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진상만,오배준,이설,최정묵,양수진,박성우,김광원,김재현,박철영 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.5
Purpose: Although the presence of cannabinoid type 1 (CB1) receptor in islets has been reported, the major contributor to the protective effect of rimonabant on islet morphology is unknown. We determined whether the protective effect of rimonabant on pancreatic islet morphology is valid in established diabetes and also whether any effect was independent of decreased food intake. Materials and Methods: After diabetes was confirmed, Otsuka Long-Evans Tokushima Fatty rats, aged 32 weeks, were treated with rimonabant (30 mg/kg/d, rimonabant group) for 6 weeks. Metabolic profiles and islet morphology of rats treated with rimonabant were compared with those of controls without treatment (control group), a pair-fed control group, and rats treated with rosiglitazone (4 mg/kg/d, rosiglitazone group). Results: Compared to the control group, rats treated with rimonabant exhibited reduced glycated albumin levels (p<0.001), islet fibrosis (p<0.01), and improved glucose tolerance (p<0.05), with no differences from the pair-fed control group. The retroperitoneal adipose tissue mass was lower in the rimonabant group than those of the pair-fed control and rosiglitazone groups (p<0.05). Rimonabant, pair-fed control, and rosiglitazone groups showed decreased insulin resistance and increased adiponectin, with no differences between the rimonabant and pair-fed control groups. Conclusion: Rimonabant had a protective effect on islet morphology in vivo even in established diabetes. However, the protective effect was also reproduced by pair-feeding. Thus, the results of this study did not support the significance of islet CB1 receptors in islet protection with rimonabant in established obesity-associated type 2 diabetes.
진상기(陳尙基),박영원(朴榮遠) 한국지역정보화학회 2017 한국지역정보화학회지 Vol.20 No.3
2016년 다보스 포럼 이후 활발히 전개되고 있는 제4차 산업혁명에 대한 논쟁은 2017년 대한민국 대선을 거치면서 우리사회의 큰 화두로 자리 잡게 되었다. 이처럼 정책적, 학술적 논의가 급증하고 있는 현실속에서 본 연구는 제4차 산업혁명에 대한 정책적 개념정립과 정책적 추진전략을 도출할 필요성을 제시하고 본 연구를 설계 시행하였다. 이를 위해 본 연구는 언론(신문과 방송 기사)과 웹에서의 연관어 분석을 통해 제4차 산업혁명 관련 빅데이터 분석을 실시하였고, 더불어 선행연구 및 유사국가들의 정책분석을 통해 제4차 산업혁명에 대한 정책적 개념 정립과 전략적 가치체계를 도출해 낼 수 있었다. 도출된 계층구조는 전문가 의견과정을 거쳐 최종 수정 확정할수 있었고 이를 설문지화 하여 전문가 50명을 대상으로 계층분석(AHP)을 실시하여 대안별 가중치를 도출해 낼 수 있었다. 계층분석 결과를 요약해 보면 제4차 산업혁명에 대한 접근방식 중 ① 산업적 측면, ② 기술적 측면 ③ 사회적 측면, ④ 법제적 측면 순으로 전문가들이 접근방식의 가치우선순위를 달리 부여하고 있음을 알 수 있었다. 또한 그 하위 대안들에 대해 정책추진 우선순위도 각각 부여 하여 이를 바탕으로 본 연구는 대한민국의 미래대응 제4차 산업혁명 정책추진체계를 정책적 시사점으로 제시할 수 있었다. 또한 이러한 과정에서 정책 참여자들의 이해관계와 그 다양성에 따라 정책내용(Marsh & Smith, 2000 등) 정책구조(Waarden, 1992 등), 정책 관계(권기헌, 2007 등)들이 서로 상이하게 해석되고 접근방식에 차이가 있음을 확인할 수 있었다. Discussion about the 4<SUP>th</SUP> Industrial Revolution, that has been actively developing since the 2016 Davos Forum, turned into a big conversation topic of our society, after going through the 2017 presidential election. In this reality that academic and political discussion on this issue is arising rapidly, this research has been planned and implemented, suggesting the necessity to define the political notion about the 4<SUP>th</SUP> Industrial Revolution and the necessity to draw up political strategy. In order to do this, this research carried out big data analysis about the 4th Industrial revolution by analysing the related terms in the websites and the press(newspaper and broadcast articles). And also by analyzing the preceding research and policies of similar countries, we were able to define the political notion about the 4<SUP>th</SUP> Industrial Revolution and draw up the strategic value system. We could make final determination about the concept hierarchy that has been