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대한내과학회> Korean Journal of Medicine(구 대한내과학회지)> 류마티스 관절염에서 갑상선 자가항체 및 갑상선 기능에 관한 연구

류마티스 관절염에서 갑상선 자가항체 및 갑상선 기능에 관한 연구

Thyroid autoantibodies and thyroid dysfunction in rheumatoid arthritis

이용욱(Yong Wook Lee) , 김동선(Dong Sun Kim) , 김태영(Tae Young Kim) , 이창범(Chang Beom Lee) , 박용수(Yong Soo Park) , 최웅환(Woong Hwan Choi) , 김태화(Tae Wha Kim) , 김신규(Think You Kim) , 전재범(Jae Bum Jun) , 배상철(Sang Cheol Bae) , 유대현(Dae Hyun You) , 김성윤(Seong Yoon Kim)
  • : 대한내과학회
  • : Korean Journal of Medicine(구 대한내과학회지) 58권3호
  • : 연속간행물
  • : 2000년 03월
  • : 317-323(7pages)

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Background : Autoimmune thyroid diseases have been shown to occur in association with connective tissue disorders. This study was undertaken to elucidate the prevalence of thyroid autoantibodies and thyroid dysfunction in Korean patients with rheumatoid arthritis (RA). Methods : We have compared the prevalence of thyroid autoantibodies in 108 RA patients with 81 age-matched controls. Antimicrosomal antibody (AMA) and antithyroglobulin antibody (ATA) were measured by passive hemagglutinin assay. T3, T4, Free T4, and TSH were measured by chemiluminescence method. Rheumatoid factor was measured by nephelometry. Statistical analysis was performed by chi-square, Fisher's exact test, and Pearson correlation test . Results : 1) The presence of AMA/ATA in patients with RA was significantly higher (28.7%/26.7% in 108 patients) than that of controls (11.1%/9.9% in 81 controls). The positive rates of AMA/ATA in female patients were also higher (28.9%/28.9% in 97 patients) than those of female controls (15.5%/12.1% in 58 controls).  2) Thirty three (17.6%) of 187 patients with RA had the abnormalities of thyroid function; 14 (7.5%) revealed subclinical hypothyroidism, 5 (2.7%) revealed biochemical primary hypothyroidism, 7 (3.7%) revealed sick euthyroid syndrome, and 7 (3.7%) revealed hyperthyroidism. Conclusion : These results suggest that autoimmune thyroiditis is highly associated with RA in Korean patients, showing the increased prevalence of thyroid autoantibodies and thyroid dysfunctions. (Korean J Med 58:317-323, 2000)

UCI(KEPA)

I410-ECN-0102-2009-510-004704015

간행물정보

  • : 의약학분야  > 내과학
  • :
  • :
  • : 격월
  • : 1738-9364
  • : 2289-0769
  • : 학술지
  • : 연속간행물
  • : 1949-2020
  • : 12086


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1종설 : 협심증의 진단

저자 : 김기식 , 한성욱

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 253-266 (14 pages)

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2악성 혈액질환의 동종골수이식 후 형성된 복합 키메리즘의 면역조정 치료가 이식편대 숙주병, 질병의 재발 및 생존에 미치는 영향

저자 : 박수정(Soo Jeong Park) , 민우성(Woo Sun Min) , 양일호(Il Ho Yang) , 김희제(Hee Je Kim) , 민창기(Chang Ki Min) , 엄현석(Hyeun Suok Eom) , 홍희선(Hee Sun Honh) , 엄기선(Ki Sseong Eom) , 서정곤(Jung Gon Suh) , 이종욱(Jong Wook Lee) , 김춘추(Chun Choo Rim)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 267-275 (9 pages)

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3간경변증 환자에서 일회성 대량 복수천자에 따른 혈역동학적 변화 -혈장증량제로서 알부민 투여가 미치는 영향을 중심으로-

저자 : 백순구 , 백순구(Soon Koo Baik) , 김현수(Hyun Soo Kim) , 김일회(Il Hee Kim) , 권상옥(Sang Ok Kwon)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 276-282 (7 pages)

