제2형 당뇨병 환자에게 적용한 표준진료지침이 혈당, 당화혈색소, 당뇨지식 및 재원일수에 미치는 효과

김희승,윤건호,유양숙,오정아,송민선,신미옥,김경희,송복례 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.1

연구배경 : 당뇨병 환자의 평균 재원기간을 단축시키고, 제한된 입원기간 내에서 질적인 면과 비용효과성을 고려한 총체적인 건강관리체계의 필요성이 요구됨으로써 생겨난 것이 당뇨병 표준진료지침(Critical Pathway: CP)이다. 현재 개발된 당뇨병 CP를 통한 진료가 환자의 당뇨병에 관한 지식을 개선시키고 이에 따라 장기적으로 당뇨병 환자의 혈당조절이 개선되었다는 과학적인 검증은 당뇨병 CP를 여러 병원에 정착시키기이전에 반드시 선행되어야 할 과제이다. 이에 본 연구는 2000년 3월부터 1년간 강남성모병원에 입원하는 당뇨병 환자를 대상으로 현재 개발된 1주일 CP를 적용한 실험군의 혈당, 당뇨병 관련 지식 및 재원일수가 대조군에 비하여 차이가 있는지를 조사하였다. 방법 : 1주일 CP를 적용한 실험군은 내과병동에 입원한 당뇨병 환자 89명이었고, 대조군은 기타병동에 입원한 당뇨병 환자 22명이었으며 CP를 적용하지 않았다. CP를 적용하기 전인 입원시에 실험군과 대조군의 공복혈당, 식후 2시간혈당, 당화혈색소 및 당뇨관련 지식을 측정하였고, 퇴원 시에 실험군과 대조군에게 공복혈당과 당뇨관련 지식을 재측정하고 재원일수를 파악하였다. 그리고 두 군에게 퇴원 3개월 후의 공복혈당, 식후 2시간 혈당 및 당화혈색소를 조사하였다. 결과 : 1) 실험군의 공복혈당은 입원 시 238.7: 1) 실험군의 공복혈당은 입원 시 238.7mg/dL에서 퇴원 시 139.4mg/dL로 감소하는 경향이었으나 퇴원 3개월 후에는 150.6mg/dL로 약간상승하는 경향을 보였다. 대조군은 입원 시 251.5mg/dL에서 퇴원 시 136.2mg/dL로 감소하는 경향이었으나, 퇴원 3개월 후에는 219.3mg/dL로 현저히 증가하는 경향이었다. 2) 실험군의 입원 시 식후 2시간 혈당은 312.5mg/dL에서 퇴원 3개월 후 248.5mg/dL로 감소하는 경향이었다. 대조군도 입원 시 식후 2시간 혈당이 300.1mg/dL에서 퇴원 3개월 후 262.5mg/dL로 감소하는 경향이었으나 실험군보다 감소의 폭이 적은 경향이었다. 3) 실험군과 대조군의 입원 시 당화혈색소는 각각 10.3%와 9.7%로 유의한 차이가 없었으나,퇴원 3개월 후 실험군은 7.5%로 대조군의 9.1% 보다 유의하게 감소하였다. 4) 실험군의 입원 시 당뇨지식 점수는 실험군이 12.1점 대조군은 12.0점으로 유의한 차이가 없었으나 퇴원 시는 실험군이 15.5점으로 대조군의 14.6점 보다 높은 경향이었다. 5) 재원일수는 실험군이 8.4일로 대조군의11.0일 보다 유의하게 적었다. 결론 : 따라서 당뇨병 환자를 위한 CP는 재원일수의 감소뿐만 아니라 환자의 자가관리에 대한 체계적인 교육과 개선의 기회를 가짐으로써 장기적인 혈당 조절의 향상을 도모할 수 있는 효과적인 방법이라고 생각한다. Background: The aim of this study was to examine the effects of the critical pathway for the admitted patients with type 2 dia betes me llitus on glycemic control, the knowledge on the disease, and the length of hospital stay. Methods: 89 diabetic in-patients were applied with the 1 week critical pathwa which was consisted of intensive education program for self-management of diabetes me llitus such as glucose monitoring, excercise prescription, diet control, self-a djustment of the drugs and so on. The results were compared with 22 diabetic inpatients who were treated with conventional way. We assessed the effects of critical pathway on the degree of glycemic control, the knowledge on the disease, and the length of hospital stay. Results: Although fasting and postprandial 2 hours blood g lucose levels did not showed sta tistically significantd ifference between critical pathway group and conventional group on discharge , HbA1c was significantly decreased in critical pathwa group compared with the conventional group (7.5±1.8% vs 9.1±2.6%) on 3 months after discharge . Knowledge on the disease tended to increase in critical pathway group compared with the conventional group on discharge. The Length of hospital stay was significantly decreased in critical pathway group compared with the conventional group (8.4±2.8day vs 11.0±3.9da ) Conclusion: These results showed that critical pathway for the patients with diabetes mellitus might be a usefulway for improving the long term glycemic control through motivation, enhancing the knowledge on the disase as well as reducing the length of hospital stay.

