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

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

통풍성 관절염의 임상적 고찰

윤채중,정승문,김영학,김동규,허광식,김태원,배학연,정종훈,이승일,김평남 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

통풍은 Purine 대사의 이상으로 발생하는 질환으로, 고뇨산혈증인 사람의 전부가 통풍으로 발현되지 않고 증상의 출현 양상이 다양하여 진단과 치료에 주의가 필요하며, 조기에 적절한 조치를 한다면 충분히 조절이 가능한 질환이다. 본대학 내과학교실에서는 통풍으로 치료한 32명의 환자에서 임상양상, 병력과 검사소견을 분석하여 다음과 같음 결과를 얻었다. 1. 32명 모두 남자이며, 최초 발병 시기는 24세에서 72세로 평균 43.8±11.9세이었으며, 30대에서 40대까지가 19명(59.4%)으로 대부분을 차지하였다. 내원 당시 나이는 27세에서 75세까지로 평균 52.3±10.4세였으며, 내원시 까지 평균 유병기간은 8.5±6.8년으로 나타났다. 2. 동반 질환으로는 고지혈증 12례, 신장질환 10례, 고혈압 12례, 비만 8례, 당뇨 2례 등이었다. 3. 이환된 관절은 단관절 침범이 19례(59.4%), 다관절 침범이 13례 이었으며, 최초 이한된 관절은 족무지 중족골지골 관절로 19례(59.4%)로 가장 많았고, 통풍 결절은 20례(62.5%)에서 관찰되었으며, 유병기간이 10년 이상된 12례중 11례 (91.7%)에서 결절이 관찰되었다. 4. 평균 혈중 요산치는 9.17±1.75 ㎎/dl이었으며, 8.0 ㎎/dl에서 9.9 ㎎/dl 사이가 19명으로 전체의 59.4%를 차지하였다. Objective: The gout is a heterogeneous group of diseases resulting from tissue deposition of monosodium urate or uric acid crystals from extracellular fluids supersaturated with respect to this end product of human purine metabolism. The clinical manifestations are such as hyperuricemia, gouty arthritis, gouty nephropathy, uric acid nephrolithiasis. We analyze of clinical manifestations and associated factors in gout. Method: We have reviewed the medical records, radiologic findings and clinical results of thirty-two patients admitted at our department from April 1996 to July 1997. Result: 1) All patients were male. The mean age at initial attack was 43.8 years old, ranging from 24 to 72 years old. 2) The mean level of serum uric acid was 9.17mg/dl on admission. 3) The first metatarsopharyngeal joint was involved in 19 cases (59.4%). Tophus was observed in 20 cases (62.5%). 4) Hyperuricemia was associated with hypertension, obesity, nephrolithiasis and hyperlipidemia.

임상교정 교육용 멀티미디어 데이터베이스 웹서버 구축에 관한 연구

박재우,이종기,장영일,남동석,김명기,양원식,김태우,백승학 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

본 연구는 인터넷상의 가상공간에 다양한 자료로 구성된 환자 증례를 통해, 교정을 배우고자 하는 임상의나 학생들의 교육에 필요한 멀티미디어 데이터베이스를 구축하기 위한 것이다. 이러한 시스템을 구현하기 위해서는 이미지 자료의 처리, computer network를 통한 빠른 정보처리 기능, 진단 분석법의 개발, 데이터베이스의 구축 기술, 데이터베이스와 인터넷과의 연계, 증례를 통한 교육방법론과 같은 기술적 문제점들이 있다. 진단과 치료계획을 위한 분석은 모델 분석과 두부방사선 사진분석으로 나누어 제공하였다. 모델분석법은 arch length discrepancy와 Bolton tooth ratio를 환자 정보란에 제공하였다. 두부방사선 사진분석은 초진란에 제공하였다. Cephalometric analysis ver 2.0과 Power Ceph pro 3.3.5를 이용하여 Tweed, Steiner, Jarabak분석법 등을 제공하였으나, 본문에서는 주로 Kim's analysis와 몇 가지 계측치를 추가하여 설명하였고, 나머지는 tracing란에서 제시하였다. 또한 치료 종료 후나 보정란에서 치료 전, 후의 두부방사선 사진을 중첩해서 보여줌으로써 치료에 의한 효과를 직접 볼 수 있도록 하였다. The Objective of this research was to construct the multimedia database system that was necessary for the education of the practitioners and the students. To establish this system, there were technical problems as follows : 1) The processing of the images, 2) The rapid processing of the information with the computer network, 3) The development of diagnosis tools, 4) The technique to establish the database system, 5) The link between the database system and the internet, and 6) The method to educate through many cases. The analysis for diagnosis and treatment planning were provided as two parts : model analysis and cephalometric analysis. As a model analysis, arch length discrepancy and Bolton tooth ratio were provided for the part of patient information. Cephalometric analyses were provided in the part of initial diagnosis. The Cephalometric analysis ver 2.0 and the PowerCeph pro 3.3.5 were used to show Tweed, Steiner and Jarabak analysis. In the main part, Kim's analysis and some measurements were added. In the post-treatment or retention part, we show the superimposition of the cephalometrics with which you can find the effectiveness of the various orthodontic treatment. The address of this home page is "http://damis.snu.ac.kr/orthodontics"

