Tc-99m Sestamibi Scintigraphy를 이용한 부갑상선과 갑상선 결절의 감별진단

서승원<SUP>1<,SUP>,주재균<SUP>1<,SUP>,윤정한<SUP>1<,SUP>,제갈영종<SUP>1<,SUP>,범희승<SUP>2<,SUP>,Seung Won Seo,M,D,<SUP>1<,SUP>,Jae Kyun Joo,M,D,<SUP>1<,SUP>,Jung Han Yoon,M,D,<SUP>1<,SUP>,Young Jong Jaegal,M,D,<SUP> 대한갑상선-내분비외과학회 2002 The Koreran journal of Endocrine Surgery Vol.2 No.1

Purpose: Differentiation of parathyroid and thyroid nodule is often difficult even with aids of ultrasonography and computed tomography. Tc-9m sestamibi (MIBI) scintigraphy is useful in the detection of hyperfuntioning parathyroid nodules. However, its role in the differentiation between parathyroid and thyroid nodules including malignancies is not well studied. Therefore, the purpose of this study is to evlauate the role of Tc-99m MIBI imaing in the differentiation of parathyroid adenoma from thyroid malignancy. Methods: Six patients (4 women, 2 men, mean age 43 years) with parathyroid adenoma and 4 patients (2 women, 2 men, mean age 56 years) with thyroid papillary cancer were enrolled. Ten and 180 minutes after injection of 740 MBq Tc-99m MIBI, pinhole image of the anterior neck was obtained. Nodule-to-thyroid ratio (N:T) was measured from same sized region of interests over nodule and normal thyroid bed. Retention Index (RI) was calculated as N:T 10 minus N:T 180 divided by N:T 10. Results: Patients with parathyroid adenoma showed similar N:T 10 as those with thyroid cancer (1.09 ⁢/⁣ 0.35, 1.24⁢/⁣ 0.36, respectively, P>0.05 ). However, RI of parathyroid patients was higher than thyroid cancer patients (0.64 ⁢/⁣ 0.29, ⁣0.12⁢/⁣ 0.20, respectively, P<0.05). Conclusion: Parathyroid adenoma showed higher retention rate of Tc-99m MIBI than thyroid cancer. Therefore, differntiation of parathyroid and thyroid nodule could be possible using Tc-99m MIBI scintigraphy. (Korean J Endocrine Surg 2002;2:15-18)

갑상선 결절에 동반된 퇴행성 낭종의 재발과 낭액내 VEGF의 관련성

조은호,박희붕,김현만<SUP>1<.SUP>,이관우<SUP>1<.SUP>,정윤석<SUP>1<.SUP>,소의영,Eun Ho Cho,M.D.,Hee Boong Park,K.D.,Hyun Man Kim,M.D.<SUP>1<.SUP>,Kwan Woo Lee,M.D.<SUP>1<.SUP>,Yun Suk Jung,M.D.<SUP>1<.SUP> and Euy Young 대한갑상선-내분비외과학회 2002 The Koreran journal of Endocrine Surgery Vol.2 No.1

Purpose: VEGF, a potent angiogenic factor, increases vascular permeability and induces the fluid accumulation in the peritoneal and pleural cavities. This study is designed to know whether the VEGF concentration are associated with the formation of cystic fluid of thyroid nodules and the results of treatment. Methods: To know whether thyroid follicular cells produce VEGF, we measured the VEGF concentration in the conditioned medium after primary culture of the normal thyroid follicular cells (NT 1.0). Thirty seven patients, who had visited Ajou University Medical Center, were divided into two groups; group A (n=19) is patients whose cystic nodules disappeared completely with 1 or 2 times fine needle aspirations. In Group B (n=18), the cystic nodules recurred rapidly and required aspiration more than 3 times. Clinical records of patients were analyzed and compared with TSH and VEGF levels in cystic fluids. Results: The VEGF concentration in basal conditioned medium were 8.2⁑1.2 ng/ml in NT 1.0 and 8.2⁑0.6 ng/ml in thyroid cancer cell line (FTC-133). NT 1.0 was not affected by TSH stimulation. Mean concentration of TSH of all cystic fluids was 4.36μIU/ml (0.13∼21.7) and there was no difference between 2 groups. Mean concentration of VEGF of all cystic fluids was 140.7 ng/ml (11.1∼688.8). The VEGF concentration (287.9⁑289.6 ng/ml) in group B was significantly higher than that (104.2⁑97.1 ng/ml) in group A (P<0.05). Conclusion: This study suggests that thyroid follicular cells produce and secrete VEGF, and VEGF is related with the accumulation of cystic fluid in degenerative cysts of thyroid. Cysts with high VEGF concentration promote rapid reaccumulation of the cystic fluid and possibly necessitate operation in selected patients. (Korean J Endocrine Surg 2002;2:25- 30)

