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제2형 당뇨병 환자에서 혈청 C-reactive protein과 인슐린 저항성과의 관계
김소영 ( So Young Kim ),정수진 ( Su Jin Jeong ),진흥용 ( Heung Yong Jin ),김종화 ( Chong Hwa Kim ),백홍선 ( Hong Sun Baek ),박태선 ( Tae Sun Park ),박지현 ( Ji Hyun Park ) 대한내과학회 2008 대한내과학회지 Vol.74 No.3
목적: 염증반응은 죽상경화증의 주요 병인이다. 제2형 당뇨병 환자를 대상으로 염증 반응의 표지자로 알려진 CRP와 인슐린 저항성과의 상관관계를 살펴보고자 하였다. 방법: 평균유병기간이 8.5년인 제 2형 당뇨병 환자 102명을 대상으로 하였다. CRP와 HOMA-IR과의 상관관계 및 대사 위험 요소들 간의 연관성을 분석하였다. 결과: CRP값은 HOMA-IR값과 양의 상관관계를 보였으며(r=0.4, p<0.01), 특히 공복시 인슐린과 밀접한 상관관계를보였다(r=0.319, p=0.001). 대상군을 CRP 값 1 mg/L를 기준으로 구분하였을 때 1 mg/L이상인 군에서 1 mg/L미만인 군에 비하여 유의하게 높은 HOMA-IR 값의 분포 양상을 보였다(p=0.001). 공복시 인슐린, 지질, 고혈압 유무로 보정을 한후에도 이러한 상관관계는 지속되었다. 결론: 본 연구에서는 제2형 당뇨병 환자에 있어 CRP가정상 범위내에 있을지라도, 정상 범위내에서 HOMA-IR 값과 양의 상관관계를 가진다는 것을 알 수 있었다. 향후 예후와 관련된 의미있는 CRP 상승의 정도 규명 및 이러한 CRP상승을 일으키는 HOMA-IR 값에 대한 추가적인 연구들이필요하다. Background/Aims: Low grade inflammation has been suggested to be a risk factor for development of atherosclerosis. C-reactive protein (CRP) is very sensitive acute phase reactant, and it is considered as an important marker of atherosclerosis and related disorder. Insulin resistance is also known to be associated with atherosclerosis. However, the relationship between insulin resistance and CRP has not been thoroughly studied in patients with type 2 diabetes. This study aimed to determine whether insulin resistance in type 2 diabetes is related with CRP. Methods: 102 subjects with type 2 diabetes were included in the study. Fasting blood samples were taken for measurement for CRP, insulin and glucose. To estimate insulin resistance, the HOMA (homeostasis model assessment)-IR (insulin resistance) was calculated by the standard formula. We divided the subjects into two groups depending on their CRP levels (Group A: <1 mg/L, Group B: ≥1 mg/L), and analyzed HOMA-IR indexes in each group. Results: There was significant correlation between CRP and HOMA-IR (r=0.4, p<0.01). HOMA-IR and fasting insulin levels in group B were higher than that of group A on the univariate analysis. On the multivariate analysis, among several variables such as fasting insulin, HOMA-IR, total cholesterol, and triglyceride, HOMA-IR were significantly related with CRP level independently. Conclusions: The serum CRP level, even if existed in normal range, was positively correlated with HOMA-IR in type 2 diabetes. Further studies are needed to determine the CRP level considered as clinically significant, and relating HOMA -IR.
강명신 ( Myung Shin Kang ),김종화 ( Chong Hwa Kim ) 대한내과학회 2015 대한내과학회지 Vol.89 No.3
Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus. The prevalence of neuropathic pain is estimated to occur in about 30-50% of all diabetic patients. Clinical symptoms vary depending on the nerves affected, and may include both positive and negative symptoms. Many patients with DPN experience pain or discomfort, anxiety, depression, and limitations in activity, which can significantly impact their physical, emotional, and social well-being. Early diagnosis is essential for the successful management of DPN. Routine management consists of glucose and risk factor control, and symptomatic relief, along with therapies designed to target the underlying disease pathology. Pharmacological treatment of DPN includes tricyclic compounds, serotonin noradrenalin reuptake inhibitors, the antioxidant α-lipoic acid, anticonvulsants, opiates, membrane stabilizers, topical capsaicin, and other drugs. Management of DPN must be tailored to each individual, and depends on a variety of factors, including disease severity and response to treatment. (Korean J Med 2015;89:277-281)
각종 간질환에서의 B 형 간염 Virus 표식자 발현에 대한 임상적 고찰
김종화,이충규,김광일,유병희,이종석 대한핵의학회 1983 핵의학 분자영상 Vol.17 No.2
By radioimmunoassay, serologic markers of Hepatitis B Virus were studied in 44 patients with acute viral hepatitis, 10 patients with chronic persistent hepatitis, 10 patients with chronic active hepatitis, 44 patients with liver cirrhosis and 25 patients with primary hepatocellular carcinoma. The results were follows: 1) HBsAg was present in 77.2% of AVH, 40% of CPH, 80% of CAH, 55.1% of LC and 68% of PHC. In this HBsAg positive groups, all but one in liver cirrhosis had Anti-HBc. 2) Anti-HBs was most commonly detected in CPH and accompanied by Anti-HBc except one case in AVH. 3) Anti-HBc was the only marker detected in 11.4% of AVH, 20% of CPH, 20% of CAH, 16.3% of LC and 8% of PHC. 4) HBeAg was most commonly found in HBsAg-positive CPH but Anti-HBe was most frequently detected in PHC. 5) The absence of HBV markers was noted in 2.3% of AVH, 10% of CPH, 8% of PHC except CAH and LC.
