제2형 당뇨병 환자의 치료에서 복약순응도가 혈당 조절에 미치는 영향

김경선,김민정,박소현,박영주,허정순,이은경,김선영,이수형,김상수,강양호,손석만,김인주,김용기 한국병원약사회 2009 병원약사회지 Vol.26 No.2

Abstract: As known in clinical trial like DCCT, UKPDS, tight glycemic control is essential to prevent complications from diabetes mellitus(DM). In type 2 diabetes taking multiple medication, nonadherence to medications is common problem. The aim of our study is to investigate adher-ence rate of patients with type 2 DM and to evaluate association between many factors including adherence rate and HbA_(1C). 441 patients with type 2 DM who visited Busan National University Hospital endocrine internal department from Aug 13 to Sep 2, 2008(3weeks) were enrolled. We conducted a man-to-man questionnaire survey about general knowledge about diabetes mellitus, medicine and adherence, and measured HbA_(1C). Among them, 305 patients taking oral hypo-glycemic agent(OHA) were analyzed to investigate correlation between adherence rate and glycemic control. We studied 305 patients(male 126, female 179, average age 61.2±9.8 years, DM duration 8.6±6.4 years, average adherence 88.8±16.2%, average HbA_(1C) 7.03± 1.18%). HbA_(1C) showed significant relation with DM duration(r=0.137, p=0.017), number of aHA in regimen (r=0.135, p=0.018), dosage frequency(r=0.132, p=0.026), Medication Refill Adherence(MRA)(r=-0.124, p=0.030) and adherence(r=-0.168, p=0.003). Adherence had significant relation with MRA(r=0.148, p=0.010) but didn't have statical corelationship with DM duration, number of aHA and dosage frequency. Patients that their adherence rate exceed 90% took fewer OHA(p=0.011) and went on a better dietary treatment(p=0.007). In patients controlling diabetes mellitus with aHA, when adherence rate and MRA was higher, HbA_(1C) was lower. As a result, to improve adher-ence rate, it is necessary to enhance patient education, do careful consideration about prescrip-tion medicine number and dosage frequency

Case Report : Hepatoid Carcinoma of the Pancreas Combined with Neuroendocrine Carcinoma

( Ji Ye Jung ),( Yoon Jae Kim ),( Hee Man Kim ),( Hong Jeoung Kim ),( Seung Woo Park ),( Si Young Song ),( Jae Bock Chung ),( Chang Moo Kang ),( Joo Yeon Pyo ),( Woo Ick Yang ),( Seung Min Bang ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.1

Hepatoid carcinoma is a primary extrahepatic carcinoma whose morphology, immunohistochemistry, and behavior are similar to those of hepatocellular carcinoma. The most common sites of extrahepatic carcinoma are the stomach and ovary, but nine cases of hepatocellular differentiation of the pancreas have been reported in the literature. We report another case of hepatoid carcinoma of the pancreas that was associated with the development of a pancreatic endocrine carcinoma in a 46-year-old man. Serum alpha-fetoprotein (AFP) was elevated to 262.49 IU/mL and radiological examinations revealed a mass measuring 7.5 cm in diameter in the head of the pancreas. He underwent a conventional Whipple operation, and light microscopy showed adenocarcinoma that was immunopositive for AFP, hepatocyte antigen, cytokeratin, chromogranin, synaptophysin, and alpha-1 antichymotrypsin. Although hepatoid differentiation was not shown unequivocally histologically, other immunohistochemistry findings supported the diagnosis of hepatoid carcinoma combined with neuroendocrine carcinoma. The patient was healthy and had no evidence of recurrence at 4 months after the surgery. This report describes why hepatoid carcinoma should be considered as a differential diagnosis of a pancreatic mass, especially when serum AFP is elevated. (Gut Liver 2010;4:98-102)

산성강하물의 침착량과 동태 해명에 관한 연구 -춘천과 서울 강우의 화학조성 비교 : Comparison of Chemical Composition of Rain Water between Chunchon and Seoul