수술 전 혈청 갑상선 자극 호르몬(TSH)수치와 갑상선 유두암과의 상관관계

송금종,한선욱,이진형<SUP>1<,SUP>,우희두<SUP>2<,SUP>,김성용,김재우<SUP>3<,SUP>,박래경<SUP>1<,SUP>,백무준,김창호,Geum Jong Song,M,D,Sun Wook Han,M,D,Jin-Hyung Lee,M,D,<SUP>1<,SUP>,Hee-Doo Woo,M,D,<SUP>2<,SUP>,Sung Yong Kim,M,D,Ph 대한갑상선-내분비외과학회 2012 The Koreran journal of Endocrine Surgery Vol.12 No.3

Purpose: Recent research has shown that there is a relationship between the level of preoperative serum TSH and a papillary thyroid carcinoma. Therefore, this study examined the correlation between the serum TSH and papillary thyroid carcinoma. Methods: The preoperative serum TSH level of papillary thyroid carcinoma and nodular hyperplasia of 418 patients from 2009 Jan. to 2011 Dec. was examined. The patients were divided into 3 groups, nodular hyperplasia, less than 1 cm micropapillary carcinoma and more than 1 cm papillary carcinoma, and their TSH levels were compared. Results: Nodular hyperplasia and total papillary carcinoma was found in 98 (23.0%) and 322 (77.0%) patients, respectively. After dividing the patients according to the size of the mass, there were 224 (53.6%) patients with a mass less than 1 cm in size and 98 (23.4%) patients with a mass more than 1 cm in size. The preoperative serum TSH level of the 3 groups showed a significant difference, which was 1.180±1.168 ՌIU/ml in the nodular hyperplasia group, 1.670±1.224 ՌIU/ml in the micropapillary carcinoma group and 2.279±2.837 ՌIU/ml in the papillary carcinoma group (P<0.001). On the other hand, there were no significant correlations between the preoperative serum TSH level and gender, age, metastasis to lymph node, number of masses and extrathyroidal extensions. Conclusion: The larger size of the papillary thyroid carcinoma, the higher the preoperative high serum TSH level. Therefore, the stimulation of TSH can affect the progression of papillary thyroid carcinoma but more study will be needed.

갑상선 자극호르몬이 갑상선암세포의 VEGF, 신생혈관 형성, 성장, 침윤 및 전이에 미치는 영향

소의영,박희붕,김혜진,김현만<SUP>1<,SUP>,Euy Young Soh,M,D,Hee Boong Park,M,D,Hye Jin Kim,M,D,and Hyun Man Kim,M,D,<SUP>1<,SUP> 대한갑상선-내분비외과학회 2001 The Koreran journal of Endocrine Surgery Vol.1 No.1

