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).

뇌실외 배액술 관리에 대한 이해 및 업무수행 실태

김정숙,윤미선,송소이,이지은,문경선,고지운,임분남,김경희,박경숙 중앙대학교 간호과학연구소 2001 중앙간호논문집 Vol.5 No.2

The objective of this study was to investigate the managing realities of EVD and provide a descriptive survey with the attempt to obtain basic data needed for the standardization of EVD management. For that purpose, 220 questionnaire copies were distributed to those nurses who were working with intensive care units at university hospitals, general hospitals, semi-general hospitals in Seoul, Kyongki-de and local areas. Of 158 returned questionnaire copies, 139 were used for analysis. Data were collected during the term of academic seminars of Neurosurgery Nursing Committee and KICA (Korea Intensive Care Association), ranging from Oct. 26 through 27. 2000. The tools utilized a structured questionnaire form consisting of 21 questions on general characteristics, the level of understanding, the level of work performance, standard management guidelines, etc. The data collected were analysed with frequency, percentage, mean vague, chi -square test using the SPSS 10.0 program Findings were revealed, as follows: For managing the prevention of EVD infection, aseptic technique was found to be of the most importance (48.9%),'the technique should be carried out at an operation room'(92.8%), but it was actually performed at intensive care units (over 51.5%). 'The term of antibiotics use should be less than 7 days' (81.8%), while it was actually executed for less than 7 days (49.5%). 'The proper time of quittance from it should be within less than 7 days'(74.1%) but actual quittance was executed only by 51.1%. 'Set exchange is needed' by 54.0% but actual exchange was implemented merely by 28.1%. 'The subject of management should be nurses' was reflected by 40% but actually 52.0% were carried out. As a result of hating analysed the understanding of the management of EVD by general characteristics, a significant difference was found in the necessity for set exchange by hospitals, in the time of quittance of a catheter, and in ablution items by work experience. The result of hating analysed the work performance levels of EVD management by general characteristics revealed that a significant difference in administration facilities of medicine by the classification of hospitals, especially the use of antibiotics and the quitting time of a catheter by the classification of intensive care units, and in the use of antibiotics and ablution items by the standard management guidelines.

ATM망의 가상경로상에서 Threshold를 이용한 효율적인 대역관리

김상철,고승일,고성택,김경식,김경연 濟州大學校 情報通信硏究所 1999 情報通信硏究所論文集 Vol.2 No.-

Effective bandwidth allocation is desirable to control the ATM traffic. It should provide high fairness and utilization for different kinds of services in call admission. Complete bandwidth sharing is efficient for utilization of bandwidth but not efficient for fairness of call admission. Complete bandwidth partitioning is efficient for fairness but not efficient for utilization. We propose a new CST(Complete Sharing with Threshold) algorithm using threshold in a VP to improve fairness and utilization. Using CST algorithm. the system performance is improved by 1.4% compared with the RSC(Reserved Sharing with Common pool) algorithm.

Caffeine이 지구성 운동 수행능력에 미치는 영향과 억제성 아미노산에 의하여 활성화되는 이온통로의 조절작용

김은경,김영표,천병옥,이계영,김연정,임백빈,조영욱,김창주,김성수 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

To investigate the effect and mechanism of caffeine on endurance exercise, two experiments were performed. First, to test caffeine effect on aerobic exercise, 200-300g Sprague-Dawley rats were used and three groups, control group, low caffeine injection group and high caffeine injection group, were divided. Blood smpling by heart puncture were done at rest, after 30 min treadmill exercise, and after maximal exercise. Blood glucose, free fatty acid concentration were detected and following results were obtained. Glucose concentration showed significant difference between groups(p=0.0305) and also significant changes were exhibited between time(p=0.0004). Free fatty acid concentration had no difference between groups. but had significance between times(p=0.00065). Exercise endurance performance time showed significant difference(p=0.02350 in high caffeine injection group compared to control group. In this experiments, endurance exercise capacity was increased by caffeine injection. Therefore, second experiment was performed to investigate the effect of caffeine on ion current induced inhibitory amino acid neurotransmitter. GABA and glycine. Single periaqueductal gray neuron was acutely dissociated and nystatin perforated patch clamp was performed under voltage clamping condition. Caffeine evoked outward current in PAG neuron dose dependent manner. 1mM of caffeine application had no response. but 3mM caffeine evoked about 32.5±8.539pA outward ion current and 10mM caffeine evoked about 215.46±19.4pA outward current. 10^-2mM GABA activated Cl￣current and recorded by inward current. Caffeine inhibited GABA activated Cl￣ current concentration dependent manner. 10^-2mM of caffeine had no effect on 1-^-2mM of GABA response. but 10^-1mM caffeine inhibited GABA activated Cl￣ current about 5.74±2.13%, 1mM caffeine inhibited about 17.25±2.70%, 10mM caffeine inhibited GABA response about 45.31±7.71%. 10^-1mM of glycine activated Cl￣ current and also recorded by inward current. Caffeine inhibited glycine activated Cl￣ current concentration dependent manner. 10^-2mM caffeine decreased glycine activated Cl￣ current about 4.61±1.650%, 10^-1mM caffeine decreased about 6.49±2.24%, 1mM caffeine decreased about 26.82±4.27%, and 10mM caffeine decreased glycine response about 94.47±1.39%. These results suggest that caffeine inhibite inhibitory amino acid, GABA and glycine, this response causes excitation of CNS and this seems to be the basic mechanism of increasing effect to aerobic exercise performance by caffeine.

