• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.171-176
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• 2021

Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

• The Journal of Internal Korean Medicine
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• v.42 no.1
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• pp.40-52
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• 2021

Objective: This study was conducted to investigate the hypoglycemic effect and safety of Ojeok-san in patients with type 2 Diabetes Mellitus. Methods: We investigated type 2 diabetes mellitus patients at Kyung-Hee University Korean Medical Hospital who were administered Ojeok-san for at least one day between January 2012 and September 2020, basal characteristics and laboratory tests were reviewed retrospectively. The hypoglycemic effect of Ojeok-san was assessed by comparing fasting blood sugar (FBS) and two hours post-prandial plasma glucose (PP2) levels from before and after taking Ojeok-san. Subgroup analyses were conducted according to baseline hypoglycemic treatments and glycated hemoglobin levels (< or ≥6.5%). The safety of Ojeok-san was assessed by comparing levels of aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase, blood urea nitrogen, and creatinine. Results: After Ojeok-san administration, FBS and PP2 were significantly reduced to an average of 14.33 mg/dL and 27.67 mg/dL respectively. In the subgroup analysis, PP2 in patients receiving metformin mono therapy was significantly reduced to 28.67 mg/dL, and those receiving a dual therapy of metformin and DPP-4 inhibitor, it was significantly reduced to 32.33 mg/dL. In patients with glycated hemoglobin of lower than 6.5%, FBS was significantly reduced to 12.20 mg/dL, and both FBS and PP2 were significantly reduced, to 15.50 mg/dL and 40.00 mg/dL, respectively, in those with glycated hemoglobin levels of more than 6.5%. The safety profile showed no significant difference after Ojeok-san administration. Conclusions: Ojeok-san has significant hypoglycemic effects in patients with type 2 diabetes mellitus who are also taking hypoglycemic agents.

• Journal of Nutrition and Health
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• v.54 no.3
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• pp.247-261
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• 2021

Purpose: This study was conducted to identify the association between insulin resistance and the major dietary patterns of Korean adults. Methods: This study used data from the 2015 Korea National Health and Nutrition Examination Survey. The subjects were 2,276 adults aged 19 to 64 years old. Based on the food frequency questionnaire data, 112 food items were reclassified into 30 food groups. The principal component analysis method was applied to identify major dietary patterns. We used homeostatic model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) value as indicators of insulin resistance. The association between major dietary patterns and insulin resistance was investigated using logistic regression analysis. Results: Three major dietary patterns were identified and assigned descriptive names based on the food items with high loadings: 'healthy Korean meal pattern', 'western meal pattern', and 'white rice, alcohol, meat pattern'. As the 'white rice, alcohol, meat pattern' score increased, significant increasing trends for fasting glucose concentration and HOMA-IR and a significant decreasing trend for QUICKI were observed after adjusting for age and sex. The odds ratio of insulin resistance according to the 'healthy Korean meal pattern' and the 'western meal pattern' were not statistically significant. the 'white rice, alcohol, meat pattern' showed a significant positive association with the risk of insulin resistance after adjusting for covariates. Conclusion: These results suggest that the 'white rice, alcohol, meat pattern' is positively associated with the risk of insulin resistance. The white rice, alcohol, meat pattern was related to the high consumption of alcohol together with rice or meat. This pattern was also associated with the high intake of sodium and low intakes of vitamin C, calcium, potassium, and dietary fiber. To confirm the association, further longitudinal studies are required.

• Annals of Pediatric Endocrinology and Metabolism
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• v.23 no.4
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• pp.196-203
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• 2018

