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강무일(Moo Il Kang),이만영(Man Young Lee),한제호(Je Ho Han),손현식(Hyun Sik Son),윤건호(Kun Ho Yoon),홍관수(Kwan Soo Hong),차봉연(Bong Yun Cha),이광우(Kwang Woo Lee),손호영(Ho Young Son),강성구(Seung Ku Kang) 대한내과학회 1994 대한내과학회지 Vol.47 No.1
N/A Objectives: Amiodarone, a benzofuranic derivative containing 37. 2% iodine, is widely used for the long- term treatment of cardiac arrhythmias. It affects the peripheral metabolism of the thyroid hormones, and may induce hyperthyroidism and hypothyroidism. We performed this study to evaluate the effects of amiodarone on thyroid function. Methods: To evaluate the effects of amiodarone, antiarrhythmic drug, on thyroid function, we performed cross-sectional study in 30 patients (18 men and 12 women; mean age 61, 2 yr). All had a variety of cardiac diseases (ventricular tachycardia, supraventricular tachycardia, angina pectoris, cardiomyopathy) and taking long term amiodarone therapy (maintenance dose 200 mg; mean duration of treatment 18. 9 months). Thyroid status was assessed by clinical examination and thyroid function test (T3, T4, rT3, TSH, TRH test). Thyroid antimicrosomal antibody was measured using indirect agglutination method. All the tests were perfonned at the time of study only. Results: 1) Among 30 amiodarone treated patients, 3 were hyperthyroid and 1 was hypothyroid. So the incidence of amiodarone induced thyroid dysfunction was 13.3%(4/ 30). Including subclinical thyroid dysfunction, overall rate of thyroid dysfunction was 36.6%(11/30). 2) Antimicrosomal antibody was positive in 21,7% Sf patients (5/23). 3) Goiter was observed in 30%(9/30) of amiodarone treated patients and 63.6%(7/11) of patients with amiodarone induced thyroid dysfunction. 4) After TRH test in eleven euthyroid patients, 54,5% (6/11) showed abnormal response. 5) Between normal and abnormal responders in TRH test, there was no aignifieant difference in age and duration of amiodarone treatment (p>0,05). 6) In patients with thyroid dysfunction, duration of amiodarone treatment was significantly longer than euthyroid patients (p<0.02), but there was no significant difference in age between two groups (p>0.05), Conclusion: There results suggest that the incidence of thyroid dysfunction in amiadarone treated patients is high and further prospective study will be needed for more detailed information
B 형 만성활동성간염 환자에서 합성 Interferon Alpha 2b ( INTRON A(R) ) 의 효능 및 안정성 - 제 1 보 -
이창돈(Chang Don Lee),강무일(Moo Il Kang),유혜신(Hye Sin Yu),권혁호(Hyuk Ho Kwon),김재유(Jae Yoo Kim),정진우(Jin Woo Jeong),김부성(Boo Sung Kim) 대한내과학회 1987 대한내과학회지 Vol.32 No.6
N/A To evaluate the efficacy and safety of recombinant interferon alpha-2b (INTRONA®), in eleven patients with chronic active hepatitis (CAH) type B, a course of 28-day Intron A® was given daily subcataneous injection at a dose of 1 milion unit (MU) on the first day, 3 MU on the second, 5 MU on the 3rd to 7th, 3 MU on the 8th to 28th each. In 10 patients with HBeAg positive CAH type B, DNA polymerase and transaminoferase activities were assessed and compared before, during and after INTRON A administration. The peripheral blood white blood cell (WBC), granulocyte and platelet counts were checked. The results were as follows: 1) during administration of INTRON A, DNA polymerase activities were decreased significantly within first week and sustained in spite of persistent HBe antigenemia in all patients (p<0.05). Serum alanine aminotransferase (ALT) and aspartate aminotransferase were decreased significantly from 2 and 3 weeks after therapy respectively (p<0.01). 2) After discontinuation of INTRON A, improved transaminase level lasted for 4 weeks but rebound phenomena of DNA polymerase activities were observed 7 cases (70%) within 2 weeks, 3) during follow up period, transient increase of serum ALT activities were observed 9 cases within 12 weeks. One case of seroconversion (Anti-HBe) and one case of transient loss of HBeAg were observed at 16 week during mean follow up period of 30.3 weeks (range 16-58 weeks). But transient increment of serum ALT activities were observed 9 cases (90%) within 16 weeks. 4) In all 11 patients, peripheral white blood cell, granulocyte, platelet counts were decreased significantly within first week but not decreased further during INTRON A administration and recovered within 2 weeks after discontinuation of INTRON A. 5) Myalgia and fever were noted in 10 cases (91%) and headache and high fever (>38'C) were noted in 5 cases (45%) within 4 days. Mild anorexia (36%), hair loss (27%), diarrhea (9%), nausea (9%) were noted after 2 weeks. It suggested that subcutaneous injection of 3 MU INTRON A was safe and effective in decrement of DNA polymerase and transaminase activities in patients with CAH type B transiently. Long term therapy will be nessessary for the eradication of HBe Antigenemia and clinical improvement.
