• 제목/요약/키워드: Diabetes Complications

검색결과 547건 처리시간 0.028초

당뇨병성 궤양에 사용되는 레이저의 특성에 대한 연구 (Review of the Properties of the Laser and the Spectrum of Laser Instruments for Diabetic Ulcer)

  • 강기완;강자연;정민정;김홍준;서형식;장인수
    • 한방안이비인후피부과학회지
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    • 제29권4호
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    • pp.14-23
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    • 2016
  • Objectives : One of major complications of diabetes, diabetic ulcer is also one of the main reasons for amputation, and the prevalence rate is 4-10%. Laser therapy is widely used for leg ulcer and diabetic ulcer, and it is known to improve wound epithelialization, cellular content, and collagen deposition. The purpose of this study is to investigate the properties of the laser and the spectrum of laser instruments for diabetic ulcer. Methods : We performed literature search using the PubMed, Cochrane, CINAHL and Web of science for the data in English. In addition, other databases were checked for different languages such as OASIS and NDSL for the literature in Korean, CNKI in Chinese, and CiNii and J-STAGE written in Japanese. We excluded all review article and experimental studies, and only clinical studies using laser or light emitting diode (LED) for diabetic ulcer were selected. Results : A total twenty papers were selected. Different light sources were used as follows: LED, HeNe, InGaAlP, GaAlAs, GaAs, CO2, and KTP. The number of LED studies was 9, and HeNe laser was 7, and InGaAlP and GaAlAs laser was 2, GaAs, CO2, and KTP laser was 1 for each. Various energy density of the clinical study were reported. Conclusions : It is suggested that to select appropriate laser type and give the adequate output power to treat diabetic ulcer. Further evaluation and research for the condition of laser therapy to treat diabetic ulcers are warranted.

배양된 이자섬 $\beta$세포의 미세구조적 변화와 인슐린 분포 양상 (Ultrastructural Change and Insulin Distribution of the Cultured Pancreatic Islet $\beta$-cell)

  • 민병훈;김수진
    • Applied Microscopy
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    • 제37권4호
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    • pp.249-258
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    • 2007
  • 이자섬은 이자를 구성하는 외분비조직에 둘러싸여 존재하는 내분비세포의 집단으로, 이자섬에서 분비되는 인슐린은 $\beta$세포에서 분비되는 호르몬이며, 세포질의 리보좀에서 합성되고 골지체를 경유하여 세포질로 방출되는 기작을 가지고 있다. 충분한 양의 이자섬 이식은 인슐린 의존형 당뇨병인 제1형 당뇨병에서 정상혈당을 회복시키고, 당뇨 합병증을 방지할 수 있는 치료방법으로 사용되고 있다. 하지만 당뇨병 환자에게 이식을 위한 이자섬의 양에 비해 공여자로부터 증여된 이자섬의 양은 제한적이다. 이러한 문제점은 이자섬의 증식으로 연구되고 있으나, 배양된 이자섬이 정상 조직내의 이자섬과 형태적 기능적으로 동일한 것인지에 관한 연구는 미비하였다. 따라서 본 연구에서는 분리된 이자섬과 배양된 이자섬을 구성하는 세포들의 내부구조의 변화를 주사전자현미경, 투과전자현미경을 이용하여 세포의 미세구조를 확인하고, 인슐린 항체를 이용한 $\beta$세포 내의 인슐린 분포양상을 확인하여 다음과 같은 결과를 얻었다. 분리된 이자섬의 $\beta$세포는 일반적인 핵 미토콘드리아, 세포질세망 그리고 인슐린 과립이 분포하고, 배양된 이자섬 $\beta$세포의 경우 분리된 이자섬에 비하여 일반적인 핵의 모습과 부피가 증가한 세포질과 미토콘드리아, 세포질세망 그리고 골지체의 발달이 이루어지는 것으로 관찰되었다. 인슐린 과립의 경우 분리된 이자섬에 비해 감소하며, 세포막 주위에 분포하는 것으로 관찰되었다. 배양된 이자섬에서 관찰되는 인슐린 과립 분포의 변화, 세포질세망의 증가, 골지체의 발달은 배양된 이자섬 $\beta$세포의 인슐린 생성 분비 기능의 향상과 부피의 증가가 이루어지기 위한 세포 내부의 형태적 변화가 이루어지는 것으로 추측된다.

