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      • KCI등재

        Serum TSH Level in Healthy Koreans and the Association of TSH with Serum Lipid Concentration and Metabolic Syndrome

        ( Yeo Kyung Lee ),( Jo Eun Kim ),( Hyun Ju Oh ),( Kyung Sun Park ),( Soo Kyung Kim ),( Seok Won Park ),( Moon Jong Kim ),( Yong Wook Cho1 ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.4

        Background/Aims: The proper treatment of subclinical hypothyroidism and the normal range of serum thyroid stimulating hormone (TSH) concentration are intensely debated. However, few reports have investigated TSH concentrations in Asian ethnic groups. Therefore, the present study was designed to define the TSH reference range in a Korean population and to investigate the metabolic significance of TSH concentration. Methods: We enrolled patients who underwent medical examination at the CHA Bundang Medical Center. Anthropometric data were evaluated, and serum TSH, free T4, and lipid profiles were assayed. Results: A total of 7,270 subjects were included. Mean TSH concentration of the study population was 1.82 ± 0.95 mU/L, and we observed a sex-related difference in TSH concentration (male, 1.67 ± 0.87 mU/L; female, 2.02 ± 1.01 mU/L; p < 0.01). When the 2.5 and 97.5 percentiles were calculated, 95% TSH reference limits were 0.52-4.29 mU/L. TSH concentration was higher in elderly subjects, during winter, in postmenopausal women, and in obese males. Moreover, TSH showed significantly positive correlations with serum total cholesterol, triglyceride, and low density lipoprotein cholesterol regardless of sex, age, season, obesity, or menopausal status (all p < 0.01). Finally, TSH concentration was positively related to the prevalence of metabolic syndrome. Conclusions: We demonstrated the association between TSH concentration within the normal reference range and serum lipid levels. TSH concentration varies according to sex, age, season, and body mass index (only in males). Moreover, high normal TSH levels were significantly associated with an increased prevalence of metabolic syndrome, which may be of importance when evaluating subjects with high normal TSH concentration.

      • LC, Acute : O-061 ; Mode of cirrhosis related complication in Korean patients with liver cirrhosis -A prospective multicenter cohort study

        ( Hyun Young Woo ),( Jeong Won Jang ),( Sang Gyune Kim ),( Chang Hyeong Lee ),( Tae Yeob Kim ),( Won Young Tak ),( Sung Kyu Choi ),( Mong Cho1 ),( Jong Young Choi ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

        Background: Cirrhosis-related complications are indications for transplantation. However, the mode of complication has not been evaluated so far. To better address this issue, we investigated the mode of cirrhosis related complication and impact of these complications on survival in prospective, multicenter, inception cohort study of subjects with liver cirrhosis presenting with the first onset of decompensated complication. Methods: In this observational study, 1515 patients with the confirmed onset time of the first decompensated complication were enrolled. The mortality risk of cirrhosis-related complications, including ascites, portal hypertensive gastrointestinal bleeding (PHGB), spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), hepatorenal syndrome (HRS), was analyzed in these cirrhotic patients. Result: As the first complication, ascites was the most frequent (53.8%), followed PHGB (36.2%), HE (7.6%), SBP (1.7%) and HRS (0.7%). During follow-up (mean 32±47 months), 484 (31.9%) experienced subsequent decompensations and the proportion of subsequent complication was consistently changed; the proportion of HE, SBP, HRS increased as time progressed. The interval between subsequent decompensative events was progressively shortened. The mortality rate according to the first complication was as follows; Ascites =PHGB> HE=SBP>HRS. The mortality rate of patients experienceing subsequent complication was significantly higher than those without subsequent complication. According to the kinds of subsequent complication, survival of HE was also higher than HRS but lower than ascites or PHGB and similar to that of SBP and this difference of survival disappeared after repeated complication. Conclusion: The mortality risk correlated with initial complication and the risk increases as the number of complication episodes is repeated. Patient`s mean age was 56±11.50 years and 72.1% was male. The cause of liver cirrhosis is hepatitis B virus (38.6%), alcohol (35.5%) and hepatitis C virus (8.9%).

      • KCI등재
      • FCT 5 : Fractional laser-assisted topical imiquimod 5% cream treatment for recalcitrant common warts in children

        ( Hyun Chang Ko ),( Jeong Min Kim ),( Hyun Ho Cho1 ),( Won Jeong Kim ),( Je Ho Mun ),( Margaret Song ),( Hoon Soo Kim ),( Byung Soo Kim ),( Moon Bum Kim ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

        Background: Conventional destructive modalities for warts like cryotherapy or laser ablation have some limitations that are excruciating pain during procedure, in especially pediatric patients. Imiquimod is a topical immune response modifier that was approved for treating genital and perianal warts. But, thick stratum corneum of common warts may act as a barrier against drug permeation via the skin. Objectives: To evaluate efficacy and safety of above treatment. Methods: Eleven pediatric patients (6 female and 5 male, mean age 12.5 years) were included in this study. The lesions were treated by fractional 2940 nm Er:YAG laser for achieving the penetration of stratum corneum with 1 or 2 weeks intervals. Then, imiquimod 5% cream was self-applied once daily for 5 days a week. Assessment of response and adverse effects was performed every 2 weeks until complete clearance or up to maximum of 48 weeks. Pain during procedure was checked by VAS (0-10). Results: 8 out of 11 (72.7%) patients experienced complete clearance of all warts lesions. Mean duration of total treatment was 29.7 (16-48) weeks. Mean number of fractional laser treatment was 17.5 (8-37) times. No significant adverse effect was observed. VAS score of the pain during fractional laser treatment was 2.4 (1-4), comparing with 6.2 (5-8) during cryotherapy. Conclusion: Fractional ErYAG laser-assisted topical 5% imiquimod cream is an effective and safe treatment option for recalcitrant common warts of the children do not tolerate pain well.

      • SCOPUSKCI등재

        Case Report : Improved severe hepatopulmonary syndrome after Liver transplantation in an adolescent with end-stage Liver disease secondary to biliary atresia

        ( Tae Jun Park ),( Keun Soo Ahn ),( Yong Hoon Kim ),( Hyungseop Kim ),( Ui Jun Park ),( Hyoung Tae Kim ),( Won Hyun Cho1 ),( Woo Hyun Park ),( Koo Jeong Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

        Hepatopulmonary syndrome (HPS) is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT) is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient with typical findings of an extracardiac pulmonary arteriovenous shunt on contrast-enhanced transesophageal echocardiography (TEE), and clubbing fingers, who had complete correction of HPS by deceased donor LT. The patient was a 16-year-old female who was born with biliary atresia and underwent porto-enterostomy on the 55th day after birth. She had been suffered from progressive liver failure with dyspnea, clubbing fingers, and cyanosis. Preoperative arterial blood gas analysis revealed severe hypoxia (arterial O2 tension of 54.5 mmHg and O2 saturation of 84.2%). Contrast-enhanced TEE revealed an extracardiac right-to-left shunt, which suggested an intrapulmonary arteriovenous shunt. The patient recovered successfully after LT, not only with respect to physical parameters but also for pychosocial activity, including school performance, during the 30-month follow-up period. (Clin Mol Hepatol 2014;20:76-80)

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