• 대한화상학회지
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• 제23권1호
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• pp.20-24
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• 2020

Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57~86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.

• 대한족부족관절학회지
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• 제26권1호
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• pp.30-39
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• 2022

Purpose: This study aimed to report the current trends in the management of diabetic foot over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 40 questions was sent to all KFAS members in September 2021. The questions were mainly related to the demographics of patients with diabetic foot, diagnostic tools, and multidisciplinary treatment. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Seventy-eight of the 550 members (14.2%) responded to the survey. The most common demographic factors of diabetic foot patients were male dominance with a high percentage in the 60- to 70-year-old. Although the need for multidisciplinary treatment is highly recognized in the treatment of diabetic foot patients, the actual implementation rate is about 39%. The contrast-enhanced magnetic resonance imaging (88.5%) was reported to be the most used tool for the diagnosis of osteomyelitis of the diabetic foot. It was reported that the use of antibiotics was started empirically and then changed based on bacterial culture tests in 82.1% of patients. Simple wound dressing and antibiotic treatment were most frequently reported for mild ulcers. Conclusion: This study provides updated information on the current trends in the management of a diabetic foot in Korea. Both consensus and variations in the approach to patients with diabetic foot were identified by this survey study. Further efforts are required for better access to a multidisciplinary approach, such as appropriate insurance payment policies and patient education.

• 대한방사선기술학회지:방사선기술과학
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• 제39권3호
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• pp.399-406
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• 2016

비전리-방사선의 일종인 근적외선은 비침습적이고, 비전리성을 가지며, 생체 내 높은 투과성을 가지는 전자기파로, 진단을 위한 의료영상분야에 전 세계적으로 관심이 증가하여 그 활용 가능성이 활발히 연구되어지고 있다. 그러나 현재 국내에서 근적외선 의료영상의 활용은 극히 제한되어 있으며, 큰 관심을 가지고 있지 못하여, 새롭게 형성되는 근적외선 기반 의료영상 분야의 방사선사의 대응 역량의 강화가 필요시 된다. 본 연구에서는 근적외선의 특징 및 영상화 원리를 간략히 소개하고, 이를 이용한 최신의 연구 주제 및 세계적인 연구 동향을 소개함으로서 국내 방사선사의 역량을 강화하고자 한다. 특히, 임상적 활용 가능성이 매우 높은 상처 및 당뇨발등의 연구 주제에 대해서 소개하여, 이 분야의 발전을 가속화 시키는데 기여하고자 한다.

• 한국보건교육건강증진학회:학술대회논문집
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• 한국보건교육건강증진학회 2009년도 춘계학술대회 자료집
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• pp.83-83
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• 2009

본 연구는 한국인 노년층이 대표적으로 섭취하는 강도별 음식을 조사하고 각 음식별로 씹어 먹을 수 있는 음식들이 무엇인지를 조사하여 자신이 보유하고 있는 자연치아수와의 상관관계를 알아보아 자연치아의 건강도를 유지, 관리, 예방하는데 하나의 지표로 사용하고 더 나아가 국민구강건강향상에 이바지 하고자 실시되었다. 전국의 60세 남 녀 586명을 대상으로 치과의사와 치과위생사가 구강검사와 면접법으로 설문내용을 기록하는 방식으로 진행하였다. 수집된 자료는 SPSS WIN 14.0 프로그램을 이용하여 분석하였다. 분석기법으로는 잔존치아수와 저작능력간의 관계를 상관계수와 회귀분석으로 분석 검증을 실시하여 다음과 같은 결과를 얻었다. 1. 저작능력과 구강상태와는 치석, 동요도, 충전점수, 우식경험점수, 발거치아수, 임플란트 수, 자연치아수와 나이, 고혈압, 당뇨병, 기타질환, 흡연이 유의한 것으로 나타났다(p<0.05). 2. 회귀분석 결과 나이가 높을수록 저작능력이 감소하며, 자연치아수가 많을수록 저작능력이 높은 것으로 나타났으며 회귀방정식은 저작능력=79.417-(연령$\times$0.281)+3.813$\times$치아수와 같았다(p<0.05). 3. 회귀분석결과 저작능력점수와 자연치아수와의 관계가 가장 높은 것으로 나타났고 회귀방정식은 저작능력=3.817$\times$자연치아+58.694와 같았다(p<0.05). 4. 자연치아로 식사를 하기 위해서는 한국 노인의 주식인 밥과 김치정도를 잘 씹어 먹으려면 잔존 자연치아수가 18개 정도는 있어야 아주 잘 씹어 먹을 수 있고, 잘 먹으려면 12개의 자연치아가 있어야 하며, 육류를 잘 먹기 위해서는 최소한 18개는 있어야 잘 먹을 수 있고, 25개가 있으면 아주 잘 씹어 먹을 수 있다는 연구결과가 나왔다.

