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      • 서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

        김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

        Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

      • KCI등재

        한국인 직무 스트레스 측정도구의 개발 및 표준화

        장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

        Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

      • KCI등재

        신포동 젠트리피케이션 현상에 대한 연구

        김준우(Kim Jun Woo),김용구(Kim Yong Gu),전동진(Jeon Dong Jin) 인천대학교 인천학연구원 2018 인천학연구 Vol.29 No.-

        본 연구는 신포동 젠트리피케이션 현상에 관한 연구이다. 인천의 중심지였던 신포동 지역은 1985년 시청 및 공공시설이 구월동으로 이전하고 인천시의 대규모 도시개발정착에 따라 낙후된 지역으로 변해갔다. 그러나 2008년부터 교육서비스업종, 창작 및 예술, 협회 및 단체 업종의 종사자 수를 보면 신포동이 다른 주변지역(연안동, 동인천동, 북성동)보다 크게 증가하고 있다. 같은 시기 신포동의 인구의 수는 계속 감소하는 반면에 부동산업, 교육서비스업종, 창작예술업종, 문화예술인들이 카페 등으로 등록하는 휴게음식점 종사자는 증가하고 있다. 중구지역 지가변동은 2008년부터 2012년 까지 감소하다가 2013년부터 증가한다. 2013년부터 지가변동율이 증가하자 휴게음식점업종 및 창작예술업종이 감소하고 있다. 연구 결과를 종합해보면 신포동의 인구의 수는 계속 감소하는 반면에 부동산업, 교육서비스업종, 창작예술업종, 휴게음식점 종사자의 증가하고 있으며, 2013년부터 지가변동율이 증가하자 휴게음식점업종 및 창작예술업종이 감소한다. 신포동은 2013년을 기점으로 젠트리피케이션 단계로 진입한 것으로 파악된다. This study is a study on the phenomenon of gentrification phenomena in Shinpo - dong. The Shinpodong area, which was the center of Incheon, was moved to Guwol-dong in 1985 when the city and public facilities were moved to Incheon. However, since 2008, the number of employees in the education service industry, creative arts, arts, associations and organizations has increased sharply compared to other surrounding areas (coastal dong, Dongchun-dong, and north-east). At the same time, the number of population in Shinpo - dong continues to decline, while the number of resting restaurants that real estate, educational service, creative arts, and cultural artists are registered as cafes is increasing. The fluctuation of Jungang area land prices will decrease from 2008 to 2012, but it will increase from 2013. As the land price volatility has increased since 2013, the rest restaurants and creative arts industries are declining. According to the results of the study, the number of population in Shinpo - dong continues to decrease, while the number of real estate, educational service, creative arts and resting restaurants are increasing, and the rate of change in land prices has increased since 2013. Shinpodong appears to have entered the gentrification phase starting in 2013.

      • 트레드밀 운동시 흡기근 테이핑이 폐활량에 미치는 영향

        김민지,신수영,송월섭,조수진,최동락,황미진,황진규,박진현,김경,Dennis W. Fell 대구대학교 특수교육재활과학연구소 2011 再活科學硏究 Vol.29 No.1

        이 연구는 트레드밀 운동과 키네시오 테이핑의 효과에 따른 폐활량의 변화를 알아보기 위해 26명의 비흡연자가 참가하였으며 키네시오 테이핑을 적용하지 않은 그룹과 키네시오 테이핑을 적용한 두 그룹으로 무작위로 배정하고 각 군들을 주 3회 6주간의 트레드밀 훈련을 실시하였다. 실험 전과 후, 스파이로미터를 사용하여 키네시오 테이핑의 적용 따른 폐활량 변화 효과를 측정하였다. 이 연구의 결과를 종합해보면 키네시오 테이핑을 적용 그룹에서 적용하지 않은 그룹에 비해 FVC, FEV1에서 유의한 증가를 보였다. 이러한 결과는 건강한 성인에서 키네시오 테이핑을 적용한 경우 키네시오 테이핑을 적용하지 않고 트레드밀 운동을 한 경우보다 폐활량의 향상에 효과적이라고 생각되어진다. The purpose of this study was to investigate the variation of vital capacity(VC) according to the effects of kinesio taping with treadmill exercise. Twenty-six non-smokers were participated in this research and these subjects were randomly assigned into two groups. To measure the VC variation effects of kinesio taping, spirometer was used. The collected data were analyzed statistically by using a paired Mauchly test and repeated measure ANOVA. The results of this study were as follows; A group: treadmill with kinesio taping B group: treadmill without kinesio taping. Between A and B, there were significant differences. In the case of A group, there was 11.66% increase of VC, during 3 weeks experiment(p<.01). In the case of B group, there were significant differences, 3.35% increase of VC, during 3 weeks taping intervention(p<.01). After 6 weeks experiment, the improvement of VC shown a significant difference with intergroup (p<.05). From this result, it was revealed that treadmill exercise with kinesio taping was effective to improve VC to healthy adult than treadmill exercise without kinesio taping.

