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A Comparative Study of Diabetes Mellitus Patients with Cerebral Infarction or without Cerebral Infarction - Focused on Nutrient Intakes and Dietary Quality - (뇌경색 당뇨병 환자와 비뇌경색 당뇨병 환자의 비교연구 - 영양소 섭취, 식사의 질 평가를 중심으로 -)

  • Lim, Hyun-Jung;Woo, Mi-Hye;Moon, Sang-Kwan;Choue, Ryo-Won
    • Journal of Nutrition and Health
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    • v.41 no.7
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    • pp.621-633
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    • 2008
  • Diabetes mellitus (DM) is a well-established independent risk factor for cerebral infarction (CI). Additionally, the DM as well as CI are influenced significantly by health-related behaviors and diets. The aim of this study was to compare the food habits, nutrient intakes, and dietary patterns and quality in DM patients with CI (DM-CI) and without CI. This study was accomplished with 68 subjects (DM-CI group = 28, DM group = 40). Health-related behaviors, food habits, nutrient intakes and dietary quality were investigated. As a result, the mean ages and durations of diabetes in DM-CI and DM groups were $65.6{\pm}9.2$, $10.9{\pm}8.5$ and $69.2{\pm}3.0$, $9.7{\pm}8.4$ years, respectively. The health-related behaviors such as, smoking, alcohol drinking, and regular exercising in both groups were significantly different (p < 0.05) showing the number of subjects who were smoking and drinking alcohol was significantly higher in DM-CI group and the opposit result was seen for exercise. In male subjects, the intake of carbohydrate and sodium of DM-CI group were significantly higher than those of DM group (p < 0.05). In female subjects, the intake of calorie, carbohydrate, fat, sodium, and cholesterol were significantly higher in the DM-CI group (p < 0.05). Daily intake of vitamin $B_1$, vitamin $B_2$, folate, vitamin C, and calcium were significantly higher in DM group (p < 0.05). In the comparison with the dietary reference intake for Koreans (KDRI), vitamin $B_1$, vitamin $B_2$, folate, and calcium intakes were lower in DM-CI group whereas calcium and zinc intakes were in DM group. Moreover, index of nutritional quality (INQ) of vitamin $B_1$, vitamin $B_2$, vitamin C, folate, and calcium were lower significantly in DM-CI group (p < 0.05). Dietary quality including dietary diversity score (DDS), GMVDF (grain, meat, vegetable, dairy, fruit), and dietary quality index (DQI) was significantly lower in DM-CI group (p < 0.05). According to the results, diabetic mellitus patients accompanied by cerebral infarction had poorer eating patterns and dietary quality in accordance with poorer health-related behaviors compared with the DM patients without CI.

Comparison of Left Ventricular Volume and Function between 46 Channel Multi-detector Computed Tomography (MDCT) and Echocardiography (16 채널 Multi-detector 컴퓨터 단층촬영과 심초음파를 이용한 좌심실 용적과 기능의 비교)

  • Park, Chan-Beom;Cho, Min-Seob;Moon, Mi-Hyoung;Cho, Eun-Ju;Lee, Bae-Young;Kim, Chi-Kyung;Jin, Ung
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.45-51
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    • 2007
  • Background: Although echocardiography is usually used for quantitative assessment of left ventricular function, the recently developed 16-slice multidetector computed tomography (MDCT) is not only capable of evaluating the coronary arteries but also left ventricular function. Therefore, the objective of our study was to compare the values of left ventricular function quantified by MDCT to those by echocardiography for evaluation of its regards to clinical applications. Material and Method: From 49 patients who underwent MDCT in our hospital from November 1, 2003 to January 31, 2005, we enrolled 20 patients who underwent echocardiography during the same period for this study. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), stroke volume index (SVI), left ventricular mass index (LVMI), and ejection fraction (EF) were analyzed. Result: Average LVEDVI ($80.86{\pm}34.69mL$ for MDCT vs $60.23{\pm}29.06mL$ for Echocardiography, p<0.01), average LVESVI ($37.96{\pm}24.52mL$ for MDCT vs $25.68{\pm}16.57mL$ for Echocardiography, p<0.01), average SVI ($42.90{\pm}15.86mL$ for MDCT vs $34.54{\pm}17.94mL$ for Echocardiography, p<0.01), average LVMI ($72.14{\pm}25.35mL$ for MDCT vs $130.35{\pm}53.10mL$ for Echocardiography, p<0.01), and average EF ($55.63{\pm}12.91mL$ for MOCT vs $59.95{\pm}12.75ml$ for Echocardiography, p<0.05) showed significant difference between both groups. Average LVEDVI, average LVESVI, and average SVI were higher in MDCT, and average LVMI and average EF were higher in echocardiogram. Comparing correlation for each parameters between both groups, LVEDVI $(r^2=0.74,\;p<0.0001)$, LVESVI $(r^2=0.69,\;p<0.0001)$ and SVI $(r^2=0.55,\;p<0.0001)$ showed high relevance, LVMI $(r^2=0.84,\;p<0.0001)$ showed very high relevance, and $EF (r^2=0.45,\;p=0.0002)$ showed relatively high relevance. Conclusion: Quantitative assessment of left ventricular volume and function using 16-slice MDCT showed high relevance compared with echocardiography, therefore may be a feasible assessment method. However, because the average of each parameters showed significant difference, the absolute values between both studies may not be appropriate for clinical applications. Furthermore, considering the future development of MDCT, we expect to be able to easily evaluate the assessment of coronary artery stenosis along with left ventricular function in coronary artery disease patients.

