• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7765-7768
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• 2015

This study was conducted to determine the incidence of wound complications after laparotomy for endometrial cancer and significant predictors of risks. Medical records of patients with endometrial cancer undergoing laparotomy for surgical staging at Srinagarind Hospital, Khon Kaen University between January 2007 and December 2013 were reviewed. Intravenous antibiotic prophylaxis was routinely given 30 minutes before surgery. The primary endpoint was wound complications (including seroma, hematoma, separation, or infection) requiring additional medical and/or surgical management within 4 weeks of laparotomy. During the study period, 357 patients with complete medical records were reviewed. The mean age was 56.9 years. Wound complications were observed in 28 patients (7.84%, 95% CI, 5.27% to 11.14%). Body mass index (BMI) ${\geq}30kg/m^2$, diabetes mellitus (DM), and prior abdominal surgery were observed as significant independent factors predicting an increased risk of wound complications with adjusted odds ratios (95% CIs) of 2.96 (1.23-7.16), 2.43 (1.06-5.54), and 3.05 (1.03-8.98), respectively. In conclusion, the incidence of wound complications after laparotomy for endometrial cancer was 7.8%. Significant independent predictors of risk included BMI, DM and prior abdominal surgery.

• Journal of Gastric Cancer
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• 제18권3호
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• pp.253-263
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• 2018

Purpose: With increasing life expectancy, the presence of comorbidities has become a major concern in elderly patients who require surgery. However, little is known about the impact of different comorbidities on the outcomes of laparoscopic total gastrectomy (LTG). In this study, we investigated the impact of comorbidities on postoperative complications in patients undergoing LTG for gastric carcinoma. Materials and Methods: We retrospectively reviewed the cases of 303 consecutive patients who underwent LTG for gastric carcinoma between 2005 and 2016. The associations between each comorbidity and postoperative complications were assessed using univariate and multivariate analyses. Results: A total of 189 patients (62.4%) had one or more comorbidities. Hypertension was the most common comorbidity (37.0%), followed by diabetes mellitus (17.8%), chronic viral hepatitis (2.6%), liver cirrhosis (2.6%), and pulmonary (27.1%), ischemic heart (3.3%), and cerebrovascular diseases (2.3%). The overall postoperative morbidity and mortality rates were 20.1% and 1.0%, respectively. Patients with pulmonary disease significantly showed higher complication rates than those without comorbidities (32.9% vs. 14.9%, respectively, P=0.003); patient with other comorbidities showed no significant difference in the incidence of LTG-related complications. During univariate and multivariate analyses, pulmonary disease was found to be an independent predictive factor for postoperative complications (odds ratio, 2.14; 95% confidence interval, 1.03-4.64), along with old age and intraoperative bleeding. Conclusions: Among the various comorbidities investigated, patients with pulmonary disease had a significantly higher risk of postoperative complications after LTG. Proper perioperative care for optimizing pulmonary function may be required for patients with pulmonary disease.

• 재활복지
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• 제22권4호
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• pp.83-102
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• 2018

본 연구는 척수손상이 고령이 됨에 따라 만성질환과 2차 합병증에 미치는 요인을 알아봄으로써 효율적으로 관리와 예방에 관한 기초적인 자료를 제공하고자 한다. 대상자는 2013년 4월부터 2018년 4월까지 S병원에 입원한 척수손상 200명 대상으로 하였다. 의무기록 조사를 통해 만성질환인 고혈압, 당뇨, 간염, 결핵과 2차 합병증으로 폐렴, 기립성저혈압, 욕창, 부종, 자율신경반사항진, 심부정맥 혈전증, 이소성골화증, 중추성통증, 경직(상지/하지), 근 골격계 통증, 변비, 구축, 우울증, 골절, 고칼슘혈증, 불면증, 신장결석, 신경인성 방광 및 장, 비요로감염, 비만, 골다공증, 폐혈증, 수면무호흡, 요로감염의 발생유무를 조사하였다. 연구 결과 50세 미만보다 50세 이상 척수손상이 만성질환 및 2차합병증에 영향을 미치는 요인들로 나타났다. 50세 이상의 만성질환 유병 오즈비는 고혈압 11.8배, 당뇨 6.7배이며, 2차합병증 유병 오즈비는 골다공증 7.5배, 폐렴 5.2배, 신경인성통증 0.4배로 나타났다. 고령척수손상의 만성질환 및 2차합병증의 지속적인 관리와 서비스의 필요성을 시사하고, 향후 대상자의 확대와 다양한 특성을 포함한 연구가 이루어줘야 할 것이다.

