쿠싱증후군 환자에서 당 대사 이상 정도에 따른 인슐린 감수성과 인슐린 저항성의 변화

정인경,김성훈,정재훈,민용기,이명식,이문규,유형준,안규정,노정현,김동준,김광원 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

연구배경 당질 코르티코이드는 당 대사에 매우 중요한 호르몬으로 내인성 당질 코르티코이드 과다상태인 쿠싱증후군에서는 말초조직에서 인슐린 저항이 증가하고 이를 보상하고자 인슐린 분비의 증가로 고인슐린혈증이 동반된다고 보고되고 있다. 하지만 생체 내에서와 달리 시험관내에서는 췌도세포에 당질 코르티코이드를 장시간 처리하면, 인슐린 분비 및 생합성이직접적으로 억제됨이 확인된 바 있어 쿠싱증후군 환자에서 당뇨병의 원인으로는 아마도 말초조직에서 증가된 인슐린 저항성 뿐 아니라 이를 충분히 보상하지 못하는 췌장에서의 인슐린 분비 저하가 같이 동반되어있지 않을까 하는 가설을 세우게 되었고, 아직까지 당질코르티코이드가 당대사 이상을 일으키는 기전에 대해 쿠싱증후군을 당대사 정도에 따라 인슐린 감수성과 분비능을 분석한 연구는 없었기에 이를 알아보고자 하였다. 방법: 삼성서울병원에서 쿠싱증후군으로 진단 받은 환자 15명을 대상으로 하였다. 이에 대한 대조군으로는 쿠싱증후군 환자와 같은 성별 그리고 체질량지수를 갖은 15명의 건강한 성인을 대상으로 비교 하였다 쿠싱증후군 환자를 대상으로 경구당부하 검사를 통해 당대사 정도를 정상군, 내당능장애군, 그리고 당뇨병군으로 나눈 후 정맥 당부하 검사를 시행하여 각군의 인슐린 저항성과 인슐린 분비능의 지표를 비교하고, 수술 후 쿠싱증후군이 완치된 상태에서 수술 전후의 당대사 지표의 변화를 조사하였다. 결과: 1) 쿠싱증후군 환자 중 정상인은 20%, 내당능 장애는 27%, 그리고 당뇨병은 53%였다. 체질량지수, 나이, 그리고 발병 기간은 세 군간에 의미 있는 차이가 없었으나, 24시간 소변검사의 코르티솔 농도는 당뇨병군에서 의미있게 높았다. 2) 정맥당부하 검사 결과, 인슐린 감수성 지표인 Sl는쿠싱증추린」서 1.58±0.10[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 대조군의 3.37±0.49[×10^(-4)(min^(-1)(μU/mL)^(-1)]에 비해 의미있게 낮았으나(P=0.024), 쿠싱증후군 환자 중 NGT, IGT, DM 군간에 서로 통계적인 차이는 없었다. 3) SG는 정상 대조군과 쿠싱증후군 환자간에는 의미있는 차이가 없었고, 쿠싱 증후군에 있어서 당대사가 악화될수록 감소하는 경향을 보였으나 의미있는 차이는 없었다. 4) 인슐린 분비능의 지표인 AIRg는 정상인에 비해 전체 쿠싱증후군 환자의 경우 증가하는 경향을 보였으나 의미있는 차이는 없었다. 하지만 쿠싱증후군 환자중에서 당대사 상태에 따라 NGT군은 1299 (1297∼1310)(mu/g/min ×10^(-2))로 정상 대조군(368.9±98.6[mu/g/min ×10^(-2)]) 보다도 의미있게 높았고, DM군{202.2 (91.1~371.4) [mu/g/min ×10^(-2)}은 NGT군에 비해 의미있게 낮았다(P=0.0031). 5) 15명중 현재 완치 상태에 있는 6명에 대해 수술전과 후로 비교하였다. 수술 전 당대사 상태가 1명은정상, 1명은 내당능 장애, 그리고 4명은 당뇨병이었으나 수술 후 시행한 경구 당부하 검사상 모두 정상 당대사 상태를 보였다. 6) 수술 후 완치된 환자 6명에 있어 인슐린 감수성지표인 Sl는 수술전에 중앙값이 1.22[×10^(-4)(min^(-1)(μU/mL)^(-1)]로 대조군에 비해 의미있게 감고』어 있었으나(p.0.05), 수술후 10.95 [×10^(-4)(min^(-1)(μU/mL)^(-1)]로 정상 수준으로 회복되었고(P=0.0022), 인슐린 분비능을 나타내는 AIRg [mu/g/min ×10^(-2)] 값도 정상수준으로 회복되었다. 특히 인슐린 분비능의 회복양상은 혈당농도에 따라 판이하게 나타나서, 정상과 내당능장애 상태에 있던 2명은 수술전에 1201 [mu/g/min ×10^(-2)]로 증가되어 있던 AIRg 값이 수술 후 정상 수준으로 감소하였고, 수술 전에 당뇨병 상태에 있던 4명의 경우 245.9 [mu/g/min ×10^(-2)]로 인슐린 분비능이 감고il어 있었는데 이들은 수술 후 모두 정상 수준으로 증가되었다 (P=0.0286). 결론: 쿠싱증후군 환자에서 당대사 이상은 80%로 높은 유병률을 보였다. 모든 쿠싱증후군환자에서 인슐린 감수성은 정상인에 비해 저하되어 있어 말초조직의 인슐린 저항이 선행됨을 시사하며, 인슐린 분비능은 당대사의 정도에 따라 다르게 나타났는데, 정상 당대사군에서는 인슐린의 저항성을 극복할 만큼 정상 대조군보다 더 많은 양의 인슐린 분비를 하다가 고코르티솔혈증이 심할수록 인슐린 분비능의 감소로 당뇨병으로 진행됨을 확인할 수 있었고, 이런 인슐린 저항성과 인슐린 분비장애는 수술 후 다시 회복되는 가역적인변화를 보였다. Background: Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. Methods: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequently sampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. Results: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group p=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups p=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively p=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively p=0.0286). Conclusion: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell (J Kor SOC Endocrinol 18:392-403, 2003).

