서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

Development of a noninvasive KIM-1-based live-imaging technique in the context of a drug-induced kidney-injury mouse model

Tae-Jun Kwon,Da-Sol Lee,Md. Enamul Haque,Rang-Woon Park,Byungheon Lee,Dongkyu Kim,Yong-Hyun Jeon,Kil-Soo Kim,Sang Kyoon Kim 한국실험동물학회 2021 한국실험동물학회 학술발표대회 논문집 Vol.2021 No.7

The development of reliable methods to diagnose acute kidney injury is essential to allow the adoption of early therapeutic interventions and evaluate their effectiveness. Based on the fact that kidney injury molecule-1 (KIM-1) expression levels in kidneys are markedly upregulated early after a damage event, here we developed a noninvasive KIM- 1-based molecular imaging technique to detect kidney injury. First, we took advantage of a phage-display platform to select small peptides demonstrating a specific high binding affinity to KIM-1. The promising candidate was conjugated with fluorescent probes, and its imaging potential was validated in vitro and in vivo. This peptide, with the sequence CNRRRA, not only showed a high imaging potential in vitro, allowing a strong detection of KIM-1 expressing cells by microscopy and flow cytometry but also generated a strong kidney-specific signal in live-imaging in vivo experiments in the context of a drug-induced kidney-injury mouse model. Our data overall suggest that the CNRRRA peptide is a promising probe to use in the context of in vivo imaging for the detection of KIM-1 overexpression in damaged kidneys.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

현암 김종희 회장의 생애와 경영이념 연구

김성수(Sung Soo Kim) 한국경영사학회 2009 經營史學 Vol.52 No.-

이 논문은 한국 화약산업의 개척자 한화그룹의 창업주 현암 김종희 회장의 생애와 경영활동 연구를 통한 경영이념 및 신 기업가정신(New Entrepreneurship)을 발굴하는 데 목적을 두었다. 현암 김종희 회장은 1922년 11월에 출생하여 1981년 7월(59세)에 영면 하였다. 비교적 짧은 생을 살았지만, 현암 김종희 회장은 1952년 30세 때에 화약산업의 불모지인 한국에서 한국화약㈜을 창업하였다. 그는 ‘다이너마이트’ 생산의 성공으로 혁신적인 화약류 국산화의 꿈을 실현한 훌륭한 기업가이다. 그는 한화그룹의 창업주로서 화약, 석유화학, 기계, 호텔, 건설, 무역 등 생전에 17개의 대기업집단을 이룬 창업 CEO이다. 그는 신의와 혁신, 도전과 개척 정신 그리고 변혁적 리더십 소유의 기업가로, 한국의 화약산업 개척자로서 화약산업사의 역사적 인물로 부각되며, 우리나라 화약산업의 기업 가사 연구의 중요한 경영사학적 사례를 제공한 기업인으로 평가된다. 그는 생애 경영활동을 통하여 사업보국 이념을 중심으로 ‘신용과 의리 그리고 봉사’로서 인류사회에 공헌하고자 하는 경영이념을 실현한 기업가이다. 특히 사업보국을 이념으로 발굴된 그의 신 기업가정신은 이 연구에 큰 의미를 준다. 즉, (1) 신의정신, (2) 도전과 개척정신, (3) 책임정신, (4) 근검절약정신, (5) 합리주의 정신, (6) 창의와 혁신정신, (7) 인재육성정신 등 7개의 기업가정신으로 나타나고 있다. 그리고 그의 혁신적 기업인 상은 (1) 인간성 중시의 변혁적 리더십을 소유한 기업인으로 대표되며, (2) 정도경 영을 실천한 기업인 (3) 경영이념(사업보국주의)을 통한 생산성 향상 정신을 실천한 기업인, (4) 혁신경영과 기술개발 노력을 실천한 기업인, (5) 위기극복과 문제점 해결능력을 갖춘 기업인 등으로 평가된다. 특히 (6) 국익증대의 선봉에 선 민간 외교관, (7) 스포츠 강국을 꽃피운 체육계의 거목이라는 경영인 상을 가진 기업가로도 높이 평가된다. The purpose of this study is to explore the chairman Chong-Hee Kim’s life and Managerial ideology, founder of Hanwha group. This research was to Highlight the entrepreneurship of chairman Chong-Hee Kim of Korea explosive founded (currently Hanwha Corp. Explosive Division), who carries the management principle which focuses on the devotion to business patriotism of social responsibility by providing best products and services with talent and technology. Also it aimed to revisit the life and the management principle of chairman