• 제목/요약/키워드: ST change

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제2형 당뇨비만환자의 수술요법 시 임상영양치료 프로토콜 설정 (Medical-Nutrition-Therapy for Obese Patients with Type 2 Diabetes Mellitus Undergoing Metabolic Surgery)

  • 김혜진;남궁신아;홍정임;목희정
    • 대한영양사협회학술지
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    • 제17권2호
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    • pp.206-215
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    • 2011
  • Currently, metabolic surgery (Laparoscopic Roux-en-Y gastric bypass, LRYGB) has an important role and should be recommended as an intervention in the management of obese patients with type 2 diabetes mellitus (T2DM). A successful outcome of surgery requires medical nutrition therapy. Therefore, we performed a retrospective study on 25 patients with T2DM who underwent LRYGB at Yeouido St. Mary's Hospital from October 2008 to May 2010. The patients were followed up for an average of 6 months after surgery (range: 2~19 months). Diabetes was resolved in 80% of the patients. Percentage of excess weight loss was (%EWL) was 56.2%. After surgery, fasting blood sugar (FBS) and HbA1c were significantly reduced (123 mg/dl, A1c 6.7%, P<0.001) and triglyceride was also significantly reduced to 107.6 mg/dl (P<0.05). As diets of the patients progressed from liquid to soft to regular diet, energy, carbohydrates, and fat intakes increased significantly (P<0.001). But protein intake did not change significantly. Nutrient intake of the patients after the surgery was significantly lower than the recommended diet for the non-surgery group. Patients experienced side-effects related to the diets after surgery, including hair-loss (76%), smelly gas (52%), vomiting (48%), etc. A significantly positive correlation was observed between vomiting and FBS (P<0.001). There was a significant relationship between side effects and the amount of nutrient intakes. Therefore, guide patients to a diet progression with treatment to minimize side effects, especially vomiting. And monitor their dietary life to be healthy and not to regain weight until remission of T2DM.

화소 기반 형태분석 방법을 이용한 경도인지장애 환자의 회백질 용적감소의 정량적 분석 (A Voxel-Based Morphometry of Gray Matter Volume Reduction in Patients with Mild Cognitive Impairment)

  • 유보은;한창태;이창욱;홍승철;임현국
    • 생물정신의학
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    • 제18권4호
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    • pp.232-238
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    • 2011
  • Objectives Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in the brain morphology between a group of patients with mild cognitive impairment (MCI) and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume change measured by optimized VBM in MCI subjects compared to controls. Methods Twenty patients with MCI and 20 control subjects with normal cognition were recruited for this study. We applied the optimized VBM protocol to the image data including study-specific template and the modulation of the data with the Jacobian determinants. GM volume differences between the MCI subjects and the control subjects and their correlations with the neuropsychological performances were investigated. Results Optimized VBM analysis revealed GM volume reduction in hippocampus, precentral gyrus, insula and parietal operculum in the MCI group compared to the control group (family wise error corrected p < 0.05). Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) word list recall scores were significantly correlated with the GM volumes of hippocampus, precuneus and posterior cingulate in the MCI group (FWE corrected p < 0.05). Conclusions The results confirm previous findings of atrophic changes in medial temporal lobe and parietal lobe in the MCI group and suggest that these abnormalities may be related with cognitive decline and prognosis in patients with MCI.

HDDM과 BFM을 이용한 NOx와 VOC 배출량에 대한 오존민감도계수 산정 및 결과 비교: 2007년 6월 수도권 사례 (Estimating Ozone Sensitivity Coefficients to NOx and VOC Emissions Using BFM and HDDM for A 2007 June Episode)

