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제2형 당뇨병 외래 환자의 비만도에 따른 미세혈관합병증
이성규,조남한,김현만,이관우,정윤석,채봉남,김윤정,이미덕,노혜림,홍은경,조현경 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.1
Background: Korean type 2 diabetic patients who are frequently non-obese, may be genetically different from Western type 2 diabetics who are frequently obese. Therefore, the diabetic complications of type 2 diabetes mellitus in Korea may be also different from those of Western countries. Until now, most studies reported in Korea did not analyse the microvascular complications of type 2 diabetes mellitus according to obesity, and also the criteria in the diagnosis of microvascular complications were different in each study. We investigated the microvascular complications and its relationship with obesity, in type 2 diabetic patients visiting an outpatient clinic. Methods: The study subjects were type 2 diabetic patients visiting an outpatient clinic of Ajou University Hospital. We selected patients participating in a 75 g oral glucose tolerance test, retrospectively. Type 2 diabetes was diagnosed according to the WHO/NDDG classification of diabetes. Biochemical studies including lipid profile, plasma insulin and C-peptide levels were done. Anthropometric measurements were performed. Based on BMI (㎏/㎡), the patients were divided into the following groups: the lean group, when the BMI was less than 20 ㎏/㎡ the ideal body weight (IBW) group, if the BMI was between 20 ㎏/㎡ and 25 ㎏/㎡ in women and 20 ㎏/㎡ and 27 ㎏/㎡ in men; and the obese group, when the BMI was $gt;25 ㎏/㎡ in women and $gt;27 ㎏/㎡ in men. Results: 1. Neuropathy (45.2%) was the most frequent among the microvascular complications, and the frequency of retinopathy was 15.1%, and that of nephropathy was 4.9%. Within 5 years of diabetes duration, the frequency of neuropathy, retinopathy, and nephropathy was 43.2%, 11.8%, and 2.9%, respectively. 2. Glycosylated hemoglobin (HbA_(1c)) and fasting blood glucose levels were not different among the three groups. Beta cell function{Δ (insulin 30min - insulin Omin)/Δ(glucose 30min - glucose 0min)} was the highest in the obese group. However, beta cell function(ΔI/ΔG) divided by the basal insulin level, considered insulin resistance, was not different among the three groups. 3. Within 5 years of diabetes duration, retinopathy tended to be the most frequent in the lean group, whereas neuropathy tended to be the most frequent in the obese group, and body mass index influenced the retinopathy and neuropathy, statistically significantly. Conclusion: Diabetic neuropathy was the most frequent among microvascular complications of type 2 diabetes mellitus in our study subjects. At the time of presentation within 5 years of diabetes duration, the lean group of type 2 diabetics had a tendency of the more frequent retinopathy, the obese group had a tendency of the more frequent neuropathy. These results suggest that type 2 diabetes mellitus in Korea is also not a single disease entity, as in Western countries and is a heterogenous group of disorders with a diversity of microvascular complications. However, the more studies about this will be required.
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朴範鎬,宋在萬,李勉榮,蔡奎學 홍익대학교 경영연구소 1985 경영연구 Vol.9 No.-
As accounting is an outgrowth of society, we can say that the accounting system of each country is derived from its economic situation and from the people's outlook no economic values. Thus when the economic situation of one country is different from that of another country, and the outlook of the people of one country is different from that of another country, they the accounting system for changing prices as well as general accounting systems may be different. Actually accounting systems of different countries are not identical. The writers of this paper try to find an accounting system for changing prices suitable to out country. The writers review various theories on accounting systems for changing prices, survey accounting systems of various countries and basic patterns of such systems, and in vestigate the actual conditions of our country in order to provide accounting information which reflects the effect of changing prices and to give a practicable accounting system. In this paper, the writers state their opinions about accounting systems for changing prices as follows: 1)The demand for the publication of accounting information about the effect of changing prices upon the financial status and operational result of a business is a world-wide trend. Considering that our industries are now aiming at opening a capital market, we should establich an accounting system for changing prices in order to follow the world-wide current. 2) As we intend to follow the world-wide current, to get useful accounting information, and to get a practicable accounting system, the most suitable system for us is the current value accounting system The current value accounting system mentioned here does not provide information supplementary to that of the financial statements based on the historical cost but it provides a substitute of the current value financial statements for those based on the historical cost. Financial statements based on current values are standard statements. 3) In our country, there are no active studies or discussions on the accounting systems for changing prices. We need to set up an organization entirely responsible for the establishment of a desirable accounting system for changing prices, responsible for the establishment of guidelines for putting the system to use, and responsible for the coordination of the interests of those concerned.
