Technetium - 99m Pertechnetate 갑상선 스캔에서 열결절로 나타난 갑상선암

이문호(Mun Ho Lee),문대혁(Dae Hyuk Moon),송영기(Young Kee Shong),이명혜(Myung Hae Lee),류진숙(Jin Sook Ryu) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1

In general, hot nodules on techetium scan are regarded as benign tumors, and usually no further work up for malignancy is indicated, if they are truly autonomous. The authors experienced two cases of thyroid carcinoma presenting as hot nodule on technetium-99m pertechnetate thyroid scintigraphy. One case with papillary carcinoma, and other case with follicular carcinoma are presented in addition to a review of the literature.

인슐린 비의존형 당뇨병환자에서의 사구체 여과율

황일란(Il Ran Hwang),이기업(Ki Up Lee),양원석(Won Seok Yang),문대혁(Dae Hyuk Mun),김기수(Ghi Su Kim),김순배(Sun Bae Kim),박수길(Su Kil Park),박정식(Jung Sik Park) 대한내과학회 1992 대한내과학회지 Vol.43 No.6

N/A Background: Glomerular hyperfiltration is found in 30 to 40% of patients with IDDM at the onset of disease. Several lines of evidence suggest that this may be responsible for the progression of diabetic nephropathy. Whether glomerular hyperfiltration is a frequent finding in patients with NIDDM is controversial. Methods: To define the prevalence of glomerular hyperfiltration in patients with NIDDM without clinical proteinuria, we measured GFR in 79 patients with NIDDM and 33 healthy subjects using 51Cr-EDTA clearance. Urine albumin level was determined by radioimmunoassay. Results: GFR in 58 normoalbuminuria group and 21 microalbuminuria group were 129±24 and 127±34ml/ min/1. 73 m' respective1y, which were significantly higher than that in control group (113±20). Hyperfiltration, as defined by a GFR of more than 140 ml/min/1.73 m, was found in 32% (25/79) of NIDDM without clinical diabetic nephropathy. There was no difference in GFR or the prevalence of hyperfiltration between the normoalbuminuria (29%, 17/58) and the microalbuminuria (38%, 8/21) group. Fasting plasma glucose level in patients with hyperfiltration was significantly higher than that in those without hyperfiltration. Conclusion: Glomerular hyperfiltration is frequently found in Korean NIDDM patients without clinical diabetic nephropathy. This finding is similar to the previous reports in Pima Indians and Black Americans

갑상선암의 임상적 관찰 (제3보)

이문호,이명철,김용일,최창운,박성회,최국진,조보연,문대혁,고창순,오승근 대한핵의학회 1986 핵의학 분자영상 Vol.20 No.1

Clinical features of 406 patients with histologically verified thyroid carcinomas were investigated from May, 1978 to April, 1985 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid cancer according to their histological classification was 79. 8% of papillary carcinoma, 14.5% of follicular carcinoma, 1.5% of medullary carcinoma, 2.2% of anaplastic carcinoma, 2 cases of squamous carcinoma and 3 cases of lymphoma. 2) The age distribution showed the peak incidence in the fourth decade (25.1%), followed by the fifth and the third decade. 3) The ratio of male to female patients was 1:6.1. The ratio is 1:5.9 in papillary carcinoma and 1:8.8 in follicular carcinoma. 4) The mean age was 40.2 year in papillary carcinoma, 37.4 year in follicular carcinoma, 36.5 year in medullary carcinoma, 60.3 year in anaplastic carcinoma, 62.0 year in squamous carcinoma, 59.7 year in lymphoma. 5) The diameter of the thyroid masses was smaller than 1.5cm in 19.9% of the patients, from 1.5cm to 5cm in 50.5%, from 5cm to 10cm in 25.4% and larger than 10cm in 25.4%. 6) Metastasis to the regional lymph nodes at diagnosis was noted in 44.2% of total pa tients, and distant metastasis was 5%, and local infiltration was 44.2%. 7) The clinical staging was revealed 42.1% of the patients in stage Ⅰ, 9.1% in stage Ⅱ, 35.7% in stage Ⅲ, 5.2% in stage Ⅳ, and 7.9% in undetermined stage.

