Clinical Significance of Classification of Graves` Disease According to the Characteristics of TSH receptor Antibodies

(Won Bae Kim),(Hyun Kyung Chung),(Young Joo Park),(Do Joon Park),(Hong Kyu Lee),(Bo Youn Cho) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.3

N/A Background:It has been widely accepted that the epitope (s) and/or functional characteristics of thyrotropin receptor antibodies (TSHRAb) from Graves` patients are heterogenous among patients. However, the clinical significance of such heterogeneity has not been systematically evaluatedyet. We were to elucidate and find the clinical significance of heterogeneity for TSH receptor antibodies in Graves` disease. Methods:We measured stimulating TSHRAb (TSAb) activities using CHO-hTSHR cells, FRTL-5 cells and chimeric receptor expressing cells (Mc1+2 and Mc2), specific blocking TSHRAb (TSBAb) activities using Mc2 cells and TBII activities using porcine thyroid membrane in 136 patients with untreated hyperthyroid Graves` disease. Results: Based on various TSHRAb activities from each patient, the patients could be categorized into 7 subgroups by cluster analysis; 1) Group 1 (n=41) was characterized by moderate TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, typical TSAb epitope, rare blocking antibodies and high TBII activities. 2) Group 2 (n=16) was characterized by the presence of blocking TSHRAb in most patients, albeit the other characteristics were the same as those in Group 1. 3) Group 3 (n=19) patients had low TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, seldom had blocking TSHRAb, but they had high TBII activities. 4) Group 4 (n=30) could be categorized as `mild disease` group, as they had low activities in all kinds of TSHRAb assay and had low antim icrosomal antibody activities. 5) Group 5 (n=14) was characterized by moderate TSAb activities with atypical epitope (s), rare blocking TSHRAb and moderate TBII activities. 6) Group 6 (n=10) patients had veryhigh TSAb activities with typical epitopes, seldom blocking TSHRAb and low TBII activities. 7) Group 7 (n=6) was characterized by very high TSAb activities with atypical epitopes and high TBII activities. Pretreatment serum thyroid hormone level was low only in group 4 patients compared to the other 6 groups (p<0.05). The size of goiter was significantly larger in those in group 1 and group 3 (p<0.05) compared to the other 5 groups. The prevalence of clinically significant ophthalmopathy was higher in group 2 patients than the other 6 groups (50%vs.27.5%,p=0.06). Among 6 kinds of TSHRAb activities, only the blocking TSHRAb activity was significantly associated with the presence of ophthalmopathy in multivariate analysis. Conclusion:These results suggest that the differences inepitopes for TSAb or the presence of blocking TSHRAb is not a major factor in determining the degree of thyrotoxicosis in Graves` disease. Although the pathogenic mechanism is not clearyet, we suggest that patients with ophthalmopathy have different TSHRAb repertoire from those without ophthalmopathy in Graves` disease.

Factors associated with the risk of colorectal neoplasia in young adults under age 40

Ilsoo Kim,Han Hee Lee,Young Jae Ko,Ho Eun Chang,Dae Young Cheung,Bo-In Lee,Young-Seok Cho,Jin Il Kim,Myung-Gyu Choi 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5

Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN). Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary’s Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma. Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively). Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for highrisk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.

3T Multi Voxel Spectroscopy에서 SENSE와 NEX 변화에 따른 정상인 뇌 대사물질 변화 분석

성열훈,임재동,이재현,조성봉,우동철,최보영,Seong, Yeol-Hun,Rhim, Jae-Dong,Lee, Jae-Hyun,Cho, Sung-Bong,Woo, Dong-Chul,Choe, Bo-Young 한국의학물리학회 2008 의학물리 Vol.19 No.4

