• Title/Summary/Keyword: 호르몬치료

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Clinical Usefulness of Thyrotropin Binding Inhibitor Immunoglobulin (TBII) Assay by the Comparative Method (측정법에 따른 갑상선자극호르몬 결합억제면역글로블린(TBII)의 임상적 유용성 검토)

  • Park, Hee-Won;Shin, Hee-Jung;Kim, Tae-Hoon;Noh, Gyeong-Woon;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.175-180
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    • 2009
  • Purpose: Detection of TSH-binding inhibitor immunoglobulin (TBII) in patients with hyperthyroidism is an important result of Graves' disease (GD) and hyperthyroidism treatment. This has been made out an inspection by commercial radio-receptor assays. To increase the sensitivity and the specificity of the assay, many results of the assay were reported. In this study we evaluated the clinical usetulness of TBII assays by the Comparative method. Material and Methods: We were measured by using healthy control group (n=30, male=20, female=10) of Seoul National University Hospital Healthcare System Gangnam Center from January to March in 2009. Similarly, We were measured by using hyperthyroid (TSH<$0.05\;{\mu}IU/mL$, FT4>1.80 ng/dL) experimental group (n=58, male=14, female=44) of division of endocrinology and metabolism department of internal medicine Seoul National University Hospital from January to March in 2009. We made a comparative study of each two assays from the first generation to the third generation. We were used of TSAb assay as a measurement of GD diagnostic technique. Results: The specificity of healthy control group was 100% according to the generation. (Specificity=100%, n=30) The sensitivity of hyperthyroid experimental group were the first generation RSR<%> (79.3%, n=58), RSR (51.7%, n=58), the second generation RSR-CT (93.1%, n=58), BRAHMSCT (98.3%, n=58), the third generation ELISA (94.6%, n=56), ECLIA (97.7%, n=58) and TS-Ab<%> (93.5%, n=46). Conclusion: We were used of TSAb assay as a measurement of GD diagnostic technique, The result of data showed a high correlation between the third generation TBII assay and the second generation TBII assay ($R^2$=0.923). Instead of the first generation assay, the second generation assay can be more useful in clincal diagnosis.

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Sports Psychiatry (스포츠 정신의학)

  • Han, Doug-Hyun;Na, Chul;Lee, Young-Sik
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.95-102
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    • 2004
  • Backgrounds: It was thought that sport was related with mentality. Compared to psychology, psychiatry has so far paid rather little attention to athletes. In this overview, I attempted to introduce the ideas of various observers of sports with the view of clinical psychiatry and summarized basic principle role of psychiatrist. Results and Discussions : To understand the athletic frame of mind, it is helpful to observe athletes in their psychologic development and when we do so we can quickly see trends that are not apparent by observing mature athletes alone. Psychobiology of sport would discuss some of the endogenous neurochemicals(hormone, neurotransmitter) that may be part and parcel of the athlete's psychiatric status. The psychological problems that frequently interfere with training and competition may be divided into five categories 1) choke, 2) slump, 3) injury, 4) interpersonal problem, 5) training dilemma. Psychiatric problem also arise in athletes like general people. various method for psychiatric patients like psychotherapy, group therapy, family systems perspective, and pharmacotherapy could been applied to sports psychiatry. Conclusions Although the contribution of sports psychiatry to sport is clinical one, psychiatrist's interest in role and conflict of athlete would enhance the molding of humanistic athletes who enjoy their life and sports.

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Factors Predicting the Development of Radiation Pneumonitis in the Patients Receiving Radiation Therapy for Lung Cancer (방사선 치료를 시행 받은 폐암 환자에서 방사선 폐렴의 발생에 관한 예측 인자)

  • An, Jin Yong;Lee, Yun Sun;Kwon, Sun Jung;Park, Hee Sun;Jung, Sung Soo;Kim, Jin whan;Kim, Ju Ock;Jo, Moon Jun;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.40-50
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    • 2004
  • Background : Radiation pneumonitis(RP) is the major serious complication of thoracic irradiation treatment. In this study, we attempted to retrospectively evaluate the long-term prognosis of patients who experienced acute RP and to identify factor that might allow prediction of RP. Methods : Of the 114 lung cancer patients who underwent thoracic radiotherapy between December 2000 and December 2002, We performed analysis using a database of 90 patients who were capable of being evaluated. Results : Of the 44 patients(48.9%) who experienced clinical RP in this study, the RP was mild in 33(36.6%) and severe in 11(12.3%). All of severe RP were treated with corticosteroids. The median starting corticosteroids dose was 34 mg(30~40) and median treatment duration was 68 days(8~97). The median survival time of the 11 patients who experienced severe RP was significantly poorer than the mild RP group. (p=0.046) The higher total radiation dose(${\geq}60Gy$) was significantly associated with developing in RP.(p=0.001) The incidence of RP did not correlate with any of the ECOG performance, pulmonary function test, age, cell type, history of smoking, radiotherapy combined with chemotherapy, once-daily radiotherapy dose fraction. Also, serum albumin level, uric acid level at onset of RP did not influence the risk of severe RP in our study. Conclusion : Only the higher total radiation dose(${\geq}60Gy$) was a significant risk factor predictive of RP. Also severe RP was an adverse prognostic factor.

Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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Clinical Study of Hypophosphatemic Rickets (저인산혈성 구루병에 대한 임상적 고찰)

  • Lee Chang-Jin;Cho Hee-Yeon;Kang Ju- Hyung;Shin Choong-Ho;Ha Il-Soo;Cheong Hae-Il;Yang Sei-Won;Choe Yong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.195-204
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    • 2004
  • Purpose: Hypophosphatemic rickets is a hereditary disease, characterized by hypophosphatemia due to renal phosphate wasting, impaired renal production of 1,25-dihydroxyvitamin $D_3$, rachitic bone deformities and impaired growth. The purpose of this study is to provide clinical profiles of patients with hypophosphatemic rickets in our hospital. Methods: Between July 1983 and February 2004, 56 patients were diagnosed as having hypophosphatemic rickets. The medical records of these patients were reviewed retrospectively. Clinical manifestations, family histories, laboratory data, treatment outcomes were described. Results: Fifty six patients were enrolled in this study. The average age at symptom onset and diagnosis were 20 months and 5 years respectively. Fourteen patients had family histories. The main clinical manifestations were bow legs and short stature. There was a significant negative correlation between the ages and the height z-scores at the time of diagnosis(r=-0.47, P=0.005). Initial laboratory data showed normocalcemia, hypophosphatemia, elevated serum alkaline phosphatase, decreased tubular reabsorption of phosphate and a normal range of 1,25-dihydroxyvitamin $D_3$ Radiographic examinations of bone revealed fraying, widening and cupping of the metaphyseal ends. Treatment consisted of Joulie solution and vitamin D metabolites, and resulted in improved biochemical and radiographic findings. However, height z-scores remained essentially unchanged(P=0.224). Complications of treatment were frequently observed, including hyperparathyroidism, nephrocalcinosis, and hypercalciuria. Sixteen patients had corrective osteotomy and 4 of them underwent leg lengthening together. Conclusion: There was a gap of several years between the onset of symptoms and the diagnosis. Early treatment seems to be essential to growth. For the earlier treatment, the offsprings of affected parents should be followed up closely.

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Psychology and Quality of Life in Cancer Patients on Radiation Therapy (방사선치료 중인 암 환자의 심리와 삶의 질)

  • Yang Jong-Chul;Chung Woong-Ki
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.271-279
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    • 2004
  • Purpose: The object of this study Is to investigate sociodemographic and clinical characteristics, psychology, self-esteem and quality of life in cancer patients on radiation therapy and to provide useful information for therapeutic approach to cancer patients on radiation therapy. Materials and Methods: The subjects were 36 patents who had been treated with radiation therapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients on radiation therapy were investigated, and symptom checklist-90-revised, Rosenberg Self-esteem Scale for self esteem, World Health Organization Quality of Life Assessment Instrument for quality of life were administered to subjects. And Spearman's correlation analysis was used among these. Result : The tendency of somatization, depression, anxiety and hostility in cancer group were significantly higher than normal group. Self esteem and quality of life in cancer group were significantly lower than normal group. No significant difference was found in comparison of psychology, self esteem and qualify on life according to sociodemographic variables. Among clinical characteristics, in the presence of metastasis in cancer patients, the scores of anxiety, phobia and paranoid ideation were higher In patients with pain, the score of somatization was higher And in case of weight loss, the score of somatization was higher. The higher score of depression, anxiety and hostility were significantly associated with lower self-esteem. And higher score of somatization, depression, anxiety and hostility were significantly associated with lower quality of life. Conclusion: Understanding and management of psychological symptoms, such as somatization, depression, anxiety, and hostility, and pain control are necessary to improve quality of life in cancer patients on radiation therapy.

Effect of 4 Weeks' Walking Exercise with Blood Flow Restriction on Insulin Resistance, Adipokines and Gut Hormones in Middle Aged Obese Women (혈류를 제한한 4주간의 걷기운동이 중년 비만여성의 인슐린저항성과 아디포카인, Gut hormone에 미치는 영향)

  • Oh, Du-Hwan;Kim, Jung-Hoon;Zhang, Seok-Am;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.3
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    • pp.489-498
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    • 2018
  • This study was conducted to investigate the effect of walking exercise with blood flow restriction (BFR) on insulin resistance, adipokines and gut hormones in middle aged obese women. Eleven obese women (BMI > 25kg/m2; body fat > 30%) wore pneumatic pressure belts at both femurs and performed walking exercise consisting of walking for 2 min and resting for 1min twice per day, 3 days/wk for 4 weeks. Insulin significantly increased after exercise (p<0.05), while glucose increased slightly, but not significantly. Additionally, HOMA-IR decreased significantly after exercise (p<0.05), while adiponectin and visfatin increased, but not significantly. Finally, ghrelin (p<0.05) and GLP-1 (p<0.05) increased significantly after exercise. These results suggest that walking exercise with blood flow restriction for 4 weeks improves insulin resistance, adipokines, and gut hormones in obese middle-aged women. Therefore, high intensity walking exercise with blood flow restriction for short periods of time has more positive effects on prevention and treatment of obesity-related metabolic diseases.