Original Article : Geographic difference of epidemiological features of HCV infection in Korea

( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)

Emotional branding speaks to consumers’ heart: the case of fashion brands

Youn‑Kyung Kim,Pauline Sullivan 한국의류학회 2019 Fashion and Textiles Vol.6 No.1

In this highly competitive market, fashion brands struggle to distinguish themselves to increasingly apathetic consumers. To become more competitive, fashion retailers employ emotional branding as a way to engage their customers, addressing the growing trend of consumers’ seeking emotional relationships with a brand. Although brand technicalities such as product attributes, features, and facts may be unmemorable, personal feelings and experiences better shape consumers’ evaluations of brands. This study illustrates why emotional branding is essential, especially to fashion brands, when developing brand strategies in a volatile marketplace. Trends that support a need for these strategies include consumers’ desires for positive experiences, expressing authentic self, achieving warm glow from helping others, and co-creating design or ideas with the brand. We propose a model for emotional branding strategies that focuses on sensory branding, storytelling, cause branding, and empowerment. The case studies we provide for each strategy describe how fashion brands can engage customers through emotional branding.

적응추정기를 이용한 강의 수질 감시 시스템 설계

김창일,권성숙,김경식,김경연 濟州大學校 情報通信硏究所 1998 情報通信硏究所論文集 Vol.1 No.-

An adaptive estimator to estimate the water quality in a river under unknown biased measurements environment is developed. In modeling the unknown measurement bias, it is assumed that the bias sequence is governed by semi-Markov process. By incorporating the semi-Markov probability concepts into the Bayesian estimation theory. an effective adaptive estimator which consists of parallel Kalman-type filters is obtained. Computer simulation results for the multiple-reach river system show that the proposed adaptive estimator have good estimation performance in spite of the unknown randomly switching measurement bias.

판별분석법을 이용한 관상동맥질환 고위험군의 예측

김성률,김기현,정갑열,김정만,박경일,김준연,이상주,김원술 동아대학교 부설 산업의학연구소 1995 산업의학연구소 논총 Vol.- No.2

The objective of this study is to predict the high risk group of coronary artery disease from body mass index, blood pressure, fasting blood sugar and serum lipids level using the method of discriminant analysis. Variables with significant difference between coronary artery disease group and normal group were HDS-C, LDL-C/HDL-C, LDL-C, and TG. But the acuity did not exceed 70% in any single variable. As the results of discriminant analysis, statistically significant discriminant variables were HDL-C, T-chol, FBS and TG. The discriminant equation was(Y) = -0.06759(HDL-C) + 0.01498(T-chol),+0.01923(FBS) - 0.01421(TG) + 0.5187, and the overall discriminant power using the above 4 variables was 79.3%

Newcastle Disease Virus의 Fusion 단백 유전자의 제한효소분절형태(RELP)의 특이성

장경수,김지영,김석,김태용,송영환,허지연,김현수,송희종,전무형 충남대학교 수의과대학 동물의과학연구소 2001 動物醫科學硏究誌 Vol.9 No.-

To evaluate the specificity of restriction fragment length polymorphism (RFLP) of Newcastle disease virus (NDV) fusion (F) protein gene for various NDV strains. F protein genes of NDV CBP-1 isolate, LaSota, B1 and Kyojungwon (KJW) were amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) and RFLP were examined. In RT-PCR using F primer sets for 1.7 kb F gene, the amplified products were observed in CBP-1, LaSota and B1 except KJW. However, F2 primer set for 521 bp yielded the amplified bands with all strains. The amplified F genes (1.7 kbp) were treatd with 15 different restriction enzymes to analyze RFLP and the cleavage patterns. CBP-1 showed various cleavage patterns with 8 enzymes, LaSota, with 11 enzymes and B1, with 11 enzymes. According to the cleavage patterns, the physical maps were constructed, and it was found that CBP-1, LaSota and B1 strains had specific cleavage sites with HinfI, XbaI and XhoI. These findings suggest that RFLP are worth applying in the diagnosis and molecular epidemiological studies of Newcastle disease.