태연혈(太淵穴)의 유침 시간에 따른 체온 변화 -적외선체열촬영(赤外線體熱撮影)을 중심으로-

이봉효 ( Bong Hyo Lee ),이경민 ( Kyung Min Lee ),박지하 ( Ji Ha Park ),김민서 ( Min Seo Kim ),김산들 ( San Deul Kim ),박병규 ( Byeong Gyu Park ),양현동 ( Hyun Dong Yang ),예성호 ( Sung Ho Yea ),이호정 ( Ho Jung Lee ),최재원 ( Jae 경락경혈학회 2012 Korean Journal of Acupuncture Vol.29 No.2

Objectives: This study was performed to find the desirable remaining time of needle in the acupuncture treatment. Methods: The 21 volunteers were given acupuncture at LU9 vertically and needles were remained for 2 min, 10 min, 15 min, 30 min, respectively. The thermographic change induced by acupuncture was measured with Digital Infrared Thermographic Image at the following acupoints: LU11, LU10, LU9, LU8, LU5, LU1, and PC7. The statistical significance of thermographi change was evaluated using paired t-test and post hoc Wilcoxon test. Results: The most significant changes after acupuncture were produced when needles were remained for 10 min or 15 min. LU11, LU5, LU1, and PC7 were the point at which all of the remaining time produced significant change commonly. At LU11, the biggest change was produced when needle was remained for 15 min, while at LU5, LU1, and PC7, the biggest change was produced when needle was remained for 30 min, and the smallest change was produced when needle was remained for 10 min at all of acupoints of LU11, LU5, LU1, and PC7. The unbalance between left side and right was decreased the most largely in 15 min group. Conclusions: The results of this study suggest that the desirable remaining time of acupuncture needle might be 15 min.

신장기능영상용 방사성의약품 Bz - MAG3 ( Benzoylmercaptoacetylglycylglycylglycine ) 의 키트화 및 체내분포

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),김영주(Young Ju Kim),정재민(Jae Min Jeong),장영수(Young Soo Chang),조정혁(Jung Hyuk Cho) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.3

