• Title/Summary/Keyword: Complication of Diabetes Mellitus

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A Study on the Tinnitus of Huangdi's Internal Classic $\ll$황제내경(黃帝內經)$\gg$ ($\ll$소문(素問).영추(靈樞)$\gg$에 나타난 이명(耳鳴)에 대한 연구(硏究))

  • Byun, Seok-Mi;Tark, Myoung-Rim;Kang, Na-Ru;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.1
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    • pp.224-252
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    • 2010
  • Objective : The purpose of this study is to investigate tinnitus of Plain Questions $\ll$素問$\gg$ and Miraculous Pivot $\ll$靈樞$\gg$. Methods : We conducted a study on the original text paragraphs of Internal Classic $\ll$內經$\gg$ containing the tinnitus and analysis of Yang, Ma, Zhang, Wang etc. We drew a parallel between tinnitus from Internal Classic $\ll$內經$\gg$ and matching diagnoses from western medicine. Results : The results were as follows. 1. Tinnitus in Plain Questions $\ll$素問$\gg$Tong Pyeong Heo Sil Ron <通評虛實論> was similar to the symptoms of diabetes mellitus complication and schizophreniform disorder in western medicine. 2. Liver fire tinnitus in Plain Questions $\ll$素問$\gg$ Yuk Won Jeong Gi Dae Ron <六元正紀大論> was similar to the symptoms of psychological distress in western medicine. 3. Phlegm fire tinnitus in Plain Questions $\ll$素問$\gg$ Ji Jin Yo Dae Ron <至眞要大論> was similar to the symptoms of meniere's disease and malfunction of autonomic nervous system in western medicine. 4. Blood deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Sa Gi Jang Bu Byeong Hyeong <邪氣藏府病形> was similar to the symptoms of anemia in western medicine. 5. Tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gyeong Geun <經筋> was similar to the myofacial pain syndrome of the sternocleidomastoid muscle and the masseter muscle in western medicine. 6. Gallbladder deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gwol Hyeong <厥病> was similar to the symptoms of otitis media and labyrinthitis in western medicine. 7. Kidney deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gyeol Gi <決氣> and Hai Ron <海論> was similar to the symptoms of degenerative auditory organ in western medicine. 8. Tinnitus in Internal Classic $\ll$內經$\gg$ showed close relations with the symptoms of the wind character. Conclusion : We analyzed the original text paragraphs of Internal Classic $\ll$內經$\gg$ and explanations about tinnitus. Further studies are needed to compare oriental medicine and western medicine diagnoses to develop better treatments for tinnitus.

Event-related Potentials of Pre- and Post-Hemodialysis in Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석 전후의 P300 인지유발전위검사)

  • Bae, Jae-Chun;Lee, Sang-Moo
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.136-142
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    • 2001
  • Background : Nervous system dysfunction is a major complication of end stage renal disease. Although severe neurologic symptoms are partially or completely reversed by adequate hemodialysis, even optimally dialyzed patients will usually not return to normal neurocognitive function. To investigate the influence of chronic renal failure and hemodialysis on higher cognitive function electrophysiologically, we studied auditory P300 event-related potentials in 14 hemodialysis patients and 14 age- and sex-matched normal healthy controls. Methods : The subjects consisted of 14 patients(M: 6, F: 8) with chronic renal failure(CRF) for 1 to 10 years and 14 age- and sex-matched healthy controls(M: 5, F: 9). For the reliability of study, patients with diabetes mellitus, abnormal brain CT findings, or low mini-mental state score(below 20) were excluded. Event related potentials(ERPs) for hemodialysis patients were performed at pre- and post-hemodialysis. To obtain ERPs, subjects underwent 2-tone auditory discrimination test(oddball paradigm). Results : Although the age(control: $48.79{\pm}10.31years$, CRF: $51.21{\pm}7.61years$) and mini-mental state score(control: $27.00{\pm}1.71points$, predialysis CRF: $25.07{\pm}3.58points$) were not different in normal control and CRF groups significantly(P>0.05), P300 latencies at Cz(control: $288.11{\pm}17.36msec$, predialysis CRF: $332.35{\pm}42.34msec$) were significantly delayed(P<0.05)and the duration of Trail making test A was significantly prolonged(control: $64.2{\pm}24.2sec$, CRF: $118.9{\pm}101sec$) in CRF group. P300 latencies between pre- and post-hemodialysis CRF patients(predialysis CRF: $332.35{\pm}42.34msec$, postdialysis CRF: $325.82{\pm}38.69msec$) were not significantly different. The P300 latency was not related with the duration of CRF(Spearman's correlation test, r=0.25, P>0.05) and the frequency of hemodialysis(Spearman's correlation test, r=0.28, P>0.05). Conclusions : From these results, we suggest that P300 latency is valuable in evaluating cognitive brain dysfunction in patients with CRF and hemodialysis does not have a significant effect on cognitive brain dysfunction in patients with CRF.

