갑상선 결절의 진단과 치료

안일민 대한외과학회 1998 대한외과학회 학술대회 초록집 Vol.1998 No.11

갑상선 결절의 진단

안일민 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.4

한국정상인에서 혈청내 Glucose , Glucagon , Insulin 및 C-peptide 의 일중변동에 관한 연구

이홍규,안일민,이명식,홍기석,이명철,이문호 대한핵의학회 1982 핵의학 분자영상 Vol.16 No.1

간동정맥루에서 99mTc-macroaggregated albumin 검사의 의의

김동순,안일민 대한핵의학회 1985 핵의학 분자영상 Vol.19 No.2

The radioisotop study using 99mTc-macroaggregated Albumin is a simple, non-invasive test for the diagnosis of pulmonary arteriovenous fistula(PAVF). It can show the presence . of the right-to-left shant at the lung level using the dynamic study, and also the shunt fraction can be estimated. Here we presented the results of the radioisotope study on two patients with PAVF. In one patient, the cardiac catheterization was done and calculated shunt fractions by both method were well matched.

알레르기 질환 치료의 전망

강석영,안일민 주식회사 녹십자 1982 녹십자의보 Vol.10 No.3

99mTc-MDP 골주사의 골격외 섭취에 관한 연구

임상무,이영열,안일민,최성재,조보연,고창순 대한핵의학회 1981 핵의학 분자영상 Vol.15 No.1

^131I 전신스캔 음성 재발 분화 갑상선암에서 FDG PET 의 임상적 의의 : ^99mTc-MIBI Scintigraphy 와 비교분석 A Comparative Analysis With ^99mTc-MIBI Scintigraphy

김하영,원종철,안일민,이태윤,이시열,류진숙,이성진,남궁일성,문대혁,한정희 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4

Background: In patients with differentiated thyroid cancer treated by surgery and radioactive iodine ablation, serum thyroglobulin (Tg) and ^131I whole body scan (WBS) are recognized as being the best cooperative indicators for detection of recurrence or metastasis. However, in some cases, ^131I WBS shows no specific lesions despite elevated serum Tg. Therefore, 18-Fluorine-fluorodeoxyglucose (FDG) positron emission tomography (PET) has emerged as a useful method for the detection of ^131I WBS negative thyroid cancers. The aims of the present study are to evaluate the clinical usefulness of this technique in detection and to compare the results with ^99mTc-MIBI scintigraphy (MIBI) in cases of final results being confirmed by histologic diagnosis and other imaging methods. Methods: We conducted a retrospective analysis amon ^131I WBS negative recurred papillary thyroid carcinoma patients (male: female ratio=9:22, median age=42 yr). FDG PET was performed in 28 patients and MIBI 28 patients, 25 of whom were common to both groups. All patients had histologically proven recurrence/metastasis and negative ^131I WBS results but persistently elevated serum Tg levels. In each case overall clinical evaluations were performed including histology, cytology, thyroglobulin level, other imaging methods, posttherapy ^131I WBS and subsequent clinical course, to allow comparison with the results of FDG PET. Results: In 19 cases of patients with negative ^131I WBS, proven recurrence/metastasis lesions were detected in FDG PET. Compared with MIBI, FDG PET was found to be superior in 8 cases (including 2 patients with distant metastases). No FDG-negative/MIBI-positive tumor was observed. One FDG PET negative and MIBI negative case was proven 3 months later to be metastatic cervical lymph nodes, Sensitivities were 94.7% in the FDG PET group and 52.6% in MIBI. Diagnostic accuracy of FDG PET was superior to that of MIBI (93% vs. 62%, respectively, p=0.003). Conclusion: Our results confirmed the clinical usefulness of FDG PET for detection of ^131I negative differentiated thyroid cancers and suggested the value of FDG PET as an initial diagnostic step, rather than MIBI, in these cases

