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투석 치료중인 만성 신부전 소아에서의 지질 및 지질단백 이상
김정수,송정한,박혜원,정해일,김진규,최용,고광욱,Kim Jung-Sue,Song Jung-Han,Park Hye-Won,Cheong Hae-Il,Kim Jin-Q,Choi Yong,Ko Kwang-Wook 대한소아신장학회 1997 Childhood kidney diseases Vol.1 No.2
목적 : 말기 신부전 환자에서 심혈관계 질환은 유병율 및 사망율의 중요한 원인중 하나이다. 이들 환자에서 흔히 동반되는 고지질단백 혈증은 심혈관계 질환의 위험인자로 작용하며, 특히 lipoprotein(a)[Lp(a)]는 관상동맥 질환과 혈전증의 위험 인자로 알려져 있다. 소아에서도 만성 신부전시 고지질 혈증이 보고되어 있다. 저자들은 투석 치료중인 만성 신부전 소아를 대상으로 혈중 지질, 지질단백 및 Lp(a)의 농도 변화를 분석하였다. 방법 : 서울대학교 어린이병원 소아과에서 유지 혈액 투석을 받고 있는 환아 10명과 지속성 외래 복막 투석을 받고 있는 환아 14명을 대상으로 정맥 혈청중 지질, 지질단백 및 Lp(a)농도를 측정하여 건강 대조군과 비교하였으며, Lp(a)의 혈중 농도에 따른 다른 지질단백의 혈중 농도를 비교하였다. 혈액투석(hemodialysis, HD)환아군의 평균 연령이 $162{\pm}59$ 개월, 남녀비는 7:3 이었으며 복막투석(peritoneal dialysis, PD)환아군의 평균 연령은 $123{\pm}69$개월, 남녀비는 6:8 이었다. 결과 : 1) 연령, 성별, 비만지수, 투석기간은 HD군과 PD군 간의 차이가 없었으나 혈중 단백과 알부민치는 PD군에서 유의하게 낮았다. 2) HD군과 PD군 모두에서 혈중 콜레스테롤, 중성지방, 저비중 지질단백 콜레스테롤(low density lipoprotein-cholesterol, LDL-콜레스테롤)과 고비중 지질단백 콜레스테롤(high density lipoprotein-cholesterol, HDL-콜레스테롤)의 비는 대조군에 비해 증가되어 있었으며, HDL-콜레스테롤과 콜레스테롤의 비는 대조군에 비해 유의하게 낮았다. 3) 혈중 아포단백 B치는 대조군에 비해 상승되어 있었지만 아포단백 Al과 아포단백 B의 비는 차이가 없었고, 혈중 Lp(a)치는 PD군에서만 대조군보다 상승되어 있었다. 4) 혈중 Lp(a)치가 30 mg/dl 미만인 환아는 13명, 30 mg/dl 이상인 환아는 11명으로 이들 간에 연령, 비만지수, 투석방법, 투석기간은 차이가 없었으나 혈중 알부민은 Lp(a)가 상승된 환아들에서 감소되어 있었다. 5) 혈중 Lp(a)농도와 다른 지질 단백과의 비교에서 아포 단백 B만이 유의한 차이를 보였다. 결론 : 투석 치료중인 만성 신부전 소아에서 혈중 지질단백 이상이 관찰되었으며 특히 PD군에서는 혈중 Lp(a)치가 증가되어 있었다. 따라서 만성 신부전 소아에서 관상 동맥 질환의 위험도가 높을 것으로 사료되며 이에 대한 장기적이고 지속적인 관찰이 필요하다. Purpose : Chronic renal failure is often accompanied by severe dyslipidemia, a known risk factor for cardiovascular disease. Lipoprotein(a) [Lp(a)] has recently been characterized as a risk factor for atherosclerosis and thrombosis. Cardiovascular disease is the leading cause of death in adult patients on dialysis. However, there are only limited data available concerning risk factors for atherosclerosis in uremic children. We have measured serum levels of lipids, lipoproteins, apolipoproteins and Lp(a) in uremic children with maintenance dialysis. Methods : Ten uremic children with hemodialysis (HD) and 14 with peritoneal dialysis (PD) in our dialysis unit were included in this study. The mean age of HD patients was $162{\pm}59$ months and the male to female ratio was 7:3. The mean age and sex ratio of PD patients were $123{\pm}63$ months and 6:8, respectively. The levels of cholesterol, triglyceride, lipoproteins, apolipoproteins and Lp(a) were measured from serum sampled after 14 hours of fasting. The normal control levels were cited from 2 articles presenting the normal blood lipid and lipoprotein levels of primary school and middle school children in Korea. Results : There was no difference in age, sex ratio, body mass index and duration of dialysis between the HD and the PD group. The serum concentration of the cholesterol, triglyceride and apolipoprotein B were significantly elevated in dialysis patients compared with normal subjects. The serum level of Lp(a) was significantly elevated in only PD group. The serum Lp(a) level was below 30 mg/dl in 13 and above 30 mg/dl in 11 patients. The serum albumin level was significantly decreased in high Lp(a) group than in low Lp(a) group. Conclusion : The uremic children receiving dialysis reveal abnormal serum lipid and lipoprotein profiles. These results suggest that they have a higher risk for coronary heart disease, although there has been no clinical evidence of coronary heart disease at present. A long-term follow-up study of these children to clarify the suggestion should be started now.
