산후 자가면역성 갑상선염 환자의 병후경과에 관한 연구

김현만,허갑범,이현철,임승길,김경래 대한내분비학회 1986 Endocrinology and metabolism Vol.1 No.1

Autoimmune postpartum thyroiditis is thought of as the same or the variant of Hashimoto's thyroiditis, but is characterized by several clinical aspects, such as the occurrence afterdelivery or abortion, and the reversiblity of thyroid function.The present study was performed on the patients followed up more than 12 months after delivery.1) The age of patients with autoimmune postpartum thyroiditis at diagnosis was the range of 22 to 38 years(mean 28.4 years).2) Of 55 cases who were followed-up during 12 to 73 months(mean 31.8 months), 48 cases(87.3%) recovered, 5 cases(9.1%) remained in hypothyroidism and 2 cases(3.6%) transformed to hyperthyroidism.3) Of 16 cases who were known to deliver subsequent baby, 10 cases(62,5%) recurred transient postpartum thyroiditis, among the cases with transient sypothyroidism, 2 cases were induced by unknown precipitating factors. 4) The male and female bagies of patients were 72.7%(16 cases), 27.3%(6 cases), respectively. 5) Although there were a little differrences in clinical feature among recovery, hypothyriodism and hyperthyroidism groups, the cases of the latter two groups were too small to characterize each group. These data indicate that the majority of patients with autoimmune postpartum thyroiditis recover, but some transform to hypo- or hyperthyroidism, and following subsequent delivery, more han half patients recur the same disease.

M10CN전자교환기와 EMD형 PABX간 DID 회선신호정합

김현만,박종구,Kim, Hyeon-Man,Park, Jong-Gu 한국전자통신연구원 1981 전자통신 Vol.3 No.3

당뇨병 교육, 왜 중요한가?

김현만 사단법인 한국당뇨협회 1999 당뇨 Vol.112 No.-

여름철의 당뇨관리

김현만 사단법인 한국당뇨협회 1996 당뇨 Vol.80 No.-

당뇨인의 일상생활

김현만 사단법인 한국당뇨협회 1995 당뇨 Vol.62 No.-

[수필] 두타산을 오르다

김현만 고시계사 2020 考試界 Vol.65 No.7

흰쥐 엽상유두미뢰의 조직화학적 연구

김현만,고재승,황성명 대한구강해부학회 1982 대한구강해부학회지 Vol.6 No.1

한국 성인에서 뇌하수체 기능부전증의 원인 및 내분비학적 특성

김현만,허갑범,이현철,이은직,홍욱균,오미희 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.4

Pituitary insufficiency can be caused by various diseases. The present study was perfomed on Korean patients with pituitary insufficiency, who were examined from January 1982 to June 1991. Cases under hormone treatment or cases with hypopituitarism developed after surgery or radiotherapy on the pituitary gland were excluded in this study. Two hundred fory senen cases with pituitary insufficiency, which was confirmed by high resolution sella CT scan and combined pituitary stimulation test, were classified basing on their primary causes. The results were as follows: 1) Anomg 247 cases with pituitary insufficiency, 169 cases (68.4%) were pituitary adenoma, 64 cases (25.9%) ischemic necrosis of pituitary gland, 3 cases (1.2%) head trauma, and 11 cases (4.5%) idiopathic 2) Seventy two out of 93 male patients with pituitary insufficiency (77.4%) were pituitary adenoma, with the most prevalent age being the 4 th 5 th decade. 3) Dighty one out of 154 female patients with pituitary insufficiency (51.6%) were pituitary adnoma and 57 cases(37.0%) were Sheehan's syndrome. Most pituitary tumors were found in the 3 rd decade but Sheehan's syndrome were found in the 6 th decade. 4) There was no significant change in nmber of the annual cases with Sheehan's syndrome. 5) Pan-or near total hypopituitarism were observed in 86.1% of cases with Sheehan's syndrome and in 40.4% of cases with pituitary insufficiency caused by tumors. It can be concluded that the most common cause of pituitary insufficiency in Korea is pituitary tumor. However, Sheehan's syndrome is the main cause of pituitary insufficiency in female patients after age of 40. And the degree of pituitary insufficiency in cases with Sheehan's syndrome is more serious than that in pituitary tumor. (J Kor Soc Endocrinol 8:390~397, 1993)

그레이브스병 환자에서 약물치료 반응 예측 지표로서의 ADCC

김현만,이관우,신영구,채봉남,김윤정,이성규,홍은경,정윤석,노혜림 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.4

Background: The several forms of treatment of Graves disease-thyroidectomy, antithyroid drugs and radioiodide therapy-are in wide use now. But which therapy is best is a matter of debate. Some authors reported that in patients who underwent thyroidectomy, higher titers of serum antimicrosomal antibody were associated with 1) higher formation rates of germinal centers, 2) more lymphocyte infiltration in the thyroid tissue, 3) higher incidence of hypothyroidism, and 4) lower incidence of recurrence. We were interested in the relationship of thyroid autoantibody titers, ADCC(antibody-dependent cell-mediated cytotoxicity) activity and the clinical response to antithyroid medication. Methods: We measured ADCC activities from patients in Graves disease(n-48), Hashimoto thyroiditis(n=17) and normal control(n=9). The patients of Graves disease were followed up for more than 1 year, and they were grouped into A(n=17, well responsed group to antithyroid medication) and B(n=31, poorly responsed group). We examined ADCC activities of patients' sera by chromium release assay. Results: 1) Mean age of patients with Graves disease was 34.4210.4 years and 15 patients were male(31%). 2) Results of thyroid function tests of the Graves' patients were T 585.9 +- 255.3 ng/dL, T4 21.3 +- 12.2 mg/dL, TSH 0.11 +- 0.06mIU/mL. Concentrations of antimicrosomal antibody, antithyroglobulin antibody and thyrotropin binding inhibitory immunoglobulin were 1279.1 +- 1486.7 IU/mL, 488.1 +- 751.1 IU/mL, and 38.5 +- 33.4U/L respectively. 3) There was no significant difference between levels of thyroid hormones or concentrations of thyroid autoantibodies and ADCC activities in graves patients. 4) The ADCC activity of the Graves patient group(24.49%) was significantly higher than that of the normal control group(3.76%), and significantly lower than that of the Hashimotos thyroiditis group(36.34%). 5) There was no significant difference in ADCC activity between group A(18.24 +- 13.44%) and B(27.91 +20.02%). Conclusion: From this results, we suggested that ADCC activity seems to be no value as a prognostic factor in predicting the response to antithyroid drugs in Graves disease patients. But, further studies, larger number of patients and long-term follow up, are needed (J Kor Soc Endocrinol 13:554-562, 1998).

Lithium Carnonate 치료 중 발생한 갑상선종 4예

김현만,이관우,신영구,이성규,이성근,정윤석 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.4

Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment. (J Korean Soc Endocrinol 12:621-626, 1997)