정상인 및 갑상선질환 환자에서 요중 요드배설량에 관한 연구

조보연,이홍규,고창순,김성연,박혜영,이석인,김원배 대한내분비학회 1995 Endocrinology and metabolism Vol.10 No.4

An adequate supply of dietary iodine is essential for the synthesis of the thyroid hormons. The measurement of dietary iodine intake is important for the clinical assessment of thyroid disease, especially in areas where iodine intake is excessive or deficient. To evaluate dietary iodine intake in Korean and its effects on thyroid function, we measured urinary iodine excretion with morning urine by electrode method in 184 normal subjects, 96 postpartum women and 181 patients with thyroid disease from October 1994 to February 1995. The results were as follows; 1) In normal control, the mean value of urinary iodine excretion was 3.8+-2.7mg/L (range 0.1-15.0mg/L). However, there was no sex and age differences in the urinary iodine excretion. 2) In postpartum women, the urinary iodine excretion was 9.0+-10.8mg/L who were not taken high iodine diet(Miyok-Guk), the mean value was statistically higher than normal control(p$lt;0.01) and significant increased the urinary iodine excretion after eating of high iodine diet(p$lt;0.01). 3) In volunteer, there were increase of urinary iodine excretion more than 10 folds after high iodine diet and medication. 4) The urinary iodine excretion in patients with thyroid diseases was not different from normal control, and there were no significant differences of urinary iodine excretion among the patient groups. The urinary iodine excretion in the acute stage of patients with subactue thyroiditis or painless thyroiditis was significantly increased compared to the recovery stage. However, it was not significantly different from that of normal control. In conclusion, urinary iodine excretion in Korean population is very high comparing to the reported data in Western population but similar with Japanese. The urinary iodine excretion is significant increase( more than 10-folds of basal level) after high iodine diet or high iodine containing medication in postpartum women or healthy persons. As a clue of destruction induced thyrotoxicosis, the urinary iodine excretion measurement is not valid in area where iodine intake is excessive like Korea(J Kor Soc Endocrinol 10: 386-394, 1995).

ECG Gated Cardiac Blood Pool Scan에서 좌심실기능 분석에 관한 연구

조보연,이명철,고창순,한만청,정준기,김광원,이정균,이용우 대한핵의학회 1980 핵의학 분자영상 Vol.14 No.1

심질환 환자에서 임상적으로 중요한 좌심실의 기능을 측정하기 위해서 종전에는 심도자법과 심장영화조영술, 초음파심음향도등이 사용되어 왔으나 시술의 복잡성, 위험성, 부정확성 등의 제한점이 있어 왔다. ECG gated cardiac blood pool scan 방법은 간단하고 안전하면서도 정확하여 널리 쓰이고 있고, computer에 연결시켜 정량적인 분석도 하고 있다. 저자들은 ECG gated cardiac blood pool scan으로 좌심실의 기능을 측정하기 위하여 1979년 4월부터 1980년 3월까지 서울대학교병원에 입원한 각종 심질환환자 165명과 정상대조군 26명에서 blood pool scan을 시행하고 분석하였다. 1) 20명에서 blood pool scan에서 구한 심박출계수를 X-ray의 심장영화조영술에서 구한 심박출계수와 비교하여 보았다. 상관계수가 0.885로 높은 정확도를 보이고 있었다. 2) 심박출계수를 New York Heart Association의 functional class에 따라 분류하여 보았다. 정상대조군에서는 66.7±6.1%, class Ⅰ에서 62.1±9.0%, Ⅱ에서 53.4±9.1%, Ⅲ에서 42.2±12.3%, Ⅳ에서 31.0±8.8%로 심질환의 정도를 잘 반영하여 주고 있었다. 3) 각종 심질환에서의 심박출계수를 구해 보았다. 허혈성심질환에서 34.4±16.7%, 심근병증에서 20.1±4.8%로 다른 심질환에 비해 심하게 감소되어 있었다. 심장경색증에서 경색의 범위가 넓을수록 심박출계수가 떨어져 있었다. 4) 확장기말과 수축기말에서 심장윤곽을 중첩시켜 좌심실의 벽운동을 분석하여 보았다. 심장병증 환자에서는 전반적인 hypokinesia가 있었고, 심장경색증 환자에서는 심전도소견과 상응하는 부위에서 akinesia를 관찰할 수 있었다. 이와같이 ECG gated cardiac blood scan은 비관혈적으로 간편하게 좌심실의 기능을 관찰할 수 있고 또 성적이 종래의 방법과 비교하여 매우 정확하였다. 또한 내과학적인 치료나 수술후의 경과를 쉽게 관찰할 수 있고 그 예후도 미리 예측할 수 있어 임상적으로 크게 유용하다. Most of clinical morbidity in cardiology are associated with abnormalities of the left ventricle. Several methods have been developed to measure the left ventricular function, including cardiac catheterization with cineangiography, echocardiography, and systolic time interval. But these methods have many limitations. ECG gated cardiac blood pool scan provides a safe, noninvasive, repeatable method for determining the left ventricular function. Utilizing the cardiac blood pool scan, we measured the left ventricular function in 165 cardiac patients, and in 26 normal subject. 1) Left ventricular ejection fractions were measured by cardiac blood pool scan, and compared in 20 patients with that measured by x-ray cineangiography. Correlation coefficient was 0.855. 2) Ejection fractions were classified by funtional class made in New York Heart Association. Ejection fractions well represented the functional status. 3) Ejection fractions decleased in cardiomyopathy (20.1±4.8%) and ischemic heart disease (34.4±16.7%)Impaired ejection fractions in myocardial infarction were associated with the extent of infarction. 4) Regional left ventricular wall motion was evaluated from the end-diastolic and end-systolic images. In cardiomyopathy diffuse hypokinesia was noted and in myocardial infarction akinesia was noted on the infarcted areas.

