단시간의 혈당량 변화에 따른 당화혈색소량의 변동

안재수 ( An Jae Su ),최은진 ( Choe Eun Jin ),박상선 ( Park Sang Seon ),이대호 ( Lee Dae Ho ),정민영 ( Jeong Min Yeong ),이태희 ( Lee Tae Hui ) 대한내과학회 1993 대한내과학회지 Vol.44 No.1

연구배경 : 혈당농도가 올라감에 따라 혈중의 혈색소가 당화되어 당화혈색소가 증가됨은 잘 알려져 있다. 이러한 당화혈색소는 적혈구 성숙과정동안 서서히 당화되므로 이를 측정함으로써 수주전의 혈당조절 상태를 알수 있다. 이렇게 당화혈색소는 장기간에 걸쳐 서서히 당화되는 것으로 알려져 있으나, 저자들은 짧은 시간의 혈당농도 변화에도 약간의 변동이 있음을 경험할 수 있었다. 이에 저자들은 인슐린 비의존형 당뇨병환자를 대상으로 공복 및 식후 두시간의 혈당농도 및 당화혈색소량, 안정형 당화혈색소량, 불안정형 당화혈색소량을 측정한 후 비교검토하였다. 방법 : 인슐린 비의존형 당뇨병환자 166예를 대상으로 공복 및 식후 두시간의 혈당농도와 당화혈색소량을 동시에 측정한 후 식후 두시간에 공복시의 당화혈색소량을 뺀 값이 -0.3%이하를 Ⅰ군(n=9), +0.3%이상을 Ⅱ군(n=88), 그 사이를 Ⅲ군(n=69)으로 나누어 공복 및 식후 두시간의 혈당농도 변화에 따른 당화혈색소량의 변동을 고찰 하였다. 음식 및 치료에 따른 당화혈색소량의 변화를 배제하기 위하여 15예의 치료받지 않은 인슐린 비의존형 당뇨병환자에서 75g 경구당부하 검사를 하면서 혈당농도 변화에 따른 당화혈색소량의 변화를 관찰하였다. 단시간의 당화혈색소량 변동이 불안정형 당화혈색소량의 변동에 의한 것인가를 알아보기 위하여 37예의 인슐린 비의존형 당뇨병환자에서 식사전후에 혈당량 및 안정형 당화혈색소량과 불안정형 당화혈색소량을 측정한 후 비교 검토하였다. 혈당은 glucose oxidase 법으로 측정하였고 당화혈색소는 HPLC 법을 이용하여 측정하였다. 불안정형 당화혈색소는 식염수로 전항온을 이용하여 얻어진 안정형 당화혈색소를 총당화혈색소에서 빼내어 구하였다. 결과 : 1)공복시 혈당농도는 Ⅰ, Ⅱ, Ⅲ군에서 각각 264.9±51.63(평균±SEM)mg/dl, 203.1±12.16mg/dl, 205.5±13.40mg/dl였고, 공복시 당화혈소량은 11.1±1.37%, 9.8±1.32%, 10.5±0.36%로 각군간의 유의한 차이는 없었다. 2) 식후 두시간 혈당농도는 Ⅰ, Ⅱ, Ⅲ군에서 각각 185.1±33.42mg/dl, 306.3±13.69mg/dl, 248.4±10.25mg/dl로 각군간에 유의한 차이를 보였으나(p<0.01), 식후 두시간 당화혈색소량은 10.5±1.42%, 10.5±1.22%, 10.6±0.36%로 유의한 차이가 없었다. 3) 식후 두시간 혈당농도에서 공복시 혈당농도를 뺀값은 Ⅰ, Ⅱ, Ⅲ군에서 각각 -79.8±43.79mg/dl, 103.2±14.61mg/dl, 42.9±11.17mg/dl,로 각군간의 유의한 차이를 보였고 (p<0.001), 당화혈색소량의 찻값은 각각 -0.6±0.49%, 0.6±0.33%, 0.08±0.01%로 각군간의 유의한 차이를 보였다(p<0.001). 4) 75g 경구당부하 검사를 시행한 치료받지 않은 15예의 인슐린 비의존형 당뇨병환자에서 당부하전의 혈당농도가 113±13.4mg/dl에서 당부하후 두시간에 222±11.3mg/dl로 증가함에 따라 당화혈색소량은 7.2±1.3%에서 7.8±1.9%로 증가하였다(p<0.001). 5) 37예의 인슐린 비의존형 당뇨병환자에서 공복시, 식후 두시간 혈당농도가 164.1±9.61mg/dl에서 285.3±14.42mg/dl로 증가함에 따라 불안정형 당화혈색소량은 0.6±0.08%에서 1.3±0.16%로 유의한 증가를 보였으나(P<0.001), 안정형 당화혈색소량은 유의한 변화가 없었다. 6) 혈당농도와 당화혈색소량의 상관계수는 불안정형 당화혈색소량에서는 0.41, 안정형 당화혈색소량에서는 0.28로 불안정형 당화혈색소와의 상관계수가 더 높았다(p<0.001). 