Purpose: The hemoglobin glycation index (HGI) represents the degree of nonenzymatic glycation and has been positively associated with cardiometabolic risk factors (CMRFs) and cardiovascular disease in adults. This study aimed to investigate the association between HGI, components of metabolic syndrome (MS), and alanine aminotransferase (ALT) in a pediatric nondiabetic population. Methods: Data from 3,885 subjects aged 10-18 years from the Korea National Health and Nutrition Examination Survey (2011-2016) were included. HGI was defined as subtraction of predicted glycated hemoglobin ($HbA1_c$) from measured $HbA1_c$. Participants were divided into 3 groups according to HGI tertile. Components of MS (abdominal obesity, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure), and proportion of MS, CMRF clustering (${\geq}2$ of MS components), and elevated ALT were compared among the groups. Results: Body mass index (BMI) z-score, obesity, total cholesterol, ALT, abdominal obesity, elevated triglycerides, and CMRF clustering showed increasing HGI trends from lower-to-higher tertiles. Multiple logistic regression analysis showed the upper HGI tertile was associated with elevated triglycerides (odds ratio, 1.65; 95% confidence interval, 1.18-2.30). Multiple linear regression analysis showed HGI level was significantly associated with BMI z-score, $HbA1_c$, triglycerides, and ALT. When stratified by sex, age group, and BMI category, overweight/obese subjects showed linear HGI trends for presence of CMRF clustering and ALT elevation. Conclusion: HGI was associated with CMRFs in a Korean pediatric population. High HGI might be an independent risk factor for CMRF clustering and ALT elevation in overweight/obese youth. Further studies are required to establish the clinical relevance of HGI for cardiometabolic health in youth.

• 한국노년학
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• v.38 no.1
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• pp.169-185
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• 2018

The purpose of this study examined the feasibility and efficacy of a senior center-based diabetes self-management program applying action research approach. The cyclical action research method was applied for this study: plan, act, evaluate, and reflect in delivering three waves of the intervention program. Three waves of a 12 weeks-length small group diabetes self-management program were offered during the period of 15 months in a senior center in Seoul. Planning of $2^{nd}$ and $3^{rd}$ wave program were based on reflection of $1^{st}$ and $2^{nd}$ program evaluation respectively. Among the 46 participants, 93.48% (N=43) completed the program. The quantitative evaluation showed statistically significant improvement in HbA1C(p<.001), fasting plasma glucose(p<.001), BMI(p=.016), waist circumference(p=.001), systolic blood pressure(p=.036), diabetes self-management behavior(p<.001) and health knowledge(p=.008). Qualitative data revealed that individual management was very helpful in empowering and adhering for own diabetes care for the participants. Participants reported high satisfaction towards the program with mean satisfaction score of 65.12. Application of the Diabetes Self-management program with action study strategy was successful in community setting for improving participants' subjective and objective outcomes. Action research method guides the practitioner to tailor the program to respond for the participants and field needs.

• Korean Journal of Community Nutrition
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• v.24 no.2
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• pp.152-162
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• 2019

Objectives: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. Methods: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. Results: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin $B_2$ levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin $B_2$ was inadequately consumed by all groups. Conclusions: These results suggest that it is necessary to increase the intake of vitamin $B_2$ and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.4
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• pp.121-128
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• 2019

The purpose of this study was to investigate the effects of exercise program intervention in Korea for the control of blood sugar levels in elderly women patients undergoing diabetes mellitus typeII and to investigate the effects of exercise program intervention. Research methods were searched through RISS, KISS, KoreaMed, and KMbase as domestic databases and limited to domestic papers published from 2010 to May 2017. Diabetes, female diabetes, and diabetes mellitus typeII were used as the search terms related to the patient group. Programs related to intervention, intervention, exercise, blood glucose, glucose insufficiency, glucose control, fasting glucose and HbA1c were used. A total of 12 papers were provided according to the intervention method. The mediation period was 12 weeks(50%), 3 times per week(58.3%), and 50 to 69 minutes(83.4%) was the most. The combined aerobic and anaerobic exercise was found to be an effective exercise method to control not only blood glucose level but also HbA1c. Individualized exercise program intervention should be provided considering the physical fitness level and health status of elderly patients undergoing diabetes mellitus typeII and should be encouraged to maintain effective blood glucose control through continuous exercise rather than one-off exercise.

