• 여성건강간호학회지
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• 제27권4호
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• pp.358-367
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• 2021

Purpose: This study aimed to identify factors associated with diabetes management self-efficacy in pregnant women with gestational diabetes mellitus (GDM) in Korea. Methods: A total of 173 pregnant women with GDM in Korea were recruited by posting announcements at two Korean online communities focusing on pregnancy and GDM. Participants completed a structured online survey from July to September 2018. Thirteen inappropriate responses were excluded and a total of 160 questionnaires were used in the final analysis. Descriptive statistics were calculated and multiple regression with the enter method was done to identify the associations of depressive mood, anxiety, emotional intelligence, and sleep quality with diabetes management self-efficacy. Results: Respondents reported a moderately depressive mood (mean, 10.36), low to moderate anxiety (mean, 41.65), above-average emotional intelligence (mean, 78.04), moderate sleep quality (mean, 42.01), and above-average diabetes management self-efficacy (mean, 52.29). The major factor associated with diabetes management self-efficacy of pregnant women with GDM was emotional intelligence (β=.51, p<.001). Other factors, in descending order of influence, were sleep quality (β=.22, p<.001) and exercise (β=.18, p=.004). Taken together, the aforementioned factors explained 34.6% (F=39.53, p<.001) of the total variance. Conclusion: The results of this study suggest that to improve the diabetes management self-efficacy of pregnant women with GDM, it is necessary to develop an education program that can also enhance emotional intelligence, sleep quality, and exercise.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7043-7048
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• 2014

Inhibition of heat shock protein 90 (Hsp90) leads to inappropriate processing of proteins involved in DNA damage repair pathways after DNA damage and may enhance tumor cell radio- and chemotherapy sensitivity. To investigate the potentiation of antitumor efficacy of lidamycin (LDM), an enediyne agent by the Hsp90 inhibitorgeldanamycin (GDM), and possible mechanisms, we have determined effects on ovarian cancer SKOV-3, hepatoma Bel-7402 and HepG2 cells by MTT assay, apoptosis assay, and cell cycle analysis. DNA damage was investigated with H2AX C-terminal phosphorylation (${\gamma}H2AX$) assays. We found that GDM synergistically sensitized SKOV-3 and Bel-7402 cells to the enediyne LDM, and this was accompanied by increased apoptosis. GDM pretreatment resulted in a greater LDM-induced DNA damage and reduced DNA repair as compared with LDM alone. However, in HepG2 cells GDM did not show significant sensitizing effects both in MTT assay and in DNA damage repair. Abrogation of LDM-induced $G_2/M$ arrest by GDM was found in SKOV-3 but not in HepG2 cells. Furthermore, the expression of ATM, related to DNA damage repair responses, was also decreased by GDM in SKOV-3 and Bel-7402 cells but not in HepG2 cells. These results demonstrate that Hsp90 inhibitors may potentiate the antitumor efficacy of LDM, possibly by reducing the repair of LDM-induced DNA damage.

• 여성건강간호학회지
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• 제24권4호
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• pp.367-378
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• 2018

Purpose: To examine effects of a postnatal care program on self-efficacy, self-management, and glycemic control in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. Sixty-two women with GDM were enrolled and assigned to either an experimental group (n=30) or a control group (n=32). The experimental group received an intervention which was postnatal care program for women with GDM. The postnatal care program for GDM included an individual education with leaflet and mobile web-based video with three times of telephone counseling. Effects of the intervention were measured with self-efficacy, self-management questionnaire, and a 75 g oral glucose tolerance test (75g OGTT). Statistical significance was examined using independent t-test and $x^2-test$. Results: Although there was no significant difference in 75g OGTT ($x^2=.11$, p=.748) or self-management (t=-1.28, p=.206), there was a statistically significant increase in self-efficacy (t=-2.02, p=.048) in the experimental group compared to that in the control group. Conclusion: A postnatal care program is needed for women with GDM to improve their self-efficacy. Further studies are warranted to improve self-management and glycemic control through tailored education for GDM postpartum women.

