Effect of Surfactants on TiO₂ Dispersion Stability and UV-Blocking Performance

문재훈,서성백 한국고분자학회 2024 한국고분자학회 학술대회 연구논문 초록집 Vol.49 No.1

Study Protocol of Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro)

문재훈,김지훈,이은경,이규은,공성혜,김여군,정우진,이창윤,유노을,황보율,송영신,김민주,조선욱,김수진,정은재,최준영,유창환,이유진,하정훈,정유성,류준선,황윤지,Sue K. Park,성호경,이가희,박도준,박영주 대한내분비학회 2018 Endocrinology and metabolism Vol.33 No.2

Background: The ongoing Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) aims to observe the natural course of papillary thyroid microcarcinoma (PTMC), develop a protocol for active surveillance (AS), and compare the long-term prognosis, quality of life, and medical costs between the AS and immediate surgery groups. Methods: This multicenter prospective cohort study of PTMC started in June 2016. The inclusion criteria were suspicious of malignancy or malignancy based on fine needle aspiration or core needle biopsy, age of ≥18 years, and a maximum diameter of ≤1 cm. If there was no major organ involvement, no lymph node/distant metastasis, and no variants with poor prognosis, the patients were explained of the pros and cons of immediate surgery and AS before selecting AS or immediate surgery. Follow-up visits (physical examination, ultrasonography, thyroid function, and questionnaires) are scheduled every 6 months during the first 2 years, and then every 1 year thereafter. Progression was defined as a maximum diameter increase of ≥3, ≥2 mm in two dimensions, suspected organ involvement, or lymph node/distant metastasis. Results: Among 439 enrolled patients, 290 patients (66.1%) chose AS and 149 patients (33.9%) chose immediate surgery. The median follow-up was 6.7 months (range, 0.2 to 11.9). The immediate surgery group had a larger maximum tumor diameter, compared to the AS group (7.1±1.9 mm vs. 6.6±2.0 mm, respectively; P=0.014). Conclusion: The results will be useful for developing an appropriate PTMC treatment policy based on its natural course and risk factors for progression.

Digital Medicine in Thyroidology: A New Era of Managing Thyroid Disease

문재훈,Steven R. Steinhubl 대한내분비학회 2019 Endocrinology and metabolism Vol.34 No.2

Digital medicine has the capacity to affect all aspects of medicine, including disease prediction, prevention, diagnosis, treatment, and post-treatment management. In the field of thyroidology, researchers are also investigating potential applications of digital technology for the thyroid disease. Recent studies using artificial intelligence (AI)/machine learning (ML) have reported reasonable performance for the classification of thyroid nodules based on ultrasonographic (US) images. AI/ML-based methods have also shown good diagnostic accuracy for distinguishing between benign and malignant thyroid lesions based on cytopathologic findings. Assistance from AI/ML methods could overcome the limitations of conventional thyroid US and fine-needle aspiration cytology. A webbased database has been developed for thyroid cancer care. In addition to its role as a nationwide registry of thyroid cancer, it is expected to serve as a clinical platform to facilitate better thyroid cancer care and as a research platform providing comprehensive disease-specific big data. Evidence has been found that biosignal monitoring with wearable devices may predict thyroid dysfunction. This real-world thyroid function monitoring could aid in the management and early detection of thyroid dysfunction. In the thyroidology field, research involving the range of digital medicine technologies and their clinical applications is expected to be even more active in the future.

