당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

통풍성 관절염의 임상적 고찰

윤채중,정승문,김영학,김동규,허광식,김태원,배학연,정종훈,이승일,김평남 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

통풍은 Purine 대사의 이상으로 발생하는 질환으로, 고뇨산혈증인 사람의 전부가 통풍으로 발현되지 않고 증상의 출현 양상이 다양하여 진단과 치료에 주의가 필요하며, 조기에 적절한 조치를 한다면 충분히 조절이 가능한 질환이다. 본대학 내과학교실에서는 통풍으로 치료한 32명의 환자에서 임상양상, 병력과 검사소견을 분석하여 다음과 같음 결과를 얻었다. 1. 32명 모두 남자이며, 최초 발병 시기는 24세에서 72세로 평균 43.8±11.9세이었으며, 30대에서 40대까지가 19명(59.4%)으로 대부분을 차지하였다. 내원 당시 나이는 27세에서 75세까지로 평균 52.3±10.4세였으며, 내원시 까지 평균 유병기간은 8.5±6.8년으로 나타났다. 2. 동반 질환으로는 고지혈증 12례, 신장질환 10례, 고혈압 12례, 비만 8례, 당뇨 2례 등이었다. 3. 이환된 관절은 단관절 침범이 19례(59.4%), 다관절 침범이 13례 이었으며, 최초 이한된 관절은 족무지 중족골지골 관절로 19례(59.4%)로 가장 많았고, 통풍 결절은 20례(62.5%)에서 관찰되었으며, 유병기간이 10년 이상된 12례중 11례 (91.7%)에서 결절이 관찰되었다. 4. 평균 혈중 요산치는 9.17±1.75 ㎎/dl이었으며, 8.0 ㎎/dl에서 9.9 ㎎/dl 사이가 19명으로 전체의 59.4%를 차지하였다. Objective: The gout is a heterogeneous group of diseases resulting from tissue deposition of monosodium urate or uric acid crystals from extracellular fluids supersaturated with respect to this end product of human purine metabolism. The clinical manifestations are such as hyperuricemia, gouty arthritis, gouty nephropathy, uric acid nephrolithiasis. We analyze of clinical manifestations and associated factors in gout. Method: We have reviewed the medical records, radiologic findings and clinical results of thirty-two patients admitted at our department from April 1996 to July 1997. Result: 1) All patients were male. The mean age at initial attack was 43.8 years old, ranging from 24 to 72 years old. 2) The mean level of serum uric acid was 9.17mg/dl on admission. 3) The first metatarsopharyngeal joint was involved in 19 cases (59.4%). Tophus was observed in 20 cases (62.5%). 4) Hyperuricemia was associated with hypertension, obesity, nephrolithiasis and hyperlipidemia.

일 간호대학의 간호환경시스템 통합실습방안 적용 : 간호관리학과 지역사회간호학의 통합

김광숙,이경자,김의숙,이정렬,김인숙,이태화,조윤희,정제인,이현정,배선형,김은현 대한간호학회 간호행정학회 2008 간호행정학회지 Vol.14 No.1

Purpose: Integrated curriculum has been considered as a desirable method in health related school course. The present study was conducted to develop practice curriculum which integrates nursing management and community health nursing and measure the education effect. Method: Literature review and scores of professional meeting were carried out to generate main educational goals, contents, operating principle, and evaluation item. Student evaluation was done by survey and in-dept interview in right after practicum and three months respectively. Results: Six concepts were derived as main component of the integrated curriculum. From 2 to 3 sub-categories were matched to each main component as well. Subsequently, practice contents were suggested on the basis of sub-categories. Attainment of practicum goal scores ranged from 2.82 to 3.54 in four points index. Students expressed that they found nursing manager's role in the community setting. Conclusion: This new approach encouraged students to ascertain relationship between hospital oriented and community based practice. Additionally, they can be prepared to comprehend diverse health care environment.

