흡입세포진단법에 의한 결절성 갑상선종의 감별진단

노흥규,한봉헌,이헌영,고석만,김삼용 대한핵의학회 1982 핵의학 분자영상 Vol.16 No.1

갑상선 악성결절에 대한 미세침흡인검사와 침생검의 진단적 의의

노흥규,신재규,주원찬,한희정,송민호 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

To evaluate the usefulness. of fine needle aspiration (FNA) cytology and biopsy for the detection of malignant thyroid nodules in nodular nontoxic goiter. We retropsectively analyzed 70 patients who had the nodular nontoxic goiter which is highly suspicious by the cytological and biopsy findings. The results were as follows: 1) Out of 70 patients who were thyroidectomized for malignant nodules, 63 (88.6%) patients were women and 7 (11.4%) men. 2) Sensitivity and specificity of FNA cytology for the detection of malignant thyroid nodule were 72% and 15.4% respectively. 3) Sensitivity and specificity of biopsy for the detection of malignant thyroid nodule were 97.4% and 33.3%, respectively. 4) Sensitivity and specificity of combination of FNA cytology and biopsy for detection of malignant thyroid nodule were 95% and 100%m respectively. 5) Malignant thyroid nodules were almost (93.4%) cold nodules in ^99m-Tc thyroid scan single nodule (72.7%) was more common than multiple nodules, location of lesion was 1.99 times more common in right lobe than in left lobe in malignant thyroid nodule. 6) Regional lymph node and distant metastasis were identified in 43%, 3.7% of malignant thyroid nodules, respectively. We concluded that preoperative biopsy may increased detection rate of malignant thyroid nodule with benign findings in FAN cytology.

放射性 同位元素를 利用한 肝癌의 診斷에 關한 硏究

노흥규,김영건,김윤 충남대학교 의과대학 지역사회의학연구소 1981 충남의대잡지 Vol.8 No.1

Liver scan using radioactive ^198Au-Colloid, detection of HBsAg by ^125I RIA kit and measuring of serum AFP by ^125I RIA kit were done on the 122 primary hepatic carcinoma patients and 83 nonmalignant hepatic diseases and normal subjects, who were diagnosed and treated at the Department of Internal Medicine, CNU Hospital since Apr, 1980 to Apr. 1981. The results were analysed in the aspect of diagnostic significance as follows. 1. The size of cold area on the liver scan were in 5~10cm in diameter in 54.1% of the primary hepatoma, and the location of cold area were on the right lobe of the liver in 72.1% of the cases. 2. The HBsAg were positive in 66.2% of the primary hepatoma and there was no significant defference between the size of cold area and the positive rate of HBsAg. 3. The serum AFP were elevated above normal in 56.6% of primary hepatoma and in 76.5% of those cases, the serum AFP were over 200 ng/ml. The serum AFP levels were also elevated in acute and chronic hepatitis, liver cirrhosis in the range of 19.2%~37.5% of the cases but the level of serum AFP were not so high as in the primary hepatoma. 4. There was no significant relationship between the size of cold area and the level of serum AFP in primary hepatoma. 5. There were no significant relationship between the size of cold area, the level of serum AFP and the level of serum Alkaline Phosphatase in the primary hepatoma.

각종 위장관 질환에서의 빈혈에 관한 연구

노흥규 충남대학교 의과대학 지역사회의학연구소 1979 충남의대잡지 Vol.6 No.2

50 cases of peptic ulcer disease, 19 cases of gastric cancer,. 22 cases of gastritis were analysed clinically in the aspect of anemia and iron metabolism, comparing with 7 cases of liver diseases, 8 cases of intestinal diseases who were complicated with anemia and 15 healthy control group, since Feb. 1979 till Oct. 1979, at the Department of Internal Medicine, CNU Hosp. The results were as follows ; 1. The total observed cases were 56 males(46.7%) and 64 females(53.7%), aging 16-64, in which the peptic ulcer and gastric cancer were prevalent in the older males, while in the female, the age were evenly distributed. 2. Anemia were found in 31 (63.3%) cases of peptic ulcer and 14 cases (73.7%) of gastric cancer, but only 9 cases (40.9%) of gastritis and the degrees of anemia were more severe in the cases who had the history of actual bleeding. 3. The overall mean serum Fe, TIBC and Transferrin Iron Saturation of the disease groups shows no significant differences from the normal control, but in the anemic cases of the disease groups, the above date shows the tendency of low body iron and high TIBC. 4. In the cases of peptic ulcer and gastric cancer who had the history of actual bleeding, the serum iron, TIBC and iron saturation rate shows that of iron deficiency anemia patient of other authors.

