• 대한수의학회지
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• 제43권4호
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• pp.683-688
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• 2003

Caffeine (1,3,7-trimethylxanthine), a central nervous system stimulant, is contained in various foods, beverages and over-the-counter medications. Sulfadimethoxine (SDM) is one of the anti-thyroid agents and induces proliferation of thyroid capsule in two stage thyroid carcinogenesis model using N-bis(2-hydroxypropyl)nitrosamine (DHPN). In this study, we examined the effect of caffeine on fibrous proliferation of thyroid capsule in DHPN and SDM-treated rats. Five-week-old male F344 rats were given a single subcutaneous injection of DHPN (2,800 mg/kg, body weight). Starting one week thereafter, SDM (1,000 ppm in drinking water) with or without caffeine (1,500 ppm in diet) was administered for 12 weeks. All animals were autopsied and histopathological examination of the thyroid glands was performed. Thyroid follicular proliferative changes were induced in all rats treated with DHPN+SDM. In addition, the proliferation of perithyroidal fibrous tissue and pleomorphic thyroid follicular cells within the capsule were observed in DHPN+SDM treated group. Caffeine would not be related to these lesions in this experimental condition. although pentoxifylline, a methyl xanthine derivative, has an anti fibrotic effects.

• 대한두경부종양학회지
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• 제23권2호
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• pp.133-137
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• 2007

갑상선 미세유두암종은 영상 기술의 발달로 더욱 그 빈도가 높아질 것이 예상되므로 진단의 정확도를 높이는 것이 무엇보다 중요하다. 갑상선 미세 유두암종으로 진단 받은 37예를 대상으로 galectin-3, cytokeratin 19와 HBME-1 분자 표지자들을 면역조직화학적 염색을 시행한 결과 cytokeratin 19에서 1예를 제외하고 모든 예에서 갑상선 종양 세포에서 발현하였다. Galectin-3는 갑상선 종양 세포의 세포질에 강하게 염색되었으며 cytokeratin 19는 세포질과 세포막을 따라 강하게 염색되었다. HBME-1은 종양 세포의 세포막에 강하게 염색되었으나 3가지 분자 표지자 모두 정상 갑상선 조직에서는 염색되지 않았다. 이상의 결과에서 볼 때 galectin-3, cytokeratin 19와 HBME-1은 병리조직학적 소견과 함께 갑상선 미세 유두암종을 진단함에 있어 보조적 도움이 되는 표지자로 생각된다.

• 대한두경부종양학회지
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• 제13권2호
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• pp.241-246
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• 1997

It has become evident in recent years that parathyroid adenoma and well differentiated thyroid cancer occur together more than would be expected by chance alone. However, the association between them is not well understood. We have experienced 4 cases of coexistent parathyroid adenoma and well-differentiated thyroid cancer during the past 16 years. None of them had a familial incidence or a history of radiation exposure. Three cases showed symptomatic hypercalcemia(including renal stones, bone pain, joint pain) and in two of them(patient 1 and patient 2), thyroid abnormalities were detected preoperatively by neck ultrasonography or neck CT for evaluation of parathyroid lesions. However, in patient 3, a parathyoid humor was identified and removed incidentally during the course of thyroidectomy. In 3 cases, surgeries for thyroid carcinoma and parathyroid adenoma were performed during the same exploration of the neck, but in patient 4, thyroidectomy preceded parathyroidectomy; The interval between thyroidectomy and subsequent parathyroidectomy was 11 yeras. The thyroid tumors in 3 cases were papillary carcinoma, the sizes of which ranged from 1.0 cm to 1.5 cm in greatest diameter. The remaining case(patient 4) was minimal invasive follicular carcinoma. Total or near-total thyroidectomy with various types of cervical lymphnode dissection and bilateral neck exploration for the parathyroid lesion was performed in 3 cases with papillary carcinoma. Ipsilateral lobectomy and contralateral partial thyroidectomy with consequent unilateral neck exploration for the parathyroid tumor was performed in the case of follicular cancer. In our experience, parathyroid adenoma and well-differentiated thyroid carcinomas can be coexistent and we felt that the attention to the hypercalcemic patients would be needed for detection of this rare condition.

