한국형출혈열에서의 혈청보체에 관한 연구 - 범발성혈관내응고증광의 관계

이문호 ( M. H. Lee ),김응진 ( E. J. Kim ),이정상 ( J. S. Lee ),장연복 ( Y. B. Chang ),김성권 ( S. K. Kim ),최성재 ( S. J. Choi ),김광원 ( K. W. Kim ),김병국 ( B. K. Kim ) 대한내과학회 1980 대한내과학회지 Vol.23 No.4

효율적인 면적의 제어부 실현을 위한 상태 할당 방법

박순규(S. K. Park),최성재(S. J. Choi),조중휘(J. W. Cho),정정화(C. W. Jong),임인칠(I. C. Lim) 대한전기학회 1987 대한전기학회 학술대회 논문집 Vol.1987 No.7

정상인 및 당뇨병환자에서의 경구당부하시 혈중 Insulin과 C-Peptide의 변동

이명철,고창순,최성재,김응진,민헌기 대한핵의학회 1977 핵의학 분자영상 Vol.11 No.1

저자들은 정상인 및 당뇨병환자에서 insulin과 C-peptide의 변동양상의 의의를 관찰하고 또한 비만이 insulin 반응에 영향을 끼치는 것을 보고자 정상인 15명 (비비만형 10명, 비만형 5명), 중등도당뇨병환자 22례 (비비만형 13례, 비만형 9례) 및 중증당뇨병환자 9례, 총 46명을 대상으로 경구적 당부하시험을 시행하고 각 혈중 insulin과 C-peptide를 방사면역법으로 측정하여 다음과 같은 결과를 얻었기에 보고하는 바이다. 1) 10명의 비비만형정상인에서의 insulin치는 공복시 및 100 gm 경구당부하후 30, 60, 90, 120분에서 각각 15.7±3.4, 48.3±9.8, 4.4±6.7, 37.4±6.5 및 26.0±4.2uU/ml(Mean±S.E.)이고 C-peptide는 각각 1.9±0.3, 3.9±0.6, 6.3±0.6, 5.7±0.5 및 4.0±0.5 ng/ml로서 insulin가 C-peptide 평행한 반응을 보였고 insulin은 30분에서 최고치를 나타낸 반면 C-peptide는 60분에서 최고치를 보였다. 2) 비만형정상인 5례에서 insulin은 각각 38.9±12.3, 59.5±12.3, 59.2±17.1, 56.1±20.0 및 48.4±17.2uU/ml이고 C-peptide는 각각 5.5±0.4, 6.8±0.5, 7.9±0.8, 7.9±0.8 및 7.8±2.0ng/ml로서 비비만형에 비하여 반응이 현저히 증가함을 보였다. 3) 13례의 비비만형중등도당뇨병환자의 혈장내 insulin은 각각 27.1±4.9, 44.1±6.0, 37.3±6.6, 35.5±8.1 및 34.7±10.7uU/ml이고 C-peptide는 각각 2.7±0.4, 4.9±0.7, 6.5±0.5, 7.0±0.3 및 6.7±1.0ng/ml로서 비비만형정상군에 비하여 insulin 및 C-peptide의 차이는 없으나 지연되는 양상을 보였다. 4) 비비만형중등도당뇨병환자 9명에서의 insulin은 각각 22.1±7.9, 80.0±19.3, 108.0±27.0, 62.0±17.6 및 55.5±10.1 uU/ml이었으며 C-peptide는 5.2±0.4, 8.0±1.0, 10.4±1.6, 10.4±1.7 및 10.0±10ng/ml로서 insulin과 C-peptide 반응이 비비만형중둥도당뇨병환자군에 비해 각각 항진됨을 볼 수 있었다. 5) 중증당뇨병환자 9례에서의 혈중 insulin은 8.0±3.8, 12.1±3.5, 16.8±4.6, 19.6±5.2 및 15.0±5.0uU/ml이며 C-peptide는 1.6±0.3, 2.4±0.4, 4.1±0.6, 4.0±0.8 및 4.5±0.7ng/ml로서 insulin과 C-peptide가 각각 현저히 감소하였다. 이 각 당뇨병환자군에서의 총 insulin 및 C-peptide 면적, 그리고 insulinogenic index와 C-peptide index를 산출한 결과 당뇨병정도에 따른 유의한 차이를 관찰하였다. The present study was undertaken to evaluate the significance of the insulin and the C-peptide rseponse to oral glucose loads in normal and diabetic subjects and to establish the effects of the obesity. In this study, the authors have measured plasma insulin and C-peptide by means of radioimmunoassay in 10 nonobese normal, 5 obese normal, 13 nonobese moderate diabetic patients, 9 obese moderate diabetic patients and 9 severe diabetic patients. The results obtained were as follows; 1) In 10 nonobese normal subjects, the plasma insulin level at fasting state and at 30, 60, 90, and 120 min after oral glucose loads were 15.7±3.4, 48.3±9.8, 40.4±6.7, 37.4±6.5 and 26.0±4.2uU/ml(Mean±S.E.) and C-peptide were 1.9±0.3, 3.9±0.6, 6.3±0.6, 5.7±0.5 and 4.0±0.5ng/ml. The change of C-peptide was found to go almost parallel with that of insulin and the insulin value reaches to the highest level at 30 min whereas C-peptide reaches to its peak at 60min. 2) The plasma insulin level in 5 obese normal subjects were 38.5±12.3, 59.2±17.1, 56.1±20.0 and 48.4±17.2 uU/ml and the C-peptide were 5.5±0.4, 6.8±0.5, 7.9±0.8, 7.9±0.8 and 7.8±2.0ng/ml. The insulin response appeared to be greater than nonobese normal subjects. 3) In 13 nonobese moderate diabetic patients, the plasma insulin levels were 27.1±4.9, 44.1±6.0, 37.3±6.6, 35.5±8.1 and 34.7±10.7uU/ml and the C-peptide levels were 2.7±0.4, 4.9±0.7, 6.5±0.5, 7.0±0.3 and 6.7±1.0ng/ml. There was little significance compared to nonobese normal groups but delayed pattern is noted. 4) In 9 obese moderated diabetic patients, the plasma insulin levels were 22.1±7.9, 80.0±19.3, 108.0±27.0, 62.0±17.6 and 55.5±10.luU/ml and the C-peptide levels were 5.2±0.4, 8.0±1.0, 10.4±1.6, 10.4±1.7 and 10.1±1.0ng/ml and its response was also greater than that of nonobese moderate diabetic patients. 5) The plasma insulin concentrations in 9 severe diabetic subjects were 8.0±3.8, 12.1±3.5, 16.8±4.6, 19.6±5.2 and 15.0±5.0uU/ml and the C-peptide levels were 1.6±0.3, 2.4/ml and the insulin and C-peptide responses were markedly reduced in severe diabetic groups. 6) There were significant differences between each groups of patients on the magnitude of total insulin or C-peptide areas, the insulinogenic index and the C-peptide index. $quot;

