자궁내 성장 지연증 소아에서 혈청 IGF-I, Free IGF-I, IGFBP-1, IGFBP-3 농도에 대한 연구

황일태,박은애,김경희,김호성 대한소아내분비학회 1999 Annals of Pediatirc Endocrinology & Metabolism Vol.4 No.2

Noonan 증후군 환아의 임상적 특징과 성장호르몬 치료의 반응에 대한 연구

황일태,신충호,양세원 대한소아내분비학회 2003 Annals of Pediatirc Endocrinology & Metabolism Vol.8 No.2

청소년기의 다낭성 난소증후군

황일태 대한소아내분비학회 2008 Annals of Pediatirc Endocrinology & Metabolism Vol.13 No.1

Polycystic ovary syndrome (PCOS) is a syndrome of variable combinations of menstrual irregularity, hirsutism, and obesity. It is frequently diagnosed during adolescence and may be increasing in prevalence secondary to obesity among teenagers. It is associated with ovulatory dysfunction, hyperandrogenism, hyperinsulinism, and insulin resistance, and a major risk factor for metabolic syndrome and type 2 DM later in life. The goals of therapy in treating teenagers with PCOS has focused on managing body weight, improving self esteem by lessening acne and hirsutism, and regulating menses. Identifying girls at risk for PCOS and implementing treatment early in the development of PCOS may be an effective means of preventing some of the long-term complications associated with this syndrome.

Efficacy and safety of growth hormone treatment for children born small for gestational age

황일태 대한소아청소년과학회 2014 Clinical and Experimental Pediatrics (CEP) Vol.57 No.9

Recombinant growth hormone (GH) is an effective treatment for short children who are born small forgestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2–4 yearsof age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in earlychildhood, maintain a normal height gain throughout childhood, and achieve an adult height within thenormal target range. GH treatment at a dose of 35–70 μg/kg/day should be considered for those withvery marked growth retardation, as these patients require rapid catch-up growth. Factors associatedwith response to GH treatment during the initial 2–3 years of therapy include age and height standarddeviation scores at the start of therapy, midparental height, and GH dose. Adverse events due to GHtreatment are no more common in the SGA population than in other conditions treated with GH. Earlysurveillance in growth clinics is strongly recommended for children born SGA who have not caught up. Although high dose of up to 0.067 mg/kg/day are relatively safe for short children with growth failure,clinicians need to remain aware of long-term mortality and morbidity after GH treatment.

인체의 복강 내 지방조직 배양을 통한 OB 유전자 발현과 Leptin 분비에 미치는 인슐린, Dexamethasone과 성장호르몬의 단독 또는 복합적 영향에 관한 연구

황일태,김경희,황진순,신충호,양세원,Hwang, Il Tae,Kim, Kyung Hee,Hwang, Jin Soon,Shin, Choong Ho,Yang, Sei Won 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.8

목 적 : 지방조직에 존재하는 OB 유전자에서 전사된 호르몬인 leptin은 여러 가지 생리적 요인이나, 호르몬에 의해서 영향을 받는다. Leptin의 발현에 대한 호르몬에 대한 연구가 많은 동물 실험들을 상대로 시도되고 있으나 사람에서 OB 유전자와 leptin 분비를 조절하는 호르몬의 영향 및 상호작용에 대해서는 아직 명확히 밝혀져 있지 않다. 본 연구는 사람의 복강에서 추출한 조직배양에서 OB 유전자와 leptin 분비를 조절하는 호르몬의 영향 및 상호작용에 대해서 알아보고자 하였다. 방 법 : 복부수술을 위하여 입원한 환자 7명을 대상으로 복강 내 지방조직을 절제하여 배양액에 호르몬을 첨가하지 않은 상태와 배양액에 인슐린, dexamethasone 및, 성장호르몬을 단독으로 첨가하거나, 인슐린과 dexamethasone을 동시에 첨가하거나, 인슐린과 dexamethasone과 성장호르몬을 같이 첨가한 상태에서 48시간 배양한 후 RNA를 추출하여 경쟁적 역전사 중합반응(competitive RT-PCR)을 시행하여 OB 유전자의 발현을 측정하고, human leptin IRMA Kit를 사용하여 지방조직에서 분비되는 배양액 내 leptin 양을 측정하였다. 결 과 : 인슐린은 단독으로는 OB 유전자 발현과 leptin 분비에는 영향을 미치지 못하였다. Dexamethasone은 OB 유전자의 발현과 leptin 분비를 증가시켰는데, 48시간 배양 후에 대조군에 비해 의미있게 증가하였다. 인슐린과 dexamethasone을 같이 배양시에는 OB 유전자 발현에 있어서는 의미있는 차이는 없었으나, leptin 분비는 48시간 배양 후 대조군에 비해 의미있게 증가하였다. 또한 성장호르몬 단독으로는 OB 유전자의 발현에 영향을 미치지는 못하나, 인슐린, dexamethasone, 성장호르몬을 같이 배양시에 인슐린과 dexamethasone의 OB 유전자 발현과 leptin 분비증가 능력을 억제시켰다. 결 론 : 인슐린 단독으로는 leptin 분비를 증가시키지 못하나, dexamethasone에 의해 상승작용이 나타나고, 이는 dexamethasone이 OB 유전자 발현을 증가시킨 후에 인슐린이 세포질내에서의 leptin 분비를 증가시킨다고 추정할 수 있다. 성장호르몬의 억제효과는 성장호르몬이 인슐린이나 dexamethasone에 대한 지방조직의 반응성을 변화시킴으로써 간접적으로 leptin의 발현을 조절할 것으로 추정되며, dexamethasone이 OB 유전자 발현을 증가시킨 후에 인슐린이 세포질 내에서의 leptin 분비를 증가시킨다는 것에 대한 연구가 더 필요하리라 사료된다. Purpose : We investigated the hormonal control of OB gene expression and leptin secretion in cultured human visceral adipose tissue. Methods : Visceral adipose tissues were cultured for up to 48 hrs in modified Eagle's medium with varying concentration of hormones : Control(no hormone), bovine insulin(100 nM), Dexamethasone(DEX, 100 nM), growth hormone(GH, 40 ng/mL), insulin+DEX(100 nM each), insulin+DEX+GH(100 nM insulin and DEX, 40 ng/mL GH). Quantitative analysis of leptin mRNA was performed by competitive reverse transcription polymerase chain reaction, and leptin secretion in culture medium was measured by IRMA using a commercial kit. Results : The addition of dexamethasone to the medium significantly increased OB gene expression and leptin secretion(P<0.05). Unlike dexamethasone, insulin did not affect OB gene expression and leptin secretion. Both insulin and dexamethasone, at high concentration, significantly stimulated leptin secretion compared with basal values(P<0.05). Leptin gene expression was not significantly increased by GH treatment alone, however GH, in combination with high concentrations of insulin and dexamethasone, attenuated the stimulatory effects of high concentrations of insulin and dexamethasone. Conclusion : Insulin cannot increase leptin secretion without the presence of dexamethasone. The mechanism suggested is that insulin may increase leptin secretion in cytoplasm only after dexamethasone increases the expression of OB gene. Further studies are necessary to elucidate the mechanism of the action of insulin on leptin secretion after increasing OB gene expression by dexamethasone.

