PURPOSE: To make protocol on diabetic foot ulcer, with making use of this protocol, investigate hospitalized patients who have had diabetic foot wound and define pattern, characteristics and problems of diabetic foot in hospitalized patients MATERIALS AND METHODS: From Oct. 2002 to Sep. 2003, Seventy-two patients who had been admitted to our hospital due to treatment of diabetic foot wound studied with use of the protocol designed by the authors. RESULTS: The mean age of patients was 64.3 years and male patients were twice as many as female. The most common cause of hospitalization was infection of diabetic foot (77.7%). As a basic pathology of diabetic foot, the main pathology of diabetic foot was the neuropathy that is four times more than vasculopathy. The causations of wound were infection with no specific cause (40.0%). No statistical difference was found between timing of hospitalization and the results of treatment in vasculopathic group but in neuropathic ulcer group, the major procedure such as amputation, and the times of debridement in operation room and are more common in patients who were hospitalized after 3rd days of beginning of symptoms than within 3rd day. CONCLUSION: The education that the patient having a foot symptom have to visit the hospital as soon as possible on patients is important to prevent morbidity of diabetic foot wound, long hospitalization and amputation. The protocol that we are presenting can be modified for other study related to diabetic foot.
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BACKGROUND The risk of atherosclerosis is increased in subjects with diabetes mellitus. Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic vascular disease in subjects without diabetes. The contribution of Lp(a) to the increased risk for atherosclerosis and diabetic complications in subjects with diabetes is not well known. In this report we examined the relationship between Lp(a) levels and development of vascular (macro- and microvascular) complications, and the relationship between Lp(a) and other risk factors for vascular complications in subjects with non-insulin-dependent diabetes mellitus(NIDDM), METHODS: For this study we evaluated 152 patients with NIDDM(72 women and 80 men). Lp(a) level was measured with N-Latex Lp(a) Reagent. Electrocardiography, coronary angiography, brain CT/MRI, doppler velocimetry and peripheral angiography were done for diagnosis of macravascular complieations, and fundus camera, nerve conduction velocity, BBV (beat to beat variation), VPT(vibration perception threshold) and 24-hour urine protein amount were examined for diagnosis of microvascular complications. RESULTS: Lp(a) levels in subjects with ischemic heart disease, cerebrovascular disease and diabetic retinopathy were significantly higher than those in subjects without above mentioned diseases. ApoB/ApoA1 ratio and LDL-cholesterol levels in subjects with Lp(a) level>30mg/dL were significantly higher than those in subjects with Lp(a) level 30mg/dL, and Lp(a) has a positive correlation with ApoB/ApoA1 ratio and LDL-cholesterol in NIDDM patients with vasculopathy. CONCLUSION: These results suggest that high Lp(a) levels seem to be associated with macrovascular and microvascular(especially with retinopathy) complications in subjects with NIDDM and Lp(a) level should be measured in the NIDDM with high level of ApoB/ApoA1 ratio and/or LDL-eholesterol.