각종 심질환에서의 방사성 동위원소 심혈관 조영술에 관한 연구

조보연,고창순,정준기,박선양,김병국,류박영 대한핵의학회 1979 핵의학 분자영상 Vol.13 No.1

비관혈적 방법인 방사성동위원소 심혈관조영술 정성적 및 정량적인 분석을 시도하고자 1979년 3월부터 9월까지 서울대학병원에 입원한 각종 심질환환자 147명과 정상대조군 26명을 대상으로 방사성동위원소 심혈관찰영술을 시행하여 다음과같은 결과를 얻었다. 1) 심도자법으로 단락이 확진된 좌우단락 24예중 22예에서 진단할 수 있었고, 심장단락 21예에서는 전예에서 진단이 가능하였다. 방사성 동위원소법으로 좌우단락을 진단할 수 있는 최소의 Qp/Qs비는 1.3이었다. 2) 폐의 시간일방사능유선에서 최대방사능치(C1)와 같은 시간 뒤의 방사능치(C2)의 비 C2/C1는 정상대조군에서는 28.6±4.6%(21∼38%)이었고, 좌우단락에서는 67.8±12.2%로 정상대조군에 비하여 현저히 증가되어 있었다(P$lt;0.01). 3) 좌우단락 8예에서의 폐의 시간일방사능유선을 이용하여 구한 Qp/Qs비는 oxymetry법에 의한 Qp/Qs비와 유의한 상관관계가 있었다(상관계수 0.907, P$lt;0.01). 4) 개심수술후 단락의 교정여부를 방사성동위원소 심혈관조영술로 쉽게 확인할 수 있었다. 이상의 성적으로 방사성동위원소 심혈관조영술은 간단하고 안전하게 심장단락의 정성적 및 정량적인 분석을 할 수 있었으며 그 성적이 심도자법과 비교하여 높은 정확도를 보이고 있음을 알 수 있었고 반복시행이 용이하기 때문에 수술 후의 교정 여부도 쉽게 판정 할 수 있어 임상적으로 크게 유용하다고 생각되었다. Radionuclidd cardiac angiography has distinct advantages in safety, patient comfort, cost and ease of performance. This method offers diagnostic accuracy equivalent to that of cardiac catheterization. By this method the qualitative and quantitative diagnosis of the cardiac shunts are available. Also for it is repeatable tvith ease and more physiologic, it has application in following pre- and post-operative shunt patients. We performed the radionuclide cardiac angiographies in 147 cases of heart diseases and 26 cases of normal group. 1) The detection of left-to-right shunt was possible in 22 of 24 patients, and 2 patients were not diagnosed due to small shunt amount.(Qp/Qs$lt;l. 3) In 21 patients of right-to-left shunt, all were diagnosed by radionuclide cardiac angiography. 2) With the pulmonary time-activity curve, C2/C1 ratio was calculated. In normal control group, a range of C2/C1 ratios of 21∼38% was established with a mean value of 28.6±4.6%. In patients with left-to-right shunts determined by catheterizion data, the range of C2/C1 ratio was 33∼90%, with a mean value of 67.8±12.2%. 3) In 8 cases of left-to-right shunt, Qp/Qs ratios determined by radionuclide cardiac angiography were compaired with those of cardiac catheterization. The correlation coefficient was 0.907. (P$lt;0.001) 4) Postoperative radionuclide cardiac angiographies were clone in 21 cases. 3 of 13 patients with left-to-right shunts were found to have residual shunts. 8 patients with right-to-left shunts were confirmed to have no residual shunt.

