분화된 갑상선암 환자에서 수술 후 재발과 원격전이를 예측하는 혈청 갑상선글로불린치

김경수,류진숙,홍석준,김원배,송영기 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.2

연구배경 분화된 갑상선암의 재발이나 원격전이를 시사하는 혈청 갑상선글로불린치는 보고자들마다 차이가 있고, receive operating characteristics (ROC) 곡선을 이용해서 cut-off value을 구한 경우는 별로 없다. 또한 수술 후 방사성요오드 치료 직전 (Tg-RAI), T₄투여 도중(Tg-on) 및 T₄ 중단 후(Tg-off)에 측정한 갑상선글로불린의 임상적 의의에 대해서도 아직 이견이 있다. 더구나 임상에서 측정된 혈청 갑상선글로불린치의 의미를 해석할 때 보다 큰 의미를 가지는 양성 예측치와 음성 예측치를 조사한 보고는 거의 없다. 방법: 갑상선 유두암 또는 여포암으로 진단되어 갑상선 전절제술 및 고용량 방사성요오드 치료를 시행 받은 후 갑상선 자리에 잔여병소 없이 추적관찰이 이루어지고 있는 242명의 환자들 중, 항갑상선글로불린항체가 음성인 205명의 환자를 대상으로 후향적으로조사하였다. 평균 추I:기간은 5년이었다. Tg-off는 저요오드식이를 2주 이상 시행한 후 ^(131)I-전신스캔과 함께 측정되었으며, 내인성 TSH의 농도가 30 μU/mL 이상으로 상승했을 때 의미 있는 것으로 판정하였다. 재발은 경부 림프절을 포함하여 경부에 새로운 병소가 생겼을 때로, 원격전이는 종격동 림프절을 포함하여 경부 이외의 장기에 병소가 생겼을 때로 정의하였곤, 재발이나 원격전이는 각종 영상학적 또는 병리학적 검사에서 이상소견이 발견되는 경우 있는 것으로 판단하였다. 민감도와 특이도가 가장 높은 Tg의 cut-off value를 구하기 위해 ROC 곡선을 이용하였고, cut-off value에 따른 양성 예측치와 음성 예측치를 구하기 위해 2×2표를 이용하였다. 결과: 재발은 50명 (24.4%)의 환자에서 발생하였고, 원격전이는 17명(8.3%)의 환자에서 발생하였다. 재발이나 원격전이 중 어느 한 가지라도 있는 환자는 52명(25.4%)이었다. ROC 곡선 아래부분의 면적을 통해 알아본 Tg-RAI, Tg-on, Tg-off 검사의 정확도는 서로 비슷하게 높았다. 재발에 대한 혈청 갑상선글로불린치의 cut-off value는 Tg-RAl가 11.8, Tg-on이 1.4,Tg-off가 3.3ng/mL였다. 이때의 민감도는 각각 85.4,82.2, 93.3%였고, 특이도는 각각 89.2, 92.4, 88.0%였으며, 양성 예측치는 각각 71.9, 77.1, 70.0%였고, 음성 예측치는 95.0, 94.4, 97.8%였다. 원격전이에 대한혈청 갑상선글로불린치의 cut-off value는 Tg-RAl가27.4, Tg-on이 2.5, Tg-off가 7.9 ng/mL였다. 이때의민감도는 각각 86.7, 87.5, 92.3%였고, 특이도는 각각86.2, 90.8, 80.2%였으며, 양성 예측치는 각각 34.2,46.7, 25.0%였고, 음성 예측치는 각각 98.7, 98.8,99.3% 였다. 결론: 혈청 갑상선글로불린치는 분화된 갑상선암의 재발이나 원격전이를 예측하는 데 있어 민감도와 특이도가 비교적 높은 검사이나, 음성 예측치가 높은 것에 비해 양성 예측치가 낮은 단점이 있었다. 또한 Tg-on은 Tg-off에 비해 양성 예측치는 높았으나, 음성 예측치는 낮게 나타났다. 따라서 Tg-on이 cut-off value보다 높게 측정되는 경우에는 반드시 전신스캔 등 재발이나 원격전이 여부에 대한 추가적인 검사를 시행하고, Tg-on이 cut-off value보다 낮게 측정되더라도 가능하면 선별검사로서 Tg-off나 recombinant human TSH 자극 후의 혈청 갑상선글로불린치를 주기적으로 측정해야 할 것으로 사료된다. Background: Reports on serum thyroglobulin(Tg) levels being used to predict recurrence or distant metastasis during the follow-up of patients with differentiated thyrod cancer(DTC) has been inconsistent. In addition, there have been few reports that attempt to define the cut-off value of Tg for recurrence or distant metastasis obtained by a receiver operating characteristic (ROC) curve. As well, there are differences in opinions on what the value should be on the first serum Tg level measured just before radioactive iodine(RAI) ablation(Tg-RAI), during thyroxine administration (Tg-on), and after thyroxine withdrawal (Tg-off) during the follow-up. Reports on the positive predictive values(PPVs) and negative predictive values(NPYs) of these Tg values are rare. Methods: A total of 205 patients (42 males, 163 females) with DTC were studied. All patients had undergone total or near-total thyroidectomy. After surgery and RAI ablation, annual thyroxine withdrawal 131I-whole body scan (WBS) with Tg measurements was performed. The mean duration of follow-up was 5.0 (1.4~7.4) years. The most sensitive and specific Tg values)cut-off values) for tumor recurrence and/or distant metastasis were selected by using ROC curves. We also calculated the PPVs and NPVs for rcurrence and/or distant metastasis using two-by-two tables. Results: Cut-off values of Tg-RAI, Tg-on, and Tg-off for recurrence were 11.8, 1.4, and 3.3 ng/mL, respectively. For these values, the sensitivities were 85.4, 82.2, and 93.3%, with the specificities at 89.2, 92.4, and 88.0%. PPVs were 71.9, 77.1, and 77.0% while NPVs were 95.0, 94,4, and 97.8%. The cut-off values for distant metastasis were 27.4, 2.5, and 7.9ng/mL, respectively. For these cut-off values, the sensitivities were 86.7, 87.5, and 92.3%, with the specificities being 86.2, 90.8, and 80.2%. PPVs were 34.2, 46.7, and 25.0% and NPVs were 98.7, 98.8, and 99.3%. Conclusion: All three serum Tg levels were sensitive and specific markers for recurrence and distant metastasis. Their PPVs were low in contrast to the high NPVs. In comparison with Tg-on, Tg-off showed higher sensitivity and NPV as well as lower specificity and PPV. Therefore, in the case of higher Tg-on during the follow-up period, efforts to find recurrence and distant metastasis,such as 131I-WBS, should be done. In addition, regular measurement of Tg-off or Tg after stimulation with recombinant human TSH is recommended as a screening test (J Kor SOC Endocrinol 18:153-165, 2003).

