제왕절개술 후 발생한 저칼슘 발작 ( Hypocalcemic crisis ) 1 예

안유헌(You Hern Ahn),박민수(Min Soo Park),황정혜(Jung Hye Hwang) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.3

Hypoparathyoidism is rarely reported during pregnancy or the puerperium. Since hypocalcemia during pregnancy increases the mortality and morbidity of fetus, neonate, and mother, the early diagnosis and treatment of hypocalcemia, especially hypocalcemic crisis, might be very important to reduce severe complications. We experienced a case of hypocalcemic crisis induced by hypoparathyroidism developed after Cesarean section. This case represents symptoms and signs of hypocalcemia such as dyspnea, tingling sensation of upper and lower limbs, chest pain during hypocalcemic crisis. Physicians should be aware of the symptoms and signs, and treament of hypocalcemic crisis.

국제 항공 의료 이송

안유헌(You Hern Ahn) 한국항공우주의학협회 2008 항공우주의학회지 Vol.18 No.1

하시모토 갑상선염과 동반된 갑상선 림프종 1예

안유헌(You Hern Ahn),진봉준(Bong Joon Jin),김윤정(Yun Jeong Kim),태 경(Kyung Tae) 대한두경부종양학회 2007 대한두경부 종양학회지 Vol.23 No.2

Malignant lymphoma of the thyroid gland is a reletively rare and constitute up to 1-5% of all thyroid ma-lignancies. It is known to be frequently associated with Hashimoto’s thyroiditis. The clinical presentation inclu-des an enlarging neck mass, accompanied by dysphagia, hoarseness or tenderness, with its most common his-tologic type being the diffuse large B cell non-Hodgkin’s lymphoma. We have experienced a case of thyroid lymphoma arising from Hasimoto's thyroiditis in a 57-year-old woman, who presented with an anterior neck mass. We present this case with a review of the literature.

한국인 갑상선 유두상암종 환자에서 XPC-PAT 유전자 다형

안유헌(You Hern Ahn),이형석(Hyung Seok Lee),이용섭(Yong Seop Lee),김희옥(Hee Ok Kim),이근영(Keun Young Lee),태경(Kyung Tae) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.2

Background and Objectives :Thyroid carcinoma is the sixth commonest cancer in Korea and the papillary carcinoma is the most common type(88%) of the malignant thyroid tumors. Bulky DNA adducts formed by the carcinogens are repaired by DNA repair process, but failure to repair this DNA damage can cause mutations in oncogenes and tumor suppressor genes resulting in tumor formation. The xeroderma pigmentosum group C ( XPC ) gene is essential for this repair procedure and the XPC-PolyAT ( PAT ) polymorphisms may alter DNA repair capacity(DRC) and genetic susceptibility to cancer. Subjects and Methods :In a case-control study of 113 Korean patients with pathologically diagnosed thyroid papillary carcinoma and 65 control subjects, we investigated the association between the three XPC-PAT gene polymorphisms and thyroid papillary cancer susceptibility. Results :The frequency of the variant XPC-PAT allele was lower in the cases(0.349) than in the controls (0.423), but the difference was not significant(p=0.140). Using logistic regression adjusting for age and sex, risk for thyroid papillary cancer was not increased in the XPC-PAT -/+ and XPC-PAT +/+ compared to XPC-PAT -/- (adjusted overall odds ratio[95% confidence intervals ; 95%CI]=0.52[0.26-1.03] and 0.62 [0.22-1.75], respectively; trend test, p=0.167). Conclusion :There are no relationship between the XPC-PAT polymorphism and the risk of thyroid papillary carcinoma in Korean population. Based on our results, XPC-PAT polymorphism do not modulate genetic susceptibility to thyroid papillary cancer.

