당뇨병 환자에서 건강 문해력, 당뇨병 지식과 혈당조절의 상관관계

천신혜 ( Shin Hye Cheon ),나상규 ( Sang Kyu Na ),김하윤 ( Ha Yoon Kim ),임희경 ( Hee Kyung Lim ),최민규 ( Min Kyu Choi ),노용균 ( Yong Kyun Roh ) 대한의료커뮤니케이션학회 2015 의료커뮤니케이션 Vol.10 No.2

Purpose: Patients with limited health literacy usually have less disease-related knowledge, and consequently have poor health status. On the other hand, diabetes care requires complex course of strict medication and lifestyle changes to maintain appropriate glycemic levels and to prevent diabetic complications. We evaluated the association between health literacy, diabetes knowledge and glycemic control among diabetic patients. Methods: A cross-sectional study of 84 enrollees who were older than 30 years and had type 2 diabetes was conducted in a university hospital. Health literacy was measured using the short form of Newest Vital Sign (NVS), and diabetes knowledge measured using one of the two parallel diabetes knowledge tests. Participants were interviewed to determine participants’ characteristics, and HbA1c levels were identified from the clinical database of Hallym University Kang Nam Sacred Heart Hospital to assess glycemic control. Results: The mean score of health literacy was 1.8 (±1.9) and mean score of diabetes knowledge was 12.0 (±4.1). Only 23.8% of participants had adequate literacy. After adjusting sociodemographic characteristics, duration of diabetes, and treatment regimen, diabetes knowledge and health literacy were not independently associated with HbA1c levels. Only significant factor of glycemic control was duration of diabetes (r=0.489, p<0.001). Conclusion: Among patients with type 2 diabetes, health literacy and diabetes knowldege were not independently associated with glycemic control. Better strategies are needed to improve glycemic control.

가임기 간접흡연 여성에서 발생한 폐 호산구성 육아종

신재호 ( Jae Ho Shin ),김지영 ( Ji Young Kim ),오수환 ( Soo Hwan Oh ),박홍수 ( Hong Soo Park ),정상수 ( Sang Su Chung ),나상규 ( Sang Kyu Na ),김형중 ( Hyung Jung Kim ),안철민 ( Chul Min Ahn ),김해균 ( Hae Kyun Kim ),김상진 ( Sang 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.2

200㎾급 저등급 펠릿(재 10% 이상) 산업용 보일러 시스템 개발

강새별(Sae-Byul Kang),이현희(Hyun-Hee Lee),오정석(Jeong-Seok Oh),최규성(Kyu-Sung Choi),김성운(Sung-uen Kim),박기식(Ki-Sik Park),박상부(Sang-Bu Park),나상규(Sang-Kyu Na) 대한기계학회 2019 대한기계학회 춘추학술대회 Vol.2019 No.11

췌장암과 감별이 필요하였던 비알코올성 만성 췌장염 1예

이상인,강진경,윤동섭,박영년,정재복,이세준,정준표,이관식,송시영,나상규,최병기,송기섭,유정식 대한소화기학회 2000 대한소화기학회지 Vol.35 No.6

Differentiation between chronic pancreatitis and pancreatic cancer is often difficult. Some special types of chronic pancreatitis such as 'non-alcoholic duct-destructive chronic pancreatitis' and 'chronic pancreatitis with diffuse irregular narrowing of the main pancreatic duct' seem to be pancreatic cancer, but show imaging features characterized by the absence of parenchymal atrophy, significant ductal dilatation proximal to the site of stenosis, and the absence of extrapancreatic spread. Recognition of these special types of chronic pancreatitis prior to a definite treatment is important to avoid an unnecessary pancreatic resection. Recently, we experienced a case of non- alcoholic chronic pancreatitis in a 80-year-old man presenting with obstructive jaundice. His radiologic features were similar to those of non-alcoholic duct-destructive chronic pancreatitis. Recognition of this special type of chronic pancreatitis prior to a definitive treatment enabled us to manage this patient optimally.