자기공명분광법(magnetic resonance spectroscopy: MRS)은 인체내 대사물질을 정량분석하여 병변의 조기진단 및 정밀진단에 도움을 주고 있으며, 최근 임상에 이용되고 있는 자기공명분광법은 single voxel spectroscopy (SVS) 기법과 multi voxel spectroscopy (MVS) 기법이 있다. 본 연구에서는 SENSE와 NEX를 변화시킨 multi voxel spectroscopy (MVS)의 데이터와 기존 single voxel spectroscopy (SVS)의 데이터를 비교 분석하여, 각각의 데이터의 유의성 차이를 평가하고자 하였다. 정상 성인 지원자 13명(남자: 5명, 여자: 8명, 평균 41세, 표준편차 11.65세)을 대상으로 chemical shift image (CSI)를 이용한 MVS검사를 시행하였다. 장비는 3.0T Achieva Release Version 2.1 (Philips Medical System, Netherland)을 이용하였고, 8 channel head coil을 사용하여 brain thalamus 부위에서 CSI spectrum을 1 slice 획득하였다. Scan parameter로는 FOV (field of view): $230{\times}184mm^2$, TR (time to repetition): 2000 msec, TE (time to echo): 288 msec, matrix: $15{\times}12$, VOI(view of interest): $110{\times}110mm^2$, voxel size: $15{\times}15{\times}15mm^3$로 하였다. SENSE factor (S)와 NEX (N)는 S1*N1, S2*N1, S2*N2, S3*N2로 변화하여 스펙트럼을 획득하였고, 각 scan time은 5분 54초, 3분 32초, 6분 20초, 4분 20초였다. 얻은 모든 MRS 데이터는 jMRUI 3.0 Version 프로그램에서 분석하였고, SENSE factor와 NEX를 변화시켜 얻은 MVS data 그룹들이 정상 성인 뇌 대사물질의 변화에 영향을 주는지 검증하기 위해 그룹 간에 ANOVA분석을 실행하여 P 값이 0.05보다 크게 나오면 그룹들 사이에 유의한 차이가 없다고 분석하였다. NAA/Cr과 Cho/Cr의 상대적 비율은 MV와 SVS사이에서는 유의한 차이가 없었다. 즉, SENSE factor와 NEX를 변화시켜 얻은 MVS data에서 정상 성인 뇌조직의 대사물질의 변화를 관찰한 결과, S1*N1의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.88{\pm}0.03$이고, S2*N1의 NAA/Cr은 $1.44{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.05$, S2*N2의 NAA/Cr은 $1.43{\pm}0.02$, Cho/Cr은 $0.87{\pm}0.04$이며, S3*N2의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.03$으로 나타났다(F-value : 1.37, D.F : 3, P-value : 0.262). 그러나 데이터의 질을 측정하기 위한 MVS 데이터의 NAA Peak line-width는 SVS 데이터의 NAA Peak line-width 보다 약 3배 정도 넓었다. 본 연구에서는 MVS에서 SENSE factor와 NEX 값을 다양하게 변화시킨 MVS의 데이터와 SVS의 데이터가 큰 차이가 없음을 확인하였다. 즉, 어는 특정 부위의 뇌 조직의 대사물질은 MVS와 SVS 기법 모두 큰 차이가 없음을 확인할 수 있었다. 그러므로 MVS는 SVS보다 광범한 부위를 짧은 시간 안에 검사할 수 있으므로 매우 유용한 방법이라고 사료된다. To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean ($\pm$ standard deviation) age of 41 (${\pm}11.65$). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); $110{\times}110$ mm of VOI (view of interest); $15{\times}15{\times}15$ mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1~3) and 1~2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.

소득작물 전후작지 적응 극단기성 벼 ‘중모 1032’

손영보,이종희,조준현,이지윤,오성환,송유천,박동수,박노봉,김상열,여운상,남민희,권영업 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

건국대학교 의과대학의 통합강의 모델에 관한 연구

조성일,최진영,김보경 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

To develop a proper model of block lecture as an educational program, we surveyed the educational environments and problems in Konkuk University Medical College(KUMC). The major findings were as follows; 1. There is no significant differences in ratio of lecture/laboratory hour between KUMC and average of medical colleges in Korea. 2. The total lecture time is higher(138%) in KUMC than the minimal lecture time(1204 hrs) for basic medical science in the guideline of the Korean Medical Association(KMA). 3. The real lecture hours was 2,184 hrs for 4 years that is less than the time(2786 hrs) reported to Council of Korean Medical Dean. 4. The time estimated for block lecture in all course at KUMC is 1428.5 hrs. 5. A number of specialists(professors) for each course is not sufficient and many courses have to depend on lecture rather than laboratory or clinical bedside working. 6. The professors are separated at three distant sites resulting in inefficient structure. 7. The educational space in the two hospitals is not sufficient for block lecture program. 8. In KUMC at present, 9 courses can be performed with block lecture program, those are Diagnostics, Medical Ethics, Forensic Medicine, Introduction to Biomedicine, Legal Medicine, Emergency Medicine, Community Medicine, Psychiatry, and Pediatrics. And 20 courses need the further investigation to develop block lecture program. More intensive study is needed for 6 courses. From these results, although KUMC needs more space and specialists and needs effective concentration of manpower to perform block lecture, 35 block lectures can be introduced after investigation. And it is suggested that introducing the block lecture system in whole curriculum is not possible at present status of KUMC.