• International journal of thyroidology
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• 제11권2호
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• pp.123-129
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• 2018

Background and Objectives: Hypermethylation of the tumor suppressor gene RASSF1A and activating mutation of BRAF gene have been recently reported in thyroid cancers. To investigate the role of these two epigenetic and genetic alterations in thyroid tumor progression, methylation of RASSF1A and BRAF mutation were examined in thyroid tumors. Materials and Methods: During 2007 to 2017, 69 papillary carcinomas, 18 nodular hyperplasia, 3 follicular carcinomas, and 13 follicular adenomas were selected. The methylation-specific polymerase chain reaction (MSP) technique was used in detecting RASSF1A methylation and polymerase chain reaction (PCR)-single-stranded conformation polymorphism and sequencing were used for BRAF gene mutation study. Results: The hypermethylation of the RASSF1A gene was found in 84.6%, 100% and 57.9% of follicular adenomas, follicular carcinomas, and papillary carcinomas, respectively. Nodular hyperplasia showed a hypermethylation in 33.3%. The BRAF mutation at V600E was found in 60.7% of papillary carcinoma and 27.0% of nodular hyperplasia, but none of follicular neoplasms. The BRAF mutation was correlated with the lymph node metastasis and MACIS clinical stage. There is an inverse correlation between RASSF1A methylation and BRAF mutation in thyroid lesions. Conclusion: Epigenetic inactivation of RASSF1A through aberrant methylation is considered to be an early step in thyroid tumorigenesis, and the BRAF mutation plays an important role in the carcinogenesis of papillary carcinoma, providing a genetic marker.

• 대한기관식도과학회지
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• 제2권1호
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• pp.111-119
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• 1996

The medical records of 87 patients with thyroid nodule treated from May 1992 to February 1996 were retrospectively reviewed to assess complication with age, sex, pathologic classification, location of lesions, and surgical procedures. The overall rate of complication were observed 10(11.5%) in thyroid surgery. The most common complication was transient hypoparathyroidism, which occurred in 6(6.9%) of 87 patients. The 2(2.3%) patients experienced Permanent hypoparathyroidism and each 1(1.1%) patient was reported in transient recurrent laryngeal nerve paralysis and hematoma.. Well-performed thyroid surgery usually produces few complications. More extensive resections, involving bilateral thyroidectomy are associated with a higher incidence of postoperative morbidity, in particular vocal cord paralysis and hypoparathyroidism, than procedures that consist essentially of unilateral thyroidectomy. Our experience suggests that the postoperative complication relates primarily to the surgical procedure. The low incidence of permanent complications in thyroid surgery suggests the feasibility of total thyroidectomy as the operation of choice when thyroid nodules were malignant and surgeons are familiar with the technique and indications.

• 대한핵의학회지
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• 제35권3호
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• pp.117-124
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• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1135-1138
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• 2015

Background: The objective of this study was to investigate the MSCT characteristics of PTL in order to enhance the awareness of this uncommon entity among both clinicians and radiologists. Materials and Methods: The clinicopathological data and MSCT images of 27 patients with PTL were retrospectively reviewed. The MSCT appearances were classified into three types: type 1, solitary nodule surrounded by normal thyroid tissue; type 2, multiple nodules in the thyroid, and type 3, enlarged thyroid glands with a reduced attenuation with or without peripheral thin hyperattenuating thyroid tissue. Results: The patients were enrolled in the study with a mean age of 68 years (range, 51-86years) and compression symptoms or enlarged cervical lymph nodes at diagnosis. Hashimoto's thyroiditis was in 20 patients. All patients had non-Hodgkin lymphoma of B-cell in origin, including 22 cases of diffuse large B-cell lymphoma (DLBCL) and 5 of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). For MSCT appearance, type 1 pattern was observed in 2 patients, type 2 in 8, and seventeen type 3 in 17. The lesions occurred in more than one lobe with a mean maximal transverse diameter of 6.9 cm and an ill-defined margin. Most tumors showed a homogeneous attenuation equal to that of surrounding muscles before contrast and obvious enhancement after contrast. Cervical lymph node involvement and invasion of the trahea and (or) esophagus were mainly observed in patients with DLBCL. Conclusions: PTL should be clinically considered in elder patients presenting with a history of Hashimoto's thyroiditis and cervical lymphadenopathy. The MSCT characteristics of PTL includes a mass diffusely affecting more than one thyroid lobe, isointense to muscle and obvious enhancement before and after contrast. DLBCL, the most common histological subtype of PTL, is associated with a higher invasive tendency.

• Journal of Chest Surgery
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• 제43권1호
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• pp.113-116
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• 2010

심한 호흡곤란을 주소로 내원한 67세 남자의 영상소견상 종격동의 거대 낭성 종양이 기관을 압박하여 편이시키는 소견이 보여 응급 개흉술을 통해 종양을 절제하였다. 조직 소견상 갑상선의 유두상 암종에 합당하였고 수술 후 시행한 갑상선 초음파 검사와 양성자 단층촬영상 잠재성 갑상선 암종에 합당한 소견을 보였다. 갑상선의 유두상 암종이 초기에 원격 전이를 보이는 경우는 드물며 대부분 단독 결절의 형태를 취하나, 잠재성 암종이 종격동에 거대 낭성 전이를 하는 경우는 극히 드물어 보고하는 바이다.

