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

산후에 발병한 특발성 부갑상선 기능저하증 I 예

김정인,김상용,신병철,김경남,서영욱,이범주,김진화,배학연 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

Hypoparathyroidism is usually the result of an inadvertent surgical removal of all the parathyroid glands, In some instances, not all the tissues are removed, but the remainder undergoes vascular supply compromise secondary to the fibrotic changes in the neck after surgery, Previously, the surgery for hyperthyroidism was the most frequent cause of acquired hypoparathyroidism. Idiopathic hypoparathyroidism is a relatively rare disease that is characterized by hypocalcemia and hyperphosphatemia due to a parathyroid hormone deficiency of an unknown cause, It usually develops at a young age, and shows various clinical symptoms and signs accompanied with hypocalcemia. In addition, it is rarely associated with polyglandular autoimmune syndrome during the follow-up. Hypocalcemia and idiopathic hypoparathyroidism associated with labor and lactation are rarely reported condition previously. We here describe a case of a woman in whom the symptomatic severe hypocalcemia appeared after her delivery. We reviewed all the previously reported cases and suggest a possible physiological explanation for the association between pregnancy, lactation, and the appearance of symptomatic hypocalcemia.

가막사리(Bidens tripartita L.)와 미국가막사리(Bidens frondosa L.) 종자의 발아에 미치는 몇가지 요인

신혜정,신종섭,김지훈,김학윤,이인중,신동현,김길웅 경북대학교 농업과학기술연구소 1999 慶北大農學誌 Vol.17 No.-

The experiments were conducted to determine the factors such as light and darkness, phytohormone and seed coat, influencing on seed germination of Bidens tripartita L. and B. frondosa. The seeds of both species were germinated when seed coat was damaged and weakened GA3 and BA stimulated germination of both species but ABA and IAA had no effect on germination of them, which ranged 50.0% to 80.0%. In B. forndosa, when inner layer of seed coat was removed, germination was highly promoted up to 96.7% compared with 10.0% germination rate in another treatments.

도시 상업 공간 구조에 대한 차별화된 성별 이용 패턴 분석 -신촌 및 이화여대 상업 지구를 사례로-

신정엽 ( Jung Yeop Shin ),이건학 ( Gun Hak Lee ),김진영 ( Jean Young Kim ) 한국도시지리학회 2014 한국도시지리학회지 Vol.17 No.1

Urban commercial space has differentiated characteristics by gender, and a variety of urban activities are performed in that space. Notwithstanding the importance of understanding characteristics of urban commercial space by gender, there had been little research in both empirical and quantitative ways. In this regard, the purpose of this paper is to explore the urban commercial space by gender quantitatively. For empirical analysis, Shin-chon and Ewha Womans University areas were analyzed in terms of building transparency, spatial distribution of business and spatial structure, and land use. From the results of the analysis, we could find that the business domain for males is mainly spatially clustered in Shin-chon area, while the business domain for females dominates Ewha Womans University area in a spatially clustered form. Furthermore, significant differences of the land use pattern between two areas are likely to be related with social activities by gender.

흉곽 내시경을 사용한 척추 기형 수술시 학습 곡선

김학선,최윤락,이환모,문성환,김경희,박진오,하중원,신동은 대한척추외과학회 2003 대한척추외과학회지 Vol.10 No.3

鉛蓄電池用 格子合金인 납-안티몬合金의 時效析出改善에 關한 硏究

金學信 全北大學校 1979 論文集 Vol.21 No.-

In this paper, electrical resistance and micro-hardness measurements versus ageing time in order to improve ageing precipitation of battery grid alloy were performed for studying the influences of antimony content, ageing temperature, low-temperature treatment, a plastic deformation immediately after quenching and addittons of small arsenic on ageing precipitation of Pb-Sb alloys. The results obtained in this study are as follows : 1. The main mechanism of precipitation seems to be one of nucleation and growth of precipitation which give rise to the plate-shaped precipitates of pure antimony. 2. The ageing precipitation takes place faster when antimony content is higher and ageing temperature is upper. 3. The influences of a plastic deformation and a low-temperature treatment just after quenching lead to a greater rate of ageing kinetics. 4. With additions of small arsenic, the ageing precipitation of Pb-Sb alloy is greatly accelerated and suppressed the behaviour of over-ageing. 5. It is expected to contain 0.01~0.5%As of Pb-2.5~3.5%Sb alloy and to artificially 5hr at 120℃ to improve the efficiency and endurance-life of battery grid alloy.

