• Title/Summary/Keyword: Diabetes

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Comparison of Clinical Characteristics between Pulmonary Tuberculosis Patients with Extensively Drug-resistance and Multi-drug Resistance at National Medical Center in Korea (국립의료원에 내원한 광역내성 폐결핵 환자와 다제내성 폐결핵 환자의 임상적 특성 비교)

  • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.414-421
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    • 2008
  • Background: Recently, in addition to multi-drug resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB) has become rapidly growing public health threat. This study examined the clinical differences between pulmonary TB patients with extensively drug resistance (XDR) and multi-drug resistance (MDR) at the National Medical Center in Korea in order to determine the clinical characteristics associated more with XDR-TB than MDR-TB. Methods: Patients who received a diagnosis of culture-confirmed pulmonary TB and a drug sensitivity test (DST) for anti-TB drugs at the National Medical Center between January 2000 and August 2007 were enrolled in this study. The patients were identified into the XDR-TB or MDR-TB group according to the DST results. The clinical characteristics were reviewed retrospectively from the medical records. Statistical analysis for the comparisons was performed using a ${\chi}^2$-test, independent samples t-test or binary logistic regression where appropriate. Results: A total 314 patients with culture-confirmed pulmonary TB were included. Among them, 18 patients (5.7%) had XDR-TB and 69 patients (22%) had MDR-TB excluding XDR-TB. A comparison of the clinical characteristics, revealed the XDR-TB group to have a higher frequency of a prior pulmonary resection for the treatment of TB (odds ratio [OR], 3.974; 95% confidence interval [CI], 1.052~15.011; P value 0.032) and longer average previous treatment duration with anti-TB drugs, including a treatment interruption period prior to the diagnosis of XDR, than the MDR-TB group (XDR-TB group, 72.67 months; MDR-TB group, 13.09 months; average treatment duration difference between two groups, 59.582 months; 95% CI, 31.743~87.420; P value, 0.000). In addition, a longer previous treatment duration with anti-TB drugs was significantly associated with XDR-TB (OR, 1.076; 95% CI, 1.038~1.117; P value, 0.000). A comparison of the other clinical characteristics revealed the XDR-TB group to have a higher frequency of male gender, diabetes mellitus (DM), age under 45, treatment interruption history, cavitations on simple chest radiograph and positive result of sputum AFB staining at the time of diagnosis of XDR. However, the association was not statistically significant. Conclusion: Pulmonary TB patients with XDR have a higher frequency of a prior pulmonary resection and longer previous treatment duration with anti-TB drugs than those with MDR. In addition, a longer previous treatment duration with anti-TB drugs is significantly associated with XDR-TB.

Determinants of Demand for Long-Term Care (장기요양서비스 수요의 결정요인)

  • Chung, Wankyo
    • KDI Journal of Economic Policy
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    • v.31 no.1
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    • pp.139-167
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    • 2009
  • A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration.

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EFFECTS OF GINSENG COMPONENTS ON RODENTICIDE VACOR-INDUCED DIABETES MELLITUS IN RATS (인삼성분이 살서제(Vacor)로 유발시킨 쥐의 당뇨에 미치는 영향)

  • Lee Min-wha;Lee Tai-hee;Ahn Bong-whan;Park Byung-ju;Yang Sung-yeul
    • Proceedings of the Ginseng society Conference
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    • 1984.09a
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    • pp.83-88
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    • 1984
  • It is now well established that the rodenticide Vacor (N-3-pyridyl-mehtyl-N'-p-nitropheny-lurea) causes a hyperglycemia in human and rats. It is also reported that there are some components (DPG-3) in ginseng radix which cause hypoglycemic effect on alloxan diabetic mice. In the present study, attempts were made to demonstrate in Vacor-poisoned rats the hypo-glycemic activity of red ginseng component(RGC), which was extracted by Kimura's DPG-3 extraction procedure and found to be effective for lowering a hyperglycemia in alloxan-diabetic rats. Vacor in a dose of $LD_{50}$ (10mg/kg) produced a glucose intolerance with a paradoxical moderate increase in blood immunoreactive insulin and derangement in glucose metabolism of epididymal adipocytes in rats. Although RGC (20mg/kg, i.p.) did not exert any significant influence on a hyperglycemia induced by large lethal doses (25mg/kg) of Vacor ingestion, it improved the LDso Vacor-induced glucose intolerance and caused a further increase in blood insulin levels in Vacor-poisoned rats. The administration of RGC (20mg/kg, i.p.) normalized Vacor-induced depression of glucose metabolism and lipogenesis in the epididymal adipocytes with an improvement of reduced responses to insulin of adipocytes from Vacor-poisoned rats. These results suggest that some red ginsneng components contained in RGC fraction normalize the depressed peripheral glucose unitlization and insulin response and eventually lead to an improvement of abnormal glucose tolerance developed in rats poisoned with small doses of Vacor.

