항갑상선제로 치료한 Graves씨병의 재발에 관한 임상적 고찰

노흥규,장준 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Clinical differnece between 13 remitted and 9 non-remitted patients with Graves’ disease treated with antithyroid drug for about 2 years were analysed. The results were as follows: 1. Mean duration of treatment between remission group (22.1±2.28 months) and non-remission group (22.4±4.19 months) were not significantly different (P>0.1), and no difference for sex between groups. 2. Mean duration of normalization of goiter size in remission group (18.77± 2.18months) was no significantly different from non-remission group (20.14±4.25 months) (P>0.1). 3. Serum TBII activity in Graves’ disease in remission (14.14±5.79 months) was higher than non-remitted Graves’ disease (9.49±5.05%), but significant difference were not noted(P>0.01). 4. Mean serum TSH value in non-remitted patients (0.19±0.14μU/ml) was significant lower than that of Graves’ disease in remission (1.39±0.49μU/ml) (P<0.05). The above results indicate that there were no clinical difference between Graves’ disease in remission and non-remitted Graves’ disease except serum TSH value measured by IRMA, which is the most reliable index of estimating the prognosis.

B형간염 Vaccination후의 혈청 항HBs 항체 양성율에 관한 고찰 : According to the Method of Vaccination and Serologic Test

노흥규,한성필 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.1

To evaluate the positive rate of serum Anti-HBs antibody after vaccinaton for Hepatis B, the authors screened out the serum Anti-HBs Ab by PHA and RIA methods in 377 healthy subjects who finished 3 times of Hepatitis B vaccination. Those were serologically negative for HBsAg and HBsAb before vaccination in mass screening test with PHA test. The results were as follows. 1. The serum Anti-HBs were positive in 76.8% among 254 subjects with either PHA or RIA methods at 16 months after vaccination on hip or triceps muscle at various clinics. 2. In 57 cases who received the vaccine on the gluteal area the Anti-HBs(+) were in 59.6% with PHA and 63.2% with RIA test 12 months after vaccination. 3. In 66 cases who received the vaccine on triceps muscle, the Anti-HBs(+) were in 78. 0% with PHA and 92. 0% with RIA tests 4 months after vaccination at Dept. of Nuclear Medicine, CNUH. With the above results, it would be recommended that the site of injection, the careful handling of the vaccine were important to obtain immunity and the RIA method was much more correct to detect the serum Anti-HBs Antibody.

갑상선질환에서 혈청 Ferritin치의 의의

노흥규,한현석 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

In order to know the effect of thyroid hormone on the iron metabolism, serum ferritin levels obtained by the radioimmunoassay technique were analysed in 12 normal subjects(male : 5, female : 7), 15 hyperthyroid Graves' disease (male: 7, female: 8), 13 euthyroid Graves' disease (male : 4, female: 9) and 9 hypothyroid patients(female: 9) The results were as follows; 1. The serum ferritin levels of hyperthyroid patients were 96±88.2ng/ml in male and 68.6±41.2ng/ml in female and there was no significant difference compared with those of normal subjects. 2. The serum ferritin levels of euthyroid female patients and hypothyroid female patients were 27.5±14.9ng/ml and 23.5±17.5ng/ml respectively, with were significantly lower than that of hyperthyroid female patients (p<0.01) 3. There was significant correlation between serum T_4 and serum ferritin levels in all female patients(r=0.55, p<0.01).

갑상선기능 항진증에서 혈청 Thyroglobulin치의 진단적 의의

노흥규,이종화 충남대학교 의과대학 지역사회의학연구소 1983 충남의대잡지 Vol.10 No.2

The serum levels of thyroglobulin (TG) were measured by RIA method in the patients with untreated hyperthyroidism and those treated with anti-thyroid drug therapy to evaluate the prognostic significance of serum TG in the Dept, of Int. Medicine, CNU Hospital since Feb, 1983. The result were as follows: 1. The mean serum TG level in 31 untreated hyperthyroidism patients was 64.9±35.3 ng/ml and was significantly higher than that of normal controls, 20.41±5.5 ng/ml 2. The mean serum TG level in 17 treated hyperthyroidism patients was 54.4±20.3 ng/ml and there was no significant difference compared with that of untreated patients. 3. Despite of no significant difference, the mean serum TG level is slightly decreased in treated patients and it means that the measurement of serum TG level before and after treatment is worthy to evaluate the thyroid functional status after treatment in hyperthyroidism.

