당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

정신분열병 환자의 가족부담 척도 개발에 대한 예비연구

김철권,조진석,서지민,김용관,김호찬,김현수,김상수,제영묘 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.3

연구목적 : 정신분열병 환자의 가족이 느끼는 부담을 측정하기 위한 가족부담 척도를 개발하기 위함이다. 방 법 : 200명의 정신분열병 환자 가족과의 비구조적 면담과 외국 부담척도 고찰을 통하여 94문항을 수집하였고 그 다음에 전문가들과 가족들이 문항 및 영역을 분류하고 통합하여 최종적으로 36문항을 선정하였다. 그리고 정신분열병 환자의 가족 135명, 불안장애 환자의 가족 22명, 기분부전장애 및 신체화 장애 환자의 가족 26명, 치매 환자의 가족 49명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과 : 자료분석 결과 검사-재검사 신뢰도, 내적 일치도, 감별타당도 모두 높게 나타났으며, 요인분석을 통해 다섯 가지 구성요인이 추출되었다. 결 론 : 본 가족부담 척도는 정신분열병을 포함한 만성 정신질환을 앓고 있는 환자의 호전과 가족의 부담을 덜어주기 위한 다양한 프로그램의 효과를 검증하는데 유용하게 사용되어질 수 있을 것이다. Objectives : This preliminary study was carried out to develop the Family Burden Scale(FBS) of the schizophrenics. Methods : Ninety-four items were collected by interviewing in a free unstructured format with one relative of each 200 schizophrenic patients and reviewing foreign FBS's. Several professionals and relatives were asked to group and integrate them into several categories. Finally 36 burden items were chosen to constitute a FBS. The FBS was administered to the relatives of 135 schizophrenic, 22 anxiety disorder, 26 dysthymic disorder and somatization disorder, and 49 dementia patients for examining the reliability and validity. Results : The FBS showed high test-retest reliability, internal consistency, and discriminant validity. The results of the factor analysis revealed five-factor solution. Conclusion : The FBS can be used to evaluate the effectiveness of various programs intended not only to reduce decompensation among schizophrenics, but also to alleviate family burden.

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

백서의 우울모형에서의 칼슘통로 길항제 에타베린(Ethaverine)의 항우울효과

이상경,김선희,김록우,윤성환,김용관,김경태,김영훈 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 본 전임상연구에서는 우울증의 두가지 동물모형을 통해 에타베린이 단독 혹은 이미프라민과 병용처치 되었을 때의 효과를 알아보고자 하였다. 방법: 표준화된 검사법인 강제수영검사를 사용하여 옹성백서에게 에타베린(20mg/kg) 및 이미프라민 (20mg/kg)을 단독 혹은 병용 처치하였을 때의 부동시간의 변화를 관찰하였고, 경도의 만성 스트레스를 3주간 가한 후 4주간 에타베린과 이미프라민을 단독 혹은 병용 처치하였을때의 자당섭취량의 변화를 관찰하였다. 결과: 약물을 1회 단기처치 및 7일간 장기처치한 강제수영검사에서 이미프라민 및 에타베린 단독처치는 대조군에 비하여 부동시간의 단축을 보였고 에타베린은 이미프라민의 부동시간 감소에 대한 증강작용을보였다. 경도의 만성스트레스 실험에서도 3주간의 스트레스로 인하여 감소된 백서의 자당섭취량을 이미 프라민 및 에타베린이 회복시켰으며, 치료초기에 두 약물의 병용처치효과가 두드러졌다. 결론: 본 연구의 결과는 에타베린이 향우울 효과를 가지고 있음을 시사하며, 삼환계 항우울제인 이미프라민의 항우울효과를 증강시키므로 에타베린의 임상적 활용 가능성을 보여준다. Objectives: This pre-clinical study was performed to assess the effects of ethaverine in the two kinds of behavioral models of depression in rats. Methods: We observed the changes of the immobility time in the froced swimming test and the quantity of sucrose consumed in the chronic mild stress model, using ethaverine(20mg/kg) alone, imipramine(20mg/kg) alone, or ethaverine and imipramine concomitantly. Results: In the forced swimming test, both single treatment and chronic treatment(for 7days) with imipramine or ethaverine significantly reduced the immobility time, and concomitant chronic treatment with ethaverine potentiated the effect of imipramine. In the chronic mild stress model, both imipramine and ethaverine reversed the decreased sucrose consumption induced by 3-week stress and concomitantly treated ethaverine potentiated the effect of imi-pramine in the early phase of treatment. Conclusions: The data suggest that ethaverine can be used alone or concomitantly with other antidepressants in the clinical situation.

남북한 관광교류·협력방안에 관한 연구

김용관,신동주 용인대학교 산업경영연구소 1998 산업경영논총 Vol.3 No.-

One of the most important issues facing South and North Korea is finding new ways to reconciliate the relationship in the past. Because of the extremely adverse situation facing the Two Korean economies in recent years, there is a possibility that the Two Koreas will openup their doors if they want to survive the current situation. Noteworthy is the fact that North Korea already took a series of steps to stimulate its free trade zone in relation to tourism development by allowing foreigners to visit North Korea. In another pragmatic move, North Korea agreed to open its skies to civilian flights from Seoul. These actions will help Pyongyang earn millions of dollars in tourism sector a year. But it is unlikely for North Korea to make drastic changes in its economic polices regarding tourism as seen in China and East European countries. Pyonyang appears to fear that a radical tourism policy shift in tourism may push North Korea into chaos, jeopardizing Kim Jong-il's regime. In the current context of Korea, however, economic cooperation for tourism industry is perceived as a primary vehicle for rebuilding the relationship between the Two Koreas. But there is still a long way from brisk economic exchange and cooperation between the Two Koreas. Progress toward peace through tourism is not an isolated progress. It is a part of a larger social change that begins with a recognition that the fundamental social and political order is changing. This change in the current environment appears to offer an opportunity for tourism to be a vehicle for further momentum toward peace and reunification. Tourism appears to be a viable way of opening a path to peace by eroding the seemingly invincible wall that has divided Korea for 50 years.