폐농양과 감염성 낭포의 경피적 배농술 (Percutaneous Drainage of Lung Abscess and Infected Bulla)

  • 김건호;황영실;김형진
    • Tuberculosis and Respiratory Diseases
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    • 제41권2호
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    • pp.120-126
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    • 1994
  • 연구배경 : 내과적 치료에 반응이 없는 폐농양 환자와 감염성 낭포환자에서 대체 치료방법은 폐농양 환자에서는 페엽절제술과 같은 수술이나 감염성 낭포환자에서는 계속적 항생제 투여였는데, 저자들은 이와같은 경우 직경이 작은 카테타로 국소마취하에 경피적 배농술을 시행하여 그 치료효과와 부작용을 알아 보고자 본 연구를 시행하였다. 방법 : 1주 이상의 항생제를 포함한 내과적 치료에 반응이 없고, 공동의 직경이 6cm 이상인 만성적 기저질환을 가지는 폐농양 환자 9에와 감염성 낭포환자 3예에서 흉부 단순촬영과 흉부 전산화 단층촬영 후 투시하에 seldinger 방법을 사용하여 8.3~12.3 Fr의 카테타를 삽입 후 배농시키면서 임상경과를 관찰하였다. 결과 : 카테타 삽입 후 농흉이 발생한, 폐암과 동반된 1예를 제외한 8예의 폐농양과 3예의 감염성 낭포에서 경피적 배농술 후 임상적 호전을 보였다. 배농 후 평균 1.9일 내 해열되었고, 평균 배농기간은 9.9일이였다. 7예에서 퇴원 후 1~7개월간 외래 관찰되었으며, 재발 등의 문제는 없었다. 결론 : 내과적 치료에 반응이 없는 거대 폐암 환자에게 경피적 배농술은 효과적이고 안전한 방법이므로, 수술보다 우선적으로 고려되어야 하겠다. 그러나 감염성 낭포환자에 대한 경피적 배농술은 본 연구의 결과만으로 내과적 치료보다 더 안전하고 효과적이라고 할 수 없으므로 더 많은 연구가 있어야 하겠다.

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뇌졸중환자(腦卒中患者) 290례(例)에 대(對)한 임상(臨床) 고찰(考察) (III) ('Clinical Observation on the 290 cases of Cerebrovascular Accident')

  • 강관호;전찬용;박종형
    • 대한한의학회지
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    • 제18권2호
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    • pp.223-244
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    • 1997
  • Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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오디즙 및 오디박 분말이 Streptozotocin 유발 당뇨쥐의 혈당 및 혈청지질 강하와 적혈구 항산화 효소계에 미치는 영향 (Effects of Mulberry Juice and Cake Powders on Blood Glucose and Lipid Lowering and Erythrocytic Antioxidative Enzyme Activities in Streptozotocin-Induced Diabetic Rats)

  • 권은혜;장현서;김상운;최상원;이순재;조성희
    • Journal of Nutrition and Health
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    • 제40권3호
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    • pp.199-210
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    • 2007
  • The aim of this study was to investigate the effects of mulberry juice and cake powder on blood glucose and lipid status along with intestinal disaccharidase and erythrocyte antioxidative enzyme system in streptozotocin (STZ)-induced diabetic rats. Sprague-Dawley male rats weighing $100{\pm}10g$ were randomly assigned to one normal group, and eight STZ-induced diabetic groups: control diet group without mulberry juice and cake powders (DM-C), three mulberry juice powder groups (0.5%: DM-0.5J, 1%: DM-1J, 2%: DM-2J) and low mulberry cake powder groups (0.25%: DM-0.25C, 0.5%: DM-0.5C, 1%: DM-1 C, 2%: DM-2C). After three-week feeding of each experimental diet, diabetes was induced by intravenous injection of 50 mg/kg body weight of STZ in sodium citrate buffer (pH 4.3) via tail vein of eight DM groups. Rats were sacrificed at the 9th day of diabetic states. Level of blood glucose was 505 mg/dl in DM-C group but it was 28% and 39% lower in mulberry juice and cake powder fed groups, respectively, than the DM-C group. Activities of maltase, sucrase and lactase in proximal part of small intestine were significantly lower in the mulberry juice and cake powder groups by $42{\sim}47%$ than those of DM-C group. Erythrocytic superoxide dismutase, glutathione peroxidase and catalase activities were significantly reduced by STZ but increased close to normal levels along with less accumulation of thiobarbituric acid reactive substances (TBARS). Serum levels of triglyceride and total cholesterol and HDL-cholesterol by STZ-DM were reduced and increased respectively, to the norma] levels by the mulberry juice and cake powder. Except the levels of TBARS, the effects on the other measurements by the various dietary levels of mulberry juice and cake powder were almost same and the effect of the cake powder was most significant at the lowest level. These results indicate that mulberry juice and cake powders have consityerable hypoglycemic effect and strengthening antioxidant defense systems at the low levels in diabetic state and may be able to reduce diabetic complications.

