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S-470 Relationships between blood pressure and clinico-pathological findings in IgA nephropathy
( Hyung-seok Ihm ),( Da-rae Kim ),( Jin-sug Kim ),( Kyung-hwan Jeoung ),( Tae-won Lee ),( Chun-gyoo Ihm ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Objective: Several factors contribute to the development of hypertension in patients with IgA nephropathy (IgAN). This study was conducted to find the relationships between baseline blood pressure (BP) and clinico-pathological findings in patients with IgAN and normal renal function. Design and Method: Clinico-pathological findings were analyzed in a total of 163 patients with IgAN and serum creatinine £ 1.1 mg/dL from The Kyung-Hee Cohort of Glomerulonephritis. The glomerular surface area (GSA) was determined using imaging analysis software. The serum and urine angiotensinogen (AGT) concentrations were measured using human ELISA kits.?Results: Mean serum creatinine concentration was 0.86 (0.5~1.1) mg/dL. Systolic BP was ≥ 130 mmHg in 72 patients (44%) and ≥ 140 mmHg in 42 (26%). Patients with systolic BP ≥ 130 mmHg as compared with those <130 mmHg had higher GSA and tubulointerstitial fibrosis and showed worse follow-up clinical findings: higher concentrations of serum creatinine, larger amount of proteinuria and lower levels of GFR. Systolic BP was positively correlated with age, baseline and follow-up proteinuria, serum uric acid concentrations and IgM deposit and negatively with follow-up GFR and the slope of change in 1/serum creatinine for 2 years, while it has no significant relationships with serum and urine AGT and 24 hour urinary sodium excretion. Conclusions: This study showed that systolic BP was associated with renal progression and pathological findings, glomerulomegaly and tubulointerstitial fibrosis, in patients with IgAN.
증례 : 내분비-대사 ; 전립선암 남성호르몬 박탈 치료 후 발생한 비케톤성 고삼투압성 혼수 1예
이석원 ( Seok Won Lee ),이성진 ( Seong Jin Lee ),유형준 ( Hyung Joon Yoo ),강준구 ( Jun Goo Kang ),임성희 ( Sung Hee Ihm ),김철식 ( Chul Sik Kim ),홍은영 ( Eun Yeong Hong ) 대한내과학회 2010 대한내과학회지 Vol.79 No.5
저자들은 골(骨) 전이를 동반한 전립선암으로 남성호르몬 박탈 치료를 받던 중 제2형 당뇨병, 비케톤성 고삼투압성 혼수, 급성 신부전이 발생하여 충분한 수액공급과 인슐린 투여 등의 집중 치료를 시행한 후 호전된 증례를 처음으로 경험 하였기에 문헌고찰과 함께 보고하는 바이다. During advanced prostate cancer, androgen deprivation therapy (ADT) using gonadotropin-releasing hormone and antiandrogen is an effective treatment modality. Recently, it has been reported that ADT may result in diabetes mellitus (DM), metabolic syndrome, and cardiovascular disease. Here, we report the first case in the literature of new-onset DM and hyperosmolar nonketotic coma (HNKC) associated with ADT. A 69-year-old man visited our hospital because of altered mentality. The patient had been taking leuprolide and bicalutamide for metastatic prostate cancer for the past 4 months. In laboratory tests, new-onset DM with HNKC was diagnosed. The patient was immediately treated with intravenous hydration and insulin therapy, and recovered without sequela. Because ADT can cause DM, or rarely HNKC, it is necessary to monitor fasting blood glucose and lipid profiles carefully while ADT is performed. (Korean J Med 79:573-576, 2010)
DNA와 상호작용에서 T4 endonuclease V의 C-말단 부위의 역할에 관한 분광학적 연구: 핵자기공명과 형광 실험
유준석(Jun Seok Yu),임형미(Hyung Mi Lihm),임후강(Hu Kang Ihm),신정휴(Jung Hyu Shin),이봉진(Bong Jin Lee) 대한약학회 1996 약학회지 Vol.40 No.2
In order to study the role of C-terminal aromatic region of T4 endonuclease V in the interaction with substrate DNA, NMR and Fluorescence spectrum were recorded. Analysis of fluorescence emission spectra showed that C-terminal region of T4 endonuclease V is in or very near the binding site. In the HSQC spectrum of 15N-Tyr-labeled T4 endonuclease V*DNA complex, the broadening of a peak was observed. It is presumed that this peak corresponds to one among three tyrosine residues which belong to the WYKYY segment of C-terminal region of T4 endonuclease V. Interactions of peptide fragments consisting of C-terminal residues of T4 endonuclease V with DNAs(TT-, T^T-DNA) were investigated by NMR and Fluorescence experiment. The results suggest that two peptide fragments themselves bind to DNAs and their binding pattern is not an intercalation mode.
