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아급성 갑상선염을 앓았던 환자에게서 발생한 침윤성 섬유성(리들) 갑상선염 1예
김철식,이성주,박종숙,남주영,김똘미,안철우,차봉수,임승길,김경래,이현철 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4
저자들은 전세계적으로 매우 드물 질환인 리들 갑상선염, 특히 이전에 아급성 갑상선염 및 갑상선 중독증이 있었던 환자에서 발생한, 1예를 진단하고 수술적 치료 후 양호한 경과를 확인하였기에 문헌고찰과 함계 보고하는 바이다. Riedel's thyroiditis is a rare form of chronic thyroiditis, characterized by a fibroinflammatory process which partially destroys the thyroid, often involving surrounding tissues. The relationship of Riedel's thyroiditis to other forms of thyroiditis is not clear. A case of Riedel's thyroiditis in a 51-year-old female patient, admitted with a previous diagnosis of subacute thyroiditis, is reported. She was first diagnosed with subacute thyroiditis based on clinical manifestation and radiologic and laboratory results. She was treated with glucocorticoid for 8 weeks. The follow-up lasted for 12 months. However, three years later she underwent a thyroidectomy operation due to an enlargement of the thyroid nodule and suspicion of malignancy. Histopathologic examination confirmed that she had Riedel's Thyroiditis. Until now, few case of Riedel's thyroiditis in patients with a history of subacute thyroiditis have been reported in the literature. Although the etiology of Riedel's thyroiditis is unknown, it may develop in the course of subacute thyroiditis (J Kor SOC Endocrinol 18:414- 419, 2003).
제2형 당뇨병 환자에서 혈청 아디포넥틴이 경동맥 죽상경화증의 진행에 미치는 영향
김철식,박주리,유성훈,강준구,류옥현,이성진,홍은경,김두만,유재명,임성희,최문기,유형준 대한내분비학회 2012 Endocrinology and metabolism Vol.27 No.1
Background: Increased cardiovascular events, which is the leading cause of death in type 2 diabetic patients, are mainly caused by accelerated atherosclerosis. Adiponectin has been suggested as a risk factor for cardiovascular diseases in cross-sectional studies. However, little is known about the impact of adiponectin on the progression of carotid atherosclerosis in type 2 diabetic patients. This study was conducted to evaluate the impact of early adiponectin levels on the progression of carotid atherosclerosis. Methods: From March 2009, 150 patients with type 2 diabetes were consecutively enrolled in our affiliated outpatient clinic. Anthropometric and biochemical data, including adiponectin levels, were measured in each participant. We measured the carotid intima-media thickness (CIMT) at baseline and at 1-year follow-up (n = 111). Then, we prospectively studied the relationship between the serum adiponectin levels and the progression of CIMT for 1 year. Results: Adiponectin levels negatively correlated with CIMT (r = -0.219, P = 0.015). Moreover, mean progression of CIMT was 0.016 ± 0.040 mm. However, there was no correlation between adiponectin levels and the progression of CIMT within 1-year follow-up period (r = -0.156, P = 0.080). Age (β = 0.556, P = 0.004), LDL cholesterol (β = 0.276, P = 0.042), and A1C (β = 0.309, P =0.038) were found to be independent risk factors for CIMT. However, A1C (β = 0.311, P = 0.042) was found to be the only independent risk factor for the progression of CIMT. Conclusion: In our study, adiponectin levels were negatively associated with CIMT. However, it did not affect the progression of CIMT at 1-year follow-up. Overall glycemic control is the most important factor in the progression of CIMT in patients with type 2diabetes.
김철식,고승현,권혁상,김난희,김재현,임수,최성희,송기호,원종철,김대중,차봉연 대한당뇨병학회 2014 Diabetes and Metabolism Journal Vol.38 No.1
Background: Obesity is a risk factor for diabetes and several cardiovascular diseases. This study was to investigate the trends inthe prevalence, awareness, and management status of obesity among the Korean population for recent 13 years. Methods: The prevalence, subjective awareness, and management of obesity were investigated in adults aged ≥19 years by usingthe data from the Korea National Health and Nutrition Examination Surveys (KNHANES) 1998 to 2011. Results: The number of participants was 8,117, 5,826, 5,500, 3,025, 6,756, 7,506, 6,255, and 6,155 in the KNHANES in years 1998,2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively. The prevalence of obesity was 26.9%, 29.2%, 32.9%, 32.5%, 32.0%, 32.6%,32.0%, and 32.0% in 1998, 2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively, while the overall prevalence of obesity and abdominalobesity increased by 1.19-fold and 1.24-fold respectively in 2011 compared against 2001. In general, a gradual increase inthe prevalence of severe obesity has been observed as years go by. Furthermore, trends of improvements in obesity awareness andmanagement rates were visible over the period of surveys. Conclusion: Although the management status of obesity has improved during the recent years, more effective strategy to controlobesity is needed.
