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      • KCI등재후보

        일개 보건소 당뇨교실 이용 환자의 참가율이 혈당변화에 미치는 영향

        황영숙(Hwang YS),감신(Kam S),박기수(Park KS) 한국농촌의학 지역보건학회 2008 농촌의학·지역보건 Vol.33 No.1

        본 연구는 일개 보건소에서 실시하고 있는 당뇨교실에 대하여 참가율과 건강실천행위정도, 참가율과 혈당조절정도와의 관련성에 대하여 연구한 것이다. 연구대상자는 2005년 1월부터 시작하여 2006년 3월까지 월 1회 실시하는 보건소 당뇨교실에 참가자들을 대상으로 실시하였다. 연구 결과 당뇨교실의 이용정도에서 당뇨병환자 참가자의 67.3%가 50%이상 참가하였다. 당뇨교실 전후 무작위 혈당의 변화량은 176mg/dl에서 156mg/dl으로 유의하게 감소하였으며, 당뇨교실을 50%이상 이용한 군과 미만으로 이용한 군사이에 있어서 혈당의 변화는 50%미만으로 이용한 군에서는 182mg/dl에서 155mg/dl로, 50%이상 이용한 군에서는 172mg/dl에서 156mg/dl으로 감소 하였으나 군사이에 유의한 차이는 없었다. 이상의 결과 보건소 당뇨교실 최초 등록 시 혈당과 마지막 측정 혈당의 변화량은 176mg/dl에서 156mg/dl으로 유의하게 감소하였는데, 당뇨병 관리가 제대로 되지 않고 있는 현실을 감안할 때 보건소 당뇨교실이 효과가 있는 것으로 생각되어 활성화 하여야 할 것으로 생각된다. Objectives: Recently the care of cerebrovascular and cardiovascular disease is important as much as that of cancer care in public health, so the control of diabetes mellitus(DM) which is a risk factor of cerebrovascular and cardiovascular disease has been also important consideration. This study was carried out to investigate the blood glucose change of the participants in diabetes mellitus class(DM class) of a health center. Methods: Study subjects were 54 participants of DM class in a health center that had been held once a month, from January 2005 to March 2006. Results: Among the DM class participants, 67.3% participated by 50% or over in the DM class. After DM class, the level of random blood sugar decreased from 176mg/dl to 156mg/dl in DM class participants(p<0.05). In a comparison between more than 50% participation group and less than 50% participation group, more than 50% participation group got decreased level of blood sugar from 182mg/dl to 155mg/dl and less than 50% participation group also got decreased level from 172mg/dl to 156mg/dl. But there was no statistically significant difference between two groups. Conclusion: DM class of health center was effective program to manage diabetes mellitus patients in community.

      • KCI등재

        The Overexpression of Insulin-siRNA and Insulin Degrading Enzyme Decreases Insulin Levels In vitro and In vivo

        DY Hwang,JH oh,YK Kim,SB Shim,SW Jee,SH Lee,SJ Seo,YS Song,KT Nam,JY Cho,Jane Hwang,IS Jang,JS Cho 한국실험동물학회 2005 Laboratory Animal Research Vol.21 No.2

        Type 2 or noninsulin-dependent diabetes mellitus accounts for over 90% of cases and is characterized by a triad of resistance to insulin action on glucose uptake in peripheral tissues, impaired insulin action to inhibit hepatic glucose production, and dysregulated insulin secretion. To determine whether a transgene-based small interfering RNA (siRNA) for insulin and an overexpression of human insulin degrading enzyme (hIDE) decrease the insulin level in vitro and in vivo or not, several siRNA sequences and hIDE gene for insulin were overexpressed in the insulinoma cells and mouse via tail vein. The siRNAs for insulin suppression were very effective at the regions of 88-99 bp and 109-131 bp in rat insulin sequence. Insulin suppression by the specific siRNA sequences and hIDE significantly induced endoplasmic reticulumn (ER) stress and decreased insulin receptor a expression in insulinoma cells. The insulin level in plasma significantly decreased by overexpressions of the siRNAs and hIDE gene in mouse, which may be caused by the degradation of insulin due to overexpression of hIDE protein in mouse liver. These results suggest that this plasmid for the suppression of insulin secretion by the specific siRNAs and the insulin degradation by an overexpression of hIDE protein may be useful on the development of animal model for Type 2 diabetes.

