Non-functional Pituitary Adenoma Detected on 18F-fluorodeoxyglucose Positron Emission Tomography (18F-FDG-PET) in a Patient with Mucosa-associated Lymphoid Tissue Lymphoma

Magnetic resonance imaging (MRI) is the modality of choice for the detection and characterization of a pituitary adenoma. Uptake of 18F-fluorodeoxyglucose (FDG) by intrasellar tumors, including pituitary adenomas, has been reported in several previous studies. We report a case where a pituitary adenoma was detected on FDG-positron emission tomography(PET), but the tumor was not detected with the use of sellar MRI. A 31-year-old woman was referred to the clinic due to a focal increase of FDG uptake at the pituitary fossa seen on whole body FDG-PET. The patient was receiving chemotherapy due to a recurred B-cell lymphoma of the mucosa-associated lymphoid tissue type. Subsequently, sellar MRI was performed, and images showed a small non-enhancing heterogenous cystic lesion in the midline of the pituitary gland, radiologically suggestive of a Rathke`s cleft cyst. However, sellar MRI failed to identify a lesion consistent with a pituitary tumor that corresponded to the site of increased FDG uptake detected by the use of PET, despite the inclusion of a dynamic contrast enhanced sequence. Despite the negative findings of the MRI examination, basal and stimulated levels of the GnRH free α-subunit were profoundly increased. Therefore, we suspected the presence of a non-functional pituitary tumor in addition to a Rathke`s cleft cyst, rather than pituitary involvement of a lymphoma, based on the hormone levels and PET scan findings.ope

Clinical Meaning of Postprandial Insulin Secretory Function in Korean Type 2 Diabetes Mellitus

Background: Impaired pancreatic beta-cell responsiveness is associated with type 2 diabetes mellitus. Postprandial insulin deficiency is closely related with fasting plasma glucose, HbA1c and insulin responses to meals, but most studies examining postprandial beta-cell responsiveness have been limited by the small number of type 2 diabetic patients examined. The aim of this study was to evaluate fasting and postprandial insulin secretions in relation to the duration of diabetes, BMI and glycemic control in a large number of patients with variable disease durations. Methods: We evaluated the fasting plasma glucose, insulin, C-peptide, HbA1c, BMI, postprandial 2 hour glucose, insulin and C-peptide in 1,170(male 662, female 508, age 54.6+/-1.6 years, duration of diabetes 5.2+/-6.3 years, BMI 25.4+/-3.3kg/m(2)) type 2 diabetic patients. The delta C-peptide, delta insulin, fasting(M0) and postprandial(M1) pancreatic beta-cell responsiveness were also calculated. The subjects were divided into three groups according to their duration of diabetes, BMI, and fasting and postprandial C-peptide levels. After adjusting for age, sex and BMI, the correlation of diabetes and HbA1c were correlated parameters. Results: In the group of patients whose duration of diabetes was longer than 10 years, the BMI, fasting, postprandial and delta C-peptide, and M0 and M1 were significantly lower, but age, fasting and postprandial glucose, as well as HbA1c were significantly higher than those in the other groups. There were no significant differences in the fasting and postprandial glucose and HbA1c according to their fasting C-peptide tertiles. However, in the group of patients with the highest postprandial C-peptide tertile, the fasting and postprandial glucose and HbA1c were significantly lower than those in the other groups. The duration of diabetes, after adjustment of age, sex and BMI, was negatively correlated with the fasting, postprandial and delta C-peptide, M0 and M1, but was positively correlated with the fasting and postprandial 2 hour glucose and HbA1c. The HbA1c after adjustment of age, sex and BMI, was positively correlated with duration of diabetes, and fasting and postprandial glucose, but was negatively correlated with fasting postprandial and delta C-peptide, M0 and M1. Conclusion: Although the fasting and postprandial insulin secretions were decreased with duration of diabetes, the decrease in the postprandial insulin secretion was more prominent. The postprandial pancreatic responsiveness may be a more important factor in predicting glycemic control in Korean type 2 diabetic patients than the fasting pancreatic responsiveness.ope

Balsamic Vinegar Improves High Fat-Induced Beta Cell Dysfunction via Beta Cell ABCA1