N/A The MAG3 is a tubular excreting radiopharmaceutical for renal image. We synthe-sized benzoyl MAG3 (Bz-MAG3) and made a kit for labeling with Tc-99m. We checked the labeling effeciency of Tc-99m labeled MAG3 and biodistribution. Labeling efficiency was checked by TLC- SG (acetonitrile/H2O=2/1). After injecting of 1 mCi of Tc-99M-MAG3 to ICR-mice, Tmax(min), T1/2(min) were obtained in the renogram. Sequencial images (30sec, 2min, 5min, 10min, 15min, 20min) of TC-99m-MAG3 were compared with those of commercial Tc-99m-DTPA (Du Pont Merck Pharmaceutical Co.) kit. 1) The Rf value of synthesized Tc-99m-MAG3 was 0.78 and labeling efficiency was 97.5±1.9% (n=10). 2) The dynamic images of the Tc-99m-MAG3 were better than those of the Tc-99m-DTPA. 3) The Tmax(min.) and T1/2(min.) of Tc-99m-MAG3 (n=10) were 1.5±0.5 (left), 1.4±0.4(right), and 4.3±1.4 (left), 4.8±2.0 (right), respectivel. The Tmax(min.) and T1/2(min.) of Tc-99m-DTPA (n=7) were 2.7±1.6 (left), 2.7±1.6 right), and 3.8±1.7 (left), 4.5±2.7 (right), respectively. The quaility of image and labeling efficiency of the synthesized Bz-MAG3 kit were excellent, that it was supposed to be used in routine clinical work.

Influence of Aeration Rate and Reactor Shape on Composting Poultry Manure and Sawdust

( Waqas Qasim ),( Min Ho Lee ),( Byeong Eun Moon ),( Jae Min Jo ),( Frank Gyan Okyere ),( Hyeon Tae Kim ) 한국농업기계학회 2017 한국농업기계학회 학술발표논문집 Vol.22 No.2

We investigated various physicochemical properties, i.e., temperature, ammonia and carbon dioxide concentration, pH, electrical conductivity (EC), C/N ratio, organic matter content, moisture content, bacterial population, and seed germination index (GI), during the composting of poultry manure and sawdust for different aeration rates and reactor shapes. Three cylindrical-shaped and three rectangular-shaped laboratory-scale 60-L composting reactors were used in this study, with aeration rates of 0.3, 0.6, and 0.9 L min^-1kg^-1 (drymatter)DM. Results showed that the low aeration rate (0.3 L min^-1kg^-1DM) corresponded to a higher and longer thermophilic phase than did the high aeration rate (0.9 L min^-1kg^-1DM). Ammonia and carbon dioxide volatilization were directly related to the temperature profile of the substrate, with significant differences between the low and high aeration rates during weeks 2 and 3 of composting but no significant difference observed during week 1. At the end of our study, the final values of pH, EC, moisture content, C/N ratio, and organic matter in all compost reactors were lower than those at the start. The growth of mesophilic and thermophilic bacteria was directly related to the thermophilic and mesophilic condition of the compost. The final GI of the cylindrical reactor with an airflow rate of 0.3 L min^-1kg^-1DM was 82.3%, whereas the GIs of the other compost reactors were below 80%. In this study, compost of a cylindrical reactor with a low aeration rate (0.3 L min^-1kg^-1DM) was more stable and mature than the other reactors.

IGCC용 고온건식 탈화제의 반응속도 모사에 관한 연구

박소진,이영우,민세홍,나재익,위영호 忠南大學校 産業技術硏究所 1999 산업기술연구논문집 Vol.14 No.1

고온건식 탈황공정에서 탈황제의 황화, 재생 반응은 비촉매 기고 반응이다. 이러한 비촉매 기고 반응의 수학적 모사는 실험데이터의 설명, 공정의 설계 그리고 scale-up에 있어서 매우 중요한 정보가 된다. 탈황제의 황화, 재생 반응에는 spray dryer로 제조된 zinc titanate 탈황제를 사용하였고, 변형된 미반응핵 모델식에 적용하여 각 반응의 반응속도를 해석한 결과 탈황제의 황화반응에는 화학반응 저항과 고체 상태의 확산 저항이 회합하여 전체반응속도를 지배하며, 이때 반응속도상수는 367.67cm/min 이었고 고체상태의 확산계수는 29.66cm²/min이었다. 또한 재생반응시에 는 화학반응 저항만이 전체반응의 저항으로 관여하며, 이때의 반응속도상수는 3.45x10e cm/min이었다. In the dry-type high temprature gas desulfurization process, sulfidation and regeneration reactions of desulfrrization sorbents are noncatalytic gas-solid reactions. The mathematical modeling of noncatalytic gas-solid reactions is improtant in order to interpret laboratory data and in design and scale-up. Zinc titanate sorbent to manufacture by spray dryer is used in sulfidation and regeneration reactions of desulfuization sorbents. The result which analyzes reaction rate of sulfidation reaction by applying each reactions to modified unreacted core model is that the global reaction rate is controlled by associating with chemical reaction resistance and solid state diffusion resistance. In this case,reaction rate constant is367.67e cm/min and solid state diffusion coefficient is 29.66e cm²/min Also gloval reaction rate of regeneration reaction is controlled only by chemical reaction resistance. In this case, reaction rate constant is 3.45x10e cm/min.

