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주요 내분비질환의 진료 지침 : 남성갱년기 증후군 -후기 발현 남성 성선기능저하증-
유순집 ( Soon Jib Yoo ) 대한내과학회 2008 대한내과학회지 Vol.75 No.3
Male climacteric syndrome is a clinical and biochemical syndrome characterized by the decline in serum concentration of biologically active forms of testosterone with aging in men which may result in detrimental effect on the quality of life(QOL) and adversely affect the function of multiple organ systems. Androgen replacement therapy may have favorable effect in QOL, body composition, cardiovascular disease, sexual dysfunction and osteoporosis. Controversy in defining the clinical syndrome and in long-term effect of androgen replacement therapy continues. An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in males. The diagnosis of LOH requires biochemical and clinical components. Any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. There have been potential concerns regarding the effects of testosterone on prostate disease and polycythemia. The available treatment methods have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations. Periodic physician`s evaluations is required to assess the clinical response and to avoid potential adverse events and must be tailored individually. (Korean J Med 75:262-266, 2008)
내분비 질환에 의한 이차 고혈압의 진단과 치료 ; 갈색세포종의 진단과 치료
유순집 ( Soon Jib Yoo ) 대한내과학회 2012 대한내과학회지 Vol.82 No.4
Pheochromocytomas are rare neuroendocrine tumours with a highly variable and heterogeneous clinical manifestation. With a noticeable progress in genetics, biochemical diagnosis and tumour imaging techniques, modifications of the traditional rule of tens for pheochromocytomas are inevitable consequence. Diagnosis of pheochromocytoma depends on biochemical evidence of catecholamine production by the tumor. Plasma free metanephrines provide the best test for excluding or confirming pheochromocytoma and should be used as an initial screening tool, but if it is not available, urinary fractionated metanephrines could be used as an alternative method. Different anatomical and functional imaging modalities are used to localize biochemically proven pheochromocytomas. These include computed tomography, magnetic resonance imaging, single-photon emission computed tomography (SPECT) using 123/131I-metaiodobenzylguanidine (MIBG) or 111In-DTPA-pentetreotide and positron emission tomography (PET). Timely laparoscopic tumour removal in combination with appropriate pre-and intraoperative management of the effects of secreted catecholamines are essential components for excellent prognosis. (Korean J Med 2012;82:403-410)
유순집,김석헌,김용주,방병기,강문원,최의진,김석영,우제영,양철우 대한감염학회 1993 감염 Vol.25 No.3
Tuberculous arachnoiditis of the spine is a serious illness with no known definite pathogenesis and therapeutic modalities. It usually has been diagnosed by invasive procedures such as conventional myelography and CT myelography. We recently experienced two patients with arachnoiditis whose conditions were too poor to perform these invasive studies. One was CRF patient in the course of tuberculous meningitis and the other was the patient with comatous mentality and paraplegia which developed during the acute stage of tuberculous menigitis. These patients were diagnosed tuberculous arachnoiditis by spine MRI and medicated antituberculous drug and steroid combination or steroid therapy alone with successful clinical improvement. We reviewed the MRI as a diagnostic tool and steroid as a therapeutic regimen.
