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제2형 당뇨병 외래 환자의 비만도에 따른 미세혈관합병증
이성규,조남한,김현만,이관우,정윤석,채봉남,김윤정,이미덕,노혜림,홍은경,조현경 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.1
Background: Korean type 2 diabetic patients who are frequently non-obese, may be genetically different from Western type 2 diabetics who are frequently obese. Therefore, the diabetic complications of type 2 diabetes mellitus in Korea may be also different from those of Western countries. Until now, most studies reported in Korea did not analyse the microvascular complications of type 2 diabetes mellitus according to obesity, and also the criteria in the diagnosis of microvascular complications were different in each study. We investigated the microvascular complications and its relationship with obesity, in type 2 diabetic patients visiting an outpatient clinic. Methods: The study subjects were type 2 diabetic patients visiting an outpatient clinic of Ajou University Hospital. We selected patients participating in a 75 g oral glucose tolerance test, retrospectively. Type 2 diabetes was diagnosed according to the WHO/NDDG classification of diabetes. Biochemical studies including lipid profile, plasma insulin and C-peptide levels were done. Anthropometric measurements were performed. Based on BMI (㎏/㎡), the patients were divided into the following groups: the lean group, when the BMI was less than 20 ㎏/㎡ the ideal body weight (IBW) group, if the BMI was between 20 ㎏/㎡ and 25 ㎏/㎡ in women and 20 ㎏/㎡ and 27 ㎏/㎡ in men; and the obese group, when the BMI was $gt;25 ㎏/㎡ in women and $gt;27 ㎏/㎡ in men. Results: 1. Neuropathy (45.2%) was the most frequent among the microvascular complications, and the frequency of retinopathy was 15.1%, and that of nephropathy was 4.9%. Within 5 years of diabetes duration, the frequency of neuropathy, retinopathy, and nephropathy was 43.2%, 11.8%, and 2.9%, respectively. 2. Glycosylated hemoglobin (HbA_(1c)) and fasting blood glucose levels were not different among the three groups. Beta cell function{Δ (insulin 30min - insulin Omin)/Δ(glucose 30min - glucose 0min)} was the highest in the obese group. However, beta cell function(ΔI/ΔG) divided by the basal insulin level, considered insulin resistance, was not different among the three groups. 3. Within 5 years of diabetes duration, retinopathy tended to be the most frequent in the lean group, whereas neuropathy tended to be the most frequent in the obese group, and body mass index influenced the retinopathy and neuropathy, statistically significantly. Conclusion: Diabetic neuropathy was the most frequent among microvascular complications of type 2 diabetes mellitus in our study subjects. At the time of presentation within 5 years of diabetes duration, the lean group of type 2 diabetics had a tendency of the more frequent retinopathy, the obese group had a tendency of the more frequent neuropathy. These results suggest that type 2 diabetes mellitus in Korea is also not a single disease entity, as in Western countries and is a heterogenous group of disorders with a diversity of microvascular complications. However, the more studies about this will be required.
Han, Won Ho,Yehuda, Amir Ben,Kim, Deok-Hee,Yang, Seung Geun,Eom, Bang Wool,Yoon, Hong Man,Kim, Young-Woo,Ryu, Keun Won AME Publishing Company 2018 Chinese Journal of Cancer Research Vol.30 No.5
<P><B>Objective</B></P><P>Laparoscopic gastrectomy has been established as a standard treatment for early gastric cancer, and its use is increasing recently. Compared with the conventional laparoscopy-assisted distal gastrectomy (LADG), totally laparoscopic distal gastrectomy (TLDG) involves intracorporeal reconstruction, which can avoid the additional incision, resulting in pain reduction and early recovery. This study aimed to compare the short-term postoperative outcomes of TLDG <I>vs.</I> LADG in gastric cancer in a high-volume center. </P><P><B>Methods</B></P><P>A retrospective cohort study was conducted on 1,322 patients who underwent laparoscopic distal gastrectomy from June 2012 to June 2017 at the National Cancer Center, Korea. LADG was performed in the early period before July 2015, and TLDG was applied in the later period. Postoperative short-term outcomes were compared in terms of complication and clinical course between the two groups. Pain score was measured by rating the pain intensity from 0 to 10 points on postoperative day (POD) 1 and 3.</P><P><B>Results</B></P><P>A total of 667 patients underwent LADG and 655 patients underwent TLDG. Clinicopathologic characteristics were not different in both groups. Intraoperative estimated blood loss (EBL) was significantly lower in the TLDG group (P<0.001). Postoperative pain scores were significantly lower in the TLDG group than in the LADG group on POD 1 (5.1±1.5<I>vs.</I> 4.8±1.4, P=0.015). First flatus passage after operation was significantly earlier in the TLDG group (3.4±0.8 d <I>vs.</I> 3.2±0.6 d, P<0.001). There were no differences in postoperative complications and hospital stay between the two groups. </P><P><B>Conclusions</B></P><P>Based on the reported short-term postoperative outcomes, TLDG is safe and feasible as well as LADG. Moreover, compared with LADG, TLDG can reduce intraoperative EBL and postoperative pain and enhance the bowel motility in gastric cancer surgery.</P>
굴파리류에 기생하는 한국産 Dacnusa屬(벌목: 고치벌과: 장승입고치벌아과)의 2미기록종
Deok-Seo Ku,Man-Jong Han,Sung-Bok Ahn 한국응용곤충학회 1998 한국응용곤충학회지 Vol.37 No.2
Decnusa속 (벌목:고치벌과:장승입고치벌아과)의 2종 Dacnusa(Aphanta) sasakawai Takada와 Dacnusa(Dacnusa) nipponica Takada를 한국미기록종으로 보고한다. 전종은 Liriomyza broniae(Kaltenbach), 오이잎굴파리와 Chromatomyia horticole(Gourea), 완두굴파리에 기생했으며, 후종은 완두굴파리에 기생했다. Dacnusa (Aphanta) sasakawai Takada and Dacnusa (Dacnusa) nipponica Takada are reported for the first time from Korea with their redescription and figures. The former species was parasitic on the leafminers Liriomyza bryoniae (Kaltenbach) and Chromatomyia horticola (Gourea), and the latter was parasitic on the C. horticola.
