공복혈당과 당화혈색소에 의한 당뇨병 진단 비교

윤우준,신민호,권순석,박경수,이영훈,남해성,정슬기,윤용운,최진수,Yun, Woo-Jun,Shin, Min-Ho,Kweon, Sun-Seong,Park, Kyeong-Soo,Lee, Young-Hoon,Nam, Hae-Sung,Jeong, Seul-Ki,Yun, Yong-Woon,Choi, Jin-Su 대한예방의학회 2010 Journal of Preventive Medicine and Public Health Vol.43 No.5

Objectives: The American Diabetes Association (ADA) has recently recommended the HbA1c assay as one of four options for making the diagnosis of diabetes mellitus, with a cut-point of $\geq$ 6.5%. We compared the HbA1c assay and the fasting plasma glucose level for making the diagnosis of diabetes among Korean adults. Methods: We analyzed 8710 adults (age 45-74 years), who were not diagnosed as having diabetes mellitus, from the Namwon study population. A fasting plasma glucose level of $\geq$126 mg/dL and an A1c of $\geq$ 6.5% were used for the diagnosis of diabetes. The kappa index of agreement was calculated to measure the agreement between the diagnosis based on the fasting plasma glucose level and the HbA1c. Results: The kappa index of agreement between the fasting plasma glucose level and HbA1c was 0.50. Conclusions: The agreement between the fasting plasma glucose and HbA1c for the diagnosis of diabetes was moderate for Korean adults.