姙娠 白鼠의 一酸化炭素 中毒이 胎仔에 미치는 影響

文載薰 고려대학교 의과대학 1976 고려대학교 의과대학 잡지 Vol.13 No.1

姙娠 白鼠의 一酸化炭素 中毒이 胎仔에 미치는 影響

文載薰,車喆煥 고려대학교 의과대학 1976 고려대 의대 잡지 Vol.13 No.1

Although carbon monoxide poisoning of pregnant woman was reported in 1859, very little has written about the effect of carbon monoxide on the fetus in uterus. Furthermore in this country, the major heat sources in private houses are coal products and this matter has given special emphasis on the pregnant women spending most of their lives in kitchens in which the air is easily and frequently polluted with carbon monoxide. With the reasons, the primary trial to prove the pathogenesis of fetal carbon monoxide poisoning was carried out using 38 pregnant rats of Sprague-Dawley species with 37 fetuses. As for the methodology, the rats were devided into two groups of control and exposure group. The latter was exposed to 500ppm of carbon monoxide through Douglas bag for 4 hours per day for 20 days continuously. And then, the fetuses were examined. The results of the experiment were as follows; 1. The abortion rate of exposure group was 44.6% by average showing significant relative risk of 3.3 comparing with 13.4% of the rate of control group. (p<0.005) 2. The fetuses of the exposure group were significantly lighter than those of control group showing difference of 0.57 gm by average, that is, 3.91±0.08 gm of exposure group and 4.48±0.14 gm of control group. (P<0.001) 3. The brains of fetuses of exposure group were significantly ligher than ones of control group showing difference of 17.6 ㎎ by average. (P<0.05) 4. The fetuses of the exposure group are shorter in length by 0.13㎝ by average, however, the difference is not significant statistically. (p<0.1)

Endocrine Risk Factors for Cognitive Impairment

문재훈 대한내분비학회 2016 Endocrinology and metabolism Vol.31 No.2

Cognitive impairment, including Alzheimer’s disease and other kinds of dementia, is a major health problem in older adults worldwide. Although numerous investigators have attempted to develop effective treatment modalities or drugs, there is no reasonablyefficacious strategy for preventing or recovering from cognitive impairment. Therefore, modifiable risk factors for cognitive impairmenthave received attention, and the growing literature of metabolic risk factors for cognitive impairment has expanded fromepidemiology to molecular pathogenesis and therapeutic management. This review focuses on the epidemiological evidence for theassociation between cognitive impairment and several endocrine risk factors, including insulin resistance, dyslipidemia, thyroiddysfunction, vitamin D deficiency, and subclinical atherosclerosis. Researches suggesting possible mechanisms for this associationare reviewed. The research investigating modifiable endocrine risk factors for cognitive impairment provides clues for understandingthe pathogenesis of cognitive impairment and developing novel treatment modalities. However, so far, interventional studiesinvestigating the beneficial effect of the “modification” of these “modifiable risk factors” on cognitive impairment have reportedvariable results. Therefore, well-designed, randomized prospective interventional studies are needed.

최근 5년간(1996-2000) 부산지역 소아 백혈병 환자에 대한 역학적 연구

문재훈,이순용,신종범,박재선,이영호,임영탁,박수은,Moon, Jae Hoon,Lee, Soon Yong,Sinn, Jong Beom,Park, Jae Sun,Lee, Young Ho,Lim, Young Tak,Park, Su Eun 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.10