• 여성건강간호학회지
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• 제7권4호
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• pp.419-431
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• 2001

The purpose of this study was to provide the correct knowledge on GDM(Gestational Diabetes Mellitus) to nurses for effective care of pregnant women with GDM by investigating the knowledge of nurses about GDM. The subjects of this study were 557 nurses who work at six general hospitals in Seoul and Gyung-Gi province of Korea. The data were collected from November, 2000 to December, 2000, using a 30-item knowledge questionnaire about GDM consisted of eight areas developed by Choi et al. (2000): characteristics and diagnosis, influence on pregnancy, goal and method of management, diet therapy, exercise therapy, insulin therapy, hypoglycemia and hyperglycemia and postpartum care of GDM. The data were analyzed by SAS program for t-test, ANOVA and Scheffe test. The results were as follows: 1. The mean score of knowledge on GDM was 23.18. 2. There were significant differences according to age(p= 0.002), education background (p= 0.045). working period(p= 0.000), working unit(p= 0000), working experience of obstetric and gynecologic (OS & GY) units(p= 0.000), experience of pregnancy (p=0.003) and experience of delivery (p=0.014) in GDM knowledge. 3. The level of each area on GDM knowledge was as follows; 1) Area of characteristics and diagnosis of GDM The mean score of this area was 0.79. Nurses' knowledges were significantly different by age(p=0.003), marital status (p=0.018), working period(p=0.002) working unit(p=0.007), working experience of OB & GY units(p=0.005), experience of pregnancy(p=0.034) and experience of delivery(p=0.033). 2) Area of influence on pregnancy The mean score of this area was 0.93. Nurses' knowledges were significantly different by age(p=0.006), working unit (p=0.000) and working experience of OB & GY units(p= 0.000). 3) Area of goal and method of management The mean score of this area was 0.70. Nurses' knowledges were significantly different by age(p=0.004), region(p=0.006), education background(p=0.013), marital status(p=0.007), working period(p=0.000), working unit(p=0.011), working experience of OB & GY units(p=0.002), experience of pregnancy(p=0.025) and experience of delivery(p=0.043). 4) Area of diet therapy. The mean score of this area was 0.74. Nurses' knowledges were significantly different by age(p=0.002), region(p=0.011), marital status (p=0.001). working period (p=0.007). working unit(p=0.002), working experience of OB & GY units(p=0.001), experience of pregnancy(p=0.001), experience of delivery(p=0.011) and diabetes patients in family members(p=0.032). 5) Area of exercise therapy. The mean score of this area was 0.83. There were not significant differences in all general characteristics. 6) Area of insulin therapy The mean score of this area was 0.61. Nurses' knowledges were significant differences by age (p=0.024), marital status (p=0.048), working period(p=0.027), working unit(p=0.002), working experience of OB & GY units(p=0.000), experience of pregnancy (p=0.047) and experience of delivery(p=0.040). 7) Area of hypoglycemia and hyperglycemia. The mean score of this area was 0.83. Nurses' knowledges were significantly different by marital status (p=0.027), working period(p=0.001). experience of pregnancy(p=0.020) and experience of delivery(p=0.010). 8) Area of postpartum care The mean score of this area was 0.69. Nurses' knowledges were significantly different by working unit(p=0.000), working experience of OB & GY units (p=0.000) and working experience of medical unit(p=0.047). The results of this study are suggested that nurses might be taught systemically and individually about GDM so that they can become more proficient in detecting and preventing GDM, and therefore they will feel confident to teach GDM to women.

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4265-4269
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• 2014

Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.

• Neonatal Medicine
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• 제18권1호
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• pp.49-58
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• 2011

목적: 임신성 당뇨는 임신의 흔한 합병증 중의 하나이며 임신 성 당뇨 산모의 아기는 정상 산모의 아기에 비해서 체지방률이 높다. Adiponectin은 인슐린 민감성 조직에서 당과 지방 대사를 조절하는 중요한 물질이며, insulin-like growth factor(IGF)-I은 출생 전후기에 성장을 조절하는 중요한 내분비 조절물질로 알려져 있다. 본 연구에서는 임신성 당뇨 산모의 아기에서 제대혈 adiponectin과 IGF-I 수치와 태아 성장과의 관계 및 인슐린 저항성에 대해서 알아보고자 하였다. 방법: 임신성 당뇨 이외에 임신과 관련된 기타 합병증이 동반되지 않은 산모에서 태어난 아기(임신성 당뇨군, N=53)와 정상산모에서 태어난 아기(대조군, N=101)의 제대혈 adiponectin과 IGF-I 수치를 비교하였다. 신생아는 출생 체중에 따라 부당경량아(N=26), 적정체중아(N=97), 부당중량아(N=31)로 세분하였다. 제대혈 adiponectin, IGF-I 농도와 산모의 나이, 분만력, 임신 전 체질량지수, 공복 혈당 및 75 g 경구당부하검사, 임신 중산모 체중 증가, 태아-태반 무게비, 출생시 재태연령, 아기의 성별, 출생체중, 출생신장과의 관계를 비교하였다. 결과: 대조군보다 임신성 당뇨군에서 제대혈 adiponectin의평균이 의미 있게 낮았다(P<0.001). 임신성 당뇨군에서는 부당경량아군, 적정체중아군, 부당중량아군 사이의 제대혈 adiponectin 수치에 유의한 차이를 보이지 않았으나(P=0.228),적정체중아군은 대조군의 적정체중아군에 비해 의미 있게 낮은 adiponectin 수치를 보였다(P<0.001). 제대혈 adiponectin은 산모의 임신 전 체질량지수, 공복혈당, 75 g 경부당부하검사와 음의 상관관계를 가졌고, 출생시 재태연령, 출생체중, 제대혈 IGF-I과 양의 상관관계를 가졌다. 다중선형회귀분석에서 75 g 경부당부하검사가 가장 강력한 예측인자로 나왔다. 임신성 당뇨군과 대조군 사이의 제대혈 IGF-I은 의미 있는 차이를 보이지 않았다(P=0.834). 제대혈 IGF-I은 출생체중이 높은 군일수록 의미 있게 높았다(P<0.001). 제대혈 IGF-I은 산모의 연령, 분만력, 출생체중, 출생신장, 제대혈 adiponectin과 유의한 양의 상관관계를 보였고, 이 중에서 출생체중과 분만력이 가장 강력한 예측인자였다. 결론: 산모의 임신성 당뇨는 제대혈 adiponectin을 낮춘다. 제대혈 adiponectin과 IGF-I 모두 출생체중과 연관성을 보였지만 IGF-I이 태아의 성장에 좀 더 직접적인 영향을 미치며, adiponectin은 성장보다는 인슐린 저항성과 더 연관이 있는 것으로 생각된다. 그러므로 임신성 당뇨를 가진 산모에서 태어난 아기는 적정체중아일지라도 생후 성장과 인슐린 저항성의 변화를 추적 관찰하는 것이 중요할 것이다.

