<i>In vitro</i> and <i>in vivo</i> evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Park, Dae Sung,Bae, In-Ho,Jeong, Myung Ho,Lim, Kyung Seob,Sim, Doo Sun,Hong, Young Joon,Lee, So-Youn,Jang, Eun Jae,Shim, Jae-Won,Park, Jun-Kyu,Lim, Han Chul,Kim, Han Byul Elsevier 2018 Materials Science and Engineering C Vol.91 No.-

<P><B>Abstract</B></P> <P>Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO<SUB>2</SUB>) and verify its efficacy by <I>in vitro</I> and <I>in vivo</I> assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO<SUB>2</SUB> stent, everolimus-eluting N-TiO<SUB>2</SUB> (N-TiO<SUB>2</SUB>-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO<SUB>2</SUB> film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO<SUB>2</SUB> deposition (37.0%). The platelet adhesion on the N-TiO<SUB>2</SUB> surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO<SUB>2</SUB>-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO<SUB>2</SUB>-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO<SUB>2</SUB>-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, <I>n</I> = 10, <I>p</I> < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO<SUB>2</SUB> deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> N-TiO<SUB>2</SUB> surfaces can help to reduce the platelet adhesion. </LI> <LI> In porcine model, N-TiO<SUB>2</SUB> everolimus decreased in-stent restenosis and fibrin deposition. </LI> </UL> </P>

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.

혈액투석시 Double Lumen Silicone Rubber Catheter ( = Permcath ) 사용의 임상적 경험

차대룡(Dae Ryong Cha),김선숙(Sun Sook Kim),이영호(Young Ho Lee),권영주(Young Joo Kwon),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim),선경(Kung Sun),김정숙(Jung Sook Kim),함인귀(In Gui Ham),김미경(Mi Kyung Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.4

N/A Background: Repeated, long-term access of the vascular system is a prerequisite for successful extended care of the patients with end stage renal disease (=ESRD) treated with hemodialysis. Despite recent technical advances in percutaneous venous cannulation, vascular access remains a major problem in patients requiring acute Hemodialysis. Although the subclavian cannula has gained a large clinical acceptance in recent years, it carries specific risks such as hemothorax, pneumothorax, venus stenosis, thrombus formation and infection. Recently, a double-lumen, central venous catheter made of Silicone Rubber (=Perm cath) has developed for use as a vascular access device, This device is particularly useful in patients who have exhausted other vascular access sites or who have severe cardiovascular disease. Methods: A total of 23 dual-lumen silicone rubber catheters were placed through the internal jugular vein in 23 patients as a vascular access at our institution during the period of April, 1992 through November, 1992. The perm-cath (Hemocath, Quinton, Seattle) is 36 Cm long and each lumen has an internal diameter of 2 mm. Implantation of the catheters occurred in the operating room and under strict aseptic conditions through the right internal jugular vein. A 10 cm subcutaneous tunnel was then created, which extended from the in-cison to a point 2 cm above the ipsilateral clavicle. The catheter was passed out through the upper portion of the subcutaneous tunnel with the Dacron cuff placed 2 cm from the lower end of the tunnel, acting as both an anchor and a barrier to infection. The tip of the catheter was inserted through an internal jngular vein terminating in the right atrium under EKG monitoring. Each lumen of the catheter was filled with 1000 units of heparin sodium (1.5 ml in venous line, 1.5 ml in arterial line) and capped. Results : The mean duration of catheter use was 24±16 days (8 to 119 days), and the complication of perm-cath occurred in 3 cases such as venous thrombosis in 1 case, catheter exit site infection in 1 case, and exit site hematoma in 1 case. During hemodialysis, blood flow rate ranged from 190 to 313ml/min (mean:235±26ml/ min), and venous retrun pressure ranged from 20 to 150 mmHg(mean:65±16mmHg). Total 14 catheters were removed during treatment and the causes of catheter removal were patient death in 8 cases, venous thrombosis 1, recovery from acute rena1 failure 2, fistula maturation 2, infection 1. Conclusion: Internal jugular vein cannulation with silastic catheter which offers a new percutaneous method was provided safe and reliable as the temporary central vein access. The catheters are well tolerated by the patients and have the advantages of immediate use after placement, high blood flow rates, no repetitive venipuncture, and no cardiac dysfunction. Permcath is particulary useful in patients who have exhausted other vascular access site, severe cardiovascular disease, and terrified by repetitive venipuncture. Though our initial experience has been favorable, there will be needed to evaluate the outcome of permcath over longer period of time.