자율기능성 갑상선 결절

이문호,문대혁,이기업,김기수,송영기,이명혜,안세현,박건춘 대한내분비학회 1992 Endocrinology and metabolism Vol.7 No.2

To define the clinical characteristics and the course of the autonomously functioning thyroid nodule (AFTN) in Koreans, the authors reviewed case records of the patients with AFTN from May 1989 to December 1991. Among 1412 cases of thyroid nodule, 48 (3.4%) had AFTN, with 44 females and 4 males and mean age (±S.D.) of 45.2 (±15.0) years, ranging 17 to 79 years. The age and sex distribution of the patients with AFTN were not different with those in patients with cold thyroid nodules. Of the 48 patients with AFTN, 13 had hyperthyroidism (8 clinical and 5 subclinical). Hyperthyroid patients had larger nodule than euthyroid patients, however, their age was not different. Five patients with clinical hyperthyroidism were treated surgically and they maintained euthyroid until 5 to 27 months after operation. One patient had papillary carcinoma, and another four had adenomatous goiter. Five patients with subclinical hyperthyroidism and 25 patients with euthyroid AFTN were followed for 5 to 35 months without specificreatment, however, none of them showed significant changes in thyroid function. In summary, AFTN is not frequent in Koreans, some of AFTN is maligant, surgery is an effective therapeutic modality, and AFTN runs a chronic stable course without an abrupt change in function. (J Kor Soc Endocrinol 7:121~126, 1992)

Graves 병에서 배양된 쥐 갑상선 세포 (FRTL-5)를 이용한 갑상선 성장자극항체와 갑상선 아데닐사이클라제 자극항체의 동시측정

이문호,조보연,문대혁,고창순,이기업,송영기,이명혜 대한내분비학회 1991 Endocrinology and metabolism Vol.6 No.1

The relationship between thyroid growth stimulating antibody (TGSab) and thyroid adenylate cyclase stimulating antibody (Tsab) in patients with Graves' disease is of great controversy. To investigate the nature of TGSab, we measured TGSab and Tsab simultaneously using FRTL-5 cells. TGSab was measured by [3H]-thymidine incorporation, and Tsab by cAMP increase. Forty out of 46 (87%) untreated Graves' patients had detectable TGSab, and 42 (91.3%) had Tsab. TGSab was detected in 18 out of 34 (52.9%) Graves' patients under drug treatment and 4 out of 18 (22.2%) patients with Graves' disease in remission. Of 22 patients with goitrous Hashimoto's thyroiditis 8 (36.4%) had TGSab and none of 23 patients with primary myxedema had TGSab. Of 19 patients with nodular goiter, two (10.6%) had TGSab. Presence of TGSab activity was significantly associated with untreated Graves' disease. In patients with Graves' disease, TGSab activity was significantly correlated with estimated in vivo goiter size (rs=0.68, p<0.001). A significantly positive correlation was found between TGSab and Tsab (r=0.63, p<0.001), and also between TGSab and TBII(r=0.48, p<0.01) in patients with untreated Graves' disease. IgG from a patient with primary myxedema, previously shown to inhibit TSH-stimulated thyroid adenylate cyclase, inhibited both TSH and Graves' IgG stimulated [3H]-thymidine incorporation. Adenosine, which inhibits thyroid adenylate cyclase activation, also inhibited both TSH and Graves'IgG stimulated [3H]-thymidine incorporation into FRTL-5 cells. In conclusion, TGSab might be a thyrotropin receptor antibody which exerts its action through cAMP increase, in other word, TGSab might be almost identical to Tsab in Graves' disease, causing goiter and hyperthyroidism(J Kor Soc Endocrinol 6:17 24, 1991).