이철우,유진영,이광우,손호영,차봉연,유순집,강성구,원종만,송경섭,조영석,성용직 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.1
Multiple endocrine neoplasia type 1 (MEN 1) is the association of neoplastic transformation of parathyroid, pituitary, and pancreatic islet cells. This syndrome is inherited as an autosomal dominant trait. A 38-year-old woman presented with general weakness and mental changes. She had experienced same symptoms 7 years ago, after then her weight gradually increased. Insulinoma was suspected by markedly decreased blood glucose level(20mg/dL) and the increased insulin/glucose ratio(0.43) that sampled in emergency room at the time of mental change. Unusually large pancreatic tail mass and Lt, adrenal gland mass were detected by abdominal CT. Percutaneous transhepatic portal vein catheterization with insulin sampling showed sudden step up of insulin/glucose ratio at the middle portion of pancreas. Measuring of basal pituitary hormones as a screening procedure of MEN showed increased basal prolactin level. Combined pituitary stimulation test showed blunted response of prolactin to TRH and sellar magnetic resonance imaging showed intrasellar mass. Thyroid nodule was palpated on her anterior neck. Thyroid scintigram showed cold nodule, and there was no lymphadenopathy around the nodule by the thyroid sonogram. Fine needle aspiration cytology showed benign hyperplastic follicular cells only. Serum ionized calcium and parathyroid hormone level were normal. Under the impression of MEN type I, the distal pancreatectomy, splenectomy, Lt. thyroid lobectomy and Lt. adrenalectomy was performed at the same time. Histologic examination of the surgically removed tissues revealed pancreas islet cell tumor, adrenal cortical adenoma and thyroid adenoma. Transient hyperglycemia was developed after surgical intervention, but thereafter she never felt any symptoms of hypoglycemia till now and her blood glucose showed completely normal level with oral glucose tolerance tests. We present this case with a review of literature (J Kor Soc Endocrinol 12:111-119, 1997)
Kim, Sung Rae,Yoo, Ji Han,Song, Ho Cheol,Lee, Seong Su,Yoo, Soon Jib,Kim, Young-Du,Lim, Yeon Soo,Kim, Hyung Wook,Yang, Chul Woo,Kim, Yong-Soo,Choi, Euy Jin,Kim, Yong Kyun Springer International ; Oxford University Press 2011 Nephrology, dialysis, transplantation Vol.26 No.11
<P>Obesity and diabetes mellitus (DM) are established risk factors for the development of chronic kidney disease. Visceral adiposity (VAT) and subcutaneous adiposity (SAT) may be associated with the differential metabolic risk. Our study was performed to determine whether VAT or SAT was associated with the decrease of renal function in people with type 2 DM.</P>
Oak-Kee Hong,Soon-Jib Yoo,Jang-Won Son,Mee-Kyoung Kim,Ki Hyun Baek,Ki-Ho Song,Bong-Yun Cha,Hanjoong Jo,Hyuk-Sang Kwon 대한생리학회-대한약리학회 2016 The Korean Journal of Physiology & Pharmacology Vol.20 No.2
Here, we investigated whether hyperglycemia and/or free fatty acids (palmitate, PAL) aff ect the expression level of bone morphogenic protein 4 (BMP4), a proatherogenic marker, in endothelial cells and the potential role of BMP4 in diabetic vascular complications. To measure BMP4 expression, human umbilical vein endothelial cells (HUVECs) were exposed to high glucose concentrations and/ or PAL for 24 or 72 h, and the effects of these treatments on the expression levels of adhesion molecules and reactive oxygen species (ROS) were examined. BMP4 loss-of-function status was achieved via transfection of a BMP4-specific siRNA. High glucose levels increased BMP4 expression in HUVECs in a dose-dependent manner. PAL potentiated such expression. The levels of adhesion molecules and ROS production increased upon treatment with high glucose and/or PAL, but this effect was negated when BMP4 was knocked down via siRNA. Signaling of BMP4, a proinfl ammatory and pro-atherogenic cytokine marker, was increased by hyperglycemia and PAL. BMP4 induced the expression of infl ammatory adhesion molecules and ROS production. Our work suggests that BMP4 plays a role in atherogenesis induced by high glucose levels and/or PAL.