• Journal of Pharmaceutical Investigation
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• 제33권2호
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• pp.113-120
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• 2003

Drug interactions with food, on occasion, lead to serious nutritional and functional changes in the body as well as alternations of pharmacological effect. It, therefore, should be necessary to take drug interactions with food into consideration for effective and safe therapeutics. Diabetes mellitus is a heterogeneous group of disorders characterized by abnormal glucose homeostasis, resulting in hyperglycemia, and is associated with increased risk of micovascular, macrovascular, and neuropathic complications. However, the precise mechanism of diabetes mellitus remains unclear. Three basic objectives in the care of diabetic patients are maintaining optimal nutrition, avoiding hypo- or hyperglycemia and preventing complications. The purpose of this study was to investigate thε effect of Laminaria japonica diet on the absorption, distribution, metabolism and excretion of glipizide which are frequently used in the treatment of diabetes. Diabetic rats induced by streptozotocin were employed in this study. Blood concentrations of oral hypoglycemic agents were measured by HPLC and resultant pharmacokinetic parameters were calculated by RSTRIP. The mechanisms of drug interaction with food were evaluated on the basis of pharmacokinetic parameters such as $k_{a},\;t_{1/2},\;C_{max},\;t_{max}$ and AUC. Administration of glipizide in normal rats treated with Laminaria japonica diet showed significant increase in AUC, $k_{a},\;t_{1/2},\;t_{max}$ and decrease in $C_{max}$, compared to those without Laminaria japonica diet. This might result from adsorption of glipizide on components of Laminaria japonica, causing delayed absorption. Administration of glipizide in diabetic rats treated with Laminaria japonica diet showed significant increase in $t_{1/2}\;and\;t_{max}$, and decrease in $C_{max}$, compared to those without Laminaria japonica diet. This might also result from adsorption of glipizide on components of Laminaria japonica, causing delayed absorption and flattened blood concentration of glipizide. The oral glucose test showed that Laminaria japonica diet could lower blood glucose level probably through either inhibiting the activity of disaccharidases, intestinal digestive enzymes, or delaying the absorption of glucose. More studies should be followed to fully understand pharmacokinetic changes of glipizide caused by long-term Laminaria japonica diet.

• Nutrition Research and Practice
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• 제12권1호
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• pp.69-77
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• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

• Nutrition Research and Practice
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• 제3권2호
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• pp.156-161
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• 2009

Hyperglycemia in the diabetic state increases oxidative stress and antioxidant therapy can be strongly correlated with decreased risks for diabetic complications. The purpose of this study is to determine antioxidant effect of garlic and aged black garlic in animal model of type 2 diabetes. The antioxidant activity of garlic and aged black garlic was measured as the activity in scavenging free radicals by the trolox equivalent antioxidant capacity (TEAC) assay. Three week-old db/db mice were fed AIN-93G diet or diet containing 5% freeze-dried garlic or aged black garlic for 7 weeks after 1 week of adaptation. Hepatic levels of lipid peroxides and activities of antioxidant enzymes were measured. TEAC values of garlic and aged black garlic were $13.3{\pm}0.5$ and $59.2{\pm}0.8{\mu}mol/g$ wet weight, respectively. Consumption of aged black garlic significantly decreased hepatic thiobarbituric acid reactive substances (TBARS) level compared with the garlic group which showed lower TBARS level than control group (p<0.05). Activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) of garlic and aged black garlic group were significantly elevated compared to the control group. Catalase (CAT) activity of aged black garlic group was increased compared with the control group. These results show that aged black garlic exerts stronger antioxidant activity than garlic in vitro and in vivo, suggesting garlic and aged black garlic, to a greater extent, could be useful in preventing diabetic complications.

• 운동과학
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• 제21권3호
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• pp.289-298
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• 2012

본 연구는 당뇨를 유발한 흰쥐에서 트레드밀 운동이 망막 신경세포의 사멸에 억제 효과가 있는지를 실험 하였다. 본 연구에서 Sprague-Dawley계 흰쥐 28마리를 대조군, 운동군, 당뇨군, 당뇨운동군으로 분류하여 각 군당 7마리씩 배정하였다. 당뇨는 streptozotocin을 복강에 주사하여 유발하였다. 운동군은 분당 8 m의 속도로 하루 30분씩 주 5회, 총 12주 동안 트레드밀 운동을 실시하였다. 본 연구의 결과, 당뇨 유발 흰쥐의 망막에서 세포사멸 인자인 terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)-양성 세포수 그리고 caspase-3, cytochrome c, Bax의 발현이 증가되었으며, 항 세포사멸 인자인 Bcl-2의 발현은 감소되었다. 트레드밀 운동은 TUNEL-양성 세포수 그리고 caspase-3, cytochrome c, Bax의 발현을 감소시켰으며, Bcl-2의 발현은 증가시켰다. 본 실험의 결과, 당뇨에 의한 망막의 세포사멸 증가에 트레드밀 운동이 억제 작용을 나타내었으며, 따라서 트레드밀 운동은 당뇨 환자들에서 후유증을 경감시키는데 효과적인 치료법임을 알 수 있었다.

