• 대한핵의학회지
• /
• 제25권1호
• /
• pp.101-109
• /
• 1991

To diagnosis and understand the pathophysiologic status of thyroid disease, not only hormonal measurments but also thyroid scan is believed to have a unique role. Especially in the cases of the change of the thyroid function by thyroiditis, it is emphasized that thyroid scan can be helpful in differential diagnosis. Discordant results of thyroid hormone levels and thyroid scan are found in transient hyperthyroidism, or in transient hypothyroidism. We analysed and reevaluated thyroid scan to look at the importance of thyroid scan. The results are summerised as folows: 1) 80% of hyperthyroid patients had hyperthyroidism increased RAIU with even density. they are compatible with Graves' disease. 2) 2.1% of hyperthyroid patients had normal or decreased RAIU, which are classfied as high iodine turn over genuine hyperthyroidism. 3) 8.5% of hyperthyroid patients had markedly decreased RAIU at both 2 hour and 24 hour, whose patholgic processes are suggested to be heterogenous namely subacute thyroiditis, postpartum thyroiditis, Hashimoto's thyroiditis, and painless thyroiditis. 4) 45% of hypothyroid patients had increased 24hr RAIU, 30% of hypothyroid patients were normal, 25%, decreased. In conclusion, thyroid scan should be reevaluated its useful role to asses the pathophysiologic status of thyroid disease. Especially in cases of transient thyrotoxicosis, thyroid scan is essential to diagnose and follow up the disease process.

• 대한두경부종양학회지
• /
• 제14권1호
• /
• pp.54-60
• /
• 1998

Objectives: We'd like to give help in diagnosis and treatment of children's thyoid tumor through our clinical experiences and reference consideration. Materials and Methods: The authors report their experiences with 33 cases of thyroid tumor in patients younger than 16 years of age who were treated at Presbyterian Medical Center from 1979 to 1995. Results: 1) Girls were more predominant than boys by a ratio of 5.6:1. The peak incidence was in the 15 years old of age. 2) The final diagnosis in the 33 patients were thyroid carcinoma in 12 cases, nodular goiter in 6 cases, adenoma in 6 cases, Graves disease in 4 cases, Hasimoto's disease in 4 cases and cyst in 1 case. 3) All of 12 patients with thyroid cancer had nodular tumor. 4) In 5 of 6 patients with palpable cervical lymphadenopathy, the final diagnosis was thyroid carcinoma. 5) Delayed diagnosis arose in 6 of 12 thyroid carcinomas which were treated for long periods as benign disease. 6) The surgical procedures were total thyroidectomy in 3 cases, subtotal thyroidectomy in 13 cases and thyroid lobectomy in 17 cases. 7) 11 of 12 patients with thyroid carcinoma had subtotal or total thyroidectomy with lymphnode dissection and only one had lobectomy. 8) The overall rate of postoperative complication was 3%(1 of 33 patient). 9) Postoperative $^{131}I$ therapy was done in 7 case because of recurrence and distant metastasis in six and severe local invasion in one. 10) In thyroid cancer, the metastatic rate of lymph node at initial surgery was 81%(9/11) and rate of recurrence was 50%(6/12). 11) Patients with thyroid carcinoma were followed up for a mean of 12 years but only one died as a result of thyroid carcinoma 3.5 years later. Conclusion: The authors suggest that thyroid tumors in childhood should receive the benifit of joint management by endocrine pediatrician and experianced surgeons with an agreed protocol of diagnosis and management. We, also, recommend aggressive surgical and $^{131}I$ treatment as the most effective regimen for children with thyroid carcinoma.

