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

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.

다양한 냉동 및 해동공정 조합이 표고버섯의 품질에 미치는 영향

심준보 ( Jun Bo Shim ),조연지 ( Yeon Ji Jo ),최미정 ( Mi Jung Choi ),민상기 ( Sang Gi Min ),유선미 ( Seon Mi Yoo ),천지연 ( Ji Yeon Chun ) 한국산업식품공학회 2015 산업 식품공학 Vol.19 No.3

본 연구는 다양한 냉동방법(강제송풍식냉동, 극저온냉동, 일반냉동)과 해동방법(자연해동, 유수해동, 초음파해동, 전자레인지해동)을 조합하여 처리했을 때 표고버섯의 물리적 품질에 미치는 영향을 관찰하고, 표고버섯의 품질을 유지하는 가장 효과적인 냉·해동 공정을 탐색하는 것이 목적이었다. 급속냉동법(강제송풍식냉동, 극저온냉동)으로 처리한 경우 표고버섯의 해동감량, 보수력, 수분함량은 큰 변화 없이 품질을 유지 하는데 효과적인 것으로 관찰되었다. 특히 보수력은 저속냉동(일반냉동) 및 저속해동(자연해동) 처리의 유무가 영향을 미치는 것으로 나타났다. 전단력의 경우 냉동방법에 의한 영향보다, 전처리 및 해동방법에 더 영향을 받는 것을 판단된다. pH 및 색도는 냉동방법 및 해동방법에 따라 거의 차이가 없는 것으로 관찰되었다. 표고버섯의 물리적 특성을 효과적으로 유지 할 수 있는 처리 조합은 급속냉동(극저온냉동) 및 급속해동(유수해동, 초음파해동, 전자레인지해동)을 한 경우이며, 또한 유지하고 하는 물리적 특성에 따라 냉동 및 해동방법을 다양하게 조합하여 처리한다면, 식품의 품질을 보존하는데 더욱 효과적일 것으로 사료된다. In this study, the potential of various freezing and thawing combinations was investigated for frozen storage of mushroom (Lentinula edodes). Lentinula edodes were sliced (5×5×50 mm) and then blanched in boiling water for 1 min. Samples were frozen by either natural air convection freezing (NCF, -24℃), air-blast freezing (ABF, -45℃), or liquid nitrogen freezing (LNF, -100℃). Frozen Lentinula edodes were thawed to a central temperature of 4℃ using either flowing water thawing (FT, 10℃), microwave thawing (MT, 400 W), sonication thawing (ST, 40 kHz, 10℃), or natural air convection thawing (NT, 20±5℃). In LNF Lentinula edodes, MT showed the most rapid thawing within 2.5 min followed by ST (30 min), FT (37 min), and NT (75 min). Quality attributes were evaluated by thawing loss, texture (hardness), water content, water holding capacity, pH, and color. A combination of LNF and MT induced the lowest thawing loss among tested combinations of each freezing and thawing. Thawing loss of frozen Lentinula edodes by LNF method was the lowest by MT. pH values NT of ABF method were significantly higher than blanched Lentinula edodes. In our study, MT minimized the quality changes of frozen Lentinula edodes when it was combined with ABF or LNF.

습식텍스쳐를 이용한 단결정 실리콘 광학적 · 전기적 특성 연구

한규민(Han Kyu-min),유진수(Yoo Jin-su),유권종(Yoo Kwon-jong),이희덕(Lee Hi-deok),최성진(Choi Sung-jin),권준영(Kwon Jun-young),이준신(Yi Jun-sin) 한국태양에너지학회 2010 한국태양에너지학회 학술대회논문집 Vol.2010 No.4

The presence of ultrasonic wave in caustic cleaning process enhances the remove pollutants, and more homogeneous, textured structure. The silicon wafers, cleaning in Deconex OF 145 solution (0.5~2wt %) with DIW under ultrasonic environment for 5 min. The presence of uniform thin layer of SiO2 on c-Si surface enhances etching rate in the caustic etching mixture solution of NaOH (1.5 wt %), DI water and IPA (6 wt %) at 90℃ for 20 min and results in a fine, more homogeneous and small textured structure.

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.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

인체혈장 중 에탐부톨의 HPLC 분석법의 검증 및 단일용량 투여에 의한 약물동태 연구

곽혜선,박경호,최준식,송진아,성민경,장정옥,이화정 한국약제학회 2005 Journal of Pharmaceutical Investigation Vol.35 No.2

An HPLC method was employed for the determination of ethambutol in human plasma. After addition of internal standard (IS, octylamine, 2 μg/mL) and alkalinization of the plasma with 5 M sodium hydroxide, the drug and IS were extracted into the mixture of chloroform and diethyl ether (40:60, v/v). Following a 15-min vortex-mixing and a 10-min centrifugation, the organic phase was spiked with 100 pL of phenylethylisocyanate (2000 μg/mL) for chemical derivatization, mixed for 5 min and evaporated to dryness under a stream of nitrogen. The residue was reconstituted with 100 μL of mobile phase and 20 pL was injected into Cl8 column with a mobile phase consisting of methanol:water (70:30, v/v). The samples were detected utilizing an ultraviolet detector at 200 nm. The method was specific and validated with a limit of 0.15 μg/mL. Infra- and inter-day precision and accuracy were acceptable for all quality control samples including the lower limit of quantification. The applicability of this method was demonstrated by analysis of human plasma after oral administration of a single 1200-mg dose to 20 healthy subjects. From the plasma ethambutol concentration vs. time curves, the mean AUC was 9.61 ± 1.64 μg hr/mL. and Cmax of 2.68 μg/mL reached 2.73 hr after administration. The mean biological half-life of ethambutol was 3.46 ± 1.21 hr. Based on the results, this simple and validated assay could readily be used in any pharmacokinetic studies using humans.

