BACKGROUND/OBJECTIVES: Excessive sugar consumption may increase the risk for development of several diseases. Although average dietary sugar intake of Koreans is within the recommended level, an increasing trend has been found in all age groups. This study aimed to evaluate the population attributable fractions (PAF) to dietary sugar for disease and death in Korea, and to estimate the socioeconomic effects of a reduction in dietary sugar. MATERIALS/METHODS: The prevalence of sugar-sweetened beverages (SSB) overconsumption (≥ 20 g of sugar from beverages) was analyzed using the Korean National Health and Nutrition Examination Survey 2015. Disease-specific relative risks of excessive SSB consumption were obtained through reviewing previous studies. Using the prevalence of SSB overconsumption and each relative risk, PAFs for morbidity and mortality were calculated. Socioeconomic costs of diseases and death attributable to SSB overconsumption were estimated by using representative data on national medical expenditures, health insurance statistics, employment information, and previous reports. RESULTS: Disease-specific PAF to SSB consumption ranged from 3.11% for stroke to 9.05% for obesity and dental caries, respectively. Costs from disease caused by SSB overconsumption was estimated at 594 billion won in 2015. About 39 billion won was estimated to be from SSB consumption-related deaths, and a total of 633 billion won was predicted to have been saved through preventing SSB overconsumption. CONCLUSIONS: Sugars overconsumption causes considerable public burdens, although the cost estimates do not include any informal expenditure. Information on these socioeconomic effects helps both health professionals and policy makers to create and to implement programs for reducing sugar consumption.
Administrative Personnel ; Beverages ; Carbohydrates ; Dental Caries ; Dietary Sucrose ; Employment ; Health Expenditures ; Health Occupations ; Humans ; Insurance ; Korea ; Mortality ; Nutrition Surveys ; Obesity ; Prevalence ; Public Health ; Stroke

Despite overall reductions in heart disease prevalence, the risk of developing heart failure has remained 2-fold greater among people with diabetes. Growing evidence has supported that fluctuations in glucose level and uptake contribute to cardiovascular disease (CVD) by modifying proteins, DNA, and gene expression. In the case of glucose, clinical studies have shown that increased dietary sugars for healthy individuals or poor glycemic control in diabetic patients further increased CVD risk. Furthermore, even after decades of maintaining tight glycemic control, susceptibility to disease progression can persist following a period of poor glycemic control through a process termed "glycemic memory." In response to chronically elevated glucose levels, a number of studies have identified molecular targets of the glucose-mediated protein posttranslational modification by the addition of an O-linked N-acetylglucosamine to impair contractility, calcium sensitivity, and mitochondrial protein function. Additionally, elevated glucose contributes to dysfunction in coupling glycolysis to glucose oxidation, pentose phosphate pathway, and polyol pathway. Therefore, in the "sweetened" environment associated with hyperglycemia, there are a number of pathways contributing to increased susceptibly to "breaking" the heart of diabetics. In this review we will discuss the unique contribution of glucose to heart disease and recent advances in defining mechanisms of action.
Calcium ; Cardiomyopathies ; Cardiovascular Diseases ; Diabetic Cardiomyopathies* ; Dietary Sucrose ; Disease Progression ; DNA ; Gene Expression ; Glucose* ; Glycolysis ; Heart ; Heart Diseases ; Heart Failure ; Humans ; Hyperglycemia ; Metabolism ; Mitochondrial Proteins ; Pentose Phosphate Pathway ; Prevalence ; Protein Processing, Post-Translational

Development of efficient substrate formulas to improve yield and shorten production time is one of the prerequisites for commercial cultivation of edible mushrooms. In this study, fifteen substrate formulas consisting of varying ratios of palm press fibre (PPF), mahogany sawdust (MS), Gmelina sawdust, wheat bran (WB), and fixed proportions of 1% calcium carbonate (CaCO3) and 1% sucrose were assessed for efficient Lentinus squarrosulus production. Proximate compositions of mushrooms produced on the different substrate formulas were also analysed and compared. Substrate formulations containing 85% PPF, 13% WB, 1% CaCO3, and 1% sucrose were found to produce the highest carpophore yield, biological efficiency and size (206.5 g/kg, 61.96%, and 7.26 g, respectively). Days to production (first harvest) tended to increase with an increase in the amount of WB in the substrate formulas, except for PPF based formulas. The addition of WB in amounts equivalent to 8~18% in substrate formulas containing 80~90% PPF resulted in a decrease in the time to first harvest by an average of 17.7 days compared to 80~90% MS with similar treatment. Nutritional content of mushrooms was affected by the different substrate formulas. Protein content was high for mushrooms produced on formulas containing PPF as the basal substrate. Thus, formulas comprising PPF, WB, CaCO3, and sucrose at 85% : 13% : 1% : 1%) respectively could be explored as starter basal ingredients for efficient large scale production of L. squarrosulus.
Agaricales ; Calcium Carbonate ; Dietary Fiber ; Lentinula* ; Singing* ; Sucrose

OBJECTIVETo build a type 2 diabetes mellitus rat model with cardiac ischemia.