• 한국수자원학회:학술대회논문집
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• 한국수자원학회 2018년도 학술발표회
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• pp.448-448
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• 2018

In this study, the regression models (Load ESTimator and eight-parameter model) were evaluated to estimate instantaneous pollutant loads under various criteria and optimization methods. As shown in the results, LOADEST commonly used in interpolating pollutant loads could not necessarily provide the best results with the automatic selected regression model. It is inferred that the various regression models in LOADEST need to be considered to find the best solution based on the characteristics of watersheds applied. The recently developed eight-parameter model integrated with Genetic Algorithm (GA) and Gradient Descent Method (GDM) were also compared with LOADEST indicating that the eight-parameter model performed better than LOADEST, but it showed different behaviors in calibration and validation. The eight-parameter model with GDM could reproduce the nitrogen loads properly outside of calibration period (validation). Furthermore, the accuracy and precision of model estimations were evaluated using various criteria (e.g., $R^2$ and gradient and constant of linear regression line). The results showed higher precisions with the $R^2$ values closed to 1.0 in LOADEST and better accuracy with the constants (in linear regression line) closed to 0.0 in the eight-parameter model with GDM. In hence, based on these finding we recommend that users need to evaluate the regression models under various criteria and calibration methods to provide the more accurate and precise results for pollutant load estimations.

• Molecules and Cells
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• 제40권6호
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• pp.434-439
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• 2017

Gestational diabetes mellitus (GDM), one of the common metabolic disorders of pregnancy, leads to functional alterations in various cells including stem cells as well as some abnormalities in fetal development. Perivascular stem cells (PVCs) have gained more attention in recent years, for the treatment of various diseases. However, the effect of GDM on PVC function has not been investigated. In our study, we isolated PVCs from umbilical cord of normal pregnant women and GDM patients and compared their phenotypes and function. There is no significant difference in phenotypic expression, response to bFGF exposure and adipogenic differentiation capacity between normal (N)-PVCs and GDM-PVCs. However, when compared with N-PVCs, early passage GDM-PVCs displayed decreased initial rates of cell yield and proliferation as well as a reduced ability to promote wound closure. These results suggest that maternal metabolic dysregulation during gestation can alter the function of endogenous multipotent stem cells, which may impact their therapeutic effectiveness.

• 여성건강간호학회지
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• 제27권2호
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• pp.75-92
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• 2021

Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

• Journal of the Korean Society for Industrial and Applied Mathematics
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• 제9권2호
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• pp.55-64
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• 2005

In this paper, generalized difference methods(GDM) for one-dimensional viscoelastic problems are proposed and analyzed. The new initial values are given in the generalized difference scheme, so we obtain optimal error estimates in $L^p$ and $W^{1,p}(2\;{\leq}\;p\;{\leq}\;{\infty})$ as well as some superconvergence estimates in $W^{1,p}(2\;{\leq}\;p\;{\leq}\;{\infty})$ between the GDM solution and the generalized Ritz-Volterra projection of the exact solution.