Changes of Bone Mineral Density and Levels of Cytokines in the Culture Media of Peripheral blood and Bone Marrow Monocytes after Ovariectomy in Rats

박진영(Jin Yong Park),신동우(Dong Woo Shin),김승종(Seong Jong Kim),임태형(Tae Hyung Lim),여준기(Jun Ki Yeo),박근용(Keun Yong Park) 대한내과학회 1998 대한내과학회 추계학술대회 Vol.55 No.-

Helicobacter pylori의 초기 박멸요법 후 궤양치유를 위한 추가적인 산억제제가 필요한가 ?

정재진(Jae Jin Jung),이동욱(Dong Wook Lee),이동수(Dong Su Lee),정강욱(Kang Wook Chung),김영성(Young Sung Kim),김은영(Eun Young Kim),손수호(Soo Ho Son),여준기(Jun Ki Yeo),곽동협(Dong Hyup Kwak) 대한내과학회 2001 대한내과학회지 Vol.60 No.5

N/A Background : Helicobacter pylori (H. pylori) can now be eradicated in the majority of patients with 7 days of treatment with OAC ( omeprazole + amoxicillin + clarithromycin ) regimen. It is unclear if additional acid-suppressing treatment should be continued beyond 7 days in patients with active gastric or duodenal ulcers. Methods : Ninety two patients with endoscopically proven active peptic ulcers who were H. pylori positive were randomized to receive either omeprazole 20 mg plus amoxicillin 1.0g plus clarithromycin 500mg ; twice daily for 1 week alone (OAC group) or same regimen followed by 3 weeks of omeprazole (OACP group). Endoscopy and UBT (urea breath test) were performed 8 weeks after the initiation of treatment. Results: Forty four of forty five (97.8%) of OAC group and forty four of forty seven (93.6%) of OACP group were noted to have healed ulcer at week 8. Conclusion: In patients with H. pylori infection and peptic ulcers, one week of OAC therapy without further need for PPI may heal the ulcers. Following an l week course of H. pylori eradication therapy by OAC for peptic ulcers, further 3 weeks of acid-suppressing therapy with PPI was not proven to promote ulcer healing rate.(Korean J Med 60:439-443, 2001)

당뇨병환자에서 뇨증 Fibronectin농도의 증가에 관한 연구

한승범,조준승,손건영,서성문,박근용,조성래,박규영,박정모,이인규,여준기 啓明大學校 醫科大學 1994 계명의대학술지 Vol.13 No.4

Plasma fibronectin is an α₂-glyoprotein, which is produced by vascular endothelial cells. Raised level of plasma fibronectin has been observed in diabetic patients particularly in the presence of microvascular complications. However, no available data exist about urine level of this glycoprotein in diabetic patients. We measured urine fibronectin level by ELISA methods in 54 diabetic patients who have microvascular comlications or not. The following results were obtained. 1) Urine fibronectin level(㎍/g creatinine) in diabetic group(1740.0±678.0) is increased compaired with those in normal control group(471.0±59.0). but this results were not significantly different among two groups(P>0.05). 2) Urine fibronectin level(㎍/g creatinine) was significantly increased in patients with nephropathy (6188.0±3144.0) compared with those in normal control group(471.0±59.0) and patients without nephropathy(645.0±251.0)(P<0.001). 3) There were a significant correlation between BUN, creatinine, creatinine clearance, 24hr urine total protein and urine fibronectin level in diabetic patients. Our data suggest that urine fibronectin excretion level might be used as a sensitive guide for diabectic nephropathy.

반코마이신 정주투여후 발생한 위막성 대장염 1례

이동욱,권순대,박진용,한승묵,황준영,이인규,박근용,류성열,김미정,신동우,김성종,여준기 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.3

저자들은 당뇨병성 신부전환자의 족부궤양 치료로 투여한 반코마이신 정주로 인한 위막성 대장염 1례를 경험하였기에 보고하는 바이다. 특히 신부전이 있는 경우에 반코마이신 정주 요법은 C.difficile에 의한 위막성 대장염을 일으킬 수 있는 빈도가 증가되므로 정확한 약물의 용량결정과 추후 혈중 약물 농도의 측정이 반드시 필요하며 상기 환자에서 설사 및 복통이 발생시 위막성 대장염의 발생을 고려하여야 겠다. Diarrhea is a common complication of antibiotics usage. The diarrhea ascribed to antibiotics usually consist of loose or watery stools, sometimes containing mucus but rarely gross evident blood. Almost every antibiotics has been implicated. Although the pathogenesis of antibiotics-associated diarrhea is not confirmed, recent studies have shown that a toxin of Clostridium difficile is implicated as a cause of it. Diagnosis is made by detecting toxin in the stool or by positive stool culture for C. difficile. Treatment is either directed at binding the toxin with anion exchange resins such as cholestyramine in mile case, or at eradicating the C. difficile organism with oral vancomycin, metronidazole for more severe cases. We have recently experienced one patient who developed diarrhea, abdomminal pain after having received prolonged vancomycin injection. Sigmoidoscopic finding revealed typical cream-colored plaque lesions (pseudomembrane) on a red friable edematous mucosa. Light microscopic finding of the rectal mucosa showed a volcano-like appearance. The symptom improved after treatment with oral vancomycin and metronidazole. So, we report one case of pseudomembranous colitis secondary to the use of parenteral vancomycin.

