한국인 인슐린 비의존형 당뇨병 및 이차성 당뇨병 환자에서 글루코키나제 유전자 변이

남재현(Jae Hyun Nam),이현철(Hyun Chul Lee),김연의(Youn Euy Kim),권석호(Suk Ho Kwon),윤용석(Yong Suk Yoon),박석원(Suk Won Park),원영준(Young Jun Won),차봉수(Bong Su Cha),송영득(Young Duk Song),이은직(Eun Jig Lee),임승길(Sung Kil Lim) 대한내과학회 1998 대한내과학회지 Vol.54 No.6

N/A Objectives: Mutations in the glucokinase (GCK) gene are considered a possible cause of maturity-onset diabetes of the young. The purpose of this study was to evaluate the contribution of this gene to the development of non insulin dependent diabetes mellitus (NIDDM), gestational diabetes mellitus (GDM) and post-renal transplantation diabetes mellitus (PTDM). Method: Identification of GCK mutation was attempted on 39 NIDDM patients, 2 GDM patients and 58 selected renal allograft recipients with PTDM and 45 normal controls. The exons in the GCK gene were examined by polymerase chain reaction (PCR), followed by analysis of single-stranded DNA conformational polymorphism (SSCP). The abnormal bands were also confirmed by DNA sequencing analysis. The exons of affected family members were also investigated for mutations of the GCK gene. Results: Two of the 58 PTDM patients (3.4%) were found to have CKK mutations. One had the mutation on exon 5 and the other on intron 7. One control subject had the mutation on intmn 9. The mutation of exon 5 was identified as a substitution of CCT (proline) for CTT (leucine) at codon 164, which has not ever reported before. The family members of the PFDM patient with mutation of exon 5 were analyzed by PCR followed by SSCP, and two of them revealed the same mutation. The abnormal band on the SSCP analysis of exon 7 was identified as the insertion of base C/T at the 39th nucleotide in intron 7. Two family members of this patients also had same band on SSCP. The one mutation of 45 normal controls was CT located at the 8th nucleotide in intron 9, which was a common polymorphism. Conclusion: We found GCK mutations in subjects with PTDM and we speculate that these mutations may be one of the contributing cause of PTDM.

The insect community structure with indicator species along vegetation composition in Is. Nam-hae, South Korea

Jong Woo NAM,Shin Young PARK,Ik Jae CHOI,Young Min SHIN,Il-Kwon KIM 한국응용곤충학회 2015 한국응용곤충학회 학술대회논문집 Vol.2015 No.04

An insect faunal survey was carried out to investigate insect community structure along the vegetation community to monitor insect species in forest ecosystem. We performed day and night collections from June to August along three vegetation communities of Is. Nam-hae in 2014: the first stand with Pinus thunbergii, the second P. thunbergii with Quercus serrata and the third P. thunbergii with various Quercus species. In total 2,259 individuals of 532 species, 99 families, 13 orders are identified. Cluster Analyses (CA) showed that all three vegetation communities were relatively similar between vegetation community types. According to indicator species analysis (ISA) result, nine significant indicator species were identified (p < 0.05); five species were found to be affected by the vegetation cluster and four species the month cluster.

조기발병형 파킨슨병환자와 정상인의 호흡 및 발성 특성 비교

전은애(Eun Ae Chun),손영호(Young Ho Shon),백승재(Seung Jae Baek),이필휴(Phil Hyu Lee),남정모(Chung Mo Nam),이지은(Ji Eun Lee),최예린(Yaelin Choi) 한국언어청각임상학회 2010 Communication Sciences and Disorders Vol.15 No.4