고등학생의 성 관련 특성, 성 지식에 관한 기초 조사

김혜원,김남순,윤태호,김종숙,홍경자 관동대학교 의과대학 의과학연구소 2005 關東醫大學術誌 Vol.9 No.1

Purpose : This preliminary study was done to identify sex related characteristics and sex knowledge of high school students. Methods : 622 high school students participated in the survey living in Gangreung city area. The data collection was done from May 1st to October 31st, 2000 using the self administered questionnaires. Results : The teachers and the peer students had a critical position in high school sex education. Reproductive physiology such as relations with the opposite sex, AIDS, STI, and contraceptions should be intensified in further sex education for high school students. There were sex differences in contraception and permission with sex relationship. And the false belief regarding sex assaults and knowledge deficit in AIDS were discovered. Conclusion : Sex education program development and application are necessary based on the educational needs and attitude evaluation for the sexual health improvement of high school students. In further study, developing the reliable measurement tool and various educational methodologies will be studied which are enough for the include the sex education concepts.

增損五積丸(碑積方)이 사람의 各種 癌細胞株의 成長沮碍에 미치는 效果

李竝求,元秦喜,文錫哉,金東雄,元京淑,文九 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

chemosensitivity test of Geungsonojukwhan-Bijukbang was performed on the three different human cancer cell lines originated from liver, cervix and colon tissue, namely Hep 3B, Hela and HCT-15, which have similar doubling times. Semiautomated sulforhodamine B(SRB) assay appears to offer an valuable tool for chemosensitivity of unknown compounds, since it is a simple, valid and inexpensive method of assessing drug monitoring for large samples in a short time. The results obtained in this study were as follows 1. Good correlations were shown from the results of SRB assay and those of clogenetic assay. 2. As a result of exposure to Geungsonojukwhan, the proliferation of Hela cell and Hep 3B cell was slightly decreased in Geungsonojukwhan-Bijukbang(GIP), Geungsonojukwhan-Pejukbang(LUP) and Geungsonojukwhan-Sinjukbang(RTP). 3. As a result of exposure to Geungsonojukwhan, GIP showed better anticancer effect to HCT-15 cell lines than those of LUP and RTP. 4. The extract of Geungsonojukwhan-Bijukbang in 40℃ were more effective in cytotoxic response than those in 100℃. 5. The research showed that the higher concentration the more effective in the inhibition of proliferation of the cancer cell lines, however, the cytotoxic effect of Geungsonojukwhan-Bijukbang in the concentration of 1.60mg/㎖ and 3.20mg/㎖ showed the most effective inhibition rate according to the increase of concentration.

