한국인에서의 다발성 내분비선종증의 특징

양정현,우상욱<SUP>1<.SUP>,Jung-Hyun Yang,and Sang-Uk Woo,<SUP>1<.SUP> 대한갑상선-내분비외과학회 2005 The Koreran journal of Endocrine Surgery Vol.5 No.1

Purpose: Multiple Endocrine Neoplasm (MEN) is a rare, complex and familial disease. There are MEN syndromes are inherited in an autosomal dominant fashion with high penetrance. The variations in the RET gene play an important role in the MEN syndromes. Recent advances in diagnosis, treatment and genetic study of patients with MEN in Korean are reviewed. Methods: There were 79 cases and 20 families with MEN syndromes in Korea which based on my experiences and 27 published papers. According to subtypes, there were classified and analyzed. Results: Mean age was 37.9⁑11.5 years old. Sex ratio was 1:2.6. There were 7 families and 23 cases with MEN type I in Korean. The clinical characteristics of MEN I in Korean are mostly not different from the previous reports except older age (mean=43.2 old-year) at diagnosis. The frequency of the MEN I germ-line mutation in Korean MEN I (80%) families was similar to those reported previously. There were 13 families and 52 cases with MEN type II A in Korean. Three-quarters (9/12) of the Korean patients with MEN IIa had RET mutations on codon 634 of exon 11 (4 patients, C634; 4 patients, C634Y; 1 patient, C634W), but a quarter (3/12) had mutations on codon 618 of exon 10 (2 patients, C618R; 1 patient, C618S). A small medullary carcinoma in a patient of MEN type II A family was detected by genetic mutation screening in SMC. MEN IIb was reported only 4 cases. A case showed a codon 918 mutation (M918T) at exon 16 of RET proto-oncogene. Conclusion: Multiple endocrine neoplasia is rare hereditary cancer syndromes expressing a variety of tumors. Withunderstanding of the molecular and clinical pathology of MEN syndromes, genetic screening is now feasible, and treatments have become more individualized based on genetic information of Korean. (Korean J Endocrine Surg 2005;5:1-6)

양측 부신 절제술의 수술 후 결과 분석

강보라,김지영,최준호,김지수,남석진,양정현1,김정한,Bo Ra Kang,Jiyoung Kim,Jun-Ho Choe,Jee Soo Kim,Seok Jin Nam,Jung-Hyun Yang1,Jung-Han Kim 대한갑상선-내분비외과학회 2013 The Koreran journal of Endocrine Surgery Vol.13 No.4

Purpose: Because the main drawback of bilateral adrenalectomy is permanent adrenal insufficiency and the subsequent risks of life-long steroid use, adrenal preserving partial adrenalectomy is being accepted as its alternative. The aim of this study is to investigate the indications for bilateral adrenalectomy and to assess the postoperative outcomes and steroid replacement according to operative methods. Methods: From May 1996 through July 2013, a total of 25 patients who underwent bilateral adrenalectomy in our institution were reviewed retrospectively. Surgical outcomes were compared between total and partial adrenalectomy, and postoperative steroid hormone replacement were examined according to the volume of remnant adrenal gland. Results: The median follow-up duration of 25 patients was 55.8 months. The most common indication for bilateral adrenalectomy was bilateral pheochromocytoma (n=16), which was associated with genetic mutation of RET or VHL gene in 11 cases. Cushing's syndrome (n=8) and hyperaldosteronism (n=1) were another indications of bilateral adrenalectomy. Total adrenalectomy was performed in 8 patients and adrenal preserving partial adrenalectomy in 17 patients. Among the 17 patients, only 5 patients needed adrenal hormone replacement and 2 patients had a recurrence at remnant adrenal tissue. Conclusion: Adrenal preserving partial adrenalectomy might be a better option for bilateral adrenal tumor than total adrenalectomy because it can reduce complications associated with adrenal insufficiency and recurrence of the disease is not common.

