• 농촌의학ㆍ지역보건
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• 제42권4호
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• pp.226-233
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• 2017

이 연구는 입퇴원을 반복하는 치료 미순응 노인 당뇨병 환자들의 퇴원 후 자가 관리 수준을 파악하기 위하여 실시하였다. 일개 종합병원에서 고혈당으로 최근 1년 이내에 2회 이상 입원 치료받은 65세 이상 노인 당뇨병 환자 15명을 대상으로 2015년 11월 1일부터 2016년 3월 1일까지 심층 면담을 통한 질적 연구를 수행하여 다음의 결과를 얻었다. 연구 대상자들은 당뇨병 관련 지식 중 발병원인과 증상에 대한 지식수준이 낮았다. 혈당 측정은 불규칙적으로 하거나 하지 않고 있었고, 가정에 혈당기가 없어 측정을 하지 못하는 경우도 있었다. 일상생활 중 가족들로부터 스트레스를 많이 받고 있었고, 노령으로 인하여 신체 활동에 제한이 많았으며, 뇌졸중의 후유증과 근골격계 질환 등의 문제들로 운동을 거의 못하고 있었다. 규칙적인 식사도 거의 이뤄지지 않고 있었으며, 당뇨병 자가관리 교육은 받을 필요가 없다고 생각하거나 거동 불편으로 받지 못하고 있었다. 자가 혈당 측정 행위 저조, 가족으로부터의 심리적 압박, 퇴원 후 교육 기회 부재 등이 당뇨병자가 관리와 관련된 두드러진 문제점들이었다. 따라서 치료 미순응 노인 당뇨병 환자들의 자가관리 수준을 높이기 위해서는 환자와 가족을 포함하는 맞춤형 교육 프로그램을 개발하고, 교육참여 기회를 보장하여 자가 관리의 중요성과 기술습득을 통하여 자가 관리를 실천하게 하는 것이 필요하다.

• 사상체질의학회지
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• 제8권2호
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• pp.41-68
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• 1996

This thesis is a try for examining the historical characteristics of Constiutional medicine. For this purpose, I have examined their theory, and made a comparison carefully. Through this study, I have obtained several results as following. Both Chang and Lee lived in the time of change, which was unstable and uncertain. Under the condition, they both rejected following the existing trends of learned circles, and developed new thoughts and clinical techniques. They rejected superstitious beliefs and fatalism, and conducted the pursuit of experimental knowledge and rationale idea. Clinical experience was the very base of their study. They both criticized the bad habits of abuse of tonifing medication and health seeking. Especially Lee regarded control of emotion and regulation of a way of life as the best way for preservation of one's health. Chang regarded pathogenic factors as the ultimate factor of diseases, and strived for eliminating pathogenic factors, but L brought to a conclusion that the final factor of diseases was what is called "heart" itself, and emotional changes were the most essential causes of disease. It can be said that the pathogenesis insisted by Chang can be called The insistence that pathologic factors are the very etiology of all the disease (邪氣致病論), or all the diseases result from pathologic factors. And his whole remedy can be summarized as following, A study on the method of eliminating pathogenic factors. But the purpose of Constitutional medicine is to correct imbalance intrinsic to one's internal organs. In this aspect, Constitutional medicine is a "regulatory medicine". Depending on the classification of six vital substances, Chang classified all disease into six categories. These were based on symptoms and sings represented. While classification of diseases made by Lee was likely to rely upon constitutional characteristics. Chang thought that the three remedies made up of perspiration, purgation, vomiting were the most efficient way of eliminating pathogenic factors. Lee, however, thought those weren't methods of eliminating pathogenic factors but the best ways restoring one's self-regulation power. Chang thought that all the febrile disease essentially has a tendency in properties to belong to "heat", but Lee pointed out that pathologic processes are variable in accordance with constitutional features. They both regarded pathogenesis of diabetes as fire. That is to say, fire is the most essential factor of diabetes. And there are many risk factors such as inappropriate foods, drugs, climate, etc., but Lee thought what is most important is heart. Putting all accounts together, medical characteristics of Chang are similar to those of T aiyinjen and Shaoyangjen, and have no relation to those of those of Shaoyinjen. Therefore we can conclude that Chang understood pathologic processes of disease of T aiyinjen and Shaoyangjen, whether he knew about constitutional features or not.