• 대한영상의학회지
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• 제84권5호
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• pp.999-1008
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• 2023

발생률이 높고, 예후는 좋지만 재발을 잘하는 경향이 있는 갑상선암에서도 전통적인 치료법은 수술이다. 하지만, 2000년대 초반부터, 간암, 폐암, 신장암에서와 마찬가지로 고주파 절제술이 원발 갑상선암 및 재발 갑상선암에 적용되기 시작했다. 원발암에서는 1 cm 이하 크기의 미세유두암 저위험군에서 수술 불가능한 경우에 대한 많은 연구가 이뤄져 왔고, 1 cm보다 더 크고 4 cm 이하의 다양한 군에 대해서도 일부 연구가 시행되었으며, 전반적으로 모두 양호한 결과를 보고하였다. 재발암에 대해서도 주로는 국소 경부 재발암에 고주파 절제술이 시행되었으며, 일부 폐, 뼈 등의 원격 전이에 대해서도 시도되었고, 전반적으로 양호한 결과가 보고되었다. 최근 들어, 한국, 미국, 유럽 등 각지에서 갑상선암의 고주파 절제술에 대해 옹호하는 움직임이 있다. 하지만, 미국 국립 종합 암 네트워크(National Comprehensive Cancer Network) 등의 중립적인 임상지침에는 고주파 절제술이 아직 인정되지는 않은 상태이다. 지금까지의 노력들과 미래의 연구를 바탕으로 향후 가까운 미래에 갑상선암의 치료에 있어 고주파 절제술이 적절한 자리매김을 할 것으로 전망한다.

• 대한핵의학회지
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• 제33권6호
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• pp.493-501
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• 1999

목적 : 분화된 갑상선암에서 암 절제술 및 방사성 옥소 치료 후 추적관찰 중 재발이나 전이병소를 찾기 위한 효과적인 검사 방법에 대한 자료를 제시하고자 T1-201 스캔, Tc-99m MIBI 스캔, I-131 스캔 검사의 결과를 비교하였다. 대상 및 방법: 분화된 갑상선암으로 진단되어 수술 및 방사성 옥소로 치료 후 추적관찰 중 국소 재발 또는 전이로 생각되어 한번이상의 방사성 옥소 재 치료를 시행한 20명(총 33예)의 환자를 대상하여 T1-201 스캔, Tc-99m MIBI 스캔, 진단적 및 치료적 I-131 스캔을 시행하여 각 스캔에서 결과를 후향적으로 분석하였다. 모든 환자에서 갑상선글로불린을 측정하였고 임상적, 방사선학적, 조직학적 검사로 암의 재발 및 전이를 확인하였다. 결과: 4가지 검사의 비교에서 병소를 발견할 수 있는 양성률은 Tc-99m MIBI 스캔, T1-201 스캔, 진단적 I-131 스캔, 치료적 I-131 스캔에서 각각 70% (19/27), 54% (15/28), 35% (17/48), 63% (30/48)였다. T1-201 스캔과 I-131 스캔을 같이 시행한 군(20 예, 28병소)에서는 병소의 양성률은 치료적 I-131 스캔, T1-201 스캔, 진단적 I-131 스캔 순으로 높았으나(71%, 54%, 36%), T1-201 스캔과 진단적 I-131 스캔간의 차이는 없었다(p>0.05). Tc-99m MIBI 스캔을 I-131 스캔과 같이 시행한 군(20예, 27병소)에 서는 Tc-99m MIBI, 치료적 I-131 스캔, 진단적 I-131 스캔의 순으로 높았고(70%, 52%, 33%), Tc-99m MIBI는 진단적 I-131 스캔보다 양성률이 유의하게 높았다(p<0.05). 결론: 분화된 갑상선암 환자의 치료 후 추적 관찰에서 국소 재발 및 전이 병소를 찾는데 Tc-99m MIBI 스캔은 진단적 I-131 스캔보다 우수하였다. 따라서 치료 전에 진단적 I-131 스캔을 시행하기보다는 갑상선 호르몬제를 중단하지 않은 상태에서 Tc-99m MIBI 스캔을 시행한 후 결과에 따라서 치료용량의 방사성 옥소를 투여하고 치료적 I-131 스캔을 하는 것이 효과적일 것으로 사료된다.