Analytical Study on the Jehotang in Literature in Terms of Cooking Science (문헌 속 제호탕의 조리학적 분석 연구)

  • Ji, Myoung-Soon;Kim, Jong-Goon
    • Journal of the East Asian Society of Dietary Life
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    • v.18 no.4
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    • pp.446-454
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    • 2008
  • The traditional Korean drink "Jehotang", which is one of the most commonly prescribed drugs for treatment of the heat stroke accompanied by high fever, severe sweat and thirst, it is effective far quenching thirst strengthening the stomach, stopping diarrhea and regulating intestinal function. It is also known to play a role in activating the growth of useful microbes in the intestine and in multiplying intestinal immune cells. Thus, this study investigated all aspects of the drink in an effort to develop a new functional beverage. In the course of this study, the analytical research into the literature concerning Jehotang an error in the secrets of preparing the drink. The Japanese apricot, which was given the botanical name, "Prunusmume", should only be used with the flesh (scientifically referred to as "Fructusmume"), which is fumigated with straw fire before drying. and the seed should be thrown away. The honey should only be used after it is heated with a gentle fire, before removing the white foam that farms on its surface to make the "Yeonmil". Two kinds of cooking processes were found in the ancient literature. One procedure boiling down the powered Fructus mume mixed with the Yeonmil, while the other procedure involved preparing the Fructus mume's water by adding water to it and blending the water with the Yeonmil and the rest of the raw ingredient before boiling them down. The current procedure, in which the cooking is done in a double boiler, has been widely adopted to its simplicity. The finished Jehotang is put in porcelain, kept at room temperature, and consumed after mixing with cold water.

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The Serial Change of Cerebral Hemodynamics by Vascular Territory after Extracranial-Intracranial Bypass Surgery in Patients with Atherosclerosis of Cerebral Arteries (죽상 동맥 경화성 뇌혈관 폐색 환자에서의 두개외강-내강 우회로술 후의 혈관 영역별 연속 혈류역학 변화)

  • Hong, Il-Ki;Kim, Jae-Seung;Ahn, Jae-Sung;Kwon, Sun-Uck;Im, Ki-Chun;Lee, Jai-Hyuen;Moon, Dae-Hyuk
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.8-16
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    • 2008
  • Purpose: To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using $^{99m}Tc$-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). Materials and Methods: The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Results: Seventeen patients (M:F =12:5, mean age $53{\pm}2yr$) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p = 0.003) and decreased to the preoperative level at 3-6 months (p = 0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Conclusion: Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect.

Analysis by Delphi Survey of a Performance Evaluation Index for a Salt Reduction Project (델파이 조사를 통한 저염화사업 성과평가 지표 분석)

  • Kim, Hyun-Hee;Shin, Eun-Kyung;Lee, Hye-Jin;Lee, Nan-Hee;Chun, Byung-Yeol;Ahn, Moon-Young;Lee, Yeon-Kyung
    • Journal of Nutrition and Health
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    • v.42 no.5
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    • pp.486-495
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    • 2009
  • The purpose of this study was to analyze the performance evaluation index for a salt reduction project. Questionnaires were developed in order to investigate salt reduction programs nationwide. The evaluation index and programs were analyzed through the case study of a salt reduction program in public health centers. The validity of the salt reduction program's evaluation index was determined based on study of the Delphi survey and on discussion with nutrition and health care professionals. The Delphi survey showed that daily salt intake was the most valid nutritional evaluation index. Stroke mortality and stomach cancer mortality were good health care evaluation indexes. The method for measuring salt intake that had the greatest validity was a 24-hour urine collection. However, 24-hour urine collection had the lowest score for ease of performance. The combined scores of validity and ease of performance showed that the survey method for dietary attitude and dietary behavior, dietary frequency analysis (DFQ 15), and a salty taste assessment, in that order, were proper methods. The high reliability of the salty taste assessment indicated that the percentage of the population that exhibits proper salt intake (2,000 mg sodium or less daily) and the percentage of the population that consumes low-salt diets as nutritional evaluation indexes also will be helpful to evaluate performance of salt reduction programs.