BACKGROUND: The aim of this study was to investigate the effects of balsamic vinegar on β-cell dysfunction. METHODS: In this study, 28-week-old Otsuka Long-Evans Tokushima Fatty (OLETF) rats were fed a normal chow diet or a high-fat diet (HFD) and were provided with tap water or dilute balsamic vinegar for 4 weeks. Oral glucose tolerance tests and histopathological analyses were performed thereafter. RESULTS: In rats fed both the both chow diet and the HFD, the rats given balsamic vinegar showed increased insulin staining in islets compared with tap water administered rats. Balsamic vinegar administration also increased β-cell ATP-binding cassette transporter subfamily A member 1 (ABCA1) expression in islets and decreased cholesterol levels. CONCLUSION: These findings provide the first evidence for an anti-diabetic effect of balsamic vinegar through improvement of β-cell function via increasing β-cell ABCA1 expression.ope

A Case of Multiple Endocrine Neoplasia Type 1 with Mutation of MENIN Gene

Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominantly inherited syndrome, characterized by the combined occurrence of tumors of the parathyroid glands, endocrine pancreas, and anterior pituitary gland. The MENIN gene, which is a kind of tumor suppressor gene, is located at the chromosomal locus 11q13. It consists of one untranslated exon and nine exons encoding the menin protein. We report a case of a 22-yearss-old woman with MEN type 1, who was proven to have a mutation in the MENIN gene. The patient was admitted because of repeated hypoglycemia. The fasting plasma glucose level was 32 mg/dL. Seventy two hours fasting test showed an the insulin/glucose ratio as 0.33. Endoscopic ultrasonography detected multiple masses on the pancreas. The arterial-stimulated venous sampling (ASVS) with calcium showed sudden step up of insulin at the head and tail portions of the pancreas. The sellar MRI showed a pituitary mass that produced prolactin. Instead of a pathologic diagnosis from operational specimen, the genetic analysis revealed a mutation in the MENIN 1 gene (exon 2, 200~201insAGCCC).ope

Adiponectin Gene Polymorphism and Carotid Artery Intima-Media thickness in Type 2 Diabetes

Background: The aim of this study was to examine the association between the common polymorphisms of the adiponectin gene(ACDC) and the intima-media thickness(IMT) of the common carotid arteries in type 2 diabetic patients. Methods: The B mode ultrasound examination of carotid artery was performed on 133 type 2 diabetic patients. The carotid IMT was calculated using the Intimascope computer program. The SNP45 and SNP276 of the ACDC were examined. Results: There was no significant difference in the carotid IMT among the SNP45 genotypes(0.66+/-0.18mm for TT, 0.71+/-0.12mm for TG and 0.64+/-0.15mm for GG, P=NS). Subjects carrying the SNP276 GG genotype had a markedly lower serum adiponectin concentration than those carrying the TT genotype(3.35+/-2.00microgram/mL vs. 4.98+/-2.24microgram/mL, P=0.029) The carotid IMT was significantly higher in patients with the SNP276 GG genotype than those with the TT genotype (0.70+/-0.17mm vs. 0.59+/-0.13mm, P=0.032). Patients with the +45GG/+276GG genotype combination showed significantly higher mean carotid IMT than the other genotype combinations(0.78+/-0.09mm vs. 0.71+/-0.15mm, P=0.013) Conclusions: These results suggest that the adiponectin gene, SNP276 is associated with the carotid IMT in type 2 diabetic patients. Further studies are will be needed to confirm these genotypephenotype associations.ope

한국 청소년 차별경험이 건강에 미치는 영향

학위논문 (석사)-- 서울대학교 대학원 : 보건학과(보건정책관리학전공), 2011.8. 조병희.Maste

Effects of on&offline education program aimed at promoting father-infant interaction

