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제2형 당뇨병 환자에서 심혈관계 자율신경병증의 진단에 있어 Colour Change Plaster (NeuroCheck(R)) 검사의 유용성에 관한 연구
김현정 ( Hyun Jung Kim ),임윤혁 ( Yeun Hyuk Lim ),오효정 ( Hyo Jung Oh ),김병수 ( Byung Soo Kim ),김하영 ( Ha Young Kim ),박병현 ( Byoung Hyun Park ),조정구 ( Chung Gu Cho ) 대한내과학회 2006 대한내과학회지 Vol.71 No.2
목적: 최근 보고에 의하면 말초 자율신경병증(교감신경병증)이 심혈관계 부교감신경병증에 선행하여 발생하는 것으로 보고되고 있어 이를 진단하는 것이 심혈관계 자율신경병증을 조기 진단하는데 도움이 될 것으로 생각되었다. 저자들은 최근 당뇨병성 신경병증을 발한기능을 통해 진단하고자 개발된 color change plaster인 뉴로체크(R)를 이용한 말초 자율신경병증의 존재가 심혈관계 자율신경병증 및 당뇨병성 미세혈관합병증과 어떠한 연관성이 있는지 알아보고자 본 연구를 시작하였다. 방법: 평균 연령 55±14.9세, 평균 당뇨병 이환기간 11.8±8.8년인 제2형 당뇨병 환자 35명(남자 10, 여자 25)을 대상으로 뉴로체크(R)를 사용하여 발한기능을 평가하였다. 발한기능 이상은 색깔이 파란색에서 완전히 분홍색으로 변하는 시간이 10분 이상일 경우로 정의 하였으며 말초 자율신경병증(발한기능 장애)이 있는 군과 정상인 군으로 나누었고, 심혈관계 자율신경병증에 대한 검사는 Ewing 등의 방법을 사용하였다. 결과: 1) 말초 자율신경병증은 23명(65.7%)에서 발견되었다. 발한기능이 정상인 군과 비정상인 군의 색깔변화 시작 시간과 완전히 변하는데 까지 걸리는 시간은 각각 38.3±33.7 sec 대 367.1±470.3 sec (p<0.05), 372.5±198.8 sec 대 1677.4±711.9 sec (p<0.05)이었다. 두 군의 Ewing 점수는 각각 2.4±2.3점 대 4.6±2.2점이었다 (p<0.05). 발한기능 이상 군에서 나이가 더 많았다(59.2±11.7 yrs, vs 47±17.4 yrs, p<0.05). 2) 당뇨병성 미세혈관병증 중 망막병증과 발한기능 이상이 연관성이 있었다(p=0.04). 3) 말초 자율신경병증은 심혈관계 부교감 신경병증과 연관이 있었으며 확정적인 심혈관계 자율신경병증과 연관을 보였으나, 초기 심혈관계 자율신경병증과는 연관성을 보이지 않았다. 4) 확정적 심혈관계 자율신경병증의 진단에 있어서 뉴로체크(R)의 민감도, 특이도, 양성 예측률, 음성 예측률은 각각 86.7%, 62.5%, 68.4%, 83.3%이었다. 결론: 새로운 colour change plaster인 뉴로체크(R)를 이용한 발한기능 검사는 당뇨병성 망막병증과 연관성이 있었고, 확정적(definitive) 당뇨병성 심혈관계 자율신경병증을 진단하는데 도움이 될 것으로 생각되나, 초기 심혈관계 자율신경병증을 진단하기에는 좀 더 평가가 필요할 것으로 생각된다. Background: Recently, the colour change plaster (NeuroCheck(R)) has been introduced, which measures sweat production on the basis of a colour change from blue to pink. This new test was useful to detect of diabetic peripheral neuropathy. The aim of this study was to evaluate the usefulness of the colour change plaster (NeuroCheck(R)) for the diagnosis of cardiac autonomic neuropathy in type 2 diabetic patients. Methods: This study include 35 type 2 diabetic patients (10 male, 25 female) with a mean age of 55±14.9 years and a mean diabetes duration of 11.8±8.8 years. Cardiac autonomic neuropathy was diagnosed by means of Ewing`s method. Peripheral autonomic neuropathy (Sudomotor function abnormality) was assessed by means of time (more than 600 seconds) until complete colour change in the indicator test. Results: Peripheral autonomic neuropathy was diagnosed in 23 patients (65.7%). Time until starting colour change of plaster in normal and abnormal sudomotor patients were 38.3±33.7 sec and 367.1±470.3 sec (p<0.05). Time until completing colour change of plaster in normal and abnormal sudomotor patients were 372.5±198.8 sec and 1677.4±711.9 sec (p<0.05). The autonomic score of two groups were 2.4±2.3, 4.6±2.2 (p<0.05). Sudomotor abnormal group was older than normal (59.2±11.7 yrs, vs 47±17.4 yrs). Presence of retinopathy was related with sudomotor abnormality. Peripheral autonomic neuropathy was related with parasympathetic cardiac autonomic neuropathy. Sudomotor function abnormality was related with definite cardiac autonomic neuropathy, but it was not related with early cardiac autonomic neuropathy. The sensitivity, specificity, positive predictive value and negative predictive value of colour change plaster in the diagnosis of definitive cardiovascular autonomic neuropathy was 86.7%, 62.5%, 68.4% and 83.3%, respectively. Conclusions: The colour change plaster (NeuroCheck(R)) is not useful for the early diagnosis of cardiac autonomic neuropathy in type 2 diabetic neuropathy, but it may be possible for the screening test of definite cardiac autonomic neuropathy.(Korean J Med 71:166-172, 2006)
온라인 전기 자동차를 위한 비접촉 유도 전력 전달 시스템
정구호(Gu-Ho Jung),이경훈(Kyung-Hun Lee),김형국(Hyung-Guk Kim),조양진(Yang-Jin Cho),송보윤(Bo-Yun Song),손영동(Young-Dong Son),박은하(Eun-Ha Park),최주영(Ju-Young Choi),공병오(Byung-O Kong),허진(Jin Huh),손호섭(Ho-Sub Son),조정구(Jung- 대한전기학회 2010 대한전기학회 학술대회 논문집 Vol.2010 No.7
온라인 전기자동차는 도로에 매설된 급전선로로부터 유도자계를 통하여 비접촉 방식으로 전기를 집전 받아 정차 및 주행 중에 충전하는 자동차이다. 이러한 비접촉 충전을 위해서는 도로에 매설된 급전 시스템과 차량 하부에 장착된 집전 시스템으로 구성된 비접촉 유도전력 전달(IPT, Inductive Power Transfer) 시스템이 필요하며, 급전 시스템은 다시 급전 인버터와 급전선로로, 집전 시스템은 집전 모듈(pick-up)과 집전 레귤레이터로 구성된다. 본 논문에서는 이러한 비접촉 IPT 시스템 각각의 장치를 소개하며, 더불어 구축된 시스템의 성능에 대해서도 소개한다.
