즐례 : 저칼슘혈증을 동반한 급성 화농성 갑상선염 1예

유승진 ( Seung Jin Yoo ),심명숙 ( Myoung Sook Shim ),김원준 ( Won Jun Kim ),김은정 ( Eun Jung Kim ),오광훈 ( Kwang Hoon Oh ),이제훈 ( Je Hoon Lee ),권준성 ( Jun Sung Kwon ) 대한내과학회 2014 대한내과학회지 Vol.86 No.1

저자들은 급성 화농성 갑상선염을 진단하고 항생제, 칼슘 제 및 1α-OH-D3 투여로 임상증상 및 부갑상선기능, 저칼슘 혈증이 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. We report a case of acute suppurative thyroiditis complicated by idiopathic hypoparathyroidism. The patient was a 49-year-old female who visited our clinic with a painful goiter on the left lobe of the thyroid gland. She was hypocalcemic, which was accompanied unusually by acute suppurative thyroiditis. She also suffered from tetany of both hands and legs. She had undergone a right subtotal thyroidectomy at another hospital 23 years previously due to a benign thyroid nodule. Intact parathyroid hormone (PTH) levels were increased, but other laboratory findings were normal. No special treatment was administered for the acute suppurative thyroiditis, except antibiotics, to observe its natural course. Her PTH levels decreased and serum calcium returned to normal. The complication of acute suppurative thyroiditis suggested the possible involvement of idiopathic hypoparathyroidism. (Korean J Med 2014;86:79-83)

저칼슘혈증을 동반한 급성 화농성 갑상선염 1예

유승진 ( Seung Jin Yoo ),심명숙 ( Myoung Sook Shim ),김원준 ( Won Jun Kim ),김은정 ( Eun Jung Kim ),오광훈 ( Kwang Hoon Oh ),이제훈 ( Je Hoon Lee ),권준성 ( Jun Sung Kwon ) 대한내과학회 2014 대한내과학회지 Vol.86 No.2

일주기 변화가 체내시계와 호르몬계에 미치는 영향

김원준(Won Jun Kim),김진엽(Jin Yeob Kim),심명숙(Myoung Sook Shim) 한국항공우주의학협회 2012 항공우주의학회지 Vol.22 No.2

증례 : 그레이브스씨병과 동반된 원위부 신세관성 산증

황정원 ( Jung Won Hwang ),한군희 ( Koon Hee Han ),김영돈 ( Young Don Kim ),홍현일 ( Hyun Il Hong ),심명숙 ( Myoung Sook Shim ),김진엽 ( Jin Yub Kim ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-

저자들은 갑상샘과다증 환자에서 원위 신세관 산증을 진단한 1예를 경험하였다. 갑상샘과다증 환자에서 저칼륨증에 의한 근육 마비가 발생한 경우 증상 호전 후에도 저칼륨증이 지속된다면 다른 원인을 감별해야 할 것으로 생각한다. Distal renal tubular acidosis is characterized by a decrease in net hydrogen ion secretion from renal collecting tubules. The most common causes of distal renal tubular acidosis in adults are autoimmune disorders, such as Sjogren syndrome, systemic lupus erythematosus, and rheumatoid arthritis. Compared to other autoimmune disorders, the concurrence of renal tubular acidosis and autoimmune thyroid disease is extremely rare. We report a patient who presented with hypokalemic paralysis associated with Graves` disease and distal renal tubular acidosis. (Korean J Med 69:S915-S918, 2005)

감염 ; 당뇨병 발생 고위험군에서 체중 변화와 인슐린저항성의 연관성

최경진 ( Kyung Jin Choe ),김원준 ( Won Jun Kim ),신사영 ( Sa Young Shin ),우영민 ( Yeongmin Woo ),이기훈 ( Ki Hun Lee ),김은정 ( Eun Jung Kim ),심명숙 ( Myoung Sook Shim ),김진엽 ( Jin Yeob Kim ) 대한내과학회 2015 대한내과학회지 Vol.89 No.6

Background/Aims: The present study aimed to investigate the associations between a change in body weight from 20 years of age to the present with insulin resistance and several parameters of metabolic syndrome in individuals at an increased risk of diabetes. Methods: From patients with a diagnosis related to an increased risk of diabetes who were examined at our endocrinology clinic from January 2012 to December 2014, the present study recruited 125 individuals between 30 and 64 years of age with hemoglobin A1c levels from 5.7 to 6.4%. The change in body weight of each patient from 20 years of age to the present was retrospectively determined, and the associations of this change with insulin resistance and several parameters of metabolic syndrome were analyzed. Results: The average gain in body weight after 20 years of age was 11.3 kg and there was no significance difference between the male and female patients. The proportion of overweight and obese patients at 20 years of age was 14%, but was 74% at the time of the visits to our endocrinology clinic. A change in body weight was significantly correlated with body mass index, insulin resistance, and waist circumference. Additionally, as the tertile of change in body weight increased, fasting insulin levels, insulin resistance, and the prevalence of abdominal obesity significantly increased. Conclusions: In the present study, an increase in body weight from 20 years of age to the present was correlated with insulin resistance and several parameters of metabolic syndrome in individuals at an increased risk of diabetes. (Korean J Med 2015;89:681-689)