Guar gum 을 첨가한 쑥설기가 Type - Ⅱ 당뇨환자의 혈액성분에 미치는 영향

장유경,서문희,김은미,안유헌 ( Yu Kyung Chang,Mun Hee Seo,Eun Mi Kim,You Hern Ahn ) 대한가정학회 1995 Human Ecology Research(HER) Vol.33 No.1

급성심근경색증에서의 심장자기공명영상술의 진단 정확도와 심근 생존력 평가: TI-201 심근관류 SPECT와의 비교

김혜선,박동우,김용수,김영선,최요원,전석철,서흥석,함창곡,김순길,안유헌,최윤영,박충기,Kim Hye-seon,Park Dong Woo,Kim Yongsoo,Kim Young-sun,Choi Yo Won,Jeon Seok Chul,Seo Heung Suk,Hahm Chang Kok,Kim Soon Kil,Ahn You hern,Choi Yoon Young,P 대한자기공명의과학회 2003 Investigative Magnetic Resonance Imaging Vol.7 No.2

목적 : 급성심근경색을 진단하는데 있어 심장자기공명영상의 유용성을 알아보고, 생존심근을 평가하는데 있어 Tl-201 심근관류 SPECT와 비교하고자 하였다. 대상 및 방법 : 흉통 및 호흡곤란이 있는 환자 중 심장자기공명영상과 Tl-201 SPECT를 시행한 17명을 후향적으로 조사하였다. 심장자기공명영상에서는 T2강조영상에서 심벽의 고신호 강도 유무, 영화영상에서 심벽 운동, Gd-DTPA 조영 증강 후 좌심실 벽의 관류 결손 및 주입 15분 후의 지연조영증강 유무를 평가하였다. T1-201 SPECT에서는 아데노신 부하 영상과 휴식기 영상을 얻어 관류 결손 유무와 관류 결손시 가역성 여부를 평가하였다. 결과 심장자기공명영상과 T1-201 SPECT 모두 급성심근경색을 진단하는데 통계적으로 의미가 있었고, T2강조영상, T1-201 SPECT, 지연조영증강 및 심벽운동 순으로 연관성이 있는 것으로 나타났고, 관류 결손은 통계적 유의성이 없었다. 생존심근 평가에 있어서는 두 검사간 유의한 차이가 없었으며, T2강조영상과 관류영상에서 T1-201 SPECT와 높은 일치율, 지연조영증강 및 심벽운동은 낮은 일치율을 보였다. 결론 : 심장자기공명영상은 급성심근경색을 진단하는데 매우 유의한 진단율을 보였고, 생존 심근여부의 판단에 있어 SPECT와 높은 일치율을 보였다. 그러나 각 검사별 판독 기준과 방법에서 많은 연구가 필요할 것으로 생각된다. Purpose : To assess the usefulness of cardiac MR imaging (MRI) in the diagnosis of acute myocardial infarction and in the assessment of myocardial viability in comparision with T1-201 SPECT. Materials and Methods : We retrospectively studied 17 patients who complained of chest pain and dyspnea with cardiac MRI . The patients were evaluated for the presence or absence of high signal intensity on T2-weighted image (T2wI), abnormal wall motion on 2D-FIESTA, perfusion defect on Gd-DTPA enhanced T1WI, and delayed myocardial enhancement on 15-minutes delay Gd-DTPA enhanced T1WI. The results were correlated with the images on T1-201 SPECT, taken at rest and stress, through which reversibility of perfusion defect was assessed. Results : Both cardiac MRI and T1-201 SPECT proved to be useful methods for diagnosing acute myocardial infarction. In order of decreasing correspondence, T2WI, T1-201 SPECT, delayed enhancement study, and wall motion images all showed significant statistical correlation with the clinical diagnosis of myocardial infarction. Perfusion MRI, on the other hand, showed no significant statistical difference was found between T1-201 SPECT and cardiac MRI. The results on T2WI showed high accordance with those on Tl-201 SPECT, while delayed myocardial enhancement and wall motion studies showed no agreement with Tl-201 SPECT. Conclusion : Cardiac MRI is useful method for diagnosis of acute myocardiac infarction. With respect to the assessment of myocardial viability, the results obtained on cardiac MRI showed high agreement with those on Tl-201 SPECT. However, further study is necessary at this point for standardization and establishment of the methods for assessing myocardial viability on cardiac MRI.

