http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
초기 당뇨병성 신증과 동반된 Erythropoietin 결핍성 빈혈에 대한 합성 조혈호르몬의 치료효과
김대중,김수경,김형진,김유미,윤용석,안철우,차봉수,송영득,임승길,김경래,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5
연구배경:본 연구자 등은 과거에 진행성 당뇨병성 신증 이전 단계에서 원인미상의 빈혈을 동반한 환자들을 관찰할 수 있었으며, 빈형에 대한 Epo의 반응성 감소, 즉 Epo의 상대적 결핍이 빈혈의 원인이 될 수 있음을 보고한 방 있다. 이에 본 연구의 목적은 초기 당뇨병성 신증과 동반된 Epo 결핍성 빈혈에서 rHuEpo의 치료효과를 보고자 하였다. 방법:총 29명의 Epo 결핍성 빈혈을 가진 당뇨병 환자를 Epo 투여군(남:여=8:12, 평균나이 52.9±12.4세)로 무작위 배정하였다. Epo 투여군에게는 rHuEpo(Epokine,㈜제일제당)을 하루 4,000단위씩 주 3회 피하주사하였고 최대 8주간 사용하였다. 추적기간 동안 혈색소치가 2g/dL 이상 상승하거나 혈색소치가 남자 14g/dL, 여자 13g/dL 이상으로 상승한 경우를 반응군으로 하였고 나머지를 비반응군으로 하였다. 결과: Epo 투여군과 대조군 사이의 임상적 및 생화학적 특성의 차이는 없었다. 반응군(n=14)은 비반응군과 대조군에 비해 치료 8주째 의미있는 혈색소치의 상승을 보였다(각각 13.6±1.0, 10.1±1.5, 11.2±1.2g/dL, p<0.01). 반응군의 rHuEpo의 평균투여기간은 4.9±2.3주였다. Epo 투여군중 반응군과 비반응군 사이의 성별, 연령, 당뇨병의 유병기간, 혈청 크레아티닌치, 24시간 소변내 알부민농도, 당뇨병성 미세혈관합병증의 유무, 그리고 혈청 Epo 농도의 차이는 관찰되지 않았다. 그러나 반응군은 비반응군에 비해 혈청 ferritin(각각 240.3±108.4, 25.8±3.0㎍/L, p<0.05)과 transferrin saturation(각각 32.7±7.9, 21.2±5.3%, p<0.05)이 의미있게 높은 소견을 보였다. 결론:이상의 결과로 초기 당뇨병성 신증과 동반된 Epo 결핍성 빈혈에서 rHuEpo의 투여를 통해 빈혈을 교정할 수 있었으며, rHuEpo에 대한 반응의 정도는 당뇨병과 관련된 임상적 특성보다는 기능성 철결핍 정도와 관련되어 있다고 생각된다. Background : We have previously reported that reduced erythropoietin (Epo) responsiveness to anemia could explain the anemia in diabetic patients before advanced diabetic nephropathy. Thus, the aim of this randomized prospective study is to investigate the therapeutic effect of recombinant human erythropoietin (rHuEpo) on anemia with Epo deficiency in early diabetic nephropathy. Methods : Twenty-nine diabetic patients with the normocytic normochromic anemia of Epo deficiency were randomized into Epo-treatment group (n=20, M:F=8:12, mean age=52.9±9.2) and control group (n=9, M:F=4:5, mean age=53.6±12.4). Twenty patients of Epo-treatment group were treated with rHuEpo (Epokine® (CheiUedang Co.) 4,000 unit/ day SC., 3 times/ week) for 8 weeks. The Epotreatment group were divided into the responder or non-responder. Patients with increments in Hemoglobin (Hb) during the follow-up duration was above 2g/ dL, or with the final Hb was above 14g/ dL in men or 13g/ dL in women were decided the responder. In order to analyze factors affecting the therapeutic effects of rHuEpo, the clinical and biochemical characteristics were compared between the responder and non-responder group. Results : There was no difference in the clinical and biochemical characteristics between the Epo-treatment and the control group at randomization. The responder group (n=14) had significant increments in Hb, compared to the non-responder group (n=6) or the control group (13.6±1.0 vs. 10.1±1.5 vs 11.2±1.2g/ dL, p<0.001, respectively). The treatment duration of rHuEpo in the responder group was 4.9±2.3 weeks. Among the Epo-treatment group, there was no differences between the responder and the non-responder group in sex, age, duration of diabetes, serum creatinine level, 24 hour urinary album in excretion rates, HbA_1c, frequency or severity of microangiopathy, and serum Epo level. However, the responder group had higher serum ferritin (240.3±108.4 vs 25.8±3.0 ㎍/L, p<0.05) and transferin saturation level (32.7±7.9 vs 21.2±5.3 %, p<0.05). Conclusion : These results concluded that the administration of rHuEpo could be useful in treating anemia with Epo deficiency in early diabetic nephropathy and that the degree of iron storage and functional iron deficiency might affect the therapeutic effects of rHuEpo on this type of anemia (J Kor Diabetes Asso 25:364~373, 2001).
김대중 한국현대영어영문학회 2022 현대영어영문학 Vol.66 No.3
This study aims to genealogically investigate the history of utopia in English/American fictions by employing spatial theory and closely reading three fictions: Thomas More’s Utopia, Edward Bellamy’s Looking Backward, 2002-1887, William Morris’s News From Nowhere. Those fictions represent utopias differently in terms of space, social institution and ideology. Thomas More’s Utopia, a harbinger of utopian ideas and imagination, represents utopian space as an insulated space where equality dominates and people work collectively and live together. The space in Utopia contains the idea of flawless society which resembles no less socialist’s space than communist’s one. The tradition of utopia develops via several thinkers’ ideas and practices including Charles Fourier, Charles Henri de Saint-Simon, and Robert Owen. Those thinkers from France and England share the ideas of syndicalism, socialism, and in some cases anarchism. Influenced by More’s Utopia and those Utopian socialists, Bellamy and Morris represent their ideas of utopia in opposite direction. Bellamy describes vividly the future society in the U.S. where national party dominates the whole economic and political instutitions centralizing power for absolute equality and welfare of laborers. In opposite, as a response to Bellamy’s industrialized utopia, Morris represents pastoral and anarchistic utopia which is built upon long history of struggle between the have and the have-not.