• Title/Summary/Keyword: Complication of Diabetes Mellitus

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Risk Factors of Rehemorrhage in Postoperative Patients with Spontaneous Intracerebral Hemorrhage : A Case-Control Study

  • Ren, Yanming;Zheng, Jun;Liu, Xiaowei;Li, Hao;You, Chao
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.35-41
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    • 2018
  • Objective : Rehemorrhage is the most severe complication of postoperative patients with spontaneous intracerebral hemorrhage. The aim of the present study was to assess independent predictors of rehemorrhage and find the possibility of preventing rehemorrhage in postoperative patients with spontaneous intracerebral hemorrhage (sICH). Methods : Medical records of 263 postoperative patients with sICH from our Hospital were reviewed. The relationships between rehemorrhage and parameters were examined by univariate and multivariate analyses. The parameters include time from onset to surgery, hematologic paremeters, neuroimaging characteristics, level and variability of systolic blood pressure, medical histories, operation duration, and blood loss. In addition, relationship between rehemorrhage and clinical outcome were analyzed by using multivariate analyses. Results : Thirty-five (13.31%) patients experienced rehemorrhage after operation. Multivariate analyses indicated that the following factors were independently associated with rehemorrhage : history of diabetes mellitus (odds ratio [OR], 2.717; 95% confidence interval [CI], 1.005-7.346; p=0.049), and midline shift (for every 1 mm increase, OR, 1.117; 95% CI, 1.029-1.214; p=0.009). Rehemorrhage was an independent risk factor of poor functional outcome (OR, 3.334; 95% CI, 1.094-10.155; p=0.034). Conclusion : Our finding revealed that history of diabetes mellitus and admission midline shift were possibly associated with rehemorrhage in postoperative patients with sICH.

The Association between Peroxisome Proliferator-Activated Receptor-Gamma C161T Polymorphism and Type 2 Diabetic Complications (제 2형 당뇨병 및 당뇨 합병증의 발생과 Peroxisome Proliferator-Activated Receptor-$\gamma2$ C161T 유전자 다형성과의 관계)

  • Lee, Byung-Cheol;Ahn, Se-Young;Doo, Ho-Kyung;Ahn, Young-Min
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.902-910
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    • 2007
  • Objective : Peroxisome proliferator-activated receptor (PPAR)-gamma, a transcription factor in adipocyte differentiation, has important effects on insulin sensitivity, atherosclerosis, endothelial cell function and inflammation. Through these effects, PPAR-gamma2 might be involved with type 2 diabetes and vascular disease, including diabetic complications. Recently, it has been reported that the C161T polymorphism in the exon 6 of PPAR-gamma is associated with type 2 diabetes interacting with uncoupling protein 2 (UCP2) gene, and is associated with acute myocardial infarction. We studied the association of this polymorphism with type 2 diabetes and its complications, such as retinopathy, ischemic stroke, nephropathy and neuropathy in Korean non-diabetic and type 2 diabetic populations. Methods : Three hundred and thirty eight type 2 diabetic patients (retinopathy: 64, ischemic stroke: 67, nephropathy: 39 and neuropathy: 76) and 152 healthy matched control subjects were evaluated. The PPAR-gamma C161T polymorphism was analyzed by PCR-RFLP. Results : PPAR-gamma C161T genotype and allele frequency did not show significant differences between type 2 diabetic patients and healthy controls (T allele: 17.0 vs. 14.5, OR= 1.21, P=0.3188). In the analysis for diabetic complications, T allele in diabetic nephropathy was significantly higher than controls (P=0.0358). T allele in the ischemic stroke patients was also higher than healthy controls, although it had no significance (P=0.1375). Conclusions : These results suggest that the C161T polymorphism of the PPAR-gamma gene might be associated with diabetic nephropathy in type 2 diabetes.

