• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.72-82
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• 2021

Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acid-base analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning. Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart's approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests. Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality. Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.

• Journal of Digital Convergence
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• v.19 no.7
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• pp.253-261
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• 2021

This study aims to confirm the association with the willingness to quit smoking in adult smokers with chronic diseases, and the research method was analyzed using data from the 7th National Health and Nutrition Survey (2016-2018). The subjects were frequency analysis, chi-square test, and logistic regression analysis of 960 chronically ill patients aged 19 years or older, which were analyzed using the SPSS 26.0 Program. As a result of the study, depending on the level of education, high school graduation (OR=1.328, 95%CI=1.004-1.757), college graduation or higher (OR=1.556, 95%CI=1.167-2.075), the more stressed you are (OR=1.602, 95%CI) =1.217-2.109), there was an attempt to quit smoking (OR=5.263, 95% CI=4.287-6.462), which was associated with the willingness to quit smoking. It is necessary to prevent chronic diseases by reducing the smoking rate through active participation in smoking cessation programs targeting groups with high willingness to quit smoking, and by preparing measures to relieve appropriate stress.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.167-175
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• 2018

Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea.

• Translational and Clinical Pharmacology
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• v.25 no.2
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• pp.67-73
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• 2017

Glimepiride, a third generation sulfonylurea, is an antihyperglycemic agent widely used to treat type 2 diabetes mellitus. In this study, an untargeted urinary metabolomic analysis was performed to identify endogenous metabolites affected by glimepiride administration. Urine samples of twelve healthy male volunteers were collected before and after administration of 2 mg glimepiride. These samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and then subjected to multivariate data analysis including principal component analysis and orthogonal partial least squares discriminant analysis. Through this metabolomic profiling, we identified several endogenous metabolites such as adenosine 3', 5'-cyclic monophosphate (cAMP), quercetin, tyramine, and urocanic acid, which exhibit significant metabolomic changes between pre- and posturine samples. Among these, cAMP, which is known to be related to insulin secretion, was the most significantly altered metabolite following glimepiride administration. In addition, the pathway analysis showed that purine, tyrosine, and histidine metabolism was affected by pharmacological responses to glimepiride. Together, the results suggest that the pharmacometabolomic approach, based on LC-MS/MS, is useful in understanding the alterations in biochemical pathways associated with glimepiride action.

• Journal of Life Science
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• v.29 no.4
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• pp.447-454
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• 2019

Fat accumulation in adipocytes occurs through the process of adipogenesis in which preadipocytes differentiate into adipocytes. Obesity is a metabolic disorder caused by excessive accumulation of fat in the body, which increases the incidence of cardiovascular diseases, hypertension, type 2 diabetes, hyperlipidemia, and various cancers. Recently, inhibition of adipocyte differentiation was shown to be a potential antiobesity strategy. In this study, the inhibitory effect of dichloromethane fractions from Illicium verum Hooker fil. water extract on the differentiation of 3T3-L1 preadipocytes to adipocytes was investigated. Dichloromethane fractions from I. verum Hooker fil. significantly inhibited adipocyte differentiation when applied during the adipocyte differentiation process, as assessed by measuring fat accumulation using Oil-red O staining. In addition, dichloromethane fractions from I. verum Hooker fil. reduced important adipogenic transcription factors, such as CCAAT/enhancer binding protein ${\alpha}$ ($C/EBP{\alpha}$), $C/EBP{\beta}$, and peroxisome proliferator activated receptor ${\gamma}$ ($PPAR{\gamma}$). The expression of FAS and LPL, which are terminal differentiation markers of mature adipocytes, was also reduced in the 3T3-L1 adipocytes treated with dichloromethane fractions from I. verum Hooker fil. In addition, the treatment significantly inhibited mitotic clonal expansion, which is essential for adipocyte differentiation, by arresting the G1 phase of the cell cycle. Taken together, these results suggest that dichloromethane fractions from I. verum Hooker fil. may be a natural material with antiobesity effects.

