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송영기

박혜영

김철희

강문호

박중열

이기영

Hoseo University

김기수

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서찬종

이기업

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Korea Forest Service

Seoul National University Hospital

Pusan National University

Memorial Sloan Kettering Cancer Center

Kangbuk Samsung Hospital

San Diego State University

University of California, Berkeley

Dong-Eui University

Moores Cancer Center

Regenerative Medicine Institute

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원저 : 비알콜성 지방간과 대사성 질환들과의 연관성

Endocrinology and Metabolism (2002)

김홍규 서찬종 윤효중 황용하 이기영

연구배경: 비알콜성 지방간은 일반적으로 비만, 제 2형 당뇨병 및 고지혈증과 연관성이 있는 것으로 알려져 있으나, 인슐린 저항성과의 독립적인 연관성여부나, 대사 증후군과의 연관성에 관해서는 아직 연구가 많지 않다. 한편, 최근 건강검진센터를 중심으로, 초음파를 이용한 지방간의 진단이 흔하게 되었는데, 이런 대상에서의 지방간의 임상적인 의미에 대해서는 잘 알려져 있지 않았다. 따라서, 본 연구에서는 초음파로 진단된 비알콜성 지방간과 비만, 당대사이상, 이

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부신피질 기능저하증에서 저용량 및 고용량 ACTH 자극검사의 진단적 가치

Endocrinology and Metabolism (1997)

김철희 김기수 김홍규 박중열 송영기

Background: Rapid adrenocorticotropin(ACTH) stimulation test using 250ug of ACTH(1-24) has been used as a standard test in the initial assessment of adrenal function. However, it has recently been suggested that a rnaximal cortisol response can be achieved with a much lower ACTH dose, and reducing the dose might further enhance the sensitivity of the test in the detection of mild adrenal insufficiency. This study was performed to evaluate the role of low-dose(lug) ACTH stimulation test in the assessment of adrenal function and the diagnosis of subtle adrenal insufficiency. Methods: Twenty-two subjects with suspected adrenal insufficiency due to long-term corticosteroid use were included in this study. The correlations between clinical features and the serum cortisol responses to low dose(lug) and high dose(250 ug) ACTH stimulation were evaluated. Results: In high dose test, 10(67%) out of 15 subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response(peak cortisol level 18ug/dL). On the other hand, 14(93%) subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response in low dose test, while only one showed normal response. In 7 subjects without clinical features of adrenal insufficiency, 5 subject(71%) showed normal response, and 2 subjects(29%) showed decreased response in both low- and high dose tests. Conclusion: These results suggest that the 1-ug low dose ACTH stimulation test might be more sensitive than conventional 250-ug test in the detection of mild adrenal insufficiency. Further studies are needed to determine the optimal dose of ACTH and the criteria for normal response to ACTH stimulation. (J Kor Soc Endocrinol 12:222-229, 1997)

ACTH stimulation test

Adrenal function

Primary Adrenal Insufficiency

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한국인의 갑상선 자극호르몬 분비 뇌하수체선종

Endocrinology and Metabolism (1997)

김철희 김기수 김홍규 박중열 송영기

Background: Thyrotropin-secreting pituitary adenoma is an uncommon disease and about 150 cases has been reported in the world literature. In Korea, only seven cases were reported as yet. The authors recently experienced four cases of TSH secreting pituitary tumor and analyzed the clinical characteristics and treatment outcomes of TSH-secreting tumors in Korean. Methods: We analyzed clinical records of the four cases who had been recently treated at Asan Medical Center and the Korean literature which deals with the previously reported seven cases of TSH-secreting pituitary tumor. Results: The average age at diagnosis was 37 years (ranging from 11 to 55 years). Four were men and seven were women. After the detection of hyperthyroidism, TSH-secreting pituitary adenoma was diagnosed 3.6 years later on the average. Ten patients presented with hyperthyroidism, but one had primary hypothyroidism. Typical features of acromegaly were observed in two patients. Visual disturbance was present in three cases, and galactorrhea was present in one case. Serum TSH concentrations ranged from 1.5 to 42.5uIU/mL showing mildly elevated or unsup-pressed TSH levels despite of elevated serum thyroid hormone concentrations. Among six cases in whom a-subunit level was measured, five showed elevated a-subunit level and a-subunit/TSH molar ratio. Two of 11 cases had microadenoma and the remainder had macroadeno#ma. Immunohisto- cheical studies were done in eight cases and revealed that three were positive for TSH only and five patients were positive for multiple hormones. Eight patients underwent transsphenoidal pituitary surgery and seven(88%) of them were cured. External irradiation or octreotide was used as adjunctive treatment in three cases. After treatment, TSH levels decreased in all six patients studied, hyperthyroidism was eliminated in all eight patients studied and visual disturbance was improved in two patients. Conclusion: Clinical characteristics of TSH-secreting pituitary adenoma in Koreans were similar with world literature, but were more common in women, had less visual disturbance and better surgical results. Diagnosis was commonly delayed for several years. TSH-secreting pituitary adenoma may be diagnosed more frequently and earlier with widespread use of sensitive TSH assay and early and proper diagnosis would lead proper treatments with improved outcome. (J Kor Soc Endocrinol 12:165-175, 1997)

Galactorrhea

Pituitary Tumors

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원저 : 유리지방산이 배양된 백서 췌장소도에서 인슐린 분비에 미치는 영향

Diabetes and Metabolism Journal (DMJ) (1997)

김홍규 김영일 김철희 박중열 홍성관

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갑상선 호르몬이 사람 골수기질세포에서 interleukin-6 및 intereukin-11 생성에 미치는 영향

