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).

"이순신" 멀티미디어 정보 시스템 설계 및 구현

이혜정,박원환,박두순 순천향대학교 부설 산업기술연구소 2000 순천향 산업기술연구소논문집 Vol.6 No.1

The purpose of this paper is service system development which enables to carry out the mission of preserving worldwide Korean cultural relics, internationally to contact the informations about our country's cultural relics on the Cyber space, to make atmosphere that makes it possible to appreciate them, and to provide information service by performing mutimedia service which is related to Soon-sin Lee using Virual Reality. For that, creating Virtual Reality information and Video Informaion which is related to Soon-sin Lee, especially Gubooksun by using Virtual Reality technique, 3-Degree image manufacture technique, animation manufacture technique, video manufacture and service technique and Internet/Web technique, and then manufacturing and storing them in the digital data type, and carry out Information Service through connecting the system of serving these informations with the Information SuperHighway

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.

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.

경막외 Morphine, Morphine 과 Nalbuphine 병용투여, Morphine 과 Droperidol 병용투여가 제왕절개술 후 통증조절에 미치는 효과에 대한 비교

김혜자,이정은,김동일 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

Effect of Epidural Morphine, Morphine with Droperidol and Morphine with Nalbuphine after a Cesarean Section Tong0Il Kim, M.D., Hye-Ja Kim, M.D., and Jung-Un Lee, M.D. Department of Anesthesiology, College of Medicine, Chungnam National University, Daejon, Korea Background: A number of recent reoprts have described the usefullness of the epidural injection of narcotics for the relief of postoperative pain. Morphine, an ??-receptor agonist, produces strong analgesic effects with side effects. Nalbupine, a ??-antagonist and ??-agonis, has an analgesic effect comparable to morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine alone and a combination of nalbuphine and droperidol respectively to morphine were sutudied in cesarean section patients. Methods: We divided 45 patients into 3 groups utilizing a two-day Boxter infusor in normal saline 100 ml at 2.0 ml/hr: Group M (n = 15) initially a 1 mg bolus + 2 mg/day of maintenance morphine. Group M + D (n = 15): initially received a 1 mg bolus + 2 mg/day of maintenance morphine + 1.25 mg/day of maintenance droperidol. Group M + N (n = 15): initially received a 1mg morphine bolus + 2 mg/day of maintenance morphine + 5 mg/day of maintenance nalbupine. The Analgesic effect was evaluated by a visual analogue scale (0-10) at 30 min, 4 hr, 12hr and 24 hr postoperatively and the incidence of side effects was observed too. Results: The average VAS scores are below 3 in all groups. In addition, there are no significant changes between groups. There are no significant differences in side effects between groups except sedation of patients is significantly (P < 0.05) high in group M + D. Conclusion: We concluded that the analgesic effect of epidural morphine, morphine with nalbuphine and morphine with droperidol are good in all patients and there is no significant difference even though there is a belief that a combination of nalbuphine or droperidol increases analgesic effects of morphine. Comparing the incidence of side effects in the three groups, the sedative effect of morphine with droperidol is increased significantly over the other two groups.intubation. (Korean J Anesthesiol 2001; 41: 324~329)

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.

한국비서자격시험의 개선점과 비교연구

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

전문비서직에 대한 이대 비서학과 학부학생들의 의식구

구효선,김경화,윤혜정,이지연,정은희,강은정,김윤희,신해정 이화여자대학교 법정대학 비서학과 1997 비서학연구 Vol.- No.17

지역별 시판 포기배추김치의 이용실태 및 기호도 조사

이인선,김혜영B,김은정 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.4

Survey on the usage of commercial poggi Kimchi was run and consumer's acceptance test of the Kimchi in the various regions of Korea including Seoul(SE), Kyonggi Province(KG), Kangwon Province(KW), Kyungsang Province(KS), and Jeonla Province(JL) were investigated. Survey result of 34% of consumer showed that they eat Kimchi very much, and 19% answered they ate Kimchi whenever they had chance to eat. The most desired points of improvement in commercial poggi Kimchi were as following; Taste and degree of fermentation should be standardized. Order of preferences of minor ingredients of Kimchi were radish, hot pepper, welsh onion, and leek, respectively. Consumer acceptance test of KS sample group showed higher preference in whole color, salted condition, spicy hot flavor and crispness than the others. In whole color and pickled seafood properties, KG sample group showed significantly higher values than the others. In salty flavor, SE sample group showed lower preference than the others.

足三里의 電鍼刺戟이 흰쥐의 中樞神經系에서 Interleukin-6의 活性에 미치는 影響 - 求心性 體感覺 情報傳達을 中心으로- : 求心性 體感覺 情保傳達을 중심으로

이혜정,신형철,진수희,손양선,윤동학,임사비나 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2000 No.-

Objectives : Acupuncture is expected to have somewhat like the efficacy parallel increasing activity of immune system in Western modern medicine. There, already, are many animal researches on activating effect of acupuncture for the immune system in peripheral organs. So, we carried out this experiment to see whether acupuncture has controlling effect on interleukin-6(IL-6) activity in rat's brain. Methods and Results : We had topical application of IL-6(1U-1pg, 10㎕) on brain of rat. It reduced afferent sensory transmission to the primary somatosensory(SI) cortex from periphery. Whereas, electrical stimulation(ES, 2Hz, 1.5V, 15min) of ST36(足三里) with application of IL-6 prominently activated afferent sensory transmission. ES of non-acupoint(proximal tail) with IL-6 showed suppression of afferent transmission. ES of ST36 without IL-6 application also exerted facilitation of afferent transmission to the SI cortex. Conclusions : Electoacupuncture(EA) on ST36 has noticeable influences on modulating activation of IL-6 in central nervous system, which do major role in immune system.