당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

우리나라 논 관개용 지하수 수질 특성

김진호,조광래,임수정,이경자,경기천,엄미정,김희권,김찬용,이영한,이신찬,윤순강 한국환경농학회 2003 한국환경농학회지 Vol.22 No.4

This study was carried out to evaluate the status of the groundwater quality for paddy fields irrigation in Korea. Water samples were collected at 130 sites throughout the country. Samples were collected at three seasons-April, July and October-in 2000. According to our survey, the groundwater was found to be suitable for irrigation purpose. Average EC was shown 0.286 dS/m. Nitrate-nitrogen and Cl^(-) concentration was 5.6 ㎎/L, 32.95 ㎎/L which satisfied the Korean Standards for Irrigation Water. Nitrate-nitrogen concentration in each province was shown as following orders: Jeju (11.17 ㎎/L) > Chungnam (8.16 ㎎/L) > Gyeongbuk (6.64 ㎎/L) > Gyounggi (5.91 ㎎/L) > Chungnam (4.95 ㎎/L) > Gyeongnam (3.91 mgk) > Jeonbuk (3.50 ㎎/L) > Jeonnam (3.27 ㎎/L) > Gangwon (2.91 ㎎/L). The concentration by sampling seasons were October (6.62 ㎎/L) > July (5.88 mg&) > April (4.78㎎/L). As the soil of Jeju Province is usually derived from volcanic ash soils mainly used for upland drops, it may influence the nitrate-nitrogen concentration of groundwater. The amount of rainfall also influence the water quality. But the COD_(Cr), were shown April (3.17㎎/L) > July (2.91 ㎎/L) > October (2.40 ㎎/L), it is highly related in the basal dose of organic matter fertilizers. This study demonstrated that groundwater quality was suitable for irrigation, but continuous monitoring is recommended for agricultural policy and developing OECD agricultural environment indicators.

한국에서 한 일간지 신문기사 검색을 통한 IMF 전과 후의 자살 양상 비교

박상학,김경환,김학렬,김상훈,표경식,조용래 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Objectives : Under an IMF bailout program, our country's financial situation forced people to change many things suddenly. Therefore, this study was attempted to search the aspects of changes of suicide attempts in order to find out how the financial crisis affects people's suicide attempts, the extreme repertoire for psychological change Method : November 21, 1997, the day issued the application of IMF bailout program, is the basic date for comparing the changes, on a certain newspaper(Dong-A daily newspaper). The condition was divided into two, namely before and after the basic date, and the characteristics of suicide were compared between two conditions. Results : The news of suicide increased more after than before the application of IMF situation. (before:105, after:158) Specially, for 30-50 years old, active age in community, the rate of suicide attempts reached twice than that of the others. After the IMF situation, the prominent reason of suicide was the financial crisis. For the type of suicide, the family suicide was remarkably increased after the IMF situation. Conclusion : The frequency of the news of suicide was higher after than before IMF bailout program. The major reason of suicide was the financial crisis. Considering that the social and economic crisis affects people's view of death, psychosocial interventions are necessary for their mental health.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

안정된 고속 보행 휴머노이드 로봇의 개발

김승우,정용래,장경준 순천향대학교 부설 산업기술연구소 2004 순천향 산업기술연구소논문집 Vol.10 No.2

Most previous robots had used the wheels as means for movement. These structures were relatively simple and easy to control and this is why the method had been used until currently. However, there are many realistic problems to move from one place to another in human life, for instance, steps and edges. So we need to develop the two-legged walking humanoid robot. The 2-legged walking Robot system has been vigorously developed in so many corporations and academic circles of several countries. However, 2-legged walking Robot has been mostly studied in view of the static walk. We design a stable humanoid Robot which can walk in high-speed through the research of the dynamic walk in this paper. Especially, worldwide companies have been interested in developing humanoid robots for a long time to solve the before mentioned problems so that they can become more familiar with the human form. The most important thing, for the novel two-legged walk, is to create a stable and fast walking in two-legged robots. For realization of this movement, an optimal mechanical design of 12 DOFS, a distributed control and a parallel processing control are implemented in this paper. This paper proves that high speed and stable walking can be achieved, through experiments.

고립골낭에 관한 X선학적 연구

김경락,황의환,이상래 慶熙大學校 齒科大學 1994 慶熙齒大論文集 Vol.16 No.1

The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary ?.cone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University The obtained results were as follows 1. The incidence of solitary bone cyst was almost equal in males(52.2%) and in females(47.8%) and the prevalent age of the solitary bone cyst were the second decade(47.8%) and the third decade (21.7%). 2 In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17`.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 435% were asymptom and the tooth vitality involved in the solitary bone cyst, 76.5% were positive and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partialy, and 30.4% were not aeon. 5. In the change of tooth, 59.1% were intact, 18.2% were loss of the alveolar lamina dura, 13.6% were root resorption 4:55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11;1% were thickened myxofibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

귀울림증의 진단과 치료

金景來 대한의사협회 1998 대한의사협회지 Vol.41 No.11

학동기 비만아동의 피부두께의 통계적 관찰

김경석,나기찬,정은경,문경래,박상기,박영봉 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

The measurements of triceps skinfold thickness, body weight and height were done in children aged 7 to 12 years(3,142 boys and 2588 girls) in Kwangju in 1992. The author also observed degree of obesity, prevalence of obesity and average value of triceps skinfold thickness. The results were summarized as follows: 1) The mean value of triceps skinfold thickness acceding to age in male was 7 years 10.5mm, 8 years 10.5mm, 9 years 10.2mm, 10 years 12.3mm, 11 years 13.8mm, 12 years 12.3mm. In the female it was 7 years 11.9mm, 8 years 11.9mm, 9 years 11.6mm, 10 years 12.6mm, 11 years 14.1mm, 12 years 13.6mm. 2) The mean value of triceps skinfold thickness acceding to age in obese male was 7 years 16.3mm, 8 years 17.3mm, 9 years 16.0mm, 10 years 19.5mm, 11 years 23.7mm, 12 years 20.1mm. In the obese female it was 7 years 17.3mm, 8 years 17.9mm, 9 years 18.4mm, 10 years 19.5mm, 11 years 21.2mm, 12 years 20.3mm.

2-Deoxy-D-Glucose에 의한 대사성 쇼크가 무우스의 면역 반응에 미치는 영향

김양숙,장선일,박래길,조성경,정헌택 최신의학사 1991 最新醫學 Vol.34 No.2

모바일 로봇의 견실제어를 위한 제네틱 알고리즘 개발

김홍래,배길호,정경규,한성현 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-

This paper proposed trajectory tracking control of mobile robot. Trajectory tracking control scheme are real coding genetic-algorithm and back-propergation algorithm. Control scheme ability experience proposed simulation. Stable tracking control problem of mobile robots have been studied in recent years. These studies have guaranteed stability of controller, but the performance of transient state has not been guaranteed. In some situations, constant gain controller shows overshoots and oscillations. So we introduce better control scheme using Real coding Genetic Algorithm(RCGA) and neural network. Using RCGA, we can find proper gains in several situations and these gains are generalized by neural network. The generalization power of neural network will give proper gain in untrained situation. Performance of proposed controller will verify numerical simulations and the results show better performance than constant gain controller.