결막에 발생한 악성 흑색종의 보존적 치료 1 례

정윤석(Yun Suk Chung),윤영두(Young Doo Yoon),김찬윤(Chan Yun Kim) 대한안과학회 2000 대한안과학회지 Vol.41 No.4

당뇨병성 백서에서 Vanadate 투여후 혈당의 변화와 근육세포내 포도당운반체 활성도 및 유전자의 조절

이현철(Hyun Chul Lee),남문석(Moon Suk Nam),이은직(Eun Jig Lee),임승길(Seung Kil Lim),김경래(Kyung Rae Kim),허갑범(Kap Bum Huh),정윤석(Yoon Sok Chung),이관우(Kwan Woo Lee),조용욱(Yong Wook Cho) 대한내과학회 1995 대한내과학회지 Vol.48 No.3

N/A Objectives: Vanadate is known to mimic several effect of insulin including the stimulation of glucose uptake and oxidation, glycogen synthesis as well as the anti-lipolytic effect. But mechanisms for these effects of vanadate are still not completely understood. The aim of this study was to elucidate the effects of vanadate on intrinsic activity of the glucose transporter and the regulation of the glucose transporter mRNA. Methods: Using age and weight-matched male Sprague-Dawley rats (average weight 250 g), the experimental groups were divided into nondiabetic rats (n= 6), streptozotocin (STZ)-induced diabetic rats (n=6), metavanadate and pervanadate treated diabetic rats (n =12). We measured weight, blood glucose, glucose transporter activity, and glucose transporter 4 (GLUT4) mRNA change. Results: 1) STZ-induced diabetic rats became catabolic and they lost their weight, but after 3 to 4 weeks of treatment with metavanadate or pervanadate, body weights were increased. Blood glucose levels in metavanadate or pervanadate treated rats were significantly lower than STZ-induced diabetic rats after 1 week treatment. 2) There was no significant toxicity in vanadates treated rats, compared with STZ-induced diabetic rats and there was no abnormal change in kidney and liver of rats under light microscope 8 weeks after vanadates treatment. 3) The glucose transporter activity of diabetic rats was significantly decreased, compared with that of normal control rats, and increased after vanadates treatment. 4) The glucose transporter mRNA of diabetic rats was markedly decreased, compared with that of normal control rats, and increased after vanadates treatment. Conclusion: In STZ-induced diabetic rats, vanadates treatment may improve insulin sensitivity through in- creased expression of GLUT4 gene.

국내에서 분리된 G형 간염바이러스 NS-5 Region 염기서열의 계통학적 분석

지영미(Young Mee Jee),김기순(Ki Soon Kim),천두성(Doo Sung Cheon),박정구(Jeong Koo Park),강영화(Young Hwa Kang),이윤성(Yoon Sung Lee),정윤석(Yoon Suk Chung),김지은(Ji Eun Kim) 대한바이러스학회 1999 Journal of Bacteriology and Virology Vol.29 No.1

We examined the hepatitis G virus infections among 227 Koreans who were healthy or were suspected of hepatitis and determined the phylogenetic relationship based on a part of the NS-5 region of 5 positive samples. Viral RNA was extracted from sera and cDNA was synthesized and subsequently amplified by RT-PCR (reverse transcription-polymerase chain reaction) or RT-nested PCR using random hexamer and NS-5 specific primers (470-20-1-77F, 470-20-1-211R, HGVNESTFO, HGVNESTRE). Five positives were found to belong to samples of patients showing symptoms of viral hepatitis. Primers used for PCR or nested PCR were derived from the NS-5 region. On the other hand, no amplification was detected using primers derived from the 5'-NCR (G-146F, G-401R). We performed TA cloning and sequencing of 5 amplified fragments, and their sequences were compared with those of foreign isolates of HGV. The phylogenetic analysis using MegAlign programme of DNAstar has shown that the Korean isolates are clustered on the phylogenetic tree. In summary, we confirmed the hepatitis G virus infection in 5 cases out of 12 patients showing the symptoms of viral hepatitis. The phylogenetic analysis of sequences of 5 amplified fragments showed that their relations to each other were closer than those to the foreign HGV isolates reported.

