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갑상선 기능 저하증 환자에서의 혈중 Insulin과 C-peptide의 변화
이화영 ( Lee Hwa Yeong ),김광조 ( Kim Gwang Jo ),김천중 ( Kim Cheon Jung ),김병익 ( Kim Byeong Ig ),전우규 ( Jeon U Gyu ),이만호 ( Lee Man Ho ),정을순 ( Jeong Eul Sun ),이상종 ( Lee Sang Jong ) 대한내과학회 1993 대한내과학회지 Vol.44 No.1
연구배경 : 갑상선 호르몬이 인슐린과 C-peptide 대사에 영향을 미친다는 여러 연구결과들이 보고되고 있으나 아직 상반된 결과들이 많다. 방법 : 저자들은 1989년 3월부터 1992년 4월 사이에 본병원 내과에 입원한 정상대조군 14예와 갑상선 기능저하증 환자 19예에서 경구적 당부하후에 공복시, 1시간 및 2시간에 각각 혈청 C-peptide, 혈청 인슐린, 혈당치 및 C-peptide/인슐린비를 측정하였다. 결과 : 1) 혈청 C-peptide치는 갑상선 기능 저하증 환자군에서 공복시에는 정상대조군과 유사하였으나 당부하 2시간에서 의미있게 증가하였다(p<0.05). 2) 혈청 인슐린치는 갑상선 기능 저하증 환자군에서 정상대조군과 비교해 공복시보다는 당부하후 1시간, 2시간에 의미있게 증가되었다(p<0.05). 3) 혈당치는 갑상선 기능저하증 환자군에서 정상대조군과 비교시 당부하 1시간에 의미있게 증가되었다(p<0.05). 4) C-peptide/인슐린비는 양군에서 통계학적 의의는 없었다. 결론 : 이상의 결과에서 갑상선 기능저하증 환자군에서 정상대조군과 비교할 때 혈청C-peptide 및 혈청 인슐린의 충분한 분비에도 불구하고 혈당치가 증가되어 있음을 보여준다. 이는 혈청 C-peptide와 혈청 인슐린는 갑상선 기능저하증에 기인되는 대사율의 저하에 의한 결과로 추정되나 앞으로 이에 대한 연구가 계속되어야 할 것으로 생각된다. Background : Studies for the effect of thyroid hormones on secretion of insulin and glucose metabolism have been reported, but those results appear to be controversial. Methods : We have investignated the levels of serum C-peptide and insulin following the oral glucose load in 19 patients with hypothyroidism and 14 normal subjects. Results : 1) T도 mean fating level of serum C-peptide in hypothyroidism was somewhat elevated. The response of serum C-peptide was significantly enhanced 2 hours after oral glucose tolerance test in hypothyroid patients (5.16±2.31 Vs 2.01±1.05 ng/ml) (p<0.05). 2) Serum insulin response was exaggerated after oral glucose tolerance test in hypothyroidism. (GTT 1 hour : 90.74±33.56 Vs 61.19±22.91uU/ml, GTT 2 hour : 74.23±36.47 Vs 49.30±0.83 uU/ml) (p<0.05). 3) Blood glucose response has been significantly augmented in hypothyroid patients after oral glucose tolerance test. (GTT 1 hour : 129.47±40.20 Vs 98.21±9.10mg/dl) (p<0.05). 4) The ratio of C-peptide to insulin had no significant difference between patients with hypothyroidism and normal subjects statistically. Conclusion : These results suggested that the slowing of C-peptide and insulin degradation due to hypometabolism in hypothyroidism could be contributed to higher serum levels of the C-peptide and insulin.
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이풍렬(Poong Lyul Rhee),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi),김은주(Eun Joo Kim),박창영(Chang Young Park),손정일(Jong Chul Rhee),전우규(Woo Kyu Cheon),김병익(Byeong Ik Kim),정을순(Eul Sun Jung),전성국(Seong Gook Cheon),박기호 대한내과학회 1999 대한내과학회지 Vol.57 No.1
N/A To estimate bowel patterns in the Korean, we surveyed routine check-up subjects about their bowel habits, using self-reported questionnaire. Methods : We analyzed 2939 subjects (male 1430, female 1509; age range 25 - 65 years) who had visited health promotion center for routine check-up. Subjects were given a validated self-report questionnaire, which measured the defecation frequency; stool consistency; self-report of constipation; straining to defecate; and levels of laxative use. Results : Of the whole subjects 96.4% had defecation frequency between three per week and three per day. The prevalence of two or less bowel movements per week (4.1% compared to 0.6%), straining to defecate (20.8% compared to 13.0%) and hard stool (18.0% compared to 9.3%) was higher in women than men (p<0.01). The prevalence of self-reported constipation was higher in women than men (9.0% compared to 2.9%, p<0.01). Women were more likely to use laxatives than men (5.5% compared to 0.6%, p<0.01). Conclusions : Defecation frequency in most of routine check-up subjects is between three per week to three per day. Bowel dysfunction is a greater problem in women.
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박창영,손정일,김명숙,심대중,전우규,이상종,김병익,편유장,정을순 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.6
Collagenous colitis was first described by Lindstrom in 1976. Now this disorder is recognized as one of the more common causes of chronic diarrhea of obscure origin. This disorder is described as a disease of colon associated with chronic watery diarrhea and the typical histologic findings of a thickened subepithelial collagenous band. But in korea a few cases have been reported. We had observed a 52-year-old businessman with chronic watery diarrhea without abdominal pain in the past. And then we had reported previously that case. We also recently observed a 42-year-old housewife with chronic watery diarrhea with lower abdominal discomfort for 10 years. Colonoscopy disclosed no gross abnormalities through the entire colon ineluding the terminal ileum but we could find the pronounced thickening of subepithelial collageous band and chronic inflammation in the lamina propria in the histologic examination. We summarized the above two cases of collagenous colitis with a review of literatures.
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선암을 동반한 Peutz-Jeghers 증후군 : 1예 보고
박창영,손정일,이승원,조용균,전우규,이상종,김병익,김명숙,정을순 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.4
Peutz-Jeghers Syndrome, characterized by autosomal inheritance, skin pigmentation, and hamartomatous polyps, had long been considered a benign polyposis until recent studies suggested an association with increased risk of malignant neoplasia in patients who had been followed-up for long periods. The authors present a case of Peutz-Jeghers syndrome in a 44 year old man with an adenomatous malignant change in his small bowel. The patient underwent surgery following a diagnosis of intestinal intussuception. Observing the polyps resected, all the polyps had characteristics of hamartoma, excluding one which showed a malignant transformation. Although it has not been fully determined with certainty whether the adenocarcinoma developed from hamartoma, histologic examination of an excised specimen suggested, thht potency of hamartoma to undergo malignant transformation. All the members of the family were confirmed to have no evidence of Peutz-Jeghers syndrome. Our clinical experience determines the malignant potency in Peutz-Jeghers and recommends that intensive follow-up of gastrointestinal and extragastrointestinal sites is needed in patients with this syndrome.
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