노인성 골다공증의 치료 및 관리

변동원 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.2

..

High Performance Liquid Chromatography를 이용한 Hemoglobin A1C 측정

변동원,서교일,유명희,김극배 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

Hemoglobin AIc(HbAlc) has been known to be an index of long-term glycemic control (6-8weeks), and offers several practical advantages for screening of diabetes mellitus and evaluation of effects of treatment. Authors introduced to measure and investigate HbAlc levels by high performance liquid chromatoraphy (HPLC ; LDC Milton Roy, USA), with cation exchange column, Mono S HR 5/5 (Pharmacia). The results were as follows; 1. The mean HbAlc level in normal adult control group (n=50) was 4.13±0.25% (Mean±S.D). 2. Within-run precisions of HbAlc levels measured by HPLC were 4.39±0.01% (Mean±S.D.), 1.41(C.V.) in normal control, and 8.95±0.02% (Mean±S.D.), 1.65(C.V.) in intermittently treated diabetic patients, and 11.02±0.01% (Mean±S.D.) 2.93(C.V.) in untreated diabetic patients. 3. Between-run precision of HbAlc levels measured by HPLC were 4.35±0.01% (Mean±S.D.), 2.76(C.V.) in normal control, and 8.98±0.01% (Mean±S.D.), 1.22(C.V.) in intermittently treated diabetic patients, and 10.95±0.15% (Mean±S.D.), 3.51(C.V.) in untreated patients. 4. The peak level of HbAlc was obtained in about 9 minutes and the whole program could be completed within 17 minutes. 5. Blood specimens could be stored for as long as 8 days at 4℃ without changes of HbAlc levels. These results suggest that the measurement of HbAlc by HPLC using cation exchange column is so accurate, simple and rapid that the clinical use is more wider.

골다공증 치료의 최신약제들

변동원 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

..

일차성 부갑상선 기능항진증으로 인한 모든 합병증이 동반된 부갑상선 종양 1예

변동원 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Most of the primary hyperparathyroidism is resulted from parathyroid adenoma and is characterized by hypercalcemia, reduced bone density, frequent renal stone, gastric ulcer, duodenal ulcer, muscle weakness, depression, hypertension, anemia and rarely causing brown tumor. Author experienced a case of 81-year-old man showing all complications of primary hyperparathyroidism. The patient presented with decreased mentality, acute gastric ulcer, acute duodenal ulcer, GB stones with cholecystitis, renal insufficiency, previous history of 3 times of renal stones, depression and osteoporoid Serum calcium level was 16.7㎎/dl and intact parathyroid hormone level was 3,901pg/ml. Parathyroid mass was detected by neck CT and 99mTc-tetrofosmin parathyroid scan. Parathyroid tumor was removed and confirmed as a parathyroid adenoma by pathologic finding. After operation, the patient was treated with vitamin D and calcium because hungry bone syndrome was occured, Intact PTH level was also returned to normal ranges after of parathyroid adenoma.

CW Nd:YAG 레이저를 이용한 Inconel 718 절단시 절단면 형성 고찰

안동규,변경원,유영태 한국공작기계학회 2007 한국공작기계학회 추계학술대회논문집 Vol.2007 No.-

The objective of this research work is to investigate the influence of process parameters on the surface roughness and the formation of the cut section for the case of cutting of Inconel 718 sheet using high power CW Nd:YAG laser. In order to find the relationship between process parameters and surface roughness, Several linear cutting experiments have been carried out using 6-axis controlled robot laser cutting system. From the results of the experiments, the relationship between process parameters and surface roughness has been obtained. In addition, it has been shown that the surface roughness is highly related to the striation formation of the cut section. The results of experiments have been shown that the surface roughness of the cut section lies in the ranges of Ra of 1.39-5.70㎛ and R_(max), of 8.20-29.10㎛. Through the observation of the cut section, it has been shown that the cut area of the cut section has several oxidized substances and the ductile fracture occurs in the break area.

전동공구 내구성 평가 실험장치 개발

박근석,변영철,강이석,강배희,이동욱,차원준 忠南大學校 産業技術硏究所 1997 산업기술연구논문집 Vol.12 No.2

For the endurance test, it is necessary to test the portable electric tools under the same condition as the actual operation condition. It is also essential that the test equipment is convenient to fix the tool. Those are necessary to control the loaded torque and to acquire and analyze the test data with a computer. In this study, we have developed an endurance test equipment for portable electric tools, where a hydraulic control system with a proportional relief valve was applied to control the load for the test. The developed test equipment used an industrial hydraulic pump as a load supplier to ensure a firm endurance of the test equipment itself. The data acquisition system has been automated by composing with a personal computer and RS-232C communication nets. This test equipment reduced the manhour for the test and also improved the reliability of the tested data which were measured and graphed.

