Soluble alpha-Klotho as a Novel Biomarker in the Early Stage of Nephropathy in Patients with Type 2 Diabetes

OBJECTIVE: Although α-klotho is known as an anti-aging, antioxidant, and cardio-renal protective protein, the clinical implications of soluble α-klotho levels in patients with diabetes have not been evaluated. Therefore, this study evaluated whether plasma and urinary α-klotho levels are associated with albuminuria in kidney disease in diabetes. RESEARCH DESIGN AND METHODS: A total of 147 patients with type 2 diabetes and 25 healthy control subjects were enrolled. The plasma and urine concentrations of α-klotho were analyzed by enzyme-linked immunosorbent assay. RESULTS: Plasma α-klotho (572.4 pg/mL [95% CI, 541.9-604.6 pg/mL] vs. 476.9 pg/mL [95% CI, 416.9-545.5 pg/mL]) and urinary α-klotho levels (59.8 pg/mg creatinine [95% CI, 43.6-82.0 pg/mg creatinine] vs. 21.0 pg/mg creatinine [95% CI, 9.7-45.6 pg/mg creatinine]) were significantly higher in diabetic patients than non-diabetic controls. Among diabetic patients, plasma α-klotho concentration was inversely associated with albuminuria stages (normoalbuminuria, 612.6 pg/mL [95% CI, 568.9-659.6 pg/mL], microalbuminuria, 551.8 pg/mL [95% CI, 500.5-608.3 pg/mL], and macroalbuminuria, 505.7 pg/mL [95% CI, 439.7-581.7 pg/mL] (p for trend ？= 0.0081), while urinary α-klotho levels were remained constantly high with increasing urinary albumin excretion. CONCLUSIONS: Soluble α-klotho levels in plasma and urine may be novel and useful early markers of diabetic renal injur

A study on the Development of Investigation Model to Collisions at Sea: Focusing on the Human Error