소규모사업장 보건관리기술지원사업 지원여부에 따른 사업장내 의사소통 비교

정최경희,박혜숙,김정연,이경용,현성민,오지영,김수근,김현주,하은희 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

목적: 소규모사업장 보건관리기술지원사업 지원여부에 따라 사업장내 위험의사소통채널이 마련되었는지와 이 채널이 기능을 하는지, 그리고 의사소통채널마련과 사업장내 위험의사소통 활성화의 기본적이고 중요한 배경이 되는 사업주의 산업보건에 대한 관심이 차이가 있는지에 대해 살펴보고자 하였다. 방법: 서울, 안산, 대전, 광주, 포항 지역에서 보건관리기술지원사업을 받은 사업장과 받지 않은 사업장을 대상으로 비례층화무작위표본추출법을 사용하여 추출한 후 1991년 12월 6일부터 10일간 우편설문조사를 실시하였다. 설문대상은 각 사업장의 남녀 각 1명, 보건업무담당자, 사업주였으며, 설문내용은 사업장 및 응답자의 일반적 특성 및 사업장내 위험의사소통이었다. 설문에 응답이 온 463개 사업장의 자료를 자료처리하여 총 228개 사업장(단해년도지원 사업장 189개, 연속2년지원 사업장 13개, 비지원사업장 26개)을 대상으로 분석하였다. 결과: 사업장내 의사소통에 대한 단변량분석에서는 보건업무 담당자의 선정여부만이 통계적으로 유의한 차이가 있었다. 소규모사업장 보건관리기술지원사업을 지원받지 않은 사업장과 지원받은 사업장의 사업장내 위험의사소통을 비교하기 위한 로지스틱회귀분석 결과, 모든 항목에서 통계적으로는 유의한 차이를 보여주지 않았다. 그러나 사업주의 관심(OR ; 1.63, 95% CI ; 0.38~7.01)과 보건업무담당자의 선정(OR ; 3.67, 95% CI ; 1.00~13.44) 및 결정권한(OR ; 1.48, 95% CI ; 0.25~8.91), 사업주의 산업보건문제 소통(OR ; 3.07, 95% CI ; 0.81~11.71), 보건업무담당자의 정보요청경험(OR; 4.48, 95% CI ; 0.97~20.57)에서는 지원받지 않은 사업장에 비해 지원받은 사업장에서 교차비가 증가하는 양상을 보여주었다. 반면 노동자의 산업보건문제 소통가능성여부는 오히려 교차비가 0.53(95% CI ; 0.11~2.44)로 감소하는 경향을 보여주었다. 결론: 소규모사업장 보건관리기술지원사업을 의사소통의 측면에서 평가해보면, 사업주나 보건업무담당자에게는 다소 효과가 있었지만 노동자가 지속적으로 참여할 수 있도록 의사소통문화를 바꾸어내는 데에는 한계가 있었다. 개선을 위해서는 노동자 중심의 접근 프로그램의 개발 및 시행이 시급하다 할 수 있다. Objectives :This study was to evaluate the effectiveness of the government-funded subsidized occupational health program for small-scale enterprises(GSOHP_SSE) by occupational health com-munication in workplace. Methods : We sampled the 1,835 enterprises of study by proportional stratified random sampling among industries of supported and not supported by GSOHP_SSE in Seoul, Ansan, Daejeon, Kwang-joo and Pohang. Information on the general characteristics of enterprises and respondants and occupational health communication in the workplace was collected on self-reported questionnaires by post-survey between December 6 and 15 in 2001. We received answers from 463 enterprises and analyzed 228 enterprises through data-cleaning by logistic regression to evaluate effectiveness of GSOHP-SSE about occupational health communication in the workplace. Results : By multiple logistic regression analysis, GSOHP_SSE turned out not to be statistically significant factor in all dependent variables about occupational health communication in the work-place. The concern of owner(odds ratio (below OR) ; 1.63, 95% confidence interval(below 95% CI) ; 0.38-7.01), formation(OR ; 3.67, 95% CI ; 1.00-13.44) and empowerment(OR ; 1.48, 95% CI ; 0.25-8.91) of health manager, request about occupational health problem of health manager(OR ;4.48, 95% CI ; 0.97-20.57) and occupational health communication of owner (OR ; 3.07, 95% CI ; 0.81-11.71) had the trend increasing OR in the industries supported GS-OHP_SSE relative to the industries not supported. But in recognition of possibility on occupational health communication of laborers, OR of GSOHP_SSE was decreased in 0.53(95% CI ; 0.11-2.44). Conclusions: This study found that the GSOHP_SSE was some effective to the side of employer and health manager, but had a limitation about change of communication culture useful to the laborers. We suggested the laborer-centered health training programs or the empowerment-based health training programs for effective occupational health management in the workplace.