본태성 고혈압에서의 혈중 Atrial Natriuretic Peptide 농도와 Renin - Aldosterone 계의 상관관계에 대한 연구

신현호(Hyun Ho Shin),박원근(Won Kun Park),한인권(In Kwon Han),김은주(Eun Joo Kim),김선우(Sun Woo Kim),송정상(Jung Sang Song),배종하(Jong Hoa Bae),최영길(Young Kil Choi) 대한내과학회 1987 대한내과학회지 Vol.32 No.6

N/A Atrial Natriuretic Peptide (ANP) has been shown to posseses a variety of important biologic activities, in- cluding natriuresis, relaxation of vascular smooth muscle, and reduction in aldosterone secretion. This raises the possibility that ANP may play a part in the regulation of volume homeostasis and may be involved in the pathogenesis of essential hypertension. We investigated the relationship of ANP and reninaldosterone system in 12 normal subjects and 24 patients with essential hypertension. The results were as follows; 1) Plasma levels of ANP in patients with essential hypertension were significantly higher than in normotensive controls (131.1±21.7pg/ml VS 102.3±17.4 pg/ml). 2) There were no significant difference in plasma renin activity or aldosterone levels between normotensive and hypertensive subjects. 3) The patients with low renin essential hypertension had a tendency of increased ANP concentration, compared with high renin hypertension patients. 4) Plasma levels of ANP were positively and significantly correlated with blood pressure (Systolic r=0.38, p<0.05; diastolic r=0.49, p<0.005). These results suggests that increased secretion of ANP in essential hypertension may be a compensatory response to a diminished capacity for sodium excretion.

흰쥐에서 난소제거술로 유발시킨 골다공증에 유효한 기능성성분을 배합한 P 식이의 효능

서지혜(Ji He Seo),임병우(Beong Ou Lim),강순아(Sun A Kang),한인권(In Kwon Han),박동기(Dong Ki Park) 대한폐경학회 2002 대한폐경학회지 Vol.8 No.1

N/A The aim of this investigation was to examine the effects of serum alkaline phosphatase, phosphorous, calcium and bone mineral density in P diet on osteoporosis induced by ovariectomy in rats. Female Sprague-Dawely 20 rats of weighting 249±29g, were divided into four groups including the sham operation groups (5 heads) and ovariectomy groups (15 heads). They were fed low calcium diets for 4 weeks after experimental operation and 12 more weeks. The experimental group received a daily administration of P diet for 4 and 8 weeks after oophorectomy. Therefore, we measured levels of calcium, alkaline phophatase (ALP), phosphorous, trabecular density of tibia, ash weights in tibia and femur. The level of serum ALP of P diet was showed a significant decrease in comparison with sham group. Calcium and phosphorous were almost not changed between three groups. The weight of tibia and femur of P diet was increased in comparison with sham group in 8 week after oophorectomy. The trabecular bone density in ovariectomy group showed significant decrease in comparison with sham. Those in P diet-treated showed significant increase in comparison with sham after oophorectomy. Accordingly to the above results, effects of the P diet on the rat osteoporosis showed a efficiency in elevation of bone density by increasing bone weight by ovariectomy. So P diet can be used for preventing and curing of the postmenopausal osteoporosis, as for it's effects, continuous clinical study is needed.

갱년기 골다공증 환자의 HRT와 Alendronate 1년 병합치료 효과

오한진(Han Jin Oh),임창훈(Chang Hun Lim),정호연(Ho Yeon Chung),한기옥(Ki Ok Han),장학철(Hak Chul Jang),윤현규(Hyun Koo Yoon),한인권(In Kwon Han) 대한폐경학회 2000 대한폐경학회지 Vol.6 No.1

