상대적 근육량과 대사증후군 및 구성 요소들 간의 연관성 분석

학위논문 (석사)-- 서울대학교 보건대학원 : 보건학과(보건학전공), 2013. 2. 성주헌.연구배경: 연령이 증가함에 따라 근육량이 감소하는 근육감소증 (sarcopenia)은 특히 노인에서 인슐린 저항성, 당뇨, 대사증후군과 같은 심혈관계 질환의 위험인자와 관련이 있는 것으로 알려져 있다. 미국의 성인을 대상으로 시행한 한 연구에서는 근육감소증 범주까지 포함되지 않더라도, 낮은 상대적 근육량 또한 인슐린 저항성 및 당뇨전단계 (prediabetes)와 연관성이 있음을 보고한 바 있다. 목적: 이번 연구는 19세 이상의 한국인을 대상으로 상대적 근육량 (appendicular skeletal muscle mass / weight (%))과 대사증후군 및 그 구성 요소인 수축기 혈압, 이완기 혈압, 공복혈당, 중성지방, 고밀도지단백 콜레스테롤 및 인슐린 저항성 지표와 같은 심혈관계 질환 위험인자들 사이의 연관성을 알아보고자 하였다. 방법: 2008 ~ 2010년에 시행된 제4기 ~ 제5기 1차 국민건강영양조사에 참여했던 12,444명의 자료를 이용하여 단면 연구를 시행하였다. 복합표본 자료에 대한 다중로지스틱 회귀분석을 이용하여 상대적 근육량과 대사증후군 및 그 구성 요소들(혈압 상승, 공복혈당장애, 고중성지방혈증, 낮은 고밀도지단백 콜레스테롤 및 복부비만)과의 연관성을 분석하였다. 또한, 복합표본 자료에 대한 다중선형회귀분석을 이용하여 교란변수를 통제했을 때 상대적 근육량과 대사증후군의 요소들(혈압, 공복혈당, 중성지방, 고밀도지단백 콜레스테롤) 및 인슐린 저항성 지표 사이의 연관성을 조사하였다. 분석은 남녀 군으로 층화하여 시행하였으며, 남성은 60세를 기준으로, 여성은 폐경 전후를 기준으로 나눈 그룹에서도 추가적으로 분석을 시행하였다. 결과: 교란변수의 영향을 보정한 뒤, 전체 남성에서 상대적 근육량이 첫 번째 5분위 구간에 속하는 대상자와 비교할 때, 다섯 번째 5분위 구간에 속하는 사람은 대사증후군이 있을 오즈가 0.166배(95% 신뢰구간 0.088-0.272)로 나타났다. 60세 미만 남성에서는 0.184배(95% 신뢰구간 0.117-0.289), 60세 이상에서는 0.132배(95% 신뢰구간 0.073-0.289)로 모두 유의한 음의 연관성을 보였다. 대사증후군의 구성 요소인 공복혈당장애, 혈압 상승, 고중성지방혈증, 낮은 고밀도지단백 콜레스테롤 및 복부비만 또한 상대적 근육량이 낮을수록 그 위험도가 증가하였으며 60세 미만과 60세 이상의 남자 그룹에서 모두 유의하게 나타났다. 여성의 경우, 폐경 후 여성에서는 상대적 근육량이 첫 번째 5분위 구간에 속하는 대상자와 비교할 때, 다섯 번째 5분위 구간에 속하는 사람은 대사증후군이 있을 오즈가 0.423배(95% 신뢰구간 0.297-0.602)로 유의하게 낮았으며, 상대적 근육량이 높을수록 낮은 고밀도지단백 콜레스테롤을 제외한 공복혈당장애, 혈압상승, 고중성지방혈증, 복부비만의 오즈가 유의하게 감소하였다. 폐경 전 여성에서는 상대적 근육량과 대사증후군의 연관성이 유의하지 않았다. 결론: 남성 및 폐경 후 여성에서는 상대적 근육량이 낮을수록 대사증후군의 위험도가 높았으며 고밀도지단백 콜레스테롤을 제외한 각각의 구성 요소들과도 음의 연관성을 보였다. 인과성에 대한 명확한 근거는 아직 알려지지 않았으므로 향후 추가적인 경시적 연구가 필요할 것으로 보인다.국문 초록 i I. 서론 1 II. 연구 방법 4 1. 연구 대상자 4 2. 대사증후군의 진단 기준 5 3. 근육량의 측정 및 평가 5 4. 변수들의 측정 6 5. 통계 분석 7 III. 연구 결과 8 1. 연구 대상자의 일반적 특성 8 2.상대적 근육량과 대사증후군 및 구성 요소들(공복혈당장애, 혈압 상승, 고중성지방혈증, 낮은 고밀도지단백 콜레스테롤, 복부비만)과의 연관성 분석 9 3.상대적 근육량과 대사증후군 구성 요소 및 인슐린 저항성 지표와의 연관성 분석 10 IV. 고찰 11 참고문헌 16 영문 초록 45 부록 48Maste

