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박병한,김용주,윤정민,김자혜,문진화,이영호,장세민 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.4
Purpose: Insulin resistance (IR) has an important role in the development of non-alcoholic steatohepatitis (NASH). We aimed to analyze the association between liver histopathology and IR in pediatric patients with NASH. Materials and Methods: In 24 children with non-alcoholic fatty liver disease (NAFLD), we investigated whether the hepatic pathologiccharacteristics have relations with following three biochemical indices; IR index including homeostasis model assessment of IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and insulin sensitivity indices-free fatty acid (ISI-FFA). Results: Among 24 patients, 16 (66.6%) had a high NAFLD activity score (NAS), which is diagnostic of NASH. Higher serum triglyceridelevel was significantly correlated with a high NAS. Higher steatosis grades were significantly associated with low insulin sensitivity (p=0.023). In addition, severe lobular inflammation was associated with higher IR: HOMA-IR (p=0.014) and QUICKI (p=0.023). Severe fibrosis correlated with low insulin sensitivity and high IR indexes: ISI-FFA (p=0.049), HOMA-IR (p=0.028), and QUICKI (p=0.007). Conclusion: Patients with high IR had more severe lobular inflammation and hepatic fibrosis. Analyses of biochemical and endocrineparameters can be applied to determine the severity of the hepatic pathologic status in patients with NASH, especially in children who cannot undergo a liver biopsy.
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윤정민,박병한,김자혜,문진화,이영호,장세민,김용주 대한의학회 2018 Journal of Korean medical science Vol.33 No.5
Background: Histologically, nonalcoholic steatohepatitis (NASH) is categorized into adult-type (type 1) and pediatric-type (type 2). The origination of the histological difference between the two types and how they differ clinically remain uncertain. We aimed to understand the incidence and clinical characteristics of the two types of NASH in Korean children, and to investigate the association between their pathological type and clinical characteristics, using anthropometric and laboratory data. Methods: In 38 children with confirmed NASH, we investigated hepatic pathological findings, and correlating factors between pathological type and laboratory and anthropometric data (weight percentile, body mass index (BMI) z-score, and blood pressure percentile). Adult-type NASH was noted in 21 patients and pediatric-type in 17 patients. Results: Age, sex, BMI, transaminase levels, and insulin resistance were not significantly different between the two groups. Triglyceride (TG) levels were higher in adult-type NASH (P = 0.033). Hematocrit and albumin levels were lower in adult-type NASH (P = 0.016 and 0.013, respectively). Hepatic fibrosis was more common in pediatric-type. The fibrosis scores in patients with adult-type were mostly 0 and 1, whereas the score was 3 in patients with pediatric-type (P = 0.024, 0.004, and < 0.010, respectively). Anthropometric data, liver function, and insulin resistance scores did not differ between the two pathological NASH types. TG, hematocrit, and albumin may be potential factors to predict pathological types. Fibrosis was observed more frequently in pediatric-type NASH. Conclusion: Monitoring children with pediatric-type NASH for progression to fibrosis or cirrhosis is recommended.
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상업지역 내 초고층 주거건축의 주동배치방식에 따른 수평적 개방성 비교연구 - 대구지역 사례 중심으로 -
권종욱,박상민,박병한,Kwon, Jong-Wook,Park, Sang-Min,Park, Byong-Han 한국주거학회 2012 한국주거학회 논문집 Vol.23 No.3
Openness to outside is one of the most critical advantages for high-rise buildings. However, the effect of openness can be decreased if it is blocked by other high-rise buildings, especially built within the building complex of commercial district. The purpose of this study is to identify the horizontal openness of high-rise residential buildings by comparing 3 different cases of building arrangement type. A new method of evaluation has been introduced on the basis of distance to measure the openness including the matter of securing privacy. As a result of this study, comparative analysis was possible and relatively plentiful results of analysis could be drawn out. Through the process of analysis, this study set the evaluation indicators suitable to the analysis of openness of unit households. Thereby, the results of this study are expected to be used as useful basic data in planning high-rise mixed-use buildings.
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Allan-Herndon-Dudley Syndrome 환아에서 발견된 novel c.826G>A Mutation
신은경(Eun-Kyung Shin),박병한(Byung Han Park),문진화(JinHwa Moon),김자혜(Ja Hye Kim),유한욱(Han-Wook Yoo),김구환(Gu-Hwan Kim) 대한소아신경학회 2017 대한소아신경학회지 Vol.25 No.3
Allan-Herndon-Dudley syndrome (AHDS) is an X-linked intellectual disability caused by monocarboxylate transporter 8 (MCT8) deficiency. AHDS manifests in global developmental delay, axial hypotonia, quadriplegia, movement disorders in male patients, and most of them show the delayed or hypomyelination on brain magnetic resonance images. Typically, Triiodothyronine (T3) levels are markedly elevated, thyroid stimulating hormone (TSH) levels are normal or elevated, and free thyroxine (T4) levels are normal or decreased. In AHDS patients, early neurological manifestations are easily mistaken as cerebral palsy with unknown origin. Here, we present a novel c.826G>A mutation in a boy with severe axial hypotonia, limb dystonia and developmental delay. Thyroid function test including TSH, T3, and free T4 levels was the important clue for the diagnosis of AHDS of the patient.
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