결론 : 이상의 결과로 단시간의 혈당량 변동이 HPLC법에 의한 당화혈색소량의 측정에 영향을 미칠수 있는 인자의 하나로 생각되며, 이는 단시간의 혈당농도 변동에 따른 불안정형 당화혈색소량의 변동에 의한 것임을 시사한다. Background : HbA_1C is formed slowly throughout the 120-day life span of the red blood cell by non-enzymatic glycosylation of HbA_O. HbA_1C concentrations reflect mean blood glucose levels over the previous several weeks, but we experienced the changes of hemoglobin A_1C values according to the short term changes of blood glucose levels. We investigated the changes of HbA_1C values with a HPLC technique according to the short term changes of blood glucose concentration. Method : HbA_1C values were measured at fasting and postprandial 2-hour state with a HPLC method in 166 NIDDM patients, and they are divided into three groups (Group Ⅰ : ??HbA_1C<-0.3%, Group Ⅱ : ??HbA_1C>0.3%, Group Ⅲ : -0.3%≤??HbA_1C≤0.3, ??HbA_1C : postprandial 2 hour HbAlc values-fasting HbA_1C values) and compared respectively. In 15 untreated NIDDM patients, blood glucose and HbA_1C were measured during the oral glucose tolerance test to exclude the influence of food and treatment on the HPLC method. Stable HbA_1C and labile HbA_1C were measured in 37 NIDDM patients to evaluate the influence of labile HbAlC on the HPLC method. Results : 1) In group Ⅰ, Ⅱ, Ⅲ, Postprandial 2-hour blood glucose levels (man±SEM) were 185.1±33.42mg/dl, 306. different respectively (p<0.01). fasting blood glucose levels, fasting HbA_1C values and postprandial 2-hour HbA_1C values were not significantly different among three gruops. 2) In group Ⅰ, Ⅱ, Ⅲ, the differences between postprandial 2-hour levels and fasting blood glucose levels were -79.8±43.79mg/dl, 103.2±14.61mg/dl, 42.9±11.17mg/dl, and the differences were highly significant (p<0.001). The mean ??HbA_1C values were -0.6±0.49%, 0.6±0.33, 0.08±0.01% respectively. 3) In 15 untreated NIDDM patients, HbA_1C values were significantly increased from 7.2±1.3% to 7.8±1.9% according to the increment of blood glucose levels from 164.1±9.61mg/dl to 285.3±14.42mg/dl (p<0.001), but stable HbA_1C values were not significantly changed. 5) Correlation between labile HbA_1C and blood glucose (r=0.41, p<0.001) was higher than that between stable HbA_1C and blood glucose (r=0.28, p<0.001). Conclusion :From the above results we can find that HbA_1C values measured with a HPLC technique change according to the short term changes of blood glucose levels, and the changes of HbA_1C values are caused by the short term changes of labile HbA_1C values.