N/A Background; Rate of bone loss should be increased after menopause and then formation coupled with resoprtion also be increased. Alendronate (Fosamax ;MSD, Rahway, NJ, USA), an antiresorptive drug known to be helpful to prevent bone loss. Alendronate is one of antiresorptive drug for treatment of osteoporosis and resulted in a decrease of bone turnover, There are no available data about Korean people, So, we wanted to determine the effects of alendronate in Korean postmenopausal osteoporosis patients after 1- year treatment Subjects and Methods; We studied 42 women with postmenopausal osteoporosis (bone mineral density[BMD] T score<2.5) who visited osteoporosis clinic in Samsung Cheil Hospital from Jan. 1999 to Apr. 2000, Subjects were stratified in 2 groups. Group 1 treated with alendronate 10mg/day and estrogen, and Group 2 treated with estrogen alone. BMD at the lumbar spine were measured at baseline and 1-year after treatment. We also measured serum marker of bone formation (total alkaline phosphatase[Alk]), and marker of bone resorption (deoxypyridinoline [DPYD]) from urine at baseline, 3months and I-year after treatment. Results; The mean differences in changes of markers after 3 months and 1 year of treatment were remarked significantly (3-Month; delta Alk:-28,7±3.6%, delta DPYD:-31.0±5,4% vs 1-Year; delta Alk:-32.2±3.1%, delta DPYD:-23.0±3.5%). Markers of bone metabolism showed no significant responses between two groups at 3 months and 1year after treatment, Also, Bone mineral density at lumbar spine was significantly increased in Group treated with alendronatc and estrogen than estrogen only group (9.6±0,7% vs 5.3±0.6%, P<0,001). Conclusion; Our data showed that using alendronate with estrogen to the patients of Korean women with osteoporosis increase bone mineral density more, So, we concluded that alendronate therapy with estrogen was helpful to manage postmenopausal osteoporosis patients.

NIDDM 환자에서 혈당조절 전후의 Nitrogen Balance 와 IGF - I 변화에 관한 연구

최웅환(Woong Hwan Choi),박원근(Won Kun Park),신현호(Hyun Ho Shin),한인권(In Kwon Han),김은주,김선우(Sun Woo Kim),최영길(Young Kil Choi) 대한내과학회 1987 대한내과학회지 Vol.34 No.1

N/A We studied the effect of blood sugar control in patients with NIDDM on the IGF-I level and nitrogen balance as a metabolic index. The result as follows 1) There was no difference in IGF-I level between patients with NIDDM and normal control group. (222±60ng/ml vs 221±49ng/ml, p>0.1) 2) There was a statistically significant increment in IGF-I level in the NIDDM patients who improved to positive nitrogen balance from negative nitrogen balance. (217±55ng/ml vs 285±44ng/ml, p<0.05) 3) IGF-I level was not increased in patients who did not improve to positive nitrogen balance after suger control and the patient who was prositive nitrogen blance initially. (231±63ng/m1 vs 190±52ng/ml, p>0.1) 4) IGF-I level was not increased in spite of improved nitrogen balance after sugar control in patients with under body weight. (221±68ng/ml vs 213±42ng/ml, p>0.1) These reult sugested that mornitoring of serum IGF-I level in NIDDM patients is useful marker which represent metabolic compensation with treatment of diabetes.

정상 임신후반기 IGF - I / SMC 와 신생아 성장에 관한 연구

최웅환(Woong Hwan Choi),박원근(Won Kun Park),신현호(Hyun Ho Shin),한인권(In Kwon Han),김선우(Sun Woo Kim),최영길(Young Kil Choi) 대한내과학회 1988 대한내과학회지 Vol.34 No.2

N/A The polypeptide hormones of the somatemedin (SM) family have been proposed to promote growth both in pre and postnatally. The two main farm of samatomedin in serum of adults are insulin-like growth factor 1, also termed SMC and IGF-II. IGF-I activity raises in the late pegnancy, which suggest a potential effect on fetal development. The aim of the present study was to determine maternal IGF-I and placenta IGF-I levels in 12 womens with late pregnancy end evaluate the relationship of these level to the growth percentile of their infant. The result were as follow: 1) plasma levels of IGF-I/SMC in late pregnancy were signficantly higher than age mached control. (337±127ng/ml VS 232±15ng/ml, p<0.005). 2) The maternal levels of IGF-I/SMC (337±127ng/ml) were significantly greater than those in the paired newborn cord artery (84±40ng/ml) or cord vein (100±46ng/ml). 3) The maternal levels of IGF-I/SMC were not correlated with cord vein IGF-I/SMC r=18 and cord artery IGF-I/SMC r=0.16 (p>0.05). 4) The cord vein IGF-I/SMC levels were positively correlated with cord artery IGF-I/SMC levels r=0.76 (p<0.005). 5) There was an increase in the percentile of birth weight and length with increasing maternal serum 1GF-1/SMC levels. The corresponding correlation coefficients in weight and length percentile with maternal serum IGF-l/SMC were 0.44 (p<0.005) and 0.65 (p<0.005), respectively. These result suggest that increased IGF-I/SMC levels in late pregnancy may causally be related to intrauterine fetal growth.