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Antihyperlipidemic Activity of the Ethyl-acetate Fraction of Stereospermum Suaveolens in Streptozotocin-induced Diabetic Rats

  • Thirumalaisamy, Balasubramanian;Prabhakaran, Senthilkumar Gnanavadevel;Marimuthu, Karthikeyan;Chatterjee, Tapan Kumar
    • Journal of Pharmacopuncture
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    • v.16 no.3
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    • pp.23-29
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    • 2013
  • Objectives: Dyslipidemia in diabetes mellitus is a significant risk factor for the development of cardiovascular complications. The aim of this study was to evaluate the effect of the ethyl-acetate fraction of an ethanolic extract from Streospermum suaveolens on lipid metabolism in streptozotocin (STZ)-induced diabetic rats. Methods: Diabetes was induced by intraperitonial injection of STZ (50 mg/kg). Diabetic rats were treated with an ethyl-acetate fraction orally at doses of 200 and 400 mg/kg daily for 14 days. On the $15^{th}$ day, serum lipid profiles, such as total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were estimated in experimental rats. The atherogenic (AI) and the coronary risk (CRI) indices were also evaluated. Results: The ethyl-acetate fraction at doses of 200 and 400 mg/kg significantly (P < 0.001) and dose-dependently reduced serum cholesterol, triglycerides and LDL, but increased HDL towards near normal levels as compared to diabetic control rats. The fraction also significantly (P < 0.001) lowered the atherogenic index (AI) and coronary risk index (CAI) in a dose-dependent manner. Conclusion: The present study demonstrated that the ethyl-acetate fraction of Stereospermum suaveolens exhibits a potent antihyperlipidemic activity in hyperglycemic rats and suggests that the plant may have therapeutic value in treating the diabetic complication of hyperlipidemia.

Analysis of the Risk Factors for Lower Extremity Amputation due to Diabetic Foot Complications (당뇨병성 족부 합병증에 따른 하지 절단술의 위험 인자에 대한 분석)

  • Jung, Hong-Geun;Kim, You-Jin;Shim, Shang-Ho;Kim, Hee-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.149-153
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    • 2007
  • Purpose: To evaluate the possible risk factors of lower extremity amputations in diabetic foot patients. Materials and Methods: The study is based on 37 patients who received lower extremity amputations from April, 1997 to February 2005 due to diabetic foot complications with at least 1 year follow up. As for the control group, 49 diabetes patients who had been treated at the endocrinology department for at least 1 year without any diabetic foot complication were evaluated. As for the possible risk factors, age, gender, duration of diabetes mellitus, body mass index, Hb A1c, blood glucose level, total cholesterol, s-creatinine, C-peptide, smoking, alcohol, hypertension, cardiovascular disease, CVA, retinopathy and neuropathy were investigated. Results: Among the possible risk factors evaluated, age, Hb A1c, smoking, neuropathy and blood glucose level factors showed statistically significant difference between the diabetic amputation and the control group. Conclusion: In reducing the risk of the lower extremity amputations in the diabetic patients due to diabetic foot complications, strict control of blood glucose level and cessation of smoking were found to be utmost important.

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Aortopulmonary Fistula Presenting without an Endoleak after Thoracic Endovascular Aortic Repair

  • Sica, Giacomo;Rea, Gaetano;Bocchini, Giorgio;Lombardi, Romilda;Muto, Massimo;Valente, Tullio
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.287-290
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    • 2017
  • Herein, we report the case of a 60-year-old man, a smoker with a history of arterial hypertension and diabetes mellitus. After computed tomography (CT) for an episode of hemoptysis, the patient underwent elective thoracic endovascular aortic repair (TEVAR) because of a degenerative aneurysm of the descending thoracic aorta. The area of perianeurysmal pulmonary atelectasis reported on the CT scan was not considered. Three months later, he developed an aortopulmonary fistula without endoleaks. Although TEVAR is a relatively safe procedure, no detail should be overlooked in the preoperative evaluation in order to avoid life-threatening complications. Further, the effectiveness and modality of prolonged antibiotic prophylaxis and/or preoperative respiratory physiotherapy should be assessed in such cases.

Spinal Epidural Lipomatosis - Report of Four Cases - (척추경막외 지방종증 - 증례보고 -)

  • Kim, Tae Wan;Huh, Yong Suk;Chi, Moon Pyo;Kim, Jae O;Kim, Jung Chul
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1527-1532
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    • 2000
  • Althogh spinal epidural lipomatosis is relatively rare, it is a widely recognized complication of excess exogenous glucocorticoids. We report 4 cases of epidural lipomatosis. None of the patients had definitive history of steroid treatment, obesity, or diabetes mellitus, but all had sciatica and radiating pain. In all cases, the authors removed excess amount of epidural fat with surgery after which significant improvement of symptoms was noted.