• Journal of Nutrition and Health
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• v.52 no.3
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• pp.268-276
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• 2019

Purpose: Metabolic syndrome causes diabetes and increases the risk of cardiovascular disease. This study examined the correlation between metabolic syndrome, nutrition intake, and triglyceride (TG)/high-density lipoprotein (HDL) cholesterol ratio. Methods: Using the data from the $7^{th}$ KNHANES (2016), this study was conducted on healthy adults aged 19 and older. The components and existence of metabolic syndrome and nutrition intake were independent variables and the TG/HDLcholesterol ratio was a dependent variable. A complex sample logistic progress test was used with age, sex, smoking, and drinking frequency corrected. Results: The TG/HDLcholesterol ratio of people with metabolic syndrome was as high as 1.314 on average, compared to people without metabolic syndrome (p < 0.0001). Among each component of metabolic syndrome, the TG/HDL cholesterol ratio had a significant association with fasting blood glucose, TG, HDL cholesterol, and waist circumference (p < 0.05). Only energy and carbohydrate intake were significantly related to the TG/HDLcholesterol ratio (p < 0.05). Conclusion: The TG/HDLcholesterol ratio is associated with each component of metabolic syndrome, but in particular, it is positively correlated with the presence of metabolic syndrome. Lower energy intakehad a positive correlation with the TG/HDLcholesterol ratio. These results show that metabolic syndrome can be predicted using the TG/HDLcholesterol ratio, and a diet strategy through nutrition and health education is necessary to prevent metabolic syndrome.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.349-357
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• 2019

The purpose of this study was to evaluate the clinical significance of ultrasonographic classification of fatty liver in three grades. From June 2018 to April 2019, 1047 patients (818 males and 229 females) diagnosed as fatty liver among 3607 patients who underwent abdominal ultrasonography at Busan screening center. Ultrasonography was classified into three grades: Grade I (mild fatty liver), Grade II (moderate fatty liver), and Grade III (severe fatty liver) according to the degree of parenchyma texture, acoustic attenuation, Obesity index, hematological test, and metabolic syndrome. The average age of men in each sex increased with the increase of the fatty liver. Body mass index (BMI) and waist circumference were significantly increased in both men and women (p=.000). hematological analysis showed that AST, ALT, ${\gamma}-GTP$, TG, fasting blood sugar, and glycated hemoglobin were significantly different from each other (p<.05). In women, ALT, ${\gamma}-GTP$ and TG showed a significant difference with increasing fatty liver (p<.05). The prevalence of metabolic syndrome was significantly increased in both sexes as the grade of fatty liver increased (p=.000). Based on the results of this study, it is suggested that the use of ultrasound - guided fatty liver according to severity may be useful for the treatment and follow - up of fatty liver if the liver grade is divided in consideration of hematological variables and metabolic syndrome.

• Journal of the Korean Applied Science and Technology
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• v.36 no.3
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• pp.804-812
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• 2019

The purpose of this study was to investigate the effects of different types of exercise training on neurodegeneration and cognitive function in mice with impaired glucose tolerance (IGT). Thirty-six male C57BL/6 mice were randomly assigned to the control (CO, n = 9) and impaired glucose tolerance (IGT, n = 27) groups. The IGT group consumed 45% high fat diet for 4 weeks and received 40 mg/kg of streptozotocin twice in the lower abdomen to induce IGT. After the IGT induction period, the IGT group was subdivided into IGT + sedentary (IGT, n = 9), IGT + endurance exercise (IGTE, n = 9), and IGT + resistance exercise (IGTR, n = 9). The IGTE and IGTR groups performed treadmill and ladder climbing exercises 5 times per week for 8 weeks, respectively. Fasting glucose and glycated hemoglobin (HbA1c) levels were significantly higher in IGT group than in CO, IGTE, and IGTR groups (p < 0.05). HOMA-IR was significantly higher in IGT group than CO group (p < 0.05). Hippocampal catalase (CAT) was significantly lower in IGT group than in CO group (p < 0.05), while beta-amyloid ($A{\beta}$) was significantly higher in IGT group than in CO group (p < 0.05). Hippocampal tau was significantly higher in IGT group than in CO, IGTE, and IGTR groups (p < 0.05). The Y-maze test performance for cognitive function was significantly lower in IGT group than in CO, IGTE, and IGTR groups (p <0.05). These results suggest that IGT induces neurodegeneration and negatively affects cognitive function, while regular exercise may be effective in alleviating neurodegeneration and cognitive decline regardless of exercise type.