갑상선기능항진증 환자에서 병발한 심실세동 1예

김영일,이은주,안일민,이미헌,송영기,김유호 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.3

The cardiovascular manifestations in hyperthyroidism are sinus tachycardia, paroxysmal supraventricular tachycardia, atrial flutter, atrial fibrillation, atrioventricular block, bundle branch block(especially right bundle branch block), angina pectoris, heart failure and cardiomyopathy. Of these, angina pectoris is commonly seen in hyperthyroidism with coronary artery disease and the potential mechanisms have been attributed to the increased metabolic demand and consequently increased cardiac work which result in the more demand of coronary blood flow than that can be delivered via a fixed atherosclerotic coronary artery stenosis. Hyperthyroidism associated anginas without underlying coronary artery stenosis have also been reported where the mechanism of these was suspected to be the coronary vasospasm. Ventricular fibrillation may occur in the thyrotoxic patients due to myocardial ischemia such as variant angina, but it is very rare in the condition without previous heart disease. A 30-year-old male was admitted to the hospital because of palpitation, weight loss and proptosis for the previous 3 months. There was no history of effort related chest pain, syncope, drug abuse or medical illnesses such as diabetes mellitus, hypertension. The laboratory results were, TSH: 0.38uU/mL(0.4~5,0 uU/mL), free T4: 8.9ng/dL(0.8~1.9ng/dL), TSH receptor antibody: 43.6%(-15~15%), antiTPO antibody: 5000 IU/mL(0~100 IU/mL). The initial EKG showed normal sinus rhythm. He was diagnosed as Graves disease with ophthalmopathy, class 3a and was put on propylthiouracil 200 mg po tid, propanolol 40 mg po tid and started solumedrol pulse therapy for the exophthalmos on the first day of admission. He was found to have generalized tonic seizure with apnea attack on second hospital day and twice thereafter. Ventricular fibrillation was documented at that time. DC cardioversion was performed with successful response. After the attack, he was treated as accelerated hyperthyroidism namely with increased dosage of propylthiouracil, dexamethasone and Lugols solution, The echocardiogram, treadmill test, ergonovine echocardiography, coronary angiography and electrophysiologic study disclosed no abnormalities. Further episodes of ventricular fibrillation didnt occur after being euthyroid state. In conclusion, we report a case of ventricular fibrillation associated with hyperthyroidism itself without underlying coronary artery disease with brief review of literatures(J Kor Soc Endocrinol 13:459-465, 1998).

담낭염 환자에서의 99m Tc-HIDA Scan 의 진단적 의의

조보연,박난재,안일민,장연복,홍기석,윤용범,고창순 대한핵의학회 1981 핵의학 분자영상 Vol.15 No.2

Cholescintigraphic studies with Tc-99m-HIDA(dimethyl iminodiacetic acid) were performed in 22 cases of normal subjects, 21 of acute cholecystitis, 22 of chronic cholecystitis and 12 others, with the results of, 1) In normal control group, liver and intrahepatic biliary tree, CBD and gall bladder, and G-I tract appeared at 10, 20 and 30 minutes after intravenous injection of Tc-99m-HIDA respectively. 2) In acute cholecystitis, 20 among 21 cases showed non-visualization of gall bladder with the diagnostic accuracy, sensitivity and specificity of 98.290, 95.290 and 100% respectively. 3) In chronic cholecystitis, 5 among 12 cases showed non-visualization of gall bladder and remained 7 among 12 cases showed poor contraction of gall bladder (4), delayed visualization of gall bladder(l) and normal findings(2). 4) In the other disease group, the 12 cases which initially suspected as acute cholecystitis, revealed normal scan findings to exclude the cystic duct obstruction easily. With the above results, this scintigraphic procedure was found very rapid, accurate and easily available method for the determining of the cystic duct patency.

한국인의 분화 갑상선 종양에서 Gsa, ras, p53 돌연변이와 ret/PTC 재배열의 빈도

김영일,이은주,안일민,공경엽,박기영,박현주,홍석준 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.2

Background: In thyroid tumor, ras, Gsa, p53 mutation and ret/FfC rearrangement have been reported with variable prevalences in different geographic regions. We studied the prevalences of these mutations and reammgement in thyroid tumors of Korean population. Methods: Eleven cases of adenamatous goiter, 8 cases of follicular adenoma, 5 cases of foliicular carcinoma, 37 cases of papillary carcinoma were included in this study. To find mutations and rearrangement, RT-PCR, SSCP, and/or direct sequencing, after subcloning if necessary, were used. Results: We could not find any rearrangment for ret/PTC-l, -2, -3 and mutations of Gsa. For ras oncogene, K and H-ras mutations were not found, but N-ras mutations, point mutation of CAA to CGA in codon 61, were detected in 1 follicular adenoma(12.5%, 1/8) and 1 follicular carcinoma(33%, 1/3). And p53 mutations were detected only in 1 case of papillary carcinoma (3%, 1/31: exon 8, codon 266 GGA-GAA). Conclusion: ret/PTC rearrangement, Gsa, ras and p53 mutations are relatively rare in differentiated thyroid neoplasms of Korean population, which may reflect the genetic and environmental differences from those countries with high prevalence (J Kor Soc Endocrinol 13:189-197, 1998).