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

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

유착성 관절낭염에 대한 침 및 신경차단술 처치의 임상적 관찰

남동우,임사비나,김종인,김건식,이두익,이재동,이윤호,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

Objectives : To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Metbods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group ,n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW grouP, n=20). The E group received acupuncture treatment on LI15, TE_(14), GB_(21) and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. AU three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significant1y(P<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.

동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 : 견관절 가동운동범위(ROM) 변화를 중심으로

남동우,김행범,양동훈,임사비나,김건식,이두익,이재동,최도영,이윤호 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block. All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 - 견관절 가동운동범위(ROM) 변화를 중심으로 -

남동우,김행범,양동훈,임사비나,김건식,이두익,이재동,최도영,이윤호,Nam, Dong-Woo,Kim, Haeng-Beom,Yang, Dong-Hoon,Lim, Sa-Bi-Na,Kim, Keon-Sik,Lee, Doo-Ik,Lee, Jae-Dong,Choi, Do-Young,Lee, Yun-Ho 대한침구의학회 2006 대한침구의학회지 Vol.23 No.5

Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

Si Bulk Micromachining을 위한 Wafer Rolling Etching 및 그 특성

김건년,이보나,박효덕,신상모,공경준,장동근,김병철,권혁채,이봉희 경북대학교 센서기술연구소 1998 센서技術學術大會論文集 Vol.9 No.1

A wafer rolling etching system for the silicon bulk micromachining has been designed and fabricated. The silicon diaphragms were anisotropically etched in a 24.5 weight percent KOH solution. Compared to the conventional KOH etching systems, pyramidal hillocks, and wave-shaped structures on the etched surfaces were greatly reduced by using this system. After etching for time of 438 minutes, the average etched depth and the etch-rate were measured to be 537μm and 1.22μm/min, respectively. The average etching uniformity of etching depth was 0.87% in 5-inch wafer. Our results showed that the wafer rolling method enhanced etch uniformity and etch rate.

2주형 판형교의 가로보 배치에 따른 구조거동특성에 관한 연구

권기창,정경섭,김동현 충북대학교 건설기술연구소 2004 建設技術論文集 Vol.23 No.1

In the year book of Bridge Statistics published by The Ministry of Construction and Transportation of Korea, we can find the problem of Korea's Construction Situations, in these statistics, 49% of all bridges in Korea are Reinforced Concrete Slab Bridges. We can not deny that we sought not economic or rationalized types but fast construction methods. So, it is easy to see the same types of bridges throughout the Korean peninsula. As the labor cost is increasing and aesthetic values are gaining interest, new types of bridges, which show economic construction methods and beautiful shapes, are demanded. This study shows the behavior of the two girder bridge, which is an economic and effective method, trying to find the relation between the behavior of a crossbeam and the distances and locations of crossbeams. Additionally, the characteristics of the vertical bracings are evaluated.

壓延에 의한 Nylon 6 Film의 分子配向

金東建,金圭範 진주산업대학교 1999 論文集 Vol.38 No.-

This paper investigates the change of Nylon 6 molecular orientation by roller drawing treatment using X-ray diffraction method. The degree of molecular orientation of Nylon 6 film depends upon roller drawing ratio and roller temperature. That is, the molecular orientation tends to increase with roller drawing ratio and roller temperature. But the decrease of molecular orientation is observed in the Nylon 6 film treated with roller drawing at 160℃, which seems to be due to the structural change caused by the partial dissolution and recrystallization process.

요오드처리에 의한 Nylon 6의 構造變化

金東建,金圭範 진주산업대학교 1999 산업과학기술연구소보 Vol.- No.6

This study is carried out to investigate the structural changes of stretched and rolled nylon 6 monofilaments by immerse treatment with I_2-KI aqueous solution. The results obtained are as follows; The structure was changed to a-type in crystalline region and are depended upon the treating time into I_2-KI aqueous solution. According to the results of X-ray diffraction and density, r-type crystal begins to appear partially in the immersion of 2 hours and spread to almost complete r-type crystal after 24 hours immersed. The small angle X-ray diffraction patterns of rolled sample showed that the two axis orientation was disappeared by the treatment for 24 hours whereas the influence remained in microstructure.

Poly ethylene terephthalate의 저온결정화에 의한 미세구조의 변화

김동건,진영길 경상대학교 농업생명과학연구원 2002 농업생명과학연구 Vol.36 No.4

용융상태로부터 급랭한 PET의 무정형 상태는 용융온도에 크게 영향을 받아 용융온도가 낮은 경우에는 랜덤한 분자쇄 배열보다 결정화가 용이한 무정형구조를 나타내었으며 높은 용융온도에서 급랭한 경우에도 100℃의 저온 열처리에 의해 결정화시키면 부분적으로 분자쇄의 재배열이 일어나 결정화가 용이한 무정형구조로 변화하여 가는 것을 알 수 있었다. 또한, 저온결정화에 의한 발열피크가 열처리에 의해 저온쪽으로 이동하는 현상도 이러한 열처리에 의해 질서가 상대적으로 높은 무정형구조가 되기 때문으로 생각된다. 무정형 PET의 저온열처리에 의한 결정화의 과정은 무정형구조가 부분적 또는 단계적으로 질서화됨으로써 결정화가 이루어진다고 생각된다. Preparing amorphous PET films which were quenched after being melted at various temperature, we examined a change of micro structure by the cold-crystallization using DSC, XRD and TEM. The amorphous PET films quenched from the melting condition were largely influenced by the melting temperature. The PET films showed the amorphous structure that is easier to crystallize than the random molecular chain arrangement under the low melting temperature. Also, in the case of high melting temperature, the PET films were changed into the amorphous structure that is easy to crystallize by the portional rearrangement of molecular chain as a result of the 100 degree low annealing treatment. The phenomenon, the exothermic peaks by"the cold-crystallization move to the low temperature owing to the annealing treatment, can be also explained by the well-ordered amorphous structure by this annealing treatment. A crystallization process of the amorphous PET films by the low temperature annealing treatment is accomplished by the portional and gradual order of amorphous structure.