비만인에서 체중 감소가 당질 및 지질 대사에 미치는 영향

허갑범 ( Heo Gab Beom ),정윤석 ( Jeong Yun Seog ),박석원 ( Park Seog Won ),이현철 ( Lee Hyeon Cheol ),임승길 ( Im Seung Gil ),이영해 ( Lee Yeong Hae ),이종호 ( Lee Jong Ho ),백인경 ( Baeg In Gyeong ),박유경 ( Park Yu Gyeong ),이 대한내과학회 1993 대한내과학회지 Vol.44 No.4

Background: The purpose of obesity treatment is to attain optimal body weight and to maintain weight loss. We determined the effects of weight loss with a program including dietary education, exercise and behavioral modification of lifestyle on obese subjects. Methods: Middle-aged obese women (n=30) and men (n=9) participated in a 6-month weight-management program. Anthropometric parameters and visceral and subcutaneous fat areas at the umbilical level were determined before and after weight loss. Serum levels of lipids and response areas of glucose, C-peptide, insulin and free fatty acid(FFA) during oral glucose tolerance test were determined. Results: Body weight fell and average of 3.9 kg(6.3) in women and 4.1 kg (5.4%) in men. Modest weight loss showed a 23 to 48% decrease in the levels of serum LDL and total colesteorl and a 50 to 130% increase in the ratio of HDL to total cholesterol in all subjects. Although intraabdominal total fat area of females before weight loss was not different from males, females showed subcutaneous-type obesity and males visceral-type obesity. Compared with females, males before weight loss showed and increase in the levels of triglyceride, FFA and insulin. Although weight loss caused a decrease in intraabdominal total fat area in all subjects, a significant decrease in visceral fat area was only shown in men. Decreased visceral fat in males lowered FFA level and decreased FFA level lowered serum triglyceride level (49%) and response area of insulin (56%) in men. Conclusion: The results suggest that modest weight reduction through a weight management program can be viable approach to help normalize plasma lipids and lipoproteins in obese individuals. Modest and gradual weight loss can also help obese individuals succeed in the difficult task of losing weight and maintaining this substantial weight loss.

25.8㎸급 친환경 고체절연차단기(Solid Insulated Switchgear)에 대한 기계적 신뢰성(수명) 평가

이도훈(Do-Hoon Lee),이석원(Seog-Won Lee),박석원(Seok-Weon Park),김영근(Young-Geun Kim),이종호(Jhong-Ho Lee) 대한전기학회 2010 전기학회논문지 P Vol.59 No.2

In this paper, mechanical reliability(Life-time) estimation method for 25.8kV SIS(Solid Insulated Switchgear) has been studied. Recently enacted KEPCO's standard includes clause that have to submit a warrantable reliability data for life-time(over B10 25 years) of an epoxy-solid insulating material. Accordingly, this research was carried out on the ALT(Accelerated Life Test) and Life-Estimation method for SIS's insulating material. Mechanical life-time estimation for SIS's insulating material is to verify reliability for tensile creep & fatigue stress, which is the major mechanical stress of SIS. This study proved that SIS's reliability for mechanical stress and established that confidence for estimation results in further verification test.

한류기용 IGBT 모듈에 대한 안전영역 이상에서의 특성 시험

이경호(Gyeong Ho Lee),심정욱(Jungwook Sim),박해용(Hae Yong Park),이석원(Seog Won Lee),박석원(Seok Weon Park) 대한전기학회 2014 대한전기학회 학술대회 논문집 Vol.2014 No.7

인슐린 비의존형 당뇨병 환자의 직계자식에서 당수송체 유전자의 다형성과 인슐린 분비능 및 말초조직의 포도당 이용율 등의 대사적 측면과의 상호연관성에 관한 연구

