• Title/Summary/Keyword: diabetic Patients

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Clinical Safety and Effectiveness of Stent-Assisted Coil Embolization with Neuroform Atlas Stent in Intracranial Aneurysm

  • Kim, Chang Hyeun;Kim, Young Ha;Sung, Soon Ki;Son, Dong Wuk;Song, Geun Sung;Lee, Sang Weon
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.80-88
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    • 2020
  • Objective : Stent-assisted coil embolization (SAC) is commonly used for treating wide-neck intracranial aneurysms. In this study, we aimed to assess the clinical safety and efficacy of the NeuroForm Atlas Stent during SAC of intracranial aneurysms. Methods : We retrospectively analyzed data from patients with ruptured and unruptured cerebral aneurysms, who underwent SAC using the NeuroForm Atlas between February 2018 and July 2018. Favorable clinical outcomes and degree of aneurysm occlusion were defined as a modified Rankin scale score of ≤2 and a Raymond-Roy occlusion classification (RROC) class I/II during the immediate postoperative period and at the 6-month follow-up, respectively. Results : Thirty-one consecutive patients with 33 cases, including 11 ruptured and 22 unruptured cases were treated via NeuroForm Atlas SAC. Among the 22 unruptured cases with 24 unruptured aneurysms had favorable clinical outcome. Complete occlusion (RROC I) was achieved in 16 aneurysms (66.7%), while neck remnants (RROC II) were observed in six aneurysms (25%). Among the 11 patients with ruptured aneurysms, two died due to re-bleeding and diabetic ketoacidosis. In ruptured cases, RROC I was observed in eight (72.7%) and RROC II was observed in three cases (27.3%). At the 6-month follow-up, no clinical events were observed in the 22 unruptured cases. In the ruptured nine cases, five patients recovered without neurologic deficits, while four experienced unfavorable outcomes at 6 months. Of the 29 aneurysms examined via angiography at the 6-month follow-up, 19 (65.5%) were RROC I, eight (27.6%) were RROC II and two (6.9%) were RROC III. There were no procedure-related hemorrhagic complications. Conclusion : In this study, we found that stent-assisted coil embolization with NeuroForm Atlas stent may be safe and effective in the treatment of wide-neck intracranial aneurysms. NeuroForm Atlas SAC is feasible for the treatment of both ruptured and unruptured wide-neck aneurysms.

Effects of Nutrition Service Improvement Activities for Reducing Plate Waste of the Diabetic Mellitus Diet in a General Hospital (당뇨식 잔반 감량을 위한 영양서비스 개선 활동의 효과)

  • Sohn, Cheong-Min;Yeom, Hae-Sun
    • Korean Journal of Community Nutrition
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    • v.13 no.5
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    • pp.674-681
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    • 2008
  • Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.

EFFECTS OF RED GINSENG ON PLATELET FUNCTION AND LIPID METABOLISM OR OVERWEIGHTED NONINSULIN-DEPENDENT

  • Choi D.S.;Kim S.J.;Lee E.J.;Yu J.M.;Baik S.H.;Son B.R.;Kim Y.K.
    • Proceedings of the Ginseng society Conference
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    • 1993.09a
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    • pp.102-109
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    • 1993
  • Backgrounds Diabetes mellitus is associated with accelerated atherosc lerosis and predispose to specific microvascular problems. This study was performed to evaluate the usefulness of red ginseng as adjunctive therapeutic agent of NIDDM especially in preventing chronic diabetic complications. Materials and Methods We treated 50 patients with NIDDM for 5 month with 2 regimens: 1)oralhypoglycemic drug therapy only(the control group), 2)oral hypoglycemic group). The patients were recruited at Korea university hospital from June, 1992 to October, 1992 and the following inclusion criteria were used: l)age above 35 years 2)initial body weight within or above ideal body weight 3)fasting blood glucose level greater than 140mg/dl 4)no previous history of diabetes mellitus or no history of blood glucose control for recent 3 months of more. The patients were seen every 2 weeks for remaining 3 months. At every visit FBS and PP2hr blood glucose were measured with blood pressure and body weight. Lipid profiles were checked every 4 weeks and platelet function test was perfomed with aggregometer after administration of ADP, epineprine and collagen every 4 weeks. Free fatty acid were also analyzed every 8 weeks and glycosylated hemoglobin was measured every 12 weeks. Results The results were as follows: 1. The mean values for fasting and PP2hr blood glucose decreased significantly in the control group than in the ginseng group. 2. The weight gain was less in the ginseng group than in the control group. The levels of systolic blood pressure decreased' significantly in the ginseng group than in the control group. 3. There was no significant differences of lipid profiles in both groups. 4. The platelet hyperaggregation was improved more significantly in the ginseng group than in the control group. Conclusions In patients with NIDDM who were recieving oral hypoglycemic drug therapy, the addition of red ginseng improved platelet function and blood pressure, but induced less weight gain. The data suggests that red ginseng may be useful as a therapeutic adjunct especially in preventing chronic complications of NIDDM.