Scintigraphic Demonstration of Bronchopleural Fistula

조보연,고창순,오연상,박석근,정연태 대한핵의학회 1985 핵의학 분자영상 Vol.19 No.1

甲狀腺疾患

趙普衍 한국병원약사회 1985 병원약사회지 Vol.2 No.1

99m Tc-tin colloid 를 이용한 간 스캔상 " Hot spot " 로 나타난 상대정맥증후군 1예

조보연,이명철,고창순,조경삼,김병태,신영태,권기익 대한핵의학회 1981 핵의학 분자영상 Vol.15 No.1

The hot spot on liver scan was demonstrated by many authors in various conditions such as SVC obstruction, Budd-Chiari syndrome, liver abscess, hemangioma of liver, hepatic venoocclusive diseases, IVC obstruction, and tricuspid insufficiency. And the appearance of hot spot in SVC obstruction is due to unsual collateral circulation. But there was no report of this hots pov t on liver scan in our country. We have recently observed one patient with SVC obstruction who shows well-defined area of increased radioactivity between right and left lobe of liver on liver scan using 99mTc-tin colloid, and demonstrated collateral circulations with RI venograghy using 99mTc-O4. The injection site of radiocolloid was left antecubital vein. This hot spot did not appear when the radiocolloid was injected into right leg vein. We report here this hoe spot on liver scan in SVC obstruction with review of some literactures.

방사성동위원소정맥촬영술의 진단적 의의 : X-선정맥조영술과의 비교 연구 A Comparison with X-ray Contrast Venography

조보연,고창순,배상훈,박재형,한만청 대한핵의학회 1981 핵의학 분자영상 Vol.15 No.2

Radionuclide venographies were performed in 138 limbs of 58 patients and X-ray contrast venographies were performed in 23 patients of them. Positive radionuclide venography findings were area of decreased radioactivity flow corre-sponding to the region of thrombosis, abnormal collateral flows and radioactivity stasis below the lesion. The success rate of radionulide venography was 89% and the overall concordance between radionuclide venography and X-ray contrast venography was 91%. Radionuclide venography is simple and easy to perform and less invasive than X-ray contrast venography. These results indicate that radionuclide venography is the most ideal screening test for the detection of venous thrombosis in patient with signs & symptoms of deep vein thrombosis.

혈청 ferritin 측정의 정도관리에 관한 고찰

조보연,이문호,고창순,김병국,김광원,서일택 대한핵의학회 1980 핵의학 분자영상 Vol.14 No.1

혈청 ferritin의 측정법중 상품화된 kit로 2-site immunoradiometric assay법을 검토하고 측정법의 정도관리를 위한 실험적 결론를 통하여 다음과 같은 결론을 얻었다. 즉 측정에 소요되는 시간은 6시간이며 total dose 대신 maximum binding을 이용하면 표준곡선의 slope가 이상적인 범위이내로 유지될 수 있었다. 세척의 효과는 Reaction I이 끝난후보다 Reaction Ⅱ가 끝난 후에 더욱 중요하였으며 bead를 tube에 둔체 세척할 때에는 5회씩 세척으로 충분하였다. 혈청을 희석 사용했을 때 예상치와 측정치 사이에는 좋은 비례식이 성립되었으나 혈청효과를 보기위왜 혈청을 많이 넣었을 때는 검체혈청이 총 용적의 50% 이상을 초과하면 high dose hook 현상이 관찰되었다. 이 방법으로 검정한 sensitivity는 2.77 ng/ml이었으며 within-assay precision의 변이계수는 21.7%(mean 6.9 ng/ml), 9.7%(mean 44.3 ng/ml) 및 8.0%(mean 178.4 ng/ml)이었으며 between-assay reproducibility의 변이계수는 7.4%이었다. 또한 방사면역측정법의 정도관리를 위한 문헌고찰을 통하여 이 실험적 고찰을 비교 검토하였다. A 2-Site immunoradiometric assay for serum ferritin was evaluated with commercially available kit. The assay required 6 hours. The slope of the standard curve kept up ideal range with the calculation of maxium binding instead of total dose until expire date. The stage II washing was more important than the stage I washing on the modified washing procedure as the bead keeping to remain in the tube. With this modified method, three times of tube washing was sufficient to reduce the significant errors. The measured values of serially diluted sample with standard diluting buffer was proportional to the predicted values. In the experiment of serum effect on the assay, a linear relationship from 5 to 50% serum, but beyond 50% there was reduction in measured ferritin concentration. It has a sensitivity of 2.77 ng/ml, within-assay precision (CV) of 8.0%, and between-assay reproducibility (CV) of 7.4% (mean 174.8 ng/ml). $quot;

