^(131)I 전신스캔 음성 재발 분화 갑상선암에서 EDG PET의 임상적 의의 : ^(99m)Tc-MIBi Scintigraphy와 비교분석

원종철,이성진,이태윤,남궁일성,이시열,김하영,한정희,류진숙,문대혁,안일민 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4-5

스트렙토조토신으로 유발된 당뇨병 모델에서 과식증에 대한 시상하부 FoxO1의 역할

남궁일성 ( Il Seong Nam Goong ),김재근 ( Jae Geun Kim ),김세진 ( Se Jin Kim ),허성재 ( Seong Jae Hur ),이진우 ( Jin Woo Lee ),김은숙 ( Eun Sook Kim ),윤창호 ( Chang Ho Yun ),이병주 ( Byung Ju Lee ),김영일 ( Young Il Kim ) 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.5

연구배경: 스트렙토조토신으로 유발된 당뇨병 실험동물은 혈중 인슐린과 렙틴의 결핍으로 인하여 과식증이 특징적으로 발생된다. 전사조절인자인 FoxO1은 인슐린 신호전달체계를 통하여 대사 및 세포의 분화를 조절한다. 본 연구에서는 인슐린과 렙틴이 결핍된 당뇨병 동물모델에서 시상하부의 FoxO1이 당뇨병성 과식증과 연관되어 있는지를 알아보고자 하였다. 방법: 생쥐(C57BL/6)의 복강으로 스트렙토조토신(200 mg/kg)을 투여하여 당뇨병을 유발하였으며 대조군은 50 mM의 sodium citrate buffer (pH4.0)을 복강으로 투여였다. 생쥐의 뇌실로 인슐린 및 렙틴을 주입하기 위하여 정위 뇌수술 장치를 이용하여 스테인리스 관을 삽관하고 3주 후 생리식염수(2 μL), 인슐린(500 nmoL), 렙틴(1 μg/2 μL)을 각각 주입하였다. FoxO1과 시상하부 신경펩타이드의 mRNA 발현을 확인하기 위하여 각각의 실험군 및 대조군 생쥐의 시상하부를 적출하여 RNA을 분리하고 cDNA를 합성하여 real time PCR을 수행하였다. 결과: 스트렙토조토신으로 유발된 당뇨병 생쥐에서는 대조군과 비교하여 유의한 혈당 증가(25.5±2.8 mmol/L vs. 6.8±0.8 mmol/L) 및 식사섭취의 증가(7.4±0.9 g/day vs. 4.2±0.4 g/day)가 나타났다. 또한 당뇨병이 유발된 생쥐는 정상 생쥐보다 혈중 인슐린(1,303.7±687.6 pmol/L vs. 240.3±26.8 pmol/L)과 렙틴(2,116.5±465.0 pg/mL vs. 86.5±41.5 pg/mL)은 현저하게 감소하였다. 시상하부 FoxO1의 mRNA 합성은 당뇨병이 유발된 생쥐(P<0.001)에서 대조군과 비교하여 유의한 증가를 관찰하였다(2.6배 증가, P<0.001). 당뇨병이 유발된 시험군은 시상하부의 NPY mRNA의 발현이 유의하게 증가(1.85배 증가, P<0.05)하였으며 POMC mRNA는 유의하게 감소(2.1배 감소, P<0.01)하였다. 생쥐의 뇌실로 인슐린 또는 렙틴을 투여하였을 때 증가된 시상하부 FoxO1이 유의하게 감소하였다(각각 1.5배, 1.8배 감소, P<0.05). 또한, 인슐린 또는 렙틴을 뇌실 내로 투여한 결과 NPY mRNA는 감소되고(인슐린 1.5배 감소, P<0.05, 렙틴 1.6배 감소, P<0.01) POMC mRNA는 증가되었다(각각 1.6배, 1.9배 증가, P<0.05). 결론: 본 연구에서는 인슐린과 렙틴의 결핍으로 과식증이 유발된 당뇨병 모델에서 시상하부 FoxO1의 합성이 증가하였으며 뇌실로 인슐린 또는 렙틴을 주입하였을 때 FoxO1합성의 증가가 상쇄됨을 확인하였다. 이러한 결과는 당뇨병에서 나타나는 과식증이 시상하부의 전사조절인자인 FoxO1과 연관되어 있음을 나타낸다. Background: Streptozotocin-induced diabetic animals are characterized by hyperphagia due to deficiencies of insulin and leptin. Forkhead box-containing protein of the O subfamily-1 (FoxO1) regulates energy homeostasis by regulating energy expenditure and food intake as well as mediating insulin and leptin signals in the hypothalamus. To identify the mediator of diabetic hyperphagia, we examined the effects of insulin or leptin on hypothalamic FoxO1 expression in a diabetic animal model. Methods: Diabetes was induced in mice (C57BL/6) by intraperitoneal administration of streptozotocin (200 mg/kg). Stainless steel cannula was implanted into the lateral ventricle of the brain in each mouse. After three weeks, the mice were administered saline, insulin or leptin via intracerebroventricular (ICV) route. The medial hypothalamus was isolated to evaluate the mRNA expressions of FoxO1 and neuropeptides. Results: Streptozotocin-induced diabetic mice exhibited significant elevations of blood glucose and food intake and significantly low levels of serum insulin and leptin. The levels of hypothalamic FoxO1 mRNA were significantly increased in diabetic mice. The hypothalamic expression of neuropeptide Y (NPY) mRNA was increased, but the expression of preproopiomelanocortin (POMC) mRNA was decreased in diabetic mice. ICV administration of insulin or leptin attenuated the upregulation of hypothalamic FoxO1 mRNA, and resulted in downregulation of NPY mRNA and upregulation of POMC mRNA in diabetic mice. Conclusion: We observed that the expression of hypothalamic FoxO1 mRNA was increased in streptozotocin-induced diabetic mice, and that it was significantly attenuated by central administration of insulin or leptin. These results suggest that hypothalamic FoxO1 is the direct mediator of diabetic hyperphagia. (Korean Diabetes J 33:375-381, 2009)

