갑상선 기능항진증 환자에서 인슐린감수성 및 인슐린분비능의 변화

최은진,강호철,이태희,정민영,이대호,장연진,박상선,조재현 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.2

The impairement of glucose metabolism is frequently associated in hyperthyroidism. The present study was performed to determine the effect of the thyroid hormone excess on insulin sensitivity and on insulin secretory function in vivo. Ten newly diagnosed hyperthyroid patients and fifteen healthy control subjects were subjected to frequently sampled intravenous glucose tolerance tests(FSIGT) after an overnight fast. Insulin sensitivity, represented by the insulin sensitivity index(S_1), was assessed by minimal model analysis of FSIGT data. Insulin secretion was measured by the total area under the insulin curve after glucose load. The results were as follows. 1) The K_G values, which represent glucose tolerance, were not different between the hyperthyroid patients and the normals(2.2+-0.3 vs. 2.5+-0.3%/min, p$gt;0.05). 2) S_1 was significantly decreased in the hyperthyroid patients in comparison to the normals(7.5+-1.4 vs. 2.6+-0.3X10^-4 min^-1/uU/ml, p$lt;0.05). 3) The basal insulin concentration was higher in the hyperthyroid patients than in the normals(8.3+-2.4 vs. 4.6+-0.4 uU/ml, p=0.07). In addition, the insulin secretory response to a glucose load was increased in the hyperthyroid patients as evidenced by the peak plasma insulin level(168.2+-30.4 vs. 89.2+-13.9 uU/ml, p$lt;0.05) and by the total area under the insulin curve(2641.1+-443.2 vs. 1696.7+-204.3 min uU/ml, p$lt;0.05). These results clearly demonstrated that insulin sensitivity was impaired in these newly diagnosed hyperthyroid patients. However, glucose tolerance was maintained by the increased insulin secretion (J Kor Soc Endocrinol 9:108-114, 1994).

대장직장 종양에 대한 내시경 점막하 절제술의 연대순 임상 결과와 학습 곡선

이상민 ( Sang Min Lee ),김은수 ( Eun Soo Kim ),박경식 ( Kyung Sik Park ),조광범 ( Kwang Bum Cho ),김동춘 ( Dong Choon Kim ),강유진 ( Yu Jin Kang ),이유진 ( Yoo Jin Lee ),이정민 ( Jung Min Lee ),최은성 ( Eun Sung Choi ),최재혁 ( Ja 대한소화기학회 2014 대한소화기학회지 Vol.64 No.4

Background/Aims: Endoscopic submucosal dissection (ESD) is an effective procedure for en-bloc curative resection of the colorectal tumor. As it requires high technical skills and experience in therapeutic endoscopy, it is important to understand learning curve of ESD technique. The aim of this study was to retrospectively describe the clinical results of ESD and to evaluate learning curve for the ESD of colorectal tumors. Methods: A total of 90 patients with 90 colorectal neoplasms, who had undergone ESD at a tertiary referral hospital from July 2009 to December 2012, were enrolled. The ESD was performed by a single endoscopist. All ESD cases were divided into three periods: first, cases 1-30; second, cases 31-60; and third, cases 61-90. Results: The en-bloc resection rates in third period (100%) was significantly higher than that of the first (93.3%) and second period (80%) (p=0.025). The perforation rate in third period (0%) also significantly decreased compared with that of the first (13.3%) and second period (20%) (p=0.032). To calibrate the difference of tumor size among periods, proficiency was calculated, as the procedure time per specimen area (min/cm2). The proficiency in third period (4.3) was significantly shorter than that of the first (16.8) and second period (10.2) (p=0.004). Conclusions: The learning curve of colorectal ESD in our study shows that at least 60 cases of ESD have to be conducted to acquire sufficient skill of degree without perforation. (Korean J Gastroenterol 2014;64:198-205)

Involvement of calcium-mediated apoptotic signals in H₂O₂-induced MIN6N8a cell death

Choi, Sung-E,Min, Se-Hee,Shin, Ha-Chul,Kim, Hyo-Eun,Jung, Min Whan,Kang, Yup Elsevier 2006 european journal of pharmacology Vol.547 No.1