노인의 갑상선기능저하증에 대한 임상적 연구

정윤석,남문석,이은직,김경래,이현철,김현승,허갑범 한국노화학회 1993 한국노화학회지 Vol.3 No.1

골형성부전증 10예의 임상적 특징

이형숙,김현주,조재현,이승원,김현아,최준혁,송영준,김대중,이관우,정윤석 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경 및 방법: 골형성부전증은 비교적 희귀한 유전병으로 교원질 대사 장애로 인한 골의 취약성과 다발성 골절 및 척추측만증 등을 특징으로 한다. 유전방식과 표현형의 발현 정도에 따라 다양한 임상 양상을 보이며, 임상적 중증도에 따라 4가지 형태로 분류된다. 지금까지 국내 보고는 분만과정이나 태아 진찰시 골격이상으로 발견된 증례보고가 주였다. 저자들은 비교적 경미한 임상 양상을 보이는 예를 포함한 다수의 골형성부전증 환자들의 전반적인 임상적 특징에 대해 보고하는 바이다. 결과: 2001년 6월부터 2003년 2월까지 골형성부전증으로 진단받은 6 가계, 10예를 대상으로 하였다. 평균 나이는 27.3(5∼56)세였고 소아가 2예였다. 모두 상염색체 우성으로 유전되었으며, 제 I형이 4예, 제 III형이 4예, 그리고 제 IV형이 2예였다. 전 예에서 다수의 골절 경험이 있었고, 골밀도 저하와 골피질 두께 감소 소견이 관찰되었다. 전신의 평균 골밀도는 0.690(0.421∼1.039) g/cm²였다. 골형성지표로 측정된 sAlk는 소아의 경우만 증가되어 있었고, 골흡수지표로 측정된 uDPD의 평균치는 12.9(4.4∼36.3) nM/mM Cr으로 증가된 소견을 보였다. mobility score는 대부분 3,4단계에 속해 있었다. 중증형일수록 진단 시의 mobility score가 낮은 경향을 보였다. 결론: 한국인 골형성부전증 환자의 임상적 특징을 살펴본 결과 기존의 보고된 II형 외에도 I, III, IV형이 다양하게 존재함을 알 수 있었으며, 모든 예에서 상염색체 우성으로 유전됨을 확인할 수 있었다. 또한 모든 예에서 증가된 골흡수로 인한 골밀도 저하와 골절을 확인할 수 있었다. Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis (J Kor Soc Endocrinol 18:496∼503, 2003).

한국인에게서 그레이브스병 약물치료의 적정기간

이형숙,이동훈,정희선,이종우,김정은,신승수,정윤석,이관우,김현만 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.1

연구배경: 그레이브스병의 치료에는 항갑상선제, 수술 및 방사성 요오드법이 선택되어 사용되고 있다. 이중 항갑상선제는 가장 많이 선호되고 있으나 낮은 관해율과 높은 재발율로 장기간 치료기간이 요구된다. 저자들은 그레이브스병 환자에게서, 선택되는 치료법의 선호도와 각 치료법의 관해율을 조사하고자 본 연구를 시행하였다. 또한 본 연구에서는 항갑선제 치료의 적정기간을 평가하고자 하였다. 방법: 아주대학교병원에 내원한 환자 중 1년 이상 추적관찰이 가능한 205명의 그레이브스병 환자를 대상으로 조사하였다. 항갑상제군, 수술군 및 방사성 요오드군은 각각 170명, 29명 그리고 6명이었다. ROC curve를 이용하여 약물치료의 예후예측인자를 분석하였다. 결과: 1) 그레이브스병 환자의 치료 방법의 선택은 항갑상선제군, 수술군 및 방사성 요오드군 각각 170명(83.0%), 29명(14.1%) 그리고 6명(2.9%)으로 항갑상선제 치료가 가장 선호되었다. 2) 그레이브스병의 관해율은 항갑상선제군, 수술군 및 방사성 요오드군에서 각각 60.0%(102/170명), 96.5%(28/29명) 그리고 83.0%(5/6명)으로 수술군이 가장 높았다. 3) ROC curve의 AUC는 치료기간과 진단시 TBII가 각각 0.709 및 0.648이었고 적절한 약물투여 추적 관찰기간은 26개월이었다. 결론: 그레이브스병의 일차 치료법으로는 항갑상선제가 선호되고 있으나 수술 및 방사성 요오드 치료군에 비해 상대적으로 낮은 관해율을 보였다. 따라서 항갑상선제 치료로 26개월 이상 관해가 되지 않을 경우에는 치료 방법의 변경을 고려하는 것이 관해율을 높이는데 도움이 될 것으로 생각된다. Background: Graves' disease in an organ specific autoimmune disease. Three kinds of therapeutic modalities (antithyroid drugs, ablation with radioactive iodine and subtotal thyroidectomy) are frequently performed for the management of this disease. The most popular therapeutic policy for the disease in Korea is antithyroid treatment. We analysed and compared the remission rates of all three modalities for Graves' disease, and evaluated the antithyroid modality to determine the correct duration of treatment. Subjects & Methods : The medical records of 205 patients with Graves' disease were reviewed. For the evaluation of the antithyroid modality medical treatment, antithyroid drugs were administered for more than 1 year. The prognostic factors associated with remission were analysed by means of an ROC curve. Results: 1) Of the 205 patients, proportions that received medical therapy, subtotal thyroidectomy and radioiodine therapy were 83.0, 14.1 and 2.9%, respectively. 2) The remission rates of the medical therapy, surgery and radioiodine therapy were 60.0, 96.5 and 83.0%, respectively. 3) The remission rate of the medical therapy was associated with the duration of medication and TBII activity. The determined proper duration for the antithyroid treatment was 26 months from the ROC curve analysis. Conclusion: The above results suggest that the proper duration of antithyroid treatment for Graves' disease is 26 months, after which time the subtotal thyroidectomy or radioiodine therapy should be considered if the disease has not remitted (J Kor Soc Endocrinol 18:24∼31, 2003).