Chong-Hee Kim who, with the business patriotism of righteousness and sense of mission, tried to found korea’s first gunpowder corporation. This research was mainly divided into two parts:literature-history research method and managerial history research method, and it analyzed the managerial accomplishment chronically according to the literature history documents, and managerial history method. This study took 12 months in which the document collecting process, writing process, and 6 party joint research processes were completed. The content of the research divided and categorized chairman Chong-Hee Kim’s life and managerial principle in the following order:(1) Social back ground at time of his birth (2) Elementary, middle and high school education in his teenage period (3) Business career begins (age 20-30) in his adolescent (4) 30s (age 31-40):president inauguration of the korea explosive founded, (currently Hanwha corp.explosive division), and his management his managerial growth process in his early adult life, in case, oct, 1952 korea explosive founded (gunpowder corp), oct, 1955 Incheon explosive plant acquired, jan,1959 all domestics industrial explosive suppled by korea explosives (5) 40s (age 41-50):his managerial revolution process in his middle the prime of the life, in case, Jan, 1964 Shinhan bearing industrial acquired, Nov, 1969 Kyungin energy established (6) 50s (age 51-59):genius management and establishment of the leading corporation in the Korean defense industrial and diversified management in his latter the prime of the life. In case, dec,1972, Hankook plastics industrial established, sept, 1974, union polymer established (currently Hanwha polydreamer), may 1975, Cheon-an Bukil foundation established, may 1976, sundo securities acquired (currently Hanwha securities). Next, the entrepreneurship through chairman Chong-Hee Kim’s managerial creed and ideology was examined. The 7 elements of Chong-Hee Kim’s new entrepreneurship of business patriotism that were examined are as follows : (1) Spirit of faithfulness (2) Spirit of challenge and pioneer (3) Responsibility for the fulfillment of obligation (4) Spirit of diligence and frugality (5) Spirit of rationalism for management (6) Spirit of creative and Innovation (7) Spirit of corporative social responsibility and service to society His entrepreneurship is based on the transformational leadership of rich humanity and management of righteousness, he is pioneer of schumpeter’s (J.A), and the creative entrepreneur who seeks for Innovation. The management philosophy of Hanwha (chong-hee, kim) is embedded in the Hanwha TRI circle ; the three circles Represent Trust, Respect and Innovation, respectively. They are the three pillars of how it’s conduct our business. Vision of Hanwha (chong-hee, kim) is just as committed being trustworthy, respected and Innovative as a responsible member of society as the Hanwha be to becoming dynamic global enterprise. As symbolized in the Hanwha TRI Circle, Trust, Respect and Innovation are core value as its interact with customer, serve our community and improve the everyday lives of people in general.