Reliability of hip migration index in children with cerebral palsy: the classic and modified methods

OBJECTIVE: To determine reliability and clinical use of two methods of migration index (MI) in CP patients with or without hip dysplasia. METHOD: The materials included radiographs of 200 hips of children with cerebral palsy. Conventional anteroposterior radiographs of the pelvis were taken with the child in the supine position with standardized methods. Two rehabilitation doctors measured the migration index using two methods. In the classic method, the lateral margin of the acetabular roof was used as a landmark and in the modified method the lateral margin of the sourcil was used as a landmark. Each rater measured the migration index at three separate times with a time interval of at least one week. Intraclass correlation (ICC) was used to test the inter- and intra-rater reliability. RESULTS: MI shows excellent intra-rater reliability in both the classic and modified methods, but the inter-rater reliability was higher in the classic method than in the modified method. When categorized according to the sourcil classification, inter-rater reliability was higher in the normal sourcil type and lower in the dysplastic sourcil types. CONCLUSION: Generally, the classic method showed higher reliability than the modified method, even though the reliability of the MI measurement was relatively high with both methods. KEYWORDS: Cerebral palsy, Hip joint, Migration index, Radiography, Reliabilityope

The Assessment of Reliability of Cognitive Evoked Potential in Normal Person

Objective To evaluate intra-tester reliability of P300 more precisely, this study was designed. Event-related potential (ERP) is the result of endogenous brain response following cognitive stimulus. The P300 component of the human ERP is a positive wave with a latency of 300 ms or greater. Our purpose of this study was to estimate reliability of P300 latency and amplitude with 30 normal persons without head injury, as well as to set up them as the reference values in the event that they would be found to be highly reliable.Methods ERP was performed at three separate times on 30 normal adults in their 20s and 30s. We measured P300 latency and amplitude among ERP.Results P300 latency show excellent reliability with intraclass correlation coefficient (ICC) of 0.81. As to P300 amplitude, reliability was good to fair with ICC of 0.53. Average value of P300 latency was 311.3±37.0 ms, shorter than reference value of previous study in Korea.Conclusion P300 latency revealed higher reliability than P300 amplitude, although reliability of P300 was confirmed in both component. After further study including precise mechanism, influence factor on measurement and method standardization, it is expected to be an objective indicator to assess the cognitive state and predict prognosisope

Diagnostic Value of Facial Nerve Antidromic Evoked Potential in Patients With Bell’s Palsy: A Preliminary Study

