주폐경기 여성의 골다공증 유병률과 연관인자

강무일(Moo Il Kang) 대한내과학회 2002 대한내과학회지 Vol.62 No.1

N/A

Amiodarone 투여와 동반된 갑상선 기능 이상

강무일(Moo Il Kang),이만영(Man Young Lee),한제호(Je Ho Han),손현식(Hyun Sik Son),윤건호(Kun Ho Yoon),홍관수(Kwan Soo Hong),차봉연(Bong Yun Cha),이광우(Kwang Woo Lee),손호영(Ho Young Son),강성구(Seung Ku Kang) 대한내과학회 1994 대한내과학회지 Vol.47 No.1

Objectives: Amiodarone, a benzofuranic derivative containing 37. 2% iodine, is widely used for the long- term treatment of cardiac arrhythmias. It affects the peripheral metabolism of the thyroid hormones, and may induce hyperthyroidism and hypothyroidism. We performed this study to evaluate the effects of amiodarone on thyroid function. Methods: To evaluate the effects of amiodarone, antiarrhythmic drug, on thyroid function, we performed cross-sectional study in 30 patients (18 men and 12 women; mean age 61, 2 yr). All had a variety of cardiac diseases (ventricular tachycardia, supraventricular tachycardia, angina pectoris, cardiomyopathy) and taking long term amiodarone therapy (maintenance dose 200 mg; mean duration of treatment 18. 9 months). Thyroid status was assessed by clinical examination and thyroid function test (T3, T4, rT3, TSH, TRH test). Thyroid antimicrosomal antibody was measured using indirect agglutination method. All the tests were perfonned at the time of study only. Results: 1) Among 30 amiodarone treated patients, 3 were hyperthyroid and 1 was hypothyroid. So the incidence of amiodarone induced thyroid dysfunction was 13.3%(4/ 30). Including subclinical thyroid dysfunction, overall rate of thyroid dysfunction was 36.6%(11/30). 2) Antimicrosomal antibody was positive in 21,7% Sf patients (5/23). 3) Goiter was observed in 30%(9/30) of amiodarone treated patients and 63.6%(7/11) of patients with amiodarone induced thyroid dysfunction. 4) After TRH test in eleven euthyroid patients, 54,5% (6/11) showed abnormal response. 5) Between normal and abnormal responders in TRH test, there was no aignifieant difference in age and duration of amiodarone treatment (p>0,05). 6) In patients with thyroid dysfunction, duration of amiodarone treatment was significantly longer than euthyroid patients (p<0.02), but there was no significant difference in age between two groups (p>0.05), Conclusion: There results suggest that the incidence of thyroid dysfunction in amiadarone treated patients is high and further prospective study will be needed for more detailed information

B 형 만성활동성간염 환자에서 합성 Interferon Alpha 2b ( INTRON A(R) ) 의 효능 및 안정성 - 제 1 보 -

이창돈(Chang Don Lee),강무일(Moo Il Kang),유혜신(Hye Sin Yu),권혁호(Hyuk Ho Kwon),김재유(Jae Yoo Kim),정진우(Jin Woo Jeong),김부성(Boo Sung Kim) 대한내과학회 1987 대한내과학회지 Vol.32 No.6

N/A To evaluate the efficacy and safety of recombinant interferon alpha-2b (INTRONA®), in eleven patients with chronic active hepatitis (CAH) type B, a course of 28-day Intron A® was given daily subcataneous injection at a dose of 1 milion unit (MU) on the first day, 3 MU on the second, 5 MU on the 3rd to 7th, 3 MU on the 8th to 28th each. In 10 patients with HBeAg positive CAH type B, DNA polymerase and transaminoferase activities were assessed and compared before, during and after INTRON A administration. The peripheral blood white blood cell (WBC), granulocyte and platelet counts were checked. The results were as follows: 1) during administration of INTRON A, DNA polymerase activities were decreased significantly within first week and sustained in spite of persistent HBe antigenemia in all patients (p<0.05). Serum alanine aminotransferase (ALT) and aspartate aminotransferase were decreased significantly from 2 and 3 weeks after therapy respectively (p<0.01). 2) After discontinuation of INTRON A, improved transaminase level lasted for 4 weeks but rebound phenomena of DNA polymerase activities were observed 7 cases (70%) within 2 weeks, 3) during follow up period, transient increase of serum ALT activities were observed 9 cases within 12 weeks. One case of seroconversion (Anti-HBe) and one case of transient loss of HBeAg were observed at 16 week during mean follow up period of 30.3 weeks (range 16-58 weeks). But transient increment of serum ALT activities were observed 9 cases (90%) within 16 weeks. 4) In all 11 patients, peripheral white blood cell, granulocyte, platelet counts were decreased significantly within first week but not decreased further during INTRON A administration and recovered within 2 weeks after discontinuation of INTRON A. 5) Myalgia and fever were noted in 10 cases (91%) and headache and high fever (>38'C) were noted in 5 cases (45%) within 4 days. Mild anorexia (36%), hair loss (27%), diarrhea (9%), nausea (9%) were noted after 2 weeks. It suggested that subcutaneous injection of 3 MU INTRON A was safe and effective in decrement of DNA polymerase and transaminase activities in patients with CAH type B transiently. Long term therapy will be nessessary for the eradication of HBe Antigenemia and clinical improvement.