Salvage of Infected Breast Implants

  • Song, Joon Ho;Kim, Young Seok;Jung, Bok Ki;Lee, Dong Won;Song, Seung Yong;Roh, Tai Suk;Lew, Dae Hyun
    • Archives of Plastic Surgery
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    • 제44권6호
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    • pp.516-522
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    • 2017
  • Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.

뇌졸중(腦卒中)에 관(關)한 임상통계적(臨床統計的) 연구(硏究) (Clinical Observation on C.V.A.)

  • 윤진구;조기호;김영석;이경섭
    • 대한한방내과학회지
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    • 제10권1호
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    • pp.25-38
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    • 1989
  • Clinical observation was done on 1092 cases of cerebrovascular disease which were confirmed by Brain CT scan in Oriental Medical Hospital in Kyung Hee Univ. from May 1987 to May 1988. Specially, clinical prognosis of 250 patients who had been hospitalized for over 4 weeks, were obserbed. The results were obtained as follows; 1. In this study, Occlusive CVD was 77.9%, Cerebral hemorrhage was 18.8%, Subarachnoid hemonhage was 0.8%. 2. The ratio of male to female was 1.4:1. In the age distribution, 60th decade, 50th decade, 40th decade, 30th's, 20th's were in order of frequency and specially 60th decade was 35.53% over 70th decade was 17.1% in ratio. 3. The most common preceding disease of CVD was hypertension (54.21%) and diabetes mellitus (19.96%) was second. 4. Almost, the duration of hospitalization was 2-4 weeks in 34.8%, within 4 weeks in 78.02%. 5. Primary attack was 75.7%, 2nd attack was 17.9%, over 3rd attack was 3.1% in ratio of recurrence. 6. The level of consciousness was Grade I in 96.4%, Grade II in 3.2%, Grade III in 1% at attack. 7. A few complications of C.V.A. were observed in the studies: pneumonia was noted frequently in 3.2%, bed sore, urinary tract infection, gastro intestinal bleeding in order of frequency. 8. The ratio of neurologic deficiency in occlusive CVD decreased from 51.9% to 29.3% in upper limb, 52.6% to 24.4% in lower limb, and that in cerebral hemorrhage decreased from 69.5% to 25% in upper limb, 50% to 20% in lower limb. 9. The ratio of left side hemiplegia to right was 1.04:1 in male, 1:1.18 in female. 10. The herb medications for C.V.A. were various Chungg-Paesagantang, Sunghanggeonggisan were used most frequently to Chungyeold, Geopung, Soongi, Haldam and Chungsimtang, the drugs for Bogiheol were used as discharge. In these oriental medical therapy of C.V.A. objective diagnosis and more various therapeutic method must be obtained through east-west medical co-operation.

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잠양자음약물(潛陽滋陰藥物)이 뇌출혈(腦出血) 환자(患者)의 고혈압(高血壓)에 미치는 영향(影響)에 대한 임상적(臨床的) 고찰(考察) (The clinical study of the effect of Jamyang.Jaum prescriptions on the hypertension evolution in cerebral hemorrhage patients)

  • 최철원;김동웅;신선호;전희준;황보연;정대영
    • 대한한의학회지
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    • 제18권1호
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    • pp.72-81
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    • 1997
  • The causes of stroke are presumed hypertension, atherosclerosis,. cardiac disease, diabetes mellitus and old age and risk factors of stroke are suggested hypertension, hyperlipidemia. obesity, smoking and drinking etc. Especilly, hypertension is one of the most important cause and risk factor of stroke, therfore without therapy hypertension leads to stroke. The frequence of hypertension is significantly higher in hemorrhage patients of intracranial hemorrhage and subarachnoid hemorrhage. Antihypertensive therapy has an impact not only on the primary prevention of stroke but also on stroke recurrence and the declining of stroke motality has been attributed to the widespread availability and use of antihypertensive therapy. The goals of antihypertensive therapy decrease the complications and motalitv of cardiovascular system and prevent the promoting arteriosclerosis. In this study, we observed the blood pressure change of cb-hemorrhagic patients with hypertension who were hospitalized from 1996. 3. 1 to 1997. 2 .26 in Wonkwang Oriental Hospital. These patients had no antihypertensive therapy and were supplied herb med(Jaum sikpoongtang, Chungrijagamtang, Gojinumja) in medication. Our results suggested as follows. 1. Systolic and diastolic average BP at admission is $150.71{\pm}15.61mmHg$ and $95.00{\pm}8.8mmHg$ and this is hypertension state defining WHO 2. During one week in admission, the blood pressure demostrated a marked declination by SBP 8.97mmHg and DBP 6.22mmHg. 3. During two week in admission, the declination of SBP was significant in paired t-test(p<0.05) but, the declination of DBP was non-significant in paired t-test. 4. The blood pressure during third and fourth weeks gradually declined but, non-significant in test. According to the above results, we suggested that the BP declination Was affected by $Jamyang{\cdot}Jaum$ prescriptions in acute stage of cerebral hemorrhage.

