제2형 당뇨병 환자에서 적극적 환자 교육이 혈당조절에 미치는 효과

이윤욱,황원선,최선정,이동훈,김도현,이은희,홍은경,노혜림,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 현재까지의 당뇨병 교육에 대한 노력은 제한되었으며, 연구 결과를 보면 식사 조절 교육과 체중 조절 프로그램을 수행한 환자들 중 적극적이고 기간이 긴 교육을 받은 경우, 성공적 결과가 나타남을 알 수 있었다. 자가관리나 체중감량 등의 당뇨병 치료의 중요한 목표는 적극적이고 긴 기간의 교육 없이는 시행되기 어렵다. 본 연구에서는 외래에서 당뇨병 환자를 대상으로 시행할 수 있는 행동 및 식사 교육 등의 적극적 교육 프로그램을 개발하여 제2형 당뇨병 환자들을 대상으로 이들에게 식사 조절 방법에 대한 목표설정과 문제에 직면하였을 때의 해결 방법 등을 교육해서 궁극적으로는 적극적 자아관리에 연결될 수 있도록 도와주는 것을 목적으로 기존의 통상적 교육과 보다 적극적인 교육이 당뇨병 환자의 혈당 조절에 어떠한 영향을 미치는지에 대해 알아보기 위해 다음과 같은 연구를 시행하였다. 방법: 본 연구는 아주대학교 병원 내분비 대사 내과를 처음으로 방문하여 치료받았던 58명의 제2형 당뇨병 환자를 대상으로 하였다. 내원 환자들을 무작위하게 추출하여 진찰권 번호 끝자리에 따라 홀수는 통상적 교육군(conventional education group, CE)과 짝수는 적극적 교육군(intensive education group, IE)으로 나누어 교육하고, 3개월후에 교육의 효과를 평가하였다. 결과: 1) 연구 대상자들의 교육 전과 후의 공복혈당, 식후2시간 혈당 및 HbA_lc 치는 IE군과 CE군 모두 각 그룹 내에서, 유의적으로 감소하였다(p<0.05). IE군에서는 공복혈당이 12.4nmol/L에서 7.7nmol/L로, 식후2시간 혈당이 20.3nmol/L에서 10.9nmol/L으로, HbA_lc치가 9.4%에서 7.0%로 모두 교육 전에 비하여, 교육 후에 감소(p<0.05)하였고, CE군도 공복혈당은 10.9nmol/L에서 9.4nmol/L로, 식후2시간 혈당은 17.1nmol/L에서 14.6nmol/L으로 HbA_lc가 8.5%에서 7.3%으로 모두 교육 후에 감소하였다(p<0.05). 또한, 교육 전에 비하여 교육 후에 공복 혈당 및 HbA_lc치가 감소하는 정도는 IE군에서의 감소가 CE군에 비해 더 현저하였다Op<0.05). 2) 식사에 대한 태도는 3부분으로 나누어 식사에 대한 규칙성, 식사 내용의 균형성, 식사에 대한 태도 등으로 나누어 각각의 점수 및 총점을 비교하였으며 교육 전에 비해 교육 후에 연구 대상자들의 식태도가 향상되었음을 알 수 있었다. 두 그룹간의 차이를 분석한 결과 식사의 균형성 항목에서와 총점에서 유의적으로 두 그룹의 차이를 보여서 IE군에 CE군에 비해 식사의 균형성 측면이 향상되었고, 전체적인 식태도가 좋아졌음을 알 수 있었다(p<0.05). 결론: 비교적 긴 기간은 아니지만 적극적 교육을 받은 당뇨병 환자들이 통상적 교육을 받은 군보다 혈당 및 HbA_lc, 식태도 점수등의 수치의 호전뿐만 아니라 당뇨병 환자의 삶에서 중요한 부분을 차지하는 식사요법 관리 부분에 있어 향상됨을 알 수 있었다. Background: To this date, efforts to develop effective methods for the education of diabetic patients have been limited. The important goal of self-management and weight control for diabetic treatment can not be attained without long and intensive period of education. This study was undertaken to assess the effectiveness of an intensive educational program, of behavior and diet control, which was carried out on subjects with type 2 diabetes, on and out-patient basis. we compared the effectiveness of an intensive education programme with that of a conventional education programme for the self-management of type 2 diabetic patients. Methods: Subjects with type 2 diabetes were randomly selected, and allocated to one of two groups. One group received a conventional education programme of self-management(the CE group), and the second group received an intensive education progammes for three months, after which the effectiveness of the programmes were evaluate. Results: 1) The levels of fasting blood sugar(FBS), postprandial 2 hour blood sugar(PP2h) and HbA1c were significantly lowered in both groups following the intervention(p<0.05). In the IE group, the FBS declined from 12.4nmol/L to 7.7nmol/L, PP2h declined from 20.3nmol/L to 10.9nmol/L, and the HbA_lc showed a similar decline from 9.4 to 7.0% after intervention(p<0.05). In the Ce group, the FBS declined from 10.9 to 9.4nmol/l, the PP2h decreased from 17.1 to 14.6nmol/l, and the HbA_lc also decreased from 8.5 to 7.3% after intervention(p<0.05). The decrease in the FBS and HbA_lc following the educational intervention was more pronounced in the IE group than the CE group(p<0.05). 2) The effectiveness of the education programmes in promoting appropriate dietary behavior in the diabetic subjects was assessed by a scoring system in three parts: a regularity score, a balance score and an attitude score. From a comparative study of the three scores, the patients attitudes were observed to be much improved in both the groups following the intervention compared to before the programmes, but the balance and total scores were significantly higher in the IE group than the CE group(p<0.05). Conclusion: We can conclude that the intensive diabetic education programme is more effective than a conventional programme, not only in improving the patients' levels of glucose, HbA_lc, and dietary score, but also the diabetic patients self-control abilities, promoting behavioral change, and prompting problem solving capabilities in respect to the everyday problems that they have to face throughout their lives(J Kor Soc Endocrinol 18:63∼72, 2003).