간장 및 담도 : 개의 동종 간이식에 있어서 단계별 아미노산 대사에 변화
김상준(Sang Joon Kim),김수태(soo Tae Kim),이건욱(Kuhn Uk Lee),조흥래(Hong Rae Cho),정중기(Joong Ki Chung),서경석(Kyunng Suk Suh),박규주(Kyu Joo Park),안세현(Sae Hyun Ahn),배성환(Sung Han Bae),김진규(Jin Q Kim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1
N/A ln an attempt to determine the function of hepatic allografts, we studied the metabolic changes of plasma amino acids intraoperatively in 3 cases of hepatic transplantation in dogs for indicators of hepatic function.The operation was divided into four sampling periods; baseline, hepatectomy (portal vein and inferior vena cava clamping time) anhepatic, and reperfusion.1) During the baseline period & anhepatic period, there was no significant change in labaratory data except slight increasing of SGOT and lower level of total protein and albumin. 2) During the anhepatic period, total free plasma amino acids levels (TFPAA) rose significant statistically (p<0.01), but the branched chain amino acids (valine, leucine, isoleucine) and methionine did not rise but reduce or remain steady. And during reperfusion period, TFPAA had a tendency to decrease. 3) The molar ratio of BGAA/aromatic amino acids had a trend to decrease in anhepatic period. 4) There was no different change between essential amino acids and non-essential amino acids in anhepatic period.
당뇨병 환자 혈청에 있어서 Direct-potentiometry와 Flame-photometry에 의한 Na 측정비교
정하승 ( Ha Seung Jung ),김진규 ( Jin Q Kim ),한석종 ( Suk Jong Han ) 대한임상검사과학회 1983 대한임상검사과학회지(KJCLS) Vol.15 No.1
The percentage of flame photometric to direct potentiometric (Na values depends upon water content, hyperprotein, hyperlipid, bicarbonate-Na+ binding etc. We have studied on the relationship between direct potentiometric .and flame photometric measurement of sodium in serum of diabetic patients and normal. The results are as follows; 1. The correlation between direct potentiometric and flame photometric Na measurement in serum of diabetic patients, r is 0.5809. 2. The correlation between direct potentiometric and flame photometric Na value in normal serum, r is 0. 9370. In clinical conditions such as hyperlipemia (diabetic ketoacidosis), the water content of serum is decreased. Under such conditions, direct photentiometric value are more clinically approciate.
양윤선(Yoon Sun Yang),조한익(Han Ik Cho),박성섭(Sung Sup Park),김진규(Jin Q Kim),김상인(Sang In Kim) 한국의학교육학회 1992 Korean journal of medical education Vol.4 No.2
To improve practical skills and problem-solving ablihty of the medical students, authrs introduced unique teaching program composed of 10 laboratory tests, essential for primary care physicians and ar ound 200 problem-solving and actual questionaires which can be met in situations of the clinical setting. The program was applied to the two-week clerkship for the senior class of Seoul National University College of Medicine in 1992. The problem-solving questionaires were revised three times in 1992, according to the results of analysis for new questionaires made by teachers and students. Around 5% of practical problem-oriented questionaires were made by students themselves. Favorable responses from the students were 99.1% for overall program and 96.1% for problem-solving questionaires. The long-term impact of this clerkship should be re-evaluated when students educated by this program become primary care physicians including interns or residents.