• Journal of Chest Surgery
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• 제37권7호
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• pp.553-558
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• 2004

심장 박동상태에서 시행하는 관상동맥우회술(off-pump CABG)은 심폐체외순환하에서 시행하는 관상동맥우회술(on-pump CABG)에 비해 수술 후 유병률을 줄일 수 있는 방법으로 보고되고 있다. 저자들은 특히 수술 후 합병증의 발생 가능성이 높은 당뇨환자에 있어서 off-pump CABG와 on-pump CABG의 임상 결과를 비교하여 off-pump CABG가 당뇨환자의 유병률에 미치는 영향을 알아보고자 한다. 대상 및 방법: 2001년 1월부터 2003년 6월까지 연세대학교 심장혈관병원에서 관상동맥우회출만을 시행받은 682명(off-pump CABG군: 424명, on-pump CABG: 258명)의 환자들 중 당뇨가 있는 환자 244명을 대상으로 하였다. 이 중 off-pump CABG는 154명, on-pump CABG는 90명의 환자들에서 시행하였다. 이 환자들을 대상으로 수술 전 위험요소들과 수술 후 결과를 비교하였다. 결과: 연령, 남녀 비 및 수술 전 고혈압 등의 위험요소와, 수술 전 뇌경색이나 심근경색의 기왕력 등 수술위험 요소도 두 군간의 통계적인 차이를 보이지 않았다. 이식편수는 on-pump CABG에서 유의하게 많았으나, 수술 시간은 off-pump CABG에서 통계적으로 유의하게 짧았고, 수술 후 강심제 사용빈도는 off-pump CABG에서 유의하게 낮았다. 수술 사망은 차이가 없었으며, 수술 후 측정한 CK-MB, 중환자실 인원기간 및 호흡기 사용시간은 off-pump CABG에서 통계적으로 유의하게 낮았다. 그러나 출혈로 인한 재수술, 수술 후 심근경색증, 감염, 신부전증, 신경학적 합병증 및 수술 후 입원 기간 등은 두 군간에 통제적 유의성이 없었다. 결론: 당뇨환자에서 시행한 off-pump CABG는 on-pump CABG에 비해 심근의 손상이 적으면서 수술 후 회복이 빨랐다. 따라서 두 방법 모두 좋은 결과를 보여 주었으나, off-pump CABG가 당뇨환자에서 좀 더 효과적인 수술 방법이라고 생각한다. 그러나 전향적인 연구 등 더 많은 연구가 필요하리라 생각한다.

• 생명과학회지
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• 제17권11호
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• pp.1464-1471
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• 2007

당뇨병은 만성적 대사질환으로 말초뿐만 아니라 중추신경계에서도 다양한 합병증을 유발시키는 것으로 알려져 있다. 특히, 당뇨환자는 인지기능의 손상으로 인해 치매 유병율이 높은 것으로 보고되고 있다. 규칙적인 운동은 당뇨병의 이차 합병증을 예방하기 위한 치료적 방법으로 흔히 권장된다. 이에 본 연구는 당뇨흰쥐를 대상으로 트레드밀 운동이 기억력과 해마 BDNF 발현에 미치는 효과를 조사하였다. SD계열 흰쥐를 실험동물로 하여 STZ (50 mg/kg) 투여로 유발시킨 당뇨흰쥐를 8주간 주 5회 30분씩 트레드밀에서 달리도록 하였다. 운동프로그램 종료 후, Morris water maze로 기억력을 측정하고, 해마조직을 적출하여 Western으로 brain-derived neurotrophic factor (BDNF) 발현을 정량화하였다. 본 연구결과 8주간의 당뇨는 선행연구과 유사하게 기억력 손상과 함께 해마 조직의 BDNF 발현을 유의하게 감소시키는 것으로 나타났다. 하지만 트레드밀 운동은 당뇨흰쥐에서 기억력과 해마 BDNF 발현을 유의하게 향상시키는 것으로 나타났다. 이러한 결과는 당뇨동물에서 운동이 해마 BDNF 발현의 증가를 통해 인지기능의 손상을 완화시킬 수 있음을 보여주는 것이다.

• The Korean Journal of Physiology and Pharmacology
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• 제7권1호
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• pp.39-45
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• 2003

Reactive oxygen species (ROS) have been suggested to be contributory factors in complications of diabetes mellitus. In the present study, we investigated the generation of superoxide, the lipid peroxide level measured as thiobarbituric acid reactive substances, the vasorelaxation of isolated thoracic aorta and the iNOS expression in kidney of streptozotocin induced diabetic rats. Sprague Dawley rats were divided into four groups: control, ascorbate (400 mg/kg rat weight daily in drinking water), diabetic (single dose of 50 mg of STZ/kg i.p.) and diabetic simultaneously fed with ascorbate for 12 wk. Rats in groups were studied at tri-weekly intervals (0 to 12 wk). Diabetic rats were evaluated periodically with changes of plasma glucose levels and body weight. The ascorbate supplimentation attenuated the development of hyperglycemia and weight loss induced by STZ injection in rats. In the present experimental condition, the ascorbate supplimentation had no significant effect on plasma glucose levels and changes in body weight of normal rate. The superoxide generation, formation of thiobarbituric acid reactive substance and iNOS expression in kidney were significantly increased in STZ-treated rats that were decreased by ascorbate supplimentation. The ascorbate supplimentation had no effect on vasorelaxation of isolated thoracic aorta. These results indicate that ascorbate supplimentation may exert an inhibitory effect on STZ-induced oxidative tissue damage through protection of pancreatic islet cells by scavanging reactive oxygen species. The ascorbate supplimentation may possibly attenuate the renal complication of diabetes mellitus.