제 2유형 당뇨환자를 위한 타이치 자조프로그램이 혈당조절, 심혈관 위험요소, 삶의 질에 미치는 효과

송라윤(Song Rhayun),이은옥(Lee Eun Ok),배상철(Bae Sang-Cheol),안유헌(Ahn You Hern),Paul Lam,이인옥(Lee Inok) 대한근관절건강학회 2007 근관절건강학회지 Vol.14 No.1

증례 : 내분비-대사 ; 클라인펠터증후군과 동반된 제2형 당뇨병 1예

박용수 ( Yong Soo Park ),김동선 ( Dong Sun Kim ),윤지영 ( Ji Young Yoon ),안유헌 ( You Hern Ahn ),최웅환 ( Woong Hwan Choi ),김태화 ( Tae Wha Kim ),홍상모 ( Sang Mo Hong ) 대한내과학회 2010 대한내과학회지 Vol.79 No.6

제2형 당뇨병 환자가 경구 혈당강하제로 불규칙적인 치료를 해오던 중 뒤늦게 성선기능저하증이 발견되어 클라인 펠터증후군을 진단받고 테스토스테론 보충요법과 인슐린치료를 시행한 증례로서 당뇨병 및 인슐린저항성과 성호르몬 결핍 간의 밀접한 연관성에 대한 인식을 제고하는 바이다. An increased frequency of diabetes or impaired glucose tolerance in Klinefelter`s syndrome has been previously reported. Insulin resistance is considered to be the cause of this phenomenon in Klinefelter`s syndrome, which is associated with low serum SHBG and sex hormone deficiency. Sex hormone deficiencies also result in dyslipidemia and metabolic syndrome. The interrelationship between diabetes, metabolic syndrome, and androgen deficiency is complex. Here we report a case of an 18-year-old man first diagnosed with diabetes mellitus 3 years ago. Upon physical examination the patient showed characteristic phenotypes compatible with primary hypogonadism. Subsequently, tests aimed at determining the cause of hypogonadism, including a chromosomal analysis, suggested Klinefelter`s syndrome. The patient`s HOMA-IR score was compatible with insulin resistance. Therefore, when diabetes mellitus develops at a young age with characteristic phenotypes, a careful history and physical examination may be needed to determine whether the patient might have primary hypogonadism caused by Klinefelter`s syndrome. (Korean J Med 79:701-704, 2010)

비비만 환자와 비만 환자에서 루와이 위우회술 후 체중과 혈청 지질 농도의 변화 비교

박정환 ( Jung Hwan Park ),홍상모 ( Sang Mo Hong ),이창범 ( Chang Bum Lee ),안유헌 ( You Hern Ahn ),김동선 ( Dong Sun Kim ) 대한비만학회 2014 The Korean journal of obesity Vol.23 No.3

Background: This study was aimed to investigate the effects of bariatric surgery in non-obese patients through the comparison of the changes in body weight (BW) and serum lipid profile between non-obese and obese patients after Roux-en-Y gastric bypass. Methods: In this study, 116 patients who received laparoscopic Roux-en-Y gastric bypass due to early gastric cancer were included. Patients were divided into two groups, non-obese group (N=76), defined as body mass index <25 kg/m2, and obese group (N=40), body mass index ≥25 kg/m2. BW and serum lipid profile before surgery and at 3, 6, 9, and 12 months after surgery were examined. Results: In all groups, BW and triglyceride (TG) showed significant (P<0.05) decrease after surgery, while high-density lipoprotein cholesterol (HDL-C) showed a significant increase during the first 3 months after surgery, in obese group. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) decreased. However, the effect was significant for only a limited time period after surgery. Mean percentages of BW loss and TG decrease were greater in the obese group after surgery, however, the change was significant for only a limited time period after surgery. Mean percentage of HDL-C increase in non-obese group was greater but was not statistically significant. There were no differences in mean percentages of total cholesterol and LDL-C decrease between the two groups. Conclusion: At 12 months after surgery, all groups showed significant improvement in BW and serum lipid profile. However, mean percentages in BW loss, TG decrease, and HDL-C increase between the two groups were different.

