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).

Effect of Hydride Reorientation on Delayed Hydride Cracking In Zr-2.5Nb Tubes

Yun Yeo Bum,Kim Young Suk,Im Kyung Soo,Cheong Yong Moo,Kim Sung Soo Korean Nuclear Society 2003 Nuclear Engineering and Technology Vol.35 No.6

The objective of this study is to investigate the reorientation of hydrides with applied stress intensity factor, the peak temperature and the time when to apply the stress intensity factor in a Zr-2.5Nb pressure tube during its thermal cycle treatment. Cantilever beam (CB) specimens with a notch of 0.5 mm in depth made from the Zr-2.5Nb tube were subjected to electrolytic hydrogen charging to contain 60 ppm H and then to a thermal cycle involving heating to the peak temperature of either 310 or $380^{\circ}C$, holding there for 50 h and then cooling to the test temperature of $250^{\circ}C$. The stress intensity factor of either 6.13 or $18.4\;MPa\sqrt{m}$ was applied at the beginning of the thermal cycle, at the end of the hold at the peak temperatures and after cooling to the test temperature, respectively. The reorientation of hydrides in the Zr-2.5Nb tube was enhanced with the increased peak temperature and applied stress intensity factor. Furthermore, when the CB specimens were subjected to $18.4\;MPa\sqrt{m}$ from the beginning of the thermal cycle, the reoriented hydrides occurred almost all over the Zr-2.5Nb tube, surprisingly suppressing the growth of a DHC crack. In contrast, when the CB specimens were subjected to the stress intensity factor at the test temperature, little reorientation of hydrides was observed except the notch region, leading the Zr-2.5Nb to grow a large DHC crack. Based on the correlation between the reorientation of hydrides and the DHC crack growth, a governing factor for DHC is discussed along with the feasibility of the Kim's DHC model.

남자 고등학교 세팍타크로 경기의 공격기술에 관한 분석 연구

김영호,고문석,제임스전,이영익,차정훈,현종건,김범수,임종만,이석인 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

This research aims at analysis of attack technique in sepaktakraw games. For this purpose, 3 high school coaches observed and recorded each game Five times in videos of high school male players' thirty games in 2003. The conclusion from the analysis of the recorded data are as follows. 1. Scissors spike was the most popular (favorite) attack technique. Rolling spike, tapping spike and heading spike was popular in order. 2. Heading spike showed the highest success rate (73.5%) in attack technique. And tapping spike (69.5%), scissors spike (57.8%) and rolling spike (67.11) showed a lower success rate in order. In failure rate, heading spike (5.5%), tapping spike (36.5%), scissors spike (32.2%) and rolling spike (32.9%) had a higher percentage in order. 3. When receive was stable, the success rate in attach technique was 47.1%, the failure rate was 20.1%. On the other hand, when receive was unstable, the success rate in attach technique was 16.5%, the failure rate was 14.3%.

利用者의 心理行態에 의한 公園綠地의 休養評價에 관한 硏究

金範洙,鄭玧洙 建國大學校 自然科學硏究所 1994 建國自然科學硏究誌 Vol.5 No.1

Green park was measured on value of evaluation of resorters. Based on accessability to green park, adequacey of usefulness and management and operation; these three points are analyzed in relation with resorters' psychology and behavior and characteristics of green park. Conclusions are drawn as follows: An approach of measuring factor of accessability was adopted to indentify inter-relation ship of between environmental features of green park and resorters' psychology and behavior. It was found that there was useful effect on evaluation of green park environment of large size. Green parks of large size has strong advantage of rest and recreation due to natural rich resources compare with urban forest. Size of green park and park facilities dominate and retain a great influence on frequency of resorters and scope of resorter's residence. Resorters of large parks can be divided into resorters from far distance and resorters of local vicinity. In order to enlarge useful effect of large green park, a proper measure should sought to display sufficient functions of favoring urban forest. It is found necessary to expand parking space and other facilities of conveniences for benefit of resortors to green parks. Resorters favoring green parks are seen very cooperative with management of large sized green parks. This phenomenon contribute much to preserving the environment better effectively.

도시 근교 산촌주민의 생활환경과 개발에 대한 의식 조사

김범수 건국대학교 자연과학연구소 1998 建國自然科學硏究誌 Vol.9 No.2

As it be mentioned earlier, the purpose of this study was to investigate suburban mountain area residents' attitudes toward improvement of living condition and regional development. The residents who were impacted directly by the regional tourism development were sampled by Ri-unit which is basic living village. The results of this study were followings: Local residents' income was significantly lower than that of urban areas. Traditional family system has been collapsed in rural areas. The residents unsatisfied with living and working condition. However, their unsatisfaction with accessibility which considered as main factor of unsatisfaction was not significantly high. Furthermore, they were even satisfied with natural condition of their living places. In other words, their unsatisfaction originated from lack of developmental and political support rather than condition of location. Regarding to future living plan, they wanted to live in the same places. Therefore, the improvement in working and cultural condition should be important factors. In regional development, they wanted to have natural conditions. Development in production activities and development for tourism were their favorite direction. In addition, they preferred co-development and comanagement system with local government and resident council. Contributions to the region by people from urban areas were evaluated lowly by the local residents. They were concerned about water pollution, garbage, and speculative trade of lands. However, they expected significant income from recreationists. Therefore, appropriate recreational activities and migration should be considered as mail policy. Conclusively, the local residents required improvement of working and living conditions as development and income aspects. Therefore, development should be proceeded in stages with consideration of cultural and social issues.

