• 대한의생명과학회지
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• 제21권4호
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• pp.198-207
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• 2015

ST-segment elevation myocardial infarction (STEMI) and chronic total occlusion (CTO) of coronary artery are well-known atherosclerotic vascular diseases. However, the difference of intima-media thickness and plaque characteristics of carotid arteries between STEMI and CTO patients were not directly compared in previous studies. Medical records of a total of 158 (101 STEMI, 57 CTO) patients, who underwent carotid artery ultrasonography, were selected for the analysis. The baseline characteristics, ultrasonography findings, and clinical outcomes of the two groups were compared. The prevalence of hypertension, diabetes mellitus, and dyslipidemia was significantly higher in CTO patients. Carotid intima-media thickness ($0.97{\pm}0.13$ vs. $0.78{\pm}0.17cm$, P < 0.0001) and number of plaques ($2.2{\pm}1.0$ vs. $1.7{\pm}1.2$, P < 0.0001) were greater in CTO than STEMI patients. Multiple (${\geq}3$) or echogenic plaques were more frequently observed in CTO patients. During the median follow-up duration of 27 months, major adverse cardiovascular events occurred in 31% of CTO and 14% of STEMI patients (P = 0.008). We found that, compared with STEMI, CTO patients have higher burden of carotid artery atherosclerosis associated with more comorbid diseases and poor clinical outcomes.

• Journal of Nutrition and Health
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• 제27권2호
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• pp.172-180
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• 1994

This study showed the psychological symptoms, nutritional status and eating behaviors of diabetic patients. General informations on subjects nutritional status were collected by questionnaire, whereas Symptom Check List-90-Revision(SCL-90R) was used for gathering the data related to psychological problem. 34 diabetics in the hospital, aged 49$\pm$10.5 years old, were chosen as the subjects of this study. Their average height was 162.3$\pm$9.4cm and weight was 57.0$\pm$9.5kg. The average period of their suffering from DM was 54.1 weeks. Among, the subjects, 71.0% adapted diet therapy for their disease, whereas 36.7% and 40.7% did diabetic drugs and daily exercise like walking and jogging, respectively, Among 9 psychological symptoms observed, the scores of somatization, depression, anxiety, phobic anxiety and psychoticism were higher than the standard score, however they were not statistically significant. The score of paranoid ideation was lower than standard score. It was statistically significant. As the measure of their clinical status, BMI(body mass index), PIBW(percent ideal body weight) and fasting blood sugar(FBS) were selected 21.6$\pm$2.8, 102.4$\pm$14.8% and 207.8$\pm$19.9mg/이 respectively. The somatization was significantly correlated with subjects duration of DM. Subjects with psychological problems showed wrong eating behaviors. The fasting blood sugar was significantly correlated with the level of depression.

• Journal of Korean Neurosurgical Society
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• 제38권6호
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• pp.445-449
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• 2005

Objective : This study is performed to evaluate the clinical manifestations and prognostic factors among patients with pyogenic spinal infections. Methods : The records and radiologic data of 27 patients treated between 2001 and 2003 were retrospectively evaluated. Results : All patients [mean age, 55.2yrs] were treated with i.v. antibiotics and 13[48.1%] required surgical treatment. Mean follow up duration was 38.9 weeks. The sixteen patients[59.2%] had previous surgical procedure on spine and six patients[22.0%] had local injections. The ten patients had predisposing factor [such as, diabetes mellitus, UTI, liver cirrhosis, septic condition]. The most common symptoms are lower back pain and motor weakness. Causative organisms determined only in ten patients[37%] and Staphylococcus aureus[50%] was most common. C-reactive protein[CRP] and white blood cell[WBC] count were more correlated with clinical outcome than erythrocyte sedimentation rate[ESR]. Conclusion : CRP and WBC level can be significant parameters of treatment and prognosis in pyogenic spinal infection.

