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).

태산반석산이 면역기능에 미치는 영향

남경수,김희진,이태균 동국대학교 생명과학연구소 1995 생명과학연구논문집 Vol.2 No.-

To invesitigate the immunoadjuvant effect of Taesanbanseok-san(TBS), TBS was pretreated to Ballb/c mice for 10 days with intraperitioneally. After 10 days, haptenic antigen (VCR-BSA, vincristine-bovine serum albumin) complexed with Freund's complete adjuvant was immunized. The results are as follows. The antibody production in Balb/c mouse immunized with VCR-BSA was markably increased in the pretreated group of TBS compared with saline treated(control) group. The number of macrophage in Balb/c mouse immunized with VCR-BSA was considerably increased about 2.3 times in the pretreated group of TBS compared with control group. The lysozyme activity of macrophage in Balb/c mouse that was immunized with VCR-BSA was increased gradually in the pretreated groups of TBS compared with control group. In the TBS pretreated group, B cell proliferation was increased with a dose dependent manner. At the concentration of twenty microliter/well of TBS, B cell proliferation activity was most highest. On the other hand, in the T proliferation, TBS pretreated group had less considerable activity than B cell proliferation. These results may suggest that TBS will have immunoadjuvant effects on the cells which concerned with immuno mechanism.

경사 슬래브교의 지간/폭, 경사각에 따른 응력 상관성

남문희,정희효,이관희,이수경 慶尙大學校生産技術硏究所 1996 生産技術硏究所論文集 Vol.12 No.-

Skewed slab bridge have designed a width beam, stress of skewed slab bridge is quite different in according with skew and width /length. Especially in case that we analyse skewed slab bridge as a width beam, stress of right angle direction against axis of bridge is not analysed. In this study we will present the stress of transverse axis to longitudinal axis of bridge according to skew and width/length.

하악의 측방운동 재현성과 저작운동 간의 관계에 관한 연구

남천우,한경수 대한 두개하악 장애학회 1997 대한두개하악장애학회지 Vol.9 No.1

This study was performed to investigate the relationship between reproducibility of mandibular lateral movement and chewing movement in subjects with preferred chewing side. 44 dental students without any signs and symptoms of temporomandibular disorders participated in this study. BioEGN of the Biopak^� (BioResearch Inc. USA) was used to record mandibular lateral movement and chewing movement. Mandibular lateral movement was performed acceding to the method used for Pantographic reproducibility index, and from this, reproducibility index devised by the author and named as BioEGN reproducibility index(BERI) was computed. Chewing movement was observed as to chewing velocity and range of movements. The data were categorized by the preferred chewing side and the correlationship between reproducibility of mandibular lateral movement and chewing movement was also analyzed with SAS/stat program. The results obtained were as follows : 1. There were no statistical difference in most of the measurement items of chewing movement according to preferred chewing side, but mean value of some items such as velocity and total lateral distance in horizontal plane in left-side preferred chewing subjects were higher than those in right-side preferred chewing subjects. 2. Reproducibility indexes on lateral movements to both preferred chewing side and contra-lateral side were statistically same in each chewing subjects group. 3. In right-side preferred chewing subjects, correlationship between reproducibility of mandibular lateral movement and chewing movement were significant contralaterally, but in left-side preferred chewing subjects, the correlationship were observed in left-side chewing movement only. 4. In right-side preferred chewing subjects, there was a negative correlationship between reproducibility of mandibular lateral movement and slight mandibular protrusion in early stage of chewing movement, and in left-side preferred chewing subjects, the items of significant correlations with mandibular reproducibility were sagittal mouth opening range and horizontal distance to preferred chewing side.

