1.Exercise Strategies to Prevent Hypoglycemia in Patients with Diabetes
Ah Reum JUNG ; Hyunah KIM ; Hun-Sung KIM ; Churlmin KIM ; Whan-Seok CHOI
Korean Journal of Family Medicine 2021;42(2):91-95
The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.
2.Exercise Strategies to Prevent Hypoglycemia in Patients with Diabetes
Ah Reum JUNG ; Hyunah KIM ; Hun-Sung KIM ; Churlmin KIM ; Whan-Seok CHOI
Korean Journal of Family Medicine 2021;42(2):91-95
The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.
3.Association between Allergic Rhinitis-Related Factors and Risk of Obstructive Sleep Apnea in Korean Adults over 40: The 8th Korea National Health and Nutrition Examination Survey (2019–2021)
Korean Journal of Family Practice 2024;14(2):98-104
Background:
The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults.
Methods:
We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea.
Results:
The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics).
Conclusion
Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.
4.Association between Allergic Rhinitis-Related Factors and Risk of Obstructive Sleep Apnea in Korean Adults over 40: The 8th Korea National Health and Nutrition Examination Survey (2019–2021)
Korean Journal of Family Practice 2024;14(2):98-104
Background:
The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults.
Methods:
We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea.
Results:
The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics).
Conclusion
Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.
5.Association between Allergic Rhinitis-Related Factors and Risk of Obstructive Sleep Apnea in Korean Adults over 40: The 8th Korea National Health and Nutrition Examination Survey (2019–2021)
Korean Journal of Family Practice 2024;14(2):98-104
Background:
The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults.
Methods:
We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea.
Results:
The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics).
Conclusion
Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.
6.Association between Allergic Rhinitis-Related Factors and Risk of Obstructive Sleep Apnea in Korean Adults over 40: The 8th Korea National Health and Nutrition Examination Survey (2019–2021)
Korean Journal of Family Practice 2024;14(2):98-104
Background:
The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults.
Methods:
We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea.
Results:
The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics).
Conclusion
Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.
7.Comparison of Monocyte Selection Method by Immunomagnetic Adsorption or Adherence for the Generation of Dendritic cells.
Kyung Ah CHEONG ; Ok Mi CHOI ; Sung E CHOI ; Hyunah LEE ; Young Joon LEE
Korean Journal of Blood Transfusion 2004;15(2):213-219
BACKGROUND: Dendritic cells (DCs) are the most potent stimulators of immune response including antitumor response. DCs are currently being pursued clinically in the development of cancer vaccines; therefore there are demands for large-scale and clinical-grade generation of DCs. In the present study, to find out the most efficient separation method of DC precursors, we compared two separation methods, namely, based on magnetic based selection and plastic adherence selection. METHODS: MNCs were collected by leukapheresis from healthful donors and separated by CD14 + immunomagnetic adsorption or plastic adherence. DC precursors separated using the two methods were differenciated in the same condition. Matured DCs were compared in terms of yield, viability, the expression of surface markers and ability to induce immune reaction. RESULTS: This study demonstrated that mature DCs from CD14 + monocytes separated using CD14 + immunomagnetic adsorption had higher expression of surface markers of DCs, yield (1.9 +/-0.5% vs. 0.5 +/-0.2%), viability (94.7 +/-2.5% vs. 72.8 +/-7.5%) and better functionality in inducing immune reaction than those from plastic adherent cells. CONCLUSION: These results demonstrated that CD14 + immunomagnetic adsorption was found to be more effective than the adherent selection for the generation of DCs. This study will allow researcher to facilitate choosing the appropriate protocol to obtain DCs.
Adsorption*
;
Cancer Vaccines
;
Dendritic Cells*
;
Humans
;
Leukapheresis
;
Monocytes*
;
Plastics
;
Tissue Donors
8.Effect of Dendritic Cell Based Cancer Vaccine Using Allogeneic Tumor Cell Lysate in Melanoma Pulmonary Metastasis Model.
Young Joon LEE ; Myung Joo KIM ; So Hee IN ; Ok Mi CHOI ; Soyoung BAEK ; Young Do KWON ; Hyunah LEE
Immune Network 2005;5(3):163-171
BACKGROUND: To perform the successful dendritic cell-based cancer immunotherapy one of the main issues to be solved is the source of antigen for DC pulsing. Limitations occur by using auto-tumor lysate due to the difficulties obtaining enough tumor tissue(s) quantitatively as well as qualitatively. In this study the possibility of allogeneic tumor cell lysate as a DC pulsing antigen has been tested in mouse melanoma pulmonary metastasis model. METHODS: B16F10 melanoma cells (1x10(5)/mouse) were inoculated intravenously into the C57BL/6 mouse. Therapeutic DCs were cultured from the bone marrow myeloid lineage cells with GM-CSF and IL-4 (1,000 U/ml each) for 7 days and pulsed with lysate of either autologous B16F10 (B-DC), allogeneic K1735 (C3H/He origin; K-DC) or CloneM3 (DBA2 origin; C-DC) melanoma cells for 18 hrs. Pulsed-DCs (1x10(6)/mouse)[CGP1] were injected i.p. twice with one week interval starting from the day 1 after tumor cell inoculation. RESULTS: Without observable toxicity, allogeneic tumor cell lysate pulsed-DC induced the significantly better anti-tumor response (tumor scale: 2.7+/-0.3, 0.7+/-0.3 and 0.3+/-0.2 for saline, B-DC and C-DC treated group, respectively). Along with increased tumor specific lymphocyte proliferations, induction of IFN-gamma secretion against both auto- and allo-tumor cell lysates was observed from the DC treated mice. (w/B16F10-lysate: 44.97+/-10.31, 1787.94+/-131.18, 1257.15+/-48.27, w/CloneM3 lysate: 0, 1591.13+/-1.83, 1460.47+/-86.05 pg/ml for saline, B-DC and C-DC treated group, respectively) Natural killer cell activity was also increased in the mice treated with tumor cell lysate pulsed-DC (8.9+/-[CGP2]0.1, 11.6+/-0.8 and 12.6+/-0.7% specific NK activity for saline, B-DC and C-DC treated group, respectively). CONCLUSION: Conclusively, promising data were obtained that allogeneic-tumor cell lysate can be used as a tumor antigen for DC-based cancer immunotherapy.