• Journal of Yeungnam Medical Science
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• 제37권4호
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• pp.314-320
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• 2020

Background: A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU). Methods: The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery. Results: Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561-10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087-5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981-0.999), ulcer size (HR, 1.247; 95% CI, 1.107-1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224-0.73) were associated with risk of amputation. Conclusion: Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

• 한국식품영양과학회지
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• 제25권4호
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• pp.601-607
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• 1996

Nineteen non-insulin-dependent diabetic(NIDD) and healthy control women were investigated to study the relationship between glycemic control and the level of calcium, zinc, and magnesium in the serum and urine. Urinary calcium, zinc and magnesium levels in the NIDD women were significantly higher(p<0.01) than those of the control women. There were no difference in serum magnesium and zinc levels between the two groups, but se겨m calcium level was lower(p<0.01) in the NIDD women compared to that of the control group. In the NIDD women, serum magnesium was negatively related to fasting blood glucose(r=-0.533 : p<0.05), urinary glucose(r=-0.767 ; P<0.001), urinary protein(r=-0.476 : p<0.05), and urine volume(r=-0.571 : p<0.05). The levels of zinc in both serum (r=0.515, p<0.05) and urine(r=0.623 : p<0.01) were related to urinary protein but only urinary zinc level(r=0.570 : p<0.01) was related to serum albumin. Urinary magnesium, not calcium was correlated with the urinary glucose(r=0.563 : p<0.05) and urinary protein(r=0.568 ; p<0.05). Fasting blood glucose was positively correlated with duration of diabetes, as well as dietary fat and calorie intake. The results of this study suggest that NIDD alters all magnesium, zinc, and calcium utilization, particularly magnesium is involved in glycemic control in this condition.

• 대한간호학회지
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• 제7권2호
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• pp.83-94
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• 1977

Diabetes Mellitus is a worldwide disease affecting millions of persons and appears to be on the increase in Korea. At the present time it can not be cured but can be controlled. To achieve control the patient must know about the disease. Education of the patient is an essential part of the management of the diabetic and is the responsibility of the nurse. The educational program must be adapted according to patient's knowledge and attitude about their diseases. Therefore, the opportunity to assess the knowledge and attitude of diabetics must provided. The objectives of this study were : 1. To describe the general characteristics of the study population. 2. To find out the characteries of experience of treatment. 3. To exams the knowledge and attitude of diabetics about the self-control. 4. To learn the influencing factors affecting the knowledge and attitude of diabetics about self - control. The study population defined and selected was 65 diabetics registered at the Diabetic Clinic of 5. hospital who visited the Diabetic Clinic from April 16, 1976 to May 14, 1976. The direct interview method was used. Statistical analysis of the data was X²- test. The following results were obtained : A. General characteristics of the study population : The respondent's average age was 50. 8 years old, sex ratio(male to female) revealed as 1 : 1.1, economic background was upper middle class, the most respondents had better than- average education, 75.4 Percents of the respondents lived in Seoul, 47. 2 percents were unemployed, the average size of family was 5.3 and 47.7 percents of respondents had religions. B. The characteristics of clinical experience : The average duration was 7.0 years, 46.1 percents of respondents had experience of hospitalization, 56.9 percents was taking oral drugs, 67.7 percents examined urine- sugar at home, 60.0 Percents had treat compilations and 20.0 percents had experience of coma. C. There was significant difference in the relationship : Between complications and durations of diabetes, hospitalization and therapeutic methods.

• The Korean Journal of Physiology and Pharmacology
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• 제22권5호
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• pp.577-584
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• 2018

Bladder dysfunction is a common complication of diabetes mellitus (DM). However, there have been a few studies evaluating bladder smooth muscle contraction in DM in the presence of pharmacological inhibitors. In the present study, we compared the contractility of bladder smooth muscle from normal rats and DM rats. Furthermore, we utilized pharmacological inhibitors to delineate the mechanisms underlying bladder muscle differences between normal and DM rats. DM was established in 14 days after using a single injection of streptozotocin (65 mg/kg, intraperitoneal) in Sprague-Dawley rats. Bladder smooth muscle contraction was induced electrically using electrical field stimulation consisting of pulse trains at an amplitude of 40 V and pulse duration of 1 ms at frequencies of 2-10 Hz. In this study, the pharmacological inhibitors atropine (muscarinic receptor antagonist), U73122 (phospholipase C inhibitor), DPCPX (adenosine $A_1$ receptor antagonist), udenafil (PDE5 inhibitor), prazosin (${\alpha}_1$-receptor antagonist), verapamil (calcium channel blocker), and chelerythrine (protein kinase C inhibitor) were used to pretreat bladder smooth muscles. It was found that the contractility of bladder smooth muscles from DM rats was lower than that of normal rats. In addition, there were significant differences in percent change of contractility between normal and DM rats following pretreatment with prazosin, udenafil, verapamil, and U73122. In conclusion, we suggest that the decreased bladder muscle contractility in DM rats was a result of perturbations in $PLC/IP_3$-mediated intracellular $Ca^{2+}$ release and PDE5 activity.

