제2형 당뇨병 외래 환자의 비만도에 따른 미세혈관합병증

이성규,조남한,김현만,이관우,정윤석,채봉남,김윤정,이미덕,노혜림,홍은경,조현경 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.1

Background: Korean type 2 diabetic patients who are frequently non-obese, may be genetically different from Western type 2 diabetics who are frequently obese. Therefore, the diabetic complications of type 2 diabetes mellitus in Korea may be also different from those of Western countries. Until now, most studies reported in Korea did not analyse the microvascular complications of type 2 diabetes mellitus according to obesity, and also the criteria in the diagnosis of microvascular complications were different in each study. We investigated the microvascular complications and its relationship with obesity, in type 2 diabetic patients visiting an outpatient clinic. Methods: The study subjects were type 2 diabetic patients visiting an outpatient clinic of Ajou University Hospital. We selected patients participating in a 75 g oral glucose tolerance test, retrospectively. Type 2 diabetes was diagnosed according to the WHO/NDDG classification of diabetes. Biochemical studies including lipid profile, plasma insulin and C-peptide levels were done. Anthropometric measurements were performed. Based on BMI (㎏/㎡), the patients were divided into the following groups: the lean group, when the BMI was less than 20 ㎏/㎡ the ideal body weight (IBW) group, if the BMI was between 20 ㎏/㎡ and 25 ㎏/㎡ in women and 20 ㎏/㎡ and 27 ㎏/㎡ in men; and the obese group, when the BMI was $gt;25 ㎏/㎡ in women and $gt;27 ㎏/㎡ in men. Results: 1. Neuropathy (45.2%) was the most frequent among the microvascular complications, and the frequency of retinopathy was 15.1%, and that of nephropathy was 4.9%. Within 5 years of diabetes duration, the frequency of neuropathy, retinopathy, and nephropathy was 43.2%, 11.8%, and 2.9%, respectively. 2. Glycosylated hemoglobin (HbA_(1c)) and fasting blood glucose levels were not different among the three groups. Beta cell function{Δ (insulin 30min - insulin Omin)/Δ(glucose 30min - glucose 0min)} was the highest in the obese group. However, beta cell function(ΔI/ΔG) divided by the basal insulin level, considered insulin resistance, was not different among the three groups. 3. Within 5 years of diabetes duration, retinopathy tended to be the most frequent in the lean group, whereas neuropathy tended to be the most frequent in the obese group, and body mass index influenced the retinopathy and neuropathy, statistically significantly. Conclusion: Diabetic neuropathy was the most frequent among microvascular complications of type 2 diabetes mellitus in our study subjects. At the time of presentation within 5 years of diabetes duration, the lean group of type 2 diabetics had a tendency of the more frequent retinopathy, the obese group had a tendency of the more frequent neuropathy. These results suggest that type 2 diabetes mellitus in Korea is also not a single disease entity, as in Western countries and is a heterogenous group of disorders with a diversity of microvascular complications. However, the more studies about this will be required.

초음파 기관지 내시경으로 진단한 기관기관지 골연골형성증 1예

이천우,옥철호,정만홍,장태원,임성경,조은주,이신준,이혜원,구상건,천봉권 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.2

Tracheobronchopathia osteochondroplastica (TO) is a rare benign disease of unknown etiology characterized by accumulation of calcium phosphate in the submucosa of large airways and benign proliferation of bone and cartilage resulting in nodular formation. We report a case of tracheobronchopathia osteochondroplastica diagnosed by Endobronchial ultrasonography in a 56-year-old man. Chest Computed Tomography revealed thickening of tracheal and bronchial wall, and multiple nodules through whole trachea. Endobronchial ultrasonography showed numerous submucosal nodules with hetero-echogenecity in the third and fourth layers. Histopathological examination revealed nonspecific bronchitis with squamous metaplasia and metaplastic ossification. We confirmed tracheobronchopathia osteochondroplastica. The patient's symptoms were successfully treated with antibiotics and oxygen supplyment. endobronchial ultrasonography can helpful diagnosis in tracheobronchopathia osteochondroplastica.