METHODSMale Wistar rats were fed high sucrose and high fat diet for four weeks and then injected with streptozoticin (STZ) (40 mg/kg .i.p.). The levels of fasting blood glucose and serum insulin were monitored every week. The body weights of rats were also measured every week. The blood levels of creatine kinase and lactate dehydrogenase (LDH) were measured following the electrocardiograph used BL-410 biological experiment system.

RESULTSThe serum insulin levels of diabetic rats were 4.05 ng/ml after four weeks high sucrose and high fat diet. The fasting blood glucose levels of diabetic rats were 17.9 mmol/L after injection. Compared with normal group, there was obvious change of S-T segment in the electrocardiograph of diabetic group at the fourteenth week. The levels of creatine kinase and lactate dehydrogenase in diabetic group significantly increased in comparison with those in normal group.

CONCLUSIONThe cardiac ischemia of diabetic rats model is suitable for investigating cardiac disease of diabetes mellitus.

Animals ; Creatine Kinase ; blood ; Diabetes Mellitus, Experimental ; physiopathology ; Diabetes Mellitus, Type 2 ; chemically induced ; physiopathology ; Diet, High-Fat ; adverse effects ; Dietary Sucrose ; adverse effects ; Disease Models, Animal ; L-Lactate Dehydrogenase ; blood ; Male ; Myocardial Ischemia ; physiopathology ; Rats ; Rats, Wistar ; Streptozocin

The American Diabetes Association (ADA) revised the standards of care in diabetes patients in 2014. An important component of the revised guidelines is increased consideration of individual patient factors, with patient-specific recommendations about glycemic index/glycemic load, dietary fiber, sucrose, fructose etc. Education of diabetic patients needs to include information about the amount and quality of carbohydrate intake. It can be difficult to understand the factors affecting the quality of carbohydrate intake; therefore, we have to take into these factors into consideration when providing clinical nutrition education and assistance.
Diabetes Mellitus* ; Dietary Fiber ; Education ; Fructose ; Humans ; Nutrition Therapy ; Standard of Care ; Sucrose

The number of sedations performed for diagnostic and therapeutic procedures that do not require general anesthesia is increasing. As most sedations are performed by non-anesthesiologists, safety is has become a critical issue in light of recent adverse outcomes reported in the media. To ensure the safety of patients undergoing sedation for minor procedures, standards regarding patient selection, education, drugs, equipment, facilities, sedation protocols, recovery, and monitoring should be developed and publicized as they have been in the US and European countries. Guidelines developed regarding sedation and analgesia are similar and share their most important goal: patient safety. Any barriers that interfere with achieving this goal should be identified and eliminated. A Korean version of sedation guidelines should be developed. Guidelines that have both the clinical integrity of evidence and consideration of the real world should be developed and enforced.
Analgesia ; Anesthesia, General ; Dietary Sucrose ; Humans ; Light ; Patient Safety ; Patient Selection

BACKGROUND/AIMS: Laparoscopic Heller myotomy with antireflux procedure is considered to be a standard treatment for achalasia. Recently, peroral endoscopic myotomy (POEM) was developed and performed on patients with achalasia. However, there is no report on POEM use in South Korea. The aim of this study was to evaluate the technical feasibility of POEM in a porcine model. METHODS: POEM was performed on two mini pigs. We performed upper endoscopy under general anesthesia. A submucosal tunnel was created and the circular muscle layer was incised using several knives. The mucosal entry was closed using resolution clips. We performed a follow-up endoscopy and sacrificed the pigs 2 weeks after the POEM. The myotomy site was evaluated grossly and histologically. RESULTS: POEM was successfully performed on the two mini pigs. No injuries to any abdominal or mediastinal structures occurred. Two weeks after the POEM, the esophageal mucosa healed without any endoscopic evidence of complications. Necropsy revealed that the circular muscle layer was completely lost and replaced with fibrotic tissue. CONCLUSIONS: We found that POEM is a technically feasible method which can be performed on an animal model. However, to ensure safe use on patients with achalasia, further studies on technical methods and long-term follow-up examinations are required.
Anesthesia, General ; Animals ; Dietary Sucrose ; Endoscopy ; Esophageal Achalasia ; Esophagus ; Feasibility Studies ; Follow-Up Studies ; Humans ; Models, Animal ; Mucous Membrane ; Muscles ; Republic of Korea ; Swine