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A Case of Polyradiculomyelitis Associated With Herpes Zoster (대상포진성 다발신경뿌리척수염 1예)

  • Kim, Doo-Hyun;Park, Min-Su
    • Annals of Clinical Neurophysiology
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    • v.13 no.1
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    • pp.64-67
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    • 2011
  • Shingles is a latent viral infection of the sensory ganglia. It can be accompanied by a variety of neurologic complications, including polyradiculitis and myelitis. A 66-year-old man with diabetes mellitus presented with progressive weakness, hypethesia and neuralgic pain in his right arm after herpes zoster infection in right C5 dermatome. He was diagnosed with zoster polyradiculomyelitis and treated with intravenous acyclovir and corticosteroid. It is a rare case of zoster neurologic complication in spite of oral acyclovir treatment.

A Clinical Proterties on Nutrients Intake and Serum Concentration of Diabetic Subjects by Duration in Ansung Kyunggi-do (경기도 안성지역 당뇨병 환자의 유병기간에 따른 영양소 섭취 실태와 혈액성상의 임상적 특징)

  • 노숙령
    • Journal of Nutrition and Health
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    • v.30 no.10
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    • pp.1203-1210
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    • 1997
  • This study was performed from March to June 1994 in ANsung Medical Center. We investigated serum components of 78 diabetics in the center, in addition to the nutrient intake status and anthrophometric status of 60 diabetics among them. We separated the latter into 2 groups(ⅰ) less tan 5 years of diabetic duration and ⅱ) more than 6 years of diabetic duration) and analyzed the clinical characteristics of each group. The results are as follows : \circled1 The average ages of male and female subjects were 57.1 and 58.9 years, respectively. The average diabetic duration of male subjects was 4.8 years and that of female subjects was 5.9 . The major occupational field of both male and female subjects was agriculture(33.3%, 36.1%). 50% of male and 75% of female subject's monthly incomes were less than 600, 000 won and 75% of male and 94.4% of female subjects had weekly food expense less than 40, 000 won. The nutrient intake status of the subjects was lower than RDA on the whole. There was no big differences between 2 the male groups of different diabetic duration , but calorie, protein , fat carbohydrate, phosphorus, iron and Vit B$_1$intakes of the above 6 year female group were appearently higher than those of the under 5 year female group (p<0.05). There were different intake tendencies between male and female subjects . For females. the longer the diabetic duration, the less intakes of calorie, protein , fat carbohydrate, phosphorus, iron Vit B$_1$, Vit B$_2$, and niacin were observed. Furthermore, the longer the diabetic duration in females , the more intakes of energy and nutrients, except Vit C were observed. Fasting blood glucose levels were 155mg/dl and 164mg/dl and Postprandial glucose levels were 242mg/dl and 247mg/dl for males and females respectively. Hb of both males and females , and Ht of males met the lower limit of normal status, The serum TG level was higher than normal , so that they seemed to suffer from hyperlipidemia ; their high HbAIC status indicated that the management of diabetes mellitus was poor. The total protein level of female subject was higher when compared with that of males(p<0.05). All subjects blood pressure were higher than normal , and the longer the diabetic duration, the higher was the blood pressure. The serum HDL-cholesterol levels of the above 6 year group male subjects were lower(p<0.05) than those of the under 5 year male group subjects, and the former group's systolic and diastolic blood pressures were higher than those of the latter(p<0.05). Levels of serum total protein, albumin and TG of the above 6 year female group were lower than those of the under 5 year female group(p<0.05). As the diabetic duration was extended, HDL-cholesterol and LDL-cholesterol levels showed a tendency to increase, while Hb, Ht, total protein, albumin, and A/G, which represent the nutrients state of iron and protein, were inclined to decrease. This result showed that serum lipid components went bad. To summarize the results, the longer the diabetic duration, the worse were the male subjects nutrient intake status, but those of the female subjects were good. With respect to serum components and serum lipid subjects Fe, protein, nutrition status and serum lipid component got worse as the diabetic duration was extended , implying the possibility of diabetes mellitus complication grows.