Park, Chan Seok,Ihm, Sang-Hyun,Park, Hun-Jun,Shin, Woo-Seung,Kim, Pum-Jun,Chang, Kiyuk,Kim, Hee-Yeol,Youn, Ho-Joong,Chung, Wook-Sung,Seung, Ki Bae,Kim, Jae-Hyung The Korean Society of Cardiology 2011 Korean Circulation Journal Vol.41 No.4
<P><B>Background and Objectives</B></P><P>Adipokines have been suggested for their potential use in tracking the clinical progress in the subjects with metabolic syndrome (MS). To investigate the relationship between the serum levels of adipokines {adiponectin and retinol-binding protein 4 (RBP4)} and the serum level of uric acid in hypertensive (HTN) patients with MS.</P><P><B>Subjects and Methods</B></P><P>In this study, 38 totally untreated HTN patients were enrolled. Anthropometric measurements, blood pressure (BP) were taken in the 12 HTN patients without MS and the 26 HTN patients with MS. Fasting blood samples were collected for measurement of adiponectin, RBP4, nitric oxide (NO), glucose, creatinine, uric acid, lipid profile and insulin.</P><P><B>Results</B></P><P>The HTN with MS group had significant higher values of body mass index, waist length, serum uric acid and triglyceride levels than the HTN without MS group. Compared to the HTN without MS group, the HTN with MS group showed significantly lower adiponectin (p=0.030), NO (p=0.003) and high density lipoprotein levels (p<0.001). Serum adiponectin levels negatively correlated with insulin level (R=-0.453, p=0.026) and uric acid level (R=-0.413, p=0.036), and serum RBP4 levels positively correlated with uric acid level (R=0.527, p=0.006) in the HTN with MS group. Multiple linear regression analysis using RBP4 and adiponectin levels as the dependent variables showed that uric acid level correlated with serum RBP4 level (p=0.046) and adiponectin level (p=0.044).</P><P><B>Conclusion</B></P><P>The HTN with MS group showed a correlation with two types of adipokines (adiponectin, RBP4) and uric acid. Adiponectin, RBP4 and uric acid may be important components associated with MS, especially when associated with hypertension.</P>
Park, Chan Seok,An, Gun-Hee,Kim, Young-Woon,Park, Youn-Jung,Kim, Mi-Jeong,Cho, Eun Joo,Ihm, Sang-Hyun,Jung, Hae-Ok,Kim, Hee-Yeol,Jeon, Hui-Kyung,Youn, Ho-Joong,Kim, Jae-Hyung Korean Society of Echocardiography 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.4
<P><B>Background</B></P><P>Non-dippers were reported as showing different left atrial function, compared to dippers, but no study to date investigated the changes in the left atrial function according to the diurnal blood pressure pattern, using tissue Doppler and strain imaging.</P><P><B>Methods</B></P><P>Forty never treated hypertensive patients between 30 and 80 years of age were enrolled in this study. Patients were classified as non-dippers when, during night time, they had a blood pressure decrease of less than 10%. Strain of the left atrium was measured during late systole, and peak strain rates of the left atrium were measured during systole, early and late diastolic periods.</P><P><B>Results</B></P><P>The left atrial expansion index, left atrial active emptying volume and left atrial active emptying fraction were all significantly increased in non-dippers. They also had increased values of mean peak left atrial strain (dippers = 21.26 ± 4.23% vs. non-dippers = 24.91 ± 5.20%, <I>p</I> = 0.02), strain rate during reservoir (dippers = 1.29 ± 0.23 s<SUP>-1</SUP> vs. non-dippers =1.52 ± 0.27 s<SUP>-1</SUP>, <I>p</I> = 0.01) and contractile period (dippers = -1.38 ± 0.24 s<SUP>-1</SUP> vs. non-dippers = -1.68 ± 0.32 s<SUP>-1</SUP>, <I>p</I> < 0.01).</P><P><B>Conclusion</B></P><P>Strain and strain rate acquired from color Doppler tissue imaging demonstrate exaggerated reservoir and booster pump function in never-treated, non-dipper hypertensive patients. These methods are simple and sensitive for the early detection of subtle changes in the left atrial function.</P>
원발성 부갑상선 기능항진증 2예에서 수술 전후 내당능 및 인슐린 분비능의 변화
최용석,박성우,유형준,임성희,최문기,전상현,이건용,임인서 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.1
It is reported that patients with primary hyperparathyroidism(PHPT) have disturbances in carbohydrate metabolism: in particular, hyperinsulinemia and insulin resistance are characteristic early metabolic aberrations of this disease. However, it is not clear whether changes of insulin secretion or insulin sensitivity are observed in all patients with PHPT, including those with normal glucose tolerance. Also, it is not clear whether these changes are reversible after surgical correction of PHPT. In the present study, glucose tolerance and insulin secretion were evaluated in 2 symptomatic patients with PHPT during 100g oral glucose tolerance test before and after parathyroid adenoma removal. Comparing these patients before and after surgery, glucose tolerance was not significantly different. However, C-peptide and insulin secretion was low after surgical correction of PHPT compared to the preoperative situation. This observation suggests that insulin hypersecretion in patients with PHPT precedes glucose intolerance and this early disturbance is reversible after surgery(J Kor Soc Endocrinol 9:54-58, 1994).