폐경후 여성에서 에스트로겐, 이프리플라본, 칼시토닌 투여에 따른 골대사 표지자의 변화

노흥규,주원찬,한희정,채수흥,송민호 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

The measurements of metabolic bone markers are important for assesment of risks of osteoporotic fractures and efficacy of anti-osteoporotic treatment in postmenopausal women. We measured bone mineral densites, serum total alkaline phosphatases, and osteocalcin levels in estrogen replacement group(n=13), lpriflavone group(n=8), Calcitonin gruop(n=8) and untreated group(n=50). We used the dual energy X-ray absorptiometry for measurement of bone mineral densities in vertebra, used the p-nitrophenylphosphate and radioimmunoassay for serum alkaline phosphatase and serum osteocalcin, repectively. We compared the metablic hone markers, serum alkaline phosphatase, and osteocalcin between differrent treatment groups and analyzed the correlation between bone mineral densities with above metahlic bone markers. The treatment groups; estrogen, ipriflavone, and calcitonin groups showed significant low osteocalcin (p<0.05) levels but total alkaline phosphatase levels showed no significant difference compare to untreated group (p>0.05). There were no statistical significance of serum osteocalcin and alkaline phosphatase levels beween Ipriflavonc and untreated control group. Calcitonin group showed significant high alkaline phoshatase levels compare to untreated group(p<0.05) but osteocalcin levels showed no significant difference to untreated group. In conclusion, The biochemical bone markers such total alkaline phosphatase and serum osteocalcin are useful markers for the assesment of anti-osteoporotic treatment efficacy in postmenopausal women and reflect the high bone turnover in untreated postmenopausal women

갑상선 기능항진증 환자의 골밀도에 관한 연구 : 예보

노흥규,성기양,윤상임 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

A preliminary study to evaluate the effect of thyroid function on the bone mineral density(BMD) was done. BMD was measured at lumbar spine 2, 3, 4 (A-P view) in 10 euthyroid nodular goiter, 8 primary hypothyroidism and 20 hyperthyroidism patients, perimenopausal or postmenopausal periods. Serum calcium, phosphorus, thyroid hormone concentrations and other parameters were measured to analysis. The results were as follows. 1. The BMDs of euthyroidism, hypothyroidism, and hyperthyroidism were 0.85± 0.16gm/㎠ (M±SD), 0.83±0.29 and 0.79±0.16 respectively, without any significant difference, but the BMD of hyperthyroidism was lowest. 2. The BMD of postmenopause of all thyroid disease patients was significantly lower than that of perimenopause patients. 3. There was no significant relationship between BMD and serum calcium, phosphorus, T_3, T_4 or duration of treatment for thyroid disease. In conclusion, the BMD is affected mainly by the age and thyroid function, so attention to osteoporosis must be considered for the patients of thyroid disease in menopause.

골밀도 측정의 부위별 차이에 따른 임상적 의의

노흥규,안봉수,신재규 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Osteoporosis is a common clinical problem with high risk of fracture in old age, especially postmenopausal women. Secondary causes of osteoporosis can be identified in 20% of women and 40% of men with vetebral fracture. One of the cause of secondary osteoporosis is endocrine disease such as hypogonadism, ovarian agenesis, hyperthyroidism, hyperadrenocorticism, hyperparathyroidism and diabetes mellitus. The degree of bone loss in cortical and trabecular bone is different according to the cause of osteoporosis and the measurement of bone mineral densities on various sites is important to assure the feature of bone loss in various types of osteoporosis. To determine changes in the bone mineral density in women with postmenopause and with hyperthyroidism, we measured the bone mineral density (BMD) of lumbar spine and femoral neck by dual energy X-ray absorptiometry (DEXA) in 47 patients with postmenopause and 24 patients with hyperthyroidism. The result were as follows : 1) The BMD of lumbar spine and femoral neck in postmenopausal osteoporosis and hyperthyroidism patients are significantly lower than normal controls. 2) No significant difference in the patient/normal ratios of spine and femoral neck in both diseases.

