• 대한의용생체공학회:의공학회지
• /
• 제22권4호
• /
• pp.369-375
• /
• 2001

The statistical regression model is one of the most frequently used clinical analysis methods. It has basic assumption of linearity, additivity and normal distribution of data. However, most of biological data in medical field are nonlinear and unevenly distributed. To overcome the discrepancy between the basic assumption of statistical model and actual biological data, we propose a new analytical method based on artificial neural network. The newly developed multilayer perceptron(MLP) is trained with 120 data set (60 normal, 60 patient). On applying test data, it shows the discrimination power of 0.76. The diabetic risk factors were also identified from the MLP neural network model and the logistic regression model. The signigicant risk factors identified by MLP model were post prandial glucose level(PP2), sex(male), fasting blood sugar(FBS) level, age, SBP, AC and WHR. Those from the regression model are sex(male), PP2, age and FBS. The combined risk factors can be identified using the MLP model. Those are total cholesterol and body weight, which is consistent with the result of other clinical studies. From this experiment we have learned that MLP can be applied to the combined risk factor analysis of biological data which can not be provided by the conventional statistical method.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권2호
• /
• pp.152-156
• /
• 1994

Rhinocerebral mucormycosis is an acute fulminant opportunistic fungal infection in debilitated patients with underlying pathologic conditions, which are diabetic ketoacidosis, immunosuppressed disease. We experienced a case of rhinocerebral mucormycosis. The patient was 41 year-old female, who had diabetes for five years and suffered from left facial swelling and pain, left ophthalmoplegia and facial skin necrosis. Total maxillectomy was done combined with systemic Amphotericin B therapy, Biopsy proved mucormycosis but she expired.

• 한방안이비인후피부과학회지
• /
• 제33권3호
• /
• pp.125-137
• /
• 2020

Objectives : Charcot neuroarthropathy(CN) is condition characterized by a progressive joint deformation with sensorial and autonomic neuropathy. This study is to report a case of CN improved by Korean medical treatment. Methods : The patient's left foot with CN was treated by Shudihuangkushen-tang, Haifu-san wet dressing, acupuncture and herbal acupuncture. We evaluated the progress by laboratory investigation, radiograph and photograph comparison, visual analogue scale(VAS) of edema and pain sensation. Results : After treatment, VAS score of edema dropped from 6 to 1, of pain sensation slightly improved from 0 to 1. Average blood sugar level decreased and rebounded, but Hemoglobin A1c level improved from 9.5% to 7.7%. Improvement of the left foot was recognized from the radiograph and photograph comparison. Conclusions : This study suggests Korean medicine is effective in treating CN, especially using Shudihuangkushen-tang, Haifu-san wet dressing.

• Tuberculosis and Respiratory Diseases
• /
• 제70권4호
• /
• pp.338-341
• /
• 2011

Hydatid disease is caused by the larval stage of taenia $Echinococcus$, which endemic in the Mediterranean region. Recently, the prevalence of the disease has increased worldwide due to an increase in the frequency of travel and immigration. As the infested larvae migrate through the bloodstream, the final destination is most commonly the liver or lungs; direct pleural invasion is very rare. A 50-year-old diabetic Korean man presented with an incidentally noted 2 cm right pleural nodule. On follow up imaging after three months, its size had increased. To confirm the diagnosis of the lesion, surgical excision was performed. Histopathological examination showed the diagnosis of a hydatid cyst. The patient had no history of overseas travel, but lives in an urban area where many foreign workers from endemic countries reside. This is the first reported case of primary pleural hydatid disease in a non-endemic country.

• 기본간호학회지
• /
• 제13권2호
• /
• pp.235-241
• /
• 2006

Purpose: The purpose of this study was to evaluate the effect of a six month web-based diabetic education on plasma glucose in people with diabetes. Method: A randomized design with control and experimental groups being assessed pre- and post-intervention was used. Seventeen patients were randomly assigned to a control group and 18 to an experimental group. Participants were requested to input the blood glucose level weekly to http://www.biodang.com by cellular phone or wire Internet for 6 months. The researcher sent optimal recommendations to each patient using the short message service (SMS) for cellular phone and wire Internet. Messages were sent weekly for 6 months. Results: Glycosylated hemoglobin ($HbA_1c$) decreased 1.5 percentage points at 3 months and 1.4 percentage points at 6 months compared with baseline in the intervention group. Patients in the intervention group had a decrease in 2 hours post meal glucose (2HPMG) of 94.3mg/dl at 3 months and 82.5mg/dl at 6 months compared with baseline. Conclusion: This web-based intervention using SMS for cellular phone improved HbAlc, and 2HPMG for six months in patients with type 2 diabetes.

• 중환자간호학회지
• /
• 제12권1호
• /
• pp.57-70
• /
• 2019

Purpose : The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ${\geq}81$, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.

