남부 평야지 자운영재배답에서 논유형과 질소수준이 벼 생육 및 토양 화학성에 미치는 영향

윤봉기,김병호,이인,최형국,박인진,김용웅 한국국제농업개발학회 2003 韓國國際農業開發學會誌 Vol.15 No.3

녹비작물로서 자운영을 재배한 논에 벼를 재배할 때 질소비료의 절감기준을 구명하고자 평야지인 전남 나주의 보통답과 사질답에서 관행, 자운영+질소 70%, 자운영+질소 50%, 자운영+질소 30%, 자운영+무질소의 5처리로 1999년부터 2001년까지 3년동안 시험한 결과는 다음과 같다. 1. 자운영의 개화성기 생육은 초장 43.6~43.9㎝, 생초중 21.79~24.99Mg ha^(-1)이였으며 무기성분 함량은 T-N 2.40~2.64%, P₂O_(5) 0.42~0.46%, K₂O 1.83~2.01%였다. 자운영의 생육은 보통답이 사질답에 비하여 생초중이 많았고 T-N, T-C, P₂O_(5), CaO, MgO의 함량도 높았다. 2. 토양중 NH₄-N함량의 경시적 변화는 이앙후 7일에 20.7~47.4㎎ kg^(-1)으로 점차 감소하였는데 처리에 따라서는 자운영+질소 70%, 자운영+질소 50% 시용구에서 높았다. 3. 벼의 생육은 사질답이 보통답에 비하여 초장 및 간장이 크고 ㎡당경수가 많았고 처리에 따라서는 자운영+질소 50%, 자운영+질소 30%시용구에서 생육이 좋았다. 식물체중의 T-N, P₂O_(5), K₂O함량도 자운영+질소 70%, 자운영+질소 50%시용구에서 많은 편이었다. 4. 시험후 토양의 화학성은 관행에 비하여 보통답의 자운영 시용구에서 OM, CEC, Ava, P₂O_(5)함량이 증가하였고 사질답에서는 CEC가 증가하였다. 5. 벼의 수량은 관행(보통답 5.15Mg ha^(-1), 사질답 5.16Mg ha^(-1))에 비하여 보통답에서는 자운영+질소 70%, 50%, 30%시용구에서 각각 3, 6, 4% 증수되었고, 사질답에서는 자운영+질소 70%, 50%시용구에서 각각 3, 5%증수되었다. 6. 남부 평야지에서 자운영을 재배하여 생초 20Mg ha^(-1)를 녹비로 투입하면 벼를 재배시 질수시용 적정량을 보통답에서는 관행시비량의 30%, 사질답에서는 관행시비량의 50%이였다. This study was conducted to find out an amount of N fertilizer for rice culture followed after milk vetch(MV) cultivated at normal and sandy paddy field in Naju which lies to southern plain region from 1999 to 2001. The amounts of N fertilizer were 110(normal paddy) and 130(sandy paddy)㎏ ha^(-1) at control and 0, 30, 50, 70% of control. At flowering stage of MV, Plant height was 43.6~43.9㎝ and fresh weight was more than that of sandy paddy field. Also, the contents of T-N, T-C, P₂O_(5), CaO, MgO in MV plant cultivated normal paddy field were higher than those of sandy paddy field. Content of NH₄-N in soil was 20.7~47.4㎎ ㎏^(-1) at 7days after transplanting and 6.1~8.1㎎ ㎏^(-1) at 70days after transplanting of rice plant. Content of NH₄-N in soil was high at the treatments of MV+N50% and MV+N70%. Rice plant height, culm length and the number of tiller per ㎡ in sandy paddy field were higher than those of normal paddy field. Growth of rice plant in MV+N70% and MV+N50% was higher than that in others. And the content of T-N, P₂O_(5) and K₂O of rice plant in MV+N70% and MV+N50% were higher than those in others. Chemical properties of soil after experiment were pH 5.1~5.9, OM 15.6~20.9g ㎏^(-1). CEC 10.1~13.8cmol ㎏^(-1) and Ava. P₂O_(5) 152~244㎎ ㎏^(-1). The contents of OM. CEC and Ava. P₂O_(5) in soil applied MV at normal paddy field were higher than those of the control, and the content of CEC in soil applied MV at flowering stage, rice yields of MV+N70%, 50%, MV+N30% were increased 3, 6, 4% more than that of control (5.15Mg ha^(-1)) at normal paddy field. Rice yields of MV+N70%, MV+N50% were increased 3, 5% higher than that of control(5.16Mg ha^(-1)) at sandy paddy field. Nitrogen application rate of normal paddy field was 30%, and sandy paddy field was 50% of conventional fertilization rate when 20Mg ha^(-1) MV cultivated paddy field was inputed for rice culture in the southern plains.

