• Journal of Pharmaceutical Investigation
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• 제33권3호
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• pp.171-178
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• 2003

Drug interactions with food, on occasion, lead to serious nutritional and functional changes in the body as well as alterations of pharmacological effect. It, therefore, should be necessary to take drug interactions with food into consideration for effective and safe therapeutics. Diabetes mellitus is a heterogeneous group of disorders characterzed by abnormal glucose homeostasis, resulting in hyperglycemia, and is associated with increased risk of microvascular, macrovascular, and neuropathic complications. However, the precise mechanism of diabetes mellitus remains unclear. Three basic objectives in the care of diabetic patients are maintaining optimal nutrition, avoiding hypo- or hyperglycemia and preventing complications. Laminaria japonica is a brown macroalgae which can be used as a functional diet due to high content of diatery fiber. The purpose of this study was to investigate the effect of Laminaria japonica diet on the pharmacokinetics of metformin which are frequently used in the treatment of diabetes. Diabetic rats induced by streptozotocin were employed in this study. Blood concentrations of oral hypoglycemic agent, metformin, were measured by HPLC and resultant pharmacokinetic parameters were calculated by RSTRIP. The mechanisms of drug interaction with food were evaluated on the basis of pharmacokinetic parameters such as $k_{a},\;t_{1/2},\;C_{max},\;t_{max}$, and AUC. Administration of metformin in normal and diabetic rats treated with Laminaria japonica diet showed significant decrease in AUC, $C_{max},\;and\;k_a$, and increase in $t_{max}$, compared to those with normal diet. This might result from adsortion of metformin on components of Laminaria japonica, causing delayed absorption. The oral glucose test showed that Laminaria japonica diet could lower blood glucose level probably through either inhibiting the activity of disaccharidases, intestinal digestive enzymes, or delaying the absorption of glucose. More studies should be followed to fully understand pharmacokinetic changes of metformin caused by long-term Laminaria japonica diet.

• 고려인삼학회:학술대회논문집
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• 고려인삼학회 1993년도 학술대회지
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• pp.102-109
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• 1993

Backgrounds Diabetes mellitus is associated with accelerated atherosc lerosis and predispose to specific microvascular problems. This study was performed to evaluate the usefulness of red ginseng as adjunctive therapeutic agent of NIDDM especially in preventing chronic diabetic complications. Materials and Methods We treated 50 patients with NIDDM for 5 month with 2 regimens: 1)oralhypoglycemic drug therapy only(the control group), 2)oral hypoglycemic group). The patients were recruited at Korea university hospital from June, 1992 to October, 1992 and the following inclusion criteria were used: l)age above 35 years 2)initial body weight within or above ideal body weight 3)fasting blood glucose level greater than 140mg/dl 4)no previous history of diabetes mellitus or no history of blood glucose control for recent 3 months of more. The patients were seen every 2 weeks for remaining 3 months. At every visit FBS and PP2hr blood glucose were measured with blood pressure and body weight. Lipid profiles were checked every 4 weeks and platelet function test was perfomed with aggregometer after administration of ADP, epineprine and collagen every 4 weeks. Free fatty acid were also analyzed every 8 weeks and glycosylated hemoglobin was measured every 12 weeks. Results The results were as follows: 1. The mean values for fasting and PP2hr blood glucose decreased significantly in the control group than in the ginseng group. 2. The weight gain was less in the ginseng group than in the control group. The levels of systolic blood pressure decreased' significantly in the ginseng group than in the control group. 3. There was no significant differences of lipid profiles in both groups. 4. The platelet hyperaggregation was improved more significantly in the ginseng group than in the control group. Conclusions In patients with NIDDM who were recieving oral hypoglycemic drug therapy, the addition of red ginseng improved platelet function and blood pressure, but induced less weight gain. The data suggests that red ginseng may be useful as a therapeutic adjunct especially in preventing chronic complications of NIDDM.

• 한국콘텐츠학회논문지
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• 제18권12호
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• pp.208-217
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• 2018

당뇨병 유병기간에 따른 심혈관 질환의 혈청학적, 합병증의 양상을 국민건강영양조사 6기(2013-2015)의 모든 가용 데이터를 사용하여 당뇨병 환자의 치료뿐 아니라 향후 관리에 대한 정보를 제공함에 목적을 두고 있다. 국민건강영양조사는 건강 설문, 검진, 영양조사로 이루어져 있으며, 18~80세 미만으로 나이를 제한하였고, 당뇨병 유병기간을 응답한 1,316명을 조사 대상으로 하였다. 당뇨병 유병기간에 따라 0-5, 6-10, 11-15, 16-20, 20년 이상으로 구분하였다. 당뇨병 유병기간이 길어질수록 나이는 많아지고, BMI는 낮고, 흡연자의 비율은 떨어지며, HbA1c는 상승하고 사구체 여과율은 낮아졌다. 총 콜레스테롤, LDL-C, 중성 지방 수치는 낮고, HDL-C 수치는 비슷하였다. 인슐린 및 경구용 항고혈당제제를 치료 받는 환자의 비율은 증가하였다. 당뇨병 기간이 길수록 혈당 조절이 악화되었고, 미세혈관 및 대혈관합병증의 위험도는 상승하였다. 이러한 합병증을 예방하기 위해 집중적인 치료와 모니터링으로 위험요인을 통제해야 할 것이다.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.25-33
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• 2024

Backgrounds/Aims: Parenchymal-sparing anatomical hepatectomy (Ps-AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps-AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α-Fetoprotein was 25.2 ng/mL. All cases (100%) had Child-Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien-Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions: Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권1호
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• pp.83-91
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• 2008