교정환자에서 MRI를 이용한 측두하악관절 장애의 연구

김태우,변은선,백승학,장영일,남동석,양원식 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

측두하악관절의 자기공명영상(MRI)은 하악과두와 관절원판(disc)의 관계를 잘 보여주기 때문에 관절내장증(internal derangement)의 진단을 위해 매우 유용하다. 이번 연구의 목적은 서울대학교 치과병원 교정과에 내원한 측두하악관절 장애가 의심되는 환자들의 MRI자료를 평가하여 관절 내장증의 유무, 발생빈도 및 심도를 파악하는 것이다. MRI를 촬영한 표본은 남자 10명, 여자 40명으로 총 50명이었고 평균 나이는 22.9세였다. 전체 50명 중에 43명에서 positive finding이 관찰되었다. Positive finding을 나타낸 환자 중에서 전방관절원판변위 (anterior disc displacement : ADD)는 비정복성이 56%로 가장 많았으며, 양쪽 관절에서 동시에 일어난 경우가 65%로 가장 많았다. Positive finding을 나타낸 환자를 Angle 분류 시, Ⅱ급 1류 부정교합 환자가 39.6%, Ⅱ급 2류 부정교합 환자가 2.3%로 Ⅱ급 부정교합이 41.9%로 가장 많았고, 1급 부정교합 환자는 37.2%, Ⅲ급 부정결합 환자가 18.6%, 확인 안된 경우가 2.3%였다. Positive finding을 나타낸 환자 중에서 안면 비대칭 환자는 8.6%, 개교 환자는 55.8%였다. 결론적으로 측두하악관절의 관절 내장증을 가진 환자에서는 Ⅱ급 부정교합이 차지하는 비율이 매우 크다고 할 수 있다. 개교나 안면 비대칭은 측두하악관절 장애로 인한 보상적 또는 비보상적인 변형에 의해 나타날 수 있으며 퇴행성 관절 질환으로 진행되는 과정 중 안면 골격 개조의 결과로 보인다. 그러므로 개교 및 안면 비대칭이 있는 환자는 교정 치료 시작 전에 측두하악관절의 이상 유무를 MRI로 확인(screening)할 것이 권장된다. 측두하악관절 장애가 있는 경우 교정 치료 후에도 재발의 경향이 크고 측두하악관절에 대한 계속적인 관찰이 필요하므로 감별진단이 필수적이다. Magnetic resonance imaging(MRI) of the temporomandibular joint(TMJ) is very useful method to diagnose internal derangement of the TMJ because of its high specificity for identification of condyle-disc relationships. The purpose of this study was to evaluate the existence, incidence and severity of internal derangement of the TMJ by the MRI of patients who are suspected to leave TMJ disorder. MRI sample was composed of 50 subjects(10 males, 40 females) and the mean age was 22.9 years. 43 subjects of the sample were found to have positive findings. 56% of the subjects with positive findings had ADD(anterior disc displacement) without reduction, and 65% had internal derangement of bilateral joints. Distributions in the types of malocclusion in patients with positive findings, the Angle's classification had shown : the largest 41.9% for Cl II(39.6% for Cl II div 1 and 2.3% for Cl II div 2), 37.2% for Cl I, 18.6% for Cl III, and 2.3% for the unidentified. 8.6% of the subjects with positive findings had facial asymmetry and 55.8% had openbite. We can conclude that the percentage of Cl II is the highest in patients with internal derangement of the TMJ. Openbite or facial asymmetry is considered to be uncompensated or compensated deformity which results from facial skeleton remodeling in the process of degenerative joint disease(DJD) due to TMJ degeneration. Therefore it is recommended to screen the patients with facial asymmetry or openbite by MRI before the beginning of orthodontic treatment. Differential diagnosis is essential because the tendency of relapse is high after the orthodontic treatment and continuous observation of TMJ is needed in patients with TMJ disorder.

