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).

A Comparative Experimental Study of the, In-vitro Efficiency of Hypertonic, Saline-Enhanced Hepatic Bipolar and, Monopolar Radiofrequency Ablation

Lee, Jeong Min,Han, Joon Koo,Kim, Se Hyung,Sohn, Kyu Li,Lee, Kyoung Ho,Ah, Su Kyung,Choi, Byung Ihn Korean Radiological Society 2003 Korean Journal of Radiology Vol.4 No.3

실험적 급성 허혈성 신부전에서 Verapamil 이 혈중 Polyamine 동태에 미치는 영향

원동준(Dong Jun Won),권현민(Hyun Min Kwon),김용섭(Yong Seop Kim),구자룡(Ja Ryong Gu),권영주(Young Ju Kwon),조원용(Won Yong Cho),김형규(Hyung Kyu Kim) 대한내과학회 1991 대한내과학회지 Vol.40 No.6

N/A It has been proposd that calcium entry from an external medium increases intracellular free calcium to toxic levels during ischemic acute renal failure, and verapamil (ARF) has been suggested as the agentblocking calicium entry into renal cells and protecting renal function during ischemic injury. Polyamines, anorganic cations that play various roles in normal cellular proliferation and differentiation, accumulate in renal failare. Alsa it has been suggested tht the synthesis and metabolism of polyamine are influence by acute changes of the general condition, such as acute renal failure, and are mediated by a calcium influx into the cells. The study was designed to study the protective effects of systemic verapamil pretreatment on renal function and the influence on polyamine metabolism in experimental ischemic ARF in cats. For these purpose, the experimental animals were divided into 2 groups. While Group I (n=5) was an ischemic ARF model by renal artery clamping for 60 minutes, Group II (n=5) was ischemic ARF with systemic verapamil (5 ml/min/kg) pretreatment. The creatinine clearance and plasma and urinary polyamine were measured in each group before and after the renal artery clamp. The results were as follows: 1) Creatinine clearance before and after the renal artery clamp were 10.64±7.18 ml/min/kg and 2.09±1. 70 ml/min/kg in Group I, 4.47±3.38 ml min/kg and 0.60±0.79ml/min/kg in Group II, respectively, So creatinine clearance decreased more significantly in Group II campared with Group I. 2) Plasma polyamine increased after ischemia in Group I. In group I, plasma levels of putrescine, spermidine, and spermine before ischemia were 4.75±0.40 nmol/ml, 0.69±0.09 nmol/ml, and 0.83±0.63 nmol/ml, were elevated to 7.17±2.91 nmol/ml, 9.83±1.46 nmol/ ml, and 2.64±1.14nmol/ml after ischemia. But in Group II, the plasma level of polyamine was not changed, and especially, spermine decreased significantly from 0.83±0.27 before ischemia to 0.49±0.23 nmol/ml after ischenmine (p=0.033). 3) Urine polyamine excretion decreased after ischemia in Group I and Group II. In Group II, urinary excretion of spermidine and spermine before ischemia, 0.13±0.10 nmol/min and 0.17±0.13nmol/min, decreased after ischemia to 0.01±0.01nmol/min (p=0.019) and 0.032±0.26 nmol/min (p=0.0257). 4) In renal tissue, spermine content vas highest. In Group II, preischemic spermine were 397.20 nmol/g and increased to 646.66nmol/g after ischema, But there were no significant changes in the polyamine contents in Group II. From these data, it was suggested that systemic verapamil pretreatment exerts no protective effect on ischemic ARF. Plasma polyamines are elevated in ischemic ARF, and verapamil may protect these elevations.

Effective Surface Modification of a Germanium Layer by using an Atmospheric Pressure Plasma Jet with a Round Ended Nozzle

Min Kim,M. G. Kim,S. R. Kim,H. Y. Chung,J. G. Choi,조혜민,정태훈,Hyung Soo Kim,김용 한국물리학회 2013 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.63 No.5

We investigate the surface modification of a germanium epitaxial layer grown on a silicon substrate by means of an atmospheric-pressure plasma jet. The plasma jet contains a large density of highly reactive radicals, as confirmed by optical emission spectra. The plasma jet with a nozzle with a round end has a higher current level compared to cylindrical and pencil-shaped nozzles, indicating the usefulness of this plasma jet for semiconductor processing. Raman spectra reveal a significant modification of the germanium surface under exposure to an atmospheric pressure plasma jet even for 1 min. The first-order Raman peak at 320 cm−1 has an asymmetric shoulder on the lowfrequency side, which can be attributed to amorphization/oxidation of the germanium layer due to highly reactive radicals. The rapid surface change under short-time exposure indicates the practicality of the plasma jet for semiconductor processing.