  • 김순태
    • 한국환경과학회지
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    • 제20권11호
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    • pp.1465-1481
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    • 2011
  • The accuracy of ozone sensitivity coefficients estimated with HDDM (High-order Decoupled Direct Method) can vary depending on the $NO_x$ (Nitrogen Oxides) and VOC (Volatile Organic Compound) conditions. In order to evaluate the applicability of HDDM over the Seoul Metropolitan Area (SMA) during a high ozone episode in 2007 June, we compare BFM (Brute Force Method) and HDDM in terms of the $1^{st}$-order ozone sensitivity coefficient to explain ozone change in response to changes in NOx and VOC emissions, and the $2^{nd}$-order ozone sensitivity coefficient to represent nonlinear response of ozone to the emission changes. BFM and HDDM estimate comparable ozone sensitivity coefficients, exhibiting similar spatial and temporal variations over the SMAduring the episode. NME (Normalized Mean Error) between BFM and HDDM for the episode average $1^{st}$- and $2^{nd}$-order ozone sensitivity coefficients to NOx and VOC emissions are less than 3% and 9%, respectively. For the daily comparison, NME for the $1^{st}$- and $2^{nd}$-order ozone sensitivity coefficients are less than 4% ($R^2$ > 0.96) and 15% ($R^2$ > 0.90), respectively. Under the emission conditions used in this study, two methods show negative episode average $1^{st}$-order ozone sensitivity coefficient to $NO_x$ emissions over the core SMA. The $2^{nd}$-order ozone sensitivity coefficient to $NO_x$ emissions leads ozone to respond muchnonlinear to the reduction in $NO_x$ emissions over Seoul. Nonlinear ozone response to reduction in VOC emissions is mitigated due to the $2^{nd}$-order ozone sensitivity coefficient which is much smaller than the $1^{st}$-order ozone sensitivity coefficient to the emissions in the magnitude.

다성분 산화물 요업체의 고온 물라이트화 반응 정량분석 (Quantitative Analysis of High-Temperature Mullitization from a Multicomponent Oxide System)

  • 신현호;김철수;김창욱;장순남;성완;장동환;강석원;최석홍
    • 한국세라믹학회지
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    • 제35권1호
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    • pp.5-10
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    • 1998
  • Mullitization in a multicomponent oxide system(alumina-kaolin-quartz-feldspar-talc) was studied as a function of sintering temperature from 1200 to 1500$^{\circ}C$ based upon a quantitative X-ray diffraction analysis. In the present study mullite grew as wiskers and its formation reaction showed characteristic there stages as follows In the first stage(1255-1295$^{\circ}C$) an appreciable mullitization(nucleation) occurred while corun-dum dissolution into glass (increasing glass content ) limited the rate of the reaction. At 1295-1335$^{\circ}C$ (second state) the reaction was significantly enhanced with a considerable glass consumption and with no appreciable change in corundum content. Finally (above 1335$^{\circ}C$) the reaction rate was attenuated re-markably with an apparent decrease in glass consumption rate. The impingement of mullite whiskers by oth-er whiskers and crystals was speculated to cause mullite growth in thickness direction with a slow growth rate resulting in the diminished reaction rate in the final stage.

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중학생의 식생활 단원에 대한 인식과 식행동에 관한 연구 (A Study on the Perceptions of Food & Nutriton Section and Eating Behaviors of Middle School Students)

  • 김경애;최현덕
    • 한국가정과교육학회지
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    • 제11권2호
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    • pp.89-110
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    • 1999
  • The purpose of this study was to investigate the perception and eating behaviors of middle school students in Kwangju area about food and nutrition section of Home Economics course. The subjects were 480 middle school students. The major results were as follows: On the perception f food and nutrition section, the 1st graders learned ‘how to settle the problems related to food and nutrition and food choices’. The 2nd graders learned ‘the knowledge and principle of food and nutrition for improving dietary life’. The 3rd graders learned ‘actual dietary life functions like arranging menu and preparing meals’. Consequently, there was a significant difference in each grade and all boy and girl students have the highest response to the item ‘they learn how to settle the nutrition problem and foods choices’. On the interests in food and nutrition section, lower graders and girl students have higher interest than hgiher graders and boy students. The area which was considered as most interesting in food and nutrition sections was ‘cooking’ in all students. The perception of the concern on dietary life after learning food and nutrition section was higher in the 1st graders. On the perception of the area where was a great change in their own dietary life after learning food and nutrition section, the 1st graders responded there was a great change in ‘balanced dietary life’, the 2nd graders in ‘eating habit and nutrition of adolescence’and the 3rd graders in ‘cooking’. Especially, girl students showed more changes. On the perception of degree which food and nutrition section gives a help to actual life, students over 50% responded that it was helpful to their actual life. This showed that the lower the grades, the more help it gave to those students. On the perception of mother’s job, the students with working mother considered that they learned ‘actual dietary life functions like functions like arranging menu and preparing meals’from the food and nutrition section. In addition, they had high interests in the area of ‘cooking’. It was recognized that as the family size was greater, the food and nutrition section gave more helps to actual life. On eating behaviors of breakfast, the higher the grade, the more frequent they don’t have breakfast, boy students have more frequencies of having breakfast than girl students and the primary reason of not having breakfast is poor appetite. On whether going without a meal affects study or not, most of the 1st, 2nd and 3rd graders whether they are boys and girls or not responded it affected their study. On eating behaviors of lunch, most of boy and girl students in the 1st, 2nd 3rd grade have lunch box. On eating behaviors of supper, eating time is usually between 7:00 and 8:00 p.m and eating hour is mostly 10 or 15 minutes. On eating behaviors between meals, frequency of eating between meals is mostly once or twice a day and girl students have more frequencies of eating between meals, and the cause was hunger commonly in boy and girl students and ‘killing time’in girl students. The focus in getting the foods is ‘taste’and favorite food is fruit regardless of the grade.