이현철(Hyun Chul Lee),이영식(Young Sik Lee),박석원(Seog Won Park),정윤석(Yoon Sok Chung),안광진(Kwang Jin Ahn),이은직(Eun Jig Lee),임승길(Sung Kil Lim),김경래(Kyung Rae Kim),허갑범(Kap Bum Huh),김태연(Tae Yeun Kim),임정수(Jung Soo Rh 대한내과학회 1993 대한내과학회지 Vol.45 No.1

Background: First-degree relatives of non-insulin dependent diabetes mellitus are generally accepted to be high risk group for development of non-insulin dependent diabetes mellitus. So we are intended to identify the early metabolic defects in the young first-degree relatives of non-insulin dependent diabetes mellitus. Methods: Ten offsprings of non-insulin dependent diabetes mellitus and ten healthy men were included in this study. They were all third decade male subjects and matched well with age and body mass indices. Both groups were not different in anthropometric measurements (IBW, BMI, WHR), dilay calorie intake and total energy consumptions (total energy expenditure, physical activity). Results: 1) Oral glucose tolerance test showed normal responses of plasma glucose levels and C-peptide levels in both groups. 2) There were statistically significant differences (p<0.05) in plasma glucose, C-peptide and insulin levels at 60 minutes between two groups (Glucose 100±19 vs. 77±19mg/dl; C-peptide 5.47±1.7 vs. 3.32±1.88ng/ml; Insulin 90.3±41.3 vs. 38.6±29.4 μU/ml). 3) The result of euglycemic hyperinsulinemic clamp study showed that offsprings of non-insulin dependent diabetes mellitus had significantly diminished rates of insulin-mediated glucose disposal compared to the control group (5.61±1.01 vs. 8.87±0.92mg/kg B.W/min, p<0.01). 4) Simple linear regression analysis showed a good correlation between peripheral glucose utilization rates and the lean mass composition measured by body composition analyzer (Futrex-5000, Futrex Co., USA). As the lean mass percentage increases, peripheral glucose utilization rate also increases with positive 1inear relationship (r2=0.49, p<0.05). 5) By the method of restriction fragment length polymorphism, we found two polymorphic Kpn I sites of 6.5 kb and 5.8 kd as described previously without any new polymorphism for GLUT4 gene DNA in both groups. We also used other two restriction endonucleases, Bam HI and Eco RI, but did not discover polymorphism at GLUT4 gene locus. Conclusion: This study supports the genetic tendency of non-insulin dependent diabetes mellitus and showed that the early metabolic defect in the young offsprings is expressed as insulin resistance rather than pancreatic beta-cell dysfunction, The insulin resistance is in the negative linear relationship with the lean mass composition and seems to arise from the skeletal muscle tissue. For preventing the development of glucose intolerant status and overt diabetes, the avoidance of obesity and maintenance of muscle mass by means of careful diet control and continuous exercise program may be helpful.

인슐린비의존형 당뇨병 환자에서 인슐린 분비능력이 당질 및 지질대사에 미치는 영향

허갑범(Kap Bum Huh),이현철(Hyun Chul Lee),정윤석(Yoon Sok Chung),박석원(Seog Won Park),박유경(Yoo Kyoung Park),박은주(Eun Ju Park),이종호(Jong Ho Lee) 대한내과학회 1994 대한내과학회지 Vol.47 No.3