Adherence is defined as 'the extent to which a patient's behavior corresponds with recommendations from a health care provider'. In all chronic diseases, including asthma, patient nonadherence to medical recommendations is common. In asthma, low rates of adherence to preventive medication are associated with higher rates of hospitalization and death. Many patients choose not to take their medication because they perceive it to be unnecessary or because they are concerned about potential adverse effects. Approximately one third of asthma patients have strong concerns about adverse effects from inhaled corticosteroids (ICSs). Clinicians must be prepared to work in an ongoing partnership with patients to ensure that they are offered a clear rationale as to why ICS are necessary and to address their concerns about potential adverse effects. This approach, based on a detailed examination of patients' perspectives on asthma and its treatment, and an open, nonjudgmental manner on the part of the clinician, is consistent with the idea of concordance. Both the efficacy of a medication and patient adherence to the therapeutic regimen influence the effectiveness of a treatment. This article will review the underlying reasons for patient nonadherence and describe the role played by clinicians in promoting optimal medicine management.
Adrenal Cortex Hormones ; Asthma ; Chronic Disease ; Delivery of Health Care ; Dietary Sucrose ; Guideline Adherence ; Hospitalization ; Humans ; Patient Compliance

PURPOSE: We analyzed whether any problems existed in terms of the homogeneity of the Korean International Prostate Symptom Score (IPSS) questionnaire used in real practice. MATERIALS AND METHODS: Between July 2012 and August 2012, 48 Korean IPSS questionnaires used in real practice were collected. All the items on the questionnaire, including the quality of life (QoL) questions, were compared and we then determined the homogeneity of each question in comparison with the originally validated Korean version of the IPSS from 1996. RESULTS: Only 5 of 48 sources (10.4%) of the Korean IPSS totally corresponded with the original Korean version of the IPSS questionnaire. The consistency rate with the originally validated version was generally low for the answer choice items for each question, ranging from 16.6% for "less than half the time" to 35.4% for "almost always," with the exception of the item "not at all" (100.0%). The consistency rate was 60.4% for question 3 (intermittency) and 18.8% for question 6 (straining). No homogeneity was found in any of the QoL-related questions. The average consistency rate with the originally validated version was 42.2% and ranged from 22.9% for "unhappy" to the highest rate of 95.8% for "mostly satisfied." CONCLUSIONS: Compared with the originally validated Korean version of the IPSS, various Korean IPSS questionnaires used in real practice had significant problems in terms of homogeneity for both the questions and the answer choice items. Efforts are needed to ensure the uniform use of the validated Korean version of the IPSS questionnaire.
Dietary Sucrose ; Prostate ; Quality of Life ; Reproducibility of Results

BACKGROUND: We analyzed the prevalence of anti-tuberculosis drug resistance in Mycobacterium tuberculosis isolates from respiratory specimens of patients with newly diagnosed and previously treated tuberculosis. METHODS: From February 2010 to July 2010, a total of 542 M. tuberculosis clinical isolates were collected from pulmonary tuberculosis patients in six university hospitals distributed throughout Korea. We analyzed the results of anti-tuberculosis drug resistance tests according to treatment history and geographic location. RESULTS: Among the 542 isolates, 473 (87.3%) were from newly diagnosed cases and 69 (12.7%) were from previously treated cases. The rates of multi-drug resistance (MDR), fluoroquinolone (ofloxacin, levofloxacin, and moxifloxacin) resistance, and extensive drug resistance (XDR) were 3.8%, 1.1-1.5%, and 0%, respectively, in new cases, and 21.7%, 13.0-17.4%, and 4.3%, respectively, in previously treated cases. In the previously treated cases, the proportions of XDR-TB in MDR-TB were 20% (3/15). The resistance rates were variable according to geographic location. CONCLUSION: As the anti-tuberculosis drug resistance rates are much higher in newly diagnosed cases than in previously treated patients, efforts should be made to ensure that tuberculosis treatment is successful. In addition, before the selection of an anti-tuberculosis drug treatment for previously treated patients, the susceptibility test results, including to fluoroquinolone, should be verified.
Dietary Sucrose ; Drug Resistance ; Drug Resistance, Multiple ; Extensively Drug-Resistant Tuberculosis ; Hospitals, University ; Humans ; Korea ; Mycobacterium ; Mycobacterium tuberculosis ; Ofloxacin ; Prevalence ; Tuberculosis ; Tuberculosis, Pulmonary