매독의 혈청학적 검사 - VDRL , FTA - ABS 및 TPHA 검사 결과의 비교 -
조정구(Chung Koo Cho),이정복(Jung Bock Lee),이성낙(Sung Nack Lee),한신원(Shin Won Han) 대한피부과학회 1984 大韓皮膚科學會誌 Vol.22 No.4
On a total 375 sera with reactive results on VDRL and/or FTA-ABS test(s), derived from severance Hospital, qualitative and quantitative TPHA tests were carried out. The objectives of the present study were to compare the result of VDRL, FTA-ABS and TPHA teats in different syphilis stages, and to as sess the suitability of the TPHA test as a screening test for syphilis. The results are summarized as follows: 1. The sensitivity of VDRL test was poor compared with TPHA and FTA-ABS tests except in secondary syphilis. 2. The FTA-ABS test(10Qp,) was more sensitive than the TPHA test(86g) in primary syphilis, but it is time consuming and costly. 3 The TPHA titers were relatively low in primary syphilis. 4, Below 1: 32Q in TPHA titer, the percentage of sera from patients tested over 1 year(64%) after the completion of treatment was higher than within 1 year(41%). The TPHA test showed 77%. agreement with VDRL test and 89% agreement with FTA-ABS test. The VDRL test is easy to perform and economic, but it showed poor effeetiveness as screening test for the detection of syphilis. On the other hand the TPHA test had a wide spectrum of reactivity in different stages of syphilis and was easy to perform. So on the basis of the results presented, we concluded that the TPHA test provides a very effective screen for syphilis.
선천성 매독 : 매독에 감염된 산모에서 태어난 태아의 운명과 조기 선천성 매독의 임상증세
이정복(Jung Bock Lee),이동건(Dong Kun Kim),조정구(Chung Koo Cho),이성낙(Sung Nack Lee) 대한피부과학회 1984 대한피부과학회지 Vol.22 No.3
A retrospective study was made of the medical records of 114 pregnant women with untreated syphilis and their offsprings, and 19 pregnant women with treated syphilis and their offsprings at Severance Hospital, Yonsei University College of Medicine during the years 1972 through 1981. We analyzed the outcornes of offsprings from both untreated and treated syphilitic mothers and the clinical manife- stations of early congenital syphilis. The results obtained were as follows: Of 30 offsprings from 30 untreated syphilitic mothers with VDRL titer below 1: 4, six(20%) had congenital syphilis, one(3%) was a stillbirth, and twenty-three were normal infants. Of 84 offsprings from 84 untreated syphilitic mothers with VDRL titer above 1: 8, fifty-six(67g) had congenital syphilis, ten(12g,) were neonatal deaths, and eighteen(21%) were stillbirths, Normal infants were not observed. The mean weight ratio of placenta to fetus was 0 29 in g8 offsprings from syphilitic mothers. The ratios were as follows: 0. 25 in 14 living infants with con- genital syphilis, 0. 27 in 5 neonatal deaths, and (), 33 in 19 stillbirths respectively. 3, Of 19 pregnant women with treated syphilis, the qualitative tests of VDRL were all reactive except for one case and the quantitatis e tests of VDRL were 1: 1 weakly reactive to 1: 4 reactive. FTA-ABS tests demonstrated reactive results in all cases. The qualitative tests of VDRL in the infeants of the treated mothers were 1: 1 weakly reactive to 1: 2 reactive and FTA-ABS tests were reactive in all cases.-countinue-
나용호(Yong Ho Nah),조정구(Jung Gu cho) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1
N/A Lsing cutaneous electrodes an electrogastrographic study was made of gastric myoelectrical activity in both the fasting and postprandial state in 24 patients with diabetes mellitus (l4 autonomic neuropathy patients) and in 12 control subjects. In 80% of the diabetic autonomic neuropathy, abnormal myoelectrical activity was found which was characterized by: (1) instability of the gastric pacemaker frequency; (2) tachygastrias; (3) the absence of the normal amplitude increase and the frequency dip in the postprandial electrogastrogram. The present study shows that abnormal gastric myoelectrical activity of diabetic autonomic neuropathy is related to parasyrnpathetic dysfunction and inappropriate sympathet.ic dominance.