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.

두개강내 정맥기형들과 동반된 안와내 해면상 혈관종 1례

조도상,송준혁,김명현,박향권,김성학,신규만,박동빈 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.6

선천성 관동정맥루의 경피적 경도관 Coil 색전 1례

조준식,김동수,서정기,장양수,김현승,이도연 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

제주 지역의 B형 간염 바이러스 유전자형

조지현,박도심,김태현,염주진,김학철,문주현,양재식 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.1

목적: HBV 감염이 무증상의 자연 회복부터 간경변 혹은 간세포성 간암까지 다양하게 나타나는 요인들로 숙주의 요인과 바이러스의 요인으로 구분되어 제시되는데, 바이러스 요인으로는 감염된 바이러스이 유형이나 염기 변이들이 논의된다. HBV 유형을 구분하는 데는 혈청형과 유전자형이 이용되는데 근자에는 주로 유전자형이 이용된다. 이러한 HBV의 분포는 지역적으로 다르나 지역에 따라서 다른 유형들이 혼재되어 있다. 동남아시아는 B형이지만 극동아시아는 C형으로 알려져 있으며, 대만과 오키나와에서는 B와 C형이 혼재되어 나타난다. 이러한 결과로 미루어 보아 우리 나라의 남부지역에서는 B과 C형이 혼재되어 있을 가능성이 있다. 이에 본 연구는 제주 지역에서 HBV의 유전자형을 조사하고자 하였다. 대상과 방법: 원적지가 제주도이면사, HBsAg가 양성이었던 107명(평균 연령: 46.5세)을 대상으로 하였다. 이들의 혈청으로부터 HBsAg/antiHBe를 분석하고, DNA를 추출하여 7개의 유전자형에 따라 특이성을 갖는 시발체(genotype specific primer)들을 이용하여 PCR로 증폭한 후 이를 분석하였다. 주된 유전자형의 일부와 다른 유형에서 증폭에 이용되었던 시발체를 다르게 이용하여 hemi nested PCR로 증폭한 후 염기를 분석하여 계통발생학적 분석법을 이용하였다. 결과: 1. PCR에 의한 HBV DNA 양성은 107명 중 59명(55.1%)이 양성이었다. HBeAg/anti HBe의 발현 양태에 따라 음성/음성에서 2명(66.7%), 음성/양성에서 30명(41.1%), 양성/음성에서 24명(85.7%), 양성/양성에서는 3명(100%)에서 증폭되었다. 2. Multiplex PCR에서는 58명의 유전자형이 C형, 1명에서는 B형과 C형이 동반 출현하였다. 3. Genotype specific primer를 이용하여 각각 따로 PCR을 시행한 경우에 A형에 의하여 증폭된 예가 1예, B형에 의하여 증폭된 예가 1예, C형에 의하여 증폭된 예가 59예로 A형과 B형 모두가 C형에서 증폭된 예였다. 4. 한 쌍의 시발체에 의하여 증폭되었던 A형과 B형 및 C형의 일부에서 염기를 분석한 결과 모두 C 유전자형이었다. 결론: HBsAg이 양성인 제주 지역 주민의 HBV의 유전자형은 C형일 것으로 생각된다. Background/Aims: Hepatitis B virus (HBV) was classified into 8 genotypes by a sequence divergence in the entire genome designated from A o H. HBV genotypes have distinct geographic distributions. Recently, HBV genotypes have been partially found as influencing the clinical manifestation of chronic liver disease in hosts. In Korea, the distribution of HBV genotypes remains unclear. The aim of this study was to evaluate the prevalence of the HBV genotype on Jeju Island. Methods: Hepatitis B virus genotypes were evaluated among 107 hepatitis B carriers residing on Jeju Island. We used single PCR and multiplex-PCR assay with genotype-specific primer pairs for HBV genotypes A-F for the genotyping. Results: 1. Fifty nine samples (55%) were positive for HBV DNA. The positivity was different according to the pattern of HBeAg/anti-HBe expression, as -/-; 2/3 (66.7%), -/+; 30/73 (30%), +/-; 24/28 (85.7%) and +/+; 3/3 (100%). 2. In the single primer set of genotype-specific PCR, 59 samples (100%) were detected as genotype C and 2 (3%) were also detected as genotype A and B. 3. In multiplex-PCR, 58 samples (98%) were detected as genotype C and only one (2%) as a mixed pattern of genotype B and C. 4. When the PCR products were amplified with universal sense and genotype specific anti-sense from one genotype A, one B, and 2 C, all were included in genotype C. Conclusions: These results suggest that on Juju Island, almost all HBV genotypes are C.(Korean J Hepatol 2004;10:42-50)

Al-Zn-Mg合金의 加工熱處理에 미치는 遷移元素의 影響

趙顯驥,李基大,金熙都 慶北大學校 1982 論文集 Vol.33 No.-

An investigation for influence of a small additions of transition metals (Mn, Zr, Cr) on the thermomechanical treatment (TMT) in Al-Zn-Mg alloys has been carried out by means of the measurements of tensile strength and micro-vickers hardness. The results obtained from this experiment are summarized as follows; 1) Hardness and strength of Al-Zn-Mg alloys are increased remarkable by a small additions of transition metals (Mn, Zr, Cr) at as-quenched state. 2) Influence of a small additions of transition metals like Mn, Zr and Cr added to Al-Zn-Mg alloys on ageing phenomena was retarding the ageing character. 3) The mechanical properties (hardness and strength) of Al-Zn-Mg alloys which were processed by TMT are increased when the deformation rate is lower than 30%, on the other hand those of Al-Zn-Mg alloys added transition metals were decreased with increasing deformation rate.