백반증과 이차성 부신피질 기능저하증을 동반한 Graves' Disease 1예

심명숙,석기태,김영욱,신영구,최응호,김명순,정춘희 연세대학교 원주의과대학 2000 원주의대논문집 Vol.13 No.1

46 XX 남성 증후근 1 예

이재명,정춘희,신영구,심명숙,김영욱 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.1

The 46, XX male syndrome is rare disease that is characterized by a phenotypic male who has a 46, XX female karyotype. Since the first report by de la Chapelle and associates in 1964, several cases have been reportc4 but it is still a rare entity. Recently we examined a 20-year-old XX male who had the symptoms of gynecomastia, an infantile appearance of the external genitalia, scanty pubic hair, no Adams apple, and no axillary hair. We presently describe a patient with the 46, XX male syndrome who showed a 46, XX karyotype on chromosomal study and review the literatures (J Kor Soc Endocrinol 16:148-152, 2001).

노인 당뇨병 환자의 가족지지와 삶의 질

최윤정,김형방,김문규,심명숙,이준상,김미진,정춘희 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.3

연구배경: 현대의학의 급속적인 발달로 사람의 평균수명이 연장되고 경제가 고도성장함에 따라 생활양식이 서구화되면서 당뇨병의 유병률이 증가하고 있다. 최근 여성의 사회참여율 증가와 부부만 사는 가정, 노인 혼자 사는 가정들이 늘어나는 추세이다. 그러므로 노인 당뇨병 환자에 대한 가족의 지지와 삶의 질에 관해 알아보고 자 본 연구를 시행하였다. 방법: 연세대학교 원주기독병원 내분비대사내과에 내원하는 60세 이상의 노인 당뇨병 환자147명을 대상으로 조사하였으며 노인 당뇨병 환자의 가족지지의 하위영역인 치료적지지, 심리적 지지와 삶의 질의 하위영역인 정서적 삶의질, 신체적 삶의 질, 사회·경제적 삶의 질을 분석하였다. 결과: 첫째, 노인 당뇨병 환자는 주로 부부만 사는 가정이 50.3%로 나타났으며, 혼자 산다가 9.5%로 조사되었다. 둘째, 수발의 도움에서는 배우자가 51.7%로 나타났고, 도움이 필요하나 도와 줄 사람이 없다가 12.9%로 나타났다. 셋째, 사회복지 서비스는 필요하다가 68.0%, 모르겠다 22.5%로 조사되었다. 넷째, 가족지지와 심리적지지의 신뢰도는 0.8331로 높게 조사되었다. 다섯째, 신체적 삶의 질(p<0.05), 사회·경제적 삶의 질(p<0.01)에서 여자보다 남자가 의미가 있었고, 교육정도에서는 학력이 높으면(p<0.001)로 상당히 유의하게 나타났다. 여섯째, 정서적, 신체적삶의 질의 신뢰도 계수는 0.681, 사회·경제적 삶의 질의 신뢰도 계수는 0.7521로 비교적 양호하게 조사되었다. 결론: 노인 당뇨병 환자에게 가족의 지지는 꼭 필요하며 더불어 국가차원에서 노인들의 재가복지의 확대와 의료보험수가의 차등화 정책을 실행한다면 노인 당뇨병 환자의 삶의 질은 향상 될 것이다. Background: With the extension of average life span of human being by rapid medical development and robust economical growth, lifestyle of the domestic individual have become westernized causing an increase in the prevalence of diabetes. Nowadays, working females, no-kid couples and old people who live alone are increasing. This study was carried out to investigate the family support, quality of life and social welfare of old age diabetic patient Methods: The study was carried out in 147 diabetics over the age of 60 .at the Wonju Christian Hospital. Treatment and psychological support as well as emotional, physical and socioeconomic quality of life were investigated. Results: First, 50.3% of the old age diabetics were no-children couples and 9.5% lived alone. Second, 51.7% were receiving aid from their spouses and 12.9% had no one to ask for aid. Third, 68.0% replied 'yes' to the 'necessity of social welfare services' category, 22.5% replied 'not sure' asked for leisure activities. Fourth, 43.7% of the old aged diabetics replied 'no' to the 'did your family accompany you to the education programs?' category. The reliability index for the treatment support was 0.8934. Fifth, the reliability index for family support and psychological support recorded as 0.8331. Sixth, men took more meaning in the physical(p<0.05) and socioeconomic of life(p<0.01) categories and education levels seemed to take much influence from 'level of school education taken' category. Seventh, the reliability index for emotional and physical quality of life recorded as 0.681 and the index for socioeconomic quality of life recorded as 0.7521. Judging from the results above, the quality of life for old age diabetic patients can be improved if the 'reliance on family' index of the family support and quality of life categories are increased. Conclusion: Family support is crucial in old age diabetic patients in order to improve their quality of life.