제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

가변 비트율을 통한 적응형 스트리밍 서비스 시스템의 설계

양명섭, 김기원, 박승배 초당대학교 초고속정보화센터 2001 초고속정보화센터논문집 Vol.2 No.-

최근 VOD(Video On Demand)나 AOD(Audio On Demand) 서비스가 급증하면서 멀티미디어 스트리밍 기술에 대한 관심이 커지고 있다. 기존의 스트리밍 서비스는 정적으로 멀티미디어를 전송하므로 네트워크 환경의 대역폭(bandwidth) 변화에 대처하는데 한계가 있다. 이러한 문제점을 해결하기 위하여 본 논문에서는 적응형 스트리밍 서비스(ASS; Adaptive Streaming Service) 시스템을 제안한다. ASS 시스템은 가변 비트율을 통한 미디어 스케일링방식을 이용하여 멀티미디어 데이터를 동적으로 전송한다. 기존의 스트리밍 서비스의 버퍼링 방식의 단점을 해결하기 위하여 본 논문에서는 프레임 조정방식과 화질 조정방식을 동시에 채택하여 적용함으로써 고화질이 보장되는 전송환경(비디오의 프레임 정보는 단위 시간당 프레임 수 3단계, 화질 5단계)과 느린 회선에서도 끊김없이 안정적인 스트리밍 서비스를 제공받을 수 있도록 한다. ASS시스템을 실제 네트워크 환경에서 사용하면 멀티미디어 전송시 대역폭 변화에 대처하는 한계를 극복할 수 있으며, 보다 안정된 스트리밍 서비스를 제공받을 수 있을 것이다. As the service of VOD(Video On Demand) and AOD(Audio On Demand) increases, the need for multimedia streaming technique is on the increase. Because of static transmission of existing multimedia streaming service, it is difficult to deal with variation of bandwidth. Thus we propose a ASS(Adaptive Streaming Service) system in order to provide more efficient multimedia streaming service. Because ASS system use the method of media streaming using variable bit rate, ASS system is possible to dynamic transmission. As the ASS system accept both control method of frame and control method of quality, ASS system is possible to provide stable streaming service without cutting at slow line and to provide high quality at transmission environment(video frame : step 3, quality : step 5 frame per hour). If we implement ASS system on network, then we'll solve the problems about variation of bandwidth and it'll be provide us stable streaming service.

광선각화증, 각화극세포종과 Bowen's병에서 p53과 p21의 표출 양상

조명구,조현득,양승하,김의한 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background The function of the p53 protein was known to regulate cell proliferation by inhibiting cells entering Sphase. So DNA damaged cell proliferation was inhibited by apoptosis. P21 is a cyclin dependent kinase inhibitor induced by wild type p53, not mutant p53. Thus p21 is thought go mediate the signal of p53 induced by DNA damaged agents to arrest the cell cycle in G1 phase. p53 and p21 were expressed in many malignant tumors, and its role in oncogenesis, tumor progression and prognosis were important. The authors analyzed immunohistochemical expression of mutant p53 and p21 protein in some skin tumors. Method Thirteen cases of actinic keratosis, 7 cases of keratoacanthoma and 8 cases of Bowen's disease were immunohistochemically stained with p53 and p21 monoclonal antibodies. Results; 1. In cases of positive p53 protein and negative p21 protein, the expressed p53 protein was suggested as mutant form. 2. Positive expression of p53 protein and p21 protein in prickle cell layer of actinic keratosis and Bowen's disease was suggesded that the composing cells of prickle cell layer were transformed into the proliferated cell. The p21 protein expression was suggested to be induced by the p53 independent pathway. 3. Negative expression of p53 protein and p21 protein in prickle cell layer of keratoacanthoma was suggested that the composing cells of prickle cell layer were completely mature cells, so the keratoacanthoma had good prognosis.