각종 갑상선 질환에서 혈청 Thyroxine 결합글로부린 (TBG) 의 진단적 의의

노흥규,한봉헌,이헌영,고석만,윤상룡 대한핵의학회 1981 핵의학 분자영상 Vol.15 No.2

In an attempt to evaluate the diagnostic significance of the serum thyroxine binding globulin(TBG) in various thyroid disease states, the authors measured serum T3 uptake, T3, total T4, free T4, TSH and TBG by radioimmunoassay technique, and calculated the free T4 index(FT4I) and T4/TBG ratio in 10 cases of normal subjects, 11 eases of hypothyroidism, 62 cases of euthyroidism and 37 cases of hyperthyroidism. The data were analysed in the aspects of diagnostic significance in each thyroid disease state, and the results were as follows; 1) In 10 cases of normal subjects, serum TBG was 17.4∼26.8ug/ml, FT4I was 5.1∼9.7, and T4/TBG ratio was 21.9∼49.9(Mean±S.D.). 2) 62 cases of euthyroidism with diffuse and nodular goiter, FT4I was 7.26±1.82, T4/TBG ratio was 31.47±10.42, and there were no significant difference from those of normal subjects(p〉0.5). 3) In 11 cases of hypothyroidism, the FT4I was 3.13±2.15, T4/TBG ratio was 11.3±5.31, significantly lower than normal controls(p〈0.01). 4) In 37 cases of hypsm, the FT4I was 30.0±12.01 T4/TBG ratio was 121.4±62.2, significantly higher than normal controls(p〈0.01). 5) There were significant correlations between the FT4I and T4/TBG ratio, total T4 and T4/TBG radio, in each thyroid function states. 6) The FT4I showed 100% of diagnostic value in hyperthyroidism, 89.2% in euthyroidism, and 80% in hypothyroidism group. The T4/TBG ratio showed 100% of diagnostic value in hyperthyroidism and hypothyroidism, and 80.6% in euthyroidism group. The above results suggest that T4/TBG ratio and FT4I showed same diagnostic value in hyperthyroidism group, but T4/TBG showed higher diagnostic significance than FT4I in hypothyroidism.