      • 性別 및 年齡에 따른 體格과 體力의 特性과 變化에 關한 縱斷的 硏究Ⅱ : Emphasised on College Men of Department of Physical Education 體育專功 大學生을 中心으로

        金尙國,姜東洹,張周鎬,金昇一,徐再均,金耕知,孫斗玉,鮮于攝,崔榮烈,尹宇相,金亨燉,方永鎭,朴英震,柳在忠 慶熙大學校 體育科學大學 1989 體育科學論叢 Vol.- No.2

        The purpose of this study was to compare the characteristics, change in physique and physical function of college students majoring physical education and Taekwondo (454 males and 64 females of age groups ranging from 18 to 26). The results are as following: 1. The male group of 23yrs old in physical education showed highest values in 7 items(Weight, Chest Girth, Fore Arm Girth, Thigh Girth, Calf Girth, Scapular Skinfold Thickness and Suprailiac Skinfold Thickness). 2. In the Physical function, the male group of 18yrs old showed highest values in Power, Flexibility, and then 21yrs old at Back Strength, Vital Capacity, and 23yrs old at Grip Strength, and 25yrs old at Blood Pressure, respectively. 3. In the physique, the male group of 22yrs old showed highest values in Weight, Chest Girth, Thigh Girth, Calf Girth, and then 24yrs old Upper Arm Girth, Fore Arm Girth, and 19yrs old at Height, Upper Limb Length, respectively. 4. In Physical Function, the 22yrs old showed highest values in Back Strength, Vital Capacity, and then 23yrs old at Side Step, Trunk Extension, but 18yrs old showed lower Values in Grip Strength, Side Step, Vital Capacity and Blood Pressure. 5. The female group of 22yrs old showed highest values in 8 items(Height, Sitting Height, Waist Girth, Upper Limb Length, Lower Limb Length, Skinfold Thickness), and then 18yrs old at 5 items (Weight, Upper Arm Girth, Fore Arm Girth, Thigh Girth, Calf Girth), respectively. 6. In the physical function, the 22yrs old showed highest Values in Grip strength, Back Strength, Power, 5 Minute Run, and 18yrs old at flexibility, Harvard Step Test, respectively. 7. In the change of the physique for two years(1988-1989) in the male group, majoring Physical education the 22yrs old showed increase in 4 items, and the 20yrs old in 3 items, but 18yrs old showed decrease in 3 items. 8. In the change of the physical function for two years in the male group, the 20yrs old showed increase in 4 items, and the 21, 25, 26yrs old in 3 items, but the 19yrs old showed decrease in 6 items, and 18, 22 yrs old in 5 items, respectively. 9. The change of the physique for two years in all female group, of 18, 19, 20, 21yrs old showed increase in 11 items except Skinfold Thickness. 10. In the change of physical function for two years in female group, the 18yrs old showed increase in 3 items, and then 20yrs old in 5 items, but 19, 22yrs old decreased 12 items, respectively. 11. The highest significant difference in physique between male and female was found in weight(mean Value 17.5%), and the lowest difference was found Thigh Girth, Calf Girth(1,3%), Upper Limb Length, Lower Limb Length(2.5%). 12. The Highest difference in physical function was Strength (mean Value 40%), Vital Capacity (33%), Power(22%), but Lower Trunk Flexion, Foot Balance(3.4%). 13. In the difference of Physique and physical function between physical education major and taekwondo major, the physical education showed higher values in skinfold Thickines (mean Value 16.5%), Weight, Waist Girth(4.7%) and Strength(33%), Endurance(5.6%), but subjects majoring Taekwondo showed higher values in Flexibility and Foot Balance. 14. In all male groups, Waist Girth, Scapular Skinfold Thickness, Back Strength, Sargent Jump, Trunk Extension and Diastolic Blood Pressure were showed a significantly related at 0.001 level.