• 대한두경부종양학회지
• /
• 제13권1호
• /
• pp.16-23
• /
• 1997

Although normal thyroid epithelial cells do not constitutively express HLA-DR antigen, their expression in wide spread within thyroid glands obtained from the human with autoimmune thyroid disease and with many neoplastic thyroids. We have, therefore, studied immunohistochemically with regard to the expression of HLA-DR antigen of thyroidectomy specimens from 50 patients of various thyroid diseases with use of paraffin-embedded tissue. One or two sections from each case were stained with commercially available mouse monoclonal antibody for class II HLA-DR antigen(HLA-DR/Alpha, DAKO) and examined by semiquantitative counting system for thyrocytes, neoplastic thyrocytes and other cells expressing HLA-DR antigen. All patients with lymphocytic thyroiditis(2/2) and diffuse hyperplasia(Graves' disease)(5/5), most patients with Hashimoto's disease(9/ll) expressed HLA-DR antigens in thyrocyte with abundant HLA-DR expressing lymphocytic infiltrates with lymph follicle formation in its vicinity or adjacent to the lesion. Most patients with papillary carcinoma(9/1l) had HLA-DR antigen detected in malignant thyrocytes ; while follicular carcinoma(0/3) and follicular adenoma(0/5) did not have detactable HLA-DR immunoreactivity. Adenomatous goiter(3/7) had HLA-DR antigen detected focally in lesser than half cases. Conversely, in four papillary carcinomas and three adenomatous goiters, HLA-DR expression of thyrocytes was found in the absence of HLA-DR expressing lymphoid infiltrates. In such cases therefore other factors more than thyroid autoimmunity must be causative for HLA-DR immunoreactivity. The results of this study indicate as follows. 1) The expression of HLA-DR on thyrocytes involved in autoimmune reactions appeared to be secondary to cytokine release from associated lymphocytic infiltrates. 2) Thyrocytes in thyroid lesions with equal degrees of lymphocytic infiltration without HLA­DR expression exhibited no HLA-DR immunoreactivity. 3) In neoplastic thyrocytes, most papillary carcinoma(9/11) exhibited detactable HLA-DR expression, while follicular carcinoma/adenoma(0/3/0/5) exhibited no detactable HLA-DR immunoreactivity which suggest the existence of divergent mechanisms inducing and modulating HLA-DR expression of different types of neoplastic thyrocytes.

• 대한두경부종양학회지
• /
• 제11권2호
• /
• pp.119-124
• /
• 1995

Traditionally, wound drainage after thyroid or parathyroid surgery has been widely used to prevent airway obstruction due to accumulation of hematoma or seroma within the paratracheal dead space. Recently, however, the routine use of drains after thyroid or parathyroid surgery has become a matter of controversy. To determine whether the rouine use of drains after thyroid or parathyroid surgery is warranted, a prospective study on the complications after various types of thyroid or parathyroid surgery without wound drains was conducted. Three hunded sixty-six consecutive patients underwent thyroid or parathyorid surgeries by one surgeon from January through December 1994 were included in this study. Of these, only 38 patients (10.4%) required the wound drains. Indications for drainage included the patients with a large dead space(n=9) or wet operative field at the conclusion of surgery(n=11), and patients with radical neck disection(n=18). In the remaining 328 patients(89.6%), the wounds were closed without drains after thyroid lobectomy and isthmusectomy(n=226), bilateral subtotal thyroidectomy(n=21), total or near-total thyroidectomy(n=62), isthmusectomy(n=9) and parathyroid surgery(n=l0). Histologic findings revealed benign tumors in 214(65.2%), carcinoma in 89(27.1%), Graves' disease in 15(4.7%), hyperparathyroidism in 7(2.1%) and parathyroid cyst in 3(0.9%). Among the 328 patients without drain used, wound related complications were seen in only 15 patients(4.6%); 12 patients with seroma and 3 patients with hematoma. All but one complications could be controlled by two or three aspirations, and the remaining one patient required re-exploration. There were no instances of laryngeal nerve palsy or wound infection. The mean length of hospital stay after surgery was 2.8 days with a range of 1 to 11 days. These results support the routine use of drains is not warranted in most thyroid or parathyroid surgeries.

