• 제목/요약/키워드: Diabetes mellitus, Type 2

검색결과 638건 처리시간 0.028초

허혈성 뇌졸중의 재발과 연관된 위험인자 (The Risk Factors of Recurrent Ischemic Stroke)

  • 정철;김욱년;김민정;최석문;어경윤;박미영;하정상;변영주
    • Journal of Yeungnam Medical Science
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    • 제10권2호
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    • pp.423-431
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    • 1993
  • 허혈성 뇌졸중의 재발에 관여된다고 생각되는 주요 위험인자들을 파악하기 위하여 영남대학교 의과대학 부속병원 신경과에 내원한 환자들중 재발된군과 비재발된군을 선정하여 통상적으로 알려진 뇌졸중 위험인자들을 조사하여 그 중 뇌졸중 재발에 영향을 끼치는 요인을 분석 검토하였다. 재발군의 성별은 77명중 남자가 55명, 여자가 22명이었으며, 비재발군은 124명중 남자가 84명, 여자가 40명으로 성별차이를 분석해보면 의미있는 위험인자로 작용하지 못했다. 재발군의 연령은 29세에서 85세까지 평균 62.1세였고 비재발군은 27세에서 90세로 평균연령은 60.7세로 두군 모두 다 60대에서 가장 높은 발병율을 보였고 이 역시 통계적 유의성이 없었다. 당뇨병, 심근경색, 심방세통, 일과성 뇌 허혈증등과 같은 위험 요인이 있더라도 재발에는 영향을 미치지 못한것으로 나타났고 또한 뇌졸중의 병형이나 병변부위도 재발에 미치는 영향은 별로 없는 것으로 조사되었다. 그러나, 고혈압의 병력이나 입원기간중 높은 혈압을 보인 경우는 두군간에 유의성이 있는 차이를 보였다(P<0.05). 이상의 결과로 처음 뇌졸중이 발병하여 입원중 측정한 혈압이 160mmHg/95mmHg 이상으로 높았거나 고혈압의 병력이 있는 경우에는, 그렇지 않은 환자에 비해 향후 2년 내에 허혈성 뇌졸중이 재발할 가능성이 높으므로 적절한 치료로서 예방에 도움을 얻는 것이 필요할 것으로 생각되며, 이외의 위험인자들에 대해서도 지속적 연구가 있어야 할 것으로 사료된다.

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The association of PBX1 polymorphisms with overweight/obesity and metabolic alterations in the Korean population

  • Ban, Ju-Yeon;Kang, Soon-Ah;Jung, Kyung-Hee;Kim, Hak-Jae;Uhm, Yoon-Kyung;Kim, Su-Kang;Yim, Sung-Vin;Choe, Bong-Keun;Hong, Seung-Jae;Seong, Yeon-Hee;Koh, In-Song;Chung, Joo-Ho
    • Nutrition Research and Practice
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    • 제2권4호
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    • pp.289-294
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    • 2008
  • Pre-B-cell leukemia transcription factor 1 (PBX1), which is located on chromosome 1q23, was recently reported to be associated with type 2 diabetes mellitus. We examined whether single nucleotide polymorphisms (SNPs) of the PBX1 gene are associated with overweight/obesity in a Korean population. We genotyped 66 SNPs in the PBX1 gene and investigated their association with clinical phenotypes found in 214 overweight/obese subjects and 160 control subjects using the Affymetrix Targeted Genotyping chip array. Seven SNPs (g.+75l86C>T, g.+78350C>A, g.+80646C>T, g.+138004C>T, g.+185219G>A, g.+191272A>C, and g.+265317T>A) were associated with the risk of obesity in three models (codominant, dominant, and recessive) (P=0.007-0.05). Haplotype 1 (CAC) and 3 (TAC) of block 3 and haplotype 2 (GGAAT) of block 10 were also strongly associated with the risk of obesity. In the control group, subjects that had homozygote for the major allele for both g.+185219G>A and g.+191272A>C showed lower high density lipoprotein-cholesterol (HDL-C) level compared to those possessing the minor allele, suggesting that the association between the homozygote for the major allele for both g.+185219G>A and g.+191272A>C and HDL-C is attributable to the increased risk of obesity. This study suggests that the PBX1 gene is a possible risk factor in overweight/obese patients.