Purpose: Vascular endothelial growth factor (VEGF) is a vascular endothelial cell specific mitogen and a major regulator of angiogenesis. VEGF secretion is activated in some thyroid cancers and that VEGF secretion is stimulated by TSH. So we postulated that TSH may promote growth and invasion in some thyroid cancers by stimulating VEGF secretion and angiogenesis. Methods and Results: We investigated the TSH effect for the VEGF secretion, endothelial cell proliferation and invasion in vitro with the primary cultured normal thyroid cell (NT-1) and thyroid cancer cell line (TPC-1). And to evaluate the relationship between TSH and VEGF, angiogenesis and tumor growth in vivo, we xenografted human dermal matrix inoculated with thyroid cells into nude mice or directly injected subcutaneously. For the study, mice were made hypothyroid (Group 1) by antithyroid hormone p.o, hyperthyroid (Group 2) by L-thyroxine injection and euthyroid (Group 3). One week after the treatment, significant difference were noted in T3, T4 and TSH level between each group, but the VEGF level showed significant difference in group 1 only compared with group 2 and 3. NT-1 or TPC-1 were seeded in the upper chamber of Transwell and HUVEC were cultured in lower chamber, and added different concentration of TSH. NT-1 and TPC-1 secreted VEGF under basal condition, but the level were similar. TPC-1 cells secreted significantly more VEGF than NT-1 after TSH (1, 10, 100 mIU/dl) stimulation, which were also parallel with the concentration of TSH. In low concentration of TSH (0, 1 mIU/dl), there were no difference of HUVEC proliferation between NT-1 and TPC 1. In high concentration of TSH (10, 100 mIU/dl), however, TPC-1 enhanced HUVEC proliferation than NT-1 significantly (p<0.05). Similar findings were noted in thyroid cell invasion. Invasion was higher in TPC-1 than in NT-1 in high concentration of TSH (10, 100 mIU/dl). In vivo study using the dermal matrix showed that number of blood vessels ingrowth were higher in Group 1 (25/HPF) than Group 2 (16/HPF) or Group 3 (17/HPF). But there was no difference between Group 2 and Group 3. Level of TSH and VEGF were also increased significantly in Group 1 compared with in Group 2 and Group 3. The size of tumor did not showed significant difference between each group during observation. The tumor from Group 1 (6.2 gm) were larger compared with Group 2 (5.1 gm) or Group 3 (5.6 gm), but this difference was not significant statistically (p>0.05). The number of blood vessels in tumor were also more increased in Group 1 and were commonly located in the peripheral portion of tumor. Conclusion: We conclude that thyroid cancer cell line secrete the VEGF and TSH secretion is more enhanced by the stimulation of TSH. And increased VEGF promote the vascular endothelial cell proliferation, invasion and angiogenesis in thyroid cancer. (Korean J Endocrine Surg 2001; 1:51-60)

갑상선암의 내시경 갑상선 절제술에서 근전절제술 및 전절제술의 임상적 비교

유한모,김태원,배자성<SUP>1<,SUP>,조항주,김기환,안창혁,박우찬<SUP>2<,SUP>,이동호<SUP>3<,SUP>,김정수,Han Mo Yoo,M,D,Tae Won Kim,M,D,Ja Sung Bae,M,D,<SUP>1<,SUP>,Hang Joo Cho,M,D,Kee Hwan Kim,M,D,Chang Hyuk An,M,D,Woo Chan Park,M 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.4

Purpose: The aim of this study was to evaluate and compare the surgical outcomes of endoscopic total and near-total thyroidectomies in patients with thyroid cancer. Methods: Between February 2000 and January 2009, among 387 patients who underwent endoscopic thyroidectomy in our hospital, we evaluated 50 patients who underwent endoscopic total or near-total thyroidectomy. Thirty- five and 15 patients underwent endoscopic total thyroidectomy and near-total thyroidectomy, respectively. We analyzed the patients' clinicopathologic characteristics and post-operative complications between the two groups. Results: The mean size of tumors was 1.08 cm (range, 0.1∼3.5 cm) and the mean operative time was 192 minutes. Forty-nine tumors were papillary cancers and 1 tumor was a follicular cancer. Two patients in the endoscopic total thyroidectomy group underwent re-operation because of bleeding. In the near-total thyroidectomy group, one patient had transient hypocalcemia and one patient had temporary recurrent laryngeal nerve palsy. In the total thyroidectomy group, nine patients had transient hypocalcemia and one patient had temporary recurrent laryngeal nerve palsy. There was no statistical difference in the post-operative complicationrates between the two groups (P=0.254 for hypocalcemia and P=0.470 for injury to the recurrent laryngeal nerve). Conclusion: Based on our experience, endoscopic total thyroidectomy is a safe and feasible alternative to endoscopic near-total thyroidectomy. (Korean J Endocrine Surg 2009; 9:201-205)

후복막강경 부신절제술 41예

홍석경,홍성관<SUP>1<.SUP>,홍석준,Suk Kyung Hong,M.D.,Sung Kwan Hong,M.D.<SUP>1<.SUP> and Suk Joon Hong,M.D. 대한갑상선-내분비외과학회 2003 The Koreran journal of Endocrine Surgery Vol.3 No.2