제2형 당뇨병 환자에서 Voglibose와 Acarbose의 비교임상연구

정인경,정재훈,민용기,이명식,이문규,김광원,정윤이,박중열,홍성관,이기업 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:아카보스와 보글리보스는 ­glucosidase inhibitors로써 비록 약리학적 작용이나 부작용에 있어서 두 약물간에 차이가 있다는 것은 잘 알려져 있으나 당뇨병 환자를 대상으로 아직 이에 대한 두 약물간에 직접적인 비교에 대해 연구된 바는 없었다. 이에 저자등은 국내 2형 당뇨병 환자에 대해 유효성과 부작용 발현에 대해 두 약제를 비교하고자 무작위법에 의한 위약 대조군의 이중 맹검법 연구를 시행하였다. 방법:시험 약제 투여 4주간의 관찰기를 설정하여 공복혈당의 변화가 30㎎/dL 이하이고, 식후 혈당이 200㎎/dL 이상인 환자로 기타 제외 기준에 해당하지 않은 환자 53명을 대상으로 하여 보글리보스 군(24명)과 아카보스 군(29명)으로 무작위로 나누었다. 치료기간은 총 8주로 하였으며, 4주간 간격으로 혈청학적 검사와 부작용을 분석하여 치료 효과가 부작용을 평가하였다. 결과:1)혈당 변화:보글리보스군은 식후 1시간 혈당이 치료 후 4주, 8주째 의미 있게 감소하였도, 아카보스군은 식후 1시간과 2시간 혈당이 치료 후 4주, 8주째 의미있게 감소하였다. 또한 관찰기 혈당에 대한 치료 4주째 감소량은 아카보스군에서 더 큰 경향을 보였으나, 치료 8주째에는 두 군 간의 강하정도에 의미있는 차이가 없었다(p=0.569). 2)인슐린 치의 변화:보글리스 군은 식후 1시간 인슐린 치가 치료 전에 비해 치료 4주, 8주째 감소하는 경향을 보였고, 공복 인슐린이나 식후 2시간 인슐린치는 치료전 후에 의미 있는 차이가 없었다. 아카보스군에서는 치료 전후로 공복 인슐린, 식후 1시간과 2시간 인슐린치에 의미 있는 차이를 보이지 않았다. 두약제 간에 치료 전과 치료 8주사이의 식후 2시간 인슐린의 감소량이 보글리보스 군에서 의미있게 높았다(p=0.040). 3)당화혈색소:보글리보스 군은 치료 전에 비해 치료후 당화혈색소가 감소하는 경향을 보였고, 아카보스군은 치료 전에 비해 의미있게 감소하였다. 당화혈색소 변화량은 두 군간에 의미 있는 차이는 없었다(p=0.412). 4)지질대사의 변화:중성지방, 콜레스테롤, 고밀도 진단백 콜레스테롤에 대해 두 군간에 의미 있는 차이는 없었다. 5)부작용:소화기계 부작용의 빈도는 치료 4주째 보글리보스 군에서 의미 있게 낮았으나(p=0.028), 치료 8주째 부작용의 빈도는 두 군간에 의미 있는 차이가 없었다(p=0.215). 결론:2형 당뇨병 환자에서 보글리보스와 아카보스의 두 약제의 임상적 유효성과 부작용발현에 대해 비교한 결과 치료 후 8 주 후 혈당강화효과는 두 약제간에 유사한 효과를 보였으나 보글리보스군에서 4주째의 초기 위장관 부작용이 적었다. Background : Acarbose and voglibose are alpha-glucosidase inhibitors. Although different pharmacological effects and adverse abdominal events associated with the two drugs have been reported, no study directly compared acarbose and voglibose in diabetes has been undertaken. To compare the pharmacological effects and gastrointestinal adverse events between two drugs, a randomized, placebo-controlled, double-bind study was performed in type 2 diabetes patients. Methods : The period of study was 12 weeks(observation period: 4 weeks; treatment period: 8 weeks). Fifty-three patients were randomized into two groups(the acarbose group: 24 patients; the voglibose group: 29 patients). The serum glucose, insulin, fructosamine, HbA_1c, cholesterol, triglyceride and the incidence of adverse events were measured. Results : 1) The reduction of glucose from before treatment to 4 weeks after treatment was significantly higher in the acarbose group, but the change before treatment and 8 weeks after treatment in the two groups was similar(p=0.569). 2) The insulin significantly decreased after voglibose treatment(p=0.040). 3) HbAa_1c level tended to decrease in voglibose group, and there was a significant decrease after acarbose treatment. However, the change in HbA_1c level before and after treatment was similar between the two groups(p=0.412). 4) The two drugs did not cause any other changes in the total, HDL-cholesterol and triglyceride. 5) The number of patients with gastrointestinal adverse events was significantly low 4 weeks after voglibose treatment (p=0.049), but the incidence in the two groups was similar after 8 weeks(p=0.215). Conclusions : Acarbose and voglibose significantly improved postprandial hyperglycemia in diabetes. The incidence of gastrointestinal adverse events was low 4 weeks after voglibose treatment(J Kor Diabetes 26:134~145, 2002).

