당뇨병 환자에서 혈장 Thrombin-Antithrombin Ⅲ 및 Plasmin-α_2-Plasmin Inhibitor 복합체의 임상적 의의

김경욱,김은숙,정상수,윤수지,박우일,이준희,남수연,안철우,문병수,김경래,차봉수,송영득,임승길,이현철,허갑범 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.5

연구배경:당뇨병 환자에서 혈액응고 및 섬유소용해 체계의 이상경향이 있어 그 결과로 여러 혈관합병증의 발생위험이 높다는 사실은 널리 알려져 있다. 그 기전은 아직 확실히 밝혀지지 않았으나, 고혈당으로 인한 혈장 단백질들의 비효소성 당화작용이나 산화성 스트레스로 인한 유리 라티칼 작용으로 응고항진이나 섬유소용해 활성의 저하를 유발하는 것으로 생각되고 있다. 최근 응고 및 용해인자와 그 억제자의 복합체들의 증가가 이 상태를 비교적 예민하게 반영한다고 알려져 있다. 방법:본 연구에서는 당뇨병 환자 101명과 정상 대조군 20명에서 혈장내 thrombin­antithrombin complex(TAT)와 plasmin­α₂­plasmin inhibitor complex(PIC)를 측정하여 비교하고, 당뇨병 환자에서 미세혈관 합병증과 대혈관합병증의 유무에 따른 차이와, 이미 혈관 질환의 위험인자로 알려져 있는 인자들간의 상관성을 알아보고자 하였다. 결과:1. 환자의 분포를 살펴보면 혈관합병증이 있는 군은 85명, 혈관합병증이 없는 군은 16명이었고, 평균연령은 각각 57.9±14.1세, 49.9±16.6세로 혈관 합병증이 있는 군에서 더 나이가 많았고, 체질량지수는 23.2±3.4㎏/㎡, 24.1±3.4㎏/㎡로 두 군간 유의한 차이는 없었다. 또 두 군간의 혈압 및 HbA1c, 공복혈당 및 인슐린과 C­peptide, 총 콜레스테롤, 중성지방, HDL­콜레스테롤, Lp⒜는 유의한 차이가 없었고, 미세혈관합병증이 있는 군에서 당뇨병의 유병기간이 길었다. 2. TAT 및 PIC의 농도는 정상 대조군에서는 2.8±1.2 ng/mL, 240.4±69.7 ng/mL이었고, 당뇨병 환자군에서는 9.5±22.6 ng/mL, 472.2±258.7 ng/mL이었다. TAT와 PIC 모두 당뇨병 환자군에서 정상 대조군에 비해 유의하게 증가되어 있었고(p<0.001), TAT/PIC ratio는 두 군간 차이가 없었다. 3. 당뇨병 환자의 혈관합병증에 따른 TAT 및 PIC, fibrinogen 농도는 합병증이 없는 군은 각각 4.1±2.4ng/mL, 362.2±272.0ng/mL, 322.7±102.4mg/mL으로 PIC와 fibrinogen의 증가를 보였으나, 연령을 보정한 후에는 통계학적 유의성은 없었다. 또 대혈관 합병증군에서는 각각 6.0±4.9 ng/mL, 507.4±321.6 ng/mL, 427.1±194.7 mg/dL이었으며 미세·대혈관 합병증군에서는 10.4±6.4 ng/mL, 484.8±269.7 ng/mL, 388.4±132.4 mg/dL으로 TAT의 증가를 보였으나 역시 연령을 보정한 후에는 통계학적 유의성은 없었다. 4. 미세혈관합병증군에서 HbA1c(>8%)가 높은 군의 PIC 농도가 유의하게 높았고(p=0.049), 대혈관합병증군에서 HbA1c(>8%)가 높은 군의 총 콜레스테롤 농도가 유의하게 높았다(p=0.042). 5. 총 당뇨병 환자군에서 PIC는 fibrinogen과 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며(r=0.47, 0.31,-0.25), 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다(r=0.67). 결론:이상의 결과에서 혈장 TAT 및 PIC 농도는 당뇨병 환자에서 정상 대조군에 비해 의미있게 증가되어 있었고, 당뇨병 환자군에서는 연령의 증가와 유병기간이 혈액응고항진 및 용해의 장애에 큰 역할을 함을 알 수 있었으며, 총 당뇨병 환자군에 PIC와 HbA1c와 양의 상관관계를, BMI와 음의 상관관계를 보였으며 혈관 합병증이 없는 당뇨병 환자군에서만 TAT는 HbA1c와 양의 상관관계를 보였다. 따라서 당뇨병 환자에서 혈액응고 및 용해의 장애가 동반되어 있다고 볼 수 있으며, 혈장 TAT 및 PIC는 혈관합병증으로의 진행을 예측하는 지표로서 유용하리라 생각된다. 또 혈당조절정도와 상관성이 있으므로 혈당조절후에 추적검사를 시행하여 합병증의 예방이 가능한지 추후 연구가 필요하리라 생각된다. Background : Abnormality of coagulation and fibrinolystic system is known as a predisposing factor of vascular complication in diabetes. Although the pathogenesis is not well known, non-enzymatic glycation reaction and the increase in production of free radicals due to an increased oxidative stress may be linked to the hypercoagulibility and hypofibrinolytic activity. As indices of abnormality in coagulation and firinolysis in peripheral blood, plasma thrombin-antithrombin Ⅲ complex (TAT) and plasmin-α_2-plasmin inhibitor complex (PIC) were measured. The purpose of this study was to clarify whether hypercoagulability exists in diabetic patients with or without vascular complication. Methods : In our study, we measured plasma thrombin-antithrombin Ⅲ compelx (TAT) and plasmin-α_2-plasmin inhibit or complex (PIC) in 101 