얼굴 연조직 강화를 위한 자가지방 이식 후 발생한 급성 경계부위 뇌경색

민경현, 이혜림, 여민주, 김지선, 이성현, 이상수, 신동익 충북대학교 의과대학 충북대학교 의학연구소 2016 忠北醫大學術誌 Vol.26 No.1

본문참고

이탈리안 라이그래스의 성숙종자 유래 캘러스로부터 효율적인 식물체 재분화

우현숙,이상훈,이동기,김진수,원성혜,이병현 Plant molecular biology and biotechnology research 2004 Plant molecular biology and biotechnology research Vol.2004 No.-

As an initial step for future genetic manipulations to improve forage characteristics of Italian ryegrass (Lolium multiflorum Lam.), an efficient tissue culture system was established and the factors affecting plant regeneration were evaluated. MS medium containing 5 ㎎/L 2,4-D was optimal for embryogenic callus induction from mature seed and had a strong effect on successive plant regeneration. The plant regeneration frequency was observed at above 70% when embryogenic calli induced were transferred to N6 medium supplemented with 1 ㎎/L 2,4-D and 5 ㎎/L BA. Among several basic media tested, MS and M6 medium were optimal for callus induction and plant regeneration, respectively. Genotype was an important factor in plant regenerability. 'Jeanne' showed the highest regeneration frequency of 73%. A short tissue culture period and high-frequency regeneration system established in this study will be useful for molecular breeding of Italian ryegrass through genetic transformation.

노화로 인한 신체적 기능 쇠퇴와 고령자를 위한 욕실 디자인 가이드라인 관계 연구

이연숙(Lee, Yeun-Sook),임현진(Lim, Hyun-Jin),이지혜(Lee, Ji-Hye),안창헌(Ahn, Chang-Houn) 한국실내디자인학회 2013 한국실내디자인학회논문집 Vol.22 No.5