난소절제후 Estrogen을 투여한 흰쥐 대동맥에서 Protein Kinase C-α와 Fas 발현의 변화

이왕수,이상엽,안지현,송영빈,김학진,이광재,유재격,김상욱,김태호,김치정,류왕성 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3

Estrogen is believed to decrease coronary artery disease. Protein kinase C-α(PKCα)appear to be important in signal conduction pathways. Estrogen treatment increases catalytic activity of PKCα,and activation of PKCαcan modulate estrogen receptor levels and responsiveness. And it was reported that activation of PKC can protect cells from apoptosis induced by Fas ligation. But the beneficial effect of estrogen on PKCαwas not clearly demonstrated. The objective of this study was to evaluate the role of PKCαafter ovariectomy and estrogen therapy in rat aorta. The results were summarized as below: 1. The significant pathological changes were not observed in the rat aorta irrelevant to ovariectomy and estrogen therapy. 2. The expression of Fas was decreased in the aorta of estrogen-treated rats than that of ovariectomized rats without estrogen therapy. 3. Increased expression of PKCαwas more marked in the aprta of estrogen-treated rats than that of ovariectomized rat without estrogen therapy. In conclusion,PKCαmay be important in signal conduation pathway on the effect of estrogen. Activation of PKCαby estrogen reduced Fas expression, suggesting that PKCαactivation may play a role in protection against atherasclerosis. Further studies are needed to elucidate the role of PKCαafter estrogen therapy.

금속 결합제를 사용한 Nd-Fe-B 영구자석에 관한 연구

金炯太,金學信 全北大學校 1994 論文集 Vol.38 No.-

Recently there has been a great deal of interests Nd-Fe-B permanent magnet materials because of the broad availability, the low cost of constituents and impressive magnetic properties. Powder metallurgical method is mostly used for fabrication of Nd-Fe-B hard magnets. Nd-Fe-B plastic magnets are fabricated by mixing melt spun magnetic powders with resin. In this study metal powders as a binder are used. MQ powder and Nd-Fe-B alloy powder by mechanical grinding compacted, heat-treated and hot-pressed with additive Zn, Ag-Zn, Al-Cu binders and the magnetic properties on two kinds of permanent magnets were investigated with DC-fluxmeter, SEM and AES. The results obtained in this experiment are as follows; 1. Nd-Fe-B isotropic magnets with mechanical grinding and additive Zn, Ag-Zn, Al-Cu were fabricated, but obtained not above B_r 4.5kG because of no densitification. 2. Nd-Fe-B isotropic magnet which used MQ powder with additive 6wt% Zn and heat-treated at 650℃ for 1 hour is increased to _iH_c 2.7kOe, while Nd-Fe-B magnet with additive 6wt% Ag-Zn at 700℃ for 1 hour is increased _iH_c 5.5kOe. 3. Nd_16Fe_78B_6 isotropic permanent magnet which added Al-Cu 3wt% and hot-pressed at 700℃ is obtained B_r 6.7kG, _iH_c 18.4kOe.