Rhythmic Control and Physiological Functional Significance of Melatonin Production in Circadian Rhythm (주기적 리듬 조절에 의한 멜라토닌 생산과 생리적 기능의 중요성)

  • Kim, Min Gyun;Park, Seul Ki;Ahn, Soon Cheol
    • Journal of Life Science
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    • v.23 no.8
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    • pp.1064-1072
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    • 2013
  • Circadian rhythm is controlled by hormonal oscillations governing the physiology of all living organisms. In mammals, the main function of the pineal gland is to transform the circadian rhythm generated in the hypothalamic suprachiasmatic nucleus into rhythmic signals of circulating melatonin characterized by a largely nocturnal increase that closely reflects the duration of night time. The pineal gland has lost direct photosensitivity, but responds to light via multi-synaptic pathways that include a subset of retinal ganglion cells. Rhythmic control is achieved through a tight coupling between environmental lighting and arylalkylamine-N-acetyltransferase (AANAT) expression, which is the rhythm-controlling enzyme in melatonin synthesis. Previous studies on the nocturnal expression of AANAT protein have described transcriptional, post-transcriptional, and post-translational regulatory mechanisms. Molecular mechanisms for dependent AANAT expression provide novel aspects for melatonin's circadian rhythmicity. Extensive animal research has linked pineal melatonin for the expression of seasonal rhythmicity in many mammalian species to the modulation of circadian rhythms and to sleep regulation. It has value in treating various circadian rhythm disorders, such as jet lag or shift-work sleep disorders. Melatonin, also, in a broad range of effects with a significant regulation influences many of the body's physiological functions. In addition, this hormone is known to influence reproductive, cardiovascular, and immunological regulation as well as psychiatric disorders.

Vitamin D in autoimmune, allergic, and infectious diseases (비타민 D의 자가면역, 알레르기, 감염질환에서의 역할)

  • Shim, Chae-Hyeon;Choi, Je-Min
    • Food Science and Industry
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    • v.55 no.3
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    • pp.276-283
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    • 2022
  • Vitamin D is a fat-soluble vitamin helps to retain calcium and phosphorus but also has shown to affect immune regulation and homeostasis. In humans, vitamin D3 and vitamin D2 and their metabolite has intensively studied in both innate and adaptive immune system that they are important to regulate overwhelmed inflammation. The vitamin D receptor is a nuclear hormone receptor which regulate various downstream target gene expressions as a transcription factor related to metabolism, immune regulation, etc. Vitamin D deficiency is a high-risk factor for inflammatory diseases like autoimmune disease and allergy. In addition, reduced vitamin D seem to correlate with susceptibility to the virus infection such as HIV and COVID-19. In this review, we will summarize up-to-date vitamin D's role in various immune cells, immune regulatory functions during autoimmune, allergic, and infectious diseases. We will also discuss about vitamin D supplement effects in human trial studies for COVID-19.

Roles of Local Estrogen and Progesterone Mediated Receptors in the Regulation of Endometrial Inflammation (자궁내막 염증에 대한 지엽적 에스트로겐 및 프로게스테론 매개 수용체의 역할)

  • Gyesik Min
    • Journal of Life Science
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    • v.33 no.1
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    • pp.102-113
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    • 2023
  • This review discusses the cellular and molecular mechanisms by which the endometrial estrogen and progesterone receptors regulate local estrogen production, expression of the specific estrogen receptors, progesterone resistance, inflammatory responses and the differentiation and survival of endometriotic cells in endometrial inflammation. The epigenetic aberrations of endometrial stromal cells play an important role in the pathogenesis and progression of endometriosis. In particular, differential methylation of the estrogen receptor genes changes in the stromal cells the dominancy of estrogen receptor from ERα into ERβ, and results in the abnormal estrogen responses including inflammation, progesterone resistance and the disturbance of retinoid synthesis. These stromal cells also stimulate local estrogen production in response to PGE2 and the SF-1 mediated induction of steroidogenic enzyme expression, and the increased estradiol then feeds back into the ERβ to repeat the vicious inflammatory cycle through the activation of COX-2. In addition, high levels of ERβ expression may also change the chromatin structure of endometrial mesenchymal stem cells, and together with the repeated menstrual cycles can induce formation of the endometriotic tissue. The cascade of these serial events then leads to cell adhesion, angiogenesis and survival of the differentiation-disregulated stromal cells through the action of inflammatory factors such as ERβ-mediated estrogen, TNF-α and TGF-β1. Therefore, understanding of the dynamic hormonal changes during the menstrual cycle and the corresponding signal transduction mechanisms of the related nuclear receptors in endometrium would provide new insights for treating inflammatory diseases such as the endometriosis.