drawn up by listening to the experts’ opinions, and by making this into survey and carrying out analytic hierarchy process(AHP) to 50 experts, we could draw up the weight for each alternatives. If we could summarize the AHP results, among the approach methods towards the 4<SUP>th</SUP> Industrial Revolution we could find out that in the order of ① Industrial aspect, ② technical aspect, ③ social aspect, ④ legal aspect, experts prioritize the values of approach methods differently. Besides, we granted policy enforcement priority for each lower alternatives, and based on these results this research could suggest policy enforcement system of future strategies for preparing the 4<SUP>th</SUP> industrial revolution as policy implication. Also, we could confirm that during this process depending on the interests of policy participants and their diversity, the content of policy (Marsh & Smith, 2000 etc.), policy structure (Waarden, 1992 etc.), policy relationship (Ki Heon Kwon, 2007 etc.) are interpreted differently from one another, and difference in approaching methods could be observed.
진상만,송선옥,정창희,장진선,서성환,강승민,정인경,박철영,김재현,조재형,이병완 대한의학회 2014 Journal of Korean medical science Vol.29 No.2
It has not yet been determined whether chronic exposure to relatively low doses of pioglitazone increases risk of bladder cancer. We aimed to assess the risk of bladder cancer associated with pioglitazone in Korean patients. This was a retrospective cohort study of diabetic patients who had ≥2 clinic visits between November 2005 and June 2011 at one of four tertiary referral hospitals in Korea. A prevalent case-control analysis nested within the cohort was conducted to further adjust confounders. A total of 101,953 control patients and 11,240 pioglitazone-treated patients were included, in which there were 237 and 30 cases of incidental bladder cancer (64.9 and 54.9 per 100,000 person-years; age, sex-adjusted HR 1.135, 95% confidence interval [CI] 0.769-1.677), respectively. In the prevalent case-control analysis nested within the cohort, use of pioglitazone for a duration of >6 months, but not ever use of pioglitazone, was associated with an increased rate of bladder cancer as compared to never use of pioglitazone. In conclusion, we failed to exclude the possible association between use of pioglitazone for a duration of >6 months and bladder cancer.
진상만 대한내분비학회 2017 Endocrinology and metabolism Vol.32 No.2
Impaired awareness of hypoglycemia has been found to be prevalent in 20% to 40% of people with type 1 diabetes. If a similar prevalence exists in Koreans with type 1 diabetes, at a minimum, thousands of people with type 1 diabetes suffer at least one unpredicted episode of severe hypoglycemia per year in Korea. For patients with problematic hypoglycemia, an evidence-based stepwise approach was suggested in 2015. The first step is structured education regarding multiple daily injections of an insulin analog, and the second step is adding a technological intervention, such as continuous subcutaneous insulin infusion or real-time continuous glucose monitoring. The next step is a sensor-augmented pump, preferably with a low glucose suspension feature or very frequent contact, and the final step is islet or pancreas transplantation. In Korea, however, none of these treatments are reimbursed by the National Health Insurance, and thus have not been widely implemented. The low prevalence of type 1 diabetes means that Korean physicians are relatively unfamiliar with the new technologies in this field. Therefore, the roles of new technologies and pancreas or islet transplantation in the treatment of problematic hypoglycemia need to be defined in the current clinical setting of Korea.