당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

비강상악동 미분화암종

김운규,김수관,조세인,윤정훈 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

Sinonasal undifferentiated carcinoma(SNUC) is an uncommon aggressive malignancy of the nasal cavity and paranasal sinuses. Since the initial recognition of SNUC as a distinct clinicopathological entity, treatment regimens have evolved to include the current recommendation of combined radical resection, radio-therapy and chemotherapy. Despite this aggressive therapy, outcomes have remained dismal, with the mean survival time still being less than 1 year after diagnosis. SNUC present with locally advanced disease, with a tendency for the tumor to spread from the paranasal siuses to the orbit and anterior cranial fossa. A case of SNUC occurred in the left maxilla showing an unusual clinical manifestations and a fulminant course of disease, is described with literatures review. A 77-year-old female patient presented with rapidly growing tumor-like bulging of the left maxilla and slight ulceration of the right upper posterior vestibule. At the first biopsy, diagnosis was a radicular cyst, but SNUC was made subsequently by the second biopsy 6 month later. Rapid and wide extension from the maxilla to the orbit and nasal cavity developed with infection. Although the time relationship is not clear, local invasion could be developed from localized disease of SNUC. Despite combined therapy with chemotherapy and radiotherapy, She has been expired 13 months after the first biopsy. Focal positivity of immunohistochemical stain(CK, EMA), which is a specific characteristic of SNUC, may serve as a factor showing unfavorable prognosis.

비양론성 TiO₂-x에서 전기전도도와 결함 형태

김명호,강상수,백운규 國立 昌原大學校 産業技術硏究所 1996 産技硏論文集 Vol.10 No.-

The defect model of nonstoichiometric rutile ( TiO₂-x ) has been studied by means of the electrical conductivity measurement as function of temperature and oxygen partial pressure(Po₂). The Po₂dependence of σindicates that the major defects in rutile are doubly charged oxygen vacancies and tetravalent charged interstitial titanium ions. The interstitial titanium Ti ??'''' prevails at temperatures above 1170˚C. But the doubly charged oxygen vacancy Vo " predominates at low Po₂and temperature under 1170˚C. The proposed defect model in rutile is consistent with our previous result which was investigated by the O?? tracer diffusion.

정상교합자에서 골격 형태에 따른 치성 변이에 관한 연구

김운수,김상철 원광대학교 치의학연구소 2003 圓光齒醫學 Vol.12 No.1

It is a useful guidline for diagnosis and treatment of malocclusion to study dental variations in normal occlusion with different facail patterns. The purpose of this study was to evaluate the dentoalveolar compensation related to skeletal pattern in 153 adult(male:92, female:61) with normal occlusion. Cephalometric radiographs were taken with standard method, traced, and digitized. Skeletal patterns of normal occlusion subjects were sagittally classified into three groups by cluster analysis. The measurements were evaluated statistically among the groups by ANOVA and Correlation analysis. The results were as follows; 1. As mandibular position was posterior to the maxilla, the upper incisors inclined more lingually and the upper anterior vertical height was increased to the palatal plane. 2. As mandibular position was posterior to the maxilla, the lower incisors inclined more labially. 3. As mandibular position was anterior to the maxilla, the upper posterior teeth inclined more mesially and the upper posteiror vertical height was increased to the palatal plane . 4. As mandibular position was posterior to the maxilla, the occlusal plane inclined more downward and forward to the SN plane, FH plane and palatal plane.

초음파 비선형 음향 효과 및 X-선 회절법을 이용한 2.25Cr-1Mo 강의 열화 손상 평가

김덕희,박은수,박익근,변재원,권숙인 한국산업안전학회 2002 한국안전학회지 Vol.17 No.4

It was attempted to evaluate the degree of degradation of thermally aged 2.25-1Mo steel by ultrasonic nonlinear parameter(UNP) measurement and X-ray diffraction analysis of extracted carbide. Artificial aging was performed to simulate the microstructural degradation in 2.25Cr-1Mo steel arising from long time exposure at 540℃. Microstructural analysis (number of carbides per unit area) and measurements of mechanical properties(Vickers hardness, DBTT) and degradation evaluation parameters(UNP and intensity ratio of X-ray diffraction peak of electrolytically extracted carbied) were performed. Both of UNP and intensity ratio of X-ray diffraction peak for M6C carbied to that of M23C6 carbied(IR) increased abruptly in the initial 100 hour of aging and then changed little. UNP and IR were proposed as potential parameters to evaluate the degree of aging degradation of 2.25Cr-1Mo steel.

