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Graves 병에 있어서 항갑상선제 치료효과 예측지표로서의 T₃ / T₄ 비
김유리(Yoo Lee Kim),김현만(Hyeon Man Kim),김경래(Kyung Rae Kim),임승길(Sung Kil Lim),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh) 대한내과학회 1987 대한내과학회지 Vol.33 No.2
N/A To evaluate the significiance of T₃/T₄ ratio as a prognostic indicator in medical treatment of Graves' disease, 73 patients with the disease were investigated. The remission group consisted of 31 cases (42.5%) and the relapse group 42 cases (57.5%). 1) The T₃/T₄ ratio of the remission group before treatment (19.5±5.1) and of on follow up (14.3±3.6) were significantly lower than those of the relapse group (23.3±6.9, 23.2±7.3). 2) The rate of relapse in patients with persistently high T₃/T₄ ratio was 71.4% and that in patients with persistently low 47.9%. These data indicate that T₃/T₄ ratio may be helpful, but not definite indicator in prediction of the outcome of medical treatment of Graves' disease.
정윤석(Yoon Sok Chung),김현만(Hyeon Man Kim),이은직(Eun Jig Lee),정재희(Jae Hee Chung),이경미(Kyung Mi Lee),박석원(Seog Won Park),조홍근(Hong Keun Cho),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh),박유경(Yoo Kyoung Park),김희선(Hee Son 대한내과학회 1994 대한내과학회지 Vol.47 No.3
N/A Objectives: Growth hormone secretory capacity of adults decrease with aging, Growth hormone secretory capacity and prevalence of growth hormone deficiency in Korean adults were studied. Methods: History, physical examination, and routine blood tests were performed to roule out ill patients among ordinary subjects. Anthropometry, nutritional history, serum insulin-like growth factor-1 (IGF-1) levels, L-dopa stimulation tests, and urinary growth hormone levels were measured in 309 Korean adults, ages 20-87 years. Results: The mean serum IGF-1 levels were 258,2+6. 8 ng/ml. The mean serum IGF-1 levels of adult males were significantly higher than those of the females. The serum IGF-1 levels decreased with aging. The prevalence of growth hormone deficiency defined by serum IGF-1 levels (< 150 ng/ml) were 0.0% in the 3rd decade, 5.5% in the 4th decade, 12.2% in the 5th decade, 10.0% in the 6th decade, 32.1% in the 7th decade, 48.1% in the 8th decade, respectively. The serum IGF-1 levels were positively correlated with total energy expenditure, but negatively correlated with body fat mass. The peak serum growth hormone levels after L-dopa stimulation and urinary growth hormone levels of the younger subjects were significantly higher than those of the older subjects, There were goad correlations among serum IGF-1 levels, peak growth hormone levels after L-dopa stimulation, and urinary growth hormone levels. Conclusion: Growth hormone secretory capacity decreased significantly with aging, and growth hormone deficiency was found in about 1/3 of subjects aged over 60 years.
관상동맥죽상경화증 환자에서 식생활요법 후 관상동맥경화증의 변화
정윤석(Yoon Sok Chung),김현만(Hyeon Man Kim),김한수(Han Su Kim),탁승제(Seung Jea Tahk),이웅구(Woong Ku Lee),정익모(Ick Mo Chung),조홍근(Hong Keun Cho),조승연(Seung Yun Cho),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh),백인경(In Kyung Pa 대한내과학회 1995 대한내과학회지 Vol.48 No.2
N/A Objectives: Coronary atherosclerosis is a life-style disease. Recently, Ornish et al. reported regression of coronary atherosclerosis in subjects with coronary artery disease who participated in a strict life-style modification program. We studied the effects of a life-style modification program on Korean patients with coronary atherosclerosis. Methods: Fourteen patients with angiographically documented coronary artery narrowing of over 50% in at least one vessel were studied prospectively. Subjects were divided into two groups. Subjects of group 1 (n=8) had a strict diet program composed of daily intake of less than 15% of fat and less than 100㎎ cholesterol; subjects of group 2 (n=6) had a usual diet program (American Heart Association step 1 diet) with daily intake of less than 30% fat and less than 300㎎ of cholesterol. All subjects were recommended with 200kcal per day exercise and instructed to stop cigarette smoking. Diet, anthropometric parameter, blood pressure measurements, serum lipid levels, and coronary angiography were recorded before and after the life-style modification program. Results: In group 1 (strict program) subjects, whose dietary intake of cholesterol and saturated fatty acid decreased, waist to hip circumference ratio and body fat decreased after the program. In contrast, there was no significant change in waist to hip circumference ratio and body fat of group 2 (usual program) subjects, whose dietary intake of cholesterol and saturated fatty acid did not decrease. In group 1, systolic blood pressure, serum total cholesterol and low density lipoprotein cholesterol levels decreased. There was no significant change in systolic blood pressure, serum total cholesterol, and low density lipoprotein cholesterol levels in group 2. Diameter stenosis of coronary artery regressed from 63.2±3.9% to 56.8±3.6% in group 1. There was no significant change (65.8±4.5% to 66.6±7.7%) in group 2. Conclusion: Coronary atherosclerosis significantly regressed in subjects who followed a strict life-style modification program, but not in subjects who continued their usual life-style program. Therefore, strict life-style change should be advised for coronary atherosclerotic patients.
