• The Journal of Korean Medicine
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• v.28 no.3 s.71
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• pp.57-69
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• 2007

Objectives : Diabetes is a disease in which the body does not produce or properly use insulin. Etiological studies of diabetes and its complications have shown that oxidative stress might play a major role. Therefore, many methods have been tried to regulate free oxygen radicals for treating diabetes and its complications. Ojung-hwan, composed of five crude herbs, has been considered effective for treating symptoms of aging. In male ob/ob mouse of severe obesity, hyperinsulinemia and hyperlipidemia, which are features of NIDDM, the hyperglycemic activities and mechanisms of Ojung-hwan were examined. Methods : Mice were grouped and treated for 5 weeks as follows. Both the lean (C57/BL6J black mice) and diabetic (ob/ob mice) control groups received standard chow. The experimental groups were fed a diet of chow supplemented with 30 and 90 mg Ojung-hwan per 1 kg of body weight for 14 days. The effects of Ojung-hwan extract on the ob/ob mice were observed by measuring the serum levels of glucose, insulin, lipid components, and the kidney levels of superoxide anion radical (${\cdot}\;O{_2}{^-}$), MDA+HAE, GSH/GSSG ratio, and also the enzyme activities involved in polyol pathway. Results : Ojung-hwan lowered the levels of serum glucose and insulin in a dose-dependent manner. Total cholesterol, triglyceride and free fatty acid levels decreased, while the HDL-cholesterol level increased, in Ojung-hwan treated groups. Renal aldose reductase and sorbitol dehydrogenase activities increased in the ob/ob mice, whereas they were inhibited in the Ojung-hwan treated groups. Ojung-hwan inhibited the generation of ${\cdot}\;O{_2}{^-}$ in the kidney. Finally, MDA+HAE levels increased and GSH/GSSG ratio decreased in the ob/ob mice, whereas they improved in the Ojung-hwan treated groups. Conclusions : Ojung-hwan showed antidiabetic and antihyperlipidemic activities by regulating theactivities of polyol pathway enzymes, scavenging reactive oxygen species and reducing the MDA+HAE levels in the ob/ob mice.

• Korea-Australia Rheology Journal
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• v.17 no.3
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• pp.117-123
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• 2005

Background: Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day­to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. Methods: We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemo-dialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. Results: We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy: control (P = 0.0001). Conclusions: The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.54-62
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• 2018

Background: The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery. Methods: This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery. Results: Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups. Conclusion: Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

• The Korean Journal of Urological Oncology
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• 제15권3호
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• pp.137-142
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• 2017

Purpose: To examine and compare the perioperative outcomes of laparoscopic adrenalectomy (LA) and to determine its efficacy in patients with nonfunctioning adrenal adenomas (NFA) and subclinical Cushing syndrome (SCS). Materials and Methods: We retrospectively analyzed the clinical data obtained from 79 consecutive patients who underwent LA for the treatment of either NFA (n=35) or SCS (n=44) between 2011 and 2016. All patients had undergone computed tomography, as well as endocrinological tests to confirm the diagnosis prior to the adrenalectomy. The primary endpoint was improved metabolic parameters relating to diabetes, hypertension, dyslipidemia, and obesity. Results: Patients with SCS compared to those with NFA showed a higher occurrence of diabetes (29.5% vs. 11.4%), hypertension (59.1% vs. 34.3%), and dyslipidemia (43.2% vs. 14.3%). Patients with SCS showed a smaller median tumor size compared to those with NFA (2.5 cm vs. 5 cm). No significant perioperative complications ${\geq}$ Clavien-Dindo classification grade III were observed in any patient (SCS or NFA group). In terms of their metabolic profile, patients with SCS showed a significant postoperative improvement in hypertension (50.0%), diabetes (53.9%), dyslipidemia (31.6%), and obesity (29.2%). However, patients with NFA showed a postoperative improvement only in dyslipidemia (40.0%) and obesity (4.8%). Conclusions: Owing to absence of significant perioperative complications and the marked postoperative improvement in metabolic impairment, LA is a useful treatment strategy in patients diagnosed with SCS. In contrast, LA was not observed to show beneficial effects in correcting/improving the metabolic profile in patients presenting with NFA.