「공공기관의 운영에 관한 법률」상 공공조달법제의 현황과 발전방안

김대인(Kim, Dae In) 행정법이론실무학회 2011 행정법연구 Vol.- No.31

우리나라의 「공공기관의 운영에 관한 법률」상 공공조달계약법제와 EU의 공공조달지침, 공익산업지침을 비교해보면 다음과 같은 차이점이 발견된다. 일단 우리나라는 계약의 주체에 따라 규율이 달라지는 모습을 보여주고 있다. 국가, 지방자치단체, 공공기관에 적용되는 각각의 법률이 독립하여 존재하고 있기 때문이다. 이에 비해 EU는 국가, 지방자치단체, ‘공법의 규율을 받는 기관’ 간에 원칙적으로 차이를 두지 않고 공공조달지침의 적용을 받도록 하고 있다는 점에서 차이가 있다. 다만 EU에서도 공익산업의 경우에는 별도의 규정을 둠으로써 차별성을 기하고 있다. 우리나라 공공기관법상 ‘공공기관’의 개념을 EU의 유사개념과 비교해보면 다음과 같은 차이가 나타난다. EU 공공조달지침상 ‘공법의 규율을 받는 기관’에서는 개념요소로 “공익의 수요를 충족하는 특정한 목적으로 설립되어야 하며 산업적이거나 영업적 성격을 갖지 않아야 한다”는 점을 들고 있다. 이러한 점에서 보면 자체수입액이 총수입액의 50% 이상인 공기업까지 포함하고 있는 우리나라의 공공기관 개념보다는 그 외연이 좁은 것으로 볼 수 있다. 그리고 우리나라의 공기업에 해당되는 기업들에 대해서는 공익산업에 해당하는 경우에만 EU 공익산업조달지침에서 규율하고 있는 것으로 볼 수 있다. 이상과 같은 비교를 토대로 우리나라 「공공기관의 운영에 관한 법률」상 공공조달계약법제의 발전 방안을 제시해보면 다음과 같다. 우선 우리나라 법제에서는 ‘국가’에 적용되는 공공조달법제와 ‘공공기관’에 적용되는 공공조달법제의 차이점에 대한 고민이 부재하다고 할 수 있다. 법률상으로는 별도로 규율되고 있지만 그 실제내용을 분석해보면 지명경쟁입찰이나 수의계약입찰사유를 약간 확대해놓은 것 이외에는 특별한 차이를 발견하기 힘들다. EU에서 일반적인 공공조달지침보다 탄력성을 확대해놓은 내용으로 공익산업지침이 제정되어 있는 점은 우리나라에 주는 시사점이 크다고 할 수 있다. 그리고 이처럼 ‘국가’에 적용되는 공공조달법제와 ‘공공기관’에 적용되는 공공조달법제간에 차별성을 둘 때에도 공공기관의 유형별로 다르게 볼 여지가 있다. 우리나라 법제에서는 공기업과 준정부기관의 공공조달법제가 동일하게 규율되는 모습을 취하고 있으나 이 부분도 재고를 요한다. EU에서 공공성이 주를 이루는 ‘공법의 규율을 받는 공공기관’에 대해서는 공공조달지침을 적용하고, 상업성이 주를 이루는 공기업에 대해서는 주로 공익산업조달지침을 적용하고 있는 점을 고려할 필요가 있다. 물론 우리나라에서 공기업과 준정부기관을 공공조달에 있어서 동일하게 취급해온 것은 공기업의 경우에도 계약사무의 투명성을 확보해야 할 필요성이 준정부기관에 못지 않게 매우 높다는 점을 반영한 것이라고 할 수 있다. 그러나 장기적으로 볼 때에는 공기업의 ‘상업성’을 적절하게 고려하여 ‘준정부기관’에 비해서 탄력적으로 공공조달법제를 운영하는 것이 필요하다고 할 수 있다. Some differences can be found from comparison between public procurement regulations of "Act on the Management of Public Institutions" in Korea and those of EU Public Procurement Directive and Utilities Procurement Directive. In Korea, state, local government and public institution have their own respective public procurement regulations. EU, meanwhile, have integrated public procurement regulation applying to state, local government and "bodies governed by public law" all together (EU Public Procurement Directive). However, EU has separate legislation on utilities (EU Utilities Procurement Directive). "Public institutions" in "Act on the Management of Public Institutions" differs from "bodies governed by public law" in EU Public Procurement Directive. "Bodies governed by public law" are bodies "established for the specific purpose of meeting needs in the general interest, not having industrial or commercial character." At this point, "bodies governed by public law" (EU) has relatively narrow meaning than "public institution" (Korea) which include "public enterprise" whose self revenue exceeds 50% of total revenue. From this comparison, following improvements is needed for public procurement regulation in "Act on the Management of Public Institutions". First, similarities and differences between "state" procurement and "public institution" procurement should be clearly defined. Although there is separate legislation to each procurement, there are no specific differences between theses regulations except some provisions relating to contract type. EU Utilities Procurement Directive has more flexible regulation in comparison to EU Public Procurement Directive. Korea can learn some lessons from EU"s experience. Furthermore, differences among various types of "public institutions" should be considered. In Korea, public enterprises and quasi-governmental agencies are regulated similarly. However, this system needs to be reformed. In EU, "bodies which are regulated by public law" are principally regulated by EU Public Procurement Directive, whilst public enterprises are principally regulated by EU Utilities Procurement Directive. Korean legislation which regulates public enterprises and quasi-governmental agencies altogether can be understood through transparency needs in both systems. However, there needs more flexible regulation of public enterprises in comparison to quasi-governmental agencies considering commercial or industrial character of public enterprises. Korea differentiates between "public enterprises & quasi governmental agencies" and "other public institutions" by type of regulation. The former is regulated by departmental degree, while the latter is regulation by in-house directive. However, this system cannot be legitimized, because there are many "other public institutions" whose depth of publicness or effect to market cannot be overlooked. This difference of regulation type gives rise to vacuum of rights protection in debarment cases. Therefore, this difference of regulation type should be removed. According to Korean Supreme Court Decisions, "public enterprises & quasi governmental agencies" debarment can be challenged by administrative lawsuit, while "other public institutions" debarment cannot. However, administrative lawsuit should be permitted to "other public institutions" debarment also, because in-house directive relating "other public institutions" debarment can be evaluated as a "statute-complementary" directive and contents of regulations are very similar to those of "public enterprises & quasi governmental agencies".

