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      • 항갑상선제로 치료한 그레이브스병 환자의 관해예측인자

        남일송,윤여일,김선규,김용현,이주영,목지오,윤석기,김철희,김영선,변동원,서교일,유명희 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

        Background: Most cases of Graves' disease have been treated by antithyroid drugs in Korea. The major drawbacks of antithyroid drugs are the relative high rate of relapse and the inconvinience of long term therapy. Measurement of TBII and TRH stimulation test have been considered as the most reliable tests predicting relapse, but the predictive power is not high enough to use in clinical situation. This study was performed to find good prognostic indicators in Graves' disease patients after the discontinuation of antithyroid drug therapy. Subjects and methods : We restrospectively evaluated 96 patients with Graves' disease who showed normal TRH test at the end of antithyroid drug therapy and were followed for more than one year. Serum T3, T4, T3/T4 ratio, TBII, Anti-TPO Ab and TGAb levels were measured at the time of diagnosis and at the end of therapy. Two to three months after withdrawal of antithyroid medication, serum TSH and free T3 responses to TRH were examined. These parameters were compared between the relapse group and the remission group. Results : Among the 96 patients, 22 patients(22.9%) relapsed(Group Ⅱ) and 74 patients(77.1%) remained in remmision(Group Ⅰ). No significant difference was observed between the relapse and the remission group in clinical parameters, serum T3, T4, TSH, T3/T4 ratio, TBⅡ and Anti-TPO Ab determined before and after treatment. Serum TSH and free T3 levels measured after TRH stimulation were also similar in both groups. Serum TGAb levels determined at the end of treatment were significantly higher in the remission group(p<0.05). Relapse following the discontinuation of therapy occured within 24 months in 72.7% of the relapsed cases. After 24 months, relapse rate was reduced significantly. Conclusion : These results suggest that high serum TGAb levels could be a favorable prognostic indicator for the long term remission of Graves' disease treated with antithyroid drugs, and may suggest that Hashimoto's thyroiditis is combined with Graves' disease in those patients.

      • 제2형 당뇨병 환자에서 체내 총항산화능 측정의 의의

        윤여일,윤석기,김선규,김용현,남일송,차건영,황의원,김영선 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

        Background: The diabetic patients are at significantly increased risk of developing vascular disease. It's etiology may involve oxidative damage by free radiacals and protection againse such damage can be offered by antioxidants. We investigated that oxidative stress as assessed by measurement of total antioxidant status may play a role in development of diabetes mellitus. Method: We measured total antioxiant status using merchandised kit, glycated hemeglobin(HbA1c) in 46 type 2 diabetes mellitus patients and 50 healthy matched control subjects. Result: The total antioxidant status(TAS) was 2.10(±0.04) mmol/L in uncontrolled type 2 DM patients, 2.60(±0.03) in controlled type 2 DM patients and 2.70(±0.16) in healthy control subjects. TAS was significantly lower(P<0.05) in uncontrolled type 2 DM patients, but no significant association between in controlled type 2 DM patients and healthy control subjects. The TAS was 2.00(±0.17) mmol/L in complicated type 2 DM patients and 2.10(±0.29) uncomplicated type 2 DM patients. There was no significant associations between complicated type 2 DM patients and uncomplicated type 2 DM patients. Conclusion: Poor glycemic control is associated with reduced TAS in type 2 DM patients. TAS was thought indirect index that predict glycemic control of type 2 DM patients.

      • KCI등재후보

        하시모트 갑상선염과 동반된 갑상선 MALT 림프종(MALToma) 1 예

        김영선,이태영,한찬희,유명희,김철희,변동원,진소영,남일송,류은상,홍기영,윤석기,서교일 대한내과학회 2001 대한내과학회지 Vol.61 No.3

        Primary thyroid lymphomas constitute of up to 5% of all thyroid malignancies. Recently, mucosa-associated lymphoid tissue (MALT) lymphoma are relatively recognized as a B cell subset of non-Hodgkin's lymphoma. MALT-lymphomas are thought to develop from acquired lymphocytic tissue during the course of a chronic inflammatory or autoimmune process. In the thyroid , which is normally devoid of lymphocytic tissue, chronic autoimmune thyroiditis (Hashimoto's disease) has been associated with an increased risk of lymphoma, including MALT type. The clinical presentations include the enlarging of the neck mass, dysphagia, hoarsenes and choking or cold thyroid nodule. We report a case of MALToma of the thyroid accompanied by Hashimoto's thyroiditis with a review of the literature.(Korean J Med 61:281-285, 2001)