Background: Many studies have shown that obesity is closely related to non-insulin-dependent diabeties mellitus (NIDDM). This study was conducted to manifest the capacity of insulin secretion in Korean. Method: Fasting blood glucose and insulin level were measured in nondiabetic subjects and NIDDM patients. Overweight-obese subjects were divided into 3 groups; normal glucose tolerant, impaired glucose tolerant and NIDDM. Blood gIucose, insulin concentration, serum lipid and lipoprotein profiles were measured for all subjects. Result: In overweight-obese patients, fasting glucose level increased progressively from 70 to 150 mg/dl while plasma insulin concentration showed a 2 5 time in- crease. Shortly after when fasting glucose exceeded 150 mg/dl plsma insulin concentration precipitated and when the glucose level reached 260 mg/dl, they secreted an amount of insulin that is similar to that in healthy nondiabetic individual. The relationship between the response area of plasma insulin and fasting blood glucose was similar. The percent ideal body weight was not significantly different within each group, but waist to hip ratio of the NIDDM groups was higher than control. Overweight-obese NIDDM subjects with fasting glucose more than 150 mg/dl, showed a decreased insulin response area and similar glucose response area compared with the normal weight NIDDM patients. The progression from normal to glucose intolerance and NIDDM was associated with increase in free fatty acid area, Serum triglyceride level was high in overweightobese NIDDM patients, lipid profiles was apparently better in the normal glucose tolerant subjects. Conclusion: The result showed that overweight-obese Korean NIDDM patients were hyperinsulinemic. Insulin resistance represented the initial disturbance in NIDDM and the chronic hyperglycemic state eventually led impaired insulin secretion. NIDDM patients with normal weight had a lower insulin secretion compared with overweight-obese, and poor goucose control increased serum lipid profiles of the patients. From the result we can suggest that well controlled diabetes can minimize the impairment of p-cell function and may both augment insulin secretion and improve lipid metabolism.

한국인 정상 성인에서 성장호르몬의 분비능

정윤석(Yoon Sok Chung),김현만(Hyeon Man Kim),이은직(Eun Jig Lee),정재희(Jae Hee Chung),이경미(Kyung Mi Lee),박석원(Seog Won Park),조홍근(Hong Keun Cho),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh),박유경(Yoo Kyoung Park),김희선(Hee Son 대한내과학회 1994 대한내과학회지 Vol.47 No.3

Objectives: Growth hormone secretory capacity of adults decrease with aging, Growth hormone secretory capacity and prevalence of growth hormone deficiency in Korean adults were studied. Methods: History, physical examination, and routine blood tests were performed to roule out ill patients among ordinary subjects. Anthropometry, nutritional history, serum insulin-like growth factor-1 (IGF-1) levels, L-dopa stimulation tests, and urinary growth hormone levels were measured in 309 Korean adults, ages 20-87 years. Results: The mean serum IGF-1 levels were 258,2+6. 8 ng/ml. The mean serum IGF-1 levels of adult males were significantly higher than those of the females. The serum IGF-1 levels decreased with aging. The prevalence of growth hormone deficiency defined by serum IGF-1 levels (< 150 ng/ml) were 0.0% in the 3rd decade, 5.5% in the 4th decade, 12.2% in the 5th decade, 10.0% in the 6th decade, 32.1% in the 7th decade, 48.1% in the 8th decade, respectively. The serum IGF-1 levels were positively correlated with total energy expenditure, but negatively correlated with body fat mass. The peak serum growth hormone levels after L-dopa stimulation and urinary growth hormone levels of the younger subjects were significantly higher than those of the older subjects, There were goad correlations among serum IGF-1 levels, peak growth hormone levels after L-dopa stimulation, and urinary growth hormone levels. Conclusion: Growth hormone secretory capacity decreased significantly with aging, and growth hormone deficiency was found in about 1/3 of subjects aged over 60 years.

시상하부성 성선기능저하증 남성환자에서 성선자극호르몬 방출호르몬의 치료 효과

박기현,김성은,허갑범,이현철,이은직,정춘희,정윤석,최형기,박석원,이무상 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.1