경도 갑상선기능항진증환자에서 TRH 자극시험과 T3 억제시험과의 비교연구

고창순,최성재 대한핵의학회 1980 핵의학 분자영상 Vol.14 No.1

임상적으로 갑상선기능항진증이 의심되나 일상갑상선기능검사에서 거의 정상으로 나타나는 13예에서 TRH 자극시험과 T3 억제시험을 시행하고 이 두 검사방법의 장단점을 비교하여 다음과 같은 결과를 얻었다. 1) T3 억제시험에 정상으로 나타나는 6예에는 모두 TRH 자극시험에도 정상으로 정상갑상선기능증으로 확진할 수 있었다. 2) T3 억제시험에서 이상으로 나타나는 7예는 모두 TRH 자극시험에 대한 혈청 TRH 반응이 없어 용이하게 갑상선기능항진증으로 확진할 수 있었다. 이상과 같은 성적으로 보아 TRH 자극시험은 T3 억제시험에 비해 간편신속하고 환자에 별 부담없이 경도 또는 조기의 갑상선기능항진증을 진단할 수 있는 유용한 검사방법이라 할 수 있다. TRH stimulation tests and T3 suppression tests were done in 13 patients with clinically suspected mild or early hyperthyroidism who were all conventional thyroid function tests gave results within the accepted normal range. The results were as follows 1) 6 paatients with normal T3 suppression test revealed normal TRH stimulation test and could be easily diagnosed as euthyroidism 2) 7 patients with abnormal T3 suppression test exhibited rao TSH response to TRH stimulation test and could be easily diagnosed as hyperthyroidism. The TRH stimulation test is a single, sensitive and reliable test of thyroid function and can well replace T3 suppression test in the diagnosis of marginal hyperthyroidism.