• The Journal of Internal Korean Medicine
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• v.42 no.4
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• pp.672-686
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• 2021

Objectives: The purpose of this study is to assess the efficacy and safety of Baekhogainsam-tang for type 2 diabetes without complications by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: For a systematic review and meta-analysis, we set a key question in accordance with PICOT-SD. We searched the following up to March 31. 2021: PubMed, EMBASE, The Cochrane Library, CNKI, CiNii, KISS, KMBASE, OASIS, and ScienceON. A meta-analysis was conducted by synthesizing the results, including fasting plasma glucose level, postprandial 2-hour plasma glucose level, and Glycated Hemoglobin (HbA1c). Results: A total of five trials are included in this systemic review. The treatment group (Baekhogainsam-tang plus conventional treatment) showed more statistically significant effect than did the control group (conventional treatment only) in fasting plasma glucose level, postprandial 2-hour plasma glucose level, and glycated hemoglobin (HbA1c). Conclusions: Baekhogainsam-tang showed statistically significant effects in hypoglycemic effect and in improving insulin resistance. However, the number of studies included in the meta-analysis was insufficient, and the BIT used in the included studies was not standardized. This topic requires further attention and more clinical research.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.5
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• pp.251-258
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• 2015

Objectives: This study was performed to evaluate the impact of glycosylated hemoglobin (HbA1c) level on characteristics and prognosis of maxillofacial fascial infection in diabetic patients. Materials and Methods: We reviewed the medical records of 72 patients (35 patients with HbA1c lower than 7.0% and 37 patients with HbA1c higher than 7.0%) diagnosed with maxillofacial fascial space infection and hospitalized for treatment at the Department of Oral and Maxillofacial Surgery in Dankook University Hospital (Cheonan, Korea) from January 2005 to February 2014. We compared demographics, parameters of glucoregulation (HbA1c), laboratory parameters of inflammation (white blood cell [WBC], C-reactive protein [CRP] count), type and number of involved spaces, type and number of antibiotics, period of hospitalization, number of surgical operations, need for tracheostomy, complications, computed tomography (CT), and microorganisms between the two groups. Results: Compared with the well-controlled diabetes mellitus (DM) group (HbA1c <7.0%), patients in the poorly-controlled (HbA1c ${\geq}7.0%$) DM group had the following characteristics: longer hospitalization periods, higher values of laboratory parameters of inflammation (WBC, CRP count) at the time of admission, higher number of antibiotics prescribed, more frequent complications, frequent deep neck space involvement, and distinctive main causative microorganisms. As the HbA1c level increases, hospitalization periods and incidence of complications increase gradually. Conclusion: This retrospective study suggests that regulation of DM significantly impacts maxillofacial fascial infection. Poorly controlled DM with high HbA1c level negatively influences the prognosis of infection.

• The Journal of the Korean dental association
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• v.53 no.4
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• pp.249-258
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• 2015

Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

• Health Policy and Management
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• v.26 no.2
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• pp.125-134
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• 2016

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.1-13
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• 2009

Type 1 diabetes mellitus commonly occurs in childhood and adolescence, although the prevalence of type 2 diabetes mellitus in these age groups is now being increased in the western world and Korea. Diabetic nephropathy developing in 15-25% of subjects with type 1 diabetes mellitus and in similar or higher percentage of type 2 diabetes mellitus patients is the leading cause of end-stage renal disease worldwide. Although prepubertal diabetic duration may contribute less to the development of microvascular complications than pubertal and postpubertal duration, diabetic nephropathy in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Type 1 diabetes is commonly associated with a period of hyperfiltration followed by the development of persistent microalbuminuria after as little as 7-10 years of type 1 diabetes. Microalbuminuria is associated with pathologic lesions that are so advanced as to overlap with those seen in patients with overt proteinuria and declining kidney function, therefore, microalbuminuria currently considered the best clinical indicator of overt diabetic nephropathy risk. This review covers the natural history and renal manifestations of diabetic nephropathy in children and adolescents.

• Journal of the Korean Society of Food Culture
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• v.35 no.5
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• pp.493-502
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• 2020

The objective of this study was to investigate the effects of dietary vitamin B intake on biomarkers related to lipid metabolism, inflammation and blood glucose control, that are important in the development of type 2 diabetes and its complications. Seventy-six adults (42 males, 34 females) were recruited from a group of diabetes patients who had visited the medical center for treatment. Data on anthropometric characteristics and dietary intake of thiamine, riboflavin, niacin, vitamin B₆ and folate were collected using 24-hour diet recall and the CAN Pro 4.0 program. Also, data on clinical indices such as serum lipids, blood pressure, high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c) and homeostasis model assessment 2-insulin resistance (HOMA2-IR) were collected and analyzed for correlation with dietary vitamin B intake. Results from the dietary intake survey showed that riboflavin and folate intake (in males) and folate intake (in females) were below the Dietary Reference Intake for Koreans. Statistical analysis revealed a negative correlation between hs-CRP and dietary intake of B vitamins. Riboflavin intake was inversely associated with systolic blood pressure after adjustments for age, BMI, smoking, alcohol consumption, exercise, ingestion of diabetes mellitus medication and energy intake (p<0.05). Our results suggest that dietary vitamin B may influence inflammation and consequently may help in better management of type 2 diabetes.