• 대한한방부인과학회지
• /
• 제34권3호
• /
• pp.114-136
• /
• 2021

Objectives: The purpose of this study is to analyze the effectiveness and safety of herbal medicine treatment for treating hyperthyroidism. Methods: We searched for randomized controlled trials of Hyperthyroidism treated with herbal medicine, published from January 2016 to May 2021, through electronic database such as Pubmed, EMBASE, China Academic Journal (CAJ). Interventions and results of the selected clinical studies were analyzed. Results: The 25 randomized controlled trials were finally included according to the inclusion and exclusion criteria. Treatment group was treated with herbal medicine alone in 2 studies, and with herbal medicine and conventional medicine in 23 studies. Control group was treated with conventional medicine. Outcome measures are total efficacy rate, thyroid function test, Traditional Chinese medicine (TCM) syndrome scores, liver function test, recurrence rate, etc. Prunellae Spica (夏枯草) (60%) was the most frequently used herb in herbal medicine treatment. In all of 25 studies, treatment group was more effective and safer for hyperthyroidism than the control group. Conclusions: This study indicates that herbal medicine treatment alone or combined with conventional medicine treatment could be helpful in improving the therapeutic effect on hyperthyroidism and reducing side effects as well.

• 대한한의학방제학회지
• /
• 제31권3호
• /
• pp.203-213
• /
• 2023

본 증례는 그레이브스병에 의한 갑상선기능항진증으로 진단된 환자에서 메티마졸 단독 투여에도 계속된 갑상선기능항진증의 증상치료를 위하여 한의 변증진단(辨證診斷) 과정을 통하여 심담허겁(心膽虛㥘)과 심화상염(心火上炎) 변증형(辨證形)을 도출하고 가미온담탕(加味溫膽湯)에 청심연자음(淸心蓮子飮)을 합방(合方)한 한약을 메티마졸과 병행투여 한 사례이다. 본 증례에서 한약이 메티마졸의 갑상선 호르몬 억제 효과는 계속 유지하면서 갑상선기능항진증 환자의 증상을 완화한 효과를 보여준 결과는 갑상선기능항진증 치료에 있어서 한약이 베타 차단제를 대체하여 메티마졸과 병행투여할 수 있는 약물로써 가능성이 있다는 것을 보여준다.

• 한국산림과학회지
• /
• 제81권2호
• /
• pp.191-199
• /
• 1992

본(本) 실험(實驗)의 목적(目的)은 천원(天原), 영동(永東), 괴산(塊山)에서 재배(栽培)하고 있는 호두나무(Juglans sinensis Dode)에 가지마름과 고사(枯死)를 일으키는 병원균(病原菌)을 분리(分離)하여 동정(同定)하고 이들 병원균(病原菌)의 병원성(病原性) 및 배양적(培養的) 특성(特性), 발병율(發病率) 등(等)을 조사(調査)하는 것이었다. 분리(分離)된 병원균(病原菌)의 균학적(菌學的) 특성(特性)을 조사(調査)한 결과(結果), 이들균(菌)은 Botryosphaeria dothidea (Mou g. ex Fries) Casati et de Notaris(가지마름병(病)), Phomopsis albobestita Fairman (Phomopsis 가지마름병(病)), Melanconis juglandis (Ellis et Everhart) Graves(검은 돌기 가지마름병(病))로 동정(同定)되었다. 온실내(溫室內)에서 이들균(菌)의 병원성(病原性)을 검정(檢定)한 결과(結果) 2년생(年生) 호도나무 묘목(苗木)에서 병원성(病原性)이 입증(立證)되었다, 균사생육(菌絲生育)에 미치는 온도(溫度)의 영향(影響)을 조사(調査)한 결과(結果) B. dothidea와 P. albobestita는 $25{\sim}30^{\circ}C$ 사이에서 생육(生育)이 양호(良好) 하였으며, M. juglandis는 $20{\sim}25^{\circ}C$에서 생육(生育)이 가장 좋았으며 세 가지 균(菌)모두 $4^{\circ}C$와 $40^{\circ}C$에서는 생장(生長)하지 않았다. 분리(分離)된 세 균(菌)의 생육(生育)은 배지(培地)에 따라 차이(差異)를 보이지 않았으며 생육최적(生育最適) pH는 B. dothidea와 M. juglandis의 경우 4.0~8.0의 범위(範圍)이며 P. albobestita의 경우(境遇) 4.0~5.0으로 나타났다. 균사생육(菌絲生育)에 미치는 탄소원(炭素源)과 질소원(窒素源)의 영향(影響)을 조사(調査)한 결과(結果) B. dothidea의 경우(境遇) 탄소원(炭素源)으로는 glucose, sucrose, starch 및 maltose을, 질소원(窒素源)으로는 histidine과 potassium nitrate를 첨가(添加)한 배지(培地)에서 생육(生育)이 좋았다. P. albobestita의 경우(境遇) 탄소원(炭素源)으로 glucose 와 sucrose를 질소원(窒素源)으로 alanine과 potassium nitrate를 함유(含有)한 배지(培地)에서 생육(生育)이 좋았으며 M. juglandis는 glucose, sucrose, potassium nitrat, 함유(含有) 배지(培地)에서 생육(生育)이 좋았다. 주요 호도나무 재배지역(栽培地域)에서 발병(發病) 상황(狀況)을 조사(調査)한 결과(結果) 조사지역(調査地域) 모두에서 P. albobestita에 의한 피해(被害)가 가장 심하였으며, 15년생(年生) 이상(以上)된 수목(樹木)이 어린나무보다 더 피해(被害)가 큰 것으로 나타났다.