Advancement toward aging society has presented the importance of house planning in consideration of the elderly, increasing the necessity of such planning. Therefore the importance of indoor design guideline for elderly houses has been stressed and the understanding of the aging in regard to this trend will create more mature spaces. In line with this trend the purpose of this study is to study the medical factors related with bathroom interior design guidelines of the existing elderly houses from the viewpoint of deteriorating physical functions due to aging process. In order to research the deterioration of physical functions due to aging literatures of medical and exercise physiology were used and concerning the existing bathroom design guidelines for the aged people, the guideline items of behavior facilitation, physiological maintenance and perceptual maintenance aspects out of Murtha & Lee’s user benefit criteria(1976) related with physical functions were selected to research in relation with the knowledge about the deterioration phenomena of physical functions. Physical aging and deterioration aspects were classified from the viewpoint of musculoskeletal disorder, cardiovascular disorder, respiratory disorder, gastronomy disorder, urology disorder, somatosensory disorder, endocrine disorder, immune disorder, nervous disorder and skin diseases and these were utilized in interpreting total 100 items of bathroom design guideline. Because bathroom is the space where many physical movements are done, it had the closest relationship with the deterioration of musculoskeletal health in general and as bathroom is the space where people use water and feel the difference in temperature and moisture more than other spaces, deterioration of skin and somatosensory health had the next closest relationship. The result of this study revealed that regarding the deterioration of physical functions of the elderly people in aspect of their perceptibility as designers will design creatively and sincerely based on its relationship with nervous system in future, the result of this study will be used to develop better spatial designs efficiently to meet for the aging society.

한국비서자격시험의 개선점과 비교연구

남자현,이미정,이미영,이아영,정해금,최유정,이미숙,전인선,정혜림 이화여자대학교 법정대학 비서학과 1997 비서학연구 Vol.- No.17

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

The Effects of Participation in Physical Activity Programs Based on Self-Determination on Developmentally Disabled Children`s Gross Motor Skills, Concentration, and Communicative Competence

( So Hyung Kim ),( Hye Min Kim ),( Hyun Su Lee ) 한국체육학회 2015 국제스포츠과학 학술대회 Vol.2015 No.1

Purpose: The purpose of this study is to provide children with developmental disorders with physical activities that are preferred based on self-determination theory and verifying the effects. This study is a follow-up study of one conducted by So Hyung Kim, Hye-Min Kim, and Hyun-Su Lee(2015) and it chose a type among preference types classified through Q methodologies. Afterwards, programs were developed based on physical activities preferred by children who fit that type, and then applied. Method: The study selected 28 children meeting the criteria through purposive sampling from six- to twelve-year-old disabled children living in C City and attending a kindergarten, special- education school, or general school`s special class. The subjects were made to classify 24 adapted physical activity cards developed for this research, and their preferred types were analyzed with QUANL PC Program. The type (Type 1) that had the most subjects in Type Q conducted the adapted physical activity they preferred twice a week, for 50 minutes in each session, for total 15 weeks. To examine the effectiveness of the program, the ATA concentration test, frostig-MSTB, percentage of correct consonants test, and maximal phonation time test were performed. Lastly, to analyze data for verifying hypotheses, SPSS for Window 10.0 was employed for repeated measured two-way ANOVA. Result: First, developmentally disabled children participating in the adapted physical activity program based on their self-determination showed more change in bending forward, standing long jump, shuttle run walking on a balance beam, balancing on one leg than does not in gross motor skills. Second, developmentally disabled children participating in the adapted physical activity program based on their self-determination showed more change in omission error than those not in concentration skills. Third, developmentally disabled children participating in the adapted physical activity program based on their self-determination did not show more change in the percentage of correct consonants (%) and in maximal phonation time (MPT) which is one of the aerodynamic outcomes than those not in communicative competence. Conclusion: Research results allowed recognition of the academic importance of the self-determination of disabled children through program applications made by the decisions of the disabled children themselves. Efforts to develop self-determination enhancement programs for disabled children in physical training fields will also be needed.

