• Journal of Veterinary Science
• /
• 제24권6호
• /
• pp.86.1-86.14
• /
• 2023

Background: Long-term comparisons of phacoemulsification with topical medication are limited in canine diabetic cataracts. Objectives: To compare outcomes of eyes submitted to phacoemulsification with those of topical medication for canine diabetic cataracts and identify risk factors for complications. Methods: Through medical records review, 150 eyes (76 dogs) with diabetic cataracts were included; 58 eyes (31 dogs) underwent phacoemulsification (phaco-group) and 92 eyes (48 dogs) received ophthalmic solution alone (medication-group). The medication-group was divided into owner-led and vet-led groups depending on who elected not to perform surgery. Comparisons involved time-to-complications, vision, and the number and type of ophthalmic solutions administered. The association between complications and pretreatment clinical findings was investigated. Results: No difference was found in complication risk between the phaco and owner-led medication groups. Conversely, the vet-led medication-group had a higher complication risk than the other groups. At the last follow-up, 94.8% of the phaco-group had vision, whereas 7.6% of the medication-group restored some visual axis. Poor glycemic control in the medication-group and younger age in the phaco-group increased complication risk. At 1-year post-treatment, the average number of ophthalmic solutions administered was 1.7 and 2.6 in the phaco and medication groups, respectively. The medication-group used anti-inflammatories the most throughout the follow-up, whereas the phaco-group used anti-inflammatories the most until 1-year post-treatment and lacrimostimulants at 1.5-year post-treatment. Conclusions: For canine diabetic cataracts, phacoemulsification is recommended because it is superior to topical management alone in terms of maintaining vision and reducing the number of ophthalmic solutions required in the long term.

• Journal of Cerebrovascular and Endovascular Neurosurgery
• /
• 제25권2호
• /
• pp.160-174
• /
• 2023

Objective: Carotid artery stenting (CAS) is currently widely used for the treatment of carotid artery stenosis. The objective of this study was to analyze the outcomes of CAS performed in a single institution. Methods: We retrospectively analyzed 313 CAS cases from January 2007 to December 2020, including 206 (66%) symptomatic and 107 (34%) asymptomatic cases. Procedure-related morbidity and mortality were assessed. Rates of periprocedural (≤30 days after CAS) and postprocedural ipsilateral strokes (>30 days after CAS) were also assessed. Logistic regression analysis was used to identify risk factors for the periprocedural complication, in-stent restenosis (ISR), and ipsilateral stroke. Results: The success rate of CAS was 98%. Among 313 cases, 1 patient died due to hyperperfusion-related intracerebral hemorrhage (ICH). The CAS-related mortality rate was 0.31%. The overall incidence of periprocedural complications is 5.1%. A risk factor for periprocedural complication was a symptomatic carotid artery stenosis (7.3% vs. 0.9%, p=0.016). Twenty cases of ISR occurred during 63.7±42.1 months of follow-up. The overall incidence of ISR was 10.2% (20/196). A risk factors for ISR were diabetes mellitus (17.6% vs. 5.7%, p=0.008) and patients who used Open-cell stents (19.6% vs. 6.9%, p=0.010). The overall incidence of ipsilateral stroke is 5.6%. A risk factors for ipsilateral stroke was ISR (95% CI, p=0.002). Conclusions: CAS is a safe and effective procedure for carotid artery stenosis. Although the incidence of complications is low, fatal complication such as hyperperfusion-related ICH can occur. To prevent hyperperfusion-related ICH, several methods such as strict blood pressure (BP) control, intentional less widening of stenotic segment should be used. To prevent ISR or stroke occurrence, special attention should be paid to patients who have ISR or ipsilateral stroke risk factors.