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폐종양 환자에서 방사선치료에 의한 폐손상 (Radiation-induced Pulmonary Damage in Lung Cancer Patients)

  • 정수미;최일봉;강기문;김인아;신경섭
    • Radiation Oncology Journal
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    • 제11권2호
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    • pp.321-330
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    • 1993
  • Purpose: A retrospective analysis was performed to evaluate the incidence of radiation induced lung damage after the radiation therapy for the patients with carcinoma of the lung. Method and Materials: Sixty-six patients with lung cancer (squamous cell carcinoma 27, adenocarcinoma 14, large cell carcinoma 2, small cell carcinoma 13, unknown 10) were treated with definitive, postoperative or palliative radiation therapy with or without chemotherapy between July 1987 and December 1991. There were 50 males and 16 females with median age of 63 years (range: 33~80 years). Total lung doses ranged from 500 to 6,660 cGy (median 3960 cGy) given in 2 to 38 fractions (median 20) over a range or 2 to 150 days (median in days) using 6 MV or 15 MV linear accelerator. To represent different fractionation schedules of equivalent biological effect, the estimated single dose (ED) model, $ED=D{\dot}N^{-0.377}{\dot}T^{-0.058}$ was used in which D was the lung dose in cGy, N was the number of fractions, and T was the overall treatment time in days. The range of ED was 370 to 1357. The endpoint was a visible increase in lung density within the irradiated volume on chest X-ray as observed independently by three diagnostic radiologists. Patients were grouped according to ED, treatment duration, treatment modality and age, and the percent incidence of pulmonary damage for each group was determined. Result: In 40 of 66 patients, radiation induced change was seen on chest radiographs between 11 days and 314 days after initiation of radiation therapy. The incidence of radiation pneumonitis was increased according to increased ED, which was statistically significant (p=0.001). Roentgenographic changes consistent with radiation pneumonitis were seen in $100\%$ of patients receiving radiotherapy after lobectomy or pneumonectomy, which was not statistically significant. In 32 patients who also received chemotherapy, there was no difference in the incidence of radiation induced change between the group with radiation alone and the group with radiation and chemotherapy, among the sequence of chemotherapy No correlation was seen between incidence of radiation pneumonitis and age or sex. Conclusions: The occurrence of radiation pneumonitis varies. The incidence of radiation pneumonitis depends on radiation total dose, nature of fractionation, duration of therapy, and modifying factors such as lobectomy or pneumonectomy.

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황백약침이 콜라겐 유도 관절염 생쥐에 미치는 영향 (A Study on the Effect of Herbal-acupuncture with Phellodendri Cortex Solution on Collagen-induced Arthritis in DBA/1J Mice)