• Child Health Nursing Research
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• 제20권3호
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• pp.168-175
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• 2014

목적 본 연구는 당뇨병 캠프에 참여한 1형 당뇨병 아동 및 청소년을 대상으로 자가간호 교육을 제공하고, 이 교육이 아동의 당뇨관리행위, 당뇨지식 그리고 당뇨관리 자아효능감에 미치는 효과를 파악하기 위함이다. 방법 본 연구는 단편적 서술연구로 인천지역 1개 대학병원에서 시행되었고, 대상자는 당뇨병 캠프에 참여한 제1형 당뇨병을 가진 만 8세-19세의 어린이 및 청소년을 편의추출 하였다. 인구사회학적 변수와 임상적 변수를 포함하여 당뇨관리행위, 당뇨지식 그리고 당뇨관리 자아효능감을 자가보고 방법을 이용하여 수집하였다. 결과 연구에 참가한 대상자들은 15명으로 평균 만 12 (${\pm}2.3$)세였고 여자가 53.3%로 약간 많았으며, 평균 HbA1c는 8.8 (${\pm}2.0$)%였다. 자가간호 교육 후, 당뇨관리행위($.56{\pm}.13$ vs $.60{\pm}.17$, p =.101)와 당뇨지식($70.2{\pm}15.7$ vs $71.6{\pm}14.7$, p =.606)은 점수가 향상하였고, 당뇨관리 자아효능감($6.2{\pm}2.1$ vs $6.1{\pm}2.6$, p =.883)은 감소하였으나 모두 통계적으로 유의하지는 못하였다. 또한, 자가간호 교육 후 향상된 당뇨관련 행위점수와 인구사회학적, 임상적, 사회 심리적 변수와의 상관관계를 탐색해 본 결과 총점과 통계적으로 유의한 상관관계를 보인 변수는 없었다. 결론 당뇨병 캠프 안에서 자가간호 교육 제공은 제1형 당뇨병 아동 및 청소년의 당뇨에게 당뇨관리행위, 당뇨지식 및 당뇨관리 자아효능감의 일부 영역을 향상시켰다. 앞으로 이러한 아동들의 다양한 건강 요구를 반영하면서, 집중적이고 지속적인 교육을 제공할 수 있는 다양한 형태의 교육이 개발되어야 한다.

• Clinical and Experimental Pediatrics
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• 제50권2호
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• pp.190-197
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• 2007

목 적: 1형 당뇨병 소아, 청소년에서 혈당 조절이 불량하면 성장 장애와 미세혈관 합병증이 발생할 수 있다. 1형 당뇨병이 성장에 미치는 영향과 미세혈관 합병증(당뇨병성 신병증 또는 망막병증) 발생과 관련된 요인을 파악하고자 하였다. 방 법: 서울대병원에서 추적 중인 16세 이상의 154명 환자들의 의무기록을 후향적으로 분석하였다. 성인키 SDS(standard deviation score)에 영향을 미치는 요인을 분석하였고 합병증 유무, 미세알부민뇨의 경과에 따라 군을 나누어 특징을 비교하였다. 결 과: 성인키 SDS는 $-0.11{\pm}1.15$(여 $-0.26{\pm}1.33$, 남 $0.04{\pm}0.91$)였다. 성인키 SDS는 중간부모키 SDS에 비해 작았고(여 P=0.001, 남 P=0.002), 진단시 키 SDS에 비해서도 유의하게 감소하였다(여 P<0.001, 남 P=0.013). 진단시 사춘기 유무, 합병증 유무, 혈당 조절 정도, 이환 기간은 성인키 SDS에 영향을 미치지 않았다. 사춘기 시작시 키 SDS, 중간부모키 SDS, 사춘기 성장이 성인키 SDS에 영향을 미치는 요인이었다. 합병증이 발생한 37명(24%) 중에서 신병증은 29명, 망막병증은 19명, 동반된 경우는 11명이었다. 사춘기 전에 발병한 환자들은 사춘기에 발병한 환자들에 비해 첫 합병증이 발생한 연령은 더 낮았으나 첫 합병증 발생까지의 유병 기간은 더 길었다. 합병증이 발생한 그룹은 합병증이 없는 그룹보다 평균당화혈색소가 더 높았다. 미세알부민뇨가 소실된 환자들은 미세알부민뇨가 지속되거나 현성 신병증으로 진행한 환자들에 비해 평균당화혈색소, 수축기 혈압, 두 번째 측정한 24시간 소변 미세알부민 수치가 더 낮았다. 결 론: 1형 당뇨병 환자의 성인키는 혈당 조절 정도의 영향을 받지 않았지만, 중간부모키, 진단시 키에 비해 감소하여 당뇨병의 여러 요인에 의해 성장소실이 가능함을 알 수 있었다. 미세혈관 합병증 발생을 예방하기 위해서는 철저한 혈당 조절이 필요하다. 혈당 조절이 불량하거나 사춘기가 시작되면 미세혈관 합병증에 대한 선별검사를 시행해야 한다.

