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Soo Lim,
So-Youn Kim,
Jung Im Kim,
Min Kyung Kwon,
Sei Jin Min, Soo Young Yoo,
Seon Mee Kang,
Hong Il Kim,
Hye Seung Jung,
Kyong Soo Park,
Jun Oh Ryu,
Hayley Shin,
Hak Chul Jang
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ABSTRACT: Advanced information technology can be used when developing diagnostic and treatment strategies to provide better care for diabetic patients. However, the levels of need and demand for the use of technological advances have not been investigated in diabetic patients. We proposed and developed an individualized, ubiquitous (U)-healthcare service using advanced information technology for more effective glucose control. Prior to our service initiation, we surveyed patient needs and other pertinent information.
During August 2009, we conducted a 34-item questionnaire survey among patients with diabetes who were older than 40 years in two certain hospitals in Korea.
The mean age of the 228 participants was 61.2±9 years, and males made up 49.1% of the sample. Seventy-one percent replied that they wanted individualized healthcare service, and they also wanted their health information to be delivered through mobile devices such as a cellular phone or a personal digital assistant (40.4%). Most patients had never heard of U-healthcare services (81.1%); however, after explaining the concept, 71.1% of participants responded that they would use the service if it was provided. Despite their willingness, participants were concerned about technical difficulty in using the service (26.3%) as well as the cost of the service (29.8%).
The current study suggests that more than 70% of diabetic patients are interested in using U-healthcare services. To encourage widespread use, the application program or device of U-healthcare services should be simple, easy to use and affordable while also including a policy for the protection of private information.
Diabetes & metabolism journal 02/2011; 35(1):50-7.
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Soo Lim,
Seon Mee Kang,
Hayley Shin,
Hak Jong Lee,
Ji Won Yoon,
Sung Hoon Yu,
So-Youn Kim, Soo Young Yoo,
Hye Seung Jung,
Kyong Soo Park,
Jun Oh Ryu,
Hak C Jang
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ABSTRACT: To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology.
We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C <7% without hypoglycemia at 6 months. U-healthcare system refers to an individualized medical service in which medical instructions are given through the patient's mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone.
After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P < 0.001) in the u-healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C <7% without hypoglycemia was 30.6% in the u-healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P < 0.05).
The CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients.
Diabetes care 02/2011; 34(2):308-13. · 8.09 Impact Factor
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ABSTRACT: The etiology of meconium obstruction without cystic fibrosis is unclear. Interstitial cells of Cajal (ICC) function as pacemakers in gut motility and may play a role in the pathophysiology of the disease.
The ICC were examined by immunohistochemical staining with anti-c-kit antibody in the bowel walls of 6 neonates who had meconium obstruction without cystic fibrosis, and the results were compared with specimens from normal neonates (n = 2).
Six patients underwent ileostomy between 2 and 15 days after birth, and 5 of them presented with microcolon. Ganglion cells were present in the ileum and colon. Whereas ICC were evenly distributed in the control specimens, they were not seen at the time of ileostomy in the colons of 2 patients, and the other 4 showed scanty distribution in muscle layers. However, ileum showed normal distribution of ICC in all patients. The ileostomies were closed between 39 and 104 days of age, and the ICC distribution was changed to a normal pattern in the colons of all 6 patients. Their bowel movements were restored to normal after closure.
The findings of this study suggest that delayed maturity of ICC may be a cause of meconium obstruction without cystic fibrosis.
Journal of Pediatric Surgery 01/2003; 37(12):1758-61. · 1.45 Impact Factor
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ABSTRACT: A case of primary signet-ring-cell carcinoma of the rectum is presented. Colorectal carcinoma is uncommon in childhood; moreover, the signet-ring-cell type is very rare even in adults. The clinical, pathologic, and biologic characteristics of this carcinoma are different from ordinary colorectal carcinomas. Our patient was a 12-year-old boy, the youngest with a signet-ring-cell carcinoma of the rectum in the English literature, who had a Dukes'' C lesion. Pathologically, the tumor is characterized by diffuse infiltration of the bowel wall by signet-ring-cells. The prognosis is extremely poor.
Pediatric Surgery International 01/1994; 9(4):284-286. · 1.25 Impact Factor
