우리나라 당뇨병성 족부질환의 현황: 건강보험자료 분석결과

정춘희,오지영,이준영,박이병,김대중,민경완,백세현,손현식,박석원,박정현,안철우,최경묵,김재용,김혜영,김화영,이선희,최인정 대한당뇨병학회 2006 Diabetes and Metabolism Journal Vol.30 No.5

-Background: Foot ulcer diseases are more prevalent in diabetic patients than that those of non-diabetic patients. Several reports showed the risk of amputation and the medical cost were increased when foot ulcer developed. Therefore, strict glycemic control from the initial period of diabetes is necessary. Since there is no enough epidemiologic data, large scaled studies for medical and economic consequences about diabetic foot ulcer are needed. Methods: This study was based on health insurance claims submitted to the National Health Insurance Review Agency during the period from December 1994 through December 2002. We investigated the incidence and medical cost of foot disorders in Korean population using the disease-classification codes on the health insurance claim forms.접수일자: 2006년 8월 4일, 통과일자: 2006년 9월 28일, 책임저자: 박이병, 가천의과대 길병원 내분비내과 연구배경: 당뇨병환자에서 족부궤양의 빈도는 비당뇨인 보다 높고 족부궤양 발생 시 절단의 발생률이 높으며 의료 비용이 많이 드는 것으로 보고되고 있어 당뇨병 초기부터 철저한 혈당 관리가 필요함은 자명하다. 그러나 현재까지 국내에서는 이에 대한 근간이 되는 연구가 거의 전무한 상태로서 학회 차원의 대규모 역학 연구가 필수적이다. 방법: 저자들은 1994년 12월 1일부터 2002년 12월 31일까지 당뇨병을 주 또는 부상병으로 건강보험심사평가원에 1회이상 청구된 3,911,647명의 환자 중 사망자와 기존 유병자를 제외한 3,587,547명의 환자를 대상으로 2003년도의 당뇨병성 족부질환의 발생률과 의료비용을 알아보고자 본 연구를 시행하였다. 결과: 당뇨병환자 (391만 1647명)의 1.2%에서 족부질환이 있었으며 이는 전체 족부질환의 47.9%였고 이중 족부절단은 전체 족부절단의 54.4%, 족부궤양은 전체 족부궤양의 52.5%, 족부손상은 전체 족부손상의 11.7%였다. 당뇨병환자에서 인구 10만 명당 족부질환 발생률은 족부절단 49.7명, 족부궤양 99.7명, 족부손상 1,051명이며 비당뇨병환자에서는 각각 4.2명, 10.3명, 943명이었다. 비당뇨병과 당뇨병환자간의 족부질환 발생건수의 비교에서는 족부절단의 경우 당뇨병환자가 비당뇨병환자에 비해 11.7배, 족부궤양의 경우 9.7배, 족부손상의 경우 1.1배 많았다. 1인당 평균 총 진료비는 족부절단 1162만원, 족부궤양 780만원, 족부손상 354만원으로 비당뇨병환자에 비해 각각 2.0배, 1.7배, 2.1배 많았고 평균 입원일수는 족부절단 76일, 족부궤양 61일, 족부손상 33일로 비당뇨병환자에 비해 각각 1.6배, 1.3배, 1.7배 길었다.

인슐린 수용체 자가항체 양성인 흑색극세포증 환자의 임상상

정춘희,원영준,신영구,김홍승,이미덕 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.3

Background: Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. Methods: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. Results: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyper- ininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. Conclusion: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity (J Kor Soc Endocrinol 13:410-416, 1998).

