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      • KCI등재후보

        <SUP>18</SUP>F-FDG PET-CT에서 진단된 갑상선 우연종의 악성종양 발견율 및 특징

        이강영,고건<SUP>1<.SUP>,김선국<SUP>1<.SUP>,고진철<SUP>1<.SUP>,김행수,최상용,박신희,박용휘<SUP>2<.SUP>,Kang,Young,Rhee,Gun,Koh,<SUP>1<.SUP>,Sun,Kuk,Kim,<SUP>1<.SUP>,Jin,Chul,Koh,<SUP>1<.SUP>,Haeng,Soo,Kim,Sang,Yong,Choi,Shin 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        <B>Purpose: </B>PET-CT is often used to differentiate benign or malignant thyroid incidentalomas. In this retrospective study, we evaluated whether the <SUP>18</SUP>F-FDG uptake pattern and PET-CT findings improved accuracy over the standardized uptake value (SUV). <B>Methods:</B> <SUP>18</SUP>F-FDG PET-CT was performed on 2,178 subjects from August, 2004, to October, 2007, in Sung-ae Hospital. PET-CT was performed on 806 patients (37%) with suspected or known nonthyroidal cancer and 1,372 healthy subjects (63%) without a previous history of cancer. We investigated the clinical characteristics of patients, history, standardized uptake value (SUV), ultrasonography, and hormone levels in blood. Thyroidal cancer was confirmed by ultrasonography-guided fine needle aspiration and pathology after thyroid operation. <B>Results:</B> The prevalence of focal thyroid lesions on PET-CT was 8.8% (191/2178). Thyroid cancer confirmation was 7.9% (15/191). The maximum SUV of malignant thyroid lesions were significantly higher than that of benign lesions (7.00±3.08 vs. 4.49±1.84, P<0.001). <B>Conclusion:</B> PET-CT image interpretation that includes 18F-FDG uptake and SUV is better than PET-CT alone for differentiating benign and malignant lesions. Thyroid cancer risk increases as SUVmax levels increase. <B>(Ko</B><B></B><B>rean J Endocrine Surg 2008;8:38-42)</B>

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      • KCI등재

        Ca<SUP>2⁢</SUP> Sensitization Mechanism in Stretch-induced Myogenic Tone

        Jung-Sup,Kim,Sung-Kyung,Ryu,Duck-Sun,Ahn,Bok-Soon,Kang,Young-Ho,Lee 대한생리학회-대한약리학회 2002 The Korean Journal of Physiology & Pharmacology Vol.6 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        <P> It has been suggested that Ca<SUP>2⁢</SUP> sensitization mechanisms might contribute to myogenic tone, however, specific mechanisms have not yet been fully identified. Therefore, we investigated the role of protein kinase C (PKC)- or RhoA-induced Ca<SUP>2⁢</SUP> sensitization in myogenic tone of the rabbit basilar vessel. Myogenic tone was developed by stretch of rabbit basilar artery. Fura-2 Ca<SUP>2⁢</SUP> signals, contractile responses, PKC immunoblots, translocation of PKC and RhoA, and phosphorylation of myosin light chains were measured. Stretch of the resting vessel evoked a myogenic contraction and an increase in the intracellular Ca<SUP>2⁢</SUP> concentration ([Ca<SUP>2⁢</SUP>]<SUB>i</SUB>) only in the presence of extracellular Ca<SUP>2⁢</SUP>. Stretch evoked greater contraction than high K<SUP>⁢</SUP> at a given [Ca<SUP>2⁢</SUP>]<SUB>i</SUB>. The stretch-induced increase in [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> and contractile force were inhibited by treatment of the tissue with nifedipine, a blocker of voltage-dependent Ca<SUP>2⁢</SUP> channel, but not with gadolinium, a blocker of stretch-activated cation channels. The PKC inhibitors, H-7 and calphostin C, and a RhoA-activated protein kinase (ROK) inhibitor, Y-27632, inhibited the stretch-induced myogenic tone without changing [Ca<SUP>2⁢</SUP>]<SUB>i</SUB>. Immunoblotting using isoform-specific antibodies showed the presence of PKCα and PKCε in the rabbit basilar artery. PKCα, but not PKCε, and RhoA were translocated from the cytosol to the cell membrane by stretch. Phosphorylation of the myosin light chains was increased by stretch and the increased phosphorylation was blocked by treatment of the tissue with H-7 and Y-27632, respectively. Our results are consistent with important roles for PKC and RhoA in the generation of myogenic tone. Furthermore, enhanced phosphorylation of the myosin light chains by activation of PKCα and/or RhoA may be key mechanisms for the Ca<SUP>2⁢</SUP> sensitization associated with myogenic tone in basilar vessels.