企業文化 및 意思疏通과의 相互作用에 의한 組織有效性

金學敦,趙炳泰 東亞大學校 經營問題硏究所 1990 經營論叢 Vol.11 No.-

인슐린 비의존형 당뇨병 환자에서 만성합병증과 혈청 sialic acid농도

김태종,배학연 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

Background: An elevated serum sialic acid concentration has recently been shown to be a potent predictor of cardiovascular mortality in the general white population. Microalbuminuria has been shown to be a independent risk factor or predictor of diabetic nephropathy and macroangiopathy in NIDDM. Several studies have shown a elevated serum sialic acid concentrations in NIDDM patients compared with nondiabetic subjects and in IDDM patients with microalbuminuria and clinical proteinuria. Methods : We studied 29 patients with NIDDM who had a normal urinary albumin excretion rate, 16 patients who had microalbuminuria, and 23 patients with clinical proteinuria. We also investigated sialic acid levels related to blood pressure, microalbuminuna, glycemic control, lipid analysis, serum sialic acid levels, and retinopathy. Results : 1) This study shows that NIDDM patients with macroalbuminuna had significantly higher serum sialic acid concentrations than control group, normoalbummuria, and microalbuminuria group.(meand:SE : 90.41±5.6 vs. 69.7±3.8, 68.2±2.4 and 72.6±2.9mg/dl, p<0.05 respectively). 2) Multiple linear regression analysis showed that systolic blood pressure, duration of diabetes, diastolic blood pressure, triglyceride, ESR, and albumin excretion rate (AER) correlate independently with logarithmic serum sialic acid concentrations. 3) The presence or absence of diabetic retinopathy had no impact on serum sialic acid concentration. Conclusions : This study shows that the serum sialic acid concentration is raised in NIDDM patients with macroalbuminuria. And there are no relationships between serum sialic acid and diabetic retinopathy. Further study is needed to confirm the mechanism of elevated serum sialic acid in NIDDM. And prospective studies are thought to be required to evaluate whether serum sialic acid concentration can be used as a predictor of microvascular and macrovascular complications in diabetes.

한란 및 심비디움의 기내 증식에 미치는 생장조절물질의 효과

김학윤,권순태 경북대학교 농업과학기술연구소 2000 慶北大農學誌 Vol.18 No.-

This study was carried out to determine the effects of plant growth regulators on organogenesis from Cymbidium kanran and Cymbidium hybrida. Optimal rhizome formation from Cymbidium kanran was obtained on MS medium with 10 ppm kinetin+2 ppm NAA, and optimal protocorm formation from Cymbidium hybrida was obtained on MS medium with 10 ppm kinetin+0.05 ppm NAA. However, in this study the optimal media for the callus induction from both explants was not identified. Optimal shoot induction from rhizome of Cymbidium kanran was obtained on MS medium with 10 ppm BA+2 ppm NAA and 5 ppm BA+2 ppm NAA. Optimal shoot induction from protocorm of Cymbidium hybrida was obtained on MS medium with 10 ppm kinetin+2 ppm NAA.

한국의 전자무역 네트워크 구축사업의 현황과 개선방안에 대한 연구

김태환,김재학,김인경,강성모 한국관세학회 2007 관세학회지 Vol.8 No.1

E-trade network potential is not readily evident due to incomplete legal groundwork, lacks of standardization, mutual certification and institutional system, and insufficient information in trading circles, etc. To reap full benefits, e-trade network should be harmonized and inter- connected with trading partners through multilateral or regional cooperation to set relevant inter-operable infrastructure, operate electronic document reposition center. Global certified networks are needed to streamline e-Trade through Grobal e-Trade networks. And to complete global e-Trade network, global e-Trade cooperation between nation is required. To complete global e-Trade, Letter of credit and shipping documents and bill of exchange must be dematerialized. The purpose of this thesis is to identify the current situation and korea problems of e-trade network which has been recently designed by Korea and another countries. Especially it deals with PAA, Korea-Japan e-trade Hub network, ASEM e-trade projects.