• 핵의학기술
• /
• 제13권3호
• /
• pp.175-180
• /
• 2009

서론 : 갑상선 기능 항진을 보이는 환자를 대상으로 항갑상선제 치료후 재발유무를 예측하거나 정확한 그레이브스병을 진단하기 위해 임상에서는 갑상선자극호르몬 결합악제면 역글로블린을 측정하는데 지금까지 1세대 liquid phase (RIA Precipitate)를 사용하였다. 그 후 예민도가 높아진 다음 세대 측정법이 다양하게 개발되었으며 실제 임상적 유용성이 보고되었다. 따라서 세대별 갑상선자극호르몬 결합억제면역글로블린 측정법 임상적 유용성 검토해 보고자 한다. 실험재료 및 방법 : 2009년 1월에서 3월까지 본원 강남건강증진센터에 내원한 환자 중 TSH, FT4, Microsome Ab 측정값이 정상범위에 드는 30명 (남자 20명, 여자 10명)을 대조군으로 하였다. 마찬가지로 2009년 1월에서 3월까지 본원 내분비내과를 내원한 환자 중 TSH<$0.05\;{\mu}IU/mL$, FT4>1.80 ng/dL인 갑상선기능항진증 진단을 받은 58명 (남자14명, 여자 44명)을 실험군으로 하였다. 측정법은 각 세대별로 1세대에서 3세대까지 각각 2가지종류의 시약을 사용하였으며, 확진 검사로 TS-Ab 검사를 실시하였다. 결과 : 대조군을 대상으로 각 세대별 측정법의 특이도를 확인하였다. (Specificity=100%, n=30) 실험군에서 민감도는 1세대 RSR<%> (79.3%, n=58), 1세대 RSR (51.7%, n=58), 2세대 RSR-CT (93.1%, n=58), 2세대 BRAHMS-CT (98.3%, n=58), 3세대 ELISA (94.6%, n=56), 3세대 ECLIA (97.7%, n=58), TS-Ab<%> (93.5%, n=46)이었다. 결론 : 갑상선자극호르몬 결합억제면역글로블린 측정법의 세대별 검토 결과 TS-Ab(%)를 확진 검사로 기준했을 때 3세대 ECLIA에 대해 2세대 BRAHMS-CT 측정법이 가장 높은 상관성을 보였다($R^2$=0.923). 따라서 기존에 사용했던 1세대 측정법을 대신하여 2세대 측정법을 사용함으로써 보다 정확하고 신속한 결과보고에 유용할 것으로 판단된다.