인슐린 비의존형 당뇨병환자의 혈장아미노산 농도에 관한 연구
김유리(Yoo Lee Kim),조용욱,김현만(Hyeon Man Kim),임승길(Sung Kil Lim),김경래(Kyung Rae Kim),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh),정미라(Mi Ra Chung),이귀녕(Kui Nyung Lee),이해선(Hae Sun Lee) 대한내과학회 1989 대한내과학회지 Vol.36 No.2
N/A In 105 non-insulin dependent diabetics, composed of 20 under-weight, 66 non-obese, and 19 obese diabetics admitted to Severance Hospital, Yonsei University College of Medicine, plasma amino acid levels were measured by HPLC (High Performance Liquid Chromatography) in the fasting state before control of the blood sugar level. The following results were observed: 1) Plasma levels of branced chain amino acids-leucine, isoleucine, and valine-were higher in the diabetic group than in the control group (p<0.05) 2) Plasma levels of tyrosine, phenylalanine, tryptophan, glutamate, and serine were also higher in the diabetic group than in the control group (p<0.05). 3) The plasma level of threonine was lower in the diabetic group than in the control group (p<0.05). 4) In under-weight, non-insulin dependent diabetics, plasma levels of threonine, lysine, and alanine were lower than in the eontrol group (p<0.05). It could be concluded that in non-insulin dependent diabetics, both the uncontrolled state of the diabetes and the nuritional state influnence the changes of plama amino acid levels.
이은직(Eun J . Lee),김도영(Doe Y . Kim),허갑범(Kap B . Huh),김현만(Hyeon M . Kim),임승길(Sung K . Lim),김경래(Kyung R . Kim),이현철(Hyun C . Lee),김덕회(Duk H . Kim) 대한내과학회 1987 대한내과학회지 Vol.33 No.6
N/A Of 501 Korean diabetics admitted to Severance Hospital, Yonsei University College of Medicine, non-obese non-insulin-dependent diabetes mellitus (NIDDM) comprised 319 cases (63.7%), obese NIDDM 100 cases (19.9%) and insulin-dependent diabetes mellitus (IDDM) 82 cases (16.4%). And in the IDDM group thus collected, juvenile-onset diabetes (JOD) comprised 17 cases (3.4%), youth-onset underweight diabetes (YOUD) 25 cases (5.0%) and maturity-onset underweight diabetes (MOUD) 40 eases (8.0%). The caloire intakes just before the onset of diabetes in YOUD and MOUD patients were found to be 63.1% and 60.9% and the intakes of protein 55.9% and 79.8% of the recommended dietary allowance, respectively. Among JOD, YOUD and MOUD, there were no significant differences in body weight, and fasting blood glucose and HbA1c levels at the time of admission. The basal and peak serum C-peptide levels in YOUD (1.03±0.61ng/ml, 1.59±1.23ng/ml) were slightly higher than those in JOD (0.64±0.30ng/ml, 1.05±0.54ng/ml), but significantly lower than those in MOUD (1.61±0.73ng/ml, 2.65±1.30ng/ml). Between JOD and YOUD, there was no significant difference in family histories (23.5%, 24.0%) or clinical features. However, MOUD turned out to have significantly lower family history (2.5%), no history of diabetic ketoacidosis and more pulmonary tuberculosis than the former 2 groups. Of 29 young diabetics (JOD and YOUD) who were followed-up at OPD, 14 cases (5 JOD and 9 YOUD) were ketosis-resistant. These data suggest that, in Korea which is located in temperate zone, malnutrition-related diabetes mellitus (MRDM) can be mainly classified into 2 groups: The youth-onset one had the characteristics of IDDM with the history of undernutrition and ketosis-resistance, and the maturity-onset one may belong to NIDDM with the higher susceptibility to pulmonary tuberculosis.
조용욱(Yong Wook Cho),임승길(Sung Kil Lim),김현만(Hyeon Man Kim),이영식(Young Sik Lee),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh) 대한내과학회 1987 대한내과학회지 Vol.33 No.6
N/A There are several reports indicating that ICA is important marker of persistent islet cell damage. It has been suggested that the presence of ICA in patient with NIDDM implies a high risk of future insulin dependency. Islet cell antibody (ICA) was determined by the indirect immuno fluorescence technique in 9 insulin dependent diabetes mellitus (IDDM), 12 atypical diabetes, 49 under-weight non-insulin dependent diabetes mellitus (NIDDM), 106 non-obese NIDDM, 45 obese NIDDM and 67 non-diabetic controls. We obtained the results as follows; 1) The prevalence of ICA was 0% in non-diabetic control and 14.9% in overall diabetes; 44.4% in IDDM, 41.7% in atypical diabetes, 22.4% in underweight NIDDM, 11.3% in non obese NIDDM and 2.2% in obese NIDDM. 2) In IDDM and atypical diabetes, 75% (3/4) and 60% (3/5), respectively, had short duration of diabetes (less than 1 year). However, in NIDDM patients with ICA, 87.5% (21/24) had the duration of disease more than 3 years. 3) In atypical diabetes and underweight NIDDM with ICA, the basal and peak C-peptide levels were significantly lower than in those without ICA. 4) Most of diabetics with ICA needed insulin for control of diabetes. These data indicated that atypical diabetes is similar to IDDM and high prevalence of ICA in underweight may reflect the early stage of IDDM and destruction of beta cell.