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

定着村癩患者의 再發實態에 關한 調査硏究

金道一,高英勳,金潤元,李惠映,金學鵬,金起會 大韓癩學會 1982 癩學 會誌 Vol.15 No.1

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

신이식에서 이식신의 생존분석

오선미,김종학,황평주,구영선,강민규,나기량,김종섭,김성숙,이강욱,신영태,설종구,배진선,손기섭 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

To investigate the prognostic factors for the survival of transplanted kidney in patients with end-stage renal failure, 59 cases of renal transplantation from September 1986 to Feburary 1997 in Chungnam National University Hospital were analyzed retrospectively. The results were as follows: 1)The mean age of recipients was 33.8 years and that of doners was 38.9 years. The male to female ratio of recipients was 2.5:1, and that of donors was 1.03:1 2) Living related donore(LRD) were 79.6% and living non-related donors were 20.3%. The HLA-identical donors(ID) in LRD were 18.7% and HLA-haploidentical donors(HID) were 61.0%. In living non-related donors(LNRD), mean matched HLA-AB antigens were 1.56 and mean matched HLA-DR antigens were 0.56. 3) The average 5-year patient survival fate was 94%, and average 5-year graft survival rate was 70%. The 5-year graft survival fate of HLA-ID was 100%, and those HLA-HID and LNR were 70% and 36% respectively. 4) Total 33 episodes of acute rejection were found in 45.8% of transplanted patients. The number of acute rejection episode did not show significant difference between LRD and LNRD(P > 0.05). There was no significant difference in MLC between two groups(p > 0.05). 5) In comparison between the 18 patients who lost their graft function in 5 years and 17 patients who are maintaining graft function for more than 5 years, MLC was significantly lower in patients with functioning graft than of patients with non-functioning graft (p < 0.05). The number of rejection episode was also lower in patients with functioning graft than that of the patients with non-functioning graft(p < 0.05). However, there were no significant difference in recepient and donor age and history of pre-transplantation donor specific transfusion between two groups. With the results above, we can speculate that adequate donor selection according to good matched HLA typing and low MLC is very important for graft survival in renal transplantation. Prevention and treatment of acute rejection in renal transplantation is also na important factor for graft survival.

특발성 과호산구 증후군 환자의 치료 도중 발생한 간혈종 1례

이영태,김동기,박지훈,김윤정,김기향,박보민,권민정,김애란,이원식,주영돈,손창학 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Idiopathic hypereosinophilic syndrome is characterized by marked elevation of eosinophil count ( >1,500/㎣) in peripheral blood without explaining etiology. It shows tissue involvement in many organs such as liver, G-I tract, myocar dium, lung, skin, kidney and nerve. Some case of hypereosinophilic syndrome with hepatic involvement have been reported, but not much. We have recently experienced a case with idiopathic hypereosinophilic syndrome of a 40 year old man who presented with RUQ pain. By abdominal CT, ill- defined subcapsular hematoma was detected. Liver biopsy showed eosinophilic infiltration within the portal tract and sinusoid. Drain procedure and corticosteroid adminiiatbrought marked improvement of clinical manifestation, hematologic abnormality and radiologic abnormality.

임상교정 교육용 멀티미디어 데이터베이스 웹서버 구축에 관한 연구

박재우,이종기,장영일,남동석,김명기,양원식,김태우,백승학 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

본 연구는 인터넷상의 가상공간에 다양한 자료로 구성된 환자 증례를 통해, 교정을 배우고자 하는 임상의나 학생들의 교육에 필요한 멀티미디어 데이터베이스를 구축하기 위한 것이다. 이러한 시스템을 구현하기 위해서는 이미지 자료의 처리, computer network를 통한 빠른 정보처리 기능, 진단 분석법의 개발, 데이터베이스의 구축 기술, 데이터베이스와 인터넷과의 연계, 증례를 통한 교육방법론과 같은 기술적 문제점들이 있다. 진단과 치료계획을 위한 분석은 모델 분석과 두부방사선 사진분석으로 나누어 제공하였다. 모델분석법은 arch length discrepancy와 Bolton tooth ratio를 환자 정보란에 제공하였다. 두부방사선 사진분석은 초진란에 제공하였다. Cephalometric analysis ver 2.0과 Power Ceph pro 3.3.5를 이용하여 Tweed, Steiner, Jarabak분석법 등을 제공하였으나, 본문에서는 주로 Kim's analysis와 몇 가지 계측치를 추가하여 설명하였고, 나머지는 tracing란에서 제시하였다. 또한 치료 종료 후나 보정란에서 치료 전, 후의 두부방사선 사진을 중첩해서 보여줌으로써 치료에 의한 효과를 직접 볼 수 있도록 하였다. The Objective of this research was to construct the multimedia database system that was necessary for the education of the practitioners and the students. To establish this system, there were technical problems as follows : 1) The processing of the images, 2) The rapid processing of the information with the computer network, 3) The development of diagnosis tools, 4) The technique to establish the database system, 5) The link between the database system and the internet, and 6) The method to educate through many cases. The analysis for diagnosis and treatment planning were provided as two parts : model analysis and cephalometric analysis. As a model analysis, arch length discrepancy and Bolton tooth ratio were provided for the part of patient information. Cephalometric analyses were provided in the part of initial diagnosis. The Cephalometric analysis ver 2.0 and the PowerCeph pro 3.3.5 were used to show Tweed, Steiner and Jarabak analysis. In the main part, Kim's analysis and some measurements were added. In the post-treatment or retention part, we show the superimposition of the cephalometrics with which you can find the effectiveness of the various orthodontic treatment. The address of this home page is "http://damis.snu.ac.kr/orthodontics"

