아급성 갑상선염을 앓았던 환자에게서 발생한 침윤성 섬유성(리들) 갑상선염 1예

김철식,이성주,박종숙,남주영,김똘미,안철우,차봉수,임승길,김경래,이현철 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.4

저자들은 전세계적으로 매우 드물 질환인 리들 갑상선염, 특히 이전에 아급성 갑상선염 및 갑상선 중독증이 있었던 환자에서 발생한, 1예를 진단하고 수술적 치료 후 양호한 경과를 확인하였기에 문헌고찰과 함계 보고하는 바이다. Riedel's thyroiditis is a rare form of chronic thyroiditis, characterized by a fibroinflammatory process which partially destroys the thyroid, often involving surrounding tissues. The relationship of Riedel's thyroiditis to other forms of thyroiditis is not clear. A case of Riedel's thyroiditis in a 51-year-old female patient, admitted with a previous diagnosis of subacute thyroiditis, is reported. She was first diagnosed with subacute thyroiditis based on clinical manifestation and radiologic and laboratory results. She was treated with glucocorticoid for 8 weeks. The follow-up lasted for 12 months. However, three years later she underwent a thyroidectomy operation due to an enlargement of the thyroid nodule and suspicion of malignancy. Histopathologic examination confirmed that she had Riedel's Thyroiditis. Until now, few case of Riedel's thyroiditis in patients with a history of subacute thyroiditis have been reported in the literature. Although the etiology of Riedel's thyroiditis is unknown, it may develop in the course of subacute thyroiditis (J Kor SOC Endocrinol 18:414- 419, 2003).

정신분열병 환자의 복부지방 및 대퇴중간 저밀도 근육 면적 평가

김철식,남윤영,박종숙,김혜진,노태웅,남지선,안철우,김경래,차경렬,김찬형 대한정신약물학회 2007 대한정신약물학회지 Vol.18 No.2

Objective: Patients with schizophrenia are at a higher risk for developing insulin resistance and type 2 diabetes mellitus (T2DM). However, few studies have examined abdominal fat and mid-thigh low-density muscle areas, which are known risk factors for insulin resistance and T2DM, in patients with schizophrenia. Therefore, we measured the abdominal fat and mid-thigh low-density muscle areas of schizophrenics and compared them with normal controls. Methods: Nineteen (four men and 15 women) drug-naïve or -free subjects who met the DSM IV criteria for schizophrenia and 19 age- and sex-matched controls were recruited. We measured weight, height, waist circumference, and percent body fat, and calculated the body mass index (BMI). Abdominal fat and mid-thigh low-density muscle areas were evaluated using computed tomography. Results: There was no significant difference in terms of age and BMI between the two groups. The areas of abdominal fat (262.4 ± 101.8 vs. 257.1 ± 93.8 cm2; p = 0.919), subcutaneous fat (182.4 ± 72.8 vs. 180.5 ± 75.1 cm2; p = 0.988), visceral fat (79.9 ± 47.2 vs. 76.6 ± 49.3 cm2; p = 0.872), and mid-thigh low-density muscle (15.0 ± 9.9 vs. 15.4 ± 5.2 cm2, p = 0.373) did not differ between schizophrenics and controls. Conclusion: Abdominal obesity is a well-recognized risk factor for developing certain medical conditions such as insulin resistance and T2DM. We demonstrated that drug-naïve or -free patients with schizophrenia do not have increased visceral fat or mid-thigh low-density muscle areas, which might have explained the higher prevalence of insulin resistance and T2DM in these patients. 정신분열병 환자는 일반인에 비해 인슐린저항성 및 제 2 형 당뇨병이 많이 발생한다. 그러나 정신분열병 환자에서 인슐린저항성 및 당뇨병의 위험인자인 체지방의 분포에 대한 연구는 별로 없다. 따라서 본 연구는 정신분열병 환자에서 fat measured computed tomography(fat CT)를 촬영하여 체지방의 분포를 구하여 일반인과 비교하고자 하였다. DSM-Ⅳ 기준에 의해 정신분열병을 처음 진단받은 환김철식 등 85자 또는 이미 진단받고 추적관리하고 있는 환자 중 최소한 6주 이상 항정신병약물을 투여 받지 않은 환자 19명(남:녀=4:15)과 이들과 성별, 나이를 맞춘 정상대조군을 19명 선정하여 이들의 체질량지수 및 체지방률을 측정하고 전산화 단층촬영으로 피하지방, 내장지방 및 대퇴중간 저밀도 근육 면적의 차이를 비교하였다. 양 군간의 나이, 체질량지수 및 허리둘레의 차이는 없었으며 체지방률도 양 군간에 차이는 없었다. 또한 양 군간에 총복부지방 면적, 복부피하지방 면적, 복부내장지방 면적 및 내장지방 면적/피하지방 면적비, 대퇴중간 저밀도 근육 면적의 차이는 관찰되지 않았다. 복부비만은 인슐린저항성이나 당뇨병을 유발하는 위험요인이다. 본 연구를 통해 정신분열병 환자의 체지방의 분포는 정상 대조군과 별 차이가 없음을 알아냈다.