      • KCI등재후보

        갑상선 수질암의 재발에 미치는 예후인자에 관한 연구

        이주희<SUP>1<,SUP>,이규언<SUP>1,2<,SUP>,박경식<SUP>1,2<,SUP>,구도훈<SUP>1,2<,SUP>,오승근<SUP>1<,SUP>,윤여규<SUP>1,2<,SUP>,Ju,Hee,Lee,M,D,<SUP>1<,SUP>,Kyu,Eun,Lee,M,D,<SUP>1,2<,SUP>,Kyung,Sik,Park,M,D,<SUP>1,2<,SUP>,Do 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.3

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        <B>Purpose:</B> Medullary thyroid carcinoma (MTC) is an uncommon thyroid tumor and the clinical course is variable. Many prognostic factors for MTC have been studied, but the significance of some of these factors remains con</B>troversial. This study aimed to evaluate the prognosis of recurrent disease in patients suffering with MTC. <P><B>Methods: </B>Fifty three patients who were operated for MTC from 1987 to 2006 in Seoul National University Hospital (SNUH) was retrospectively analyzed. Their medical records were reviewed for the demographic data, the laboratory data and the clinical course, the treatment and the long-term outcome. The median duration of follow-up was 66.5 months. Forty-two patients who were operated on primarily in this hospital were analyzed for their recurrence free survival. <P><B>Results:</B> The mean age atdiagnosis was 41.8 years. There were 28 femaleand 25 male patients. Eleven patients (22.9%) had multifocal disease. There were 32 sporadic MTC patients, 15 MEN2A patients, 3 familial medullary thyroid carcinoma (FMTC) patients and 1 MEN 2B patient. The 10- and 15-year overall survival rates were 91.9% and 76.5%, respectively; the 5- and 10-year recurrence-free survival rates were 70.6% and 45.5%, respectively. By univariate statistical analysis, the stage (stage I/II vs. III/IV, P= 0.025), extrathyroidal extension (P=0.039), cervical lymph node metastasis (P=0.044), and the postoperative calcitonin level (≥25 pg/ml) (P=0.003) were the significant factors that influenced recurrence. <P><B>Conclusion:</B> The overall prognosis of MTC is favorable. The significantfactors for a poor prognosis were the presence of lymph node metastasis, TNM stage III and IV, positive extrathyroidal extension at the first diagnosis and a high postoperative calcitonin level.<B> (Korean J Endocrine Surg 2008;8:183-188)</B>

      • KCI등재후보

        변형 근치 경부 림프절 절제술시 Iron-Intern 사용의 초기 경험

        박융석<SUP>1<,SUP>,정승필<SUP>1<,SUP>,구민영<SUP>2<,SUP>,최준호<SUP>1<,SUP>,김정한<SUP>1<,SUP>,김지수<SUP>1<,SUP>,Yoong,Seok,Park<SUP>1<,SUP>,Seung,Pil,Jung<SUP>1<,SUP>,Min,Young,Koo<SUP>2<,SUP>,Jun-Ho,Choe<SUP>1<,SUP> 대한갑상선-내분비외과학회 2013 The Koreran journal of Endocrine Surgery Vol.13 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        Purpose: Modified radical neck dissections (MRND) in papillary thyroid cancer surgery usually leave a long incision in the neck, causing cosmetic problems. We introduce a new surgical approach to MRND, with minimal lateral extension of transverse collar incisions, using the Iron-Intern. Methods: Between Jan 2008 and Dec 2008, 135 patients with papillary thyroid cancer who had undergone MRND were enrolled in this study. Total thyroidectomy and central node dissection with Kocker transverse collar incision with minimal additional lateral extension were performed before MRND. MRND were performed including level II, III, IV and V. Among 135 patients, we performed MRND with the Iron-Intern in 70 patients (Group I) and 65 patients who had MRND performed without the Iron-Intern (Group II) were included as a control group. In Group I, the Iron-Intern, with some modifications, was applied during the dissection of the level II area. The postoperative outcomes of the patients were analyzed and compared retrospectively. Results: The median hospital stay was significantly lower in Group I compared to Group II (P=0.003). The median operation time was significantly higher in Group I than Group II (P=0.002). The median numbers of harvested central and lateral lymph nodes were 10, 29 (group I) and 8, 23 (group II), respectively (P=0.073, P=0.148). Median levothyroxine off thyroglobulin levels were 1.2 and 1.8 in Group I and II, respectively (P=0.110). Conclusion: MRND, with minimal lateral extension using the Iron-Intern, can be easily and safely performed, leaving only minor scars in the neck.

