제 3형 Gaucher세병으로 인한 진행성 근간대성 간질 2예

허경,예종수,김상진,김성은,김응규,조효근,김찬환,김현주 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3

한국인 제2형 당뇨병 환자의 골격근에서 인슐린 신호전달체계의 결함

최준혁,이관우,김효정,이동훈,이종우,김정은,엄현채,김경미,최성이,정윤석,김현만 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 제2형 당뇨병에서 나타나는 인슐린 저항성은 간, 지방, 근육 같은 말초조직에서 인슐린의 작용이 떨어지는 것을 말한다. 제2형 당뇨병의 발생기전에 인슐린 저항성과 인슐린 분비능 저하가 같이 관여함은 잘 알려진 사실이다. 인슐린의 세포내에서의 저항성을 규명하기 위한 인슐린의 세포내 신호전달체계에 대한 연구가 활발히 진행되고 있으며 몇몇 연구에서 인슐린 저항성을 가진 골격근육에서 IRS와 관련된 PI3-kinase의 활성감소와 Akt kinase의 활성감소를 보고하고 있으나 아직까지 명확하게 그 기작이 설명되어지지 않고 있다. 본 연구에서는 정상성인, 제2형 당뇨병 환자를 대상으로 경구당부하검사 및 인슐린 클램프검사를 시행하고 인슐린 클램프 검사시 대상인의 근육을 채취하여 인슐린 신호전달 체계(IR-β, IRS, Akt(PKB, Rac) kinase, GSK-3)를 연구하였다. 방법: 연구대상자는 한국인으로서 경구당부하검사상 정상인 및 당뇨병 환자 각각 11명, 9명을 대상으로 하였으며, 정상인은 건강인으로 과거력상 당대사에 영향을 줄 질환이 없고, 현재 당대사에 영향을 줄 약물 복용 및 다른 소견이 없는 경구당부하검사상 정성 내당능을 보이는 대상자로 하였다. 당뇨병환자는 모두 제2형 당뇨병 환자로 이환기간이 만 5년 이내인 경우로 하고, 인슐린으로 치료하는 대상자는 제외하도록 하였다. 대상자의 연령, 체질량지수, 체지방량, 공복시 총콜레스테롤, 중성지방, 고밀도지단백 콜레스테롤 및 HbA1c, 인슐린, C-peptide를 측정하였고, "HOMA model"을 이용하여 베타세포의 기능와 인슐린저항성 정도를 평가하였다. 정상혈당클램프 검사(euhlycemic hyperinsulinemic clamp test)를 시행하고 인슐린 투입 전과 인슐린 투입 30분후, 두차례에 걸쳐 대퇴부 근육생검을 실시한후 western 법으로 IR-β, IRS, Akt kinase, GSK-3의 인산화량을 측정하였다. 결과: 정상인 11명과 당뇨병 환자 9명을 대상으로 하였으며 대상자의 평균 연령, 평균 체질량지수, 체지방량, 허리/엉덩이 둘레의 비(waist hip ratio; WHR)는 두 군간에 차이가 없었다. 평균 공복혈당은 정상군 98.0±0.3㎎/dL, 당뇨병군 208.1±16.5㎎/dL(p<0.05), HbA1c는 정상군 5.4±0.5%, 당뇨병군 9.2±0.6%(p<0.05)였다. "HOMA model"을 이용한 베타세포의 기능과 인슐린저항성은 정상군 56.4±8.5%, 1.4±0.2, 당뇨병군 72.2±52.3%(p<0.01), 10.2±6.3(p<0.01)였으며 정상혈당클램프 검사상 포도당 이용률은 정상군 8.2±0.6㎎/㎏/min, 당뇨병군 3.7±1.1㎎/㎏/min(p<0.01)로 정상군과 당뇨병군간에 유의한 차이를 나타내었다. Western blot법으로 IR-β, IRS, Akt kinase, GSK-3의 인산화량을 인슐린 투입전과 인슐린 투입 30분후 측정하였을 때 IR-β에서는 정상군이 103.9±2.3에서 241.3±18.6, 당뇨군이 108.9±2.2에서 198.7±6.3으로 증가하였다(p=NS). 이는 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 통계적인 차이가 없었다. IRS에서는 정상군이 111.6±7.3에서 295.6±17.2, 당뇨군이 114.5±6.1에서 222.0±23.2로 증가하였으며(p<0.05), 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 약 24% 감소하였다. Akt kinase에서는 103.4±6.0에서 416.8±29.5로 증가하였으며(p<0.01), 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 약 43% 감소하였다. GSK-3에서는 정상군이 107.7±6.7에서 595.7±28.1, 당뇨군이 104.3±4.8에서 443.3±12.9로 증가하였으며(p<0.01), 인슐린 투입후 당뇨병군이 정상군과 비교하여 인산화량의 증가정도가 약 25% 감소하였다. 결론: 제2형 당뇨병 환자에서 정상인과 비교하여 인슐린 자극후 IR-β는 인산화량의 증가정도가 큰 차이가 없었으나, IRS, Akt kinase, GSK-3에서는 인산화량의 증가 정도가 감소되는 것으로 보아 상위 인슐린 신호전단체계부터 결함이 있는 것으로 생각된다. Background: The glucose uptake rate is the limiting step in glucose utilization and storage. The failure of insulin to stimulate glucose uptake in muscle appears to be a primary defect of insulin resistance. This study was undertaken to examine the effect of physiological hyperinsulinemia on the phosphorylation of the insulin receptor (IR-β), insulin receptor substrate (IRS), Akt kinase and GSK-3 in isolated skeletal muscle, in people with type 2 diabetes(n=9) and control subjects(n=11). Methods: 75g OGTT and euglycemic hyperinsulinemic clamp test were done. And vastus lateralis muscle was obtained before and 30 min into the euglycemic clamp. Western blots were performed for tyrosine phosphroylation of insulin receptor substrate (IRS) and phosphorylation of the insulin receptor(IR-β), Akt and GSK-3. Result: There were no statistical differences in the mean age, BMI and body fat between the control subjects and diabetic patients. The fasting blood sugar and HbA_1c in controls and diabetic patients were 98.0±0.3 and 208.1±16.5ng/dl, and 5.4±0.5 and 9.2±0.6%, and 1.4±0.2 in the control subjects, and 72.2±52.3%(p<0.01) and 10.2±6.3(p<0.01) in the diabetic patients, respectively. The insulin resistance from the euglycemic hyperinsulinemic clamp test were 8.2±0.6㎎/㎏/min and 3.7±1.1ng/㎏/min in the control subjects and in the diabetic patients, respectively(p<0.01). Compared with the normal controls, insulin-stimulated IR phosphorylation was no different to that in the diabetic patients. However, insulin-stimulated IRS phosphorylation, insulin-stimulated Akt phosphorylation and insulin-stimulated GSK-3 phosphorylation were reduced in the diabetic patients compared with the normal controls by 24, 43 and 25%, respectively(p<0.05). Conclusion: In Korean type 2 diabetic patients, the insulin resistance may be due to the impairment of the upstream insulin signal molecular network. Further studies will focus on determining whether these signaling defects are the cause of the development of insulin resistance, or secondary to the altered metabolic state, associated with type 2 diabetes mellitus (J Kor Soc Endocrinol 17:685∼697, 2002).

