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홍은경 ( Eun Gyoung Hong ) 대한내과학회 2011 대한내과학회지 Vol.80 No.6
The worldwide prevalence of type 2 diabetes increases with age and almost 40% of men and more than 50% of women in Korean diabetic patients are over the age of 65. Recent clinical trials suggest that early intensive glycemic control reduces chronic complications associated with morbidity and mortality in type 2 diabetic patients. The principles of management of type 2 diabetes in the elderly are not different from those in middle-aged patients. However, before initiating any form of glucose-lowering therapy in the elderly it is necessary to assess the patient overall health status, coexisting illnesses, social environment, psychological well-being and degree of cognitive function. Furthermore, it should be considered to keep glucose control on individualized target without the risk of hypoglycemia in elderly diabetic patients due to the more deleterious and serious conditions. The old and more recent oral glucose-lowering agents and insulins are effective in the elderly patient. The characteristics and side effects of diabetic agents should be carefully reviewed by clinician before starting any form of medication in the elderly. (Korean J Med2011;80:635-642)
이상무 ( Sang Mu Lee ),홍은경 ( Eun Gyoung Hong ),이성진 ( Seong Jin Lee ),정인경 ( In Kyung Jeong ),김현구 ( Hyeon Kyu Kim ),최철수 ( Cheol Soo Choi ),유재명 ( Jae Myung Yu ),김두만 ( Doo Man Kim ),임성희 ( Sung Hee Ihm ),최문기 대한내과학회 2003 대한내과학회지 Vol.64 No.1
Background : Idiopathic hypoparathyroidism is a relatively rare disease characterized by hypocalcemia and hyperphosphatemia due to parathyroid hormone deficiency of unknown cause. It usually develop at young age and various clinical symptoms and signs acc
한국인에게서 당뇨병성 말초 신경병증을 선별하기 위한 문진표의 유용성
정윤석(Yoon Sok Chung),채봉남(Bong Nam Chae),홍은경(Eun Gyoung Hong),이성규(Seong Kyu Lee),노혜림(Hae Lim Noh),김윤정(Yoon Jung Kim),신영구(Young Goo Shin),이관우(Kawn Woo Lee),김현만(Hyeon Man Kim) 대한내과학회 1999 대한내과학회지 Vol.57 No.1
Discrepancies exist in the currently available data on the prevalence of diabetic neuropathy. Variations in the prevalence of diabetic neuropathy have reflected the different criteria used to form its diagnosis. The majority of diagnostic criteria are less practical in many routine clinical settings where there is a need for a simple assessment using widely available techniques to rapidly screen large numbers of patients. We already reported that the questionnaire of Feldman's two-step assessment was less useful in Koreans, because of the different expression of neuropathic symptoms. We proposed a representative questionnaire which was based on patients' own complaints, and assessed its clinical availability. Methods : Ninety diabetic patients(45 cases with diabetic neuropathy, 45 cases without neuropathy) were included in this study. Diabetic neuropathy was diagnosed by neurologic examination and nerve conduction velocity. The questionnaire consisted of 7 questions on foot sensation (prickling, lancinating, burning, numb), which are frequent complaints of diabetic patients. All subjects were assessed with the questionnaire. Results : 1. The most sensitive symptom was tingling sensation (75.6%) and the least sensitive one was numbness(28.9%). 2. The most specific symptom was numbness(82.2%) and the least specific one was tingling sensation(33.3%). 3. If we would assume that three or more of symptoms were diagnostic, the sensitivity and specificity were 66.7% and 53.3%, respectively. Conclusion : Our new questionnaire can be used as a screening test or a follow-up tool for the diagnosis of diabetic peripheral neuropathy in Koreans.
김우중(Woo Joong Kim),천진옥(Jin Ok Chun),홍은경(Eun Gyoung Hong),성현주(Hyun Joo Sung),임인기(In Kee Rim),전용철(Yong Cheol Jeon),전노원(Rho Won Chun),이명석(Myung Seok Lee),정규원(Kyu Won Chung) 대한내과학회 1995 대한내과학회지 Vol.48 No.1
Objectives: It is well known that adult experimental rats parenterally poisoned with a lethal dose of phalloidin die of hemorrhagic necrosis of liver. Although the precise mechanism is unknown so far, it is believed that interaction of microfilamentous structures with phalloidin is the primary toxic event of phalloidin poisonings. The purpose of these experiments was to examine the influence of phalloidin on hepatocyte ultrastructure, and to determine the possible mechanism by which this agents interferes with normal microfilament function. Methods: Rats were divided into 3 groups: normal control, intravenously phalloidin injected group (10 min, 30 min and 60 min group respectively), intraperitoneally phalloidin administered group (1st day, 7th day and 14th day group respectively). At the time of sacrifice, blood was withdrawn for liver function tests and the liver tissues were observed under the light microscope and transmission electron microscope. Results: 1) Compared with control, the ratio of liver/body weight increased from 30 minutes and sustained in elevated level unti114 days after phalloidin administration. 2) Liver function test showed no significant change in serum bilirubin levels, but serum glucose levels decreased significantly in intravenously injectioned group than that of control. SGOT levels were elevated through experimental period and SGPT levels were higher in 60 minute and 14th day groups than that of control. 3) Light microscopic examination in the intravenously injected group showed highly vacuolized cytoplasm with erythrocytes-containing vacuoli in the hepatocytes and the foci of hemorrhagic necrosis scattered throughout the hepatic lobules. No significant changes in liver tissue were noted light microscopically in intraperitoneally administered group. 4) Transmission electron microscopic examination in the intravenously injected group revealed numerous variously sized vacuoles filled with erythrocytes and fibrins in the cytoplasm of hepatocyte. In intraperitoneally administered group, proliferation of microfilaments beneath the plasma membrane of hepatocytes, canalicular luminal dilation and loss of canalicular microvilli were most prominent findings. Conclusion: Hepatic injury induced by intravenous and intraperitoneal administration of phalloidin mainly involves cytoplasmic vacuole formation in the hepatocytes and proliferation of microfilaments especially around bile canaliculus, respectively. This effect of phalloidin may prove a useful tool for the study of drug-induced liver injury and of the role of microfilament in the process of bile secretion.