A 20-Year-Old Woman with Hashimoto's Thyroiditis and Evans' Syndrome

강미연,함종렬,정태식,이경원,김덕룡,박명희 연세대학교의과대학 2006 Yonsei medical journal Vol.47 No.3

Here we report the case of a 20-year-old female patient previously diagnosed with Hashimoto's thyroiditis and overt hypothyroidism, and who had been taking synthetic thyroxine (100μg/day) for eight months. She experienced intermittent dizziness and generalized weakness, and was diagnosed as having severe autoimmune hemolytic anemia (AIHA). We prescribed prednisolone treatment and continued synthetic thyroxine administration. Two years and five months later, she developed idiopathic thrombocytopenic purpura (ITP) and was diagnosed with Evans' syndrome. Thereafter, laparoscopic splenectomy was performed because her autoimmune hemolytic anemia was refractory and dependent on steroid therapy. The HLA genotypes of the patient were HLA-A*020101/A* 2602, HLA-B*270502/B*5401, HLA-Cw*0102/Cw*020202, HLA-DRB1*0404/DRB1*0405, and HLA-DQB1*0302/DQ B1*0401. Hashimoto's thyroiditis is often associated with other nonendocrine autoimmune diseases, and antithyroid antibodies are frequently observed in Evans' syndrome (coexistence of AIHA and ITP). However, there is no report of Evans' syndrome developing in patients with overt hypothyroidism and Hashimoto's thyroiditis. This case suggests that three autoimmune diseases (AIHA, ITP, and Hashimoto's thyroiditis) might share a common immunogenetic pathway in pathogenesis.

Blood electrolyte disturbances during severe hypoglycemia in Korean patients with type 2 diabetes

강미연 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.5

Background/Aims: To investigate abnormalities in blood electrolyte levels during severe hypoglycemia in Korean patients with type 2 diabetes mellitus (T2DM) in a clinical setting. Methods: Blood electrolyte levels in adult T2DM patients during severe hypoglycemia were collected from January 1, 2008 to December 31, 2012. Patients who maintained normal serum creatinine and blood urea nitrogen levels were utilized in the study. Severe hypoglycemia was defined as a condition requiring medical assistance, such as administering carbohydrates when serum glucose levels less than 70 mg/dL were observed, in conjunction with other symptoms of hypoglycemia. Results: A total of 1,068 patients who visited the emergency room with severe hypoglycemia were screened, of which 219 patients were included in this study. The incidence of abnormal levels for any electrolyte was 47%. Hypokalemia (< 3.5 mmol/L) was the most common type of electrolyte disturbance observed at 21.9%. A decrease in serum potassium levels was associated with decreases in blood glucose levels (r = 0.151, p = 0.025). During severe hypoglycemia, median blood glucose levels, incidence of tachycardia (> 100 beats per minute) and severe hypertension (≥ 180/120 mmHg) were 30 mg/dL (range, 14 to 62) and 35 mg/dL (range, 10 to 69; p = 0.04), 18.8% and 7.2% (p = 0.02), and 20.8% and 10.2% (p = 0.05) in the hypokalemia and normokalemia groups, respectively. Conclusions: During severe hypoglycemia, hypokalemia occurred in 21.9% of T2DM patients and was associated with tachycardia and severe hypertension. Therefore, the results suggest that severe hypoglycemia may increase cardiovascular events in T2DM.

조직내 따돌림 지각이 반생산적 과업행동과 이직의도에 미치는 영향 : 자존감의 조절효과 검증

강미연,최항석,신이현,이동현 한국경영컨설팅학회 2023 경영컨설팅연구 Vol.23 No.6

As bullying within organizations has been recently recognized as a serious social problem in Korea as well as in major overseas countries, a law to prohibit workplace bullying has been implemented since 2019 to create a working environment where organizational members should not be bullied. However, one in three office workers still appears to have experienced workplace bullying in the past year, and even the rate of bullied experience has been gradually increasing. Therefore, this study conducted an empirical research to confirm that an individual’s perception of bullying within an organization can have a direct and negative impact on job behaviors such as counterproductive task activities and turnover intentions. In addition, it was intended to provide an integrated understanding of managing bullying within organizations by examining the role of the moderating effect of self-esteem, which is an individual’s internal mechanism and personal resource. This study carried out a survey targeting domestic office workers, and a total of 287 valid samples were used for analysis. The results of the empirical analysis are as follows. First, an individual’s perception of bullying within an organization was found to have a positive(+) influence on the negative effects such as counterproductive task behavior toward others, counterproductive task behavior toward the organization, and turnover intention. Second, self-esteem showed a moderating effect in the relationship between bullying within the organization and counterproductive task behavior toward others, but did not have a moderating effect in counterproductive task behavior toward the organization. Third, self-esteem had a significant moderating effect in the relationship between perception of bullying within the organization and turnover intention, but the higher the self-esteem, the rather stronger the turnover intention. As an empirical analysis of domestic office workers, this study is significant in that it examined how the perception of bullying within an organization affects negative behavioral intentions. In addition, it was found that the higher the self-esteem, the more different the way to recover the emotions lost by an individual’s perception of bullying, so it aims to emphasize the importance of institutional support from the organization as a solution.

포스터 전시 발표 : 호흡기,내분비-대사 ; 비면역성 전격성 제1형 당뇨병 1예

강미연,정정화,이강완,함종열,정순일 대한내과학회 2003 대한내과학회 추계학술대회 Vol.65 No.10

탈냉전 자본주의 : 전쟁도 상품이다!