알코올의 섭취가 흰쥐의 혈액과 간의 지질대사에 미치는 영향

이명숙,김영연,김효숙,김매하,전진순,서진숙,송선미,양영재,윤원손,이미라,이효영,정승현 誠信女子大學校 生活文化硏究所 2004 生活文化硏究 Vol.18 No.-

To investigate the effects of ethanol on the lipid metabolism in blood and liver, twenty one male Sprague Dawley rats had orally taken the 25% alcohol and 50% alcohol by 5g per Kg of weight during 3 weeks after the adjusting period. For the energy balance, 85% sucrose and 45% sucrose was added in control group and 25% alcohol group each. The weight was reduced by alcohol treatment according to the levels, otherwise the weight of liver and heart was little increased in alcohol groups rather than in control without significance. Moreover, RBC, WBC, hemoglobin and hematocrit were increased by alcohol treatment according to the levels without significance. Otherwise, adjusted bilirubin levels by 100g of weight was significantly increased by alcohol treatment dose dependently. Alcohol induced RBC degradation and increased circulated bilirubin because of liver damage. For blood lipid profiles, blood cholesterol was increased in 50% of alcohol group compared to that of 25% and control groups, otherwise, blood triglycerides (TG) was increased by 30% in 25% alcohol groups rather than in control but not significantly different. The hepatic lipid composition, cholesterol levels in alcohol treatment groups was lower than those in control. The hepatic TG was not influenced by alcohol treatment. The two reasons of decreasing hepatic lipids were suggested by 85% sucrose of control for energy balance more synthesized cholesterol and TG than those in 25 or 50% alcohol groups, and by cholesterol and TG could not be synthesized because of liver damage from alcohol.

한국인 당뇨병 및 비당뇨병 환자에서의 뇌혈관 질환 유무에 따른 PAI-1 촉진자 유전자형과 인슐린저항성에 관한 연구

오승준,김영설,박철영,김덕윤,김성운,양인명,김진우,최영길,팽정령,정경천 대한비만학회 2000 The Korean journal of obesity Vol.9 No.2

