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쯔쯔가무시병의 조기진단을 위한 발진, 림프절염 및 가피 관찰의 중요성에 대한 재검토
고완,이강수,이원영,유승근,배진기,정윤섭,김기열 대한감염학회 1991 감염 Vol.23 No.3
Early diagnosis of tsutsugamushi disease (scrub typhus) is important for antimicrobial treatment of the patient. Previously, we repored that early diagnosis was possible based on the observation of rash, lymphadenitis or eschars in most of the suspected patients. However, the low frequency of these findings in some reports may indicate we may miss some tsutsugamushi disease patients. In this study the accuracy of the clinical diagnosis based on these findings were reevaluated. Two groups of febrile patients, seen at clinics in Chinhae in 1990, were tested for IFA antibdy against R. tsutsugamushi. Among the 32 patients with rash, lymphadenitis or eschars, 94% showed serological evidence of tsutsugamushi disease, while none of the 31 febrile patients without these findings. It is concluded that most of the clinical diagnosis of tsutsugamushi disease of the patients with these findings are accurate and that febrile patients without these findings in the early stage of the disease are rarely tsutsugamushi disease.
고 Prolactin 혈증 환자의 당불내인성 ( Glucose Intolerance ) 의 기전에 관한 연구
고완(Wan Ko),이승재(Seung Jae Lee),곽진구(Jin Koo Kwark),박원근(Won Kun Park),한인권(In Kwon Han),김선우(Sun Woo Kim) 대한내과학회 1988 대한내과학회지 Vol.34 No.6
N/A Prolactin may have a diabetogenic action. But underlying mechanisms how prolactin induce changes in glucose homeostasis are unknown. To ascertain the potential contribution of altered insulin receptor to this phenomenon, we studied insulin binding to erythrocyte and internalization of insulin in 5 patients of hyperprolactinemia and 8 healthy, non-pregnant female control. The results were as follows: 1) Glucose tolerance deteriorates in hyperprolactinemic patients compaired with nofmal control. 2) Plasma insulin and c-peptide concentration after oral GTT of hyperprolactinemic patients were not different that of normal control. 3) Insulin binding to erythrocyte was lower in hyperprolactinemic patients than normal control. 4) Internalization of insulin was lower in hyperprolactinemic patients than normal cotnrol. Above data suggested that hyperprolactinemia is accompanied with significant insulin resistance which is partly due to reduced number of insulin receptor without changes of binding affinity and reduced internalization of insulin.
상부소화관 내시경검사가 혈중 Catecholamine 농도에 미치는 영향에 관한 연구
김은주,김선우,고완,윤세옥 대한소화기내시경학회 1988 Clinical Endoscopy Vol.8 No.2
Cardiovascular changes induced by a variety of physiological, surgical or emotional stresses are associated with increased sympathetic nervous system activtity. Sympathetic stimulation lowers the ventricular resistance in patients with ischemic heart disease. Thus sympathoadrenal aetivation may play role in sudden cardiac death. We measured the catecholamine levels just before and after fiberoptic gastroscopy, The results were as follows: 1) Though there was no statistical significance, plama catecholamine levels tends to increase during and after fiberoptic gastroscopy. 2) Significant changes in mean blood pressure did not occur during and after fiberoptic gastroscopy. 3) Before fiberoptic gastroscopy, norepinephrine level of three hypertensive patients were lower than the levels of studied patients, But during and after fiberoptic gastroacopy, norepinephrine level increased by 3 times. 4) The highest norepinephrine level was 847 pg/ml and epinephrine level was 110 pg/ml. Though sympathetic response was enhanced by fiberoptic gastroscopy, norepinephrine level did not increase up to the level shown in myocardial infarction or severe exercise.
Type 2 DM 환자에서 인슐린 또는 경구혈당강하제등의 치료에 의한 인슐린 내지환와 Dagradation 장애의 회복
박원근(Won Kun Park),고완(Wang Ko),최웅환(Woong Hwan Choi),한인권(In Kwon Han),김선우(Sun Woo Kim),정운원(Woon Won Jeng),문인걸(In Gul Moon) 대한내과학회 1988 대한내과학회지 Vol.35 No.4
N/A The internalization of I-insulin in human erythrocytes was studied using an acid extraction technique (pH 5.7, PBS) from 7 patients with type 11 diabetes mellitus (DM) and 14 normal subjects before and after glucose control. Insulin degradation products from 4 patients with type 11 DM and 14 normal subjects in the same period were assayed using HPLC with Sephadex G-50 column and a radioisotope detector. The maximal rates of insulin internalization (Incubation time: 4 hours, at 37°C) which were decreased before glucose control (50.25±6.99%vs 80.23±7.73%), returned toward normal levels after glucose control (89.5±5.45%). The maximal degradation products of insulin (incubation time: 4 hours, at 37°C) which were decreased before glucose control (62.25±10.50vs 87.75±6.66%), returned toward normal levels after glucose control (91.4±7.60%). These results suggest that in type 11 DM, the decreased rate of insulin internalization and degradation may be one of the contributory factors in the pathogenesis of postbinding resistance, which is reversible with insulin or sulfonylurea treatment.