고온용 판-휜 열교환기 개발

곽재수(Jae Su Kwak),안원근(Won Geun An),김형모(Hyung Mo Kim),박영일(Young Il Park),양수석(Soo Seok Yang) 대한기계학회 2005 대한기계학회 춘추학술대회 Vol.2005 No.5

Performance tests of the plate-fin type heat exchanger for high temperature application have been performed with a high temperature heat exchanger performance test facility. The facility consists of air compressor, electric heaters, venturi flow meters, flow control valves, and combination probes which can measure temperature, total and static pressures at the same time. The performance tests were carried out near the heat exchanger design condition and off-design conditions, and the test results were compared with the calculated results. The test results showed lower heat exchanging efficiency and smaller pressure drop than the calculated results. Based on the difference, the modified design of the heat exchanger was offered.

표면압력 분포 가시화를 위한 압력감응 페인트의 제작

안최란,기효진,진병규,김정균,김석범,조용화,노영철,최용덕,곽재수,최용규,An, Choiran,Ki, Hyojin,Jin, Byeong Kyou,Kim, Jung Kyun,Kim, Sug Bum,Jo, Yong Hwa,Nho, Young Cheol,Choi, Yong Duk,Kwak, Jae Su,Choi, Yong Gyu 항공우주시스템공학회 2008 항공우주시스템공학회지 Vol.2 No.3

We have fabricated pressure sensitive paint films consisting of PtTFPP activators dispersed in fluorinated polymer matrix. This matrix material is unique in its composition and structure. We evaluated the oxygen quenching effects, and thus the pressure sensitivity, of the fabricated films in terms of various processing parameters. Based on the experimental results, we anticipate that a good but new pressure sensitive paint would be presented through further elaboration of the polymer compositions and optimization of the processing conditions.

당뇨병성 말초신경장애에서의 Vibratory Perception Threshold

윤재영(Jae Young Yoon),정동진(Dong Jin Chung),최종상(Jong Sang Choi),안재수(Jae Su An),장현주(Hyun Ju Jang),정민영(Min Young Chung),이태희(Tae Hee Lee) 대한내과학회 1991 대한내과학회지 Vol.41 No.4

N/A To assess the relation between vibratory perception threshold (VPT) and diabetic neuropathy, we checked beat-to-beat variation test (BBV) and VPT in 67diabetics (24insulin-dependent diabetes mellitus (IDDM), 43 non-insulin dependent diabetes mellitus (NIDDM)) and 35control subjects of similar age, and the following results were obtained. 1) In the control subjects, the VPT value was 7.2at the left 1st metacarpal area and 19.0at the left anterior superior iliac spine. The values in the lower extremities were higher than those of the upper extremities, and there were no differences between the left and right. 2) NIDDM patients had significantly higher VPT values at all sites, especially in the lower extremities, than those of the control subjects (p<0.01) (mean VPT values at the left and right lateral malleolus, medial malleolus, 1st metatarsal, and great toe were 26.8, 24.8, 25.1, 25.7, 20.2, 21.9, 18.9 and 18.3 in diabetics, and 16.5, 17.2, 17.3, 18.8, 14.5, 14.1, 12.1 and 11.0 in the controls, respectively). 3) The VPT values of NIDDM patients with symptoms of peripheral neuropathy were significantly higher in the upper and lower extremities (mean VPT values at the left and right radial and ulnar tubercle in the upper extremities were 14.2, 16.3, 12.2 and 15.8, respectively (p<0.05) and at the left and right lateral malleolus, medial malleolus, 1st metatarsal and great toe in the lower extremities were 31.4, 29.3, 30.1, 30.0, 23.6, 27.2, 22. 5 and 21.7 respectively (p<0.01)) than those of the control and asymptomatic subjects. 4) Among the asymptomatic NIDDM patients (n=16), the VPT values of 5 were higher than those of the others at olecranon, radial tubercle, and ulnar tubercle (p<0.05, respectively). However, the BBV showed no significant differences between them. 5) There were associations of the VPT values with age in the diabetic and control subjects (diabetic; r=0.52, p<0.001, control; r=0.74, p<0.001) and those in the lower extremities in NIDDM patients were associated with duration of diabetes (r=0.49, p<0.001) and age (r=0.43, p<0.01). 6) There were no relations between VPT values and angiographyically comfirmed retinopathy in NIDDM patients. 7) VPT values and BBV in IDDM patients were not significantly different from age matched control subjects (in BBV test; 14.4 in IDDM patients and 12.3 in controls). These results suggest that measurement of VPT is useful aid for early diagnosis of peripheral neuropathy in NIDDM patients, and diabetic peripheral neuropathy could be developed without automonic neuropathy.