직장 자궁내막증: 증례보고 및 국내문헌 고찰

이상인,강진경,박영년,이세준,정준표,이관식,나상규,송종원,채보원,김희정 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.4

Endometriosis is the abnormal growth of endometrial tissue outside the uterine cavity. Involvement of the gastrointestinal tract is seen in 3∼34% of patients affected by this condition. Although the commonest sites involved are the sigmoid colon and rectum, only 4 cases have been reported in Korea. The most frequent symptoms are lower abdominal and pelvic pain typically worsening at the time of menstruation. Bleeding per rectum is uncommon since the mucosa is rarely involved. Endoscopy has not been thought to be helpful in the evaluation of patients with suspected colonic endometriosis. However, endoscopy is often used as the first test in patients with rectal bleeding, excluding malignancy or other sources of bleeding. There are few reports of endoscopic documentation of colorectal endometriosis. A 26 year-old woman having a history of endometriosis with cyclic hematochezia and lower abdominal pain is herein reported. A flexible sigmoidoscopy revealed a protrusion of hyperemic mucosa with a surrounding foldformation on the rectum 8 cm above the anal verge. The subsequent biopsy of the lesion gave rise to a diagnosis of endometriosis.

식도 운동이상 진단에 있어서 Marshmallow 식도조영술의 임상적 가치

이상인,박효진,박인서,나상규,김기황,송종원 대한소화기학회 2000 대한소화기학회지 Vol.35 No.4

Background/Aims: We reported previously that marshmallow esophagography was more sensitive than conventional esophagography in evaluation of esophageal symptoms. To verify our previous study, we have investigated the clinical value of marshmallow esophagography in detecting esophageal dysmotility. Methods: Seventy-eight symptomatic patients who showed no organic disorders on esophagoscopy or conventional esophagography underwent esophageal manometry and marshmallow esophagography within one week. Forty-one of the patients also underwent esophageal transit scintigraphy. Marshmallow transit was considered normal when it passed the esophagus within 30 seconds on the supine position. Abnormal marshmallow transit was graded as mild, moderate, and severe. Results: The results of esophageal manometry were normal in 30 of 52 (57.7%) subjects with normal marshmallow transit, whereas the results were abnormal in 19 of 26 (73.1%) patients with abnormal marshmallow transit (χ2=5.405, p=0.02). The grade of marshmallow trnsit was correlated to the degree of esophageal dysmotility manometrically (χ2M-H=7.588, p$lt;0.01). The percentage of abnormal marshmallow transit was significantly higher in patients with achalasia, diffuse esophageal spasm, or non-specific esophageal motility disorder than in normal subjects. The grade of marshmallow transit was correlated with the scintigraphic residual fractions. Conclusions: These findings support that marshmallow esophagography would be useful as one of good functional methods for detecting esophageal dysmotility.

고춧가루와 Capsaicin 이 위배출에 미치는 영향

윤선,이상인,박효진,이송미,박인서,김정호,나상규,김기황,정대호 대한소화기학회 1999 대한소화기학회지 Vol.33 No.4

Background/Aims: Capsaicin stimulates the release of several neuropeptides and has diverse effects on gastrointestinal function. We investigated the effect of intragastric red pepper or capsaicin on the gastric emptying in human. Methods: Fourteen healthy male volunteers were recruited. Gastric emptying was assessed by radio-opaque markers (ROMs) method and plasma acetaminophen (AAP) levels. Results: The clearance of ROMs at 2 hours and 3 hours was 10.6±15.9 and 73.1 ±34.6% after administration of placebo, 17.6±26.0 and 78.7±40.2% after administration of red pepper 3 g 27.8 ±34.0 and 73.2 ±31.9% after administration of red pepper 6 g, 2.1 ±5.1 and 15.5 ±20.7% afte administration of capsaicin 17.3 mg. Capsaicin significantly delayed the gastric emptying of ROMs The serum AAP concentrations were measured at 30, 45, 60, 75 and 90 min after administration o placebo (4.09 ±3.45, 8.09 ±4.13, 13.55 ±4.90, 15.50 ±3.44 and 13.0 ±7.53 ㎍/ml), red pepper 3 g (5.63 ±4.84, 8.88 ±4.76, 14.25 ±5.01, 15.0 ±6.57 ㎍/ml), red pepper 6 g (7.0 ± 7.19, 8.09 ±5.63, 12.09 ±6.04, 13.73 ±4.65 and 14.28 ±3.77 ㎍/ml), capsaicin 17.3 mg (4.50 ±2.88, 7.17 ±3.19, 11.50 ±4.76, 11.17 ±3.71 and 13.33 ±3.72 ㎍/ml). Intragastric red pepper or capsaicin made no significant difference of serum acetaminophen level from placebo. Conclusions: Intragastric administration of capsaicin delayed gastric emptying of indigestible solid meal, whereas red pepper did not. The gastric emptying of liquid meal was affected by neither capsaicin nor red pepper.

