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김준우,안철우,남주영,김똘미,김영균,추적금,박종숙,박진아,조승현,김동연,김도연,윤수지,이경열,차봉수,김경래,임승길,이현철,허갑범 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2
본 저자들은 인위적인 인슐린 투여로 인한 인간성 저혈당증 1예에서 보존적인 치료로 의식기능은 회복하였으나, 현저한 인지능력 저하를 하였기에 문헌고찰과 함께 보고하는 바이다. Factitious hypoglycemia is a covert attempt to lower the blood glucose concentration with insulin or a sulfonylurea agent. This attempt is mainly performed by the patients themselves. In a large series of diabetics who had overdosed on drug, less than 5% had used insulin for suicidal or homicidal purposes. Additionally, 4 of 204 hypoglycemic episodes were due to a suicide attempt with insulin. The onset of insulin action, its peak level, and duration, and the degree of hypoglycemia, are determined by insulin's pharmacokinetics. However, the final outcomes are not associated with the amount of insulin used. The complications related to insulin overdose are cerebral damage and hypokalemia. Other complications include, pulmonary edema attributed to congestive heart failure and hypertensive crisis, as well as respiratory insufficiency. We report this case with a review of the literature.
성인원외폐렴의 원인미생물에대한 전향적 다기관 연구 : 성인원외폐렴의 원인으로 세균의 역할을 중심으로
우준희,강재명,김양수,신완식,류진홍,최정현,김양리,정희진,어수택,박춘식,정문현,정기석,이찬주,류지소 대한감염학회 2001 감염 Vol.33 No.1
Background : Communite-acquired peumonia (CAP) is one of the leading causes of mortality and morbidity. Despite progress in diagnostic techniques and treatments, management of pneumonia remains challenging, because the precise etiology remains uncertain in as many as 49% of cases. The limitaions of identifying etiologic agents make it necessary to use empiric antibiotics in almost all patients, and furthermore emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric antibiotic regimen. For the optimal choice of empirical antibiotics, we should know the frequency of etiologic agents and antimicrobial resistance rates in the community. Methods : A prospective multicenter study of community-acquired pneumonia in Korea was carried out between May 1997 and April 2000. The microbiologic diagnosis was based on the results of sputum culture, blood culture and pleural culture. Results : Five hundred eighty eight cases of community-acquired peumonia in 562 patients admitted to the hospitals. The mean age was 59.9 with male predominance (58.3%), and 370 (63%) had underlyin gillness. The etiologic agents were identified in 38.3%, and the list of individual agents, in decreasing order, was Streprococcus pneumoniae (21.7%), Klebsiella pneumoniae (14.8%) Pseudomonas aeruginosa (9.8%), Staphylococcus aureus (9.5%), viridans group streptococci (5.7%), Enterobacter cloacae (4.2%), Hemophillus Influenza (3.8%), The rates of admission to the intensive care unit was 10.4%. The motality was 7.1%. Susceptible rates of S. pneumoniae to penicillin was 36.6% and showed multidrug resistant. Forty percents of S. aureus were methicillin-resistant S. aureus. K. penumoniae were susceptible to cephalosporin and quinolone. Conclusion : In Korea, S.pneumoniae is the most important agent causing community-acquired pneumonia. Susceptible rates of S. pneumoniae to penicillin was 36.6% and showed multidrug resistant. Gram negative bacteria such as K. pneumoniae, P. aeruginosa showed high incidence when compared with that of other countries. Most of them had underlying diseases including bronchiectasis and chronic obstructive pulmonary diseases. (Korean J Infect Dis 33:1∼7, 2001)
Kim Jieun,Myung Rangmi,Kim Bongyoung,Kim Jinyeong,Kim Tark,Lee Mi Suk,Kim Uh Jin,Park Dae Won,Kim Yeon-Sook,Lee Chang-Seop,Kim Eu Suk,Lee Sun Hee,Chang Hyun-Ha,Lee Seung Soon,Park Se Yoon,Choi Hee Jun 대한의학회 2024 Journal of Korean medical science Vol.39 No.12
Background: Since the emergence of hypervirulent strains of Clostridioides difficile, the incidence of C. difficile infections (CDI) has increased significantly. Methods: To assess the incidence of CDI in Korea, we conducted a prospective multicentre observational study from October 2020 to October 2021. Additionally, we calculated the incidence of CDI from mass data obtained from the Health Insurance Review and Assessment Service (HIRA) from 2008 to 2020. Results: In the prospective study with active surveillance, 30,212 patients had diarrhoea and 907 patients were diagnosed with CDI over 1,288,571 patient-days and 193,264 admissions in 18 participating hospitals during 3 months of study period; the CDI per 