배경 및 목적: 파킨슨병은 호흡과 발성에 영향을 준다. 49세 이전에 발병하는 조기발병형 파킨슨병(young-onset parkinson’s disease: YOPD, 이하 YOPD)도 호흡과 발성에 문제가 있는지 보기 위해 정상군과 비교하여 살펴보고자 하였다. 또한 파킨슨병 환자의 음성에 관한 연구는 있었지만 YOPD 환자의 음성특성에 대한 호흡과 발성 기능에 대해서 연구된 선행연구는 찾아보기 어렵다. 방법: YOPD 환자군 6명과 빈도대응 시킨 정상군 6명을 대상으로 호흡기능 평가를 위하여 MicroQuarkⓇ를 이용하여 노력성 폐활량(forced vital capacity: FVC, 이하 FVC), 1초간 노력성 호기량(forced expiratory volume at one second: FEV1, 이하 FEV1)과 1초간 노력성 호기량의 노력성 폐활량에 대한 비(이하 FEV1/FVC)를, 음향학적인 평가를 위하여 Multi-Dimentional Voice Program(이하 MDVP)를 이용하여 주기간 주파수 변동률 (이하 jitter)과 주기간 진폭 변동률(이하 shimmer)을, 공기역학적인 평가를 위하여 Phonatory Aerodynamic System(이하 PAS)를 이용하여 평균호기류율(mean airflow rate: MFR, 이하 MFR)과 성문하압(subglottal pressure: Psub, 이하 Psub)을, MDVP를 이용하여 최대발성지속시간(maximum phonation time: MPT, 이하 MPT)을 측정하고 분석하였다. 이비인후과 전문의사가 후두 스트로보스코피(stroboscopy)를 통해 후두의 병리 유무를 평가하였다. 두 집단의 호흡기능, 발성기능의 차이는 맨-휘트니 U검정(Mann-Whitney U-test)을 실시했다. 결과: MPT는 YOPD 환자군에 비하여 정상군이 통계적으로 유의하게 길었고, jitter와 shimmer는 정상군에 비하여 YOPD 환자군이 통계적으로 유의하게 컸다. 그러나 두 군간의 FVC, FEV1, FEV1/FVC, MFR, Psub은 통계적으로 유의한 차이가 없었다. 논의 및 결론: 두 집단 간의 호흡기능에서 차이가 없고 YOPD의 MPT, jitter, shimmer가 정상범주를 벗어나 차이가 있다. 이들 변수들이 YOPD의 음성적 진단, 치료계획과 예후를 판단하는데 도움이 될 것이다. 따라서 본 연구는 ‘연령’이라는 혼란변수를 배제하고 파킨슨병의 음성 특성을 규명 하는데 의의가 있다고 할 수 있다. Background & Objectives: Parkinson’s disease affects respiration as well as phonation. Young-onset Parkinson’s disease (YOPD) can occur even before the age of 49 years. The present study selected YOPD patients in such a manner as to exclude the confounding variable of ‘age’ and thus examine the vocal characteristics of Parkinson’s disease solely. We aimed to compare the respiration function and phonation characteristics of these YOPD patients with a normal group. Methods: The present study’s subjects included a YOPD group comprised of 6 patients whose chronological ages were between 38 and 49 years and onset ages were prior to 49 years, and a normal group comprised of 6 subjects selected by frequency-matching. For testing respiration function, FVC, FEV1 and FEV1/FVC were measured using Cosmed’s MicroQuarkⓇ as a basic test for the ventilation function of the lung. For vocal sampling, the Multi-Dimensional Voice Program (MDVP) and the Advanced Model 5105 of KayPENTAX’s Computerized Speech Lab (CSL) Model 4400 were used to analyze maximum phonation time (MPT), jitter, and shimmer. Additionally, KayPENTAX’s Phonatory Aerodynamic System (PAS) 4500 was utilized to analyze mean air flow rate (MFR) and subglottal pressure (Psub). Otolaryngologists and neurologists participated in the research cooperatively, and the otolaryngologists assessed the presence of laryngeal disease directly through larynx stroboscopy in the all subject. Mann-Whitney’s U test was used to analyze the difference between the 2 groups’ respiration and phonation function. Results: The MPT was longer in the normal group than YOPD patient group, and both jitter and shimmer were larger in the YOPD patient group than the normal group; both of these differences were statistically significant. However, there was no statistically significant difference in FVC, FEV1, FEV1/FVC, MFR, and Psub. Discussion & Conclusion: The 2 groups’ respiration function did not differ, and YOPD patients’ MPT, jitter, and shimmer differed beyond the normal range. Thus, these variables will help in YOPD patients’ phonation diagnosis and therapeutic plans or prognosis. Although there have been studies on the phonation of Parkinson’s disease patients, limited advanced research can be found on the respiration and phonation function of YOPD patients’ vocal characteristics. The results of this study are meaningful and provide a better understanding of Parkinson’s disease because the subjects were selected such that confounding by age was avoided.

