당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

Lidocaine, Thrombin, Epinephrine 의 항균효과

김진우,이동건,전혜선,김승준,김석찬,안중현,김치홍,권순석,김영균,김관형,문화식,신완식,송정섭,박성학 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

목적 : 기관지내시경 검사에서 흔히 사용되는 국소마취제인 lidocaine과 내시경시 지혈목적으로 사용되는 thrombin과 epinephrine이 각종 균주에 미치는 항균효과에 대해 알아보고자 하였다. 재료 및 방법 : 균주는 가톨릭대학교 성모병원에서 2004년 3월부터 2004년 9월까지 임상검체 에서 동정된 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 각각 42, 42, 42, 43주를 대상으로 하였다. Lidocaine, thrombin, epinephrine 감수성 검사는 National Committee for Clinical Laboratory Standards (NCCLS, 2002)의 기준에 따랐다. 결과 : Lidocaine은 S. aureus, S. pneumoniae, P. aeruginosa에서 MIC_(50), MIC_(90) 모두 20,000 ㎍/mL 이었다. K. pneumoniae는 각각 10,000 ㎍/mL이었다. Thrombin은 S. aureus와 P. aeruginosa에서 MIC50 500 lU/mL 과 MIC_(90) 500 IU/mL 이상이었고, K. pneumoniae에서는 MIC_(50)과 MIC_(90)이 모두 500 lU/mL이상이었으나 S. pneumoniae에서는 MIC_(50)과 MIC_(90)은 125 IU/mL이었다. Epinephrine은 K. pneumoniae, S. pneumoniae에 대한 MIC_(50), MIC_(90)가 모두 >500 ㎍/mL이었고, S. aureus와 P. aeruginosa에 대한 MIC_(50), MIC_(90)가 모두 500 ㎍/mL이었다. 결론 : 기관지 내시경 검사에서 흔히 쓰이는 lidocaine, thrombin, epinephrine 등의 약제들이 호흡기 질환의 흔한 병원균인 S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa 균주들에 대해 항균 효과가 있을 수 있어 세균배양검사에 영향을 미칠 수 있겠다. Background : We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. Materials and Methods : The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. Result : MIC_(50) and MIC_(90) of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 ㎍/mL and that for K. pneumoniae were 10,000 ㎍/mL. MIC_(50) and MIC_(90) of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC_(50) and MIC_(90) of epinephrine for K. pneumoniae and S. pneumoniae were above 500 ㎍/mL; that for S. aureus and P. aeruginosa were 500 ㎍/mL. Conclusion : We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.

AHP를 활용한 국내 위탁급식사업의 KPI 우선순위 및 가중치개발에 관한 연구

김학준(Hak Jun Kim),김홍길(Hong Kil Kim),김대관(Dae Kwan Kim) 한국관광연구학회 2011 관광연구저널 Vol.25 No.4

The contracted foodservice business as an intangible service industry requires measurement in intangible values. By these measurements the limited capitals should be selected and invested to differentiate itself from competitors and secure competitiveness. Currently, there are items to evaluate the present, future, and past of the Contracted Foodservice Business, however no academically established priority of the items. The purpose of this research, a follow-up research of Kim, Hak-Jun & Kim, Ju-Yeon(2009) is development on significancy and priority of KPI in Korea. As a result of the study, customer perspective was understood to be most important, next financial perspective, internal process, and lastly the learning and growth perspective. KPI`s priority consists of customer satisfaction measurement in first place with a significant rate of 0.187. Next, following up was achieved profit targets and achieved sales goals. The results implicate that in the contracted foodservice business in Korea the business strategy should select and invest in limited capitals by investing in the increased customer satisfaction measurement and corresponding to the needs and wants of the customer to increase customer satisfaction measurement.

배면뛰기의 시뮬레이션 프로그램에 관한 연구

김관현,이상철,강상학 龍仁大學校 1997 용인대학교 논문집 Vol.14 No.-

The purpose of this study is to analize present studies regarding the computer simulation of human movement and to make the animation program of simulated movement and computer simulation program based on this study. This study used the fosbury flop movement of high jump style using video analysis system as experimental events, and the conclusion is as follows. As a result of simulation experiment about 1 scene of 3 trial of fosbury flop of high jump, the somersault rotation error increased gradually but decreased as time goes by. As a 0.6 second simulation result, the maximum error of somersault rotation was on the tenth frame(0.333sec) after simulation started and the error value was 34.25 degree. The twist error also increased gradually but decreased in the final stage of simulation and the error value was 4.45 degree, and the maximum twist error was the ninth frame(0.267sec) and the error value was 28.12 degree. The test of simulation model and simulation program was the same as expected value, and the graphic of animation program can view movement scene on any derection by the removal of hidden line and hidden surface.

