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A Case of Autoimmune Hypoglycemia Combined with Diabetic Ketoacidosis
심명숙,김문영,김미진,이연,이병준,정춘희,신영구 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.1
Autoimmune hypoglycemia is characterized by hyperinsulinemia, fasting hypoglycemia, and the presence of insulin auto- antibodies without previous exposure to exogenous insulin. We experienced a case of autoimmune hypoglycemia without diabetes mellitus or any evidence of insulinoma. The insulin auto-antibody and insulin receptor auto-antibody were present. We diagnosed the patient as having autoimmune hypoglycemia and treated with glucocorticoid. After treatment, the hypoglycemic symptoms were resolved. However, four months later, the patient was readmitted with transient diabetic ketoacidosis. After recovery, he showed no signs of diabetes mellitus. We believe that insulin auto-antibodies may play a role in autoimmune hypoglycemia and diabetic ketoacidosis, but its role and mechanism are not precisely known. Further studies are needed to define the action mechanisms and the functions of insulin auto-antibodies: here we present case with a relevant literature.
유아 리듬학습 대한 Orff와 Dalcroze 프로그램의 효과
심명숙 한국아동교육학회 1995 아동교육 Vol.4 No.2
The purpose of the present study is to study the comparative effectiveness of the Orff and Dalcroze methods for rhythm instruction for the kindergartens on the aptitude of children's rhythm, their expression ability of rhythm. The subjects of this research is 90 kindergarteners selected from the 2 kindergartens in Taegu. Children were assigned to 6 experimental groups making 15 for each group. The independent factors of this research design are sex(boys, girls), the method of trainning(Orff method, Dalcroze method, control group), and the time of testing (pretest, immediate post-test, delayed post-test). According to the experimental step, the learning program on rhythm is performed by Orff method, Dalcroze method for 20 minutes each for 6 weeks and five times a week. Their ability is evaluated by pretesting, posttesting, post-delaying testing. The conclusion of this research are as followings. 1. The aptitude on rhythm and the rhythmic expressional ability were different according to the learning program for rhythm(Orff method, Dalcroze method, control group). That is, Dalcroze method improved mare effectively the aptitude on rhythm and the expressional ability of rhythm. 2. The aptitude on rhythm and the rhythmic expressional ability were different among the testing time (pre-testing, post-testing, post-delaying testing) by the performing step of the learning program for rhythm. Dalcroze method, Orff method exert an effect on the improvement of learning for rhythm. 3. The aptitude on rhythm had the effect of interrelation between the learning program on rhythm and sex. Dalcroze method is effective on both sex, Orff method is effective only on the boys to have the aptitude on rhythm.
중학교 수학과 도형영역에서의 교과서 재구성에 관한 효율성 연구
심명숙,전재복 국민대학교 2002 기초과학연구소 논문집 Vol.21 No.-
The study was conducted by choosing, applying, and testifying the following research questions. 1. How do 40 math ematics teachers of Mathematics 7-B step of middle schools in S-district in Seoul understand the problem regarding textbook recomposition? And what is the result of its application? 2. What is the difference in student understanding between the comparison groups, where the text book was recomposed according to the topics in the 7th education curriculum mathematics textbook and where the instruction was applied according to the order of mathematics textbook of the 7th education curriculum. 3. What is the difference in terms of definition area between the comparison groups where the textbook was recomposed according to the topics in the 7th education curriculum mathematics textbook and where the instruction was applied according to the order of mathematics textbook of the 7th education curriculum?
심명숙,남수민,유진세,김혜경,이상준,이미영 대한갑상선학회 2017 International Journal of Thyroidology Vol.10 No.2
Background and Objectives: The recurrence rate of patients with Graves’ disease (GD) is estimated to be 50-55% after withdrawal of antithyroid drug therapy, and relapse is frequent in the first year after discontinuing the medication. Follow-up examination of these patients frequently reveals laboratory findings consistent with subclinical thyrotoxicosis in the first year after stopping the antithyroid agents. We investigated the risk of recurrence of GD among patients with resurfacing subclinical thyrotoxicosis state after remission of initial GD with antithyroid treatments. Materials and Methods: We reviewed the patients diagnosed with GD who visited the Department of Endocrinology at two tertiary medical centers: Wonju Severance Christian Hospital and Gangneung Asan Hospital. We enrolled patients whose GD was completely treated after initial treatment with antithyroid agents who then developed subclinical thyrotoxicosis after discontinuation of antithyroid agents. Results: We reviewed a total of 44 patients (29 females, 15 males; age, 48.93±18.04; range, 17-85 years). The recurrence rate was 27.3% (12/44 patients), and recurrence occurred 3 months to 12 months later resurfacing of subclinical thyrotoxicosis. Patients with recurred GD was significantly older than non-recurred patients (44.63±17.75 years vs. 58.58±15.48 years, p=0.02). Other clinical parameters measured at the time of initial diagnosis were not different between the two groups. Conclusion: The recurrence rate of GD in patients with resurfacing subclinical thyrotoxicosis after initial remission of the disease was less than 30%. A close monitoring is recommended in these subgroup patients, especially in older patients.
무선센서 네트워크 환경에서 지연 및 신뢰성을 고려한 클러스터 기반의 라우팅 알고리즘
심명숙 ( Myung-sook Shim ),박명순 ( Myong-soon Park ) 한국정보처리학회 2010 한국정보처리학회 학술대회논문집 Vol.17 No.1
본 논문에서는 선형적인 무선 센서 네트워크에서 지연 및 신뢰성을 고려한 클러스터 기반의 멀티홉 라우팅 알고리즘을 제안한다. 제안한 알고리즘은 선형적인 네트워크 환경에서 전송 지연시간 및 Single Point Of Failure 를 해결하기 위해 짝수 ID 노드일 경우 다음 짝수 ID 노드로 전송하고, 홀수 ID 노드일 경우 다음 ID 노드로 데이터를 전송하는 방법을 사용한다.
인슐린 자가항체 및 인슐린 수용체 자가항체와 연관된 자가면역성 저혈당증 1예
김미진,심명숙,김문규,이연,김영욱,신영구,정춘희 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2
Autoimmune hypoglycemia is caused by the interaction of endogenous antibodies with insulin or insulin receptor. Insulin autoantibody(IA) complexes are present in most patients who receive insulin therapy, but have also been reported in nondiabetic patients with autoimmune disease. IA may also be detected in 1% to 8% of healthy subjects with no history of diabetes or autoimmune disease. Insulin receptor autoantibody(IR-A) complexes are associated with the inhibition of insulin binding to insulin receptors, accelerated receptor degradation, receptor downregulation, and extreme insulin resistance and hyperglycemia, but can also lead to refractory hypoglycemia. We experienced a case of autoimmune hypoglycemia with IA and IR-A without previous insulin injection therapy or evidence of insulinoma. Therefore we started glucocorticoid therapy, and the hypoglycemic symptom improved. Herein, we present this case with a review of the literatures.