Cystic Medullary Thyroid Carcinoma: A Case of Undergoing Endoscopic Thyroid Lobectomy

Dong Hae Chung,Jae Yeon Seok,Yoo Seung Chung1,Eun Mee Oh1,Jung Won Ryu1,Young Don Lee1 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.1

On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.

네모나프라이드의 유효성 및 추체외로 부작용 : Haloperidol 및 Risperidone과의 자연관찰적 개방형 비교연구 A Naturalistic Open Comparative Study with Haloperidol and Risperidone

서영수,김용관,신동환,공보금,이정구,박정환,윤성환,정치영,이상경,김영훈 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.2

Objectives : This open prospective study was performed in order to evaluate the efficacy and extrapyramidal adverse effects of nemonapride in the schizophrenic patients, and was compared wit one of typical antipshchotics. haloperidol and one of atypical antipsychotics, risperidone. Methods : Thirty male and female schizophrenic patients(DSM-Ⅳ) were treated for 12 weeks with haloperidol(n=10), risperidone(n=10) and nemonapride(n=10). The overall efficacy was assessed at baseline, 1st week, 2nd week, 4th week, 8th week, and 12th week by the Positive and Negative Syndrome Scale for Schizophrenia(PANSS). Also the overall safety was assessed in the same time period by the Extrapyramidal Symptom Rating Scale(ESRS). Results : There were no significant differences in PANSS scores(total, positive, negative, and general psycho­pathology subscale) among haloperidol, risperidone, and nemonapride groups, Treatment responders, defined as at least 20% reduction of baseline total PANSS score, were achieved by 8 patients(80%) in haloperidol group, 10 patients(100%) in risperidone group, and 8 patients(80%) in nemonapride group. And there were no significant differences in ESRS total scores among haloperidol, risperidone, and nemonapride group. Inter-group comparison among haloperidol, risperidone and nemonapride group, as assessed by the ESRS, revealed no significant differences in the shifts to the maximum score, 9.4(±9.4), 6.2(±8.4), and 11.3(±8.1) respectively, and also revealed no significant differences in the mean time reaching the maximum score, 4.5(±4.5) week, 7.8(±4.8) week, and 4.6(±4.4) week, respectivily. Conclusion : There wee no significant differences in the efficacy and extrapyramidal adverse effects among haloperidal, rispecridone and nemonapride groups. These results suggest that nemonapride was as efficacious and safe in he treatment of schizophrenia, as well known and widely used antipsychotics, haloperidol and risperidone.

Brassica 種들의 花뢰크기에 의한 小胞子 發育段階 및 胚發生 比較

장영석(Young Seok Jang),민경수(Kyung Soo Min),오용비(Yong Bee Oh),정동희(Dong Hee Chung) 한국육종학회 1997 한국육종학회지 Vol.29 No.4

The purpose of this study is to search for the identifing method that could separate buds with embryogenic potential from collected buds for increasing the efficiency of embryogenesis by microspore culture in Brassica species. It was investigated developmental stage of microspore by bud-size and ratio of petal/anther length and compared to amount of embryogenesis through isolated microspore culture from the buds with late-uninucleate stage. In Brasica napus, Lisandra of spring type showed bud-size of 3.2~4.1mm which belongs to late-uninucleate stage as embryogenic microspores and their range of petal/ anther length ratio were 1/2~3/4. Hallayuchae of winter type rapeseed showed bud-size of 3.1~3.6mm which belongs to late-uninucleate stage as embryogenic microspores and their range of petal/anther length ratio were 1/3~1/2. Two genotypes of B juncea had the same petal/anther length ratio as range of 1/2~3/4 with embryogenic microspores but their bud-size were some difference as bud-size of Young-sanpohwanggyeja were 2.9~4.0mm and bud-size of Hwanggyeja were 2.9~4.1mm. Also, two genotypes of B. campestris had the same petal/anther length ratio as range of 2/3~3/4 with embryogenic microspores but bud-sizes were some difference as bud-size of Hyakusai were 2.9~3.4mm and bud-size of Sosongchae were 2.9~3.2mm. In B. oleracea, the petal/anther length ratio with embryogenic microspores according to bud-size were showed range of 1/2~2/3 in all of two genotypes and bud-size of Broccoli were 2.4~3.2mm and bud-size of Cauliflower were 2.9~3.7mm. In the embryo yield per 100,000 microspores by isolated microspore culture from the buds with embryogenic microspores, Young-sanpohwanggyeja of B. juncea were 47 embryos and Hwanggyeja of B. juncea were 23 embryos, B. campestris of Hyakusai were 367 and Sosongchae were 123, B. oleracea of Broccoli were 678 and Cauliflower were 562. However in B. napus was showed much differences by the growth habit, the spring type of Lisandra were producted 7,047 embryos of which higher about 9.2 times than those of winter type Hallayuchae.