      • KCI등재후보

        제초제 Glyphosate 중독환자의 임상적 고찰

        이주영(Ju Young Lee),황규윤(Kyu Yoon Hwang),남일송(Il Song Nam),임현진(Hyun Jin Yim),김은나(Eun Na Kim),정재화(Jae Hwa Jung),김선규(Sun Kyu Kim),이은영(Eun Young Lee),홍세용(Sae Yong Hong) 대한내과학회 2001 대한내과학회지 Vol.60 No.4

        N/A Background: Although glyphosate, organophosphorus herbicide, has been used extensively in agricultural area, no clinical data of acute poisoning have been reported in Korea. The current study evaluated clinical characteristics of acute intoxication by glyphosate. Methods: We retrospectively collect and analysed the clinical data of 16 acute glyphosate poisoned patients admitted to the department of internal medicine, Soonchunhyang University Chunan hospital from January 1999 through June 2000. Results: 1) Thirteen of sixteen poisoning were male and mean age was 44.2 year-old. 2) The main cause of glyphosate ingestion was suicide intent (12 cases, 75%), and clinical severity was divided into 3 categories : mild (14 cases), moderate (1 case) and severe (1 case). 3) Nausea and vomiting were the most frequent clinical features (each 6 cases) and dyspnea (4 cases), cough (3 cases), sputum (3 cases) and sore throat (3 cases) were followed. Leucocytosis, hepatotoxicity, anemia, hypoxia and renal toxicity were observed in 9,8,5,6 and 3 cases, respectively. 4) No fat al case and severe complication, except 1 aspiration pneumonia and 1 acute respiratory failure, were observed in acute glyphosate poisonings. Conclusion: Our data supported that acute glyphosate poisoning dose not result in fatal in humans even after intentional ingestion of glyphosate.(Korean J Med 60:383-387, 2001)

      • SCOPUSKCI등재

        한국인 제 2 형 당뇨병 환자에서 Uncoupling protein 1(UCP-1)유전자와 지방산 결합단백(FABP2)유전자의 다형성

        김영선,이주영,김선규,김용현,유명희,서교일,김철희,변동원,박형규,윤석기,윤여일,남일송,목지오 대한당뇨병학회 2001 Diabetes and Metabolism Journal Vol.25 No.4

        Background: It is well known that genetic component plays an important role in developing obesity and type 2 diabetes mellitus. A number of candidate genes have been suggested, but the major gene determining the development of obesity and type 2 diabetes has not yet been uncovered, Previous studies suggest that polymorphisms of the intestinal fatty acid binding protein (FABP2) and uncoupling protein 1 (UCP-1) gene were related with obesity and/or insulin resistance in several populations. Methods: We examined 76 type 2 diabetic patients (aged 44±6years) and 96 healthy controls (aged 25±3 years). AIa54Thr polymorphism of the FABP2 gene and A to G polymorphism (-3826) of the UCP-1 gene were determined by polymerase chain reaction and restriction fragment length polymorphism method. Results: The Thr54 allele of the FABP2 gene was found with a frequency of 0.33 in nondiabetic controls and 0.36 in type 2 diabetic patients. The genotype frequency of the AIa54Thr polymorphism was similar in nondiabetic and diabetic subjects (x²=0.87, P=0.64). The -3826 G allele of UCP-1 gene was found with a frequency of 0.51 in nondiabetic controls, and 0.46 in type 2 diabetic patients. The genotype frequency of the -3826 A to G polymorphism was also similar in nondiabetic and diabetic subjects (x²=1.46, p=0.46). When the subjects of each Groups were subdivided into nonobese and obese group by BMI of 25 kg/㎡, there was no significant difference in genotype frequencies of the UCP-1 and FABP2 gene polymorphisms. Conclusion: These results suggest that either the AIa54Thr polymorphism of the FABP2 gene or the A to G polymorphism (-3826) of UCP-1 gene do not play a major role in developing type 2 diabetes mellitus or obesity in Korean.

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