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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).
李敏炯,蔡鴻遠,金正子 慶北大學校 體育科學硏究所 1991 체육과학연구지 Vol.7 No.-
The purpose of this study is to analyze a maximal aerobic power(MAP) and % fat of the urban female. The subjects are 73 urban females who were devided into three groups(27 young femeles, 35 middle females, and 11 old age females) I measured Margaria bench stepping, VO_2 max calculated by Margaria's estimation expression, and % fat was calculated by using Nagamine's estimation expresstion. Therefore, The results of this study is to be compared to the cross sectional analysis among three groups. The results are as follows : 1. 「MAP」 Young female groups MAP was 41.4±13.99㎖/㎏·min, middle age females 39.2±13.95㎖/㎏·min, and old age females, 38.2±10.4㎖/㎏·min. This data showed that 3 groups were in fitness. 2. 「% Fat」 %fat in young female groups % fat was 31.4±5.46%, middle age females, 32.5±8.09%, and old age females, 31.3±6.92%. According to the results, 3 groups have no statistical significance(P>.05). These data showed that three groups were over weight(obesity).
엄용대,신민교,이영미,김형민,신태용,정종길,송호준 대한본초학회 2000 大韓本草學會誌 Vol.15 No.1
We investigated the effects of methanol extract of Fructus Chebula (MEFC) on local and systemic anaphylaxis. Passive cutaneous anaphylaxis inhibited to 61.42 12.8 % by oral administration of MEFC(I.0 glkg). MEFC inhibited compound 48/80-induced anaphylactic shock 100% with doses of 0.05-1.0 glkg . Administrations of MEFC (1.0 glkg) 60 min before, 5 min after, and 10 min after the compound 48/80 treatment were shown the mortality rates as 0%. MEFC (0.01-1.0 glkg) inhibited the histamine release significantly from the rat peritoneal mast cells by compound 48/80. These results indicate that MEFC inhibits mast cell mediated anaphylactic reactions by inhibition of mast cell degranulation in vivo and in vitro.
Purification and Characterization of Helicobacter pylori ${\gamma}$-Glutamyltranspeptidase
Song, Jae-Young,Choi, Yeo-Jeong,Kim, Jeong-Min,Kim, Yoo-Ree,Jo, Jin-Seong,Park, Jin-Sik,Park, Hee-Jin,Song, Yun-Gyu,Lee, Kon-Ho,Kang, Hyung-Lyun,Baik, Seung-Chul,Youn, Hee-Shang,Cho, Myung-Je,Rhee, Kw The Korean Society for Microbiology 2011 Journal of Bacteriology and Virology Vol.41 No.4
Gamma-glutamyltranspeptidase (GGT) was purified to electrophoretic homogeneity from the cell extract of H. pylori. The purified enzyme consisted of heavy and light subunits with molecular weights of 38 kDa and 21 kDa, respectively. N-terminal amino acid sequence of heavy and light subunits revealed that H. pylori GGT was processed into 3 parts for a signal peptide of 27 amino acid residues, a heavy subunit of 352 residues, and a light subunit of 188 residues during translation. The reaction rate for hydrolysis of ${\gamma}$-GpNA was 84.4 ${\mu}mol/min$ per milligram of protein, and that for the ${\gamma}$-glutamyl transfer from ${\gamma}$-GpNA to gly-gly was 23.8 ${\mu}mol/min$ per milligram of protein. The apparent Km values of H. pylori GGT for ${\gamma}$-glutamyl compounds were on the order of $10^{-3}$ to $10^{-4}$ M and those for acceptor peptides and amino acids were on the order of $10^{-1}$ to $10^{-2}$ M. The GGT protein kept approximately 80% of the initial enzymatic activity on incubation at $60^{\circ}C$ for 15 min. The optimum temperature and pH for reactions of both hydrolysis and transpeptidation were $40^{\circ}C$ and 9.0, respectively. The transpeptidation and hydrolysis reactions catalyzed by H. pylori GGT were strongly inhibited by L-Gln and moderately inhibited by L-Ala, L-Ser, ${\beta}$-chloro-L-Ala, and L-Glu. These results demonstrated that the biochemical properties of H. pylori GGT are different from those of other bacterial GGTs. Further, H. pylori GGT might degrade glutathione in the gastric mucous layer of humans if the enzyme could be secreted in the bacterial niches.