Endocrinology and Metabolism (1997)

김철희 김동관 김홍규 송영기 김기수

Background: It is well known that excessive thyroid hormone in the body is associated with bone loss. However, the mechanism by which thyroid hormone affects bone cell metabolism remains unclear. It has been shown that thyroid hormones stimulate osteoclastic bone resorption indirectly via some unknown mediators secreted by osteoblasts, This study was undertaken to determine if interleukin-6(IL-6) or interleukin-11(IL-l1) could be the mediator(s) of thyroid hormone-induced bone loss. Methods: We treated primary cultured human bone rnarrow stromal cells with 3,5,3- triiodo- thyronine(T) and measured basal and interleukin-l(IL-1)-stimulated IL-6/IL-ll production. We also investigated the possible modulating effect of 17B-estradiol(17B-E2.) on thyroid hormone action. Results: T3 at 10(-12) ~ 10(-8) M concentration, significantly increased the basal IL-6 production in a dose-dependent manner, and also potentiated the stimulatory effect of IL-1 on IL-6 production. However, T failed to elicit a detectable effect on basal or IL-1-stimulated IL-11 production. Treat#ment with l7B-E2. inhibited IL-1-stimulated IL-6 production, but the effects of T3 on IL-6 production were not affected by 17/B-E. Conclusion: These results suggest that thyroid hormone may increase bone resorption by increasing basal IL-6 production and potentiating IL-1-induced IL-6 production from osteoblast- lineage cells, and these effects were independent of estrogen status. (J Korean Soc Endocrinol 12:557-564, 1997)

Bone remodeling

Basal (medicine)

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Recurrence of Subacute Thyroiditis: Report of Two Cases

Endocrinology and Metabolism (2002)

윤효중 황용하 이기영 김홍규 박혜영

Subacute thyroiditis

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갑상선 질환의 기왕력이 없는 성인에서 갑상선 초음파 선별검사로 발견된 갑상선 결절의 유병률

석지혜 Tae-Yong Kim 김미경 김원배 김홍규

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제13차 대한당뇨병학회 춘계학술대회 (제24권 부록2호) : 포스터 구연 : 12. 폐경후 제2형 당뇨병 여성 환자에서 에스트로겐의 혈관에 대한 효과

대한당뇨병학회 학술발표논문집 (2000)

강문호 서찬종 김홍규 박혜영 황희영

당뇨병 여성 환자는 비당뇨병 여성 환자에 비해 심혈관 위험이 매우 높다. 또한 에스트로겐 투여가 폐경후 여성에서 심혈관 위험을 감소시킨다. 본 연구는 폐경후 당뇨병 여성 환자에서 혈관내피기능 검사와 지질검사 및 혈액 응고 검사 등을 통하여 에스트로겐의 심혈관 위험에 대한 효과를 알아보고자 하였다. 20명의 폐경후 당뇨병 여성 환자를 대상으로 이중 맹검 무작위 방법으로 위약과 에스트로겐을 교차로 각각 8주간 투여하였다. 고혈압, 흡연, 최근 2개월 사이에 지질저하제나 에스트로겐 및 항산화 비타민제 복용 자는 제외하였고, 비스테로이드성 항소염제 약물은 검사 최소 2주전에는 중단하였다, 혈관 검사는 10MHz linear-array transducer가 있는 ATL HDI 3000 초음파 기계를 이용하여 우측 상완동맥에서 시행하였고, 혈관내피 의존성 혈관이완 기능은 반사성 충혈을, 혈관내피 비의존성 혈관이완 기능은 니트로글리세린 설하제를 이용하여 측정하였다. 위약과 비교하여 에스트로겐은 LDL 콜레스테롤을 유의하게 감소시키고(15±23%, P=0.007), HDL 콜레스테롤은 증가시켰다(8±16%, P=0.034). 중성지방은 16±48% 증가시켰으나 통계적인 의의는 없었다(P=0.295). 반사성 충혈에 대한 혈류 매개성 혈관 이완은 위약보다 16±48% 증가시켰으나 통계적인 의의는 없었다(P=0.295). E-selectin, ICAM-1, and VCAM-1, MCP-I, 및 MMP-9 치는 차이가 없었고, 조직인자 활성도는 통계적인 의의는 없었으나 5±34% 증가 경향을 보였다(P=0.117). 혈장 PAI-1 치는 16±31% 감소하였다 (P=0.043). 결론적으로 폐경후 당뇨병 여성 환자에서 에스트로겐 투여는 혈중 콜레스테롤에 대한 유익한 효과는 있었으나, 혈관 내피 기능과 혈전 기능에 대한 유익한 효과는 뚜렷하지 않았다.

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원저 : 제2형 당뇨병 환자에서 Rosiglitazone 사용 전후 체지방의 양 및 분포의 변화

Diabetes and Metabolism Journal (DMJ) (2003)

김홍규 윤효중 유승민 이기영 박혜영

연구배경: Rosiglitazone이 총체지방량을 증가시키는지 알아보고, 체지방의 변화 및 체성분의 변화가 신체 부위에 따라 차이가 있는지를 알아보고자 본 연구를 실시하였다. 또한, rosiglitazone사용 후에 troglitazone사용에서 처럼 복강내지방 및 피하지방에 다른 영향을 주는지도 확인해 보고자 하였다. 방법: 가천의대 길병원 내분비내과 외래에서 진료를 받고 있는 제2형 당뇨병 환자 중, 현재의 치료로 혈당조절이 만족스럽지 않은 환자 2

Rosiglitazone

Troglitazone

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