Poster Session : PS 1308 ; Endocrinology : Carvenous Sinus Thrombophlebitis and Meningitis as a Complication in Osteopetrosis

( So Hyun Park ),( Seong Nam Goong ),( Eun Sook Kim ),( Young Il Kim ),( Sun Ho Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Osteopetrosis is a rare hereditary bone disorder presenting with variable clinical features and is characterized by increased bone density and reduction of marrow spaces that result from a defect in the function of osteoclasts. Among three primary types of autosomal dominant osteopetrosis, osteopetrosis type II is characterized by sclerosis of bones, predominantly involving the spine, the pelvis, and the skull base. Fragility of bones and dental abscess are leading complications. This report presents a case of osteopetrosis in a 52-years-old female, which was complicated by the development of carvenous sinus thrombophlebitis and meningitis. The complete resolution of infection was obtained with right sphenoidectomy and antibiotic therapy for 12 weeks. She was born after a normal pregnancy and delivery and did not have visual or hearing disturbances. She was suffered from multiple fractures since 7 years ago. Laboratory data revealed elevated serum levels of tartrate resistant acid phosphatase (TRAP) without carbonic anhydrase II DNA mutation. A plain radiograph of the spine showed endplate thickening and sclerosis producing the classic "sandwich vertebra" appearance. These radiographic finding and clinical finding were typical of osteopetrosis type II (Albers- Schonberg disease). Her healthy elder sister also showed sandwich spine appearance. We report a case of autosomal dominant osteopetrosis type II with carvenous sinus thrombophlebitis and meningitis that was successfully treated with operation and long-term antibiotics.

Thyroid Transcription Factor-1 Facilitates Cerebrospinal Fluid Formation by Regulating Aquaporin-1 Synthesis in the Brain

Kim, Jae Geun,Son, Young June,Yun, Chang Ho,Kim, Young Il,Nam-goong, Il Seong,Park, Jun Heon,Park, Sang Kyu,Ojeda, Sergio R.,D'Elia, Angela Valentina,Damante, Giuseppe,Lee, Byung Ju American Society for Biochemistry and Molecular Bi 2007 The Journal of biological chemistry Vol.282 No.20

Osteopontin Levels in Patients with Papillary Thyroid Cancer According to the Presence of Hashimoto's Thyroiditis

Park, So-Hyun,Park, Chan-Sung,Kim, Young-Il,Nam-Goong, Il-Seong,Kim, Yon-Seon,Lee, Jong-Cheol,Choi, Jung-Il,Park, Jeong-Woo,Kim, Eun-Sook Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.6

