• Title/Summary/Keyword: Clinical Practice

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Effect of diabetes-specific oral nutritional supplements with allulose on weight and glycemic profiles in overweight or obese type 2 diabetic patients

  • Jihye Tak;Minkyung Bok;Hyunkyung Rho;Ju Hyun Park;Yunsook Lim;Suk Chon;Hyunjung Lim
    • Nutrition Research and Practice
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    • v.17 no.2
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    • pp.241-256
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    • 2023
  • BACKGROUND/OBJECTIVES: Diabetes-specific oral nutritional supplements (ONS) have anti-hyperglycemic effects, while D-allulose exerts anti-diabetic and anti-obesity effects. In this study, we investigated the efficacy and safety of diabetes-specific ONS, including allulose, on glycemic and weight changes in overweight or obese patients with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A single-arm, historical-control pilot clinical trial was conducted on 26 overweight or obese patients with T2DM (age range: 30-70 yrs). The participants were administered 2 packs of diabetes-specific ONS, including allulose (200 kcal/200 mL), every morning for 8 weeks. The glycemic profiles, obesity-related parameters, and lipid profiles were assessed to evaluate the efficacy of ONS. RESULTS: After 8 weeks, fasting blood glucose (FBG) level significantly decreased from 139.00 ± 29.66 mg/dL to 126.08 ± 32.00 mg/dL (P = 0.007) and glycosylated hemoglobin (HbA1c) improved (7.23 ± 0.82% vs. 7.03 ± 0.69%, P = 0.041). Moreover, the fasting insulin (δ: -1.81 ± 3.61 μU/mL, P = 0.017) and homeostasis model assessment for insulin resistance (HOMA-IR) (δ: -0.87 ± 1.57, P = 0.009) levels decreased at 8 weeks, and body weight significantly decreased from 67.20 ± 8.29 kg to 66.43 ± 8.12 kg (P = 0.008). Body mass index (BMI) also decreased in accordance with this (from 25.59 ± 1.82 kg/m2 to 25.30 ± 1.86 kg/m2, P = 0.009), as did waist circumference (δ: -1.31 ± 2.04 cm, P = 0.003). CONCLUSIONS: The consumption of diabetes-specific ONS with allulose in overweight or obese patients with T2DM improved glycemic profiles, such as FBG, HbA1c, and HOMA-IR, and reduced body weight and BMI.

Development and Validation of AI Image Segmentation Model for CT Image-Based Sarcopenia Diagnosis (CT 영상 기반 근감소증 진단을 위한 AI 영상분할 모델 개발 및 검증)

  • Lee Chung-Sub;Lim Dong-Wook;Noh Si-Hyeong;Kim Tae-Hoon;Ko Yousun;Kim Kyung Won;Jeong Chang-Won
    • KIPS Transactions on Computer and Communication Systems
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    • v.12 no.3
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    • pp.119-126
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    • 2023
  • Sarcopenia is not well known enough to be classified as a disease in 2021 in Korea, but it is recognized as a social problem in developed countries that have entered an aging society. The diagnosis of sarcopenia follows the international standard guidelines presented by the European Working Group for Sarcopenia in Older People (EWGSOP) and the d Asian Working Group for Sarcopenia (AWGS). Recently, it is recommended to evaluate muscle function by using physical performance evaluation, walking speed measurement, and standing test in addition to absolute muscle mass as a diagnostic method. As a representative method for measuring muscle mass, the body composition analysis method using DEXA has been formally implemented in clinical practice. In addition, various studies for measuring muscle mass using abdominal images of MRI or CT are being actively conducted. In this paper, we develop an AI image segmentation model based on abdominal images of CT with a relatively short imaging time for the diagnosis of sarcopenia and describe the multicenter validation. We developed an artificial intelligence model using U-Net that can automatically segment muscle, subcutaneous fat, and visceral fat by selecting the L3 region from the CT image. Also, to evaluate the performance of the model, internal verification was performed by calculating the intersection over union (IOU) of the partitioned area, and the results of external verification using data from other hospitals are shown. Based on the verification results, we tried to review and supplement the problems and solutions.

The Effect of Flipped Learning in Health and Physical Assessment Practice Classes on Academic Self-efficacy, Achievement Goal, Cognitive Engagement of Nursing Students (건강사정실습 수업에서의 플립러닝이 간호대학생의 학업적 자기효능감, 성취목표, 인지적 관여에 미치는 영향)

  • Mihye Lim;Taehui Kim
    • Journal of Industrial Convergence
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    • v.21 no.3
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    • pp.107-115
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    • 2023
  • This study was conducted to test the effect of flipped learning on academic self-efficacy, achievement goal, cognitive engagement of nursing students. This study used a one group pre-post test design. Participants were 91 students who were taking the health and physical assessment in nursing. The flipped learning was provided for 5 times (10 hours). The data of 91 people who agreed to the study and responded to the pre and post questionnaires were analyzed. Data were collected between September 26 and November 25, 2022. Data were analyzed by frequencies, paired t-test using SPSS WIN 24.0. The results showed that self-efficacy of learning(t=-5.445, p<.001), and cognitive engagement(t=-2.120, p=.035) increased significantly. As a result of the study, it was proved that flipped learning is effective for self-efficacy of learning and cognitive engagement. But it is necessary to conduct repeated studies due to limitations in research design, and to explore ways to utilize various teaching-learning strategies to improve the learning ability and clinical performance of nursing students.

