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).

골형성부전증 10예의 임상적 특징

이형숙,김현주,조재현,이승원,김현아,최준혁,송영준,김대중,이관우,정윤석 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경 및 방법: 골형성부전증은 비교적 희귀한 유전병으로 교원질 대사 장애로 인한 골의 취약성과 다발성 골절 및 척추측만증 등을 특징으로 한다. 유전방식과 표현형의 발현 정도에 따라 다양한 임상 양상을 보이며, 임상적 중증도에 따라 4가지 형태로 분류된다. 지금까지 국내 보고는 분만과정이나 태아 진찰시 골격이상으로 발견된 증례보고가 주였다. 저자들은 비교적 경미한 임상 양상을 보이는 예를 포함한 다수의 골형성부전증 환자들의 전반적인 임상적 특징에 대해 보고하는 바이다. 결과: 2001년 6월부터 2003년 2월까지 골형성부전증으로 진단받은 6 가계, 10예를 대상으로 하였다. 평균 나이는 27.3(5∼56)세였고 소아가 2예였다. 모두 상염색체 우성으로 유전되었으며, 제 I형이 4예, 제 III형이 4예, 그리고 제 IV형이 2예였다. 전 예에서 다수의 골절 경험이 있었고, 골밀도 저하와 골피질 두께 감소 소견이 관찰되었다. 전신의 평균 골밀도는 0.690(0.421∼1.039) g/cm²였다. 골형성지표로 측정된 sAlk는 소아의 경우만 증가되어 있었고, 골흡수지표로 측정된 uDPD의 평균치는 12.9(4.4∼36.3) nM/mM Cr으로 증가된 소견을 보였다. mobility score는 대부분 3,4단계에 속해 있었다. 중증형일수록 진단 시의 mobility score가 낮은 경향을 보였다. 결론: 한국인 골형성부전증 환자의 임상적 특징을 살펴본 결과 기존의 보고된 II형 외에도 I, III, IV형이 다양하게 존재함을 알 수 있었으며, 모든 예에서 상염색체 우성으로 유전됨을 확인할 수 있었다. 또한 모든 예에서 증가된 골흡수로 인한 골밀도 저하와 골절을 확인할 수 있었다. Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis (J Kor Soc Endocrinol 18:496∼503, 2003).

제통단이 퇴행성 슬관절염 환자의 삶의 질에 미치는 영향

서병관,류성룡,강중원,우현수,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : to evaluate the effects of Jetongdan, the newly developed herbal medicine, on the quality of life in patients with osteoarthritis of knee Methods : Placebo-controlled, randomized clinical trial on the 80 patients with osteoarthritis of the knee was fulfilled. After enrollment, they took medication as they enrolled. And they were asked to answer the questionnaires (Korean Health Assessment Questionnaire (KHAQ), Lequesne's functional index (LF1), visual analogue scale (VAS)) and analysed with the erythrocyte sedimentation rate (ESR) at baseline, after 4 weeks and 8 weeks of medication. Results : Total KHAQ score, some categories of KHAQ like hygiene, activities were significantly improved after 8 weeks of medication. And the change of the KHAQ score was significantly correlated with the change of VAS. But LFI, VAS, ESR level was not significantly improved, and it was considered because of the short medication period and small size of study population. Conclusion : In conclusion, Jetongdan could improve the health-related quality of life in patients with osteoarthritis of knee. Further study in the large population, in long period were recommended.

급성 심근허혈에 의해 윤발된 승모판 폐쇄부전의 기전에 관한 실험적 연구

강덕현,송현,송재관,김현숙,이재환,임희영,이재원,박성욱,박승정,송명근 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.8

원통 연삭에서 가공 능률 향상을 위한 연삭 저항의 측정에 관한 연구

김원일,이진,이윤경,왕덕현,이상복,이관철,문원길 경남대학교 공업기술연구소 2000 硏究論文集 Vol.18 No.-

본 연구에서는 원통 연삭 가공에서 가공 능률 향상을 위한 연삭 저항을 측정하고자 연삭 가공 중에 발생하는 연삭 저항의 추이를 확인하였고 다음과 같은 결과를 얻었다. 숫돌과 공작물간의 연삭 강성은 공작 속도의 증가에 따라 지지계의 강성이 높은 경우 증가하였고 절삭 깊이와 연삭 숫돌의 속도에는 연삭 강성이 감소하는 경향을 보였다. 또한 총합 강성은 공작 속도, 절삭 깊이 및 연삭 숫돌의 속도 증가에 따라 지지계의 강성이 높을 수록 증가하였다. 연삭기의 강성 변형과 가공 능률에 영향을 주는 값으로 연삭 강성비는 지지계의 강성이 높을 수록 감소하였다. In this study, the measurement of grinding resistance to improve grinding efficiency in cylindrical grinding was studied and the following conclusions could be obtained. Relation grinding wheel and workpiece, grinding stiffness increases according to increase of work speed for high machine stiffness and decreases depth of cut and grinding wheel speed. Also, resultant stiffness increases high machine stiffness according to increase work speed, depth of cut and grinding wheel speed. The values of the effect stiffness deflection in grinding machine, grinding stiffness ratio decrease according to high machine stiffness.