diabetic subjects and 20 controls. Comparing TAT and PIC levels in diabetic microvascular complication group, diabetic macrovascular complication group and controls, we examined correlation between risk factors associated with diabetic vascular complication. Results : 1. The group with diabetic vascular complication was older than group without complication. There was no significant difference in BMI, blood pressure, HbA_ic, blood sugar level, insulin, C-peptide, serum creatinine, total cholesterol, triglyceride, HDL-cholesterol, Lp (a) between two groups. The group with diabetic microvascular complication had longer duration of diabetes. 2. Concentration of TAT and PIC were 2.8±1.2 ng/ mL, 240.4±69.7 ng/ mL in controls and 9.5±22.6 ng/ mL, 472.2±258.7 ng/ mL in diabetic patients, respectively. TAT and PIC were significantly higher in diabetic patients than in control (p<0.001). But TAT/PIC ratio was no significant difference between two groups. 3. In diabetic patients, concentration of TAT and PIC and fibrinogen were respectively 4.1±2.4 ng/ mL, 362.2±272.0 ng/ mL, 322.7±102.4 mg/ dL in group without vascular complication and 5.3±4.1 ng/ mL, 529.5±258.7 ng/ mL, 374.9±106.2 mg/ dL in group with microvascular complication, which group had increase in PIC and Fibrinogen but no significance after correction of age. Concentration of TAT and PIC and Fibrinogen were 60.±4.9 ng/ mL, 507.4±321.6 ng/ mL, 427.1±194.7 mg/ dL in macrovascular complication, and 10.4±6.7 mg/ mL, 484.8±269.7 ng/ mL, 388.4±132.4 mg/ dL in combined vascular complication which group showed increase of TAT but also had no significant increase after correction of age. 4. In diabetic microvascular complication patients, group of high HbA_1c (>8%) (p=0.049) had significant high PIC concentration. In diabetic macrovascular complication patients, group of high HbA_1c (>8%) (p=0.042) had significant high total cholesterol concentration. 5. In all diabetic patients, PIC was positively correlated with fibrinogen and HbA_1c and negatively correlated BMI (r=0.47, 0.31, -0.25). Only in daibetic patients without angiopathy, TAT was positively correlated with HbA_1c (r=0.67). Conclusion : In this study, plasma TAT and PIC concentration significantly increased in diabetic patients compared with controls, and PIC was increased in group with microvascular complication, TAT were increased in group with combined micro macrovascular complication. However, there was no significance relationship existed when correctinf for age. PIC was correlated with HbA_1c. TAT was correlated with HbA_1c only in the group without angiopathy. Abnormality of coagulation and fibrinolysis were combined in diabetes, plasma TAT and PIC can be used as an index of vascular complication. Also we found the correlation with the degree of the blood glucose control. Therefore we need follow up study for the possibility of prevention of vascular complication after controlling the blood glucose to age-matched patients (J Kor Diaabetes Asso 25:354~363, 2001).

