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).

Effect of Hydride Reorientation on Delayed Hydride Cracking In Zr-2.5Nb Tubes

Yun Yeo Bum,Kim Young Suk,Im Kyung Soo,Cheong Yong Moo,Kim Sung Soo Korean Nuclear Society 2003 Nuclear Engineering and Technology Vol.35 No.6

The objective of this study is to investigate the reorientation of hydrides with applied stress intensity factor, the peak temperature and the time when to apply the stress intensity factor in a Zr-2.5Nb pressure tube during its thermal cycle treatment. Cantilever beam (CB) specimens with a notch of 0.5 mm in depth made from the Zr-2.5Nb tube were subjected to electrolytic hydrogen charging to contain 60 ppm H and then to a thermal cycle involving heating to the peak temperature of either 310 or $380^{\circ}C$, holding there for 50 h and then cooling to the test temperature of $250^{\circ}C$. The stress intensity factor of either 6.13 or $18.4\;MPa\sqrt{m}$ was applied at the beginning of the thermal cycle, at the end of the hold at the peak temperatures and after cooling to the test temperature, respectively. The reorientation of hydrides in the Zr-2.5Nb tube was enhanced with the increased peak temperature and applied stress intensity factor. Furthermore, when the CB specimens were subjected to $18.4\;MPa\sqrt{m}$ from the beginning of the thermal cycle, the reoriented hydrides occurred almost all over the Zr-2.5Nb tube, surprisingly suppressing the growth of a DHC crack. In contrast, when the CB specimens were subjected to the stress intensity factor at the test temperature, little reorientation of hydrides was observed except the notch region, leading the Zr-2.5Nb to grow a large DHC crack. Based on the correlation between the reorientation of hydrides and the DHC crack growth, a governing factor for DHC is discussed along with the feasibility of the Kim's DHC model.

뇌 아밀로이드 혈관병과 고혈압성 뇌출혈의 감별에 있어서 Apolipoprotein Eε4와 점상 출혈 분포의 유용성

김용범,이광호,이수주,나덕렬,조수진,정진상,이원용 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

Simulation Model을 利用한 自然景觀과 建築物의 相關性에 關한 硏究

金範洙,鄭玧洙 建國大學校 自然科學硏究所 1995 建國自然科學硏究誌 Vol.6 No.-

本 硏究는 自然景觀을 배경으로 建築物의 形態와 규모를 合成하여 작성한 景觀 Simulation Model을 이용하여 自然景觀과 建築物과의 調和性을 平價하에 있어서 景觀構成要素와 景觀評價特性과의 相互關係를 究明하기 위하여 수행되었다. 寫眞合成에 사용한 自然景觀과 建築物은 1994年 7月부터 8月에 걸쳐서 撮影하였으며, Simulation Model에 5段階 尺度에 의한 心理測定法을 適用하여 1994年 8月에 評價하였다. 이번 硏究의 주요 內容은 自然景觀과 建築物과의 調和性을 모색하기 위한 문제점의 제기와 아울러 代案을 제시하였으며, 그 결과를 요약하면 다음과 같다. 1) 양호한 自然景觀에 建築物을 도입하게 되면 어떠한 형태이든 負의 상관이 나타나는 것으로 판명되었다. 2) 전반적으로 中層의 建築物이 高層의 建築物에 비하여 高度의 경관적 評價値를 보이고 있음이 밝혀졌다. 3) 建築物의 占有率과 導入 建物의 棟數가 증가함에 따라 綜合的 景觀性 및 自然性의 평가치는 저하된다. 4) 建築物이 自然景觀을 해치는 경향을 적게 하고 相互 調和를 도모하는 방법으로서 다음과 같은 사항을 제시코자 한다. ① 建築物의 높이를 낮게 제한한다. ② 규모에 있어서도 建築物의 시각적 점유율이 15% 범위를 초과하지 않도록 한다. ③ 配置形態는 連立形式으로 建築하거나 또는 建築物의 幅을 약간 넓도록 설계한다. ④ 視覺的으로 棟數를 적게 한다. The aim of this study was to explain the relationship between the landscape organization and evaluating factors to harmonize the buildings with natural landscape using the landscape simulation models controled the form and size of buildings and obtain some knowledges about the introduction of buildings into natural landscape. Through this study, the results were summerized as follow. It was proved that the introduction of buildings into good natural scenery, whatever form they might be had negative effect. It was revealed that the multistoried building, overall showed a high value of scenery in comparision with the high-rise building. As the occupancy rate of the building and the number of buildings increased, the evaluation of comprehensive scenery and natural quality became low. To attempt the harmony between the building and natural scenery to reduce the impact that the former had on the latter, an attempt is made to present the following matter; ① The hight of the building should be restricted to its low hight. ② The visual occupancy rate of the building should be made be within 15 percent in terms of its size. ③ The layout form of the building is in the form of the tenement house or the width of the building should be somewhat widely set. And, ④ The visual number of building should be made low.

