현훈 환자 Neuron Specific Enolase의 임상적 의의

김원주,김선곤,유철형,김원찬,김용덕,최영철,이명식 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

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

알루미늄 합금과 고장력 강판 접합을 위한 헬리컬 SPR의 단조공정 설계

김원영, 김동범, 김기호, 김도훈, 이인환, 조해용 충북대학교 산업과학기술연구소 2013 산업과학기술연구 논문집 Vol.27 No.2

A self-piercing rivet(SPR) is a mechanical component for joining dissimilar materials. It is used for joining dissimilar material sheets such as aluminum alloy and steel. The self-piercing rivet directly pierces into sheets without drilling sheets beforehand unlike conventional rivets. However, the self-piercing rivet occurs buckling when piercing high strength steel. Therefore, a helical SPR which can pierce high strength steel sheet was designed. In this study, forging process was designed for manufacturing the helical SPR and simulated by using commercial FEM code DEFORM-3D. In the simulation of forging process for manufacturing rivet, process sequence, formability, forging load were investigated. The suitable forging process could be designed by comparisons of simulated results. Experimental trials have been carried out for same conditions as simulated ones. The simulated results agreed with the experimental ones. So, the analytic approach in this thesis is useful to save cost and time in the forging industry

중추성 요붕증으로 발현된 랑거한스세포 조직구증식증 1례

김준성,윤원상,김근모,최영권,박기원,김병희,유용상 대한소아내분비학회 2004 Annals of Pediatirc Endocrinology & Metabolism Vol.9 No.1

면양에서 개량된 제1위 누관 형성술 1례

김명철,김종만,김용국,김덕환,이영원 충남대학교 수의과대학 동물의과학연구소 1999 動物醫科學硏究誌 Vol.7 No.-

We performed rumen fistula operation in a sheep. In sheep, the procedure for a rumen fistula is quite successful, but choice of an appropriate cannula is of prime importance. The sheep was anesthetized by xylazine(0.1 ㎎/㎏ IM) administration 5 minutes after administration of atropine sulfate(0.1 ㎎/㎏ IM). We inserted rubber cannula in rumen incised and put rubber ring after employing purse-string suture in rumen. We marked the area for the puncture incision in the body wall through which the cannula is drawn. We drew the cannula as near the transverse process of the lumbar vertebrae as possible to minimize leakage. We isolated the cannula by fixing the stainless washer which has small holes. The sheep was given postoperative penicillin(20,000 IU/㎏ IM) to prevent secondary infection for 3 days. There were not observed the leakage of rumen contents, the entering of rubber cannula into abdominal cavity, and necrosis on incision site and skin, over months after surgery.

알데히드탈수소효소 2(ALDH2) 및 CYP2E1 유전자 다형성에 따른 요중 뮤콘산 농도와 요중 8-hydroxydeoxyguanosine과의 관련성

김용대,강종원,엄상용,장연위,김성훈,김은영,이철호,문재동,김헌 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2

주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 as biomarkers of patients with established acute kidney injury

( Won Yong Cho ),( Sung Yoon Lim ),( Ji Hyun Yang ),( Se Won Oh ),( Myung-gyu Kim ),( Sang-kyung Jo ) 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.3

Background/Aims: Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been recently discovered and validated as sensitive biomarkers that can predict stage 2 or 3 acute kidney injury (AKI) development in high-risk patients. We aimed to assess whether these biomarkers could predict adverse outcomes and renal recovery in established AKI patients. Methods: This was a single-center study prospectively enrolling 124 patients diagnosed with AKI. TIMP-2, IGFBP7, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule 1 (KIM-1) levels were measured at the time of diagnosis and the predictive performance of short-term outcomes and renal recovery was assessed. Results: Patients were divided into 4 quartiles according to the initial urinary TIMP-2/IGFBP7 levels. Stage 3 AKI (odds ratio [OR], 17.86), classified by the Kidney Disease Improving Global Outcomes (KDIGO), as well as the third and fourth quartiles of TIMP-2/IGFBP7 (OR, 5.75 and 44.98, respectively), were found to be independent predictors of renal replacement therapy at the time of AKI diagnosis. In addition, KDIGO stage 3 AKI (OR, 2.468) or the third of fourth quartiles of urinary TIMP-2/IGFBP7 (OR, 1.896 and 3.622, respectively) were also found to be useful in predicting nonrecovery of renal function. In a separate analysis of patients with renal recovery at discharge, initial urinary TIMP-2/IGFBP7 or urinary IGFBP7 at discharge could also predict new-onset or progressive chronic kidney disease (CKD). Conclusions: In AKI patients, urine TIMP-2/IGFBP7 could serve as a biomarker for predicting adverse outcomes, renal recovery, or the development and progression of CKD.

만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

생리식염수 및 포도당수액 정액 투여가 에탄올 농도에 미치는 효과에 관한 연구

김원율,이상래,안지영,안성훈,류석용,김경환,김홍용 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: In emergency department, there are many drunken patients with various emergency medical situations. In these patients, evaluation and management of the medical problems are delayed from time to time because of the uncooperative nature of the patients and because of consciousness and sensory changes. A precise evaluation can only be obtained when the patients become sober. For this purpose, most clinicians start IV fluid loading. This study was carried out to evaluate the effect of IV fluid(normal saline and glucose solution) on the rate of ethanol clearance in such patients Methods: Ten volunteers(healthy males in their twenties and with a Michigan alcohol screening test below 4) were enrolled in this study. Alcohol intake was restricted to at least 48 hours before the test and food intake to at least 4 hours. For the test, A predetermined dose of ethanol(1 gm/kg) was given to the volunteers. Each volunteer was tested on three consecutive times with 3 or more days interval for alcohol wash out period . On the lst day, the volunteers received ethanol only per os. On the second day, they received ethanol and a liter of IV 10% dextrose solution. Each day, blood was drawn from the antecubital vein to measure the ethanol level at the time of ethanol ingestion and at 0.5, 1, 1.5, 2, 3, 4, 5 and 6 hours after ingestion. The repeated measure ANOVA test was used for the statistical analysis. Results: The difference in the blood ethanol level between the 3 test was F=1.7, p=0.184 and the difference corrected by the time factor was F=0.32, and p=0.985. Conclusion: There was no significant difference in the blood ethanol level between the tests. In conclusion, the IV normal saline or glucose solution does not accelerate ethanol clearance in suffering