• 대한간호학회지
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• 제25권3호
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• pp.472-484
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• 1995

The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

• 농촌의학ㆍ지역보건
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• 제38권1호
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• pp.25-38
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• 2013

이 연구목적은 일부 지역 재가 노인을 대상으로 보완대체요법 이용행태와 그 영향요인을 구명하는데 있다. 2단계 집락추출로 선정된 대구광역시와 경상남도의 2개 시 군의 노인복지시설(9개)을 이용한 60세 이상 노인 233명을 대상으로 보완대체요법 이용현황, 보완대체요법 인지 여부, 만성질환유형에 따른 이용실태 등을 파악하기 위해 교차분석 및 로지스틱 회귀분석을 실시하였다. 그 결과 조사대상 노인의 70.4%(164명)가 지난 1년간 보완대체요법 이용 경험이 있었다. CAM 종류별로 48.8%(64명)~60.7%(88명)의 노인들이 보건의료 전문가와의 상담 없이 이용하고 있었다. 보완대체요법을 인지하고 있는 경우의 이용 경험은 2 이상 높았으며, 이환된 만성질환 수가 많은 경우의 이용경험은 수기요법 5.85(95% CI 1.97-17.34), 영양요법 2.92(95% CI 1.07-7.97), 약물요법 2.92(95% CI 1.04-8.17)로 높았으며, 만성질환 중 당뇨병을 진단받은 경우의 영양요법 이용 경험은 3.76(95% CI 1.49-9.47) 높았다. 노인 만성질환관리를 위해서는 보완대체요법에 대한 명확하고 체계적인 분류, 효과 및 안전성에 대한 객관적 검증과 함께 노인들의 건강상태를 고려한 전문가 및 의료인의 보완대체요법 이용 중재가 필요하다.

• 식품과학과 산업
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• 제51권4호
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• pp.302-312
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• 2018

우유 단백질과 같은 식이 단백질은 분해되기 전에는 대사 조절을 위한 생물학적인 활성을 나타내지 않으나 장에서의 소화과정이나 단백질 분해 효소, 또는 미생물 발효 과정을 통하여 저분자의 펩타이드로 분해되어 수용체 결합을 통하여 생체조절기능을 발휘하거나, 체내 대사의 조절에 관여하는 다양한 효소의 활성을 억제함으로써 기능을 발휘하기도 한다. 우유단백질의 섭취에 의한 혈당 감소 효과는 여러 연구자에 의하여 확인되었으며, 그 작용 기전은 주로 분지사슬 아미노산에 의한 인슐린 분비촉진 기전과 음식물의 소화 과정 중 위장관에서 췌장에서 인슐린 분비 촉진, glucagon의 분비를 감소시켜 혈당을 감소시키는 역할을 담당하는 내분비 호르몬의 일종인 GLP-1의 작용에 영향을 미치는 기전을 생각할 수 있다. 생리적 환경에서 GLP-1은 GLP-1을 가수분해하여 불활성화시키는 DPP-4에 의하여 빠르게 분해되어 생물학적 활성을 소실하기 때문에 DPP-4 억제제는 제 2형 당뇨의 새로운 치료 방법으로써 주목을 받고 있다. DPP-4의 억제 효능을 가진 다수의 기능성 펩타이드가 우유단백질의 분해에 의하여 생성됨이 보고되었으며 그 효능이 in vitro 연구는 물론 동물 모델을 이용한 연구에서도 증명되었다. 이상의 연구 결과를 근거로 할 때 우유 단백질 유래 DPP-4 억제 펩타이드는 인체 적용 연구를 통하여 혈당 조절에 도움을 주는 기능성 소재로 개발될 수 있는 충분한 가능성을 가지고 있다고 판단된다.

• 대한간호학회지
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• 제30권5호
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• pp.1219-1229
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• 2000

The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of : 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.676-680
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• 2010

Purpose: Median nerve entrapment syndrome within carpal tunnel is usually called carpal tunnel syndrome and it is the most common form of peripheral nerve entrapment syndrome. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement theraphy, corticosteroid use, rhematoid arthritis and wrist fractures may cause carpal tunnel syndrome. To the best of our knowledge, this is the first case report of median nerve entrapment syndrome due to adhesion of laceration wound after suicidal attempt. Methods: A 28-year-old woman presented with a sensory change and thenar hypotrophy on her left hand. On her history, she attempted suicide by slashing her wrist. Initial electromyography (EMG) showed that the nerve conduction velocities of median nerve was delayed. Therefore, we performed surgical procedures. When exploration, Fibrous scar tissue observed around the median nerve but nerve had not been injured. Transcarpal ligament was completely released and adjacent fibrous tissue was removed to decompress the median nerve. Results: The postoperative course was uneventful until the first year. Opposition difficulty and thenar hypotrophy were improved progressively after the surgery. Sensory abnormality was slowly improved over one year. Conclusion: We report a case of median nerve entrapment syndrome that was caused by adhesion of laceration wound after suicidal attempt. This is an unusual cause of median nerve entrapment syndrome, the symptoms were relieved after transcarpal ligament release and fibrous scar tissue removal.