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

비만 환자에서 비만관련 유전자 다형성에 따른 체중감량차이 : 지방흡수억제제를 복용한 환자를 대상으로 In Cases of Subjects with Orlistat for Weight Reduction

서영성,김대현,이인규,이근미,김영훈 대한비만학회 2003 The Korean journal of obesity Vol.13 No.4

연구배경: 지금까지 유전자 이상과 비만의 관계에 대한 연구는 대부분 단면연구이며 결과 또한 서로 상반된 경우가 많았다. 그러므로 이들 유전자가 비만에 미치는 영향을 보기 위해서 단면연구보다 장기적인 연구가 더 적절하다. 본 연구의 목적은 체중조절을 목적으로 인정된 약물 중 식욕, 대사율 증가및 지방분해에 직접 관여하지 않는 orlistat를 복용하는 비만환자에서 식욕에 관여하는 leptin 수용체 유전자와 지방의 분해와 기초대사량 증가에 관여하는 베타-3 아드레날린 수용체 유전자의 다형성에 따른 체중감량의 차이에 대하여 알아보고자 하였다. 방법: 대상군은 2001년 10월부터 2002년 8월까지 대구시내 3개 병원에 비만치료를 목적으로 내원한 환자 중 BMI 27 kg/m² 이상인 18∼65세 남녀로 orlistat를 복용한 환자 81명이었다. 이들은 매 방문시마다 신체계측하였고 2주마다 저열량 식사교육을 실시하였다. 유전자 분석은 베타-3 아드레날린 수용체 Trp64Arg 다형성과 렙틴수용체 Gln223Arg 다형성을 보았고 분석결과에 따라 두 군으로 나누었다. 결과: 1. Orlistat를 12주 복용한 결과 체중, 허리둘레 및 BMI는 각각 4.1±0.4 kg, 4.6±0.5 cm, 1.7±0.3 kg/m² 감소하였다. 2. 렙틴유전자 다형성에 따라 정상 동형접합체 및 이형접합체군과 변이 동형접합체군 간의 체중, 허리 둘레, 및 BMI 감소정도는 12주 후 체중이 변이 동형접합체에서 더 많이 감소하였으나 통계적인 차이는 없었다. 베타-3 아드레날린 수용체 유전자 다형성에 따라 정상동형접합체군과 이형접합체군 및 변이 동형접합체군 간의 체중 허리둘레 BMI 감소 정도는 12주 후 이형 및 변이동형접합체 군에서 더 많이 감소하였으나 현저한 차이는 없었다. 3. Orlistat를 12주 동안 복용한 56명 중 5% 이상 체중 감소한 환자는 렙틴수용체 유전자 다형성에 따른 변이 동형접합체군이 60.0%로 타 군의 38.1%에 비해 높았으나 통계학적인 차이는 없었다. 또한 베타수용체 유전자에 따른 체중감소율의 비교 결과 이형 및 변이 동형접합체군에서 5%이상 체중 감소한 환자율는 57.7%로 정상동형접합체군의 46.7%에 비해 높았으나 통계학적인 차이는 없었다. 결론: 한국인을 대상으로 시행된 본 연구 결과 렙틴수용체 유전자 및 베타-3 아드레날린 수용체 유전자의 다형성은 체중감소 치료에 미치는 영향이 적을 것으로 생각된다. Background: From a lot of cross-sectional studies, the relationship between obesity and variants of obesity related gene is inconsistent. In addition, some longitudinal studies showed different results, too. Therefore, we investigated the response of anthropometric data to 12 weeks weight loss program in obese patients with Trp64Arg variants in the β-3 adrenergic receptor and Gln223Arg variants in the leptin receptor gene. Method: 81 adult obese subjects with BMI >27 kg/m² were included for this study. They were recruited for weight management from 3 hospitals in Daegu and had taken orlistat for 4 week at least. Anthropometric measurements were weight, height, waist and hip circumference. The genotypes for both genes of study subjects were determined by protocols. Results: Subjects lost significantly more weight, waist circumference, and BMI than those of before study for 12 weeks (P<0.0001). Reductions in body weight, waist circumference, and BMI. There were not significantly different between Gln carriers and noncarriers of Gln223Arg variants in leptin receptor gene or Arg carriers and noncarriers of Trp64Arg variants in -3 adrenergic receptor gene (P>0.05). During the 12 weeks of treatment, 60.1% of patients in completer with Gln noncarriers of leptin receptor lost more than 5% of their initial body weight and, however, were not significantly different than 38.1% of those in completer with Gln carriers. Conclusion: These results suggest that the presence of Gln223Arg variants in the leptin receptor and Trp64Arg variants in the -3 adrenergic receptor in subjects with orlistat may not be a hindrance or a help to reduce body weight.

특성화고 ‘인간발달’ 교과서의 인구교육 내용 분석: 저출산·고령화 사회 대비를 위한 인구교육 내용체계(2015)를 중심으로

윤인경 ( Yoon In Kyung ),이수정 ( Lee Soo Jeong ),김민정 ( Kim Minjeong ) 인구교육센터 2016 인구교육 Vol.9 No.1