Insulin 비의존형 당뇨병환자에서 Insulin 과 Gliclazide 병합요법의 효과에 관한 연구

윤재영(Jae Young Yoon),장현주(Hyun Ju Jang),안재수(Jae Su An),정동진(Dong Jin Chung),최종상(Jong Sang Choi),정민영(Min Young Chung),이태희(Tai Hee Lee) 대한내과학회 1990 대한내과학회지 Vol.39 No.2

N/A This study was performed on the acute effect of gliclazide and insulin combination in non insulin dependant diabetic (NIDDM) patients who had been in secondary failure with oral hypoglycemic agents treatment. Thirty minutes after premedication with 80 mg gliclazide or placebo, 11.25 unit of rapid acting recombinant human insulin were infused through the forearm vein for 45 minutes. Blood sugar measurements were made at 10-minute intervals, whereas serum insulin and C-peptide levels were measured at 30-minute intervals. The results were as follows: 1) There was no significant difference in the basal serum insulin concentration before the insulin infusion after placebo and gliclazide administration. Peak serum insulin concentration was attained 30 minutes after insulin infusion. The values were 312±26 μU/ml after placebo administration and 312±19 μU/ml after gliclazide adminisration. 2) Blood sugar levels of both groups fell to 130 mg/dl one hour after insulin infusion and remained at euglycemic state during the study. 3) Although both showed no difference in the basal C-peptide concentration, the serum C-peptide concentration of the gliclazide group was significantly higher than that of the placebo group. These results indicate that gliclazide combined with insulin may increase endogenous insu1in secretory capacity, even in the presence of secondary failure of oral hypoglycemic agents.

Nylon 6 Film의 결정화도가 응력 완화거동에 미치는 영향

조대현,장동호,안재수,Jo, Dae-Hyeon,Jang, Dong-Ho,An, Jae-Su 한국섬유공학회 1990 한국섬유공학회지 Vol.27 No.1

The stress-relaxation behaviour of uniaxially drawn nylon 6 films was studied under with various crystallinty and varous initial strain at temperature range from 248K or 298K. In case of the same crystallinity, the change of stress-relaxation moduli of small strain was faster than that large. The absolute value of stress-relaxation modulus increased with the increase of crystallinity and the slope of stress-relaxation curves of small crystallinity was faster than that of large. The apparent activation energy of stress-relaxation increased with the increase of crystallinity.

당뇨병성 자율신경장애에서의 타액내 포도당 분비율

박상선 ( Park Sang Seon ),안재수 ( An Jae Su ),장현주 ( Jang Hyeon Ju ),이대호 ( Lee Dae Ho ),정민영 ( Jeong Min Yeong ),이태희 ( Lee Tae Hui ) 대한내과학회 1993 대한내과학회지 Vol.44 No.4

