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엄영실 ( Young Sil Eom ),김병준 ( Byung Joon Kim ) 대한내과학회 2014 대한내과학회지 Vol.87 No.1
The prevalence of diabetes is increasing worldwide. Glycemic control has been shown to prevent microvascular complications. Many oral hyperglycemic drugs and insulin are being used in the treatment of diabetes, but the effects of those treatments are suboptimal. The two incretin hormones GLP-1 and GIP are released from L- and K-cells, respectively, in response to nutrient intake. GLP-1 stimulates glucose dependent insulin release. Recently, incretin hormone-based therapies, including GLP-1 agonists and DPP-4 inhibitors, have been used as new treatment options to control glucose levels in patients with type 2 diabetes mellitus. The purpose of this article is to review the efficacy and safety of GLP-1 agonists in the treatment of type 2 diabetes. (Korean J Med 2014;87:9-13)
증례 : 신장 ; 혈액투석 환자에서 자연적으로 발생한 요관자연파열 1예
오병천 ( Pyung Chun Oh ),엄영실 ( Young Sil Eom ),박재찬 ( Jae Chan Park ),한우진 ( Woo Jin Han ),성주영 ( Ju Young Sung ),정우경 ( Woo Kyung Chung ),이현희 ( Hyun Hee Lee ) 대한내과학회 2009 대한내과학회지 Vol.76 No.2
요관자연파열은 요관의 기계적 조작, 외부 손상, 신수술의 과거력, 파괴성 신질환 없이 발생하는 경우를 말하며 매우 드물게 발생한다. 임상증상이 다양하고 급성복증(acute abdomen)과 감별하기 힘들기 때문에 진단이 어렵고 적절한 치료가 지연될 수 있다. 저자들은 진균성 농신장의 기왕력이 있는 혈액투석 환자에서 진균성 요로감염이 재발하고 요관자연파열이 발생하여 감염성 요종과 농양이 발생한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Spontaneous ureteral rupture is rare, and refers to leakage in the absence of prior ureteral manipulation, external trauma, previous surgery, or any destructive kidney disease. It presents a major diagnostic challenge due to the diversity at presentation. Here, we present a rare case of spontaneous ureteral rupture in a 62-year-old man with a history of fungal pyonephrosis (Candida) on maintenance hemodialysis, causing a large infected urinoma and abscess and a review the literature. (Korean J Med 76:229-233, 2009)
홍준식 ( Jun Shik Hong ),박재찬 ( Jae Chan Park ),엄영실 ( Young Sil Eom ),김민정 ( Min Jung Kim ),박상희 ( Sang Hui Park ),정우경 ( Woo Kyung Chung ),박연호 ( Yeon Ho Park ),양재석 ( Jae Seok Yang ),이현희 ( Hyun Hee Lee ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.2
Malignancy is one of the important complications after renal transplantation, and decreases both patient survival and graft survival. Hepatic angiosarcoma is the most common sarcoma in liver, but a rare malignant tumor which occupies about 2% of all hepatic malignancies. We report a case of primary hepatic angiosarcoma after renal transplantation, the first case of post-transplantation angiosarcoma in Korea. A 27-year old man had received a living related renal transplantation. He was admitted due to clinical manifestations of liver cirrhosis such as ascites, spontaneous bacterial peritonitis, and varix bleeding at 8 months after transplantation. Whole liver was infiltrated with angiosarcoma; therefore, he was managed only by supportive care. Considering the poor prognosis of hepatic angiosarcoma, both careful screening of malignancy before transplantation and periodic surveillance of malignancy after transplantation are essential.
급성 관동맥증후군에서 예후평가를 위한 NT-proBNP, troponin 1, hs-CRP의 유용성
오병천 ( Pyung Chun Oh ),한승환 ( Seung Hwan Han ),정욱진 ( Wook Jin Chung ),강웅철 ( Woong Chol Kang ),서일혜 ( Yiel Hea Seo ),엄영실 ( Young Sil Eom ),문찬일 ( Chan Il Moon ),봉정민 ( Jeong Min Bong ),신미승 ( Mi Seung Shin ) 대한내과학회 2009 대한내과학회지 Vol.77 No.2
Background/Aims: Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), troponin I, and high-sensitivity C-reactive protein (hs-CRP) are each associated with higher rates of death and recurrent myocardial ischemia in patients with acute coronary syndrome (ACS). We evaluated the prognostic value of NT-proBNP and a multi-marker risk approach with the simultaneous assessment of NT-proBNP, troponin I, and hs-CRP in patients with ACS. Methods: We included 277 patients who were admitted for ACS between January and December 2006. We measured NT-proBNP, troponin I, and hs-CRP within 24 hours of the onset of symptoms. Patients were followed for a an of 559 days for cardiovascular events, including death, new myocardial infarction, heart failure, or rehospitalization for ACS. Results: NT-proBNP was the most powerful predictor of clinical outcome among the biomarkers (HR 3.65, 95% CI 2.11-6.30), followed by the peak troponin I and hs-CRP (HR 2.08, 95% CI 1.12-3.87; HR 1.99, 95% CI 1.18-3.37, respectively), but not the baseline troponin I. A multi-marker risk approach with the simultaneous assessment of NT-proBNP, hs-CRP, and peak troponin I was significantly associated with cardiovascular events, especially the presence of three positive biomarkers (adjusted HR 4.20, 95% CI 1.39-12.67). Conclusions: NT-proBNP is the most powerful, independent predictor of clinical outcome among the cardiac biomarkers. Since the peak troponin I level provides more prognostic information than the baseline level, follow-up measurement of troponin I may be warranted for risk stratification. The multi-marker risk approach appears to have better prognostic performance than any marker in isolation. (Korean J 77:200-210, 2009)
성인에서 Mycoplasma pneumoniae 페렴과 동반된 Stevens-Johnson 증후군 1예
이정현,엄영실,한우진,윤규현,이서영,서종구,김진용,김수연,박윤수,서일혜,조용균 대한감염학회 2008 감염과 화학요법 Vol.40 No.6
Stevens-Johnson syndrome is an acute mucocutaneous syndrome that is related to drugs and infections. Mycoplasma pneumonias infection is known as one of the causes of Stevens-Johnson syndrome in children and young adults, In Korea, Mycoplasma pneumoniae infection is rarely reported as a cause of Stevens-Johnson syndrome in adults. We report a case of Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia in an adult patient. A 34-years old woman was admitted to our hospital and was diagnosed with mycoplasma pneumonia. At the time of admission, she had hemorrhagic crusts on her lips. On the 2nd day of admission, target lesions also developed on her skin. We diagnosed her disease as Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia. She completely recovered from pneumonia and Stevens-Johnson syndrome after treatment with antibiotics and conservative management.