Development of Self-microemulsifying Drug Delivery System for Enhancing the Bioavailability of Atorvastatin

( Shun Ji Jin ),( Won Kyung Cho ),( Hee Jun Park ),( Kwang Ho Cha ),( Jun Sung Park ),( Ja Seong Koo ),( Hun Sik Wang ),( Jeong Soo Kim ),( Min Soo Kim ),( Sung Joo Hwang ) 한국약제학회 2011 Journal of Pharmaceutical Investigation Vol.41 No.2

The objective of the study was to prepare self-microeulsifying drug delivery system (SMEDDS) incorporating atorvastatin calcium and evaluate its properties and oral bioavailability. Solubility of atorvastatin in various vehicles was determined. Pseudo-ternary phase diagrams were constructed to identify the good self-emulsification region. The droplet size distributions of the resultant emulsions were determined by dynamic light scattering measurement. The mean droplet size of chosen formulation (20% ethyl oleate, 40% tween-80, 40% Carbitol(R)) was 23.4±1.3 nm. The SMEDDS incorporating atorvastatin calcium appeared to be associated with better performance in dissolution and pharmacokinetic studies, compared with raw atorvastatin calcium. In dissolution test, the release percentage of atorvastatin from SMEDDS mixture could rapidly reach more than 95% within 3 min. Oral AUC0→8(hr)values in SD rats was 1994±335 ng·hr/mL, which significantly increased (P<0.05) compared with raw atorvastatin calcium. The SMEDDS formulation was relatively stable when stored at 4˚C during 3 months. Our studies illustrated the potential use of SMEDDS for the delivery of hydrophobic compounds, such as atorvastatin, by the oral route.

배추의 형질전환용 선발항생제로서 Paromomycin의 이용

조미애,민성란,고석민,유장렬,이준행,최필선,Cho, Mi-Ae,Min, Sung-Ran,Ko, Suck-Min,Liu, Jang-Ryol,Lee, Jun-Haeng,Choi, Pil-Son 한국식물생명공학회 2006 식물생명공학회지 Vol.33 No.4

정상' 배추와 '서울' 배추의 배축절편을 선발마커로서 hygromycin 저항성유전자를 갖고 있는 pCAMBIA1301와 paromomycin저항성유전자를 갖고 있는 pPTN290으로 각각 형질 전환된 LBA4404 또는 EHA101균주와 공동배양한 후 선발배지에서 배양하면서 형질전환체를 선발하였다. 형질전환빈도는 사용된 항생제와 품종에 따라서 현저하게 차이가 있었으며, 특히 paromomycin은 hygromycin보다 효과적이었고 정상 배추는 서울배추보다 양호하였다. 가장 높은 형질전환빈도는 (0.70%) 100mg/L paromomycin이 첨가된 선발배지에서 정상배추의배축을 배양할 경우 얻어졌다. GUS양성반응으로 확인 한 결과 정상배추에서 9개체와 서울배추에서 3개체를 각각 얻었으며, 온실에서 생장한 후 $T_1$종자를 수확하였다. $T_1$ 종자를 다시 발아시켜 유식물체를 얻은 후 GUS양성반응을 확인함으로서 외래유전자가 안정적으로 발현하고 있음을 확인하였다. Hypocotyl explants of Chinese cabbage (us. 'Jeong Sang' and 'Seoul') produced adventitious shoots on Murashige and Skoog (MS) basal medium supplemented with 4mg/L $AgNO_3$, 5 mg/L acetosyringone, 4 mg/L 6-benzyladenine and 3mg/L alpha-naphthaleneacetic acid (SI) after cocoultivation with strains of Agrobacterium tumefaciens (LBA4404) harboring the pCAMBIA1301 and the $_PPTN290$ containing hygromycin-resistance gene and paromomycin-resistance gene as a selectable marker genes, respectively. There was a significant difference in the frequency of transgenic plants depending on antibiotics and cultivars used. Paromomycin was better than hygromycin, and cultivar 'Jeong-sang' was higher than 'c.v. Seoul' in the frequency of transgenic plants. In particular, the highest frequency (0.70%) of transgenic plants was obtained from selection medium (SI) containing 100mg/L paromomycin in c.v., 'Jeong-sang' GUS positive response were obtained 9 plants and 3 plants from the cultivars, 'Jeong-sang' and 'Seoul', respectively. They were grown to maturity in a greenhouse and normally produced $T_1$ seeds. GUS histochemical assay for progeny $(T_1)$ revealed that the transgenes were expressed in the plant genome.