• Annals of Clinical Neurophysiology
• /
• 제25권1호
• /
• pp.32-37
• /
• 2023

Background: Type 2 diabetic mellitus (T2DM) is an emerging global pandemic which is associated with lots of co-morbidities and reported vascular dysfunctions. T2DM associated vascular dysfunctions leads to vasculopathy in the form of altered peripheral vascular dynamics. Cold stress test (CST) is a reliable sympathetic reactivity test used for assessing vascular dysfunctions. In this study we are trying to quantify vascular dysfunctions in T2DM patients non invasively by various parameters of photoplethysmography (PPG) of cold stress test. Methods: Case control study had done in referral health center AIIMS, Raipur. Parameters are recorded by finger-PPG before, during and after CST (1 min) in 2 groups, control (n = 20 healthy volunteers) and case (n = 20 diagnosed T2DM patients). Results: Due to cold stress, PPG parameter peak amplitude was significantly decreased in both healthy and T2DM groups (p <0.001 and p <0.001, respectively). However, recovery trend of amplitude was significantly slow in T2DM compared to healthy subjects. Another PPG parameter peak to peak interval was significantly higher in healthy group compared to T2DM patients. Conclusions: This study showed that T2DM patients has significant deranged pulse volume parameters like amplitude and peak to peak interval can be used to objectively quantify the vasculopathy in T2DM patients by using sympathetic reactivity to cold stress.

• 핵의학기술
• /
• 제13권3호
• /
• pp.67-75
• /
• 2009

목적 : Tl-201 심근관류 SPECT의 정량적 평가를 위해 사용되는 다양한 프로그램은 자료의 분석 방법에 있어서 각각 차이가 있는 것으로 보고되고 있다. 따라서 동일한 환자의 자료를 대상으로 정량적 분석을 하여도 프로그램 상호간의 측정치 오차가 발생할 것으로 예상된다. 그 중 심근의 관류결손 정도를 표현할 수 있는 정량적 지표를 이용하여 현재 각 병원에서 가장 일반적으로 사용하고 있는 심근관류분석 프로그램 QPS (Quantitative Perfusion SPECT)와 4DM (4DMSPECT) 그리고 ECT (Emory Cardiac Toolbox)의 분석값을 이용하여 프로그램 상호간의 연관성을 알아보고자 한다. 실험재료 및 방법 : 2008년 12월 1일 부터 2009년 2월 14까지 서울아산병원 핵의학과에서 Tl-201을 이용하여 게이트 심근관류 SPECT를 시행한 환자 145명을 대상으로 하였다. 이들 중 심혈관 질환의 가능성이 비교적 적다고 판단된 정상군 80(남/여=38/42, $65.1{\pm}9.9$세)명과 게이트 심근관류 SPECT의 판독결과를 통해 가역성 관류결손이나 고정 관류결손 등 심혈관 질환의 판정을 받은 비정상군 65(남/여=45/20, $63.0{\pm}8.7$세)명을 선별하였다. QPS와 4DM 그리고 ECT 프로그램을 이용하여 각각의 군에서 분석된 정량적 지표인 LAD, LCX, RCA 영역에서의 관류결손 범위율의 합(Total Defect Extent, TDE)과 부하기 관류점수합(Summed Stress Score, SSS)을 이용하여 상관관계 분석과 차이분석(paired t-test, Bland-Altman)을 이용하여 통계 결과를 비교 분석하였다. 결과 : 연구 대상 145명의 4DM:QPS, QPS:ECT, ECT:4DM 프로그램의 상관 계수는 SSS에서 각각 0.84, 0.86, 0.82이었고, TDE에서 각각 0.87, 0.84, 0.87로 SSS와 TDE 모두 높은 상관관계가 있었다. paired t-test 분석 결과에서는 QPS:ECT만 SSS (p=0.92)와 TDE (p=0.33) 모두 통계적으로 유의한 차이가 없었고, 4DM:QPS, ECT:4DM은 SSS와 TDE 모두 통계적으로 유의한 차이가 있었다(p<0.01). 비정상군 65명의 4DM/QPS, QPS/ECT, ECT/4DM 프로그램의 상관 계수는 SSS에서 각각 0.72, 0.72, 0.70이었고, TDE에서 각각 0.77, 0.70, 0.77로 SSS와 TDE 모두 높은 상관관계가 있었다. 비정상군 역시 paired t-test 분석 결과 QPS:ECT만 SSS (p=0.89)와 TDE (p=0.23) 모두 통계적으로 유의한 차이가 없었고, 4DM : QPS, ECT:4DM은 SSS와 TDE 모두 통계적으로 유의한 차이가 있었다(p<0.01). 정상군 80명의 분석 결과에서도 QPS : ECT만 SSS (p=0.95)와 TDE (p=0.73) 모두 통계적으로 유의한 차이가 없을 뿐, 4DM:QPS, ECT:4DM은 SSS와 TDE 모두 통계적으로 유의한 차이가 있었다(p<0.01). 결론 : 심혈관 질환을 가진 환자뿐 아니라 심혈관 질환의 가능성이 적은 환자에서도 Tl-201 심근 관류 SPECT의 관류 결손을 분석한 결과, 4DM은 QPS와 ECT 프로그램에 비해 SSS와 TDE 모두 낮게 분석되는 경향을 보였지만 프로그램 상호간에는 좋은 상관관계가 있다는 것을 확인 할 수 있었다. 하지만 이와 같이 좋은 상관관계에도 불구하고 Bland-Altman 분석 결과에서 프로그램간의 큰 변이 차이 때문에 임상에서 각각의 프로그램을 이용한 분석값을 서로 호환하여 사용할 수는 없을 것으로 판단된다. 그렇지만 이러한 분석결과는 임상적인 판독을 위한 참고 자료로서 유용하게 이용될 수 있을 것이라 기대된다.

