Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.
The purpose of this study is to examine to control of glucose level and the occurrence of chronic complications of diabetes by compliance groups with health care regimen The subjects were consisted of 300 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's compliance level with health care regimen was assessed at questionnaire. However, the blood glucose level and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed by SAS program for chi square test and t-test. The results were as follows. 1. Significant differences were found among the factors such as duration of diabetes, the number of participation of diabetes educational program, job, smoking, self monitoring of blood glucose and the methods of diabetes therapy between high and low compliance groups. High compliance group patients had a diabetes longer than low compliance group patients. High compliance group patients more frequently attended the educational program and checked themselves monitoring blood glucose than low compliance group patients. Also, they did not work recently, smoked less and got more insulin injection therapy compared to low compliance group patients. 2. No significant differences were found among the result of fasting blood glucose. 2-hour postprandial blood glucose, and $HbA_{l}c}$ between high and low compliance groups. 3. The occurrence rate of macrovascular complications of chronic complications of diabetes were lower, however, the occurrence rate of microvascular complications were higher in high compliance group than in low compliance group with health care regimen.
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Type 1 diabetes, or juvenile-onset diabetes, results from a cellular-mediated autoimmune destruction of the ${\beta}$-cells of the pancreas. Type 2 diabetes, or adult-onset diabetes, is a term used for individuals who have insulin resistance, a condition that makes it harder for the cells to properly use insulin, and usually have relative insulin deficiency. The diabetes causes the onset of chronic complications and diabetic neuropathy is one of the most debilitating complications. In this study, the hypoglycemic effect and the preventive effect of diabetic complications of Dioscorea rhizoma extract(DRE) were examined in rodent model. We investigated the glucose tolerance test and long term hypoglycemic effect of DRE in Type 1 streptozotocin-induced diabetic rats and Type 2 diabetic db/db mice. DRE showed a hypoglycemic effect on blood glucose levels than that of control group in Type 1 streptozotocin-induced diabetic rats and Type 2 diabetic db/db mice. On the basis of our results, we conclude that long-term use of DRE might help decrease blood glucose level and prevention of diabetes-associated complication.
Kim, Min-Kyung;Choi, Ah-Ri;Han, Gi-Sung;Jeong, -Seok-Geun;Oh, Mi-Hwa;Kim, Dong-Hun;Ham, Jun-Sang
Journal of Dairy Science and Biotechnology
/
v.29
no.1
/
pp.17-22
/
2011
Milk intake is widely recommended for healthy diet, not only for bone growth and maintenance, but also as a protein, calcium and magnesium sources as part of an adequate diet. Many research suggest that milk and dairy products are associated with a lower risk of type 2 diabetes mellitus (T2DM). Milk and dairy products are low Glycemic index (GI) and Glycemic load (GL) foods. The GI and GL are useful tools to choose foods to help control blood glucose levels in people with diabetes. The GI and GL of milk are 32~42 and 4~5, respectively, and which are about 1/2 and 1/5 of boiled rice. The mechanisms underlying the effects of dairy on T2DM development includes the calcium and vitamin D content in dairy foods and the possible positive effect of high milk and calcium intake on weight control. The role of dairy products on reducing the risk of diabetes can be inferred from the reports that lower serum IGF-1 levels were positively associated with diabetes and the girls with low milk intake had significantly lower IGF-1. Accumulating data from both patients and animal models suggest that microbial ecosystems associated with the human body, especially the gut microbiota, may be associated with several important diseases, such as inflammatory bowel disease, obesity, diabetes and cardiovascular disease. It was thought that fermented milk containing lots of probiotics can be useful for controling blood glucose levels and preventing complication of diabetes, but sucrose in commercial yogurt should be substituted. There are some reports of oligosaccharide, xylitol, and stevia as a potentially useful sweetener in the diabetic diet.