( Tae Wook Kim ),( Jong Hyuck Kim ),( Nam Eun Bae ),( Hyung Seok Seo ),( Young Soo Baik ),( Jeong Beom Lee ),( Hun Mo Yang ),( Young Ki Min ) 한국운동영양학회 2012 Journal of exercise nutrition & biochemistry Vol.16 No.4
This study investigated whether the recruitment of activated sweat gland density during passive heating [immersion of the lower body into hot water, 41℃ for 30 min (PH), room temperature 23 ± 0.5℃ with 60 ± 3% relative humidity] is different in endurance-trained (Trainee), compared with that of untrained subjects (Control), as indicated by VO2max. Eight trainees and seven control female subjects (38.31 ± 4.91 ml·kg-1·min-1 and 31.8 ± 0.92 ml·kg-1·min-1, respectively, p < 0.01) were similar on all other physical characteristics. To compare the changes between the trainees and controls, serum cortisol and prolactin (PRL), tympanic temperature (TYMP), local activated sweat gland density (L-ASGD) and the mean whole body sweat loss volume (M-WBSLV) changes were measured after PH. The cortisol was significantly higher (p < 0.05) and the PRL tended to be higher in the Trainee than in the Control. The TYMP increased more in the Trainee than in the Control (p < 0.001). The L-ASGD showed a higher tendency in the Trainee than in the Control, there was a significant difference in the mean activated sweat gland density (p < 0.01) and the L-ASGD was significantly correlated with the VO2max (p < 0.001). The M-WBSLV was significantly higher in the Trainee (p < 0.001) and significantly correlated with the VO2max (p < 0.001). The results suggest that in humans, a high aerobic capacity is associated with a greater recruitment of activated sweat glands, whole body loss of volume and TYMP. Therefore, the decline in the heat loss responses, due to decrease in maximal oxygen consumption, may be masked by repeated endurance exercise training.
직접 검화법을 이용한 조제분유의 콜레스테롤 분석법 개발
김진만,박정민,윤태형,임동길,윤창용,정자영,정인식,곽병만,안장혁,Kim, Jin-Man,Park, Jung-Min,Yoon, Tae-Hyung,Leem, Dong-Gil,Yoon, Chang-Yong,Jeong, Ja-Young,Jeong, In-Seek,Kwak, Byung-Man,Ahn, Jang-Hyuk 한국축산식품학회 2011 한국축산식품학회지 Vol.31 No.6
본 연구에서는 조제분유 중의 콜레스테롤을 신속하고 정확하게 분석하기 위해 지방 추출 과정을 거치지 않는 직접 검화 방법을 선택하여 분석법 개발을 시도하였다. 조제분유 분말시료를 직접 검화 수기에 취하여 검화 온도, 검화 시간, KOH 농도의 3가지 인자에 대해 콜레스테롤 회수율이 가장 양호하게 나타나는 최적 검화조건을 확립하고, 검화 후 수세과정에서 액액 분배가 용이한 용매 조건도 확립하였다. 또한 콜레스테롤 피크의 완전한 분리를 위한 적정 기기 조건을 확립하였다. 그 결과, 시료 약 2 g에 16 M-KOH 10 mL를 넣고 $90^{\circ}C$에서 60분 가열하여 검화한 후 diethyl ether로 3회 추출하고 hexane을 최종시험용액으로 하여 기기분석을 했을 때의 회수율이 98.80%로서 가장 양호하게 나타났다. 본 연구를 통해 개발된 조제분유의 효율적인 액액분배 및 직접가열 검화법은 일원배치 분산법에 의해 유화가공식품의 콜레스테롤 분석법으로 유효성이 검증되었으며, 아울러 개발된 전처리 방법 및 기기 분석 조건을 활용해 다양한 분석 기관에서 신속 정확하고 효율적인 콜레스테롤 분석을 수행할 수 있을 것으로 기대된다. 또한 산업체의 품질관리 및 검증기관에서 필요시 모니터링에 적극 활용 가능할 것으로 사료되며, 이를 통해 유화가공식품 류의 함량표시 및 규격관리의 정확성과 효율성 증대에 기여하여 제조업체의 정확하고도 효과적인 품질 및 안전성 확보에 기여할 수 있을 것으로 판단된다. 특히 위해 물질에 대한 정확한 함량 판단이 중요한 조제분유 등의 영 유아용 식품의 안전성 확보에 지대한 공헌을 할 수 있을 것으로 기대된다. An improved cholesterol analysis method was developed for powdered infant formula by gas chromatographic separation after liquid-liquid extraction and partition. In the official Korea Food Standard method for cholesterol analysis, the water phase and solvent phase were not well separated in the case of emulsified foods such as powdered infant formulas and baby foods. For the rapid and simple sample preparation method, an optimized direct saponification condition was established for heating temperature, heating time, and KOH concentration. From the results, the optimum conditions were as follows: heating temperature $90^{\circ}C$, heating time 60 min, and 16 M KOH 10 mL for a 2 g infant formula sample; improved separation condition for gas chromatography was as follows: the initial oven condition was $250^{\circ}C$ for 25 min, the oven temperature was increased to $290^{\circ}C$ by $10^{\circ}C$/min ratio, and finally the oven temperature remained at $290^{\circ}C$for 9 min. The developed method could be implemented for the study of cholesterol, providing the advantages of reduced inspection time and cost in emulsified foods such as infant formula.
민병형,김가현,이승휘,이정환,유상호 동아대학교 건설기술연구소 2001 硏究報告 Vol.25 No.1
The concern for a cleaner environment together with the need to conserve and reuse our resources has created a challenge for which sanitary engineers, working with environmentalist, will be called upon to find new solutions over the next few years. The result of the study of development of the River's waterfront run as follows. 1. The introduction of the water facilities (which is) utilized in the neighborhood by adjacent citizens and the development of the water site (which is) equipped with facilities for environment must be actually progressed. 2. The concerned authority's favorable complation of the budget must be made up to construct the facilities as the district. 3. Close investigation on the coast and arbores and so on, must be progressed to develop the river in a manner (which is) close to nature.