‘인간발달’ 과목은 특성화고 학생의 인간발달 기초에 대한 전반적인 이해와 이를 토대로 한 직업 세계에서의 발달 지향적 인간으로서의 관계 형성을 위한 교과이다. 이 연구는 2009 개정 교육과정에 의해 개발된 특성화고 인간발달 교과서에 대한 인구교육에 대한 반영 정도를 양적·질적 분석을 통해 향후 인구교육에 대한 교육적 함의를 도출하는 데 목적이 있다. 교과서 분석 준거는 윤인경 외(2006)에서 개발한 인구교육 내용 체계를 수정·보완한 4개의 대영역, 10개의 중영역, 23개의 중영역, 71개의 내용요소로 이루어진 윤인경 외(2015)의 ‘저출산·고령화 사회 대비 학교 인구교육의 내용 체계’를 활용하였다. 분석을 통해 얻은 연구 결과는 다음과 같다. 첫째, ‘Ⅰ. 인간존중’ 영역에서는 중영역 ‘1. 인권’의 경우에는 모든 소영역을 다 다루고 있었으나, 중영역 ‘2. 평등’의 경우에는 소영역 ‘3) 소수자 평등’에 대한 내용이 다루어지지 않았으며, ‘2) 연령 평등’에 대한 언급 역시 부족하였다. 자료 유형은 거의 본문만을 활용하였다. 둘째, ‘Ⅱ. 가족’ 영역에서는 중영역 ‘3. 출산과 양육’의 경우에는 다양한 자료를 활용하여 모든 소영역을 다 다루고 있으나, ‘1. 가족의 의미 변화’와 ‘2. 결혼’의 경우에는 활용한 자료 유형이 제한적이었음은 물론, ‘1. 가족의 의미와 변화’ 내 소영역 ‘1) 가족구조의 변화’에 대해 제시하고 있지 않았다. 셋째, ‘Ⅲ. 인구’ 영역의 경우에는 다루는 내용의 불균형이 가장 많이 나타났다. 구체적으로 중영역 ‘1. 인구변동’과 ‘2. 저출산’에 대한 어떠한 언급이 나타나지 않았다. 또한 ‘3. 고령화’의 경우에는 단지 자료 유형은 본문 만 활용한 것으로 나타났다. 넷째, ‘Ⅳ. 복지’ 영역의 경우에는 중영역 ‘1. 공적대비(제도 및 정책)’ 내 소영역 ‘1) 가족친화 정책’, ‘2) 고령친화 정책’과 함께 중영역 ‘2. 사적 대비(진로 및 생애 설계)’ 내 소영역‘1) 생애설계와 노후 준비’에 대한 언급이 본문’과 읽기자료’를 통해 제시되어 있었다. 이와 같은 연구 결과를 통해 ‘인간발달’ 과목은 특성화고 학생의 인간발달 기초에 대한 전반적인 이해와 이를 토대로 한 직업 세계에서의 발달 지향적 인간으로서의 관계 형성을 위한 교과임에도 불구하고 인구교육과 관련된 내용 영역 간 불균형이 나타나고 있음을 알 수 있었다. 또한 이를 제시하는 방식 역시 ‘본문’과 ‘읽기자료’라는 텍스트에 한정되어 있어 학습자의 다양한 자료 유형에 대한 경험이 제한될 우려가 있었다. 따라서 향후 교과서 집필 시, 관계 부처와의 협의를 통해서 인구교육과 관련된 내용의 불균형 문제 해결 및 이를 제시함에 있어서 다양한 자료 유형을 활용할 수 있는 방안을 마련할 필요가 있을 것으로 판단된다. 저출산·고령사회 대비를 위해서는 무엇보다 교사, 학생 더 나아가 국민의 인식 변화를 위해서는 학교 교육 내에서의 교육이 중요하다. 그러므로 이에 대한 학교에서부터의 교육이 중요하므로 교육을 위해 활용되는 교과서 집필에 많은 노력을 기울여야 하며, 이 연구는 이를 위한 하나의 방안을 제시할 것으로 기대된다. The purpose of this study is to draw an educational undertone of future population education through a quantitative and qualitative analysis of reflection level of population education in human development textbook of characterization high school developed 2009 revised curriculum. Analysis criteria of textbook is ‘The Content System of Population Education in School Adapting for Low Fertility and Aged Society’ of Yoon In-kyung(2015) consisting of 4 large sections, 10 middle sections, 23 small sections, and 71 components modifying and supplementing a content system in population education developed by Yoon In-kyung(2006). Study results gained through the analysis are as follows. First, in a section ‘Ⅰ. Respect for Man´s Life and Dignity’, a middle section ‘1. Human Rights’ dealt with