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

DBD(Dielectric Barrier Discharges)에서 플라즈마 발생 해석

김종봉,신명수,김종호,김성영,이혜진 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

DBD(Dielectric Barrier Dischages) plasma is often used to clean the surface of semiconductor. The cleaning performance is affected mainly by plasma density and duration time. In this study, the plasma density is predicted by coupled simulation of flow, chemistry mixing and reaction, plasma, and electric field. 13.56 MHz of RF source is used to generate plasma. The effect of dielectric thickness, gap distance, and flow velocity on plasma density is investigated. It is shown that the plasma density increases as the dielectric thickness decreases and the gap distance increases.

다중 중합효소 연쇄반응을 이용한 소의 Johne병 진단 기법 확립

김종배,송혜원,김근희,김홍,신광순,김두 대한의생명과학회 2000 Journal of biomedical laboratory sciences Vol.6 No.1

반추수에서 발생하는 Johne병의 조기 진단 방법을 제시하고 이 질병의 원인체와 미생물학적 특징이 유사한 M. bovis, M. avium 등의 mycobacteria감염증을 감별 진단하는 방법을 개발하기 위하여 Mycobacterium 균속의 표준균주를 사용하여 중합효소 연쇄반응을 확립하였다. Johne병으로 의심되는 소의 혈액과 유즙을 채취하여 분리한 단핵구 및 거식세포로부터 genomic DNA를 추출하였다. 각 시료로부터 추출한 DNA를 template로 이용하여 Mycobacterium spp.에 특이적인 16S rDNA primer set를 이용한 PCR을 수행하여 시료내의 mycobacterial DNA 보유 여부를 확인하였다. 한편 mycobacteria 양성으로 확인된 시료는 M. avium complex 균종에 특이한 16S rDNA 염기서열을 기초로하여 제작한 primer set와 M. paratuberculosis 의 IS900 sequence에 특이한 primer set를 이용하여 duplex PCR을 수행하여 Johne병 원인체의 보균 여부를 조사하였으며, 이 결과를 oligonucleotide probe를 사용한 Southern blot hybridization을 통하여 다시 확인하였다. 이와 같은 duplex PCR 기법을 실제 축산 현장에서 수집한 유즙과 말초혈액으로부터 분리한 단핵구 및 거식세포 시료에 적용한 결과 본 연구에서 확립한 duplex PCR기법 유용성을 확인할 수 있었다. Diagnosis of Bovine Johne's Disease Using Multiplex Polymerase Chain Reactions In order to improve the early diagnosis of Johne's disease in ruminants, duplex polymerase chain reaction system for the detection of the etiologic agent of M. paratuberculosis and for the differentiation of other mycobacterial animal pathogens, such as M. bovis and M. avium, was applied. Genomic DNAs were purified from peripheral blood monocytes or milk macrophages and were used as templates in the duplex PCR. Detection of Mycobacterium spp. in the specimen was carried out by PCR using primer set specific to the mycobacterial 16S rDNA. And then, mycobacterial DNA-positive specimens were further differentiated with duplex PCR system which was composed of primer sets specific to 16S rDNA of M. avium complex and IS900 gene of M. paratuberculosis. The results were re-confirmed by Southern blot hybridization with oligonucleotide specific to the internal sequence of IS900 PCR amplicons. The applicability of this duplex PCR system was evaluated with DNAs extracted from clinical specimens of peripheral blood monocytes and milk macrophages. In summary, the duplex PCR amplification system described in this experiment is promising molecular technique for the early diagnosis of Johne's disease in ruminants.

페디그리 사료 섭취에 의한 급성신부전증의 치료 1례

김영실,신영지,박정희,김명철,신상태,조종기,김덕환 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

A 4 years old male poodle dog with gastro-intestinal distress was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. The patient was presented with history of vomiting, hemorrhagic diarrhea and inappetence. Laboratory evaluation revealed that WBC (23.8 x 10^(3)/㎕). BUN (87.9 ㎎/㎗), creatinine (7.3 ㎎/㎗) and phosphate (9.6 ㎎/㎗) was elevated, and proteinuria, hematuria and bilirubinuria were detected on urinalysis. Increased renal cortical echogenicity and parenchymal calcification of kidney were observed by ultrasonography. Based on the findings of history, clinical signs, laboratory assessment and ultrasonography, it was diagnosed as acute renal failure. The present patient showed favorable therapeutic response by fluid therapy. diuretics, peritoneal dialysis and blood transfusion.