경연 대회를 통한 초ㆍ중고생의 창의력 신장 효과에 관한 연구

이희복,육근철,류해일,김현섭,김희수,박달원,유병환,김선효,김여상,서광수,변두원,서명석,배성효,박종석,심규철,이성희 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

미래 사회를 대비하기 위한 개인의 개성을 존중과 창의적인 능력을 지닌 인간을 양성을 목적으로 충청남도 지역의 초 ㆍ 중고등학생들을 대상으로 한 창의력 경연대회가 공주대학교 과학교육연구소에서 개최되었다. 충청남도 초 ㆍ중 ㆍ 고등학생들을 대상으로 실시한 창의력 경연대회는 창조적 아이디어를 내어 스스로 문제를 해결해 나갈 수 있는 교육 프로그램을 제공하는 좋은 기회였음이 확인되었으나, 일부의 팀에서만 참신하고 재미있는 아이디어들이 제안되었다. 여학생의 참가자 수가 상당히 증가하였으며, 대체적으로 입상권의 학생들의 상당 부분이 여학생이라는 것이 특이할만하다. 학년이 올라감에 따라서 창의적인 아이디어를 내는 양이나 질에 있어서 뒤떨어지는 것으로 분석되었으며, 토론 학습의 적응력이 미흡하고 발표력 및 청취력에 있어서도 떨어지는 것으로 나타났다. 따라서 중 ㆍ고등학교의 학교교육에서도 학생들에게 프로젝트형 탐구학습 프로그램의 적용은 물론 토론식 수습을 통한 학생들의 사고의 전환의 기회를 제공해야 할 것으로 사료된다. The creativity competition was held to foster the creativity of elementary and secondary school students in the Institute of Science Education, Kongju national University. It was found that the creativity competition effected on the improvement of inventing creative ideas and problem solving activities. But, only some competitors participated in semifinal and final contests, presented original and interesting ideas. More female students participated in competition than last year. More female participants were awarded a prize than males. Totally, participants were defective in discussion and communication, and presentation and listening ideas. Increasing grades correlated inversely with creativity and originality. There is need of inquiry project teaming programs and presenting opportunities of conversion of thinking by discussing instructions in school