• Journal of Life Science
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• v.29 no.6
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• pp.735-739
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• 2019

The dried rhizomes and roots of Gentiana scabra (GS) have been frequently prescribed as a traditional folk medicine in East Asia (including China, Japan, and Korea) for the treatment of various pathophy-siological conditions, such as inflammatory skin diseases, anorexia, indigestion, gastric infections, and diabetes mellitus. In the present study, the effects of aqueous (GS-W) and ethanolic (GS-E) extracts of GS on gastrointestinal (GI) motor function were investigated by measuring the in vivo gastric emptying rate (GER) and the intestinal transit rate (ITR) in mice. The GER was significantly increased by GS-W at a dose of 1 g/kg. The ITR was significantly increased by GS-W (at doses of 0.1 and 1 g/kg) or GS-E (at a dose of 1 g/kg) in a dose-dependent manner. Furthermore, the ITR value of GS-W (at a dose of 1 g/kg) appeared to be higher than that of cisapride, which was the most prominent prokinetic agent in the 1900s but was removed from the market in 2000 due to its fatal side effects. The above results suggest that GS-W might be a potential prokinetic agent to replace cisapride.

• Journal of Nutrition and Health
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• v.52 no.3
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• pp.268-276
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• 2019

Purpose: Metabolic syndrome causes diabetes and increases the risk of cardiovascular disease. This study examined the correlation between metabolic syndrome, nutrition intake, and triglyceride (TG)/high-density lipoprotein (HDL) cholesterol ratio. Methods: Using the data from the $7^{th}$ KNHANES (2016), this study was conducted on healthy adults aged 19 and older. The components and existence of metabolic syndrome and nutrition intake were independent variables and the TG/HDLcholesterol ratio was a dependent variable. A complex sample logistic progress test was used with age, sex, smoking, and drinking frequency corrected. Results: The TG/HDLcholesterol ratio of people with metabolic syndrome was as high as 1.314 on average, compared to people without metabolic syndrome (p < 0.0001). Among each component of metabolic syndrome, the TG/HDL cholesterol ratio had a significant association with fasting blood glucose, TG, HDL cholesterol, and waist circumference (p < 0.05). Only energy and carbohydrate intake were significantly related to the TG/HDLcholesterol ratio (p < 0.05). Conclusion: The TG/HDLcholesterol ratio is associated with each component of metabolic syndrome, but in particular, it is positively correlated with the presence of metabolic syndrome. Lower energy intakehad a positive correlation with the TG/HDLcholesterol ratio. These results show that metabolic syndrome can be predicted using the TG/HDLcholesterol ratio, and a diet strategy through nutrition and health education is necessary to prevent metabolic syndrome.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.536-544
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• 2019

Objective : The objective of this study was to evaluatelong-term radiologic prognosis and characteristics of in-stent stenosis (ISS) after stent assisted coiling (SAC) for cerebral aneurysm and analyze its risk factors. Methods : Radiological records of 362 cases of SAC during 10 years were retrospectively reviewed. Patients were included in this study if they had follow-up angiogram using catheter selected angiography at least twice. All subjected were followed up from 12 months to over 30 months. Of 120 patients, 123 aneurysms were enrolled. Patient data including age, sex, aneurysm size, neck size, procedural complication, kinds of stent, ISS associated symptom, ruptured state, location of ISS, degree of ISS, radiologic prognosis of ISS, follow-up period of time, and medical comorbidities such as hypertension, diabetes mellitus (DM), dyslipidemia, and smoking were collected.Statistical comparisons of group clinical characteristics were conducted for the total population. Results : Among 123 casesof aneurysm, 22 cases (17.9%) of ISS were revealed on follow-up angiography. Multiple stenting was performed in three cases and intra-procedural rupture occurred in two cases. Most cases were asymptomatic and symptomatic stenosis was identified in only one case. Sixteen cases were ruptured aneurysm. Mild stenosis was observed in 11 cases. Moderate stenosis was found in eight cases and severe stenosis was identified in three cases. Mean timing of identification of ISS was 8.90 months. The most common type was proximal type. Most cases were improved or not changed on follow-up angiography. Only one case was aggravated from mild stenosis to occlusion of parent artery. Mean follow-up period was 44.3 months. We compared risk factors and characteristic between ISS group and non-ISS group using univariate analysis. Multiple stenting was performed for three cases (13.6%) of the ISS group and four cases (4.0%) of the non-ISS group, showing no statistical difference between the two groups (p=0.108). Additionally, the proportion of patients who had more than two risk factors among four medical risk factors (hypertension, DM, dyslipidemia, and smoking) was higher in the ISS group than that in the non-ISS group, the difference between the two was not statistically significant either (31.8% vs. 12.9%, p=0.05). Conclusion : Clinical course and long-term prognosis of ISS might be benign. Most cases of ISS could be improved or not aggravated. Control of medical co-morbidity might be important. To the best of our knowledge, our study had more cases with longer follow-up period of time than other reports.