폐결핵 환자의 우울 상태

홍정표,최선희,조만종,이성주,박종,김기순,김양옥 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.1

The main purpose of this study is to identify and evaluate the depressive states for the patients with chronic pulmonary tuberculosis. A questionnaire(Self-rating Depression Scale, SDS) survey was performed toward 57 pulmonary tuberculosis patients with initial treatment who started chemotherapy and 53 pulmonary tuberculosis patients with retreatment, admitted to one tuberculosis-centered hospital and two general hospital. Fifty three healthy persons as control group were investigated with the same questionnaire for comparison. The survey was performed from July to August 1996. The results are as follws : 1. The patients had significantly high scores in the depression than control and the patient with retreatment showed significantly high scores in the depression than the patient with initia1treatment(P<0.01). 2. The depressive levels of the patients were associated with duration of admission and the expectancy of recovery (P<0.05). 3. The percentage of the subjects with 40 or more scores tentatively classifiable as psychologically depressed was 67.1% of the total subjects, 48.4% of the control groups, 75.0% of the patient with initial treatment and 84.1% of the patient with retreatment. Because patient with pulmonary tuberculosis with initial treatment showed higher depression scores than normal persons, and patients with retreatment due to failure of initial treatment showed higher depression scores than initial treatment, it is necessary to give attention to depression of the patients during treatment of pulmonary tuberculosis.

각종 암종질환에서 혈청구리 및 아연농도의 변화에 관한 연구

김만우,오금탁,장경식,채종구,홍순표,조건국 朝鮮大學校 附設 醫學硏究所 1987 The Medical Journal of Chosun University Vol.12 No.1

The copper and zinc concentrations were measured in sera of 27 cases of hepatoma, 20 cases of stomach ca., 7 cases of esophageal ca., 12 cases of colorectal ca., 9 cases of lung ca., 18 cases of ovarian ca. and 48 cases of normal control in Chosun University Hospital from Jan. 1986 to July 1986. The results are as follows; 1. The mean concentration of copper in serum of normal control group was 96.0±5.02㎍/㎗ (Mean±2SE), in hepatoma, stomach ca., esophageal ca., colorectal ca., lung ca. and ovarian ca. concentrations were significantly increased each 126.4+12.77, 125.6±11.29, 140.5±14.23, 117.3±11.91, 181.4±30.56 and 130.5±13.80㎍/㎗ (P < 0. 001) in comparison with the mean value of normal control group. 2. The mean concentration of zinc in serum of normal control group was 104.8±3.40㎍/㎗ (Mean±2SE), in hepatoma and lung ca. concentrations were significantly decreased each 65.1±7.27 and 72.7±12.86 ㎍/㎗ (P < 0. 00l). 3. The ratio of serum copper level to zinc level (Cu/Zn ratio) in serum of normal control group was 0.94±0.057 in hepatoma, stomach ca., esophageal ca., lung ca. and ovarian ca. concentration ratios were significantly increased each 2.09±0.324, 1.86±0.122, 1.50±0.114, 2.55±0.513 and 1.51±0. 243 (P < 0.001).

종격동 종괴를 의심케한 우대동맥궁 1례

김만우,백학연,정춘해,장경식,홍순표,조건국,김종진 朝鮮大學校 附設 醫學硏究所 1987 The Medical Journal of Chosun University Vol.12 No.1

Developmental anomalies of the aortic arch, commonly known as vascular rings, are relatively rare congenital vascular anomalies which can compress the trachea and esophagus. One routine chest film of a patient who was checked and hepatoma-diagnosed in Internal Medicine, Chosun University Hospital left the room for doubt of mediastinal mass. But no subjective symptoms for the mass was told by the patient. This is to report our experience of a patient having right side aortic arch with aberrant left subclavian artery, as proved by diagnosis, but none of congenital heart disease. This right side aortic arch with aberrant left subclavian artery is the most frequent type among right aortic arch, the anomaly of which is usually detected from the incidental suspicion for mediastinal mass at routine chest film; because no symptoms are accompanied therewith.

식도암의 임상적 고찰

김만중,김만우,채종구,정춘해,홍순표,조건국 朝鮮大學校 附設 醫學硏究所 1987 The Medical Journal of Chosun University Vol.12 No.1

A Clinical observation was made in 52 cases of patients with esophageal cancer at Chosun University Hospital during about 5years from january 1981 until may 1986. The following results were obtained: 1. The peak age of patients was fifth decade. The average age of patients is 55.7 years old. The sex ratio is 7.6 : 1 with a greater prevalence male. 2. Duration of the disease before admission was relatively long, about 4~6 months is 48% of all case. 3. The most common initial symptoms were swallowing difficulty, weight loss, substernal pain. 4. On the majority of patients, Heavy s.noking was manifested. 5. In blood type, A type was predominent. 6. In location of tumor, 69.2% of total cases were located in mid esophagus. 7. In histopathologic finding, 73% of total cases was squamous cell ca.