• Archives of Plastic Surgery
• /
• 제49권1호
• /
• pp.86-90
• /
• 2022

Performing a skin graft is not feasible for tendon-exposed defect reconstruction because tendons are fibrous connective tissues with relatively poor blood supply. This study proposes a method to effectively perform skin graft surgery in tendon-exposed wounds. A 48-year-old male patient with diabetes mellitus had a very large left dorsal foot defect (8×8 cm). The wound bed had healthy granular tissue, with tendon exposure. The tendons were turned over so that the posterior side would behave as the anterior side. The edge of the paratenon was then fixed together to the surrounding granulation tissue or dense remnant fascia using absorbable sutures, and the close granulation tissue was approximated and buried. A split-thickness skin graft was performed after 1 week. The graft site was stably taken on postoperative day 3. A small disruption was then observed at the graft site within 1 week postoperatively, but conservative treatment was continued for 1 month, after which the defect site was completely restored. This technique can increase the success rate of skin grafts for defects with tendon exposure.

• 한국간호교육학회지
• /
• 제8권1호
• /
• pp.95-107
• /
• 2002

The purpose of this study is to determine the clinical nurses' knowledge of DM and diabetes patient education aptitude so as to provide a basis for clinical nurse training with respect to diabetes patient education program. The data has been collected through the questionnaires of 42 items from the Knowledge on DM and each 16 item from the Importance on the elements of diabetes patient and the Recognition for clinical nurses, respectfully. 166 nurses from a general hospital who had participated in clinical nurse training in Sep. 28 and Oct. 4, 2001 were subject to respond the questionnaires. Analysis has been done by using statistical method such as percentage, average, standard deviation, t-test, ANOVA, Duncan test and Pearson correlation coefficients. The findings are as follows: 1. Clinical nurses' knowledge levels of diabetes 1) The average level of nurses' knowledge about diabetes is 29.37 (right answer- finding rate: 70%), which is intermediate. 2) Amongst the nurses classified by their knowledge levels about diabetes, the group with less than one year career and that with more than 5 year careers are found to have higher knowledge levels. The item with the highest right answer-finding rate was 'Please find the wrong out of the following examples about foot care'. Meanwhile, the item with highest incorrect answer-finding rate was 'what does blood sugar control aims for amongst gestational diabetes?'. 2. Clinical nurses' importance and perception levels of educational training about diabetes 1) There were no differences amongst nurses' importance level about diabetes. 2) Nurses usually had high scores(4.30) in terms of the items related to the importances about educational training. 3) There were quite high recognitions of general characteristics and symptoms about diabetes, amongst the nurse cohorts working more than one year and less than 5 years, and over 5 years, the group belonging to the internal department, that having the previous experiences of dealing with diabetes, and that having their diabetic relatives and other close people. Meanwhile, strangely, the group who identified themselves as 'not good at treating diabetes' had a high recognition level of educational training about diabetes. 3. Relationship between knowledge levels and importance & perception levels of diabetes 1) The higher knowledge about diabetes nurses had, the more importance they recognized. 2) It is found that there was no relationship between knowledge and perception of diabetes. 3) The more importance about diabetes nurses had, the higher perception they obtained. In conclusion, there is an urgent need for systematic educational programs about diabetes including technical aspects, in order to upgrade and improve nurses knowledge levels. In addition, re-educational training should be provided at regular intervals. Further, we believe the nurses with high knowledge about diabetes and interests in the provision of educations for patients can be far more confident, and in return, patients can have better self-management about diabetes obtained through educations. Based on the above-mentioned findings, we would like to make the suggestion: re-evaluation about nurses' knowledge and cognition levels should be carried out after job training programs about diabetes.

• Nutrition Research and Practice
• /
• 제14권3호
• /
• pp.218-229
• /
• 2020

BACKGROUND/OBJECTIVES: Type 2 Diabetes mellitus (T2DM) is a hereditary disease that is also strongly dependent on environmental factors, lifestyles, and dietary habits. This study explored the relationship between lifestyle habits and glycosylated hemoglobin management in T2DM patients to provide empirical outcomes to improve T2DM management and patient health literacy. SUBJECTS/METHODS: This study enrolled 349 diabetic patients with more than 5 care visits to a Diabetes Mellitus care network under the Health Management Plan led by Taiwan Department of Health (DOH). Based on relevant literature, an Outpatient Record Form of Diabetes Mellitus Care was designed and lipid profile tests were conducted for data collection and analysis. RESULTS: When modeling the data, the results showed that the odds for HbA1c > 7.5% in T2DM patients duration over 10 years was 3.785 (P = 0.002) times that in patients with disease duration of fewer than 3 years. The odds of HbA1c > 7.5% in illiterate patients was 3.128 (P = 0.039) times that in patients with senior high school education or above. The odds of HbA1c > 7.5% in patients with other chronic illness was 2.207 (P = 0.019) times that in participants without chronic illness. Among 5 beneficial lifestyle habits, the odds of HbA1c > 7.5% in patients with 2 or 3 good habits were 3.243 (P = 0.003) and 3.424 (P = 0.001) times that in patients with more than 3 good habits, respectively. CONCLUSION: This empirical outcome shows that maintaining a good lifestyle improves T2DM management and patients' knowledge, motivation, and ability to use health information. Patients with longer disease duration, education, or good lifestyle habits had optimal HbA1c management than those in patients who did not. Thus, effective selfmanagement and precaution in daily life and improved health literacy of diabetic patients are necessary to increase the quality of T2DM care.

• Nutrition Research and Practice
• /
• 제12권1호
• /
• pp.69-77
• /
• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.