• 한국식품영양과학회지
• /
• 제33권9호
• /
• pp.1457-1462
• /
• 2004

Wistar계 흰쥐에게 두릅, 오가피 및 느릅의 열수추출물을 급여하여 7주간 급여하였으며 희생 2주전에 STZ으로 당뇨를 유발하여 혈당이 300 ㎎/dL 이상인 흰쥐를 대상으로 혈장 중의 포도당 농도 및 바이오마커에 미치는 영향을 구명하였다. 혈장의 포도당 함량은 두릅나무과 식물의 열수추출물 급여시 대조군에 비해 유의적인 혈당저하 효과가 관찰되었으며, 혈장의 인슐린과 C-펩타이드 함량 역시 두릅, 오가피 및 느릅 열수추출물 급여시 STZ 투여에 의한 변화가 완화되었다. 혈장 중의 알부민 함량은 당뇨대조군이 정상군에 비하여 유의적으로 감소되었으며 실험식이 급여시 증가되는 경향이었다. 빌리루빈과 크레아티닌 함량은 STZ 투여로 유의적으로 증가되었으나 실험식이를 급여한 모든 군에서 유의적으로 감소되었다. 두릅, 오가피 및 느릅 열수추출물은 당뇨 유발로 증가된 혈장의 AST, ALT, ALP 및 LDH의 활성을 유의적으로 억제하였다. 따라서 두릅나무과 식물 중 두릅, 오가피 및 느릅의 열수추출물은 STZ 투여 흰쥐의 혈당강하 및 혈장바이오마커의 변화 개선에 효과적인 것으로 관찰되었다.

• The Korean Journal of Physiology and Pharmacology
• /
• 제4권3호
• /
• pp.185-195
• /
• 2000