소의 대동맥 내피세포에서 산화저밀도 지단백에 의한 아포프토시스에 백일해 독소 및 콜레라 독소가 미치는 영향

손호영(Ho Young Son),강성구(Sung Ku Kang),강무일(Moo Il Kang),차봉연(Bong Youn Cha),이광우(Kwang Woo Lee),장상아(Sang Ah Chang),최윤희(Yoon Hee Choi),문성대(Sung Dae Moon),안유배(Yoo Bae Ahn),손현식(Hyun Sik Son),윤건호(Kun Ho Yoon) 대한내과학회 1999 대한내과학회지 Vol.56 No.5

Objectives : Oxidized LDL is thought to play a key role in atherogenesis. Among their wide variety of biological properties, oxidized LDL injures the endothelium as an early event of atherogenesis. However, the mechanisms by which oxidized LDL injures endothelial cells are not definitely known. In order to evaluate the involvement of GTP-binding protein on the mechanism of apoptosis, we studied the effects of pertussis and cholera toxin on oxidized LDL-induced apoptosis in bovine aortic endothelial cells(BAECs). Methods : Oxidized LDL elicited apoptosis in cultured BAECs as shown by characteristic morphological and biochemical changes. Chromatin condensation and nucleus fragmentation were visualized by using fluorescence microscopy of intact cells staining by acridine orange/ ethidium bromide. DNA fragmentation was quantified by an ELISA with specific antibody for bromodeoxyuridine- labelled DNA fragments and confirmed with DNA ladder formation. Results : Studies using a combination of bacterial toxins which change the function of GTP-binding protein suggest that oxidized LDL-induced apoptosis was regulated by GTP-binding protein. Oxidized LDL-induced apoptosis was not changed by pretreatment of BAECs with pertussis toxin. In contrast, pretreatment with cholera toxin completely prevented the oxidized LDL- induced apoptosis. Conclusion : These results show that oxidized LDL induces apoptosis of BAECs and suggest that cholera toxin-sensitive G-proteins are involved in signal transduction of oxidized LDL-induced apoptosis of BAEC.

증례 / 갈색종양 ( brown tumor ) 골절로 우연히 진단된 상종격동 부갑상선 선종 1예

손호영(Ho Young Son),강성구(Sung Ku Kang),이승규(Seung Kyu Lee),문성대(Sung Dae Moon),김현수(Hyun Su Kim),박은정(Eun Jung Park),안석주(Suk Ju Ahn),한제호(Je Ho Han),강무일(Moo Il Kang),차봉연(Bong Youn Cha),이광우(Kwang Woo Lee) 대한내과학회 1999 대한내과학회지 Vol.56 No.1

Primary hyperparathyroidism is characterized by hypercalcemia and increased intact parathyroid hormone, and associated with reduced bone density and bony change. We experienced the case of a 18-year-old man presenting as fracture of brown tumor. And then ectopic superior mediastinal parathyroid adenoma was detected by preoperative localization studies (Tc-99m sestamibi scan, neck CT). The patient presented with fracture of the right 5th proximal phalanx which was brown tumor, and was diagnosed as having primary hyperparathyroidism due to elevated serum calcium level (12.1 mg/dl) and intact parathyroid hormone levels (1631.8 pg/ml). Ultrasonography, Tl-201/Tc-99m subtraction scan, Tc-99m sestamibi scan, computed tomography was performed, and then revealed an enlarged parathyroid gland in the superior mediastinum. Tumor was removed via a transcervical approach. Pathologically, the tumor was confirmed to be a parathyroid adenoma. After his operation, his calcium level rapidly returned to within normal ranges, and increased bone density and some remineralization of brown tumor has occurred after eight months.