• Korean Journal of Plant Resources
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• v.32 no.3
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• pp.220-227
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• 2019

Stevia rebaudiana (Asteraceae), a perennial plant, has been used as a low-calorie sweetener and is being developed as a therapeutic agent for diabetes, hypertension, myocardial diseases, and microbial infections. Despite the common use of its leaves and stem, the bioavailability of the components present in S. rebaudiana flowers, when used as ingredients of cosmetics, has not been well investigated. Herein, we investigated the antioxidative and antimelanogenic effects of an aqueous extract of S. rebaudiana flowers (Stevia-F). Total flavonoid and phenolic content in Stevia-F were determined to be $8.64{\pm}0.23mg$ of quercetin equivalents/100 g and $631.5{\pm}2.01mg$ of gallic acid equivalents/100 g, respectively. The $IC_{50}$ values of Stevia-F for reducing power, and 2,2-diphenyl-1-picryl-hydrazyl-hydrate radical, hydrogen peroxide, and nitric oxide scavenging activities were 5541.96, 131.39, 466.34, and $10.44{\mu}g/mL$, respectively. Stevia-F showed inhibitory effects on the tyrosinase ($IC_{50}=134.74{\mu}g/mL$) and ${\alpha}$-glucosidase ($IC_{50}=114.81{\mu}g/mL$) activities. No significant cytotoxicity of Stevia-F was observed in B16F10 cells, treated with up to $100{\mu}g/mL$ of the extract for 24 and 48 h (p > 0.05). Stevia-F ($1-100{\mu}g/mL$) suppressed ${\alpha}$-melanocyte stimulating hormone-induced melanin production in B16F10 cells (p < 0.05) and also inhibited the cellular tyrosinase activity (p < 0.05). Overall, our results show that Stevia-F possesses potential for inhibiting tyrosinase and ${\alpha}$-glucosidase activities and has significant antioxidant capacity. The antimelanogenic potential of Stevia-F should extend the usage of S. rebaudiana flowers in the development of skin-whitening products.

• Laboraroty Animal Research
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• v.34 no.4
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• pp.288-294
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• 2018

A few clues about correlation between endoplasmic reticulum (ER) stress and mulberry (Morus alba) leaves were investigated in only the experimental autoimmune myocarditis and streptozotocin-induced diabetes. To investigate whether a novel extract of mulberry leaves fermented with Cordyceps militaris (EMfC) could suppress ER in fatty liver, alterations in the key parameters for ER stress response were measured in high fat diet (HFD)-induced obese C57L/6 mice treated with EMfC for 12 weeks. The area of adipocytes in the liver section were significantly decreased in the HFD+EMfC treated group as compared to the HFD+Vehicle treated group, while their level was higher in HFD+Vehicle treated group than No treated group. The level of the eukaryotic initiation factor 2 alpha ($eIF2{\alpha}$) and inositol-requiring enzyme 1 beta ($IRE1{\alpha}$) phosphorylation and CCAAT-enhancer-binding protein homologous protein (CHOP) expression were remarkably enhanced in the HFD+Vehicle treated group. However, their levels were restored in the HFD+EMfC treated group, although some differences were detected in the decrease rate. Similar recovery was observed on the ER stress-induced apoptosis. The level of Caspase-3, Bcl-2 and Bax were decreased in the HFD+EMfC and HFD+orlistat (OT) treated group compared to the HFD+Vehicle treated group. The results of the present study therefore provide first evidence that EMfC with the anti-obesity effects can be suppressed ER stress and ER stress-induced apoptosis in the hepatic steatosis of HFD-induced obesity model.