic result in diabetic patients was changed by compliance. This study was conducted on the basis of assumption that the therapeutic result id diabetic patients could control according to compliance. This study was conducted to analyze the related factors in association with compliance to drug, diet and exercise therapy. Methods : 224 diabetic patients in Kyungpook National University Hospital were selected through the interviews and HbA1c values from 1 Jan. to 28 Feb.1997. The drug compliance was tested by regularity of drug administration, the diet compliance was tested by restriction of food, exactly allocation, balance of nutrient, measuring food and the exercise compliance was tested by regularity of exercise per day. We assessed compliance by percentage, $x^2-test$ and generalized logit regression model(method:enter). Results : The significant variable was the satisfaction to medical personnels in drug, the knowledge to disease in diet, the participation of the diabetic education in exercise therapy and the satisfaction to medical personnels in HbA1c. Using the generalized logit model(method : enter) in compliance change, the significant variables were the satisfaction to medical personnels and the complication in drug; the significant variables were the age at the first diagnosis, the family history, the concern of health, the knowledge of disease, the self-exertion for therapy and the complication in diet: the only significant variable was the gender in exercise therapy. Conclusions : The degree of glycemic control in diabetic patients was influenced by compliance. In order to improve patient's compliance, we must foster the knowledge on the diseases, lead participation for diabetic education. Because the satisfaction to medical personnels was the important variables, we must build up good relationship between doctors and patients.

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A Study of Occurrence of Secondary Complications and Chronic Diseases due to Aging of Spinal Cord Injury (척수손상환자의 고령화에 따른 2차합병증 발생과 만성질환발병에 관한 연구)

  • Min, Yeo Jin;Kim, Jong Bae
    • 재활복지
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    • v.22 no.4
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    • pp.83-102
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    • 2018
  • The purpose of this study is to provide basic data for effective management and prevention of chronic diseases and secondary complications as elderly spinal cord injuries(SCI). The subjects were 200 spinal cord injuries admitted to S hospital from April, 2013 to April, 2018. We investigated the occurrence of chronic diseases and secondary complication through medical records. The results showed that SCI were affected chronic diseases and secondary complications over 50years. The prevalence of chronic diseases and secondary complications over 50 years of age had the odds ratio 11.8 times higher in hypertension and 6.7 times diabetes mellitus. Secondary complications had the odds ratio Osteoporosis 7.5 times, Pneumonia 5.2 times, and central pain 0.4 times. We suggest that continuous management and service of chronic diseases and secondary complications of elderly SCI are necessary. It will be necessary to expand the target population and to study various characteristics including.

The change of signaling pathway on the electrical stimulated contraction in streptozotocin-induced bladder dysfunction of rats

  • Han, Jong Soo;Min, Young Sil;Kim, Gil Hyung;Chae, Sang-hyun;Nam, Yoonjin;Lee, Jaehwi;Lee, Seok-Yong;Sohn, Uy Dong
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.5
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    • pp.577-584
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    • 2018
  • Bladder dysfunction is a common complication of diabetes mellitus (DM). However, there have been a few studies evaluating bladder smooth muscle contraction in DM in the presence of pharmacological inhibitors. In the present study, we compared the contractility of bladder smooth muscle from normal rats and DM rats. Furthermore, we utilized pharmacological inhibitors to delineate the mechanisms underlying bladder muscle differences between normal and DM rats. DM was established in 14 days after using a single injection of streptozotocin (65 mg/kg, intraperitoneal) in Sprague-Dawley rats. Bladder smooth muscle contraction was induced electrically using electrical field stimulation consisting of pulse trains at an amplitude of 40 V and pulse duration of 1 ms at frequencies of 2-10 Hz. In this study, the pharmacological inhibitors atropine (muscarinic receptor antagonist), U73122 (phospholipase C inhibitor), DPCPX (adenosine $A_1$ receptor antagonist), udenafil (PDE5 inhibitor), prazosin (${\alpha}_1$-receptor antagonist), verapamil (calcium channel blocker), and chelerythrine (protein kinase C inhibitor) were used to pretreat bladder smooth muscles. It was found that the contractility of bladder smooth muscles from DM rats was lower than that of normal rats. In addition, there were significant differences in percent change of contractility between normal and DM rats following pretreatment with prazosin, udenafil, verapamil, and U73122. In conclusion, we suggest that the decreased bladder muscle contractility in DM rats was a result of perturbations in $PLC/IP_3$-mediated intracellular $Ca^{2+}$ release and PDE5 activity.

Slow Development of Diabetic Cataract in Streptozotocin-induced Diabetic Rats via Inhibition of Aldose Reductase Activity and Sorbitol Accumulation by Use of Aster koraiensis Extract (알도즈 환원효소 활성억제와 소비톨 축적 억제로 인한 벌개미취 추출물의 당뇨병성 백내장 발병 지연 효능)

  • Kim, Chan-Sik;Kim, Jung-Hyun;Jeong, Il-Ha;Kim, Young-Sook;Lee, Jun;Jang, Dae-Sik;Kim, Jin-Sook
    • Korean Journal of Pharmacognosy
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    • v.40 no.4
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    • pp.339-344
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    • 2009
  • Diabetic cataract is a major complication of diabetes mellitus. Excess accumulation of sorbitol plays an important role in the pathogenesis of diabetic complications such as cataract formation. In this study, we investigated the inhibitory effect of the extract of the aerial parts of Aster koraiensis (AK) on diabetic cataractogenesis. To examine this further, we evaluated sorbitol accumulation during cataract development using streptozotocin-induced diabetic rat, an animal model of type 1 diabetes. Diabetic rats were treated orally with AK (100 mg/kg and 200 mg/kg body weight) once a day orally for 9 weeks. In vehicle-treated diabetic rats, lens opacity was increased, and lens fiber swelling and membrane rupture were observed. In addition, sorbitol accumulation in diabetic lens was markedly enhanced. However, AK treatment delayed the progression of diabetic cataract through the inhibition of sorbitol accumulation, and prevented lens fiber degeneration in a dose-dependent manner. These observations suggest that AK treatment can delay the progression of lens opacification in the diabetic rats during the early diabetic cataractogenesis.

