정신지체 특수학교 전공과 및 전환교육의 운영실태와 개선방향

조인수,도금숙,전보성 한국특수교육문제연구소 2001 특수교육저널 : 이론과 실천 Vol.2 No.1

본 연구의 목적은 정신지체 특수학교의 전공과 및 전환교육의 운영실태와 개선방향을 탐색하는데 주안점을 두었다. 전공과 및 전환교육의 운영실태는 16개 영역으로 조사하고 문제점과 개선방향은 10개 영역을 중심으로 세부적인 내용을 조사 분석하였다. 여기서 조사분석된 내용은 정신지체 직업 · 전환교육에 좋은 지침이 될 수 있을 것이며 타장애영역 학생들의 직업진로 및 전환교육에 실질적인 도움을 줄 수 있을 것이다. The aims of this study are finding out the reality of the operation of the majored subjects and problems and finding out the improved methods about them. And 1 surveyed special teachers who are attending 17 special schools in Korea in which have the majored subjects about the reality of operating them and improved methods about them. First, about surveying the reality of operation, as to the majored subjects, they are mainly teaching students in the form of work training, guiding job, preparing job and daily Iiving skills through classes. The selection of majored subjects conceming jobs are made through school's direction and the cooperation among teachers, students and parents, and teaching jobs are now changed or will be changed because of the maladjustment to student' s aptitude, the assessment on their job aptitude is not being made now. There are many qualified teachers who have the certification in special school and they think that their roles as directors, guiders are important. The majoring students don’t have enough practicing places and factories. Even though they are received training about job in school, they get jobs unrelated with their received training. And they have verγ low employment as a whole. Though the transitional education program whose aims are selection in jobs, employment and enjoying jobs, it is started especially in the middle and high school courses. And it is thought that official and individualized education program is very important, also needed the cooperation among related authorities and it’s major program is used as the programs on job training. programs on job training. Next, as to the problems and improved methods, the problems about the majored subjects are the unrelatedness with job training and unreality and only one line of selection in job training. The problem about the transitional education program is the shortage in social skills, in the basement of job training and in carrγing out ability. The professional ability which is required in job guiding teacher is job training guide, many methods, the ability about assessing job aptitude, and testing their ability. The construction of the curriculum is not applying the guided curriculum rather than transforming the curriculum according to the atmosphere, and their school year should not be stuck to any one standard but be varied according to their ability and improvement. In the operation of majored subjects, it is necessarγ for them to provide real career education, the opportunity to receive various job training and the supported employments in which they can be included in their society actively.

In_xGa_1-xN/GaN 다중양자우물 구조의 광학적 성질 연구

김기홍,김인수,박헌보,배인호,유재인,장윤석,Kim, Ki-Hong,Kim, In-Su,Park, Hun-Bo,Bae, In-Ho,Yu, jae-In,Jang, Yoon-Seok 한국진공학회 2009 Applied Science and Convergence Technology Vol.18 No.1

$In_xGa_{1-x}N$/GaN 다중양자우물 구조의 EL 특성을 온도와 주입전류 변화에 따른 특성을 조사하였다 저전류와 고전류 주입시 EL 효율의 온도 의존 변화는 매우 다르게 나타나는데, 이러한 온도와 전류의 변화에 의한 독특한 EL 효율의 변화는 내부전기장의 존재 하에 순방향 바이어스에 기인한 외부전기장의 영향인 것으로 볼 수 있다. 그리고 $In_xGa_{1-x}N$/GaN 다중양자우물 구조에서 In 성비의 증가는 발광파장위치의 적색이동을 보였다. 15K에서 주입 전류의 증가에 따라 녹색 양자우물 구조는 80 meV와 청색 양자우물 구조는 22 meV의 청색 편이를 하였다. 이는 전류의 증가에 의해 단위 시간당 생성되는 캐리어 수가증가하게 되고 그에 따라 subband가 급격히 채워지는 band filling 현상이 일어나게 되어 짧은 파장에서 재결합이 증가하기 때문이다. 그리고 청색과 녹색 다중 양자우물구조의 짧은 파장 쪽으로의 편이 차이는 In 농도에 기인한 것으로 In 농도가 높으면 양자우물 깊이가 증가되어 더 강한 양자속박효과가 작용하여 캐리어 구속력이 증가하기 때문 것으로 볼 수 있다. Temperature and injection current dependence of electroluminescence(EL) spectral intensity of the $In_xGa_{1-x}N$/GaN multi-quantum wells(MQW) have been studied over a wide temperature range and as a function of injection current level. It is found that a temperature-dependent variation pattern of the EL efficiency under very low and high injection currents shows a drastic difference. This unique EL efficiency variation pattern with temperature and current can be explained field effects due to the driving forward bias in presence of internal(piezo and spontaneous polarization) fields. Increase of the indium content in $In_xGa_{1-x}N$/GaN multiple quantum wells gives rise to a redshift of 80 meV and 22 meV for green and blue MQW, respectively. It can be explained by carrier localization by potential fluctuation of multiple quantum well and MQW structures also shows a keen difference owing to the different indium content in InGaN/GaN MQW.