폐경후 여성에서 경피적 에스트라디올 겔과 경구영 프로게스테론 주기적 병합요법의 임상적 유효성에 관한 연구

정호연 ( Ho Yeon Chung ),최규홍 ( Kyu Hong Choi ),이창욱 ( Chang Uk Lee ),김해성 ( Hae Sung Kim ),임창훈 ( Chang Hoon Yim ),한기옥 ( Ki Ok Han ),장학철 ( Hak Chul Jang ),윤현구 ( Hyun Koo Yoon ),한인권 ( In Kwon Han ) 대한폐경학회 2001 대한폐경학회지 Vol.7 No.1

N/A Objectives: The purpose of our study was to evaluate the effects of transdermal 17β -estradiol gel combined with oral progestogen in terms of serum lipid, bone markers and bone mineral density in Korean postmenopausal women Subjects and methods: Nine healthy postmenopausal women were asked to volunteer for pharmacokinetic analysis of estradiol gel. Subjects received daily application of 1.5 ㎎ of estrogen gel in the morning. Peripheral venous samples were drawn at 0, 0.5, 1, 2, 4, 8, 24, 48, 72 hours after the daily gel application and serum E2 levels were analyzed. 41 postmenopausal women with intact uterus and no menstruation for more than 12 months were treated with 1.5 ㎎ of estradiol gel (day 1-25) sequentially combined with 2.5㎎ of medroxyprogesterone acetate (day 16-25) orally for 1 year. Results: Although one volunteer showed increment of serum E2 one hour after application of estrogen gel, pharmacokinetic study showed increase of serum E2 after 24 hours in the most volunteers. The mean serum E2 level at 72 hour after application was 59.6±58.8 pg/㎖. The acceptability of the combined treatment was 73.2%. Only 1 (3.3%) woman complained skin irritation during treatment. The combined estradiol gel and oral progestogen therapy significantly decreased serum cholesterol levels by 7.8%, LDL by 8.5%. Markers of bone turnover significantly decreased 3 months after treatment. The increase of the annual percent change in bone density was 4.8% at the lumbar spine and 4.4% at the femoral neck. Conclusion: The combined estradiol gel with oral progestogen therapy is acceptable and effective treatment in postmenopausal women.

Type 2 DM 환자에서 적혈구를 이용한 인슐린 내재화율과 Degradation Products 에 관한 연구

최웅환(Woong Hwan Choi),박원근(Won Kun Park),한인권(In Kwon Han),김선우(Sun Woo Kim),정운원(Woon Won Jung),문인걸(In Gul Moon) 대한내과학회 1988 대한내과학회지 Vol.34 No.3

N/A We studied insulin internalization and degradation at 37℃ in human erythrocytes from patients with type II DM and normal subjects. The internalization of 125I-Insulin in human erythrocytes was studied by using an acid extraction technique (pH 5.7, PBS) from 54 patients with type II DM and 14 normal subjects. Insulin degradation products was assayed with using Sephadex G-50 column, HPLC with radioisotope detector from 4 patients with type II DM and 14 normal subjects. The maximal rate of insulin internalization (Incubation time: 4hours, at 37℃) was decreased in patients with type II DM [51.40±14.67% (±SD) VS 80.23±7.73 % (±SD). P<0.001]. The maximal degradation products of insulin (Incubation time: 4hours, at 37℃) was decreased in patients with type II DM [62.50±10.50% (±SD) VS 87.75±6.66% (SD). p<0.001]. In conclusion, insulin internalization and degradation in human eryhrocytes from patients with type II DM are significantly reduced. These defect may be related to the cellular insulin resistance present in these patients.

영양막 질환 환장에서의 혈청 β - HCG 치 및 24 시간 소변의 HCG 양과 갑상선 기능과의 관계

김용태(Yong Tae Kim),조진아(Jin A Cho),박찬문(Chan Mun Park),이선화(Sun Hwa Lee),정호연(Ho Yeon Chung),한인권(In Kwon Han),민현기(Hun Ki Min) 대한내과학회 1996 대한내과학회지 Vol.51 No.2

N/A Objectives: It has been recognized that hyperthyroidism occur in patients with trophoblastic disease, either hydatidiform moles or choriocarcinoma. Recently, several lines of evidence have shown that human chorionic gonadotropin, secreted by the trophoblastic disease, is a thyroid stimulator and cause hyperthyroidism. The study was undertaken to evaluate the incidence of hyperthyoidism in patients with trophoblastic disease and relationship between level of thyroid hormone and human chorionic gonadotropin. Methods: In 51 patients with hydatidiform mole and 13 patients with choriocarcinoma, we measured level of thyroid hormone, serum β -HCG and amount of urinary excretion of HCG. Results: 1) Hyperthyroidism was observed in 19.6% of the patients with hydatidiform mole and in 7,6% of the patients with choriocarcinoma. 2) The level of serum β -HCG and the amount of 24 hour urinary excretion of HCG in patients with hyperthyroidism were more than that in euthyroid patients, 3) The amount of 24 hour urinary excretion of HCG in patients with hydatidiform mole was more than that in choriocarcinoma patients. 4) The level of serum β -HCG and the amount of 24 hour urinary excretion of HCG had significant correlation with serum T3 and T4 levels, but, the level of serum β -HCG had beteer correlation. Conclusion: The occurrence of hyperthyroidism is more frequent in patients with trophoblastic disease, and the degree of thyroid function is related with the level of serum B -HCG and urinary excretion of HCG, but, more closely related with serum β -HCG level.

