하시모토 갑상선염과 동반된 갑상선 유두암에서 BRAFV600E의 발현과 임상적 특징

남성진,최영식,박요한,김정훈 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: An association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) is still controversial. Studies to date established the coexistence of HT in 11% to 36% of PTC patients. BRAFV600E mutation was presented 90% with no HT, 64% with HT in PTC patients. Therefore, BRAFV600E mutation is associated with the pathogenesis of PTC arising in HT. The purpose of this study was to identify predictive factors for the coexistence of PTC and HT and to evaluate the association of the BRAFV600E mutation with the clinicopathological features of coexistence of PTC and HT. Methods: A total of 247 patients underwent surgery for thyroid disorders between January 2007 and April 2009. In all, 212 patients was diagnosed as thyroid papillary carcinoma only (PTC group), 33 had coexistence of PTC and HT (PTC+HT group), and 2 had been diagnosed with HT. DNA was extracted from paraffin embedded thyroid tumor specimens taken from 99 patients with PTC, 13 coexistence of PTC and HT, and 2 was HT. The presence of the BRAFV600E mutation was determined by polymerase chain reaction amplification of exon 15 followed by direct sequencing. Results: Among clinicopathological features sex, age, tumor size and capsule invasion was not significant between PTC group and PTC+HT group. Lymph node metastasis and stage was significantly lower in PTC+HT group than PTC group (p=0.044). BRAFV600E mutation was found in 34 of the 99 PTC group (34.3%), 1 of the 13 PTC+HT group and 2 HT show no BRAFV600E mutation. Conclusion: These data demonstrated that the coexistence of PTC and HT was less aggressive than PTC only.

PTEN 유전자 돌연변이를 동반한 Cowden병 1예

남성진,최영식,박요한,김규종,박선자 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Cowden's disease, also known as various hamartomatous malformations of multiple organs, is a rare autosomal dominant disorder. The most important feature of Cowden's disease is an increased incidence of malignant neoplasm, particularly in the breast and thyroid gland. PTEN (phosphatase and tensin homologue deleted in chromosome 10) is a candidate tumor suppressor gene. Mutations of this gene are responsible for PTEN hamartoma tumor syndromes, including Cowden's disease, Bannayan-Riley-Ruvalcaba syndrome, Proteus syndrome, and Proteus-like syndromes. After identification of PTEN as the gene for Cowden's disease, the incidence of Cowden's disease was estimated to be 1 in 200,000. However Cowden's disease with malignant neoplasm is quite rare in Korea so far. Recently we experienced a family with Cowden's disease who carry a frame shift germline mutation(C.606del T) at 10q23, exon 6 of PTEN gene. The authors report this case with literature review.

란크릭 캅셀(플루옥세틴 20mg)에 대한 프로작 캅셀의 생물학적 동등성 시험

심상범,조요나,오한석,류재환,이경태,김남재,서성훈 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2000 No.-

Bioequivalence of two flouxetine capsule, ProzacR (Lilly kora Ltd.) and LanclicR (Samsung Pharm. IND. Co.), was evalated according to the guideline of KFDA. Twenty four healthy male volunteers (21-26 years old) were divided into two groups and a randomized 2×2 cross-over study was employed. After 60mg of fluoxetine was orally administered, blood was taken at 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 24, 32, 48 and 72 hours after administration and just before administration. Plasma was analyzed for fluoxetine and internal standard (clomipramine) by a sensitive and validated HPLC assay. The pharmaco kinetic parameters (AUCt, Cmax and Tmax) wre calculated and ANOVA test was used for the statistical analysis of parameters. Differences in (AUCt, Cmax and Tmax between two capsules were -0.90, 3.46 and -14.08% respectively. All powers (1-β) for AUGt, Cmax and Tmax were more than 0.9. Detectable differences (Δ) and confidence interval were all less than ±20%. All the parameters above met the criteria of KFDA for bioequivalence and indicated that LanclicR capsules are bioequivalent to ProzacR capsules.

蟾津江流域에 있어서 Metagonimus屬 吸蟲感染에 관한 疫學的 硏究

노승직,최희옥,정요한 조선의대 1984 The Medical Journal of Chosun University Vol.9 No.1

말초혈액에서 Tg mRNA에 대한 역전사 중합효소 연쇄 반응법의 갑상선 재발암의 분자생물학적 진단

권성일,박기룡,김현영,신채희,임영찬,최영식,박요한,이강대,장희경,이재화,염하용 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4

