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황정원 ( Jung Won Hwang ),한군희 ( Koon Hee Han ),김영돈 ( Young Don Kim ),홍현일 ( Hyun Il Hong ),심명숙 ( Myoung Sook Shim ),김진엽 ( Jin Yub Kim ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 갑상샘과다증 환자에서 원위 신세관 산증을 진단한 1예를 경험하였다. 갑상샘과다증 환자에서 저칼륨증에 의한 근육 마비가 발생한 경우 증상 호전 후에도 저칼륨증이 지속된다면 다른 원인을 감별해야 할 것으로 생각한다. Distal renal tubular acidosis is characterized by a decrease in net hydrogen ion secretion from renal collecting tubules. The most common causes of distal renal tubular acidosis in adults are autoimmune disorders, such as Sjogren syndrome, systemic lupus erythematosus, and rheumatoid arthritis. Compared to other autoimmune disorders, the concurrence of renal tubular acidosis and autoimmune thyroid disease is extremely rare. We report a patient who presented with hypokalemic paralysis associated with Graves` disease and distal renal tubular acidosis. (Korean J Med 69:S915-S918, 2005)
하동천 ( Dong Cheon Ha ),윤준영 ( June Young Yoon ),조성원 ( Sung Won Cho ),정정임 ( Jeong Ihm Jeong ),김진엽 ( Jin Yub Kim ),김한권 ( Han Gwun Kim ),엄대운 ( Dae Woon Eom ),김성수 ( Sung Soo Kim ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.2
Wegener`s granulomatosis is a rare disease that pathologically causes necrotizing granulomatous vasculitis in the arterioles and venules and it can invade the whole body. In addition, it is difficult to distinguish between a nontuberculous mycobacteria infection that shows manifestations of granuloma and Wegener`s granulomatosis. There has been no reported on a patient who had the 2 abovementioned two diseases at the same time. A 69 year old male patient had Wegener`s granulomatosis that had invaded the prostate. He also had a scrotal swelling and back pain. He had manifestations of granulomatous infection on the scrotum and spine biopsies. However, there was no clinical evidence of Wegener`s granulomatosis. As a result, we examined him for other diseases that can cause a granuloma. Consequently, he was also diagnosed as suffering with a nontuberculous mycobacteria infection. We report here on this case and we review the relevant medical literature.
갑상선 유두암과 여포 선종에서 Microsatellite Marker를 이용한 Allelotying과 Comparative Genomin Hybridization 소견
김은숙,김진엽,김상희,김성배,안일민,공경엽,한정희,박기영,박현주,홍석준,이성진,지관자 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.2
Background: In our previous study, the prevalence of the known causes of thyroid tumorigenesis was relatively rare in Korean population, suggesting genetic and environmental differences exist. Screening of genetic alteration in papillary thyroid carcinoma(PTC) and follicular adenoma(FA) in whole genomic scale was needed prior to search on individual genes of possible causes. Methods: Ten cases of PTC without ret/PTC-I, -2, -3 rearrangement and 5 cases of follicular adenoma were included in the study of microsatellite marker allelotyping. Sixty two microsatellite markers available, were chosen to cover the known sites of loss of heterozygosity(LOH) involved in thyroid tumors, tumor suppressor genes and terminal portion of each chromosomes. PCR was performed on tumor DNA and leukocytes DNA from each patient with MDE gel electrophoresis to detect LOH. Same specitnens as above, 3 case of normal thyroid tissues and NPA, ARO cell lines were included in the study of comparative genomic hybridization(CGH). Tumor and control DNAs were hybridized to metaphase chromosome with differential stainings with fluorescein and rhoda-mine-dUTP. Obtained results were analyzed by multicolor fluorescence computer assisted image analyzer. Results: In allelotyping, LOH were detected in 5 cases of PTC, 2 cases on D10S1435, 1 case each on D2S1780, DSS1099, D11S1986, D16S539, 1 case of PTC revealed LOH on DSS1099, D11S1986. In FA, LOH were detected in 3 cases on D1S534, D1S226, Dl 1S907, D22S683, DXS9807. In CGH, Xp addition was noticed in 1 case of PTC, 12q and 10p addition was noticed in 1 case each, 16q deletion and 17q addition in 1 case of FA. Conclusion: No hot spot of LOH was noticed in microsatellite marker allelotyping, neither of common chromosomal change in CGH study suggesting unbalanced translocation or gene amplification more than 5-10 Mb may be involved in the genetic alteration of PTC and FA. (J kor Soc Endocrinol 14:314-322, 1999)
김은숙,이태진,김진엽,김상희,김성배,안일민,공경엽,홍석준 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.3