<P><B>Abstract</B></P><P>Reactive oxygen species are believed to be the central mediators of beta-cell destruction that leads to type 1 and 2 diabetes, and calcium has been reported to be an important mediator of beta cell death. In the present study, the authors investigated whether Ca<SUP>2+</SUP> plays a role in hydrogen peroxide (H<SUB>2</SUB>O<SUB>2</SUB>)-induced MIN6N8a mouse beta cell death. Treatment with low concentration H<SUB>2</SUB>O<SUB>2</SUB> (50?μM) was found to be sufficient to reduce MIN6N8a cell viability by 55%, largely via apoptosis. However, this H<SUB>2</SUB>O<SUB>2</SUB>-induced cell death was near completely blocked by pretreatment with BAPTA/AM (5?μM), a chelator of intracellular Ca<SUP>2+</SUP>. Moreover, the intracellular calcium store channel blockers, such as, xestospongin c and ryanodine, significant protected cells from 50?μM H<SUB>2</SUB>O<SUB>2</SUB>-induced cell death and under extracellular Ca<SUP>2+</SUP>-free conditions, 50?μM H<SUB>2</SUB>O<SUB>2</SUB> elicited transient [Ca<SUP>2+</SUP>]<SUB>i</SUB> increases. In addition, pharmacologic inhibitors of calpain, calcineurin, and calcium/calmodulin-dependent protein kinase II were found to have a protective effect on H<SUB>2</SUB>O<SUB>2</SUB>-induced death. Moreover, H<SUB>2</SUB>O<SUB>2</SUB>-induced apoptotic signals, such as c-JUN N-terminal kinase activation, cytochrome <I>c</I> release, caspase 3 activation, and poly (ADP-ribose) polymerase cleavage were all down-regulated by the intracellular Ca<SUP>2+</SUP> chelation. These findings show that [Ca<SUP>2+</SUP>]<SUB>i</SUB> elevation, possibly due to release from intracellular calcium stores and the subsequent activation of Ca<SUP>2+</SUP>-mediated apoptotic signals, critically mediates low concentration H<SUB>2</SUB>O<SUB>2</SUB>-induced MIN6N8a cell death. These findings suggest that a breakdown of calcium homeostasis by low level of reactive oxygen species may be involved in beta cell destruction during diabetes development.</P>

Comparisons of obstetrical outcomes among vaginal, intramuscular progesterone treatment and conservative management for the prevention of preterm birth in twin pregnancies with a short cervix

( Young Li Kim ),( Young Jae Lee ),( Hee Young Cho ),( Eun Ah Kim ),( Min Jung Baek ),( Young Ran Kim ),( Sukho Kang ),( Ji Yeon Lee ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: To determine the differences in pregnancy outcomes among cases treated by vaginal progesterone, intramuscular(IM) progesterone and conservative management in twin pregnancies with a short cervix. 방법: This is a retrospective study of 273 twin pregnancies complicated by a short cervix(<2.5cm) who delivered from 2007 to 2016 in CHA Bundang Medical Center. Women who received cervical cerclage were excluded. Treatment groups included 1) group I; conservative management group without progesterone treatment(n=174), 2) group II; vaginal progesterone suppository group(n=30), 3) group III; IM progesterone injection group(n=69). Primary outcomes were spontaneous birth at <28, 32, 34, or 36 weeks of gestational age(GA). The secondary outcomes included hospitalized for tocolytics or antenatal corticosteroids, small for gestational age and low APGAR score(<7) at 5 min. 결과: Preterm birth before 36 weeks of GA was different among 3 groups(29.3%[51/174] vs.20.0%[6/30] vs.43.5%[30/69], p=0.034). Low APGAR score(<7) at 5min was significantly different among 3 groups(7.8%[27/348] vs.5.0%[3/60] vs.15.2%[21/138], p=0.018). After multivariate analysis, preterm birth(<36 weeks) occurred more frequently in group III than group I(aOR 6.90 95%CI:1.06-45.04, p=0.044). However, there was no significant difference between group II and III. Meanwhile, there were more cases with low APGAR score(<7) at 5 min in group III than group I(aOR 6.58 95%CI:1.43-30.21, p=0.015) and group II(aOR 17.04 95%CI:1.56-185.74, p=0.020) after multivariate analysis. 결론: In twin pregnancies complicated by short cervical length, IM progesterone group showed significantly greater occurrence of preterm birth before 36 weeks of GA in comparison with vaginal progesterone group and conservative management group.

