• 제목/요약/키워드: Parathyroid gland

검색결과 28건 처리시간 0.025초

그레이브스병의 갑상선 아전절제술후 저칼슘혈증 (Symptomatic Hypocalcemia After Subtotal Thyroidectomy for Graves' Disease)

  • 김승일;박정수
    • 대한두경부종양학회지
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    • 제11권2호
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    • pp.185-190
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    • 1995
  • Transient and permanent hypocalcemia after various types of thyroidectomy are well-known complications, and are more common after bilateral subtotal thyroidectomy for Graves' disease. However, their causative mechanisms are not well explained. Four hundred thirty patients with Graves' disease who underwent bilateral subtotal thyroidectomy from January 1983 through December 1992 were analyzed to determine the incidence and risk factors for the development of postthyroidectomy hypocalcemia. Of the 430 patients underwent bilateral subtotal thyroidectomy, symptomatic transient and permanent hypocalcemia developed in 24.2 % (104/430) and 0.5 % (2/430), respectively. With analysis of potential risk factors, the increase in incidence of the postthyroidectomy hypocalcemia was found to be statistically related to the larger thyroid gland, the larger amount of blood loss during thyroidectomy, the smaller remnant thyroid tissue, the higher levels of serum alkaline phosphatase and TBII titers. Our data suggest that impairment of parathyroid gland blood supply, degree of thyrotoxic osteodystrophy and autoimmune process of each patient are regarded as main mechanisms of postthyroidectomy hypocalcemia in patients with Graves' disease.

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$^{201}T1/^{99m}Tc$ Pertechnetate 감영스캔을 이용한 부갑상선 항진증의 진단 ([ $^{201}T1/^{99m}Tc$ ] Subtraction Scan in the Diagnosis of Hyperparathyroidism)

  • 안보영;손형선;김의녕;김성훈;정수교;김춘열;박용휘;신경섭
    • 대한핵의학회지
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    • 제29권4호
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    • pp.460-464
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    • 1995
  • 임상적으로 부갑상선 항진증이 의심되는 8명의 환자들을 대상으로 하여 수술 전에 정확한 병변의 위치를 확인하고자 $^{201}T1/^{99m}Tc$ 감영 스캔을 시행하였다. 6예에서 부갑상선 선종이 진단되었고 이들 전부가 수술 소견과 동일한 위치에서 양성소견을 보였으며, 수술 후 병리조직학적으로 확진 되었다. 나머지 2예는 만성 신부전, MEN type I 과 동반된 미만성 부갑상선 과형성증이었다. 결론적으로 $^{201}T1/^{99m}Tc$ 감영 스캔은 부갑상선 항진증의 진단에 유리하며, 특히 수술 전, 부갑상선 선종의 위치 확인에 유용하다.

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공터키안(Empty sella)을 동반한 급성췌장염으로 발현된 부갑상선 선종 1예 (A Case of Parathyroid Adenoma Presenting as Acute Pancreatitis Accompanied with Empty Sella)

  • 전언주;오지혜;배경륜;장샛별;전승운;정의달;손호상;원규장
    • Journal of Yeungnam Medical Science
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    • 제26권1호
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    • pp.63-69
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    • 2009
  • The incidence of coexisting hyperparathyroidism and empty sella syndrome is rare and the etiology end incidence of their coexistence is not known. The association of hyperparathyroidism and the empty sella syndrome may be related to multiple endocrine neoplasia (MEN) syndrome due to a genetic disorder. We experienced a rare case of hyperparathyroidism presenting as acute pancreatitis combined with empty sella. We report here a 37-year old female who manifested epigastric pain because of acute pancreatitis. She had hypercalcemia due to parathyroid adenoma. A pituitary gland was not visible in the sella turcica on MRI scans. On genetic analysis, she did not show a mutation of the MENIN gene. Empty sella is thought to be a coincidental finding with hyperparathyroidism.

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신생아에서 발견된 갑상샘의 아가미틈새양 낭종 (Intrathyroidal branchial cleft-like cyst in neonate)

  • 강준원;오상민;설지영;이충식;장미영
    • Clinical and Experimental Pediatrics
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    • 제49권9호
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    • pp.1005-1009
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    • 2006
  • 아가미틈새(branchial cleft) 낭종은 흔히 경부측면에 위치하나, 아가미틈새 낭종의 조직학적 소견을 보이는 낭종이 비전형적인 위치에서 발견되기도 한다. 갑상샘의 아가미틈새양(branchial cleft-like) 낭종은 이제까지 보고된 14례 중 7세 여아에서 발견된 1례를 제외하고는 모두 성인에서 발견되었다. 저자들은 좌측경부의 종물을 주소로 내원한 신생아에서 초음파 검사, 컴퓨터 단층촬영, 병리조직학 검사를 통하여 진단된 갑상샘의 아가미틈새양 낭종 1례를 경험하였기에 보고하는 바이다.

