• 대한두경부종양학회지
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• 제23권1호
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• pp.32-36
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• 2007

Background and Objective：A post-operative hypertrophic scar of the anterior neck is the leading complaint of the patients who underwent conventional thyroid surgery. In order to minimize the post-operative scar of the anterior neck, we performed thyroidectomy via axillary approach using operating microscope and a specialized retractor to determine technical feasibility. Patients and Methods：From January 2005 to December 2006, we performed thyroidectomy via axillary approach under operating microscope(f=400mm, ${\times}2.5$；OPMI $pico^{(R)}$；Zeiss, Germany) for benign unilateral nodule in 25 cases(all female, average age 34.5yrs). Under general anesthesia less than 7cm of skin incision was made in the axilla of ipsilateral side. A subcutaneous tunnel went over the pectoralis major muscle and the clavicle, and then through the sternocleidomastoid muscle and sternothyroid muscle was excised. The area around the thyroid was sufficiently dissected, and then a retractor designed for exposure via axillary approach was placed within the tunnel and under operating microscope thyroidectomy was performed. Results：There were 17 cases of thyroid nodulectomy and 8 cases of subtotal lobectomy. The mean average operative time was 102.64minutes. Postoperative complications included one case of postoperative bleeding, one case of temporary vocal cord paralysis, two cases of delayed wound healing, two cases of paresthesia of shoulder and arm, and two cases of hypertrophic scar of the axilla. Postoperative histopathology includes 17 cases of adenomatous hyperplasia, six cases of cyst, and two cases of follicular adenoma. For all cases hospitalization period was two days. Conclusion：Thyroidectomy via axillary approach under operating microscope has a good cosmetic advantage without a post-operative scar of the anterior neck. The procedure is simple due to direct vision using operating microscope, easy to identify important structures by magnifying them, and therefore surgical time can be reduced.

• Mass Spectrometry Letters
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• 제5권2호
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• pp.35-41
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• 2014

Gas chromatography-mass spectrometry (GC-MS) methods have been used extensively in clinical steroid analyses. Evaluating the metabolic ratios of precursors to products by accurate quantification of individual steroid levels in biological samples can reveal the activities of enzymes associated with steroid metabolism. This review article discusses the impact of GC-MS-based steroid profiling on our understanding of the biochemical role of steroids and their metabolic enzymes in hormone-dependent diseases, such as congenital adrenal hyperplasia (CAH), cortisol-mediated hypertension, apparent mineralocorticoid excess (AME), male-pattern baldness, and breast and thyroid cancers. Steroid profiling is a comprehensive analytical technique that can be applied whenever the highest specificity is required and may be a reasonable initial diagnostic approach.

• Journal of Endocrine Surgery
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• 제18권4호
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• pp.236-239
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• 2018

Secondary hyperparathyroidism (SHPTH) occurs commonly in patients with end-stage renal disease (ESRD). Uncontrolled SHPTH is associated with complications of calcium deposition including calciphylaxis and elevated rates of cardiovascular morbidity. Current treatment recommendations for medically refractory disease include total parathyroidectomy, often with autotransplantation (TPTH+AT) of minced parathyroid gland. Surgical intervention is associated with a reduction in cardiovascular mortality. We report a case of a 56-year-old man with ESRD who developed SHPTH and underwent TPTH+AT of parathyroid tissue into the right brachioradialis muscle. Over the course of 7 years he developed a mass at the site of the autotransplanted gland as well as recurrent refractory hyperparathyroidism with increased forearm uptake noted on sestamibi scan. After excision of this mass, pathology demonstrated hyperplasia of the minced gland fragments which were embedded within a mass of fibroadipose tissue rather than the muscle tissue it was originally transplanted in.

• 대한한방부인과학회지
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• 제23권2호
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• pp.71-84
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• 2010