  • 김재영;이현
    • Korean Journal of Acupuncture
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    • 제24권2호
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    • pp.163-184
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    • 2007
  • Objectives & Methods : The purpose of this study is to observe the effects of Phellodendri Cortex Herbal-acupuncture solution (PC-HAS) at Joksamni (ST36) on collagen II induced arthritis in DBA-1J mice. The author performed several experimental items to analyze arthritis evaluation, change of weight, spleen size and adhesion rate, change of cytokine level, IgG, IgM and anti-collagen II, chang of immunocyte count, histological change of CIA mouse joint. Results : 1. In the PC-HA group, arthritis index, the incidence of arthritis and joint edema were significantly decreased. 2. In the PC-HA group, the change of spleen size, spleen adhesion rate and the knee joint were significantly decreased. 3. The levels of $IL-1{\beta}$, IL-6 and INF- in serum of the CIA mouse were significantly decreased by PC-HA. 4. The levels of IgG, IgM and anti-collagen II in serum of the CIA mouse were significantly decreased by PC-HA. 5. In the CIA mouse spleen cell culture, the levels of IFN- , IFN- / IL-4, IL-10 were significantly decreased by PC-HA, but the level of IL-4 was significantly increased by PC-HA. 6. In the PC-HA group, the ratios of $CD3e^+$ to $CD45R^+$ cell, $CD4^+$ to $CD8^+$ cell and $CD4^+/CD25^+$ cell were similarly maintained as normal group in the CIA mouse spleen cell. 7. In the PC-HA group, $CD4^+CD25^+$ and $CD45R^+/CD69^+$ cell were significantly decreased in the lymph nodes. 8. In the PC-HA group, $CD3^+/CD69^+$ and $CD11b^+/Gr-1^+$ cell were significantly decreased in knee joint. 9. In histology, the cartilage destruction and synovial cell proliferation in the PC-HA group were similar with that of the normal group and the collagen fiber expressions in the PC-HA group were similar with that of the normal group. Conclusions : Form the result above, the results suggest that the PC-HA at ST36 has significant effect on collagen-induced arthritis, and can be put to practical use in the future rheumatoid arthritis clinic.

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폐암 환자의 정위적방사선 치료 시 이중 에너지를 이용한 치료 방법의 유용성 평가 (Evaluation of useful treatment which uses dual-energy when curing lung-cancer patient with stereotactic body radiation therapy)

  • 장형준;이영규;김영재;박영규
    • 대한방사선치료학회지
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    • 제28권2호
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    • pp.87-99
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    • 2016
  • 목 적 : 종양의 위치에 따라 단일에너지를 이용한 치료계획과 이중에너지를 사용하는 치료계획을 정위적방사선 치료에 적용하여 실제 종양에 부여되는 선량의 변화와 종양과 인접한 부분에 위치하는 정상조직의 선량을 비교하여 임상적 유용성을 평가하고자 한다. 대상 및 방법 : 총 10명의 환자 CT 영상을 획득한 후 각각 단일에너지, 이중 에너지에 대한 체적변조회전치료 기법에 대한 치료 계획을 수립하였다. 종양 측 변화 요인을 분석하기 위하여 조형계수(CI)와 균질성 지수(HI), 최대 선량을 각각 계산했으며, 정상 조직에 대한 선량 분포를 비교하기 위하여 $V_{10}$$V_5$, 종양에 가장 근접한 첫 번째 ~ 네 번째 갈비뼈($1^{st}{\sim}4^{th}$ Rib), 척수(Spinal Cord), 식도(Esophagus)와 기관(Trachea)를 선정하였다. 또한 계획한 선량 분포가 실제 전달되는 정확성을 확인하기 위하여 2차원 이온전리함 배열을 이용하여 선량 측정을 시행하였다. 결 과 : 종양 측 인자의 경우 조형계수와 균질성 지수는 두 에너지를 사용했을 경우가 1에 가까운 값을 나타냈다. 최대 선량의 경우 앞쪽 흉벽은 약 2%, 등쪽 종양의 경우는 동등한 값을 나타냈다. 정상 조직의 경우 앞쪽 흉벽 종양은 인접한 갈비뼈에서 두 에너지를 동시에 사용한 경우 각각 4%, 5% 감소하였고, 기관지의 경우 11%, 17% 감소하였다. 폐의 선량 분포의 경우 $V_{10}$의 경우 1.5%, $V_5$의 경우 1%로 감소함을 나타냈다. 뒤쪽 흉벽의 경우 종양에 인접한 갈비뼈는 두 에너지를 이용한 경우에서 각각 6%, 1%, 4%, 12% 감소하였고, 폐의 선량 분포에서는 $V_{10}$ 3%, $V_5$ 3.1% 감소됨을 나타내었다. 선량 측정의 경우 모든 에너지에서 감마지표 3mm/3%의 결과에 부합하였다. 결 론 : 단일 에너지를 이용한 치료 계획 보다 두 에너지를 동시에 사용하는 경우가 표재성 종양에 대해 보다 유용하게 적용될 수 있을 것으로 사료된다.