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Factors affecting Diabetic Eye disease and Kidney disease Screening in Diabetic Patients (당뇨병 환자의 당뇨성 안질환 및 신장질환 합병증 검사 수검 여부에 영향을 주는 요인)

  • Kang, Jeong-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.4
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    • pp.226-235
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    • 2020
  • This study was undertaken to investigate factors that affect the assessment of complications in diabetic eye and kidney diseases. Data was obtained from the National Community Health Survey, 2017. The subjects included were 25,829 respondents who had been diagnosed with diabetes. Logistic regression analysis was applied to determine the factors affecting associated diabetic eye disease (fundus examination) and kidney disease (microalbuminuria examination) complications. The diabetic eye disease complication rate was 35.6%, and diabetic kidney disease complication rate was 39.8%. Complications arising due to diabetes were determined to be 35.6% for eye diseases and 39.8% for kidney related diseases. Ed. Notes: The original sentence is not very lucid. I have suggested an alternate edit. I leave it to the author's discretion to accept or reject the same. Please delete whichever sentence is not suitable. Walking activity (OR=1.03, OR=1.02), hemoglobin A1c (HbA1c) recognition (OR=2.33, OR=2.33), blood glucose level recognition (OR=1.61, OR=1.71), diabetes drug therapy (OR=2.67, OR=3.05), and diabetic management education (OR=1.45, OR=1.47) were more likely to be evaluated for eye and kidney disease complications. Our results indicate that to increase the rate of screening for diabetic complications, it is necessary to develop a diabetes management system that includes the type and timing of diabetic complications, as well as different promotional methods that recognize HbA1C and blood glucose levels. Ed. Notes: Do you mean 'screening' methods? Please revise appropriately, if required. In addition, it is essential to develop a guideline for the management of diabetes mellitus, and to incorporate a screening test for diabetic complications in the national screening system.

The Risk Factors for Infectious Complications after Elective Gastrectomy for Gastric Cancer (위암의 정규 위절제술 후 감염성 합병증의 위험인자)

  • Kim, Seon-Kwang;Kim, Chan-Young;Yang, Doo-Hyun
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.237-243
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    • 2008
  • Purpose: Postoperative Infectious complications are recognized as major complications that are associated with surgery. Although many studies have focused on the risk factors of postoperative complications, little is known about the risk factors of infectious complications after gastric cancer surgery, and especially after elective gastrectomy. There is now more and more interest in the risk factors of infectious complications in relation to controlling infection and as indicators of qualitatively assessing infectious complications. The aim of this study was to evaluate the risk factors related with infectious complications after performing elective gastrectomy for treating gastric cancer. Materials and Methods: We retrospectively reviewed a total of 788 patients who had undergone elective gastrectomy for gastric cancer between Jan. 2000 and Dec. 2007. The characteristics of the patients were divided according to the patients' factors and the operations' factors. Results: The patients' mean age was 58.9 (range: 24~91) years; 545 were male and 243 were female. The mean duration of the hospital stay was 20.3 days (range: 5~135 days), the mean operation time was 181.3 minutes (range: 65~440 minutes). The total complication rate was 17.1% (n=135) and the complication rate was 38.5% (n=52) among the 135 patients with infectious complications. The infectious complications were surgical site infection (59.7%), Pneumonia (19.3%), intra-abdominal abscess (11.5%), pseudomembranous colitis (5.7%), bacteremia (1.9%) and hepatic abscess (1.9%). On the univariate analysis, the significant risk factors were male gender, blood transfusion, smoking at the time of diagnosis, alcohol drinking, diabetes mellitus and previous cardiovascular disease (P<0.05 for all). On multivariate analysis that used a logistic regression model, the significant independent risk factors were smoking at the time of diagnosis (OR: 2.877. 95% CI: 1.449~5.713), blood transfusion (OR: 3.440, 95% CI: 1.241~9.534), diabetes mellitus (OR: 3.150, 95% CI: 1.518~6.538), and previous cardiovascular disease (OR: 2.784, 95% CI: 1.4731~5.2539). Conclusion: Pre- or post-operative blood transfusion and the patient's medical history such as previous cardiovascular disease, diabetes mellitus, smoking etc. are the risk factors for infectious complications after undergoing elective gastrectomy for gastric cancer. The patients that have these risk factors need to be treated with great care to prevent infectious disease after elective gastrectomy.

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