10,000 patientdays was 7.04 and the CDI per 1,000 admission was 4.69. The incidence of CDI was higher in general hospitals than in tertiary hospitals: 6.38 per 10,000 patient-days (range: 3.25–12.05) and 4.18 per 1,000 admissions (range: 1.92–8.59) in 11 tertiary hospitals, vs. 9.45 per 10,000 patient-days (range: 5.68–13.90) and 6.73 per 1,000 admissions (range: 3.18–15.85) in seven general hospitals. With regard to HIRA data, the incidence of CDI in all hospitals has been increasing over the 13-year-period: from 0.3 to 1.8 per 10,000 patient-days, 0.3 to 1.6 per 1,000 admissions, and 6.9 to 56.9 per 100,000 population, respectively. Conclusion: The incidence of CDI in Korea has been gradually increasing, and its recent value is as high as that in the United State and Europe. CDI is underestimated, particularly in general hospitals in Korea.
Kim Hyung-Sook,Park Kyung-Hwa,Choi Heun,Park Ji Young,Lee Mi Suk,Eun Byung Wook,Lee Hyukmin,Choi Jun Yong,Kim Hong Bin,Jeong Su Jin,Uh Young,Kim Bongyoung 대한감염학회 2022 Infection and Chemotherapy Vol.54 No.3
Background It is necessary to develop a roadmap for antimicrobial usage monitoring in order to perform monitoring of antimicrobial use at the national level properly. Therefore, this study aimed to develop a roadmap for establishing surveillance and monitoring of antimicrobial use in medical institutions at the national level. Materials and Methods A modified Delphi study was conducted, including 3 rounds of an online survey and a virtual meeting with 16 expert panels. The survey items were developed based on a literature review of the surveillance systems for antimicrobial use in 12 countries and interviews with experts. The questionnaire was designed to include both the surveillance and benchmarking systems. Results Regarding the scope of target institutions to be included in the surveillance system, medical institutions for sentinel surveillance had the highest proportion of agreement among the panels (75.0%, 9/12). For the benchmarking system, “tertiary- and secondary-care hospitals” were accepted as the scope of target institutions at the current moment. Furthermore, the National Health Insurance claims and prescription data of individual hospitals were considered appropriate data sources for the surveillance system. As for the measures to promote the participation of hospitals in the benchmarking system, “compensation through the establishment of antimicrobial management fees” and “set the participation in the program as a quality evaluation or accreditation index for hospital evaluation” were accepted. Conclusion This study provides a roadmap for establishing an antimicrobial use monitoring and benchmarking system for medical institutions at a national level in Korea. Background It is necessary to develop a roadmap for antimicrobial usage monitoring in order to perform monitoring of antimicrobial use at the national level properly. Therefore, this study aimed to develop a roadmap for establishing surveillance and monitoring of antimicrobial use in medical institutions at the national level. Materials and Methods A modified Delphi study was conducted, including 3 rounds of an online survey and a virtual meeting with 16 expert panels. The survey items were developed based on a literature review of the surveillance systems for antimicrobial use in 12 countries and interviews with experts. The questionnaire was designed to include both the surveillance and benchmarking systems. Results Regarding the scope of target institutions to be included in the surveillance system, medical institutions for sentinel surveillance had the highest proportion of agreement among the panels (75.0%, 9/12). For the benchmarking system, “tertiary- and secondary-care hospitals” were accepted as the scope of target institutions at the current moment. Furthermore, the National Health Insurance claims and prescription data of individual hospitals were considered appropriate data sources for the surveillance system. As for the measures to promote the participation of hospitals in the benchmarking system, “compensation through the establishment of antimicrobial management fees” and “set the participation in the program as a quality evaluation or accreditation index for hospital evaluation” were accepted. Conclusion This study provides a roadmap for establishing an antimicrobial use monitoring and benchmarking system for medical institutions at a national level in Korea.