관상동맥 질환에서 SDF-1α의 농도

김보영,박용규,박형서,노상필,정승현,이유선,이정우,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

HBsAg 및 류마토이드 인자 공존예의 분석 : Frequency and Clinical Significance

신보문,조종래,백인기,박성섭 대한임상병리학회 1996 대한임상병리학회지 Vol.16 No.5

Robert Lowell의 詩想形成

沈仁輔 釜山大學校 1983 人文論叢 Vol.23 No.1

<Abstract>Robert Lowell(1917-1977) was born in Boston, with James Russell Lowell for great-great-uncle and Amy Lowell for distant cousin. He attended St. Mark's School under the poet Richard Eberhart who showed the boy's poetic genius. He enrolled at Harvard University; after two years he transferred to Kenyon College so he could study with John Crowe Ransom. At Lousiana State University he studied with Robert Penn Warren and Cleanth Brooksi forming a close friendship with Allen Tatei so that he was immersed in the group of New Critics, and in their prediction for "formals difficult poems". As was showed above, Lowell was apprenticed to the leading contemporary American critics and poetsi and experimented in the most divergent style under those influences.In 1938 Lowell was invited to read his poems in the Kathryn Irene Glascock Intercollegiate Poetry Contest sponsored by Mount Holyoke College, representing Kenyon College. Included were six short poem: 'Epitaph', the first·poem·iin the contest, memorialize a monitor at the school Ivho died in an automobile accident. It is one of Lowell's last efforts under the easygoing guidance of Eberhart before he devoted higlself to the rigorous predecessors, Tate and Ransom. The second poem, 'The Dandelion Girls' is famous for his imaginative use of imagery and his willingess to take on complex problems of human experience. It was reshaped into 'The Drunken fisherman' in Lord Weary's Castle. The third poem, entitled 'The Lady,' memorializes a recently deceased acquaintance. In this peon Lowell was trying to infuse ambiguity and ambivalence into his works imitating New Critical guidelines for good poetry, Indeed he all·kwardly attempted to come to deal with his complex feelings for his dead matemal grandmother.The fourth poems 'Aunt Hecuba,' was expressed the Lowell's obsession with death into the historical, spiritual morbidity which runs Lowell's families in Boston. 'A Suicidal Fantasy' , the last poem in which he used the extensive alegory, was based on 'The Slough of Despond' in Bunyan's "The Pilgrim's" and developed the paradox of the body and the soul in the setting of the modern age's automobiles and train trestles. Especially he shows his arllbitions for the meditated dictions imageryi hermetic symbolisms irony and ambiguity which was the main targets of New Critics. He published five poems in Hika which was Kenyonis journal. In 'Lake View' he demonstrated his concern for the regular form and craftsmansllip learned by Ransom and Tate, so that he exhibited his real poetic talent and ambition. "A Prelude to Summer" was a stiff, awkward attempt with the Petrarchan sonnets but he showed some of the flairs for incongruity and compression of his mature verse. fcloudsi in which he worked with the difficult relationship between the spirit and the body was an experimental poem of metaphysical ideas. 'Cloisters' ties opposite elements by the means of irony and sarcastic mockery of him, which showed a decidedly New Critical metaphysical flavor.'Sublime Feriam Sidere Vertice$apos; was a good poem because he incorporated the apocal-yptic, religious violence that led his works to characterize appropriate inspiration for young poets. A portion of this poem became a part of 'Leviathan' later in Land of Unlikeness.In conclusion, Robert Lowell writes his poem in thought through experiences: family mentorsi religion, political and social affairs. His early poems in which he exercised all the poetic talent and contradictory logic were composed of very different elements which resulted in the good formations of later poems. Thus, in order to know the Lowell's poetic characters, images and forms, the reader should snrvey the aspects of his early days.