갑상선 기능상태에 따른 혈청 갑상선자극홀몬의 변동에 관한 연구

노흥규 대한핵의학회 1975 핵의학 분자영상 Vol.9 No.2

방사면역측정법을 이용하여 서울대학교 의과대학 부속병원 내과 동위원소실에서 관찰한 각종 갑상선 질환 환자 135명과 정상 대조군 98명을 대상으로 하여 혈청 TSH치를 측정하여 갑상선 기능상태의 변동에 따른 혈청 TSH치의 변화와 그 진단적 가치를 보기 위하여 각종 갑상선 기능 검사치 및 임상 증세와 비교하여 다음과 같은 결론을 얻었다. 1) 정상 대조군의 혈청 TSH치는 (1.3∼8.0μU/ml)이었고, 원발성 갑상선 기능 저하증 환자는 전예가 정상대조군보다 높았다. 2) 원발성 갑상선 기능 저하증 환자의 진단에서 혈청 TSH치의 측정은 전예에서(100%) 상승되어 혈청 T₄치(75.0±12.2%), free T₄ index(64.2±15.2%), 혈청 T₃치(41.0±21.0%) 및 T3 resin uptake(41.1±15.8%)보다 더 진단적 의의가 있었다. 3) 뚜렷한 임상 증세를 보이는(overt) 갑상선 기능 저하증에서는 혈청 TSH치나 혈청 T4치는 모두 진단에 의의가 있었으나 경한 증세의 (preclinical 혹은 mild) 기능 저하증에서는 혈청 T₄치(41.2±23.8%, 50.0±25.0%)는 그 진단적 의의가 낮아졌다. 4) 원발성 갑상선 기능 저하증 환자의 치료시 1 grain의 desiccated thyroid의 투여로서 대부분의 경우(76.9±23.4%) 혈청 TSH치가 정상범위로 돌아왔으며 혈청 TSH치의 주기적인 측정으로 치료효과를 판정하는데 도움이 됐다. 5) 방사성 동위원소 옥소나 항갑상선제에 의한 갑상선기능 항진증 환자의 치료시 혈청 TSH치의 측정은 선상선 기능 저하증으로서 발현을 초기 발견할 수 있었으며 그 치료방침의 결정에 중요한 지표가 되었다. The serum concentrations of thyrotropin (TSH) were measured by means of radioimmunoassay, in 98 cases of normal controls, 51 cases of hyperthyroidism, 80 cases of primary hypothyroidism and 4 cases of secondary hypothyroidism to evaluate the diagnostic significance in various functional states of the thyroid. The obtained data were analyzed in correlation with other thyroid function test values in various phases of the functional thyroid diseases. The results were as follows: 1) The serum TSH concentration in normal control group was (1.3∼8.0μU/ml). 2) The measurement of serum TSH was more significant in diagnostic accuracy compared with that of serum T4 (75.0±12.2%). Free T4 Index (64.2±15.2%), serum T3(41.0±21.0%) or T3 resin uptake (41.1±15.8%) in evaluation of primary hypothyroidism. 3) In case of overt hypothyroidism, the serum TSH and T4 were both abnormal, compatible with the clinical diagnosis, while in csse of preclinicai or mild hypothyroidism, the serum T₄ (41.2±23.8% or 50.0±25.0%) was muchliable than serum TSH. 4) In the treatment of primary hypothyroidism with desiccated thyroid, the administration of 1 grain of the hormone per day was sufficient to suppress the serum concentration of TSH to normal range. It showed that the measurement of serum TSH concentration was a significant criteria in evaluating the efficiency of the treatment of hypothyroidism. 5) The measurement of serum TSH concentration is a very significant method in the early detection of hypothyroidism induced during or after the treatment of the hyperthyroidism with antithyroid drugs or radioactive Iodine ((131)^I).

Dopaminergic Activity 가 부종상태에서 혈청 Aldosterone 분비에 미치는 영향

노흥규,한봉헌 대한핵의학회 1985 핵의학 분자영상 Vol.19 No.2

To evaluate the effect of dopaminergic activity on aldosterone secretion, the plasma renin activity, serum cortisol and aldosterone were measured by radioimmunoassay in 6 normal controls and 12 patients who had hyponatrernia and generalized edema or ascites with possible condition with secondary aldosteronism before and after(l5,30, and 60 min) 15mg of metoclopramide by iv bolus injection and same method with 500mg of L-dopa by per oral in 6 normal controls and 12 patients with edema ascites. The result were as follows; l) The basal level of PRA was higher in patients rather than norrnal controls but PRA was not influenced by MC or L-dopa adrninistration on both normal controls and patients group. 2) The serum cortisol level was significantly elevated at 30 min after MC injection compared with basal level in normal controls but no significant change was not patients group. After L-dopa administration the serum cortisol level was noted in changed in both normal controls and patients group, 3) The serum aldosterone level was significantly elevated in 15,30 and 60 min after MC injaction in normal controls, and there also same tendency of aldosterone secretion was noticed in patients group. On the other hands, there was no changes in aldosterone level in both normal controls and patients group with L-dopa administration. Above result means that MC stimulate aldosterone secretion by dopaminergic antagonist and aldoaterone secretion in normal subject is controlled by maximaI tonic dopaminergic inbibition. In edematous patients, however, both of the dopaminergic inhibitory and stimulating effect of PRA, ACTH etc o#n the aldosterone secretion seems to be variable.