Current Trends in the Treatment of Ankle Ligament Injuries: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (족관절 인대 손상 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Lee, Myoungjin;Lee, Jun Young;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.22-29
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    • 2022
  • Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

A literatual study on the acupuncture and moxibustion for hemiparesis of stroke in Euibujipsung (중풍 후 운동 장애에 대한 『의부집성(醫部集成)』의 침구치료 고찰)

  • Jeong, Dong-won;Min, In-kyu;Moon, Sang-kwan;Park, Seong-uk;Jung, Woo-sang;Park, Jung-mee;Ko, Chang-nam;Cho, Ki-ho;Bae, Hyung-sup;Kim, Young-suk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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    • pp.34-39
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    • 2006
  • Objectives and methods : The Euibujipsung is the one of the huge-scale encyclopedias about Oriental Medicine. To investigate the most frequently used acupoints for hemiparesis after stroke, we used Euibujipsung CR-ROM database with several key words concerned with motor weakness (半身不遂 不遂不隨 癱瘓 中臟 中腑 風痱, etc.). Results : In the result, we found five popular acupoints (GV20, LI11, LI15, ST36 and GB39), and four meridians (Stomach, Gall bladder, Large intestine and Small intestine). We also found that the Yang meridians were cited more frequently than the Yin. Conclusion : Therefore we think that these findings can give further ideas to clinical practice and research fields for stroke rehabilitation in Oriental medicine.

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A Literatual Study on the Acupuncture and Moxibustion for Dysarthria of Stroke in Euibujipsung (중풍 후 언어 장애에 대한 ☐☐의부집성(醫部集成)☐☐의 침구치료 고찰)

  • Jeong, Dong-won;Min, In-kyu;Moon, Sang-kwan;Na, Byong-jo;Hong, Jin-woo;Park, Seong-uk;Jung, Woo-sang;Park, Jung-mee;Ko, Chang-nam;Cho, Ki-ho;Bae, Hyung-sup;Kim, Young-suk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.8 no.1
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    • pp.28-33
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    • 2007
  • Objectives and methods : The Euibujipsung is one of the huge-scale encyclopedias about Oriental Medicine. To search the most frequently used aupoints for dysarthria after stroke, we used Euibujipsung CD-ROM database with several chinese character keyword concerned with vernal function(語, 言, 音, 啞, 瘖, etc). Results : We found four popular acupoints(PC5, GV20, GV16, TE6), and five meridians (Governor vessel, Gall Bladder, Heart, Large Intestine and Triple Energizer). We also found that the extra meridians were used more frequently than other type of meridians. Conclusion : We think that these findings can give further ideas to clinical practice and research fields for stroke rehabilitation in Oriental medicine.

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Research for the Development of an Integrated Medical System for Idiopathic Pulmonary Fibrosis: Based on an Analysis of Questionnaire Survey in Doctor and Patient Groups (특발성 폐섬유증의 통합의료 협진 모델 개발을 위한 의료진 및 환자 대상 설문조사 연구)

  • Jiwon Park;Beom-Joon Lee;Jeong-Won Shin;Su-Hyun Chin;Jung-Min Yang;Sooduk Kim;Kwan-Il Kim;Hye Sook Choi;Hee-Jae Jung
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.366-386
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    • 2023
  • Objective: In this study, a questionnaire survey was conducted for doctors and patients to obtain basic data necessary for the development of an integrated medical system for idiopathic pulmonary fibrosis (IPF). Methods: Questionnaires were developed separately for doctors and patients through an expert group meeting. The survey subjects were recruited online and offline, and finally, responses from 231 doctors and 59 patients were used for statistical analysis. Results: The most important parts in the treatment of IPF for both doctors and patients were the "improvement of respiratory symptoms," "improvement of quality of life," and "prevention of disease progression." Antifibrotic agents were prescribed at a high rate, and 100% of the specialists in Western medicine (WM) and 45.8% of patients reported experiencing side effects. As for the additional payment costs that patients considered as affordable for an integrated medical system, "under 50,000 won (about 38$)" was reported the most in both doctor and patient groups. With regard to the reasons for their reluctance to recommend an integrated medical system for IPF, specialists in WM responded highly to "uncertain evidence for treatment effectiveness." Regarding complementary and alternative medicine therapies that can be beneficial in patients with IPF, "lifestyle management," "diet management," "herb," "relaxation therapy," and "psychotherapy" were ranked high in both doctor and patient groups. Conclusions: In this study, a questionnaire survey on IPF was conducted to review actual treatment status, analyze shortcomings, and identify considerations for the development of an integrated medical system for IPF in the future.

