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강유미,조윤경,이지우,이승은,이우제,박중열,김예지,정창희,Michael A. Nauck 대한당뇨병학회 2019 Diabetes and Metabolism Journal Vol.43 No.4
Background Based on reported results of three large cardiovascular outcome trials (CVOTs) of glucagon-like peptide 1 receptor agonists (GLP-1 RAs), we aimed to investigate the overall effect of GLP-1 RAs on major adverse cardiovascular events (MACEs) and to identify subpopulations exhibiting the greatest cardiovascular (CV) benefit. Methods Three CVOTs reporting effects of long-acting GLP-1 RAs were included: LEADER (liraglutide), SUSTAIN-6 (semaglutide), and EXSCEL (exenatide once weekly). In all studies, the primary endpoint was three-point MACE, comprising CV death, non-fatal myocardial infarction, and non-fatal stroke. Overall effect estimates were calculated as hazard ratios and 95% confidence intervals (CIs) using the random-effects model; subgroup analyses reported in the original studies were similarly analyzed. Results Overall, statistically significant risk reductions in MACE and CV death were observed. Subgroup analysis indicated a significant racial difference with respect to CV benefit (P for interaction <0.001), and more substantial risk reductions were observed in subjects of African origin (relative risk [RR], 0.78; 95% CI, 0.60 to 0.99) and in Asians (RR, 0.35; 95% CI, 0.09 to 1.32). However, post hoc analysis (Bonferroni method) revealed that only Asians exhibited a significantly greater CV benefit from treatment, compared with white subjects (P<0.0001). Conclusion Long-acting GLP-1 RAs reduced risks of MACE and CV deaths in high-risk patients with type 2 diabetes mellitus. Our findings of a particularly effective reduction in CV events with GLP-1 RA in Asian populations merits further exploration and dedicated trials in specific populations.
Bioceramic-Poly D,L-Lactic-co-Glycolic Acid(PLGA) Scaffold에접종한 인간지방조직-유래중간엽줄기세포의골형성
강유미,홍순갑,도병록,김해권,이준영 한국발생생물학회 2011 발생과 생식 Vol.15 No.2
본실험은bioceramic을첨가하여만든다공성poly D,L-lactic-co-glycolic acid(PLGA)-scaffold가인간지방조직에 서유래된중간엽줄기세포(human adipose tissue derived mesenchymal stem cells, ATMSCs)의골형성과정에효과적인지를알아보고자수행하였다. ATMSCs를well plate에접종하여골형성유도(osteogenic induction, OI) 배양액으로28일동 안배양하였다. OI배양액군의증식률은세포접종후14일까지는세포증식이활발하게진행됐지만, 21일이후세포의 증식이둔화되는양상을보였다. 반면, 기본배양액군은 꾸준한세포증식을보이며21일이후에는OI배양액군 보다더높은증식을나타냈다. OI배양액군의 alkaline phosphatase(ALP) 활성은 세포배양 21일까지는 증가했지만, 8일에는 감소한 반면에 기본배양액군은 계속 감소하는 양상을 띠었다. OI배양액군의 세포는 배양 21일에는 뚜렷한 nodule의 형성을 관찰할 수 있었고, nodule에 칼슘의 축적이 일어남을 확인하였다. ATMSCs를 scaffold에 접종하여 OI배양액으로 배양하였다. Scaffold 내 골아세포 분화에 따른 ALP 활성은 PLGA scaffold와 Bioceramic-PLGA scaffold 모두에서 세포 배양 21일에 급격히 증가하였고, Bioceramic-PLGA scaffold의 ALP 활성이 PLGA scaffold보다 크게 증가하였다. 칼슘과 인의 함량 역시 Bioceramic-PLGA scaffold에서 높게 나타났으며, Bioceramic-PLGA scaffold의 Ca/P ratio가 PLGA scaffold보다 높게 나타났다. 생체내에 이식된 scaffold의 생분해성과 광물화는 bioceramic-PLGA scaffold에서 더욱 뚜렷하게 관찰되었다. 본 실험의 결과들을 종합해 볼 때 ATMSCs의 골형성능은 well plate보다 scaffold가 더 효과적이며, bioceramic이 scaffold의 세포 부착률과 ALP 활성을 증가시켜 골형성능에 효과적으로 작용하는 것으로 생각된다. 또한 bioceramic이 ATMSCs의 골형성 분화에 따른 광물화단계의 scaffold 내 칼슘과 인의 함량을 증가시키는 것으로 사료된다. 생체 내 scaffold의 생분해성은 PLGA scaffold보다 Bioceramic-PLGA scaffold가 빠른 분해를 나타내며, 광물화에 따른 칼슘 침착이 더 활발한 것은 scaffold에 포함된 bioceramic이 생체 내 세포의 부착, 증식, 분화를 증가시켜 골형성을 촉진시키는 물질로 작용한 것으로 사료된다.
