• Archives of Plastic Surgery
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• v.45 no.1
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• pp.62-68
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• 2018

Background Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Methods Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated $90^{\circ}$ cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. Results The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. Conclusions While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

• Korean Journal of Clinical Laboratory Science
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• v.41 no.2
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• pp.62-66
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• 2009

HbA1c is the major fraction of glycated hemoglobin, and used primarily to identify the average plasma glucose concentration over prolonged periods of time, mostly 2-3 months. It is used as markers for the diagnosis and monitoring of diabetic patients and increasingly used a marker in health screening check up for general populations. In this study, HbA1c was measured with Cobas integra 800 (Roche Diagnostics, Mannheim, Germany), using immunoturbidimetry principles. We established the reference interval for HbA1c with Cobas integra 800 and evaluated its significance. The study subjects were 36,140 (male 57.5%, and female 42.2%) who visited the Health Promotion Center of a tertiary care center in Seoul for health checkup from January to September, 2008. HbA1c levels were measured with immunoturbidimetric method. Statistical evaluation was done with SPSS. Comparison between male and female was checked with Mann-Whitney test, and among age groups with Kruskal-Wallis test. Reference interval for HbA1c was from 4.8% to 6.1%. There was no significant difference between male and female with Mann-Whitney test (P=0.539). There was significant difference among age groups with Kruskal-Wallis test (P<0.05). Reference interval for HbA1c with Cobas integra 800 was 4.8~6.1%, which was different from conventional one, 4.4-6.4%. Establishment of reference interval for each principle is needed.

• Nutrition Research and Practice
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• v.11 no.4
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• pp.327-333
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• 2017

BACKGROUND/OBJECTIVES: Complications of diabetes, such as cardiovascular disease, are associated with increased mortality among type 2 diabetes mellitus patients. Homocysteine has been recently identified as a predictor of cardiovascular disease-related complications in diabetes. We investigated whether or not supplementation with folic acid tablets can lower homocysteine levels and improve parameters related with vascular complications. SUBJECTS/METHODS: We conducted a non-randomized 8-week trial involving postmenopausal diabetic women (n = 25) supplemented with $800{\mu}g$ of folic acid ($400{\mu}g$ twice a day) daily. Subjects' serum levels of folate, homocysteine, and vitamin $B_{12}$ were measured, along with vascular function and brachial-ankle pulse wave velocity. RESULTS: Folic acid supplementation significantly increased serum folate levels (P < 0.0001), reduced homocysteine levels (P < 0.0001), and increased vitamin $B_{12}$ levels (P = 0.0063). There were significant decreases in low-density lipoprotein cholesterol levels as well as the ratios of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol and total cholesterol to high-density lipoprotein cholesterol. Brachial-ankle pulse wave velocities were not altered by supplementation. Changes in serum vitamin $B_{12}$ after folic acid supplementation were negatively correlated with changes in brachial-ankle pulse wave velocity. CONCLUSIONS: In this study on postmenopausal Korean women with type 2 diabetes mellitus, folic acid supplementation reduced serum homocysteine levels, increased serum folate and vitamin $B_{12}$ levels, and lowered lipid parameters.

• The Journal of the Korea Contents Association
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• v.21 no.9
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• pp.714-722
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• 2021

In this study, intends to propose virtual reality education contents for fundamental nursing skills to develop various teaching methods in nursing education. Blood sugar test & insulin subcutaneous injection among the 20 core fundamental nursing skills is one of that frequently performed and can be used for self-management education for diabetic patients. This study designed a core fundamental nursing skill on immersive VR contents by dividing the learner's experience into three stages: guide, mission, and feedback with these skills. And it is designed by tracking the movement of the hand through finger joint recognition without using a controller for immerse in training. This study will help develop VR nursing education contents that can improve clinical practice competency and the effect of the nursing education.

• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.190-198
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• 2021

Objectives: Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. Methods: This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. Results: Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members' advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). Conclusions: Knowledge of the adverse effects of diabetes, physicians' and healthcare providers' advice about the benefits of early disease detection, and family members' advice were independent predictors of screening adherence.

