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).

운동이 백서 스테로이드 근병증에 미치는 효과

박상준,이민철,김세종,박상준,이민철,김세종 대한신경과학회 1999 대한신경과학회지 Vol.17 No.5

충남대학교 학술림 산책로 훼손실태 및 관리방안에 관한 연구

이준우,김명준,최윤호,전용준,오도교,김민호,이소연,이경형 충남대학교 농업과학연구소 2004 농업과학연구 Vol.31 No.2

This study concentrates an the trail of the CNU(Chungnam National University) forest. The amount of use and the pattern of damage are considered, as well as the extent of environmental damage. Finally, some managerial strategies are proposed in connection with sustainable maintenance. The trail of the university forest is composed of three sections; one is the neighborhood park and the Institute of Information Technology/Communications, the second is the Institute of Information Technology/Communications and the Dormitory, and the third section is the Dormitory and the Foreign prof's Apt. The total length of the trail is 2.6km. The daily amount of use is 1,269 visitors per day. The amount of using increased three times the amount of that in 1998. This study shows the pattern of damage of the trail in the order of root-exposure, widening, rock-exposure, deepening and the divergence in the frequency of occurrence of all these factors. Environmental damage is also graded thus: grade 3 is 27.4m, grade 4 is 0.8m, grade 5 is 1.5m, and grade 6 is 0.2m. Accordingly, some managerial strategies were proposed in connection with the sustainable trail maintenance.

가상공간의 가공 공정과 상태 구현에 관한 연구

이수훈,김봉석,홍민성,김종민,JUN NI,박상호,송준엽,이창우,하태호 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

This paper presents virtual machining system in order to realize turning process in virtual space. A reliable virtual turning process simulation was developed based on the surface shaping system which is capable of considering geometric model, thermal error model, and vibration model. Accuracy of surface shape resulting from proposed machining simulator was verified experimentally. This paper also developed the watchdog agent that continuously assessed, diagnosed, and predicted performance of products and machines in machining. The Watchdog agent extracted feature signal using time-frequency analysis among various signals from multi-sensor and evaluated machining condition using performance confidence value.

휴대폰 카메라용 자동초점 구동기의 충격해석

이성민,김봉석,송준호,이수훈,이혜진,이문구,송준엽,이창우 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

Recently, the robustness against daily impact is important according to portablization and downsizing of mobile electronics. Especially, almost parts of cellular phone should undergo drop test when they fall 1.5 m above ground. This test simulates the case when cellular phone slips through user's fingers while he is talking on the phone. This paper studies a drop test of auto focusing (AF) actuator for camera module in cellular phone. This component is composed of voice coil motor (VCM) as an actuator and leaf spring as a guide and suspension. The leaf spring's deformation is essential for the test because its permanent distortion disables the focusing, and then, a high quality photograph cannot be obtained. Up to now the drop test has been carried out after fabricating real AF actuator. We propose a dropt test model which simulates the drop test based on finite element analysis. This model makes us enable investigate the stress acting on the clamping and curved parts of leaf spring. Stress over Von Mises criterion lets the spring deformed permanently, and then AF actuator malfunctioned, It helps us to design and modify AF actuator without manufacturing the real product. And also, it saves the time and cost for the development of new products.

Min-Hash를 이용한 효율적인 대용량 그래프 클러스터링 기법

이석주(Seok-Joo Lee),민준기(Jun-Ki Min) 한국정보과학회 2016 정보과학회논문지 Vol.43 No.3

그래프 클러스터링은 서로 유사한 특성을 갖는 정점들을 동일한 클러스터로 묶는 기법으로 그래프 데이터를 분석하고 그 특성을 파악하는데 폭넓게 사용된다. 최근 소셜 네트워크 서비스와 월드 와이드 웹, 텔레폰 네트워크 등의 다양한 응용분야에서 크기가 큰 대용량 그래프 데이터가 생성되고 있다. 이에 따라서 대용량 그래프 데이터를 효율적으로 처리하는 클러스터링 기법의 중요성이 증가하고 있다. 본 논문에서는 대용량 그래프 데이터의 클러스터들을 효율적으로 생성하는 클러스터링 알고리즘을 제안한다. 우리의 제안 기법은 그래프 내의 클러스터들 간의 유사도를 Min-Hash를 이용하여 효과적으로 추정하고 계산된 유사도에 따라서 클러스터들을 생성한다. 실세계 데이터를 이용한 실험에서 우리는 본 논문에서 제안하는 기법과 기존 그래프 클러스터링 기법들과 비교하여 제안기법의 효율성을 보였다. Graph clustering is widely used to analyze a graph and identify the properties of a graph by generating clusters consisting of similar vertices. Recently, large graph data is generated in diverse applications such as Social Network Services (SNS), the World Wide Web (WWW), and telephone networks. Therefore, the importance of graph clustering algorithms that process large graph data efficiently becomes increased. In this paper, we propose an effective clustering algorithm which generates clusters for large graph data efficiently. Our proposed algorithm effectively estimates similarities between clusters in graph data using Min-Hash and constructs clusters according to the computed similarities. In our experiment with real-world data sets, we demonstrate the efficiency of our proposed algorithm by comparing with existing algorithms.

