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조홍근,김범수,허갑범,이현철,김경래,정윤석,송영구 대한내과학회 1995 대한내과학회지 Vol.48 No.4
The syndrome of resistance to thyroid hormone are disorders in which the body's tissue are resistant to the effects of thyroid hormone. They are characterized by reduced clinical and biochemical manifestations of thyroid hormone action relative to the circulating hormone levels. In practice, such patients are identified because they have increased serum thyroxine (T₃) and triiodothyronine (T₄) and normal thyrotropin (TSH) levels in the absence of intercurrent acute illness, drugs, or alterations of thyroid hormone binding to serum proteins. Since the publication of the index cases in 1967 by Refetoff et al., about 200 cases have been reported. Mutations which result in single amino acid substitutions in the T₃ binding region of the β receptor molecule is suggested for causal mechanism. We experienced a case of 26 year old female with generalized resistance to thyroid hormone. She had increased serum concentration of free thyroxine (fT₄ 5.42 ng/dl) and triiodothyronine (T₃$gt;800ng/dl). Serum TSH level were increased (TSH: 2.08 μIU/ml). The serum α-subunit/TSH molar ratio was less than 1.0 and Magnetic Resonance Imaging showed no evidence of pituitary mass. These features are characteristics of the syndrome of generalized resistance to thyroid hormone. So we present this case of syndrome of generalized resistance to thyroid hormone with a literature review.
High Density Lipoprotein Cholesterol Comes of Age
조홍근 대한심장학회 2007 Korean Circulation Journal Vol.37 No.5
Despite the excellent success of lowering low-density lipoprotein cholesterol (LDLc) cholesterol for treating coronaryheart disease (CHD), a major part of the population still suffer from CHD. This fact is more prominent among thehigh risk patients who receive lipid lowering treatment with statins. This treatment is based on the prevailing viewthat LDL cholesterol (LDLc) is the only important risk factor for CHD. It is well known that HDL plays a crucial rolefor preventing CHD. Several epidemiologic studies and clinical trials have reported that high density lipoproteincholesterol (HDLc) is an independent risk factor for CHD as well. A large scale meta-analysis of clinical trialsclearly supports that increasing HDLc is equally important as decreasing LDLc, suggesting that physicians should payattention to increasing HDLc as well as decreasing LDLc. Ongoing trials that are focused on this issue will test thishypothesis in the near future. (Korean Circulation J 2007;37:187-190)