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Factors affecting Amputation Level in Diabetic Foot (당뇨발 환자에서 절단 부위 결정에 영향을 주는 요인에 관한 연구)

  • Park, In-Heon;Song, Kyung-Won;Shin, Sung-Il;Lee, Jin-Young;Lee, Seung-Yong;Song, Si-Young;Park, Jae-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.83-87
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    • 2003
  • Purpose: To evaluate the factors which affect the level of the amputation for treatment of DM foot excluding arterial occlusion. Materials and Methods: We selected 30 patients (10 of major amputations, 20 of minor amputations) who were amputated from May, 1999 to April, 2001 because of DM foot. Major amputation is BK amputation, and minor amputation is amputation below ankle joint. Gender, age, size of the wound, extent of the necrosis, infectious organism, medical com orbidity, duration of DM and blood glucose level, duration of DM foot and treatment history were investigated. Results: In major amputations, male to female ratio was 9:1, average of the age was 63.8, the average of sizes of the wound was 16cm2, duration of DM was 15.0 years, duration of DM foot was 10.6 weeks, and 80% of patients had necrosis and the organisms were S. aureus, E. faecium, Streptococcus, P. vulgaris, average of the blood glucose levels was 301 and 40% of them had been treated for DM foot. In minor amputations, male to female ration was 9:1, average of the age was 56.6, the average of sizes of the wound was 4.8cm2, duration of DM was 11.2 years, duration of DM foot was 5.7 weeks, and 40% of patients had necrosis and the organisms were S. aureus, Streptococcus, M. morganini, E. faecium, average of the blood glucose levels was 257 and 20% of them had been treated for DM foot. Conclusion: In DM foot patients, extents of the necrosis, duration of DM, duration of DM foot, the infectious organism were significant factors to decide extent of the amputation level.

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A Study on Wound Care Knowledge and Concerns of Patients at Discharge (퇴원하는 환자의 상처관리에 대한 지식과 염려에 관한 연구)

  • Han, Il-Kyoung;Lee, Myung-Seon;Kim, Jung-A;Ha, Won-Choon;Kim, Myung-Hee;Hwang, Sun-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3434-3443
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    • 2009
  • This study was done to examine patients' wound care knowledge and concerns prior to discharge from a tertiary hospital. The participants in this descriptive survey were 112 patients having wounds. During interview, a structured self-administered questionnaire was filled out. The participants were 71 males and 41 females. Wound types were surgical incision (52.7%), percutaneous wound (26.8%), pressure ulcer (9.8%) and diabetic foot and arterial ulcers (5.4%). Their wound care knowledge was 52.0% of correct answer and the mean of concerns (range 1-7) was 2.79. There was no significant correlation between their knowledge and concerns of wound care. The factors influence on wound care concerns were fear of wound care, wound pain, length of hospital stays, and perceived health condition. This findings showed that discharge patients with a wound had some incorrect knowledge and various concerns about wound care. They may help to direct patient teaching in discharge plan.

Assessment of Regulatory Effect of Electro-acupuncture at Jogsamni($ST_{36}$), on Electrogastrography in Diabetic Patients with Gastric Dysrhythmia;A Case Series Study (위장 비율동성 당뇨환자에서 족삼리(足三里)($ST_{36}$) 전침처치의 위전도 조절 영향 사례군 연구)

  • Oh, Dal-Seok;Choi, Jun-Yong;Jung, So-Young;Shin, Mi-Suk;Kim, Ae-Ran;Kang, Kyung-Won;Kim, Jong-In;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.25 no.4
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    • pp.95-103
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    • 2008
  • Objectives : This study was to investigate the regulatory effect of electro-acupuncture on Jogsamni ($ST_{36}$) in bradygastric condition or gastroparesis which is a neuropathic complication of type 2 diabetes mellitus(T2DM), assessed using 4-channel electrogastrography (EGG). Methods : It was a case series study. Each patient was given electro-acupuncture(EA) one point, Jogsamni($ST_{36}$) or Gyeonu($LI_{15}$) bilaterally for thirty minutes with 2Hz bipolar square wave frequency and moderate intensity of stimulation. With attaching electrodes around stomach region throughout pre-acupuncture, acupuncture, and post-acupuncture session, these parameters were produced; percent rate of bradygastria power compared to sum of power in all kind of gastric rhythm(% bradygastria), dominant frequency(DF) and dominant power(DP). Parameter was analysed per each channel's variable change from pre-acupuncture session by paired t-test. Results : There was statistically significant decrease in % bradygastria parameters on one of the $ST_{36}$ treated patients from pre-acupuncture session and to post-acupuncture session(P=0.015, P=0.008 respectively). A marginal significant decrease of DP was shown in the other $ST_{36}$ treated patient from pre-acupuncture session through post-acupuncture session(P=0.049). Combined data of two $ST_{36}$ Treated patients showed that there was significant decrease of %bradygastria from pre-acupuncture session to acupuncture session(P=0.020), and was decrease of DP from pre-acupuncture session to post- acupuncture session(P=0.020). Conclusions : EA at $ST_{36}$ resulted in statistically significant decrease in %bradygastria and DP for dysrhythmic condition in T2DM gastroparesis patients. Considering this limited results, further study will be needed to elucidate the effect of multiple-acupuncture on gastric myoelectrical activities.

