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박근규 ( Keun Gyu Park ) 대한간학회 2013 Postgraduate Courses (PG) Vol.2013 No.-
Patients with type 2 diabetes have high rates of cardiovascular disease (CVD), much of which may be preventable with appropriate treatment of lipid abnormalities. Diabetic dyslipidemia most commonly manifests as elevated triglycerides and low levels of HDL cholesterol, with a predominance of small, dense LDL particles amid relatively normal LDL cholesterol levels. Elevated serum triglycerides commonly associate with insulin resistance. In diabetic patients, despite the insulin resistance of the gluconeogenic arm, persistently elevated hepatic lipogenesis in response to hyperinsulinemia could neatly account for the increased hepatic triglyceride output. Insulin`s ability to activate lipogenesis is mediated by both transcriptional and post-translational activation of SREBP-1c. Recently, we demonstrated that fenofibrate, which is a drug used to treat hypertriglyceridemia, decreases hyperinsulinemia-stimulated hepatic lipid synthesis through induction of ER membrane bound transcription factor, CREBH. In the study, we also found that fenofibrate and CREBH induce hepatic fibroblast growth factor 21 (FGF21) expression. FGF21 has emerged as an important metabolic regulator of glucose and lipid metabolism. In this symposium, I will review diabetic dyslipidemia and present the data showing positive regulators of hepatic FGF21 expression.
양시용,강창원,안규철,이강연,이중일,김정훈,박근규,Yang, Si-Yong,Kang, Chang-Won,Ahn, Gyu-Chul,Lee, Gang-Yeon,Lee, Jung-Il,Kim, Jeong-Hoon,Park, Keun-Kyu 한국축산식품학회 2010 한국축산식품학회지 Vol.30 No.3
This study was conducted to the evaluate nutritional value of corn taffy residue (CTR), a by-product from Korean traditional taffy, and to investigate the dietary effect of CTR on the yield and composition of milk from dairy cows. Relatively high concentrations of residual enzymes and sugars were found in CTR. Protein and fat concentrations were high, comparable to those of corn gluten meal. Inclusion of 1, 3, and 6% CTR in total mixed rations yielded more milk (p<0.05) than in the control group, and increased milk fat (p<0.05) in high-producing cows (approximately 30 kg). In low-producing cows, (approximately 20 kg), milk yield was increased by 1 and 6% CTR, and milk protein was enhanced by 3% CTR (p<0.05). Based on these results, utilization of CTR is recommended for production of high quality and economical animal products.
증례 : 갑상선기능항진증 환자에서 propylthiouracil 복용 후 발생한 typhlitis 1예
류성열 ( Seong Yeol Ryu ),장영윤 ( Young Yun Jang ),김상윤 ( Sang Yoon Kim ),박근규 ( Keun Gyu Park ),김혜순 ( Hye Soon Kim ) 대한내과학회 2007 대한내과학회지 Vol.73 No.6
Typhlitis은 주로 급성 백혈병으로 항암 치료 후 호중구 감소증 상태에서 발생하는 대장염을 말하는데, 간혹 골수 이식 후 면역억제재 치료 또는 약물에 의한 무과립구증, AIDS, 고형암의 화학요법 후에도 발생할 수 있다. 저자들은 갑상선기능항진증 치료에 사용되는 propylthiouracil을 복용한 후 호중구 감소 상태에서 발생한 Typhlitis 1예를 경험하였으므로 문헌고찰과 함께 보고하는 바이다. 드물지만 갑상선기능항진증 환자에서 propylthiouracil 투여 후 복통, 설사와 발열 등의 증상이 동반되면 typhlitis의 가능성을 고려하여 조기에 적절한 진단과 치료를 하여야 할 것으로 사료된다. Typhlitis is one of the most ominous complications in immunocompromised patients. Neutropenic enterocolitis or typhlitis is a clinical syndrome characterized by fever, diarrhea and abdominal pain that occurs in neutropenic patients. It has been reported as a complication of childhood leukemia, but is now known to occur in adults with solid malignancies, acquired immunodeficiency syndrome (AIDS) or bone marrow transplantation (BMT). The association of typhlitis and propylthiouracil has not been previously reported. We report a case of a 42-year-old female patient with typhlitis due to propylthiouracil patient with hyperthyroidism. (Korean J Med 73:666-669, 2007)
김종호 ( Jong Ho Kim ),배귀현 ( Kwi Hyun Bae ),최연경 ( Yeon Kyung Choi ),하인균 ( In Gyoon Ha ),박근규 ( Keun Gyu Park ),김정국 ( Jung Guk Kim ),이인규 ( In Kyu Lee ) 대한내과학회 2013 대한내과학회지 Vol.84 No.5
Fever of unknown origin (FUO) is not infrequently a diagnostic dilemma for clinicians. Common infectious causes include endo-carditis and abscesses in adults, and noninfectious causes include neoplasms and certain collagen vascular diseases. Endocrine causes of FUO are rare. The only endocrine disorder likely to present as FUO is subacute thyroiditis. Subacute thyroiditis usually occurs in middle-aged women as viral prodrome, neck tenderness, classic symptoms of thyrotoxicosis, and an elevated erythrocyte sedimentation rate. The patient may have abrupt onset of fever and chills with complaints of thyroid pain, or only low-grade fever with poorly characterized anterior neck pain. We present a case of FUO in a 48-year-old female who had had fever and neck pain for more than one month. Despite an extensive evaluation, the patient had persistent fever and no cause was found, with the exception of subacute thyroiditis. The fever resolved from the second day of treatment with low-dose steroid (prednisolone, 10 mg per day). This case illustrates that subacute thyroiditis should be considered in cases of FUO. (Korean J Med 2013;84:733-736)
