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( Ah Reum Khang ),( Eun Ki Kim ),( Eun Shil Hong ),( Hyung Jin Choi ),( Chan Soo Shin ),( Kyong Soo Park ),( Seong Yeon Kim ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
Parathyroid cysts are very rare among the causes of primary hyperparathyroidism (PHPT). They are divided into functional and nonfunctional cysts. Operative removal is a treatment of choice for a functional cyst. 99mTc-Sestamibi parathyroid scan is a highly effective and sensitive diagnostic tool for localization of hyperparathyroidism, however it shows a false-negative result, occasionally. We found one case which was presumed to have cystic parathyroid adenoma based on clinical findings and neck computed tomography (CT) with negative finding in parathyroid scan. A male patient who was 44 years-old visited to hospital due to legs pain and it was occurred 5months ago and deteriorated gradually. In addition, he presented with the compressive symptoms such as dysphagia and hoarseness. Serum calcium level was 14.4 mg/dl, phosphorus 2.0 mg/dl, creatinine 0.99 mg/dl and intact parathyroid hormone (iPTH) was increased to 478.1 pg/ml. On neck CT, 6.2×3.8×2.7 cm sized cystic nodule was found in inferior part of right thyroid gland. Sestamibi uptake for the found nodule was not detected on 2 hour delayed imaging of 99mTc-Sestamibi parathyroid scan. Fine needle aspiration for diagnosis and localization was done and intracystic iPTH was increased to 61,600 pg/ml. The iPTH monitoring for focused parathyroidectomy led to successful enucleation of right inferior parathyroid. It was a parathyroid adenoma and serum calcium, phosphate and iPTH was normalized after operation. A cystic parathyroid adenoma can be hardly detected on 99mTc-Sestamibi parathyroid scan sometimes. The multidisciplinary approach which considered clinical findings, laboratory results, physical examination and other imagings (CT, Ultrasound, etc) is important for differential diagnosis of hyperparathyroidism. The iPTH monitoring helps the focused parathyroidectomy.
이동원,Min Jin Lee,Ah Reum Khang,강양호 대한골다공증학회 2022 Osteoporosis and Sarcopenia Vol.8 No.4
Objectives: To investigate the association between serum uric acid (UA) and relative hand grip strength (HGS) in comparison with metabolic syndrome components. Methods: We analyzed the data of 5247 Korean adults aged ≥ 20 years (2422 men and 2825 women) who participated in the KNHNES VII (2018). Results: Among women, relative HGS was significantly lower in participants with hyperuricemia (1.65 ± 0.04) than in those without (1.95 ± 0.01) and was significantly decreased in the highest quartile (4Q: 1.77 ± 0.02) of serum UA compared with that in the lowest quartile (1Q: 1.98 ± 0.02). Among men, relative HGS was lower in participants with hyperuricemia (3.09 ± 0.04 vs. 3.16 ± 0.02) and decreased in 4Q (3.08 ± 0.03) of serum UA compared with that in 1Q (3.15 ± 0.03); however, these results were not statistically significant. In age- and multivariate-adjusted analyses in men, relative HGS was significantly lower in 4Q compared with that in 1Q in model 1 (adjusted for age), but there were no significant differences in model 2 (adjusted for age, BMI, and waist circumference) and model 3 (adjusted for age, BMI, waist circumference, systolic and diastolic blood pressure, fasting blood glucose, triglycerides, and high-density lipoprotein cholesterol). Meanwhile, in women, relative HGS was significantly decreased in 4Q compared with that in 1Q in all models. Conclusions: A significant inverse correlation was observed between serum UA levels and relative HGS in women, and their significance was maintained even after adjusting for age and metabolic syndrome components.
제2형 당뇨병 환자를 위한 자동 맞춤형 셀프케어 프로그램 개발
박가은(Park, Gaeun),이해정(Lee, Haejung),강아름(Khang, Ah Reum) 한국간호과학회 2022 Journal of Korean Academy of Nursing Vol.52 No.5
Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion: The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients’ self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.