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대한내과학회> Korean Journal of Medicine(구 대한내과학회지)

Korean Journal of Medicine(구 대한내과학회지) update

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  • : 대한내과학회잡지(~1992)→대한내과학회지(1993~)→Korean Journal of Medicine(1996~)

수록정보
수록범위 : 1권1호(1949)~94권5호(2019) |수록논문 수 : 12,013
Korean Journal of Medicine(구 대한내과학회지)
94권5호(2019년 10월) 수록논문
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14차 산업혁명 시대의 적정 의료 기술

저자 : 이상열 ( Sang Youl Rhee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 387-390 (4 pages)

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2메타분석의 명과 암

저자 : 이영호 ( Young Ho Lee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 391-395 (5 pages)

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Meta-analysis is a statistical method that combines and synthesizes multiple studies and integrates their results. Meta-analysis increases the sample size, and in turn, the power to study the effects of interest by combining primary studies and providing a precise estimate of the effects. Data synthesized from meta-analyses are usually more beneficial than the results of narrative reviews. In a meta-analysis, the decisions are transparent, and statistical analysis yields an objective measure of the integrated quantitative evidence. The biases of narrative reviews can be limited or overcome by conducting a meta-analysis. The systematic approach and transparency in meta-analysis help to resolve conflicts and uncertainties between studies, while leading to significant conclusions. However, this method is controversial and may not always be the best tool. Moreover, meta-analysis has several shortcomings, and in some cases, it may not be appropriate. Although meta-analysis has been criticized due to its limitations, there are solutions to such problems. The aim of this review is to describe and discuss the strengths and weaknesses of meta-analysis. (Korean J Med 2019;94:391-395)

3고지혈증 치료 가이드라인

저자 : 이상학 ( Sang-hak Lee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 396-402 (7 pages)

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The major guidelines for lipid-lowering therapy (LLT) have been revised recently. Although “higher cardiovascular risk-aggressive LLT with greater absolute clinical benefit” is the main idea underlying all guidelines, there are some differences in the details among them. The US guidelines recommend pharmacological LLT based on a patient's risk category, independently of their low-density lipoprotein-cholesterol (LDL-C) level. However, the European and Korean guidelines consider the patient's risk category and LDL-C at the same time. Lifestyle modifications are suggested in parallel in all guidelines. The newest US guidelines have characteristically revived target LDL-C values in some patient groups and indications for non-statin drugs (ezetimibe and PCSK9 inhibitors), whereas the European and Korean guidelines have maintained target LDL-C values as usual. It is universally accepted that statins are the first-line agent. Adding ezetimibe, bile acid sequestrants, or PCSK9 inhibitors is recommended as a second line treatment. Appreciating the trend and background of the newest LLT guidelines will be essential to maximize cardiovascular prevention in patients. (Korean J Med 2019;94:396-402)

4비만의 소화관 생리변화

저자 : 윤소희 ( So Hee Yun ) , 박종규 ( Jong Kyu Park ) , 신정은 ( Jeong Eun Shin )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 403-409 (7 pages)

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Obesity is a prevalent disease with significant morbidity and mortality. It is a state of chronic low-grade inflammation due to excess body fat. Weight homeostasis is maintained through changes in various gastrointestinal hormones caused by dietary intake. However, being overweight or obese breaks the balance of these appetite-related gastrointestinal hormones and creates resistance to the actions of these hormones. The sensitivity of vagal afferent neurons to peripheral signals becomes blunted. Cytokines produced by excessive fat tissue damage our normal immune system, making us vulnerable to infection. In addition, various changes in gastrointestinal motility occur. Therefore, this review focuses on the various changes in gastrointestinal hormones, the immune state, the vagus nerve, and gastrointestinal movement in obese patients. (Korean J Med 2019;94:403-409)

5비만에서의 장내 미생물 무리의 역할

저자 : 김혜원 ( Haewon Kim ) , 백명기 ( Myong Ki Baeg ) , 김지현 ( Jie-hyun Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 410-413 (4 pages)

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Obesity is a critical target for public health interventions worldwide. There are many causes of obesity, and the importance of the gut microbiota in its pathogenesis has recently been recognized. The composition and function of the gut microbiota play a role in obesity and metabolic disease, yet the underlying mechanisms are unclear. Advances in our understanding of the link between obesity and the gut microbiota have suggested the potential of its manipulation for treating obesity. In this review, we summarize current knowledge of the interactions between the gut microbiota and obesity as well as the therapeutic potential of its modulation. (Korean J Med 2019;94:410-413)

6비만의 진단과 바이오마커

저자 : 방창석 ( Chang Seok Bang ) , 오정환 ( Jung Hwan Oh )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 414-424 (11 pages)

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Obesity is associated with various comorbidities, such as type II diabetes, hypertension, dyslipidemia, and cardiovascular disease. Gastrointestinal complications are also frequent and obesity is a direct cause of nonalcoholic fatty liver disease, and are risk factors for gastroesophageal reflux disease, pancreatitis, gallstone disease, diarrhea, dyssynergic defection, and various gastrointestinal cancers. Diagnosis is usually made by measuring body mass index (BMI). Although BMI is correlated with body fat mass, it may overestimate subjects with high muscle mass and underestimate subjects with low muscle mass. Co-measurement of waist circumference as a reflection of abdominal obesity for subjects with BMIs ranging from 25 to 35 kg/㎡ has been recommended; however, it is still an anthropometric diagnosis that does not clearly discriminate subjects at risk for developing comorbidities. Biomarkers reflect the underlying biological mechanisms of obesity and can be used to characterize the obesity phenotype (i.e., at high risk for disease development) as well as a target for disease-causing factors. In this article, we describe the conventional diagnosis, biomarkers of obesity, and current challenges. (Korean J Med 2019;94:414-424)