Thermal Resistance Characteristics of Bacillus cereus, Escherichia coli O157:H7, and Listeria monocytogenes in a Multi-grain Soy Milk Product

김남희,구재명,이민석,Kim, Nam Hee,Koo, Jae Myung,Rhee, Min Suk Korean Society of Food Science and Technology 2015 한국식품과학회지 Vol.47 No.5

This study determined the thermal resistance of Bacillus cereus, Escherichia coli O157:H7, and Listeria monocytogenes in multi-grain soymilk and proposes processing conditions that meet the national standard for retort food products in Korea. D and z values were calculated from thermal inactivation kinetic curves after heating at 55, 60, and $65^{\circ}C$. The D value for B. cereus at $55^{\circ}C$ was the highest (22.8 min), followed by that for E. coli O157:H7 (18.8 min) and L. monocytogenes (17.6 min). At $60-65^{\circ}C$, the order was L. monocytogenes ($D_{60-65^{\circ}C}=3.4-0.9min$), E. coli O157:H7 (3.0-0.3 min), and B. cereus (1.2-0.3 min). The z values for these species were 5.2, 5.5, and $7.7^{\circ}C$, respectively. The Korean national standard for retort food products was achieved by thermal processing at $124{\pm}2^{\circ}C$ for 0.3-2.2 min. This study provides useful data for ensuring both the microbiological safety and product quality of multi-grain soymilk products.

동충하초 투여가 최대하 운동 시 지방연소에 미치는 영향

김철우,이용수,이상현,이상호,하민수,윤영조,이재일 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.4

The purpose of this study was to evaluate effects of Cordyceps militaris on fat oxidation during submaximal exercise. Fifteen healthy male collegiate students(ingestion group, N=7; control group, N=8) participated as subjects after signing an informed consent following overnight, subjects completed maximal graded execise test on treadmill to determine exercise intensity(50%VO2max). To evaluate the fat oxidation using indirect calorimeter, it was performed submaximal treadmill to determine exercise lasting. 40min at 50%VO2max after 5day and consumed Cordyceps militaris on separate days. This study was used 2×4 two way repeated ANOVA to analyze physiological and metabolic variables between two groups and metabolic variables between two groups and four exercise periods(l0min, 20min, 30min 40min), and used Scheffe to post-hoc test. Significance was set at α=.05. The results of this study were as followed: First, there were significantly highest in ingestion group for V02, percentage of fat oxidetion(%fat), fat per kilocarolies(Fkcal), and total per kilocarolies(Tkcal)(p<.05), but respiratory exchange ration(RER) and heart rete(HR) were significantly lower in ingestion group(p<.05). Second, RER, %fat, Fkcal were significantly difference in 10, 20, 30, 40min of exercise period(p<.05). This results suggest that there is the effect of Cordyceps militaris on fat oxidation submaximal exercise. Additionally, to evaluate effect of Cordyceps militaris as ergogenic aid, it should be required the future study that included extend subjects, various dosage, and chronic consumption.

Comparative evaluation of the algorithms for parametric mapping of the novel myocardial PET imaging agent ¹⁸ F-FPTP

Kim, Ji Who,Seo, Seongho,Kim, Hyeon Sik,Kim, Dong-Yeon,Lee, Ho-Young,Kang, Keon Wook,Lee, Dong Soo,Bom, Hee-Seung,Min, Jung-Joon,Lee, Jae Sung Springer Japan 2017 Annals of nuclear medicine Vol.31 No.6