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A Literature Review of The Senile Hypotension (노인(老人) 저혈압(低血壓)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Kwak, Ik-Hoon;Kim, Jong-Dae;Jeong, Ji-Cheon
    • The Journal of Dong Guk Oriental Medicine
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    • v.4
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    • pp.161-187
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    • 1995
  • This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

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Effect of Dietary Supplementation with Bitter Melon on Lipids and Hepatic Enzyme Levels in Streptozotocin Induced Diabetic Rats (여주열매 첨가식이가 당뇨 흰쥐의 지질과 항산화효소 수준에 미치는 영향)

  • Kim, Myung-Wha
    • Journal of the East Asian Society of Dietary Life
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    • v.24 no.6
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    • pp.759-767
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    • 2014
  • This study examined the effect of Momordica charantia L. (bitter melon: BM) on lipid and hepatic antioxidative enzyme levels in diabetic rats. Diabetes mellitus was induced in male Sprague-Dawley rats by injection of streptozotocin (STZ), and rats were fed for 4 weeks with experimental groups divided into four groups: a normal control group, STZ-control and STZ-BM 5% & STZ-BM 10% treated groups. Levels of free fatty acids (FFA), high-density lipoprotein cholesterol (HDL-chol), triglycerides (TG) in plasma and malondialdehyde (MDA) & protein in liver, catalase (CAT), superoxide dismutase (SOD), glutathione-S-transferase (GST), and xanthine oxidase (XOD) were measured in liver cytosol. Level of HDL-chol significantly increased in the STZ-BM 5% diabetic group. TG & FFA levels were significantly higher in all diabetic groups compared to the control group. MDA and protein levels were significantly higher in the STZ-BM 5% group compared to all other experimental group. CAT level was higher in the supplementary group with BM compared to the STZ-control group, although the difference was not significantly different. SOD level was not significant in any experimental groups. GST level was significantly higher in the BM-treated groups compared to the STZ-control group. XOD level was significantly lower in the BM 5% group and significantly decreased in all experimental groups. These results show that supplementation of BM fruit powder may have beneficial effects on diabetic complications and damage caused by oxidative stress.

A comparative Study of Changing Pattern of Cause of Death Analysis of Korean, Korean in Japan and Japanese (재일한국인의 생활문화의 이질화와 적응과정에 관한 보건학적 연구(제 1보 한국, 재일한국인, 일본의 사인구조분석)

  • 김정근;장창곡;임달오;김무채;이주열
    • Korea journal of population studies
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    • v.15 no.2
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    • pp.15-59
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    • 1992
  • After world war II Japanese life expectancy has been improved remarkably, and reached the highest level in the world around late 1970's. The life expectancy of Korean has also shown tremendous improvement in recent years with about 20 year's gap from the Japanese. The reason of rapid improvement of life expectancy can be explained by changes in the structure of cause of death due to health system, living standard, social welfare, health behavior of individuals and so on. Korean in Japan is placed under different situations from both Korean in Korea and Japanese in these regards, and expected to show different picture of cause of death pattern. The objective of this study is the comparision of changing patterns of cause of death of three population groups, Korean in Japan, Korean in Korea and Japanese, and to investigate the reasons which effect to the structural difference of mortality cause with special emphasis on health ecological aspects. One of the major limitations of the Korean causes of death statistics is the under-registration which ranges about 10% of the total events, and inaccuracy of the exact cause of death. Some 20% of registered deaths were unable to classify by ICD. However, it is concluded that the Korean data are evaluated as sufficient to stand for over-viewing of trends of cause of death pattern. The evaluation is done by comparing data from registration and field survey over the same population sample. Population data of Korean in Japan differ between two sources of data; census and foreigner's registration. Correction is done by life table method under the assumption that age-specific mortality pattern would accord with that of the Japanese. The crude death rate was lowest among Korean in Japan, 5.7 deaths per 1,000 population in 1965. The crude death rates of Korean in Japan and Japanese are increasing recently influenced by age structure while Korean in Korea still shows decreasing tendency. The adjusted death rate is lowest among Japanese, followed by Korean in Japan, and Korean in Korea. The leading causes of death of Korean in Korea until 1960's was infectious diseases including pneumonia and tuberculosis. The causes of death structure changed gradually to accidents, neoplasm, hypertensive disease, cerebro-vascular disease in order. The main difference in cause of death between Korean and Japanese if high rate of liver diseases and diabetes for both Korean in Japan and Korea. A special feature of cause of death among Korean in Korea is remakably high rate of hypertensive disease, which is assumed to be caused by physicians tendency in choosing diagnostic categories. The low ischemic heart disease and high vasculo-cerebral disease are the distinctive characteristic of the three population groups compared to western countries. Specific causes of death were selected for detailed sex, age and ethnic group comparisons based on their high death rates. Cancer is the cause of death which showed most dramatical increase in all three population groups. In Korea 20.1% of all death were caused by cancer in 1990 compared with 10.5% in 1981. Cancer of the liver is the leading cause of cancer death among Korean in Japan for both sexes, followed by cancer of the lung and cancer of the stomach, while that of Korean in Korea is cancer of the stomach, followed by cancer of the liver and cancer of the lung for male. Causes of infant mortality were examined among the three population groups since 1980 on yearly bases. For both Japanese and Korean in Japan, leading cause of death ranks as conditions originating in the perinatal period, congenital anomalies, accidents and other violent causes. Trends since 1980 for these two population groups in the leading cause of infant mortality showed no changes. On the contrary, significant changes in leading cause of death structure in Korea were observed : the ranking of leading cause of death in 1981 were congenital asnomalies, pneumonia bronchitis, infectious disease, heart disease, conditions originating in the perinatal period, accident and other violent causes ; in 1990 the ranking shifted to congenital anomalies, accident, pneumonia bronchities, conditions originating in the perinatal period, infectious disease. The mortality rate by congenital anomalies in Korea continuously grew than any other causes. Larger increase ocurred during the 1990's