천연한약재(목통, 삼릉, 치자) 추출물의 항산화효과 및 항균활성효과

김정균,강영미,엄광식,고영민,김태영 경상대학교 농업생명과학연구원 2003 농업생명과학연구 Vol.37 No.4

한약재로 많이 이용되고 있는 목통, 삼릉 및 치자의 항산화활성과 항균활성 정도를 검토하기 위해 한약재를 물, 70% methanol(MeOH) 및 100% MeOH로 추출한 후 각 추출물의 페놀화합물함량, 전자공여능, hydroxy radical 소거효과, reducing power 및 항균활성시험을 하였다. 그 결과 실험에 사용한 3가지 한약재 모두 항산화효과와 항균활성이 뛰어났으며, 특히 목통 70% MeOH 추출물이 그 효과가 가장 컸으며 다음이 100% MeOH, 물추출물 순이었다. Antioxidant activity and antimicrobial activity of medicinal plants extracts from 3 edible or medicinal plant were examined. The extracts from Akebia quinate Decaisne, Scirusfluviatilis A. Gray, Gardenia jasminoides for. grandiflora Makino showed comparatively strong antioxidative activity on test. Electron donatating abilities and hydroxy radical scavenging ablities of 70% methanol, 100% methanol extracts were higher than thoes of water extracts. Some extracts of medicinal plants showed antimicrobial effect, especially, the extracts showed antimicrobial effect in the 70% methanol higher than other extracts.

강우시 불포화 토사사면의 간극수압 변화 특성

심태섭,김선학,신태욱,이광모 朝鮮大學校 建設技術硏究所 2004 建設技術硏究 Vol.24 No.2

This study manufactured model slope in soil. When it is rainfall. It experimented weathered granite soil to be distributed in korea mostly as dividing into two soil sample SP, SM, Moreover, inclination of slope(1:1~1:2) and rainfall strength (50~150mm/hr) divided into five step and it observed seepage behavior of slope according to inclination of slope and rainfall strength. It has manufactured six pore water pressure cells in the lower end of model soil box for measuring pore water pressure to be most important factor of slope failure and analyzed change of pore water pressure according to location of slope when rainfall is continued. Change of saturation depth according to experiment condition is measured through the whole soil box by eyes. In result, in case of being in different rainfall strength in sample inclination. The higher rainfall strength rises, The faster seepage of rain progresses. If angle become gentle from 1:1 to 1:2, The seepage velocity increase, too. If compared theoretical number to calculate by ◁수식 삽입▷ (원문을 참조하세요), that Lumb propose with seepage depth to be measured through indoor model test. As a result, Seepage velocity to measure actually is faster than seepage velocity by formula for Lumb to propose If angle become steep, If shows a tendency for pore water pressure to increase in slope angle from 1:22 to 1:1.5. But in angle from 1:1.5 to 1:1, If angle become steep, It shows a tendency for pore water pressure to decrease gradually as standardizing slope angle 1:1.5, According to rainfall strength increases from 50mm/hr to 150mm/hr. Pore water pressure increases in proportion to rainfall strength.es with the much increase of the pore water pressure.

牙山灣 底魚類 : Ⅱ. 鍾組成의 晝夜 및 季節變動 Ⅱ. Diurnal and Seasonal Variation in Abundance and Species Composition

李泰源,金光天 충남대학교 기초과학연구소 1992 연구논문집 Vol.12 No.-

Diurnal and seasonal variation of demersal fishes of Asan Bay were studied using seasonal samples collected by an otter trawl from autumn 1989 to summer 1990. For each sampling period, three to five trawl hauls were completed to obtain day and night samples. Of 32 species identified, Chaturichthys stigmatias, Cynoglossus joyneri, Thrissa koreana, Repomucenus lunatus and Hexagrammos otakii accounted for 79.5% of the individuals collected, and C. joyneri, T. koreana, H. otakii, Raja kenojei and Kareius bicoloratus constituted 67.1% of the biomass obtained. Apparently, larger number of individuals and greater biomass were collected in night hauls. However, there is no significant difference between day and night samples in community structure, mean abundance and body length of the dominant demersal species. The greatest numbers and biomass of fishes were collected in summer and the lowest in winter. The abundance of fishes in the study area were dependent upon seasonal effects such as temperature.

