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대한내과학회> Korean Journal of Medicine(구 대한내과학회지)

Korean Journal of Medicine(구 대한내과학회지) update

  • : 대한내과학회
  • : 의약학분야  >  내과학
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  • : 대한내과학회잡지(~1992) → 대한내과학회지(1993~) → korean journal of medicine(1996~)

수록정보
수록범위 : 1권1호(1949)~95권4호(2020) |수록논문 수 : 12,066
Korean Journal of Medicine(구 대한내과학회지)
95권4호(2020년 08월) 수록논문
최근 권호 논문
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1비대면 의료서비스의 장점 및 필요성

저자 : 김종엽 ( Jong Yeob Kim ) , 이관익 ( Kwan Ik Lee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 217-227 (11 pages)

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2원격의료의 다른 이름, 비대면 의료 서비스에 대한 고찰

저자 : 김대하 ( Dae-ha Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 228-231 (4 pages)

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3코로나바이러스19 감염증과 안지오텐신전환효소2

저자 : 신진호 ( Jinho Shin )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 232-235 (4 pages)

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A role of angiotensin-converting enzyme 2 (ACE2) in the coronavirus disease 2019 pandemic has been suggested, because it is the molecular receptor for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2). ACE2 is known to provide a protective effect for cardiac and vascular tissues, because it generally counteracts angiotensin II (Ang II) activity. ACE2 downregulation has been implicated in the pathogenesis of cardiovascular disease. ACE inhibitors and angiotensin receptor blockers may enhance ACE2 mRNA expression and enzyme activity. However, this has not been demonstrated in lung tissue. In the lungs, Ang II induces vasoconstriction to prevent ventilation perfusion mismatch, while also increasing vascular permeability (which can precipitate pulmonary edema). ACE2 is expressed in 0.67% of human lung cells, 80% of which are type 2 alveolar cells. Men (of all ethnicities) and Asian individuals have been shown to express higher levels of ACE2 than women and non-Asian individuals, respectively. However, there are no data from human studies indicating that high ACE2 expression increases the likelihood of SARS-CoV2 infection. In animal studies, an increase in Ang II caused by SARS-CoV2 or spike protein interactions, in turn due to ACE2 downregulation, has been identified as the key mechanism underlying lung injury. In human studies of SARS-CoV2 infection, ACE2 overexpression was shown to cause inflammatory apoptosis and a cytokine storm. The actions of ACE2 and Ang II in SARS-CoV2-infected vascular and lung tissues differ between animals and humans. ACE2 expression levels pre- and post-SARS-CoV2 infection should be differentiated. (Korean J Med 2020;95:232-235)

4제2형 당뇨병 환자에서 장기간의 Sodium-glucose Cotransporter 2 억제제 치료가 신장기능에 미치는 효과

저자 : 백종하 ( Jong Ha Baek ) , 오태정 ( Tae Jung Oh ) , 문주영 ( Ju-young Moon ) , 김태희 ( Taehee Kim ) , 고승현 ( Seung Hyun Ko ) , 문민경 ( Min Kyong Moon ) , 김현정 ( Hyun Jung Kim ) , 이동원 ( Dong Won Lee ) , 허규연 ( Kyu Yeon Hur )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 236-245 (10 pages)

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Chronic kidney disease is developed commonly in type 2 diabetes mellitus (T2DM) and is the most common cause of end-stage renal disease and related cardiovascular complications. Meanwhile, despite the current standard of care including optimized glucose control and the use of single-agent blockade of the renin-angiotensin-aldosterone system (RAAS), patients with T2DM remain at increased risk for death and complications from cardiorenal causes. The recent studies using sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown not only glucose lowering effect, but also a reduction in blood pressure, weight loss, and a lowering cardiovascular risk. Regarding renal outcomes, the use of SGLT2 inhibitor slows the progression of kidney disease compared to placebo when added to standard care. However, concern has been raised that currently available SGLT2 inhibitors in Korea may be also associated with improved renal outcomes with long-term treatment. As a result, we aimed to evaluate the effect of long-term SGLT2 inhibitor treatment on renal function in the patients with T2DM using meta-analysis. (Korean J Med 2020;95:236-243)

5위마비

저자 : 형례창 ( Li-chang Hsing ) , 정기욱 ( Kee Wook Jung )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 244-250 (7 pages)

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Gastroparesis is a condition characterized by delayed gastric emptying without evidence of mechanical obstruction in the stomach. Its symptoms include nausea, vomiting, early satiety, abdominal bloating, and abdominal pain. Most cases of gastroparesis are either idiopathic, due to diabetes mellitus, or post-surgical complications. The diagnosis of gastroparesis requires upper endoscopy, contrast radiography, or validated gastric scintigraphy. Gastroparesis is managed with nutritional support and treatment of any underlying disorders, such as diabetes. Pharmacological treatments have been tried, including prokinetics and novel medications. Interventions focused on the pylorus have shown promising results. (Korean J Med 2020;95:244-250)