한국인 남성에서의 렙틴 농도와 비만도 및 다른 생화학적 지표들과의 연관성

김은숙,허갑범,이현철,임승길,신재호,김경래,송영득,차봉수,남수연,나상규 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.2

Background: Leptin, the product of obese(ob) gene, is thought to be a lipostatic hormone that contributes to body weight regulation through modulating food intake and energy expenditure. Animals with leptin deficiency are obese and lose body weight when they are given leptin. However little is known about the physiologic actions of leptin in humans. Plasma leptin concentrations are shown to be elevated in obese humans. So far, the factors that regulate plasma leptin concentrations remain to be identified. This work is undertaken, therefore, to examine the basal leptin concentrations in lean and obese korean males, and relation between leptin concentrations, body fat and other biochemical pararneters. Methods: We measured the height, weight, waist/ hip ratio, fasting blood glucose, insulin, total cholesterol, triglyceride, free fatty acid and leptin concentrations in 45 obese and 45 normalweight males without medical and surgical problems. Results: Means of percent IBW were 136.3+-10.3%(mean+-SD) and 97.2+-6.5% in obese and control group respectively. Pasting blood sugar, free fatty acid, total cholesterol concentrations were not different between obese and control group. But the insulin and triglyceride concentrations were higher in obese group than those in control group(p$lt; 0.05). Also, the mean leptin concentrstion was higher in obese group than that in control group(5.8+-3.5 vs 3.0+-2.1). The leptin concentrations were not correlated with fasting blood sugar, free fatty acid, total cholesterol levels, triglyceride, insulin or age, but correlated with WHR(r2=0.203), BMI and percent IBW. Conchasions: These findings suggest that the leptin coneentrations are positively correlated with adiposity. The mean serum leptin concentrations in korean obese males were lower than those reported in other studies, probably because the subjects of this study were only males and had lower fat amount compared to other studies, and the change of body weight and calorie intake before study was not considered (J Kor Soc Endocrinol 13:216-222, 1998).

공터키안 증후군의 임상적 및 내분비학적 고찰

김은숙,허갑범,이현철,임승길,이은직,송영득,남수연,문윤재,김인재,나상규,김경래 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.3

Backbround: Primary empty sella syndrome(PES) is thought to arise from an incompetent diaphragma allowing progressive herniation of arachnoid membrane with secondary compression and atrophy of the pituitary gland. As a consequence of the improvement and widespread use of neuroradiological techniques, such as computerized tomography(CT) and magnetic resonance imaging(MRI), empty sella is more frequently disclosed. The aim of this study is to assess the associated clinical characteristics and endocrinologic disturbance in empty sella syndrome. Methods: From January 1986 to June 1996, 171 patients with empty sella syndrome have undergone analysis for clinical characteristics and associated disease. Result: In our study, PES was diagnosed in 131 of the 171 patients(77%). Primary empty sella syndrome was frequent in middle aged women(female:male 115:16, mean age: 50.6+12.6 years). The common clinical features were headache(80.2%), obesity(72.5%), and hypertension(27.5%). Most of patients with PES have normal pituitary function(75%). The frequent pituitary dysfunction was hyperprolactinemia in PES(21%). Partial and total emptiness of sella on sella CT or MRI were in 111(84.7%) patients, and in 20(15.4%) patients, respectively. The most common associated disease with empty sella syndrome was pituitary adenoma. Conclusion: PES should be considered as a possible cause in obese middle aged women with unexplained headache. The combined pituitary function test should be considered for evaluation of pituitary dysfunction when clinically suspected. (J Kor Soc Endocrinol 12:386-392, 1997)

복강경적 담낭 절제술 후 부담관에서 발생한 담즙 유출 1예

이상인,박효진,김동주,강진경,정재복,이세준,정준표,이관식,나상규,정미경 대한소화기내시경학회 2000 Clinical Endoscopy Vol.21 No.1

Bile leak is one of the complications of both open and laparoscopic cholecystectomy. The majority of postcholecystectomy leaks occur from the cystic duct stump. Due to their location and small size, accessory ducts are vulnerable to injury during cholecystectomy. A clinical significant leak from the injured accessory bile duct is rare and has rarely been reported in Korea. Endoscopic retrograde cholangiopancreatography (ERCP) has a major role both in detecting such a leak, determining its site, and in managing it. A case was experienced involving a significant bile leak after laparoscopic cholecystectomy from the accessory bile duct in a 49 year-old man. The site of the leak was diagnosed by ERCP and the leak was successfully treated endoscopically by using biliary stenting. However, the diagnosis of the accessory bile duct was established only by a follow-up ERCP done after the healing of the bile leak. This case in herein reported with a review of the related literature.