대학교 신입생의 특성에 관한 실태조사(Ⅱ) : 1995학년도 조선대학교 신입생을 대상으로 1995 chosun University Entrants

조용래,박상학,김상훈,표경식,김학렬,김양옥,김기순,박종 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.

産地別 Oriental백합 種球의 生育特性 및 切花品質比較

김학기 강릉대학교동해안지역연구소 1999 東海岸硏究 Vol.10 No.1

Oriental 계통 백합의 종구수입 대체의 수출 경쟁력 제고를 위해 국내에서 생산력 구근의 종구로서의 활력을 검토코자 평난지의 고랭지에서 생산된 종구를 화란산과 비교 시험한 결과는 다음과 같다. 1. 강릉, 양구의 고랭지산 종구는 구중이 다소 적지만 화란산 이상이나 버금가는 생육상을 보였으나 남부산은 출아에서부터 개화까지 전반적인 활력이 다수 부진 했다. 2. Casablanca, Marco Polo 양품종 공히 양액재배에서 생육이 촉진되어 초장이 길었으나 화수등 다른 요소에는 차이가 없었다. 3. Casablanca의 경우 국내산 종구는 초장 엽장, 엽폭, 엽수등 모든 요소의 생육이 화란산에 비슷하거나 상회하는 생육을 보였다. 4. Marco Polo에서는 화란산이 양액재배, 토양재배를 막론하고 모든 요소의 생육이 국내산에 비해 우세하였으나 그것은 공시 종구중이 상대적으로 컷기 때문인 것으로 사료된다. 5. 경경(莖徑)은 대체로 0.9∼1.0Cm로 비슷하였고 경도 차이도 산지별, 품종별로 차이를 볼 수 없었다. 6. virus 이병율은 강릉과 양구의 고랭지산이 2~6% 정도로 낮았으나 남부산이 5.5∼15.6%까지 다소 높았으나 이는 화란산보다 오히려 낮은 수치를 보였다. 이상의 결과로 국내 백합 종구는 화란산 종구에 비해 거의 손색이 없으며 특히 고랭지 산이 다소 활력이 높았다. To evaluate potentials for seed bulb import substitution and improvement of export competition of Lilium Oriental Hybrieds, bulbs produced from low and high land (alpine) area in Korea were compared with those from the Netherlands. The results were as following. 1. Qualities of seed bulbs produced from high lands such as Kangnung and Yanggu areas were almost same as those of bulbs from the Netherlands, but bulbs from the south area of Korea seemed to be undesirable from bulb sprouting to flowering. 2. Growth of Casablanca and Marco Polo cultivars in hydroponics was improved to be higher plant height, but there were no differences in flower numbers and other characters. 3. In case of Casablanca, bulbs produced from the domestic area showed more excellent growth in plant height, leaf length and leaf number than bulbs from the Netherlands. 4. In case of Marco Polo, bulbs from the Netherlands in hydroponic and soil culture were better than bulbs from domestic production, but these results seemed to be related with bulbs weight of which was heavier at planting time, compared with bulbs from the domestic. 5. Stem diameter(0.9-1.0cm) in both cultivars and production area was almost the same in both cultivation and production area. Stem hardness showed the same results shown in stem diameter. 6. Virus infection rate of bulbs from Kangnung and Yanggu was 2-6% and that of bulbs from the south area of Korea was 5.5%-18.8%. however these rate was much lower than that of bulbs from the Netherlands. As a results, the bulbs produced from high lands especially such as Kangnung and Yanggu in Korea area were considered to be highly valuable as seed bulbs, compared to bulbs from the Netherlands.

저항성 운동이 비만 여고생의 혈청지질과 면역반응에 미치는 영향

김기봉,이재학,이정아 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

The purpose of this study was to analyze the effects of resistance training on serum lipids and Imumunity Response in obese high school girls participated in resistance training for 12 weeks. The conclusions are as follows ; 1. Total cholesterol, triglyceride, and low-density lipoprotein cholesterol were significantly decreased, but high-density lipoprotein cholesterol was significantly increased in the changes of serum lipids factors. 2. T-cell, helper T-cell and natural killer cell were significantly increased, but B-cell and helper T cell/suppressor T cell ratio were decreased but suppressor T cell was increased. In conclusions, resistance training may be very effective to decrease the obesity and geriatric diseases by changing the serum lipids factors and immunity responses.