A Study on The Nursing Needs of Users and their Service Status at Short-Stay Centers for The Elderly (단기노인보호소 이용자의 간호요구도 및 서비스 실태연구)

  • Shin Kyoung Hi;Rhee Seon Ja
    • Journal of Korean Public Health Nursing
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    • v.16 no.2
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    • pp.354-377
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    • 2002
  • Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.

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Age-related Changes of the Finger Photoplethysmogram in Frequency Domain Analysis (연령증가에 따른 지첨용적맥파의 주파수 영역에서의 변화)

  • Nam, Tong-Hyun;Park, Young-Bae;Park, Young-Jae;Shin, Sang-Hoon
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.12 no.1
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    • pp.42-62
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    • 2008
  • Objectives: It is well known that some parameters of the photoplethysmogram (PPG) acquired by time domain contour analysis can be used as markers of vascular aging. But the previous studies that have been performed for frequency domain analysis of the PPG to date have provided only restrictive and fragmentary information. The aim of the present investigation was to determine whether the harmonics extracted from the PPG using a fast Fourier transformation could be used as an index of vascular aging. Methods: The PPG was measured in 600 recruited subjects for 30 second durations, To grasp the gross age-related change of the PPG waveform, we grouped subjects according to gender and age and averaged the PPG signal of one pulse cycle. To calculate the conventional indices of vascular aging, we selected the 5-6 cycles of pulse that the baseline was relatively stable and then acquired the coordinates of the inflection points. For the frequency domain analysis we performed a power spectral analysis on the PPG signals for 30 seconds using a fast Fourier transformation and dissociated the harmonic components from the PPG signals. Results: A final number of 390 subjects (174 males and 216 females) were included in the statistical analysis. The normalized power of the harmonics decreased with age and on a logarithmic scale reduction of the normalized power in the third (r=-0.492, P<0.0001), fourth (r=-0.621, P<0.0001) and fifth harmonic (r=-0.487, P<0.0001) was prominent. From a multiple linear regression analysis, Stiffness index, reflection index and corrected up-stroke time influenced the normalized power of the harmonics on a logarithmic scale. Conclusions: The normalized harmonic power decreased with age in healthy subjects and may be less error prone due to the essential attributes of frequency domain analysis. Therefore, we expect that the normalized harmonic power density can be useful as a vascular aging marker.

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The Cross-sectional Mass Flux Observation at Yeomha Channel, Gyeonggi Bay at Spring Tide During Dry and Flood Season (단면 관측을 통한 경기만 염하수로의 대조기 평수시와 홍수시 유출입량 변화특성 조사)

  • Lee, Dong-Hwan;Yoon, Byung-Il;Kim, Jong-Wook;Gu, Bon-Ho;Woo, Seung-Buhm
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.24 no.1
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    • pp.16-25
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    • 2012
  • To calculate the total mass flux that change in dry and flood season in the Yeomha Channel of Gyeonggi Bay, the 13 hour bottom tracking observation was performed from the southern extremity. The value of the total mass flux(Lagrange flux) was calculated as the sum of the Eulerian flux value and stroke drift value and the tidal residual flow was harmonically analyzed through the least-squares method. Moreover, the average during the tidal cycle is essential to calculate the mass flux and the tidal residual flow and there is the need to equate the grid of repeatedly observed data. Nevertheless, due to the great differences in the studied region, the number of vertical grid tends to change according to time and since the horizontal grid differs according to the transport speed of the ship as a characteristic of the bottom tracking observation, differences occur in the horizontal and vertical grid for each hour. Hence, the present study has vertically and horizontally normalized(sigma coordinate) to equate the grid per each hour. When compared to the z-level coordinate system, the Sigma coordinate system was evaluated to have no irrationalities in data analysis with 5% of error. As a result of the analysis, the tidal residual flow displayed the flow pattern of sagging in the both ends in the main waterway direction of dry season. During flood season, it was confirmed that the tidal residual flow was vertical 2-layer flow. As a result of the total mass flux, the ebb properties of 359 cm/s and 261 cm/s were observed during dry and flood season, respectively. The total mass flux was moving the intertidal region between Youngjong-do and Ganghwa-do.