• 한국임상약학회지
• /
• 제24권1호
• /
• pp.33-38
• /
• 2014

Background: Diabetes is accompanied by complications. One of the chronic complications, diabetic retinopathy is the most common cause of the loss of eyesight and thus has enormous impacts on the quality of life to the patients. It has been reported that thorough glucose regulation can prevent or postpone the outset of diabetic retinopathy in diabetic patients and that the patients who received anti-diabetic manage & care education would be capable of more thorough glucose-level regulation than those who did not. Method: This study set out to investigate the current state of education on anti-diabetic manage & care in South Korea and connections between anti-diabetic manage & care education and occurrence of diabetic retinopathy in diabetic patients based on the Korea National Health and Nutrition Examination Survey of 2011. Results: Of the 410 diabetes patients, 74 received anti-diabetic manage & care education, which means that only 15% of diabetic patients benefited from the education in the nation. The occurrence rate of diabetic retinopathy was 28% in the education group and 24% in the non-education group with no significant differences between them. The anti-diabetic manage & care education group recorded a higher occurrence rate of diabetic retinopathy, one of the chronic diabetic complications, than the non-education group contrary to the hypothesis. One of the reasons was that the educated group had a significantly longer duration of diabetes and significantly higher HbA1c than the noneducated group, which indicates that anti-diabetic manage & care education is provided to those who have progressed farther along the course of diabetes instead of the early stage and cannot regulate their glucose-level well in the nation. Conclusion: Those findings raise a need for active educational policies in order to provide anti-diabetic manage & care education under the goals of preventing complications through anti-diabetic education for many patients in early stages of diabetes.

• 한국식품영양과학회지
• /
• 제26권4호
• /
• pp.682-688
• /
• 1997

본 논문에서는 당뇨에 의한 CYP2El의 유도와 이에 따른 지질과 산화의 증가에 비타민 C가 미치는 영향을 간 소포체와 미토콘드리아에서 알아보고자 하였다. Cy-tochrome P450의 함량은 간 소포체와 미토콘드리아 모두에서 정상과 당뇨간에 차이를 보이지 않았고, 비타민 C의 공급은 영향이 없었다. Superoxide anion에 의한 지질과 산화에 가장 큰 영향을 끼친다는 CYP2El에 대하여 immunoblotting으로 그 함량을 알아본 결과, 간 소포체 CYP2El이 당뇨에서 증가하고 비타민 C의 보강은 50mg/d의 공급으로도 현저한 감소를 보여 간 소포체 P450의 함량과는 다른 결과를 나타냈다. 간 미토콘드리아의 경우 소포체와 동량(20$\mu\textrm{g}$)의 단백질을 loading하였는데 CYP2El의 발현을 볼 수 없었다. 간 소포체와 미토콘드리아 NDMA demethylase의 활성이 정상군과 당뇨군에서 유의적인 차이를 보이지 않았으나, 250mg/d의 비타민 C 공급시 간 소포체에서는 유의적으로, 간 미토콘드리아에서는 유의적이지는 않으나 감소하였다. NDMA demethylase의 활성은 CYP1El의 함량을 반영한다고 알려져 있는데 본 연구에서는 동일한 pattern으로 진행되지는 않은 듯하다. NADPH-cyto-chrome c reductase의 활성은 NDMA demethylase의 활성과 양의 상관관계를 보였다. 따라서, 비타민 C의 공 급은 당뇨에 의한 CYP2El의 유도를 감소시키고 NDMA demethylase, NADPH-cyto-chrome c reductase와 같은 약물대사계 효소의 활성을 감소시켜 지질과 산화를 낮출 것으로 사료된다 그러나, 비타민 C의 공급량에 따라 조금씩 다른 결과를 보여 당뇨에 있어 가장 좋은 효과를 보일 수 있는 최적의 비타민 C 보강량을 결정하는 연구가 요구된다. 당뇨군에서 지질과 산화의 지표인 thiobar-bituric acid reactive substances(TBARS)의 함량이 간 소포체에서 유의적으로 증가하였고, 비타민 C의 공급랑에 의존하여 TBARS의 함량이 감소하였다. TBARS의 함량은 NDMA demethylase의 활성과 양의 상관관계를 보여 CYP2E1이 당뇨의 지질과 산화에 영향을 끼친다고 생각된다. 이러한 비타민 C의 항산화 효과는 비타민 C 자체의 항산화 능력, 비타민 E와 glutathione 같은 다른 항산화제의 절약 효과, CYP2El의 유도 저하를 통하는 것으로 생각되며 그중 어떤 것에 가장 큰 영향을 받는 지는 아직 알려지지 않았고 더욱 많은 연구가 요구된다.