Purpose: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. Methods: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1∼6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. Results: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21 cases. Conclusion: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience. (Korean J Endocrine Surg 2003;3:178-182)

OGLE-2011-BLG-0265Lb: A JOVIAN MICROLENSING PLANET ORBITING AN M DWARF

Skowron, J.,Shin, I.-G.,Udalski, A.,Han, C.,Sumi, T.,Shvartzvald, Y.,Gould, A.,Dominis Prester, D.,Street, R. A.,Jørgensen, U. G.,Bennett, D. P.,Bozza, V.,Szymań,ski, M. K.,Kubiak, M.,Pietrzy&#x1 IOP Publishing 2015 The Astrophysical journal Vol.804 No.1

<P>We report the discovery of a Jupiter-mass planet orbiting an M-dwarf star that gave rise to the microlensing event OGLE-2011-BLG-0265. Such a system is very rare among known planetary systems and thus the discovery is important for theoretical studies of planetary formation and evolution. High-cadence temporal coverage of the planetary signal, combined with extended observations throughout the event, allows us to accurately model the observed light curve. However, the final microlensing solution remains degenerate, yielding two possible configurations of the planet and the host star. In the case of the preferred solution, the mass of the planet is M-p = 0.9 +/- 0.3 M-J, and the planet is orbiting a star with a mass M = 0.22 +/- 0.06 M-circle dot. The second possible configuration (2 sigma away) consists of a planet with M-p = 0.6 +/- 0.3M(J) and host star with M = 0.14 +/- 0.06M(circle dot). The system is located in the Galactic disk 3-4 kpc toward the Galactic bulge. In both cases, with an orbit size of 1.5-2.0 AU, the planet is a 'cold Jupiter'-located well beyond the 'snow line' of the host star. Currently available data make the secure selection of the correct solution difficult, but there are prospects for lifting the degeneracy with additional follow-up observations in the future, when the lens and source star separate.</P>

이온선택(選擇) 전극법(電極法)과 염광광도법(炎光光度法)에서의 혈청내(血淸內) Na+K+ 농도(濃度)에 대(對)한 정상참고치설정(正常參考値設定)을 위(爲)한 시도(試圖)

정혜인 ( Hae In Jeong ),성일영 ( Il Young Sung ),이현숙 ( Hean Suk Lee ),김영희 ( Young Hee Kim ),유순임 ( Soon 1m Yu ),정악승 ( Nak Seung Chung ) 대한임상검사과학회 1984 대한임상검사과학회지(KJCLS) Vol.16 No.1

Using Corning 405 flame photometer and Corning 902 Na/K analyzer, we have studied on the normal range of Na+ and K+ level in serum by flame photometry and ion selective electrode analyzing method (1) Among the 265 healthy male and female employees, we measured mean, S.D. and obtained recalculated results with excluding those outside::t 3 S.D. The results are as follows; Na+(mEq/L), 405-Flame. 902-I.S.E. Normal range. (X±2 S.D.) 140.66+7.02 142.13+8.02 *N.R. : Normal Range. K+ (mEq/L), 405-Flame. 902-I.S.E. 4.06±0.74 4.12±0.80 Borderline (N.R.*~3 S.D.) N.R.~ ±10.53 N.R.~±12.03 N.R.~±1.11 N.R.~±12.03 (2) Also we tried to calculate the normal range applying Hoffmann`` s method based on the laboratory records of Seoul Paik Hospital during the period of Jan. 1982-Dec. 1982 by flame photometer and Jan. 1983-Dec. 1983 by ion selective electrode analyzer. It was 1, 970 cases (M: F=1. 25 : 1) for flame photometry and 2, 919 cases (M: F=1. 27 : 1) for ion selective electrode analyzing method. The range of 95% on the probability paper are as follows; Na+(mEq/L), 405-Flame. 902-I.S.E. 140.3±7.2 141.2±8.8 K+(mEq/L), 405-Flame, 902-I.S.E. 4.0+0.77 4.1+0.85 (3) After grouping of sex and age on the laboratory records, we measured mean, S.D. with exception of the groups that showed severely irregular pattern and recalculated same above (1) Na (mEq/L) (X±t2 S.D.) 405-Flame, 130.5-148.0 902-I.S.E 127.4-153.3 K (mEq/L) 405-Flame 3.5-5.5 902-I.S.E 2.6-5.4 These ranges are scattered broadly in comparison with above the results of (1), (2). Even though out-ranged groups were excluded from the statistical analysis, it is not suggested as proper method to calculate the mean value under applicated by normal distribution. The result, however, appeared significant for reference value for normal range in or out.patients.