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Background : In patients with cirrhosis, single large volume paracentesis(SLVP) is an effective and safe treatment for the tense ascites. But the need for routine administration of albumin remains controversial. We investigated the necessity of albumin administration in cirrhosis with tense ascites after SLVP. 
Methods : 23 patients with cirrhosis with tense ascites were recruited, and examined before and 48 hour after a SLVP. Patients were randomly assigned to be administrated with albumin(6 g/L of ascites removed, n=11) or not(n=12). Systemic and renal hemodynamic parameters(mean arterial blood pressure, cardiac index, systemic vascular resistance index, resistive index of kidney, and serum creatinine), indices associated with sodium homeostasis(urine sodium and osmolarity) and neurohumoral factors such as plasma renin activity and plasma concentration of aldosterone were measured before and 48 hour after a SLVP. 
Results : There was no significant difference in clinical and laboratory parameters between two groups at entry into the study. Plasma renin activity was significantly increased 48 hour after a SLVP in patients without albumin administration, but the change of plasma renin activity before and after paracentesis(Δplasma renin activity) was not significantly different between two groups. There was no difference in the mean arterial blood pressure, cardiac index, systemic vascular resistance index, resistive index of kidney, serum creatinine, urine sodium and osmolarity and plasma concentration of aldosterone between two groups after SLVP. Conclusion : Single large volume paracentesis without albumin administration is a safe and effective treatment in cirrhosis with tense ascites.(Korean J Med 58:276-282, 2000)

4가족성 고콜레스테롤혈증 유전자 진단에서 저밀도지단백 수용체 유전자 및 인접 유전 표식자의 유용성

저자 : 최병주(Byoung Joo Choi) , 박현영(Hyun Young Park) , 김건영(Geon Young Kim) , 남상민(Sang Min Nm) , 조승연(Seung Yun Cho) , 장양수(Yang Soo Jang)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 283-292 (10 pages)

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Background : Familial hypercholesterolemia(FH) is an autosomal dominant metabolic disorder caused by the mutation in low density lipoprotein receptor(LDLR) gene. However, direct genetic diagnosis of LDLR gene mutation is not easily available because more than 300 mutations have been described in LDLR gene of FH patients. Therefore indirect genetic diagnosis using the genetic markers can be used to follow the inheritance of defective gene in FH families. The purpose of this study was to evaluate the usefulness of indirect genetic markers for detecting identical-by-descent LDLR gene abnormalities in FH families.
Methods : We examined the allele frequency, heterozygosity, polymorphism information content(PIC) of each genetic markers(D19S394, Taq I, Hinc II, Ava II, ATn, D19S221) in 94 unrelated healthy subjects. The genetic polymorphic haplotypes in 3 FH families were also determined.
Results : The heterozygosity and PIC values of RFLP's(Taq I, Hinc II, Ava II) were 0.51/0.344, 0.25/0.223, 0.28/0.233 and microsatellite markers(D19S394, ATn, D19S221) were 0.64/0.558, 0.56/0.455, 0.60/0.475. Hinc II and Ava II were significantly linked(|D|=0.72, p<0.05). The cumulative PIC values of Taq I+Hinc II, Taq I+Hinc II+ATn, D19S394+ATn were 0.520, 0.814, 0.813, respectively.
When applied in the FH pedigree, the genetic diagnosis using only one marker was not available in most cases. However, combination of two or more genetic markers could successfully discriminate
the affected and unaffected members in FH families. Among the several combinations of the genetic markers, the combination of D19S394 and ATn was supposed to be the most effective and informative. Because one case of recombination was suspected in D19S221 allele, it was thought to be carefully used for genetic diagnosis of FH.
Conclusion : We concluded that indirect genetic diagnosis using intragenic or extragenic genetic markers was useful for detecting identical-by-descent LDLR gene abnormalities in FH families and the most effective and informative combination of genetic marker seemed to be D19S394 and ATn.
(Korean J Med 58:283-292, 2000)

5급성 중증 폐색전증의 임상양상과 예후에 미치는 인자

저자 : 박윤수(Yoon Soo Park) , 하종원(Jong Won Ha) , 권기환(Ki Hwan Kwon) , 장양수(Yang Soo Jang) , 정남식(Nam Sik Chung) , 심원흠(Won Heum Shim) , 조승연(Seung Yun Cho) , 김성순(Sung Soon Kim)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 293-300 (8 pages)