Graves 병 환자에서 항갑상선제 투여에 의한 TSH 수용체 항체의 변동에 관한 연구 : 치료 용량 및 기간에 따른 차이 및 임상상과의 관계 its relation to dose and duration of treatment~and clinical features

이문호,조보연,문대혁,고창순,민헌기,서교일 대한내과학회 1986 대한내과학회지 Vol.30 No.3

We undertook a prospective study of 59 patients with Graves' disease in order to clarify the influence of antithyroid drug on the immunological indices and to determine the association of the changes of TSH receptor antibodies activities with drug dosage, duration of treatment and clinical features according to mode of antitbyroid drugs treatment. Patients were divided into two groups. High dose group included 28 patients and conventional dose group 31 patients. We measured TBII activities, antimicrosomal antibodies, and the size of goiter every 3 months, comparing them with clinical features and laboratory findings. TBII activities declined from R months until 9 months following drug treatment. Therafter no significant change of TBII activities were observed. Antimicrosomal antibodies showed the same pattern of change. There was no statistically significant difference of declining rate of TBII activities, antimicrosomal antibodies, and reduction of size of thyroid between two treatment groups. TBII activities fell into normal range in 15 patients among those 44 patients who had been followed for more than 9 months (8 high dose group, 7 conventional dose group). In those 15 patients, TBII activities and frequency of exophthalmos were less than those whose TBII activity did not normalized. We conclude that TSH receptor antibodies activities and antithyroid autoantibodies are diminished by antithyroid drug treatment in patients with Graves disease and there is no relationship between dose of drug and declining of TBII activities. We suggest that changing levels of TBII activities might be secondary phenomenon which can be achieved by control of thyroid function by antithyroid drug rather than direct immunosuppressive effect of antithyroid drug per se.

악성종양환자에서 혈청 Tissue Polypeptide Antigen 치의 임상적 의의에 관한 연구

이문호,이명철,조보연,문대혁,고창순,박성기,김노경,김병국 대한핵의학회 1984 핵의학 분자영상 Vol.18 No.1

To evaluate the clinical significance of serum tissue polypeptide antigen (TPA) levels in patients with malignancy, serum TPA levels were measured by radioimmunoassay in 49 normal controls, 9 patients of postoperative colon cancer without recurrence and 68 patients with various untreated malignancy, who visited Seoul National University Hospital from February, 1983 to September, 1983. The results were as follows; 1) Serum TPA levels in 49 normal controls were in the range of 22-135U/L (74±28U/L, mean±S.D.). There was no sex or age difference. Normal upper limit of serum TPA was defined as 130U/L (mean+2 S.D.). 2) Serum TPA levels in 68 patients with various untreated malignancy (stomach cancer 33 cases, colon cancer 11 cases, lung cancer 10 cases, primary liver. cancer 9 cases and metastatic cancer of unknown primary site 5 cases) were in the range of 10-800U/L (189±170U/L, mean±S.D.) and significantly elevated, compared with those of normal controls (p〈0.005). 3) The sensitivities of serum TPA in varioureated malignancy were 39% in stomach cancer, 55% in colon cancer, 50% in lung cancer, 67% in primary liver cancer and 80% in metastatic cancer of unknown primary site respectively. 4) The sensitivities of serum TEA related to resectability in stomach and colon cancer were 32% in resectable stomach cancer, 50% in unresectable stomach cancer, 29% in resectable colon cancer and 100% in unresectable colon cancer respectively. 5) The mean value of serum TPA levels in 9 patients of postoperative colon cancer without recurrence was 70±39U/L and significantly decreased, compared with that of untreated colon cancer, 180±150U/L (p〈0.05). 6) In patients with stomach or colon cancer, there was no significant correlation between serum TPA and serum CEA levels, but simultaneous measurement of serum TPA and serum CEA levels increased sensitivieties. From above results, we concluded that serum TPA level is a useful indicator reflecting tumor actiivity and responses to anticancer treatment in patients with malignan

뇌종양의 Thallium-201 SPECT 고찰

고도일,이정교,문대혁,김창진,임승철,권병덕,황충진 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.7

Thallium-201 SPECT studies were done on 32 patients with brain h o r s : 20 patients with glioma, 3 patients with meningiomas, 2 patients with metastasis, 2 patients with pineal tumors, 1 patient each With germinoma, neurinoma, neurocytoma, and 2 postradiation patients. A BIT1 index was based on the ratio of thallium uptake tumor versus the homologous contralateral brain. It was calculated and compared with tumor histology. There was a substantial uptake of mlTl in high grade gliomas with no uptake in low gnide glioma. Meningiomas and metastatic tumors show hot uptake, revealing that aolTl uptake is not exclusive to high grade gliomas In conclusion, %lT1 SPECT could distinguish the benign and malignancy, and seems to be useful in the follow-up after treatment, to predict Iowa high-grade lesions