• Nuclear Medicine and Molecular Imaging
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• 제40권3호
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• pp.155-162
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• 2006

목적 : 당뇨병 환자에서는 관동맥질환의 이환율이 높고 무통성 심근경색과 심근허혈의 빈도가 높아 조기발견이 어렵다. 또한 진단될 당시에 이미 심각한 수준의 관동맥질환을 가지고 있는 경우가 많다. 본 연구에서는 Tc-99m MIBI 심근관류 SPECT을 이용하여 당뇨병 환자에서 관동맥질환의 빈도를 평가하고 전통적인 심장위험 인자들을 포함한 여러 임상시험인자들 중에서 진단이 필요한 고위험군 환자들을 예측할 수 있는 인자들을 알아보고자 하였다. 대상 및 방법 : 2000년 1월부터 2004년 7월 사이에 심근관류 SPECT 검사가 의뢰된 203명의 당뇨병환자(남 64명, 평균연령 $64.9{\pm}9.0$세)를 대상으로 하였다. 심장사망 및 비치명적 심근경색을 중증심장사건으로 정의하였고, 검사 후 60일 이후에 경피적 관동맥성형술이나 관동맥 우회수술을 시행한 정도의 심근허혈의 악화를 경증심장사건으로 정의하였다. 환자들은 운동 부하 (n=6) 혹은 adenosine (n=197) 부하 Tc-99m MIBI 심근관류 SPECT을 시행하였다. 이중검출기(ADAC, USA) 혹은 삼중검출기 감마카메라(PRISM 3000, Picker, USA)를 이용하여 SPECT 영상을 획득하였다. 결과: 심근관류 SPECT 결과 관동맥질환이 진단된 환자들은 58명으로 전체 대상 환자 중 28.6%였다. 총 11건의 중증심장사건, 즉 비치명적 심근경색이 발생하였고 10건의 경증심장사건이 관찰되었다. 전체 대상 당뇨병 환자들의 연간 심장사건 발생률은 1.1%였다. 임상인자들의 단변량 분석 결과, 전형적인 협심증상, 말초혈관병증, 다발성 말초신경병증, 그리고 안정시 심전도상 이상이 심장사건의 발생과 유의한 관련성이 있는 것으로 나타났다. 다변량 분석에서는 전형적인 협심증상, 말초혈관병증, 그리고 안정시 심전도상 이상만이 비치명적 심근경색 발생에 대한 독립적인 예측인자인 것으로 나타났다. SPECT 검사상 관류 이상 소견이 있었던 환자들에게서 중증 심장사건이 일어나는 빈도도 높았으나 심장사건의 독립적인 예측인자는 아니었다. 결론: 당뇨병 환자에서 관동맥질환의 빈도는 정상건강인들에 비해 높았다. 특히 남자, 20년 이상의 긴 당뇨병 이환 기간, 말초혈관병증, 다발성 말초신경병증, 또는 안정시 심전도 이상을 가지고 있는 환자들에서 유의하게 더 높은 빈도로 관동맥질환이 나타남을 알 수 있었다. 그리고 전형적인 협심증상, 말초혈관병증, 다발성 말초신경병증, 안정시 심전도 이상이 있는 환자들에서 이후 중증 심장사건이 발생할 위험이 더 큰 것으로 나타났다.