시상하부 과오종

정춘희,정연수,신영구,이한효,김홍승 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.3

Protective Effects of Curcumin on Renal Oxidative Stress and Lipid Metabolism in a Rat Model of Type 2 Diabetic Nephropathy

정춘희,김보환,이은수,최란,Jarinyaporn Nawaboot,이미영,이은영,김현수 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.3

Purpose: Diabetic nephropathy is a serious complication of type 2 diabetes mellitus, and delaying the development of diabetic nephropathy in patients with diabetes mellitus is very important. In this study, we investigated inflammation, oxidative stress, and lipid metabolism to assess whether curcumin ameliorates diabetic nephropathy. Materials and Methods: Animals were divided into three groups: Long-Evans-Tokushima-Otsuka rats for normal controls, Otsuka-Long-Evans-Tokushima Fatty (OLETF) rats for the diabetic group, and curcumin-treated (100 mg/kg/day) OLETF rats. We measured body and epididymal fat weights, and examined plasma glucose, adiponectin, and lipid profiles at 45 weeks. To confirmrenal damage, we measured albumin-creatinine ratio, superoxide dismutase (SOD), and malondialdehyde (MDA) in urine samples. Glomerular basement membrane thickness and slit pore density were evaluated in the renal cortex tissue of rats. Furthermore,we conducted adenosine monophosphate-activated protein kinase (AMPK) signaling and oxidative stress-related nuclearfactor (erythroid-derived 2)-like 2 (Nrf2) signaling to investigate mechanisms of lipotoxicity in kidneys. Results: Curcumin ameliorated albuminuria, pathophysiologic changes on the glomerulus, urinary MDA, and urinary SOD relatedwith elevated Nrf2 signaling, as well as serum lipid-related index and ectopic lipid accumulation through activation of AMPK signaling. Conclusion: Collectively, these findings indicate that curcumin exerts renoprotective effects by inhibiting renal lipid accumulationand oxidative stress through AMPK and Nrf2 signaling pathway.

단계적 당뇨병 관리 : 경구 혈당 강하제 단계

정춘희 대한당뇨병학회 2001 임상당뇨병 Vol.2 No.1

정신박약아의 사춘기특성에 관한 연구

정춘희 세종대학교 교육학과 1971 군자교육 Vol.1 No.-

병원 수익 증대를 위한 간호수가 누락 방지 활동

정춘희,이미화,손윤순,오보영,김은희,윤유진,김수연,홍성숙,김정숙 한국의료QA학회 2005 가을학술대회 Vol.2005 No.2

Perkin 反應法 및 Knoevenagel 反應法에 依한 Cinnamic Acid 合成에 관한 硏究

정춘희,채경자,천기정,하명희 이화여자대학교 약학회 1970 梨花藥學會誌 Vol.- No.11

Perki's and Knoevenagel reactions have been known of the Synthesis of Cinnamic acid. The former is method from acetic anhydride and the latter method from malonic acid. In this paper, the yield from two methods have been observed.

Perkin 反應法 및 Knoevenagel 反應法에 依한 Cinnamic Acid 合成에 관한 硏究

정춘희,채경자,천기정,하명희 이화여자대학교약학회 1970 梨花藥學硏究 Vol.- No.11

Perki's and Knoevenagel reactions have been known of the Synthesis of Cinnamic acid. The former is method from acetic anhydride and the latter method from malonic acid. In this paper, the yield from two methods have been observed.

11-deoxycortisol을 과분비한 부신피질암 1예

정춘희,김홍승,김영욱,조미연,이미덕,김윤미 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.2

The adrenocartical carcinoma is a rare tumor with an estimated incidence of 1 case per 1,700,000 population. Despite its rarity, a large number of investigators have studied this neoplasm for the following two reasons. The First is the occasional difficulty of differentiation between careinoma and adenoma at the time of initial surgery, even by histopathologic examination. The other is its unique feature of corticosteroidogenesis. Steroid metabolism of adrenocortieal carcinoma is characterized by its low efficiency of steroid production due to deficiency of steroidogenic enzyme. The deficieney of 11 B-hydroxylase has been indieated in case of adrenoeortical carcinoma by several investigators. In this study, the serum level of cortisol was within normal range, but the serum level of 11-deoxycortisol was 50 times higher than normal. After the removal of tumor, the serum level of ll-deoxycortisol was markedly decm. In conclusion, the results from the this case suggest that measurement of serum 11-deoxy- cortisol may be a useful tool in the diagnosis and follow-up of adrenocortical carcinoma (J Kor Soc Endocrinol 13:27I-279, 1998).