OBJECTIVE: To assess the practical diagnostic value of facial nerve antidromic evoked potential (FNAEP), we compared it with the diagnostic value of the electroneurography (ENoG) test in Bell's palsy. METHODS: In total, 20 patients with unilateral Bell's palsy were recruited. Between the 1st and 17th days after the onset of facial palsy, FNAEP and ENoG tests were conducted. The degeneration ratio and FNAEP latency difference between the affected and unaffected sides were calculated in all subjects. RESULTS: In all patients, FNAEP showed prolonged latencies on the affected side versus the unaffected side. The difference was statistically significant. In contrast, there was no significant difference between sides in the normal control group. In 8 of 20 patients, ENoG revealed a degeneration ratio less than 50%, but FNAEP show a difference of more than 0.295±0.599 ms, the average value of normal control group. This shows FNAEP could be a more sensitive test for Bell's palsy diagnosis than ENoG. In particular, in 10 patients tested within 7 days after onset, an abnormal ENoG finding was noted in only four of them, but FNAEP showed a significant latency difference in all patients at this early stage. Thus, FANEP was more sensitive in detecting facial nerve injury than the ENoG test (p=0.031). CONCLUSION: FNAEP has some clinical value in the diagnosis of facial nerve degeneration. It is important that FNAEP be considered in patients with facial palsy at an early stage and integrated with other relevant tests.ope

Aza-Claisen 전위를 이용한 macrolactam의 합성

학위논문(석사)--서울대학교 대학원 :약학과 약품제조화학전공,1999.Maste

Nanohybrid photocatalyst made of titania nanosheets and zinc oxide nanoparticles via exfoliation-restacking method

Thesis(master`s)--서울대학교 대학원 :화학부 물리화학전공, 2006.Maste

EGFR T790M 돌연변이를 지닌 비소세포폐암에서 당 대사의 저해를 통한 BIBW2992의 항종양 효능 증대

Dept. of Medical Science/박사The secondary epidermal growth factor receptor (EGFR) T790M is the most common mechanism of resistance to reversible EGFR tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC) patients with activating EGFR mutations. Although BIBW2992 has been expected to overcome the resistance to reversible EGFR TKIs due to EGFR T790M mutation, it showed a limited efficacy in recent phase III clinical study. Increased glycolysis, a common feature of most cancer cells, has been considered as a potential target for treatment of cancer. In this study, it was found that the inhibition of glycolysis using 2-deoxy-D-glucose (2DG) improves the efficacy of BIBW2992 in H1975 and PC9-GR cells, the NSCLC cells with EGFR T790M. The combination treatment of 2DG and BIBW2992 induced intracellular ATP depletion in both H1975 and PC9-GR cells, resulting in activation of AMP-activated protein kinase (AMPK), the major energy-sensing kinase. The AMPK activation played a central role in the cytotoxicity by the combined treatment of 2DG and BIBW2992 through inhibition of mammalian target of rapamycin (mTOR). The alteration of AMPK/mTOR signaling pathway by the inhibition of glycolytic metabolism induced downregulation of Mcl-1, a member of anti-apoptotic Bcl-2 family which is critical for survival in H1975 and PC9-GR cells, by translational control. In in vivo xenograft study using PC9-GR cells, the combined treatment of 500 mg/kg 2DG and 5 mg/kg BIBW2992 showed more effective anti-tumor activity than the treatment of 2DG alone or BIBW2992 alone. In conclusion, this study examined whether glucose metabolism inhibition using 2DG enhances the sensitivity to BIBW2992 in NSCLC cells with EGFR T790M. Addition of 2DG increased the sensitivity to BIBW2992 accompanying apoptotic cell death in the cells. The cytotoxicity by the combination treatment of 2DG and BIBW2992 was mediated by Mcl-1 downregulation via alteration of AMPK/mTOR signaling pathway. These data suggest that the combined use of inhibitor of glycolytic metabolism and BIBW2992 is a potential therapeutic strategy for treatment of patients with acquired resistance to reversible EGFR TKIs due to secondary EGFR T790M.prohibitio

가공인삼의 대사산물에 관한 연구

학위논문(석사)--서울대학교 대학원 :약학과 약품분석화학전공,2003.Maste

CAND1 (Cullin-associated and neddylation-dissociated protein 1) and CSN5 regulate cullin protein stability during Drosophila development

Thesis(masters) --서울대학교 대학원 :생명과학부,2008. 8.Maste

치매환자를 위한 치유환경을 도입한 옥외공간설계지침

학위논문(석사)--서울대학교 대학원 :생태조경·지역시스템공학부 생태조경학전공,2006.Maste