肺結核을 同伴한 肺癌 患者에 대한 臨床的 硏究

경란호,柳南壽 梨花女子大學校 韓國生活科學硏究院 1986 韓國生活科學硏究院 論叢 Vol.38 No.-

의학 및 항결핵제의 발달로 폐결핵환자의 평균수명이 높아지고 폐암발생율의 중가와 더불러 기관지경검사 및 암세포 검출방법의 발달로 폐암발견이 더욱 용이해짐에 따라 우리나라와 같이 폐결핵 유병율이 높은 나라에서는 폐결핵을 동반한 폐암환자의 수가 증가하는 경향을 볼 수 있다. 폐암은 암 중에서도 악성종양에 속하며 조기진단만이 치유율을 높일 수 있으나 폐결핵을 동반한 경우에는 폐암조기진단의 시기를 종종 놓치게 되어 환자의 사망률이 증가되므로 이에 저자등은 1981년 1월초부터 1984년 9월말까지 국립의료원 흉곽내과에 입원하였던 1,044예의 폐결핵환자 중 비활동성폐결핵을 동반한 폐암환자 9예와 활동성폐결핵을 동반한 폐암환자 9예를 대상으로 임상적 관찰을 하여 다음과 같은 결과를 얻었다. 1. 18예 모두 남자 환다였다. 환자의 연령은 46세~75세로 평균연령은 62세였으며 70대(33%)가 가장 많았다. 2. 환자의 증세는 흉통(44%)이 가장 많았으며 기침 및 객담(39%)< 혈담(33%),호흡곤란(33%), 체중감소(11%), 아성(11%), 발열(11%)의 순이였다. 3. 입원 당시 임상적 진단명은 18예중 8예(44%)가 폐결핵으로 진단되었고 폐결핵을 동반한 폐암으로 진단된 환자는 6예(33%), 폐암 1예(5.5%), 기타 3예(16.5%)였다. 4. 흉부 X-선상 폐암은 종괴(Mass) 5예(28%), 허탈변화(collapse change) 5예(28%), 폐문종대(hilar enlargement) 4예(22%), 늑막엽동반 2예(11%), 팽륭(bulging) 공동 형성이 각각 1예(5.5%)였다. 5. 폐암의 조직학적 변화는 18예중 15예(83%)가 편평상피세포암으로 가장 많았다. 6. 폐암의 확진방법은 객담암세포검사로 발견된 경우가 18예중 14예(78%)로 가장 많았다. 7. 폐암이 타장기로 전이된 예는 18예중 8예(44%)였고 그중 쇄골상부임파선 전이가 5예(63%)로 가장 많았다. Eighteen cases with lung cancer associated with pulmonary tuberculosis were found in 1044 patients with pulmonary tuberculosis who were seen in the National Medical Cancer from January 1981 to September 1984. 1. All patient were male. The youngest was 46 years old and the oldest was 75. The average age was 62. 33% of the 18 cases were over 70 years old. 2. The most common symptoms were chest pain (44%), couching and expectoration (39%), bloodv sputum (33%), dyspnea (33%), weight loss (11%), hoarsness (11%) and fever (11%) in that order. 3. Among the 18 cases, 8 cases (44%) were diagnosed as pulmonary tuberculosis, 6 cases (33%) were suspected to pulmonary tuberculosis with lung cancer. Diagnosis was more difficult in active pulmonary tuberculosis. 4. Chest X-ray finding of lung cancer were mass shadow 5 cases (28%), hilar enlargement 4 cases (22%), pleurisy findings 2 cases (11%), bulging shalow 1 case (5.5%), cavity formation 1 case (5.5%). 5. Diagnosed type of lung cancer were 15 cases (83%) of epidermoid cell carcinoma, 2 cases (11%) of adeno carcinoma, 1 case (6%) of mixed type of epidermoid and small cell carcinoma. 6. In 14 cases (78%) malignant cells were revealed by the sputum cytology examination. 7. Metastasis to other organs were noted in 8 cases(44%), supra clavicular lymph node metastasis is the most common (5 cases).