Risk Factors and Preoperative Risk Scoring System for Shunt-Dependent Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

  • Kim, Joo Hyun;Kim, Jae Hoon;Kang, Hee In;Kim, Deok Ryeong;Moon, Byung Gwan;Kim, Joo Seung
    • Journal of Korean Neurosurgical Society
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    • 제62권6호
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    • pp.643-648
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    • 2019
  • Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

Compound K attenuates hyperglycemia by enhancing glucagon-like peptide-1 secretion through activating TGR5 via the remodeling of gut microbiota and bile acid metabolism

  • Tian, Fengyuan;Huang, Shuo;Xu, Wangda;Chen, Lan;Su, Jianming;Ni, Haixiang;Feng, Xiaohong;Chen, Jie;Wang, Xi;Huang, Qi
    • Journal of Ginseng Research
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    • 제46권6호
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    • pp.780-789
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    • 2022
  • Background: Incretin impairment, characterized by insufficient secretion of L-cell-derived glucagon-like peptide-1 (GLP-1), is a defining step of type 2 diabetes mellitus (T2DM). Ginsenoside compound K (CK) can stimulate GLP-1 secretion; however, the potential mechanism underlying this effect has not been established. Methods: CK (40 mg/kg) was administered orally to male db/db mice for 4 weeks. The body weight, oral glucose tolerance, GLP-1 secretion, gut microbiota sequencing, bile acid (BA) profiles, and BA synthesis markers of each subject were then analyzed. Moreover, TGR5 expression was evaluated by immunoblotting and immunofluorescence, and L-cell lineage markers involved in L-cell abundance were analyzed. Results: CK ameliorated obesity and impaired glucose tolerance in db/db mice by altering the gut microbiota, especially Ruminococcaceae family, and this changed microbe was positively correlated with secondary BA synthesis. Additionally, CK treatment resulted in the up-regulation of CYP7B1 and CYP27A1 and the down-regulation of CYP8B1, thereby shifting BA biosynthesis from the classical pathway to the alternative pathway. CK altered the BA pool by mainly increasing LCA and DCA. Furthermore, CK induced L-cell number expansion leading to enhanced GLP-1 release through TGR5 activation. These increases were supported by the upregulation of genes governing GLP-1 secretion and L-cell differentiation. Conclusions: The results indicate that CK improves glucose homeostasis by increasing L-cell numbers, which enhances GLP-1 release through a mechanism partially mediated by the gut microbiota-BA-TGR5 pathway. Therefore, that therapeutic attempts with CK might be useful for patients with T2DM.

노인성 전신질환 입원환자에서 치성감염 관리에 관한 임상적 연구 (A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE ADMISSION PATIENTS WITH AGE-RELELATED GERIATRIC DISEASES)

  • 유재하;최병호;한상권;정원균;노희진;장선옥;김종배;남기영;정재형;김병욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권5호
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    • pp.414-421
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    • 2004
  • This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer

  • Kim, Yong-Hyub;Song, Sang-Yun;Shim, Hyun-Jeong;Chung, Woong-Ki;Ahn, Sung-Ja;Yoon, Mee Sun;Jeong, Jae-Uk;Song, Ju-Young;Nam, Taek-Keun
    • Radiation Oncology Journal
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    • 제33권1호
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    • pp.12-20
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    • 2015
  • Purpose: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT) Materials and Methods: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). Results: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. Conclusion: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.

유기 수경재배 시 천연배지 조성에 의한 명월초 생육 및 항산화 활성 (Growth and Antioxidant Activity of Gynura procumbens by Natural Media Composition in Hydroponic Cultivation Using Organic Nutrient Solution)