목 적 : 소아 백혈병은 소아 악성종양 중 빈도가 가장 높으며 타 질환에 비하면 아직도 사망률이 높기 때문에 발생률에 대한 기초자료는 대단히 중요하다. 저자들은 1996년부터 2000년까지 5년 동안 부산지역에서 발생한 소아 백혈병 환자들에 대한 역학적 연구를 시도하였다. 방 법 : 해당기간 동안 부산시내 4개 대학병원과 11개 종합병원의 소아 입원 환자들 중에서 백혈병으로 최초 진단된 133명(남아 87명, 여아 46명)에 대하여 역학적인 조사를 하여 시행하였다. 결 과 : 1) 1996-2000년의 5년 동안 부산지역에서 발생한 소아 백혈병 환자수는 총 133명이며 연간 환자수는 20-33명의 범위였고 연평균 26.6명(남아 17.4명, 여아 9.2명)이었다. 남녀 성비를 보면 1.89 : 1로 남아가 훨씬 많았다. 2) 이 기간 동안 15세 이하의 부산시 소아인구 100,000명당 연령 및 성별 정정 연간 발생률을 보면 2.37-4.53의 범위로 평균 3.29이었으며 남아의 경우는 2.47-5.29의 범위로 평균 4.05이었고 여아는 0.76-3.36의 범위로 평균 2.43이었다. 3) 연령 특정 연간 발생률은 0-4세군이 3.78, 5-9세군이 3.08, 10-14세군이 3.08로 0-4세군에서 가장 높았다. 4) 소아 백혈병의 병형별 분포는 ALL이 71.4%, AML이 23.3%, CML이 4.5%이었고, 병형별 남녀 성비를 보면, ALL에서는 1.97 : 1로 남아가 거의 두 배나 많았고 AML에서는 1.21 : 1로 남아가 약간 많았다. CML은 6명 전원이 남아였다. 5) 연령군에 따른 소아 백혈병의 병형 분포를 보면, 급성 림프구성 백혈병은 5-9세 군에서, 급성 골수성 백혈병은 0-4세군과 10-14세군에서 공히 가장 많았다. 6) 백혈병의 병형별 남녀 성비를 보면, 급성 림프구성 백혈병은 1.97 : 1, 급성 골수성 백혈병은 1.2 : 1이었으며 만성 골수성 백혈병은 전원 남아였다. 결 론: 1996-2000년의 5년 동안 부산지역에서 발생한 소아 백혈병 환자들의 연령 및 성별 조정 연간 발생률은 평균 3.29였다. 저자들의 이와 같은 성적은, 이와 관련된 문헌들과 비교해 볼 때, 부산지역 소아 백혈병의 발생률이 1981년부터 지난 20년간 완만하게 증가되었음 시사하였다. Purpose : For the control of childhood leukemia, of which the mortality is still high, the basic data for the incidence has a great importance. The authors analyzed the data from 133 new patients with childhood leukemia between 1996-2000 in Busan, Korea. Methods : The data were obtained from 133 new cases(87 males and 46 females from 0 to 15 years old) of childhood leukemia who were residents of Busan and who were admitted to the 4 university hospitals and 11 general hospitals from 1996 to 2000. Results : The total number of the new childhood leukemia patients was 133 between 1996-2000; the average annual number of new patients was 26.6. The age-and-sex adjusted annual incidence rate (/100,000) was in the range of 2.37-4.53(male 2.47-5.29, female 0.76-3.36) with an average of 3.29 (male 4.05, female 2.43). Age-specific annual incidence rate(/100,000) was 3.78 in the 0-4 year age group, 3.51 in the 5-9 year age group and 3.08 in the 10-14 year age group. Of the major types of childhood leukemia, the distribution of ALL was average 71.4%, of AML 23.3%, and of CML 4.5%. Of the major types of leukemia by age range, ALL showed highest in the 5-9 year age group, while AML in 0-4 and 10-14 year age groups. Sex-ratio(male to female) of major type of leukemia was 1.97 : 1 and 1.21 : 1, in ALL and AML groups, respectively, while all were male in CML. Conclusion : The average age-and-sex adjusted annual incidence rate(/100,000) of childhood leukemia in Busan from 1996 to 2000 was 3.29. Compared to data in related articles, this data suggests a steady increase in the incidence of childhood leukemia in the Busan area over the last 20 years since 1981.

The Diagnosis and Management of Hyperthyroidism in Korea: Consensus Report of the Korean Thyroid Association

문재훈,이가희 대한내분비학회 2013 Endocrinology and metabolism Vol.28 No.4

Hyperthyroidism is one of the causes of thyrotoxicosis and the most common cause of hyperthyroidism in Korea is Graves disease. The diagnosis and treatment of Graves disease are different according to geographical area. Recently, the American Thyroid Association and the American Association of Clinical Endocrinologists suggested new management guidelines for hyperthyroidism. However, these guidelines are different from clinical practice in Korea and are difficult to apply. Therefore, the Korean Thyroid Association (KTA) conducted a survey of KTA members regarding the diagnosis and treatment of hyperthyroidism, and reported the consensus on the management of hyperthyroidism. In this review, we summarized the KTA report on the contemporary practice patterns in the diagnosis and management of hyperthyroidism, and compared this report with guidelines from other countries.

