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The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus (제2형 당뇨병환자에서 임상영앙치료의 임상적 효과와 비용효과 연구)

  • Cho, Youn-Yun;Lee, Moon-Kyu;Jang, Hak-Chul;Rha, Mi-Yong;Kim, Ji-Young;Park, Young-Mi;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.41 no.2
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    • pp.147-155
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    • 2008
  • Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

Antimicrobial Effect of Red Ginseng Against Major Food Poisoning Microorganisms Including Staphylococcus aureus (황색포도상구균을 포함한 식중독 미생물들에 대한 홍삼의 항균효과)

  • Kwak, Yi-Seong;Jung, Myung-Gyun;Jang, Kyoung-Hwa;Han, Min-Woo;Yu, Byeung-Il
    • Journal of Food Hygiene and Safety
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    • v.35 no.4
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    • pp.382-390
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    • 2020
  • This study was carried out to evaluate the antimicrobial effect of red ginseng (Panax ginseng C.A. Meyer) against several foodborne pathogens including Staphylococcus aureus, Escherichia coli, Candida albicans and Aspergillus niger. The antimicrobial effect was determined by agar diffusion method using red ginseng extract, crude saponin and non-water-soluble fractions. Red ginseng extract showed antimicrobial effect against S. aureus, but not C. albicans or A. niger. The extract showed anti-bacterial activity at concentration above 30% against S. aureus, which cause both food poisoning and atophic dermatitis. Crude saponin showed antibacterial activity above 7.5% against the bacterium. However, the ginsenosides purified from crude saponin showed no antimicrobial activities at 100-200 ㎍/mL. To investigate the mode of growth inhibition, red ginseng extract and crude saponin were added to 0.85% NaCl solution containing S. aureus and then incubated at 35℃ for 12 h. The results showed that viable cells were rapidly reduced in above 10% concentration of red ginseng extract and above 2% of crude saponin, respectively. However, the crude saponin and red ginseng extract did not inhibit the bacterial cells completely at those same concentrations. On the other hand, whereas all non-water-soluble fractions showed inhibition zones above 10 mm against S. aureus, they showed no inhibition effects against E. coli, C. albicans or A. niger. The methanol fraction-1 (MF-1) showed the highest antibacterial activity against S. aureus, and the MIC (minimal inhibitory concentration) was 0.625 mg/mL. These results suggest that red ginseng extract, crude saponin and non-water-soluble fractions show selective antibacterial activity against S. aureus, and non-water-soluble fractions might be used as natural antibacterial agents.

Evaluation of a Serodiagnostic Method for Tuberculosis by Using Secreted Protein Antigens of Mycobacterium Tuberculosis (결핵균 분비항원을 이용한 결핵의 혈청학적 진단 방법에 대한 평가)

  • Bai, Gill-Han;Park, Eun-Mi;Kim, Sang-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.315-323
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    • 2000
  • Background : An immunochromatographic assay (ICT Diagnostics) which facilitates the diagnosis of tuberculosis(TB) by detecting serum antibodies mainly directed against specific 38KDa of Mycobacterium tuberculosis has come into the market. The test consists of a cardboard folding device containing nitrocellulose strip and absorbent pads. The whole procedure is completed within 15 min and does not require any additional equipment. The test has been reported to be sensitive and specific in diagnosing active TB. Thus the test had been evaluated with sera from TB patients and TB-free subjects. Method : Sera from patients with active pulmonary tuberculosis(40 sputum positives for Mycobacterium tuberculosis, 79 sputum negatives, and 3 extrapulmonary tuberculosis) were obtained from the Double-Cross Chest Clinic of the Korean National Tuberculosis Association (KNTA) in Seoul. The control group consisted of TB-free 68 subjects(21 children under 7 years old and 47 healthy staff members of KNTA). Results : Nine out of 68(13.2%) TB-free controls had positive antibody response. Total 106 of 122(86.9%) radiologically active patients had positive antibodies while 16 (13.1%) showed negative reaction. Antibody was detected in 38 of 40(95.0%) sputum positive patients and 68 of 82(82.9%) sputum negative patients who were under the antituberculosis chemotherapy. The sensitivity and specificity were all 87% and the positive predictive value was 92.2% while the negative predictive value was 78.7%, when the prevalence of TB in the sample was 64.2%. Our results clearly show that the detection of antibodies which mainly react with the 38KDa antigen of M. tuberculosis is not suitable as the first-line method of diagnosis but considered only as an adjunctive test to standard techniques of tuberculosis diagnosis. when considering its high false positivity.

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Usefulness and Comparison of $^{201}TI$-chloride, $^{99}mTc$-MIBI, $^{99}mTc(V)$-DMSA Single Photon Emission Computed Tomography in Distinguishing Lung Cancer from Benign Lesion (폐암과 양성질환의 감별에 $^{201}TI$-chloride, $^{99}mTc$-MIBI, $^{99}mTc(V)$-DMSA 단일광자전산화단층촬영술의 비교 및 가치)

  • Kim, Chang Ho;Chae, Sang Cheol;Park, Jae Yong;Jung, Tae Hoon;Ahn, Byeong Cheol;Lee, Jae Tae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.720-727
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    • 1996
  • Objectives: $^{201}TI$ - chloride, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we perfonned three consecutive SPECT using $^{201}TI$, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods: SPECT was carried out at 10min and 3hr for $^{201}TI$ after injection of 20mCi, and 2hr for $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - background(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for $^{201}TI$. Results: The diagnostic sensitivity of $^{201}TI$, $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer. Conclusion : $^{201}TI$ and $^{99m}Tc$ - MIBI showed higher sensitivity than $^{99m}Tc$(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.