개의 췌도분리에서 췌장의 팽창과 콜라겐 분해요소

이상훈,김성주,박정환,김종성,오승훈,한진수,정인경,양태영,김동준,김광원,이문규,민용기,이명식,정재훈,함종렬 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.2

Backgrounds: One of the main problems conditioning the outcome of islet transplantation is the ability to separate a sufficient number of viable islets with preserved function. Islet purification is critically affected by all of the isolation stages. Thus, it is necessary to set up the standard isolation method that islets are separate well from acinar without compromising islet yield and viability. Methods: Twenty three adult mongrel dogs were used for the experiment of total pancreatectomy with islet isolation. The islets were properly isolated by a modified Recordi method. The obtained islets were further purified by centrifugation on discontinuous gradients using cell separation system (Model 2991, Cobe, Lakewood Colo). We evaluated islet number (islet equivalent number, 150 um equivalents/kg of recipient body weight, IEq/kg), purity, cell volume, viabilty, recovery rate, and comparison of outcome according to the isolation conditions. Results: 1) The mean of islet numbers before purification were 13543±9431Eq/kg, digestion times were 13.8±2.6 min., digestion temperature was 37.4±0.2℃, purity was 59.7?.0%, viability was 90.0±2.1%, cell volume was 4.7±1.1 mL, islet number after purification were 4064±361 IEq/kg, and recovery rate was 29±2.9%. 2) Isolated islet numbers were different according to the degree of pancreas distension with collagenase, digestion temperature, and digestion time. 3) The best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase. 4) According to multiple regression adjusted by variable factors, the degree of pancreas distension with collagenase and digestion time were independently associated factors for successful islet isolation. Conclusions: In this study, we concluded that the degree of pancreas distension with collagenase and digestion time were independent factors for successful islet isolation and the best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase.

Effect of Impact Velocity on Interface Characteristics of HT‑9 Steel Joints Fabricated by Magnetic Pulse Welding

Jun‑Woo Song,Jin‑Ju Park,Gyoung‑Ja Lee,Min‑Ku Lee,Kyu‑Hyun Park,Soon‑Jik Hong,Jung Gu Lee 대한금속·재료학회 2020 METALS AND MATERIALS International Vol.26 No.3

The weldability window in magnetic pulse welding (MPW) is proposed for the end-closure joining of HT-9 steel tubularworkpieces. Based on both theoretical and experimental investigations, the impact velocity of the flyer tube at the momentof collision had a dominant effect on the bonding characteristics of the resultant joints and the optimal impact velocity wasestimated to be in the range of 265–290 m/s in this alloy system. Under the optimal process conditions, no leak was detectedduring helium leak testing. Moreover, the integrity of the joint interface was preserved until the tube section ruptured duringinternal pressure burst testing. For HT-9 steel, the ductile δ-ferrite phase produced by the localized interfacial melting duringMPW acted as an effective obstacle to crack propagation, thereby enhancing the fracture resistance of the joint interface. Allof the results demonstrated the high integrity and durability of the HT-9 steel tube assembly fabricated by the MPW process.

Doping effect of CNT and nano-carbon in magnesium diboride bulk.

Lim, Jun Hyung,Lee, Chang Min,Park, Jin Hyun,Choi, Jun Hyuk,Shim, Jong Hyun,Joo, Jinho,Lee, Young Hee,Kang, Won Nam,Kim, Chan-Joong American Scientific Publishers 2009 Journal of Nanoscience and Nanotechnology Vol.9 No.12

<P>We fabricated carbon nanotube (CNT)- and nano-carbon (NC)-doped MgB2 using an in-situ process in order to improve the critical current density (J(c)) at high magnetic field. We then evaluated the effects of the doped carbon content on phase formation, microstructure, and critical properties. CNT had a diameter and length of 5-10 nm and 0.5-1 microm, respectively, and NC was a sphere with a diameter of 5-30 nm. The bulk MgB(2-x)C(x) samples with x = 0, 0.05, and 0.1 for NC and CNT were fabricated by pressing into pellets and then sintered at 900 degrees C for 30 min. NC was more effective than CNT for carbon doping at the B site in MgB2 and, therefore, the NC-doped MgB2 samples had a lower critical temperature (T(c)) of 35.0-34.7 K than that of the CNT-doped samples (36.4-36.1 K). In addition, the J(c)(B) behavior was improved when NC and CNT were doped due to doping effect. Microstructural observation suggested that the nano-sized and unreacted NC particles and the nanodomain MgB2 acted as effective flux pinning centers for the NC- and CNT-doped MgB2, respectively.</P>

흡연이 Gastric Emptying Time에 미치는 영향

조민구(Min Koo Cho),정순영(Sun Young chung),김소연(So Yon Kim),문희승(Mun Hee Seung),김진석(Jin Suk Kim),이석호(Suk Ho Lee),이권전(Gwon Jun Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2

The effect of cigarette smoking on gastric emptying was examined in 25 healthy volunteers by means of Tc-sulfur colloid labeled-solid meal. The volunteers underwent GET measurement two times: before smoking and after smoking two cigarettes. Before smoking, the each average of GET T25% T50%, T75%, was 18 +- 5.2, 40 +- 6.7, 90 +- 18.4 min and after cigarette smoking the each average of GET T25%, T50%, 75% was 30 +- 8.3, 64 +- 12.6, 114 +- 7.0 min. We concluded that cigarette smoking significantly delayed gastric emptying of a solid meal (p< 0.05).