소의 대동맥 내피세포에서 산화저밀도 지단백에 의한 아포프토시스에 백일해 독소 및 콜레라 독소가 미치는 영향
손호영(Ho Young Son),강성구(Sung Ku Kang),강무일(Moo Il Kang),차봉연(Bong Youn Cha),이광우(Kwang Woo Lee),장상아(Sang Ah Chang),최윤희(Yoon Hee Choi),문성대(Sung Dae Moon),안유배(Yoo Bae Ahn),손현식(Hyun Sik Son),윤건호(Kun Ho Yoon) 대한내과학회 1999 대한내과학회지 Vol.56 No.5
N/A Objectives : Oxidized LDL is thought to play a key role in atherogenesis. Among their wide variety of biological properties, oxidized LDL injures the endothelium as an early event of atherogenesis. However, the mechanisms by which oxidized LDL injures endothelial cells are not definitely known. In order to evaluate the involvement of GTP-binding protein on the mechanism of apoptosis, we studied the effects of pertussis and cholera toxin on oxidized LDL-induced apoptosis in bovine aortic endothelial cells(BAECs). Methods : Oxidized LDL elicited apoptosis in cultured BAECs as shown by characteristic morphological and biochemical changes. Chromatin condensation and nucleus fragmentation were visualized by using fluorescence microscopy of intact cells staining by acridine orange/ ethidium bromide. DNA fragmentation was quantified by an ELISA with specific antibody for bromodeoxyuridine- labelled DNA fragments and confirmed with DNA ladder formation. Results : Studies using a combination of bacterial toxins which change the function of GTP-binding protein suggest that oxidized LDL-induced apoptosis was regulated by GTP-binding protein. Oxidized LDL-induced apoptosis was not changed by pretreatment of BAECs with pertussis toxin. In contrast, pretreatment with cholera toxin completely prevented the oxidized LDL- induced apoptosis. Conclusion : These results show that oxidized LDL induces apoptosis of BAECs and suggest that cholera toxin-sensitive G-proteins are involved in signal transduction of oxidized LDL-induced apoptosis of BAEC.
증례 : 내분비-대사 ; 무균성 뇌수막염으로 오인된 뇌하수체졸증 1예
윤유선 ( Yu Seon Yun ),김은숙 ( Eun Sook Kim ),신정아 ( Jung Ah Shin ),강무일 ( Moo Il Kang ),윤건호 ( Kun Ho Yoon ),차봉연 ( Bong Yun Cha ),손호영 ( Ho Young Son ) 대한내과학회 2011 대한내과학회지 Vol.80 No.1
본 저자들은 뇌수막염 증상으로 오인되어 치료가 지연, 부신 위기 동반으로 악화된 후 진단된 뇌하수체 선종의 뇌하수체졸증 1예를 경험하여, 무균성 뇌수막염이 호전되지 않을 경우에는 드물지만 치명적인 경과를 보일 수 있는 뇌하수체졸증일 가능성을 상기하고자 이를 보고하는 바이다. Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident. Although pituitary apoplexy is an emergency, it is often overlooked because it is rare and presents with various signs and symptoms, including those of neurologic and endocrine disorders. We describe a case of pituitary apoplexy misdiagnosed as aseptic meningitis accompanied by acute-onset headache and nausea, followed by fever. Subsequently, it was revealed as pituitary apoplexy by brain magnetic resonance imaging (MRI) performed when the clinical course worsened and ophthalmoplegia developed. We suggest that pituitary apoplexy be included in the differential diagnosis of patients presenting with headache or signs of meningeal irritation; when there is no clinical improvement, prompt steroid treatment should be started, while considering neurological decompression to prevent neurological sequelae. (Korean J Med 2011;80:102-107)
만성신부전증 환자에서 혈액투석, 복막투석 및 신장이식이 혈중 Apolipoprotein(a) 농도에 미치는 영향
윤건호 ( Kun Ho Yoon ),유순집 ( Soon Jip Yoo ),강무일 ( Moo Il Kang ),차봉연 ( Bong Yun Cha ),윤영석 ( Young Suk Yoon ),이광우 ( Kwang Woo Lee ),손호영 ( Ho Young Son ),강성구 ( Sung Koo Kang ),방병기 ( Byung Kee Bang ) 한국지질동맥경화학회(구 한국지질학회) 1996 韓國脂質學會誌 Vol.6 No.1
