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성인병 검진을 위해 내원한 60세 이상 노인에게서 연령증가에 따른 질환의 분포
김용훈(Yong Hoon Kim),곽현진(Hyun Jin Kwak),정홍배(Hong Bae Jeong),안명수(Myoung Soo Ahn),염주협(Ju Hyup Yum),조대경(Dae Kyoung Cho),남홍우(Hong Woo Nam),이홍순(Hong Soon Lee),유수웅(Soo Wong Yoo) 대한내과학회 1999 대한내과학회지 Vol.56 No.2
N/A With increasing life expectance and improvement of the overall health of the elderly, the understanding of geriatric disease becomes an important aspect of medical services. In the elderly, the frequencies of hypertension, DM, & anemia are increased according to aging and renal function is decreased progressively. As screening test for cervical cancer Papanicolaou smear is recommended due to its cost-effective benefits in females. In age-adjusted elderly male and female study populations, authors investigated the alterations of the above diseases, hypercholesterolemia, liver disease, obesity, & proteinuria distributions. Methods : This study included 1,181 aged 40 years (600 males, 581 females) visitors between January 1, 1997 and December 31, 1997 in National Medical Center, Seoul, South Korea. Authors divided these populations into two large groups such as group A and B. Group A was composed of 40-59 years, group B 60 years and older. Group A and B were subdivided into 4 subgroups each other, such as A-1, A-2, A-3 and A-4, B-1, B-2, B-3 and B-4 by means of age-adjusted dividing scale. We used our inclusion criteria to define each disease. Results : Hypertension was the most common disease in males of group B, but obesity was in females. The age-adjusted frequencies of hypertension, anemia, obesity & proteinuria were increased according to aging in the elderly aged 60 years and older. Though hypercholesterolemia revealed non-specific distribution in each group, increased frequency was observed in females compared to males in group B. With increasing their age, abnormal findings of Papanicolaou smear were found in females of group B. Conclusions : As the frequencies of hypertension, anemia, obestiy, proteinuria & abnormal findings of Papanicolaou smear were increased in the elderly aged 60 years and older as increasing their age. Much more attentions and follow up plans for these disease should be needed in the elderly.
당뇨병 교육 방법이 당뇨병 환자의 식사요법 수행과 당화혈색소에 미치는 영향
김을상,문현경,이영남,이태훈,김성곤,고재민,손진희,유형준,송오금,남흥우,정성오,위준환,염주협,조대경 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.5
Background: Diet control plays an important role in diabetic management, but it is often hard for diabetic patients to follow the dietary control program. Poor dietary compliance leads to metabolic derangements in patients with diabetes and it may derive mainly from defects in dietary education program rather than from patients themselves. Therefore, we performed a randomized prospective study to compare the effects of three different teaching methods for diet control. Methods: Forty eight diabetic patients with poor glycemic control (mean HbA1c 11.4±1.5%) were enrolled during hospitalization and allocated at random to three different teaching methods i.e. Conventional diet sheet instruction (Group 1), Food recording on every meal (Group 2), and Meal time demonstration (Group 3). For evaluation, knowledge about DM diet and barriers to diet control were assessed by a questionnaire. Consistency in carbohydrate intake (Coefficient of variation) and serial HbA1C measurements were used for the estimation of dietary compliance and glycemic control respectively. Results: During five months' follow-up period, there was no remarkable improvement in knowledge about diabetic diet control, dietary compliance and glycemic control in Group 1 patients. But both dietary compliance and glycemic control improved in Group 2 and 3 patients during follow-up period. In Group 2 CV (Coefficient of Variation) fell from 36.4±15.2% to 27.7±17.3% and in Group 3 from 32.1±9.6% to 23.2±10.5% (p$lt;0.05). In Group 2 HbA_(1c) fell from 12±2.2% to 8.3±2.0% and in Group 3 from 11.5±2.0% to 7.5±1.9%(p$lt;0.01). The change of HbA1c level showed an appreciable correlation with dietary compliance (r= 0.75). Among the perceived barriers to dietary practice in patients of Group 2 and Group 3, extrinsic factors related to knowledge lowered during the intervention (p$lt;0.05). Even though Group 3 patients had good dietary compliance, they still felt that intrinsic factors related to motive and attitude were the major barriers at the end of the study (p$lt;0.05). Conclusion: We found that meal time demonstration teaching method may improve dietary compliance and glycemic control compared with the conventional diet sheet instruction method.