유약 흰쥐에서 장 허혈이 장 조직에 미치는 영향 및 Interleukin-10의 효과

박영실,김동철,전정식 대한소아과학회 2004 小兒科 Vol.47 No.3

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

당뇨병성 합병증을 가진 환자에서 혈중 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

연구 배경 : 고혈당성에 의한 산화환원반응 이상(가저산소증)이 조절 되지않는 당뇨병의 특징으로 혈관과 신경 기능에 대한 진성 저산소증의 효과와 유사하며, 당뇨 합병증의 병태생리에 중요한 역할을 한다. 고혈당이 있는 인슐린 비의존형 당뇨병 환자에서 인슐린 수준이 정상이듯이, 빈혈이 있는 당뇨병 환자에서 EPO의 농도는 실제 혈색소 농도의 감소비율과 차이가 있을 것이라 추측된다. Friedman 등은 당뇨병성 합병증 원인 인자로 가저산소증(pseudohypoxia) 또는 저산소증(hypoxia)을 제기하였고 이런 인자들이 EPO의 상대적 또는 절대적 결핍에 의한 것임을 보고하였다. 방법 : EPO-Trac^(TM 125)I RIA kit을 이용하여 방사면역측정법으로 EPO 수준을 검사하였다. 전혈 3㎖을 5-10㎖ 시험관에 정맥 채혈하였으며, 용혈과 장기간의 보존을 위하여 원심분리를 즉시 시행하여 혈청을 영하 200C에서 냉동 보관 후 일괄적으로 검사 결과를 얻었다. 결과 : 1996년 9월부터 1997년 2월까지 조선대학교 부속병원 내과에 입원한 2형 당뇨병 환자 63례를 대상으로 하여 다음과 같은 결과를 얻었다. 1) 당뇨병성 합병증이 없는 군과 있는 군간의 혈색소, 혈중 EPO농도의 차이는 유의한 차이가 있었으며 혈색소의 감소율보다 혈중 EPO의 감소율이 더 높았다. 2) 당뇨병성 망막증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으나 혈중 EPO농도는 유의한 차이가 있었다. 증식성군에서만 혈중 EPO의 감소비율이 혈색소에 비해 높았다. 3) 당뇨병성 신증의 유무에 따른 혈색소, 혈중 EPO농도는 유의한 차이가 있었고 혈색소 감소율에 비해 EPO농도의 감소율이 높았다. 신증의 중증도에 따른 혈색소, EPO의 차이는 미세알부민뇨군을 제외하고는 유의한 차이를 보였고 혈색소 감소율에 비해 EPO의 감소율이 더높았다. 4) 당뇨병성 신경병증의 유무에 따른 혈색소 농도의 차이는 유의한 차이가 없었으며 EPO농도는 유의한 차이를 보였다. 혈색소와 EPO의 감소비율은 비슷하였다. 신경병증의 중등도에 따른 혈색소와 EPO농도의 변화는 유의한 차이가 없었으나 stage 3에서는 혈색소감소율보다 EPO감소율이 더높았다. 결론 : 당뇨병성 합병증을 가진 환자에서 빈혈의 정도는 대부분 혈청 EPO치의 절대적 감소에 의함을 간접적으로 밝혀낼 수 있었으며 차후 더 많은 대상으로 비교 분석이 필요하리라 사료된다. Background: Hyperglycemic-induced redox(pseudohypoxia) imbalance is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural functions and plays an important role on the pathogenesis of diabetic complications. As is true for apparently "normal" insulin levels typically found in NIDDM even in the presence of hyperglycemia, a "normal" erythropoietin level in an anemic diabetic subject may be disproportionally low for the actual red cell mass. Therefore, Friedman et al suggested that pseudohypoxia or hypoxia as an etiological factor of diabetic complications are due to absolute or relative erythropoietin deficiency Method: EPO-TracTM 125I RIA kit was used for the quantitative determination of erythropoietin(EPO) in serum by radioimmunoassay. An adequate sample of blood (3ml whole blood) was collected aseptically by venipuncture in a 5~10ml glass tube to yield a minimum of 400 L of serum per assay. The serum was promptly removed from the clot by centrifugation in order to avoid hemolysis. Then to increase its storage time it was frozen at -200C in a nonself defrosting freezer. Finally, tests were undertaken simultaneously Results We studied 63 cases with diabetes mellitus, who were admitted to Chosun University Hospital from September, 1996 to February, 1997 at the Department of Internal Medicine. We defined the control group, as diabetic patients who did not have anemia(<13mg/dl), diabetic complications(retinopathy, nephropathy, neuropathy) and the remainders were defined as the experimental group(we excluded anemic patients, who had secondary causes of anemia and diabetic patients with end stage renal disease)Data were as follow 1) The relationship of Hb and the 24hr urine protein between diabetic patients with and without complications significantly differed(p=0.02, < 0.001 respectively), but the Hb level was poorly related between diabetic patients with and without retinopathy(except in preproliferative, proliferative subgroups) and neuropathy. 2) Subgroups of patients with diabetic complications had higher 24hr urine protein than patients without diabetic complications, except stage I diabetic neuropathy 3) The EPO level was significantly different between diabetic patients with and without complications. 4) The correlation between EPO and Hb was significantly different, especially in diabetic patients with retinopathy and nephropathy according to severity of diabetic complications, compared with patients who did not have diabetic complications such as retinopathy and nephropathy. Conclusion: We know that anemia induced by diabetic complications is due to relative EPO deficiency than absolute EPO deficiency, and further evaluation and studies are needed on many cases in the future