Hypothalamic hypogonadism characterized by low plasma gonadotropin and gonadal steroid hormone concentrations results in absent or incomplete pubertal development and it appears to be due to a deficiency of gonadotropin-releasing hormone (GnRH). Early attempts at reversing GnRH deficiency with continuous administration of GnRH or alternatively, using long-acting GnRH agnosists, were largely unsuccessful in achieving a complete normalization of pituitary and gonadal function. But recently pulsatile infusion pump was developed and long term pulsatile administration of GnRH can be possible. So we applied long term GnRH therapy using pulsatile infusion pump in six male patients with hypothalamic hypogonadism. Plasma luteinzing hormone, follicle-stimulating hormone and testosterone levels were followed-up monthly and Tanner staging, measurement of testicular volume and semen-analysis were performed before and after treatment. The results were as followings: 1) Plasma luteinzing houmonek follicle-stimulating houmone and testosterone levels were significantly increased after pulsatile administration of GnRH. 2) Testicular volume was significantly increased from 7.33ml to 13.17ml(mean value) after pulsatile administraion of GnRH. 3) Tanner stage was significantly increased from 2 to 3.5 ( mean value) after pulsatile administration GnRH. 4) After pulsatile administration of GnRH, four among six patients showed the evidence of effective spermatogenesis. In concousion, GnRH therapy using pulsatile infusion pump could successfully induce pituitary gonadotropin release, develop secondary sexual chracteristics and stimulate effecive spermatogenesis. (J Kor Soc Endocrimal 8 : 27~34, 1993)

본태성 고혈압을 동반한 인슐린 비의존형 당뇨병환자에서 Celiprolol 의 임상적 효과

박승우,허갑범,이현철,임승길,정윤석,박석원,박준오 대한당뇨병학회 1993 Diabetes and Metabolism Journal Vol.17 No.3

중추 신경계를 침범한 전신성 홍반성 낭창의 임상적 연구

정윤석,박석원,이돈행,김시찬,박중원,홍천수 대한내과학회 1992 대한내과학회지 Vol.42 No.1

1987년 7월부터 1990년 6월까지 연세의대 세브란스 병원에 입원한 전신성 흉반성 낭창 환자 103예를 대상으로 조사하여 신경학적 증상과 징후가 있거나 뇌 전산화 단층 촬영상 또는 뇌파 검사상 이상이 있는 경우, 또는 정신병적 증상과 징후가 나타난 경우를 중추 신경계 낭창이라고 정의하였을때 다음과 같은 결과를 얻었다. 1) 전체 103예중 43예(41.7%)에서 중추 신경계 침범을 보였다. 2) 중추 신경계 낭창군은 비 중추 신경계 낭창군에 비하여 높은 초기 사망률을 나타내었다. 3) 중추 신경계 낭창군은 비 중추 신경계 낭창군에 비하여 신장 기능이 의의 있게 저하되어 있었다. 4) 중추 신경계 낭창군과 비 중추 신경계 낭창군 사이에 유병기간, 침범된 장기, 자가면역 항체 등에 있어서는 유의한 차이를 보이지 않았다. 결론적으로 전신성 홍반성 낭창환자, 특히 신장 기능이 저하되어 있는 환자는 중추 신경계 침범 여부를 조심스럽게 관찰하여 조기에 진단하고, 중추 신경계 침범이 확인된 경우는 사망률을 저하시키기 위하여 보다 적극적인 치료를 요할 것으로 사료된다. Central nervous system involvement in systemic lupus erythematosus (CNS lupus) is characterized by difficulty in it's proper diagnosis, treatment, and poor prognosis. We analyzed 103 systemic lupus erythematosus patients who have admitted to Severance Hospital, Yonsei University, from July 1987 to June 1990. The results were as followed: 1) 43 cases out of 103 systemic lupus erythematosus patients had central nervous system involvement. 2) Immediate mortality in CNS lupus was significantly higher than non-CNS lupus group. 3) Renal functions in CNS lupus were more significantly impaired than non-CNS lupus group. 4) There was no significant difference in duration of disease, number of organ involved, autoantibodies between CNS and non-CNS lupus group. These results suggest that patients with imparied renal function should be carefully followed up for early detection of central nervous system involvement. And, if central nervous system involvement is suspected, then more aggressive treatment may be required to reduce high mortality rate.

인슐린비의존형 당뇨병의 병인에 있어서 양양결핍의 문제

허갑범,이현철,박석원 대한당뇨병학회 1996 Diabetes and Metabolism Journal Vol.20 No.1