Bowel infarction due to intestinal mucormycosis in an immunocompetent patient
Han Lim Choi,Yoon Mi Shin,Ki Man Lee,Kang Hyeon Choe,Hyun Jeong Jeon,Ro Hyun Sung,Kyeong Seob Shin,Young Deok Shin,Hyo Yung Yun,Young Jin Song,Jae-Woon Choi,Dong Hee Ryu 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.5
Mucormycosis is a fatal opportunistic fungal infection that typically occurs in immunocompromised patients. The classical manifestation of mucormycosis is a rhinocerebral infection, and although primary gastrointestinal infection is uncommon, it has an extremely high mortality rate in immunocompromised patients. Furthermore, cases of gastrointestinal mucormycosis in an immunocompetent host are rarely reported. Here, we describe our experience of a male patient, with no underlying disease, who succumbed to a bowel infarction caused by intestinal mucormycosis during mechanical ventilatory care for severe pneumonia and septic shock.
( Deok Gie Kim ),( Jee Youn Lee ),( Seung Hwan Song ),( Jae Geun Lee ),( Han Dai Hoon ),( Dong Jin Joo ),( Man Ki Ju ),( Gi Hong Choi ),( Jin Sub Choi ),( Myoung Soo Kim ),( Soon Il Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: This retrospective study evaluated lactate clearance (LC) as a predictor of early allograft dysfunction (EAD) and short-term outcomes in patients receiving deceased donor liver transplantation. Methods: We performed a retrospective analysis for 181 consecutive deceased donor liver transplantation from January 2011 to May 2016. LCs were calculated at 6, 12, 18 and 24 hours after reperfusion (LC6, LC12, LC18 and LC24). Results: Of 181 transplant recipients, 44 (24.3%) developed EAD and had lower LCs than those who did not develop EAD. A receiver operating characteristic analysis showed that LC determined at 6 hours showed the highest area under curve value of 0.828 (95% confidence interval [CI]: 0.755-0.990) for predicting the development of EAD at a cutoff value of 25.8% with 76.7% sensitivity and 77.9% specificity. LC values that fell below the cutoff values were significantly associated with EAD in a multivariate analysis, with values at 6 hours having the highest adjusted odds ratio (11.891, 95% CI: 4.469- 31.639). In-hospital and 6-month mortalities were higher in patients with LC values below the cutoffs compared with those above the cutoff values at each time point. Conclusions: LC calculated shortly after reperfusion of an allograft is significantly discriminative for the development of EAD and is associated with short-term prognosis after deceased donor liver transplantation.
Clinical Outcomes of Late Conversion to Once-Daily Tacrolimus after Liver Transplant
( Deok Gie Kim ),( Yoon Bin Jung ),( Jee Youn Lee ),( Jae Geun Lee ),( Sung Hoon Kim ),( Han Dai Hoon ),( Man Ki Ju ),( Gi Hong Choi ),( Jin Sub Choi ),( Myoung Soo Kim ),( Soon Il Kim ),( Dong Jin Jo 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Since a once-daily tacrolimus (TAC-OD) has been introduced in the field of transplantation, many studies reported advantages of the new drug, such as the better adherence and the less intrapatient variability than the twice-daily tacrolimus (TAC-TD). Recently, promising results were announced regarding better clinical outcomes of the early conversion to TAC-OD in liver transplant patients. In this study, we investigated clinical outcomes of late conversion to TAC-OD more than 6 months after transplantation. Methods: A total 281 patients who received liver transplant patient from January 2012 to January 2017 took TAC-TD from operation. Of them, 38 patients were converted to TAC_OD 6 months after transplantation, while others remained with TAC-TD. We compared graft survival and postoperative complication between two groups, especially with regard to biliary complication known as implication of chronic rejection. Results: Among the patients, 151 were living donor liver transplantation. There was no difference in demographics and operative characteristics between two groups. Biliary stricture occurred later after 6 month after transplantation was 18 (7.4 %) in TAC-TD and 2 (5.3 %) in TAC-OD. The cumulative incidence was not statistically different. However, overall graft survival rate was significantly higher in TAC-OD than that in TAC-TD (P=0.049). Biliary stenosis free survival was also higher without significance (P=0.065). Adverse event of drug was similar between two groups. Conclusions: Late conversion to TAC-OD was safe and feasible. It has advantages of graft survival compared to TAC-TD.