보존용액에 첨가된 ethionine이 절화장미 화판의 물리적 구조에 미치는 영향
채수천,손기철,김종화 한국화훼연구회 1996 화훼연구 Vol.5 No.2
Effect of ethionine in the preservative solution on the thickening phenomenon of petal of cut rose 'Red Sandra' was investigated. According to the result of cross section's observation by microscope, plasmolysis was observed in petal cell of cut rose maintained in the distilled water but not in that of cut rose maintained in the preservative solution containing ethionine on 10 days after experiment. On 13 days after experiment, epidermal and mesopyll cells of petal of cut rose maintained in the distilled water showed a profound shrinkage whereas epidermal and vascular bundle tissue of cut rose maintained in the preservative solution showed a fairly normal condition. Therefore, it was found that thickening phenomenon of petal on the basis of visual observation during vaselife is not due to either the division of epidermal cells or production of secondary cell wall but tugor pressure according to maintenance of the membrane integrity.
골수의 이형성 변화를 동반한 연소성 류마티스 관절염 1예
박태선,박지현,류완희,김종화,라방주,김현각,최보금,백홍선 대한내과학회 2000 대한내과학회지 Vol.59 No.5
Juvenile rheumatoid arthritis (JRA), an autoimmune disease, was characterized by chronic synovitis and associated with various extra-articular manifestations. Abnormal hematologic findings have been reported in all form of JRA, especially anemia due to chronic disease or iron deficiency. Dysplastic changes were rarely noted in the peripheral blood and bone marrow. We experienced a 15-year-old female patient with pauciarticular JRA who have pancytopenia in peripheral blood and a number of dysplastic changes in bone marrow, and present the case here with brief review of literatures.(Korean J Med 59:587-590, 2000)
당뇨병성 다발성 신경병증에 대한 thioctic acid의 유효성 및 안정성에 관한 연구
황진수,염정필,조용근,김종화,이치국,최유진,김현각,류완희,박태선,백홍선 의과학연구소 1999 全北醫大論文集 Vol.23 No.2
Diabetic neuropathy is a major factor in determining the morbidity of diabetic patients and most common complication, so the majority of diabetic patients have diabetic polyneuropathy. The most common causes of amputation of lower extremities are diabetic neuropathy and vascular insufficiency, taken over 50% of all causes. Near-normoglycemia is now generally accepted as the primary goal in the prevention of diabetic neuropathy. However, relatively long periods of near normal glycemic control for several months or even years may be needed to retard the progression of nerve dysfunction in diabetic patients with advanced stages of peripheral neuropathy. Hence, additional pharmachological treatments of painful neuropathic symptoms are frequently required to maintain the quality of life in symptomatic diabetic neuropathy. Antioxidant treatment has been shown to prevent nerve dysfunction in experimental diabetes mellitus, thus providing a rationale of potential therapeutic value for diabetic patients. The effects of thioctic acid, anti-oxidant α-lipoic acid, were studied in a eight weeks schedule in 21 diabetes mellitus patients with symptomatic peripheral neuropathy. They were assigned to treatment with thioctic acid 600㎎ once daily before breakfast. Neuropathic symptoms(pain, burning, parethesia, and numbness) were scored at baseline and each visits(4th week and 8th week later). Biochemical status was checked via blood sampling at baseline and 8th week of treatment. As a result, the mean value of total symptom scores were 6.6±2.0, 6.1±2.2, and 4.5±1.7 at baseline, second, and third visit. Although there was no significant statistical change in total symptom scores of neuropathic symptoms between first and second visit, significant improvements were observed at third visit compared with second visit(p=0.03). But no specific unfavorable effects or biochemical changes were not noted during the treatment with thioctic acid. So, we observed the significant beneficial effects of thioctic acid 600㎎ once daily before the breakfast for eight weeks in controlling symptoms of diabetic neuropathy without specific adverse reaction.