각종 갑상선질환에서 합성 TRH 정주후 혈중 TSH 변도에 관한 연구

이문호,최성재,김광원 대한핵의학회 1980 핵의학 분자영상 Vol.14 No.1

뇌하수체 TSH 방출예비능을 평가하고 그 진단적 가치를 보기 위하여 합성 TRH를 15명의 정상대조군과 55명의 원발성 갑상선질환(14명의 정상갑상선기능군 24명의 갑상선기능항진군 및 17명의 갑상선기능저하군)에 정주후 혈청 TSH를 측정하여 다음과 같은 결과를 얻었다. 1) 15명의 정상대조군에서 합성 TRH를 정주후 혈청 TSH의 반응은 기본치가 3.2±1.0, 10분후에는 8.0±4.0, 20분후에는 11.7±5.0, 30분후에는 13.7±7.1, 60분후에는 9.7±5.0, 120분후에는 5.2±2.0 및 180분후에는 3.6±0.4 μU/ml로써 정주후 20∼30분에 혈청 TSH는 최고치를 보이며 180분에는 거의 기본치로 돌아옴을 볼 수 있었다. 2) 14명의 정상갑상선기능군에서 혈청 TSH 반응은 기본치가 3.3±1.6, 10분후에는 8.6±8.0, 20분후에는 10.9±8.5, 30분후에는 12.5±8.4, 60분후에는 9.0±5.9, 120분후에는 5.6±2.6 및 180분후에는 3.5±1.3 μU/ml로 정상대조군과 통계학상 유의한 차이가 없었다(P$gt;0.05). 3) 24명의 갑상선기능항진군에서 혈청 TSH의 반응은 기본치가 1.5±0.6, 10분후에는 2.2±0.8, 20분후에는 2.3±1.0, 30분후에는 2.4±1.5, 60분후에는 2.1±1.1, 120분후에는 1.9±0.2 및 180분후에는 1.5±0.8 μU/ml로 합성 TRH 정주에 대해 거의 혈청 TSH의 반응을 보이지 않았다. 4) 17명의 갑상선기능저하군에서 혈청 TSH 반응의 평균치는 기본치가 42.0, 10분후에는 60.6, 20분후에는 124.8, 30분후에는 123.0, 60분후에는 101.6, 120분후에는 64.3 및 180분후에는 15.5 μU/ml로 기본혈청 TSH치가 현저히 상승됐음에도 불구하고 정상대조군에 비해 현저히 상승된 혈청 TSH의 반응을 보였다(P$gt;0.01). 5) 합성 TRH 정주에 대한 부작용으로 악성(59.0%), 요의(59.0%), 홍조감(19.7%), 현기증(45.9%), 금속성 맛(9.8%) 및 두통(19.7%) 등이 정주후 수조에서 수분사이에 경하게 일과성으로 나타났으며 아무런 증상도 나타나지 않은 경우는 16.4%이었다. TRH 자극시험은 일반갑상선기능검사에서 정상범위로 나타나는 경도의 또는 조기갑상선기능저하증 및 항진증환자의 진단에 유의한 검사방법으로 결론지을 수 있겠다. Serum TSH levels were ,measured by radioimmunoassay before and afeer intravenous administration of synthetic thyrotropin-releasing hormone(TRH) to 15 normal subjects and 55 patients with primary thyroid disease(l4 patients with euthyroidism, 24 patients with thyrotoxicosis and 17 patients with hypothyroidism) to evaluate pituitary TSH reserve and its diagnostic availability. The observed results were as follows. 1) In normal subjects, serum TSH responses to synthetic TRH were 3.2±1.0 at 0 min(baseline TSH level), 8.0±4.0 at I0 min, 11.7±5.0 at 20min, 13.7±7.1 at 80min, 9.7±5.0 at 60min., 5.2±2.0 at 120min. and 3.6±0.4 μU/ml at 180 min. Serum TSH peaked at 20∼30 minutes and returned nearly to baseline at 180 minutes. 2) In euthyroid group, serum TSH responses to synthetic TRH were 3.3±1.6 at 0 min, 8.6±8.0 at l0 min, 10.9±8. 5 at 20 min, 12.5±8.4 at 30 min, 9.0±5.9 at 60 min, 5.6±2.6 at 120 min and 3.5±1.3 μU/ml at 180 min. No significant difference revealed between euthyroid group and normal 3) In hyperthyroid group, serum TSH responses to synttretic TRH were 1.5±0.6 at 0 min, 2.2±0.8 at I0 min., 2.3±1.0 at 20 min., 2.4±1.5 at 30 min., 2.1±1.1 at 60 min,, 1.9±0.2 at 120 min, and 1. 5±0.8 μU/ml, at 180 min., No response to TRH showed. 4) In hypothyroid group, mean values of serum TSH response to synthetic TRH were 42.0 at 0 min., 60.6 at 10 min., 124.8 at 20 min., 123.0 at 30 min, 101.6 at 60 min., 64.3 at 120 min. and 15.5 μU/ml at 180 min., Patients with primary hypothyroidism showed an exaggerated TSH response to synthetic TRH despite their high basal TSH. 5) Side effects attending synthetic TRH administration were transient nausea(59.0%), desire to micturate(59.0%), feeling of flushing(l9.7%), dizziness (45.9%), metallic taste(9.8%) and headache(l9.7%). Any side effect didn't show in 16.4%. These symptoms began almost immediately after TRH intravenous injection and lasted several minutes, and not related to dose or response in the person experiencing it. It can be concluded that TRH on test would be useful as a means of detecting early or marginal forms of hypothyroidism and hyperthyroidism in the absence of abnormalities in conventional indices of thyroid function.