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Oral Health and Self-Rated Health among the Elderly in Busan (부산지역 65세 이상 노인의 구강건강과 자가건강평가수준(SRH))

  • Yoon, Hyun-Seo;Chun, Jin-Ho;Lee, Jung-Hwa
    • Journal of dental hygiene science
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    • v.12 no.3
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    • pp.197-207
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    • 2012
  • The purpose of this study was to examine the impact of the oral health status and health care of elderly people on their self-rated health(SRH). The subjects on this study were 479 senior citizens who were at the age of 65 and up and resided in the city of Busan. They got a dental checkup, and a survey was conducted by having an one-on-one interview. After the collected data were analyzed, the following findings were given: The senior citizens were diagnosed with a mean of 1.43 systemic diseases, and hypertension(51.8%) was the most prevalent disease among them, followed by diabetes(25.1%), arthritis(41.8%), oral diseases(75.6%), stroke(9.0%) and heart diseases(15.9%). Their self-rated health was better when they were male, when they were aged between 65 and 69, when there was someone with whom they lived, when they were better educated and when they owned their own houses. But their self-rated health was poorer when they felt more oral symptoms, when they had more missing teeth and when they needed both of maxillary and mandibular dentures. Their self-rated health was more positively affected when they were better educated($\beta$=0.894), when they owned their own houses($\beta$=4.220), when they got a dental checkup on a regular basis($\beta$=2.997) and when the rate of their functional tooth was larger($\beta$=0.081). And that was more negatively influenced when they had a denture($\beta$=-1.110), when they had more oral symptoms($\beta$=-1.590) and when they had more systemic diseases($\beta$=3.363). There is a close relationship between the oral health and self-rated health of elderly people. Therefore how to promote their oral health should carefully be considered.

Effect of Conjugated Linoleic Acid on Nuclear Factor-${\kappa}B$ Activation and Tumor Necrosis Factor-${\alpha}$ Production in RAW 264.7 Cells Exposed to High Concentration of Glucose (고농도의 당에 노출된 RAW 264.7 세포에서 conjugated linoleic acid의 TNF-${\alpha}$ 생산과 NF-${\kappa}B$의 활성 효과)

  • Lee, Minji;Kang, Byeong-Teck;Kang, Ji-Houn;Yang, Mhan-Pyo
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.361-367
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    • 2012
  • Diabetes-related complications in human and veterinary medicine have been shown to be associated with hyperglycemia-induced inflammation. It has been recently suggested that the onset of insulin resistance may be caused by over-production of inflammatory cytokines such as tumor necrosis factor (TNF)-${\alpha}$ from immune cells. Conjugated linoleic acid (CLA) regulates inflammatory response through modulation of TNF-${\alpha}$ expression. The objective of this study was to examine the effect of CLA on nuclear factor kappaB (NF-${\kappa}B$) p65 binding activity, inhibitory kappaB ($I{\kappa}B$)-${\alpha}$ expression, and TNF-${\alpha}$ production from high glucose-treated RAW 264.7 cells. CLA was added to RAW cells that had been previously cultured with low or high concentration of glucose. The levels of TNF-${\alpha}$ protein in the culture supernatant of RAW cells exposed to high concentrations of glucose were higher than those of cells exposed to low concentrations of glucose. The treatment with the high concentration of glucose in RAW cells increased levels of NF-${\kappa}B$ p65 binding activity and the decreased $I{\kappa}B-{\alpha}$ expression when compared with those of low glucose. The treatments in combination with CLA and glucose (low and high) glucose in RAW cells increased TNF-${\alpha}$ production when compared with that glucose alone. These treatments with CLA increased TNF-${\alpha}$ production in high glucose-treated RAW cells than those with low glucose. These treatments of CLA also showed higher NF-${\kappa}B$ p65 binding activity and lower $I{\kappa}B-{\alpha}$ expression in high glucose than those in low glucose condition. This suggests that CLA can increase NF-${\kappa}B$ p65 binding activity and TNF-${\alpha}$ production from high glucose-treated RAW 264.7 cells and is likely to promote hyperglycemia-induced inflammation.