  • 이규회;이성희;김주형;박재호
    • 한국유기농업학회지
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    • 제27권3호
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    • pp.341-351
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    • 2019
  • 본 연구는 2018년 충북 괴산군 유기농업연구소에서 노지재배의 단점을 보완할 수 있는 수경재배 기술의 일환으로 명월초 유기 수경재배 시 천연배지 종류가 생육에 미치는 영향을 조사하여 최적의 천연배지를 선발하고자 수행하였다. 실험에 사용한 유기양액은 생육증 진용 유기농자재로 등록된 시판자재 34종을 성분 분석한 후 2종을 혼합하여 사용하였으며, pH 5.5~6.5, EC 0.5~1.0 ds/m로 5월 20일부터 1일 1회, 회 당 50 L씩 점적관수(Ø13 mm, Nam Kyung Co.)를 이용하여 처리하였다. 명월초 정식 후 5월~6월 중순까지 배지별 근권의 최저 온도는 코코피트가 포함된 배지의 최저온도가 다른 배지에 비해 높은 경향을 나타내었으며, 상대적으로 펄라이트가 포함된 배지의 최저온도가 다른 배지에 비해 낮은 경향을 나타내었다. 혼합배지를 제외한 단용 배지별 최저온도는 코코피트 배지가 가장 높게 나타났으며, 그 다음이 버미큘라이트 배지, 펄라이트 배지가 가장 낮게 나타났다. 명월초 정식 후 50일의 천연배지 조성에 따른 초기 생육특성(초장, 엽수, 엽장, 엽폭)은 버미큘라이트 배지에서 가장 우수하게 나타났다. 천연배지 조성별 명월초 수량은 버미큘라이트 배지와 코코피트 : 버미큘라이트 : 펄라이트(2:1:1) 혼합배지가 가장 우수하게 나타났다. 주요 항산화 성분인 총 폴리페놀의 함량은 버미큘라이트 배지에서 1.45 mg g-1으로 가장 높게 나타났다. 따라서, 천연배지 조성에 따른 명월초 생육, 수량 및 총 폴리페놀 함량 등을 비교했을 때 버미큘라이트 단용 배지가 유기 수경재배 시 천연배지로 적합할 것으로 판단된다.

미만성 긴 병변이 있는 급성심근경색환자에서 긴 단일 용출 스텐트 시술과 중첩 스텐트 시술의 효과 비교 (Comparison of Efficacy of Overlapped Versus Long Eluting Stent in Acute Myocardial Infarction Patients with Diffuse Long Lesion)

  • 김원효;김인수;공창기;한재복
    • 한국방사선학회논문지
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    • 제14권3호
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    • pp.319-336
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    • 2020
  • 미만성 긴 병변이 있는 급성심근경색증 환자에서 장기적인 임상 결과에 대해 중첩된 약물용출스텐트와 긴 단일 약물용출스텐트라는 두 가지 중재 방법으로 시술한 환자의 관상동맥조영술 결과와 임상결과를 비교·분석하였다. 2008년 6월부터 2019년 3월까지 급성심근경색환자 (65.9±11.0세, 남성 306명)가 미만성 긴 관상동맥 병변 30 mm이상 병변에 대해서 두 그룹으로 나뉘었습니다. 그룹I (중첩 약물용출스텐트 그룹; n=140) 및 그룹II (긴 단일 약물용출스텐트 그룹; n=298). 주요심장사건의 발생률을 비교하였다[주요심장사건; 두 그룹 사이에서 12개월 동안 심장사망률, 심근경색, 표적병변 재개통술 및 스텐트 혈전증]. Everolimus-용출 스텐트는 그룹I보다 그룹II에서 더 일반적으로 사용되었고(28.1% vs. 51.8% p<0.001), 시술 전 평균 병변직경은 그룹II에서 약간 굵었고 (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), ACC / AHA 병변 유형C의 유병률은 그룹I에서 더 높았다(41.7% vs. 25.4%, p<0.001). 12개월 동안 주요심장사건의 발생률은 그룹II보다 그룹I에서 더 높았고(18.5% vs. 14.4%, p=0.034), 심장 사망률 (2.1% vs. 4.4%, p=0.667), 심근경색 (5.0% vs. 2.7%, p=0.260) 및 스텐트 혈전증률 (0.7% vs. 1.7%, p=0.669)은 두 그룹 차이가 없었다. 그러나 표적병변 재개통술 비율은 그룹I에서 더 높았다(10.7% vs. 5.6%, p=0.041). 다변량 로지스틱 회귀 분석에서 당뇨병의 존재[위험률 2.383, 95 % 신뢰 구간 1.332-4.260, p=0.003]과 파클리탁셀-용출 스텐트[위험률 2.367, 95 % 신뢰 구간 1.371-4.086), p=0.002]는 12개월 주요심장사건의 독립적 예측인자였으며, 두 그룹 사이의 유병률에 큰 차이가 없었다. 미만성 병변이 있는 급성심근경색 환자에서 12개월의 추적 관찰 기간 동안 중첩 약물용출스텐트 그룹에서 표적병변 재개통술 비율이 더 높았고 당뇨병의 존재 및 파클리탁셀-용출 스텐트의 사용은 주요심장사건의 독립적인 예측인자였다.