Streptozotocin으로 유발된 당뇨쥐에서 췌도의 문정맥내 동계 이식

박근용,여준기,이인규,강구정,조원현 啓明大學校 醫科大學 1994 계명의대학술지 Vol.13 No.2

저자들은 췌도이식 여구의 첫단계로 collagenase 소화법 및 Ficoll density gradient법을 이용하여 분리한 흰쥐 췌도를 10마리의, streptozotocin으로 당뇨병이 유발되는 동계쥐의 문정맥에 이식하였다. 1) 성공적으로 이식된 예는 3례였으며 이식을 위해 사용된 분리췌도수는 250±310개였고 이식이 성공한 경우는 모두 이식후 1일째 혈당치가 정상으로 회복되었다.(121±15.5mg/dl). 2) 성공저긍로 이식된 예에서 이식췌도의 생존은 각 3일,8일,14일이었다. 이상의 결과를 종합하면 collagenase 소화법 및 Ficoll density gradient법을 이용하여 분리한 췌도를 사영한 문정맥내 췌도이식은 이식의 성공률을 높이기 위한 마취상의 미숙점을 보완한다면 기술적으로 어려움없이 가능하다고 사료된다. We evaluated this functional ability of fresh isolated islet of rats by the methods of collagenase digestion/Ficoll density gradient and we performed istransplantation of rat islet into portal vein as a first step procedure to islet cell transplantation. The results obtained were as follows. 1) Three out of 10 transplanted rats receiving 250±310 isolated islets normalized their nonfasting morning blood glucose(121±15.mg/이) and insulin levels(32.1±5.4uU/ml). 2) Normoglycemia has been maintained for 3 days, 8 days and 14 days in each 3 successfully transplanted rats. This study suggests that the islet isotransplantation into protal vein by the methods of collagenase digestion of Ficoll denisty gradient is feasible and appopriate method in treating the diabetes and can be used in the human also for the treatment of diabetes and could be used in the human diabetes.

동맥혈관 평활근세포에서 Sodium butyrate ( SB ), Halofuginone hydrobromide ( HH ) 및 고농도 포도당이 세포성장 및 유전자 발현의 변동에 미치는 영향

권기영,이상준,김정철,송홍석,한승범,이인규,박준호,여준기,전영준 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.2

Background : Vascular smooth muscle cell(VSMC) proliferation associated with arterial injury causes restenosis, which remains to be resolved in cardiovascular disease, especially after balloon angioplasty. Although numerous factors including hyperglycemia, hyperinsulinemia, angiotensin, basic fibroblast growth factor(BFGF), etc are suggested as potent mitogens for VSMCs, other mechanisms are still needed to take into new consideration. Advances in molecular biology have led to the development of powerful methods for the analysis of differential gene expression. There, we clarified the effect of glucose, sodium butyrate and halofuginon hydrobromide on gene expression which play a role in VSMC growth. Methods : Therefore, we evaluate the changes of gene expression in response to high glucose concentration, sodium butyrate which is an inhibitor of platelet-derived growth factor(PDGF), and halofuginon hydrobromide which is an inhibitor of specific type 1 collagen, using differntial expressed sequence tag(EST) sequencing and cDNA microarray hybridization. Human mammary artery VSMC isolated from patients undergoing coronary bypass surgery. Cells from passage 3 to 5 were used in experiment with serum-free media with varying conditions. Results : After 6 days of culture, the cells(VSMC) were resuspended with PBS and counted in a hemocytometer, and viable cells were counted using the trypan blue test. VSMC number reached 36?04 cell under high glucose concentration(H/G: 22mM) and 29?04 cell under low glucose concentration(L/G: 5.5 mM) at 6 day of culture(p$lt;0.01). Sodium butyrate(SB) inhibited VSMC growth at varying butyrate concentrations(0.625, 1.25, 2.5, 5.0, 10.0mM) by 84%, 87%, 94%, 96%, 98%, respectively. Halofuginon hydrobromide(HH) also inhibited VSMC growth at varying halofuginon concentrations (10-11, 10-9, 10-7, 10-5mM) by 15%, 30%, 85%, 100%, respectively. Using a differential EST screening technique to assay the relative level of expression of each of large numbers of cloned cDNA sequences after treatment with high glucose concentration(22mM), sodium butyrate(5 mM), and halofuginon(1?M). Among the total 1,730 cDNA clones, 6 cDNA clones were down-regulated after treatment with sodium butyrate(5mM) and halofuginon(1?M). Those were revealed homology to genes encoding connective tissue growth factor(cTGF), Betaig-H3, nm23-H1 nm23-H2, enigma and copine 1. On the contrary, four clones were up-regulated after treatment with high glucose concentration(22mM). Those clones(BO94-5, K1316-5, K1764-5, B1835-5) didn't match any sequence in the public data base. Conclusion : These results indicate that this EST analysis is useful technique in targeting genes which are associated with atherosclerosis in VSMC. These identified clones may be used to assist in the positional cloning of genes which are related with atherosclerosis(J Kor Soc Endocrinol 15:272-285, 2000).