법랑아세포종에서의 p53 및 MIB-1 발현 : 임상 및 병리학적 요인들간의 연관성 Correlation Between Clincopathologic Parameters

이수운,한지용,권창석,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Thirty five patinets' paraffin embedded biops block , which was previously diagnosed ameloblastoma and obtained from oral and maxillofacial surgery dept. of pusan paik hospital and OMS dept of collage dentistry, pusan national university hospital, from January 1994 to march 1999, were performed immunohistochemistry with p-53 and MIB-1. On investigating the expression, correlation between clinical and histologic factor and correlation between prognosis and moleculopathologic property were examined. And we obtained the following results; 1. Age over forty, recurrence rate was 58.5%. 91.4% of the tumor was developed on mandibule, recurrence rate of maxilla area tumor was 66.7% On radiologic and histologic feature, multilocular and follicular type has high recurrence rate but no significance statistical difference was found 2. Expression of p-53 was 25.7%, When underage of forty. location on mandibule, multilocular and plexiform type, the expression of p-53 was somewhat higher and recurred cases of tumor, expression rate was 12.5%. 3. MIB-1 expression rate was 77.1%. When location on mandibule, unilocular, plexiform type tumor and previously recurred case, MIB-1 expression was 87.5% which was somewhat higher than no recurrence case of 74.1%. 4. 33.3.% of positive on MIB-1 have expression of p-53 and all p-53 positive case express MIB-1 positive. All p-53 positive case have high cell proliferation rate. From this result, age and location have closely related with the prognosis of tumor, histologic feature and MIB-1 expression has related with the prognosis of tumor. But p-53 has highly expressed on cell proliferation area, not closely related with the prognosis of tumor.

상악 전치부 후방 견인 시 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구

정애진,김운수,이수행,강성수,최희인,조진형,김상철 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.2

상악 전치부 후방 견인 시의 이동 양상 및 응력 분포를 건조 두개골을 전산화 단층 촬영에 의해 3차원 영상화한 유한 요소 모델 상에서 알아보고자 하였다. 피질골 절단술의 시행 여부와 고정원, 힘의 작용점을 각기 달리 설정하여 8개의 실험군을 구성하여 비교하였다. 통상적인 T-loop을 이용하여 공간폐쇄를 하는 경우 전치부는 후하방으로 경사이동 하였으며, 구치부에서도 약간 전방 이동하였다. 피질골 절단술을 동반하여 전치부를 견인한 경우, 전치부 골편에서의 응력 분포가 전반적으로 넓게 분포되었으며, 전치부 경사의 정도가 적은 반면에 변위량은 훨씬 더 많았다. 협측에서의 견인 시 상악 협측에 식립된 미니 임플랜트와 견치 power arm간에 견인력을 가한 경우가 미니 임플랜트로 고정원이 강화된 제2소구치와 견치 브라켓 간에 견인력을 가한 경우보다 전치부의 후하방 경사 정도가 적었다. 구개측에서 power arm에 대한 견인 시 정중구개봉합 부위에 식립한 미니 임플랜트로부터 견인력을 가한 경우가 상악 제1, 2대구치 간 구개면에 식립된 미니 임플랜트로부터 견인력을 가한 경우보다 전치부의 후하방 경사 정도가 컸다. 이러한 결과로써 치아이동 시 피질골 절단술의 효과와 저항중심에 대한 교정력 벡터 조정의 의미를 확인할 수 있었다. Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.

한국어 대용량 음성인식에서의 효율적인 시간 감축에 관한 연구

장춘서,이기수,신윤식,임은기,김병만,김현수 금오공과대학교 산업기술개발연구원 2000 産業技術開發硏究 Vol.16 No.-

In this paper a time reduction algorithm for large vocabulary speech recognition system has been studied. TDNN(Time Delay Neural Network) was used to classify vowel using phonetical fetures. To increase performance of vowel classification, modular TDNN architecture associated with 2 states input layer has been suggested.