Synthesis and Characterization of the Temperature/pH-Sensitive Polymers for Drug Delivery Systems

Yoo, Mi-Kyong,Sung, Yong-Kiel 동국대학교 자연과학연구원 2000 자연과학연구 논문집 Vol.5 No.-

The stimuli-sensitive polymers were synthesized by copolymerizing varying ratios of N-isopropyl acrylamide(NIPAAm) and acrylic acid(AAc). The influence of polyelectrolytes on the lower critical solution temperatures(LCSTs) of these temperature/pH sensitive polymers was investigated in the pH range of 2∼12. The polyelectrolyte complexes were prepared by mixing poly(NIPAAm-co-AAc) as anionic polyelectrolyte with poly(allyl amine)(PAA) or poly(L-lysine)(PLL) as cationic polyelectrolytes, respectively. The effect of polyelectrolyte complex formation on the conformation of PLL was studied as a function of temperature by means of circular dichroism(CD). Swelling ratio of poly(NIPAAm-co-AAc) hydrogels as a function of pH at various temperature was obtained by measuring the weight of the hydrogels in buffer solutions. The LCSTs of the poly(NIPAAm-co-AAc) were strongly affected by pH, polyelectrolyte solutes, AAc content, and charge density. The influence of more hydrophobic PLL as a polyelectrolyte on the cloud point of PNIPAAm/water in the copolymer was stronger than that of poly(allyl amine)(PAA). Indomethacin was loaded into these hydrogels and their drug release characteristics were determined under various temperature and pH conditions using UV/Vis spectrophotometer.

All-Trans Retinoic Acid (atRA) Release from atRA-Loaded Folate-Poly(Ethylene Glycol)/Polyethylenimine Nanoparticles for Folate-Mediated Tumor Targeting

Yoo, Mi Kyong,Kim, You Kyoung,Jeong, Hwan Jeong,Bom, Hee Seung,Cho, Chong Su Trans Tech Publications, Ltd. 2007 Key Engineering Materials Vol.342 No.-

<P>To improve the specific accumulation in tumor sites and aqueous solubility of atRA, the core-shell type of folate-PEG-g-PEI/atRA nanoparticles were prepared by complexation between cationic PEI segments in the copolymers and anionic charged atRA, and then characterized by 1HNMR, ELS, XRD, and TEM. In vitro atRA release from the nanoparticles was investigated as a function of drug content in sink condition. Cytotocicity of atRA against HepG2, KB cell lines were also evaluated by MTT assay. The lower the drug content, the faster atRA release. atRA incorporated in folate-PEG-g-PEI/atRA nanoparticles showed much higher cytotoxic effect compared with atRA itself.</P>

Folated Poly(ethylene glycol)-g-Polyethylenimine/Retinoic Acid Nanoparticles for Tumor Targeting

Mi Kyong Yoo,Eun Mi Kim,Hwan Jeong Jeong,Hee Seung Bom,Chong Su Cho 한국고분자학회 2006 한국고분자학회 학술대회 연구논문 초록집 Vol.2006 No.10

Effect of Polyelectrolyte Complex Formation on the Thermosensitivity of PNIPAAm Copolymers

Yoo, Mi-Kyong,Sung, Yong-Kiel 동국대학교 자연과학연구원 1995 자연과학연구 논문집 Vol.15 No.-

A series of pH/temperature sensitive polymers which cotain both temperature and pH sensitive components were synthesized by copolymerizing varying ratios of N-isopropylacrylamide(NIPAAm) and acrylic acid(AAc). The influence of polyelectrolyte on the lower critical solution temperature(LCST) of pH/temperature sensitive polymer was investigated in the range of pH 2-12. A polyelectrolyte complex was prepared by mixing poly(NIPAAm-co-AAc) and poly(allyl amine) solutions as anionic and cationic polyelectrolytes, respectively. The LCSTs of the polymers were determined by cloud point experiments. The LCSTs of poly(NIPAAm-co-AAc) were strongly affected by the pH, the presence extend of pH formed polyelectrolyte complex was above pKa of AAc below pKb of PAA, and the degree of change in LCST depended on the charge density on the polymer according to pH and solute's concentration.