      • 서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

        김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

        Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

      • KCI등재후보

        조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

        김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

        Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

      • KCI등재

        중년기 우울증 여성의 생활사건, 대처방식, 사회적 지지 및 가족관계

        김동인,이진욱,김임,이선미,은헌정 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

        국문초록본 연구는 중년기 우울증 여성의 생활사건 스트레스, 대처 방식, 사회적 지지, 가족 관계 등의 정신사회적 요인들을 알아보기 위한 것으로 각 변인들이 어떻게 우울과 관계가 있는지를 우울증 환자 집단과 정상인 집단으로 나누어서 비교 연구하였다. 이를 위해 35세 이상 64세 이하의 116명의 우울증 환자와 113명의 정상인을 대상으로 Beck 우울 질문지(BDI), 생활사건 질문지, 대처방식 척도, 대인관계 지지 평가척도(ISEL), 가정환경척도 등의 검사를 하였고 다음과 같은 결과를 얻었다. 1) 최고 스트레스는 환자 집단의 경우 결혼생활 스트레스(42명, 36.2%), 정상인 집단의 경우는 가정생활 스트레스(44명, 38.9%)였다. 2) 소극적 대처(t=0.93, p=.35)만을 제외하고 환자 집단과 정상인 집단에서 BDI 우울 점수(t=15.94, p<.0001), 생활사건 스트레스 점수(t=4.73, p<.0001), 적극적 대처점수(t=6.29, p<.0001), 사회적 지지점수(t=7.20, p<.0001), 가족 관계 점수(t=5.75, p<.0001)에서 유의한 차이를 보였다. 3) 우울증 환자 집단에서 BDI 우울 점수는 생활사건 스트레스(r=.24, p<.01) 변인과 유의한 정적 상관을 보였고, 적극적 대처(r= -.22, p<.01) 변인, 사회적 지지(r= -.35, p<.001) 변인, 가족관계(r= -.30, p<.001) 변인과는 유의한 역 상관을 보였다. 4) 우울증 환자 집단에서 BDI 우울에 대한 각 변인들의 중다회귀분석은 사회적 지지(12.3%, β= -.281, T= -3.162, P=.002, 생활사건 스트레스(5.1%, β=.279, T=3.195, P=.002), 적극적 대처(3.5%, β= -.204, T= -2.225, P=.028) 변인이 합하여 20.9%의 설명력을 나타냈다. 5) 중년기 여성에서 생활사건 스트레스는 가족 관계에서 겪는 스트레스가 가장 큰 스트레스였고, 대처방식은 우울과의 관계에서 일관성이 부족하였으며, 사회적 지지는 우울에 영향을 주는 가장 중요한 요인이었고, 가족관계는 양 집단에서 유의한 차이는 있었으나 우울에 대하여 의미있게 설명하지 못하고 있다. ABSTRACTLife Events, Coping Styles, Social Support, and Family Relationships of Middle-Aged Depressed Women Jin-Wook Lee, M.D., Yim Kim, M.D., Sun-Mi Yi, M.S., Dong-In Kim, M.D., Heon-Jeong Eun, M.D. Department of Neuropsychiatry, Presbyterian Medical Center, Chonju The objective of this study was to explore the psychosocial factors such as life events, coping styles and family relationships in middle-aged depressed women. This study was designed to compare how different variables relate to depression in two different test groups : a depressed patient group and a normal group. The Beck Depression Inventory(BDI), The Ways of Coping Checklist, Interpersonal Support Evaluation List(ISEL), Family Environment Scale were administered to 116 depressed patients and 113 normal persons between the ages of 35 and 64. The results were as follows : 1) The highest stress was marital stress(n=42, 36.2%) in patient group and family stress(n=44, 38.9%) in normal group, respectively. 2) There were significant differences between patient group and normal group in BDI scores(t=15.94, p<.0001), life events(t=4.73, p<.0001), active copinig(t=6.29, p<.0001), social support(t=7.20, p<.0001), and family relationships(t=5.75, p<.0001) except for passive coping(t=0.93, p=.35). 3) In depressed patient group, BDI scores had a significantly positive correlation with the scores of the life events(r=.24, p<.01) and negative correlation with active coping(r= -.22, p<.01), social support(r= -.35, p<.001) and family relationships(r= -.30, p<.001). 4) In depressed patient group, multiple regression analysis showed that social support(12.3%, β= -.281, T= -3.162, P=.002), life events(5.1%, β=.279. T=3.195, P=.002), and active coping(3.5%, β= -.204, T= -2.225, P=.028) had predictability on the BDI scores and the total predictability was 20.9%. 5) Stress experienced in family relationships were highest in life events and there was a lack of consistency(in the BDI scores of the coping styles). Social support was the most important factor and there were no significant differences between the two groups in family relationships.