• 한국산학기술학회논문지
• /
• 제12권2호
• /
• pp.765-774
• /
• 2011

본 연구는 효율적인 당뇨관리사업을 할 수 있는 기초자료를 제공하기 위해 수행되었다. 연구를 위해 2007년, 2008년도 국민건강영양조사를 통해 검진에 참여한 당뇨인지환자 666명의 자료를 수집하여 분석하였다. 당뇨인지 환자의 관리행태에 대한 군집분류는 K-means 기법을 이용하였고 관리행태에 대한 요인분석은 의사결정나무와 다중로지스틱 회귀분석을 이용하였다. 당뇨인지환자의 군집은 크게 3개로 분류되었다. 건강행태사업 대상군은 당뇨 치료와 합병증 검사는 잘 받고 있으나 음주, 흡연, 운동실천 등 건강행태 개선이 보다 적극적으로 이루어져야 하는 집단이다, 중점관리사업 대상군은 치료를 제대로 받지 않고, 합병증검사도 하지 않으며 혈당관리를 위한 건강행태 개선도 적극적으로 하지 않는 집단이다, 합병증검사사업 대상군은 치료를 잘 받고 있으며 건강행태도 개선하고 있지만 급만성 합병증을 조기 발견하기 위한 합병증검사를 소흘히 하는 집단이다. 군집을 분류하는데 가장 중요한 요인은 고지혈증 유무로 나타났으며 그 외 성, 소득, 연령, 직업, 주관적 건강상태도 주요한 변수였다. 당뇨 조절율을 향상시키기 위해서는 각 군집의 특성에 따라 보다 특화된 당뇨관리 프로그램이 적용되어야 할 것이다.

• Journal of Oral Medicine and Pain
• /
• 제45권1호
• /
• pp.12-16
• /
• 2020

Chronic otitis media (COM) is a chronic inflammatory disease which affects the middle ear, mastoid cavity. It presents hearing loss, ear pain, dizziness, headache, temporomandibular joint (TMJ) inflammation and intracranial complication. Intracranial complications such as skull base osteomyelitis (SBO) may occur secondary to COM due to transmission of infection by a number of possible routes. SBO is an uncommon condition with a significant morbidity and mortality if not treated in the early stages. We report a-67-year-old male patient with diabetes and untreated COM who presented atypical severe TMJ, periorbital and postmandibular pain. By computerized tomography (CT), magnetic resonance imaging (MRI) and whole body bone scan (WBBS), he was diagnosed with SBO spreading from untreated COM via infective arthritis of TMJ. Through this case, we suggest proper utilization of diagnostic imaging, especially CT or MRI for the early detection of SBO in the case of COM accompanying with the greater risk of infection developments such as diabetes.

• Preventive Nutrition and Food Science
• /
• 제14권1호
• /
• pp.1-7
• /
• 2009

Control of hyperglycemia and dyslipidemia is strongly correlated with decreased risk for cardiovascular disease, the most common and fatal diabetic complication. The purpose of this study is to determine the effects of garlic and aged black garlic on glycemic control and blood lipid profile in animal model of type 2 diabetes. Three week-old db/db mice (C57BL/Ks, n=21) were fed AIN-93G semipurified diet or diet containing 5% freeze-dried garlic or aged black garlic for 7 weeks after 1 week of adaptation. Fasting serum glucose, insulin, triglyceride, total cholesterol, and HDL-cholesterol and blood glycated hemoglobin were measured. Body weight and food intake of garlic and aged black garlic group were not significantly different from those of the control group. Fasting serum glucose and blood glycated hemoglobin levels were significantly decreased and insulin level was significantly increased in garlic group compared with control group (p<0.05). Consumption of aged black garlic significantly decreased homeostasis model assessment for insulin resistance (HOMA-IR) and tended to decrease serum glucose. Garlic consumption significantly decreased total cholesterol, while aged black garlic significantly reduced serum total cholesterol and triglyceride and increased HDL-cholesterol levels. These results suggest that garlic exerts hypoglycemic and hypocholesterolemic effect and aged black garlic improved insulin sensitivity and dyslipidemia in db/db mice.