한국인과 미국인의 생애주기별 칼슘섭취 현황 비교

유아름 ( Areum Yu ),양윤정 ( Yoon Jung Yang ),정사랑 ( Sa Rang Jeong ),김지혜 ( Ji Hye Kim1 ),김유진 ( You Jin Kim ),권오란 ( O Ran Kwon ),오세영 ( Se Young Oh ),김정현 ( Jung Hyun Kim ) 대한영양사협회 2013 대한영양사협회 학술지 Vol.19 No.1

Calcium intake has been insufficient in all age groups in previous Korean national surveys. This study was conducted to investigate calcium intake in Korean and American populations at different ages. We analyzed two national survey data: the 2007∼2009 Korean National Health and Nutrition Examination Survey (KNHANES) and the 2007∼2008 National Health and Nutrition Examination Survey (NHANES). Statistically, survey procedures were applied using the weight, cluster, and strata variables. The mean calcium intake of Koreans at ages of 1∼2 y, 3∼5 y, 6∼11 y, 12∼18 y, 19∼64 y, and 65+y was lower than American populations at those ages. The sufficient proportions based on Korean Estimated Average Requirement (EAR) of 1∼2 y, 3∼5 y, 6∼11 y, 12∼18 y, 19∼64 y, and 65+y in Koreans were 45.5%, 33.1%, 24.3%, 16.6%, 32.7%, and 19.0%. While the sufficient rates based on American EAR of 1∼3 y, 4∼8 y, 9∼13 y, 14∼18 y, 19∼30 y, 31∼50 y, 51∼70 y, and 71+y in US population were 88.5%, 54.4%, 35.2%, 35.8%, 55.3%, 55.2%, 40.6%, and 24.5%. Overall, the major foods contributing to calcium intakes in Koreans were milk, baechukimchi, and anchovies, whereas, milk products, pasta, or bread were major contributions to calcium in American populations. The calcium supplement intakes in the American population were 5.5 mg (1∼2 y), 15.5 mg (3∼5 y), 13.9 mg (6∼11 y), 35.7 mg (12∼18 y), 150.3 mg (19∼64 y) and 334.4 mg (≥65 y). These results suggest that Korean adolescents and older adults are the most insufficient in dietary calcium intakes among Koreans. In order to accurately estimate calcium intakes in Korean populations, calcium supplements and calcium-fortified foods should be considered.

갑상선 유두암에서 BABA 내시경 갑상선 절제술에 대한 임상적 고찰

천보성,김재홍,박경식,배수연,정성일,유영범,양정현,윤여규<SUP>1<,SUP>,Bo Sung Cheon,Jae Hong Kim,Kyoung Sik Park,Soo Youn Bae,Sung Il Jung,Young Bum Yoo,Jung-Hyun Yang,and Yeo-Kyu Youn,<SUP>1<,SUP> 대한갑상선-내분비외과학회 2011 The Koreran journal of Endocrine Surgery Vol.11 No.3

Purpose: The aim of this study was to evaluate the operative feasibility and safety of endoscopic thyroidectomy via bilateral axillo breast approach (BABA) compared to conventional thyroidectomy in papillary thyroid carcinoma (PTC) patients. Methods: From July 2009 to November 2010, patients underwent BABA endoscopic thyroidectomy (ET group; n=41) or conventional open thyroidectomy (OT group; n=61) for PTC. Clinical and pathologic characteristics of patients, operation time, post-operative complications, cosmetic satisfaction and thyroglobulin (TG) level were analyzed retrospectively. Results: The mean age of the patients was 40.05±9.58 years (range 25∼61 years) and 46.21±13.68 years (range 19∼79 years) for the ET and OT group, respectively. The operative extent in the ET group did not include advanced thyroid cancer or lateral neck dissection. The size of the tumor was 0.78±0.59 cm (range 0.1∼3.00 cm) and 1.54 ±1.05 cm (range 0.3∼6.00 cm) for the ET and OT group, respectively. Extrathyroidal extension and number of retrieved lymph nodes were significantly higher in the OT group. Postoperative radioactive iodine ablation was performed on 25 patients (72.43%) in the ET group and 48 patients (78.69%) in the OT group. There was no abnormal uptake on radioactive iodine scans in the iodine-treated patients and no significant differences in postoperative off-T4 TG levels between the two groups. There were no significant differences in operative time, amount of drainage, postoperative hospitalization period, hypocalcemia, and vocal cord palsy between the two groups. Cosmetic results of ET group were rated as excellent in a 3-month postoperative questionnaire by 25 (72.43%) of 35 patients. Conclusion: Endoscopic thyroidectomy via the bilateral axillo breast approach can be a feasible and effective option for PTC in selected cases. (Korean J Endocrine Surg 2011;11:158-163)