갑상선 내부 및 갑상선 주위에 발생한 새열낭종 (An Intrathyroidal Branchial Cleft Cyst and a Perithyroidal Branchial Cleft Cyst)

  • 이승아;정웅윤;윤종호;장항석;홍순원;박정수
    • 대한두경부종양학회지
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    • 제19권1호
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    • pp.63-66
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    • 2003
  • Branchial cleft cysts typically are characterized as lateral swellings anterior to sternocleidomastoid muscle in upper third of the neck. However, cysts have been reported in unusual location such as the thymus, oral cavity, parotid gland, pancreas, and thyroid. Perithyroidal branchial cleft cysts are also rare and preoperative diagnosis is very difficult. Recently we have experienced a case of intrathyroidal branchial cleft cys and a case of perithyroidal branchial cleft cyst, which were diagnosed preoperatively as the parathyroid cyst. So, we report these two cases with review of the literatures.

경부 종괴의 임상 및 병리학적 고찰 (A Clinicopathologic Analysis of Neck Masses)

  • 김정호;오상훈;김상효
    • 대한두경부종양학회지
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    • 제13권1호
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    • pp.51-57
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    • 1997
  • A mass appearing in the anterior or lateral side of neck often can be a diagnostic challenge. Differential diagnosis of the neck mass covers a broad spectrum of diseases and the proper evaluation and management of a neck mass requires an impressive amount of anatomic and pathologic information. Because improper diagnosis and management may convert a potentially curable malignant metastasis into incurable disease, a differential diagnosis must be considered in all patients who present with a neck mass. Authors reviewed 2,148 cases of neck mass who were diagnosed by surgical resection, biopsy or aspiration during the period between October 1982 to December 1993, excluding those with thyroid and parathyroid disease. The evaluated characteristics were age, sex, site of lesion, and pathologic diagnosis. The results were as follows: Of 2,148 cases of neck mass, the overall ratio of benign to malignant tumor was 3 : 1. In 1,603 cases of benign mass lesion, the most common disease was lymphadenitis(non-specific and tuberculosis) showing 53% incidence, the second was salivary gland tumor(13%), and the third was congenital lesion(12%). The minor problems such as lipoma and sebaceous cyst were 21 %. In the age distribution of benign lesion, tuberculous lymphadenitis showed peak incidence in second decade, non-specific lymphadenitis was main disease of childhood, salivary gland tumor was peak in fourth decade, and most of congenital lesions were diagnosed at the age below 15. In 545 malignant tumors, the most common lesion was metastatic cancer to cervical lymph nodes yielding 71 % incidence(head and neck primary 52%, infraclavicular primary 42%, unknown primary 5%), the second common disease was lymphoma(19%), and the third was salivary gland cancer(9%). In the age incidence of malignant tumor, 60% of them developed in the fifth and sixth decade, head and neck primary was more common in the fifth decade than sixth, however lymphoma showed higher incidence in sixth decade. In the analysis of mass location according to lymph node level grouping(I - V), lymphadenitis developed mostly in level V nodes, the next common occurring site was level IV in tuberculous lymphadenitis and level II in non-specific lymphadenitis. The majority of metastatic cancers were found in level IV and III, and common occurring site of lymphoma was in level II and IV. Pathologic diagnosis of neck masses were made by fine needle aspiration cytology 80 cases, incisional biopsy 533 cases, excisional surgery 1,399 cases, and neck dissection 116 cases. For the proper management of neck mass, a proper diagnostic modality should be selected from imaging techniques, cytology, biopsy or neck dissection, with the consideration of patient's age, history and clinical findings. The scapel biopsy could be used freely in the inflammatory disease or inoperable metastatic cancer, but it should be reserved in the curable metastatic cancer or clinically possible malignancy.

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원발성 부갑상선 기능 항진증의 수술전 병소확인에서 $^{99m}Tc$-Sestamibi 스캔의 유용성 (The Usefulness of $^{99m}Tc$-Sestamibi Scan in Preoperative Localization in Primary Hyperparathyroidism)