( Dong Jun Oh ),( So My Koo ),( Yang Ki Kim ),( Ki Up Kim ),( Soo-taek Uh ),( Do Jin Kim ),( Yong Hoon Kim ),( Choon Sik Park ) 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-
Background and objectives: There is a debate regarding the level of vitamin D and its impact on lung function in patients with COPD. We evaluated the relationship of vitamin D with lung function and quality of life (QOL) in persons with obstructive airway disease (OAD) in Korea. Methods: The present study was based on the Korean National Health and Nutrition Examination Survey 2010-2014. The plasma level of vitamin D (25-hydroxyvitmain D) was measured by radioimmunoassay. The EuroQol-5D (EQ-5D) index was used to assess the QOL. OAD was defined as less than 0.7 of FEV1/FVC and more than 40 years old. Results: The study population comprised of 1,475 persons with OAD and 9,406 healthy persons. OAD itself was not risk factor for vitamin deficiency after adjustment for sex, age, smoking, and BMI. Vitamin D was correlated with FEV1 pred. % (FEV1%) and FEV1 (p=0.014 and p=0.000, respectively) in persons with OAD. Vitamin D was risk factor for decrease of FEV1% and FEV1 after adjustment for sex, age, smoking, and BMI in persons with OAD. Vitamin D deficiency group (lower than 20 ng/mL) showed lower FEV1 than did non-deficiency group (p=0.005) in persons with OAD. However, vitamin D did not affect any factors of EQ-5D after adjustment of sex, age, BMI, and smoking in persons with OAD. Conclusion: Vitamin D related with decrease of lung function, but not QOL in persons with OAD.
FGF21 induced by carbon monoxide mediates metabolic homeostasis <i>via</i> the PERK/ATF4 pathway
Joe, Yeonsoo,Kim, Sena,Kim, Hyo Jeong,Park, Jeongmin,Chen, Yingqing,Park, Hyeok-Jun,Jekal, Seung-Joo,Ryter, Stefan W.,Kim, Uh Hyun,Chung, Hun Taeg Federation of American Societies for Experimental 2018 The FASEB Journal Vol. No.
<P>The prevalence of metabolic diseases, including type 2 diabetes, obesity, and cardiovascular disease, has rapidly increased, yet the molecular mechanisms underlying the metabolic syndrome, a primary risk factor, remain incompletely understood. The small, gaseous molecule carbon monoxide (CO) has well-known anti-inflammatory, antiproliferative, and antiapoptotic effects in a variety of cellular- and tissue-injury models, whereas its potential effects on the complex pathways of metabolic disease remain unknown. We demonstrate here that CO can alleviate metabolic dysfunction <I>in vivo</I> and <I>in vitro</I>. We show that CO increased the expression and section of the fibroblast growth factor 21 (FGF21) in hepatocytes and liver. CO-stimulated PERK activation and enhanced the levels of FGF21 <I>via</I> the eIF2α–ATF4 signaling pathway. The induction of FGF21 by CO attenuated endoreticulum stress- or diet-induced, obesity-dependent hepatic steatosis. Moreover, CO inhalation lowered blood glucose levels, enhanced insulin sensitivity, and promoted energy expenditure by stimulating the emergence of beige adipose cells from white adipose cells. In conclusion, we suggest that CO acts as a potent inducer of FGF21 expression and that CO critically depends on FGF21 to regulate metabolic homeostasis.—Joe, Y., Kim, S., Kim, H. J., Park, J., Chen, Y., Park, H.-J., Jekal, S.-J., Ryter, S. W., Kim, U. H., Chung, H. T. FGF21 induced by carbon monoxide mediates metabolic homeostasis <I>via</I> the PERK/ATF4 pathway.</P>