• Journal of Yeungnam Medical Science
• /
• 제30권2호
• /
• pp.136-140
• /
• 2013

Diabetic nephropathy (DN) is a common complication and the leading cause of end-stage renal disease (ESRD) in diabetic patients. The occurrence of non-diabetic renal disease (NDRD) in diabetic patients has been increasingly recognized in recent years. Generally, renal injuries in DN are deemed difficult to reverse, whereas some NDRDs are often treatable and even remittable. Thus, the diagnosis of NDRD in patients with diabetes mellitus (DM) via a kidney biopsy would be significant for its prognosis and therapeutic strategy. According to recent studies, the most common NDRD is IgA nephropathy in type 2 diabetic patients, and some cases of minimal change disease and membranous glomerulonephritis have been reported in Korea. However, membranoproliferative glomerulonephritis (MPGN) is an uncommon condition in diabetic patients. To our knowledge, there has been no case yet of MPGN, except in a child with type 1 DM. We present an unusual case of a 27-year-old woman who had type 2 DM with MPGN, as confirmed via a kidney biopsy.

• 동의생리병리학회지
• /
• 제23권4호
• /
• pp.919-924
• /
• 2009

The liver is one of the principal organs involved in glucose metabolism. Diabetes mellitus(DM) commonly develops in patients with liver cirrhosis as a result of hepatocyte dysfunction. Hepatic encephalopathy(HE) is a major neuropsychiatric complication of liver cirrhosis. HE develops frequently in advanced stage of liver cirrhosis due to portal hypertension. We experienced a case of liver cirrhosis with DM and HE in 67 years old male patient. The patient's symptoms were lethargy, general malaise, asterixis, dizziness, and heavy headedness. Hwangryunjihwang-tang, Saengkankunbi-tang, Injinchija-tang and Injinho-tang were prescribed to the patient. Finally, the symptoms had been improved, however significant change was not observed from serum ammonia, fasting blood sugar and postparandial blood sugar. So we hope that this case report will be helpful in treating patient of liver cirrhosis.

• 대한임상검사과학회지
• /
• 제52권3호
• /
• pp.188-193
• /
• 2020

뇌졸중은 사망발생 및 장애를 일으키는 주요 원인 질환이며, 당뇨병은 뇌졸중의 주요 위험인자이다. 당뇨병 환자가운데 뇌졸중을 동반한 환자에서 적정 혈압 관리의 중요성을 알아보고자 한다. 제6기 국민건강영양조사 자료를 바탕으로 18세 이상 80세 미만자 총 16,389명을 대상으로 회귀분석을 통하여 당뇨병 유병기간에 따른 혈압조절을 통한 뇌졸중의 위험도를 산정하였다. 당뇨병 유무에 따른 뇌졸중의 유병률은 당뇨병 환자 군에서 높았고, 당뇨병의 유병기간이 길어질수록 고혈압과 뇌졸중의 위험도는 상승하였으며, 당뇨병과 고혈압에 대한 치료 비율은 높았다. 고혈압군에 비해 적정 혈압 유지군(<140/<90 mmHg)에서 뇌졸중 위험비(HR)는 0.57 낮았다. 당뇨병과 고혈압에 대한 치료가 동반됨에도 불구하고 고혈압의 빈도는 상승하였고, 당뇨병 유병기간 5년 이후 뇌졸중의 유병률이 상승함에 따라 이 시기의 효과적인 혈압관리가 더욱 중요하다. 당뇨병 환자에서 지속적으로 적정 혈압으로 관리함으로써 뇌졸중 위험도를 낮추는 것이 중요하다.