K형 강관접합부의 보강효과에 관한 실험적 연구

김갑순,한병찬,성수용,김우범,정수영 충남대학교 산업기술연구소 2000 산업기술연구논문집 Vol.15 No.2

In current design, the strength formula for a Gusset-Tube connections stiffened with rib-plate is proposed only in the limited case because of its complexity of the behavior. So in this study, experimental study and finite element analysis were performed to investigate the behavior and strength of a Gusset-Tube connections stiffened with rib-plate. Because of limitations in loading capacity, the specimens were fabricated with 1/3 scale of full size. Tensile coupon tests and stub column tests were also carried out. Of primary interest here are the stiffened effect of Gusset-Tube connections considering lateral force ratio, gusset plate length, eccentricity, stiffened length. Consequently, we intend to obtain accumulated database to propose practical strength equation and suggest rational reinforcing method of Gusset-tube connection.

대학생의 건강·체력·영양섭취상태에 관한 연구

김범수,이종영 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

For the purpose of acquiring basic data regarding gudiance method for health improvement the following result could be obtained by conducting survey on physical strength test, blood pressure, urine, blood test and amount of nutrition absorption on 52 male and 51 female college students. 1) For physical strength test with males they were superior in running sidewise repetitiously, panel climbing than college students and in terms of hand gripping strength and running they were same as college students. With females running was same level as that of ordinary college students but they fell behind in terms of hand gripping strength, running sidewise repetitiously and panel climbing. 2) In terms of blood pressure male and female fell within the scope of normalcy. In terms of result of blood test females showed slight level of anemia of about 20% and there was not abnormalcy for males or females in connection with blood. Result of urine test showed there was only one person from whose urine sugar was detected. 3) In terms of amount of nutrition absorption amount of energy and nutrient was more or less satisfactory for male and female. In terms of absorption of micro nutrients male shows slight deficiency in calcium and female in calcium and iron and in terms of vitamins males and females showed considerable shortage in vitamin A and B₂.

뇌 아밀로이드 혈관병과 고혈압성 뇌출혈의 감별에 있어서 Apolipoprotein Eε4와 점상 출혈 분포의 유용성

김용범,이광호,이수주,나덕렬,조수진,정진상,이원용 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

쓰레기 埋立場 浸出水 處理施設 運轉 報告 (Ⅰ)

金秀生,玄龍範,鄭賑化 동아대학교 환경문제연구소 1986 硏究報告 Vol.9 No.1

The result of the four-month survey of the leachate quality and treatment facility operation in the refuse landfill of Hwamyeong-dong. Pusan, is as follows: 1. For the efficient biological treatment of leachate, suitable amount of phosphorus should by supplemented, and as it has been made clear that in case of the period of reclaimation is long. BOD_(5)/COD_(Cr) is low whereas that of reclaimation is short. BOD_(5)/COD_(Cr) is high, BOD_(5)/COD_(Cr) ratio should be reflected in the designing of leachate treatment facilities. 2. In case of biological treatment includeed, the period of test working is required about 70 days. 3. As the atmospheric temperature has considerable effects on the operation of biological treatment plant, it is necessary to install aeration and retaining facility. 4. It has been found that more than 90% of treatment efficiency of refuse landfill in Hwamyeong-dong was maintained regardless of fluctuation of water quality, and the two step contact aeration system especially introduced too the Hwamyeong-dong treatment plant was maintaining continuous biological treatment efficiency.

고온에서의 P92강 용접부의 피로균열 성장거동

김범준,임병수 成均館大學校 科學技術硏究所 2002 論文集 Vol.53 No.1

To meet the demand for higher efficiency of power plant, high strength and heat resisting steels have been developed to improve the fatigue crack resisting properties under high steam pressure and temperature condition in power plants. As the result, P92 steel which has tempered martensitic 9% Cr and which is strengthened by replacing Mo with W, can be used for piping material that is critical in fossil power plant. Since the pipes are jointed by welding, the fatigue property, strength and life of weldment at high temperature is very important. In this study, the effect of high temperature on fatigue crack growth behavior in weld metal, HAZ(Heat Affected Zone) and base metal of P92 steel were investigated. Fatigue test was conducted under sinusodial waveform with constant load ratio(R=0.1) and frequency(f=20㎐) using CT specimens. Test temperatures were 600Δ℃. 650℃ and 700℃ and fatigue crack growth rates were characterized by the ΔK parameter at each test temperature.