공동주택 단지내 외부 소음의 예측에 관한 연구

이광태,김흥수 慶南大學校 附設 工業技術硏究所 1997 硏究論文集 Vol.14 No.2

공동주택의 건설예정지로서 소음의 면에서 문제가 없는 부지를 선정할 수 있다면 최선이겠지만, 도시역에서 편리성이 높은 지역은 거의 간선도로, 고속도로 또는 철도 등에 근접하여 결코 좋은 음환경이라고는 말할 수 없는 경우가 많다. 이와같은 지역에 집합주택을 건설할 때는 당연 소음대책을 고려하지 않으면 안된다. 우선, 음원조건의 조사로부터 시작해서 문제가 있으면 음원대책을 행하는 것이 가장 효과가 기대되지만, 일반적으로는 여러 조건으로 움직이기 어려운 경우가 많기 때문에, 많은 경우 배치계획 이후의 단지계획 중에서 처리할 수 밖에 없다. 본 연구는 이러한 점에 착안하여 건물의 단지계획에 따른 단지내의 소음값과 도로교통의 조건에 따른 소음값을 사전에 예측할 수 있는 시뮬레이션을 개발하고 예측치와 실측치를 비교 ·검증 ·분석한다. 본 연구는 소음에 대한 문헌고찰을 통하여 올바를 소음예측의 바탕이 되는 이론적 고찰을 한후, 이것을 근거로 공동주택 단지내의 외부소음 예측을 위하여 조사.분석을 아래와 같은 방법으로 행한다. ①도로소음조건에 따라 소음원의 음향파워를 예측 또는 실측한다. ②소음점과 수음점 사이의 소음전파 경로를 분석하여 이를 유니트화하고, 이를 조합하여 단지내의 소음레벨을 예측한다. ③도로소음을 패치패턴에 따라서 결정하는 ??과 교통량의 조건에 따라 결정하는 ??를 예측한다. ④부산, 마산, 창원 소재 공동주택단지를 대상으로 단지내 소음을 측정하고 예측치와 실측치를 비교.검증한다. It is the best to select out the quiet site on the stage of making a plan for the apartment. But almost all districts convenient for living in the city are of bad environment, because it usually is next to the ordinary-way and the railroad. We should seek for the means for the noise control before building the apartments on such districts. First of all, it is the most effective to investigate the acoustic problems on the side of the sound source, and to consider a counter-measure of the noise control for those problems. But those cannot be improved because it takes long times to develope the low-noised apparatus with the engine included. On those concepts, we developed the simulation for predicting the noise level on the basis of the apartment layouts and the traffic conditions. But it is difficult to calculate the noise level decided by the layouts, and so we made the multitude of units for sound propagation(Fig.22)and added them to that level. We measured the sound pressure levels of outdoor noise in four apartment sites locationed in Pusan, Changwon and Masan. And after analyzing the predicted values and the measured ones, we approximately found the differences 2∼3dB(A). Therefore it is considered that the developed simulation will be used for predicting the outdoor noise level in apartment districts. But there were a lot of problems solved on the curved road or the one where the traffic light is established.

감마선투과검사 장치의 자동 원격조작기 개발

주광태,신진성,김동언,송정호,주승환,장홍근 한국비파괴검사학회 2002 한국비파괴검사학회지 Vol.22 No.5

국내 감마선투과검사용 조사장치는 1,000여대로 2,500여명의 종사자가 대부분 수동으로 원격 조작하는 실정으로 작업의 효율화와 방사선피폭 저감화를 위하여 자동 원격조작기의 사용이 요구된다. 이에 연구팀은 실무에 적합한 토크와 안전계수로부터 54kgf·㎝의 출력을 지닌 24V, 200W의 BLDC모터를 이용하여 0.4∼1.2 m/s 범위의 선원 이동속도를 조절할 수 있는 구동장치와 RF 센서로 구동 속도 조절, 광전센서에 의한 선원 위치 및 timer로 노출시간을 제어할 수 있는 무선 원격조작기를 개발하였다. 이와 같이 개발한 자동원격조작기는 AC와 DC 겸용, 그리고 기존의 수동 원격조작기에 탈착이 가능하여 자동과 수동을 겸용할 수 있는 경제적 이점 등으로 활용도가 클 것으로 기대된다. Recently, gamma radiographic equipments have been used about 1,000 sets manually and operated by about 2,500 persons in Korea. In order for a radiography to work effectively with avoiding any hazard of the high level radiation from the source, many field workers have expected developing a wireless automatic remote exposure controller. The KITCO research team has developed an automatic remote exposure controller that can regulate the speed of 0.4∼1.2 m/s by BLDC motor of 24V 200W which has output of 54 kgf·㎝, suitable torque and safety factor for the work. And the developed automatic remote exposure controller can control rpm of motor, pigtail position by photo-sensor and exposure time by timer to RF sensor. Thus, the developed equipment is expected that the unit can be used in many practical applications with benefits in economical advantage to combine the use of both automatic and manual type because attachment is possible existent manual remote exposure controller, AC and DC combined use.

우관상정맥동에서 기시하는 단일 관상동맥 1예

정현광,김태우,조윤성,김강민,장재훈,이재우,정준훈 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Coronary artery anomalies are found incidentally in approximately 1% of all patients undergoing routine coronary angiography. Of these, an isolated single coronary artery anomaly is the rarest one. Patients with an isolated single coronary anomaly may present with symptoms such as angina pectoris, myocardial infarction, arrhythmias, syncope, sudden death, and congestive heart failure. We report a case of single coronary artery anomaly with the left anterior descending and left circumflex coronary artery originating from the right coronary artery.