한국 남성에서 테스토스테론 농도와 대사 증후군 및 관상동맥 질환과의 연관성

한호 ( Ho Han ),신진호 ( Jin Ho Shin ),이창범 ( Chang Beom Lee ),박용수 ( Yong Soo Park ),김동선 ( Dong Sun Kim ),안유헌 ( You Hern Ahn ),김태화 ( Tae Wha Kim ),최웅환 ( Woong Hwan Choi ) 대한내과학회 2007 대한내과학회지 Vol.73 No.1

목적: 복부 비만은 대사 증후군의 필수 요소로서, 인슐린 저항성을 초래한다. 여성과 다르게 남성에서는 혈청 테스토스테론 농도는 내장 지방량과 반비례 관계를 보인다. 따라서 저자들은 한국인 중년 및 노인 남성에서 혈청 테스토스테론과 대사 증후군 그리고 관상동맥 질환과의 관계를 알아보고자 하였다. 방법: 2005년 1월부터 12월 말까지 흉통으로 한양대 병원 심장 내과에 입원한 211명의 남자 환자들(평균 연령 59.1±10.7세)을 대상으로 하였다. 테스토스테론과 에스트라디올을 포함하는 모든 검사실 검사를 위한 혈액채취는 오전 6시부터 8시 사이에 시행되었다. 관상동맥질환을 진단하기 위해서 관상동맥 조영술을 시행하였고, 관상동맥 질환은 50% 이상의 혈관 내경이 좁아져 있을 때로 정의하였다. 대사 증후군은 NCEP-ATP III 지침에 따라 진단되었다. 결과: 다른 심혈관계 위험인자보다 대사 증후군은 관상동맥 질환의 발생에 가장 중요한 역할을 보였다(adjusted OR=4.32;95% CI, 1.96-9.52). 연령, 체질량 지수, 흡연 및 음주 여부 그리고 고혈압을 보정한 상태에서 테스토스테론의 농도가 낮을수록 공복 혈당은 증가하였고(p<0.01) 인슐린에 대한 저항성은 증가하였다(p<0.05). 테스토스테론 농도가 1 표준 편차(1.88 ng/mL) 상승함에 따라, 대사 증후군의 발병 위험은 51% 감소하였다(OR=0.49; 95% CI, 0.36-0.68). 관상동맥 질환을 가진 남성에서 테스토스테론의 농도가 낮은 경향을 보였지만 통계적인 의미는 없었다. 결론: 낮은 테스토스테론의 농도는 인슐린에 대한 저항성을 유도함으로써 대사 증후군의 발생과 아마도관상동맥 질환의 발생을 일으키는 원인이 될 것으로 생각된다. Background: Abdominal obesity is an essential component of metabolic syndrome and it causes insulin resistance. In contrast to women, the serum testosterone level has an inverse relationship with the visceral fat mass in men. Therefore, we investigated the relation of the serum testosterone concentration with metabolic syndrome and coronary artery disease in Korean middle-aged and elderly men. Methods: 211 male subjects who were admitted to the cardiology department due to chest pain at Hanyang University Hospital from January to December, 2005 (mean age: 59.1±10.7 yrs) were enrolled in this study. All the blood samplings for laboratory tests, including the testosterone and estradiol tests, were done between 6 AM to 8 AM. Coronary artery disease was defined when there was more than 50% narrowing of the vascular lumen on the coronary angiography. Metabolic syndrome was defined according to the NCEP-ATP III guidelines. Results: Among the other cardiovascular risk factors, metabolic syndrome was the most important contributor to coronary artery disease (adjusted OR=4.32, 95% CI: 1.96-9.52). Even after adjustment for age, BMI, smoking, alcohol consumption and hypertension, lower testosterone was associated with a higher fasting glucose level (p<0.01) and higher insulin resistance (p<0.05). Each SD (1.88 ng/mL) increase in the total testosterone was associated with a 51% reduced risk of having metabolic syndrome (OR=0.49; 95% CI, 0.36-0.68). Although men with coronary artery disease tended to have lower testosterone levels, there was no statistical significance. Conclusions: Lower testosterone levels might have a causative role in the development of metabolic syndrome and possibly coronary artery disease through the induction of insulin resistance.(Korean J Med 73:34-43, 2007)