김만구,강미희,임양석,박기준,황훈,이보경,홍승희,이동수 江原大學校 附設 環境硏究所 1999 環境硏究 Vol.16 No.-

The rain water samples were collected at Chunchon and Seoul by using wet only automatic sampler from January 1996 through December 1997. The daily base rain water samples collected over than 95% rainy events during the whole period. The samples were measured both pH and conductivity, and were analysed major ionic components, SO₄^(2-), NO₃^(-), Cl^(-), NH₄^(+), Ca^(2+), Na^(+) and K ^(+), by ion chromatography. In 1996, about 77% sampled rain water showed below pH 5.6 and the 60% of rain water was lower than pH 5.0. The volume weighted average pH was 4.7 at all sites. In 1997, the volume weighted average pH was 4.6 and 4.9 at Seoul and Chunchon, respectively. Among the rain water samples, 87% and 55% of samples showed below than pH 5.6 and 5.0, respectively. The pH value of Chunchon was significantly (p<0.05) lower than Seoul at the rain samples for less than 20 ㎜ rainfall. However conductivity of the rain samples were 20.9 μS/㎝ for 1996 and 27.7 μS/㎝ for 1997 at Seoul, and 19.1 μS/㎝ for 1996 and 14.1 μS/㎝ for 1997 at Chunchon. H₂SO₄AND HNO₃CONTRIBUTED 65.9% and 29.6% of free acidity at Seoul, respectively. The ratio of [NO₃^(-)]/[nss-SO₄^(2-)] were 0.43 at Seoul and 0.51 at Chunchon for rain samples for less than 20 ㎜ rainfall. The annual wet deposition of Cl^(-), NO₃^(-), SO₄^(2-), H^(+), Na^(+), NH₄^(+), K ^(+), Mg^(2+) and Ca^(2+), respectively, 568.8 ㎏/㎢, 1489.3 ㎏/㎢, 3184.8 ㎏/㎢, 20.9 ㎏/㎢, 249.4 ㎏/㎢, 1091.2 ㎏/㎢, 189.8 ㎏/㎢, 90.2 ㎏/㎢, and 702.4 ㎏/㎢ at Seoul for 1996; 656.4 ㎏/㎢, 2029.7 ㎏/㎢, 3280.7 ㎏/㎢,27.2 ㎏/㎢, 229.4 ㎏/㎢, 1063.9 ㎏/㎢, 106.9 ㎏/㎢, 7802 ㎏/㎢, and 645.3 ㎏/㎢, at Seoul for 1997; 116.9 ㎏/㎢, 983.3 ㎏/㎢, 1797.0 ㎏/㎢, 21.4 ㎏/㎢, 83.2 ㎏/㎢, 648.1 ㎏/㎢, 78.0 ㎏/㎢, 22.2 ㎏/㎢ and 368.8 ㎏/㎢ at Chunchon for 1996; 100.2 ㎏/㎢, 1077.6 ㎏/㎢, 1754.0 ㎏/㎢, 13.4 ㎏/㎢, 146.0 ㎏/㎢, 602.3 ㎏/㎢, 88.8 ㎏/㎢, 16.2 ㎏/㎢ and 206.8 ㎏/㎢ at Chunchon for 1997.

위선암에서 조직면역학적 방법을 이용한 P-glycoprotein의 분포에 관한 연구

김만성,양승하,김의한,강상균 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

P-glycoprotein, as a pleotropic membrane transport protein, shows specific localization in many normal tissue and malignant tumor. It act as an energy dependent drug pump in malignant tumors and makes difficulty for treating these tumors with anticancer drugs. Many malignant tumors such as colon carcinoma, renal cell carcinoma, hepatoma, islet cell tumor of pancreas, and adrenal cortical carcinoma, show high expression of P-glycoprotein and resistance to chemotherapy. However reports for P-glycoprotein in gastric adenocarcinoma is rare. The difference of its expression according to differentiation of gastric adenocarcinoma has been studied and its results are controversial. To observe the relationship of P-glycoprotein positivity according to differentiation of carcinoma, age and sex, adenocarcinoma 82 cases and dysplastic lesions 12 cases were analysed then processed for immunohistochemical stain by avidin-biotin complex using mAB JSB-1. The results were as followings : 1. Positive rate of P-glycoprotein in gastric adenocarcinoma and dysplastic lesions were 48.78%(40/82) and 50%(6/12). 2. Well, moderate and poorly differentiated adenocarcinoma showed positive reaction of P-glycoprotein in 51.28%(20/39), 46.43%(13/28) and 46.67%(7/15) respectively. 3. Positive reaction of P-glycoprotein in male was 53.85%(35/65) and female in 29.41%(5/7) which indicate high positive rate in male. 4. Positive rate of P-glycoprotein according to age distribution were 25%(1/4) in 20-30 decade, 42.8%(6/14) in 40 decade, 44.83%(13/29) in 50 decade, 57.14(12/21) in 60 decade and 57.14%(8/14) in 70 decade. It indicate that P-glycoprotein positivity is increased with age. The above results reveal that the expression of p-glycoprotein in gastric adenocarcinoma as related with sex and age but not with differentiation of carcinoma. These results implies that P-glycoprotein may be implicated with hormone dependent.