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Background : Pulmonary embolism is a relatively common disease but may also be manifestated as a lethal disease. Most previous studies on pulmonary embolism included hemodynamically stable patients who were able to tolerate a confirmative diagnostic workup, including ventilation-perfusion lung scan or pulmonary angiography. However, in most cases of acute massive pulmonary embolism, patients are unstable to tolerate a confirmative diagnostic workup. Studies of only stable patients with pulmonary embolism may have a bias on evaluating the clinical course and prognosis of pulmonary embolism. Therefore, we designed a study to observe the clinical manifestations, diagnostic methods, treatment modality, and to investigate the prognostic factors of patients with acute pulmonary embolism who present with overt or impending right heart failure using the diagnostic criteria suggested by MAPPET study. Methods : Among 103 patients diagnosed as pulmonary embolism from 1990 to 1997, 63 patients(male/female : 21/42, mean age : 56 15) were enrolled as acute major pulmonary embolism by MAPPET's diagnostic criteria. Patients were included in the study if they showed clinical, echocardiographic and cardiac catheterization findings signifying acute right heart failure or pulmonary hypertension due to pulmonary embolism, together with: 1) a diagnostic pulmonary angiogram, or 2) a lung scan indicating high probability of pulmonary embolism, or 3) at least 3 of the followings: ① syncope; ② tachycardia (heart rate > 100 beats /min); ③ dyspnea or tachypnea (> 24 breaths/min or need for mechanical ventilation); ④ arterial hypoxemia (partial arterial pressure of oxygen < 70mmHg while breathing room air) in the absence of pulmonary infiltrates on chest x-ray; ⑤ ECG signs of right heart strain. Results : Among the 63 patients, 15 patients(23.8%) did not have an underlying disease. Eleven patients(17.5%) had malignancy, 8 patients had an operation in the recent 20 days, 6 patients had chronic pulmonary disease, 5 patients had a history of congestive heart failure and cerebrovascular accident respectively, 4 patients had a previous history of pulmonary embolism, 3 patients had vasculitis such as Behcets' disease and systemic lupus erythematosus and a history of venous thrombosis, respectively. The main clinical manifestation on the time of diagnosis was dypnea in 55 patients(87.3%), which was the most frequent, and chest pain in 18 patients(28.6%), syncope in 10 patients(15.9%), and tachycardia in 2 patients(3.2%). The diagnostic methods were echocardiography(43 patients, 68.3%), lung perfusion scan(39 patients, 61.9%), chest computed tomography(16 patients, 26.4%), pulmonary angiography(4 patients, 6.3%) and right heart catherization(2 patients, 3.2%). In order to examine deep vein thrombosis, lower extremity Duplex ultrusonography and venography were performed in 11 patients(17.5%) and 7 patients(11.1%) respectively. The overall in-hospital mortality was 38.1%(24 patients). The factors influencing in-hospital mortality were associated malignancy(p<0.01) and unstable vital sign(systolic blood pressure of less than 90mmHg)(p<0.05). Conclusion : Acute pulmonary embolism with overt or impending right heart failure is a significant lethal disease with a high in-hospital mortality. The predictors of mortality were associated malignancy and unstable vital sign.(Korean J Med 58:293-300, 2000)

6비호지킨 림프종에서 발생한 급성 종양용해 증후군

저자 : 김대중(Dae Jung Kim) , 한지숙(Jee Sook Hahn) , 장준호(Joon Ho Jang) , 이승태(Seung Tae Lee) , 민유홍(Yoo Hong Min) , 고윤웅(Yun Woong Ko)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 301-309 (9 pages)

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Background : Acute tumor lysis syndrome(TLS) has been defined as the metabolic abnormalities that occur after rapid tumor breakdown. In this study, we have evaluated the types or degrees of metabolic abnormalities and clinical characteristics in patients with non-Hodgkin's lymphoma(NHL) who developed TLS. Methods : Patients were considered to have 'laboratory TLS(LTLS)' if any two of the following metabolic abnormalities occurred spontaneously or within 4 days of treatment: hyperphosphatemia, hyperkalemia, hyperuricemia, azotemia, and hypocalcemia. 'Clinical TLS(CTLS)' was defined as LTLS plus one of the following: a serum potassium level greater than 6.0mEq/L, a creatinine level greater than 2.5mg/dL, a calcium level less than 6.0mg/dL, the development of a life-threatening arrhythmia, or sudden death. Results : Of 111 cases with NHL, TLS occurred in 16(14.4%), LTLS in 11(9.9%), and CTLS in 5(4.5%). There was a significant difference of gender, histologic type, clinical stage, performance status, extranodal involvement, serum lactate dehydrogenase(LDH), LDH index, β2-microglobulin, uric acid, and blood urea nitrogen(BUN) level in the TLS versus control group. In multiple regression analysis, TLS occurred more frequently in patients with pre-treatment azotemia, aggressive histologic type, and elevated serum LDH level(p<0.05, respectively). Pre-treatment and post-treatment TLS occurred in 8 cases(50%) respectively. The common metabolic abnormalities included hyperphosphatemia(87.5%), azotemia(81.3%), and hypocalcemia(75%). Of 11 cases with conservative care, 8 cases recovered within several days, but 3 cases died with multi-organ failure from disease progression. All 5 cases after hemodialysis for TLS recovered without any significant complications. Conclusion : The current study suggests that all patients with high-grade lymphomas and pre-treatment azotemia or a high serum LDH level be carefully monitored for at least 4 days after chemotherapy.(Korean J Med 58:301-309, 2000)