Thermocouple을 이용한 Buchanan Plugger 표면의 온도상승 분석

조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 전남대학교 치의학연구소 2003 구강과학 Vol.15 No.4

This study was performed to confirm the actual temperature rise on the surface of Buchanan plugger by evaluating the temperature rise on the surface of it, the peak temperature of pluggers of various size using thermocouple. The heat carrier system 'System B Heatsource' (Model 1005, Analytic Technologies, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200 which Dr. Buchanan's "Continuous wave of condensation" technique recommended on digital display and the power level on it was set to 10. The touch mode was used. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 ㎜ increments from the tip to the 4 ㎜ length of shank. Each thermocouple was secured with cyanoacrylate adhesive and orthodontic resin block. The two wire leads of each thermocouple were connected to the appropriate channels of Data Logger. This was configured to simultaneously record input from the five thermocouples. The heat control spring was touched for 1, 2, 3, 4 and 5 seconds, and the temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01. Ten trials was determined for each plugger. The average of temperature rise and standard deviation was calculated for each size of plugger. The data were statistically analyzed by one-way ANOVA to determine their significance. The results as follows. 1. The position at which the temperature peaked was approximately at 1∼2㎜ far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F type and followed by, in descending order, FM type, M type. ML type showed the lowest peak temperature (p<0.01). This results suggest that the actual temperature on the surface of the pluggers does not correlate well with the temperature set on digital display. Heat concentrates around the tip. The larger plugger reveals lower temperature rise relatively.

흉부 위국소화 감각 수준으로 발현된 경부 추간판 탈출증

이보람,조동신,윤신구,조상걸,안무영,성기범 대한신경과학회 1999 대한신경과학회지 Vol.17 No.5

열전대(thermocouple)를 이용한 Buchanan Plugger 표면의 온도상승 분석

조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.4

This study was performed to evaluate the actual temperature rise on the surface of Buchanan plugger using thermocouple. The heat carrier system 'System B Heatsource'(Model 1005, Analytic Technologies, Redmond, WA, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200℃ on digital display and the power level on it was set to 10. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 mm increments from the tip to the 4 mm length of shank. The heat control spring was touched for 5 seconds, and temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01 using Data Logger. The data were statistically analyzed by one-way ANOVA. The results were as follows. 1. The position at which the temperature peaked was approximately at 1~2 mm far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F plugger and followed by, in descending order, FM plugger, M plugger. ML plugger showed the lowest peak temperature (p<0.01). 3. The temperature on the pluggers was decreased with the increase of touching time. This results suggest that the actual temperature on the surface of the pluggers dose not correlate well with the temperature set on digital display. Heat concentrates around the up. The larger plugger reveals lower temperature rise relatively.

우리나라 의과대학의 통합강의에 관한 연구

조성일,김보경,최진영 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

The aim of this paper is to analyze the educational program that focused on the block lecture system of 41 medical colleges for 10 years in Korea. The data were obtained from Korean Medical Education Condition from 1988 to 1998. The major findings were as follows; 1. Throughout past 10 years, the mean of lecture hours per college had been decreased(-164 hrs) and mean of the laboratory hours increased(+223 hrs). Therefore, total lecture hours had been increased during the period. 2. Thirty-two colleges have performed the block lecture as an educational program. According to the established years of the colleges, those started before 1980 showed much more hours and courses of block lecture than those after the time. 3. In the colleges with the courses of block lecture, the rate of lecture and laboratory hours was 44.2% and 55.8%, respectively. 4. In the colleges with block lecture program, the mean number of the courses was 8.5; mean of credits per college was 19.8; the mean of lecture hours per course was 51.5; and lecture hour per credit was 23.3. 5. Among the courses, the respiratory was the commonest and held at 23 colleges. The gastroenterology was held at 22 colleges and was the biggest in nationwide sum of lecture hour(2056 hrs). The neuroscience was the longest in mean of lecture hours(144 hrs). 6. The maximum number of the courses was 42. In conclusion, the scale and time of block lecture were increased in 1998 than in 1988 at medical colleges in Korea. And with the basis of this trend and socioeconomic situation of this country, the block lecture will be a main program at medical colleges in Korea.

韓國과 獨逸 消費者의 製品評價에 關한 比較硏究 : 耐久性 消費財의 例를 中心으로

뵈커, 프란츠,조희영 동국대학교 경영관리연구소 1991 經營經濟論叢 Vol.15 No.-