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)

Molecular subtypes of triple-negative breast cancer: understanding of subtype categories and clinical implication

Yong‑Moon Lee,Man Hwan Oh,Jai‑Hyang Go,Kyudong Han,Song‑Yi Choi 한국유전학회 2020 Genes & Genomics Vol.42 No.12

Background: Triple-negative breast cancer (TNBC) is a heterogeneous entity that encompasses several subtypes with distinct molecular characteristics. The patients with TNBCs show unpredictable response to the chemotherapy, and further there is the lack of effective agents. Thus, many studies have been underway to discover targeted therapy suitable for patients with specific genetic alterations in each molecular subtypes. TNBCs are classified as four major molecular subtypes according to the gene expression patterns. These are luminal androgen receptor (LAR), mesenchymal-like, immunomodulatory (IM), and basal-like types. Conclusion: Here, we discuss the unique molecular features of each subtype as well as promising targets for anti-cancer therapy.

거골 경부 골절의 치료

조용만,이영기,리건영,이천동 대한골절학회 1996 대한골절학회지 Vol.9 No.4

The talus has some important anatomic features. Approximately 60% of its surface is cartilage and The talus often has problems with circulation. Talar neck fracture have a high association with ostonecosis and osteoarthritis. Authors have analysed l6 cases of the talar neck fractures treated at Lee-Rha General Hospital from January l990 to December l995 with minimal I year follow up. The results were as follows; 1. In thr l6 cases, there were l4 males and 2 females. the age between 20 and 40 years old was 10 cases(63%). 2. The most common cause of injury was traffic accident(63%), with sudden hyperextension as its mechanism. 3. associated injuries were 4 malleolar fracutres, 3 calcaneous fractures, 3 spine fractures, 3 tiviofibular fractures and 2 femur fractures. 4. According to the Hawkins classification: 3 cases in type I, 4 cases in type I, 5 cases in type l. 4 case in type N fractures were observed. 5. The method of treatment, all 3cases of Hawkins type I fractures were treated by closed reduction and cast immobilization, 3 cases of Hawkins type l and I case of Hawtins type III fracture were treated by closed reduction and internal fixation, other 9 cases were treated by open reduction and internal fixation. 6. Excellent results were observed in 8 cases good in 5 cases, fair in 2 cases . poor in l case with the Hawkins' therapeutic criteria. 7. Complications was observed 3 avascular necrosis, 2 post-traumatic arthritis, 2 ankle stiffness and l skin necrosis. From the above results, authors believe that early anatomical reduction k internal fixation is impotent to get a satisfactory result in de treatment of talar neck fracture.

수부 주상골 요부의 전위골절에 대한 수술적 치료

조용만,이영기,강흥식,리건영,이천동,오상수 대한골절학회 1997 대한골절학회지 Vol.10 No.1

The authors surveyed the clinical study of 17cases of scaphoid fractures from March 1989 to September 1994 with minimal I year follow up at Department of Orthopedic Surgery, Lee-Rha general Hospital. The following conclusions were obtained through clinical survey. l. Of all l 7 cases, they were l3 males and 4 females; Among the 13 males, 10 cases were aged between 20 and 39 years. forming 56.8% of all. 2. All 17 cases were treated by open reduction. Unions were obtained at average l l.5 weeks in 7 cases treated with Herbert screw fixation and l 2 weeks in l 0 cases treated with K-wire fixation. 3. Two of ten K-wire treated cases resulted in delayed union, one of seven Herbert screw treated cases resulted in delayed union. 4. Unions were obtained at average 20 weeks in 3 cases of delayed union. We concluded that open reduction and K-wire fixation were recomanded for the compatible treatment method of displaced waist fracture of scaphoid.

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.