Factors Influencing Quality of Life in Type II Diabetes Mellitus Patients Registered at Public Health Center (일개 시 보건소에 등록한 제2형 당뇨병 대상자의 삶의 질 영향요인)

  • Ryu, Soon-Hang;Park, Yeon-Sook
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.679-688
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    • 2002
  • Purpose: The purpose of this study was to examine the relationships among self-care, self-care agency, self-efficacy, and quality of life in type II diabetic patients registered at a public health center. Method: The study subjects were 128 type II diabetic patients who were living in G city. The data were collected from March 2001 to February 2002. The instruments used for this study were the self-care scale developed by Jeung(1997) and designed by Park (1984) based on the original scale, the self-care agency scale developed by So (1992), the self-efficacy scale developed by a Jeung (1997) and designed by Paek (1996) based on the original scale, and the quality of life scale developed by Ro (1988). The data were analyzed using descriptive statistics, pearson correlation coefficient, and stepwise multiple regression. Results: 1. The relationships among self-care, self-care agency, self-efficacy, and quality of life were significant. Self-care was significantly related to self-care agency (r=.609. p<.01), self-efficacy (r=.763. p<.01), and quality of life (r=.493. p<.01). 2. The stepwise multiple regression analysis was performed to identify factors influencing quality of life of the subjects. The most powerful predictor was self-care agency (48.4%). The combination of self-care, complication status, age, education level, and self-efficacy accounted for 88.7% of the variance of quality of life in type II diabetic patients. Conclusion: The results suggest that self-care, self-care agency, self-efficacy, and quality of life are important variables for development of nursing intervention programs for patients with diabetes.

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Early Aggressive Surgical Treatment of Multiloculated Empyema

  • Baek, Jong Hyun;Lee, Young Uk;Lee, Seok Soo;Lee, Jang Hoon;Lee, Jung Cheul;Kim, Myeong Su
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.202-206
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    • 2017
  • Background: Empyema is the collection of purulent exudate within the pleural space. Overall, 36%-65% of patients with empyema cannot be treated by medical therapy alone and require surgery. Multiloculated empyema is particularly difficult to treat with percutaneous drainage. Therefore, we describe our experiences with early aggressive surgical treatment for rapid progressive multiloculated empyema. Methods: From January 2001 to October 2015, we retrospectively reviewed 149 patients diagnosed with empyema who received surgery. The patients were divided into 2 groups according to whether they underwent emergency surgery or not. We then compared surgical outcomes between these groups. Results: The patients in group A (emergency surgery, n=102) showed a more severe infectious state, but a lower complication rate and shorter length of hospital stay. The incidence of lung abscess was higher in group A, and abscesses were associated with diabetes and severe alcoholism. Conclusion: Early aggressive surgical treatment resulted in good surgical outcomes for patients with rapid progressive multiloculated empyema. Furthermore, we suspect that the most likely causes of multiloculated empyema are lung abscesses found in patients with diabetes mellitus as well as severe alcoholism.

Assessment of Regulatory Effect of Electro-acupuncture at Jogsamni($ST_{36}$), on Electrogastrography in Diabetic Patients with Gastric Dysrhythmia;A Case Series Study (위장 비율동성 당뇨환자에서 족삼리(足三里)($ST_{36}$) 전침처치의 위전도 조절 영향 사례군 연구)

  • Oh, Dal-Seok;Choi, Jun-Yong;Jung, So-Young;Shin, Mi-Suk;Kim, Ae-Ran;Kang, Kyung-Won;Kim, Jong-In;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.25 no.4
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    • pp.95-103
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    • 2008
  • Objectives : This study was to investigate the regulatory effect of electro-acupuncture on Jogsamni ($ST_{36}$) in bradygastric condition or gastroparesis which is a neuropathic complication of type 2 diabetes mellitus(T2DM), assessed using 4-channel electrogastrography (EGG). Methods : It was a case series study. Each patient was given electro-acupuncture(EA) one point, Jogsamni($ST_{36}$) or Gyeonu($LI_{15}$) bilaterally for thirty minutes with 2Hz bipolar square wave frequency and moderate intensity of stimulation. With attaching electrodes around stomach region throughout pre-acupuncture, acupuncture, and post-acupuncture session, these parameters were produced; percent rate of bradygastria power compared to sum of power in all kind of gastric rhythm(% bradygastria), dominant frequency(DF) and dominant power(DP). Parameter was analysed per each channel's variable change from pre-acupuncture session by paired t-test. Results : There was statistically significant decrease in % bradygastria parameters on one of the $ST_{36}$ treated patients from pre-acupuncture session and to post-acupuncture session(P=0.015, P=0.008 respectively). A marginal significant decrease of DP was shown in the other $ST_{36}$ treated patient from pre-acupuncture session through post-acupuncture session(P=0.049). Combined data of two $ST_{36}$ Treated patients showed that there was significant decrease of %bradygastria from pre-acupuncture session to acupuncture session(P=0.020), and was decrease of DP from pre-acupuncture session to post- acupuncture session(P=0.020). Conclusions : EA at $ST_{36}$ resulted in statistically significant decrease in %bradygastria and DP for dysrhythmic condition in T2DM gastroparesis patients. Considering this limited results, further study will be needed to elucidate the effect of multiple-acupuncture on gastric myoelectrical activities.

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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.