Animals
;
Bone Marrow
;
Dendritic Cells*
;
Granulocyte-Macrophage Colony-Stimulating Factor
;
Immunotherapy
;
Interleukin-4
;
Killer Cells, Natural
;
Lymphocytes
;
Melanoma*
;
Mice
;
Neoplasm Metastasis*
9.Immunogenic Cell Death Induced by Ginsenoside Rg3: Significance in Dendritic Cell-based Anti-tumor Immunotherapy.
Keum Joo SON ; Ki Ryung CHOI ; Seog Jae LEE ; Hyunah LEE
Immune Network 2016;16(1):75-84
Cancer is one of the leading causes of morbidity and mortality worldwide; therefore there is a need to discover new therapeutic modules with improved efficacy and safety. Immune-(cell) therapy is a promising therapeutic strategy for the treatment of intractable cancers. The effectiveness of certain chemotherapeutics in inducing immunogenic tumor cell death thus promoting cancer eradication has been reported. Ginsenoside Rg3 is a ginseng saponin that has antitumor and immunomodulatory activity. In this study, we treated tumor cells with Rg3 to verify the significance of inducing immunogenic tumor cell death in antitumor therapy, especially in DC-based immunotherapy. Rg3 killed the both immunogenic (B16F10 melanoma cells) and non-immunogenic (LLC: Lewis Lung Carcinoma cells) tumor cells by inducing apoptosis. Surface expression of immunogenic death markers including calreticulin and heat shock proteins and the transcription of relevant genes were increased in the Rg3-dying tumor. Increased calreticulin expression was directly related to the uptake of dying tumor cells by dendritic cells (DCs): the proportion of CRT+ CD11c+ cells was increased in the Rg3-treated group. Interestingly, tumor cells dying by immunogenic cell death secreted IFN-gamma, an effector molecule for antitumor activity in T cells. Along with the Rg3-induced suppression of pro-angiogenic (TNF-alpha) and immunosuppressive cytokine (TGF-beta) secretion, IFN-gamma production from the Rg3-treated tumor cells may also indicate Rg3 as an effective anticancer immunotherapeutic strategy. The data clearly suggests that Rg3-induced immunogenic tumor cell death due its cytotoxic effect and its ability to induce DC function. This indicates that Rg3 may be an effective immunotherapeutic strategy.
Animals
;
Apoptosis
;
Calreticulin
;
Carcinoma, Lewis Lung
;
Cell Death*
;
Dendritic Cells
;
Heat-Shock Proteins
;
Immunotherapy*
;
Melanoma
;
Mortality
;
Panax
;
Saponins
;
T-Lymphocytes
10.Increasing Individual Target Glucose Levels to Prevent Hypoglycemia in Patients with Diabetes
Juyoung SHIN ; Hyunah KIM ; Hun-Sung KIM ; Churlmin KIM ; Whan-Seok CHOI
Korean Journal of Family Medicine 2021;42(4):269-273
Hypoglycemia is one of the severe complications of diabetes. To prevent hypoglycemia, an emphasis is placed on maintaining an appropriate balance between nutrition, activity, and treatment, which can be achieved by the repetition of self-trials based on self-monitoring. Clinicians routinely focus on patients’ contribution, including timely intake of an adequate amount of carbohydrates, physical activity, antidiabetic medication, and abstinence from alcohol. Recently, many guidelines have highlighted the importance of clinicians’ factors and recommend individualized treatments according to lifestyle patterns and specific needs following the de-intensification of treatment. The optimal value of hemoglobin A1c (HbA1c) levels for blood glucose level regulation remains controversial among countries, but it generally does not exceed 8.0%. In populations that are at a risk of hypoglycemia, such as the older adults, it is advisable to adjust the target blood glucose level to less than 8.0%. Meanwhile, a blood glucose level of 7.0%–7.5% is generally recommended for healthy older adults. If the expected lifetime is shorter than 10 years or in patients with chronic kidney disease and severe cardiovascular disease, the HbA1c level target can be increased to 7.5%–8.0%. For even shorter lifetime expectancy, the target can be adjusted up to 8.0%–9.0%. To prevent hypoglycemia, the target blood glucose level needs to be adjusted, particularly in older adult patients. Ultimately, it is important to identify the maximum blood glucose levels that do not cause hypoglycemia and the minimum blood glucose levels that do not cause hyperglycemia-associated complications.