LETTER TO THE EDITOR : Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia with abnormal cortisol secretion mediated by catecholamines

( Harin Rhee ),( Yun Kyung Jeon ),( Sang Soo Kim ),( Yang Ho Kang ),( Seok Man Son ),( Yong Ki Kim ),( In Joo Kim ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.5

Adrenocorticotropic hormone (ACTH)- independent macronodular adrenal hyperplasia (AIMAH) is a rare cause of Cushing syndrome. In AIMAH, cortisol secretion is independent of ACTH, and various hormones and/or cytokines have been thought to stimulate cortisol secretion via the aberrant expression of adrenal receptors or the increased activity of eutopic hormone receptors. Schorr and Ney [1] f irst proposed this concept, and subsequently the ectopic expression of gastric inhibitory peptide (GIP), V2 and V3-vasopressin, β -adrenergic, luteinizing hormone (LH)/human chorionic gonadotropin (hCG), serotonin, and angiotensin receptors, as well as increased activity of a eutopic V1-vasopressin receptor, have been identified in the adrenal gland [1,2]. Several genetic factors, such as Gs α-subunit mutations associated with McCune-Albright syndrome and MC2R (ACTH receptor gene) mutations, have also been postulated as causes of AIMAH. A 50-year-old male was referred and admitted to our hospital due to uncontrolled hypertension. He had suffered from hypertension for 6 years. His blood pressure was originally well controlled for the first 5 years using a calcium channel blocker, but poorly controlled for 1 year before he visited our hospital, despite his regular use of antihypertensive agents. He was initially referred to the Cardiology Department and underwent cardiologic evaluation after complaining of paroxysmal palpitation and dizziness. His 24-hour Holter monitoring and coronary angiographic results were normal, except for several antigen- presenting cells and a minimal coronary arterial obstruction at the middle left anterior descending artery. He had a past history of major depression and had been prescribed an antidepressive agent 18 months before he visited our hospital. On physical examination, he had a moon face, marked central obesity (height, 167 cm; weight, 77.65 kg; body mass index, 27.84 kg/m2), and multiple bruises on his extremities. He also had prominent purple abdominal striae, and all of his morphological features were consistent with Cushing syndrome. Laboratory examinations revealed 145.7 mEq/L serum sodium and 2.86 mEq/L serum potassium. Arterial blood gas analysis revealed metabolic alkalosis (pH 7.519, HCO3, 37.4 mM/L). His hemoglobin A1c level was 5.9%, and his serum fasting blood glucose was 118 mg/dL. The results of basal endocrinological examinations are summarized in Table 1. The circadian variation in serum cortisol production was disrupted, and basal ACTH levels were suppressed. A 24-hour urinary free cortisol test and overnight dexamethasone suppression test (DMST) were both suggestive of Cushing syndrome. Low- and high-dose DMST revealed Cushing syndrome of primary adrenal origin. An abdominal computed tomography scan and magnetic resonance imaging (MRI) revealed bilateral large macronodular adrenal tumors. His pituitary gland was normal on brain MRI scans. We thus diagnosed this patient with Cushing syndrome secondary to AIMAH. To identify aberrant receptors on the adrenal gland, we followed the investigative protocol described by Lacroix et al. [3]. Postural and various provocation tests, including ACTH (250 μg, intravascular), arginine vasopressin (AVP; 10 IU, intramuscular), 5-hydroxy triptamine (5-HT; 10 mg, intravascular), isoproterenol (20 ng/kg/min, intravascular for 30 minutes) and mixed meal tests, were performed. His serum cortisol level showed a positive response to ACTH, AVP, and isoproterenol provocation tests, but a negative response to the postural stimulation test. The results are summarized in Fig. 1A. If the patient had β-adrenergic or AVP receptors on his adrenal gland, then he would have responded to the postural stimulation test; but he did not. We repeated the postural stimulation test, and checked his endogenous antidiuretic hormone (ADH) level. He exhibited an increased ADH level on the postural test, but no cortisol secretion (Fig. 1B). A bilateral adrenalectomy was performed. The subsequent pathological examination of both adrenal glands showed hyperplasia with a multinodular growth pattern: the right and left adrenal glands were sized 14.0 × 5.0 × 3.0 cm and 9.0 × 5.0 × 3.0 cm, respectively, and multiple golden yellow nodules measuring up to 4 cm in diameter were present. Microscopic findings showed that the nodules consisted of variable- sized nests of lipid-laden clear cells similar to those of the normal fasiculata layer (Fig. 2). The final clinical and pathological diagnosis was Cushing syndrome secondary to β-adrenergic agonist-responding AIMAH. After the