오동준 ( Dong Jun Oh ),구소미 ( So-my Koo ),김양기 ( Yang Ki Kim ),김기업 ( Ki Up Kim ),어수택 ( Soo-taek Uh ),김현조 ( Hyun Jo Kim ),김동원 ( Dong Won Kim ) 대한내과학회 2016 대한내과학회지 Vol.91 No.1
흡연연관 간질성 섬유증(SRIF)은 콜라젠 침착으로 인한 폐포 중격의 비후가 있고, 호흡세기관지염과 폐기종이 동반되어 있다는 것이 특징이다. 2010년도에 처음으로 SRIF 용어를 사용하기 시작하였으며, 임상, 조직, 영상 소견이 특발성폐섬유증과 구별되는 병리 소견이다. SRIF는 현재까지 국내에서 보고된 적 없으며, 세계적으로도 보고가 드물다. 저자들은 SRIF 3예를 1년간 추적 관찰하여 보고하는 바이다. Smoking-related interstitial fibrosis (SRIF) is characterized by marked alveolar septal fibrosis seen as distinct thick collagen bundles, along with emphysema and respiratory bronchiolitis. In 2010, SRIF was deemed a new entity that differed from idiopathic pulmonary fibrosis (IPF) clinically, pathologically, and radiologically. No case of SRIF has been reported in Korea and it is rare worldwide. Here, we report the 1-year follow-up of three cases of SRIF. (Korean J Med 2016;91:49-56)
김지연 ( Ji Yon Kim ),배준용 ( Jun Yong Bae ),정은정 ( Eun Jung Jung ),김양기 ( Yang Ki Kim ),이영목 ( Young Mok Lee ),김기업 ( Ki Up Kim ),어수택 ( Soo Taek Uh ),황정화 ( Jung Hwa Hwang ),진소영 ( So Young Jin ),이동화 ( Dong Wha 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.4
A 29-year-old male patient was admitted due to his general weakness and poor oral intake for several months. He was diagnosed as having Crohn disease 16 years ago and total colectomy was performed 10 years ago. On the 3rd day after admission, gross hematuria and sudden hemoptysis combined with diffuse infiltration were noted on chest X-ray. His symptoms and the diffusely increased lung opacities improved with administering high-dose steroid therapy. Later, anti-GBM antibody was found to be positive on the laboratory findings. We report here on a rare case of Goodpsture syndrome combined with prolonged Crohn disease along with a review of literature. (Tuberc Respir Dis 2006; 61: 384-388)
김종화 ( Jong Hwa Kim ),김양기 ( Yang Ki Kim ),김정현 ( Jung Hyun Kim ),이영목 ( Young Mok Lee ),김기업 ( Ki Up Kim ),어수택 ( Soo Taek Uh ),노형준 ( Hyung Jun Noh ),김현조 ( Hyun Jo Kim ),장원호 ( Won Ho Jang ),김동원 ( Dong Won 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.62 No.6
A 29-year-old female patient presented with exertional dyspnea that she had suffered with for 2 months. The chest X-ray displayed right pleural effusion that was diagnosed as chyle, according to the level of cholesterol and triglyceride in the pleural fluid. VATS (video assisted thoracic surgery) of the right lung was performed on the 7th day of hospitalization for obtaining a lung biopsy and to control the of pneumochylothorax. On the 11th hospitalization day, VATS of left lung was also performed to control the recurrent pneumothorax via pleurodesis. The lung biopsy showed moderate amounts of spindle-shaped and rounded cells (so-called LAM cells), which were reactive to actin and HMB45 (on immunohistochemical stains). We report here on a rare case of lymphangioleiomyomatosis combined with chylothorax and bilateral pneumothroraces. (Tuberc Respir Dis 2007; 62: 554-559)