• Korean Journal of Transplantation
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• v.32 no.4
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• pp.104-107
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• 2018

Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.23 no.1
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• pp.77-83
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• 2019

With the recent development of medical technology, the diagnosis rate of type 1 diabetes is increasing and patients are increasing. However, diabetes education content is not aligned with the interest level of children. As a result of the interviews with experts, It was found that the measures of coping with the change of blood sugar and the behavior therapy require steady and repetitive learning. Therefore, this study proposes Edutainment content which can be repeatedly Learned by 10~11year old children. For effective learning, the contents of the laboratory practice were constructed and the hybrid method was used for the repetitive learning. Usability test showed that this configuration is effective. This study is expected to contribute to the study of diabetic education content that is suitable for the children's level of understanding which will be developed easily in the future.

• Journal of Digital Convergence
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• v.16 no.11
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• pp.363-372
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• 2018

The objective of this study is to derive specific classification rules that could be used to prevent individuals with Metabolic Syndrome (MS) from developing diabetes. Specifically, we aim to identify rules which classify individuals with MS into those without diabetes (class 0) and those with diabetes (class 1). In this study we collected data from Korean National Health and Nutrition Examination Survey and built a decision tree after data pre-processing. The decision tree brings about five useful rules and their average classification accuracy is quite high (75.8%). In addition, the decision tree showed that high blood pressure and waist circumference are the most influential factors on the classification of the two groups. Our research results will serve as good guidelines for clinicians to provide better treatment for patients with MS, such that they do not develop diabetes.

• Composites Research
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• v.34 no.3
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• pp.161-166
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• 2021

In this study, we present a research method to develop a shoe that prevents foot injury by inducing the foot pressure. An orthogonal grid sensor was used to check the foot pressure in the upright standing position, and the change in the foot pressure distribution for various conditions was compared. We checked the conditions for distributing foot pressure efficiently by changing the spring constant of the spring inserted into the sole of the shoe and the foot pressure generated with or without the arch of the insole. In order to minimize the experimental error from the randomness of the human body's behavior, it is possible to predict through foot pressure under certain conditions through finite element analysis that simulates the pressure distribution. By checking the change of foot pressure according to the number and arrangement of springs through finite element analysis, conditions were established to provide more efficient foot pressure. The result can be used for designing footwear for patients with diabetic feet.

• Journal of Biomedical Engineering Research
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• v.41 no.6
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• pp.228-234
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• 2020

Superparamagnetic iron oxide nanoparticles (SPIONs) are approved by the Food and Drug Administration (FDA) in the United States. SPIONs are used in magnetic resonance imaging (MRI) as contrast agents and targeted delivery in nanomedicine using external magnet sources. SPIONs act as an artificial peroxidase (i.e., nanozyme), and these reactions were highly stable in various pH conditions and temperatures. In this study, we report a nanozyme ability of the clustered SPIONs (CSPIONs) synthesized by the oil-in-water (O/W) method and coated with biocompatible poly(lactic-co-glycolic acid) (PLGA). We hypothesize that the CSPIONs can have high sensitivity toward H2O2 derived from the reaction between a fixed amount of glucose and glucose oxidase (GOX). As a result, CSPIONs oxidized a 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) diammonium salt (ABTS) commonly used as a substrate for hydrogen peroxidase in the presence of H2O2, leading to a change in the color of the substrate. We also utilized a colorimetric assay at 417 nm using various glucose concentrations from 5 mM to 1.25 μM to validate β-D-glucose detection. This study demonstrated that the absorbance value increases along with increasing the glucose level. The results were highly repeated at concentrations below 5 mM (all standard deviations < 0.03). Moreover, the sensitivity and limit of detection were 1.50 and 5.44 μM, respectively, in which CSPIONs are more responsive to glucose than SPIONs. In conclusion, this study suggests that CSPIONs have the potential to be used for glucose detection in diabetic patients using a physiological fluid such as ocular, saliva, and urine.