Purpose: In the theory of traditional medicine, Glenditsia spina(GS) can resolve carbuncle, relive swelling, dispel wind and destroy parasites. This study was designed to investigate the effects of GS on gene expression of ovarian tissue in polycystic ovary syndrome(PCOS) rats. Methods: In this experiment, female rats injected with a single dose of 2 mg estradiol valerate(EV) and GS was given for 5 weeks. The genetic profile for the effects on ovarian tissue in PCOS rats was measured using microarray technique, and the functional analysis on these genes was conducted. Results: 985 genes were increased in control and restored to normal level in GS group. (B), 733 genes were decreased in control group and restored to normal level in GS group. (F). Metabolic pathways related in B group genes were Graft-versus-host disease, Allograft rejection, Autoimmune thyroid disease, Cytokine-cytokine receptor interaction, Small cell lung cancer, Type I diabetes mellitus. Metabolic pathways related in F group genes were Antigen processing and present, Adipocytokine signalling pathway, Focal adhesion, ECM-receptor interaction, Pancreatic cancer, Notch signalling pathway, Tight junction. The network of total protein interactions was measured using cytoscape program, and some key molecules, such as c-Fos, c-Myc, ABL1 related in B group, MAPK8, RASA1, CALR related in F group that can be used for elucidation of therapeutical mechanism of medicine in future were identified. Conclusion: These results suggest possibility of GS as anti-cancer and anti-hyperplasia drug in PCOS. In addition, the present author also suggests that related mechanisms are involved in suppression of proto-oncogene such as c-Fos, c-Myc and ABL1, and in regulation of cell cycle such as RASA1.

• 대한핵의학회지
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• 제25권1호
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• pp.122-128
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• 1991

Multiple endocrine neoplasia type 2 (MEN type 2, Sipple's syndrome) is a rare disorder characterized by the association of medullary carcinoma of the thyroid, parathyroid hyperplasia and can be diagonsed in early stage of the disease by meticulous screening tests of the family. This case report describes the location and categorization of tumors using $^{99m}Tc-pertechnetate,\;^{131}I-NaI,\;^{99m}Tc-pentavalent(V)$, DMSA $^{131}I-MIBG$ scans in two cases of MEN type 2 occurred in a 32-year old women and her 29-year old brother. In MEN type 2, we think, combined use of $^{99m}Tc-(V)-DMSA,\;^{99m}Tc-pertechnetate\;and\;^{131}I-MIBG$ may be useful for the categorization of tumor mass lesions and planning appropriate therapy.

• Journal of Chest Surgery
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• 제29권9호
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• pp.1010-1016
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• 1996

중증근무력증환자에 있어서 흉선 절제술은 대상이 되는 환자의 선택 기준이나 수술시기, 수술 방법에 있어서 아직까지 논란이 되고 있지만 긍정적으로 적용될 수 있는 치료 방법이다. 연세대학교흉부외과 학교실 신촌 세브란스병원에서는 1983년 1월부터 1994년 12월까지 중증근무력증으로 흉선 절제술을 시행한 82명의 환자를 대상으로 연구하였다. 수술 사망은 1명에서 발생하였고 수술 후 추적은 75명에서 가능하였고 평균 추적기간은 56.9개월 이었다. 완전관해된 28명(37.3%)을 포함하여 64명(85.3%)에서 수술로 인한 효과를 볼 수 있었다. 동반된 질환으로는 갑상선 질환이 8예로 가장 많았는데 이중 7명(87. 5%)이 완전관해를 보여 갑상선 질환을 동반하지 않은 환자 67명중 21명(31.3%)의 완전관해보다 높은 치료 성공율을 나타내었다. 수술 전 병력 기간이 2년 미만인 환자 32명중 16명(50%), 2년 이상인 환자 43명중 12명(27.4%)이 완전관해를 보여 수술전병력 기간이 2년 미만인 경우 높은 치료율을 보였다. 결론적으로 중증근무력증환자에 있어서 흉선 절제술 후 완전관해율은 갑상선 질환의 동반 여부와 수술 전 병력기간에의해 영향을 받음을 알 수 \ulcorner었으며 병의 발생 연령(40세 이상),흉선종의 동반,고령 및 남자의 경우 수술 후 완전관해율을 떨어뜨리는 것으로 나타났지만 통계적 의의는 없었다. 흉선의 조 직학적 소견으로 정상과 흉선 비후사이에 있어서 완전관해율의 차이는 보이지 않았다. 일반적으로 흉선 절제술은 대부분의 중증근무력증환자에 있어서 효과가 있었으나 임상증상적 분류로 기 속한 환자군은 수술로 인한 효과가 없었다.

• 농업과학연구
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• 제13권2호
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• pp.210-218
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• 1986