• Journal of Nutrition and Health
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• 제24권1호
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• pp.1-11
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• 1991

In this study. the importance of body fat distribution as an indicator of metabolic aberrations in diabetics was'evaluated. Skinfold thicknesses at eight sites and circumferences at five sites and total body fat content were measured on 105 diabetics. 1) The waist/thigh girth ratio(WTR) was positively correlated(r=0.38-0.54) to plasma glucose levels during oral glucose loading in diabetic men alone. 2) There was no significant difference in serum total cholesterol of diabetics and nondiabetics. However, HDL-cholesterol was significantly lower(p : 0.000. in male and female) in diabetics(male : 36.31$\pm$ 16.98mg/dl, female: 37.89$\pm$14.67mg/dl) than nodiabetics(male 61.75$\pm$14.08mg/dl, female : 62.29$\pm$12.65mg/dl) and serum triglyceride was significantly higher(p=0.0212) in diabetic women(171.90$\pm$ 76.61mg/dl) than nondiabetic women(111.10$\pm$42.84mg/dl) . 3) In both sexes. anthropometric measurements that significantly correlated to serum triglyceride concentration were percentage of ideal body weight. body mass index(BMI) and waist circumference. Positive and significant correlations were found between serum cholestrol, and BMI(R: 0.31, 0.34) and waist circumference(r=0.29) in diabetic men. Moreover, skinfolds of trunk area(r=0.29~0.32) especially abdomen, were closely associated with serum lipids than other fat deposits. Increasing percentage of total body fat content was accompanied by progressively increasing serum triglyceride concentration(r=0.41) in dieabetic men. This study shows that knowledge of body fat localization may help identify risks of carbohydrate intolerance and hyperlipidemia in diabetics.

• 대한지역사회영양학회지
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• 제19권1호
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• pp.71-83
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• 2014

The purpose of the study was to implement and evaluate a nutrition capacity training program for dietitians and other professionals working at customized home visiting health services (CHVHS). This program focused on nutrition services for hypertension or diabetes mellitus patients including topics regarding CHVHS, and composed of 10 sessions with lectures, discussion and practice. Dietitians (n = 54) and other professionals (n = 20) participated in the program and completed the questionnaire to assess their understanding of nutritional management, nutrition services and CHVHS before and after the program, and to examine program satisfaction and education needs. Subjects were mostly women (98.6%) and college or university graduates (93.2%). Total score (p < 0.001), as well as all items (p < 0.001 or p < 0.01) of understanding regarding nutritional management, nutrition services and CHVHS, were significantly increased after the program both in dietitians and in other professionals. Subjects were generally satisfied with the program, showing more satisfaction with items regarding subject's participation, acquiring new knowledge, usefulness of the program for CHVHS, and education materials. In future nutrition capacity training programs, subjects wanted to have classes regarding nutrition services for specific chronic diseases, development of education materials, methods for dietary life education, modifying eating habits and so on. Other professionals compared to dietitians, showed higher education needs in meal management (p < 0.01) and nutrition counseling skills (p < 0.05). This study showed the effectiveness of a nutrition capacity training program for home-visiting dietitians and other professionals, and suggests the need and direction for future nutrition capacity training programs.

• 한국인터넷방송통신학회논문지
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• 제13권6호
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• pp.167-172
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• 2013

WPAN은 근거리 무선 개인 통신망으로 센서간의 연동과 센서와 네트워크간의 요소기술을 포함하고 있다. 유비쿼터스 센서 네트워크의 핵심 기술로 WLAN이나 CDMA망과 연계하여 더 큰 유비쿼터스 네트워크를 형성할 수 있다. 본 논문에서는 WPAN과 헬스케어의 융합의 관점으로 정기진료를 필요로 하는 환자들 중 임산부를 대상으로, 임신중의 활동사항을 스마트폰을 이용하여 체계적으로 관리할 수 있는 스마트폰 애플리케이션을 제안한다. 진단결과 데이터를 스마트폰에 WPAN 방식을 사용하여 전송하며, 스케줄링과 함께 애플리케이션의 다양한 서비스를 제공할 수 있도록 한다.