姙娠 白鼠의 一酸化炭素 中毒이 胎仔에 미치는 影響

文載薰,車喆煥 고려대학교 의과대학 1976 고려대 의대 잡지 Vol.13 No.1

Although carbon monoxide poisoning of pregnant woman was reported in 1859, very little has written about the effect of carbon monoxide on the fetus in uterus. Furthermore in this country, the major heat sources in private houses are coal products and this matter has given special emphasis on the pregnant women spending most of their lives in kitchens in which the air is easily and frequently polluted with carbon monoxide. With the reasons, the primary trial to prove the pathogenesis of fetal carbon monoxide poisoning was carried out using 38 pregnant rats of Sprague-Dawley species with 37 fetuses. As for the methodology, the rats were devided into two groups of control and exposure group. The latter was exposed to 500ppm of carbon monoxide through Douglas bag for 4 hours per day for 20 days continuously. And then, the fetuses were examined. The results of the experiment were as follows; 1. The abortion rate of exposure group was 44.6% by average showing significant relative risk of 3.3 comparing with 13.4% of the rate of control group. (p<0.005) 2. The fetuses of the exposure group were significantly lighter than those of control group showing difference of 0.57 gm by average, that is, 3.91±0.08 gm of exposure group and 4.48±0.14 gm of control group. (P<0.001) 3. The brains of fetuses of exposure group were significantly ligher than ones of control group showing difference of 17.6 ㎎ by average. (P<0.05) 4. The fetuses of the exposure group are shorter in length by 0.13㎝ by average, however, the difference is not significant statistically. (p<0.1)

갑상선기능저하증과 대사증후군

문재훈 대한갑상선학회 2013 International Journal of Thyroidology Vol.6 No.2

Metabolic syndrome is a cluster of diseases that include central obesity, hyperglycemia, dyslipidemia, and hypertension. Metabolic syndrome is a risk factor for type 2 diabetes and cardiovascular disease and the key pathophysiology is insulin resistance. Thyroid hormone has been known to play an important role in lipid and glucose metabolism and hypothyroidism causes atherosclerosis and insulin resistance. A number of clinical studies reported overt or subclinical hypothyroidism is associated with metabolic syndrome, and there has been the efforts elucidating a link between these two diseases. Recently, thyroid hormone analogue or thyromimetics has been developed to improve metabolic syndrome including dyslipidemia. I reviewed recently reported mechanisms explaining the association between hypothyroidism and metabolic syndrome, and current status of the development of thyromimetics was also reviewed.

Endocrine Risk Factors for Cognitive Impairment

문재훈 대한내분비학회 2016 Endocrinology and metabolism Vol.31 No.2

Cognitive impairment, including Alzheimer’s disease and other kinds of dementia, is a major health problem in older adults worldwide. Although numerous investigators have attempted to develop effective treatment modalities or drugs, there is no reasonablyefficacious strategy for preventing or recovering from cognitive impairment. Therefore, modifiable risk factors for cognitive impairmenthave received attention, and the growing literature of metabolic risk factors for cognitive impairment has expanded fromepidemiology to molecular pathogenesis and therapeutic management. This review focuses on the epidemiological evidence for theassociation between cognitive impairment and several endocrine risk factors, including insulin resistance, dyslipidemia, thyroiddysfunction, vitamin D deficiency, and subclinical atherosclerosis. Researches suggesting possible mechanisms for this associationare reviewed. The research investigating modifiable endocrine risk factors for cognitive impairment provides clues for understandingthe pathogenesis of cognitive impairment and developing novel treatment modalities. However, so far, interventional studiesinvestigating the beneficial effect of the “modification” of these “modifiable risk factors” on cognitive impairment have reportedvariable results. Therefore, well-designed, randomized prospective interventional studies are needed.