Drug Release from Xyloglucan Beads Coated with Eudragit for Oral Drug Delivery

Yoo Mi Kyong,Choi Hoo Kyun,Kim Tae Hee,Choi Yun Jaie,Akaike Toshihiro,Shirakawa Mayumi,Cho Chong Su The Pharmaceutical Society of Korea 2005 Archives of Pharmacal Research Vol.28 No.6

Xyloglucan (XG), which exhibits thermal sol to gel transition, non-toxicity, and low gelation concentration, is of interest in the development of sustained release carriers for drug delivery. Drug-loaded XG beads were prepared by extruding dropwise a dispersion of indomethacin in aqueous XG solution (2 wt.-$\%$) through a syringe into corn oil. Enteric coating of XG bead was performed using Eudragit L 100 to improve the stability of XG bead in gastrointestinal (GI) track and to achieve gastroresistant drug release. Release behavior of indomethacin from XG beads in vitro was investigated as a function of loading content of drug, pH of release medium, and concentration of coating agent. Adhesive force of XG was also measured using the tensile test. Uniform-sized spherical beads with particle diameters ranging from 692 $\pm$ 30 to 819 $\pm$ 50 $\mu$m were obtained. The effect of drug content on the release of indomethacin from XG beads depended on the medium pH. Release of indomethacin from XG beads was retarded by coating with Eudragit and increased rapidly with the change in medium pH from 1.2 to 7.4. Adhesive force of XG was stronger than that of Carbopol 943 P, a well-known commercial mucoadhesive polymer, in wet state. Results indicate the enteric-coated XG beads may be suitable as a carrier for oral drug delivery of irritant drug in the stomach.

Drug Release from Xyloglucan Beads Coated with Eudragit for Oral Drug Delivery

Mi Kyong Yoo,Hoo Kyun Choi,김태희,Yun Jaie Choi,Toshihiro Akaike,Mayumi Shirakawa,조종수 대한약학회 2005 Archives of Pharmacal Research Vol.28 No.6

Xyloglucan (XG), which exhibits thermal sol to gel transition, non-toxicity, and low gelation concentration, is of interest in the development of sustained release carriers for drug delivery. Drug-loaded XG beads were prepared by extruding dropwise a dispersion of indomethacin in aqueous XG solution (2 wt.-%) through a syringe into corn oil. Enteric coating of XG bead was performed using Eudragit L 100 to improve the stability of XG bead in gastrointestinal (GI) track and to achieve gastroresistant drug release. Release behavior of indomethacin from XG beads in vitro was investigated as a function of loading content of drug, pH of release medium, and concentration of coating agent. Adhesive force of XG was also measured using the tensile test. Uniform-sized spherical beads with particle diameters ranging from 692 ± 30 to 819 ± 50 μm were obtained. The effect of drug content on the release of indomethacin from XG beads depended on the medium pH. Release of indomethacin from XG beads was retarded by coating with Eudragit and increased rapidly with the change in medium pH from 1.2 to 7.4. Adhesive force of XG was stronger than that of Carbopol 943 P, a well-known commercial mucoadhesive polymer, in wet state. Results indicate the enteric-coated XG beads may be suitable as a carrier for oral drug delivery of irritant drug in the stomach.

`실버케어 전문가` 미래직업 연계형 STEAM 프로그램이 초등학생의 미래지향 시간관, 진로인식 및 과학적 태도에 미치는 영향

유미현 ( Mi Hyun Yoo ),최정진 ( Jung Jin Choi ),박문숙 ( Mun Sook Park ),채수진 ( Su Jin Chae ),김보라 ( Bo Ra Kim ),손미현 ( Mi Hyun Son ),임은경 ( Eun- Kyong Lim ),유화수 ( Hwasoo Yu ),서종원 ( Jong Won Seo ),김주미 ( Ju Mi Kim 경북대학교 과학교육연구소 2017 科學敎育硏究誌 Vol.41 No.1