학위논문 (박사) -- 서울대학교 대학원 : 간호대학 간호학과, 2021. 2. 방경숙.본 연구의 목적은 부아 상호작용 증진을 위한 영아 아버지를 위한 온 오프라인 교육 프로그램을 개발하고 그 효과를 검증하는 것이다. 블렌디 드 러닝 모형에 따라 프로그램을 개발하였다. 본 프로그램은 가정방문, 구두 및 서면 피드백, 온라인 강의, 가정방문, 구두 및 서면 피드백 단계 에 따라 매주 1회씩 5주간 총 5회기의 내용으로 구성되었다. 본 연구의 이론적 기틀은 Kathryn Barnard (1978)의 ‘아동건강가정 상호작용 이론’에서 돌봄제공자, 환경, 아동이 교차하는 상호작용 영역에 초점을 두고 있으며, 환경적 측면에서 교육 프로그램을 통해 사회적 자 원을 제공함으로써 돌봄제공자와 아동 영역에 사회적 지지를 제공하고, 결과지표로써 영아발달의 지식 증가와 부아상호작용, 부아애착의 증진을 확인하고자 했다. 개발된 프로그램의 효과를 평가하기 위해 비동등성 대조군 전후 설계 에 의한 유사실험연구를 수행하였다. 연구 대상자는 서울시 자치구 세 곳에 거주하면서 서울아기 건강 첫걸음 사업 보편방문에 참여했던 가정 의 영아기 자녀(생후 2～6개월)를 둔 아버지들 중에서 편의모집방법에 의해 선정된 실험군 18명과 대조군 18명이었고, 사후조사까지 완료한 최 종 연구참여자는 실험군 15명, 대조군 17명이었다. 실험군에게는 본 연구 에서 개발된 5주간의 부아 상호작용 증진 교육 온오프라인 교육 프로그 램을 적용하였다. 수집된 자료는 사전 동질성 확인 후 일반화 추정 방정 식 분석을 통해 가설을 검증하였고, 실험군을 대상으로 취합한 만족도 조사결과는 내용분석을 통해 정리하였다. 부아 상호작용 증진 온오프라인 교육 프로그램에 참여했던 실험군의 아버지와 대조군의 아버지의 프로그램 실시 전후 부아 상호작용 점수 변화량, 특히 돌봄제공자 측면의 점수변화량에는 유의미한 차이가 있었다 (p=.072). 그러나 영아발달지식, 부아애착은 그룹과 시간에 따른 변화량 이 통계적으로 유의하지 않았다. 본 프로그램을 통해 영아 아버지를 대상으로 한 부아 상호작용 증진 온오프라인 교육 프로그램이 아버지의 영아 신호에 대한 민감성을 높이고 인지발달을 촉진하는 환경을 조성할 수 있는 능력을 함양시킨다 는 점을 확인하였다. 본 연구를 통해 가정 내 돌봄제공자를 위한 돌봄의 질을 향상시키기 위한 교육의 일환으로 정확한 영아발달지식을 바탕으로 부아 상호작용을 개선해 나갈 수 있는 방안을 제시하였다. 온라인 교육 과 오프라인 교육을 안배하여 교육의 효과를 높이는 동시에 일과 양육을 병행하는 아버지들의 프로그램 참여를 독려하기 위하여 개별적인 스케쥴 을 허용하고, 개별적인 상담과 피드백이 이루어질 수 있도록 온라인 커 뮤니티와 전화상담을 활용하였다는 점에서 의의가 있다. 본 프로그램은 아버지뿐만 아니라 어머니, 조부모, 아이돌보미를 포함한 타인돌봄제공 자, 정상아, 질환 아동 등 각기 다른 상황의 대상에게 적용가능하다는 점 에서 폭넓게 활용이 가능할 것으로 보인다. 추후 아버지들의 직접 참여 의 기회를 확충하고, 토론 등을 통해 비슷한 처지의 아버지들 간 경험을 공유하는 프로그램의 보완 및 후속연구가 필요함을 제언하는 바이다.The purpose of this study was to develop an on·off-line education program for fathers of infants to enhance parental interaction and to verify the program's effectiveness. The program was composed of five sessions. The sessions were comprised of home visit, oral and written feedback, online lectures, home visit, and final oral and written feedback and all of them were done in the mentioned order. The theoretical framework of this study was focused on the interaction domain where the care provider, environment, and children interacted within Kathryn Barnard(1978)'s Child Health Family Interaction theory. Especially, from an environmental perspective, this research attempted to confrim the educational program provided social support for fathers of infants by figuring out whether the program increased the knowledge of infant development, father-infant interactions and attachment as outcome indicators. In order to evaluate the effect of the developed program, a quasi-experimental study was conducted by using a nonequivalent control group pre-post test design. The subjects of this study consisted of experimental groups and control groups where each group was composed of 18 people. They were selected by the convenience sampling method and they were fathers with infant children (2-6 months of age) residing in three autonomous districts of Seoul who participated in the universal visit as part of the Seoul Healthy First Step Project. The number of the final study participants who completed the follow-up investigation composed of 15 people in the experimental group and 17 people in the control group. To the experimental group the on·off-line father-infant interaction enhancement education program was applied. The collected data were hypothesized through the analysis of the generalized estimating equation(GEE) after confirmation of preliminary homogineity, and the results of the satisfaction surveys collected from the experimental group were organized through content analysis. There was a significant difference in the change of father-infant interaction scores of the experimental group, especially in the caregiver aspect (p=.075). However, the changes between the groups and times were not statistically significant when it came to infant development knowledge and infant-father attachment. Through this program, it was confirmed that father-infant interaction promoting education that targeted fathers of infants enhances the father's sensitivity to infant signals and fosters the ability to create an environment that promotes infants’ cognitive development. This study proposed possible strategies improving father-infant interactions by making sure that they have accurate knowledge regarding infant development so that the quality of care of the caregivers at home can be improved. This program is meaningful in that it did not only try to increase the effectiveness of education by using both on and off-line education, but also it tried to encourage working fathers to participate by taking into account of their schedules through individual counseling and feedback gathering by using the means of online community and phone counseling. This program can be applied to various caregivers and infants in diverse situations including mothers, grandparents, babysitters, and children with diseases. It is suggested that future opportunities for improving the program by expanding the fathers’ direct participations and by encouraging knowledge-sharing among fathers who are in similar circumstances although follow-up studies are needed in this regard.Ⅰ. 서 론 ··················································································1 1. 연구의 필요성 ················································································1 2. 연구의 목적 ····················································································3 3. 용어의 정의 ····················································································4 Ⅱ. 문헌고찰 ············································································6 1. 아버지의 영아돌봄 ········································································6 2. 아버지 역할 중재프로그램 ··························································13 3. 부아 상호작용과 애착 ··································································18 Ⅲ. 이론적 배경 ·····································································21 1. 연구의 이론적 기틀 ··································································21 2. 연구가설 ······················································································23 Ⅳ. 연구방법 ···········································································24 1. 연구설계 ······················································································24 2. 연구대상 ······················································································26 3. 연구도구 ······················································································27 4. 프로그램 개발 ············································································30 5. 자료수집 및 절차 ······································································39 6. 자료분석방법 ··············································································42 7. 연구자의 준비 ············································································43 8. 연구의 윤리적 고려 ····························································44 V. 연구결과 ···········································································45 1. 프로그램 운영 ············································································45 2. 프로그램의 효과평가 ································································50 VI. 논의 ··················································································63 1. 프로그램의 적용 ········································································63 2. 프로그램의 효과 ·········································································66 3. 연구의 제한점 ············································································71 4. 간호학적 의의 ············································································73 참고문헌 ·················································································74 부록 ·························································································93 Abstract ················································································127Docto

