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당뇨병 환자에서 자율신경병증과 교정한 QT 간격과의 관계
조정구(Chung Gu Cho),임동석(Dong Suk Lim),최석채(Suk Chae Choi),홍석욱(Seung Wook Hong),장근(Geun Jang),김동훈(Dong Hun Kim),김창일(Chang Il Kim),박옥규(Ock Kyu Park) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A A simple method for evaluating alterations in cardiac sympathetic innervation may be measurement of the QT interval. Ninety-nine diabetic patients were separated into 4 groups based on the presence and degree of cardiac autonomic neuropathy (CAN) with noninvasive cardiovascular reflexes and blood pressure responses. None of the patients had evidence of ischemic heart disease, arrhythmia, or electrolyte imbalance. The corrected QT interval (QTc) was determined at rest with Bazett's formula. As a group, diabetic patients with 4 abnormalities of cardiac autonomic function had a longer QTc interval than those with no evidence of CAN. Diabetic patients with > 1 abnormality had a prolonged QTc interval compared with the control group of 68 healthy nondiabetic subjects. The frequency of prolonged (>430 ms, normal+2SD) resting QTc intervals increased with the increased number of abnormalities (0, 1-3, ?4): 19, 33, and 49%, respectively, Thirty out of 35 (86%) patients with a QTc >430ms had evidence of CAN. However, 59% (43 out of 73) of the patients with CAN had a normal QTc interval. These data provide evidence of a relationship between the presence and severity of CAN and degree of QTc interval prolongation. Compared with cardiovascular reflexes and blood pressure tests for CAN, the QTc interval in the group of diabetic patients studied without evidence of heart or electrolyte imbalance was an insensitive but specific marker. An abnormal QTc interval may be an additional diagnostic tool for evaluating CAN in patients with diabetes mellitus.
박승택,윤향석,형근영,조정구,이강창,김원신,김형민,전병훈,윤용갑,Park Seung-Taeck,Yoon Hyang-Suk,Hyoung Keon-Young,Cho Chung-Gu,Lee Kang-Chang,Kim Won-Shin,Kim Hyung-Min,Jeon Byung-Hoon,Yun Young-Gap 대한한의학방제학회 1999 大韓韓醫學方劑學會誌 Vol.7 No.1
In order to eludidate the mechanism of oxidative stress in cultured spinal motor neurons damaged by oxygen free radicals, cytoxicity was assesed by MTT assay and NR assay after spinal motor neurons from mouse were cultured in media containing various concentrations of xanthine oxidase(XO) and hypoxanthine(HX) for 3 hours. In addition, neuroprotective effects of several herb extracts on oxidant-induced neurotoxicity were examined in these cultures, compared with nerve growth factors such as basic fibroblast growth factor(bFGF). XO/HX decreased cell viability in dose- and time dependent manners on cultured mouse spinal motor neurons, and MTT50 and NR50 values were measured at 20mU/ml XO and 0.1mM HX for 3 hours in these cultures. bFGF significantlt increased cell viability. In neuroprotective of herb extracts, Epimedium Koreanum Nakai(EK) and Alpinia oxphylla Mig(IJI) was very effective in the prevention of the neurotoxicity induced by XO/HX in cultured mouse spinal motor neurons. From the above results, it is suggested that XO/HX shows toxic effect in cultured mouse spinal motor neurons and selective herb extracts such as Epimedium Koreanum Nakai(EK) and Alpinia oxphylla Mig(IJI) were very effective in the increase of cell viability against the neurotoxicity induced by oxygen radicals in these cultures.
제2형 당뇨병 환자에서 아스피린 저항성 빈도와 연관인자에 관한 연구
임윤혁 ( Yun Hyek Lim ),박병현 ( Byoung Hyun Park ),조정구 ( Chung Gu Cho ) 대한내과학회 2009 대한내과학회지 Vol.76 No.3
Background/Aims: The risk of cardiovascular morbidity and mortality is high in patients with diabetes. Since studies suggest that aspirin is less effective in diabetic patients, this study evaluated the prevalence of aspirin resistance and related factors in Korean type-2 diabetics. Methods: All patients taking aspirin 100 mg/day for at least 4 weeks and no other anti-platelet agents were enrolled. The compliance of aspirin intake was determined from patient interviews and using the pill-count method. All other medications were continued during the study, including oral hypoglycemics, antihypertensives, and lipid-lowering agents. The effect of aspirin was assessed using the Ultegra Rapid Platelet Function Assay-ASA (VerifyNow-Aspirin, Accumetrics, San Diego, CA) and aspirin resistance was defined as >550 aspirin reaction units (ARU). Results: The prevalence of aspirin resistance in Korean type-2 diabetics was 14.8%, and was more prevalent in males than in females (28.1% vs. 7.1%). Aspirin resistance was correlated with male sex, smoking, high hemoglobin levels, a high estimated glomerular filtration rate (GFR), and low fibrinogen levels. After controlling for sex, aspirin resistance was related to the estimated GFR (r=0.247, p=0.029), hemoglobin (r=0.23, p=0.043), and fibrinogen (r=0.304, p=0.007) levels. Conclusion: The prevalence of aspirin resistance in Korean type-2 diabetics was 14.8%. Therefore, a laboratory test for aspirin resistance should be considered in diabetic patients taking aspirin to prevent cardiovascular complications. (Korean J Med 76:321-328, 2009)
증례 : 내분비-대사 ; 아급성 갑상선염 후 발병된 그레이브스병 1예
정형철 ( Hyeong Cheol Cheong ),노혜정 ( Hye Jung Noh ),박병현 ( Byoung Hyun Park ),조정구 ( Chung Gu Cho ) 대한내과학회 2011 대한내과학회지 Vol.80 No.5
저자들은 아급성 갑상선염을 진단 받고 보존적 치료를 시행 후 호전된 환자에서 2년 후 그레이브스병이 발병한 1예를 경험하여 아급성 갑상선염 환자에서 자가면역항체가 양성을 보일 경우 추후 그레이브스병의 발생에 대한 지속적인 추적 관찰이 필요할 수 있음을 강조하면서 보고하는 바이다. Subacute thyroiditis is a spontaneously resolving inflammatory disease of the tyroid gland, which is usually associated with a viral infection and genetic factors. In some cases of this disorder, thyroid autoantibodies can appear, probably due to the inflammatory release of thyroid antigens, althoughtheir pathophysiological role in the course of this disease is not yet fully understood. The occurrence of Graves` disease after subacute thyroiditis is extremely rare, and only a few cases have been reported. Here, we report a case of a middle-aged woman who developed Graves` disease after subacute thyroiditis.