한국 청소년에서 혈청 Adiponectin 농도와 비만도와의 상관관계

김현아,이형숙,김철식,안철우,정윤석,이관우,허갑범,김대중 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경: Adiponectin은 지방세포에서 특이적으로 발현되고 분비되는 adipocytokine이다. 아직 adiponectin 과 소아 비만과의 관련성을 연구한 보고는 많지 않다. 본 연구에서는 한국 청소년을 대상으로 혈청 adiponectin농도와 비만도 및 심혈관계 질환의 위험인자들과의 상관관계를 보고자 하였다. 방법: 2003년 4월 서울특별시 서대문구 소재의 한 중학교에서 12∼15세의 무작위 선발된 164명을 연구 대상으로 하여 신장, 체중, 허리둘레, 체지방을 측정하고 체질량지수를 계산하였다. 또한 공복채혈을 통하여 콜레스테롤, HDL-콜레스테롤, 중성지방, 혈당 및 인슐린 농도를 측정하고 혈청 adiponectin 농도는 ELISA 방법을 이용하여 측정하였다. 결과: 혈청 adiponectin 농도에 따라 삼등분하여 저 adiponectin군, 중간 adiponectin군, 고 adiponectin군으로 나누고 각 군간에 신체계측치 및 임상적 특성을 비교 분석하였다. 저 adiponectin군에서 다른 군에 비해 체질량지수와 허리둘레가 의미있게 크게 나타났다. 또한 저 adiponectin군에서 공복혈당 및 공복혈청 인슐린 농도가 높게 나타났으며, HOMA-IR 값도 높게 나타났다. 저 adiponectin군에서 총콜레스테롤과 중성지방치는 높게, 그리고 HDL 콜레스테롤치는 낮게 나타났다. 다변량회귀분석을 시행한 결과 혈청 adiponectin농도와 가장 상관관계가 높은 변수는 허리둘레와 성별로 나타났다. 결론: 소아에서도 성인과 마찬가지로 혈청 adiponectin농도와 복부비만 및 심혈관계 질환의 위험인자들과의 강한 음의 상관관계를 보임을 알 수 있었다. 향후 사춘기 성호르몬의 변화가 adiponectin에 미치는 영향 및 소아비만의 치료에 따른 adiponectin의 변화 등에 대한 연구가 필요하리라 사료된다. Background: Adiponectin is an adipocytokine that is highly specific to adipose tissue. In contrast to other adipocytokine, the adiponectin levels are decreased in obesity and/or type 2 diabetes. There are few studies regarding the correlation between the adiponectin concentration and obesity in children. Thus, whether the serum adiponectin concentrations are associated with adiposity in children was investigated. Methods: One hundred and sixty four subjects were selected from the participants in an ongoing study on the relationship between birth weight and insulin resistance in children. The current weights, heights, body fat percentages, waist circumferences, blood pressures, lipid profiles and insulin resistance, by the HOMA method, were measured in all the subjects. The serum adiponectin concentrations were determined by a validated sandwich ELISA, using a human adiponectin-specific antibody. Results: The serum adiponectin concentration was negatively correlated with the body mass index, waist circumference, systolic blood pressure, insulin resistance by HOMA and serum triglycerides, and positively correlated with the serum HDL cholesterol level. The serum adiponectin concentrations in the boys were significantly lower than in the girls. In a multiple regression analysis, the serum adiponectin concentration was strongly associated with waist circumference and gender. Conclusion: It is concluded that there was an inverse relationship between the serum adiponectin concentration and abdominal adiposity in children. However, further studies on independent gender differences on adiponectin are needed (J Kor Soc Endocrinol 18:473∼480, 2003).