산업자재용 폴리에스터 섬유의 강도 향상에 관한 연구

박영신,남영식,정상영,최재호,장기혁,박원호,Park, Young-Shin,Nam, Young-Sik,Jung, Sang-Young,Choi, Jae-Ho,Jang, Ki-Hyuk,Park, Won-Ho 한국섬유공학회 2012 한국섬유공학회지 Vol.49 No.1

In this work, effects of total draw ratio change on the mechanical properties of polyester fibers were studied. The process parameter was a total draw ratio and the draw ratios that were used ranged from 6.6 to 7.0. Tensile properties are determined from the tensile tester, and crystallite parameters from the density measurement and X-ray diffraction were discussed with the different total draw ratios. The tenacity, young's modulus and crystallinity were increased to 10.6 g/d, 123.2 g/d and 42.1%, respectively, with increase in the total draw ratio. The relations between total draw ratio and mechanical properties of high tenacity polyester fiber were discussed.

만성 B형 간염에서 라미부딘 치료중 발생한 Viral Breakthrough 예의 임상 결과

안수현,장윤정,오성남,최도원,백수정,정원석,최창원,김경오,임형준,조남영,박종재,김재선,박영태,이명석,연종은,변관수,이창홍 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.4

목적: 만성 B형 간염의 치료 중 발생하는 약제 내성 변이종은 임상적으로는 치료 중 음전되었던 혈청 HBV DNA가 다시 양전되는 viral breakthrough 로 진단할 수 있다. 현재 약제 내성 변이종이 발생했을 경우라도 라미부딘 치료를 계속 유지하는 것을 권장하고 있으나, viral breakthrough 발생 예들의 장기적 임상경과가 아직도 불명확하여 이것을 일반화하기는 어려운 상황이다. 이에 라미부딘 사용 중 viral breakthrough 가 발생한 예들을 대상으로 그 임상경과를 알아보고자 하였다. 대상과 방법: 9개월 이상 라미부딘을 투약한 만성 B형 간염 환자로 viral breakthrough가 발생한 74명을 대상으로 하였다(남/여 54/20, 평균연령 42세). Viral breakthrough 후 혈청 ALT치, 총 빌리루빈치, HBV DNA 역가, HBeAg, anti-HBe를 정기적으로 검사하면서 임상경과를 관찰하였다. Viral breakthrough 후 라미부딘의 투약기간은 평균 13개 월(1-41개월)이었다. 결과: Viral breakthrough 발생후 혈청 ALT치가 정상으로 유지되었던 환자는 8예(11%)에 불과했고 나머지 66예(89%)에서는 ALT치가 증가하였으며, 이중 30예(41%)에서 급성 악화(ALT 정상 상한치의 5배 이상 상승)를 보였다. 급성악화는 viral breakthrough 후 3개월 내에 19예 (63%)에서 발생하여 3개월 내에 발생한 예가 많았으나 12개월 이상 지나서 나타나는 예도 약 20%에서 있었다. 비대상성 악화는 6예에서 관찰되었다. Viral breakthrough 후 급성악화가 일어난 예와 없었던 예의 비교에서 급성악화를 예측할 수 있는 인자는 발견할 수 없었다. Viral breakthrough 후 발견할 수 없었다. Viral breakthrough 후 HBeAg이 음전된 예는 8예(11%)였으나 그 임상경과는 양호하지 않았다. 결론: 만성 B형 간염 환자 에서 라미부딘 투여 중 발생한 viral breakthrough 예 중 상당수에서 급성악화가 발생하였으며, HBeAg 이 소실되더라도 그 임상경과는 양호하지만은 않았다. Viral breakthrough 발생 후 주의 깊은 임상경과 의 관찰이 요구되며, 앞으로 viral breakthrough 후 급성악화 예에 대한 대규모 연구와 적절한 치료방향의 제시가 이루어져야 할 것으로 생각된다. Background/Aims: Long-term lamivudine therapy can induce the emergence of lamivudine resistant hepatitis B virus (HBV) mutants. Clinically emergence of the mutant is expressed by the reappearance of disappeared HBV DNA in serum. Continued lamivudine treatment has been usually recommended in cases of viral breakthrough. However, the clinical outcome in patients with viral breakthrough is not clear. The aim of this study was to investigate the clinical course of chronic hepatitis B patients after viral breakthrough during lamivudine therapy. Methods: A total of 74 patients with chronic hepatitis B who showed viral breakthrough after at least 6 months of lamivudine treatment were included in this study. They had positive HBeAg and HBV DNA before treatment. The median follow-up duration after breakthrough was 13 months. Results: After viral breakthrough, only 8 patients (11%) maintained normal ALT levels and 66 patients (89%) showed elevation of ALT. 30 patients (41%) showed acute exacerbation of hepatitis (ALT increase over five-times upper normal limit). These acute exacerbations occurred within three months after breakthrough in 19 patients (63%). In the cases of acute exacerbation, 6 patients showed decompensated progression such as elevation of serum total bilirubin. One of them died of hepatic failure. A predictive factor for acute exacerbation was not found. HBeAg seroconversion occurred in 8 patients after viral breakthrough but their clinical course was highly variable. Conclusions: Chronic hepatitis B patients who had viral breakthrough during lamivudine therapy should be followed carefully and regularly in mind of potential clinical deterioration. New strategies are needed to manage the cases of acute exacerbation after viral breakthrough.(Korean J Hepatol 2002;8:389-396)