신장 근위세뇨관세포에서 고포도당이 IGF-I 결합과 포도당운반계에 미치는 영향 (Effects of high glucose concentration on IGF-I binding and glucose transporters in renal proximal tubule cells)

  • 한호재;박권무;손창호;윤용달
    • 대한수의학회지
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    • 제37권2호
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    • pp.301-310
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    • 1997
  • Diabetes mellitus is associated with a wide range of pathophysiological in the kidney. This study was designed to examine the effects of high glucose concentration on IGF-I binding and glucose transporters in renal proximal tubule cells. The results were as follows : The binding of $^{125}I-IGF-I$ reached the peak at the 30 minutes and gradually decreased by the time dependent manner. The binding of $^{125}I-IGF-I$ was inhibited by the unlabelled IGF-I($10^{-14}{\sim}10^{-8}M$) in a concentration dependent manner. The relative affinity of IGF-I receptor for IGF-I, IGF-II and insulin exhibited typical type 1 binding(IGF-I > insulin > IGF-II). However IGF-II did not compete for the cultured cell membrane $^{125}I-IGF-I$ binding site at $10^{-14}{\sim}10^{-8}M$. Under optimal conditions, IGF-I binding to the membranes from 5mM and 20mM glucose treated cells was analyzed. It was found that 20mM glucose treated cells exhibited higher binding activity for IGF-I. In order to further substantiate this increase in IGF-I binding sites, we performed affinity-labelling studies. The cross-linked cell membrane subjected to SDS-PAGE; labelled material was detected by autoradiography. 20mM glucose treated cells exhibited higher levels. The initial rate of $methyl-{\alpha}-D-glucopyranoside({\alpha}-MG)$ uptake was significantly lower($74.41{\pm}6.71%$) in monolayers treated with 20mM glucose than those of 5mM glucose. However, 3-O-methyl-D-glucose(3-O-MG) uptake was not affected by glucose concentration in culture media. IGF-I significantly increased ${\alpha}-MG$ uptake in both 5mM and 20mM glucose treated cells. However, 3-O-MG uptake was not affected by IGF-I in both conditions. In conclusion, 20mM glucose increased binding sites of $^{125}I-IGF-I$, inhibited Na/glucose cotransporter activity. But 20mM glucose did not change facilitated glucose transporter.

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Panax ginseng (Korea Red Ginseng) repairs diabetic sensorineural damage through promotion of the nerve growth factor pathway in diabetic zebrafish

  • Nam, Youn Hee;Moon, Hyo Won;Lee, Yeong Ro;Kim, Eun Young;Rodriguez, Isabel;Jeong, Seo Yule;Castaneda, Rodrigo;Park, Ji-Ho;Choung, Se-Young;Hong, Bin Na;Kang, Tong Ho
    • Journal of Ginseng Research
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    • 제43권2호
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    • pp.272-281
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    • 2019
  • Background: Diabetic sensorineural damage is a complication of the sensory neural system, resulting from long-term hyperglycemia. Red ginseng (RG) has shown efficacy for treatment of various diseases, including diabetes mellitus; however, there is little research about its benefit for treating sensorineural damage. Therefore, we aim to evaluate RG efficacy in alloxan-induced diabetic neuromast (AIDN) zebrafish. Methods: In this study, we developed and validated an AIDN zebrafish model. To assess RG effectiveness, we observed morphological changes in live neuromast zebrafish. Also, zebrafish has been observed to have an ultrastructure of hair-cell cilia under scanning electron microscopy. Thus, we recorded these physiological traits to assess hair cell function. Finally, we confirmed that RG promoted neuromast recovery via nerve growth factor signaling pathway markers. Results: First, we established an AIDN zebrafish model. Using this model, we showed via live neuromast imaging that RG fostered recovery of sensorineural damage. Damaged hair cell cilia were recovered in AIDN zebrafish. Furthermore, RG rescued damaged hair cell function through cell membrane ion balance. Conclusion: Our data suggest that RG potentially facilitates recovery in AIDN zebrafish, and its mechanism seems to be promotion of the nerve growth factor pathway through increased expression of topomyosin receptor kinase A, transient receptor potential channel vanilloid subfamily type 1, and mitogen-activated protein kinase phosphorylation.