2 형 자가면역성 다선 증후군 1 예

유순집(Soon Jib Yoo),윤형규(Hyung Kue Yoon),윤건호(Kun Ho Yoon),강무일(Moo Il Kang),차봉연(Bong Yun Cha),최의진(Eu Jin Choi),이광우(Kwang Woo Lee),손호영(Ho Young Son),강성구(Sung Koo Kang),이해규(Hae Giu Lee),김태규(Tae Kyu Kim),한훈( 대한내과학회 1995 대한내과학회지 Vol.48 No.6

Autoimmune polyglandular syndrome encompasses a number of diseases, ranging from unusual endocrine and nonendocrine disorders to the co-occurrence of common organ specific autoimmune disease. Knowledge of these syndrome is important for several respects: given the presence of one disease, certain others become more likely(in relatives as well as in the primary patient); there are similarities in the etiology and genetics of the different diseases; and immunologic treatment of one disease may be applicable to others. We recently experienced type II autoimmune polyglandular syndrome in a twenty-two-year old female patient who had insulin dependent diabetes mellitus associated with diabetic ketoacidosis, Hashimoto's thyroiditis, autoimmune Addison's disease, primary gonadal failure and alopecia totalis. Among the family member, twenty-year-old sister showed primary gonadal failure. Evaluation of the histocompatibility leukocyte anti- gene(HLA) was done in the patient and 4 relatives by two-step polymerase chain reaction(PCR). In HLA typing, the patient showed HLA-Al, B8, DR3, DR4 haplotypes, which had been known to be related with the autoimmune polyglandular syndrome.

무균성 뇌수막염으로 오인된 뇌하수체졸증

윤유선 ( Yu Seon Yun ),김은숙 ( Eun Sook Kim ),신정아 ( Jung Ah Shin ),강무일 ( Moo Il Kang ),윤건호 ( Kun Ho Yoon ),차봉연 ( Bong Yun Cha ),손호영 ( Ho Young Son ) 대한내과학회 2011 대한내과학회지 Vol.80 No.1

Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident. Although pituitary apoplexy is an emergency, it is often overlooked because it is rare and presents with various signs and symptoms, including those of neurologic and endocrine disorders. We describe a case of pituitary apoplexy misdiagnosed as aseptic meningitis accompanied by acute-onset headache and nausea, followed by fever. Subsequently, it was revealed as pituitary apoplexy by brain magnetic resonance imaging (MRI) performed when the clinical course worsened and ophthalmoplegia developed. We suggest that pituitary apoplexy be included in the differential diagnosis of patients presenting with headache or signs of meningeal irritation; when there is no clinical improvement, prompt steroid treatment should be started, while considering neurological decompression to prevent neurological sequelae. (Korean J Med 2011;80:102-107)

만성신부전증 환자에서 혈액투석, 복막투석 및 신장이식이 혈중 Apolipoprotein(a) 농도에 미치는 영향

윤건호 ( Kun Ho Yoon ),유순집 ( Soon Jip Yoo ),강무일 ( Moo Il Kang ),차봉연 ( Bong Yun Cha ),윤영석 ( Young Suk Yoon ),이광우 ( Kwang Woo Lee ),손호영 ( Ho Young Son ),강성구 ( Sung Koo Kang ),방병기 ( Byung Kee Bang ) 한국지질동맥경화학회(구 한국지질학회) 1996 韓國脂質學會誌 Vol.6 No.1

여러 장기를 침범한 이차성 혈색소침착증 1예

김미경 ( Mee Kyoung Kim ),임동준 ( Dong Jun Lim ),백기현 ( Ki Hyun Baek ),송기호 ( Ki Ho Song ),강무일 ( Moo Il Kang ),이광우 ( Kwang Woo Lee ),이종욱 ( Jong Wook Lee ) 대한내과학회 2008 대한내과학회지 Vol.75 No.6

We report a case of transfusion-associated hemochromatosis in a 38-year-old female who had severe aplastic anemia. She had undergone conservative treatment consisting of multiple transfusions because she had no suitable HLA-matched bone marrow donor. She had received 400 units of red blood cells (RBCs) over 10 years. The transferrin saturation and serum ferritin were increased to 88.4% and 29,905 ng/mL, respectively. Abdominal computed tomography (CT) showed increased densities in the liver and myocardium, suggesting iron deposits in those organs. In general, transfusional iron overload results in primarily reticuloendothelial iron accumulation, which is considered to be less harmful than parenchymal iron accumulation. Nevertheless, our patient had many striking complications associated with hemochromatosis, such as skin pigmentation, hypogonadotropin hypogonadism, insulin-requiring diabetes mellitus, impaired liver function, and left ventricular dysfunction. (Korean J Med 75:709-713, 2008)

임상화보 : 거대 뇌하수체 낭종으로 나타난 프로락틴종

김미경 ( Mee Kyoung Kim ),신주영 ( Joo Young Shin ),임동준 ( Dong Jun Lim ),백기현 ( Ki Hyun Baek ),강무일 ( Moo Il Kang ),이광우 ( Kwang Woo Lee ) 대한내과학회 2006 대한내과학회지 Vol.71 No.6