Cu-Al-Ni 合金에 있어서 마르텐사이트 變態에 따른 內部摩擦

趙顯麒,禹基道,金圭鎭 慶北大學校 1984 論文集 Vol.37 No.-

The internal friction measurement was carried out by the torsion pendulum method with automatic recording of the virbration patterns. The critical range of the martensitic transformation was checked by measuring the electrical resistance and by morphological observation. The extent of internal friction in the region of the peak depends on the previous rate of temperature change and decreases sharply during a few minutes of isothermal holding. The high level of internal friction found in Cu~Al-Ni alloy is likely to due to the reversible movement of interfacial and twin boundaries on exposure to alternating stresses.

Chiral Cu(Ⅱ)착화합물과 촉매로 유도된 Carbenoid반응에 의한 2-phenylcyclopropane-carboxylic acid의 광화학 이성체의 합성

조남숙,신대현,이종철,나도영 충남대학교 1985 忠南科學硏究誌 Vol.12 No.2

(-)-(IR, 2R)-trans-menthyl-2-phenylcyclopropanecarboxylate has been synthesized with aid of chiral Cu(Ⅱ) complex catalyst by the addition reaction of menthyldiazoacetate to the styrene. The yield was 80%, the purity of trans-compound over 90% and optical purity 75%. These results show the possibility of synthesis of (-)-(IR, 2R)-trans-2-phenylcyclopropane-carboxylic acid with high purities of optical activity and geometric specificity.

축압축력을 받는 원통형 쉘의 비선형 붕괴해석

조현영,김성도,김미옥 부산대학교 1995 生産技術硏究所論文集 Vol.48 No.-

To investigate imperfection-sensitivity for the cylindrical shell structures, a numerical method for evaluating the equilibrium path of a cylindrical shell subjected to axial load and eccentrically axial load is presented. The effects of both material and geometric nonlinearities were also considered in the analysis. The nonlinear formulation was based on the total Lagrangian description and the nonlinear equations were solved by the Newton-Raphson method with load incremental procedures. Degenerate shell elements with layered approach were employed for the analysis. Comparing with experimental results, nonlinear collapse analysis of cylindrical shells subjected to axial compression is carried out. The characteristics of the elasto-plastic deformation can be found in several numerical examples and the local eccentricity of the axial load affects considerably on the level of critical load due to local buckling. 불완전량이 있는 원통형 쉘의 좌굴 거동을 조사하기 위해, 중심 축하중 및 편심 축하중을 받는 원통형 쉘의 평형 경로를 재료 및 기하학적 비선형성이 고려된 수채해석을 통하여 추적하였다. 이때의 비선형 중분 평형방정식은 total Lagrangian 정식에 따라 유도되며, 하중증분법과 Newton-Raphson 법으로 해를 구한다. 본 연구에는 충분할 해석이 가능한 degenerate 쉘 요소를 사용하였다. 비선형 붕괴해석 결과와 실제 실험결과와 비교하였으며, 여러 가지 해석예제를 통하여 탄소성 변형의 특성을 알 수 있었다. 그리고 원통형 쉘의 국부좌굴시 편심하중에 의한 내하력의 감소현상이 두드러짐을 알 수 있었다.

후방 추돌 사고 후 심한 증상을 보이는 경추부 병변에 대한 수술학적 소견

김명현,조도상,문준규 梨花女子大學校 醫科大學 醫科學硏究所 2003 EMJ (Ewha medical journal) Vol.26 No.1

Three cases operated on with anterior micorforaminotomy because of chronic symptoms after whiplash injury were analyzed. The indications for surgery were medically intractable, definite cervical radicular symptoms with trivial cervical pathology on preoperative usual radiological studies. On operative findings, the minor disc protrusion and thickening of posterior longitudinal ligament were the representative pathologies. At follow-up, all patients showed disappearance of pre-operative symptoms. Based on Robinson's criteria for the surgical results, all 3 patients had good results. We suggest the trivial cervical pathologies, proved by the target-oriented, anterior microforaminotomy, can be the origin of cervical radiculopathy after low-velocity, rear-car collision injury in our series.

주사 전자현미경을 통하여 확인된 단락관내 소집락 형성 : 증례보고 Case Report

남도현,왕규창,이현구,조병규 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10

Two patients who had bacterial colonies in shunt catheter confirmed by scanning electron microscopy(SEM) are described Coagulase negative staphylococcus had been cultured persistently from ventricular cerebrospinal fluid in spite of adequate medical treatment for shunt infection and the normalized profile of the cerebrospinal fluid. The authors controlled the shunt infection by removal of shunt catheters. Based on these SEM findings, it is mandatory to remove an infected shunt and replace it with a new one after proper antimicrobial therapy in cases with persistently positive culture.