      • KCI등재

        난치성 대량복수를 가진 진행된 난소상피암에서 복강내 Alpha-Interferon 치료경험 1 례

        황인택,양윤석,김선근,이관구 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.12

        저자들은 난치성 대량복수를 가진 말기난소암 환자에게 복강내 alpha-interferon 치료 후 난소암 자체에는 큰 효과는 보지 못했으나 복수조절에 탁월한 효과를 보았기에 간단한 문헌고찰과 함께 보고하는 바이다. Alpha interferon has inhibited the growth of ovarian ascitic tumor cells in colonogic assay in vitro, although cells isolated from solid ovarian tumors are often less susceptible. We administrated intraperitonial interferon-alpha to ascitic advanced epitherial cancer with pervious cytoreductive surgery and cytotoxic chemotheraphy. The usual single dosage was 3900*10^6 unit at weekly intervals from six times and 3000*10^6 units at later two times. We noted no objective solid tumor responce(CA-125, Cytology follow up), however, ascites nearly completely disappeared ; toxicity was represented by fever in majority, by hematologic complication(leucopenia and anemia), by puncture site reddness, and repoted with a brief review of literature.

      • Practical measurement of estimated blood loss in gynecologic surgery

        ( Ia Hwang ),( Yh Lee ),( Go Chong ),( Dg Hong ),( Yl Cho ),( Is Park ),( Ys Lee ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

        This study was designed to find practical measurement to estimate blood loss in gynecologic surgery We analysis 24 patients who underwent total vaginal hysterectomy without irrigation from January 2012 to June 2012. Real blood loss was measured, calculating the weight of suction fluid and gauzes. The relation between real blood loss and other factors which were considered to show the amount of blood loss indirectly was analyzed using statistic program. The factors were measured one day before surgery and postoperative one day. Using the factors which showed statistical significance (p<0.05), regression equation to calculate blood loss was made. Among all factors (age, weight, height, BMI, BSA, Hb change, WBC change, hematocrit change, CRP change, ESR change, potassium change), age (p=0.023), height (p=0.049), Hb change (p=0.36) and square root of WBC (p=0.024) showed statistical significance. Using multiple linear regression, regression equation was made. EBL= -2343 + (-35.8)X( age, year) + (8.6)X(height ,cm ) + (115.4 X Hb change, g/dL) + (414.8 X SQRT (WBC)). The regression equation showed p=0.05. Gynecologists should estimate real blood loss with objective methods before reporting surgical outcomes and the safety and efficiency of surgical technique. Until now there is no simple and practical measurement to estimate real blood loss. The suggested regression equation have not sufficient statistical significance, but the equation will be modified to be more accurate with more data in the future.

      • Postoperative drainage culture after laparoscopic incidental appendectomy in gynecologic diseases

        ( Bjh Hwang ),( Yh Lee ),( Go Chong ),( Dg Hong ),( Ys Lee ),( Is Park ),( Yl Cho ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

        This study analyzed the drainage culture after laparoscopic incidental appendectomy in gynecologic diseases. We evaluated 477 patients who underwent laparoscopic surgery with appendectomy ( 242) and without (235) from February 2011 to June 2012. Postoperative one day drainage fluid was cultured in all patients . All data were compared by two sample t-test and Pearson`s comparison test . Bacteria grew in 98 (20.7%)patients among all patients, respectively 53(21.9%) patients in appendectomy group and 45 ( 19.1%) patients in the other group. 14 geni and 26species bacteria grew in drainage(Achromobacter, Acinetobacter, Chryseobacterium, Citrobacter, Enterobacter, Enterococcus, Escherichia, Hafnia, Streptococcus, Klebsiella, Proteus, Pseudomonas, Staphylococcous, Stenotrophomonas). The commensal organisms of human intestine ( Enterococcus n=35, Enterobacter n=12, Pseudomonas n=20 ) were most common. There were no difference in the incidence of bacteria cultured in two groups(p=0.45). But the postoperative change of WBC ( p<0.01), ANC( p<0.01), CRP ( p<0.01), fever( p=0.01), operation time(p=0.01), hospital stay( p<0.01) and postoperative complication ( p=0.04) in appendectomy were higher than those of the other group Surgical and laboratory results were worse in appendectomy group. But these outcome was not related the intraabdominal bacterial infection after incidental appendectomy. These results might be related with the nature and radicality of operation.