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김형철,강길호,채만규,김성용,백무준,이문수,박상흠,이문호,김창호,송옥평,조무식,박희주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1
Purpose : The Mirizzi syndrome is relatively rare and preoperative diagnosis of this disease is difficult. In 1978, Morelli suggested the subclassification of the Mirizzi syndrome into acute or chronic form. We experienced 5 cases of acute form. We analysed clinical features, preoperative radiologic findings and operative findings of 18 cases including acute forms which were diagnosed as Mirizzi syndrome and should suggest the modified classification of Mirizzi syndrome for choice of appropriate treatment. Method : From January 1995 to December 1998, 18 cases, of which 8 cases were diagnosed at Soonchunhyang University Chunan Hospital, and 10 cases were reported in the Korean Journal were retrospectively analysed with regard to clinical features, preoperative radiologic findings and operative findings. According to the clinical features, whole cases were divided into type Ⅰ(acute form) and type Ⅱ(chronic form) and then each type of cases were subclassified according to preoperative radiologic findings and operative findings. Results : Of 18 cases there were 5 cases in type Ⅰ(27.8%), 13 cases in type Ⅱ(72.2%). Type Ⅱb was most common. Type Ⅰa cases were treated only with cholecystectomy. We applied cholecystectomy, T-tube choledochostomy and patch technique in type Ⅰb and thpe Ⅰc cases. Cholectystectomies including removal of gallstones and internal drainage procedures were done in type Ⅱ chronic forms. Conclusion : The acute form(Type Ⅰ) of Mirizzi syndrome was suggested by Morelli might be subclassified into typeⅠa,Ⅰb and Ⅰc following the presence of the necrotic defect in common hepatic duct. Through the modified classification of Mirizzi syndrome based on clinical feature, preoperative radiologic findings and operative findings, we can choice appropriate treatment.
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급성 충수염으로 진단된 예측 불가 염증성 맹장 종물에 대한 외과적 고찰
민경진,백무준,채만규,김성용,이문수,김창호,김재준,송옥평 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1
Purpose: An unexpected inflammatory cecal mass of uncertain etiology was encountered during surgery for presumed appendicitis. In this case, the surgeon couldn't exclude differential diagnosis which were severe appendicitis involving the cecal region, diverticular disease, other inflammatory bowel diseases, and neoplasm. Therefore, this finding leads to a therapeutic dilemma for the surgeon, when making surgical decisions during the operation. The aim of this study was to resolve this dilemma, a retrospective review was undertaken in this study. Methods: A retrospective study was performed to review the management of this problem at Soonchunhyang University Chunan Hospital for eight and half years from July 1991 to December 1999. A review of the emergency operation records identified 50 patients who had undergone ileocecal resection or right hemicolectomy for an inflammatory ileocecal mass of uncertain etiology when operated on for probable appendicitis. Results: Altogether, 39 patients underwent ileocecal resection, and 11 patients underwent right hemicolectomy. The final pathologic diagnosis was appendiceal abscess in 32 patients (63%), cecal diverticulitis in 7 patients (14%), neoplasm in 6 patients (12%), appendiceal phlegmon in 3 patients (6%), ileal tuberculosis in 1 patient (2%) and Anisakiasis in another patient (2%). The neoplasm of the 6 neoplasm patients was ascending colon cancer for 4 patients and cecal cancer for 2 patients. There was no mortality in this group. Conclusion: Although most inflammatory cecal masses are caused by benign disease, all cases in which the intraoperative diagnosis is unclear, any pathologic diagnosis including neoplasm cannot be ruled out. So this suggest ileocecal resection or right hemicolectomy to remove a possible underlying malignancy, and to decrease morbidity and mortality.
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간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의
김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1
Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.
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