all small sections, but a middle section ‘2. Equality’ did not deal with a small section ‘3) Minority Equality’ and also had insufficient reference of ‘2) Age Equality’. As material types, the body was used. Second, in a section ‘Ⅱ. Family’, a middle section ‘3. Childbirth and Nurture’ dealt with all small sections with various materials, but ‘1. The Variation in Meaning of Family’ and ‘2. Marriage’ used restrictive material types, and a small section ‘1) The Variation in Family Structure’ in ‘1. The Variation in Meaning of Family’ was not suggested. Third, ‘Ⅲ. Population’ had the most content balance. In a concrete form, there was no reference of middle sections such as ‘1. Population Change’ and ‘2. Low Fertility’. In addition, ‘3. Aging’ only used the body as material types. Fourth, in a section ‘Ⅳ. Welfare’, a small section ‘1) Life Design and Later Life Preparation’ in a middle section ‘2. Private Preparation(Career and Life Design’ with small sections such as ‘1) Family-friendly Policy’ and ‘2) Aging-friendly Policy’ in a middle section ‘1. Public Preparation(System and Policy)’ were suggested through ‘the body’ and ‘reading material’. Through these study results, although a subject ‘human development’ is a subject for the overall understanding of a base for human development of characterization high school students and for relationship building as a development-oriented person in the work world based on this, there is an imbalance between content sections related to population education. In addition, a method suggesting this is also limited to texts such as ‘the body’ and ‘reading material’, so it is concerned that learners’ experience of various material types can be restricted. Therefore, it is necessary to draw up a plan to use various material types in the solution of the imbalance problem and the suggestion of contents related to population education through consultation with the relevant authorities on writing textbook in the future. To adapt to low fertility and aging society, and above all things, to change recognition of teachers, students, and people, education in school education is important. Therefore, education from school of this is important, so a lot of effort should be put into writing used textbook, and it is expected that this study will suggest a plan for this.