脫施設化와 在家障碍人事業의 展開方案

金範洙 강남대학교 부설 한국사회복지연구소 1994 한국사회복지 Vol.1 No.-

Simulation Model을 利用한 自然景觀과 建築物의 調和에 關한 硏究

김범수 건국대학교 1996 學術誌 Vol.40 No.2

本硏究는 自然景觀을 背景으로 建築物의 形態와 規膜를 合成하여 작성한 景觀 Simulation Model을 이용하여 山腹部에 건축물의 도입시 자연경관과 건축물과의 調和性을 評價함에 있어서 景觀構成要素와 景觀評價特性과의 關聯性을 규명하기 위하여 수행되었다. 본 연구를 통하여 얻어진 결과를 요약하면 다음과 같다. 1) 良好한 自然景觀에 건축물을 도입한 상태에서는 어떠한 형태이든 전반적으로 負의 相關을 나타내는 것으로 판명되었다. 2) 고층의 건축물보다는 중층의 건축물이 종합적인 景觀性과 自然性에 대한 평가가 전반적으로 높게 나타나고 있음이 판명되었다. 3) 건축물의 占有率이 증가함에 따라 綜合的 景觀性 및 自然性에 대한 평가는 저하하는 경향을 보이고 있다. 4) 자연경관과 건축물과의 調和注을 도모하는 방법으로서 다음과 같은 대 안을 제시코자 한다. (1) 건축물의 높이를 되도록 낮게 制限한다. (2) 規模에 있어서도 시 각적인 점유율이 12% 이상을 초과하지 않도록 한다. (3) 配置形態는 分散配置 方式으로 건축한다. The aim of this study was to explain the relationship between the landscape organization and evaluating factors to harmonize the buildings with natural landscape using the landscape simulation models controled the form and size of buildings and obtain some knowledges about the introduction of buildings into natural landscape. Through this study, the results were summerized as follow : 1) It was proved that the introduction of buildings into good natural scenery, whatever form they might be had negative effect. 2) It was revealed that the multistoried building showed a high value of scenery in comparision with the high-rise building. 3) As the occupancy rate of the buildings increased, the evaluation of comprehensive scenery and natural quality became low. 4) To attempt the harmony between the building and natural scenery, an attempt is made to present the following matter; (1)The hight of the building should be restricted to its low hight. (2)The visual occupancy rate of the building should be made be within 12 percent in terms of its size. (3)The layout form of the building should be set in the form of dispersion arrangement.

스포츠 외상에 의한 척추·척수손상 분석

김대경,임완기,임정일,김범수,추해광,강은균 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

I have researched 46 examples, 43 are spinal column and cord injury and 3 are thoracic vertebrae and cord injury, of J hospital S health caring center. 46 patients were cured by this J hospital medical staffs, and their external injury were caused by sports accidents. I have acquired next four meaningful conclusions. First, the external injury caused by golf sports are 24 cases, and this is the primary cause of injury. Second, high-rank bonn fracture are 78.8 percent in C4, C5, C6 situation. And the bone-fracture, tear-drop fracture, figure in the activity of gold is 45.8 percent, and fracture dislocation is 63.2 percent in other sports activities. Third, there are twenty six cases of paralysis that links frankel C. Four, the sports injuries such as bone fracture are able to prevent by education and effective learning programs.