7투석전 만성신부전증 환자에서 저용량 erythropoietin의 임상효과

저자 : 권용은(Yong Eun Kwon) , 정종훈(Jong Hoon Chung)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 310-316 (7 pages)

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Background : Anemia is a most common complication of chronic renal failure and erythropoietin has proven to be a effective treatment for anemia in dialysis patient. However, in patients with pre-dialysis chronic renal failure, Use of erythropoietin is usually limited because of its high cost and frequent administration.The purpose of this study was to evaluate the efficacy of low dose erythropoietin treatment in patient with pre-dialysis chronic renal failure. Methods : We administered erythropoietin 2000U weekly to 25 patients with pre-dialysis chronic renal failure untill hemoglobin and hematocrit reached to 11g/dl,33% respectively. After then we administered erythropoietin 1000U weekly as a maintenance dose. We measured the level of hemoglobin, hematocrit, reticulocyte count, serum creatinine, BUN, serum iron, ferritin, total iron binding capacity every two weeks for 12 months.
Results : 1) In 25 patients treated for 16 weeks,hemoglobin and hematocrit level increased from 8.2g/dl,24.2% to 8.8g/dl,28.2%(p<0.05) respectively. After 28 weeks treatment, 23 patients(92%) reached target hemoglobin and hematocrit value(11g/dl,33%). 2) Serum iron level increased from 180.2ug/dl to 165.1ug/dl(p<0.05) after 16 weeks treatment. But there were no significant changes in serum ferritin and total iron binding capacitiy. 3) There was no significant change in reciprocal serum creatinine value before and after erythropoietin treatment. 5) There was no significant side effect except mild exacerabation of hypertension(2 cases) during erythropoietin treatment.
Conclusion : This result show that relatively low dose erythropoietin treatment in patient with pre-dialysis chronic renal failure can be used as a effective treatment for anemia despite of slow and gradual response.(Korean J Med 58:310-316, 2000)

8류마티스 관절염에서 갑상선 자가항체 및 갑상선 기능에 관한 연구

저자 : 이용욱(Yong Wook Lee) , 김동선(Dong Sun Kim) , 김태영(Tae Young Kim) , 이창범(Chang Beom Lee) , 박용수(Yong Soo Park) , 최웅환(Woong Hwan Choi) , 김태화(Tae Wha Kim) , 김신규(Think You Kim) , 전재범(Jae Bum Jun) , 배상철(Sang Cheol Bae) , 유대현(Dae Hyun You) , 김성윤(Seong Yoon Kim)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 317-323 (7 pages)

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Background : Autoimmune thyroid diseases have been shown to occur in association with connective tissue disorders. This study was undertaken to elucidate the prevalence of thyroid autoantibodies and thyroid dysfunction in Korean patients with rheumatoid arthritis (RA). Methods : We have compared the prevalence of thyroid autoantibodies in 108 RA patients with 81 age-matched controls. Antimicrosomal antibody (AMA) and antithyroglobulin antibody (ATA) were measured by passive hemagglutinin assay. T3, T4, Free T4, and TSH were measured by chemiluminescence method. Rheumatoid factor was measured by nephelometry. Statistical analysis was performed by chi-square, Fisher's exact test, and Pearson correlation test . Results : 1) The presence of AMA/ATA in patients with RA was significantly higher (28.7%/26.7% in 108 patients) than that of controls (11.1%/9.9% in 81 controls). The positive rates of AMA/ATA in female patients were also higher (28.9%/28.9% in 97 patients) than those of female controls (15.5%/12.1% in 58 controls).  2) Thirty three (17.6%) of 187 patients with RA had the abnormalities of thyroid function; 14 (7.5%) revealed subclinical hypothyroidism, 5 (2.7%) revealed biochemical primary hypothyroidism, 7 (3.7%) revealed sick euthyroid syndrome, and 7 (3.7%) revealed hyperthyroidism. Conclusion : These results suggest that autoimmune thyroiditis is highly associated with RA in Korean patients, showing the increased prevalence of thyroid autoantibodies and thyroid dysfunctions. (Korean J Med 58:317-323, 2000)

