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갑상선 분화암 환자의 경과 관찰에서 수술 전 , 후 혈청 갑상선글로불린 측정의 유용성
원종철,이은주,이성진,문대혁,김상욱,류진숙,안일민,홍석준,한정희,김하영 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4
Background: Thyroglobulin (Tg) measurement is primarily used to monitor patients with well differentiated thyroid carcinomas (WDTC) for tumor recurrence. We evaluated the correlations between fold responses of thyroglobulin levels and TNM stages (and MACIS scores) at recurrent group. Also correlations between preoperative Tg levels and Tg (on or off replacement) levels at the time of recurrence were evaluated. Postoperative Tg levels between recurrent and non-recurrent groups were analyzed for the use of assessing risk of recurrence. Methods: One hundred twenty five cases of WDTC who had total thyroidectomy and (131)I remnant thyroid ablation were finally included in this study. After optimal TSH stimulations ($gt;30 μIU/mL), (131)I whole body scan (WBS) was performed. We interpreted as a recurrence only when abnormal findings on the (131)I WBS were detected. Preoperative, immediate postoperative and follow-up Tg tlevels were regularly measured. Results: Difference of preoperative Tg levels between recurrent an non-recurrent groups was not significant (27.5±4.2 ng/mL vs. 16.0±10.9 ng/mL). Also differences of immediate postoperative Tg (on or off replacement) levels between two groups was not significant (2.4±3.8 ng/mL vs. 3.6±3.l ng/mL, 33.4±4.8 ng/ml vs. 24.5±4.8 ng/mL, respectively). Tg levels on replacement at 24 months after surgery between recurrent and non-recurrent groups were significantly different (2.2±4.8 ng/mL, 15.9±6.5 ng/mL, p$lt;0.001) and also Tg levels off replacement between recurrent and non-recurrent groups were significantly different (4.0±6.6ng/mL vs. 49.4±9.3 ng/mL, p$lt;0.001). Fold responses between recurrent and non-recurrent groups were significantly different (2.0±3.1 ng/mL, 5.0±4.1 ng/mL, p=0.009). Fold responses between recurrent and non- recurrent groups were significantly different according to TNM stages (p=0.002) but not different according to MACIS scores. Preoperative Tg levels were correlated Tg (on or off replacement) levels at the time of recurrence (p=0.02, r=0.4: p$lt;0.0espectively). Sensitivity, specificity, accuracy of Tg levels over 2 ng/mL on replacement were 95%, 73%, 84% but those of Tg levels over 7 ng/mL off replacement were 83%, 70%, 77%. Conclusion: Fold responses may predict prognosis of WDTC. Small postoperative increase in serum Tg levels may indicate a large increase of tumor mass in cases of normal or low preoperative Tg levels. Tg levels over 2 ng/mL on replacement or 7 ng/mL off replacement during follow-up may suggest the recurrence of WDTC (J Kor Soc Endocrinol 15:542-553, 2000).
토양트렌치법에 있어서 폐수 주입방식 , 유량부하 및 토성이 유기물 처리효율에 미치는 영향
원종철,남궁완,임연택,윤조희 한국물환경학회 1991 한국물환경학회지 Vol.7 No.3
The role of trench in soil trench systems treating septic tank effluent was evaluated in the laboratory. Parameters investigated were the waste application method (application with rest period versus continuous application), hydraulic loading rate (100 ℓ/m ·day versus 200ℓ/m day) and soil texture (Sandy Loam versus Sand). Experimental reactors (60㎝ high by 40㎝ wide by 5㎝ thick) were constructed so that two dimensional distribution of bacteria and volatile solids in the trench could be examined. TOC concentrations in the effluent from the reactors with continuous application of wastewater were lower than those from the reactors with rest period. However, the wastewater infiltration rate with continuous application of wastewater was lower than that with rest period implying possible clogging problem in the near future. TOC removal efficiency was over 80% for both systems. TOC concentration in the effluent from the reactor with 200ℓ/m day hydraulic loading rate was much higher than that from the reactor with 100ℓ/m day. The average TOC removal efficiency at 200ℓ/m day was only 63%, while that at 100ℓ/m day was 81%. TOC concentration in the effluent from the reactor packed with sandy loam was similar to that of the reactor packed with sand. Bacteria were high in number near the infiltration surface of wastewater in the trench. Volatile solids were distributed relatively evenly in the trench. There was no direct relationship between the number of bacteria and volatile solids in the soil.