내분비-대사 : 고칼슘혈증 동반 사르코이드증에서 정상 혈중 비타민 D를 보인 증례
전재한 ( Jae Han Jeon ),서정범 ( Jung Bum Seo ),황인량 ( In Ryang Hwang ),박혜윤 ( Hye Yoon Park ),김정식 ( Jeong Shik Kim ),박근규 ( Keun Gyu Park ),김정국 ( Jung Guk Kim ) 대한내과학회 2015 대한내과학회지 Vol.88 No.2
Diagnosing hypercalcemia is often challenging because a wide spectrum of diseases-such as malignancy, granulomatous disease, and primary hyperparathyroidism-should be considered. Sarcoidosis is a rare cause of hypercalcemia. The case of a 77-year-old male presenting with sarcoidosis-associated hypercalcemia whose serum 1,25(OH)2D level was normal is reported here. Despite a normal 1,25(OH)2D level and minimally enlarged hilar lymphadenopathy, the serum angiotensin-converting enzyme (ACE) level was increased. Mediastinoscopic biopsy of the right lower paratracheal lymph node revealed pathological findings compatible with sarcoidosis. Treatment with 30 mg/day oral prednisone was started. Currently, the patient is being treated with a tapered dose of oral prednisone and small doses of vitamin D and calcium. Despite its low incidence, sarcoidosis should be considered a cause of hypercalcemia. The important diagnostic factors are not only serum calcitriol levels but also serum ACE levels and pathological findings. (Korean J Med 2015;88:207-211)
갑상선 유두암에서 p16(INK4A) 촉진자 과메틸화와 p16(INK4A), cyclin D1 및 Rb 발현
김윤정 ( Yoon Jung Kim ),김혜순 ( Hye Soon Kim ),하유진 ( Yu Jin Ha ),이호영 ( Ho Young Lee ),박근규 ( Keun Gyu Park ),김미경 ( Mi Kyung Kim ),권선영 ( Sun Young Kwon ) 대한내과학회 2010 대한내과학회지 Vol.78 No.3
Background/Aims: Dysregulation of the cell cycle is believed to be important in human neoplasia. p16(INK4a), a regulator of the retinoblastoma protein, is inactivated by several mechanisms, including hypermethylation of the promoter. The aim of this study was to assess the relationship between p16(INK4a) methylation status and the expression of p16(INK4a), cyclin D1, and retinoblastoma protein in papillary thyroid cancer. Methods: Thirty-five surgically resected papillary thyroid cancer cases treated at Keimyung University Dongsan Medical Center from Jan 2003 to Dec 2005 were included in the study. We examined promoter hypermethylation of p16(INK4a) and immunohistochemically analyzed p16(INK4a), cyclin D1, and retinoblastoma protein expression. Results: Aberrant hypermethylation of 5` CpG islands of the p16(INK4a) gene promoter was observed in 17 (48.6%) out of 35 cases, and the p16(INK4a) protein was lost in 18 (51.4%) cases. With the exception of one case, p16(INK4a) promoter hypermethylation correlated with the loss of p16(INK4a) protein expression (p<0.0001). Overexpression of cyclin D1 was found in 27 (77.1%) cases and retinoblastoma immunostaining was detected in 10 (28.6%) cases. There was an inverse relationship between p16(INK4a) and pRb immunostaining (p<0.018, r=-0.398), and a strong direct correlation between cyclin D1 and pRb immunostaining (p<0.0001, r=0.710). Cyclin D1 expression was significantly associated with the pathologic T stage of cancer (p=0.04). Conclusions: These data suggest that promoter hypermethylation is a major mechanism underlying the inactivation of p16(INK4a) and alterations in the p16(INK4a)/cyclin D1/retinoblastoma pathway, which are thought to be very important in papillary thyroid cancer. (Korean J Med 78:333-340, 2010)
이호영 ( Ho Young Lee ),김미경 ( Mi Kyung Kim ),김남경 ( Nam Keong Kim ),김혜순 ( Hye Soon Kim ),류성열 ( Seong Yeol Ryu ),권기영 ( Ki Young Kwon ),박근규 ( Keun Gyu Park ) 대한내과학회 2010 대한내과학회지 Vol.78 No.4
Sunitinib은 콩팥세포암종이나 위장관 기질성 종양 치료에 사용되는 약제로 갑상선기능저하증이 흔한 부작용 중의 하나이다. 본 증례는 sunitinib 사용 1주 후 발생한 갑상선염에 의한 중증의 갑상선중독증 환자를 경험하였기에 보고하고자 한다. Sunitinib is a tyrosine-kinase inhibitor used to treat metastatic renal cell carcinoma and imatinib-resistant gastrointestinal stromal tumors. Hypothyroidism is a common side effect of sunitinib therapy. Nevertheless, overt thyrotoxicosis induced by destructive thyroiditis after sunitinib treatment is very rare. Here, we report a patient with overt thyrotoxicosis related to sunitinib therapy. (Korean J Med 78:503-506, 2010)