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Vitamin A Improves Hyperglycemia and Glucose-Intolerance through Regulation of Intracellular Signaling Pathways and Glycogen Synthesis in WNIN/GR-Ob Obese Rat Model.

  • Jeyakumar, Shanmugam M.;Sheril, Alex;Vajreswari, Ayyalasomayajula
    • Preventive Nutrition and Food Science
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    • v.22 no.3
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    • pp.172-183
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    • 2017
  • Vitamin A and its metabolites modulate insulin resistance and regulate stearoyl-CoA desaturase 1 (SCD1), which are also known to affect insulin resistance. Here, we tested, whether vitamin A-mediated changes in insulin resistance markers are associated with SCD1 regulation or not. For this purpose, 30-week old male lean and glucose-intolerant obese rats of WNIN/GR-Ob strain were given either a stock or vitamin A-enriched diet, i.e. 2.6 mg or 129 mg vitamin A/kg diet, for 14 weeks. Compared to the stock diet, vitamin A-enriched diet feeding improved hyperglycemia and glucose-clearance rate in obese rats and no such changes were seen in lean rats receiving identical diets. These changes were corroborated with concomitant increase in circulatory insulin and glycogen levels of liver and muscle (whose insulin signaling pathway genes were up-regulated) in obese rats. Further, the observed increase in muscle glycogen content in these obese rats could be explained by increased levels of the active form of glycogen synthase, the key regulator of glycogen synthesis pathway, possibly inactivated through increased phosphorylation of its upstream inhibitor, glycogen synthase kinase. However, the unaltered hepatic SCD1 protein expression (despite decreased mRNA level) and increased muscle-SCD1 expression (both at gene and protein levels) suggest that vitamin A-mediated changes on glucose metabolism are not associated with SCD1 regulation. Chronic consumption of vitamin A-enriched diet improved hyperglycemia and glucose-intolerance, possibly, through the regulation of intracellular signaling and glycogen synthesis pathways of muscle and liver, but not associated with SCD1.

Relationship of Total Body Fat Content and Its Distribution to Carbohydrate Tolerance and Serum Lipids in Diabetics (당뇨병 환자의 체지방량 및 체지방 분포와 당대사 및 혈청지질 농도와의 관계)

  • 김은경;이기열;김유리;허갑범
    • Journal of Nutrition and Health
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    • v.24 no.1
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    • pp.1-11
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    • 1991
  • In this study. the importance of body fat distribution as an indicator of metabolic aberrations in diabetics was'evaluated. Skinfold thicknesses at eight sites and circumferences at five sites and total body fat content were measured on 105 diabetics. 1) The waist/thigh girth ratio(WTR) was positively correlated(r=0.38-0.54) to plasma glucose levels during oral glucose loading in diabetic men alone. 2) There was no significant difference in serum total cholesterol of diabetics and nondiabetics. However, HDL-cholesterol was significantly lower(p : 0.000. in male and female) in diabetics(male : 36.31$\pm$ 16.98mg/dl, female: 37.89$\pm$14.67mg/dl) than nodiabetics(male 61.75$\pm$14.08mg/dl, female : 62.29$\pm$12.65mg/dl) and serum triglyceride was significantly higher(p=0.0212) in diabetic women(171.90$\pm$ 76.61mg/dl) than nondiabetic women(111.10$\pm$42.84mg/dl) . 3) In both sexes. anthropometric measurements that significantly correlated to serum triglyceride concentration were percentage of ideal body weight. body mass index(BMI) and waist circumference. Positive and significant correlations were found between serum cholestrol, and BMI(R: 0.31, 0.34) and waist circumference(r=0.29) in diabetic men. Moreover, skinfolds of trunk area(r=0.29~0.32) especially abdomen, were closely associated with serum lipids than other fat deposits. Increasing percentage of total body fat content was accompanied by progressively increasing serum triglyceride concentration(r=0.41) in dieabetic men. This study shows that knowledge of body fat localization may help identify risks of carbohydrate intolerance and hyperlipidemia in diabetics.

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Digital Sympathectomy for Treatment of Raynaud's Syndrome (레이노드 증후군의 치료에 있어서 수부 교감신경절제술)