6실신의 임상적 접근 및 진단

저자 : 최윤영 ( Yun Young Choi ) , 최종일 ( Jong-il Choi )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 251-259 (9 pages)

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Syncope, defined as a transient loss of consciousness, is commonly clinical encountered in patients of all ages at emergency and outpatient clinics. However, syncope shares various clinical features with other diseases (e.g., epilepsy), and the explicit cause may be difficult to identify because testing (e.g., electrocardiography) cannot be performed during a syncopal episode. Syncope due to a cardiac disorder may lead to a fatal outcome such as sudden cardiac death, whereas neurally mediated syncope has a much more favorable prognosis. Herein, we classify the causes of syncope and provide the clinical approach for each, focusing on recently updated guidelines. (Korean J Med 2020;95:251-259)

7생체신장이식 수혜자 및 공여자 평가

저자 : 박하열 ( Ha Yeol Park ) , 신병철 ( Byung Chul Shin )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 260-265 (6 pages)

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Kidney transplantation is the treatment of choice for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk of patients, as compared to maintenance dialysis. The number of patients awaiting kidney transplantation has steadily increased, and the gap between allograft supply and demand continues to widen despite initiatives to expand the use of nonstandard deceased-donor allografts. The use of organs from living donors is one strategy to address the need for transplants. A medical, surgical, and psychosocial evaluation is mandatory prior to living kidney donation to ensure that the donor candidate is in good health and has normal kidney function, is not a risk to the recipient with respect to transmission of infections and malignancy, and will not face unacceptable risks after donation. (Korean J Med 2020;95:260-265)

8한국 성인에서 심혈관 질환 위험인자의 성별에 따른 차이

저자 : 오미숙 ( Mi Sook Oh ) , 정명호 ( Myung Ho Jeong )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 266-275 (10 pages)

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목적: 여성의 심혈관 질환은 남성에 비하여 중장년 전에는 유병률이 낮은데 반하여, 중장년 이후에는 증가하고 있다. 본 연구는 한국 성인에서 성별에 따른 심혈관 질환의 위험인자 차이를 비교하고자 하였다.
방법: 국민건강영양조사 제5기, 제6기, 제7기 2차년도 (2010-2017년) 자료를 이용하였다. 심혈관계 질환의 유무를 확인할 수 있는 성인 총 41,386명 중 고혈압, 뇌졸중, 심근경색증, 협심증 진단을 받은 적이 있다고 응답한 11,529명을 대상으로 하였고, 남자 5,151명, 여자 6,378명을 비교 분석하였다. 결과: 한국인 심혈관 질환의 유병률은 27.9%였으며, 여성이 남성보다 많았다(44.7% vs. 55.3%, p < 0.001). 평균 연령은 여성이 유의하게 높았고(63.9 ± 11.1 vs. 66.6 ± 9.9세, p < 0.001), 남성의 유병률은 중년에서 높았고, 여성의 유병률은 70세 이후에 더 높았다(p < 0.001). 여성은 결혼의 상태, 교육수준, 주관적 건강상태, 비만도가 유의하게 높았으며, 남성은 흡연과 음주, 스트레스 정도가 유의하게 높았다. 총 콜레스테롤, 저밀도 지단백콜레스테롤은 여성에서 유의하게 높았다. 공복 혈당, 중성지방 및 백혈구가 남성에서 유의하게 높았고, 고밀도 지단백콜레스테롤은 낮았다. 심혈관 질환 유병률은 여성이 남성에 비하여 고혈압이 유의하게 많았으며, 남성에서는 심근경색증(5.5 vs. 2.5%, p < 0.001)의 유병률이 유의하게 높았다. 동반 질환 중에는 여성이 우울증(2.8 vs. 8.6%, p < 0.001), 류마티스 관절염이 있는 경우에 심혈관 질환 유병률이 높았고, 남성은 당뇨병이 있는 경우에 심혈관 질환 유병률이 높았다. 다변량 분석결과에서 남성은 높은 스트레스(OR 2.31, 95% CI 1.28-4.17, p = 0.005)와 흡연(OR 1.61, 95% CI 1.04-2.48, p = 0.031), 당뇨병, 여성은 우울증(OR 2.03, 95% CI 1.22-3.39, p = 0.007)과 낮은 교육수준(OR 9.99, 95% CI 6.91-14.22, p < 0.001), 류마티스 관절염, 주관적 건강상태가 심혈관 질환에 영향을 미치는 독립적인 위험인자였다.
결론: 한국인에서 성별에 따라 심혈관 질환의 위험인자에 차이가 있으며, 남성에서는 흡연과 스트레스가, 여성에서는 우울증과 류마티스 관절염, 낮은 교육수준, 주관적 건강상태가 대표적인 위험인자였다.