Effect of pH cycling and fluoride varnish on root surfaces

학위논문(석사) --서울대학교 대학원 :치의학과(치과보존학 전공),2010.2.Maste

Two-Dimensional Fluid Modeling and the Characteristics of Large Area Processing Plasma

Maste

제2형 당뇨병 동물 모델에서 노화와 관련된 지방 분포 변화의 기전 : PPARγ 효현제의 작용에 의한 조절

Dept. of Medicine/박사Visceral fat accretion is a hallmark of aging and is associated with aging-induced metabolic dysfunction. Many studies have reported that the peroxisome proliferator–activated receptor (PPARγ) agonist rosiglitazone improves insulin sensitivity by redistributing fat from visceral fat to subcutaneous fat. The purpose of this study was to investigate the underlying mechanisms by which aging affects adipose tissue remodeling in a type 2 diabetic animal model and through which PPARγ activation modulates aging-related fat tissue distribution. At the ages of 21, 31 and 43 weeks, male Otusuka Long-Evans Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes mellitus, were evaluated for aging-related effects on adipose tissue metabolism. Aging increased adipocyte cell size and the ratio of visceral fat weight to subcutaneous fat weight (V/S ratio). The serum levels of glucose, insulin and free fatty acid (FFA) were also increased. During aging, the mRNA expression of the genes involved in lipogenesis and fatty acid recycling were highly expressed in visceral fat as compared to subcutaneous fat. These changes were paralleled by immunohistochemical analyses. Aging increased mRNA expression related to lipolysis in both types of fat depots. The changes in the genes involved in lipid oxidation and energy expenditure, such as PDK2, mCPT1 and Acadl, varies during aging. After six weeks of rosiglitazone treatment in the OLETF rats, starting at 15 weeks of age, the PPARγ agonist resulted in fat redistribution with a decreasing V/S ratio and improved glucose intolerance. Compared with the untreated OLETF rats, the genes involved in lipogenesis and fatty acid cycling were decreased in visceral fat, whereas there were no significant changes of mRNA expression associated with lipid oxidation. Our data suggests that fat distribution was changed by stimulating the lipid uptake and esterification in the visceral fat as compared to the subcutaneous fat, thus altering the lipid oxidation during aging. Conversely, these changes might be modulated by PPAR γ action in a type 2 diabetic animal model.restrictio