강미연 한국사회학회 2009 한국사회학회 사회학대회 논문집 Vol.2009 No.1

개성공단 경제특구의 작업장 문화

강미연 동국대학교 북한학연구소 2013 북한학연구 Vol.9 No.2

The Gaeseong Industrial Complex exhibits a relatively equal relationship between the two governments for the purpose of developing a collaborative political relationship, whereas the other two forms of SEZs are often based on unequal and hierarchical relationships between state actors. The Complex, however, is susceptible to potential tensions and conflicts. Unexpected incidents can occur at any moment, due to the cultural and political differences between South and North Koreans. To ameliorate this atmosphere and maintain stable productivity, the companies in the SEZ devised “stabilizing mechanisms.” This study asserts that these mechanisms, which are constructed through daily interactions among workers in workplaces, have played a significant role in managing crises, even if the mechanisms cannot fundamentally overcome structural restraints due to ideological and political tensions. This study uses archival research, participant observations in workplaces in the Complex and in-depth interviews with the employers and managers of the companies and North Korean defectors who have worked in North Korea. The companies have devised stabilizing mechanisms to minimize the risks from potential conflicts and to secure stable production of goods. A two-track system managing labor and cultural and institutional stabilizing mechanisms have helped to create a specific workplace culture at the Complex. This workplace culture arises through the cultural creativeness that a contact zone provides, and through the personal interactions among North and South Korean agents sharing some ethnic similarities. 개성공단 경제특구는 남북협력이라는 정치적 목적에 기반하여 행위자 간 평등한 협상과 접촉의 평등적 관계를 형성한다는 점에서 자본주의 경제체계 하에서의 일반적인 경제특구와는 차별성을 보인다. 본 연구는 이러한 개성공단 경제특구의 특수성에 기반하여 남북 노동행위자들이 구축해온 개성공단 작업장 문화의 진화과정을 분석하고자 한다. 본 연구는 개성공단에서의 현지조사의 제약 때문에 주로 문헌조사와 개성공단 작업장 참관 그리고 심층면접 방법으로 이루어졌으며, 심층면접 연구 참여자는 남측 입주기업 및 관리위원회 관계자와 북한에서 노동경험이 있는 북한이탈주민이다. 개성공단은 분단의 정치적 특수성으로 인하여 체제의 충돌과 긴장이 잠재해 있으며, 언제 어떠한 제재가 내려질지 모르는 불예측적이고 불안정한 구조이다. 또한 남북의 체제와 문화의 차이는 상호간 충돌과 갈등의 요소로 작용하였다. 그러나 입주기업들은 작업장의 이러한 구조적 한계를 완화하고 안정적으로 생산 활동을 유지하기 위하여 ‘안정화 기제’를 고안하였고, 그것이 개성공단 작업장 문화로 구축되고 있다. 안정화 기제의 작업장 문화가 남북의 이데올로기 충돌과 정치적 갈등·긴장이 상존하는 개성공단의 구조적 제약을 해소할 수는 없다. 그러나 본 논문은 남북노동행위자들의 대면적 상호작용을 통하여 형성된 안정화 기제들이 정치적 영향력에 의한 개성공단 작업장의 위기를 관리하는 데 중요한 역할을 해왔음을 밝히고자 한다. 입주기업들은 남북의 정치적 갈등과 가치 충돌의 위험을 최소화하고 안정적인 생산활동을 유지하기 위한 관리방식을 통해 작업장의 안정화 기제를 발전시키고 있다. ‘투 트랙 체제(two-track system)’로 명명될 수 있는 노동관리 방식과 문화전략을 적용한 다양한 제도적·문화적 안정화 기제들이 시행착오를 거쳐 개성공단 작업장 문화로 구축되고 있다. 개성공단 작업장 문화는 상이한 체제와 문화가 공존하는 접촉지역의 문화적 창조성과 민족적 동질성에 기초한 남북 노동행위자들의 대면적 접촉의 상호작용에 근원하고 있음을 밝혔다.

눈물 대신 희망을

강미연 샘터사 2004 월간 샘터 Vol.407 No.-

주거의 관점에서 본 노숙의 사회적 배제: 쉼터 노숙인들의 생활 경험을 중심으로

강미연,김위정 한국도시연구소 2005 도시와 빈곤 Vol.74 No.-

노자 윤리사상의 이론 토대와 인성교육적 의의

강미연 동양예학회 2020 東洋 禮學 Vol.42 No.-

Glucagon-Like Peptide-1 Increases Mitochondrial Biogenesis and Function in INS-1 Rat Insulinoma Cells

강미연,오태정,조영민 대한내분비학회 2015 Endocrinology and metabolism Vol.30 No.2

Glucagon-like peptide-1 (GLP-1) is a gut-derived incretin hormone that increases glucose-stimulated insulin secretion in pancreatic β-cells. Since mitochondrial function is crucial to insulin secretion, we hypothesized that GLP-1 may increase mitochondrial biogenesis in pancreatic β-cells. We treated INS-1 rat insulinoma cells with GLP-1 or exendin-4 for 48 hours and measured mitochondrial mass and function. Both GLP-1 and exendin-4 increased mitochondrial mass by approximately 20%. The mitochondria/cytosol ratio was increased from 7.60±3.12% to 10.53±2.70% by exendin-4. In addition, GLP-1 increased the mitochondrial membrane potential and oxygen consumption. Proliferator-activated receptor-gamma coactivator 1α expression was increased approximately 2-fold by GLP-1 treatment. In conclusion, the present study presents evidence for a new mechanism of action by which GLP-1 improves pancreatic β-cell function via enhanced mitochondrial mass and performance.