연구배경 : 혈전현상을 특징으로 하는 질환에서는 Plasminogen activator inhibitor-1 (PAI-1) 이 높은 활성도를 보이는데, PAI-1 치는 당뇨병, 심근경색증, 비만 등에서 높다고 밝혀진 바 있다. 또한 당뇨병 환자들의 합병증의 주요한 병인은 죽상경화증으로 혈전현상이 특징인 질환에서 증가하는 PAI-1이 당뇨병 환자에서 높다. 목적 : 정상인에서의 PAI-1 유전자 촉진자의 유전자형의 분포 및 혈액농도를 관찰하고, 당뇨병 및 뇌혈관 질환 환자군에서의 PAI-1 유전자 촉진자 유전자형의 분포 및 혈액농도를 측정하여 정상인과 차이점을 알아본다. 당뇨병 환자군에서의 혈장 PAI-1 치와 인슐린 저항성, 전구 인슐린 등과의 상관관계를 살펴보고, 인슐린저항성과 대혈관질환의 지표로 사용될 수 있는지 알아보았다. 방법 : 대상으로는 정상인 76명, 제2형 당뇨병 환자 56명, 뇌혈관질환이 동반된 제2형 당뇨병 환자 48명, 뇌혈관질환 환자 51명을 선택하여, 환자의 혈액에서 인슐린, 공복시 혈당, 전구인슐린, 중성지방, 총콜레스테롤 및 기타 생화학 검사 및 이학적 검사를 시행하였다. 환자의 DNA를 채취하여 전사개시 -675bp를 포함하는 대립형질 특이 시발체를 사용하여 중합효소 연쇄 반응을 실시하여, 그 유전자형을 판독하였다. 결과 : 정상 대조군 76명 (46.4±11.1세), 2형 당뇨병 환자 56명 (58.3±12.6세), 뇌경색증 환자 51명 (63.1±13.2세) 대상으로 하였다. PAI-1 촉진자 유전자형의 (4G/4G, 4G/5G, 5G/5G)빈도는 정상 대조군이 각각 23.7%, 75.0%, 1.3%, 뇌경색 환자군이 19.6%, 66.7%, 13.7%, 뇌경색이 동반된 당뇨병 환자군이 33.3%, 58.3%, 8.3% 였다. (X2=12.6, p=0.05). 이러한 사실은 서구인에 비해 4G/4G, 5G/5G 동형 유전자형이 낮은 결과였다. 각 군별 혈장 PAI-1 농도는 정상 대조군 13.4, 1.8 ~ 65.2 ng/mL (중앙값 , 범위 ) 2형 당뇨병 환자군 14.4, 2.9 ~ 47.8 ng/mL, 뇌경색 환자군 21.9, 6.2 ~ 154.7 ng/mL , 뇌경색이 동반된 2형 당뇨병 환자군 28.8, 3.2 ~ 139.3 ng/mL 로 차이를 보였다 (p=0.000). 전체 대상에서 PAI-1 촉진자 부위의 유전자형에 따른 PAI-1 활성도와 항원 농도는 차이를 보이지 않았다. 그러나 PAI-1 활성도는 혈중 중성지방, 전구인슐린, 체질량지수와 독립적인 상관관계를 보였다 (p=0.000, p=0.000 and p=0.005). 결론 : 결론적으로 PAI-1 촉진자 부위의 유전자형은 뇌경색증의 지표는 아니며, PAI-1 활성도를 결정짓는 인자는 유전적 요인보다는 혈중 중성지방, 전구 인슐린, 체질량지수와 같은 대사적 요인으로 생각된다. Plasminogen activator inhibitor-1 (PAI-1) is known be related to insulin resistance and several components of the large vascular disease. Notably, the high frequencies of diseases such as coronary heart disease or stroke are related to type 2 diabetes complications. We studied to find out whether the PAI-1 promother genotype could be a marker for cerebral infarction in type 2 patients. Subject patients were; 56 type 2 diabetics (age 58.3±12.6), 51 patients with cerebral infarction (age 63.1±13.2), 48 type 2 diabetics with cerebral infarction (age 64.8±9.3) , and 76 healthy control (age 46.4±11.1). The 4G/5G genotype of PAI-1 promoter was evaluated by polymerase chain reaction and endonuclease digestion. PAI-1 promoter genotype frequency (4G/4G, 4G/5G, 5G/5G) was 23.7%, 75.0% and 1.3% in healthy control, 17.9%, 67.9% and 14.3% in type 2 diabetes patients, 19.6%, 66.7% and 13.7% in cerebral infarction patients, 33.3%, 58.3% and 8.3% in type 2 diabetics with cerebral infarction (X^2=12.6, p=0.05). This finding is lower in frequency of 5G/5G homozygote than that reported in Caucasians. The plasma PAI-1 concentrations according to the disease were 13.4, 1.8 ~ 65.2 ng/mL (median, range) for healthy control, 14.4, 2.9 ~ 47.8 ng/mL for type 2 diabetes, 21.9 6.2 ~ 154.7 ng/mL for cerebral infarction , and 28.8, 3.2 ~ 139.3 ng/mL, for cerebral infarction with type 2 diabetes (p=0.000). In the all subjects, PAI-1 concentration and activity of PAI-1 promoter genotype did not show any significant difference. However, the PAI-1 activity was independently associated with serum triglyceride level, plasma proinsulin and BMI (p=0.000, p=0.000 and p=0.005 respectively). We concluded that PAI-1 genotype is not a marker for the cerebral infarction ; however, the genotype is related to PAI-1 concentration , and therefore it seems to be that metabolic factors such as triglyceride level or plasma proinsulin or BMI are more in relations with determining the PAI-1 concentration than the genotype.