• 대한족부족관절학회지
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• 제6권2호
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• pp.172-177
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• 2002

Objectives: To validate usefulness of the three phase bone scan for the diagnosis of osteomyelitis in the diabetic foot with soft tissue inflammation. Materials and Methods: Fourteen diabetic feet with soft tissue inflammation were included in this study. We took the bone biopsy from the site of hot uptake on the three phase bone scan but no abnormal findings on the plain radiographs. We observed whether the bone has evidence of osteomyelitis on the patholgic findings such as inflammatory cell infiltration within bone, dead bone, new bone formation and fibrosis. Results: Thirteen of fourteen cases (92.8%) were compatible with osteomyelitis on the pathologic criteria. Inflammatory cell infiltration within bone was observed in thirteen cases, dead bone in twelve cases. new bone formation in four cases. fibrosis in eight cases. All of the four findings were observed in three cases. Conclusion: In the diabetic foot with soft tissue inflammation, the osteomyelitis should be included in differential diagnosis if the lesion reveals increased uptake on three phase bone scan, even though the lesion does not show any abnormal findings on the plain radiographs.

• 기본간호학회지
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• 제13권2호
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• pp.225-234
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• 2006

Purpose: This study was done to investigate the effect of self-foot reflexology on peripheral blood circulation, peripheral neuropathy and to determine the feasibility of self-foot reflexology as a nursing intervention. Method: This was nonequivalent control pretest-posttest study with 76 patients with type 2 diabetes mellitus (ages between 40-79) recruited from public health centers in Busan city. Intervention was a 6 week self-foot reflexology, and outcome variables were peripheral blood circulation and peripheral neuropathy(tactile response to monofilament, intensity of symptoms of peripheral neuropathy). ANCOVA was used to do the statistical analysis. A.05 significance level was set for evaluating the effects of self-foot reflexology. Results: The self-foot reflexology was relatively effective not only in reducing peripheral neuropathy(especially tingling sensation and pain) but also in improving ability to sense the 10-g force monofilament. Conclusion: Even though self-foot reflexology was not effective in improving peripheral circulation, it had good effect on improving peripheral neuropathy. Therefore self-foot reflexology can be used as a nursing intervention program for promoting foot care for patients with DM patients.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.543-550
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• 2007

Purpose: Diabetic foot ulcer is a representative disease of chronic would with multiple defects of wound healing factors. Many nutrition factors have been known to be essential for wound healing, but objective data are lacking. The purpose of this study is to determine those factors essential for wound healing, and to find out which of those factors are lacking in diabetic foot ulcer patients through this pilot study. Methods: We studied 100 patients who visited our clinic from March 2005 to February 2006 for treatment of diabetic foot ulcers with a duration of more than 6 weeks. We checked serum levels of protein, albumin, vitamin A, C, E, iron, magnesium, zinc, copper and hemoglobin by drawing 23cc blood after 8 hours of fasting. Protein, albumin, iron, magnesium levels were measured by colorimetry; hemoglobin levels were measured by auto analysis. Vitamin levels were measured by high performance liquid chromatography (HPLC), copper and zinc levels were measured by Inductively coupled plasma (ICP). They were compared with normal values. The patients were divided by transcutaneous oxygen pressure levels, age and sex to study the effects of these parameters. Results: 76% and 61% of patients had within-normal range serum protein and albumin levels, respectively. Among vitamins, only the level of vitamin C was low in 55% of the patients. Levels of vitamin A, E were normal or high in 93% and 100% of patients. As for trace elements, levels of iron and zinc were low in 63% and 60% of patients, but levels of magnesium and copper were usually normal or high. Levels of vitamin C, iron and zinc were lower in the low-transcutaneous oxygen pressure group. There were no definite differences according to age and sex. Conclusion: Serum levels of Hb, vitamin C, iron, zinc were low in most diabetic foot ulcer patients. The deficit was very severe in the low-transcutaneous oxygen pressure group.