<P><B>Objective</B></P><P>(<SUP>18</SUP>F-fluoropentyl)triphenylphosphonium salt (<SUP>18</SUP>F-FPTP) is a new promising myocardial PET imaging tracer. It shows high accumulation in cardiomyocytes and rapid clearance from liver. We performed compartmental analysis of <SUP>18</SUP>F-FPTP PET images in rat and evaluated two linear analyses: linear least-squares (LLS) and a basis function method (BFM) for generating parametric images. The minimum dynamic scan duration for kinetic analysis was also investigated and computer simulation undertaken.</P><P><B>Methods</B></P><P><SUP>18</SUP>F-FPTP dynamic PET (18 min) and CT images were acquired from rats with myocardial infarction (MI) (<I>n</I> = 12). Regions of interest (ROIs) were on the left ventricle, normal myocardium, and MI region. Two-compartment (<I>K</I><SUB>1</SUB> and <I>k</I><SUB>2</SUB>; 2C2P) and three-compartment (<I>K</I><SUB>1</SUB>–<I>k</I><SUB>3</SUB>; 3C3P) models with irreversible uptake were compared for goodness-of-fit. Partial volume and spillover correction terms (<I>V</I><SUB><I>a</I></SUB> and <I>α</I> = 1 − <I>V</I><SUB><I>a</I></SUB>) were also incorporated. LLS and BFM were applied to ROI- and voxel-based kinetic parameter estimations. Results were compared with the standard ROI-based nonlinear least-squares (NLS) results of the corresponding compartment model. A simulation explored statistical properties of the estimation methods.</P><P><B>Results</B></P><P>The 2C2P model was most suitable for describing <SUP>18</SUP>F-FPTP kinetics. Average <I>K</I><SUB>1</SUB>, <I>k</I><SUB>2</SUB>, and <I>V</I><SUB><I>a</I></SUB> values were, respectively, 6.8 (ml/min/g), 1.1 (min<SUP>−1</SUP>), and 0.44 in normal myocardium and 1.4 (ml/min/g), 1.1 (min<SUP>−1</SUP>), and 0.32, in MI tissue. Ten minutes of data was sufficient for the estimation. LLS and BFM estimations correlated well with NLS values for the ROI level (<I>K</I><SUB>1</SUB>: <I>y</I> = 1.06<I>x</I> + 0.13, <I>r</I><SUP><I>2</I></SUP> = 0.96 and <I>y</I> = 1.13<I>x</I> + 0.08, <I>r</I><SUP><I>2</I></SUP> = 0.97) and voxel level (<I>K</I><SUB>1</SUB>: <I>y</I> = 1.22<I>x</I> − 0.30, <I>r</I><SUP><I>2</I></SUP> = 0.90 and <I>y</I> = 1.26<I>x</I> + 0.00, <I>r</I><SUP><I>2</I></SUP> = 0.92). Regional distribution of kinetic parametric images (<I>αK</I><SUB>1</SUB>, <I>K</I><SUB>1</SUB>, <I>k</I><SUB>2</SUB>, <I>V</I><SUB>a</SUB>) was physiologically relevant. LLS and BFM showed more robust characteristics than NLS in the simulation.</P><P><B>Conclusions</B></P><P>Fast kinetics and highly specific uptake of <SUP>18</SUP>F-FPTP by myocardium enabled quantitative analysis with the 2C2P model using only the initial 10 min of data. LLS and BFM were feasible for estimating voxel-wise parameters. These two methods will be useful for quantitative evaluation of <SUP>18</SUP>F-FPTP distribution in myocardium and in further studies with different conditions, disease models, and species.</P><P><B>Electronic supplementary material</B></P><P>The online version of this article (doi:10.1007/s12149-017-1171-6) contains supplementary material, which is available to authorized users.</P>

Prediction of Leptoglossus occidentalis distribution based on climate and geographic characteristics in Europe

Jae –Min Jung,Dae-hyeon Byeon,Sunghoon Jung,Wang-Hee Lee 한국응용곤충학회 2019 한국응용곤충학회 학술대회논문집 Vol.2019 No.10

Optimization of Ascorbic Acid Extraction from Rugosa Rose (Rosa rugosa Thunb.) Fruit Using Response Surface Methodology and Validation of the Analytical Method

( Min Um ),( Ji-woo Kim ),( Jae-won Lee ) 한국목재공학회 2020 목재공학 Vol.48 No.3

In this study, ultrasound-assisted extraction was performed to extract ascorbic acid from rugosa rose (Rosa rugosa Thunb.) fruit. The optimal conditions were investigated by response surface methodology, using two variable including reaction time (16-44 min) and temperature (16-44°C). The ascorbic acid extraction was sensitive to the reaction time rather than the reaction temperature, and the optimal conditions for ascorbic acid extraction were 25°C and 30 min. Ascorbic acid and gallic acid in the rugosa rose fruit extract were completely separated by HPLC, with a resolution factor of over 1.5 between the two. The correlation coefficient of the ascorbic acid was 0.999 in a linearity test for 50-150 μg/mL concentration of extract. The limit of detection and limit of quantification values were 0.16 μg/mL and 29.89 μg/mL, respectively. The relative standard deviations (RSD) for repeatability and reproducibility were determined, and each RSD showed good precision at less than 5% (N=6).