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).

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

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

Biofilter modeling integrated with Lim’s adsorption model

Eun Ju LEE,Wui Sook JEON,Hye Min YOON,Hye Jin SONG,Byeung Soo KIM,Hee Jeong KIM,Eun Jeong OH,Kwang-Hee LIM 한국생물공학회 2011 한국생물공학회 학술대회 Vol.2011 No.10

Pneumatosis intestinalis and portal venous gas secondary to gefitinib therapy for Lung adenocarcinoma

( Joo Young Lee1 ),( Hye-suk Han ),( Sung-nam Lim ),( Young Kwang Shim ),( Yong Hyeok Choi ),( Ok-jun Lee ),( Ki Hyeong Lee1 ),( Seung Taik Kim ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

폴리아크릴릭 산으로 처리된 상아질과 글라스아이오노머 시멘트간의 전단결합강도

이혜영,임호남 慶熙大學校 大學院 1993 高凰論集 Vol.12 No.-

The purpose of this study was to evaluate the effect of dentin pretreatments on the shear bond strength of chemical or light curing glass ionomer to dentin treated with three kinds of dentin conditioners including distilled water and two commercial polyacrylic acids consisted of low and high acid concentrations. The dentin surfaces were treated with three kinds of conditioners and bonded with two types of glass ionomer cements respectively. The shear bond strengths of specimens were measured after they were stored in distilled water at 37℃, for 1 day and 7 days. And scanning electron micrographs of pretreated surface of dentine were taken to provide information on teh topographical effects of the 3 types of dentin pretreatments. The results were as follows: 1. The chemical curing glass ionomer showed the much higher shear bond strength than light curing glass ionomer in the group treated with distilled water (0%, polyacrylic acid). 2. The shear bond strength of light curing glass ionomer was higher than that of chemical curing glass ionomer in the group treated with polyacrylic acid. 3. The shear bon strength of light curing glass ionomer in the group treated polyacrylic acid was significantly increased, but the treatment with polyacrylic acid not influence on the shear bond strength of chemical curing glass ionomer. 4. While the shear bond strength of chemical curing glass ionomer appeared to be increased with aging, that of light curing glass ionomer seemed to be decreased with aging. 5. Both types of glass ionomer showed the highest shear bond strength of glass ionomer cement regarding types when treated with 25% polyacrylic acid. 6. In SEM, the dentin treated with polyacrylic acid showed opened dentinal tubule orifice and widened dentinal tubules by increase in the concentration of polyacrylic acid.

공정거래법상 부당지원행위의 규제 법리 및 개정법률 검토 : 물량몰아주기 규제에 대한 고찰

이혜림 이화여자대학교 법학전문대학원 2013 Ewha Law Review Vol.3 No.2

Recently, the Chaebol practice of supporting subsidiaries with volumes of trade has become a big issue in Korea. The practice of supporting with volumes of trade (‘Mul-lyang-mol-a-ju-gi’ in Korean) often occurs with the implicit purpose of indirectly bequeathing Chaebol control to their children, resulting in a concentration of economic power. Compared to the practice of general illegal support(「Monopoly Regulations and Fair Trade Act」, Article 23.1(ⅶ), hereinafter “Fair Trade Act”), issues arose regarding whether legal benchmark on the illegality of support is directly applicable to the act of Mul-lyang-mol-a-ju-gi. Hitherto, limitation was imposed on the regulation on ‘Mul-lyang-mol-a-ju-gi’ that no articles exist that provide explicit criteria on the assessment of illegality. Within the revised Fair Trade Act regarding ‘Mul-lyang-mol-a-ju-gi’, a new article was inserted to directly regulate Chaebol insider trading. In addition, salience condition can be proven more easily than before and types of ‘Mul-lyang-mol-a-ju-gi’ are described in the revised article. However, concrete criteria on the assessment of illegality were still not specified in the revised article. Regulation on Mul-lyang-mol-a-ju-gi should be carefully executed in order not to constrict reasonable trade. Theoretical and empirical analysis on ‘Mul-lyang-mol-a-ju-gi’ is also necessary for a reasonable regulation. 최근 대규모기업집단 내 계열회사간 물량몰아주기의 규제가 사회적으로 많은 관심을 받고 있다. 물량몰아주기는 재산증식을 위한 상속, 증여의 목적으로 대규모기업집단이 계열회사에 대한 물량몰아주기를 행하고 있다는 문제가 제기되고 있다. 일반적인 부당지원행위와는 다르게 물량몰아주기는 지원주체가 가격조건은 정상 범위에서 벗어나지 않도록 하고 수량적으로 지원을 할 수도 있고, 급부와 반대급부의 불균형이 반드시 수반되는 것은 아니므로 종전의 부당성 판단기준을 물량몰아주기에서도 그대로 적용할 수 있는가에 대한 의문이 있다. 현행법에 의한 물량몰아주기 규제는 지원행위의 현저성을 입증하는 데 초점을 맞춘 반면, 지원행위의 부당성을 입증하기에는 불명확하다는 문제점이 있다. 이번 공정거래법 개정법률은 물량몰아주기와 관련하여 대규모기업집단의 사익추구를 위한 내부거래를 제재하는 직접적인 법조항을 신설하였다는 것에 의미가 있다고 판단된다. 지원행위의 현저성에 대하여 입증요건을 완화하여 현실적으로 입증하기 어려웠던 것을 개선하였고, 물량몰아주기의 유형을 명시하여 지원행위에 대하여 이전보다 구체적으로 기준을 마련한 점은 긍정적으로 평가할 수 있다. 반면, 물량몰아주기를 규정함에 있어 부당성 여부에 대한 구체적인 기준을 마련하지 못한 한계점이 있다. 공정한 거래질서에 부정적인 효과를 야기하는 물량몰아주기만 규제하고, 규제로 인하여 공정한 거래질서를 저해하지 않는 정상적인 거래까지도 위축되지 않도록 법집행에 있어 신중하여야 한다. 이와 더불어 물량몰아주기가 경쟁제한성을 야기하는지에 대한 경제학 측면의 이론적, 실증적 분석을 하여 합리적인 규제 방안을 마련해야할 것이다.

HPLC/ELSD에 의한 Diterpenoid Alkaloids의 분석

임미애,이주선,백승경,최혜영,박유신,이한선,육창수,오세욱 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-