재발성 류마티즘 환자에서 발작의 유발인자

주유철,이동민,양종태,신병철,임태영,서정균,정기영,최동헌,김원,조영신,고희관 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : Palindromic rheumatism (PR) is known to be triggered without any obviously inciting events in most patients, although, in a few cases, attacks have been noted to relate to another events such as weather change, childbirth, ingestion of certain foods, or over-exercise. The aim of this study was to characterize the triggering factors on palindromic attacks. Materials and Methods : We evaluated sixty-four patients with PR for the presence of triggering factors and the relationship between attacks and triggering factors by interview of patients. We considered that there was an probable association between episodes and PR, if episodes within 24 hours prior to PR had triggered at least 50% of all attacks and a definite association between episodes and PR, if episodes within 24 hours prior to PR had triggered 100% of all attacks. Results : In 15 patients (35.9%), there was a possible association between episodes of PR and initiating events. In 8 patients (12.5%), there was a definite association between episodes of PR and initiating events. The triggering factors were physical over-activity including exercise (19/64: 29.7%), foods, such as rawfish, crab, and chicken, including alcohol (19/96: 19.8%). However, there were no difference between the groups with and without the triggering factor in sex ratio, duration and onset of PR, the positive rate of rheumatoid factor and involved sites. Conclusion : Our observations showed that PR was triggered by physical over-activity more than in previous reports and hypersensitivity to foods was a causative factor in some patients with PR. However, patients with triggering factors had a similiar clinical profile to patients without triggering factors.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

비정형 기관지 유암종에 의한 이소성 ACTH 증후군 1례

이창훈,천남일,홍세인,정진욱,윤인석,조동혁,강호철,정동진,정민영 全南大醫大 2001 전남의대학술지 Vol.37 No.2

외측 미칩 갑상선에서 발생하여 다발성 전이로 발현된 유두상 갑상선암 1예

천남일,이창훈,홍세인,정진욱,윤인석,조동혁,강호철,정동진,정민영 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4-5