양성 백악아세포종의 치험례

김종배,박효상,최봉주,이용규,남동석,박관수 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.2

Benign cementoblastoma is uncommon odontogenic tumor of the jaw of mesenchymal origin. It is common in male below 25 years of age, commonly occurs in mandibular molar and premolar area. Principal symptom is painless swelling. Radiologically, radiopaque mass is fused with a root or roots of teeth, surrounded, and limited peripherally by a radiolucent halo. Histologically, the tumor is composed of sheets of an osteocementum like material with basophilic reversal line. Because of unlimited growth potential, the usual treatment is complete surgical excision with extraction of the associated teeth. The patient, 16-year old male, was admitted to our hospital with chief complaint of painless swelling on right mandible body area. Surgical excision of lesion and extraction of associated tooth was performed. On follow up check, we obtained good result without any signs of recurrence of the lesion.

하악전돌 환자에서 하악골 후퇴수술이 기도공간에 미치는 영향

김효영,최현규,김은경,김정기 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.5

하악전돌증 환자의 하악골 후퇴수술로 골격적인 변화뿐 아니라 연조직에서의 변화가 동시에 일어나는데, 외부적으로 나타나는 안모 연조직의 심미적 변화와 더불어 구강내의 가동성 및 비가동성 연조직에도 영향을 미친다. 전북대학교병원 치과교정과에 하악전돌증을 주소로 내원한 환자중 수술전 교정치료를 받고 하악골만 양측성 하악지시상골절 단술로 후퇴시킨 환자 38명의 수술전, 수술직후, 수술 약 1년후의 측모 두부계측방사선 사진의 투사도를 작성하고 FH plane과 pterygoid vetical plane(PTV)을 reference plane으로 사용하여 연속된 측모 두부계측방사선 사진을 중첩시켰다. 수술후 변화된 인두부 깊이와 혀, 연구개, 설골 등의 위치변화를 위한 길이측정과 구인두부 기도공간 면적을 측정하기 위해 각 경계선을 디지타이저(Kurta digitizer XGT, Kurta Co., USA)로 컴퓨터에 입력하고 AutoCAD프로그램으로 계측하였다. 하악골 후퇴수술이 구인두부 기도공간에 미치는 영향에 대해 연구하였으며 구강내 각 구조물들의 위치변화와 각 항목들의 상호관계성을 조사하였다. 1. 구인두부 기도공간은 하악전돌증 환자의 하악골 후퇴수술후 감소되며 연속적으로 감소를 유지하고 있다(p<0.05). 2. Xi점과 제2경추 수준에서 인두의 깊이는 수술전과 비교해 수술후 유의하게 감소되었으며 감소된 채로 유지된다(p<0.05). 이수준에서의 인두부 깊이 감소는 구인두부 기도공간과 밀접한 관련이 있다.(p<0.01). 3. 제3경추와 제4경추 수준의 인두부 깊이는 수술후와 연속되는 관찰기간에도 유의하게 감소하지 않았다. 4. 설골은 수술후 하방으로 이동하였으나(p<0.05), 연속되는 관찰기간 동안 원래의 위치로 회귀되는 경향을 보였다. 5. 혀의 길이와 높이 그리고 후두개 기저의 위치는 유의하게 변화하지 않았다. 6. 연구개는 수술후 후방으로 변위하며 혀의 후방변위로 연속적으로 후방위치된 채 남아 있다(p<0.05). 연구개의 변위는 구인두부 기도공간의 면적과 유의한 상관관계를 가지며 인두후벽과의 거리는 감소되었다(p<0.01). 7. 구인두 기도공간의 감소는 후두개첨 상방부에서 수술에 의한 혀의 후방변위에 기인하며 계속 감소가 유지되었다. As a result of surgical orthodontic treatment of mandibular prognathism, changes take place in the skeletal and soft orofacial components. Although some investigators had stated that permanent reduction of airway space was observed after mandibular setback surgery, it was not clear that this permanent reduction was sustained during long-term follow-up. The purpose of this study was to assess the changes in oropharyngeal airway space and soft tissue orofacial component following the mandibular setback surgery and during the follow-up period. The correlation between the changes of the oropharyngeal airway space and the changes of other soft tissue orofacial component was also assessed. The findings of this study were as follows; 1. The oropharyngeal airway space area decreased following mandibular setback surgery for mandibular prognathism and continued to decrease during the follow-up period(p<0.05). 2. The pharyngeal depth at Xi point level and the 2nd cervical vertebra point level decreased after the surgery and remained during the follow-up period(p<0.05). The decrease of these pharyngeal depth was not significant after the surgery and during the follow-up period. 3. The decrease of pharyngeal depth at the 3rd and 4th cervical vertebra point level was not significant after the surgery and during the follow-up period. 4. The hyoid bone moved downward after the surgery(p<0.05), but returned to its original position during the follow-up period. 5. The length & height of epiglottis base did not change significantly(p<0.05). 6. The soft palate was displaced posteriorly after the surgery and remained to its changed position during the follow-up period(p<0.05) due to posterior displacement of tongue. The changes of soft palate were significantly correlated with the decrease of oropharyngeal airway space area(p<0.01). 7. The narrowing of oropharyngeal airway space was due to the posterior displacement of tongue above the level of epiglottis tip. The posterior displacement of tongue following mandibular setback osteotomy remained during the follow-up period.