담낭염 환자에서의 99m Tc-HIDA Scan 의 진단적 의의

조보연,박난재,안일민,장연복,홍기석,윤용범,고창순 대한핵의학회 1981 핵의학 분자영상 Vol.15 No.2

Cholescintigraphic studies with Tc-99m-HIDA(dimethyl iminodiacetic acid) were performed in 22 cases of normal subjects, 21 of acute cholecystitis, 22 of chronic cholecystitis and 12 others, with the results of, 1) In normal control group, liver and intrahepatic biliary tree, CBD and gall bladder, and G-I tract appeared at 10, 20 and 30 minutes after intravenous injection of Tc-99m-HIDA respectively. 2) In acute cholecystitis, 20 among 21 cases showed non-visualization of gall bladder with the diagnostic accuracy, sensitivity and specificity of 98.290, 95.290 and 100% respectively. 3) In chronic cholecystitis, 5 among 12 cases showed non-visualization of gall bladder and remained 7 among 12 cases showed poor contraction of gall bladder (4), delayed visualization of gall bladder(l) and normal findings(2). 4) In the other disease group, the 12 cases which initially suspected as acute cholecystitis, revealed normal scan findings to exclude the cystic duct obstruction easily. With the above results, this scintigraphic procedure was found very rapid, accurate and easily available method for the determining of the cystic duct patency.

악성종양의 임상적 병기에 따른 99m Tc-MDP 골주사의 비교관찰

조보연,이명철,고창순,윤휘중,김노경 대한핵의학회 1981 핵의학 분자영상 Vol.15 No.2

Bone scans with Tc-99m-MDP (methylene diphosphonate) were obtained and analysed in 574 from April, 1979 to June, 1931. Clinical staging was done in all patients without bone scan information and compared with bone scan to determine the predictive value of bone scanning. 1) Primary site of the maligancies were lung in 152, breast in 97, stomach in 43, colon in 15, esophagus in 9, liver and pancreas in 11, kidney in 14, bladder in 27, prostate in 22, thyroid in 20, skin in 11, bone in 9, head and neck in 36, ovary and uterus in 17, hematopoietic and lymphoretic ular system in 33, nervous system in 10, and others in 9 cases. Primary site was not defined in 39 cases. 2) Bone scans were positive in 186 cases(32.4%), which, included 48 cases(31.6%) of lung cancer, 27 cases(27.8%) of breast cancer, 12 cases(28%) of stomach cancer, 6 cases(40%) of colon cancer, 6 cases(43%) of kidney tumor, 4 cases(l5%) of bladder cancer, 14 cases(64%) of prostate cancer, 3 cases(l5%) of thyroid cancer and 66 other cases. 3) Bone scans were suspicious in 64 cases(11.2%) which included 29 cases(l9.1%) of lung cancer, 10 cases(l0.3%) of brest cancer, 4 cases(9.3%) of stomach cancer, one case(7%) of colon cancer, 3 cases(11%) of bladder cancer, 2 cases(l0%) of thyroid cancer and 15 other cases. 4) Out of 121 cases with early stage of malignancy (which included 20 cases of lung cancer in stage Ⅰ, Ⅱ, 38 cases of breast cancer, 13 cases of stomach cancer, 8 cases of kidney tumor, 14 cases of thyroid cancer in stage Ⅰ∼Ⅲ, and 6 cases of colon cancer, 14 cases of bladder cancer, 8 cases of prostate cancer in stage A∼C, bone scans were positive in 5 cases (4.1%) which included 3 cases of lung cancer one case of breast cancer and one case of prostate cancer, and considered as further advanced stage, Out of 121 cases with early stage of malgnancy, bone scans were suspicious in 21 cases(17.4%) which inlcuded 9 cases of lung cancer, 4 cases of breast cancer, 2 cases of stomach cancer, one case of colon cancer, 3 cases of bladder cancer, and 2 cases of thyroid cancer. Form these results, we concluded bone scan was useful in detecting bone metastasis in Patients of early stage of Malignancy, determining prognosis and establishing therapentic plan.