Background: Human papillary thyroid carcinoma (PTC) is often associated with Hashimoto's thyroiditis (HT); their coexistence improves PTC prognosis. Osteopontin, a secreted glycoprotein, plays a role in cell survival, immunity, and tumor progression, its expression being associated with a poor prognosis and metastasis in several malignancies. Osteopontin overexpression correlates with aggressive clinicopathological features in PTC. Lymph node metastases and large tumor size positively correlate with osteopontin positivity. This study aimed to: (1) confirm osteopontin overexpression in human PTC samples; (2) compare osteopontin expression levels in PTC cases with and without HT; and (3) identify correlations between tumor aggressiveness and osteopontin expression levels. Materials and Methods: Plasma osteopontin was assessed in 45 patients with PTC, 22 patients with PTC and HT, and 24 healthy controls by enzyme-linked immunosorbent assay. Thyroid tissue osteopontin mRNA and protein levels were analyzed by reverse transcription-polymerase chain reaction and Western blotting, respectively. Results: Plasma osteopontin levels were significantly higher in PTC patients than in healthy controls. Plasma osteopontin, tissue osteopontin mRNA, and tissue osteopontin protein levels were significantly lower in patients with PTC and HT than in those with PTC alone. In advanced disease stage cases, osteopontin mRNA and protein expression levels were lower in patients with PTC and HT than in those with PTC alone. However, the osteopontin expression level was not significantly associated with the TNM stage. Conclusions: Plasma osteopontin, tissue osteopontin mRNA, and tissue osteopontin protein levels were significantly lower in patients with PTC and HT than in those with PTC alone, suggesting that HT attenuates PTC aggressiveness through negative regulation of osteopontin expression.

Poster Session : PS 1317 ; Endocrinology : Adrenal Pseudocyst Presenting with Retroperitoneal Hemorrhage and Hormonal Abnormalities

( Se Eun Han ),( Myung Kwan Ko ),( Yang Won Nah ),( Jae Hee Suh ),( So Hyun Park ),( Eun Sook Kim ),( Young Il Kim ),( Il Seong Nam Goong ),( Gyeong Min Jeong ),( Chui Yong Pak ),( Kyung Hye Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Adrenal pseudocysts are rare cystic lesions and most of them are usually nonfunctional and asymptomatic, discovered incidentally during diagnostic imaging such as ultrasonography and computed tomography. However, large pseudocyst may cause compressive effects on adjacent organs, abdominal symptoms, and sometimes complications by rupture and hemorrhage or infection of pseudocyst. We report a case of a 28-year old woman with spontaneously ruptured right adrenal pseudocyst with retroperitoneal hemorrhage and hormonal abnormalities treated with delayed laparoscopic surgery. She was visited to our hospital due to sudden onset of right upper quadrant pain. A computed tomography revealed a 14cm sized retroperitoneal hematoma around the right adrenal gland due to unknown origin. She showed elevated blood pressure and increased levels of 24 hours urine catecholamines and its metabolites. After admission at intensive care unit, hemoglobin level was reduced to 7.6 g/dl and hypotension was developed. She received blood transfusion and underwent renal artery angiography, but active bleeding site was not observed. After transfusion, she became stable and surgical treatment was delayed after further absorption of retroperitoneal hematoma. After discharge, size of the retroperitoneal hematoma decreased slowly on serial computed tomography and levels of catecholamines and its metabolites remained to normal range. Laparoscopic right adrenalectomy was done after two years of initial event. And histopathologic findings diagnosed adrenal pseudocyst with fibrosis and dystrophic calcification. Our case shows that adrenal pseudocyst with retroperitoneal hemorrhage can be accompanied by catecholamine excess. In case of huge retroperitoneal hemorrhage from adrenal lesion, the delayed laparoscopic adrenalectomy may be an appropriate management strategy after stabilization of patient`s status with initial careful monitoring rather than prompt surgical exploration.

증례 : 내분비-대사 ; 인슐린 자가면역 증후군 1예

조현 ( Hyun Cho ),오쌍용 ( Ssang Yong Oh ),김유정 ( You Jung Kim ),박찬성 ( Chan Sung Bak ),김은숙 ( Eun Sook Kim ),김영일 ( Young Il Kim ),남궁일성 ( Il Seong Nam Goong ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1S