성남시 지역주민의 정신질환에 대한 태도 연구

고영,신수경,황태연,이충순,박연수,김인숙,황은숙,정원재 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.1

일부 부인과 양성 질환자의 지방조직 및 혈청의 PCBs와 DDE 농도

박성균,이강숙,노영만,구정완,민선영,한진구,고원경,김미란,정재근,이종승,김진홍 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 본 연구는 지방조직과 혈청의 PCBs와 DDE 농도를 측정하고, 이에 영향을 미치는 것으로 알려진 요인들과의 관련성을 평가하고자 하였다. 방법 : 유방암, 자궁내막증 등 유기염소계 화합물의 영향이 있는 것으로 알려진 호르몬 관련 질병을 제외한 부인과 환자 52명을 대상으로 지방조직과 혈청을 분석하였으며, 설문조사를 통하여 연령, 교육수준, 직업, 비만도, 흡연과 음주, 출산력, 수유력등을 조사하였다. 지방조직과 혈청의 PCBs와 DDE 농도는 가스크로마토그래피를 사용하여 측정하였다. 결과 : 지방조직의 경우, 13개 PCBs congeners 농도의 합은 중앙값이 48.29 ng/g, 기하평균값이 56.78 ng/g이었고, DDE 농도는 중앙값이 142.89ng/g, 기하평균값이 117.06 ng/g이었으며, 혈청의 경우는 PCBs congeners 농도의 합은 중앙값이 4.67 ㎍/L, 기하평균값이 4.85 ㎍/L이었고, DDE 농도는 중앙값이 1.75 ㎍/L, 기하평균값이 2.09 ㎍/L로 나타났다. 지방조직과 혈청의 DDE 농도 사이는 높은 상관성을 보였으나(r²=0.310, p=0,0002), PCBs는 상관성이 약한 것으로 나타났다(r²=0.029, p=0.2582). 영향요인을 범주화한 후 로그변환 시킨 지방조직과 혈청의 PCBs, DDE 평균의 차이를 분석한 결과, 지방조직의 DDE만이 출산자녀수(p=0.015), 초산연령 (p=0.014), 비만지수(p=0.035)와 연관성이 발견되었다 다중회귀분석의 결과 지방조직의 DDE는 출산자녀수가 적을수록, 초산연령이 늦을수록 증가하는 경향을 보였다. 결론 : 출산자녀수와 초산연령, 비만도가 지방조직의 DDE와 관련성을 보였으며, 또한 유기염소계 화합물의 장기간의 노출에 의한 영향을 평가하는데 있어서 혈청보다 지방조직이 더 유용한 생물지표임을 알 수 있었다. Objectives : This study was purposed to determine the levels of PCBs and DDE in adipose tissue and serum and to evaluate the relations with factors affecting these levels. Methods : We analyzed adipose tissues and sera from 52 gynecologic benign disease patients aged 27-78 years, except hormonal diseases such as breast cancer and endometriosis. We also surveyed age, education, occupation, body mass index (BMI), smoking, drinking, number of children, and duration of breastfeeding by questionnaires. Tissue and serum levels of PCBs and DDE were measured using gas chromatography. Results : The median and geometric mean levels of PCBs were 48.29 ng/g, 56.78 ng/g for adipose tissue and 4.67 ㎍/L, 4.85 ㎍/L for serum, and those of DDE were 142.89 ng/g, 117.06 ng/g for adipose tissue and 1.75 ㎍/L, 2.09 ㎍/L for serum, respectively. Adipose tissue and serum levels for DDE showed high correlation (r²=0.310, p=0.0002), but those of PCBs didn't (r²=0.029, p=0.2582). In analyses of the differences of the means of log transformed adipose tissue and serum PCBs and DDE levels for groups of potential covariates, only adipose tissue DDE levels were significantly associated with number of children (p=0.015), age at first birth (p=0.074) and BMI (p=0.035). In multiple regression analysis, adipose tissue DDE levels were significantly increased with decreasing number of children and increasing age at first birth. Conclusions : This study suggested that parity and adiposity were associated with levels of DDE in adipose tissue, and adipose tissue is a better biomarker than serum for evaluating the long-term exposure of organochlorines.