operation, he took physiological doses of prednisolone and f ludrocortisone. He then lost weight gradually and achieved optimal blood pressure with reduced doses of antihypertensive agents. Kirschner et al. [4] first described AIMAH in 1964. They demonstrated that hypercortisolism was ACTH-independent, and that the resected adrenal glands contained multiple nodules. Since then, a number of cases have been described, and the cause of AIMAH has been characterized more precisely. Previously, steroid production in AIMAH was believed to be autonomous. In the previous study that compared the adrenal glands of patients with AIMAH to those in patients with long-standing Cushing disease, and concluded that prolonged adrenal stimulation by ACTH resulted in adrenal bilateral nodular formation and varying ranges of adrenal autonomy [5]. There were also some cases in which autonomy of the adrenal gland was the result of chronic ACTH stimulation, which eventually resulted in ACTH suppression. However, the rarity of Nelson syndrome following bilateral adrenalectomy in patients with AIMAH strongly argued against the adrenal autonomy hypothesis. In 1971, Schorr and Ney [1] first introduced the concept of aberrant adrenal receptor expression in adrenocortical tissue. They performed in vitro studies, and found that cyclic adenosine monophosphate and corticosterone production in rat adrenocortical carcinoma cells were stimulated by non-ACTH hormones such as catecholamines, thyroid stimulating hormone, follicle stimulating hormone, LH, and prostaglandin E1. This hypothesis was later validated in humans by additional in vitro and in vivo studies. Several ectopic receptors such as GIP, β-adrenergic receptors, vasopressin (V2-V3-vasopressin receptor), serotonin (5-HT7 receptors), and angiotensin II receptors, and increased expression or altered activity of eutopic receptors in- cluding the V1-vasopressin receptors, LH/hCG receptors, serotonin (5-HT4 receptor), and leptin receptors was found [5]. In our patient, the serum cortisol level was increased by ACTH stimulation, exogenous AVP, and isoproterenol. Because exogenous AVP could naturally stimulate ACTH and increase serum cortisol levels, we checked serum ACTH levels during an AVP stimulation test. His serum cortisol level was increased by 82%, and serum ACTH level was increased by 11.5%. We were unable to confirm if AVP itself stimulated the adrenal cortex directly, or whether the induced ACTH caused cortisol secretion. A postural test was performed to screen for the aberrant expression of the AVP, β-adrenergic, or angiotensin II receptors. Interestingly, cortisol secretion was stimulated by exogenous AVP and a β-adrenergic agonist; however, a postural test failed to stimulate cortisol secretion. We repeated the postural test, and also checked the patient`s aldosterone level to verify if the test was accurate and determined serum ADH levels to confirm if endogenous ADH stimulated adrenal cortisol secretion. Because serum aldosterone levels increase in response to postural stimulation, the test itself was working; however, the cortisol response was negative. This suggests that the patient`s β-adrenergic receptor showed a blunted response to the test. Because we did not determine the serum catecholamine levels during postural stimulation, it was unclear whether the postural test induced sufficient endogenous catecholamine. Although a stronger stimulus (such as a treadmill test) would have induced endogenous catecholamine and increased serum cortisol levels, the patient refused because he had ischemic heart disease. In our case, exogenous AVP, but not endogenous ADH, stimulated adrenal cortisol secretion. This suggests that the cortisol response to exogenous pharmacological levels of vasopressin was mediated by AVP-induced catecholamine release [3]. We finally concluded that this patient had ectopic β-adrenergic receptors on the adrenal cortex, and recommended long-term propranolol therapy. However, because he strongly desired to undergo treatment with a rapid response, we consulted the Urological Department who recommended bilateral adrenalectomy. The identification of aberrant adrenal hormone receptors in AIMAH provides novel opportunities for specific pharmacological therapies as alternatives to adrenalectomy. In 1997, Lacroix et al. [3] reported the use of propranolol therapy for ectopic β-adrenergic receptors in adrenal Cushing syndrome in 1997. Some studies have revealed aberrant receptor expression in vitro using reverse transcription polymerase chain reaction. However, a limitation of our study is that we did not confirm aberrant receptor expression using in vitro analyses. In conclusion, we report a rare case of an AIMAH patient. In vivo examinations suggested that altered cortisol regulation due to a β-adrenergic agonist was involved in the pathogenesis of the AIMAH patient.