이 연구의 목적은 `실버케어 전문가` STEAM프로그램을 개발하고 초등학교에 적용하여 효과를 알아보는 것이다. 이 연구를 위해 경기도 소재 초등학생 110명이 참여하였다. 54명은 실험 집단으로, 56명은 비교집단으로 배치하였으며 프로그램 적용 전후에 미래지향 시간관, 진로인식, 과학적 태도 검사를 실시하였다. 본 연구에서 얻어진 결과는 다음과 같다. 첫째, `실버케 전문가` STEAM 프로그램을 적용한 실험집단 학생의 미래지향 시간관 전체 점수와 2개 하위영역 모두에서 비교집단에 비해 유의미하게 향상되었다(p<.05). 둘째, `실버케어 전문가` STEAM 프로그램을 적용한 실험집단 학생의 진로인식 전체 점수와 4개 하위영역 점수가 비교 집단에 비해 유의미하게 향상되었다(p<.05). 셋째, `실버케어 전문가` STEAM 프로그램을 적용한 실험집단 학생의 과학적 태도 전체 점수와 7개 하위영역 점수가 비교집단에 비해 유의미하게 향상되었다(p<.05). 넷째, `실버케어 전문가` STEAM 프로그램에 대한 실험집단 학생의 만족도를 조사한 결과 `나는 과학기술 분야와 관련된 직업에 대한 관심이 생겼다`라는 항목에서 가장 높은 긍정적 인식을 보여주었다. 결론적으로 본연구에서 개발 적용한 STEAM 프로그램이 초등학생의 미래지향 시간관, 진로인식, 과학적 태도를 향상시키는 데 효과적임을 시사한다. The purpose of this study was to develop `Silver Care Expert` STEAM Program for the elementary students and investigate the effects of the program on creative thinking activity, scientific attitude and leadership. Participants were 110 elementary school students. Before and after the program, the participants were asked to take the test about future time perspective, career awareness and scientific attitude. The major results of this study were as follows. First, the total score of experimental group`s future time perspective and all 2 sub-domains was significantly improved than those of comparative group(p<.05). Second, total score of experimental groups` career awareness and all 4 sub-domains were significantly increased than those of comparative group after the STEAM program(p<.05). Third, the total score of experimental groups` scientific attitude and all 7 sub-domains were significantly improved than those of comparative group(p<.05). Fourth, according to students` post-program opinions, experimental group students showed very positive perception like that science class was very interesting and they became interested in science and technology. In conclusion, `Silver Care Expert` STEAM Program was very effective to improve elementary students` future time perspective, career awareness, scientific attitudes.

Reduced Atherosclerosis in Apolipoprotein E Knockout Mice Overexpressing RELMα

Mi Ran Lee,Hyung Jun Jeon,Ji Young Yoo,Cha Kyong Song,Jong Gil Park,Mi Ni Lee,Bora Kim,In Hyuk Jung,Se Jin Jeong,Kwang Lae Hoe,Jae Wha Kim,Goo Taeg Oh 한국지질동맥경화학회(구 한국지질학회) 2007 한국지질동맥경화학회 추계학술발표논문집 Vol.2007 No.-

Photochemical Response Analysis on Drought Stress for Red Pepper (Capsiumannuum L.)

Yoo, Sung-Yung,Lee, Yong-Ho,Park, So-Hyun,Choi, Kyong-Mi,Park, June-Young,Kim, A-Ram,Hwang, Su-Min,Lee, Min-Ju,Ko, Tae-Seok,Kim, Tae-Wan 한국토양비료학회 2013 한국토양비료학회지 Vol.46 No.6

The aim of this study is to determine the drought stress index through photochemical analysis in red pepper (Capsiumannuum L.). The photochemical interpretation was performed in the basis of the relation between Kautsky effect and Photosystem II (PSII) following the measurement of chlorophyll, pheophytin contents, and $CO_2$ assimilation in drought stressed 5-week-old red pepper plants. The $CO_2$ assimilation rate was severely lowered with almost 77% reduction of chlorophyll and pheophytin contents at four days after non-irrigation. It was clearly observed that the chlorophyll fluorescence intensity rose from a minimum level (the O level), in less than one second, to a maximum level (the P-level) via two intermediate steps labeled J and I (OJIP process). Drought factor index (DFI) was also calculated using measured OJIP parameters. The DFI was -0.22, meaning not only the initial inhibition of PSII but also sequential inhibition of PSI. In real, most of all photochemical parameters such as quantum yield of the electron transport flux from Quinone A ($Q_A$) to Quinone B ($Q_B$), quantum yield of the electron transport flux until the PSI electron acceptors, quantum yield of the electron transport flux until the PSI electron acceptors, average absorbed photon flux per PSII reaction center, and electron transport flux until PSI acceptors per cross section were profoundly reduced except number of QA reducing reaction centers (RCs) per PSII antenna chlorophyll (RC/ABS). It was illuminated that at least 6 parameters related with quantum yield/efficiency and specific energy fluxes (per active PSII RC) could be applied to be used as the drought stress index. Furthermore, in the combination of parameters, driving forces (DF) for photochemical activity could be deduced from the performance index (PI) for energy conservation from photons absorbed by PSII antenna until the reduction of PSI acceptors. In conclusion, photochemical responses and their related parameters can be used as physiological DFI.