관상동맥 스텐트 내 재협착의 발생에 미치는 임상적 관동맥 조영술적 요인들

윤혁준,김기식,박형섭,이영수,현대우,한성욱,허승호,김윤년,김권배,박남희,원경숙 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.12

SPM Analysis of Brain Perfusion SPECT and F-18 FDG PET in the Korean Autosomal Dominant Nocturnal Frontal Lobe Epilepsy Family

( Kyoung Sook Won ),( Seok Kil Zeon ) 대한핵의학회 2004 핵의학 분자영상 Vol.38 No.5

Gene Analysis of Y chromosome in Humans and Apes

Kyoung-Won Hong,Jae-Won Huh,Myung-Sook Kim,Tae-Hyung Kim,Joo-Mi Yi,Osamu Takenaka,Won-Ho Lee,Heui-Soo Kim 한국생명과학회 2002 한국생명과학회 심포지움 Vol.37 No.-

Clinical correlation of metabolic parameters on ¹⁸ F-FDG PET/CT in idiopathic frozen shoulder

Won, Kyoung Sook,Kim, Du Hwan,Sung, Duk Hyun,Song, Bong-Il,Kim, Hae Won,Song, Kwang-Soon,Lee, Si-Wook,Cho, Chul-Hyun Springer Japan 2017 Annals of nuclear medicine Vol.31 No.3

<P><B>Objective</B></P><P>Because positron emission tomography/computed tomography (PET/CT) using fluorine-18-fluorodeoxyglucose (<SUP>18</SUP>F-FDG) can be used to visualize inflammation of the musculoskeletal system, it may help elucidate the pathophysiology of frozen shoulder (FS). The purpose of this study was to characterize the uptake pattern on <SUP>18</SUP>F-FDG PET/CT in patients with idiopathic FS and to determine if there is a correlation between its metabolic parameters and clinical findings.</P><P><B>Methods</B></P><P><SUP>18</SUP>F-FDG PET/CT was conducted to 35 patients with unilateral idiopathic FS. Clinical data including pain, functional scores, and passive range of motion (ROM) were collected. Maximum standardized uptake values (SUVmax) were measured at the four regions of interest (ROIs): rotator interval (RI), anterior joint capsule (AJC), axillary recess (AR), and posterior joint capsule (PJC) from the attenuation-corrected axial images.</P><P><B>Results</B></P><P>Mean SUVmax values for four ROIs of the affected shoulder were significantly higher than those of the unaffected shoulder. Mean SUVmax values of RI and AR were significantly higher than those of AJC and PJC and mean SUVmax of AJC was significantly higher than that of PJC in the affected side. Three recognizable patterns of increased uptake were noted: (1) AR dominant type (15 patients); (2) RI dominant type (9 patients); (3) both RI and AR dominant type (11 patients). The SUVmax of AR showed negative correlation with abduction and forward flexion. The SUVmax of RI showed negative correlation with external rotation and internal rotation. The SUVmax of AJC showed negative correlation with all ROMs. However, there was no significant correlation between the SUVmax of PJC and any ROM.</P><P><B>Conclusion</B></P><P>Our study demonstrates that the anterior–inferior capsular portion, including RI and AR, is the main pathologic site of idiopathic FS and reveals significant correlations between ROM and metabolic parameters on <SUP>18</SUP>F-FDG PET/CT. These results imply that AR and RI lesions are related to elevational limitations and rotational limitations, respectively.</P>

Prevalence of Trichomonas vaginalis in Women Visiting 2 Obstetrics and Gynecology Clinics in Daegu, South Korea

Youn-Kyoung Goo,Won-Sik Shin,Hye-Won Yang,So-Young Joo,Su-Min Song,Jae-Sook Ryu,Won-Myung Lee,Hyun-Hee Kong,Won-Ki Lee,Sang-Eun Lee,Won-Ja Lee,Dong-Il Chung,Yeonchul Hong 대한기생충학열대의학회 2016 The Korean Journal of Parasitology Vol.54 No.1

This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.