성장과정의 체중변화와 인슐린저항성 및 Adiponectin 농도와의 관계

김철식,박진아,조민호,남주영,박종숙,김똘미,김대중,이관우,안철우,차봉수,임승길,이현철,김경래,허갑범 대한비만학회 2003 The Korean journal of obesity Vol.12 No.4

당뇨병 환자에서 산화 스트레스에 의한 NF-κB 및 AP-1의 활성화가 죽상동맥경화증에 미치는 영향

김철식,이근택,박진아,조민호,남주영,박종숙,김똘미,안철우,차봉수,임승길,김경래,이현철 대한당뇨병학회 2004 Diabetes and Metabolism Journal Vol.28 No.4

단절과 연속성, 신자유주의와 분절

김철식 비판사회학회 2014 경제와 사회 Vol.- No.101

포항 지진과 사회운동: 갈등의 사사화와 스케일의 불일치

김철식 한양대학교 제3섹터연구소 2020 시민사회와 NGO Vol.18 No.1

This study analyzes civil society responses to the Pohang earthquake that occurred on November 15, 2017. The characteristics and limitations of the Pohang civil society movement, which have been actively developed since the earthquake, are investigated. After the earthquake, Pohang civil society actively participated in the earthquake response activities. In the early days, many residents' organizations were newly formed, and existing social movement organizations also participated in the earthquake response. Various agendas and demands erupted and citizen participation expanded. Over time, these diverse activities have been converged into a campaign to enact a special law to examinate the relation between earthquake and geothermal power generation and to compensate for the damage accordingly, as well as a civic participation lawsuit to punish those responsible and compensate for the damage. In the process, there is a tendency to privatize the conflict, such as failing attempts to spread conflict to the national agenda and reducing the scope of the conflicts participants. As the participation of the existing social movements in the response to the earthquake was almost absent, the channel to expand the agenda into the country was limited. As a result, scale discrepancy is occurring. Namely problem resolution is delayed due to the fact that the issue itself can be solved by mobilizing resources and capabilities on a national scale, while the subject of the movement is limited to the local scale. 본 연구에서는 2017년 11월 15일 발생한 포항 지진에 대한 시민사회의 대응을 분석한다. 지진 이후 활발히 전개된 포항 사회운동의 특징과 한계를 규명한다. 지진 발생 이후 포항 시민사회는 지진 대응 활동에 적극적으로 참여했다. 초창기 많은 주민 조직들이 새로 결성되고, 기존 사회운동 조직들도 지진 대응에 참여하면서 다양한 의제와 요구가 분출되고 시민 참여가 확대되었다. 시일이 흐르면서 이러한 다양한 활동들은 지진과 지열발전 연관성 규명과 그에 따른 피해보상을 위한 특별법 제정 운동, 그리고 책임자 처벌과 피해보상을 위한 시민 참여 소송 운동으로 수렴되었다. 그 과정에서 시민사회의 노력에도 불구하고 갈등을 전국적 의제로 확산시키려는 시도가 실패하고, 갈등 참여 주체의 범위가 줄어드는 등 갈등의 사사화(privatization) 경향이 나타나고 있다. 지진 대응에 대한 기존 사회운동의 참여가 거의 부재하다시피한 상황에서 의제를 전국으로 확대할 수 있는 통로는 제한적일 수밖에 없었으며, 그 영향으로 스케일의 불일치, 즉 사안 자체는 전국 스케일의 자원과 역량 동원으로 해결될 수 있는 사안임에 비해 운동주체는 지역 스케일에 국한됨으로 인해 문제해결이 지체되는 현상이 나타나고 있다.