Benzodiazepinone과 1,5-Benzodiazepine 유도체의 합성 연구

정대일,이용균,박유미,최태원,정일수,김인식,김윤영 東亞大學校 1997 東亞論叢 Vol.34 No.-

The reaction of o-phenylenediamine 5 with acrylic acid 11 in the presencce of P₂O5+H₃PO₄afforded benzodiazepinone 13 and pyridobenzodiazepinono 17. The reactions of o-phenylenediamine 5 with acrylic acid 11 in the presence of PPA or SiO₂afforded only benzodiazepinone 13. But the reaction of O-phenylenediamine 5 with acrylic acid 11 in the presence of acetonedicarboxylic acid 18 or acetonedicarboxylic acid 18 and PPA or acetonedicarboxylic acid 18 and SiO₂was respectively synthesized 2,4,4,-trimethyI-3H-5-hydro-1.5-benzodi-azepine 23 as new cyclic imine compound. We propose that formation of 2-(2`-imine)propyI-N-isopropylidene aniline proceed though 2-amino, N-isopropylidene aniline intermediate C and 2-(N-a-methylethyI) amino, N-isopropylidene aniline intermediate G. The reaction of o-phenylenediamine 5 with acetonedicarboxylic acid 18 in the presence of PPA or SiO₂or HCI gave 2,4,4-trimethyI-3H-5-hydro-1,5-benzodiazepine 23. Using acetone 19 instead of acetonedicarboxylic acid 18, the reaction of o-phenylenediamine 5 in the presence of PPA or SiO₂or acrylic acid 11 was synthesized 2,4,4-trimethyI-3H-5-hydro-1,5-benzodiazepine 23 as same product. And also the reaction of o-phenylenediamine 5 with acetone 19 and acrylic 11 in the presence of PPA or SiO₂was obtained 2,4,4-trimethyI-3H-5-hydro-1,5-benzodiazepine 23. In case of acetophenone 21 in stead of acceton 19, the reaction of o-phenylenediamine 5 in presence of PPA or SiO₂at 40~45℃ were obtained 2,4-diphenyI-4methyI-3H-5-hydro-1,5-benzodiazepine 24. The reaction of o-phenylenediamine 5 with crotonic acid 25 in the presence of PPA or P₂O5+H₃PO₄or SiO₂at 100~110℃ afforded respectively 4-methybenzodiazepinone 26 as 1:1 cycloadduct.