가토에서 CCNU 로 유발된 골수 저형성증의 혈액학적 소견과 골수스캔의 변화에 관한 연구

김승택,이명철,최두혁,고창순,김병국,이문호,박선양,최성재,김노경,최영희 대한내과학회 1986 대한내과학회지 Vol.30 No.1

To understand systematically the hematological changes including the bone marrow changes in chemotherapeutic agent-induced bone marrow hypoplasia and to define the relationship between hematological and bone marrow scan findings and prognosis of the hypoplasia, CCNU (lomustine) was given orally to 44 rabbits to induce hypoplasia of the bone marrow. And serial changes of peripheral blood and bone marrow findings and (111)In Cl(3)((111)In scan)/(99m)Tc tin colloid bone marrow scan((99m)Tc scan) were checked before and after induction of hypoplasia. With assessment of 28 evaluable rabbits, the following results were obtained: 1) Significant hypoplasia of the bone marrow developed around day 4 of CCNU administration and recovered around day 14(cellularity 51,4±13.5% and 24. 5±14.97o before and after CCNU respectively, p<005). Megakaryocyte count was significantly depressed from 95.67,26% to 36.7$gt;31.82%(P$lt;0.005). M: E ratio was decreased from 162±1.19 to 0, 0.5$lt;0. 43(p±0.005). Shift to left(475), maturation a(40%), naked nucleus and degenerated cells(20%), increase of lymphocytes(47%), monocytes and reticulum cells were also found. 2) The uptake ratio of the 99(m)Tc tin colloid bone marrow scan was markedly increased in contrast to the depression of the bone marrow(4.4±2.12 and 14.1±7.06 before and 4 days after CCNU, respectively, p40. 005). Tc scan uptake ratio was inversely related to the cellularity(r=-0.442, p$lt;0.05) and megakaryocyte number of the bone marrow(r= 0.89, p< 0.01) and peripheral blood granulocyte (r = 0. 54. Pg0.01) and platelet count(r=0.40, p$lt;0.05). There was not significant correlation between (111)In scan uptake ratio and hematologic parameters. 3) The amplitude of the change of the (99m)Tc scan uptake ratio was significantly related to the prognosis of the rabbits with experimentally induced hypoplasia of the bone marrow(dead 5.1±2,67, survivors 2,5±0.96, P<0.01). The change of the (111)In scan uptake ratio was not related to the prognosis of these rabbits. In experimentally induced rrow hypoplasia, morphologic changes in addition to the numerical changes of the bone marrow elements were observed. And serial (99)Tc scan of the bone marrow appears to be helpful assessing the severity and predicting the outcome of bone marrow hypoplasia.

全身性 紅斑性 狼瘡에서의 骨髓所見

김소연,권인순,박선양,최성재,김병국,이문호,조한익 大韓血液學會 1983 大韓血液學會誌 Vol.18 No.1

전신성 홍반성 낭창(Systemic lupus erythematosus)의 혈액학적 소견

서철원,고은미,이홍복,이영열,김승택,최성재,김병국 大韓血液學會 1987 大韓血液學會誌 Vol.22 No.1