Ji Yung Lee,Hyung-Seok Ihm,Jin Sug Kim,Hyeon Seok Hwang,Kyung-Hwan Jeong,Chun-Gyoo Ihm 전해질고혈압연구회 2019 Electrolytes & Blood Pressure Vol.17 No.2
Background: Several factors had been suggested to contribute to the development of hypertension in chronic glomerulonephritis (GN). This study was conducted to find the association of baseline blood pressure (BP) with pathophysiologic findings and later renal progression in chronic GN. Methods: Clinico-pathological findings including serum creatinine (Cr), proteinuria, pathological findings, and urinary Na excretion were analyzed in a total of 233 patients with IgA nephropathy from The Kyung-Hee Cohort of GN. Glomerular surface area (GSA) was measured by imaging analysis and urine angiotensinogen (AGT) concentrations by human ELISA kits. Results: Systolic BP was ≥130mmHg in 124 patients (53%). Systolic BP was negatively correlated with follow-up eGFR (r=-0.32, p<0.0001) and positively serum uric acid concentrations, while it had no significant relationships with initial serum Cr and eGFR. As compared with patients with systolic BP <130 mmHg, those with ≥130 mmHg were older and showed higher serum Cr, proteinuria, 24 hr urinary Na excretion, mean GSA, and T-I fibrosis, lower follow-up eGFR, and steeper decline in slope of eGFR. The results in patients with normal serum Cr concentrations were comparable to those in whole group. Systolic BP was positively correlated with age, baseline and follow-up proteinuria, serum uric acid concentrations and IgM deposit and negatively with follow-up eGFR. In subgroup analysis, systolic BP was also positively correlated with mean GSA and urinary AGT concentrations. Conclusion: This study showed that baseline systolic BP is related to urinary Na excretion, glomerulomegaly, T-I fibrosis and later renal progression in patients with IgA nephropathy.
Lee, Dong-Hyeon,Ihm, Sang-Hyun,Youn, Ho-Joong,Choi, Yun-Seok,Park, Chan-Seok,Park, Chul-Soo,Lee, Jong-Min,Kim, Hee-Youl,Oh, Yong-Seog,Chung, Wook-Sung,Seung, Ki-Bae,Kim, Jae-Hyung The Korean Society of Cardiology 2009 Korean Circulation Journal Vol.39 No.8
<P><B>Background and Objectives</B></P><P>The early morning blood pressure surge (EMBPS) has been reported to be associated with cardiovascular events. The aim of this study was to investigate the relationship between 24-hour ambulatory BP monitoring (ABPM) parameters and conventional cardiovascular risk factors.</P><P><B>Subjects and Methods</B></P><P>Patients (n=346) never-treated for essential hypertension with no other cardiovascular risk factors, such as diabetes, dyslipidemia, and nephropathy were enrolled. The EMBPS was defined as the early morning systolic BP minus the lowest night systolic BP. We compared the 24-hour ABPM parameters in two groups divided by age (<60 and ≥60 years) and examined the association between the 24-hour ABPM parameters and cardiovascular risk factor.</P><P><B>Results</B></P><P>The EMBPS (18±14 vs. 24±14 mmHg, p=0.002), 24-hour mean blood pressure {MBP; 102±9 vs. 105±11 mmHg, p=0.044}, and 24-hour mean pulse pressure (PP; 52±10 vs. 58±11 mmHg, p<0.001) were significantly increased in the elderly subjects compared to the younger subjects. The degree of decrease was less in the elderly subjects (10±8 vs. 7±10%, p=0.002). Based on multivariate analysis, age was an independent risk factor for the highest quartile of EMBPS (>28 mmHg) after adjusting for gender differences, body mass index, and various 24-hour ABPM parameters (odds ratio, 1.051; 95% confidence interval, 1.028-1.075; p<0.001).</P><P><B>Conclusion</B></P><P>Age is an independent risk factor for EMBPS in patients with never-treated hypertension. BP control in the early morning period is more important in elderly patients so as to prevent cardiovascular events.</P>
전신성 홍반성 루푸스 환자에서 발병된 크립토코쿠스 뇌막염
이창원 ( Chang Won Lee ),송상헌 ( Sang Heun Song ),배우형 ( Woo Hyung Bae ),안준협 ( Jun Hyup An ),김성일 ( Sung Il Kim ),김명규 ( Myeong Kyu Kim ),이신석 ( Shin Seok Lee ),정대수 ( Dae Soo Jung ),곽임수 ( Ihm Soo Kwak ),나하연 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.4
Cryptococcal meningitis is rare but, often fatal complication of systemic lupus erythematosus(SLE). It is difficult to differentiate cryptococcal meningitis from neuropsychiatric lupus due to similarity of clinical symptoms and laboratory findings of cerebrospinal fluid(CSF). Earlier diagnosis and effective antifungal therapy improve the prognosis of cryptococcal meningitis in SLE patients. We report a case of cryptococcal meningitis in a patient with SLE who had been medicated with low dose steroid.