김미경 ( Mee Kyoung Kim ),임동준 ( Dong Jun Lim ),백기현 ( Ki Hyun Baek ),송기호 ( Ki Ho Song ),강무일 ( Moo Il Kang ),이광우 ( Kwang Woo Lee ),이종욱 ( Jong Wook Lee ) 대한내과학회 2008 대한내과학회지 Vol.75 No.6
불가피하게 반복적인 수혈을 받는 환자에서 수혈과 관련하여 이차성 혈색소 침착증이 발생할 수 있는데, 본 저자들은 재생불량성 빈혈로 10년간 약 400pints의 수혈을 받은 환자에서 피부 색소 침착, 저성선자극호르몬에 의한 성선기능저하, 당뇨병, 간기능 장애, 확장성 심근병증에 의한 울혈성심부전 등 여러 가지 심각한 합병증을 동반한 이차성 혈색소 침착증 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. We report a case of transfusion-associated hemochromatosis in a 38-year-old female who had severe aplastic anemia. She had undergone conservative treatment consisting of multiple transfusions because she had no suitable HLA-matched bone marrow donor. She had received 400 units of red blood cells (RBCs) over 10 years. The transferrin saturation and serum ferritin were increased to 88.4% and 29,905 ng/mL, respectively. Abdominal computed tomography (CT) showed increased densities in the liver and myocardium, suggesting iron deposits in those organs. In general, transfusional iron overload results in primarily reticuloendothelial iron accumulation, which is considered to be less harmful than parenchymal iron accumulation. Nevertheless, our patient had many striking complications associated with hemochromatosis, such as skin pigmentation, hypogonadotropin hypogonadism, insulin-requiring diabetes mellitus, impaired liver function, and left ventricular dysfunction. (Korean J Med 75:709-713, 2008)
다회 인슐린 투여가 당뇨병 환자의 삶의 질, 우울 및 불안 요소에 미치는 영향
박예리 ( Ye Ree Park ),김태석 ( Tae Suk Kim ),박용규 ( Yong Gyu Park ),이성수 ( Seong Su Lee ),김성래 ( Sung Rae Kim ),손현식 ( Hyun Shik Son ),윤건호 ( Kun Ho Yoon ),강무일 ( Moo Il Kang ),차봉연 ( Bong Youn Cha ),이광우 ( Kwang 대한내과학회 2009 대한내과학회지 Vol.77 No.1
Background/Aims: Treatment using multiple daily insulin(MDI) should give diabetic patients many benefits. Nevertheless, few studies have examined the impact of an increased frequency of daily insulin injection on quality of life, anxiety levels, and depression in diabetic patients, and individual`s continued compliance with MDI is unclear. This study examined these issues using standardized questionnaires. Methods: This was a cross-sectional, randomized study. Ninety-nine insulin-treated type 2 diabetic patients (mean age 53.1±12 years, mean duration of diabetes 10.3±6.5 years) were divided a group (n=50) who injected insulin four times daily (mean age 49.6±12.3 years, mean duration of diabetes 6.5±6.4 years) and a group (n=49) who injected insulin once or twice daily (mean age 56.4±11.6 years, mean duration of diabetes 11.5±5.8 years). All patients independently completed the Korean Version of the World Health Organization Quality of Life Scale Abbreviated Version and standardized Hospital Anxiety and Depression Scale for Koreans. Results: No significant differences were evident with respect to age, gender, and duration of diabetes between the two groups (p<0.05). No significant differences were evident in the results of the questionnaires between the two groups, except for the physical health domain (p<0.05). Conclusions: Multiple daily insulin injections had nearly no influence on quality of life, anxiety levels, or depression in type 2 diabetic patients. Therefore, treatment with MDI should be considered for patients who would benefit from this. (Korean J Med 77:60-67, 2009)