Vascular diseases are significant complications of diabetes mellitus (DM), and the endothelial cells may play a pivotal role in the development of vascular disease in DM. Endothelin-1 (ET-1) released from endothelium is a potent vasoconstrictor peptide and circulating level of ET-1 is increased in a variety of disease states. The purpose of this study was to determine the changes of responsiveness to ET-1 in DM, and we experimented on the changes in the ET-1-induced contraction, levels of nitrite and lipid peroxidation, and ET-1 immunoreactivity in aorta from streptozotocin-induced DM rats. DM was induced by single injection of streptozotocin (55 mg/kg, i.p.). The immunoreactive ET-1 levels in endothelial layer of thoracic aorta were much higher in DM rats than control rats. Nitrite in tissue homogenate was decreased and plasma nitrite was increased in DM rats. Malondialdehyde (MDA) was significantly increased in DM rats and cGMP was not significantly different between control and DM rats. ET-1 produced concentration- dependent contractile responses that are significantly attenuated in DM rats compared to controls. In the presence of selective $ET_A$ receptor antagonist BQ610, the maximum contraction was decreased and the concentration ratios for BQ610 yielded $pA_2$ values of 7.3 (slope, 0.65) in control rats, whereas BQ610 had no antagonistic effect on ET-1-induced contraction in DM rats. However, pretreatment with BQ788, an $ET_B$ receptor antagonist, maximum response was decreased and the dose-response curves for ET-1 were shifted to the right in both groups and $pA_2$ values were 7.9 and 7.7 (slope, 1.05 in control and DM rats), respectively. IRL 1620 and sarafotoxin S6c, $ET_B$ agonists, induced relaxation in control rats but not in DM rats. These results indicate that endothelial cell dysfunction and enhanced immunoreactivity of ET-1 have been found in DM rat and ET-1-induced contraction was attenuated in DM rat. These attenuated responses might be at least in part caused by the alteration of $ET_A$ receptor properties (e.g. desensitization), and partly related with an alteration in intracellular mechanism for contraction to ET-1.

• 한국식품영양과학회지
• /
• 제28권3호
• /
• pp.654-662
• /
• 1999

The purpose of this study was to investigate the effects of vitamin E on the antioxidative defense system of kidney in streptozotocin induced diabetic rats. Sprague Dawley male rats weighing 100$\pm$10g were randomly assigned to one normal and three STZ induced diabetic groups, which were subdivided into vitamin E free diet(DM 0E group), 40mg vitamin E per kg diet(DM 40E group) and 400mg vitamin E per kg diet(DM 400E group). Vitamin E level of normal group was 40 mg per kg diet. Diabetes was experimentally induced by intravenous injection of 55mg/kg of body weight of streptozotocin(STZ) in citrate buffer(pH 4.3) after 4 weeks feeding of experimental diets. Animals were sacrificed at the 6th day of diabetic states. There were no significant on body weights, food intakes, and food efficiency ratio before the diabetic occurrence. But after the injection of STZ, body weights and food efficiency ratios were significantly decreased and the food intakes was increased. Kidney weights were significantly increased in diabetic groups compared to normal group. However, there were no significant differences among the diabetic groups. Plasma insulin levels of diabetic groups were significantly decreased, whereas, blood sugar levels were increased compared to that of normal group. There were no significant differences among diabetic groups in plasma insulin and glucose levels. Activities of superoxide dismutase(SOD) in DM 0E and DM 40E groups were signi ficantly decreased by 33% and 27%, respectively, compared to normal group. But that of DM 400E group was increased by 35% compared to DM 0E group. Activity of glutathione peroxidase(GSHpx) in DM 0E group was decreased by 20% compared with normal group. GSHpx activity in DM 400E group was increased by 29% compared to normal group. The contents of vitamin E in kidney were 58% and 49% lower in DM 0E and DM 40E group, respectively, than normal group. There was no significant difference in renal vitamin E contents between DM-400E group and normal group. The contents of superoxide radical(O2 ) in kidney were 150% and 98%, respectively, higher in DM 0E and DM 40E groups than normalgroup. DM 400E and normal groups were similar levels in their superoxide radical contents of kidneys. These results indicate that vitamin E functioned as chain breaking antioxidant in kidney such as in other tissues.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권4호
• /
• pp.2583-2589
• /
• 2013

Purpose: Studies have indicated that diabetes mellitus (DM) is a risk factor for bladder cancer; however, not all evidence supports this conclusion. The aim of this meta-analysis was to collate and evaluate all primary observational studies investigating the risk of bladder cancer associated with DM. Methods: The PubMed and Google Scholar databases were searched to identify studies that estimated the association of DM and bladder cancer. Summary effect estimates were derived using a random-effects meta-analysis model. Results: A total of 23 studies (8 case-control studies, 15 cohort studies) including 643,683 DM and 4,819,656 non-DM cases were identified. Analysis of all studies showed that DM was associated with an increased risk of bladder cancer compared with non-DM overall (OR=1.68, 95% CI 1.32-2.13). Analysis of subgroups demonstrated this to be the case in both case-control studies (OR=1.59, 95% CI 1.28-1.97, $I^2$=58%) and cohort studies (RR=1.70, 95% CI 1.23-2.33, $I^2$=96%). There was no gender difference in DM-associated bladder cancer risk. Bladder cancer risk was increased in Asia and the North America region, but not in Europe. Furthermore, DM-associated bladder cancer risk was obviously higher in Asia than North America and Europe or in those with Caucasian ethnicity. With extension of follow-up time, the bladder cancer risk was not increased for the patients with DM. Conclusions: This meta-analysis provided further evidence supporting theDM association with a significantly higher risk of bladder cancer obtained from observational studies.