좌측흉수로 발현된 Boerhaave 증후군 1예

이준,변유미,조민근,조주연,원경준,김영대,박찬국,김만우,유재근,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

구토 후 발생한 토혈을 주소로 내원한 환자에서 좌측 늑막 삼출 동반 시 식도 파열의 가능성을 고려하여 흉수 천자 및 지속적인 흉부 단순 촬영의 추적관찰이 필요하며 식도 파열이 배제된 후 환자의 생체 징후 및 토혈 양을 파악하여 내시경 검사 시기를 신중히 결정하는 것이 좋을 것으로 생각된다. 본 증례는 토혈을 주소로 내원하여 Mallory-Weiss 증후군 의심 하에 내시경을 통한 치료 시행 후 추적 관찰에 의해 진단된 Boerhaave 증후군을 경험하였기에 보고하는 바이다. Boerhaave's syndrome is a spontaneous perforation of the esophagus most commonly resulting from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure caused by straining or vomiting. Surgery should generally be performed within 24 hours because mortality approached 30 to 50 percent in which surgery was delayed. Therefore, early diagnosis and prompt surgical repair are critical for survival. We have experienced a case of Boerhaave's syndrome in a patient presenting with hematemesis with left pleural effusion without any signs or symptoms of pneumomediastinum or pneumothorax.

통합심리치료의 인지분화훈련이 정신분열병 환자의 기초 인지기능에 미치는 영향

이희상,현명호,조현상,이연희,김태용,장순아,노규식,정기립,이만홍,유계준 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

연구목적 : 정신분열별 환자들을 대상으로 통합심리치료의 소프로그램인 인지분화훈련을 실시하여 실행기능, 개념형성능력, 언어능력 및 추론력에 대한 훈련이 보다 더 하위단계의 인지기능인 주의력, 기억력, 반응시간 등을 호전시킬 수 있는 지를 알아보고자 하였다. 연구방법 : DSM-IV상 정신분열병으로 진단된 24명의 입원환자를 무작위로 양분하여 한 군은 인지분화훈련군으로 다른 한 군은 대조군으로 나누었다. 훈련군은 4주동안 1주일에 3회(매회 60분간)로 총 12회의 통합심리치료의 인지분화훈련을 받았으며 대조군은 동일한 시간동안 정신건강교육을 받았다. 훈련전후에 훈련군과 대조군을 대상으로 개정판 Wechsler 기억검사로 주의집중력, 장·단기 기억력을 측정하였고 Vienna test system중 결정반응시간검사로 반응시간, 반응결정시간, 반응운동시간을 평가하였다. 연구결과 : 1) 주의집중력에서는 훈련군과 대조군사이에 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 2) 단기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=10.46. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 3) 장기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=15.09. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 4) 반응시간에서는 상호작용 효과(F(1,24)=5.18, p〈.05)가 있었다. 5) 반응운동시간에서는 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 6) 반응결정시간에서는 상호작용 효과(F(1.24)=6.00, p〈.05)가 있었다. 결 론 : 통합심리치료의 인지분화훈련은 정신분열병 환자에서 하위단계의 인지기능 중 반응시간(특히 반응결정시간)을 단축시키는 효과가 있었다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training of Integrated Psychological Therapy(a training program of executive function, concept formation, language, and abstraction) on micro-level cognitive function such as attention, memory and reaction time in patients time in patients with schizophrenia. Methods : Twenty-four inpatients diagnosed as schizophrenia using DSM-IV were randomly assigned to 2 groups. The training group went through a total of 12 sessions of cognitive differentiation training for 4 weeks. The control group received psychoeducation program during the same period. Wechsler Memory Scale-Revised and Decision-Reaction Timer of Vienna Test System were administered to all patients, both before and after the training program. Results : 1) In the attention and concentration scores of Wechsler Memory Scale-Revised, between group, within group and interaction effects of training were not significant. 2) In the short-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=10.46, p〈0.05), but the between group and interaction effects did not reach significance. 3) In the long-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=15.09, p〈0.05), but the between group and interaction effects did not reach significance. 4) In the reaction time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=5.18, p〈0.05). 5) In the motor time scores of Decision-Reaction Timer, between group, within group and interaction effects of training were not significant. 6) In the decision time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=6.00, p〈0.05). Conclusion : Our findings suggest that cognitive differentiation training of Integrated Psycho-logical Therapy is partly effective on improving micro-level cognitive functions such as reaction time(especially, decision time) in patents with schizophrenia.