7비만과 소화기 기능성 질환

저자 : 이주엽 ( Ju Yup Lee ) , 권중구 ( Joong Goo Kwon ) , 김성은 ( Sung Eun Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 425-430 (6 pages)

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The prevalence of obesity and functional gastrointestinal disorders (FGIDs) is increasing worldwide. Obesity has been linked to gastroesophageal reflux disease, irritable bowel syndrome, functional dyspepsia, and various FGIDs. However, the relationship between obesity and FGIDs remains unclear. The purpose of this paper is to evaluate the published studies on this topic and clarify the relationship between obesity and the pathophysiology of various FGIDs. (Korean J Med 2019;94:425-430)

8레이노 현상의 진단적 접근

저자 : 최원호 ( Wonho Choi ) , 김현숙 ( Hyun-sook Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 431-437 (7 pages)

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Raynaud's phenomenon (RP) is a reversible vasospasm that is aggravated by cold or emotional stress. Before confirming RP, it is essential to consider other possible causes including compressive neuropathy, sensori-neuropathy, thyroid disease, hematologic conditions and offending drugs. RP is typically characterized by the three-step color change that turns pallor (white), cyanosis (blue), and then erythema (red) of reperfusion. Once RP is diagnosed, it is important to determine whether it is primary or secondary RP. To distinguish primary from the secondary RP, the specialized tests performing in clinical practice are antinuclear antibody (ANA) and nailfold capillary microscopy (NFC). The combination of ANA and NFC is most helpful for discriminating secondary RP due to autoimmune rheumatic disease. Thereby, normal findings of NFC in primary RP distinguished from secondary RP should be understood. Patients with primary RP usually improves with symptomatic treatment focused on lifestyle modification and patient education, but those with secondary RP should be treated together with associated disease or causes. (Korean J Med 2019;94:431-437)

9기능성 위장관 질환에서의 음식 과민성과 음식 불내증의 진단

저자 : 이홍섭 ( Hong Sub Lee ) , 이광재 ( Kwang Jae Lee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 438-442 (5 pages)

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Patients with a functional gastrointestinal disorder (FGID) frequently report abdominal discomfort and bloating after ingesting specific foods. However, evidence on the relationship between foods and symptoms is lacking. In addition, the diagnosis of food hypersensitivity and food intolerance does not seem to be established yet. Food hypersensitivity can be divided into immunologically mediated and non-immunologically mediated forms. The immunologically mediated forms are specifically termed food allergies, whereas the non-immunologically mediated forms are referred to as food intolerances. Various diagnostic tools are required to make an accurate diagnosis of a food allergy or a food intolerance. First, a thorough examination of the history and basic tests to rule out other organic diseases are needed. Next, diagnostic tests for immunoglobulin E-mediated food allergies are required and diseases, such as celiac disease and lactose intolerance, should be differentiated. A diagnosis for non-celiac gluten sensitivity (NCGS) is also required. A double blind, randomized, placebo-controlled, dietary challenge test can be used for diagnosing NCGS and food intolerance. Diagnostic tests for food intolerance, in which scientific evidence is lacking, may result in a misdiagnosis of food hypersensitivity or food intolerance in patients with a FGID. Therefore, an accurate diagnosis of food hypersensitivity or food intolerance based on reliable tests is required. (Korean J Med 2019;94:438-442)

10원발성 췌장 점막 연관 림프조직 림프종

저자 : 이지우 ( Jiwoo Lee ) , 남소혜 ( So Hye Nam ) , 이장호 ( Jang Ho Lee ) , 유동열 ( Dong Ryeol Yoo ) , 김진희 ( Jin Hee Kim ) , 김미정 ( Mee Jeong Kim ) , 김명환 ( Myung-hwan Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 94권 5호 발행 연도 : 2019 페이지 : pp. 443-448 (6 pages)

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원발성 췌장 림프종은 췌장 종양 중에서 매우 드문 질환이다. 원발성 췌장 림프종의 치료는 대부분 외과적 수술보다는 항암 치료 또는 방사선 치료를 먼저 시행하므로 췌장에 발생하는 다른 종양과의 감별진단이 중요하다. 또한 본 증례와 같이 림프종 중에서도 조직 아형에 따라 치료 원칙이 차이가 있을 수 있으므로 정확한 조직 진단이 치료 방침을 결정하는 데 중요하다. 저자들은 췌장 두부 종양에서 초음파 내시경 유도하에 중심부 바늘 조직 검사를 시행해서 국내에서 처음으로 원발성 췌장 MALT 림프종을 진단하였기에 이를 보고한다.


Primary lymphoma of pancreatic mucosa-associated lymphoid tissue (MALT) is extremely rare. Initial suspicion of primary pancreatic lymphoma is hampered by its low incidence. However, it should always be included in a differential diagnosis of pancreatic mass with unusual features, because an accurate diagnosis can avoid unnecessary surgical intervention. A 70-year-old woman presented with melena associated with a mass on the pancreatic head. Endoscopic ultrasonography-guided core-needle biopsy of the pancreatic mass revealed MALT lymphoma. The patient is currently undergoing radiation therapy. We present a case of primary lymphoma of the pancreatic MALT with a review of the literature. (Korean J Med 2019;94:443-448)

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