The incidence of diabetes mellitus among Koreans as shown an increasing tendency recently, probably due to the various factors such as the improving living conditions. The majority of people are ignorant or indifferent to the nature, progress and prognosis of diabetes mellitus in Korea. 107 cases of diabetes mellitus which had been admitted to Severance Hospital between January and August, 1971 were Studied. Of these 107 cases, 22 cases were interviewed thoroughly during their hospital stay and the response to their diet therapy was carefully checked. 1) Of the 107 cases 69 cases were male and 38 cases were female; the sex ratio was 18:1. The age of the onset of the disease was as follows: 2 cases were under 20 years of age; 20 cases (18.7%) were under 40 years of age and 85 cases (79.5%) were over 40 years of age. Juvenile diabetes was less frequent when compared with developed countries. 2) Patients complaints and symptoms on admission, complications of sickness, and duration of sickness until the female discharge were also studied. We found that the incidence of tuberculosis complication in diabetes melltius was alarming (13. 8%). 3) In most cases, the control of diabetes was inadequate and diet practisis by the patients was also very poor even when they had known of the diabetes mellitus for a considerable period of time. During hospitalization 75 cases (70.0%) were controlled by diet and oral medications alone. Only 16 cases (15.0%) needed insulin injection, the remaining 16 cases required both diet control and insulin injection. 4) In general, patients received hospital diet satisfactorily. Only a few cases complained of difficulties with milk intake because of no previous dietary experience or of excessive meat orfish because they preferred vegetables and fruit. 5) Patients responded well to the dietitians interviews in the hospital but follow up study and care were poorly organized after discharge from the hospital. 6) The diet exchange 1ist published by the Korean Diabetic Association was not well received by the patients or the general puplic because it is not inexpensive and detailed instructions were not given at the time of discharge from the hospital.
Purpose: This study was attempted to estimate the effects of diabetic education fortified with individual practice on plasma glucose, self-care, and self reported physical symptoms in type 2 diabetes patients Method: The subjects consisted of 46 patients with type 2 diabetes patients, who took the hospitalization diabetes education program from July 2003 until February 2004 at Seoul C university hospital. The experimental group was assessed at preand post intervention. The diabetes education was provided for one week. The education consisted of diabetes education videos for the diabetic introduction, group education for medication therapy, dietetic treatment and diabetes complication education. Also individual education for nurses examination of glycemia and insulin injection practice. Results: The HbA1c values significantly decreased from 9.6% on the time of hospitalization to 7.4% 3 months after discharge. In respect to the number of days of self-care, medication, diet, exercise, cleansing feet, and carrying sweets to prepare for hypoglycemia all significantly increased 3 months after discharge compared to the values at the time of hospitalization. Self reported physical symptoms were also significantly increased 3 months after discharge compared to the time of hospitalization. Conclusion: The diabetic education fortified with individual practice can be practically used as a plan for managing glycemia, self-care, and self reported physical symptom of diabetes patients.
Hill, Patrick;Vaishnav, Avani;Kushwaha, Blake;McAnany, Steven;Albert, Todd;Gang, Catherine Himo;Qureshi, Sheeraz
Neurospine
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v.15
no.4
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pp.376-382
/
2018
Objective: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery. Statistical significance was defined by p-values <0.05. The factors considered were age, sex, body mass index (BMI), smoking status, American Society of Anesthesiologists physical status classification, and comorbidities including hypertension, diabetes, history of dyspnea or chronic obstructive pulmonary disease, previous cardiac intervention or surgery, steroid usage, and history of bleeding. In addition, whether the operation was performed by an orthopedic or neurosurgical specialist was analyzed. Results: The number of 2-level CDA procedures increased from 6 cases reported in 2014 to 142 in 2016, although a statistically significant increase in the number of outpatient cases performed was not seen (p=0.2). The factors found to be significantly associated with inpatient status following surgery were BMI (p=0.019) and diabetes mellitus requiring insulin (p=0.043). There were no significant differences in complication and readmission rates between the inpatient and outpatient groups. Conclusion: Patients undergoing inpatient 2-level CDA had significantly higher rates of obesity and diabetes requiring insulin than did patients undergoing the same procedure in the outpatient setting. With no difference in complication or readmission rates, 2-level CDA may be considered safe in the outpatient setting in appropriately selected patients.
