Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study (Diabetes Metab J 2021;45:368-78)

전자영 대한당뇨병학회 2021 Diabetes and Metabolism Journal Vol.45 No.4

Leaky London: Permeability and Porosity of Spaces in Eastward Ho

전자영 한국중세근세영문학회 2015 고전·르네상스 영문학 Vol.24 No.1

When London is foregrounded as the most important space in Eastward Ho, it seems that the play follows the genre of city comedy’s established code of spatial setting. But London is not the only space that matters in the play. The city is presented and experienced along with other three nonurban spaces: the court, the country and the New World. By focusing on such a theatrical representation of different spaces, this essay investigates the issue of space and spatial practices in early modern England with which to go beyond a dichotomous opposition of urban and nonurban spaces. I look into each space’s individual functions and meanings but also the interrelationships among the different spaces. The nonurban spaces at once compete with and hinge on London for thematic significance. The royal court proves itself an object of social desire for Gertrude who tries to become a gentle lady by marrying Sir Petronel. The country is also at tension with the city when Gertrude runs away from it and wants to live in the country castle. Sir Petronel and his companies attempted to sail to the New World, but got shipwrecked at the Thames. This botched venture shows the ways in which the imaginary concept of the New World is intertwined with the perceptions of contemporaries on London’s cosmopolitan quality. When the play finishes by bringing all the characters back to the centripetal city, what we encounter is a variegated picture of cosmopolitan London with mobility, permeability, fluidity, and diversity. Eastward Ho, I suggest, represents the city of London in early modern England not as a single and detached entity but as a porous and permeable space. The interrelationships of the city with the three nonurban spaces reveal that spatial practices are constantly negotiated and refashioned by individual character’s experience within and without it.

『십이야』에서 에코의 목소리를 듣기: 주종관계에서의 바이올라의 창조적인 모방

전자영 한국고전중세르네상스영문학회 2023 중세근세영문학 Vol.33 No.3

This essay traces Shakespeare’s evocation of Echo in Twelfth Night (c.1600-1). Echo features in Viola’s lines where she imagines a lover’s song resounded by "the babbling gossip of the air" (1.5.227). This phrase, closely imitating Arthur Golding’s 1567 translation of Ovid’s Echo and Narcissus from Metamorphoses, comes to identify Viola with Echo, suggesting imitation and repetition as key factors in depicting the relationship between the master and his page boy. In his later comedy, Shakespeare revises and expands on the motif of the transvestite page boy’s mediating role and explores more fully Viola’s enactment of the multiple roles that she must play for Orsino: the reader, mediator, and actor of his courtship text. Recognizing the literary value of Shakespeare’s classical debts, I argue that Echo, derived especially from Ovid’s version and placed in the contemporary context of female-voiced complaint, offers an implicit but crucial model for Viola’s service as a messenger. Although Echo is only obliquely invoked in the play, the figure’s characteristic imitation suggests a version of collaborative authorship which is not attributable to a single individual speaker or writer and calls for an extensively femininized space for the articulation of desire.

Nodular lymphoid hyperplasia of the stomach in a patient with multiple submucosal tumors

전자영,임선교,김장희,이기명,조성란,한재호 대한혈액학회 2013 Blood Research Vol.48 No.4

Nodular lymphoid hyperplasia of the stomach is a rare lymphoproliferative disorder. Here, we report a 38-year-old man who presented with multiple submucosal tumors of the stomach. Histologically, the lesions were characterized by multiple discrete submucosal nodules of lymphoid cells. The infiltrates between the lymphoid follicles were composed mainly of medium-sized lymphoid cells with abundant clear cytoplasm, as well as a few large cells with vesicular nuclei. The gastric mucosa exhibited multifocal lymphoid ag-gregates and some of the epithelial cells were infiltrated by small lymphocytes mimicking lymphoepithelial lesions. Histopathology was consistent with mucosa-associated lym-phoid tissue lymphoma. However, the infiltrating lymphoid cells were positive for CD2, CD3, CD5, and CD7. In addition, polymerase chain reaction analysis of the im-munoglobulin heavy chain and T-cell receptor gene rearrangements demonstrated polyclonality. This case was diagnosed as reactive lymphoid hyperplasia of the stomach.

“You have no stomach to them”: Indigestible Revenge and Disgusting Tyranny in Antonio’s Revenge

전자영 한국셰익스피어학회 2023 셰익스피어 비평 Vol.59 No.3

In John Marston’s Antonio’s Revenge (1600), the villain Piero Sforza’s loss of tongue directly follows on the banquet scene in which the play’s revenger Antonio stewards a dessert dish containing the limbs of Piero’s young son. Taking a major departure from the revenge tragedy’s convention of making the parent unnaturally consume his own children’s flesh, Marston allows Piero no chance to eat the meal. This essay suggests that this crucial difference presents a point of contact between the conversation about male subjectivity and the early modern discourse on eating. By contextualizing the centrality of the tongue within the period’s interest in the development of interiority linked to the consumption of food, I argue that the play’s gruesome scene of tongue-cutting reflects its broader interest in nondigestive and unwholesome eating such as vomiting, over-eating, and starving. Engaged and located in the play’s rich depictions of unhealthy food-related behaviors that culminate with the final banquet, Antonio arises as the triumphant male subject who insistently beats out his enemy not only in terms of theatrical and rhetorical brilliance, but also in the culinary aspects of food making and courtly service. While his victim Piero is deprived of access to inwardness, Antonio serves as an actor for a chain of food work leading from the preparation of the sweetmeats to the amputation of the tongue, thus winning a chance to gain and manifest masculine empowerment.

Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c

전자영,고승현,권혁상,김난희,김재현,김철식,송기호,원종철,최성희,김윤아,오경원,김대중,차봉연 대한당뇨병학회 2013 Diabetes and Metabolism Journal Vol.37 No.5

Background: Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. Methods: Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. Results: When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3%(men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. Conclusion: We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.

Cardiovascular Safety of Sodium Glucose Cotransporter 2 Inhibitors as Add-on to Metformin Monotherapy in Patients with Type 2 Diabetes Mellitus

전자영,하경화,김대중 대한당뇨병학회 2021 Diabetes and Metabolism Journal Vol.45 No.4

Background Using real-world data, cardiovascular safety was investigated in metformin users newly starting sodium glucose cotransporter 2 (SGLT2) inhibitors compared with other glucose-lowering drugs in Korea. Methods This was a retrospective observational study using the National Health Insurance Service claims database in Korea. The study period was from September 2014 to December 2016. The study included subjects who were newly prescribed SGLT2 inhibitors or other glucose-lowering drugs while on metformin monotherapy; cohort 1 was composed of new users of SGLT2 inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors and cohort 2 included new users of SGLT2 inhibitors versus sulfonylureas. To balance the patient characteristics, propensity score matching was performed at a 1:1 ratio. Cardiovascular outcomes included hospitalization for heart failure (HHF), all-cause mortality, HHF plus all-cause mortality, myocardial infarction (MI), stroke, and modified major adverse cardiovascular events (MACEs). Results After propensity score matching, each cohort group was well balanced at baseline (21,688 pairs in cohort 1 and 20,120 pairs in cohort 2). As the second-line treatment, use of SGLT2 inhibitors was associated with a lower risk of HHF and HHF plus all-cause mortality compared with DPP-4 inhibitors. In addition, use of SGLT2 inhibitors versus sulfonylurea as add-on therapy to metformin was associated with decreased risks of HHF, all-cause mortality, HHF plus all-cause mortality, MI, stroke, and modified MACEs. Conclusion SGLT2 inhibitors can be a good second-line drug to reduce the incidence of cardiovascular diseases compared with DPP-4 inhibitors or sulfonylureas in people with type 2 diabetes mellitus.

Benefit and Safety of Sodium-Glucose Co-Transporter 2 Inhibitors in Older Patients with Type 2 Diabetes Mellitus

전자영,김대중 대한당뇨병학회 2024 Diabetes and Metabolism Journal Vol.48 No.5

People with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular disease, heart failure, chronic kidney disease, and premature death than people without diabetes. Therefore, treatment of diabetes aims to reduce these complications. Sodium-glucose co-transporter 2 (SGLT2) inhibitors have shown beneficial effects on cardiorenal and metabolic health beyond glucose control, making them a promising class of drugs for achieving the ultimate goals of diabetes treatment. However, despite their proven benefits, the use of SGLT2 inhibitors in eligible patients with T2DM remains suboptimal due to reports of adverse events. The use of SGLT2 inhibitors is particularly limited in older patients with T2DM because of the lack of treatment experience and insufficient long-term safety data. This article comprehensively reviews the risk-benefit profile of SGLT2 inhibitors in older patients with T2DM, drawing on data from prospective randomized controlled trials of cardiorenal outcomes, original studies, subgroup analyses across different age groups, and observational cohort studies.

Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey

전자영,김대중,고승현,권혁상,임수,최성희,김철식,안지현,김난희,원종철,김재현,차봉연,송기호 대한당뇨병학회 2014 Diabetes and Metabolism Journal Vol.38 No.3

Background: The Korea National Health and Nutrition Examination Survey (KNHANES) III (2005) reported that 22.9% of individuals with diabetes have a glycated hemoglobin (HbA1c) <6.5% and that 43.5% have an HbA1c <7%. We investigated the levels of glycemic control and the factors associated with glycemic control using data from the KNHANES V (2010 to 2012). Methods: Subjects with diabetes diagnosed by a physician or those taking antidiabetic medications were classified as individuals with known diabetes. Of 1,498 subjects aged ≥30 years with diabetes, we excluded 157 individuals who were missing HbA1c data. A total of 1,341 subjects were included in the final analysis. Results: The prevalence of known diabetes was 7.7% (n=1,498, estimated to be 2.32 million people). The proportions of well-controlled diabetes meeting a HbA1c goal of <6.5% and <7% were 27% and 45.6%, respectively. HbA1c increased as the duration of diabetes increased. HbA1c in subjects with a duration of diabetes ≤5 years was lower than in subjects with a duration >5 years. HbA1c in the group taking only oral hypoglycemic agents (OHAs) was significantly lower than that in the group administered only insulin or OHA and insulin in combination. In logistic regression analysis, a longer duration of diabetes, insulin use and the absence of chronic renal failure were associated with HbA1c levels >6.5%. Conclusion: The level of adequate glycemic control was similar to but slightly improved compared with previous levels. The glycemic control of long-standing diabetes patients is more difficult even though they receive insulin treatment.

Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports (Diabetes Metab J 2020;44: 349-53)

전자영 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.3