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A Study on the Temporomandibular Joint Disorder and School Life Stress of High School Student by Department (계열별 남자고등학생의 학교생활스트레스와 측두하악장애에 관한 연구)

  • Lee, Jung-Hwa;Choi, Jung-Mi
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.179-185
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    • 2007
  • The purpose of this study targeted on high school student in the department of liberal arts, industry in Daegu metropolitan city, is to get basic data necessary for the development of dental educational program, to discern prevention and treatment of temporomandibular joint disorder by observing the situation temporomandibular joint disorder and contribution element, of relationship of school life stress The results are as follows.: 1. The percentage of occurring temporomandibular joint disorder in the high school resulted in a joint noise at 61.8% and joint dislocation 6.9%, sharp pain 47.5% at time of chewing. 29.8% at the time of the non-chewing, lockjaw 11.3%, a headache appeared at 40.4%.2. In the contribution factor of occurring temporomandibular joint disorder, the cause of joint noise was the clench one's teeth, lip and cheek clench, For the pain at the time of chewing clench one's teeth, one side chewing, over-chewing, lip clench, sideways sleeping showed the difference. (P < 0.01) For the pain at the time of non-chewing, clench one's teeth, bruxism, one side chewing, lip and cheek clench were similar, and for the lockjaw, clench one's teeth, bruxism, sideways sleeping showed the difference. The plum evil thing period at time of the fault writing that statistically showed the difference. For the headache, the contribution factors were the all bad habits mentioned above excluding one side sleeping.(P < 0.01, P < 0.05). 3. The rate of experiencing temporomandibular joint disorder by oral and maxillofacia was 13.4% in industrial department, and 19.6% in liberal arts. And for the factor of wound was that exercise 26.8%, others 24.4%, fall-down 19.5%. And for the industrial, exercise 44.4%, fall-down 22.2%, others 14.9%. The treatment experience appeared at 5.0% in industrial department, 2.9% in liberal arts. And for the medical institutions, liberal arts were dental clinic 50%, orthopedics 50%, and the industrial department orthopedics 40%, oriental medicine clinic 30%, dental clinic 30%. 4. In case of temporomandibular joint disorder, there were no difference by grades or educational background. And at the time of chewing or non-chewing showed similar difference.(P < 0.01). 5. Compared to stress in the high school, it generally showed higher in liberal arts than in industrial department due to school record. Its scope was $3.75{\pm}1.14$ in liberal arts, $3.01{\pm}1.23$ in industrial department. 6. The school record, school life, stress problems by teachers, chewing/non-chewing pain of temporomandibular joint disorder, joint noise had a similar correlation.(P < 0.01, < 0.05).

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Prevalence and Infection Status of Salmonella in 25 Conventional Swine Farms in Korea (국내 25개 양돈장의 살모넬라 유병율 및 감염유형)

  • Park, Choi-Kyu;Kim, Hee-Jung;Kim, Jin-Hyun;Cho, Jae-Keun;Kim, Young-Hwa;Jung, Yoon-Soo;Bae, Chae-Wun;Park, Jun-Cheol;Kim, In-Cheul;Kim, Ki-Seuk
    • Journal of Life Science
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    • v.23 no.10
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    • pp.1267-1272
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    • 2013
  • The aim of this study was to determine the prevalence and infection status of Salmonella species (spp.) in 25 conventional pig farms by traditional fecal culture and serological methods to develop a Salmonella control program for Korean pig farms. The individual seroprevalence of Salmonella spp. in pigs reared in the 25 pig farms was 83.1% in sows and 6.4-32% in different aged pig groups, with the total seroprevalence 28.4% (141/848). The seroprevalence of the tested pigs increased in accordance with the decrease in maternal antibody and the rearing period on these farms. Of note, all the 25 pig farms contained at least two or more anti-Salmonella antibody-positive sows. In the fecal cultures Salmonella spp. were isolated only in three (12.0%, 3/25) of 16 serologically Salmonella-suspected farms (64.0%, 16/25), showing the limitation of the fecal culture method and the need for serum assays to understand the exact status of Salmonella infection in swine herds, which likely contain subclinically infected pigs or carriers. The results highlight the need to establish a supply system of Salmonella-free gilts for the promotion of a national Salmonella control program on swine farms in Korea. Further studies will be needed to develop an effective monitoring system for the implementation of a national Salmonella control program.