프레탈정 (실로스타졸 100mg)에 대한 실로스탄정 (한국유나이티드 제약)의 생물학적 동등성

용철순,이경희,최진석,박병주,정세현,김용일,박상만,유봉규,이종달,최한곤 한국병원약사회 2003 병원약사회지 Vol.20 No.2

Bioequivalence of one cilostazol tablets, the Pletaal^(R)(Korea Otsuka Pharmaceutical Co., Ltd.) and Cilostan^(R)(Korea united Pharmaceutical Co., Ltd.), was evaluated according to the guideline of KFDA. Sixteen normal male volunteers(age 20~30 years old)were divided into two groups and a randomized 2×2 cross-over study was employed. After one tablet containing 100㎎ of cilostazol were orally administered, blood was taken at predetermined time intervals and the concentration of cilostazol in plasma was determined with an HPLC method using UV detector. The pharmacokinetic parameters(C_(max), T_(max) and AUC_(t)) were calculated and ANOVA was utilized for the statistical analysis of parameter. The results showed that the differences in C_(max), T_(max) and AUC_(t) between one tablet were 16.08%, 18.88% and 17.57%, respectively. The powers (1-β) for C_(max), T_(max) and AUC_(t) were 85.03%, 83.92% and 80.12%, respectively. Detectable differences(Δ) and confidence intervals were all less than 20%, and confidence interval of all the parameters were also less than 20% at the significance level(α) of 0.05. All of these parameters met the criteria of KFDA for bioequivalence, indicating that Cilostan^(R) tablet is bioequivalent to Pletaal^(R) tablet.

Captopril과 Nifedipine 병합요법의 강압효과에 관한 임상적 연구

이영수,문언수,김준호,공수정,정시진,주용진,정상만 건국대학교 의과학연구소 1993 건국의과학학술지 Vol.3 No.-

Background: The hypotensive effect of captopril(angiotensin converting enzyme inhibitor) and nifedipine(calcium channel blocker) was studied. Method: Captopril(75mg) and nifedipine(30mg) were administered in 30 hypertensive adults during twelve weeks after a week observation for washout with stepwise increments of the dose according to the patient's blood pressure in every two weeks. Result: The supine blood pressure were decreased from 169.5±22.3/104.0±20.3 mmHg to 130.4±21.3/82.4±19.5mmHg at the end of twelve weeks during therapy.(p<0.05) The standing blood pressure were also decreased conferrably and to the some lower level. Hematologic examination and blood chemistry revealed no discernible abnormal findings before and after the treatment. During the period of the study a few probably drug-related symptom such as cough and headache, gastrointestinal disturbance developed but not troublesome enough to administering. Conclusion: Captopril and nifedipine regimen is well tolerated and effective in the treatment of hypertensive patients.

洛東江 流域의 土壤 特色 및 土地 利用 實態 調査

이충열,김용철,박현철,김성만,최인수 密陽産業大學校 農業技術開發硏究所 1998 農業技術開發硏究所報 Vol.2 No.1

1980년에 발표한 자료와 그 후 토양조사를 한 결과를 종합하여 낙동강 유역의 토양을 중심으로 우리 나라의 토양특성을 비롯한 각종 토양해설 자료를 근거로 요약하면 다음과 같다. 우리 나라 지형은 매우 복잡하나 산악이 대부분을 차지하고 있으며, 태백산을 중심으로 동부는 급경사의 지형이 발달하여 있고, 서부는 완만한 경사를 이루는 산악지가 많을 뿐만 아니라 우리 나라의 곡창지대라 할 수 있는 평야지는 한강을 비롯하여 낙동강, 금강, 및 영산강 유역에 분포하고 있다. 산악지의 면적이 많아 농경지의 절반 이상이 경사지에 분포하고 있는 것이 특징이라 할 수 있다. 토양 모재는 산성암 조립질인 화강암 또는 화강편마암이 전국의 2/3 이상 점유하고 있으며 수성암인 혈암 및 사암은 낙동강 유역이 위치한 경상남북도에 많이 분포하고 있다. 석회암은 강원도에 가장 많이 분포하고 있고 경기 및 경북의 북부지방에 약간 분포하며 기타 지역에는 산재하여 분포하고 있다. 이외에도 반암, 안산암, 유문암 및 편암 등이 분포하고 있으며 충적층은 주로 낙동강 유역을 포함한 4대강 및 이들 4대강의 재류에 넓게 분포하고 있다. 정밀 토양조사 결과 면적은 9,577,000ha(논 879,000ha, 밭 1,288,000ha, 과수 및 뽕밭 119,000ha, 초지 103,000ha, 임지 6,425,000ha, 기타 763,000ha), 이 중 낙동강 유역은 논, 밭을 포함한 농경지 240,731ha, 임지 1,132,655ha 및 기타 154,945ha로서 총 면적은 대략 1,565,332ha이다. The summary of the survey, which was based on the published data since 1980, on soil characteristics and land utilization of Korea including the basin of the Nakdong river is as follows : The mountainous area comprises the various physiographic features. The eastern part from Taebaeg Mountain is mostly covered by the steep sloped land and the western part perches on gently sloped hil1y area in which the major productive area is distributed along the alluvial plains of the major river basins, Han river, Nakdong river, Kum river and Youngsan river in Korea. More than half of the cultivated lands occur on the local valleys and mountain foot slopes. Soils from coarse textured acidic crystalline rocks such as granite and granitic gneiss cover more than 2/3 of the country. Soils from sedimentary rocks like shale and sandstone are mainly confined Kyungbuk province, soils from limestone are mainly in Kangwon and partly in Kyungki, Kyungbuk and other provinces, and others are from porphyry, andesite, gabbro, rhyolite and schist. Alluvial soils are mainly developed on four river basins and their tributaries. The area of whole cultivated land covered by the detailed soil survey was turned out to be 9.577.000ha, upland 879.000ha, paddy land 1,288,000ha, orchard and mulberry 119.000ha, grass land 103,000ha, forest 6,425,000ha and the others 763,000ha, In Nakdong river valley, total area was approximately 1,565,332ha and the cultivated area including upland and paddy land was 240,731ha. The area of forest and the others were respectively 1,132,655ha and 154,945ha.