      • KCI등재후보

        Tc-99m Sestamibi Scintigraphy를 이용한 부갑상선과 갑상선 결절의 감별진단

        서승원<SUP>1<,SUP>,주재균<SUP>1<,SUP>,윤정한<SUP>1<,SUP>,제갈영종<SUP>1<,SUP>,범희승<SUP>2<,SUP>,Seung,Won,Seo,M,D,<SUP>1<,SUP>,Jae,Kyun,Joo,M,D,<SUP>1<,SUP>,Jung,Han,Yoon,M,D,<SUP>1<,SUP>,Young,Jong,Jaegal,M,D,<SUP> 대한갑상선-내분비외과학회 2002 The Koreran journal of Endocrine Surgery Vol.2 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        Purpose: Differentiation of parathyroid and thyroid nodule is often difficult even with aids of ultrasonography and computed tomography. Tc-9m sestamibi (MIBI) scintigraphy is useful in the detection of hyperfuntioning parathyroid nodules. However, its role in the differentiation between parathyroid and thyroid nodules including malignancies is not well studied. Therefore, the purpose of this study is to evlauate the role of Tc-99m MIBI imaing in the differentiation of parathyroid adenoma from thyroid malignancy. Methods: Six patients (4 women, 2 men, mean age 43 years) with parathyroid adenoma and 4 patients (2 women, 2 men, mean age 56 years) with thyroid papillary cancer were enrolled. Ten and 180 minutes after injection of 740 MBq Tc-99m MIBI, pinhole image of the anterior neck was obtained. Nodule-to-thyroid ratio (N:T) was measured from same sized region of interests over nodule and normal thyroid bed. Retention Index (RI) was calculated as N:T 10 minus N:T 180 divided by N:T 10. Results: Patients with parathyroid adenoma showed similar N:T 10 as those with thyroid cancer (1.09 ⁢/⁣ 0.35, 1.24⁢/⁣ 0.36, respectively, P>0.05 ). However, RI of parathyroid patients was higher than thyroid cancer patients (0.64 ⁢/⁣ 0.29, ⁣0.12⁢/⁣ 0.20, respectively, P<0.05). Conclusion: Parathyroid adenoma showed higher retention rate of Tc-99m MIBI than thyroid cancer. Therefore, differntiation of parathyroid and thyroid nodule could be possible using Tc-99m MIBI scintigraphy. (Korean J Endocrine Surg 2002;2:15-18)

      • KCI등재후보

        갑상선 결절에 동반된 거대석회화에 대한 임상적인 고찰: 미세석회화와 비교분석

        왕서걸<SUP>1<.SUP>,백선미<SUP>2.4<.SUP>,임양수<SUP>1<.SUP>,정민희<SUP>3<.SUP>,봉진구<SUP>5<.SUP>,Hsu,Chieh,Wang,M.D.<SUP>1<.SUP>,Sun,Mi,Paik,M.D.<SUP>2,4<.SUP>,Yang,Soo,Lim,M.D.<SUP>1<.SUP>,Min,Hee,Jeong,M.D.<SUP>3< 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.4

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        Purpose: The clinical value of macrocalcifications as an indicator that predicts malignancy of thyroid nodules is controversial. The purpose of this study was to investigate additional ultrasonographic findings accompanying macrocalcifications for predicting malignancies in thyroid nodules. Methods: Between January 2005 and April 2008, 315 patients who had thyroid nodules with FNAB resulting in suspicious malignancies underwent thyroidectomy at the Wallace Memorial Baptist Hospital. Three hundred fifteen nodules, which were confirmed to be papillary thyroid carcinoma, and 192 nodules, which were confirmed to be benign, were reviewed retrospectively. We analyzed the malignancy rates according to calcification patterns and US findings of the associated solid nodules. Results: Among the 165 papillary thyroid carcinomas with microcalcifications, 161 accompanied solid nodules, and 4 were found with microcalcifications, but without solid nodules. Of the 161 papillary thyroid carcinomas with microcalcifications and solid nodules, 85.7% showed signs suggestive of malignancy. The remaining 14.3%, where only microcalcifications were present, showed indications of predicting malignancy. When solid nodules were found with macrocalcifications, there were indicators of predicting malignancy (100%). Also, for situations in which benign nodules were accompanied by solid nodules, 29% had signs of predicting malignancy. For situations in which benign nodules did not accompany solid nodules, 21% showed suspicious signs of predicting malignancy, but were all confirmed as benign. Conclusion: For nodules that accompany microcalcifications, there can be indicators that predict malignant conditions separate from other opinions that accompany microcalcifications. However, for macrocalcifications, it would be more effective to set up future treatment plans based on ultrasonographic features of solid nodules accompanying calcifications rather than the calcification itself. (Korean J Endocrine Surg 2008;8:260-265)