혈당관리 수준과 당뇨병성 망막증과의 관련성

윤우준 대한노인병학회 2010 Annals of geriatric medicine and research Vol.14 No.4

Background: The prevalence of diabetes mellitus(DM) is higher in old age, and diabetic retinopathy is the leading cause of blindness. Appropriate glycemic control is known to reduce the incidence of diabetic retinopathy in diabetic patients. We evaluated the relationship between hemoglobin A1c levels and diabetic retinopathy. Methods: Our subjects included 654 diabetic patients registered with the public health center. Following an overnight fast, venous blood and urine samples were collected and analyzed. Non-mydriatic fundus photography was done to diagnosis diabetic retinopathy. We calculated the odds ratios of hemoglobin A1c and fasting plasma glucose for diabetic retinopathy using logistic regression. Results: Diabetic retinopathy was seen significantly more often at higher levels of hemoglobin A1c(odds ratio, 3.46; 95 % confidence interval, 1.90-6.30 for <50 percentile vs. >75 percentile). Fasting glucose, however, was not significantly associated with diabetic retinopathy after adjusting for hemoglobin A1c(Hb1cA). The odds ratio for diabetic retinopathy accor- ding to HbA1c was higher in those with DM for >10 years than <10 years. Conclusion: The HbA1c level was significantly associated with diabetic retinopathy in Koreans with type 2 diabetes. 연구배경: 당뇨병의 유병률이 전 세계적으로 증가하고있으며, 당뇨병으로 인한 사회경제적 부담 역시 증가하고있다. 우리 나라에서도 당뇨병이 증가하고 있는 추세이며,특히 연령이 높을수록 유병률이 높다. 당뇨병성 망막증은신증 및 신경병증과 더불어 당뇨병의 대표적인 미세혈관합병증이며, 실명의 가장 흔한 원인이지만, 효과적인 혈당관리는 당뇨병성 망막증 발생을 줄일 수 있다고 알려졌다. 본 연구에서는 혈당수준을 반영하는 당화혈색소를 이용하여 보건소에 등록되어 관리되고 있는 당뇨병 환자들에서혈당 조절 수준과 당뇨병성 망막증과의 관련성에 대해 알아보고자 하였다. 방법: 광주광역시 일개 보건소와 전라남도 일개 보건의료원에 등록되어 있는 1,275명의 당뇨병 환자들 중 654명을최종 연구 대상자로 하였다. 혈액검사는 모든 대상자에서최소한 12시간 이상 금식을 한 뒤 채취한 정맥혈을 이용하였다. 공복혈당은 자동 분석기(Hitachi-7600 Chemical Analyzer)를 이용하여 측정하였으며 효소법으로 검사하였다. 당화혈색소는 DCCT 분석에 표준화된 VARIANT II를 이용한 HPLC 방법으로 측정하였다. 공복혈당과 당화혈색소의 검사 차례내(within-run) 변이계수는 각각 0.96%, 0.29%이었다. Topcon TRC-NW200 Non-Mydriatic Digital Retinal Camera (Topcon Co.)를 이용하여 무산동 안저촬영(non-mydriatic fundus photography)을 하였다. 촬영된 안저 사진은 안과 전문의에의해 판독되었으며, Modified Airlie House 분류법을 사용하여 중증도(moderate), 중증(severe) 비증식성과 증식성 당뇨병성 망막증으로 분류하였다. 결과: 비망막군과 당뇨병성 망막군 사이에 당화혈색소,공복혈당, 신체질량지수, 당뇨병 기간이 유의한 차이를 나타났으나, 수축기혈압, 이완기혈압, 총 콜레스테롤, 중성지방,고밀도 지단백 콜레스테롤, 그리고 흡연율은 두 군 사이에유의한 차이가 없었다. 당화혈색소가 증가할수록 당뇨병성망막증의 위험도가 높았다(OR, 3.46; 95% CI, 1.90-6.30for <50 percentile vs. >75 percentile). 체내 혈당 수준을 나타낼수 있는 다른 지표인 공복혈당의 경우 당화혈색소를 보정한분석에서는 당뇨병성 망막증과의 관련성을 보이지 않았다(OR, 1.23; 95% CI, 0.67-2.24 for <50 percentile vs. >75percentile). 당뇨병 이환기간이 10년 이상인 군이 10년 미만인 군에 비해 당화혈색소 증가에 따른 당뇨병성 망막증의위험도가 더 높았다(0.61 vs. 6.72 for 51-75 percentile; 3.12vs. 5.36 for >75 percentile). 결론: 혈당관리 수준이 낮을수록 당뇨병성 망막증의 위험이 높았으며, 당뇨병 이환 기간이 긴 경우 위험도가 더 높았다. 또한 혈당관리 수준을 나타내는 지표로서 당화혈색소가공복혈당에 비해 당뇨병성 미세혈관 합병증의 위험도를 예측하는데 더 우수함을 보여주고 있다. 당뇨병 환자들에서미세혈관 합병증을 예방하기 위해서는 당뇨병 초기에 당화혈색소 측정을 통한 혈당 관리 수준 파악이 중요할 것으로보이며, 당뇨병 환자를 관리하는데 있어 이러한 점들이 우선적으로 강조되어야 할 것이다.