      • SCOPUSKCI등재

        한국인 제1형 당뇨병에서 체도 세포질 항체의 양성률 : 항GAD항체, 항ICA512항체, 항phogrin항체의 조합 측정으로의 대체 가능성 Possible Replacement with Combined Measurement of Anti-GAD, Anti-ICA512, and Anti-phogrin Antibodies

        김경아,김동준,정재훈,민용기,이문규,김광원,진동규,고경수,김상진,이명식 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

        연구배경:최근 당뇨병의 분류를 새로 제정함에 있어 자가항체가 양성이면 임상형에 상관없이 제1형 당뇨병으로 분류하자는 제안이 나옴으로써 자가항체의 중요성은 더욱 커질 것으로 예상된다. 특히 우리나라와 같이 비비만형인 제2형 당뇨병이 많은 나라에서는 당뇨병의 병인 규명에 자가항체가 중요한 위치를 차지할 것으로 사료된다. 자가항체 중에서 전통적으로 측정되어온 췌도 세포질 항체(ICA)는 표준화하기 어렵고 기술적으로 제한점이 많으며 현실적으로도 췌장 공여자가 적은 점 등이 문제로 알려져 있다. ICA의 대응 항원들로는 GAD(glutamic acid decarboxylase), IA­2(islet­associaated antigen­2;ICA512), IA­2β(phogrin)등이 있다. 이러한 대응 항원에 대한 특이적인 자가항체의 측정은 ICA에 비해 표준화되었으며 최근에는 방사면역측정법(radioimmunoassay;RIA)키드까지 등장하여 손쉽고 정확히 이를 측정할 수 있게 되었다. 연구자들은 한국인 제1형 당뇨병에서 측정법이 표준화 되어 있는 항GAD항체 및 항ICA512항체 조합(combimation)의 조합으로 ICA의 측정을 대신할 수 있는지를 조사하였고 더 나아가 항phogrin항체의 조합 측정으로 임상적 유용성이 있는지 보고자 하였다. 방법: ICA는 면역조직화학 염색법을 이용하였다. 항 GAD항체는 상업화 된 키드(RSR??, United Kingdom)를 이용하였다. 항 ICA512항체와 항phogrin항체의 측정은 in vitro transcription&translation한 후 이를 이용해 방사면역 침전법을 이용하였다. 대상 환자로는 전형적 제1형 당뇨병 76명, 지진형 제1형 당뇨병 22명, 제2형 당뇨병 39명이었으며 각 군간의 연령은 각각 22.8±14.0, 37.9±13.9, 45.3±12.3세였다. 결과:1)전형적인 제1형 당뇨병에서는 ICA의 양성률이 30%, RIA조합만의(항GAD항체 또는 항 ICA512항체 또는 항phgrin항체 한가지에라도 양성인 경우)양성률이 57%이었다. 지진형 제1형 당뇨병에서는 각각 18%, 50%이었다. 제2형 당뇨병에서는 각각 7.7%, 5.1%이었다. 2)각 군에서 ICA가 양성인 군에서 RIA조합 양성률을 보면 전형적 제1형 당뇨병에서는 96%, 지진형 제1형 당뇨병에서는 100%에서 양성이었고 제2형 당뇨병에서는 RIA 조합 양성이 없었다. 각 군에서 ICA가 음성인 군에서도 RIA 조합시 전형적 제1형 당뇨병에서는 40%, 지진형 제1형 당뇨병에서는 39%에서 양성이었고, 제2형 당뇨병에서는 5.6%에서 양성이었다. 3)전형적 제1형 당뇨병에서 ICA가 양성인 군(n=23)에서 96%가 RIA조합 양성이었는데 이때 각각의 RIA유형을 보면 항GAD항체 양성이 87%였다. 한편 항 ICA512항체 양성이 48%, 항phogrin항체 양성이 44%이고 항GAD항체 도는 항ICA512항체 양성이 96%를 차지한다. 지진형 제1형 당뇨병에서는 ICA가 양성인 군(n=4)에서는 항 GAD항체 양성이 3명, 항ICA512항체 양성이 1명이었다. 따라서 기존의 ICA를 RIA조합으로 대체할 수 있을 것으로 사료되었는데 이때 항GAD항체와 항ICA512항체의 조합이 도움이 되겠고 항phogrin항체의 추가적인 검사는 일부의 환자에서만 도움이 되리라 사료된다. 4)이환 기간에 따라 ICA와 RIA조합을 비교시 ICA는 차이가 없었으나 RIA조합의 양성률은 지진형 제1형 당뇨병에서 4년 이상의 이환 기간이 지나면 그 이전보다 떨어졌다. 5)발병 연령에 따라 ICA와 RIA조합을 비교시 ICA 양성률이 전형적 제1형 당뇨병에서 15세 이전에 발병한 그룹에서 그 이후에 발병한 그룹보다 유의하게 높았다. 결론:이상의 결과를 요약하면 항GAD항체 및 항ICA512항체 측정의 조합은 ICA보다 민감도가 높아 기존의 ICA를 대체함은 물론 임상적 이용에서 현격한 우월성을 보이며, 성인에서 발병한 비전형적인 당뇨병의 분류에도 도움이 될 것으로 사료되었다. 추가적인 항phogrin항체의 측정은 임상적 유용성이 없었다. Background : Type 1 diabetes includes all forms of autoimmune-mediated and idiopathic beta-cell destruction leading to an absolute insulin deficiency. Evidence of an autoimune pathogenesis was assessed by studying cytoplasmic islet cell antibodies (ICA), antibodies to glutamic acid decarboxylase (GADA), antibodies reacting with an islet tyrosine phosphatase-related molecule referred to as ICA 512 (ICA 512A), or its homologue phogrin (phogrin-A). In comparison with ICA, the best validation to assess the risk of type 1 diabetes, shows that a combination of antibodies to GADA with ICA 512A has the power to detect a majority of ICA and 97 ~ 100% of subjects who progressed to overt diabetes. These findings suggest the possibility of replacing the laborious ICA test in the screening programs to identify subjects at risk of progressing to type 1 diabetes or for classifying the stage of diabetes at the time