고혈압 환자에서 경동맥 신전성의 변화

허영선,김학진,송영빈,안지현,임성훈,이왕수,김상욱,김태호,김치정,류왕성,유언호 중앙대학교 의과대학 의과학연구소 2000 中央醫大誌 Vol.25 No.3

Urapidil, Labetalol의 투여가 기관내 삽관시 심혈관계에 미치는 영향

신용섭,윤석화,손수창,이원형,이정은,황원재,김만수,김영주,김혜자,최세진 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

We have examined the comparative efficacy of small doses of intravenous urapidil and labetalol in blunting hemodynamic response to endotracheal intubation and surgical incision in 30 patients without cardiovascular diseases. After intravenous urapidil 0.2 mg/kg or labetalol 0.2 mg/kg anesthesia was induced with thiopental 5mg/kg. Endotracheal intubation was facilitated by vecuronium 0.15 mg/kg with priming principle and anesthesia was maintained with enflurane and nitrous oxide in oxygen. Systolic, diastolic and mean arterial pressure and heart rate were measured before administration of the drugs, 5 minute after administration, just prior to endotracheal intubation and 1, 3, 5, 10 minute after intubatin. Also the peak blood pressures and heart rate within 10 minutes after surgical incision were measured. Endotracheal intubation and surgical stimulation were associated with significant increases in blood pressures and heart rate in both urapidil and labetalol group. Comparison of the changes in systolic, diastolic, and mean artrial pressures and heart rate between urapidil and labetalol group showed no significant difference except peak systolic pressure after surgical incision. It is concluded that the pressor response to endotracheal intubation and surgical stimulation are not influenced significantly by urapidil 0.2 mg/kg or labetalol 0.2 mg/kg. However, urapidil and labetalol preloading may be similarly effective in the blunting of the increases in blood pressures with larger doses of the durgs during anesthetic induction.

복합재료 적층판의 화학적 수축 및 잔류 변형

김종운,이수용 한국 항공대학교 항공산업기술연구소 2000 航空宇宙産業技術硏究所 硏究誌 Vol.10 No.-

복합재료 적층판의 경화공정 시 발생하는 잔류 변형을 예측하기 위해서 점탄성 유한요소 모델을 개발하였다. 적층판의 화학적 수축 및 잔류 변형을 측정하기 위해서 실험을 수행하여 계산된 해석 결과와 비교하였다. 해석과 실험 결과가 서로 잘 일치하였다. A viscoelastic finite element model is developed to predict residual deformation occurred in laminated plates during cure. Experiments were performed to measure the chemical shrinkage and residual strains of the laminated plates, which are compared with results calculated from the model. They agree well.

음주와 질병결근의 관련성

김은화,박암,이영수,조영채 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.1

To investigate the effect of alcohol drinking on the absence pattern, we conducted survey for 606 male workers who employed at the small & medium sized manufacturing factories located in Taejon city and Chungnam region. The following results were obtained. Among the variables, age, marrital status, body mass index, smoking, working hours per day, and working climate showed significant realtionship with the alcohol drinking times. Gross absence days and sickness absence days showed significant relation with alcohol drinking frequency, but non-sickness absence days did not showed any relation with alcohol drinking frequency. After adjusting the variables which had significnat relation with absence days and alcohol drinking, there were still significant relation between absence days and alcohol drinking frequency.