• 대한두경부종양학회지
• /
• 제18권2호
• /
• pp.157-162
• /
• 2002

Background and Objectives: Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods: Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results: DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM(p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions: Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.

• 대한의생명과학회지
• /
• 제17권4호
• /
• pp.337-345
• /
• 2011

It is well recognized that conventional coronary artery bypass grafting (ONCAB) often leads to major organ dysfunction including renal injury. Diabetes mellitus is a major cause of nephropathy and poor clinical outcomes. The aim of this retrospective study was to evaluate the occurrence of adverse outcomes including renal impairment between diabetic (n=75, DM group) and non-diabetic patients (n=72, Non-DM group) underwent off-pump coronary artery bypass grafting surgery (OPCAB). Fasting glucose, hemoglobin A1c, fructosamine, fibrinogen and serum osmolality levels in the DM group were higher than those of the Non-DM group at pre-operative (Pre-OP) period ($P$ <0.05). History of hypertension and renal impairment in the DM group was higher than that of the Non-DM group ($P$ <0.05). Potassium ($K^+$), blood urea nitrogen and creatinine levels were higher, whereas sodium ($Na^+$) and glomerular filtration rate (GFR) levels were lower in the DM group than the Non-DM group at peri-operative period ($P$ <0.05). Fasting glucose levels at Pre-OP period had positive correlations with blood urea nitrogen and creatinine levels at peri-operative period, but negative correlations with GFR levels at peri-operative period in the DM group ($P$ <0.05). Incidences of renal impairment, diuretic therapy or continuous renal replacement therapy and fever in the DM group were higher than those of the Non-DM group at post-operative period ($P$ <0.05). These results suggest that blood glucose level should be tightly controlled at peri-operative period to avoid renal dysfunction in diabetic patients.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권9호
• /
• pp.3931-3936
• /
• 2015

Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권5호
• /
• pp.2121-2127
• /
• 2012

Objective: Deoxyribonucleoside kinase of Drosophila melanogaster (Dm-dNK) mutants have been reported to exert suicide gene effects in combined gene/chemotherapy of cancer. Here, we aimed to further evaluate the capacity of the mutanted enzyme and its potential for inhibiting cancer cell growth. Methods: We altered the sequence of the last 10 amino acids of Dm-dNK to perform site-directed mutagenesis and constructed active site mutanted Dm-dNK (Dm-dNKmut), RT-PCR and western bloting studies were used to reveal the expression of lentivirus mediated Dm-dNKmut in a breast cancer cell line (Bcap37), a gastric cancer cell line (SGC7901) and a colorectal cancer cell line (CCL187). [3H]-labeled substrates were used for enzyme activity assays, cell cytotoxicity was assessed by MTT assays, cell proliferation using a hemocytometer and apoptosis induction by thenannexin-V-FITC labeled FACS method. In vivo, an animal study was set out in which BALB/C nude mice bearing tumors were treated with lentivirus mediated expression of Dm-dNKmut with the pyrimidine nucleoside analog brivudine (BVDU, (E)-5-(2-bromovinyl)-(2-deoxyuridine). Results: The Dm-dNKmut could be stably expressed in the cancer cell lines and retained its enzymatic activity. Moreover, the cells expressing Dm-dNKmut exhibited increased sensitivity in combination with BVDU, with induction of apoptosis in vitro and in vivo. Conclusion: These findings underlined the importance of BVDU phosphorylated by Dm-dNKmut in transduced cancer cells and the potential role of Dm-dNKmut as a suicide gene, thus providing the basis for future intensive research for cancer therapy.