정상 한국인에서 연령증가에 따른 혈장 Dehydroepiandrosteronesulfate ( DHEA-S ) 농도 및 DHEA - S / cortisol 비의 변화

박성우,유형준,임성희,최문기,유재명,박민숙,이권엽,박철수,김철홍,김현규,김두만,박규용 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.2

Backgroud: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. Methods: Healthy Korean(men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs(such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40- 49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4(Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. Results:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels(men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women(men; y= -3.152 * +292.6, r2= 0.8459, P$lt;0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P$lt; 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA- S/cortisol ratio. Conclusion: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu(aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index. (J Kor Soc Endocrinol 12:245-254, 1997)

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

Studies on the Effects of Biomedicinal Agents on Serum Concentration of Ca2+ , P and ALP Activity in Osteoporosis-Induced Rats

Sang-keun Kim,Myung-hun Lee,Man-hee Rhee 대한수의학회 2003 Journal of Veterinary Science Vol.4 No.2

on the Effects of Biomedicinal Agents on Serum Concentration of Ca2+, P andALP Activity in Osteoporosis-Induced RatsSang-keun Kim, Myung-hun Lee1 and Man-hee Rhee2College of Veterinary Medicine, Chungnam National University, 220 Gungdong, Yusong-Gu, Daejeon 305-764, Korea1National Veterinary Research and Quarantine Service, Anyang 430-824, Korea2College of Veterinary Medicine, Kyungpook National University, Daegu 702-701, KoreaReceived April 3, 2003 / Accepted July 9, 2003J. Vet. Sci. (2003), 4(2), 151-154JOURNAL OFVeterinaryScience*Corresponding author: Sang-keun Kim Dept. of Vet. Med., Chungnam National University, Daejeon 305764, Korea Tel: +82-42-821-6754, Fax: +82-42-821-6754 E.-mail: kskkim@cnu.ac.kr

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

연 착화제 효능에 관한 동물실험적 연구

김정만,김병권,김성환,서병성,김인식,김용규,정갑열,김준연 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.1

소에서 盲腸擴張을 동반한 第4胃食滯 手術 1例

김명철,김덕환,신상태,임준호,김남중,김종만 충남대학교 수의과대학 동물의과학연구소 1998 動物醫科學硏究誌 Vol.6 No.-

Abomasal impaction with cecal dilatation was diagnosed in a 3 years old holstein cow. The clinical signs were loss of appetite, scant feces and moderate distension of the abdomen. Ping sound was revealed in the right 11th intercostal space by auscultation. Cecal dilatation and abomasal impaction were ascertained by right flank laparotomy and abdominal exploration, and intestinal content and gas were removed from the cecal apex incised. One day later, 2.5㎏ of sand was removed by ventral paramedian abomasotomy.

T 및 B cell 測定 : 1. 1次 成績 Ⅰ. Results, Primary

金在植,崔成萬,金在龍,全東錫,朴正姬,徐相喆,金仁子,金在崇,金重明 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.2

E-rosette法에 의한 T cell의 百分率과 螢光抗體法, 感作牛赤血球擔體法, 酵素抗體法 및 마우스赤血球 rosette法에 의한 B cell 의 百分率을 檢査하여 다음과 같이 요약할 수 있었다. 정상성인군의 active T cell은 26±8.2%이었고 total T cell은 72±4.9%이었다. B cell 는 螢光抗體法으로 22±5.4%, 感作牛赤血球擔體法으로 15.8±4.9%, 酵素抗體法으로 15±5.2% 그리고 mouse RBC-rosette法으로 17.2±4.1%이었다. 惡性腫瘍에 있어서 active T cell은 27.±10.4%이었고 total T cell 은 59±11.2%로서 정상인군에 비하여 유의한 감소를 보였다. 良性疾患에 있어서 T cell 은 정상인군에 비하여 유의한 차이를 볼 수 없었다. T cell percent by E-rosette and B cell by fluorescent antibody, senitized ox RBC rosette, enzyme antibody and mouse RBC rosette tests were performed. In healthy adult group the active T cell was 26±8.2% and total T cell was 72±4.9%, B cell by fluorescent antibody was 22.±5.40%, by ox RBC rosette 15.8±4.9%, by enzyme antibody 15±5.2% and by RBC-rosette 17.2±4.1%. In malignant tumor the active T cell was 27±10.4% and total T cell was 59±11.2%. In benign diseases T cell count showed no significant difference from normal adult group.

Associations of serotonergic genes with poststroke emotional incontinence

Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

<P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>

임상 가검물에서 분리된 균(대장균과 황색 포도균)의 약제 내성

김중명,김재식,김경선,김재룡,전동석,최성만,서상철,김인자,김재숭,이건일,김경숙 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.2

1981년 1월에서 12월말까지 임상 제료에서 분리한 Escherichia coli (E. coli)와 Staphylococcus aureus (S. aureus) 중에서 무작위로 각 50주 씩 선택하여 원판 확산법과 평판 희섭법으로 그 내성주를 조사하여 다음과 같은 성적을 얻었다. 전체적으로 볼 때에 Teteracyclin (TET), Chloramphenicol (CM) 및 Ampicillin (AMP)에 대한 내성주가 가장 많았고, Amikacin (AMK)에 대한 내성주는 가장 적어다. 이것을 균종별로 보면 E. coli에 있어서는 TET, AMP 및 CM는 원판 확산법으로서 74∼76%, 평판 희석법으로서는 78∼94%가 내성주임을 나타내었고, 또 Cephalothin(CEP)은 원판 확산법에서는 8%가 내성주로 나타났으나, 평판 의석법에서는 52%가 내성주로 나타났다. S. aureus에 있어서는 TET는 원판 확산법으로 82%, 평판 희석법으로서는 78%가 내성주로 나왔고 Penicillin (P)은 원판 확산법에서는 56% 평판 희석법으로는 22%의 내성주가 나왔으며, GM과 CM은 원판확산법에서는 18∼44%, 평판 희석법에서는 56∼58%가 내성주로 나왔다. Each 50 strains of Escherichia coli and Staphylococcus aureus were selected at random out of the stock cultures which were isolated from the clinical materials in the bacteriological laboratory of the department of clinical pathology. Kyungpook National University Hospital from the first of January to the end of December in 1982, and their resistance against eight antibiotics were as follows; Escherichia coli and Staphylococcus aureus had the most resistant pattern against tetracyclin, chloramphenicol, and ampicillin, while they had the most sensitive pattern against amikacin in general. Escherichia coli revealed resistant pattern to tetracyclin, ampicillin, and chloramphenicol 74-76% by the disk diffusion method and 78-94% by the plate dilution method, and revealed resistant pattern to cephalothin 8% by the disk diffusion and 52% by the plate dilution. Staphylococcs aureus disclosed resistant pattern to tetracyclin 82% by the disk diffusion and 78% by the plate dilution, and disclosed resistant pattern to penicillin 56% by the disk diffusion and 22% by the plate dilution, and to gentamicin and-chloramphenicol 18-44% by the disk diffusion and 56-58% by the plate dilution.