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

심장수술 시 농축적혈구, 자가수혈기 혈액, 체외 순환기 혈액에서의 유리 혈색소 농도 비교

송장호,구승우,백종화,정용보,이정순,최인철 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: Intraoperative autotransfusion or residual blood in a cardiopulmonaty bypass (CPB) circuit has been used to reduce the need for an homologous blood transfutsion during cardiac surgery. However, it may contain some free hemoglobin released from damaged cells. The load of blood containing free hemoglobin may cause renal dysfunction. We measured the amount of free hemoglobin in backed blood, cell saver blood and CPB blood to evaluate what is the least hemolytic blood transfused in cardiac surgery. Methods: This study was performed in 20 patients undergoing cardiac surgery. In each patient, the banked blood, intraoperative salvaged blood with a cell saver and CPB residual blood were sampled at the end of the operation. The concentration of free hemoglobin, hemoglobin and platelet counts were measured in these blood samples and percent of hemolysis was calculated (%hemolysis = [free hemoglobin] / .free hemogloben + hemoglobin]) Results: In salvaged blood with a cell saver, CPB residual blood and banked blood, hemoglobin concentrations were 20.1 ± 2.7 g/dl, 8.0 ± 1.1 g/dl, and 22.2 ± 2.7 g/dl, respectively. Free hemoglobin concentrations were 336.6 ± 239.5 mg/dl, 49.2 ± 26.8 mg/dl, and 279.5 ± 167.5 mg/dl respectively. Platelet counts were 26.1 ± 22.2 × 10^3/mm^3, 116.8 ± 56.5 × 10^3/mm^3, and 94.9 ± 43.6 × 10^3/mm^3 respectively. % Hemolysis were 1.6 ± 1.1%, 0.6 ± 0.4%, and 1.2 ± 0.7% respectively. In the comparison between the salvaged blood with a cell saver and CPB residual blood, free hemoglobin concentration, % hemolysis, and platelet counts had positive correlations (r = 0.8, 0.7, and 0.6). Conclusions: In twenty cardiac surgeries, CPB residual blood had a lower free hemoglobin level than the other two blood groups. The platelet counts in CPB residual blood were higher than those in cell saver blood but did not differ from those in banked blood. Therefore, CPB residual blood was the least hemolytic blood among the three blood groups when a transfusion was performed in cardiac surgery. (Korean J Acesthesiol 2002; 43: 588~593)

The Effect of Parental Imprinting on the INS - IGF2 Locus of Korean Type I Diabetic Patients

(Heung Sik Kim),(Dong Wook Lee),(Sang Jun Lee),(Bo Hwa Choi),(Sung Ik Chang),(Hyun Dae Yoon),(In Kyu Lee) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.4

N/A Background: Insulin-dependent diabetes mellitus (IDDM) is caused by the autoimmune destruction of pancreatic β-cells. Susceptibility to IDDM appears to depend on more than one genetic locus. Evidence of a genetic linkage for IDDM2 was found in male meioses from French and North American populations. It is linked to maternal imprinting (i.e. monoalleleic expression of the insulin gene) that is considered the most likely cause of these gender-related differences. IGF2 is expressed only in the paternal allele and therefore, is considered a candidate gene for IDDM2 transmission because of its important autocrine/paracrine effects on the thymus, lymphocytes and pancreas. Nevertheless, it remains controversial whether the parental origin of IDDM2 influences IDDM susceptibility. Methods: Using PCR and semi-quantitative RT-PCR, we analyzed the INS/PstI+1127 and IGF2/ApaIpolymorphisms and RNA expression level between PstI (+/-) and PstI (+/+) to determine genotype and allele-specific expression of the INS and IGF2 genes. Results : INS/PstI(+/+) and IGF2/ApaI(+/-) were observed in 36 (97.3%) of 37 IDDM patients and in 29 (72.5%) of 40 IDDM patients, respectively. The presence of both IGF2 alleles in RNA was observed in 21 (91.6%) of 24 IDDM patients. Our results show a 3-fold increase in RNA expression from PstI (+/-) allele over PstI (+/+) allele. Conclusion: Our conclusion does not entirely exclude IGF2 as the gene involved in IDDM2, even though the parental effect of IDDM2 transmission is not related to IGF2 maternal imprinting. The INS genotype appeared mostly in the PstI (+/+) homozygote and, therefore, we could not explain the INS imprinting pattern in Korean type 1 diabetic patients. Genetic differences between populations may account for the discrepancy between Korean type I diabetic patients and American or French type I diabetic patients.