The Relationship of Anxiety Symptoms and Depressive Symptoms to Glycemic Control in Diabetic Patients (당뇨병 환자에서 우울증상 및 불안증상과 혈당조절과의 연관성)

  • Jeon, Byung-Hee;Kim, Hyun-Woo;Kim, Hee-Jin;Lim, Myung-Ho;Lee, Seok-Bum;Paik, Ki-Chung;Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.2
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    • pp.95-102
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    • 2008
  • Objectives : Diabetes patients suffer from severe stress in maintaining the diet therapy and exercise therapy as well as the disease itself, and this stress has bad effects on controlling the glucose level and causes high prevalence rate of depressive and anxiety disorders. These symptoms again have deleterious effects on blood glucose control. A lot of researches about the relationship between glycemic control and symptoms of depression and anxiety and about the positive effects of the treatments of depression and anxiety disorder on glycemic control in diabetic patients are being performed. In Korea, the research regarding the relationship between glycemic control and depression and anxiety symptoms are seldom performed. In this study, we tried to find out the correlation between the glycemic control and depressive symptom and anxiety symptom. Methods : The study included 65 patients(male 34, female 31) with Diabetes in outpatient clinic of the Department of Endocrinology in Dankook University Hospital. We used the HbA1c levels to check glycemic control through blood sample analysis and used Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). Results : Among the 65 Diabetes patients, 21(32.30%) had mild depressive symptoms, and 6(9.23%) had moderate or severe depressive symptoms. The relation of HbA1c and BDI was not statistically significant, but was significant between HBA1c and BAI, (R=0.567, P<0.001). In the linear regression analysis, BAI had an effect on HbA1c($\beta=0.533$, T=5.012, P=0.00), but BDI, diabetes complications, diabetic morbid period and BMI had no effect on HbA1C. The relationship between HbA1c and BDI was not statistically significant, but the relationship between HbA1c and BAI was statistically significant(R=0.254, P<0.001). Conclusions : In this study, the rates of diabetic patients with depressive symptoms were higher, but those with anxiety symptoms were not higher than the general population. We could not find out significant relationship between depressive symptom and glycemic control, but found the significant relationship between the anxiety symptom and glycemic control in diabetic patients.

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Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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Supplementary Effects of Lentinus edodes with Different Harvest Period and Part on Neurotransmitters and Lipid Peroxide Levels in the Brain of Diabetic Mice (채취 시기 및 부위가 다른 표고버섯의 급여가 당뇨 마우스 뇌조직의 신경전달물질 및 지질과산화물 수준에 미치는 영향)

  • Park, Hong-Ju;Kim, Dae-Ik;Lee, Sung-Hyon;Lee, Young-Min;Jeong, Hyun-Jin;Cho, Soo-Muk;Chun, Jye-Kyung;S. Lillehoj, Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.8
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    • pp.1182-1187
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    • 2005
  • This study was designed to investigate the supplementary effects of Lentinus edodes which were harvested at different time period and part on acetylcholine content and its related enzyme activities in the brain of diabetic mouse model (KK mouse). We fed mice with standard diet (Control diet; CON) or 4 different kinds of experimental diets (DGC: on time harvested, cap of Dong Go; DGS: on time harvested, stipe of Dong Go; HSC: late harvested, cap of Hyang Sin: HSS: late harvested, stipe of Hyang Sin) to KK mouse for 8 weeks. Neurotransmitter such as acetylcholine contents, acetylcholinesterase activities, monoamine oxidase-B ac-tivities and lipid peroxide contents in the brain were measured. The results showed that acetylcholine content was significantly higher in DGC and HSC groups than CON group. The activities of acetylcholinesterase and monoamine oxidase-B enzyme were significantly inhibited in the brain of DGC and HSC groups compared with CON group. Lipid peroxide content was lower in DGC group than CON group. These results suggested that the cap of Lentinus edodes which were harvested on time and late time contain increased acetylcholine content and decreased acetylcholinesterase activities, monoamine oxidase-B activities and lipid peroxide contents. Thus the cap of Lentinus edodes which were harvested at different time periods may play an effective role in enhancing cognitive function.

Life Style and Eating Behavior of Stroke Patients in Daegu and Gyeongbuk Province, Korea (대구.경북지역 뇌졸중 환자의 생활습관 및 식행동 특성)

  • Sung, Su-Jung;Jung, Doo-Gyo;Lee, Won-Kee;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.3
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    • pp.319-332
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    • 2009
  • The present study was performed to analyze the life style and eating behavior of stroke patients and to find the risk factors related to stroke incidence in Daegu and Gyeongbuk Province, Korea. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community inhabitants who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews using questionnaires on the general characteristics, life-style, eating behavior, food intake frequency and food preference. The high body mass index, preexisting diseases such as diabetes and hypertension, stroke family history, smoking, overeating habit and high preference for sweet, greasy and meat foods appeared to be the risk factors for stroke incidence. On the other hand, the results suggest that life style of regular exercise and nonsmoking, food habits of green tea drinking and enough chewing, preference for Korean meal type, high intake frequency for legumes, vegetables, mushrooms, seaweeds, fishes and shell fishes, soy milk and green tea might be the protective factors for the stroke. Therefore, maintenance of healthy weight, the prevention and management of the deteriorative chronic diseases, change of life style and improvement of eating behaviors are considered to be important for stroke prevention.