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박태선,박지현,류완희,백홍선 대한내과학회 2000 대한내과학회지 Vol.59 No.3
The relationship between thyroid disease and rheumatic disorders has been the subject of considerable debate. Autoimmune thyroid disease (ATD), such as Graves' disease, Hashimoto's thyroiditis are occasionally associated with systemic lupus erythematosus, Sj gren syndrome, and rheumatoid arthritis (RA). Although the exact mechanism of this association is not well documented, genetic factor, immunologic defect, hormonal factor, drugs for treatment might contribute for it. There is a question of whether common factors are involved in the etiology of RA and thyroid disease, and controversy over whether an association between RA and ATD exists. The possibility of coexistent thyroid disease in patients with RA should be carefully considered throughout the course of follow-up. Recently, we experienced a 39-year-old male patient with RA during treatment of Graves' disease, and present the case here with brief review of literatures.(Korean J Med 59:325-330, 2000)
간으로 전이된 뇌막 혈관주위세포종 환자에서 발생한 저혈당 1 예
박성일,김남수,박태선,류완희,백홍선 대한내과학회 2000 대한내과학회지 Vol.59 No.3
Tumour-induced hypoglycemia is usually caused by insulinoma or non-islet-cell neoplasm, such as hemangiopericytoma, fibrosarcoma, mesotheliomas. Most of the neoplasms in non-islet-cell tumour-induced hypoglycemia are mesenchymal type, and have a common features, including large-sized, slow-growing and metastatic involvement of the liver. The mechanisms of hypoglycemia in metastatic liver disease are not clearly defined, and liver failure secondary to hepatic metastasis or insulin or insulin-like mediated process are considered. Glucagon stimulation test has been used to distinguish between insulin-mediated or insulin-like-mediated hypoglycemia and hypoglycemia induced by liver failure. We experinced a case of hypoglycemia in a patient of hemangiopericytoma with liver metastasis in which glucagon stimulation test was used for proper evaluation. We compare this case with previously reported cases, and present here with brief review of literatures.(Korean J Med 59:319-324, 2000)
원발성 갑상선 기능 저하증 환자의 아포지단백 E(Apo E) 유전자 다형성
김남수,유완희,박태선,백홍선 의과학연구소 1999 全北醫大論文集 Vol.23 No.1
The frequeney of fasting hyperlipidemia increases in most hypothyroid patients. However, the cause and mechanism of hyperlipidemia in primary hypothyroidism is not known. In this study, the genetic factor of the hyperlipidemia in primary hypothyroidism patients by the apolipoprotein E(Apo E) gene polymorphism was investigated. Apo E gene polymorphism of the 51 primary hypothyroidism patients and healthy control persons was analysed by modified Amplification Refractory Mutation System(ARMS) technique. Concurrently, total cholesterol, triglyceride, HDL cholesterol and total T₃, free T₄, TSH were measured by standard laboratory methods. The apo E gene allele and phenotype frequency in hypothyroid patients were similiar with those in healthy control person. The ap E3 allele frequency of hypercholesterolemic group was slightly decreased and the apo E4 allele frequency showed the increasing tendency. The apo E3/3 phenotype of hypercholesterolemic group was decreased and apo E2/4 and apo E3/4 phenotype of hypercholesterolemic group was increased. In conclusion, there was no difference in Apo E polymorphism between hypothyroid patiesnts and healthy control. Apo E polymorphism seemed to be associated with hypercholesterolemia in primary hypothyroidism. Further investigation is needed for the another cnadidate genes and apolipoprotein analysis in primary hypothyroidism and environmental factors. (Key Word(s) : Apo E polymorphism, Hypothyroidism, Hypercholesterolemia)