요붕증을 동반한 원발성 공허안 증후군 2예

김경래,정윤석,황의석,허갑범,이현철,임승길,이은직,안광진,정재희 대한내분비학회 1992 Endocrinology and metabolism Vol.7 No.1

Although tuberculosis is one of the most common causes of adrenal insufficiency, especially in Korea, little is known about adrenal function in patients with active tuberculosis. Rifampicin can also cause decreased bioavailability of glucocorticoid hormone related to its effect on adrenocorticosteroid metabolism consequent to hepatic enzyme induction. Fourty-two Korean adults with active pulmonary tuberculosis were assessed for adrenal function before and after 4 weeks' antituberculous chemotherapy (all patients administerd regimens including rifampicin). There was no difference in serum sodium concentration among the 3 groups, divided by response of the serum cortisol increment after cotrosyn stimulation. (p$gt;0.05) After the cotrosyn stimulation test, cortisol responses were subnormal in 3 patients (7.1%), and returned to normal in all but one patient following a 4 week of antituberculous chemotherapy. It is concluded that there is uncommon but definite incidence (7.1%) of adrenal dysfunction in patients with active tuberculosis. Antktuberculous chemotherapy that includes riampicin does not have an adverse effect on adrenal function. (J Kor Soc Endocrinol 7:61~65, 1992)

다양한 대사적 이상을 나타낸 가족성 복합 고지혈증 가계 1예

김현만,이관우,채봉남,김윤정,이성규,홍은경,박지원,정윤석 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.2

Familial combined hyperlipidemia is one af the manogenic disorders frequently found in humans and is seen in 0.5~2% of the general populatian, accounting for at least 10% of persons with pemature atlmmcletusis. The distinguishing feature of familial combined hyperlipidemia, in camparison with other single-gene abnarmalities of lipoprotein metabolism, is that not all affected members have the same plasma lipid phenotype; some individuals have an elevation of cholesterol concentration alane(type IIa lipoprotein pattern), while some athers have an elevation of triglyceride concentration alone(type IV pattem), and still others have elevations of both values(type IIb pattem). In any one persan, the lipid phenotype can change as a result of dietary or drug treatment. Familial combined hyperlipidemia should be suspected in those subjects with moderate hypertriglyceridemia and/or moderate hypercholestaolemia (lipoprotein types IIa, Ilb, IV), especially when premature coronary heart disease is evident in the family histary. Low plasma HDL-cholesterol, obesity, insulin resistance and hyperuricemia are often . Family members affected by familial combined hyperlipidemia should be identified and be treated, since tbe condition is associated with premature caronary heart diasease. We have found one family of familial combined hyperlipidemia with one member(case 1) associated with insulin resistance, hyperuricemia and gout, and another member(case 2) associated with diabetes mellitus and infertiTity. (J Kor Soc Endocrinol 14:418-424, 1999)

내당능장애를 동반한 Klinefelter 증후군 1예 : 정상혈당클램프 검사로 인슐린 저항성을 확인한 예

김현만,이관우,권오영,채봉남,김윤정,이성규,홍은경,정윤석,차충근,엄철 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.3

Klinefelter syndrome is one of the most common forms of primary hypogonadism and infertility in males. It is a clinical syndrome consisting of gynecomastia, azoospermia, and increased urinary excretion of follicle-stimulating hormone. Fequency of diabetes mellitus, emphysema, asthma, breast cancer increase in Klinefelter syndrome. We report a 16-year-old male patient with impaired glucose tolerance in association with Klinefelter syndrome, which was confirmed by chromosome analysis. The mechanism of impaired glucose tolerance in this patient was peripheral insulin resistance which clarified by euglycemic hyperinsulinemic clamp test (J Kor Soc Endocrinol 13:495-500, 1998).