저온유통용 골판지 포장상사 개발에 관한 연구 (Ⅰ) : 골판지의 흡습특성 시험 Characteristics of moisture absorption to corrugated fiberboard

이원옥,윤홍선,정훈,이현동,조광환,김만수 한국식품저장유통학회 ( 구 한국농산물저장유통학회 ) 2003 한국식품저장유통학회지 Vol.10 No.3

농산물의 저온저장 및 고습조건에서 안전하게 유통할 수 있는 골판지 포장상자를 개발하기 위하여 원지의 구성, 라이너의 발수도, 골형태의 차이에 따라 수분흡습 특성과 압축강도와의 관계를 구명하기 위해 각각 원지특성을 달리하여 이중 양면 골판지를 재료로 사용하여 시험하였다. 온도변화에 따른 골판지 함수율 변화는 골판지 원지 종류, 발수도 차이등에 관계없이 거의 일정한 값을 나타냈다. 상대습도 변화에 따른 골판지의 함수율 변화는 상대습도에 크게 영향을 받는 것으로 나타났으며 골판지의 수분흡습은 발수도 보다는 원지에 구서에 따라 영향을 많이 받는 것으로 나타났다. 또한 수직압축강도는 상대습도가 증가함을 따라 크게 감소하여 상대습도가 수직압축강도에 미치는 영향이 매우 크며 상대습도가 증가함에 따른 수직압축강도의 저하비율은 골판지의 종류에 관계없이 거의 같은 것으로 나타났다. 따라서 저온고습 조건에서 안전하게 내용물을 보호할 수 있는 저온유통용 농산물 골판지 상자의 개선을 위해서는 고품질 원지의 생산기술 개발 및 골판지 상자의 구조개선 연구가 우선되어야 할 것으로 판단된다. The hardness of corrugated packaging box decreased during storage period because of high humidity. Therefore, the strength-decreasing factor of corrugated packaging box had to be investigated to determine the compression strength of the corrugated packaging box. This study was conducted to define the characteristics of moisture absorption as well as compression strength of corrugated fiberboard. (1) The moisture content of the corrugated fiberboard was rarely influenced by the kinds of raw materials and water repellent. However, the moisture adsorption of the corrugated fiberboard was shown to be clearly affected by air temperature changes. (2) The moisture content of the corrugated fiberboard was significantly affected by relative humidity. The moisture adsorption of corrugated fiberboard was also greatly influenced by composition of raw materials rather than water repellent. The results indicated that the improvement of raw materials was more effective than the increase of water repellent of corrugated fiberboard to reduce the moisture adsorption of the corrugated fiberboard. (3) The vertical compression strength was significantly decreased with increasing relative humidity. The reduction rate of vertical compression strength was not charged with the increase of relative humidity, which was regardless of kinds of corrugated fiberboard. (4) For improving the strength of the corrugated packaging box, new technique should be found to develop better quality of raw materials. Moreover, the physical construction of corrugated packaging box should be clearly understood because the corrugated packaging box for the agricultural products was usually used for the circumstances of high humidity and low air temperature.

