• 대한핵의학회지
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• 제8권1_2호
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• pp.29-37
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• 1974

The $^{99m}Tc$-pertechnetate thyroid uptake rates(20 min) were measured in 24 healthy normal subjects, 140 patients with nontoxic goiter and 98 patients with thyrotoxicosis who were treated at the Thyroid Clinic, Seoul National University Hospital, from August 1972 to August 1973. Diagnostic reliabilities and correlations between $^{99m}TcO_4$-thyroid uptake rate (20 min) and other thyroid function tests were evaluated. The observed results were as follows 1. The $^{99m}TcO_4$-thyroid uptake rates (20 min) in normal subjects, euthyroid group and hyperthyroid group were $4.1{\pm}0.9%,\;5.2{\pm}1.8%\;and\;29.7{\pm}10.6%$. There was a significant difference between the mean of the euthyroid group and the mean of the hyperthyroid group and so differentiation between them can be easy. 2. In the diagnosis of hyperthyroidism, the reliabilities of $^{99m}TcO_4$- thyroid uptake rate(20 min), $^{131}I$ thyroid uptake rate(24hrs), serum $T_3$ resin uptake rate, serum $T_4\;and\;T_7\;were\;87.9{\sim}97.9%,\;81.2{\sim}94.4%,\;87.9{\sim}97.9%,\;90.5{\sim}99.3%\;and\;93.7{\sim}100%$. $^{99m}TcO_4$-thyroid uptake rate(20 min) is more accurate than $^{131}I$ thyroid uptake rate (24 hrs) in the diagnosis of hyperthyroidism. 3. $^{99m}TcO_4$-thyroid uptake rate (20 min) was well correlated with $^{131}I$ thyroid uptake rate (24 hrs), serum $T_3$ resin uptake rate, serum $T_4\;and\;T_7$. Points in favor of $^{99m}Tc$ are that it gives a small radiation dose to the thyroid, that tests can be repeated at the short interval, the study can be completed at a single patient visit and it is particularly well suited for the assessment of thyroid function in patients being treated with an antithyroid drug.

• 대한핵의학회지
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• 제11권1호
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• pp.49-58
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• 1977

For the assessment of antithyroid effect of lithium carbonate, it was administered to the 17 hyperthyroid and 5 euthyroid patients, who visited the Seoul National University Hospital from Jan. to Aug., 1977. Thyroid function tests were performed just before the administration of Lithium carbonate, 2 weeks and 2 months after lithium treatment. The results were as follows; 1) In the 5 euthyroid patients, no significant changes in thyroid function tests were obtained before and after lithium treatment. 2) In the 17 hyperthyroid patients, the values of the $T_3RIA$ were $370{\pm}121ng/dl$ 2 weeks after lithium treatment as compared with $506{\pm}121ng/dl$ before the administration, of which the mean percentage fall was 26.9%. $T_3RU$ was varied from $56.8{\pm}8.0%\;to\;47.3{\pm}8.1%$ (16.7% in mean percentage fall), $T_4$ was changed from $24.2{\pm}2.4ug/dl\;to\;22.0{\pm}4.2ug/dl$ (9.1% in mean fall), and $T_7$, from $13.82{\pm}2.25\;to\;10.55{\pm}3.12$ (23.7% in mean fall). 3) In the 5 hyperthyroid patients, serial thyroid function tests were performed 2 weeks and 2 months later. The mean percentage falls of $T_3RIA$ were 36.6 and 61.3%, 2 weeks and 2 months after lithium treatment respectively. Those of $T_3RU$ were 17.5 and 35.1%, those of $T_4$ were 20.4 and 44.0%, $T_7$, 35.0 and 60.7%. 4) Approximately $45{\sim}60%$ of mean fall in thyroid function tests were obtained within the second week. Normal thyroid function tests were observed in 2 among 17 patients within the second week, and 2 among 5 patients within the second month. 18 patients, however, became clinically euthyroid within the 4th week. 5) Single case of hypothyroidism was experienced, and 5 patients (29.4%) complained mild side effects. Lithium salts could be safely administered to hyperthyroid patients who are allergic to thioamides or iodine. Its use is indicated in cases of acute thyrotoxicosis in which it's necessary to reduce hormone levels very rapidly, and lithium-thioamides drug combination is a highly effective and safe means of initial routine control of hyperthyroidism.