각종 갑상선질환에서 혈청 유리 T_3의 진단적 의의

노흥규,이강욱,이종화 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

To estimate the diagnostic significance of serum free T_3 in various thyroid diseases, the serum levels of free T_3, T_3, `ree T_4, T_4 and TSH were measured by radioimmunoassay method in 43 cases of euthyroid thyroid diseases, 19 cases of hyperthyroidism, 2 cases of primary hylothdism and 10 cases of normal subjects as controls at the Dept. of Internal Medicine, CNUH, since January to July, 1984. The diagnostic sensitivity and specificity of each hormone level were calculated according to the clinical diagnosis of the cases. The results were as follow; 1. The serum levels of thyroid hormones in normal controls were; free T_3 : 6.68±2.1 pmol/ml, T_3: 1.24±0.49 ng ml, free T4: 1.27±0.38 ng/dl, T_4, : 7.80±2.04 ug/dl and TSH :1.87±0.9uU/ml(M±2SD). 2. The diagnostic sensitivity of hyperthyroidism was 100% in serum T_3, free T_4 and T_4 , 84% in _fT_3 but the specificity was 93% in _fT_3, 92% in _fT_4. 3. The diagnose c sensitivity was highest as 86% in _fT_3 and _fT_4 while the specificity was 100% in _fT_4, 80% in _fT_3. With the above results, it can be concluded that measurement of serum _fT_4, and _fT_3 levels is the most specific and sensitive measure in diagnosing the hyperthyroidism and euthyroid thyroid diseases.

산후 갑상선염의 경과에 관한 임상적 고찰

노흥규,송치운,송민호 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Postpartum thyroiditis is a disease with transient changes of thyroid function as hyperthyroidism, hypothyroidism and normal recovery 2-4 months after delivery. It occurs in 7-9% of postpartum women, is needed careful differential diagnosis from Graves' disease or Hashimoto's thyroiditis because of quite different clinical course. In order to establish the points for differentiation, we evaluated 30 cases of postpartum thyroiditis patients with the following results. 1. 14 patients were diagnosed as hyperthyroidism 4.4±1.6 months after delivery with mild degree of thyrotoxic symptoms. The anti-thyroglobulin antibody and anti-microsomal antibody were positive but thyrotropin receptor antibody were negative. 2. 16 cases were diagnosed as hypothyroidism with enlarged goiter 6.1±0.9 months after delivery and the ATA and AMA were positive both but TBII was negative in all cases. 3. The thyroid function of 71.4% of hyperthyroid patients became hypothyroidism in 1-3 months and recovered to normal in 1-3.5 months thereafter. In 68.8% of hypothyroid patients became euthyroidism within 1-8 months and 21.4% 1(3 cases) of the patients remained as hypothroidism untill 12 months' observation. In conclusion, the thyroid function changes as hyperthyroidism, hypothyroidism and euthyroidism stepwise in most cases of pospartum thyroiditis and serum TBII is negative, which are the most important features in differentiating from other autoimmune thyroid disease.

갑상선 기능항진증 환자의 골밀도에 관한 연구 : 예보

노흥규,성기양,윤상임 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

A preliminary study to evaluate the effect of thyroid function on the bone mineral density(BMD) was done. BMD was measured at lumbar spine 2, 3, 4 (A-P view) in 10 euthyroid nodular goiter, 8 primary hypothyroidism and 20 hyperthyroidism patients, perimenopausal or postmenopausal periods. Serum calcium, phosphorus, thyroid hormone concentrations and other parameters were measured to analysis. The results were as follows. 1. The BMDs of euthyroidism, hypothyroidism, and hyperthyroidism were 0.85± 0.16gm/㎠ (M±SD), 0.83±0.29 and 0.79±0.16 respectively, without any significant difference, but the BMD of hyperthyroidism was lowest. 2. The BMD of postmenopause of all thyroid disease patients was significantly lower than that of perimenopause patients. 3. There was no significant relationship between BMD and serum calcium, phosphorus, T_3, T_4 or duration of treatment for thyroid disease. In conclusion, the BMD is affected mainly by the age and thyroid function, so attention to osteoporosis must be considered for the patients of thyroid disease in menopause.