Background/Aims: The prevalence of cardiovascular disease among women is lower than that among men in middle age, but increases after middle age. This study was performed to compare the risk factors for cardiovascular disease according to sex in Koreans adults.
Methods: Data from the National Health and Nutrition Examination Survey for the 5th, 6th, and 7th years (2010-2017) were analyzed. This study examined the risk factors for cardiovascular disease among adults. From the total of 41,386 patients, 11,529 patients were selected.
Results: The overall prevalence of cardiovascular disease in Korean adults was 27.9%, and the prevalence was higher in women than in men (55.3% vs. 44.7%, respectively, p < 0.001). Women with cardiovascular disease were older than men (66.6 ± 9.9 years vs. 63.9 ± 11.1 years, respectively, p < 0.001). The prevalence of cardiovascular disease was higher in women with comorbid depression and rheumatoid arthritis and higher in men with diabetes mellitus. Multivariate regression analysis showed that stress (OR 2.31, 95% CI 1.28-4.17, p = 0.005) and smoking (OR 1.61, 95% CI 1.04-2.48, p = 0.031) were independent risk factors for cardiovascular disease in men, while depression (OR 2.03, 95% CI 1.22-3.39, p = 0.007), low education level, rheumatoid arthritis, and poor subjective health status (OR 1.70, 95% CI 1.20-2.41, p = 0.003) were independent risk factors for cardiovascular disease in women.
Conclusions: Differences were detected in cardiovascular risk factors according to sex in Korea. The most important risk factors were smoking and stress in men, and depression, low education level, rheumatoid arthritis, and poor subjective health status in women. (Korean J Med 2020;95:266-275)

9건강한 성인에서 발생한 Mycobacterium massiliense 중이염

저자 : 김미연 ( Miyeon Kim ) , 허상택 ( Sang Taek Heo ) , 이재근 ( Jae-geun Lee ) , 서지영 ( Michelle J. Suh ) , 현창림 ( Chang Lim Hyun ) , 유정래 ( Jeong Rae Yoo )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 276-280 (5 pages)

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Mycobacterium massiliense (M. massiliense) is a novel nontuberculous mycobacteria (NTM) and an opportunistic pathogen that lives in the water, soil, food, and air. It is a subspecies of the rapidly growing mycobacteria Mycobacterium abscessus. This atypical pathogen has been reported mainly in patients with lung disease or those undergoing cosmetic or surgical procedures. A 62-year-old woman presented with productive otorrhea for 10 months, no history of surgery, and chronic otitis media. M. massiliense was identified from a tissue specimen using real-time polymerase chain reaction for NTM (Biosewoom, Seoul, Korea), and NTM was identified by acid-fast bacilli culture. Successful treatment consisted of clarithromycin for 4 months. No other case of chronic otitis media related to M. massiliense has been reported. This is the first confirmed case of chronic otitis media caused by M. massiliense in a healthy adult in South Korea. (Korean J Med 2020;95:276-280)

10위를 침범한 원발성 췌장 미만성 거대 B세포 림프종

저자 : 박지영 ( Ji Young Park ) , 전태주 ( Tae Joo Jeon )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 95권 4호 발행 연도 : 2020 페이지 : pp. 281-286 (6 pages)

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Primary pancreatic lymphoma (PPL) is extremely rare, comprising fewer than 1% of non-Hodgkin lymphomas. The most common histological subtype of PPL is diffuse large Bcell lymphoma (DLBCL). A 46-year-old man presented with indigestion, epigastric pain, and weight loss for 2 months. Abdominal computed tomography showed a well-defined hypodense mass located at the pancreas head involving the stomach, as well as enlargement of several mesenteric and perigastric lymph nodes. Histological examination was performed by upper gastrointestinal endoscopy of the stomach and endoscopic ultrasound-guided fine-needle aspiration and biopsy of the pancreatic mass. Histology of the pancreatic mass and the stomach revealed pancreatic DLBCL, involving the stomach. The patient received chemotherapy and is currently in complete remission. We report a rare presentation of DLBCL, appearing as a primary pancreatic tumor involving the stomach, which we presume is the first such report in South Korea. (Korean J Med 2020;95:281-286)

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1연안해역에서 석유오염물질의 세균학적 분해에 관한 연구

(2006)홍길동 외 1명심리학41회 피인용

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(2006)홍길동심리학41회 피인용

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(2006)홍길동41회 피인용

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원광대학교 경희대학교 녹십자 마산대학교 우석대학교
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