중이 진주종상피에서 bcl-2의 발현 양상

용만강,이창수,이주연,이동욱,신시옥 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.1

연구목적:중이 진주종의 조직학적 특징은 진주종 상피의 과증식과 비정상적인 과각질화 라고 요약되는데 이러한 현상은 진주종 상피를 형성하는 각질세포의 증식, 분화 및 세포 사 멸로 이루어진 세포주기의 항상성 변화로 기인한다. 본 연구는 세포 고사(apoptsis)에 억제작용(inhibition)이 있는 것으로 알려져 있는bcl-2가 중이 진주종에서 발현되는지 알아 보았다. 대상 및 방법:만성 진주종성 중이염으로 수술을 시행했던 환자 10 예에서 중이 진주종 상피를 얻어 western blot analysis를 시행하여 중이 진주종 조직에서의 bcl-2의 발현을 관찰하였다. 결과:Western blot analysis 상 정상 피부 조직과는 달리 중이 진주종 조직에서는 10 예 모두에서 bcl-2가 발현되었다. 결론:이러한 결과는 bcl-2가 중이 진주종에서 과발현 되는 것으로 볼 수 있다. Keratin debris의 축적은 각질세포 사멸현상의 증가에 의한 것으로 세포고사 억제 작용이 있는 bcl-2가 중이 진주종의 병인(pathogenesis)에 중요한 역할을 할 것으로 판단된다. Purpose:The unique pathologic feature of cholesteatoma is known to be accumulation of keratin debris within the middle ear cavity resulting from hyperproliferation and hyperk-eratosis of keratinocyte in the cholesteatoma epithelium. This phenomenon is due to disturbance of the epithelial homeostasis in the cell cycle. This study was designed to identfy the expression of bcl-2 in the cholesteatoma epithelium. Materials and methods:Ten fresh human cholesteatoma tissues and five postauricular skins were obtained from patients undergoing middle ear operations. Western blot analysis was performed for detection of bcl-2 expression on the tissues. Results:Western blot analysis revealed that bcl-2 protein was expressed in all of choesteatoma epithelium specimens, while barely expressed in postauricular skins samples. Conclusion:These findings show that bcl-2 was overexpressed in cholesteatoma epithe-lium. The author suggests that bcl-2 may play a role in pathogenesis of chronic otitis media with cholesteatoma.

삼천지의 곤충상

이종욱,류성만,서경인,전영태,배찬영 嶺南大學校 基礎科學 硏究所 1998 基礎科學硏究 Vol.18 No.-

We studied insect fauna in the Samchun-impoundment during the period of from September 1997 to August 1998. The total number of insect taxa are composed to 95 species in 86 genera, 39 families and 8 orders in this examination.