대장선암에서 p53과 c-erbB-2의 표출 및 상관관계에 관한 연구

양승하,강상균,김대중,김의한,김만성 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Colorectal adenocarcinoma is relatively common malignant tumor in korea and various oncogenes has found in tumor cells. Colorectal adenocarcinoma show overexpression of p53 and c-erbB-2. The relation between expression of p53 and c-erbB-2 and prognosis of patients in colorectal adenocarcinoma has studied recently, but that is controversy. To evaluate relation between expression of p53 and c-erbB-2 and histopathologic finding prognostic factors, we have performed immunohistochemical staining, using mouse anti-p53 and anti-human c-erbB-2, for 52 cases of colorectal adenocarcinoma. The results were as follows; 1) Expression rate of p53 and c-erbB-2 in colorectal adenocarcinoma were 71.2% and 51.9%, respectively. 2) Expression rate of p53 in left side(70.4%), differentiated(75.6%) and invasion to serosa and surrounding adipose tissue(72.5%) were higher than in right side(37.5%), poorly differnetiated(42.9%) and invasion to muscle(50%). 3) Expression rate of c-erbB-2 in left side(51.9%), differentiated(57.8%) and invasion to serosa and surrounding adipose tissue(54.5%) were higher than in right side(37.5%), poorly differnetiated(14.3%) and invasion to muscle(37.5%). 4) The expression of p53 and c-erbB-2 showed coexpression in colorectal adenocarcinoma. 5) The expression of p53 and c-erbB-2 showed no differenece according to presence or absence of lymphatic metastasis. Above result revealed that p53 and c-erbB-2 are coexpression in colorectal adenocarcinoma. The expression of each p53 and c-erbB-2 and the simultaneous expression of p53 and c-erbB-2 may be related to left side and differentiated cases. Our studies for relation with prognosis of patients in colorectal adenocarcinoma showed different results according to depth of invation and metastasis to lymph node and we should be followed for them.

주축 변위 센서를 이용한 선삭 중의 절삭 진동 측정

김일해,김진현,박만진,김종혁,양희남,장동영 한국공작기계학회 2004 한국생산제조학회지 Vol.13 No.5

Chatter monitoring is also important for realizing an unmanned machining system. While many researches were done on this area, it is still a difficult job to detect very small amplitude amount of chattering. A monitoring system using a capacitive spindle displacement sensor was developed to monitor cutting vibration in turning in this research. The variance of the measured spindle displacement signals using the developed sensor was calculated and utilized to quantify the small vibration in machining. The results were compared with variance obtained using a tool dynamometer. The result showed that the developed system could be utilized in monitoring the subtle changes of cutting vibrations with high sensitivity confidence.