Early Percutaneous Catheter Drainage Reduces Hospital Stay but Not Mortality in Patients with Pyogenic Liver Abscess

( Chang Hun Lee ),( Yun Chae Lee ),( Jaehee Park ),( Song Yi Yu ),( Hun Gil Jo ),( Jae Sun Song ),( Gum Mo Jung ),( Yong Keun Cho ),( Eun Young Cho ),( In Hee Kim ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: To investigate the factors associated with prolonged hospital stay and mortality among patients with pyogenic liver abscess (PLA) who underwent percutaneous drainage (PCD). Methods: We retrospectively reviewed data from PLA patients admitted from 2005 to 2018 at three tertiary hospitals in Jeonbuk province. We selected patients who underwent PCD during the admission period and early PCD was defined whether the procedure was done within 3 days of admission. Results: Among 655 patients diagnosed with PLA, 366 patients who underwent PCD were enrolled for the study. The patients had a mean age of 65.5 ± 14.7 years, and mean maximal diameter of the hepatic abscess was 6.1 ± 2.6 cm and 71.9% of the lesion was single. Next, two groups were divided depending on the time period of PCD and 269 patients (73.5%) underwent PCD within 3 days of hospitalization. In baseline characteristics, early PCD group was significantly higher in the number of abscess as well as the maximal abscess diameter. However, hospitalization period was significantly lower in the early PCD group though in-hospital mortality was not different. We checked laboratory results at 1 week after the admission and CRP levels were significantly lower in the early PCD group. We further analyzed the factors related to the long-term hospitalization more than 14 days. In multivariate analysis, underlying diabetes, lower albumin levels, and PCD inserted after 3 days of admission were independent factors associated with prolonged hospital stay. Conclusions: Early PCD facilitated improvement of inflammatory laboratory markers and shortened the hospital stay. Early PCD may be beneficial in patients with PLA.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

1~2기 본태성 고혈압 환자들에서 Imidapril 대 Enalapril의 항고혈압 효과를 평가하기 위한 무작위, 이중맹검 임상시험

최영진,손대원,김용진,이홍자,채인호,김효수,김철호,오병희,이명묵,박영배,채윤식,이영우 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.11

로자탄 대 포시노프릴의 고혈압 환자들에서 항고혈압 효과, 안전성 및 내약성의 비교

박대균,이명묵,채인호,이무용,이홍자,김효수,김철호,손대원,오병희,박영배,최윤식 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.1

Low serum bilirubin level predicts the develop-ment of chronic kidney disease in patients with type 2 diabetes mellitus

( Kang Hee Ahn ),( Sang Soo Kim ),( Won Jin Kim ),( Jong Ho Kim ),( Yun Jeong Nam ),( Su Bin Park ),( Yun Kyung Jeon ),( Bo Hyun Kim ),( In Joo Kim ),( Yong Ki Kim ) 대한내과학회 2017 The Korean Journal of Internal Medicine Vol.32 No.5