동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 : 견관절 가동운동범위(ROM) 변화를 중심으로

남동우,김행범,양동훈,임사비나,김건식,이두익,이재동,최도영,이윤호 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block. All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

유착성 관절낭염 치료에 있어서 한방 치료와 양방 치료의 임상적 고찰 : 동서협진 모델 개발을 위한 기초 연구를 중심으로

남동우,정인태,김주희,박유선,임사비나,이두익,이재동,이윤호,최도영 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

Objectives : To observe the effect of acupuncture treatment and western medical treatment on frozen shoulder patients. Methods : 39 voluntary patients were randomly assigned to the Eastern treatment group(E group, n=22) and the Western treatment group(W group, n=17). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. Both groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment using Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 5.67 on a scale of 10. The W group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 7.73. But the difference between the two groups were insignificant according to CSA and SPADI. Conclusion : Both acupuncture and nerve block treatment significantly improved frozen shoulder. But the difference of the two treatments was insignificant.

유착성 관절낭염에 대한 침 및 신경차단술 처치의 임상적 관찰

남동우,임사비나,김종인,김건식,이두익,이재동,이윤호,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

Objectives : To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Metbods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group ,n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW grouP, n=20). The E group received acupuncture treatment on LI15, TE_(14), GB_(21) and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. AU three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significant1y(P<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.