대학생 흡연자의 금연경험에 따른 건강신념차이

구정일,김민정,김동희,백정희,안현실,은가희,우혜령,이명희,이수현,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

It has been generally known that smoking is one of the worst factor increasing disease and mortality in human health since in 1950's and nowadays. But regardless of various proofs about social or economical problems due to smoking, current smoking rate has not been decreased in our country. Until now, most of tobacco use and its addiction researches have been focused on the adolescent or adult women smokers not on the university students. Therefore, the purpose of this study was to investigate smoking cessation of university smokers and analyze the health belief-perceived sensitivity, severity, benefits and barriers- difference, then to provide basic data for effective smoking cessation strategy for university smokers. The subjects were comprised of 181 university smokers from 15 universities in Seoul. The data were collected by structured questionaires. The questionaires were designed to measure general characteristics, smoking cessation and health belief, based on Ahn(2003)'s result on the Study of Smoking attitude, Behavior and Smoking Cessation of Adult Male and Lee(1987)'s result on Relationships Between the Health Belief Model and Smoking Habits. The data were collected from May 5 to 16. The collected data were analyzed by SPSS program. The actual number, percentiles, means, standard deviation, t-test and ANOVA were done. The result of this study were as follows; 1. The general characteristics of the subjects of this study The range of age was from 18 to 34 and the averaging age was 23. The subjects of this study were 141 males and 40 females. The religions were Christianity 25.4%(46), Buddhism 12.7%(23), Catholic 23.2%(42), no religion 37.0%(67). The residential forms were living with family 59.1%(107), cooking food for oneself 28.7%(52), dormitory 5.0%(9), boarding house 1.7%(3). Smoking starting age were university 43.1 %(78), high school 29.8%(54), middle school 14.9%(27), in the army 6.1 %(11), elementary school 1.1 %(2). 2. The smoking cessation of the subjects 80% of current smokers showed quitting smoking decision and 20% have not tried. The frequency of quitting smoking decision were from 1 to above 8 and mean was 3.06. As for smoking cessation plan, 54.7%(99) current smokers answered yes, 3.9%(7) said no, 35.4%(64) had no idea and 6.1 %(11) didn't answer. As for the reason of never quitting smoking decision, 71.42%(25 among total 35) have no need to quit smoking and the others said difficulty of smoking cessation. As for the main reason of smoking cessation decision, 54.7%(99) answered for the health, 7.2%(13) family advice, 15.5%(28) girl/boy friend's advice, 1.7%(3) to save money. As for the reason to fail smoking cessation, 56.7%(68) were will-lack, 17.5%(21) stress, 15%(18) smoking mood, 10%(12) withdrawl symptom. As for the smoking cessation method, 85.0%(125) were oneself-will, 2.7%(4) way acquired by mass-media, 2%(3) doctor's prescription, 2%(3) religion's help, 0.7%(1) smoking cessation school. As for the difficulty in smoking cessation, 42.2%(62) were drinking meeting, 23.1 %(34) no alternative of stress release, 12.2%(18) withdrawl symptom, 11.6%(17) having nothing to do, 7.5%(11) friend's encouragement. As for the most difficult cigarette to quit, 67.8%(99) were all-day smoking except the first smoking in the morning, 32.2%(47) the first smoking in the morning. 3. Health belief as for general characteristics Gender - The total point in benefits showed higher in male(28.5177) than female(26.6750). There was significant difference(t=.778, p<.05). The total point in health belief showed higher in male (105.8298) than female(l00.5000). So there was significant difference(t=.345, p<.05). Age - There was significant difference in benefits between age(10's-25.83, 20's-28.39, 30's-32.00)(F=3.73, p<.05). Smoking starting age - There was significant difference in total point of sensitivity and health belief(sensitivity F=4.00, p<.Ol, health belief F=2.843, p<.05). As for sensitivity, subjects who started smoking in the army showed the highest(33.36) and ones in high school showed the lowest(26.96). The total point in health belief showed the highest in elementary school(l19.00) and the lowest in high school(100.98). 4. Health belief as for smoking cessation There was significant difference in health belief as for smoking cessation(t=0.189, p=0.OO2). Sensitivity point showed higher in smoking quitting trial smokers(29.2) than non-trial smoker (26.9). Severity point showed higher in trial smokers (30.7) than non-trial smokers(28.9). Benefit point showed higher in trial smokers(28.6) than non-trial smokers(26.2). There was no significant difference in barriers point.