Hong, Oak-Kee,Yoo, Soon-Jib,Son, Jang-Won,Kim, Mee-Kyoung,Baek, Ki-Hyun,Song, Ki-Ho,Cha, Bong-Yun,Jo, Hanjoong,Kwon, Hyuk-Sang The Korean Society of Pharmacology 2016 The Korean Journal of Physiology & Pharmacology Vol.20 No.2
Here, we investigated whether hyperglycemia and/or free fatty acids (palmitate, PAL) affect the expression level of bone morphogenic protein 4 (BMP4), a proatherogenic marker, in endothelial cells and the potential role of BMP4 in diabetic vascular complications. To measure BMP4 expression, human umbilical vein endothelial cells (HUVECs) were exposed to high glucose concentrations and/or PAL for 24 or 72 h, and the effects of these treatments on the expression levels of adhesion molecules and reactive oxygen species (ROS) were examined. BMP4 loss-of-function status was achieved via transfection of a BMP4-specific siRNA. High glucose levels increased BMP4 expression in HUVECs in a dose-dependent manner. PAL potentiated such expression. The levels of adhesion molecules and ROS production increased upon treatment with high glucose and/or PAL, but this eff ect was negated when BMP4 was knocked down via siRNA. Signaling of BMP4, a pro-inflammatory and pro-atherogenic cytokine marker, was increased by hyperglycemia and PAL. BMP4 induced the expression of inflammatory adhesion molecules and ROS production. Our work suggests that BMP4 plays a role in atherogenesis induced by high glucose levels and/or PAL.
Yoon, Kun Ho,Yoo, Soon Jib,Kang, Moo-Il,Son, Hyun Shik,Hong, Kwan Soo CATHOLIC MEDICAL CENTER 1992 Bulletin of the Clinical Research Institute Vol.20 No.2
Genetic predispostition to the autoimmune disease insulin dependant diabetes mellitus is determined, in part, by a gene within the major histocompatibility complex (MHC) on human chromosome 6. After amplification of exon 2 HLA-DQα chain gene with polymerase chain reaction (PCR) procedure, we used non-radioactive HLA-DQα ASO probes which labelled with horseradish peroxidase (HRP) coupled to the 5’ end of the oligonucleotide for the HLA-DQα typing. The results were as follows: 1. The first domain elf the DQα chain gene was amplified from minimum 1 ng of genomic DNA with use of the PCR. And from 1 ㎍ DNA samples, all the samples were successfully amplified which have a product of approximately 242 bp. 2. On oligonulcleotide dot blot analysis of study subjects and standard control cell lines, TAB (HLA-DQAI homozygosity) cell line was hybridized to RH 83 probe only and DKB (HLA-DQA3 homozygosity) cell line to GH 67 probe and LUY (HLA-DQA4 homozygosity) cell line to GH 66. According to these results, we accurately determined HLA-DQα subtypes in study subjects. 3. Frequency of DQA3 allele in Korean was high and DQA2 allele was low compared to other populations. In IDDM patients, DQA3 allele w as significantly increased (relative risk 6.6, P=0.03) compared with controls. Conversely the frequencies of DQA1 allele was decreased among patients (relative risk 0.25, P=0.02). These results suggest that HLA-DQA3 allele is positively associated with IDDM as in other populations and HLA-DQA1 allele is negatively associated with IDDM in Korean population.
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김정완,유문집,이성철,유석주,정홍근,김명호,권순행 대한골절학회 1998 대한골절학회지 Vol.11 No.3
The calcaneus is the most frequently fractured tarsal bone. Although there were many reports of treatment using variable methods, but no definite general agreement to the treatment method of the intra-articular calcaneus fracture. From May. 1995 to Apr. 1997, l4 displaced intra-articular fractures of the calcaneus in 12 patients underwent open reduction and heterogenous bone graft (Lubboca, TRANSPHYTO S.A., France) at the Dept. of Orthopaedic Surgery, Dankook University Hospital. The fractures were 13 joint depression type and I tongue type fractures according to the classification of Essex-Lopresti. The average follow-up was 20 months and clinical assessment underwent by Clinical Assessment Rating system of Hutchinson and Huebner; we got a satisfactory results for the treatment of displaced intra-articular calcaneus fracture by open reduction and heterogenous bone graft. We didn' t need harvesting autograft by use of heterogenous bone graft into bone defect site instead of autograft. Our purpose of using heterogenous bone were filling of defect and internal fixation. We used minimal skin incision and minimal internal fixation device, so reduced complications such as wound edge necrosis and peroneal entrapment caused by entensile appraoch. There were no posterior facet depression and decreased B hler angle for 1 year follow up.