Physicochemical Properties of Fish-meat Gels Prepared from Farmed-fish

Hyung Kwang Kim(김형광),Se Jong Kim(김세종),Fatih Karadeniz(파티카라데니즈),Myeong Sook Kwon(권명숙),Min-Joo Bae(배민주),Ya Gao(고아),Seul-Gi Lee(이슬기),Byeong Guen Jang(장병근),Jun Mo Jung(정준모),Seo yeon Kim(김서연),Chang-Suk Kon 한국생명과학회 2015 생명과학회지 Vol.25 No.11

연제품 제조에 이용되는 어육원료는 저가의 연육이 국내에서 일부 생산되고 있으며 대부분은 동남아산 또는 북아메리카산 등의 수입산에 의존하고 있다. 본 연구에서는 연제품용 어육 원료의 안정적인 수급과 고품질 연제품 개발을 위한 방안으로 우리나라에서 주로 양식되고 있는 어종의 고급 연육 및 연제품 소재로서의 가능성을 검토하였다. 양식어종인 광어(Paralichthys olivaceus), 도미(Pagrus major), 조피볼락(Sebastes schlegeli), 숭어(Mugil cephalus), 도다리(Pleuronichthys cornutus)를 원료로 하여 전통 수세법으로 연육을 제조하였다. 연육의 품질과 등급은 수분함량, 백색도, 겔 강도, 불순물의 함량 등에 의해 결정되어진다. 따라서 이들 해수어 유래 연육의 겔 형성능 및 품질은 겔 강도, 텍스쳐 실험, 백색도, 수분유출정도 및 SDS-page pattern 측정을 통해 검토하였다. 또한 이들 결과는 명태연육(FA급과 RA급)의 겔 특성과 비교하였다. 겔 특성을 검토하기 위해 미리 준비한 5 종류의 해수어 유래 연육에 2% NaCl를 첨가하여 소금갈이를 한 후 전체 수분함량이 84%가 되도록 졸 형태로 제조하였다. 졸형태의 연육을 polyvinylidene chloride 필름에 20-25 cm 길이로 충진한 후 90°C에서 20분간 가열하여 소시지 형태의 어육 겔을 제조하였다. 연육을 이용한 어육 겔의 제조에 의해 연육의 겔 강도와 백도는 증가하였다. 해수어 유래 연육의 겔 특성을 비교한 결과 광어와 도미가 가장 높은 겔 강도와 파단 강도를 나타내었으며, 수분 이수율은 광어에서 가장 낮게 나타났다. 전체적으로 해수어 유래 연육은 RA급 명태연육에 비해 높은 겔 형성능을 나타내었으며, 광어와 도미는 FA급 명태연육과 비슷한 정도의 겔 특성을 나타내었다. 이상의 결과로부터 광어와 도미를 이용한 고품질 연제품의 개발 가능성을 확인할 수 있었다. Fish-meat gel is being produced mostly relying on surimi and raw materials imported from Southeast Asia and North America and present in small amount in local markets. In this study, common farmed local fishes were examined as stable and reliable sources of surimi for fish-meat gel production. For testing, five main farmed-fish of Korea, namely; Bastard halibut (Paralichthys olivaceus), Red sea bream (Pagrus major), Korean rockfish (Sebastes schlegeli), Common mulle (Mugil cephalus), and Finespotted flounder (Pleuronichthys cornutus) were used following a traditional washing process. The quality of the surimi was determined by the values of water content, whiteness index, gel strength and impurity. Accordingly, fish-meat gel and surimi quality experiments were carried out by measuring compressive and texture properties, expressible moisture content, Hunter color scale values and SDS-page protein patterns. Also gel characteristics were compared with that of FA and RA grade surimi (Alaska Pollock). Fish-meat gels were prepared by salt mincing the farmed-fish surimi with NaCl (2% w/w) and moisture adjustment to 84% by ice water adding. Prepared fish-meat paste was filled into 20-25 cm long polyvinylidene chloride casings and heated at 90°C for 20 min. The whiteness values of fish-meat gels produced from surimi were increased by using farmed-fish and became comparable to that of FA Alaska Pollock gel. Among all tested farmed-fish, P. olivaceus and P. major exhibited better properties than RA Alaska Pollock and similar properties to FA Alaska Pollock. Therefore, current data suggests that fish farming can be an efficient and sustainable fish-meat source for fish-meat gel production in Korea.

Comparison of the Crystallization Behavior of Silica Between Mg and Al‑Phosphate Used in Tension Coatings of Grain‑Oriented Electrical Steel

Hyung‑Ki Park,Min‑Soo Han,Chang‑Hwan Chang,Jong‑Tae Park,박창수,Hyung‑Don Joo 대한금속·재료학회 2020 METALS AND MATERIALS International Vol.26 No.3

The effect of the phosphate component on the thermal stability of tension coatings was investigated with a focus on thecrystallization behavior of amorphous silica in the tension coating. After stress-relief annealing, core loss of samples coatedwith a Mg-phosphate was improved, while that coated with an Al-phosphate was deteriorated. The domain wall spacing ofthe samples coated with Mg- and Al-phosphates was respectively increased and decreased after stress relief annealing. Thismeans that the stress relief annealing did not much diminish the tensile stress for Mg-phosphate coating but much diminishedthe tensile stress for Al-phosphate coating. Based on FTIR and XRD results, we found that the crystallization temperatureof silica with Al-phosphate was lower than that of silica with Mg-phosphate. The crystallization of silica was accompaniedby an abrupt volume change, which formed cracks in the tension coating and deteriorated the tensile stress.