of diagnosis. Up to now, it is unclear whether these results are applicable to the slowly progressive type 1 diabetes that appears to be more prevalent in Asian than in western countries. The prevalence of combined autoantibody testing (1≥ of GADA, ICA512A, or phogrin-A) was investigated in the patients with type 1 diabetes (typical and slowly progressive) and type 2 diabetes, and compared with that of ICA which is a more laborious and insensitive test. Methods : The ICA assay was performed using immunoenzymatic staining of frozen human (blood group O) pancreatic sections with serial dilutions of serum samples with peroxidase-labeled protein A. For the GADA determination, commercially available GADA radiommunoassay kits utilizing the ^125I-labeled recombinant GAD65 (RSR®, United Kingdom) as an antigen was used. Either ICA512A or phogrin-A were detected by a radioligand-binding assay after in vitro transcription and translation using the clone ICA512bdc or phogrin c DNA. Serum was obtained from 76 patients with type 1 diabetes(mean age 45.3± 12.3 years). Typical and slowly progressive type 1 diabetes patients had the disease for between 4.0±4.6 and 10.1±9.5 years, respectively at the earliest serum sampling. Results: 1) In typicaltype 1 diabetes, 30% of patients tested positive for ICA and 57% for the combined autoantibody test. In type 2 diabetes, 7.7% and 5.1% tested positive, respectively. 2) Ninety-six percent of ICA-positive patients expressed one or more of the 3 auto-antibody specificities in typicaltype 1 diabetes. Among the 53 ICA-negative patients with typicaltype 1 diabetes, 40% had one or more of these auto-antibodies. In the slowly pregressive type 1 diabetes, 100% of the ICA-positive and 39% of the ICA-negative patients expressed one or more of the 3 autoantibody specificities. 3) Of the 23 patients with ICA-positive typical type 1 diabetes patients, 87% had a positive result for GADA, 48% FOR ICA512A, 44% for phogrin-A, and 96% for GADA or ICA512A. Of the 4 patients with ICA-positive slowly progressive type 1 diabetes, three had a positive result for GADA, and 1 for ICA512A. 4) When the prevalence of combined autoantibody testing was analyzed according to the duration of diabetes, the prevalence in patients tested within 4 years after the diagnosis and more than 4 years after the diagnosis was 61% and 52%, respectively in typical type 1 diabetes. Furthermore, that for the ICA was 37% and 21%, respectively. In the slowly progressive type 1 diabetes, the prevalence of combined auto-antibody testing was 88% and 25%, respectively (p<0.05), while that of ICA was 25% and 13%, respectively. 5) In typical type 1 diabetes, ICA were detected more frequently in patients younger than 15 years of age (48%) than in older patients (23%) (p<0.05), while the prevalence of combined auto-antibody testing -was not different according to the onset age(65% vs 53%). Conclusion : Combined autoantibody testing for GADA and ICA512A is more sensitive that ICA in type 1 diabetes. Therefore, it could replace the laborious ICA measurement and may be useful for discriminating the etiology of adult onset a typical diabetes(J Kor Diabetes Asso 25 :430~445, 2001).

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