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천추(天樞) 및 상거허(上巨虛)의 침자극(針刺棘)이 대장(大腸) 통과시간(通過時間)에 미치는 영향(影響) (The clinical study of colonic transit time stimulated manual acupuncture and electo-acupuncture(ST25, ST37))

  • 김동웅;이상용;이창현
    • Journal of Acupuncture Research
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    • 제15권2호
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    • pp.311-318
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    • 1998
  • 목적: 현재 소화기 증상이 없고 정상적인 배변 양상과 습관을 갖고 있으며 과거력상 만성적인 소화기 계통의 질환이 없었던 정상 성인에게 대장운동과 관계있다고 알려진 천추와 상거허에 침자극하고 대장 통과시간의 변화를 관찰하고자 하였다. 방법: 정상 성인 11명의 침자극전 대장 통과시간을 방사선 비투과성 표지자인 Sitzmarks capsule을 사용하여 우측 및 좌측 대장과 직결장, 전대장 통과시간 등으로 나누어 측정한후 대장의 하합혈인 상거허와 복모혈인 천추에 단순유침 15분 및 전침으로 침자극하고 같은 방법으로 대장 통과시간을 측정하여 비교하였다. 결과: 침자극전의 대장 통과시간 측정은 전대장 통과시간이 $10.60{\pm}12.11$시간 이었으며 우측 및 좌측 대장과 직결장의 통과시간이 각각 $3.92{\pm}7.72,\;3.27{\pm}6.37,\;3.41{\pm}5.57$시간 이었다. 단순 15분 유침후 대장 통과시간의 측정은 전대장 통과시간이 $10.48{\pm}12.35$시간, 우측 및 좌측 대장과 직결장의 대장통과 시간이 각각 $3.72{\pm}7.52,\;3.37{\pm}6.76,\;3.39{\pm}5.84$ 시간으로 유의하지 않았다(P>0.05) 전침 자극후 대장 통과시간의 측정은 전대장 통과시간이 $10.30{\pm}13.21$, 우측 및 좌측 대장과 직결장의 통과 시간이 각각 $3.92{\pm}8.02,\;3.07{\pm}5.41,\;3.31{\pm}5.49$ 시간으로 좌측 대장 통과시간이 유의한(P<0.05) 단축 소견을 보였고 우측, 직결장의 통과시간은 유의하지 않았다(P>0.05). 결론: 본 연구의 결과로서 좌측 대장의 통과시간이 천추와 상거허에 전침 자극시 유의하게 단축되는 것을 확인 할 수 있었다. 이것은 전침이 신경계나 체액성 작용에 의해서 신경의 흥분성을 증가시켜 좌측 대장에서 직결장쪽으로 대장 내용물의 이동을 촉진하는 것으로 생각 할 수 있다. 그러나 단순 유침에서는 침자극전 대장 통과시간과 차이를 보이지 않음으로서 모든 침자극이 정상인의 대장운동이 변화를 일으키지는 않는 것으로 생각되었으며 더욱이 전침자극후 좌측 대장외에 우측 대장, 직결장은 단순 유침과 전침자극에 모두 변화가 없었고 전대장 통과 시간의 변화도 유의성이 없어 천추와 상거허의 침자극은 정상인의 대장운동에 영향을 주지는 않을 것으로 사려되었다.

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기후변화에 따른 기업 공급체인의 물 리스크 대응 실태 조사 (A study of how Supply Chain companies correspond to water risk resulted from climate change)

  • 박지영;박석하;임병선;김제숭
    • 대한안전경영과학회지
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    • 제17권1호
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    • pp.149-168
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    • 2015
  • It is expected that the temperature in Pyeongyang will be similar to that ($16.6^{\circ}C$) in Seogwipo in the late 21st century, and most of South Korea will enter the subtropical climate due to climate change. Change in the precipitation pattern like the range of fluctuation caused by climate change will lead to expanded uncertainty in securing reliable water supply, along with a serious impact on demands for living and industrial water due to change in the volume and period of river outflow. As industrial water for production activities is estimated based on the contract quantity, it is difficult to apply rationalization of water usage and incentives in water recycling. Therefore many companies are making efforts in complying with the effluent standard while spending few resources on such rationalization and recycling. This study researched water risk management over 115 Korean companies by 28 questions in 4 categories. Through the research, this study aims to understand water risk management levels and seek response plans.