• 대한핵의학회지
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• 제21권2호
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• pp.133-141
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• 1987

To evaluate the values of the thyroid autoantibody measured by radioimmunoassay (RIA) and compare it with hemagglutination method (HA) in the normal and the thyroid disease, data were obtained from total 618 persons; 236 healthy persons, 217 patients with Graves' disease (including 113 patients with undertreated Graves' disease), 100 Hashimoto's disease, 31 thyroid nodule, and 34 simple goiter. RSR kit made in England was used and could be detected to at least 3 U/ml. The positive rates of normal group were antimicrosomal antibody (AMA) 31.8%, antithyroglobulin antibody (ATA) 44.5% by RIA and there was no considerable change in sex and age distribution. In Graves' disease, the positive rates of AMA and ATA were 90.4, 76.9% by RIA, 85, 39% by HA. In Hashimoto's disease, 94,91 % by RIA, and 87,48% by HA, respectively. The autoantibody titer by RIA in thyroid autoimmune disease as well as in normal group was more senisitive than that by HA, especially in ATA. There were linear relationships between the titer of RIA and that of HA in AMA of Graves' disease and AMA and ATA of Hashimoto's disease. There was no relationship among thyroid autoantibody, free $T_4$ index, TBII, and TSH. The titers of AMA and ATA were found to decrease in patients with Graves' disease during the course of antithyroid drug therapy. Of the 236 normal subjects, thirty-seven (15.7%) had concentrations of above 7.5 U/ml in AMA, forty. four (18.6%) above 9 U/ml in ATA. These values were considered as the upper limit for the normal range. In Graves' disease, 82.7, 53.8% were above 7.5, 9 U/ml, respectively; In Hashimoto's disease, 82, 79% were positive. We conclude that RIA was more sensitve than HA in measuring the thyoird autoantibody, but we will study further more for determining the normal range and its interpretation.

• Clinical and Experimental Pediatrics
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• 제46권1호
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• pp.76-82
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• 2003

목 적 : 소아 Graves병의 진단 시 발병 연령에 따른 갑상선 기능, 임상 양상, 갑상선 항체가 및 치료 기간 등이 어떻게 다른지 알아보고자 본 연구를 시도하였다. 방 법 : 1989년 1월 1일부터 1995년 12월 31일까지 7년간 가톨릭대학교 의과대학 성모병원과 강남성모병원 소아과에서 Graves병으로 진단 받고 3년 이상 추적관찰이 가능하였던 환아 52명을 대상으로 Tanner의 성 성숙도를 기준으로 사춘기 이전에 발병한 군(사춘기전군)과 사춘기 시작 후 발병한 군(사춘기군)으로 나누어 갑상선 기능상태, 갑상선 항체, TSH 수용체 항체, 치료 후 갑상선 기능검사치가 정상화되는 시기 및 치료 기간 등을 조사하였다. 결 과 : 1) 전체 52명 중 남녀간의 성비는 1 : 12로 주로 여아에서 발병하였다. 2) 사춘기전군은 14명(남아 2명), 사춘기군은 38명(남아 2명)으로 각각 평균연령은 $7.2{\pm}0.9$세, $12.4{\pm}1.5$세이었다. 3) 치료 전 사춘기전군과 사춘기군에서 $T_3$는 $3.98{\pm}1.70$과 $3.82{\pm}1.63ng/mL$, $T_4$는 $17.49{\pm}5.56$과 $19.23{\pm}6.01{\mu}g/dL$, TSH는 $0.07{\pm}0.11$과 $0.07{\pm}0.24mIU/L$ 등으로 서로 유의한 차이가 없었다. 4) 치료 전 사춘기전군과 사춘기군에서 AMA 양성률은 85%와 89%이었고, 평균 항체가는 사춘기군이 사춘기전군보다 유의하게 높았다(P<0.01). ATA 양성율은 각각 57.1%와 72.2%였으나 평균 항체가의 차이는 없었으며 TBII의 양성율은 각각 92.9%와 84.2%였고 평균 항체가는 사춘기전군에서 사춘기군보다 유의하게 높았다(P<0.05). 5) 치료 후 사춘기전군과 사춘기군에서 $T_3$, $T_4$, TSH, TBII가 정상화되는 소요되는 기간은 $T_3$는 각각 $6.8{\pm}5.0$과 $5.4{\pm}13.2$개월, $T_4$는 각각 $2.3{\pm}1.9$와 $2.1{\pm}2.2$개월, TSH는 각각 $14.6{\pm}11.0$과 $6.8{\pm}7.8$개월, TBII는 각각 $26.7{\pm}24.0$과 $20.8{\pm}12.1$개월로 사춘기전군에서 TSH가 정상화되는 기간이 사춘기군보다 더 길었다(P<0.05). 두 군 모두 $T_4$, $T_3$, TSH, TBII 순으로 정상화되었다. 6) 치료 기간은 사춘기전군($53.3{\pm}19.3$개월)이 사춘기군($37.9{\pm}16.3$개월)보다 유의하게 길었다(P<0.01). 7) 약물 치료 3년 동안 관해는 사춘기전군에서 8례(57.1%), 사춘기군에서 26례(68.4%)였고 재발율은 각각 6례(75%) 및 17례(65.3%)였다. 8) Graves병의 진단 시 연령과 치료 기간 사이에는 역상관관계가 있었다(P=0.03). 결 론 : 소아에서 사춘기 이전에 발병하는 Graves병은 사춘기 이후에 발병하는 경우보다 항갑상선제 치료기간이 더 필요하다는 사실을 알 수 있었으며 앞으로 더 많은 환자를 대상으로 장기간의 연구가 필요하다고 생각된다.