Cardiovascular Effects of Glucagon-Like Peptide-1 Receptor Agonists
강유미,정창희 대한내분비학회 2016 Endocrinology and metabolism Vol.31 No.2
Glucagon-like peptide-1 (GLP-1) is a member of the proglucagon incretin family, and GLP-1 receptor agonists (RAs) have beenintroduced as a new class of antidiabetic medications in the past decade. The benefits of GLP-1 RAs are derived from their pleiotropiceffects, which include glucose-dependent insulin secretion, suppressed glucagon secretion, and reduced appetite. Moreover,GLP-1 RAs also exert beneficial roles on multiple organ systems in which the GLP-1 receptors exist, including the cardiovascularsystem. Cardiovascular effects of GLP-1 RAs have been of great interest since the burden from cardiovascular diseases(CVD) has been unbearably increasing in a diabetic population worldwide, despite strict glycemic control and advanced therapeutictechniques to treat CVD. Preclinical studies have already demonstrated the beneficial effects of GLP-1 on myocardiumand vascular endothelium, and many clinical studies evaluating changes in surrogate markers of CVD have suggested potentialbenefits from the use of GLP-1 RAs. Data from numerous clinical trials primarily evaluating the antihyperglycemic effects ofmultiple GLP-1 RAs have also revealed that changes in most CVD risk markers reported as secondary outcomes have been in favorof GLP-1 RAs treatment. However, to date, there is only one randomized clinical trial of GLP-1 RAs (the ELIXA study)evaluating major cardiovascular events as their primary outcomes, and in this study, a neutral cardiovascular effect of lixisenatidewas observed in high-risk diabetic subjects. Therefore, the results of ongoing CVD outcome trials with the use of GLP-1 RAsshould be awaited to elucidate the translation of benefits previously seen in CVD risk marker studies into large clinical trials withprimary cardiovascular outcomes.
혼산에 의한 폭발사고의 화학반응 경로 분석 - 화학물질 운반 선박을 중심으로 -
강유미,임정빈 해양환경안전학회 2017 海洋環境安全學會誌 Vol.23 No.6
본 연구의 목적은 혼산 화물의 폭발사고에 대한 화학반응 경로를 분석하는데 있다. 분석에는 사건-가지분석기법을 적용한 구조 적인 시나리오를 이용하였다. 구조적인 시나리오는 재결서에 기록된 혼산 화물 사고의 내용에서 다양한 화학반응 경로를 추정하여 구축하 였다. 분석에는 화학 이론에 의거한 정성적 분석과 화학 반응식을 이용한 정량적 분석 및 설문조사를 통한 확률적 분석 등 세 가지 방법을 혼합 적용하였다. 분석결과, 사고 발생의 주요 경로는 진한 황산과 물이 반응하여 폭발하는 경로, 혼산과 금속이 반응하여 폭발하는 경로, 특수한 물질과 합성하여 폭발하는 경로 등 세 가지로 나타났다. 이 결과는 재결서에 기록된 경로와 유사함을 알았고, 이를 통해서 본 연구 에서 제안한 화학물질의 경로분석 기법이 타당함을 알았다. 본 연구에서 제안한 방법은 다양한 화학물질 사고의 화학반응 경로 추정에 적 용 가능할 것으로 기대된다. The purpose of this study is to analyze the chemical reaction pathway for explosion accident of mixed cargo. The analysis used a structural scenario using event-tree analysis. Structural scenarios were constructed by estimating various chemical reaction paths in the content of the mixed cargo accident recorded in the written verdict. The analytical method was applied to three kinds of analysis: chemical analysis based on chemical theory, quantitative analysis using chemical reaction formula, and probabilistic analysis through questionnaire. As a result of analysis, the main pathway of the accident occurred in three ways: the path of explosion due to the reaction of concentrated sulfuric acid with water, the path of explosion due to the reaction of metal and mixed acid, and the path of explosion by synthesizing with special substances. This result is similar to the path recorded in the validation, and it leads to thar the proposed path analysis method is valid. The proposed method is expected to be applicable to chemical reaction path estimation of various chemical accidents.
강유미,신석철,진영우,김희선 대한방사선방어학회 2009 방사선방어학회지 Vol.34 No.3
We exposed ICR mice to low-dose (0.2 Gy) and low-dose-rate (0.7 mGy/h) -radiation (137Cs) in the Low-dose-rate Irradiation Facility at the Radiation Health Research Institute to evaluate systemic effects of low-dose radiation. We compared the body and organ weights, number of blood cells (white and red blood cells and platelets), levels of biochemical markers in serum, and frequency of micronuclei in polychromatic erythrocytes between low-dose irradiated and nonirradiated control mice. The ICR mice irradiated with total doses of 0.2 and 2 Gy showed no changes in body and organ weights, number of blood cells (white and red blood cells), or frequency of micronuclei in the polychromatic erythrocytes of peripheral blood. However, the number of platelets (P = 0.002) and the liver weight (P < 0.01) were significantly increased in mice exposed to 0.2 and 2 Gy, respectively. These results suggest that a low-dose-rate of 0.7 mGy/h does not induce systemic damage. This dose promotes hematopoiesis in the bone marrow microenvironment and the proliferation of liver cells. In the future, the molecular biological effects of lower doses and dose rates need to be evaluated.