The Effect on Drooling of Applying Kinesiology Tape to the Orbicularis Oris Muscle in Children with Cerebral Palsy: A Case Study (입 둘레근에 키네시올로지 테이프 적용이 뇌성마비 아동의 침흘림에 미치는 영향: 단일대상연구)

  • Jeon, Joo young;Seo, Sang Min
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.11-22
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    • 2023
  • Objective : The purpose of this study was to examine the effects of using Kinesiology Tape (KT) for drooling in children with cerebral palsy. Methods : A single-case experimental design with an ABA design was conducted. A total of 46 sessions were conducted, consisting of three baseline sessions (A), 40 intervention sessions (B), and three baseline sessions (A'). The Drooling Impact Scale (DIS) and the Interlabial Gap (IG) were measured before and after the KT intervention, and a Goal Attainment Scale (GAS) was assessed to determine whether there was any change in the target activity for each session. The KT intervention was attached to the orbicularis oris muscle. The KT intervention time was set as the time taken for dysphagia intervention and the actual meal time, for up to one hour a day, for a total of eight weeks. Results : The results of the study showed that the KT intervention had an effect on both the DIS and the IG, and that the GAS scale indicated that target activity increased with each session. Conclusion : These results indicate that the KT intervention can easily be applied to children with cerebral palsy who suffer from drooling, whether in clinical practice, by therapists, or caregivers, and that it can be used for various purposes.

Effect of Virtual Reality-based Occupational Therapy Interventions for Disabled Children and Adolescents: A Systematic Review (장애 아동 및 청소년에게 가상현실(VR) 기반 작업치료 중재가 미치는 영향: 체계적 고찰)

  • Kim, Man-Je;Gil, Young-Suk;Kang, Set-Byul;Lee, Jae-Shin
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.34-46
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    • 2023
  • Objective : The purpose of this study was to systematically analyze the methods by which virtual reality (VR)-based occupational therapy interventions are applied to disabled children and adolescents and to assess their effectiveness. Methods : The RISS, DBpia, KCI, Science Direct, and CINAHL MEDLINE databases were searched for relevant literature from January 2012 to August 2022. The main search terms used were "virtual reality," "work therapy," "youth," "virtual reality," "occupational therapy," "child," and "adolescent." A total of 16 documents were selected for analysis by the 4th stage of the PRISMA flowchart. Results : In the 16 selected studies, VR-based occupational therapy when used with children and adolescents with disabilities and was shown to have meaningful effects. Among the types of cerebral palsy covered in the studies, the most common was hemiplegia, and the evaluation tools used for measurement of the VR effect were daily activities, cognition, exercise technology, social-interaction technology, and visual-perception evaluation. Nintendo wii and Microsoft Kinect produced the VR tools most commonly used to improve motor skills and daily life. Conclusion : The results of this study indicate that VR interventions can be used effectively in clinical practice. In the future, they may assist in the diagnosis of disabled children and adolescents, in helping to select VR tools that are suitable for the purposes of intervention, and in the presentation of specific methods.

A parallel plate viscometer for blood viscosity measurement (혈액점도 측정용 평행판 점도계)

  • Donggil Seo;Kyung Hyun Ahn;Jihoon Kang;Sangsoo Park
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.4
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    • pp.331-335
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    • 2023
  • As the viscosity of the blood increases, the blood becomes more sticky and difficult to flow, so the possibility of thrombosis increases and the probability of ischemic cerebral infarction increases. The importance of measuring blood viscosity has recently been emphasized for the prevention of circulatory system diseases, and the need for a viscometer capable of easily and accurately measuring blood viscosity has emerged. In this study, the measured values of a viscosity standard solution and an artificial blood by a parallel-plate viscometer ARS-Medi were compared with the those by Ares-G2 of TA instrument, which is internationally recognized for its accuracy and reliability. The viscosity of N44 standard solution, which is a Newtonian solution, was almost perfectly matched between the two instruments at all shear rates. In the case of an artificial blood, which is a non-Newtonian solution, the measured values between the two instruments showed a difference of about 10% at the lowest shear rate 1 rad/s; however, at a clinically significant shear rate of 10 rad/s or higher, the measured values between them were consistent within the error range. We expect that ARS-Medi, a newly developed parallel-plate viscometer for blood, using disposable plates, will be very useful in clinical practice as it improves the convenience and hygiene of blood viscosity measurement.