임의의 모양 Wavelet 영상 부호화 기법

金容寬 湖西大學校工業技術硏究所 1999 工業技術硏究所論文集 Vol.18 No.-

Recently, there has been much interest in wavelet transform due to its advantages, such as little blocking effect and high compression efficiency. However, there has been much difficulty in transforming arbitrary shape images because of boundary effects. To alleviate the boundary effects, the region-based wavelet transform(RWT) and shape-adaptive discrete wavelet transform(SADWT) have been recently reported. In this paper, these techniques are incorporated and its performances are compares in PSNR objective criteria. In addition, as coding techniques for the wavelet transform coder, the bit allocation subbanding coding(BASC) and zerotree coding(ZTC) techniques are compared.

TPA로 야기된 HL-60 세포의 기질부착 저해작용을 이용한 Protein Kinase C 저해 생약의 탐색

김선희,안종석,김삼용,유관희,안병준 충남대학교 약학대학 의약품개발연구소 1993 藥學論文集 Vol.9 No.-

Thirty-five kinds of herbal drugs, believed to be active for treatment of tumors, were selected as the experimental materials for observing their effects on TPA-induced adherence of HL-60 cell and activity of protein kinase C. They were extracted with ethyl ether(E) and ethyl acetate(EA), methanol(M) in sequence. Among the extracts, Sophorae Flos(EA), Paeoniae Radix(EA), Equisetum hiemale(EA), Phellodendri Cortex(E, EA), Mori Cortex radicis(EA), Ferula assafoetida(E, EA), Sophora subprostrata(EA, M) and Cnidium monnieri(E) inhibited the TPA-in-duced adherence of HL-60 cell more than 50% and Sophorae Flos(E, EA, M), Paeoniae Radix(E, EA, M), Eguisetum hiemale(E), Phellodenri Cortex(E,H), Mori Cortex radicis(M), Ferula assafoetida(M), Sophora subprostrata(EA, M), Cnidium monnieri(M) and Artemisia argyi(M) showed inhibiting effects on the activity of protein kinase C more than 50%. The extracts showing good inhibiting effects on the adherence and enzyme activity were Sophorae Flos(EA), Paeoniae Radix(EA), Phellodendri Cortex(E), Sophora subsprostrate(EA) and Equisetum hiemale(EA).

멧돼지 생식후 발생한 선모충증의 가족 내 집단발생사례

김에스더,편래현,박지한,김강호,최일,박홍훈,이용희,용태순,홍성관 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

선모충증은 전 세계적으로 발생하는 기생충 인수공통감염의 한로 선모충의 유충에 감염된 육류를 덜 익혀 섭식시 발생하며 감염 초기에 설사, 복통의 증상이 나타나며 후기에 유충의 체내 이행으로 발열, 근염, 안검 부종 등이 동반된다. 확진은 근육 생검을 하여 피포 유충을 확인하는 것이고 최근에는 특이 항체를 측정하거나 유전자 검사와 같은 다양한 검사가 시도되고 있다. 저자 등은 4명의 한 가족이 야생 멧돼지를 생식한 후 선모충증의 전형적인 임상 증상 및 검사 소견을 보인 가족 내 집단발생사례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Trichinosis is a worldwide parasitic infection caused by ingesting an uncooked raw meat containing viable larvae of nematode Trichinella. Although most cases have been reported in Western countries, the incidence has decreased due to strict control of meat handlings and improved hygiene in these countries. In Korea, the first case of Trichinella spiralis was reported in a patient who ingested an uncooked badger. We have also experienced four cases of Trichinella spiralis infestation among family members who showed typical clinical manifestations and laboratory findings after ingesting raw wild swine meat, and herein report the finding.

성격요인과 아동기 부모-자녀결합형태 및 가족환경과의 관련성에 관한 연구

김용관,이중용,한농교 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.1

Various theories of personality and psychopathology say that early experiences with the parents significantly influence later personality development and psychopathology. However, there has been relatively little research investigating into this relationship. In order to investigate the relations among personality factors, parent-child bonding patterns and family environment in childhood, the authors administered 16 Personality Factor Questionnaire, Parental Bonding Instrument, and questionnaire for demographic data to 398 healthy university students. The results were summarized as follows: 1) Male subjects show higher scores in imagination(M) and lower in liberalism(Q1) than female subjects. Maternal age at birth of subjects is positively correlated with self-control(Q3) and superego(SUP), and negatively with anxiety(ANX). 2) Male subjects show higher scores in maternal care than female, and levels of parental education are positively correlated with parental care. The sibling number is negatively correlated with materanl overprotection. 3) Ego Strength(C), superego(G), self-control(Q3), superego(SUP) is positively correlated with parental care and negatively correlated with parental overprotection. Surgency(F), shrewdness(N), extraversion(EXT), independence(IND) have similar tendencies. Guilt-proneness(O), anxiety(Q4), anxiety(ANX) is positively correlated with parental overprotection and negatively with parental care. Warmth(A) is correlated with paternal bonding, suspiciousness(L) is correlated with maternal bonding pattern, and self-sufficiency(Q2) in negatively correlated with parental care. 4) Groups classified by parental bonding pattern indicate that optimal group(Group Ⅰ) is correlated with more positive aspects of personality factors, and the affectionless control (Group Ⅳ) is correlated with more negative aspects of personality factors. These results support the hypothesis that early parent-child relationships and family environment influence on later personality development. Further studies with more controlled design are needed to confirm our results.