Increase of sea traffic causes continuous marine accidents and international organization, maritime industries and government authorities have been focusing on physical aspects of ship such as on-board automation control and reliability of machineries, etc to improve hard ware defects. Despite the improvement of ships physical reliability, marine accidents have been occurring continuously by the reasons of increasing number of sub-standard ships operated by under-developed countries, reduction of crew numbers for competitiveness of crew cost, communication problems of multi national crews, cultural difference of crews and lack of training. Among the marine causual factors of accidents, operational mistake caused by human error is the major factor of collisions at sea. To reduce marine accidents caused by human error, STCW Convention has been adopted and implementation of ISM Code, while training for Bridge Resource Management and others are reinforced. To prevent recurrence of marine accidents, the causal factor of accidents must be eliminated through thorough investigation. However the authority concerned, Maritime Safety Tribunal, lacks infrastructure and qualified personnel as well as has not enough investigation techniques nor guidelines to analyse the causes of human error. This study aims to develop systematic investigation model to collisions at sea focussed on the human error, which ocurred frequently and arises severe damages and to suggest improved investigation and analysis method for human error. Research methods to develop investigation model are to survey the literatures and experience from the officer, master at sea and the judge at maritime safety tribunal. 1) For the theory of human error Guidelines for the Investigation of Human Factors in Marine Casualties and Incidents and analysis method for human error. 2) Human error aspect among various causes of collisions at sea during enroute. 3) Study investigation & analysis method of marine accidents of Maritime Safety Tribunal. 4) By integrating of above, develop investigation model to collisions at sea and verify the usefulness of developed investigation model. Despite(Although there are) many studies on & analysis of ship collisions, it is not simple to categorize the primary causes in several groups. It is because marine accidents are caused by many factors needed to be considered such as the ship's size, type of ships, job fulfilment according to the seamen's competency, safety management system of the shipping company, navigating area and perils at sea. Under this circumstance, the author I categorized models for identifying causes of ship collisions into 4 parts (General Factors, Management System, Watch-keeping, COLREG factors) and named GMWC(named from initials of each mode). First, General factors are classified, as mid-range category, into natural environment, navigation area, governing laws & rules, ship, harbor facilities, Human(crew) factors, and each mid-range category breaks down to micro level. For example, Human(crew) factors breaks down into sex, age, educational background, certificate of qualifications, attitude, on-board career, health condition, and knowledge of marine skill. Second, Management system is divided into on-board management system & company management system. Company management system was categorized in mid-range such as crew management, labor matters, training & education and repair & maintenance, and if necessary it categorized into more details. On-board management system was categorized in mid-range such as on-board based safe operation, general matters, training & education, maintenance of navigational equipment. Third, Watch-keeping system is divided into general factors of watch-keeping and conning person's action carried out during the watch. Factors of general watch-keeping is categorized in mid-range such as personal matters of conning person and/or duty officer, ship's condition and watch-keeping status. The overall matters regarding conning person's action carried out during the watch is described in flow chart. The main content of conning person's action during the watch is expressed as follows. The reason why early detection of the other ship has failed, the reason why systematic observation is not carried out, and the reason why proper action was not undertaken after detection of the other ship before arriving in close distance. Forth, COLREG factors is to find out the violation of the detailed collision avoidance actions to avoid collision as stipulated in COLREG-72 and other laws in a circumstances which the concerned ship was situated. When investigate or analyse the cause of human factor by using the GMWC model developed by this study, first to investigate the observance of navigational rule, the decision of give-way vessel together with proper avoidance action was taken. And then find out the deficiencies of navigational watch keeping duty until avoidance action was performed by watch officer and point out that the cause was resulted by the deficiency of watch officer or on-board management system. This study suggests the solution to remedy the deficiencies found out.제1장 서 론 1 1.1 연구의 배경과 목적 1 1.2 선행연구의 고찰 3 1.3 연구의 방법과 구성 7 제2장 선박충돌사고와 인간과실에 관한 고찰 9 2.1 선박충돌사고와 인간과실의 의의 9 2.1.1 해양사고의 정의 9 2.1.2 선박충돌사고의 정의 10 2.1.3 인간과실의 정의 13 2.2 IMO 해양사고조사코드 13 2.2.1 조사코드의 제정 13 2.2.2 조사코드의 내용 19 2.2.3 인적요인 조사지침 23 2.2.4 조사코드의 한계점 44 2.3 요약 46 제3장 선박충돌사고의 조사 및 분석 방법 48 3.1 우리나라의 선박충돌사고 조사 및 원인분석 48 3.1.1 조사관의 해양사고 조사 48 3.1.2 선박충돌사고와 관련한 조사관의 증거수집 49 3.1.3 사고 원인분석 52 3.1.4 심판원의 선박충돌사고 원인분석에 대한 문제점과 개선점55 3.2 선박충돌사고 원인 중 인간과실에 관한 요인 56 3.2.1 안전관리체계 59 3.2.2 항해당직근무 66 3.2.3 충돌을 피하기 위한 조선자의 행위 75 3.2.4 충돌을 피하기 위한 조치 83 3.3 요약 86 제4장 선박충돌사고의 조사모델 개발 87 4.1 선박충돌사고의 원인식별 지침의 개발 87 4.1.1 원인식별 지침 작성 방안 87 4.1.2 원인요소 식별 모델 88 4.1.3 원인요소 식별의 분류 92 4.2 선박충돌사고의 원인요소 93 4.2.1 일반적인 요소 93 4.2.2 관리체계 97 4.2.3 항해당직 99 4.2.4 항법요소 106 4.3 요약 124 제5장 선박충돌사고 조사 모델 적용 126 5.1 GMWC 모델의 적용 126 5.1.1 사례분석 1 126 5.1.2 사례분석 2 130 5.2 GMWC 모델의 효과 134 5.2.1 질문조서 및 심판조서 작성량 134 5.2.2질문내용 136 5.3 요약 140 제6장 결 론 141 부록 149 참고문헌 15