Study Protocol of Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro)

문재훈,김지훈,이은경,이규은,공성혜,김여군,정우진,이창윤,유노을,황보율,송영신,김민주,조선욱,김수진,정은재,최준영,유창환,이유진,하정훈,정유성,류준선,황윤지,Sue K. Park,성호경,이가희,박도준,박영주 대한내분비학회 2018 Endocrinology and metabolism Vol.33 No.2

Background: The ongoing Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) aims to observe the natural course of papillary thyroid microcarcinoma (PTMC), develop a protocol for active surveillance (AS), and compare the long-term prognosis, quality of life, and medical costs between the AS and immediate surgery groups. Methods: This multicenter prospective cohort study of PTMC started in June 2016. The inclusion criteria were suspicious of malignancy or malignancy based on fine needle aspiration or core needle biopsy, age of ≥18 years, and a maximum diameter of ≤1 cm. If there was no major organ involvement, no lymph node/distant metastasis, and no variants with poor prognosis, the patients were explained of the pros and cons of immediate surgery and AS before selecting AS or immediate surgery. Follow-up visits (physical examination, ultrasonography, thyroid function, and questionnaires) are scheduled every 6 months during the first 2 years, and then every 1 year thereafter. Progression was defined as a maximum diameter increase of ≥3, ≥2 mm in two dimensions, suspected organ involvement, or lymph node/distant metastasis. Results: Among 439 enrolled patients, 290 patients (66.1%) chose AS and 149 patients (33.9%) chose immediate surgery. The median follow-up was 6.7 months (range, 0.2 to 11.9). The immediate surgery group had a larger maximum tumor diameter, compared to the AS group (7.1±1.9 mm vs. 6.6±2.0 mm, respectively; P=0.014). Conclusion: The results will be useful for developing an appropriate PTMC treatment policy based on its natural course and risk factors for progression.

노인에서의 갑상선질환 관리

문재훈 대한내과학회 2022 대한내과학회 추계학술대회 Vol.2022 No.2

기륭투쟁의 현재적 의의 : 기륭노동자들, 시대 투쟁의 창끝에 서다

문재훈 한국비정규노동센터 2010 비정규 노동 Vol.- No.84

특발성 저신장증 환자에서 IGF-I 프로모터 cytosine-adenine repeat 유전자 다형성의 분석

문재훈,정우영 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.3

Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature. 목 적 : 특발성 저신장증 환자에서 IGF-I 유전자 다형성의 역할에 대한 연구는 아직 보고되지 않았다. 저자들은 한국인 특발성 저신장증 환자를 대상으로 IGF-I 프로모터 CA repeat 유전자 다형성에 대한 분석을 실시하였다. 방 법 : 신장 계측에 의해 2007년에 제작된 한국 소아 발육 표준 신장표에 의거하여 나이와 성별에 따른 신장백분위수가 3백분위수 미만인 131명을 대상으로 하였다. 성장호르몬 치료의 분석은 최소한 6개월 이상 성장호르몬 치료를 받은 37명을 대상으로 실시하였다. 유전자형의 분석은 유전자 염기서열분석을 통하여 실시하였다. CA repeat 횟수에 따른 대립유전자의 분포를 조사하였고, 이를 바탕으로 유전자형을 분석하였다. CA repeat의 heterozygous의 분석은 Gene Mapper software를 이용하였다. 혈청 IGF-I 농도는 RIA방법으로 측정하였다. 결 과 : 국인 특발성 저신장증 환자에서의 CA repeat의 분포는 15부터 22까지였으며, 19 repeat가 40.6%의 빈도로 가장 높았다. 유전자형에 따른 분포는 131명 중 17명(13.0%)이 19 CA repeat homozygous 였으며, 74명(56.5%)은 heterozygous, 40명(30.5%)은 19 CA repeat noncarrier 였다. 유전자형에 따른 키, 체중, BMI는 세군 모두에서 유의한 차이가 없었다. 유전자형에 따른 혈청 IGF-I 농도는 19 CA repeat noncarrier군에서 435.67±160.29 ng/mL로, 19 CA homozygous 군에서의 435.60±131.51 ng/mL, 19 CA heterozygous 군에서의 473.76±185.01 ng/mL과 유의한 차이가 없었다. 나이와 혈청 IGF-I 농도와의 상관관계를 분석한 결과 세군 모두에서 유의한 양의 상관관계를 보였다(P<0.01). 유전자형에 따른 첫 1년 동안의 성장호르몬 치료 효과를 분석한 결과 성장호르몬 치료 후 12개월로 환산한 성장속도는 19 CA homozygote군에서 7.6±3.4 Cm, 19 CA heterozygote군에서 7.9±2.6 cm 그리고 19 CA noncarrier군에서 7.7±2.8 cm로 세군 사이에 유의한 차이가 없었다(P>0.05). 성장호르몬 치료 전후의 신장표준편차점수 차이도 19 CA homozygote군에서 0.6±0.2, 19 CA heterozygote군에서 0.5±0.4 그리고 19 CA noncarrier군에서 0.5±0.4로 세군 사이에 유의한 차이가 없었다(P>0.05). 결 론 : 특발성 저신장증 환자에서의 IGF-I 프로모터 CA repeat 유전자 다형성의 분포는 15부터 22까지였으며, 19 repeat가 40.6%의 빈도로 가장 높았다. 키, 체중, BMI 그리고 혈중 IGF-I농도는 유전자형에 따라 유의한 차이가 없었다. 유전자형에 관계없이 나이와 혈중 IGF-I 농도 사이에는 모든 군에서 유의한 양의 상관관계를 나타내었다. 유전자형에 따른 첫 1년간의 성장호르몬 치료 효과도 유전자형에 따라 유의한 차이가 없었다. 그러므로 특발성 저신장증 환자에서는 IGF-I 유전자 다형성은 기능적 역할을 하지 못한다고 생각한다.