  • Rhee, Se Whan;Ahn, Hee Chang;Choi, M Seung Suk;Kim, Chang Yeon
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.479-484
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    • 2005
  • Raynaud's syndrome causes discolorization, ischemic claudication(pain) and necrosis of the digits through insufficiency in the circulation which is induced by intermittent spasms of the digital arteries. From January, 2002 to December, 2004, 10 patients were surgically treated for Raynaud's syndrome. 9 patients were female and 1 patient was male. 2 patients showed unilateral involvement, 8 patients were operated on both hands. 6 patients had necrotic changes on the finger tips due to the disease. Ages ranged from 21 to 60 with an average of 39.1. Ischemic pain, discolorization, and cold intolerance of the digits were the common symptoms. All patients were evaluated with color doppler before the surgery. Two different procedures were applied according to the severity of the disease: Patients with decreased circulation received, what we call a limited digital sympathectomy, i.e. stripping of the adventitia of the ulnar, radial and common digital arteries. An extended procedure, radical digital sympathectomy, was performed on patients with a complete block of circulation. Stripping of the adventitia in these patients also involved the proper digital arteries. Symptoms like discolorization, ischemic pain, and cold intolerance improved immediately after the surgery. The patients did not suffer from pain even with exposure to cold weather. We conclude that digital sympathectomy could improve the symptoms in Raynaud's patients who do not respond to conservative treatment such as calcium channel blocker and other vasodilators.

A Study of the Classification of Nursing Diagnoses (간호진단 분석 일 연구)

  • Shon Young-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.1
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    • pp.119-131
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    • 1997
  • This study was conducted to analyze the nursing diagnoses applied for case studies of nursing students through their clinical practices, and to provide the educational basis of nursing diagnoses with its results. The data were collected for two years(1995 and 1996) from 70 case studies reported by the 2nd and 3rd year nursing junior college students. The students made 259 nursing diagnoses among which 230 diagnoses qualified NANDA classification and were taken for analysis. The results of the analysis were as follows : 1. The number of diagnoses indicating response patterns was 35(35.7%), whereas 98 diagnoses in NANDA table. Among the 35 diagnoses, the pattern of exchange was most frequent, then feeling, moving, knowing in rank. 2. The diagnoses were analyzed in the categories of response patterns. For Instance, 'Altered in Nutrition' was most frequent in exhange, then Risk for Infection', 'Ineffective Airway Clearance', in rank. 3. Among 230 diagnoses, 'Knowle Deficit' was most frequently mentioned, then 'Activity Intolerance' 'Anxiety', 'Pain', 'Altered in Nutrition', 'Risk for Infection', 'Ineffective airway clearance', in rank. 4. The types of word expression of each diagnoses were various. 'Activity Intolerance' was expressed in 6 types. 5. The relating factors applied to each diagnosis were analyzed. For Instance, the relating factor of 'Knowledge Deficit' were illness, and therapeutic process, lack of motivation, occurrance of complication, short experience, operation, and so on. From the above study, the researcher would like to recommend as follows : 1) The current diagnoses need to be verified its content validity, when they are applied to our culture. 2) The most effective educational method for applying nursing diagnoses should be explored. 3) Further study could be focused on not only 'relating factors' but also 'sign and symptoms'.

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Amino Acid-Based Formula in Premature Infants with Feeding Intolerance: Comparison of Fecal Calprotectin Level

  • Jang, Hyo-Jeong;Park, Jae Hyun;Kim, Chun Soo;Lee, Sang Lak;Lee, Won Mok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.189-195
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    • 2018
  • Purpose: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. Methods: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. Results: Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p<0.05). The growth velocities (g/d) and z scores were not significantly different between the FI and control group (p>0.05). Conclusion: The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.

A Study on Rehabilitation Nursing Diagnoses used for the Clients with Stroke and Spinal Cord Injury in Korea (뇌졸중과 척수손상환자에게 적용되는 간호진단에 관한 연구)

  • Suh, Moon-Ja;Lim, Nan-Young;Kang, Hyun-Sook;Kim, Keum-Soon;Yang, Kwang-Hee;Cho, Bok-Hee;Lee, Myung-Hwa;Oh, Hae-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.22-28
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    • 1999
  • The development of standards and guidelines of rehabilitation nursing has been the major concerns for providing better nursing to the rehabilitation clients. As the patients with stroke and spinal cord injuries are the most prevalent physical disabilities in Korea, this study focussed on the nursing diagnoses of these two groups of patients. In order to identify the nursing diagnoses frequently used In their practice for the patients with stroke and spinal cord injuries, a survey was done with the questionnaire form developed by the research team. The surveyee were the staff nurses working at rehabilitation wards more than 2 years from 8 general hospitals in Korea, They identified and set the priorities of 13 nursing diagnoses from 79 stroke patients and 10 nursing diagnoses from 35 patients with spinal cord injuries during the periods from March 1 to June 2, 1999. The identified nursing diagnoses for the stroke patients are impaired physical immobility, sensory-perceptual alteration, activity intolerance, self-care deficit, altered defecation, altered urination, risk for injury, unilateral neglect, impaired skin integrity, altered thought processes, pain, altered health maintenance, dysreflexia. The identified nursing diagnoses for spinal cord injuries are altered urination, altered defecation, impaired skin integrity, pain, risk for injury, reflex incontinence, impaired physical immobility, self-care deficit, activity intolerance, knowledge deficit.