형제에서 발생한 신성 요붕증

김마리,김덕수,정혜천,박범수,하태선 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

신성 요붕증은 항이뇨 호르몬(antidiuretic hormone, arginine vasopressin)의 혈중 농도가 높음에도 불구하고 신장이 항이뇨 호르몬에 반응하지 못하여 생기는 유전 질환이다.신장이 항이뇨 호르몬에 반응하지 못하면 신장의 농도 조절 작용과 수분 재흡수의 기능이 상실되어 많은 양의 저장(hypotonic) 상태의 뇨를 체외로 배출하므로써 탈수증에 이르게 된다.저자들은 다음, 다뇨 및 성장 장애를 주소로 내원한 형제에서 임상 검사를 통하여 신성 요붕증을 진단하였다.형제 중 형은 8세 남아로 생후 10개월에 다음, 다뇨 및 발열을 주소로 내원하여 신성 요붕증을 진단 받고 치료를 시작하였으나, 보호자 자의로 약물 복용을 중단하였다.14개월 남아인 동생이 다음, 다뇨 및 성장 장애의 증상으로 내원하여 같은 방법으로 신성 요붕증을 진단받았고, 현재 형과 함께 이에 대한 치료를 받고 있다.저자들은 형제에서 발생한 신성 요붕증을 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Nephrogenic diabetes insipidus is a genetic disease that the kidney cannot respond to a-ntidiuretic hormone in spite of elevated serum antidiuretic hormone.Failure of the kidney to respond to antidiuretic hormone result in decreased function of the kidney of osmore-gulation and water resorption, and therefore nephrogenic diabetes insipidus are present in large amount of hypotonic polyuria, polydipsia and dehydration.The authors experienced two case of nephrogenic diabetes insipidus in brothers who have polydipsia, polyuria and failure to thrive.One 8-year-old boy had been diagnosed as nephrogenic diabetes insipi- dus by clinical test at 7 years ago, but at 32 months of his age, his parents had disco- ntinued his medication.The other 14-month-old boy has been diagnosed nephrogenic di- abates insipidus by same method lately. So, we report two case of nephrogenic diabetes insipidus in brothers with the brief rev-iew of related literatures.

고온에서의 P92강 용접부의 피로균열 성장거동

김범준,임병수 成均館大學校 科學技術硏究所 2002 論文集 Vol.53 No.1

To meet the demand for higher efficiency of power plant, high strength and heat resisting steels have been developed to improve the fatigue crack resisting properties under high steam pressure and temperature condition in power plants. As the result, P92 steel which has tempered martensitic 9% Cr and which is strengthened by replacing Mo with W, can be used for piping material that is critical in fossil power plant. Since the pipes are jointed by welding, the fatigue property, strength and life of weldment at high temperature is very important. In this study, the effect of high temperature on fatigue crack growth behavior in weld metal, HAZ(Heat Affected Zone) and base metal of P92 steel were investigated. Fatigue test was conducted under sinusodial waveform with constant load ratio(R=0.1) and frequency(f=20㎐) using CT specimens. Test temperatures were 600Δ℃. 650℃ and 700℃ and fatigue crack growth rates were characterized by the ΔK parameter at each test temperature.

스포츠센터 지도자들의 직무형태별 근골격계의 자각증상에 관한 연구

김범수 誠信女子大學校 生活文化硏究所 2011 生活文化硏究 Vol.26 No.1

This study was conducted to examine the subjective fatigue and musculoskeletal symptoms among health trainers, and to investigate the relationship between these subjective symptoms and related factors such as demographic, job- and health-related variables. 287 health trainers and 238 ball trainers employed in fitness facilities in Seoul were surveyed using a self-questionnaire.