(A) Study on the investigation and analysis of collisions at sea

A Study on the investigation and analysis of collisions at sea The collisions at sea among marine casualties are not reduced as the tonnage and speed of ship's increase as well as the traffic quantity increase at sea, in spite of the improvement of nautical equipment, enforcement of crew's education and training as well as improvement of quality standard according to the implementation of ISM code. The measures to prevent the collisions at sea are simple, and are composed of four stage.: The first stage is that the officer on duty detect the target from his eye or radar information . The second stage is determining the type and kind of target-ship. The third stage is the target trackingenvironmental factor, and company/on board management system and navigator's act. Also described how to investigate and analyze the casual factors. Even though it was described in this paper how to detect the causal factors and reasons of collisions, and how to analyze the inter-relation of each causal factors, it is necessary to do further study how to analyze the relationship between the liability of concerned parties and the casual factors involved.for example, natural/navigational conditions, crew's human factors, ship's particular, rule or regulation, management system on board, the condition of watch keeping. Therefore the reasons and casualties are so complicated. This study aims to investigate the collision casualty at sea which needs to clarity all these causal factors of afore-mentioned, and to analyze the causes of problems so as to utilize them to establish the measures of preventing marine accidents. This study described the concepts of causal factors into three groupscalculation of target speed, course, CPA and TCPA from radar information or visual check. The fourth stage is determination of vessel in danger after calculation of third stage. The fifth stage is the judgement of situation if own ship is stand-on or give way vessel according to the 1972 COLREG. The last stage is to carry out proper action according to 1972 COLREG under the circumstances But by the case, the situations are so different under the different external condition

시스코의 한국진출 전략

Thesis(masters) --서울대학교 대학원 :경영학과(SNU Global MBA), 2009.8.Maste

Serum 25-hydroxyvitamin D levels and testosterone deficiency in middle-aged Korean men: a cross-sectional study

Previous studies have demonstrated that male hypogonadism is associated with a low level of vitamin D. However, no reports have investigated the effects of vitamin D on testosterone levels in Korean men. Our aim was to investigate whether testosterone levels are associated with serum vitamin D levels and whether seasonal variation exists. This cross-sectional study analyzed serum 25-hydroxyvitamin D [25(OH)D], total testosterone (TT), and free testosterone (FT) in 652 Korean men over 40 years of age who had undergone a comprehensive medical examination. The average age of the subjects was 56.7 ± 7.9 years, and the mean serum 25(OH)D, TT and FT levels were 21.23 ± 7.9 ng ml-1 , 4.70 ± 1.6 ng ml-1 , and 8.12 ± 3.3 pg ml-1 , respectively. In the multiple linear regression model, 25(OH)D showed positive association with TT (β =0.137, P< 0.001) and FT (β =0.103, P= 0.008). 25(OH)D and FT showed similar seasonal or monthly variation after adjustment for age. A vitamin D deficiency [25(OH)D < 20 ng ml-1 ] was associated with an increased risk of deficiencies of TT (<2.30 ng ml-1 ) (odds ratio [OR]: 2.6595% confidence interval [CI]: 1.21-5.78, P= 0.014) and FT (<6.50 pg ml-1 ) (OR: 1.4495% CI: 1.01-2.06 P= 0.048) after adjusting for age, season, body mass index, body composition, chronic disease, smoking, and alcohol use. In conclusion, we demonstrated a positive correlation between 25(OH)D and testosterone, which showed similar seasonal variation in Korean me

메모리 프로파일을 이용한 검사점 시스템의 설계 및 구현

학위논문(석사)--서울대학교 대학원 :컴퓨터공학과,2000.Maste

Verification of Consistency Between Message Sequence Diagram and Statechart Using theSymbolic Model Checking Approach

Maste

영국 `중간계급`의 형성 : 신정치사적 접근

학위논문(석사)--서울대학교 대학원 :서양사학과,1999.Maste

MARCKS의 인산화 및 탈인산화에 의한 계배 근원세포의 분화 조절에 관한 연구

Thesis (doctoral)--서울대학교 대학원 :분자생물학과,1999.Docto