인슐린 농도 변화에 따른 인슐린 내재화 ( Internalization ) 와 Degradation 의 변화

박원근(Won Kun Park),최웅환(Woong Hwan Choi),한인권(In Kwon Han),김선우(Sun Woo Kim),정운원(Woon Won Jung),문인걸(In Gul Moon) 대한내과학회 1988 대한내과학회지 Vol.34 No.4

N/A This study was conducted to investigate the effect of ambient concentration of insulin on insulin internalization and degradation in human erythrocytes. The absolute amount of internalized insulin was quantitated by multiplying the concentration of insulin by the percent specifically bound and internalized (by acid extraction method, PBS, pH 5.7) at the various insulin concentration (1.4, 2.5, 12.4, 112.4 ng/m1). The insulin degradation products (IDP) was assayed by using Sephadex G-50 column, HPLC with radioisotope detector in human erythrocytes which were incubated (37℃) at the various insulin concentration (1.43, 2.76, 14.76, 26.60ng/ml). Insulin internalization (ng/ml) increased in human erythrocytes with increasing concentration of insulin (3hr incubation time, 0.336 at 1.4, 0.275, at 2,5, 3.844 at 12.4, and 24.728ng/ml at 112.4ng/ml, 4hr incubation time, 0. 476, at 1.4, 0.925 at 2.5, 4.712 at 12.4 and 38.216ng/ml at 112.4ng/ml). Insulin degradation products (%) increased (2hr incubation time, 20.9 at 1,43; 38.0 at 2.76 and 38.0% at 14.76ng/ml) but no more than at a level of insulin concentration (2.76ng/ml) in normal human erythrocytes. In diabetic human erythrocytes, insulin degradation products (%) also increased (3br incubation time, 14.1 at 1.43, 19.0 at 2,76, 23.0 at 14.76, and 23.2% at 26.60ng/ml, 4hr incubation time, 39.4 at 1.43, 46.9 at ~2.76, 52. S at 14.76 and 53.0% at 26.60ng/ml) but no more than at a level of insulin concentration (14.76ng/ml), This result indicated that the ambient concentration of insulin may play an important role in the regulation of intracellular processing of insulin.

정상 및 임신성 당뇨병 임신부의 임신 중 체중 증가량와 신생아 체중

김문영(Moon Young Kim),양재혁(Jae Hyug Yang),장학철(Hak Chul Jang),박정은(Jung Eun Park),임창훈(Chang Hoon Yim),정호연(Ho Yeun Chung),한기옥(Ki Ok Han),윤현구(Hyun Koo Yoon),한인권(In Kwon Han),김미정(Mi Jeong Kim),한혜경(Hye Kyung H 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

N/A Objective : The purpose of this study was to determine the independent factors that predict neonatal birthweight and find the relationship between maternal weight gain and neonatal birthweight in women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). Methods : Forty-six women with GDM and one hundred fifty women with NGT were included in the study. All subjects had singleton pregnancies and no medical diseases that may affect the fetal growth and were certain of gestational age by early ultrasonography. Maternal weight at each prenatal visit was recorded and neonatal anthropometic measurement was done within 2 days of birth. Results : The average rate of weight gain (kg/week) in NGT was lowest during the first trimester (0.09±0.10), peaked during the second trimester (0.52±0.14), and slowed after 34 gestational weeks (0.46±0.26). In women with GDM, the average rate of weight gain was also lowest during the first trimester (0.18±0.23), but it was twofold higher compared with women with NGT. There was a significant decrease of the rate of weight gain after 28 gestational weeks in women with GDM. Total weight gain during pregnancy was 3.4 kg less in women with GDM. Neonatal birthweight was correlated with maternal weight gain and the rate of weight gain during 14-27 and 28-33 weeks in NGT. However, birthweight was correlated with maternal weight gain and the rate of weight gain during the first trimester and 14-27 weeks in GDM. Conclusion : This result suggests that the women with GDM who have greater weight gain during the first and the second trimester have a increased risk of excessive fetal growth. Thus strict glycemic control during pregnancy is needed especially in these women.