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말단비대증 환자의 뇌하수체 종양조직에서 H - ras 유전자 변이의 가능성
임승길(S . K . Lim),권이현(Y . H . Kwon),정윤석(Y . S . Chung),안광진(K . J . Ahn),이은직(E . J . Lee),김경래(K . R . Kim),이현철(H . C . Lee),허갑범(K . B . Huh),김태승(T . S . Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.3
N/A Backround: Little is known about the mechanism of tumorigenesis in pituitary adenomas. An important finding in somatotroph adenomas is that a somatic mutation may convert a G protein, Gs(α) into a putative oncogene termed gsp via point mutations at two critcal sites. The ras protooncogenes are structurally related to the G-protein family and are involved in cell proliferation and differentiation. Although ras oncogene mutations have been indentified in a wide variety of human neoplasm, only one case was reported as containting single point mutation in a patient with invasive prolactinoma, In this report we used oligonucleotide-specific hybridization to screen ras mutations in 13 acromegalic tumors. Methods: Pituitary tissue samples were derived from a central portion of the paraffin embedded pituitary tumor to minimize the possibility of contamination with normal tissue. Genomic DNA was isolated and purified from tumor tissue and amplified by the standard PCR method. Amplified DNAs from each of the region of H-ras genes (12/13 and 61) were analyzed for potential ras mutations using oligonucleotide-specific hybridization as described previously. Results: Wild type radiolabelled oligoncleotides were hybridized to the amplified DNAs from the patients' tumor and to the positive specimens. They were, however, easily striped out at 68℃ by nonstringent washing procedures except control (wild type) specimens. All radiolabelled mutant oligonucleotides could be easily striped out of 13 specimens except a control mutant specimen by the same procedure. Conclusion: We could not find any H-ras mutation that might not be frequently found in acromegalic patients, and that gsp (Gsa mutation) or mutations in the PKA system-related proteins might be the main oncogene in acromegalic patients. However further efforts to find the other somatic mutations including K-ras and N-ras should be given to these patients for more precise understanding of pathogenesis and for planning of the better treatment.
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전근재(G . J . Jeon),임승길(S . K . Lim),이현철(H . C . Lee),김경래(K . R . Kim),허갑범(K . B . Huh) 대한내과학회 1988 대한내과학회지 Vol.35 No.6
N/A We studied 59 patients who had received a diagnosis of graves' disease or myxedema by dual photon absorptiometry from August 1986 to July 1987 at the Department of Internal Medicine, Yonsei University Severance Hospital. The results were summarized as follows: 1) Patients with Graves' disease of a mean duration of 19.2 weeks demonstrated an average of 9.37 mg/dl Ca and 4.29 mg/dl P in their blood samples while the 24 hr urine specimen showed 194.26 mg/dl 24 hr of Ca and the P revealed 520.36 mg/24 hr, which is higher than those of myxedema. 2) The patients with Graves' disease revealed a prevalance of osteoporosis in the following, Ward's triangle 18,8%, femora) neck 20.8%, trochanter 25%, but the spine, while observed at 22.9% in hyperthyroidism, also was detected at 18.2% in myxedema. 3) In females with Graves' disease, the values of BMD were relatively lower than those of the control group but showed a greater at traction to osteoporosis than the males. 4) Most womon in their postmonopaunal poriod showed a strong tondency to develop osteoporosis in the femoral neek but they demonstrated a greater relationship to the spine. 5) Even after treatment, the BMD revealed a tendency to continue increasing, however, there was still a possibility for incomplete recovery. Excess thyroid hormones lead to negative bone mineral balance. The revealed bone loss was clinically significant in postmenopausal women despite its short dyratuib abd ut aooeared ti be at keast oartuakkt reversubke after treatment.
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이은직(Eun J . Lee),김도영(Doe Y . Kim),허갑범(Kap B . Huh),김현만(Hyeon M . Kim),임승길(Sung K . Lim),김경래(Kyung R . Kim),이현철(Hyun C . Lee),김덕회(Duk H . Kim) 대한내과학회 1987 대한내과학회지 Vol.33 No.6
N/A Of 501 Korean diabetics admitted to Severance Hospital, Yonsei University College of Medicine, non-obese non-insulin-dependent diabetes mellitus (NIDDM) comprised 319 cases (63.7%), obese NIDDM 100 cases (19.9%) and insulin-dependent diabetes mellitus (IDDM) 82 cases (16.4%). And in the IDDM group thus collected, juvenile-onset diabetes (JOD) comprised 17 cases (3.4%), youth-onset underweight diabetes (YOUD) 25 cases (5.0%) and maturity-onset underweight diabetes (MOUD) 40 eases (8.0%). The caloire intakes just before the onset of diabetes in YOUD and MOUD patients were found to be 63.1% and 60.9% and the intakes of protein 55.9% and 79.8% of the recommended dietary allowance, respectively. Among JOD, YOUD and MOUD, there were no significant differences in body weight, and fasting blood glucose and HbA1c levels at the time of admission. The basal and peak serum C-peptide levels in YOUD (1.03±0.61ng/ml, 1.59±1.23ng/ml) were slightly higher than those in JOD (0.64±0.30ng/ml, 1.05±0.54ng/ml), but significantly lower than those in MOUD (1.61±0.73ng/ml, 2.65±1.30ng/ml). Between JOD and YOUD, there was no significant difference in family histories (23.5%, 24.0%) or clinical features. However, MOUD turned out to have significantly lower family history (2.5%), no history of diabetic ketoacidosis and more pulmonary tuberculosis than the former 2 groups. Of 29 young diabetics (JOD and YOUD) who were followed-up at OPD, 14 cases (5 JOD and 9 YOUD) were ketosis-resistant. These data suggest that, in Korea which is located in temperate zone, malnutrition-related diabetes mellitus (MRDM) can be mainly classified into 2 groups: The youth-onset one had the characteristics of IDDM with the history of undernutrition and ketosis-resistance, and the maturity-onset one may belong to NIDDM with the higher susceptibility to pulmonary tuberculosis.
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김유리(Y . L . Kim),김현만(H . M . Kim),임승길(S . K . Lim),이현철(H . C . Lee),허갑범(K . B . Huh),최은정(E . J . Choi),문수재(S . J . Moon) 대한내과학회 1988 대한내과학회지 Vol.35 No.5
N/A Nutritional assessment was performed on admission of 106 consecutive medical patients by anthropometry, biochemical tests, and dietary survey. Factors included in anthropometric measurements were height, weight, triceps skin fold, and mid-arm muscle circumference. Biochemical tests included serum total protein, serum albumin, and a complete blood cell count. Dietary intakes of nutrients before the development of disease were investigated by the 24 hour reca11 method. Using these parameters for malnutrition, (anthropometry<90% of standard value, serum albumin<3.0 g %, total lymphocyte count<1200/mm, intake of total calorie and protein<80fo of RDA, 39.6% of the patients showed a moderate degree of malnutrition. Based upon the above result, it could be concluded that the prevalence of malnutrition in hospitalized medical patients is similar to that indicated in foreign reports. This suggests that nutritional education for the general population, assessment of the nutritional status of patients, and nutritional support are needed for the prevention and effective treatment of disease.
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