      • KCI등재후보

        갑상선 유두암의 우측 식도곁림프절(Right Paraesophageal Lymph Node) 전이 및 예방적 절제에 관한 후향적 연구

        김윤경<SUP>2<.SUP>,민선영<SUP>1<.SUP>,이영미<SUP>1<.SUP>,정기욱<SUP>1<.SUP>,정유석<SUP>1<.SUP>,류준선<SUP>1<.SUP>,김석원<SUP>1<.SUP>,Yun,Gyoung,Kim<SUP>2<.SUP>,Sun,Young,Min<SUP>1<.SUP>,Young,Mi,Lee<SUP>1<.SUP>,Ki-Wook,Ch 대한갑상선-내분비외과학회 2013 The Koreran journal of Endocrine Surgery Vol.13 No.2

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        Purpose: The purpose of this study is to determine the status of nodal disease, including the right paraesophageal node, in papillary thyroid carcinoma (PTC). Methods: A total of 116 patients with PTC underwent total thyroidectomy and prophylactic central node dissection, including right paraesophageal lymph nodes (RPE LNs). Metastases to RPELNs were analyzed by site and clinicopathologic variables. Recurrence rate and post-operative complications were also evaluated by comparing the right paraesophageal lymph node dissection (RPE LND) with the non-RPE LND group. Results: Central node metastases were detected in 57 (49.1%) patients; paratracheal and pre-tracheal lymph node metastases, total RPE LN metastases, and metastases only in RPE LN occurred in 50 (43.1%), 18 (15.5%), and 5 (4.3%) patients, respectively. Age, tumor size, tumor longitudinal location, extrathyroidal extension, and multicentricity were insignificant in RPE LN metastasis (P>.05). Although there was no significant statistical difference, tumors with lymphatic invasion and larger tumors (>1 cm) had more frequent RPE LN metastases. RPE LN metastases were frequent in deeply located tumors instead of superficially located tumors (P=0.015). Compared with the non-RPE LND group, the incidence of post-operative complications (transient hypocalcemia and vocal cord palsy) was not significantly different and there was no recurrence in both groups during the follow up period. Conclusion: The metastatic rate of the right paraesophageal lymph nodes was 15.5%; 83.3% of these were macrometastatic. Prophylactic RPE dissection compared with the non-RPE LND group, however, did not show a survival difference for 5 years.


        Extracellular ATP Stimulates Na<SUP>⁢</SUP> and Cl<SUP>⁣</SUP> Transport through the Activation of Multiple Purinergic Receptors on the Apical and Basolateral Membranes in M-1 Mouse Cortical Collecting Duct Cells

        Jin,Sup,Jung,Sook,Mi,Hwang,Ryang,Hwa,Lee,Soo,Kyung,Kang,Jae,Suk,Woo,Yong,Keun,Kim 대한생리학회-대한약리학회 2001 The Korean Journal of Physiology & Pharmacology Vol.5 No.3

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        <P> The mammalian cortical collecting duct (CCD) plays a major role in regulating renal NaCl reabsorption, which is important in Na<SUP>⁢</SUP> and Cl<SUP>⁣</SUP> homeostasis. The M-1 cell line, derived from the mouse cortical collecting duct, has been used as a mammalian model of the study on the electrolytes transport in CCD. M-1 cells were grown on collagen-coated permeable support and short circuit current (I<SUB>sc</SUB>) was measured. M-1 cells developed amiloride-sensitive current 5∼7 days after seeding. Apical and basolateral addition of ATP induced increase in I<SUB>sc</SUB> in M-1 cells, which was partly retained in Na<SUP>⁢</SUP>-free or Cl<SUP>⁣</SUP>-free solution, indicating that ATP increased Na<SUP>⁢</SUP> absorption and Cl<SUP>⁣</SUP> secretion in M-1 cells. Cl<SUP>⁣</SUP> secretion was mediated by the activation of apical cystic fibrosis transmembrane regulator (CFTR) chloride channels and Ca<SUP>2⁢</SUP>- activated chloride channels, but Na<SUP>⁢</SUP> absorption was not mediated by activation of epithelal sodium channel (ENaC). ATP increased cAMP content in M-1 cells. The RT-PCR analysis demonstrated that M-1 cells express P2Y<SUB>2</SUB>, P2X<SUB>3</SUB> and P2Y<SUB>4</SUB> receptors. These results showed that ATP regulates Na<SUP>⁢</SUP> and Cl<SUP>⁣</SUP> transports via multiple P2 purinoceptors on the apical and basolateral membranes in M-1 cells.

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