만성신부전증 환자에서 Recombinant Human Erythropoietin 치료에 따른 혈액지표와 Hemoglobin A1c에 대한 연구

이세영,배성한,변동원,서교일,유명희,김극배 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Hemoglobin A1c is produced by a progressive, non-enzymatic reaction between glucose and hemoglobin within the erythrocytes. The HbA1c concentration is dependent on the plasma glucose level and the stage of development of the erythrocytes. Immature erythrocytes contain lower levels of glycosylated hemoglobin than mature erythrocytes. HbA1c level was decreased in short RBC life span. Therefore, HbA1c level is not only measure for assessment of moderate to long term glycemic status in diabetics, but also as a possible diagnostic parameter of anemia. The aim of this study was to evaluate the HbA1c level in patients with chronic renal failure with anemia. HbA1c concentration, iron, ferritin, TIBC and hematologic parameters were measured before treatment and 1, 2 months after administration of recombinant human erythropoietin. The HbA1c concentration was measured by high performance liquid chromatography with cation exchange column (Pharmacia). The results were as follows; 1. The mean of hemoglobin was 8.66 g/dL in the controls and 7.84 g/dL in the patients with chronic renal failure. The mean of hematocrit was 25.19 % in the controls and 23.14 % in the patients with chronic renal failure. The mean of MCV was 93.23 fL in the controls and 92.73 fL in the patients with chronic renal failure. The mean of MCH was 32.56 pg in the controls and 31.76 pg in the patients with chronic renal failure. The mean of HbA1c was 3.15 % in the controls and 2.95 % in the patients with chronic renal failure. 2. Hematologic parameters in the patients with chronic renal failure 1) The results of hemoglobins were 7.84 g/dL, 8.11 g/dL, 8.92 g/dL, the MCH were 31.76 pg, 32.87 pg, 33.20 pg, the results of MCV were 92.73 fL, 97.37 fL, 92.85 fL at before treatment and 1, 2 months after administration of r-HuEpo. 2) The results of hematocrits were 23.14 %, 23.73 %, 26.73 % at before treatment and 1, 2 months after administration of r-HuEpo. 3. Iron metabolism parameters in the patients with chronic renal failure 1) The results of iron test were 180.92 ㎍/dL, 137.79 ㎍/dL, 126.83 ㎍/dL at before treatment and 1, 2 months after administration of r-HuEpo. 2) The results of ferritin test were 1500.2 ng/ml, 1311.6 ng/ml, 1151.0 ng/ml at before treatment and 1, 2 months after administration of r-HuEpo. 3) The results of TIBC test were 282.17 ㎍/dL, 282.45 ㎍/dL, 278.83 ㎍/dL at before treatment and 1, 2 months after administration of r-HuEpo. 4. The results of HbA1c test were 2.95 %, 3.08 %, 3.18 % at before treatment and 1, 2 months after administration of r-HuEpo. It is suggested that, in patients with chronic renal failure, evaluation of HbA1c in diabetics who have anemia with chronic renal failure should be consider possible hematologic parameters, and HbA1c level would be one of the marker of anemia status, but further studies are needed.

모 주물공장 근로자의 작업공정별 분진폭로량, 자각증상 및 건강진단판정 비교

이범식,조영채,변정식,김동현,원선혜,김정윤 忠南大學校 環境問題硏究所 1995 環境硏究 Vol.13 No.-

The relationship among dust exposure dose, special health diagnosis results and subjective symptom questionaire survey for 109 casting foundry workers supervised by a local laber office has been studied from august to october 1993. Subjective symptom, dust exposure dose and health examination evaluation of respective working processes have been analized and concluded as follows; 1. Metal fume concentration in melting process measured 3.21±1.46㎎/㎥ is under threshould limit value(TLV;5.0㎎/㎥), casting sand dust measured in molding and desanding process is 5.8 ±3.41㎎/㎥ and 9.69 ±2.64㎎/㎥ which is 3-5 times higher than TLV(2.0㎎/㎥), metal fume, welding fume and metal dust in finishing process measured 9.34 ±1.32, 13.73 ±16.97 and 10.17 ±3.50㎎/㎥ respectively, which are also 2-3 times higher than TLV(5.0㎎/㎥). 2. The complain rate subjective symptoms appeal evaluated for finishing process are 35.9%, 46.2%, 27.2% and 42.2% for eye smptoms, respiractory, skin, general symptom respectively and the rates above express the highest values and the complain rates for melting process are 24.4%, 37.5% and 35.7% for eye smptoms, respiratory and mental system respectively and for molding and desanding it is 24.3%. 3. Perceived occupational disease rate is found 0.9% with are out of 109 worker surveyed who have been exposed in metal fume of finishing process. 4. 33.0% of workers surved are found to require close examination, the worker of hepatopathy suspected are 21.4% which is the highest and 3.7% for circulatory disturbance suspected. 5. The statistically significant variables in general chracteristics that affect health examination evaluation are smoking(P<0.001), respirator put-on (P<0.05) and working career(P<0.05). 6. Cough(P<0.001), "headache"(P<0.05) and "easily skin exchange by slight stimulation" (P<0.05) are statistically significant to the subjective symptom variables affect health examination evaluation.

신우신염으로 오인된 부종양증후군을 동반한 신세포암

한민철,김재헌,박성재,변동원,강덕희,심봉석 이화여자대학교 의과대학 2004 EMJ (Ewha medical journal) Vol.27 No.2

Renal cell carcinoma can presents wide range of signs and symptoms, and commonly associated with paraneoplastic syndrome. Paraneoplastic manifestations are present in up to 20% of patients with renal cell carcinoma. There is convincing evidence that renal cell carcinoma tumor cells elaborate proteins that serve as mediators of endocrine (ex ; ectopic production of parathyroid hormone-related protein or erythropoietin) as well as nonendocrine paraneoplastic syndromes. A paraneoplastic syndrome may be the various clinical presentation of renal cell carcinoma in a significant number of patients, therefore mimicked other general disease. We report a case of renal cell carcinoma associated with paraneoplastic syndrome mimicking pyelonephritis.