당뇨병환자에서 호흡이 심박수에 미치는 영향

남수현,오용구,박경욱,윤영길 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.1

당뇨병환자에서 자율신경 기능장애를 알아내기 위한 검사로서 심호기 심흡기율이 건강인에 비해 떨어져 있음을 심전도를 이용하여 검사하므로서 환자 침대에서 간단하게 그리고 정확하게 검사할 수 있었다. 당뇨병환자는 안정시 정상인에 비해 빈맥이 있으며, 심박수의 감소 또한 유의하게 적었다. 특히 건반사가 이상이 있는 당뇨병환자에서 건반사가 정상인 환자에 비해 심박수의 변화가 유의하게 적었으며 건반사가 이상인 환자에서 심흡기 심호기율이 1.10 이하는 56명중 49명으로 88%나 되었다. Retinopathy가 있는 환자에서 역시 심박수의 변화는 유의하게 적었고 심흡기 심호기 율이 1.10 이하인 예가 47명중 38명으로 78%나 되었다. 또한 단백뇨가 있는 환자에서도 심박수의 변화는 그 정도는 낮았으나 유의하게 적었다. 당뇨병의 병력기간이 길수록 심흡기 심호기율은 더 작아지는 경향은 확실하며 저자의 예에서는 병력기간이 1년이상 5년이하까지는 1.11±0.21 이였고, 5년이 넘어서서 10년 이하에서 1.07±0.03으로 1.10을 하회(下廻)하였다. 이와 같은 성적으로 미루어 보아 심호흡시 흡기 호기의 율을 계산함으로써 외과수술환자의 급성심폐부전에 의한 높은 사망율을 줄이는 데는 많은 도움이 될 것이다. To find a simple and accurate test of autonomic nervous dysfunction in diabetes mellitus, we performed maximal deep breathing procedures while undergoing electrocardiographic recording at bed side. Normal indivisuals at rest show variation in heart rate induced by respiration. During maximal deep breathing these changes are accelltuated and electrocardiographic recording will show the increase in heart rate during inspiration and the decrease during expiration. This variation is reduced or abscent in diabetics with autonomic neuropathy. Forty eight of the 56 with sensory neuropathy(88%) had an DE/Dl ratio below of 1.10. Diabetics with retinopathy also had significantly smallest variation and thirthy eight of the 47 with retinopathy(78%) had an DE/DI ratio below of 1.10. Also diabetics with proteinuria had significantly smaller variation. Relation between duration of diabetics and DE/DI ratio was inverse proportion accurately. For example in diabeticc of duration which above 1 year and below 5 years DE/DI ratio was 1.11±0.21 and in diabtiecs with below 10 years duration was 1.07±0.03. Our study cleary shows that diabetics with sensory neuropathy have a high prevalence of autonomic dysfunction, with may be important clinically. Since sudden cardiorespiratory deaths are common in diabetics with autonomic neuropathy during and after sugery, the determination of the DE/DI ratio might be a suitable preoperative test for those diabetics at risk. Patients with an abnormal ratio should probably be closely monitered in an intensive care unit after operation.

Phosphatidylserine에 대한 Anti-Idiotypic Antibody를 이용하여 Human 적혈구 막에서 30Kd의 단백질 확인

남경수 동국대학교 생명과학연구소 1994 생명과학연구논문집 Vol.1 No.-

A series of monoclonal antibodies that interact with phospholipids(phosphatidylcholine and phosphatidylserine) have been investigate. Among them, PS4A7 is highly specific to phosphatidylse-rine(PS) and no cross-reaction with other acidic and neutral phospholipids were observed. PS4A7 recognizes the stereo-specific configuration of serine residue in PS. Anti-idiotypic(Id) antibody against was produced from rabbits(New Zealand White, female). Anti-Id antibody raised against antibodies to a variety of ligands have been shown to bind the ligands' receptors. Using ELISA inhibition assay and Western blotting method, it was shown that anti-Id antibody had binding affinity with a 30Kd protein on human erythrocytes membrane. This binding ability was further identified with preincubation of PS liposomes. The anti-Id antibody may prove useful in understanding the conformation of the 30Kd protein.