그레이브스병에서 치료에 따른 폐동맥압의 변화

남택만,조한수,이진서,송영림,김두만,두영철,박철영,정인경,홍은경,이성진,오기원,김현규,유재명,최문기,유형준,박성우 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경: 갑상선기능항진증에 의한 갑상선중독증 환자들은 호흡곤란을 호소하며, 그 원인으로 호흡근의 근력 약화, 좌심실부전으로 인한 폐모세혈관의 울혈, 기도저항의 증가, 갑상선종으로 인한 기관의 압박, 호흡기능 이상 등이 거론되고 있다. 폐동맥고혈압이 동반된 그레이브스병 환자가 여러 증례가 보고되었으며, 폐동맥고혈압 환자에게서 갑상선 자가항체와 갑상선기능저하증의 빈도가 높음이 알려지면서 갑상선중독증이 동반된 그레이브스병 환자에게서 관찰되는 호흡곤란의 한 원인으로 폐동맥압 증가가 작용할 가능성이 제시되고 있다. 이에 저자 등은 그레이브스병 환자를 대상으로 폐동맥압을 측정하고 치료 전후의 폐동맥압의 변화를 전향적으로 연구하였다. 방법: 갑상선중독증이 동반된 그레이브스병 환자와 정상 갑상선기능을 나타낸 대조군을 대상으로 갑상선기능검사 및 갑상선 자가항체를 측정하고, 심초음파를 이용하여 치료 전후로 폐동맥압을 측정하여 폐동맥압과 갑상선기능 및 갑상선 자가항체와의 관계, 폐동맥압의 변화 등을 관찰하였다. 결과: 1. 연구대상은 대조군 10명 (남녀비 1:9, 관해 상태의 그레이브스병 3명, 갑상선종 3명, 정상인 4명), 그레이브스병 환자 26명 (남녀비 7:19)이었다. 2. 대조군과 치료 전 그레이브스병 환자의 폐동맥압은 각각 23.5±2.32 mmHg, 29.6±10.3 mmHg이었고, 치료 전의 폐동맥압과 혈청 갑상선자극호르몬 결합억제 면역글로불린 (TBII) 농도는 유의한 양의 상관관계를 보였다. 3. 26명의 그레이브스병 환자 중에서 10명 (38.5%)이 폐동맥고혈압 (기준: 폐동맥압 > 30 mmHg)으로 진단되었다. 4. 치료 전후로 폐동맥압을 측정한 13명은 폐동맥압이 치료 전 29.6±10.3 mmHg에서 치료 후 폐동맥압 22.2±6.48 mmHg로 의미있게 감소하였다. 결론: 갑상선중독증을 보이는 그레이브스병 환자의 약 40% 정도에서 폐동맥고혈압이 발견되어 폐동맥고 혈압은 그레이브스병에 흔하게 동반하는 질환으로 생각된다. 향후 그레이브스병 환자에서 관찰되는 폐동맥압의 증가와 관련한 병인, 발생기전 및 임상적 의의 등에 대한 연구가 필요할 것으로 생각된다. Background: Exertional symptoms, dyspnea and impaired effort tolerance are common in patients with Graves' disease. Proposed explanations include: high-output left heart failure, ineffective oxygen utilization and respiratory muscle weakness. In addition, pulmonary hypertension has also been reported in patients with Graves' disease. A high prevalence of hypothyroidism and positive thyroid autoantibody were also observed in patients with pulmonary arterial hypertension. Therefore, the pulmonary artery pressure in patients with Graves' disease was evaluated. Methods: Two-dimensional and Doppler echocardiographic examinations (Hewlett Packard Sonos 2500) were performed to determine the pulmonary artery (PA) pressure in 26 Graves' disease patients, both before and after treatment (23 patients with propylthiouracil and 3 with RAI), and in 10 euthyroid controls. The changes in the PA pressure after treatment were evaluated in 13 patients with Graves' disease, who became euthyroid after treatment. Results: The pulmonary artery pressure was increased in the untreated Graves' disease patients compared to the normal controls (23.5±2.32 vs. 29.6±10.3 mmHg). 38.5% of the Graves' disease patients (10/26) showed pulmonary arterial hypertension (PA>30 mmHg) and the serum TBII level was higher in the Graves' disease patients with pulmonary arterial hypertension than in those with normal PA pressure (P<0.05). In the Graves' patients who became euthyroid after treatment, the PA pressure was significantly decreased. Conclusion: 38.5% of the untreated Graves' disease patients showed pulmonary arterial hypertension, and the pulmonary artery pressure was significantly decreased in those who became euthyroid after treatment. The pathogenesis and clinical importance of pulmonary arterial hypertension in Graves' disease requires further studies (J Kor Soc Endocrinol 18:465∼472, 2003).

자궁외임신 216례

남상욱,송재경,최종호,홍순도,이종학,허광현,박일영 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

This study was undertaken to review the case series of 216 ectopic pregnancies admitted to the Department of Obstetrics and Gynecology, Pohang Sunrin Hospital from January, 1990 to December, 1991. The incidence of ectopic pregnancy was relatively high, being found to be 1 in 34.4 delivery cases. On the symptomatology, low abdominal pain was encountered in 96.8 percent, amenorrhea in 93.5 percent and vaginal bleeding in 16.2 percent in order. The fallopian tube was the most frequently, being found to be 98.6 percent, followed by the ovary with 0.9 percent and the cervix with 0.5 percent.