여가활동 유형과 여가만족 및 생활만족의 관계

김승곤,양명환 濟州大學敎 體育科學硏究所 1995 체육과학연구 Vol.1 No.-

The purpose of this study was to determine the relationship of leisure activity types, leisure satisfaction and life satisfaction among college students. Specifically, two purposes were established for this study. The first purpose was to examine the effects of gender, age and types of leisure activity on leisure satisfaction and life satisfaction. The second purpose was to examine a casual relationship among types of leisure activity, leisure satisfaction, and life satisfaction. The subjects in this study were 115 male and 109 female college students. A purposive sampling method was used to select subjects who participated in three leisure activities including sport & exercise program(n=70,31.3%), hobby & creative activity(n=68, 30.4%),and amusement activity(n=86, 38.4%). Data were collected from all subjects during the fall of 1995. The Leisure Satisfaction Scale(Ragheb & Beard, 1980)was used to provide a measure of the extent to which individuals perceive that certain needs are met or satisfied through leisure activities. Life satisfaction was assessed by using a semantic differential technique. A 5 point Likert response scale was adopted for the instruments. One-way MANOVA, ANOVA and multiple regression analyses were used for research problems testing. MANOVAs indicated that gender, age, and leisure activity type had a significant effects on leisure satisfaction. Posttesting showed that male group perceived significantly higher in leisure satisfaction(psychological, educational, social, relaxational physio1ogical)than female group. The higher the age, the greater the leisure satisfaction(psychologica1, educational, social, relaxational physiological), and sport activity group perceived more leisure satisfaction (psychological, educational, social, relaxational, physiological, physical environment)than did the hobby & creative activity group and amusement group. ANOVA indicated that gender, age, leisure activity types had a significantly effects on life satisfaction. The male group perceived significantly higher in life satisfaction than female group. Scheffe multipe comparison indiacted that the higher the age, the greater the life satisfaction, and sport activity group perceived more life satisfaction than did the hobby & creative activity group and amusement group. Also multiple regression analysis and path analysis revealed that life satisfaction could be the best predicted from leisure satisfaction and could be affected through the sport activity indirectly. The findings provide significant casual relationships among leisure activity type, leisure satisfaction and life satisfaction in college students.

족근골에 발생한 고립성 골낭종 : 증례 보고 Case Report

문명상,이규성,양승욱,심규형 최신의학사 1986 最新醫學 Vol.29 No.4

샤피충격시험기를 이용한 PVC/MBS 재료의 파괴인성치에 관한연구

박명균,양진승,최영식 명지대학교 산업기술연구소 2001 産業技術硏究所論文集 Vol.20 No.-

The notched charpy and Izod impact test is the most prevalent technique used to characterize the effect of high impulse loads on ploymeric materials. A method of analysis in rubber toughened PVC is suggested to evaluate the critical strain energy release rate Gc from the Charpy and Izod impact energy measurement. Instrumented Charpy impact tester was used to extract ancilliary information concerning fracture properties in addition to total fracture properties and maximum critical load. The stress intensity factor Kd was calculated for the variation of rubber contents from the obtained maximum critical load and toughned effects were investigated.

전화망 음성인식 시스템

김기원, 양명섭, 박승배 초당대학교 초고속정보화센터 2001 초고속정보화센터논문집 Vol.2 No.-

본 논문에서는 전화선을 통해 사랑이 발성한 음성을 저장, 학습하여 사용자가 다시 그 내용을 발성할 경우 자동적으로 이를 인식하는 시스템을 설계, 구현한다. 본 논문에서 구현한 시스템은 신경 회로망과 동적 시간 정합법을 이용하는 하이브리드 형태의 시스템으로, 특징 파라미터로는 필터 뱅크 계수를 사용하였으며 필터 뱅크 계수의 차원수를 줄여 처리 속도를 빠르게 하기 위한 방안으로 자기 조직화 지도를 사용하였다. 또한 자기 조직화 지도에 대응하여 동작하는 상부 인식기로는 소규모 고립단어 인식에 적합한 동적 시간 정합법을 채택하였다. In this study, we design and implement the system which learn a speech registered by people through telephone network and recognize it automatically when a user repeats it. What we have done in this study is to make hybrid type system which uses a neural network and a dynamic time warping. We performed a summary end point detection by using Rabiner & Sambur method which was a corrected form, using only log energy, as end point detection of a speech. We used filler bank coefficient as a feature parameter and self organization feature map to make its proceeding fast by decreasing filter bank coefficient. We took a dynamic time warping which was proper for recognizing small isolated words as an upper recognition system which is against self organization feature map.

고양이 위 평활근에서 KCI에 의한 근수축에 대한 Protein Kinase의 조절

심상수,김승록,심혜선,이덕주,한상준,윤신희,조양혁,김명석 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3