김재철 회장의 생애와 기업가정신 연구

김성수(Sung soo Kim) 한국경영사학회 2009 經營史學 Vol.50 No.-

이 논문의 목적은 “성실한 기업활동으로 사회정의 실현”과 “도전과 정도경영”에 바탕을 둔 동원그룹의 창업자 김재철 회장의 생애와 경영활동을 통한 기업가 정신(Entrepreneurship)을 발굴하는 데 있다. 김재철 회장은 1969년 34세때 동원산업(주)를 창업한 현재(2009년 4월)까지 40여년간 한국수산업계를 선도해온 창업자이면서 전문경영자(CEO)이며, 식품산업으로 시작하여 1차산업에서 2차산업으로 그리고 3차산업의 금융 및 서비스산업까지 사업다각화로 동원그룹을 세계적(Global)기업으로 발전시킨 창조적, 혁신주의 기업가이다. 이러한 동원그룹의 김재철 회장의 연구는 다음과 같은 네 가지의 중요성을 가지고 있다. 첫째, 동원그룹 창업자 김재철 회장의 생애와 경영이념을 고찰하여, 동원창업자의 Entrepreneurship을 발굴하여, 한국기업가사 연구의 체계적 정립을 마련하는 데 있다. 둘째, 동원 김재철 회장은 슘페터(J. A, Schumpeter)가 지적한 혁신적(Innovation) 경영활동을 적용해서 “동원경영학”의 정립을 체계화시키는 데 노력하고 있다는 점이다. 셋째, 대표적 수산업의 CEO 김재철 회장 경영활동을 통하여 “동원수산경영”의 발전과정을 경영사학계에 보급시키고자 하는 기초자료 제공에 있다. 넷째는 앞으로 해양수산업의 관리자 및 CEO가 되고자하는 청소년 및 대학생들에게 기업가 정신(Entrepreneurship)의 중요성을 인식케 하는 기초자료를 제공하는 데 있다. 본 논문은 경영사연구방법론을 채택하였다. 경영사의 개척자인 미국하버드 경영대학원(Harvard University, Graduate School of Business Administration=HBS) 경영사 교수인 그라스(Norman Scott Brien gras)와 챈들러(Alfred, D. Chandler)박사 등이 개발하고 활용하여 전 세계 학계에 보급한 ‘경영사연구방법론’을 도입하여 활용하였다. 이에 따라 동원의 김재철 회장이 추구하는 가치와 정신은 고객/주주 제일주의, 1등주의, 현금흐름주의 등이며, 21세기 그의 정신은 (1) 창조정신, (2) 열성정신, (3) 도전정신 등 ‘Candoism’으로 요약된다. 또한 그의 기본사상은 (1) from the basic(기본의 철저한 준수) (2) fact finding(현장주의 업무수행 자세) (3) global standard(국제수준의 업무품질) 등으로 나타났다. 그리고 성실한 기업 활동으로 사회정의 실현을 선도하는 가치는 (1)생활문화의 New Leader로서 위상을 향상시키는 사업가치 (2) 고객을 존중하고 만족시키며, 동원그룹을 창조기업으로 승화시키는 고객가치 (3) 1등주의 인재육성과 성과조직을 인적자원관리의 최우선으로 하는 인재가치 등을 확인할 수 있었다. This study was to highlight the entrepreneurship of chairman Jae-Chul Kim the founder of Dongwon Industries Co., Ltd, who carries the management principle which focuses on the devotion to under the realization of social justice, the function of the enterprise will be done in honesty and loyalty. Dongwon creates fresh and new experiences into the customers’ lives. it will be the prime company that leads the lifestyle culture in the 21st century. Also it aimed to revisit the life and the management principle of chairman Jae-Chul Kim who, with the new management, tried to found world’s first human corporation social responsibility. This study was mainly divided into two parts:literature-history research method and managerial history research method, and it analyzed the managerial accomplishment chronically according to the literature history documents, and managerial history method. this research took 8 months in which the document collecting process, writing process, and 7 party joint research processes were complete. The content of the research divided and categorized chairman Jae-Chul Kim’s life stages and managerial principles in the following order:(1) social back ground at the time of his birth (2) elementary, middle and high school education in his teenage period (3) university and establishment of oneself in life, one’s youth period is the time of adventure and daring (4) president inauguration and the foundation of the Dongwon Industries Co., Ltd and his management and his managerial growth process in his early adult life, (5) genius management and new experience creator-Dongwon group of the leading enterprise in the world in his latter adult life Next, the entrepreneurship through chairman Jae-Chul Kim’s managerial principle was examined. The 10 element of Jae-Chul Kim’s new the Entrepreneurship that were examined are as follows : (1) Spirit of a Sincerity and Credit (2) spirit of creativity and Innovation (3) spirit of earnestness (4) spirit of challenge and cultivation(development). (5) spirit of customer satisfaction (6) spirit of human respect (7) spirit of Justice (right) management (8) spirit of responsibility and autonomous(self-control) (9) spirit of stage management or artistic management (10) spirit of corporate social responsibilities. Dongwon corporation’s chairman Jae-Chul Kim carries the entrepreneurship principles such as (1) management that gives happiness to the customers (2) management that respects people (3) management that creates new value (4) living up to the fundamental principle (5) applying significance to even a small matter (6) challenging any new tasks, etc. His entrepreneurship is based on the righteous managerial spirit, known as “I need to be the challenge and innovation”, which aims to reflect the past and analyze today’s critical situation. especially his righteous managerial spirit is leading the Dongwon Group as the global corporation through Business ethics, humanity, innovation, etc. therefore, he is pioneer of Schumpeter’s(J.A), and the creative entrepreneur who seeks for innovation. He is reviewed as one of the greatest 21st century manager who carries these 6 characteristics:(1) artistic mind of stage management (2) positive mind (3) emphasis on self-changing (4) faith and trust (5) keeping endurance and rule (6) having courage not to be afraid of failure (7) emphasis on social contribution.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

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).

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

장관골에 발생한 거대세포 종양의 국소 재발에 관한 연구

김인,김정만,이승구,장한,김용식,김성수,한창환,김형관 가톨릭 중앙의료원 가톨릭 암센터 1991 가톨릭 암센터 論集 Vol.5 No.1