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증례 : 내분비-대사 ; 아급성 갑상선염 후 발병된 그레이브스병 1예
서혜미 ( Hye Mi Seo ),범종욱 ( Jong Wook Beom ),김수희 ( Su Hee Kim ),유소연 ( So Yeon You ),김지영 ( Ji Young Kim ),고관표 ( Gwan Pyo Koh ),이상아 ( Sang Ah Lee ) 대한내과학회 2015 대한내과학회지 Vol.89 No.2
Graves` disease following subacute thyroiditis is uncommon. Some patients in these cases showed positive for thyroid antibody only transiently in the resolving phase. However, Graves` disease can rarely be caused by the presence of antibodies after subacute thyroiditis, although the pathophysiology of this is unclear. A 40-year-old woman presented with anterior neck pain and swallowing difficulty. Thyroid function testing showed reduced thyroid-stimulating hormone (TSH) and elevated free thyroxine levels. A thyroid scan revealed decreased uptake in the bilateral thyroid gland. The patient was initially diagnosed with subacute thyroiditis and treated with steroids. Five months later, thyroid function testing showed recurrent hyperthyroidism with positive conversion of TSH receptor antibody, indicating Graves` disease. Since then, she needed the long-term methimazole treatment. In summary, we herein report a case of Graves` disease occurring after subacute thyroiditis. (Korean J Med 2015,89:225-228)
서혜미 ( Hye Mi Seo ),문태훈 ( Tae Hoon Moon ) 한국환경정책학회 2010 環境政策 Vol.18 No.1
The purpose of this study was to identify factors contributing success of sustainable development program for green growth and to find out policy implications for successful implementation of green growth program. For this purpose, administrative, economic, social, and environmental dimensions with several variables within each dimension were used as a framework of analysis. Three cases from Ham Pyung County, Yang Pyung County, and Jeon Ju City was analyzed qualitatively and some 400 of questionnaire survey was conducted for quantitative analysis. Result of the case study shows that administrative factors, especially county chief`s strong leadership was most important factors for success of green growth program. However, empirical result shows that social and environmental factors were statistically significant while administrative factor was insignificant for the success of green growth. Meaning and policy implications of the result were discussed.
증례 : 내분비-대사 ; 고칼륨혈증 주기성 마비로 나타난 무통성 갑상선염 동반 애디슨병 1예
고명주 ( Myeong Ju Koh ),서혜미 ( Hye Mi Seo ),김영욱 ( Young Uck Kim ),김성택 ( Seongteag Kim ),이상아 ( Sang A Lee ),유원상 ( Won Sang Yoo ),김소미 ( So Mi Kim ) 대한내과학회 2015 대한내과학회지 Vol.88 No.4
고칼륨혈증성 주기성 마비는 매우 드물지만 애디슨병과 연관되어 나타날 수 있는 치명적 합병증이다. 애디슨병은 임상증상이 점진적으로 나타나고 비특이적이어서 진단이 늦어지는 경우가 많아 고칼륨혈증, 저나트륨혈증과 같은 전해질이상, 피부나 점막 등의 색소침착, 과거 결핵력 등을 면밀히 살피는 것이 중요하며 급성 부신기능저하가 발생한 경우에는 반드시 유발인자 유무를 감별해야 하겠다. In cases of hyperkalemia with preserved renal function, the differential diagnoses that should be considered are drug-related disorders, primary tubular disease, and hormonal diseases including primary adrenal insufficiency. Addison`s disease represents a rare disorder characterized by primary adrenal failure, general weakness, poor appetite, nausea, dizziness, and hyperpigmentation. It may also cause fatal adrenal crisis, involving hypotension, loss of consciousness, hyperkalemia, or hyperkalemic periodic paralysis under stressful conditions. We describe herein the case of a 54-year-old Korean male who developed Addison`s disease, due to adrenal tuberculosis, in addition to painless thyroiditis, which led to hyperkalemic periodic paralysis.