Background/Aims: We evaluated whether serum bilirubin levels can predict the development of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T₂DM). Methods: This was a retrospective observational longitudinal study of patients presenting at the Pusan National University Hospital. A total of₃₄₉ patients with T₂DM and preserved kidney function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m²) were enrolled. The main outcome was the development of CKD stage 3 or greater. The patients were divided into four groups according to the quartiles of the total serum bilirubin levels at baseline. Results: The group with the lowest range of total serum bilirubin level (Q₁) showed the highest cumulative incidence of CKD stage 3 or greater than that of the other lower quartiles (Q₁ vs. Q₄; hazard ratio [HR], 6.75; 95% confidence in-terval [CI], 1.54 to 29.47; p = 0.011). In multivariate analysis, the risk of developing CKD stage 3 or greater was higher in the second lowest quartile of the serum bili-rubin level than that in the highest quartile of the serum bilirubin level (Q₂ vs. Q₄; HR, 9.36; 95% CI, 1.33 to 65.73; p = 0.024). In the normoalbuminuria subgroup (n = 236), multivariate analysis showed that the risk of developing CKD stage 3 or greater was higher in the lowest quartile of the serum bilirubin level than that in the highest quartile of the serum bilirubin level (Q1 vs. Q4; HR, 7.36; 95% CI, 1.24 to 35.82; p = 0.019). Conclusions: Serum bilirubin might be an early clinical marker for predicting the progression of CKD in patients with T₂DM and preserved renal function.

Radiocobalt의 體內 汚染에 對한 除染效果

정인용,정현우,김태환,진수일,윤택구 대한방사선 방어학회 1988 방사선방어학회지 Vol.13 No.1

국내 原子力 産業의 施設增大로 放射線核種汚染의 가능성이 날로 증가되고 있음에도 불구하고 종사자 및 인근주민에 대한 診療對策에 관한 연구가 전무한 실정에 있어 이에 대한 기초자려마련의 일환인 應急處置方案을 수립코자 58CoCl2 1μCi를 마우스 (NIH-(GP))의 腹腔內에 投與한 후 CoNa3 DTPA 8.4mg/0.2ml saline, CoNa3 DTPA 8.4mg/0.2ml saline, saline 5ml등을 각각 投與하였으며, cobalt의 全身殘存量, 體內分布 및 尿內 含有된 量을 測定하기 위해 投與 後 4, 8, 12, 48시간, 그리고 7일에 MCA의 Ge-detector로 放射能을 計測하였고, 또한 각 實質臟器內 殘存된 cobalt의 放射能을 測定하기 위하여 각 group당 6마리의 마우스를 屠殺解體하여 測定하였던바 다음과 같은 결론을 얻었다. CoNa3 DTPA 處置群에서는 汚染된 放射性 cobalt의 全身殘存率의 減少 및 排泄率 增加에 유효한 效果가 있었으며, system contamination에 대한 방어효과는 CoNa3 DTPA, CoNa3 DTPA 그리고 saline 順으로 유효하였다. 결론적으로 본 실험결과로 볼 때 放射性 cobalt의 體內汚染에 대한 緊扱措置는 CoNa3 DTPA와 다량의 물을 동시에 投與함으로써 體內汚染된 放射性 cobalt의 排泄을 促進시킬 것으로 사료된다. In case of the acute intake of radionuclide, an early medical treatment may be necessary, but the little is established the procedures to decontaminate the victims of internal contamination in Korea. The purpose of the present investigation is to study chemical agents to remove radiocobalt from the victims and to provide a more reliable procedure for the treatment. The removals of radiocobalt from the NIH-(GP)mice injected intraperitoneally with lμCi of 58Co as CoCl2 were investigated with doses of either CaNa3 DTPA 8.4mg/0.2ml saline, CoNa3 DTPA 8.4mg/0.2ml saline, or saline 5ml. The radioactivity was determined by MCA and Ge-detector on 4, 8, 12, 48 hours and 7 days for the whole body, organ distribution and urine excretion. Six mice per each group were sacrificed for the measurement of cobalt retention in the parenchymal tissue. The cobalt trisodium chelate had a pronounced effect on reducing the whole body retention and increasing the excretion rate. Regarding to the systemic protective effects, CoNa3 DTPA, CaNa3 DTPA and saline were effected significantly in order. In conclusion, the extrapolations from these results to human were suggested that the rapid administration of cobalt trisodium chelate and an amount of saline to the contaminated person after internal contamination of radiocobalt were markedly increasing the decontamination effects.