폐경기 여성에서의 Cyclofenil의 효능에 관한 연구 : 갱년기 장애 및 Ca 장흡수에 관하여

노흥규,윤상임,성기양,이경숙,이강욱 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

In postmenopausal syndrome, most common symptoms are those of vasomotor irritability such as hot flush and palpitation, irritable bladder symptoms and dyspareunia according to atrophy of urogenital epithelium, anxiety, nervousness, depression and insomnia. Approximately 40 percent of women in postmenopausal period develop symptoms serious enough to seek medical assistance. Among non-steroid agents, cyclofenil(4, 4' cyclohexidene methlyene diphenoacetate) is known to be a quite interesting substance according to the action at the level of the hypophyseal and hypothalamic centers by reducing the incretion of FSH and restoring normal endorphin, dopamine and norepinephrine activities, thus favorably affecting the whole postmenpausal neurovegutative symptomatology. In order to evaluate effect of cyclofenil on postmenopausal symptomatology and calcium metabolism, we examined 32 patients with postmenopausal syndrome before and after 200mg/day of oral cyclofenil treatment for 30-60 days. The results were as follows: 1. With 30 days of cyclofenil administration, subjective symptoms such as facial flush, palpitation, anxiety, nervousness and dyspareunia were improved significantly (p<0.001, p<0.001, p<0.01, p<0.005, respectively). But insomnia and depression were improved significantly after 60 days of cyclofenil administration (p<0.05, p<0.001, respectively). 2. Intestinal calcium absorption rate disclosed tendency of improvement without statistical significance 30 days after cyclofenil treatment. 3. Serum calcium and phosphorus level were not changed significantly before and after cyclofenil. 4. There was no definite evidence of side effects such as uterine bleeding due to cyclofenil. In conclusion, we thought that cycofenil is effective in management of postmenopausal syndrome but for the effect on calcium metabolism, further evaluation should be needed.

갑상선기능저하증의 임상적 고찰

노흥규,유철재 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

119 Cases of hypothyroidism were analysed in clinical features, laboratory data and pathologic findings, comparing with 21 healthy control group, since Jan. 1984 till Sept. 1985, at the Department of Internal Medicine, Chungnma National University Hospital. The results were as follows; 1. The age distribution was from 16 to 69 with the mean age of 36.9 years and M:F was 1:13.8. 2. The major presenting manifestations were easy fatigability, facial edema and weakness. Physical examination revealed diffuse goiter in 61.6% Major abnormalities were facial puffiness(16.1%), myxedema(6.2%) and thick tongue(2.7%), 3. The causes of hypothyroidism were primary (69.7%), post thyroidectomy (15.9%), post radiation (8.4%) and postpartum (5.9%). 4. The serum T_3, T_4 and TSH levels of the overt hypothyroid patients were 0.52±0.18mg/ml, 1.68±1.04㎍/dl and 40.53±9.82μU/ml respectively, and were significantly different to the normal controls. In the subclinical patients, the serum TSH level was significantly higher than normal controls. 5. The serum anti-microsomal Ab were positive in 71.8% and anti-thyroglobuline Ab was positive in 29.6%. 6. The pathologic findings in 44 cases revealed Hashimoto's thyroiditis in 70.4%, adenomatous goiter in 1630, papillary carcinoma in 6.8%, follicular carcinoma in 4.5% and subacute thyroiditis in 2.3%.

폐경기후 골다공증의 약물요법

노흥규,송치운,이진홍,안미애,송민호 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Postmenopausal osteoporosis is an enormous public health problem. Estrogens, and various drugs were developed and used for prevention and treatment of postmenopausal bone loss. In this study, We evaluated the effects of cycloprogynova, cyclofenil and ipriflavone on postmenopausal bone loss. Fourty post menopausal women were divided into 3 groups by treatment modalities Cyclofenil group (groupl), Cycloprogynova group(group 2) and Ipriflavone group(group 3). Basal bone mineral densities in all subjects were determined by DEXA(Dual Energy X-ray Absorptiometry) and those were compared with bone mineral densities after medication. The durations of medication in all groups were showed no statistical difference, group 1 11.4 ± 3.4 months, group 2 10.6 ± 3.9 months, group 3 12.9 ± 3.4 months. The patients of group 2 showed significant increase in bone mineral densities and the patients of group 1 and group 3 revealed no significant bone loss on paired T-test. Comparing with rates of bone loss in normal Korean postmenopausal women, the rates of bone loss in all subjects were effectively retarded. The significant bone loss (above longterm intertest coeffcient of variation) was noted in 8 patients out of 23 subjects in group 1, in 9 patietns out of 11 subjects in group 2 and in 2 patients out of 6 subjects in group 3. In conclusion, estrogen/progesteron(Cycloprogynova) replacemnt therapy showed most prominent bone preserving effect and Cyclofenil and Ipriflavone also effectively delays shorterm bone loss in postmenopausal women.