네트워크 통신 보안을 위한 암호화 조건부 접속시스템

박남철,이철형,최명수,김경호,이성로 木浦大學校 應用科學硏究院 2001 應用科學硏究誌 Vol.1 No.-

We can improve encryption speed at the home networking which transmit high density information. In this paper, We applicate DES encryption algorithm in the proposed encryption chip which dose operation that encrypts with block of 64 bits. And we improved key problems about transmitting external key by the conditional contact algorithm which solves the problem about periodical refresh in the symmetric algorithm with public key structure.

소각재 용융슬래그를 이용한 제올라이트 Na-A의 합성

장영남,채수천,배인국,류경원 한국광물학회 2005 광물과 암석 (J.Miner.Soc.Korea) Vol.18 No.1

소각재 용융슬래그를 출발물질로 하여 알카리 조건하에서 활성화시킴으로써 Na-A형 제올라이트를 합성하였다. 합성실험은 스텐레스 철재로 제작된 반응용기를 사용하였다. 출발물질은 슬래그 외에 수정인공합성 공장에서 배출되는 '규산질 수용액'과 NaA1O₂수용액을 사용하였는데, 전자의 화학조성은 SiO₂5.7 wt% Na₂O 3.2 wt%이고, 후자는 몰비가 Na₂O/A1₂O₃= 1.2와 H₂O/Na₂O=9의 조건으로 알루미늄 드로스와 NaOH 수용액을 반응시켜 제조하였다. 위에서 언급된 슬래그, '규산질 수용액' 그리고 NaAlO₂ 수용액을 혼합시킨 혼성물을 약 80℃에서 7~8시간 반응시키면 Na-A형 제올라이트가 단일상으로 합성되었다. 출발물질의 이상적인 혼합비율은 Na₂O : Al₂O₃: SiO₂의 물비가 1.3~l.4 : 0.8~0.9 : 2이었으며 반응용액과 슬래그의 비율은 1 : 7~10 (g/㏄)이었다. 합성된 제올라이트의 형태는 균일한 입방형이었으며 입도는 약 1 ㎛이었다. 한편, Ca^(²+)이온에 대한 이온교환 용량(CEC)은 180~210 meq/100 g이었으므로 통용되는 세제용 제올라이트와 비교하면 약 80% 수준이었으므로 폐수처리나 오염된 중금속처리와 같은 환경처리용으로 사용될 수 있을 것이다. Na-A zeolite were synthesized from melting slag of the incinerated ash by the alkaline activation processes. The experiments were performed in stainless steel vessels, with continuous stirring during the reaction periods. The silica-rich solution, a starting material, which was the waste of crystal growth factory, contains 5.7 wt% SiO₂ and 3.2 wt% Na₂O And NaAlO₂was made by the reaction of aluminium dross and NaOH solution and its molar ratios were Na₂O/ Al₂O₃ = 1.2 and H₂O/Na₂O=9. During the residence time of 7~ 8 h at 80℃, the mixing of the silica-rich solution, NaAlO₂and melting slag yields the production of homogeneous Na-A zeolite. The optimal reactant composition in molar ratio of Na_₂O : Al₂O₃: SiO₂was 1.3~l.4 : 0.8~0.9 : 2 and mixing ratio of solution and slag was 1/7~10 (g/㏄). Synthesized Na-A zeolite has cubic form uniformly and its size ranges about 1㎛. Ca^(²+) ion exchange capacity of the Na-A was about 180~210 meq/100 g, corresponding approximately 80% to the commercial detergent builder.

열교환기 구조 변화에 따른 NH₃와 R22의 성능특성연구

하옥남,하경수,이승재,정송태 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

Nowadays HCFCs refrigerant are restricted because it cause depletion of ozone layer. However, natural gases such as ammonia as an organic compound, propane and propylene as hydrocarbon are easy and cheap to obtain as well as environmental. Accordingly, this experiment apply the NH3 and R22 to study the performance characteristic from the superheat control and compare the energy efficiency of two refrigerants from the high performance. The condensing pressure of refrigeration system is increased from 15bar to 16bar and degree of superheat is increased from 0 to 10℃ at each condensing pressure. As the result of experiment, when comparing the each COP, we knew the NH₃ is suitable as the alternative refrigerant of the R22.