고칼슘혈증의 빈도 및 원인 (1) : 입원환자를 대상으로

이인규,김경례,조성래,박근용,여준기,박정모,변호영,허정욱 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.1

To evaluate the incidence and causes of hypercalcemia in a hospital po;ulation in korea, all 7332 patients in the Dong San Medical Center hospital between June and December 1992 were evaluted for plasma calcium and plasma phosphate, albumin. We defined hypercalcemia as plasma calcium concentration above 2.40 mmol/L adjusted for albumin. Plasma calcium above 2.40 mmol;L was found in 192 (2.6%). The main causes of hypercalcemia were malignancy (30.3%), immobilization (26.9%), diuretics(thaizide) (10.9%), chronic renal failure(9.2%), and primary hyperparathyroidism(3.4%). The remainders were unknown carses(73 patients). In malignancy as a cause of hypercalcemia, lung cancer was the most common(27.7%). We concluded that malignancy is the most common cause of hypercalcemia and the primary hyperparathyroidism is relatively uncommon in admitted patients.(J Kor Soc Endocrino 8:72~77, 1993)

신증후출혈열 회복 후 발생한 뇌하수체 기능 저하증 1례

김민수,신동우,김성종,이상수,여준기,박근용,서상혁,곽진호 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.1

신증후출혈열 이완시 출혈성 합병증은 어느 장기에서나 발생할 수 있으며 특히 부검시 뇌하수체 전엽의 선택적 울혈, 출혈 및 응고성 괴사(coagulation necrosis)는 거의 전 예에서 관찰된다. 하지만 실제로 이 질환의 생존예에서 질병의 경과중이나 그 후유증으로 뇌하수체 기능 저하증을 보인 문헌적 고찰은 드문편이다. 이에 저자들은 신증후출혈열의 회복 후 발생한 뇌하수체 기능저하증1례를 경험하였기에 보고하는 바이다. Hemorrhagic fever with renal syndrome is acute viral disease caused by Hantaan virus, its clinical features are high fever, hypotension, bleeding tendency and renal failure. In the autopsy finding of hemorrhagic fever with renal syndrome, almost all patients shows coagulation necrosis of anterior pituitary gland which is known as one of the most characteristic microscopic finding but there has been rare reports of panhypopituitarysm in living patients with hemorrhagic fever with renal syndrome. Recently we have experienced one case of panhypopituitarysm patient. He was admitted our hospital under the impression of hemorrhagic fever with renal syndrome and had managed 17 years ago. After discharge he recognized general weakness, axillary and pubic hair loss but he didn't have any evalutation or treatment. 17 years later, he visited our hospital this time due to severe general weakness and febrile sensation. In patients serum, we could find high titer of antibody against Hantaan virus. The patient was confirmed as panhypopituitarysm by combined anterior pituitary function test. There was no evidence of other hypothalamic or pituitary disease by several test including sella MRI. After hormonal substitution therapy with prednisolone and thyroid hormone was started, clinical picture became normalized. We conclude that hemorrhagic fever with renal syndrome can be a cause of panhypopituitarysm and high index of suspicion should be maintained to detect hypopituitarysm in patient with past history of hemorrhagic fever with renal syndrome when appropriate symptoms and signs are present.

단일 갑상선 결절에 대한 갑상선 호르몬 투여 효과에 대하여

한승범,우성구,이인규,박근용,박정모,여준기 대한내분비학회 1992 Endocrinology and metabolism Vol.7 No.1

To evaluate the efficacy of thyroid hormone suppressive therpy and the hormonal characteristics during suppressive therapy for solitary thyroid nodule, we measured plasma T3, T4, TSH concentration and thyroid volume by high-resolution ultrasonography in 42 patients with benign solitary nodule proved by fine-needle aspiration biopsy before and after treatment. After suppressive therapy, TSH stimulation testing was done. Forty-two patients were randomized to receive the comthyroid treatment (group A, n=24) or a placebo (group B, n=18). The duration of therapy was between 3 and 6 months. The results were as follows: 1) The clinical characteristics showed no significant differences between group A and group B. 2) Forty-two patients had 131I scintiscans. Two patients as functional nodule, 10 patients as hypofunctional nodule, 30 patients as nonfunctional nodule. 3) After thyroid hormone suppressive therapy, plasma TSH concentrations were lower in group A (1.7±0.8 uU/ml) than in those of group B (7.0±3.8 uU/ml) as own by the TRH stimulation test (p$lt;0.0001). 4) Before and after treatment, the maximal dimension and volume of the thyroid nodules showed no significant differences between group A and group B (p$gt;0.05). After treatment, there were significant decrement in those of group A (p$lt;0.05) and only the maximal dimension in group B (p$lt;0.05). Therefore we concluded that the efficacy of thyroid hormone suppressive therapy in reducing the size of solitary thyroid nodules is not apparent sithin 3 to 6 months, despite effective suppression of thyrotropin. (J Kor Soc Endocrinol 7:39~45, 1992)