Background: Proteins of the Bcl-2 family are intracellular membrane-associated proteins that regulate programmed cell death either positively or negatively by as yet unknown mechanism. Bcl-2 family proteins have an antiapoptotic function, such as the Bcl-2, the long form of Bcl-x and Mcl-l, or a proapoptotic function, like the short form of Bcl-x and Bax. To investigate the potential role of Bcl-2 family proteins in thyroid tumorigenesis, the authors examined the pattern of expression of the Bel-2 family proteins in various thyroid neoplasms. Methods: Bcl-2 family proteins, including Bcl-2, Bcl-x, Mcl-1 and Bax proteins were immunohistochemically stained in 57 cases of various thyroid neoplasms using formalin-fixed and paraffin embedded tissues; 18 cases of papillary carcinoma, 6 cases of medullary carcinoma, 4 cases of anaplastic carcinoma, 10 cases of follicular adenoma, 9 cases of adenomatous goiter, and 10 autopsy cases of fetal thyroid galnd. The intensity and frequency of the immunostaining were evaluated with the program of Image-Pro Plus Version 3.0 for image analysis. Result: Consistent expression of Bcl-2, Mcl-1, and Bax proteins were present in the surrounding normal thyroid tissue, however the expression of Bcl-x protein was not observed. Compare to the expression patterns of adenomatous goiter, and fetal and surrounding normal thyroid tissues, papillary and anaplastic carcinomas showed the decreased Bcl-2 and increased Bcl-x protein expressions(p (0.05). Medullary carcinoma revealed the increased Bcl-x protein expression only(p 0.05). Conclusion: These data suggest that combined patterns of decreased Bcl-2 and increased Bcl-x protein expressions may eontribute to the carcinogenesis of thyroid cancers originated from thyroid follicular cells, and an increased expression of Bcl-x protein may be related to the pathogenesis of medullary carcinoma from parafollicular C cells (J Kor Soc Endocrinol 13:359-365, 1998).
I 전신스캔 음성이면서 혈청 갑상선글로불린 양성인 분화된 갑상선암 환자에서 방사성요오드 치료의 효과
김은숙,문대혁,김상욱,류진숙,김진엽,김기수,홍석준,송영기 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.2
Background: After total thyroidectomy the presence of detectable serum thyroglobulin(Tg) concentration is an index of residual or metastatic thyroid tissue and is usually well correlated with positive I whole body scan. However, it is not rare to find a patient with detectable serum Tg levels but without any uptake on I whole-body scan. At present it is not certain how to manage such patients. We performed whole body scan after administration of therapeutic dose of 131I to evaluate the usefulness of radioactive iodine therapy in the above setting. Methods: Fifteen patients (4 males and 11 females, ranging in age from 17 to 74 years) were studied. They had been previously treated with total thyroidectomy for papillary thyroid cancer followed by therapy with 131I for ablation of their thyroid residue. Tg levels were determined by immunoradiometric assay method. 131I (100-200 mCi) therapy was administered and whole body scan was performed. 99mTc MIBI scans were taken in 9 patients. Follow up data of Tg were available in 12 patients at time interval of 6 12 months from the first study and treatment. Results: Tg(on) levels of these patients were in a range of 2.2210 ng/mL (mean 36.1 +- 59.1 ng/mL) and Tg(off) levels were 17.3 1,592 ng/mL (mean 197.3 +- 400.3 ng/mL). After radioiodide therapy, Tg(on) levels were in 1.48.5 ng/mL (mean 11.0 +- 13.5 ng/mL), Tg (off) were 11.9 478.0 ng/mL (mean 159.3 +- 159.8 ng/mL). The Tg (on) levels were decreased significantly after RAI therapy, but Tg (off) levels had no significant difference, In 8 of the 15 patients (53.3%), posttreatment whole body scan showed definite positive uptakes which were not evident in pretreatment diagnostic scan. There were local recurrence in 3 cases, regional lymph node metastasis in 4 cases, and lung in I case. Diffuse hepatic uptake was definitely seen in 7 cases. The MIBI scan showed abnorml uptakes in 4 of 9 cases. Conclusion: The therapeutic usefulness of 100 to 200 mCi of 131I treatment in patients with 131I scan-negative and Tg-positive was unclear. And the MIBI scan was only partially effective. Further studies with other diagnostic and therapeutic approachs are required to evaluate the exact lesions and to improve prognosis. (J Kor Soc Endocrinol 14:330-338, 1999)