그레이브스병 여성의 산후 갑상선 중독증 감별진단에서 항갑성선 수용체 측정의 임상적 의의
원종철,정윤이,문대혁,류진숙,안일민,김암,한정희,김하영,이성진 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.1
Background: It is known that pregnancy markedly influences the clinical course of autoimmune thyroid diseases. In the postpartum period, various kinds of autoimmune thyroid dysfunctions can be observed. Thyroid dysfunction is found in 5.57. L /r of postpartum women in the general population. Among those who show thyroid dysfunction after delivery, some will develop Graves disease and others will develop postpartum thyroiditis. It is also known that patients with Graves disease may manifest thyrotoxicosis in the postpartum period because of postpartum thyroiditis or relapse of the Graves disease itself. We evaluated the clinical features of postpartum thyrotoxicosis in Graves disease patients to find diagnostic indices that could be used in differentiating between postpartum thyroiditis and relapse of Graves' disease. Method: We reviewed the cases with postpartum thyrotoxicosis in patients that had a history of Graves disease between 1995 and 2000. The diagnosis of postpartum thyroiditis had been made by means of a 99m Tc thyroid scan or by the observation of a typical triphasic thyroid function change, in cases where a ' 99m Tc thyroid scan was not possible because of breast feeding. We measured the serum TSH, free T4, free T3, TSH binding inhibiting immunoglobulin (TBII), anti-thyroid peroxidase (TPO) antibody, and anti- thyroglobulin (Tg) antibody serially from the time of the diagnosis of Graves' disease to the time of postpartum thyroid dysfunction. Results: Eleven patients, 5 patients in the postpartum thyroiditis (PPT group) and 6 patients with relapse of the Graves' disease (GD group), were identified. The mean values of TBII of two groups at the time of diagnosis of Graves disease were 40.9?4.8 IU/mL (PPT group), 58.9+23.5 ?IU/mL (GD group) respectively, which were insignificant. The mean values of TBII of the two groups at early pregnancy were 3.2+1.9 ~pIU/mL (PPT group), 41.6+22.6 ~pIU/mL (GD group) and this difference was statistically significant (p=0.009). The mean values of TBIJ of the two groups the time of postpartum thyrotoxicosis were 1.9?1.6?IU/mL(PPT group), 51.5?23.2?IU/mL(GD group) which were also statistically significant (p0.003). The mean values of anti-TPO antibody, anti-Tg antibody, disease duration, and treatment duration between the two groups were not significantly different. The onsets of thyroid dysfunction after delivery in the two groups were 2.6?2.0 (PPT group), 4.0?3.9 (GD group) months which were statistically insignificant. Conclusion: These data suggest that the measurement of TBII at the time of the postpartum thyrotoxic period, could help to differentiate postpartum thyroiditis from a relapse of Graves disease in those patients that have a history of Graves disease especially when thyroid scan is not possible because of breast feeding (J Kor Soc Endocrinol l6:75-84, 2001).
원종철,권혁상,문성수,전성완,김종화,박이병,김인주,이지현,차봉연,박태선 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.4
Background: This study was a multicenter, parallel-group, double-blind, double-dummy, randomized, noninferiority trial to evaluate the efficacy and safety of γ-linolenic acid (GLA) relative to α-lipoic acid (ALA) over a 12-week treatment period in type 2 diabetes mellitus (T2DM) patients with painful diabetic peripheral neuropathy (DPN). Methods: This study included 100 T2DM patients between 20 and 75 years of age who had painful DPN and received either GLA (320 mg/day) and placebo or ALA (600 mg/day) and placebo for 12 weeks. The primary outcome measures were mean changes in pain intensities as measured by the visual analogue scale (VAS) and the total symptom scores (TSS). Results: Of the 100 subjects who initially participated in the study, 73 completed the 12-week treatment period. Per-protocol analyses revealed significant decreases in the mean VAS and TSS scores compared to baseline in both groups, but there were no significant differences between the groups. The treatment difference for the VAS (95% confidence interval [CI]) between the two groups was −0.65 (−1.526 to 0.213) and the upper bound of the 95% CI did not exceed the predefined noninferiority margin (δ1=0.51). For the TSS, the treatment difference was −0.05 (−1.211 to 1.101) but the upper bound of the 95% CI crossed the noninferiority margin (δ2=0.054). There were no serious adverse events associated with the treatments. Conclusion: GLA treatment in patients with painful DPN was noninferior to ALA in terms of reducing pain intensity measured by the VAS over 12 weeks.