• 대한족부족관절학회지
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• 제7권1호
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• pp.83-87
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• 2003

Purpose: To evaluate the factors which affect the level of the amputation for treatment of DM foot excluding arterial occlusion. Materials and Methods: We selected 30 patients (10 of major amputations, 20 of minor amputations) who were amputated from May, 1999 to April, 2001 because of DM foot. Major amputation is BK amputation, and minor amputation is amputation below ankle joint. Gender, age, size of the wound, extent of the necrosis, infectious organism, medical com orbidity, duration of DM and blood glucose level, duration of DM foot and treatment history were investigated. Results: In major amputations, male to female ratio was 9:1, average of the age was 63.8, the average of sizes of the wound was 16cm2, duration of DM was 15.0 years, duration of DM foot was 10.6 weeks, and 80% of patients had necrosis and the organisms were S. aureus, E. faecium, Streptococcus, P. vulgaris, average of the blood glucose levels was 301 and 40% of them had been treated for DM foot. In minor amputations, male to female ration was 9:1, average of the age was 56.6, the average of sizes of the wound was 4.8cm2, duration of DM was 11.2 years, duration of DM foot was 5.7 weeks, and 40% of patients had necrosis and the organisms were S. aureus, Streptococcus, M. morganini, E. faecium, average of the blood glucose levels was 257 and 20% of them had been treated for DM foot. Conclusion: In DM foot patients, extents of the necrosis, duration of DM, duration of DM foot, the infectious organism were significant factors to decide extent of the amputation level.

• 한국산학기술학회논문지
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• 제10권11호
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• pp.3434-3443
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• 2009

본 연구는 3차병원에서 퇴원하는 환자의 상처관리에 대한 지식과 염려사항을 파악하기 위해 112명의 피부상처를 지니고 퇴원을 앞둔 112명 환자에게 구조화된 설문지로 면담을 통해 조사하였다. 상처의 유형은 외과적 절개(52.7%), 삽관상처(26.8%), 욕창(9.8%), 당뇨발과 동맥궤양(5.4%) 등이었다. 상처관리에 관한 지식은 52.0%의 정답률을 보였고, 상처관리에 대한 염려(범위1-7)는 2.79였고, 상처관리에 대한 지식과 염려는 상관관계가 유의하지 않았다. 퇴원후 상처관리에 관한 염려에 영향을 미치는 요인으로 유의한 변수는 상처관리에 대한 두려움, 상처통증, 입원기간, 및 주관적 건강인식으로 나타났다. 상처를 지니고 퇴원하는 환자들의 상처관리에 대한 지식은 부정확한 것이 많으며 다양한 염려사항들을 가지고 있으므로 퇴원계획시 이에 대한 구체적인 교육이 필요할 것이다.

• 한국조리학회지
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• 제10권2호
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• pp.107-120
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• 2004

점진적으로 식품에서도 건강지향성 및 패션성을 추구하는 시대조류에 발 맞추어 과거 드레싱의 대명사로 불려오던 마요네즈가 퇴조해가면서 그 대용품의 개발이 절실히 요청되고 있다. 이에 본 연구에서는 일반적으로 조미료의 일환으로 흔히 사용되는 간장, 식초, 마늘 등 총 13종의 원료를 이용하여 고추조미유, 조미간장, 조미액, 조미유를 제조하고, 이를 혼합하여 새로운 형태의 드레싱오일을 제조하였다. 야채류, 피자류, 육류 등에 대한 관능검사 결과 특성화가 요망되었으며, 따라서, 여기에 각종 기능성 원료를 첨가한 고추 드레싱오일, 당뇨병 환자용, 성인병 환자용, 어린이용, 일식용, 일반인 대상 기능성 드레싱오일 등의 제조에 관하여 검토하였다. 뿐만 아니라 이 드레싱오일은 상층부의 기름층과 하층부의 조미간장층을 흔들어 섞어서 사용하는 특성상 중간에 미관상 좋지 않을 층이 생성되는 문제점이 발생하였다. 이는 gum류 및 유화제를 겸용하여 어느 정도 해결이 가능한 것으로 밝혀졌다.