The Toxicological Pathologic Study of Amanita muscaria in Sprague-Dawley Rat (Amanita muscaria 경구투여 시 Sprague-Dawley Rat에서의 독성병리 연구)

  • Kim, Jin;Kim, Hyeong-Jin;Kim, So-Jung;Kim, Byeong-Soo;Kim, Sang-Ki;Park, Byung-Kwon;Park, Young-Seok;Cho, Sung-Dae;Jung, Ji-Won;Nam, Jeong-Seok;Choi, Chang-Sun;Lee, Seung-Ho;Jung, Ji-Youn
    • Journal of Life Science
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    • v.19 no.8
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    • pp.1152-1158
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    • 2009
  • For the toxicological pathologic study of amanita muscaria, we have investigated single and repeated dose toxicity in Sprague-Dawley (SD) rats. Single dose toxicity study was identified as catalepsy, incline and tail pinch methods (control 0 mg/kg, low 3.3 mg/kg, middle 16.5 mg/kg, high 33.0 mg/kg). Repeated dose toxicity study was carried out in blood tests, serum tests and histopathological methods. Neurotoxicity - muscle paralysis, and convulsion and loss of movement - was observed at 33.0 mg/kg group in the single dose toxicity study. Dysfunction of liver and kidney were shown in the repeated oral administration of the amanita muscaria at 3${\sim}$4 weeks. Serum chemistry results revealed a marked increase of LDH [Lactate Dehydrogenase (3181.5 IU/L; normal 230-460 IU/l)], ALT [Alanine transaminase (124.0 IU/l; normal <40 IU/l)] but the kidney was normal. Histopathological results show interstitial edema and tubular epithelial necrosis in the kidney. These results suggest that amanita muscaria has a neurotoxic effect and causes dysfunction of liver and kidney in the SD rat.

Sargassum sp. Attenuates Oxidative Stress and Suppresses Lipid Accumulation in vitro (모자반추출물의 항산화활성 및 지방세포 생성억제 효과)

  • Kim, Jung-Ae;Karadeniz, Fatih;Ahn, Byul-Nim;Kwon, Myeong Sook;Mun, Ok-Ju;Kim, Mihyang;Lee, Sang-Hyeon;Yu, Ki Hwan;Kim, Yuck Yong;Kong, Chang-Suk
    • Journal of Life Science
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    • v.24 no.3
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    • pp.274-283
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    • 2014
  • Oxidative stress causes tissue damage and facilitates the progression of metabolic diseases, including diabetes, cardiovascular heart diseases, and obesity. Lipid accumulation and obesity-related complications have been observed in the presence of extensive oxidative stress. As part of an ongoing study to develop therapeutic supplements, Sargassum sp. were tested for their ability to scavenge free radicals and intracellular reactive oxygen species (ROS), as well as to suppress lipid accumulation. Three species, S. hemiphyllum, S. thunbergii, and Sargassum horneri, were shown to scavenge free radicals in a di(phenyl)-(2,4,6-trinitrophenyl)iminoazanium (DPPH) assay. In addition, Sargassum sp. was shown to scavenge intracellular ROS and to decrease nitric oxide (NO) production in $H_2O_2$ and lipopolysaccharide (LPS)-induced in RAW264.7 mouse macrophages, respectively. Taken together, the results suggest that Sargassum sp. possess huge potential to relieve oxidative stress and related complications, as well as lipid-induced oxidation. They indicate that S. hemiphyllum, S. thunbergii, and S. horneri are potent functional supplements that can produce beneficial health effects through antioxidant and antiobesity activities, with S. hemiphyllum being the most potent among the Sargassum sp. tested. A potential mechanism for the effect of Sargassum sp. on the suppression of lipid accumulation in differentiating 3T3-L1 mouse preadipocytes through deactivation of the peroxisome proliferator-activated receptor ${\gamma}$ (PPAR ${\gamma}$) is presented.