웹사이트 스포츠몰 서비스 정보특성이 고객만족과 재구매 의도에 미치는 영향

김학신 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

This study was intended to provide the suggestions for activation of sports shopping mall business in the future by identifying the effect specialized sport shopping mall service information characteristics on Internet customer satisfaction and the repurchase intentions. As a result, the factors influencing the sports mall service information characteristics were shown to be in the orders of creditability, convenience of use, mutual service, individual service, mail service. The detailed results were suggestive of the following points: First, the transparency of transactions should be secured. For this purpose, sports shopping mall businessmen should continue to make efforts to reduce users' perceived risk by providing customers with information on the stability of transactions, the regulation on guarantee and recall, accuracy of the delivery time and the like. Second, the processing of transactions on the Internet should be designed to provide all of operators, sellers and buyers with convenience and efficiency. Third, it is necessary to secure customer information to provide individual service first and then meet customers' wanted needs through effective communication based on this information. Fourth, sport shopping mall websites should not only introduce products but provide a diversity of information and services and resolve customers' wanted needs in real time when customers linking to them.

전력계통과 연계된 열병합 발전설비의 최적운용에 관한 연구

신명철,김학만 成均館大學校 科學技術硏究所 1994 論文集 Vol.45 No.1

This paper presents exact modelling and optimum operation method of cogeneration with interconnected with power system for effective energy use. Cogeneration system consists of electric energy storage, on--site electric load, thermal energy storage, auxiliary boiler and on-site thermal load. By using linear programming, general model of cogeneration is estabilished in this paper. Therefore exact and powerful optimum operation schedule of cogeneration interconnected with power system can be estabilished. Through a case study an example is given to show optimum operation schedule of cogeneration interconnected with power system. And the efficient configuration of cogeneration system is proposed by comparing results of some case studies.

일부 전문대 응급구조학생의 응급구조전문직관의 변화에 대한 연구

김학수,최은숙,김진회,신동민,이인수 한국응급구조학회 1997 한국응급구조학회지 Vol.1 No.1

The purpose of this study was to identify the change of perceptions related to E.M.T. profession of E.M.T. student and to provide the basic data for development of curriculum. The subjects of the survey were 216 students from 3 junior college by questionnaire from November 25 to November 29. 1996 in Kwang-Ju, Cheong-Ju, and Kong-Ju. The results were analyzed using the SAS and can be summarized as follows : 1. The view on profession was a statistically significant difference inspecial knowledge & skill training (t=-1.686, P<.001), high income (t=-0.753, p<.05) 2. The view on competence as a E.M.T. was a statistically significant difference in sufficient professional knowledge on the E.MT (t=-1.144. p<.001).own s health (t=-0 808, P<.001), sincerity and responsibility (t=-1.429. p<.01), satisfaction and effort (t=-1.335, p<.01) , boundary of affairs (t=-1.356, p<.01) 3. The view on E.M.T. profession was a statistically significant difference inprotect of pt. life & to relieve the pain (t=-2.388, p<.001) 4. The view on necessary knowledge of E.M.T. was a statistically significant difference in patient assessment (t=-2.168, p<.001), ACLS (t=1.678, p<.001), hemorrhage & shock (t=-3.252, p<.001), trauma (t=-4.284, p<001), cardiopulmonary disturbance (t=-2.897, p<.001), acute abdomen(t=-4.284, p<.001), neonatal disease(t=-4.032, p<.001), OBGY disease(t=-4.151, p<.001), emergency delivery (t=-2.825, p<.001), infectious disease (t=-2.930, p<.01), environmental emergency (t=-3.123, p<.05), recording(t=2.22, p<.05) 5. The view on ideology of E.M.T was a statistically significant difference in belief & faith (t=-2.344, p<.001), knowing of own (t=-2.142, P<.01) humanity (t=-2.581, p<.05), knowing of patient (t=-2.079, p<.05)