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자가면역성 갑상선질환에서 TSH 수용체 항체의 역활에 관한 연구
고창순 대한핵의학회 1986 핵의학 분자영상 Vol.20 No.2
To evaluate the clinical and pathogenetic roles of TSH receptor antibodies in autoimmune thyroid diseases, TBII were measured by TSH-radioreceptor assay methods in 352 patients with Graves disease, 108 patients with other thyroid diseases and 69 normal persons. The normal range of TBII activity was less than 15%. The frequencies of detectable TBIl in 169 patients with untreated Graves disease, 31 patients with hyperthyroidism under treatment and 70 patients with euthyrodism under treatment were 92.4%, 87.1% and 54.3% respectively. However 12 (21.8%) out af 55 patients who have been in remission more than one year after discontinuation of antithyroid drugs treatment had detectable TBII activities in their sera. In 196 patients with untreated Graves disease, the frequency of TBII increased by increasing size of goiter and the frequency of proptosis was significantly high in patients whose TBII activities were more than 60%. TBll activities were roughly correlated with total TT, and free T, index but low r(2) value(less than 0.1). In 67 patients with Graves disease who were positive TB1I before antithyroid drugs treatment, TBII activities began to decrease from the third months and it was converted to negative in 35.8% of patients at 12 months after treatment. There were no significant differences of the declining and disappearing rates of TBII activities between high dose and conventional dose groups. TBII aotivities were significantly increased initially (2-4 months) and then began to decrease from 5-9 months after 'I treatment. There were two groups, one whose TBII activities decreased gradually and the other did not change untill 12 months after subtotal thyroidectomy. Alkhough preoperative clinical and laboratory findings of both groups were not different, TBII activities of non-decreasing group were significantly higher than those of decreasing group(74.6+18.6% vs 39.2+15.2%; P(0.01). Thirty three(55.9%) out of 59 patients with Graves disease relapsed within 1 year after discontinu- ation of antithyroid drugs. The positive rate of TBII at the end of antithyroid drug treatment in refapse group(n=33) was significantly higher than those in remission group (n=26) (63.6% vs 23,1%; P $lt; 0.05). The mean value of TBII activities at the end of antithyroid drug treatment in relapse group was significantly elevated (29.7+21.4% vs 14.7+11.1%; P$lt;0.05). Positive predictive value of TRII for relapse was 77.8%, which was not different from those of TRH not$gt;responsiveness(78.6%). The frequencies of detectable TBII in 68 patients with EIashimotos thyroiditis, 10 patients with painless thyroiditis and 5 patients subacute thyroiditis were 14.i /o, 20% and 0%, respectively. However in 25 patients with primary nongoitrous myxedema, 1 1 patients(44%) showed TBII activities in their sera. 9 out of ll patients who had TBII activities in their sera showed high TBIl activities(more than 70'/ binding inhibition) and their IgG concentrations showing 50% binding inhibition of 125I-bTSH to the TSH receptor were ranges of 0.1 2.6 mg/dl. One patierrt who had high titer of TBII in her serum delivered a hypothyroid baby due to transplacental transfer of maternal TBII. These findings suggested that 1) TSH receptor antibodies are closely related to a pathogenetic factor of Graves hyperthyroidism and of some patients with primary non-goitrous myxedema, 2) measurement of TSH receptor antibodies is helpful m evaluating the clinical outcome of patients with Graves disease during antithyroid drug treatment and in predicting the neonatal transient hypothyr- oidism of baby delivered from primary myxedema patients. 3) there are 2 or more different types of TSH receptor antibodies in autoimmune thyroid diseases including one which stimulates thyroid by binding to the TSH receptor and another which blocks adenylate cyclase stimulation by TSH.
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주사용(走査用) $^{113m}In$ 교질(膠質)의 조제(調製) 및 흰쥐에서의 장기분포(臟器分布)에 관(關)한 연구(硏究)
고창순,이종헌,장고창,홍창기,Koh, Chang-Soon,Rhee, Chong-Heon,Chang, Ko-Chang,Hong, Chang-Gi D. 대한핵의학회 1969 핵의학 분자영상 Vol.3 No.1
The newly developed diagnostic method with application of $^{113}Sn-^{113m}In$ cow system ($^{113}Sn:\;T\frac{1}{2}$ 118 days, $^{113m}In:\;T\frac{1}{2}$ 1.7 hrs, 390 Kev, Single ${\gamma}$) has the remarkable advantages such as increased diagnostic ability by single large dose administration of $^{113m}In$ with no subsequent radiation hazard and shortened examining time. We reformed the research of following scope with the use of developed $^{113}Sn-^{113m}In$ cow (25 mCi) generator: The sizes of particles produced under various conditions were investigated, and possibility for application to the scannings of various organs such as brain, liver, lung, bone marrow and blood pool etc. were studied. Results: $^{113m}InCl_3$ solution eluted from diluted HCl solution (pH 1.5) passed through $^{113}Sn-^{113m}In$ generator, and there can be produced various sized particles of colloidal indium. And there observed the state of distribution of $^{113m}In$ in each organ which showed many differences according to the particle sizes of colloidal indium. The results are stated as follows: 1. The adjustment of pH is the most important factor in making the desirable particle size of colloidal indium. The colloid for blood pool showed the highest level as 7.1%/gm blood, at pH 1.7, the colloid of pH 3.5 for liver scanning showed the highest level, 88.4%, in the liver, the colloid pH 6 showed the highest level, 3.1%, in the spleen, and the colloid of pH 11.0 showed the highest level, 85.3%/gm, in the lung. 2. The colloid for liver scanning made with NaCl-NaOH system showed the highest liver uptake at pH 7.2, and at either higher or lower pH than 7.2 showed decrease of liver uptake more or less. 3. The activity of $^{113m}In$ eluted through $^{113}Sn-^{113m}In$ generator indicated over 90% in the initial 4 ml, and particularly 88.1%-86.0% in the initial 2 ml. 4. The incubation time, tempertaure and mechanical irritation related to colloid formation and coating of colloid were not the definite condition of influence.
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