2.25Cr-1Mo 강 인공 열화재의 고주파수 초음파 감쇠특성에 관한 연구

박익근,박은수,김정석,김현묵,권숙인,변재원 한국비파괴검사학회 2001 한국비파괴검사학회지 Vol.21 No.4

재료나 설비의 고온 장시간 사용으로 인하여 발생되는 재질열화 평가에는 파괴적인 방법이 널리 사용되고 있으며, 신뢰도가 높다. 그러나, 시험편의 채취가 어렵고 많은 경비와 시간이 소요된다. 전기저항법, 레프리카법, 바크하우젠 노이즈법, 전기화학적방법, 초음파법 등과 같은 비파괴적인 열화손상 평가 방법이 주목을 받고 있다. 본 연구에서는 2.25Cr-1Mo 강을 630℃에서 장시간 등온열처리로 모의 열화시험편을 제작하고, 고온설비부재에서 발생되는 미세조직의 변화와 고주파 초음파의 전파특성(감쇠계수)과의 일대일 상관관계를 규명하여 초음파 비파괴평가에 의한 열화도 평가의 유용성 유무를 실험적으로 검증하였다. 그 결과 2.25Cr-1Mo 인공열화재의 경우 열화가 진행됨에 따라 탄화물의 석출 및 조대화가 일어나며 초음파 감쇠계수는 증가하는 경향을 나타내었으며, 그 정도는 침상의 탄화물이 거의 소멸되는 1,000 시간 이후에 초음파 감쇠계수가 급격히 증가하는 매우 좋은 상관성을 나타내었다. The destructive method is reliable and widely used for the estimation of material degradation but, it have time-consuming and a great difficulty in preparing specimens from in-service industrial facilities. Therefore, the estimation of degraded structural materials used at high temperature by nondestructive evaluation such as electric resistance method, replica method, Barkhausen noise method, electro-chemical method and ultrasonic method are strongly desired. Ultrasonic nondestructive evaluation technique has been reported good to attain efficiency of measurement, high sensitivity of measurement, and rapidity and reliability of result interpretation. In this study, it was verified experimentally the feasibility of the evaluation of degraded 2.25Cr-1Mo steel specimens which were prepared by the isothermal aging heat treatment at 630℃ by high frequency longitudinal wave method investigating the change of attenuation coefficient by FFT analysis and wavelet transform. Because of carbide precipitation increase and spheroidization near grain boundary of microstructure to aging degradation, attenuation coefficient had a tendency to increase as degradation proceeded. It was identified possibly to evaluate degradation using the characteristics of high-frequency ultrasonics. Frequency dependence of ultrasonic attenuation coefficient to aging degradation appeared large, which made sure that attenuation coefficient is an important parameter for evaluation of aging degradation.

초음파탐상 PD-RR Test의 통계적 신뢰도 평가 (Ⅲ) : a Round Robin Test Reesult (Part Ⅲ)

박익근,박은수,김현묵,박윤원,강석철,최영환,이진호 한국비파괴검사학회 2003 학술대회 논문집 Vol.- No.1

국내 원전의 건전성 및 안전성 확보에 직결되는 자동 초음파검사의 신뢰도 및 검사시스템의 기량을 평가하기 위해 자동UT-PD RRT를 수행하였다. 수행된 RRT의 조건은 2001년 수동 PD-RRT에 적용된 설계변수와 동일하다. 본 연구에서는 자동 UT의 결함검출확률 및 오판확률과 결함크기측정에 대한 불확도 분석을 이용하여 자동 초음파검사의 통계적인 신뢰도를 평가하고 수동 UT PD-RRT의 결과와 비교하여 기량을 검증하고자 한다. 이러한 연구결과를 토대로 향후 각종 비파괴검사에 대한 RRT를 수행하여 기술수준을 파악하고 비파괴검사기술의 발전을 도모할 수 있을 것으로 판단된다.