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The Clinical Implications of Hepatic Enzymes in Metabolically Healthy Obese Men (대사적으로 건강한 비만남성에서 간 효소의 임상적 의의)

  • Shin, Kyung-A
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.3
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    • pp.248-255
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    • 2017
  • Increased hepatic enzymes are associated with insulin resistance, metabolic complications, and type 2 diabetes mellitus. Metabolically healthy obese (MHO) phenotype is not accompanied by metabolic complications and maintains insulin sensitivity, despite excessive body fat. The purpose of this study was to evaluate the clinical implications of hepatic enzymes in MHO men. The diagnostic criteria for MHO were based on NCEP-ATP III and obesity in adults was defined using WHO Asian-Pacific criteria. We used the data from 9,683 obese men aged between 20 and 70 years. The subjects were divided into three groups according to the diagnostic criteria: The metabolically healthy non-obese (MHNO, N=2,878), metabolically healthy obese (MHO, N=5,427), and metabolically abnormal obese (MAO, N=1,378). Obesity criteria were classified according to the standards set forth by WHO Asia-Pacific Criteria. AST, ALT, and GGT were significantly lower in the MHO group than in the MAO group (p<0.001, respectively). However, the hepatic enzyme levels were higher in the MHO group than in the MHNO group (p<0.001). Liver enzymes were associated with metabolic syndrome risk factors. Waist circumference, fasting glucose, total cholesterol, triglyceride, and HDL-C were risk factors for metabolic syndrome affecting liver enzymes. In conclusion, hepatic enzymes were found to predict metabolic abnormalities in metabolically healthy obese men.

Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients (간 또는 심장이식을 시행 받은 환자에서의 결핵의 발생률 및 임상양상)

  • Jung, Hoon;Oh, Yeon-Mok;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Kim, Jae-Joong;Lee, Sung-Gyu;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.440-446
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    • 2006
  • Background: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea. Methods: The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively. Results: The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was $2.1{\pm}3.6$ months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of $7.8{\pm}3.5$ months. One patients died of TB. Conclusion: The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

Clinical Observation for the 161 Cases of CVA (뇌졸중환자(腦卒中患者) 161례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Kang, Myeong-Seog;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.16 no.2 s.30
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    • pp.17-35
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    • 1995
  • Clinical observation was made on 161 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1994. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, hypertensive encephalopathy, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through western medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission, the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 11.4 days and with cerebral hemorrhage 22.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. The next was pneumonia. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

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'Clinical Observation for the 226 Cases of CVA' (뇌졸중환자(腦卒中患者) 226예(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Seong-Hun;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.5-24
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    • 1997
  • Clinical observation was made on 226 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1995. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in spring and summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through vestern medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission. the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 6.4 days and with cerebral hemorrhage 9.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

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Clinical observation for the Geriatric C.V.A. (노인(老人) 뇌졸중(腦卒中)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Seo, Un-Kyo;Jeong, Ji-Cheon;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.14 no.2
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    • pp.50-70
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    • 1993
  • Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

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Surgical Experiences for Non-ST-segment Elevation Acute Coronary Syndrome (ST분절의 상승을 동반하지 않은 급성 관동맥 증후군의 수술 치험)

  • Yu Song-Hyeon;Lim Sang-Hyun;Chang Byung-Chul;Yoo Kyung-Jong;Hong You-Sun
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.754-758
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    • 2006
  • Background: Surgical role for acute coronary syndrome has been reduced in recent years due to development of drug eluting stent. We evaluated the surgical results of acute coronary syndrome in our hospital. Material and Method: Between January 2001 and August 2005, 416 patients underwent coronary artery bypass grafting (CABG) under diagnosis of non-ST-elevation acute coronary syndrome (NSTE ACS). Mean age was $61.8{\pm}9.0$ years and 276 (66.3%) patients were male. 324 (77.9%) patients had triple vessel disease and 92 (22.1%) had left main disease at angiographic study. 236 (56.7%) patients had hypertension and 174 (41.8%) had diabetes mellitus. Conventional on-pump CABG was performed in 194 patients (46.6%) and off-pump CABG in 222 (53.4%). Total arterial revascularization with no touch technique was done in 97 patients (23.3%). The number of total distal anastomosis was 1,306 and the number per patient was $3.21{\pm}1.71$. Result: Surgical mortality rate was 1.0% (4 patients) and postoperative complication rate was 15.6% (65 patients). Graft patency was checked at mean $3.7{\pm}7.6$ months (from 1 to 37 months) postoperatively with multi-directional computed tomography in 152 patients. Left internal mammary artery was patent in 95.3%, right internal mammary artery in 98.1%, radial artery in 92.2% and saphenous vein in 89.0%. Conclusion: The surgical treatment of NSTE ACS showed relatively low mortality rate and good graft patency rate. Further study is needed to compare the long term results with drug eluting stent.

Snuffbox Arteriovenous Fistula Formation for Hemodialysis (Snuffbox에 시행한 혈액투석을 위한 동정맥루조성술)

  • 서필원;류재욱;박정옥;장성욱;김미순;박성식;김삼현
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.154-159
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    • 2004
  • The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. Material and Method: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001 The records of the patients except six patients who were lost from follow up were analyzed retrospectively, Mean age and male:female ratio were 52$\pm$15 years (range, 17∼79 years) and 80 : 60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09$\pm$3.68 mg/dL (range, 2.55∼20.09 mg/dL) and 4.7$\pm$0.9 mmol/L (range, 2.3∼8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. Result: Mean follow up period of the patients was 41.8$\pm$31.0 months (range, 0.2∼108,8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8$\pm$10.1 months (range, 0.1∼40.4 months). The patency rates of f month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. Conclusion: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.