9마이코플라즈마 폐렴에 합병된 급성 호흡부전증후군 1예

저자 : 유철웅(Cheol Woong Yu) , 정희진(Hee Jin Cheong) , 강민승(Min Seung Kang) , 우흥정(Heung Jeong Woo) , 김우주(Woo Joo Kim) , 김민자(Min Ja Kim) , 박승철(Seung Chull Park)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 324-329 (6 pages)

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Pneumonia caused by Mycoplasma pneumoniae is manifested as a mild and self-limited. However, several overwhelming cases have been reported. Recently, we experienced a case of M. pneumoniae pneumonia that progressed into ARDS in a 68-year old man who was admitted because of fever and erythema multiforme on whole body. On admission, serum cold agglutinins and anti-mycoplasma Ab were negative. Lobar consolidation was visible at initial chest X-ray. But, bilateral infiltration was noted at follow-up chest X-ray and his condition was aggravated to ARDS. Anti-mycoplasma Ab was elevated up to 1:640. He was treated with roxithromycin, prednisolone and mechanical ventilator in ICU for 2 weeks. And after this, his clinical condition was recovered completely.(Korean J Med 58:324-329, 2000)

10Prophylthiouracil에 의한 antineutrophil cytoplasmic autoantibodies 양성 급성 사구체 신염 1예

저자 : 황석재(Seok Jae Hwang) , 김영설(Young Seol Kim) , 나학렬(Hak Reol Naa) , 오승준(Seung Joon Oh) , 양인명(In Myung Yang) , 김진우(Jin Woo Kim) , 최영길(Young Kil Choi) , 양문호(Moon Ho Yang)

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 58권 3호 발행 연도 : 2000 페이지 : pp. 330-334 (5 pages)

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Vasculitis is a rare complication of antithyroid drugs. Recently it was reported in association with ANCA. In most cases, the ANCA was specific for myeloperoxidase. The glomerulonephritis was key clinical manifestation in majority of cases. When antithyroid drugs were discontinued, clinical disease generally improved and ANCA titers were tended to fall. We experienced a 44 year old woman who presented with gross hematuria and generalized edema, after she had been treated with prophylthiouracil for 6 week for thyrotoxicosis. Renal biopsy was done, which showed mesangial proliferative glomerulonephritis. Indirect immunoflurorescence staining showed highly positive perinuclear pattern of ANCA in her serum. Prophylthiouracil associated ANCA positive glomerulonephritis was suspected. After cessation of prophylthiouracil and administration of prednisolone, renal function recovered gradually and ANCA titers were reduced. We hereby report a case of prophylthiouracil associated ANCA positive glomerulonephritis with a brief review of literature.(Korean J Med 58:330-334, 2000)

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Korean Journal of Medicine(구 대한내과학회지)
95권 6호 ~ 95권 6호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 6호 ~ 14권 6호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 6호 ~ 14권 6호

대한내과학회 추계학술발표논문집
2020권 1호 ~ 2020권 2호

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대한소화기학회지
76권 5호 ~ 76권 5호

KCI등재

Allergy asthma & respiratory disease
8권 4호 ~ 8권 4호

KCI등재 SCOUPUS

Intestinal research (Intest Res)
18권 4호 ~ 18권 4호

대한당뇨병학회 학술발표논문집
2020권 0호 ~ 2020권 0호

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Journal of Neurogastroenterology and Motility
26권 4호 ~ 26권 4호

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Clinical and Molecular Hepatology(대한간학회지)
26권 4호 ~ 26권 4호

KCI등재 SCI

The Korean Journal of Internal Medicine
35권 6호 ~ 35권 6호

KCI등재 SCOUPUS

대한소화기학회지
76권 4호 ~ 76권 4호

KCI등재 SCI SCOUPUS

Diabetes and Metabolism Journal (DMJ)
44권 5호 ~ 44권 5호

KCI등재 SCOUPUS

Clinical Endoscopy
53권 5호 ~ 53권 5호

춘·추계 학술대회 (KASL)
2020권 1호 ~ 2020권 1호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호

KCI등재 SCOUPUS

Kidney Research and Clinical Practice(구 대한신장학회지)
39권 3호 ~ 39권 3호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호
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자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

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