특발성 저신장증 환자에서 IGF-I 프로모터 cytosine-adenine repeat 유전자 다형성의 분석

문재훈,정우영 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.3

Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature. 목 적 : 특발성 저신장증 환자에서 IGF-I 유전자 다형성의 역할에 대한 연구는 아직 보고되지 않았다. 저자들은 한국인 특발성 저신장증 환자를 대상으로 IGF-I 프로모터 CA repeat 유전자 다형성에 대한 분석을 실시하였다. 방 법 : 신장 계측에 의해 2007년에 제작된 한국 소아 발육 표준 신장표에 의거하여 나이와 성별에 따른 신장백분위수가 3백분위수 미만인 131명을 대상으로 하였다. 성장호르몬 치료의 분석은 최소한 6개월 이상 성장호르몬 치료를 받은 37명을 대상으로 실시하였다. 유전자형의 분석은 유전자 염기서열분석을 통하여 실시하였다. CA repeat 횟수에 따른 대립유전자의 분포를 조사하였고, 이를 바탕으로 유전자형을 분석하였다. CA repeat의 heterozygous의 분석은 Gene Mapper software를 이용하였다. 혈청 IGF-I 농도는 RIA방법으로 측정하였다. 결 과 : 국인 특발성 저신장증 환자에서의 CA repeat의 분포는 15부터 22까지였으며, 19 repeat가 40.6%의 빈도로 가장 높았다. 유전자형에 따른 분포는 131명 중 17명(13.0%)이 19 CA repeat homozygous 였으며, 74명(56.5%)은 heterozygous, 40명(30.5%)은 19 CA repeat noncarrier 였다. 유전자형에 따른 키, 체중, BMI는 세군 모두에서 유의한 차이가 없었다. 유전자형에 따른 혈청 IGF-I 농도는 19 CA repeat noncarrier군에서 435.67±160.29 ng/mL로, 19 CA homozygous 군에서의 435.60±131.51 ng/mL, 19 CA heterozygous 군에서의 473.76±185.01 ng/mL과 유의한 차이가 없었다. 나이와 혈청 IGF-I 농도와의 상관관계를 분석한 결과 세군 모두에서 유의한 양의 상관관계를 보였다(P<0.01). 유전자형에 따른 첫 1년 동안의 성장호르몬 치료 효과를 분석한 결과 성장호르몬 치료 후 12개월로 환산한 성장속도는 19 CA homozygote군에서 7.6±3.4 Cm, 19 CA heterozygote군에서 7.9±2.6 cm 그리고 19 CA noncarrier군에서 7.7±2.8 cm로 세군 사이에 유의한 차이가 없었다(P>0.05). 성장호르몬 치료 전후의 신장표준편차점수 차이도 19 CA homozygote군에서 0.6±0.2, 19 CA heterozygote군에서 0.5±0.4 그리고 19 CA noncarrier군에서 0.5±0.4로 세군 사이에 유의한 차이가 없었다(P>0.05). 결 론 : 특발성 저신장증 환자에서의 IGF-I 프로모터 CA repeat 유전자 다형성의 분포는 15부터 22까지였으며, 19 repeat가 40.6%의 빈도로 가장 높았다. 키, 체중, BMI 그리고 혈중 IGF-I농도는 유전자형에 따라 유의한 차이가 없었다. 유전자형에 관계없이 나이와 혈중 IGF-I 농도 사이에는 모든 군에서 유의한 양의 상관관계를 나타내었다. 유전자형에 따른 첫 1년간의 성장호르몬 치료 효과도 유전자형에 따라 유의한 차이가 없었다. 그러므로 특발성 저신장증 환자에서는 IGF-I 유전자 다형성은 기능적 역할을 하지 못한다고 생각한다.

소아기 류마티스 관절염 환아에서 발생한 이차성 신유전분증 1 례

문재훈,이숙진,강미선,정우영,Moon Jae-Hoon,Lee Suk-Jin,Kang Mi-Seon,Chung Woo-Yeong 대한소아신장학회 2002 Childhood kidney diseases Vol.6 No.2

저자들은 소아기 류마티스 관절염으로 진단되어 간헐적으로 NSAID를 투여 받아 오던 중학교 신체검사에서 우연히 발견된 단백뇨와 혈뇨를 주소로 내원하였던 12세 여아에서 신생검상 신장의 아밀로이드의 침착을 확인하여 이차성 유전분증으로 진단된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Amyloidosis comprises a diverse group of systemic and local diseases characterized by organ involvement by the extracellular deposition of fibrils composed of subunits of a variety of normal serum proteins. Secondary amyloidosis is caused by the deposition of amyloid A(AA) protein in chronic inflammatory disease. Juvenile rheumatoid arthritis(JRA) has been known to be the most common cause of secondary amyloidosis. We experienced one case of secondary renal amyloidosis in a 12-year-old girl who had suffered from JRA for several years who had visited our renal clinic to evaluate the proteinuria with microscopic hematuria which was detected by chance at school urine screening examination. Apple green birefringence was observed under polarized light with Congo red stain at)d characteristic electron microscopic findings was also noted in renal tissues which was obtained by percutaneous renal biopsy. In our knowledge, this is the first case report of secondary renal amyloidosis developed in pediatric age in Korea.