연구배경 및 방법 : 당뇨병 환자 54예와 대조군 60예를 대상으로 심혈관 자율신경의 반사기능을 이용한 검사방법으로 당뇨병성 자율신경장애의 유무를 조사하여 정상군(Ⅰ군, n=60), 자율신경장애를 동반하지 않은 당뇨병 환자(Ⅱ군, n=25), 자율신경장애를 동반한 당뇨병 환자 (Ⅲ군, n=29)로 구분하였고, 각군에서 타액 분비율, 타액내 포도당 농도, 타액내 포도당 분비율을 측정 비교하여 다음과 같은 결과를 얻었다. 결과 : 1) 공복시 타액 분비율은 Ⅰ군에서는 34.85±1.49 ml/hr,Ⅱ군에서는 33.86±1.80 ml/hr 였으며 Ⅲ군에서는 27.41±1.73 ml/hr로 Ⅰ군 및 Ⅱ군에 비해 각각 유의하게 낮았다(p<0.05). 2) 공복시 타액내 포도당 분비율은 Ⅰ군에서는 2.66±0.23 mg/hr,Ⅱ군에서는 2.95±0.33 mg/hr 였으며 Ⅲ군에서는 1.87±0.15 mg/hr로 Ⅰ군 및 Ⅱ군에 비해 각각 유의하게 낮았다(p<0.01). 3) 식후 2시간의 타액 분비율에 있어 Ⅱ군과 Ⅲ군은 32.28±1.79 ml/hr, 31.86±1.30 ml/hr 였고 식후 2시간의 타액내 포도당 농도에 있어 Ⅱ군과 Ⅲ군은 각각 8.44±0.65 mg/dl, 7.61±0.66 mg/dl였으며 식후 2시간의 타액내 포도당 분지율에 있어 Ⅱ군과 Ⅲ군 각각 2.72±0.27 mg/hr, 2.29±0.19 mg/hr로 모두 두 군간에 유의한 차이는 없었다. 4) 공복 및 식후 2시간의 타액 분비율, 타액내 포도당 농도, 타액내 포도당 분비율에 있어, 그 각각은 혈당과 유의한 상관 관계가 없었고, 또한 그 각각은 당화혈색소와도 유의한 상관 관계가 없었다. 결론 : 공복시 타액내 포도당 분비율의 측정이 당뇨병성 자율신경장애의 진단에 있어서 도움이 될 것임을 시사하였다. Background & Methods: It usual for patients with diabetic neuropathy to have symptoms of autonomic neuropathy, and we see many studies about the methods for the usefulness of measurement of fasting salivary glucose secretory rate for assessing the presence of diagbetic autonomic neuropathy, but there are few papers about these in our country. The 54 diabetic patients and 60 control subjects were studied and the diabetic patients were divide into three groups according to the results of tests utilizing cardiovascular autonomic nervous reponses (group Ⅰ: normal control subjects, n=60; group Ⅱ: diabetic patients without autonomic neuropathy, n=25; group Ⅲ: diabetic patients with autonomic neuropath, n=29). Salivary flow rate, salivary glucose concentration and salivary glucose secretory rate were measured with a glucose osidase method in each group. Results: 1) The fasting salivary flow rate in group Ⅲ was 27.41±1.73 ml/hr, which was significantly lower than that of group Ⅰ(34.85±1.49 ml/hr) and Ⅱ(33.96±1.73 ml/hr)(p<0.05). 2) The fasting salivary glucose secreatory rate in group Ⅲ was 1.87±0.15 mg/hr, which was significantly lower than that of group Ⅰ(2.66±0.23 mg/hr) and Ⅱ(2.95±0.33 mg/hr)(p<0.01). 3) There are no significant correlations among the values of postprandial 2 hours salivary flow rate, salivary glucose concentration, salivary glucose secretory rate of group Ⅰ, Ⅱ and Ⅲ. 4) None of the fasting and postprandial 2 hours salivary flow rate, salivary glucose concentration, salivary glucose secretory rate are related to the levels of blood glucose and HbAlc. Conclusion: Measurements of fasting salivary glucose secretory rate are helpful for the diagnosis of diabetic autonomic neuropathy.

인슐린비의존형 당뇨병 환자에서 단시간 운동부하에 의한 혈소판응집능의 감소

정동진(Dong Jin Chung),장현주(Hyun Ju Jang),안재수(Jae Su An),최종상(Jong Sang Choi),윤재영(Jae Young Yoon),정민영(Min Young Chung),이태희(Tai Hee Lee) 대한내과학회 1991 대한내과학회지 Vol.41 No.2