소에서 盲腸擴張을 동반한 第4胃食滯 手術 1例

김명철,김덕환,신상태,임준호,김남중,김종만 충남대학교 수의과대학 동물의과학연구소 1998 動物醫科學硏究誌 Vol.6 No.-

Abomasal impaction with cecal dilatation was diagnosed in a 3 years old holstein cow. The clinical signs were loss of appetite, scant feces and moderate distension of the abdomen. Ping sound was revealed in the right 11th intercostal space by auscultation. Cecal dilatation and abomasal impaction were ascertained by right flank laparotomy and abdominal exploration, and intestinal content and gas were removed from the cecal apex incised. One day later, 2.5㎏ of sand was removed by ventral paramedian abomasotomy.

The Proposal of a Verbal Interaction Framework for Elementary Science Teachers

Kim,Jong-young(Jong-young Kim),Shin,Myeong-kyeong(Myeong-kyeong Shin),Kim,Eun-jeong(Eun-jeong Kim) 경인교육대학교 교육연구원 2022 교육논총 Vol.42 No.-

This study is purposed to specifically present and suggest two of the five aspects of the existing framework using data recorded by science class teachers. Mortimer and Scott (2003) viewed teaching purposes, content, communicative approach, patterns of discourse, and teacher intervention as five aspects of classroom discourse analysis, analyzed for secondary science classes. In this study, four episodes were extracted from elementary science classes, the entire analysis was conducted, and the analysis frame developed in this study was applied. The results of the study showed that elementary science classes were analyzed differently according to class flow and the score of the Reformed Teaching Observation Protocol (RTOP). In addition, the analysis framework presented in this study and the score of the RTOP were slightly consistent.

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.

만성 견비통에 대한 동씨침 치료의 무작위 대조군의 임상 연구

김찬영,권나현,신예지,남동우,김건형,김종인,최도영,이윤호,이재동 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 treatment in chronic shoulder pain patients. Methods : 36 voluntary patients were randomly assigned to an acupuncture treatment group(E GrouP, n=18) and a control group(C GrouP, n=18). The E Group patients received acupuncture treatment on LI_(15), TE_(14), GB_(21) and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for four weeks. The C Group patients received no treatment. All patients in both groups were instructed to practise self exercise in their daily lives. Evaluations were made at baseline and after four weeks of study. The Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's subjective pain was measured by Visual Analogue Scale(VAS). The obtained data was analyzed. Results '. The E Group showed significant(p<0.05) improvement in CSA, SPADI and VAS after four weeks of treatment. The C Group showed significant(p<0.05) improvement in CSA, but the change of SPADI and VAS was insignificant(P>0.05). CSA and SPADI of E Group significantly(p<0.05) improved compared to the C GrouP, but the difference of VAS change in the two groups was insignificant(p>0.05). Conclusions : Four weeks of acupuncture treatment significantly improved CSA, SPADI and VAS. The improvement of CSA and SPADI was significant(p<0.05) compared to untreated patients.

목형의 엔드 밀링시 절삭조건에 따른 가공 특성에 관한 연구

김성일,김종택,김민호,신형곤,김태영 한국공작기계학회 2006 한국공작기계학회 추계학술대회논문집 Vol.2006 No.-

The cutting tests of wood patterns are carried out using CNC milling machine. The cutting forces and surface characteristics of machined surface are investigated at various cutting conditions such as spindle speed, feed speed, cutting direction of wood pattern and wood material. In the CNC end-milling, the surface roughness increases as feed speed increases and decreases as spindle speed increases. However, the cutting force and surface roughness are different along the cutting direction and material of wood pattern.

Callus distraction method를 이용한 하악골 신장술 : 계단골절단술식의 적용

김명진,윤필영,신동준,김수경,김종원,김규식 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regeneracted bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1974 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.