초등학교 운동선수들의 체격, 신체 구성 및 체력의 특성 분석

김만호,윤양진,최민동 釜山大學校 附設 體育科學硏究所 1998 體育科學硏究所 論文集 Vol.14 No.-

The purpose of this study was to look into the factors influencing ability of the game and to give information on selecting the superior player. In elementary school, twenty body of sixth grade were selected as subject for swimmer, football player and, athletes. It measured and compared eight items of physique, four items of body composition and six items of physical fitness as test items The correlation was analyzed to find out the relationship of physique to body composition, physical fitness to body composition, and physique to physical fitness in each sports. 1. The correlation analysis of physique, body composition and physique fitness. 1) The football play was superior to swimmer and athletes only in the thing girths. 2) Standing height, sitting height, up lime length, lower limb length, lower limb length, upper arm girth, chest girth, and body weight all had litter significance. 2. Body composytion comparison 1) Swimmer was better than football player and athletes in percentage of body fat(%fat) and total body fat(%TBF). 2) Football players and athleres were superior to swimmer when comparing body density. 3) there were no significant differences in lean body mass. 3. Comparison of physical fitness 1) Athletes was superior to swimmer and football player in muscular endurance, power, flexibility and agility. 2) There weren't any significant differences in muscle strength and balance. 4. The canonical correlation analysis of physique, body composition and physical fitness 1) Swimmer, football player, athletes all had high interrelationships between physique and body composition(.987), body composition and physical fitness(.973), physique and physical fitness(.967).

종합병원 병동부의 공공공간에 관한 건축계획적 연구 : 복도 및 휴게 공간을 중심으로

김만영,양내원 한국의료복지시설학회 2000 의료·복지 건축 Vol.6 No.10

Most of the existing studies of hospital ward were concentrated on the bed room and there was no study on the day place and corridor space for the inpatient. According to the existing study, 50% inpatients move here and there freely and they want to have a rest in the day place or corridor of the general hospital. So the purpose of this study is to find out the reason why the inpatients prefer to rest in the day place, to survey the inpatients' behavior there and to stress the importance of exterior environment except the bed room in the public space of hospital.

육상경기 선수들의 체격과 운동능력 특성 분석

김만호,윤양진 釜山大學校 附設 體育科學硏究所 1997 體育科學硏究所 論文集 Vol.13 No.-

The purpose of this study was to analyse the characteristics of physique and physical fitness and to investigate the effects of athlete's body conposition and physical fitness to athletic performance of sprinters, middle and long distance runners, jumpers and throwers group with 160 track and field athletes of Boy's and Girl's middle and high school in Pusan metropolitan city. In this study 7 factors in body conposition, 9 factors in physical fitness and 16 factors in were measured and analyzed. The results of the study were as follows; 1. The characteristics of the body conposition factors 1) In Boy's middle school throwers group was the biggest and middle and long distance runners group was the smallest in each factors. Throwers group was the biggest in girth bulk among all groups and smaller than jumpers group in standing height in Girl's middle school. 2) In Boy's hight school jumpers grour in length factors and throwers group was bigger in girth and bulk than other groups. Throwers group was the biggest and middle and long distance runners group was the smallest in each factors in Girl's high school. 2. The characteristics of the physical factors 1) In Boy's middle school throwers group was higher in muscular strength agility and flexibility, sprinters group in muscular strength and power, and middle and long distance runners group in balance than other groups. Throwers group was higher in muscular strength and balance, and middle and long distance runners group was the lowest in muscular strength and power than other groups in Girl's middle school. 2) In Boy's high school throwers group was higher in muscular strength, sprinters group in power, flexibility and balance, and middle and long distance runners group in balance, but they were the lowest in other factors. Throwers group was higher in muscular strength, jumpers group in power and balance than other group's in Girl's high school.

The Study on Medicinal Flora of Several Uninhabited Islands in Jindo-gun, Chonnam province

Yang,Hyo-Sik,Kim,Jong-Wook,Oh,Man-Ho 한국자원식물학회 2003 Plant Resources Vol.6 No.1

The medicinal plants in 22 unhabited islands of Jindo-gun, Chonnam provincde were investigated from March 2000 to October 2002. The medicinal plants in 22 uninhabited islands of Jindo-gun were consisted 366 taxa; 95 families, 269 genus, 309 species, 52 varieties, 3 forma, and 2 subspecies. Important medicinal plants on survey area were Lemmaphyllum microphyllum, Dendropanax morbifera, Ficus erecta, Farfugium japonicum, Machilus thunbergii, Juniperus chinensis var. procumbens, Dendrobium moniliforme, Pyrrhosia tricuspis, Cinnamomum japonicum, Pittosporum tobira, Kadsura japonica, and Daphniphyllum macropodum, This result can be used as basic information data for medicinal research and the conservation of uninhabited islands.