유화조건이 홍화적색소의 물성에 미치는 영향

이승룡,장규섭,이석건,윤혜현,한태룡 충남대학교 농업과학연구소 2000 농업과학연구 Vol.27 No.1

상기 실험으로부터 얻어진 결과를 요약하면 다음과 같다. 1. Hunter-value를 측정한 결과 hunter L-value 즉, 백색도에 있어서는 glycerin+carthamin+locithin의 경우가 실온저장 및, 열악조건 그리고 광조사시에 있어서 모두 8 시간이 경과하면서부터는 급격하게 상승하는 모습을 보였다. 2. 실온하에서 hunter a-value 즉, 적색도에 있어서는 carthamin 첨가구가, b-value 즉, 황색도에 있어서는 paprika 첨가구가 더 강하게 나타났다. 열악조건에서는 실온저장의 경우와 다소 다른 양상을 보여주었는데. D.W+carthamin+lecithin의 경우에 있어서도 hunter L-value가 낮은 값을 나타냈으며, hunter a-value의 경우 soybean oil+paprika에서도 높은값을 보여주었다. 3. 유변학적 특성에 대한 실험에서 비교적 고점도를 가지고 있는 glycerin을 base material로하였을 때는 이에 비해 저점도라고 할 수 있는 soybean oil이나 증류수가 쓰여졌을 때보다 spindle의 rpm에 따른 viscosity나 shear rate 및 shear stress등의 같이 월등히 높은 값을 나타냈다. 그리고, 일반적으로 spindle의 rpm에 대한 shear rate 및 shear stress의 값은 비례적으로 증가하는 경향을 나타냈다. 유화제의 사용여부에 있어서는 lecithin을 사용했을 경우. 사용하지 않았을 때보다 높은 점도를 나타냈고, 동일한 조건에서 carthamin보다는 paprika가 두 배 정도 더 높은 점도를 나타냈다. 4. soybean oil을 사용한 실험구에 있어서는lecithin의 첨가유무가 점도에 아무런 영향을 미치지 않는 것으로 나타났으나, glycerin을 사용한 실험구에 있어서는 유화제인 lecithin을 병행했을 경우, 특이하게도 오히려 paprika에서보다 carthamin에서 더 높은 점도를 나타냈다. 5. Shear stress의 경우 soybean oil 첨가구와 glycerin 첨가구가 현저한 차이를 보이며 증가한 반면, shear rate에 있어서는 두 가지 경우모두 거의 같은 경향을 나타낸 점이 특이했다. This study was peformed to evaluate the food technological properties according to different emulsion state of carthamus red pigment. For making emulsion, lecithin was used as an emulsifier and polyglycerol monooleate(PGMO) and polyoxyethylene sorbitan monooleate(Tween 80) were used as an assistant, and glycerin, distilled water and soybean oil were used as base materials respectively. Paprika stock solution was used for comparing carthamin on the rheological properties. The results were described as following; 1. Hunter L-value was not drastically increased until passed by 8 hours for glycerin, carthamin, and lecithin mixed sample. 2. Hunter a-value was higher at carthamin added sample than others, and b-value was higher to paprika added sample than others. 3. The viscosity, shear rate and shear stress levels in which glycerin was used as base material were higher than soybean oil or distilled water. 4. In which soybean oil was used as base material, lecithin was not affected on the rheological properties. But, in which glycerin was used, the lecithin was higher affected on carthamin than paprika. 5. The value of shear stress was increased both carthamin and soybean oil. However, that of shear rate was shown similar trends.

과학 데이터 처리를 위한 질의어 표현

이혜명,주해종,이시현 건국대학교 1997 대학원 학술논문집 Vol.44 No.-

The multimedia dafabase system, which provides functionalities of storing, managing and querying the multimedia data, becomes the essential system software to support various newly emerging multimedia application such as speech, online hand-written character, electrocardiogram (ECG). Above all, particular processes are needed for manipulating scientific data, a kind of multimedia data, because data are massive and their sequent order must be kept. In this paper, it is proposed that a convenient user's query language, called SDQL(Scientific Data Query Language), to store scientific data into database. And SDQL is based on standard SQL-like syntax.