국내 부당경량아의 현황

황일태 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.2

Depending on the definition used, between 3% and 10% of live neonates are small for gestational age (SGA). The definition of SGA requires the following: (1) accurate knowledge of gestational age; (2) accurate measurements at birth of weight, length, and head circumference; (3) a cutoff, which has been variably set at the 10th percentile, 3rd percentile, or at less than 2 standard deviation from the mean, and (4) race and ethnicity-specific growth curve. Consensus statements are needed on the management of growth hormone therapy in SGA children, as well as treatment and long-term health outcomes such as impaired cognitive function, increased risk of adult cardiovascular disease, and type 2 diabetes.

영유아 급성 천식에서 Spacer를 이용한 정량식 흡입치료와 분무기를 이용한 분무치료의 비교 연구

황일태,홍영미,이승주 대한알레르기학회 1993 천식 및 알레르기 Vol.13 No.2

Nebulizer has been widely used to treat acute asthma in children including infants, but recently metered dose inhaler attached with spacer(MDIS) was reported to results in significantly greater bronchodilator than nebulizer, and has several advantages: it is cheaper, more convenient, easy to clean, independent of eletricity and reduces the problem of coordination. This study was done to compare the therapeutic effect of metered dose inhaler with spacer(MDIS) with those of the nebulizer in 40 acute asthmatic children who were admitted to department of Pediatrics of EWHA, from Jan. 1990 to July 1991. The subjects were randomly allocated into MDIS and nebulized salbutamol groups. The results were as follows: 1) In MDIS group, wheeze score was 0.8 ±0.5 which was significantly lower than 1.6 ±0.9 in nebulized group (P$lt;0.01). Respiratory rate in MDIS group was 30.7 ±5.8 which was significandy lower than 35,1 ±5.7 in nebulized group (P$lt;0.05). Heart rate and retraction score were not significantly different between two groups. 2) Duration of wheezing in MDIS group 4.7 ±2.1days which was not significantly different to 4.9 ±2.2days in nebulized group. Initial and maintenance dose for salbutamol in MDIS group were 790 ±238ug/dose, 800ug/ day which were much smaller than 2.5mg/ dose, 10mg/day in nebulizer group. 3) The side effects in MDIS group were not significantly different to nebulized group. Significant paradoxical bronchoconstriction in nebulized group was not documented in the study. In conclusion, method dose inhaler with spacer is cheaper, more convenient, and more effective than nebulizer. So we think that MDIS could be recommended in acute childhood asthma.

신생아에서의 부신기능 평가와 질환

황일태 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.4

Majority of sick full term newborns have adequate adrenal cortical function in response to stress. Acutely ill neonates with a basal cortisol level less than 15 µg/dL (414 nmol/L) suggest adrenal insufficiency and require function testing of adrenal function. In premature infant, immaturity of hypothalamic-pituitary adrenal axis (HPA axis), may limit the ability to increase cortisol production in response to stress. The response to low dose ACTH and CRH appears to be useful as an additional test of adrenal function. CRH stimulation has been used increasingly in neonates. The ACTH and CRH stimulated cortisol response of more than 17 µg/dL (469 nmol/L) indicates a normal response.

신생아에서의 부신기능 평가와 질환

황일태,Hwang, Il Tae 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.3

Majority of sick full term newborns have adequate adrenal cortical function in response to stress. Acutely ill neonates with a basal cortisol level less than $15{\mu}g/dL$ (414 nmol/L) suggest adrenal insufficiency and require function testing of adrenal function. In premature infant, immaturity of hypothalamic-pituitary adrenal axis (HPA axis), may limit the ability to increase cortisol production in response to stress. The response to low dose ACTH and CRH appears to be useful as an additional test of adrenal function. CRH stimulation has been used increasingly in neonates. The ACTH and CRH stimulated cortisol response of more than $17{\mu}g/dL$ (469 nmol/L) indicates a normal response.

소아 성장호르몬 결핍증 환아의 성인시기 관리

황일태 대한소아내분비학회 2003 Annals of Pediatirc Endocrinology & Metabolism Vol.8 No.2