제2형 당뇨병 환자에서 혈청 아디포넥틴이 경동맥 죽상경화증의 진행에 미치는 영향

김철식,박주리,유성훈,강준구,류옥현,이성진,홍은경,김두만,유재명,임성희,최문기,유형준 대한내분비학회 2012 Endocrinology and metabolism Vol.27 No.1

Background: Increased cardiovascular events, which is the leading cause of death in type 2 diabetic patients, are mainly caused by accelerated atherosclerosis. Adiponectin has been suggested as a risk factor for cardiovascular diseases in cross-sectional studies. However, little is known about the impact of adiponectin on the progression of carotid atherosclerosis in type 2 diabetic patients. This study was conducted to evaluate the impact of early adiponectin levels on the progression of carotid atherosclerosis. Methods: From March 2009, 150 patients with type 2 diabetes were consecutively enrolled in our affiliated outpatient clinic. Anthropometric and biochemical data, including adiponectin levels, were measured in each participant. We measured the carotid intima-media thickness (CIMT) at baseline and at 1-year follow-up (n = 111). Then, we prospectively studied the relationship between the serum adiponectin levels and the progression of CIMT for 1 year. Results: Adiponectin levels negatively correlated with CIMT (r = -0.219, P = 0.015). Moreover, mean progression of CIMT was 0.016 ± 0.040 mm. However, there was no correlation between adiponectin levels and the progression of CIMT within 1-year follow-up period (r = -0.156, P = 0.080). Age (β = 0.556, P = 0.004), LDL cholesterol (β = 0.276, P = 0.042), and A1C (β = 0.309, P =0.038) were found to be independent risk factors for CIMT. However, A1C (β = 0.311, P = 0.042) was found to be the only independent risk factor for the progression of CIMT. Conclusion: In our study, adiponectin levels were negatively associated with CIMT. However, it did not affect the progression of CIMT at 1-year follow-up. Overall glycemic control is the most important factor in the progression of CIMT in patients with type 2diabetes.

프랜차이즈 거래관계 실태 연구

김철식 한국노동연구원 2015 노동리뷰 Vol.127 No.-

Prevalence, Awareness, and Management of Obesity in Korea: Data from the Korea National Health and Nutrition Examination Survey (1998–2011)

김철식,고승현,권혁상,김난희,김재현,임수,최성희,송기호,원종철,김대중,차봉연 대한당뇨병학회 2014 Diabetes and Metabolism Journal Vol.38 No.1

Background: Obesity is a risk factor for diabetes and several cardiovascular diseases. This study was to investigate the trends inthe prevalence, awareness, and management status of obesity among the Korean population for recent 13 years. Methods: The prevalence, subjective awareness, and management of obesity were investigated in adults aged ≥19 years by usingthe data from the Korea National Health and Nutrition Examination Surveys (KNHANES) 1998 to 2011. Results: The number of participants was 8,117, 5,826, 5,500, 3,025, 6,756, 7,506, 6,255, and 6,155 in the KNHANES in years 1998,2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively. The prevalence of obesity was 26.9%, 29.2%, 32.9%, 32.5%, 32.0%, 32.6%,32.0%, and 32.0% in 1998, 2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively, while the overall prevalence of obesity and abdominalobesity increased by 1.19-fold and 1.24-fold respectively in 2011 compared against 2001. In general, a gradual increase inthe prevalence of severe obesity has been observed as years go by. Furthermore, trends of improvements in obesity awareness andmanagement rates were visible over the period of surveys. Conclusion: Although the management status of obesity has improved during the recent years, more effective strategy to controlobesity is needed.

The Relation between Birth Weight and Insulin Resistance in Korean Adolescents

김철식,박종숙,박진아,남지선,강은석,안철우,차봉수,임승길,김경래,이현철,허갑범,김대중 연세대학교의과대학 2006 Yonsei medical journal Vol.47 No.1

Low birth weight is associated with insulin resistance and type 2 diabetes in adults. The fetal programming hypothesis has shown that insulin resistance and its associated metabolic disturbances result from a poor gestational environment, for which low birth weight is a surrogate. An at-home questionnaire survey was performed on 660 middle school students (12-15 years) in Seoul, Korea, and 152 cases were randomly selected based on their birth weight. Subjects were divided into three groups according to birth weight. We recorded their birth weight and measured their current anthropometric data, blood pressure, lipid profile, HOMA-IR, and HOMA- , and compared these parameters among the groups. The relation of birth weight to physiological characteristics in adolescence was examined. Systolic blood pressure, lipid profiles, and fasting plasma glucose, HOMA- were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C-peptide, and HOMA-IR were higher in the lower birth weight tertile. After adjustment for confounding factors, birth weight was inversely related to diastolic blood pressure, insulin, C-peptide, and HOMA-IR. We conclude that low birth weight may predict the risk of the insulin resistance and its progression over age, and that adequate gestational nutrition is therefore necessary to prevent low birth weight.