백모동에 의한 IgE 생성의 증가

강부경,이종섭,신태용,이은희,김형민 원광대학교 생명공학연구소 1996 생명공학연구소보 Vol.4 No.1

We determined for IgE in serum based on the enzyme-linked immunosorbent assay(ELISA) in vivo after intraperitoneal injection of Solanum lyratum extract for 14 days. The experiment showed as well whole spleen cells that Solanum lyratum extract enhanced IgE production in vivo. Solanum lyratum extract significantly facilitated the production of IgE by LPS-stimulated murine spleen cells. Solanum lyratum THUNB. also enhanced IgE production from mouse whole spleen cells. Lypopolysaccharide(LPS) stimulated IgE production was enhanced 1.4-fold to 2.7-fold by the addition of Solanum lyratum extract over a period of 7 days.

수근관 증후군의 국소 스테로이드 주사

조민규,이성훈,강은영,전평식,최영태 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.5

A rare case of extensive papillary muscle calcification in senile cardiac calcification syndrome

김은진;송봉근;강민호;손형래;홍수민;박동원;허승혜;김계연;최석구 인제대학교 2011 仁濟醫學 Vol.32 No.-

광범위 유두근 석회화는 흔하지 앉으며, 원인과 임상적 중요성에 관한 문헌만 드물게 찾아볼 수 있다. 반면에 작은 석회 침착은 노인에서 흔하며 심장 첨부에 주로 나타난다. 유두근 석회화는 관상동맥질환, 확장성 심근병증, 승모관 질환, 고칼슘혈증, 그리고 말기신부전에서 인산칼슘의 중가와 연관성이 있다. 저자는 심장초옴파와 MDCT를 통해 진단된 전외측 유두근의 광범위 석회화의 드문 사례가 있어 보고한다.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

두경부 편평세포암종세포주에서 retinoic acid가 linear-quadratic 모델을 적용한 방사선감수성과 apoptosis 유발에 미치는 영향

이은숙,강범현,허민석,이삼선,최현배,최순철,박태원 대한구강악안면방사선학회 2001 Imaging Science in Dentistry Vol.31 No.3

Purpose : To evaluate the effect of all-trans-retinoic acid on radiosensitivity and radiation-induced apoptosis in NHOK, HEp-2 and FaDu cell lines. Material and Methods : We measured the changes in survival fraction at 2 Gy (SF2), α and β after treatment of retinoic acid (1μM) prior to irradiation with doses of 2,4,6 and 10 Gy and correlated the radiosensitizing effect of retinoic acid with them. Also, apoptosis induction was assayed with the flow cytometry on days 1, 2, 3, 4 and 5 after irradiation (2,10 and 20 Gy) combined with retinoic acid. Results and Conclusion : SF2 values for NHOK, HEp-2 and FaDu cell lines were 0.54, 0.64 and 0.41, respectively and the cell line of FaDu was the most radiosensitive, For cell lines of NHOK and HEp-2, pretreatment of cells with retinoic acid resulted in a significant decrease of the SF2 values. The α/β ratios of x-ray survival curve were 8.714(NHOK), 4.098(HEp-2) and 11.79(FaDu). The α/β ratio for NHOK decreased on pretreatment with retinoic acid, whereas those for HEp-2 and FaDu increased. Radiation induced apoptosis in all cell lines but, retinoic acid did not affect the apoptosis. (Korean J Oral Maxillofac Radiol 2001; 31 : 135-43)

제2형 콜라겐으로 경구관용을 유도한 관절염 모델 마우스의 비장림프구내의 보조자극인자 및 STAT/SOCS 신호전달 인자의 발현 양상조사

이강은,황수연,민소연,김호연 Official Journal of the Korean society for immunol 2003 Immune Network Vol.3 No.3