청소년 인터넷 중독증과 우울, 사회적 불안, 또래관계 문제와의 연관성 조사

이명수,오은영,조선미,홍만제,문재석 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 본 연구는 한국 청소년들의 인터넷 사용 현황조사와 더불어 인터넷 중독증과 우울, 사회적 불안, 또래관계 문제등과의 연관성을 알아보고자 하였다. 방 법 : 수원시 소재 고등학교 학생 869명(남/여=371/498)을 대상으로 인터넷 사용과 연관된 기본 설문을 실시하였다. 인터넷 중독여부를 알아보기 위하여 Young의 인터넷 중독척도를 사용하였고 우울증상의 평가는 Beck Depression Inventory(BDI)를 사용하였다. 사회적 불안 및 회피정도는 Social Avoidance and Distress Scale을, 부정적 평가에 대한 두려움 측정은 Fear of Negative Evaluation-Brief척도를 , 또래관계의 문제는 Index of Peer Relations척도를 사용하였다. 인터넷 중독의 현황조사를 위해서 실수와 백분율, chi-square test를 실시하였고, 인터넷 중독증과 우울, 사회적 불안 및 또래 관계 문제의 연관성을 알아보기 위하여 일원변량분석(ANOVA)을 실시하였다. 결 과 : 1) 총 869명의 대상자 중 남학생이 371명(43.7%)이었으며 여학생이 498(57.3%)이었고 평균연령은 16.27세(표준편차=0.82)로 남녀간에 유의미한 차이는 없었다. 2) 총 869명의 대상자중 291명(33.4%)이 인터넷 중독 가능성을 가지고 있는 것이고 나타났고 그 중 18명(2.07%)은 명백한 중독경향이 있는 것으로 나타났다. 본 연구에서는 인터넷중독척도 상위 30%를 중독경향군으로, 하위30%를 정상대조군으로 분류하였다. 3) 인터넷 중독척도 평균점수의 비교를 보면 남학생이 여학생보다 통계적으로 유의미하게 점수가 높음을 알 수 있었고 또 남학생이 여학생보다 중독경향군에 포함되는 비율도 더 높음을 알수 있었다. 을, 정상대조군에서는 정보검색을 상대적으로 더 많이 하는 것으로 나타났으며 게임은 두 집단간에 차이가 없었다. 5) 중독경향군에서 더 우울성향이 높고 외부의 부정적 평가에 더 예민하게 반응하고 또래관계의 문제가 많은 것으로 나타났고 사회적 상황에서의 불안정도는 집단간에 차이가 나지 않았다. 결 론 : 인터넷 중독으로 비교적 명백하게 분류된 비율은 이제까지의 다른 연구조사와 비교하여 볼 때 상대적으로 낮게 나왔으나 중독경향군까지 포함했을 겨우, 조사대상자의 약 30%에서 인터넷과 연관된 문제가 있음을 알수 있었다. 또한 인터넷 과다사용으로 문제가 되는 경우에 우울이나 또래관계등의 문제가 더 심각한 것으로 판명되어 향후 인터넷 사용자체에 대한 중독치료적 접근이외에 동반 정신병리에 대한 치료적 접근이 필요할 것으로 생각된다. Objective : The purpose of this study was to survey the present conditions of adolescents' Internet use and to investigate the relation of Internet addiction to depression, social anxiety and problems in peer relationship. Method : Eight hundred and sixty-nine high-school students(male/female=371/498) were included in the study, each of whom completed a standard questionnaire related to Internet use determined. We assessed internet addiction and depressive symptoms of adolescents using Youngs Internet Addiction Scale and the Beck Depression Inventory(BDI), respectively. Social Avoidance and Distress Scale were employed to measure social anxiety and avoidance. Fear of Negative Evaluation-Brief Scale was for fear of negative evaluation by other people. An Index of Peer relation was devoted to problems in peer relationships. Chi-square test and ANOVA were used to identify the present conditions of Internet addiction and to analyze the relations of Internet addiction with depression, social anxiety and problems in peer relationship. Results : 1) Of these 869 subjects, 371(42.7%) were male students and 498(57.3%) were female. The mean age was 16.27 years(SD=0.82) and there was no significant difference between two sex groups. 2) Of these 869 subjects, 291(33.4%) showed addictive tendency and among them 18 subjects(2.07%) were classified into obvious addiction group. In this study, we defined upper 30% of Internet addiction scores as 'addiction group' and lower 30% as 'normal control group'. 3) Male students had significantly higher mean scores of Internet addiction scale than females and there was significantly higher rates of male students in addiction group. 4) Comparing two groups, there was no statistically significant difference in terms of the preferred types of Internet media, although addiction groups tended to use chatting and E-mail more, normal control group tended to use information search more, And there was no significant difference regarding games on the Internet. 5) There was more depressive tendency in line with more sensitive response against negative-evaluation and more problems of peer relationship in addiction group. However, there was no significant difference regarding anxiety on social situation. Conclusion : Compared to previous studies, findings from this study showed that the rates classified as the group of obvious Internet addiction were relatively lower. However, including those who had tendency of Internet addiction, about 30% of all subjects had problems related to Internet use. In addition, depression or relationship problems were triggered more severely in Internet addiction group. With these findings in mind we finally suggest that therapeutic approach to comorbid psychopathology as well as Internet addiction itself should be required.