C_(1)-HVOCs 제거를 위한 Ru-Sn/γ-Al_(2)O_(3) 촉매 제조 및 반응성 평가

김영주,황운연,구기갑,김용렬,박종수,윤왕래 한국화학공학회 2004 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.42 No.1

HVOCs 제거에 사용되는 백금-팔라듐계보다 저렴한 촉매 개발을 목적으로 다양한 루테늄계 촉매를 제도하여 C_(1)-HVOCs 분해 특성 평가 실험을 수행하였다. 그 결과 Ru[2]-Sn[2]/γ-Al_(2)O_(3) 촉매가 가장 우수한 성능을 보였다. 구조 증진제인 주석은 흡착 산소의 양을 증가시키고, 다양한 산소 이온 종의 생성에 기여함을 알 수 있었다. HVOCs 분해 반응에 첨가되는 산소 원자는 주로 루테늄과 주석에 흡착되며, CH_(3) 등 HVOCs는 지지체인 γ-Al_(2)O_(3)의 브뢴스테드 및 루이스 산점에 흡착됨을 알 수 있었다. 흡착된 HVOCs의 염소와 브뢴스테드 산점의 수소 화학 결합에 의한 HCl의 생성 반응이 HVOCs 분해의 주 반응 기구임을 알 수 있었다. Various ruthenium(Ru) based catalysts, which were less expensive than Pt-Pd based catalysts, were prepared and their activity with C_(1)-HVOCs(Halogenated Volatile Organic Compounds) was evaluated. Ru[2]-Sn[2]/γ-Al_(2)O_(3) was found to have the most desirable effect on the destruction of HVOCs. Tin taken as a structural promoter was found to increase the amount of oxygen adsorption and to generate various oxygen ions. Oxygen atoms were found to be mainly adsorbed on the surface of ruthenium and tin and HVOCs such as CH_(3)Cl to adsorbed on Bronsted and Lewis acid sites of γ-Al_(3)O_(3) supports. It was found that the formation of HCl by the reaction of chlorine in HVOCs with hydrogen atom on Bronsted acid site was the main reaction mechanism in the destruction of HVOCs.

선형액튜에이터에 사용되는 원추형정압베어링의 부하특성에 관한 연구

김수태,김정언 國立 昌原大學校 産業技術硏究所 1996 産技硏論文集 Vol.10 No.-

A study is numerically carried out for the load capacity characteristics of conical hydrostatic bearings in the linear actuator. A numerical analysis is performed using the finite difference method, and the pressure distributions, load capacities and leakage flows of conical bearings according to bearing land, eccentricity and velocity, are obtained. Analysis shows that double bearing has the maximum load capacity between land ratio L??=0.0 and 0.1 independent of ε, A, T, L, and the double bearing with L??=0.1 is recommanded in the linear actuator.

저수준 하드웨어에서 구동 가능한 3D아케이드 게임

이용운, 김수균, 안성옥 배재대학교 공학연구소 2011 공학논문집 Vol.13 No.1

Arcade games created after the game, and I still getting a lot of attention in the games category. Arcade games with cute graphics, is characterized by providing things to do. In this paper, these characteristics utilizing 3D arcade game is aimed at making. In particular, the game engine without the use of the whole process by making DirectX libraries by using only low-level PC that can be used in the benefits and advantages are efficient in terms of memory.

Aspirin 諸合性에 關한 再考

김정란,박숙자,유영자,박옥운,김정은,노수자,오경희,조연자 梨花女子大學校 藥學硏究所 1962 梨花藥學硏究 Vol.- No.3

양극성 장애와 Monocyte Chemoattractant Protein-1 유전자 다형성

배치운,김태석,장우영,김정진,이창욱,이수정,전태연,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : Several studies suggested that cytokines could be involved in the pathogenesis of mood disorders, while data for bipolar disorder is relatively deficient (BD). BD, Knowned to have a inherited tendency, has been considered to be related with T-helper cell system. This study was designed to investigate the association between polymorphism of monocyte chemoattractant protein-1 (MCP1) gene at promoter-2518 and BD. Methods : Patients with BD (n=92) in accordance with DSM-FV criteria and control subjects (n=114) participated in this study. DNA was extracted from whole blood and the MCP-1 gene promoter region was amplified by polymerase chain reaction-based method. Results : Genotype and allele distributions in patients with BD were not different from those of control subjects (p=0.587 ; p=0.384). Genotype and allele distributions in accordance to presence or absence of suicide attempt (p=0.423), family history (p=0.733) and psychotic feature (p=0.436) were not different between the two groups. Conclusion : Present study suggests that the MCP1 promoter -2518 polymorphism may not affect the susceptibility and clinical diversity of the development of BD.