직업계고 출신 조기취업 노동자들의 노동세계: 반월시화공단을 중심으로
김철식 한국산업노동학회 2021 산업노동연구 Vol.27 No.3
This study analyzes the labor market entry and early career history of early-employed workers from vocational high schools, and the institutional and psychological mechanisms that supply them with low-wage labor. Early-employed workers come to industrial sites mainly through a field practice system when they are underage. Rather than becoming ‘trainees’ who practice and train the skills learned in school in the field, they are functioning as an important source of labor for poor and inexpensive jobs in SMEs. Various institutions and systems in Korean society are working in combination to support their supply with low-wage labor. Schools that supply students with low-wage labor, companies that want cheaper labor than skilled workers, and systems that keep workers from leaving poor labor sites, are all together serving for supplying low-wage labor. Based on interviews of early-employed workers from vocational high schools, this study analyzes the institutional and psychological mechanisms that allow them to choose early employment and stay in the labor market even after graduation despite the poor working conditions of low wages. 본 연구에서는 직업계고 출신 조기취업 노동자들의 노동시장 진입과 초기 이력 형성과정, 그리고 이들을 저임금 노동력으로 공급하는 제도적, 심리적 기제를 분석한다. 조기취업 노동자들은 주로 미성년의 시기에 현장실습이라는 제도를 통해 산업현장에 첫발을 내디딘다. 현장실습생이지만, 이들은 학교에서 배운 기능들을 현장에서 실습하고 훈련하는 ‘실습생’이 되기보다는 오히려 중소영세사업장 열악하고 저렴한 일자리의 중요 노동력 공급원으로 기능하고 있다. 이들이 저임금 노동력으로 공급되는 것을 뒷받침하기 위해 한국사회의 여러 기관과 제도들이 복합적으로 작용하고 있다. 취업실적제고를 위해 학생들을 노동력으로 공급하는 학교, 기능인력보다는 저렴한 노동력을 원하는 회사, 열악한 노동현장을 떠나지 못하도록 노동자들을 묶어두는 제도들이 결합되어, 한국사회가 필요로 하는 저임금 노동력을 공급하는 기제로 작동하고 있다. 직업계고 출신 조기취업 노동자들에 대한 면접조사에 근거하여 본 연구에서는 저임금의 열악한 노동조건에도 불구하고 이들이 조기취업을 선택하게 만들고, 또 졸업 이후에도 노동시장에 머물게 하는 제도적, 심리적 기제를 분석한다.
김철식,남주영,박종석,김똘미,윤수지,안철우,임승길,김경래,이현철,허갑범,차봉수 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.SUP
Central obesity with visceral fat accumulation and the amount of skeletal muscle mass may influence insulin sensitivity via its capacity for glucose load uptake. We investigated the relationships among the following metabolic variables: ratio of fat area to skeletal muscle area (VMR), percent ideal body weight, body mass index, waist-to-hip circumference (WHR) and visceral fat to subcutaneous fat ratio (VSR) in 114 nondiabetic middle-aged women. Anthropometric parameters, lipid profiles and sex hormone- binding globulin were measured. Visceral and subcutaneous fat areas at the umbilical level and the skeletal muscle area at the mid-thigh level were measured and computed. 75-gram OGTT tests were performed, along with measuring plasma glucose, insulin and free fatty acid levels, according to which area under the curve of glucose (Glu-AUC), insulin (Ins-AUC), free fatty acid (FFA-AUC) and glucose/insulin ratio (GIR=Glu- AUC/Ins-AUC), were calculated. 1) Triglyceride was more correlated with VSR than VMR. 2) The independent anthropometric parameters for each metabolic variable were In conclusion, VMR for Ins-AUC, WHR for Glu-AUC and total cholesterol, and VSR for triglyceride. 3) For subjects with higher VMR, age, Ins-AUC and triglyceride were significantly higher. 4) Subjects with higher VMR were older and showed higher Ins-AUC and lower GIR than the subjects with lower VMR. In conclusion, VMR is an anthropometric parameter that reflects insulin resistance concerning glucose metabolism, and VSR is thought to be a good parameter that that reflects the serum lipid levels. Further prospective studies are necessary to reevaluate the visceral fat vs. skeletal muscle relationship.