갑상선암 수술 중 발생하는 의도하지 않은 부갑상선 절제의 임상적 의의

김영균,김정구,이동호,이혜경<SUP>1<.SUP>,유영경,안창준,Young Gyun Kim,M.D.,Jeong Gu Kim,M.D.,Dong Ho Lee,M.D.,Hae Gyung Lee,M.D.<SUP>1<.SUP>,Young Kyoung Yoo,M.D. and Chang Joon Ahn,M.D. 대한갑상선-내분비외과학회 2006 The Koreran journal of Endocrine Surgery Vol.6 No.1

Purpose: Many surgeons intend to preserve all of the parathyroids during a thyroid operation; however, they have had the unpleasant experience of achieving unintentional parathyroidectomy. We studied the risk factors for unin-tentional parathyroidectomy and whether these unintentional parathyroidectomies caused symptomatic hypocalcemia. Methods: We conducted a retrospective review of the medical records and pathologic reports of 95 papillary carcinoma patients who underwent operations between January 1994 and December 2003. We statistically analyzed the correlation between unintentional parathyroidectomy and the risk factors such as tumor size, capsular invasion, including extra-thyroidal extension, and the operation method. Results: Of the total 95 procedures, 14 (14.7%) produced patho-logy reports stating that incidental parathyroid tissue was identified within the thyroidectomy specimen. The majority of the 14 reported cases contained only a single focus of inci-dental parathyroid tissue; however, one of these thyroidectomy specimens contained two foci of parathyroid tissue. The factors such as tumor size, capsular invasion and extensive surgery were not correlated with the prevalence of unintentional parathyroidectomy. There was no association of unintentional parathyroidectomy with postoperative hypocalcemia (P=.449).Conclusion: Unintentional parathyroidectomy is not associated with symptomatic postoperative hypocalcemia. The factors such as tumor size, capsular invasion or extensive surgery are not risk factors for unintentional parathyroidectomy. (Korean J Endocrine Surg 2006;6:17-21)

Optimization of Streptococcus macedonicus MBF10-2 Lysate Production in Plant-based Medium by Using Response Surface Methodology

Dini Andyanti1,Fatin M. Dani,Wibowo Mangunwardoyo,Muhamad Sahlan,Amarila Malik 한국미생물·생명공학회 2019 한국미생물·생명공학회지 Vol.47 No.2

Bacterial lysates have become a common ingredient for natural health care. Lactic acid bacteria (LAB) could serve as potential candidates for lysate production: the lactic acids produced by LAB have been utilized for their moisturizing, antimicrobial, and rejuvenating effects, while other substances provide topical benefits and health effects for the skin. Our study aimed to obtain lysate from a LAB S. macedonicus MBF 10-2 through an optimized fermentation using the Response Surface Methodology. Strain MBF10-2 was cultivated in a 2L fermenter tank in de Man Rogosa and Sharpe (MRS) medium and in plant-based peptone modified MRS, i.e. Soy-peptone and Vegitone. The duration and the medium composition (dextrose and soy peptone or proteose peptone) were adjusted to obtain an optimum production of cell lysate. Central Composite Design was employed for Design Expert 7.0.0 by adjusting 3 factors: dextrose (1%, 1.5%, 2%, 2.5%, 3%), soy or proteose peptone (0.5%, 0.75%, 1%, 1.25% and 1.5%), and duration of fermentation (8, 10, 12 14, and 16 h for MRS-Soy peptone and 15, 17, 19, 21, and 23 h for MRS Vegitone). Bacteriocin-Like Inhibitor Substance activity of lysate and pH were used as indicators. The optimum condition for lysate production using MRS Soy Peptone and Vegitone are as follows: dextrose concentration 2.5%, plant-based peptone 1.25%, while optimum fermentation duration were 11.18 h (MRS Soy Peptone) and 17 h (MRS Vegitone) with a starter concentration of 10% at OD600nm 0.2 ± 0.05. However, the standard MRS medium produced better quality lysate compared to MRS plant-based peptones.