Snoring Clinic Visitors' Knowledge of Obstructive Sleep Apnea Syndrome (코골이 클리닉을 방문한 환자들의 폐쇄성 수면무호흡증 인식도)

  • Lee, So-Jin;Lee, Jin-Seong;Shin, Hong-Beum;Cho, Sang-Yong;Rhee, Chae-Seo;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.18 no.2
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    • pp.87-94
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    • 2011
  • Objective: OSAS (obstructive sleep apnea syndrome) is a common disorder and its consequences are often serious. It is important to detect the disorder early in the course for proper treatment. This study is to grasp the snoring clinic visitors' knowledge level of OSAS. Method: One hundred and seventy-nine visitors at the of snoring clinic of Seoul National University Hospital were surveyed by questionnaire about reasons of visit and knowledge of treatment methods of snoring and OSAS, diagnostic method, OSAS-related symptoms, and complications. Results: Most of the respondents (89.4%) "have already heard about OSAS" and the major sources of information was the mass media (58.1%) such as television and radio. More than half (60.3%) were aware that snoring is closely related to OSAS. More than half (59.8%) recognized that a nocturnal polysomnograpy was necessary for proper diagnosis. Two thirds (67%) of the respondents noted surgery as a treatment for snoring. More than half (55.9%) answered that they would follow the doctor's advice on the treatment choice. Only 12.3% of respondents "have heard about nCPAP". No one chose nCPAP (nasal continuous positive airway pressure) as a treatment for either snoring or OSAS. About one third (34.6%) of the respondents were aware that OSAS is related to hypertension. Only 12.8% noted that OSAS is related to diabetes mellitus. Conclusion: Visitors at the snoring clinic were found to have substantially limited knowledge of health risks and proper treatments of OSAS. We suggest that it is crucially important to educate patients and offer easy-to-understand information on snoring and OSAS. We predict that provision of educaiton and information to patients and general public will faciliate the diagnosis and treatment of snoring and OSAS and reduce the related disorders such as hypertension, stroke, and diabetes mellitus.

Off Pump Total Arterial Myocardial Revascularization (동맥 도관만을 이용하여 체외심폐순환 없이 시행한 관상동맥우회술)

  • Youn Young Nam;Lee Kyo Joon;Lee Gy Jong;Joo Hyun Chul;Lim Sang Hyun;Kim Seung Ho;Kwak Young Lan;Yoo Kyung Jong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.349-356
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    • 2005
  • Background: Arterial conduits using in coronary artery bypass grafting (CABG) have been known a great long term patency rates, and improved short and long term clinical outcomes. It has been reported that Off pump CABG has better clinical results than CABG using cardiopulmonary bypass. To evaluate the advantage of arterial conduits over venous conduits and to avoid the adverse effects of cardiopulmonary bypass, we performed total arterial Off pump CABG. Material and Method: From January 2001 to October 2004, Off pump CABG using only arterial conduits was performed on 325 patients with a mean age of $59.3\pm11.9$ years ($36\~83$). Mean ejection fraction was $55.4\pm14.0\%\;(15\~86).$ Angiography showed left main disease or triple-vessel disease in $81.9\%$ of the patients. Indications of using arterial conduits was stenosis $\ge50\%$ of left anterior descending artery, stenosis $\ge80\%$ of branches of left circumflex artery, and stenosis $\ge90\%$ of right coronary artery and its branches. Multi-slice computed tomography was performed on 194 patients to evaluate the short term patency rates. Result: A total of 928 distal anastomoses were performed and the average anastomoses per a patient were $2.86\pm0.78$. There was 1 operative mortality. Postoperative complications were mediastinitis in 6 patients ($1.8\%$), renal failure in 4 patients ($1.2\%$), perioperative myocardial infarction in 3 patients ($0.9\%$), reoperation for bleeding in 3 patients ($0.9\%$). There was no postoperative stroke. Patency rate of arterial conduits was $99.3\%$ (581/585). There were 4 stenoses or competitive flows in 2 radial arteries and 2 right internal mammary arteries. Conclusion: Total arterial Off pump CABG appears to be safe, showing a low surgical mortality and morbidity and excellent short term patency rates of arterial conduits.