증례 : 내분비 ; 저칼륨혈증성 주기성 마비로 발현된 제2형 당뇨병 1예
염동한 ( Dong Han Yeom ),김하영 ( Ha Young Kim ),박병현 ( Byoung Hyun Park ),조정구 ( Chung Gu Cho ) 대한내과학회 2009 대한내과학회지 Vol.76 No.4
본 저자들은 인슐린 과반응에 의한 고인슐린혈증에 의한 저칼륨혈증성 주기성 마비로 처음 제2형 당뇨병을 진단받은 49세 남자 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Hypokalemic periodic paralysis may be precipitated by stress, rest after exercise, or events that lower serum potassium levels, such as carbohydrate ingestion or the use of insulin or diuretics. In healthy subjects, insulin activates Na+/K+ATPase, which elicits potassium influx and transient hypokalemia; however, hypokalemia is compensated by K+ATP channel activation. Recently, we encountered a 49-year-old male patient with type 2 diabetes mellitus and hyperinsulinemic hypokalemic periodic paralysis. The patient had no family history of muscle weakness or diabetes mellitus. At the time of the attack, plasma glucose was 142.4 mg/dL, plasma insulin was 116. 86 uIU/mL, serum potassium was 2.08 mEq/L, and thyroid hormone, renin, aldosterone, ACTH, and cortisol levels were normal. Symptoms improved rapidly upon potassium replacement. Oral glucose tolerance testing revealed high glucose and insulin levels at 2 h, and serum potassium and phosphate levels decreased from 5.1 to 4 mEq/L and 3.6 to 2.0 mg/dL, respectively. (Korean J Med 76:499-501, 2009)
나용호(Yong Ho Nah),김철우(Chull Woo Kim),김형곤(Hyung Gon Kim),이상곤(Sang Kon Lee),조정구(Chung Gu Cho),김학철(Hack Chel Kim),박양규(Yang Kyu Park) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.2
N/A Rotor's syndrome is a familial disorder characterized by chronic, nonhemolytic, predominantly conjugated hyperbilirubinemia. The incidence of Rotors syndrome is very rare and only 11 cases were reported in Korea. Recently we observed three patients of Rotor's syndrome in two families. In these three cases, jaundice started at an early teenage and has shown a persistent but fluctuating course. The condition appeared compatible with normal life. These three patients of Rotor's syndrome had persistent elevation of the free and conjugated bilirubin and impaired ability to conjugate Bromosulphalein. The liver biopsy specimens were morphologically normal. The gallbladder were visualized on oral cholecytogram.
증례 : 내분비-대사 ; 다발성 골수종이 동반된 미만성 정상지질혈증성 편평 황색종 1예
진애령 ( Ae Ryoung Jin ),유태양 ( Tae Yang Yu ),노혜정 ( Hye Jung Noh ),박병현 ( Byoung Hyun Park ),조정구 ( Chung Gu Cho ) 대한내과학회 2011 대한내과학회지 Vol.81 No.1
저자들은 20년 전 정상지질혈증성 편평 황색종을 진단받고 특별한 치료 없이 지내온 환자에서 20년 후 다발성 골수종이 진단된 1예를 경험하여 정상지질혈증성 편평 황색종 환자의 지속적인 추적관찰이 필요함을 강조하면서 보고하는 바이다. Diffuse plane xanthoma is a group of plane xanthomas that appear as yellow to yellowish-brown flat patches or slightly elevated plaques with a widespread distribution. It is often associated with, or preceded by several years of, hematologic problems. Here, we describe a 63-year-old woman diagnosed with diffuse normolipemic plane xanthoma who developed multiple myeloma 20 years later. This case suggests that patients with diffuse normolipemic plane xanthoma should be followed for their entire life to detecthealth problems. (Korean J Med 2011;81:107-110)