In diabetes mellitus, renal disease is a common complication, characterized by increased urinary albumin excretion and reduced eGFR. According to KDIGO CKD stage classification, Korean characteristics were analyzed according to urinary albumin and eGFR using the National Health and Nutrition Examination Survey VI raw data. According to KDIGO classification, diabetic patients were classified as Low risk 72.0%, Moderate risk 19.3%, High risk 5.6% and Very high risk 3.0%. Low risk decreased from 74.7% to 52.2%, and moderate to very high risk increased from 25.4% to 47.8% as the duration of diabetes mellitus was prolonged. The risk factors were CKD stage 1 (HR 2.064) to stage 4 (HR 11.049), the highest risk of hypertension. The incidence of renal disease was elevated according to duration of hypertension and HR 0.42 of kidney disease was decreased in the group maintaining proper blood pressure. In the hypertensive patients, the group administered with target blood pressure had a reduction of the kidney disease by 42% than the group with the hypertension. Therefore, controlling and managing hypertension to target blood pressure is important for the prevention of kidney disease.
To investigate the antihyperglycemic and antihyperlipemic effect of 80% ethanol extract of Schizandra Chinensis fruit, we induced diabetes in the rats with streptozotocin (STZ) and administered schizandra extract or Acarbose to diabetic rats for 21 days by oral administration. Consequently, the groups treated using schizandra extract decreased blood glucose levels more 39% than no treatment group and the case of Acarbose group was decreased it about 21%. The concentration of cholesterol, triglyceride and LDL-C in blood was also decreased while treating schizandra extract, on the other hand, HDL-C concentration was significantly increased it about 26%. Those results induced that anti-atherogenic index (AAI) in blood was improved more than 82% level like normal condition, especially in treatment of schizandra extract 100 mg. The lipid profiled in feces was likewise showed apparent tendency to decrease and food efficiency ratio of diabetic rats was became higher for treatment with schizandra extract, but Acarbose group had low efficiency in compared with the result of glucose level and lipid profile in blood. As a result, schizandra extract is regard a good medicine for diabetes due to improve physical constitution, blood glucose and lipid level caused hyperglycemia and suggest that schizandra extract has real effects on the diabetes complication as atherosclerosis, coronary heart disease, high blood pressure.
New onset diabetes is a major complication after kidney transplantation. However, the natural course of posttransplantation diabetes mellitus (PTDM) remains unclear. The aim of this study was to demonstrate the detailed natural courses of PTDM according to the onset and persistency of hyperglycemia, and to investigate risk factors for development of different courses of PTDM in renal allograft recipients. The purpose of this study is to develop novel immune suppressants for PTDM using of action mechanism of them. The use of immunosuppressive drugs in transplanted patients is associated with the development of diabetes, possibly due to ${\beta}$-cell toxicity. To better understand the mechanisms leading to post-transplant diabetes, we investigated the actions of prolonged exposure of ${\beta}$-cells to therapeutical levels of tacrolimus (FK506) or cyclosporin A(CsA). The immunosuppressive drug cyclosporine(CsA) is a potent agent widely used after organ transplantations and various autoimmune disorders. After using CsA, some patients suffer severe complications including renal and vascular toxicity. The renal or vascular toxicity is influenced by the degree of the endothelial damage. FK506(tacrolimus) is a widely used immunosuppressive agent in the treatment of various medical conditions, including autoimmune disease, bone marrow and organ transplantations. We found some interesting clusters and confirmed the feasibility of cDNA microarray in the study of Immunosuppressant. In this study, we investigated gene expression patterns induced by Immunosuppressant in RIN-m5F of rat insulinoma cell line. Gene expressions evaluated using cDNA microarry in two clusters were increased or decreased. this study provides comprehensive comparison of the patterns of gene expression changes induced by CsA and FK506 in ${\beta}$-cells. This study could establish that the mode of action mechanism by which currently used insulin inhibitors inducing PTDM could be elucidated at least in part, which raises the possibility that novel immune suppressive PTDM can be developed. The molecular biological study on PTDM will also contribute the progress in diabetes research field as well as in that of PTDM.
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