      • SCIESCOPUSKCI등재
      • KCI등재

        Subrenal Capsule Tumor Implant Assay의 판단기준으로서의 조직 병리학적소견에 관한 연구

        장윤석,황태영 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.6

        1987년 1월부터 1988년 10월까지 서울대학교병원 산부인과에서 입원치료를 받은 부인과 악성종양 환자중 자궁경부암 46례, 난소암 8례, 자궁내막암 6례, 육종2례, 융모상피암 1례를 대상으로 신피막하종양 이식분석법을 시행하고 생쥐의 신장의 조직병리학적변화를 PAPAN score를 이용하여 관찰하여 다음과 같은 결과를 얻었다. 1. SRCA에서의 항암제독성은 단일화학요법에서 비교적 적은 독성을 나타내었으며, epirubicin과 cisplatin 및 5-FU과 cisplatin복합화학요법의 경우는 중증도의 독성을 보인 반면 CAP 및 VAC의 복합화학요법의 경우는 심한 독성을 보였다. 2. 신피막하 종양이식분석법의 분석가능율은 94%(59/63)이었으며, 각종 항암제에 대한 감수성을 보면, 자궁경부암에서는 epirubicin과 cisplatin의 복합화학요법에서 85%(27/32)로 제일 높았고, 난소암에서는 CAP복합화학요법에 80%(8/10)의 감수성을 자궁내막암의 경우에는 5-FU 및 epirubicin에 각각 100%의 감수성을 보였다. 3. 생쥐의 조직병리학적 점수인 PAPAN score는 항암제에 대한 감수성과 반비례함을 확인할 수 있었다. 이상의 결과로 미루어 향 후 생쥐종양이식편의 조직병리학적 점수인 PAPAN score를 부인과 악성종양에 대한 생체내화학감수성 검사인 SRCA의 판단기준으로 사용함으로써 SRCA의 신뢰도를 높일 수 있을 것으로 사료된다. The chemosensitivity testing is important in the research of cancer biology, development and screening of anticancer drug, and improvement of chemotherapy modalities. Subrenal capsule tumor implant assay (SRCA) is a promising rapid method in the selection of individual chemotherapy for cancer patients clinical. A total of 63 SRCA were performed with gynecologic malignancies. Fresh human gynecologic tumors of 1mm x 1mm x 1mm fragments were implanted under the renal capsule of immunocomponent female adult balb-c mice and tested against several chemotherapeutic agents or their combination. After chemotherapy, the implanted tumor under the renal capsule showed various histopathologic changes. They were regression of cancer, reduction in the number of cancer cell, tumor stroma, mitoses, and increase in tumor necrosis. These histopathologic changes were defined as PAPAN score. The toxicity of chemotherapeutic agents was minimal in single agent chemotherapy, but combination chemotherapy (CAP, VAC) induced moderate toxicities. The evaluability of SRCA was 94 % and EP combination chemotherapy was the most sensitive to cervical carcinoma (85 %) in ovarian cancer, CAP combination chemotherapy showed 88 % chemosensitivity. And they showed to reflect the different response of each tumor as well as the heterogeneity of cell population comprising each tumor against the chemotherapeutic agents. The PAPAN score was inversely proportional to chemotherapeutic responsiveness in gynecologic malignancies. Finally this study showed that the histopathologic changes (PAPAN score) that occurred in the implanted tumor under the renal capsule can be used as a parameter of SRCA in future.

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