N/A Increased platelet aggregation in diabetes mellitus is considered to be one of the etiologic factors of diabetic microangiopathy. The mechanism influencing platelet aggregation by physical exercise in non-insulin-dependent diabetes mellitus (NIDDM) is poorly understood. This study was performed to evaluate the effectiveness of short-term exercise on platelet aggregation in patients with non-obese, non-insulin-dependent diabetes mellitus compared with the normal group. Before and after submaximal exercise using ergometer, platelet aggregation responses to adenosine diphosphate (ADP), collagen, and epinephrine were measured, and the following results were obtained. 1) In platelet aggregation test, in NIDDM patients (n=45), the maximal platelet aggregations [to ADP; 78.7% (p<0.01), to epinephrine; 74.5% (p<0.05)] were significantly higher than those [to ADP; 65.1%, to epinephrine; 67.3%] of control subjects(n=15). 2) In control subjects (n =9), platelet aggregations after exercise was not significantly changed [before exercise; ADP 65.8±3.55%, collagen 70.2±2.35%, epinephrine 58.3±6.08%, after exercise; ADP 68.0±2.84%, collagen 68.9±2.46%, epinephrine 59.5±5.73%, respectively]. 3) In NIDDM patients (n =13), platelet aggregations to ADP and collagen after exercise were significantly decreased [before exercise; ADP 73.4±3.98%, collagen 79.3±4.24%, epinephrine 72.8±3.57%, after exercise; ADP 67.9±3.27% (p<0.05), collagen 69.3±3.49% (p<0.01), epinephrine 66.8±3.97%, respectively]. 4) There were no differences in the plasma thromboxane B2 levels between controls (4.6±1.44 pg/ml) and NIDDM patients (8.5+1.95pg/ml), and after exercise, thromboxane B2 was decreased, but not significantly, in NIDDM patients (before exercise; 18.1±5.36pg/ml, after exercise; 11.5±2.58 pg/ml). 5) Duration of diabetes, hemoglobin Ai, and fasting blood sugar did not affect the platelet aggregation. These results indicate that short-term exercise decreases platelet aggregation in NIDDM patients.

당뇨병성 망막증의 위험인자에 관한 고찰

최종상(Jong Sang Choi),장현주(Hyun Ju Jang),안재수(Jae Su An),정동진(Dong Jin Choung),윤재영(Jae Young Yoon),정민영(Min Young Chung),이태희(Tai Hee Lee) 대한내과학회 1991 대한내과학회지 Vol.40 No.4

N/A It is very important to identify the risk factors for diabetic retinopathy because diabetic retinopathy is a major problem for the diabetic patient and represents the commonest cause of acquired blindness in adults. To evaluate the risk factors for diabetic retinopathy, 325 diabetic patients underwent both polaroid fundus photography and fluorescent retinal angiography using a Canon CF-U fundus camera. Clinical characteristics and the laboratory findings of patients with proliferative retinopathy and patients with background retinopathy were compared with diabetic patients with normal retinal findings. The results were as follows: 1) Of the 325 patients, 96 patients (29.5%) had diabetic retinopathy, 90 paitents (27.7%) had background retinopathy, and 6 patients (1.8%) had proliferative retinopathy. 2) In the background diabetic retinopathy group, the duration of diabetes (5.9±4.68 years) was significantly longer than the normal retinal group (3.6±3.80 years) (p < 0.01). 3) The frequency of diabetic retinopathy increased from 22.5% in those with diabetes for less than 5 years to 50.6% in those who have had it for 5 to 10 years, and to 72.2% in those who have had it for more than 10 years (p < 0.01). 4) No significant differences were observed in sex, current age, age at diagnosis, systolic blood pressure, hematocrit, serum cholesterol hemoglobin Alc, fasting blood sugar, and obesity between the diabetics with normal retinal findings and the diabetic retinopathy group. 5) The average diastolic blood pressure of the proliferative retinopathy group (88.3±7.53mmHg) was higher than that of the normal retinal findings (79.0±10.13mmHg) (p<0.05) 6) When the results of fundus photography were compared to fluorescent retinal angiography, the sensitivity and specificity of fundus photography was 66.7% and 93.9%, respectively. 7) An analysis of the distribution of microaneurysms showed microaneurysms were found to occur most frequently in the perimacular area (44.4%), and secondly in the temporal-to-macula area (26.7%). These results suggest that fluorescent retinal angiography was more valuable in detecting early diabetic retinopathy that was missed by fundus camera. The risk factors for diabetic retinopathy were the duration of the diabetes not only in the background but also proliferative retinopathy and diastolic blood pressure in proliferative retinopathy.