머리염색이 인체에 미치는 영향

윤형식,황성호,이현륭,김수호,박연석,권낙현,정호진,김동훈,노현주,홍성호,박병찬,이관,정해관 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

일상생활에서 모발염색은 흔히 접할 수 있는 미용의 한 종류로 특히 젊은층을 중심으로 폭발적으로 유행하고 있다. 염색을 위항 사용하는 약제는 표백제와 발색제 등 각종 화학약품이 사용되고 있으나 이로 인한 건강장해에 대한 연구는 그리 많지 않다. 저자들은 염색이 인체의 모발건강에 미치는 영향을 파악하기 위하여 염색과 관련된 주관적 증상과 모발의 변화에 대한 실험적 연구를 시행하였다. 동국대학교 경주 캠퍼스 재학생 80명을 대상으로 설문조사를 시행하여 염색 유 ·무 및 염색 후에 경험한 증상에 대해 설문 조사하였고, 의과대학 재학생 46명을 대상으로 피부 반응 테스트를 실시하였다. 또한 염색 전후의 모발 탄성도를 측정하였고 모발의 상태를 파악하기 위해 전자 현미경검사를 실시하였다. 설문조사 결과 염색 전에 비하여 염색 후 안구혼탁, 안구건조, 시력저하, 발진 및 접촉성 피부염, 모발손상, 모근손상 등의 증상을 더 많이 경험한다고 호소하였다(p<0.05). 모발손상과 모근손상은 헤어드라이어 사용 빈도에 따라 증가하는 것으로 조사되었다(p<0.05). 피부반응검사에서 가려움증이 가장 많은 증상이었으며 이는 여성보다는 남성에서 높은 것으로 조사되었다. 염색 전후의 모발장력은 염색 전 134.5±10.37g, 염색 128.0±30.69g, 염색 이틀 후 112.5±19.69g으로 나타났다. 염색 전후의 모발의 전자현미경 케라틴 층이 현저히 감소하고 모발이 가늘어지는 차이를 보였다. 염색은 모발손상, 모발 케라틴 손상 및 모근 손상, 발진 및 접촉성 피부반응, 안구혼탁, 안구건조, 시력 저하를 유발한다. 따라서 염색약으로 인한 손상에 대한 주의와 예방이 필요하다고 생각한다. 예방대책으로 염색 전 피부테스트를 통한 적합성 여부를 판단하는 것이 필요하며 가급적 염색을 피하는 것이 좋을 것이다. 염색약에 발암물질이 포함되어있다는 보고도 있어 염색 제조사의 철저한 실험과 염색 물질의 선별이 염색으로 인한 부작용을 최소화하는데 중요한 역할을 할 것이다. Hair coloring has became one of the most popular cosmetic activities to younger generations during last decade. However, there are few studies on the health effect of widespread use of chemical dyes. This study was conducted to study the effects of hair coloring dye on hair and other systems. We conducted a questionnaire survey of 80 persons in Kyongju campus, Dongguk University. We have done open patch skin test on 46 medical students. We also conducted scanning electron microscopy to examine the hair strength and structure before and after hair coloring process. Injury of hair and hair bulb, contact dermatitis, turbid eyes, xerophthalmia, and poor visual acuity were the main symptoms complained after hair coloring (p<0.05). Injury of hair and hair bulb were increased by frequency of hair-dryer use(p<0.05). In open patch test, pruritus was complanined by more than half of the subjects. Mean strength of hairs before and after hair coloring was as follows; 134.5 (SD 10.37)g before hair coloring, 128.0 (SD 30.69)g immediately after hair coloring, and 112.5 (SD 19.69)g after two days. The scanning electron microscopic findings of hair surface before and after hair coloring showed decreased keratin layer and thinning of the hair. Hair coloring induces injury to hair, its keratin layer, and hair bulb as well as contact dermatitis, turbid eyes, xerophthalmia, and poor visual acuity. Therefore, we think that precaution is needed in use of hair coloring dye. To prevent complications induced by hair coloring dye, it is necessary, especially to those with allergy or skin disorders, to perform skin test before action and avoid hair coloring whenever possible. Longterm health effects of hairdye should be studied and manufacturing companies should try to minimize complications induced by hair coloring dye.