연구배경: 갑상선암은 다른 조직에 발생한 암에 비해 비교적 천천히 자라므로 대부분 예후가 양호하지만, 일부에서는 주위 조직으로 침윤하거나 혹은 원격 전이로 인하여 치명적인 결과를 초래할 수 있다. 갑상선전절제술 및 131^I 제거술 후 경과 관찰시 갑상선암의 재발과 전이의 진단에 있어 131^I 스캔과 혈청 Tg의 측정이 현재 임상에서 가장 많이 이용되고 있으나 이 방법에는 여러 가지의 결점이 있다. 최근 Tg mRNA에 대한 RT-PCR법을 이용한 여러 연구결과는 131^I 스캔과 혈청 Tg 측정의 결점을 보완할 수 있는 좋은 보조적인 진단법으로 이용할 수 있을 가능성을 제시하였다. 이에 말초혈액에서 측정한 Tg mRNA에 대한 RT-PCR법이 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무의 진단에 유용한가를 알아보고자 이 연구 시행하였다. 방법: 분화된 갑상선암으로 진단된 후 갑상선전절제술을 시행받고 방사성요드 치료를 받은 환자 중 현재까지 한차례에 이상 추적 방사성요드 전신 스캔을 시행하고 추적관찰이 가능했던 유두선암 35예, 여포선암 5예를 대상으로 연구를 시행하였다. 대상군은 131^I 스캔 소견상 음성인 군(Group Ⅰ), 잔여조직이 있는 군(Group Ⅱ), 국소전이가 있는 군(Group Ⅲ), 및 원격전이 군(Group Ⅳ)으로 구분하였다. 정상 대조군은 갑상선질환이 없는 10예의 건강인으로 하였다. 대상환자의 말초혈액을 이용한 Tg mRNA에 대해 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행하였다. 결과: 본 연구 결과는 다음과 같다. 1) 131^I 스캔 소견상 음성인 군 21예 중 1예에서 Tg가 양성소견을 보였다. Anti Tg Ab가 양성인 4예 모두 Tg가 음성을 보였다. 잔여조직이 있거나 국소전이 및 원격전이를 보인 군 19예 중 Tg가 양성인 경우는 4예였으나, Tg mRNA는 전예에서 양성이었다. 2) 131^I 스캔에서 국소 및 원격전이 소견을 보인 8예 중 4예에서 Tg가 음성으로 131^I 스캔과 혈청 Tg 사이에 불일치 소견을 보였다. 3) 말초혈액에서 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행한 결과 대상군 40예 및 정상 대조군 10예 모두에서 Tg mRNA가 양성을 보였다. 결론: 본 연구에서 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무를 평가함에 있어 역전사 중합효소 연쇄 반응법을 이용한 Tg mRNA 측정의 의의는 재평가되어야 한다고 생각된다. Background: Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyriod ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluated the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy. Methods: Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg. Results: The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131^I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls. Conclusion: From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications (J Kor Soc Endocrinol 17:501∼513, 2002).

소세포 폐암의 갑상선전이 1예

장리라,최영식,박요한,문대성,김자경,김성은,최인수,유찬희,남성진 고신대학교 의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

Metastasis to the thyroid gland is usually considered uncommon. The most frequent sites of the primary tumor include the kidney, breast and lung. Its presence often indicates poor prognosis. Metastases represent the advanced stage of the tumors and fine needle aspiration cytology is and important way of diagnosis in thyroid metastasis. we experienced a case of Metastatic Small cell Lung Carcinoma to the Thyroid Gland. A 58-year-old man with Graves' disease diagnosed pulmonary nodule in the left upper lung field on his chest X-ray film. The patient's thyroid gland was diffusely swollen, and elastic to hard. A thyroid ultrasonography showed 1cm sized hypodense nodule on the left thyroid gland. The patient underwent a ultrasonography guided fine needle aspiration cytology of the mass. Cytological diagnosis was a metastatic small cell carcinoma. Then Chemotherapy was administered to the patient. The authors report this rare case of metastatic small cell lung carcinoma to the thyroid with literature review.

流域特性을 考慮한 流出 모델링에 관한 硏究

金治弘,安元植,韓成大,尹如松 成均館大學校 科學技術硏究所 1985 論文集 Vol.36 No.1

This study have been carried out as a sector of the rainfall-runoff relationship research. First of all, the runoff research has the difficult problem due to non-linearity of hydrological phenomena. In this study, according to the method of runoff separation into components by Hino and Hasebe (1980) is applied. This theory considers sufficiently the physical mechanism of runoff process to separate into the groundwater, interflow, and surfaceflow, respectively. Then each component of runoff time series can be reduced to the linear subsystem, that is, ARMA model can be obtained in each subsystem. Actual flood hydrograph of the every two major gauging stations in the Han River basin, the Naktong River basin and the Kum River have been analyzed, and have taken out the characteristics of each river basin. Also the runoff model have obtained for these basins.

동종골수이식 환자에서 발생한 지역사회발생 Parainfluenza virus 3형 폐렴 1예

신종욱,조요한,강철인,김성한,이상윤,김의석,오명돈,이환종,박선양,김병국,최강원 대한감염학회 2002 감염 Vol.34 No.5

일과성 전 기억상실증으로 나타난 크로이츠펠트 : 야콥병 1례

신대수,이승희,이한샘,박성욱,박현영,장혁,장성조,김요식,조광호 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.1

고립성 폐 결절로 나타난 경화성 혈관종의 폐엽 절제술에 의한 치험 1예 : A case report

황은구,이송암,황재준,김상윤,권혁중,김요한 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Patient was sixty-eight years old female. She was transferred to our department to resect the solitary pulmonary nodule on right lower lobe. Intraoperative frozen-section revealed bronchioloalveolar carcinoma. So, we performed right lower lobectomy and mediastinal lymph node dissection. Permanent pathologic diagnosis of this patient was sclerosing hemangioma. We report experience of treatment of sclerosing hemagioma presenting solitary pulmonary nodule by lobectomy with the review of literatures.