성인에 발생한 외상성 뇌경막하 수활액낭종

김기동,이종수,이현개,이승재,박효일 인제대학교 1983 仁濟醫學 Vol.4 No.3

저자 등은 성인에서 외상 후 발생한 뇌경막하수활액낭종 26예를 보고하고 이 질환의 임상 및 방사선학적 양상, 처치, 수술 결과, 그리고 발병 원인 등에 대하여 기술하였다. 이 질환은 손상의 정도 및 발병 유형이 다양하였고, 수술 전 요추천자시의 뇌척수액은 흔히 황백색을 보이면서 단백치의 증가를 보였다. 두개골절은 35%데서 발견되었으며 뇌경막하수활액낭종은 대뇌피질 위축, 뇌좌상, 뇌경막하혈종 및 뇌경막상혈종과 동반되어 발생하였다. 병변의 위치는 뇌혈관 조영술에 의해서도 확인할 수 있었으나 뇌경막하혈종과의 수술 전 감별은 Brain CAT Scan에 의해서만 가능하였다. 사망율은 15.4%이었으며 만족할만한 결과를 보인 것은 76.9% 이었다. 저자 등은 Simple burr hole(s) drainage를 선택적 치료 방법으로 택하였으며 때로 수활액낭종이 재발하여 재수술을 시행한 경우도 있었다(Fig.5). The authors reported a series of 26 cases of post-traumatic subdural hygroma in adults and discussed the clinical and radiological features, management, 'surgical results, and pathogenesis. There was marked diversity in the severity of injury and in chronictiy. The lumbar cerebrospinal fluid often showed xanthochromic nature and elevation of the protein content. Skull fracture were found in 35% of the cases, and subdural hygroma were associated with cerebral atrophy, cortical contusions, subdural hematomas, and overlying epidural hematomas. The sites of the lesion was delineated by angiography, but preoperative differentiation from subdural hematoma was possible only with computed tomography. The mortality rate was 15.4%. Satisfactory outcome occurred in 76.9%. The authors advocated simple burr hole drainage as the treatment of choice. Significant reaccumulation may occur occasionally.

Cyclosporin에 의한 치은증식증의 치험 2례

김종배,박효상,김창환,이용규,최봉주,장학원 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.2

Cyclosporin is a relatively new immunosuppressive agent which has been used to prevent organ transplant rejection, to treat type-I diabetes mellitus and several other autoimmune disorders. It is anticipated that the therapeutic use of cyclosporin will increase progressively in the future to treat numerous other disorders. As its clinical use broadens, it will needed for health professionals to be familiar with the beneficial effects as well as some of the undesirable side effects of cyclosporin therapy. A side effect of this drug in dentistry appears to be pronounced gingival hyperplasia. Cyclosporin induced gingival hyperplasia is indistinguishable from gingival hyperplasia induced by phenytoin and nifedipine in clinical and histopathologic finding. We experienced two cases of gingival hyperplasia secondary to cyclosporin therapy in patients, 48-year old & 28-year old females who received a kidney allograft transplant. Clinical examinations revealed a severely overgrown and inflammed gingiva. Surgical excision of the excess tissue was accomplished under local anesthesia. On follow-up check, gingival hyperplasia in a 48-year old patient whose oral hygiene was very poor showed successive recurrence after three times surgical excision, another patient who could control oral hygiene thoroughly showed good healing. Conclusively, it seems to be very important to control oral hygiene thoroughly to decrease occurrence and recurrence of cyclosporin-induced gingival hyperplasia.