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.

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.

유지 투석중인 만성 신부전환자에서 허혈성 심질환의진단 지표로서의 심장트로닌-I의 유용성

신병철,강대웅,정지용,류봉관,서영욱,김정인,김범윤,김현리,정종훈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background : Coronary disease is highly prevalent in patient with end stage renal disease (ESRD) and account for much of their observed morbidity and mortality. Troponin-I consistently maintains a high sensitivity and specificity and is most sensitive marker for ischemic heart disease (IHD). Method : We examed 49 hernodialyzed patients (22 male, 27 female) without evidence of acute coronary syndrome (ACS) for 6 months. Biochemical markers were measured in serial predialysis blood samples. For analysis, we used two cardio-specific assays for troponin-T (cTnT) as well as for troponin-I (cTnI) and compared the results with CK-MB (reference value ≤ 4.0 ng/mL) concentration. Results : Myocardial ischemia was observed in 47% (23/49) of patients. cTnT level above 0.1 ng/mL. and cTnI level above 0.5 ng/mL, were observed in 22% (11/49) and 20% (10/49) of patients respectively. cTnI revealed significantly higher positive rate in patients with myocardial ischemia than the patients without myocardial ischemia (43 % vs 30%) (p<0.05). cTnT and CK-MB revealed no difference in positive rate between the patients with and without myocardial ischemia (cTnT : 30% vs 15% and CK-MB : 30% vs 19%). The sensitivity and specificity of cTnI to myocardial ischemia were higher than those of cTnT and CK-MB (sensitivity 43% vs 30% and 30%. specificity 100% vs 85% and 81%). Conclusion: Both cTnT and cTnI are useful in ruling out myocardial injury in chronic renal failure patients. But. cTnI is a more sensitivity and excellent specificity of ischemic heart disease than cTnT and CK-MB in hemodialyzed patients. In patients with ischemic heart disease, the presences of DM and advanced age were higher than those in patients without ischemic heart disease (p<0.05). Among the baseline characteristics old age, elevated LDH and diabeties were significant more frequent in the patients with elevation of cardiac troponin-I (p>0.5 ng/mL) than those with cardiac troponin-I (p<0.5 ng/mL), p=0.038, p=0.049, and p=0.045, respectively. Our results suggest that these cTnI is the potential diagnostic marker for the prediction of IHD in ESRD patients.