초등수학 예비교사들의 분수에 대한 표상의 분석

이대현,서관석 한국수학교육학회 2003 初等 數學敎育 Vol.7 No.1

Representation has been main topic in teaching and learning mathematics for a long time. Moreover, teachers' deficiency of representation about fraction results in teaching algorithms without conceptual understanding. So, this paper was conducted to investigate and analysize the elementary preservice mathematics teachers' representation about fraction. 38 elementary preservice mathematics teachers participated in this study. This study results showed that, the only model of a fraction that was familiar to the preservice teachers was the part of whole one. And research showed that, they solved the problems about fraction well using algorithms but seldom express the sentence which illustrates the meaning of the operation by a fraction. Specially, the division aspect of a fraction was not familiar nor readily accepted. It menas that preservice teachers are used to using algorithms without a conceptual understanding of the meaning of the operation by a fraction. This results give us some implications. Most of all, teaching programs in preservice mathematics teachers education have to devise to form a network among the concepts in relation to fraction. And we must emphasize how to teach and what to teach in preservice mathematics teachers education course. Finally, we have to invent the various materials which can be used to educate both preservice teachers and elementary school students. If we want to improve the mathematical ability of students, we will concentrate preservice teachers education.

河川 및 湖沼에서의 富營養化 因子 管理方案에 關한 硏究

이관영,박상현 대구대학교 과학기술연구소 1995 科學技術硏究 Vol.2 No.2

Eutrophication in rivers and lakes brings such undesirable results as killing aquatic lives, pollution of water resources, etc. With this regard, this study aims at finding out measuring methods of current pollution load quantity by night-soil, livestock excrement, and their by-products which are key factors of eutrophication. This study, thereby, seeks to find out problems, solutions, and improvement methods on them. Conclusions of this study are as follows : 1. Untill efficient waste treatment system on livestock excrement is established, meeting the Environmental Quality Standard(EQS) in the main stream of Nakdong River is impossible. 2. To accomplish a satisfactory standard of water quality by eliminating eutrophication factors, in addition to the First Disposal Plant Nakdong River, Taegu city needs to equip additional advanced eutrophication treatment system. 3. To prevent eutrophocation in lakes and reservoirs in Taegu, financial support by the municipal government is urgently required. 4. As well as the legal limitation and control of Nitrogen(N), Phosphorus(P) disposal to maintain water quality which will be in force from January 1, 1996, attention by the municipal government should be drawn to technological development for advances waste treatment system.

체육교사의 자기수업장학이 교수행동에 미치는 영향

이병익,김관현,김진표,김기환,김윤태 龍仁大學校 2001 용인대학교 논문집 Vol.19 No.-

This study was to analyze the effect of psical teacher's self-directed super- vision on teaching behavior. The prpose of this study is to identify the effect of pysical teacher's self director supervision of their teaching trough other teacher's teaching and all of physical education methods. Therefore research models and hypothesis were established on previous research and theories. Background variable was physical teacher's personal factor and Independent variable was physical teacher's sect-directed supervision. Dependent variable was teaching behavior of physical teacher. The data were collected by using simple random sampling of 360 physical teacher's in Seoul , Kyung-gi-Do, and In-chun. To survey the data question paper was used. T-test and one-way ANOVA were used to test hypothesis. Multiple-Regression Analysis was used to know effect of physical teacher's self-directed supervision on teaching behavior. Each hypothesis was tested at the significance level of 0.5 The conclusions were drawn as the followings First. influence of self- directed supervision by physical teacher's personal factor was following. According to sender there was no difference in teaching behavior. There was a significant influence in understanding students according to school's situation(girls, boys, and co-ed). There was a significant influence in class managing, understanding students, class preparing, teaching method according to class reflection. Second. influence of teaching behavior by physical teacher's personal factor was following influence. The gender had influence on dynamism and creativity. School situation(boys, girls, co-ed) had influence on individuality and creativity. Class reflection had influence on dynamism, creativity, obviousness and individuality. Third. effect of physical teacher's self-directed supervision on teaching behavior was followings. In dynamism, it had influence on teaching method, class managing, understanding students, sequentially. But not on preparation. In Individuality, it had influence on preparation, understanding students. Class managing sequentially. But not on teaching method. In obviousness. It had influence on class managing and Preparation. sequentially. but not on understanding students. and teaching method. In creativity, it had influence on understanding students, preparation, class manacling sequentially, but not on teaching method.

신경회로망을 이용한 가상 로봇 팔의 제어에 관한 연구

이현관,서상혁 호남대학교 정보통신연구소 2001 정보통신연구 Vol.11 No.-

This paper discusses an EMG based control method of a virtual robot arm as an adaptive human supporting system or remote control system, which consists of an shoulder control part, elbow control part, and wrist control part. The system uses three surface electrodes to acquire the electromyography(EMG) signal from operator. It is shown from the experiments that the EMG patterns during arm motions can be classified sufficiently by using SOFM(self-organizing feature map). The interface system based on PC environment is constructed to 3-D graphic user interface(GUI) program.