호흡기 감염에서 Sparfloxacin 의 임상적 유용성에 대한 Enoxacin과의 비교 검토

김주옥,김선영,김관형,서지원,박석영,이종진,박성학 대한감염학회 1995 감염 Vol.27 No.4

목적:폐렴, 기관지염, 만성기관지염에서 fluoroquinolone제제로서 항균력이 강하고, 혈중 반감기가 길고, 객담과 조직내 농도가 높은 sparfloxacin의 안전성과 효과를 enoxacin과 비교하기 위해 본 연구를 시행 하였다. 방법:1994년 10월부터 1995년 4월까지 충남대 부속병원과 대전 성모병원에 내원한 폐렴, 급성기관지염, 만성기관지염이 급성으로 악화된 환자 63명을 대조군(32명)(enoxacin 100 mg 1일 3회 경구투여), 실험군(31명)(sparfloxacin 200mg 1일 1회 경구투여)으로 나누어 임상증상, 세균학적 객담 검사, 혈액검사, 실험실내 항균력검사로 그 치료율 및 안전성을 비교하였다. 결과: 1) 임상종합 평가, 세균학적 균소실, 안전성, 유용성에서 두군간에 의미 있는 차이는 없었다. 2) 시험관내 항균력검사상 MIC가 실험군이 대조군보다 현저하게 낮았다.(p<0.05). 3) 경미한 두통, 식욕감퇴, 상복부 불쾌감, 설사등이 대조군 9예, 실험군 7예에서 발생하였고, 검사실 소견상 SGOT 혹은 SGPT 의 일시적 경미한 상승이 대조군 2명, 실험군 3명에서, 혈중 creatinine 상승이 실험군 2명에서 있었으나 경미하였다. 결론:이상의 결과로 sparfloxacin은 폐렴, 급성기관지염, 만성기관지염의 악화에서 하루 한번 투여로 enoxacin 하루 3번 투여와 유사하게 효과적이고 안전하며, 시험관내 항균력이 enoxacin보다 월등히 우수하여 임상에서도 유용하게 사용될수 있을것으로 생각된다. Background: Sparfloxacin, a new oral quinolone, has a broad spectrum, potent antimicrobial activity, prolonged half life, high concentration in sputum. The clinical efficacy and safety of sparfloxacin have been reported by some previous clinical studies performed in Japan. The objectives of this study were to evaluate the clinical and antimicrobial efficacy of this drug in respiratory tract infections compared to those of enoxacin. Methods:We performed an open controlled, randomized study in 63 patients with acute bronchitis, pneumonia, and exacerbation of chronic bronchitis at Chung Nam University hospital and Dae Jeon St. Mary's hospital from October, 1994 to April, 1995. In the control group(n=32), 100 mg enoxacin was administered orally 3 times a day and in the test group(n=31), 200 mg sparfloxacin once a day. Results: The results were as follows; 1) There were no significant differences between the two groups in clinical efficacy, bacteriological finding, and usefulness. 2) Means and SD of MICs were 0.44±0.89 ㎍/ml in the control group, 0.13±0.24 ㎍/ml in the test group. There was a significant difference in MICs between the two groups(p<0.05). 3) Headache, epigastric discomfort, and loss of appetite were observed in 7 cases of the control group and in 9 cases of the test group, and transient elevations of hepatic enzyme in 2 cases of the control group, and in 3 cases of the test group. There was mild elevation of serum creatinine in 2 cases of the test group. Those laboratory abnormalities by therapy might be associated with their underlying diseases. There were no significant adverse effects caused by the drugs Conclusion:In conclusion, sparfloxacin of 200 mg once a day was as effective and well tolerated as enoxacin of 100 mg three times per day in the treatment of respiratory tract infections. Sparfloxacin is more potent antibiotics because MICs of sparfloxacin were very lower than those of enoxacin.

용접부에 작용하는 구동력에 의한 용융풀 거동 분석

김일수,김학형,조선영,강봉용,강문진,유관종 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

Over the last few years, there has been a growing interest in quantitative representation of the weld pools in order to relate the processing conditions to the driving forces of the weldment produced and to use this information for the optimization of the welding process. A theoretical model offers a powerful alternative to check the physical concepts of the welding process and the effects of driving forces. To solve this problem, a 2-D thermo-fluid model were developed for determining temperature and velocity distribution for the GMA welding process.