  • 백세현;김수미;최경묵;최윤상;김상진;유재명;최동섭;최재걸
    • 대한핵의학회지
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    • 제29권4호
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    • pp.465-472
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    • 1995
  • 목적 : 원발성 부갑상선기능 항진증의 대부분의 원인인 부갑상선 선종의 유일한 완치는 수술이며 수술의 성패에 가장 중요한 것은 수술전의 정확한 ??소의 확인이다. 다양한 영상검사들이 동원되고있으나 각가 결점이 있고 가장 특이도가 높은 $^{201}T1-^{99m}Tc$감영 촬영방법도 검사방법등에 문제점이 있다. 이에 원발성 부갑상선기능 항진증 환자에게 최근에 사용되고있는 $^{99m}Tc$-Sestamibi 부갑상선 스캔의 유용성을 알아보고자 하였다. 대상 및 방법 : 19명의 부갑상선기능 항진증환자에서 모든 환자에게 초음파 검사, CT, $^{201}T1-^{99m}Tc$감영 촬영을 시행하고 그중 5명은 $^{99m}Tc$-Sestamibi 부갑상선 스캔을 시행하여 수술후 확진결과와 함께 비교하였다. 결과 : 초음파 검사와 CT 및 $^{201}T1-^{99m}Tc$감영 스캔은 19예중 각가 12예(67.1%), 14예(78.9%) 그리고 17예(89.5%)에서 병소확인이 가능하였고 $^{99m}Tc$-Sestamibi 부갑상선 스캔은 시행한 5예(100%) 모두에서 병소 확인이 가능하였다. 결론 : 이상의 결과로 $^{99m}Tc$-Sestamibi 부갑상선 스캔은 원발성 부갑상선기능 항진증의 수술전 병소확인에서 유용한 검사법으로 이용될 수 있으리라 사료된다.

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방사성동위원소옥소(放射性同位元素沃素)($^{131}I$)가 "마우스"의 주요장기(主要臟器)의 병리조직상(病理組織像)에 미치는 영향(影響)에 관(關)한 연구(硏究) (Histopathological Studies of Mice after Administration of Radioactive Iodine($^{131}I$))

  • 노재성;이문호
    • 대한핵의학회지
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    • 제1권2호
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    • pp.85-97
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    • 1967
  • Histopathological changes of various organs of the mice after intra-peritoneal injections of radioactive iodine ($^{131}I$) were experimentally observed. Sixity healthy female mice, weighing average 25 gm, devided into 6 groups, were used. The various doses of $^{131}I$ were injected intraperitoneally at different intervals. The histopathological changes after these treatments were observed in organs such as thyroids, parathyroids, livers, kidneys and gonads. Following were the results; 1) Thyroid: In the group A given $^{131}I$ with a single dose of $10{\mu}C$ per gm body weight, it was observed that the protoplasms of follicular epithelial cells were destroyed, the nuclei were expanded or dissoluted, showing pyknotic changes of nuclei and vacuolizations of protoplasms. In the group B given $^{131}I$ with a single dose of $5{\mu}C$ per gm body weight, hyperemias, hemorrhages and hyaline degenerations in the whole area were observed. In the group C given $^{131}I$ with 3 doses of $2.5{\mu}C$ per gm body weight every week, the thyroid parenchyms were destroyed and epithelial cells of varing size were observed in the fibrinous tissues. In the group D given $^{131}I$ with 6 doses of $0.5{\mu}C$ per gm body weight every week, some destroyed follicles and new borne follicles were observed. But the histopathological changes resemble the follicles of the normal thyroid gland. In the group E and F given $^{131}I$ with 8 and 10 doses of $0.2{\mu}C\;and\;0.01{\mu}C$ for each group per gm body weight every two days, both pyknotic changes of nuclei and cytoplasmic vacuolizations of the follicular epithelia, hypertrophies of follicles and abnormal irregular follicular structures were observed, and in the group F, lymphocytes appeared around the thyroid glands. 2) Parathyroid: In the group A, hyperemia, proliferations of connective tissues, karyorrhexes and vacuolizations were observed. In other experimental groups, no particular pathological change was observed. 3) Liver: The degnerative changes and acute or chronic inflammatory changes were observed in proportion to the amount of $^{131}I$ injected. Atrophies of the liver cells, dilatations of sinusoids, hyaline degenerations and necrotic pictures were observed. 4) Kidney: In the group A, congestions and infiltrations of mononuclear cells and granulocytes were observed around the cortical arteries, and in the group B, the degenerative changes of cortexes, and, in the group C and D, hydronephrotic changes were observed respectively, and hyaline degenerations were partially observed. 5) Gonad: In the group A, the follicles were degenerated. The ova in the follicles showed irregular figures. The changes in the group B were almost the same as in the group A, but the changes were mild. In the group C, the destructions of whole ova, the hypertrophies of ovarian follicular membranes and pyknotic changes of nuclei were observed. In the group D, the pathological changes were similar to that of group C, but mild in the grade. In the group E, almost none of ovarian follicular fluid was observed, and in the group F, the tissue pictures were almost similar to that of the normal group.

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