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The Effect of Herbal Medicine on Blood Glucose in Type 2 Diabetes Patients: A Retrospective Study (한약 복용이 제 2형 당뇨 환자의 혈당 변화에 미치는 영향 : 후항적 차트 리뷰)

  • Yu, Chang-hwan;Kang, Sung-woo;Hong, Sung-eun;Kim, Kwan-il;Jung, Hee-jae;Lee, Beom-joon
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1066-1077
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    • 2020
  • Objective: This study was conducted to evaluate the effect of herbal medicine on blood glucose in diabetic patients. Methods: The subjects were patients with diabetes mellitus (DM) who had been admitted to Kyung Hee University Korean Medicine Hospital for more than 8 weeks for a primary diagnosis other than DM and who had taken herbal medicine for more than 8 weeks from January 2010 to February 2020. The medical records were analyzed retrospectively to confirm the characteristics of the subjects, and examination results included hemoglobin A1c (HbA1c), total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine. Changes in HbA1c before and after taking herbal medicine and changes according to subgroups were analyzed. Results: A total of 149 subjects with type 2 DM were selected as participants. After taking the herbal medicine, the HbA1c value was significantly decreased, and the statistical significance was maintained even when the effect of controlling antidiabetic agents was excluded. The decrease in HbA1c was higher in the poor glycemic control group. Liver and kidney functions did not show any significant changes after taking the herbal medicine. Conclusions: Administration of herbal medicine for a long period of 8 weeks or longer did not increase HbA1c in patients with DM complicated by other various diseases.

Type 2 Diabetes Mellitus in Children (소아연령에서의 2형 당뇨병의 임상적 고찰)

  • Park, Jee Min;Yoo, Eun Gyong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.646-653
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    • 2002
  • Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

Analysis of the Physiological Healing Effects by Forest Types - Focused on Hypertensive and Diabetic - (숲의 종류에 따른 생리적 치유효과 분석 - 고혈압과 당뇨병 환자를 중심으로 -)

  • Jeong, Na-Ra;Ahn, Deug-Soo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.5
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    • pp.1-12
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    • 2015
  • This study analyzes the physiological healing effects on users according to forest types. Forest types are classified into Chamaecyparis obtusa, Quercus serrata and Pinus densiflora and the subjects of this study, 64 hypertensives, 59 diabetics and 59 ordinary people, were tested to observe their physiological effects. The index of physiological reaction comprises electroencephalogram(EEG), heart rate variability(HRV), blood pressure and cortisol level. An analysis of the stress-buffering effect from the physiological reactions of the overall subjects indicates that Quercus serrata forests have a higher stress-buffering effect than others in terms of central nervous, endocrine and autonomic nervous systems. Chamaecyparis obtusa forests are contributory to soothing stress in the central nervous and endocrine systems. Pinus densiflora forests contribute in some indexes of the endocrine and autonomic nervous systems. In contrast, Pinus densiflora forests are less influential on a stress-buffering effect than the other two. In the level of the effect for lowering blood pressure, Chamaecyparis obtusa and Quercus serrata forests are more effective than Pinus densiflora forests. Therefore, staying in the first two forests can heighten the healing effect of the lowering of blood pressure for hypertensive patients. Every forest is efficacious to lowering diabetic blood glucose levels. Spending time in Quercus serrata forests is more effective for hypoglycemic.

Attitudes toward Complementary and Alternative Medicine in Suwon City (수원시 주민의 대체의학 수용실태 조사)

  • Chun, Ki-Hong;Song, Hyun-Joug;Park, In-Whee;Yoo, Seung-Chul;Song, Mi-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.162-169
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    • 1999
  • Objectives: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. Methods: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc., mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications Results: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou(15.3%) Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. Conclusions: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.

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