21세기 새로운 시대를 준비하는 원광대학교 의과대학의 교육목표 개정과정

이학승,김요식,송윤강,오재민,양연식,정선관 원광대학교 의과학연구소 2009 圓光醫科學 Vol.24 No.1

교육목적은 대학의 교육이 지향하는 대전제이다. 그러므로 대학교육 목적과 목표가 어떤가에 따라 교육과정과 교육방법이 달라진다. 원광대학교 의과대학의 교육목표는, '지덕겸수'로 요약되는 '과학과 도학을 겸비한 전인교육'의 건학정신과 '학술탐구'와 '덕성함양'의 원광대학교 교육목표와 일치하게 현재까지 유지되었다. 그러나 현행 교육목표의 여러 문제점이 발견되었고, 시대상의 변화에 따라 원광대학교 의과대학에서도 사회적 변화 빛 의료인에 대한 시대적 요구에 걸맞은 의학교육의 목적 및 목표의 재설정 과정을 시작하게 되었다. 그 결과 개정 작업을 통해 새로운 교육목표를 설정하게 되었으며 그 내용은 다음과 같다. 1. 기본진료능력을 지닌 의사를 양성한다. 2. 원불교 교리 이념을 반영한 윤리적, 도덕적인 의사를 양성한다. 3. 평생 학습하는 연구하는 의사 혹은 의과학자를 양성한다. 4. 사회적 책무를 수행하는 리더십을 갖춘 의사를 양성한다. 5. 지역 사회에 공헌하는 봉사정신을 갖춘 의사를 양성한다. Purpose : With the changes to the medical environments and to the medical educational systems, we aimed to evaluate the current mission statement of the School of Medicine, Wonkwang University, and to revise it. Methods : To establish the new goal and mission statement, a Special Committee for the Revision of Medical School Mission and advisory group were organized in 2008. This special committee conducted through five steps of action, which are composed of investigation, education, development, surveillance of various opinions, and announcement. Results : For the development of new goal and mission, the revised, final goal and mission statements decided through the five steps of action. The new mission of Wonkwang University School of Medicine was as follows; 1. Doctor who can diagnose and treat easily 2. Ethical and moral doctor who practice Won Buddhism 3. Doctor or Medical Scholar who studies lifelong study 4. Doctor who has leadership to social responsibility 5. Doctor who goes into service to a local community. Conclusion : The authors expect that the new goal and mission of Wonkwang University School of Medicine would be helpful in giving the guideline on the educational process of medical school and will give the information to reform the medical school system according to the rapidly changing educational environment.

Antigenieity Study of CFA-001,Cefazolin,a Cephalosperin Derivative Produced by an Enzymatic Semisynthesis

Park, Jong Il,Han, sang seop,Jeong, Tae Cheon,Roh, Jung Koo,Kim, Hyoung Chin,Kim, Jeong Hwan,Jeon, Yeong Joong,Kim, Dal Hyun,Kim,Je Hak,Park, Kwan Ha 한국응용약물학회 1997 Biomolecules & Therapeutics(구 응용약물학회지) Vol.5 No.1

The antigenic potential of CFA-001, cefazolin, a cephalosporin derivative produced by an enzymatic semisynthesis, was determined in Hartley guinea pigs. A battery of tests employed consisted of active systemic anaphylaxis (ASA), passive cutaneous anaphylaxis (PCA), and indirect hemagglutination test (IHA). The results were as follows: 1) In ASA, no signs attributable to anaphylaxis was observed in guinea pigs sensitized with CFA-001, whereas OVA-sensitized animals induced severe anaphylactic symptoms; 2) guinea pigs did not produce antibodies against CFA-001 when sensitized with or without Freund's complete adjuvant (FCA) in homologous PCA tests. Meanwhile, antibodies against ovalbumin (OVA) were clearly detected; 3) No CFA-001-specific hemagglutination was observed in the IHA using sera obtained from CFA-001-sensitized guinea pigs. These results suggest that CFA-001 has no antigenicity potential in guinea pigs.

Fabrication of Electrochromic Devices Using Double Layer Conducting Polymers for Infrared Transmittance Control

Kim, Jin Kyu,Koh, Jong Kwan,Kim, Bumsoo,Jeon, Seokwoo,Ahn, Joonmo,Kim, Jong Hak Korean Society of Photoscience 2014 Rapid communication in photoscience Vol.3 No.2

We report the performance improvement of electrochromic devices for modulating the transmittance contrast of long wavelength infrared light between 1.5 and 5.0 ${\mu}m$ based on a double layer of conducting polymers. The device, fabricated with poly(3-hexylthiophene) (P3HT) and poly(3,4-ethylenedioxythiophene) (PEDOT) as the first and second layers, respectively, showed an transmittance contrast of 60% with a response rate under 5 s, which is greater than the transmittance contrast of cells based on only P3HT or PEDOT (approximately 40%).