목재유물 분석에 의한 주거환경 복원 가능성 검토

윤우준(Yoon Woo-Jun) 중부고고학회 2003 고고학 Vol.2 No.1

고고학의 목적은 인류에 대한 이해로서 과거 인간이 경험한 모든 분야에 관심을 가지고, 그들이 남긴 물질 흔적을 통해 그들의 문화상을 밝혀내는 학문이다. 따라서 지금의 모든 학문분야는 과거를 이해하고 밝힐 수 있는 중요한 도구인 셈이며, 물질적 자료의 분석에서는 자연과학적 방법의 활용이 당연한 일이다. 이 연구는 유적에서 확인된 목재유물의 수종분석을 중심으로 유적지의 과거 자연환경과 인문환경, 그리고 주거환경을 실험적으로 추론 해보고자 하는 것이다. 수목은 그 생태적인 특성상 수종에 따라 한정된 지역에만 고유의 수종이 분포하며, 비교적 손쉽게 가공할 수 있음에 따라 가구, 도구, 연료재 등 생활도구의 재료로서 뿐만아니라 목선재, 건축재, 목관재 등으로 가장 광범위하게 쓰였고, 1년을 단위로 생육 당시의 환경을 종합적으로 기록하는 특성을 갖고 있다. 따라서 목질유물의 수종을 식별하고 그 조직구조를 규명하는 것은 목재의 사용시기와 당시의 생태학적 기후학적 자연환경, 그리고 사람들의 목재 이용 실태를 통한 문화상을 파악할 수 있고 지역간의 교류상태를 규명하는 귀중한 고고학적 가치를 가진다. 즉 유적에서 확인되는 각종 목재류의 수종분석을 통해서 고고학적 의미를 구하는데는 많은 한계가 있기는 하지만, 자연ㆍ인문환경을 추론할 수 있다. 그리고 이를 토대로 유적별로 각각의 거주인들이 단지 주변에서 구하기 쉬운 목재를 건축재로 사용한 것인지 아니면 특정한 수종을 선호하였는지, 건축규모와 최대 지붕하중은 어느정도였는지, 건축재를 획득하는데 어떠한 도구를 사용하였는지, 건축재의 획득시기 및 건축시기는 어느 계절이었는지, 연소재는 어떤 목재를 선호하였는지, 식용으로 할 수 있는 목재는 어떠한 것이 있는지, 목재도구 및 생활도구에 결합해 사용했던 것은 어떠한 목재였는지, 목재가공기술은 어느정도였는지, 사용된 건축재의 분포가 생활공간의 입지에 어떠한 영향을 주었는지 등등 다양한 주거환경을 밝혀낼 수 있는 기초자료로 제시될 수 있을 것이다. 본고는 이 모든 질문들에 대하여 잠정적인 해결방안을 명백히 하지 못하였다. 이 글의 목적이 새로운 사실을 밝혀내거나 정밀한 분석을 의도하는 것이 아니기 때문이다. 다만, 본고에서는 목재류 출토유물에 대한 수종분석방법 식별과 이용양상에 대한 연구결과들을 정리하고, 용인시 죽전동 주거유적에서 검출된 목탄 시료를 대상으로 실험적 수종분식을 시도하였으며, 기존의 연구성과와 대비하여 그 분석결과가 함축하고 있는 고고학적 의미와 활용방안에 대한 가능성을 생각해보았다. Since the aim of archaeology is the understanding of humankind, it is a discipline tnat discloses the cultural aspects of the ancient people, mainly through the examination of material traces, considering the full range of human experience of the past. For that purpose, all fields of science are to serve to make the past revealed and understood. not to mention natural science for the analysis of material evidence. This, study is to reconstruct experimentally a natural, cultural and residential environment of the past through species identification or wooden materials excavated in the sites. The geographical distribution fo a tree is regularly limited to a certain area. Trees also characterized by recording growth environment every year. They are very flexible that is easy to process and form for daily necessaries such as household goods, tools and fuel. They are also used most widely for boats, buildings and coffins. Hence, species identification and structural investigation or wooden remains are of great archaeological value, revealing the period of the use, ecological and climatological environment, cultural aspects of the user and relationship between areas, and so on. Although species Identification fo wooden remains is partly subject to limited credibility, it allows us to reconstruct the natural and cultural environment to a respectable extent, It can yield a variety of basic information about the residential environment of a certain period of the past : whether the user preferred to wood which was to obtain easily from the neighborhood or to that of a specific species; how to the scale of the building and the maximum load or a roof were: which tools they used to obtain materials: which was the most favored firewood; what kind of wood was edible at that time; what time of a year they usually obtained materials and build house: which kind of wood was used for tools; how the processing technique of wooden material was; how relevant was the relationship between the distribution of a certain wood species and the condition of living space, etc. This study doesn’t answer all of these questions, even provisionally. After all, the purpose of this study was not to find out new facts or to analyze the given facts precisely, First, this study simply rearranges the research results considering identification method of species or wooden remains and its application. Then, it experimentally tries to identify the species of charcoal excavated at the residential site in Jukjeun-dong, Yongin, Kyunggi-do, examining the archaeological meaning of the species identification correlated with and its possible application.