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위령탕(胃苓湯) 추출물의 사람 유래 신장 메산지움 세포에서의 당뇨병성 신장 손상 개선 효과 (Wiryeongtang attenuates diabetic renal dysfunction in human renal mesangial cells)

  • 윤정주;한병혁;최은식;남궁승;정다혜;김혜윰;안유미;이윤정;강대길;이호섭
    • 대한본초학회지
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    • 제31권5호
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    • pp.71-78
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    • 2016
  • Objectives : Diabetic nephropathy is one of the most common chronic complications of diabetes and a leading cause of end-stage renal failure in the world. Mesangial cell proliferation is known as the major pathologic features such as glomerulosclerosis and renal fibrosis. Wiryeongtang (WRT) is a well-known traditional herbal formula as therapeutic agents for chronic edema and dysuresia of renal homeostasis. In the present study, we investigated whether WRT inhibits high glucose (HG)-induced renal dysfunction by TGF-β/Smads signal regulation in cultured mesangial cells.Methods : Inhibitory effect of WRT (10-50 ㎍/ml) on HG-stimulated mesangial cells proliferation and dysfunction were evaluated by [3H]-thymidine incorporation, Western blot, and RT-qPCR.Results : WRT significantly decreased HG-accelerated thymidine incorporation in human renal mesangial cell in a dose-dependent levels. WRT induced down-regulation of cyclins/CDKs and up-regulation of CDK inhibitor, p21waf1/cip1 and p27kip1 expression. In addition, HG enhanced expression of dysfunction biomarker such as collagen IV and CTGF, which was markedly attenuated by WRT. WRT decreased TGF-β1 and Smad-2/Smad-4 expression, whereas increased Smad-7 expression under HG. Furthermore, WRT inhibited HG-induced inflammatory factors level such as ICAM-1 and MCP-1 as well as NF-κB p65 nuclear translocation and intracellular ROS production.Conclusions : These results suggested that WRT may alleviate mesangial proliferation and inflammation possibly involved in renal fibrotic process, further diabetic nephropathy through disturbing TGF-β1/Smad signaling and NF-κB/ROS pathway. Thus, WRT might prove to be effective in the treatment of renal dysfunction leading to diabetic nephropathy.

Fermented Chaga Mushroom (Inonotus obliquus) Effects on Hypolipidemia and Hepatoprotection in Otsuka Long-Evans Tokushima Fatty (OLETF) Rats

  • Cha, Jae-Young;Jun, Bang-Sil;Yoo, Ki-Soo;Hahm, Jong-Ryeal;Cho, Young-Su
    • Food Science and Biotechnology
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    • 제15권1호
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    • pp.122-127
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    • 2006
  • The effects of fermented chaga mushroom (Inonotus obliquus) powder on the lipid concentrations and the activities of liver marker enzymes of serum in genetically diabetic Otsuka Long-Evans Tokushima fatty (OLETF) rats were investigated. Rats were fed a semisynthetic diet supplemented with 50 g/kg chaga mushroom powder (CM) or 50 g/kg fermented chaga mushroom powder (FCM) for 8 weeks (26 to 34 weeks of age). Nondiabetic Long-Evans Toknshima Otsuka (LETO) rats were used as age-matched nondiabetic control animals. Water consumption was significantly higher in the OLETF control than the LETO rats. Water consumption in the FCM-fed OLETF rats tended to be less than in both the OLETF control and CM-fed OLETF rats. Serum concentrations of triglycerides and total cholesterol were significantly higher in the OLETF control rats than in the LETO rats while within the OLETF rat groups, the consumption of FCM resulted in a significantly lower serum triglyceride concentration and slightly lowered serum total cholesterol concentration when compared to the OLETF control and CM-fed rats. The alanine aminotransferase (ALT) activity was significantly higher in the OLETF control than in the LETO rats, but this difference was significantly reduced compared to the CM-fed rats and essentially no difference in the ALT levels was observed between the LETO and OLETF-FCM rats. This observation suggests an adaptive effect of the fermented chaga mushroom in liver function. Livers of the LETO rats showed no histopathological changes, whereas those of the OLETF control rats were characterized by many fat depositions in the central zone of the hepatocytes. The livers of the OLETF CM-fed rats showed less fatty changes compared to the OLETF control rats and fat deposition in the hepatocytes was nearly absent. These results suggest that orally ingested fermented chaga mushroom has a potential beneficial effect on the complications known to occur in the obesity-related non-insulin dependent diabetes mellitus (NlDDM) OLETF rat.