A Case of Hypervascular Hyperplastic Nodules in a Patient with Alcoholic Liver Cirrhosis

문재훈,안철민,정현수,안상훈,박영년 연세대학교의과대학 2006 Yonsei medical journal Vol.47 No.6

Most hypervascular nodules in a cirrhotic liver are hepatocellular carcinomas (HCCs); however, some are benign hypervascular hyperplastic nodules. We report a case of benign hypervascular hyperplastic nodules in a 41-year-old male patient without hepatitis B or C virus infection, with a history of alcohol abuse, and diagnosed with an aortic aneurysm. The dynamic computerized tomography of the liver demonstrated multiple nodular lesions on both liver lobes with arterial enhancement and delayed washout. The hepatic angiography showed multiple faint nodular staining of both lobes in the early arterial phase. Magnetic resonance imaging revealed numerous nodules showing high signals on T1 weighted images, with some nodules showing a low central signal portion. The clinical impression was HCC. The ultrasonography-guided liver biopsy, which was performed on the largest nodule (2.5 cm in size), revealed hepatocellular nodules with slightly increased cellularity, unpaired arteries, increased sinusoidal capillarization, and focal iron deposition. However, both cellular and cytological atypia were unremarkable. Although the clinical impression was HCC, the pathological diagnosis was hypervascular hyperplastic nodules in alcoholic cirrhosis. Differential diagnosis of hypervascular nodules in cirrhosis and HCC is difficult with imaging studies; thus, histological confirmation is mandatory.

Corrigendum: Author's Name Correction. Study Protocol of Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro)

문재훈,김지훈,이은경,이규은,공성혜,김여군,정우진,이창윤,유노을,황보율,송영신,김민주,조선욱,김수진,정은재,최준영,류창환,이유진,하정훈,정유석,류준선,황윤지,Sue K. Park,성호경,이가희,박도준,박영주 대한내분비학회 2018 Endocrinology and metabolism Vol.33 No.3

저위험 미세갑상선유두암의 진단과 치료

문재훈,박영주 대한의사협회 2018 대한의사협회지 Vol.61 No.4

Recent guidelines for the treatment of thyroid nodules and differentiated thyroid cancer include active surveillance as an alternative option for the treatment of low-risk papillary thyroid microcarcinoma (PTMC). PTMC is defined as having a tumor diameter of ≤1 cm, and low-risk PTMC is defined as PTMC without currently known risk factors (e.g., metastases, local invasion, or cytologic evidence of aggressive disease). Some researchers have suggested that active surveillance can be the first-line treatment of low risk PTMC based on reports showing that the oncological outcomes of active surveillance and immediate surgery were similarly excellent and that immediate surgery can occasionally be accompanied by surgical complications. Nonetheless, many concerns still exist about the full implementation of active surveillance in current clinical practice because the biology of PTMC still has not been fully elucidated and there is little evidence regarding the long-term prognosis of active surveillance. In this review, we discuss the current concept of low-risk PTMC and its treatment modalities, comparing immediate surgery and active surveillance in terms of clinical applications, prognosis, adverse effects, quality of life, and medical costs. This review aims to enable healthcare providers to provide patients with well-balanced information about immediate surgery and active surveillance for the treatment of low-risk PTMC.