성남시의 문화정책 현황과 과제

윤우준(Yoon Woo Jun) 가천대학교 아시아문화연구소 2006 아시아문화연구 Vol.10 No.-

Since it is culture that is a topic for the 21st century, every city in the world shares advocacy for making itself city of culture. Whatever such advocacy by cities implies, nowadays it becomes the most popular slogan and cities competitively propose and formulate a variety of programs and plans for its fulfillment. The reason of advocacy for making culture city by cities is that cityscape is one of the firsthand indices representing the culture, identity and opulence of city residents and, in global paradigm for the 21<SUP>st</SUP> century, a city as such comes to be recognized as a brand. In other words, culture of a city becomes one of the most pivotal factors making up competitiveness of the city. Local governments or municipalities have already made out specified action plans for making culture city which is being acknowledged as a crux of urban competitiveness. Similarly, Seongnam city enormously proposes a variety of culture policies, orienting toward a culture city. Nonetheless, it seems necessary for the city to put a lot of effort in setting the basic direction of its culture policies. Mostly, culture policies by Seongnam city work around the establishment of large-scale hardware without well-defined objectives and hollow, event-like programs. Because such policies are mostly implemented on beneficent basis, city residents remain as mere objects or spectators, not subjects or participants. For the rebirth of Seongnam city as a culture city of genuine value, its culture policies premise clear understanding of its specific historical background and current problems as well. The most urgent problems that Seongnam city now has can be summed up as follows: dissemination of the sense of community among its residents through the improvement of former negative image of the city as a poor region and the conflict resolutions between residents living at old and new downtown; establishment of the city identity which can be shared among its residents and satisfaction of their cultural needs; and development and commercial use of a variety of cultural assets. For success in its culture policies, Seongnam city should need radical reconsideration and well-placed implementation process of such policies from the long-term perspective. First of all, the municipality should build cooperative network with the experts and relevant organizations from diverse fields and be well equipped with administrative leadership and planning capacity based on such network. Basically, Seongnam city is required to inquire and develop those cultural-historic assets and narratives that help the city identify and establish its historical root and cultural identity and make use of such assets and narratives in educational facilities for cultural experience, tourism and cultural industry, enhancement of the city image, activation of various city festivals, and so on. It is expected that such policies enable the municipality to earn financial advantages as well as provide a breeding ground for the city that is necessary to lead its residents into a sense of cultural homogeneity and change and improve their life into more cultural one. In short, based on development and establishment of abovementioned fundamental cultural and historic assets, Seongnam city should consider outcomes from relevant academic fields including urban planning and conduct coordination and consultation with them in order to formulate comprehensive, integrated medium-and long-term plans for culture city that present persuasive and specified future vision of the city for the 21st century. Only if above processes precede, Senognam city will be able to grow to a city of culture in a real sense, a state that is the very essence of urban competitiveness in the future. Kyungwon University is the best partner for Seongnam city in its progress into culture city. Though Kyungwon University is the only a big, well-established university rooted in the Seongnam city, it has

일개 농촌지역 저소득층 당뇨병환자의 관리 상태

김혜연,윤우준,신민호,권순석,안혜란,최성우,이영훈,조동혁,이정애,Kim, Hye-Yeon,Yun, Woo-Jun,Shin, Min-Ho,Kweon, Sun-Seong,Ahn, Hye-Ran,Choi, Seong-Woo,Lee, Young-Hoon,Cho, Dong-Hyeok,Rhee, Jung-Ae 대한예방의학회 2009 예방의학회지 Vol.42 No.5

Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

빅데이터, IoT, AI 기술을 이용한 춘천시 생활폐기물 관리 정책 개선

최희수 ( Heesu Choi ),윤우준 ( Woojoon Yun ),안종화 ( Johnghwa Ahn ) 한국폐기물자원순환학회 2023 한국폐기물자원순환학회 추계학술발표논문집 Vol.2023 No.0

SCM440H의 레이저 열처리 연구

전용호(Y. Jeon),염현호(H. Yeom),윤우준(W. J. Youn),정명찬(M. C. Chung),김성환(S. H. Kim),임채원(C. W. Lim),한상배(S. B. Lee),양승철(S. C. Yang) 한국생산제조학회 2013 한국생산제조시스템학회 학술발표대회 논문집 Vol.2013 No.4