시차주사열량분석기를 이용한 치과용 접착시멘트의 경화기전 및 반응열에 관한 연구

김철위,이용근,윤태호,김효종,남세진 大韓齒科器材學會 2000 대한치과재료학회지 Vol.27 No.3

The working time of dental cement has a close relation with the setting time, where the setting reaction can be said as the result of the chemical reaction between cement liquid and powder. The purpose of this experiment was to investigate the setting characteristics and setting rate of dental cements by measuring the exothermic heat(Joule/gram) from the setting reaction at specified times using a differential scanning calorimeter (Differential Scanning Calorimeter, DSC 204, TASC 414/3A Controller, Netzche, Germany). Graphs of time-exothermic heat at 37℃ isothermal condition, showing the setting reaction of dental cements were plotted. Three types of luting cements studied were zinc-phosphate cement (ZPC), polycarboxylate cement (PCC), and glass ionomer cement (GIC). The effects of powder-liquid ratio on the setting characteristics of cements were also included. The amount of heat (calory) released per one gram of cement was calculated at each specified time, and was analyzed. ANOVA and Scheff's multiple comparison test (p=0.05) were used for statistical analysis using SPSS/PC+. The setting rate of cement was not constant during the setting reaction, and different setting characteristics were observed depending on the type of cement and powder/liquid ratio. Generally, 70∼90% of the setting reaction, measured by the exothermic heat release, occurred within 5 minutes after mixing. The exothermic heat released by ZPC was very high immediately after mixing, and the duration of the heat release was prolonged compared with other cements. The exothermic heat release of PCC finished most rapidly. It was generally observed that the amount of heat release (rise in temperature) per one gram of cement was highest for ZPC, followed by GIC, and then PCC. However, heat release during the first 2∼5 minutes after mixing was highest for GIC, followed by ZPC and then PCC. According to the Scheff's multiple comparison test, the duration of the total setting reaction did not show any significant difference among the cements(p>0.05), and also among the different power/liquid ratio groups(p>0.05). It was observed that more heat was released with the lower powder/liquid ratio than the higher powder/liquid ratio.

最近發刊된 韓國 어린이 雜誌의 分析

金孝貞 韓國圖書館學會 1973 圖書館學 Vol.3 No.1

The magazine in mordern society is a powerful mass media. Children are generally interested in magazines, which are relatively in expensive, readily and reguarly, and easy to read. The research chose 5 children's magazines published in Korea in 1973 for close analysis. The Sonyon (Youth) was found to be closer to a pure literary reading for children; the Sae Sonyon (New youth) and Sonyonsegeh (World of the youth) were purposes oriented toward popular amusement purposes carrying a great number of catoons; the Sonyon Chungang (Chungang youth) carried too many advertisements; and the Okae Dong Mu (Rear group) was rather weak in contents in fine contrast with its colourful appearance. The following characteristics were generalized from analysis of the five children's magazines published in Korea: (1) The function of periodic information dissemination was very weak, feared in danger of being wiped out. (2) The educative and guidance function was found rather weak. (3) Economic motives seemed stronger in spite of the expressed zeal for missions of magazine. (4) In terms of contents variety was lackey, with little individuality for each magazine. (5) Generally emphasis was given to pictoral contents rather than to reading articles

비등 40% MgCl_2 용액에서 22Cr5Ni2Mo 2상 스테인리스강 용접재의 응력부식균열 특성

김효종,이성근 동아대학교 공과대학부설 생산기술연구소 1996 生産技術硏究所硏究論文集 Vol.1 No.2

The microstructure and stress corrosion cracking behaviors in 22Cr5Ni2Mo suplex stainless steel weldment have been investigated. The SCC has been examined in terms of relevant electrochemical parameters in boiling 40% MgCl₂solution. The austenite content of the weld metal had twice as much as that of the base metal due to the effect of additive elements Ni, N and reheat effect by the multipass welding. The steel had the threshold stress of 29.1 kg/㎟ and the critical cracking potencial(E_CC) of -410mV immune to the SCC, and possessed superior SCC resistance compared to the austennitic stainless steel. Above the E_cc the SCC of the weldment occurred at the base metal regardless of the welding method. Cracks were initiated and propagated transgranularly without retarding effect by the phase the austenite phase in high stress region.