The goal of reconstruction following ablative therapy for intraoral cancer is the restoration of form and function to permit a return to activities of daily life. Traditional reconstruction includes split thickness skin grafts, myocutaneous flaps and, more recently, various free flaps. Free flaps provide higher level of functional recovery relative to that seen with other techniques but require the complexity of the technique and microvascular anastomosis and thus, extended surgical time and occasionally a second team for harvesting. The platysma myocutaneous cervical flap is a possible alternative for intraoral reconstruction. It is thin and pliable like the tissue provided by the radial forearm free flap. It can be harvested with enough tissue to close most head and neck ablative defects. There is virtually no donor site morbidity involved. This study evaluated 7 patients affected by intraoral squamous cell carcinoma (SCC). All patients underwent the resection of intraoral SCC with neck dissection and subsequent intraoral reconstruction with the superiorly based platysma myocutaneous cervical flap. Flap-related complications occurred in 3 patients. Adjuvant radiation therapy was performed in 3 patients. Average follow-up was 24.1 months after surgery, with a range of 8 to 42 months. All patients presented self assessment of discomfort associated with intraoral recipient sites and cervical donor sites. However, the neck function measured by two-inclinometer technique was within the normal range during relatively long term follow-up period. Our study concluded that superiorly based platysma myocutaneous cervical flap is good alternative to free flaps, especially for relatively smaller defects and for the defects appropriate for the rotation arc of the flap.

• 대한골관절종양학회지
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• 제15권2호
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• pp.93-103
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• 2009

목적: 종양절제 후 남은 골 결손을 재생 자가골과 생비골 이식술을 이용하여 치료하고 그 임상적 결과를 분석하였다. 대상 및 방법: 1997년 이후 종양 절제 후 남은 골 결손을 재생 자가골과 생비골 이식술을 이용하여 재건하고 1년 이상 추시가 가능하였던 10례를 대상으로 골 유합 시기, 기능적 결과 및 합병증 등 임상적 결과를 분석하고 관련인자에 따른 차이를 알아보았다. 결과: 재생골-숙주골 접합부 총 20부위 중 13부위(65%)에서 일차수술 후 골 유합을 얻었으며 골 유합까지의 기간은 골간단부는 평균 3.7개월, 골간부는 평균 8개월이었다(P<0.05). 골간부에서 나이가 20세 미만인 군과 생비골을 골수강내 이식한 군에서 골 유합까지의 기간이 짧았다(P<0.05). 기능적 결과는 평균 81%였다. 합병증으로 불유합이 3부위, 지연유합이 4부위에서 있었으며 2예에서 재생 자가골의 심한 흡수와 함께 이식골의 골절이 발생하였다. 결론: 우수한 결과를 얻기 위해서는 이식된 비골의 혈행을 유지할 수 있는 정확한 술기와 견고한 내고정, 접합부를 가로지르는 이식 생비골의 충분한 길이, 골 유합 또는 이식 생비골의 비후가 일어나기까지의 적절한 보호가 필요하다.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.1-5
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• 2000

The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

• 한국식품영양과학회지
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• 제37권1호
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• pp.42-47
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• 2008

본 연구는 전분 가수분해효소인 ${\alpha}$-amylase의 효소활성 저해를 통해 식후 혈당조절제 개발 가능성을 확인하고자 메밀의 꽃, 잎, 줄기 및 곡립을 부위별로 분류하고 각각의 시료를 물, 40%, 70%, 100% 에탄올로 추출하고 건조한 추출건조물과 메밀건조 분말시료를 이용하여 in vitro에서 ${\alpha}$-amylase 활성 저해율을 측정하였다. 메밀부위별 물추출건조물(10%, w/w, starch basis)의 ${\alpha}$-amylase 활성 저해율은 꽃 66%, 잎 65%, 곡립 28%, 줄기 12% 순이었다. 이러한 결과는 추출 용매를 40%, 70%, 100% 에탄올로 하였을 때에도 유사하게 나타났다. 단지 잎추출건조물의 경우 70% 에탄올추출건조물의 효소활성 저해율이 100%와 40% 에탄올추출건조물보다 낮게 나타났다. 메밀 꽃과 잎 추출건조물을 기질의 0.1%, 0.5%, 1%, 2.5%, 5%, 10% 농도로 각각 첨가했을 때 에탄올로 추출한 꽃추출건조물의 경우 $0.5%{\sim}10%$ 농도에서 ${\alpha}$-amylase 활성을 약 90% 저해하였으며 이는 ${\alpha}$-amylase inhibitor인 acarbose와 유사한 수준이었다. 잎의 경우 100% 에탄올추출건조물에서 꽃과 비슷한 결과를 보였으며 40% 에탄올추출건조물에서는 꽃추출건조물보다 저해율이 다소 낮게 나타났다. 물추출건조물과 건조분말의 경우 에탄올추출물보다 꽃과 잎의 효소활성 저해율이 낮았다. 이러한 결과로 볼 때 메밀 꽃과 잎 추출건조물은 메밀 줄기 및 곡립 추출 건조물과 비교해서 효소활성 저해율이 높게 나타났으며, 물 추출이나 건조분말보다 100%, 40% 에탄올을 이용했을 때 추출건조물의 효소 저해율이 더욱 큰 것으로 나타나 이들 추출건조물은 식후 혈당조절제로 이용 가능성이 기대되는 소재로 사료된다.