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Validation of the Korean Version of Brief Multidimensional Measure of Religiousness/Spirituality Scale (다차원적 종교성/영성척도 단축형 한국어판의 타당화)

  • Yoon, Hyae-Young;Kim, Keun-Hyang
    • Journal of the Korea Convergence Society
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    • v.6 no.5
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    • pp.257-274
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    • 2015
  • The purpose of the current study was to validate Fetzer Institute & National Institute on Aging Working Group[NIA](1999)'s Brief-Multidimensional Measure of Religiousness/Spirituality Scale (BMMRS) in Korean adults. The Korean version of BMMRS, Spiritual Well-Being Scale(SWS), Korean Sprituality Scale(KSS), Penn State Worry Questionnaire(PSWQ), and Intolerance of uncertainty Scale(IUS) were administered to the 286 students and community samples. A principle axis factoring analysis with direct oblimin rotation and Kaiser normalization identified a six-factor solution accounting for 66.24% of the variance in scores, labeled as: positive spiritual experience, negative spiritual experience, forgiveness, religious practices, negative congregational support, and positive congregational support. Confirmatory factor analysis results showed that 6 factor model of BMMRS have a good fitness. Also, the internal consistency(.64~.97) and the test-retest reliablity was adequate.(.72~.88) Korean version of BMMRS has adequate psychometric characteristics so it can be used to verify the effects of various compassion-related psychotherapeutic approaches.

Sinoatrial Reentrant Tachycardia in a Yorkshire Cross Dog (요크셔테리어 잡종견에서 나타난 동방회귀성 빈맥증)

  • Nam, So-Jeong;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.391-395
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    • 2008
  • An 8-year-old intact male Yorkshire cross dog (7.5 kg of body weight) was referred with the primary complaint of exercise intolerance and occasional syncope. Initial cardiological examination could not identify any abnormalities except mild mitral regurgitation. Exercise stress test revealed chronotrophic incompetence. Furthermore the 1 hr-digital event recording found the sudden onset of paroxysmal sinus tachycaridas (156-172 bpm) lasting few minutes and stopping abruptly. In addition, the tachycardia terminated by vagal maneuver and verapamil administration. Based on this finding, the case was diagnosed as sinoatrial reentrant tachycardia (SART). The dog was treated with diltiazem and enalapril. Although the dog still has exercise intolerance, no syncope has been observed after medication.

A Study on the Classification of Nursing Diagnoses by Student Nurses (간호학생이 내린 간호진단 분석에 관한 연구)

  • Min, Soon
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.457-471
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    • 1995
  • This research was done to promote improvement of practical application of nursing diagnoses and to improve the quality of nursing. The subjects of this research were 156 second year students of C junior nursing college who were giving adult patient care. The nursing diagnoses of 312 reports were analyzed using NANDA. In these case reports only nursing diagnoses were considered, of which there were a total of 982. In the data analysis the 9H of the nursing students' nursing diagnoses matched with 105 NANDA nursing diagnoses, Of these, the most frequent diagnoses were pain(165, 17.48%), anxiety(101, 10.70%), alteration in nutrition(83, 8.79%) , sleep disturbance (67, 7.10%), in activity intolerance (67, 7.10%), ineffective breathing pattern(51,5.40%). The etiology for the students' nursing diagnoses were compared with NANDA's nursing diagnoses by frequency. The most frequent etiology for the nursing diagnoses of pain was a biological etiology(50, 31%), for anxiety, situation crisis(58, 57.43%), for alteration in nutrition, indigesion(23, 27.71%), for sleep disturbance, external etiology(25, 37.32%), for activity intolerance, immobile position(22, 32.84%), for ineffective breathing pattern, pain(35, 68.63%), and for ,impaired physical mobility, pain(31, 65.96%). The most frequent etiology for constipation was inadquate digestion of water and cellulose (16, 34.78%), for fluid volume felicity, loss of body fluid (21, 52.50%), for impaired skin integrity, external etilogy(16, 43.24%), for impaired physical mobility, pain(22, 62.86%) , for knowledge deficits, cognition disturbance(9, 27.27%), for ineffective air way clearance, secretion obstruction(14, 48.27%) , for impaired gas exchange, loss of transport ability of blood oxygen(9, 37.50%) , and for powerlessness, therapy environment (5, 22.73%). The number of nursing diagnoses by pattern was exchange(16), moving(6), feeling(4), choosing(4), relating(3), communication(1), perceiving(1), knowing(1), valuing(1).

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The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study

  • El Koofy, Nehal Mohamed;Rady, Hanaa Ibrahim;Abdallah, Shrouk Moataz;Bazaraa, Hafez Mahmoud;Rabie, Walaa Ahmed;El-Ayadi, Ahmed Ali
    • Clinical and Experimental Pediatrics
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    • v.62 no.9
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    • pp.344-352
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    • 2019
  • Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.