고지방식이가 운동시 흰쥐의 글리코겐 이용에 미치는 영향

민경선,장응찬,김형렬,민진아,신덕수 慶山大學校 2000 論文集 Vol.18 No.1

Carbohydrate and fat ingestion during exercise are essential nutrient, but a number of opinion is different from their contents of food. In this point of view, to study how high-fat dietary contents affects glycogen utilization, 48 female Sprague-Dawley rats were trained on the treadmill trained for 4wk with consuming two high-fat diet and one high-carbohydrate diet. All animals were fed 79%high-fat diet(n=16, 79F), 40% high-fat diet(n=16, 40F), 70% high-carbohydrate diet(n=16, 70C). After the final day of training, one-half of rats in each the three groups were run to exhaustion (E), whereas the remaining rats served as rested controls (R). All animals were trained on a motorized rodent treadmill. The animals ran for 30min/d at 28m/min(0% grade), analysis items were glycogen, body weight and %Fat were measured. All data were examined by means of one-way ANOVA and significance was set at the p<0.05. The Duncan method was used for a post hoc test. Body weight were similar among the 79F, 40F and 70C groups. %Fat was significantly greater in animals that consumed the 79F group than in those on the 70C group (P<0.05), even though similar body weight each other. Generally liver and muscle glycogen concentration had more in 79FR, on the other hand, had less in 79FE compared with the others. The mean overall glycogen utilization rate was depressed in muscle and liver after animals were on the 79% F diet. In summary, the present study has suggested that consumption of 79% F diet during endurance training can lead to an increase in exercise performance in female rats. Some of the consequences training on F diet are an increase in body fat deposition and slower utilization of glycogen during exercise. These data indicate that rats exposed to a high-fat diet are capable of prolonging exercise in spite of limited glycogen stores. This improved capacity for exercise appears to be partially the result of muscular adaptations to the diet, which apparently increase the ability to oxidize fat and concomitantly spare glycogen.

都市主婦의 MAP와 %Fat 調査分析

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).

비만세포주에서 Histamine 유리에 관한 연구

김형룡,국윤아,신민,이홍수,원진숙,김형민,이영미,정헌택,이혜숙,안녕형 원광대학교 생명공학연구소 1995 생명공학연구소보 Vol.3 No.1

Precise determination of the lithium isotope ratio in geological samples using MC-ICP-MS with cool plasma

Choi, Min Seok,Ryu, Jong-Sik,Park, Ha Yan,Lee, Kwang-Sik,Kil, Youngwoo,Shin, Hyung Seon The Royal Society of Chemistry 2013 Journal of analytical atomic spectrometry Vol.28 No.4

<P>Lithium has two naturally occurring isotopes, <SUP>6</SUP>Li and <SUP>7</SUP>Li, with approximate relative abundances of 7.5% and 92.5%, respectively. Due to large Li isotope variations in nature, lithium isotopes have the potential to reveal important information relevant to nuclear technology, biomedicine, astrophysics, and geochemistry. With the advent of multi-collector inductively coupled mass spectrometry (MC-ICP-MS), studies of Li isotopes have largely focused on the analysis of geological materials, with varying degrees of accuracy. However, this technique has often been affected by either baseline interferences or isobaric interferences on mass 6 and 7 during ionization in Ar plasma, which is mainly due to the Li compound with hydrogen gas, and double-charged nitrogen and carbon ions at higher levels of RF power. In this study, we reduced baseline interferences in Ar plasma using a cool plasma (∼800 W) technique with a X-type cone. Lithium was separated using a cation exchange column (BioRad AG50W-X8, 200–400 mesh) with a mixture of 6 N HNO<SUB>3</SUB> and 80% methanol at <0.2 mL min<SUP>−1</SUP> elution speed. The short-term reproducibility of <I>δ</I><SUP>7</SUP>Li values of the NASS-5 seawater standard was 30.55 ± 0.45‰ (2<I>σ</I>, <I>n</I> = 15). Measured <I>δ</I><SUP>7</SUP>Li values of rock and seawater standards ranged from 2.48 to 30.55‰, in good agreements with reported values.</P> <P>Graphic Abstract</P><P>Average <I>δ</I><SUP>7</SUP>Li values of a pure L-SVEC Li solution and one passed through the column were 0.00 ± 0.23‰ (2<I>σ</I>, <I>n</I> = 26) and ¬0.01 ± 0.20 ‰ (2<I>σ</I> , <I>n</I> = 9), respectively, indicating that our chemical separation procedure for Li induces no mass fractionation. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c2ja30293d'> </P>