본(本) 실험(實驗)은 thyroxine 및 propylthiouracil의 투여(投與)에 의(依)한 갑상선(甲狀腺)의 기능변화(機能變化)와 아울러 체성장(體成長)에 미치는 영향(影響)을 구명(究明)코저 실시(實施)하였는 바, 25일령(日齡)의 암 흰쥐를 갑상선척출군(甲狀腺剔出群), propylthiouracil 처리군(處理群), Thyroxine 처리군(處理群) 및 정상대조군(正常對照群)의 사개군(四個群)으로 나누어 배치(配置)하고 각군(各群)을 처리후(處理後) 시간경과(時間經過)에 따라 도살(屠殺)하여 갑상선(甲狀腺)의 중량측정(重量測定) 및 조직학적(組織學的) 검색(檢索)과 아울러 체중(體重)의 변화(變化)를 조사(調査)하였다. 1. 갑상선(甲狀腺)의 중량(重量)은 모든 관찰시간(觀察時間)에서 비교군간(比較群間)에 유의성(有意性)이 인정(認定)되었는데 PTU 처리군(處理群)은 정상대조군(正常對照群)에 비(比)하여 높은 중량(重量)을 나타냈고, Thyroxine 처리군(處理群)은 낮은 값을 나타냈다. 2. 갑상선(甲狀腺)의 조직상(組織像)은 PTU 처리군(處理群)에서는 처리(處理) 1주후(週後)부터 여포상피세포(濾胞上皮細胞)가 증식(增殖) 비대(肥大)를 동반(同伴)하는 원주화현상(圓柱化現象)을 나타내기 시작하여 실험기간(實驗期間)이 경과(經過)될 수록 더욱 진행(進行)되는 조직소견(組織所見)을 보였으며, Thyroxine 처리군(處理群)에서는 여포상피세포(濾胞上皮細胞)가 도평화(屠平化)되는 퇴행성(退行性) 변화(變化)가 인지(認知)되었다. 3. 체중(體重)은 처리(處理) 2주후(週後)부터 비교군간(比較群間)에 유의성(有意性)이 인정(認定)되는 변화(變化)를 보였는데 PTU 처리군(處理群)과 갑상선척출군(甲狀腺剔出群)은 정상대조군(正常對照群)에 비(比)하여 낮은 값을 나타냈고 Thyroxine 처리군(處理群)은 높은 체중치(體重値)를 보였다. 그러나, 다중검정결과(多重檢定結果) PTU 처리군(處理群)과 갑상선척출군(甲狀腺剔出群) 상호간(相互間)에는 유의성(有意性)이 인정(認定)되지 않았다.

• 대한두경부종양학회지
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• 제9권2호
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• pp.210-220
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• 1993

Histologically proven 465 cases of neck mass in children were analized for the determination of the nature of lesions. Pathologic specimens were obtained during 10 years from January 1981 to December 1989 at Severance Hospital, Yonsei University, College of Medicine. 1) Congenital lesion was most common in neonate(80%) and congenital lesion and inflamatory disease were common in infancy and inflammatory disease was most common in more than one year old children. Thyroglossal duct cyst was most common(35.4%) disease of the congenital lesion. followed by cytic hygroma(34%) and branchial cleft remnants(29.2%). 2) Benign tumors were discovered most frequently in adolescence (55.2%) and thyroid adenoma(23.7%) and epithelial tumor(21.1%) and hemangiomas(19.7%) were most common. Most common malignant tumors were malignant lymphoma (50%) and Hodgkin's disease and were present in the older children. Metastatic cancers were very rare and their primary sites were deductable in all cases. 3) Reactive hyperplasia of lymph node was most common in inflammatory disease(23.7%). Tuberculosis lymphadenitis was more common than nonspecific lymphadenitis. 4) Bilaterality of lesion was commonly seen in malignant disease(41.7%), reactive hyperplasia of lymph node (38.85%) and metastatic disease(33.3%). Size and duration of the masses were not helpful in the differential diagnosis of the cause of the masses. Pediatric neck mass must be evaluated with its characteristics. sites, bilaterality, size and its cange, duration and patient's age but any of these alone cant not be predicted its causes without biopsy or excision. Biopsy or excision can be done with few complication but biopsy of lymph node for diagnosis is carefully made because a large number of lymph node biopsy showed no definite diagnosis in these selected cases of patients.

• 대한두경부종양학회지
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• 제17권2호
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• pp.205-209
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• 2001

Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

• 대한한방부인과학회지
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• 제27권1호
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• pp.41-64
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• 2014

Objectives: This study was to evaluate the effect of Jaeumkanghwa-tang (JEKHT) on the propylthiouracil (PTU)-induced rat hypothyroidism. Methods: Six groups, each of 8 rats per group were used in the present study - intact vehicle control, PTU control, Levothyroxine ($LT_4$), JEKHT 500, 250 and 125 mg/kg treated groups. JEKHT were administered once a day for 42 days as an oral dose of 500, 250 and 125 mg/kg, and hypothyroidism was induced by daily subcutaneous treatment of PTU 10 mg/kg for 28 days. The changes on the body and organ weight, serum hormone and lipid profiles, liver and testis antioxidant defense factors were observed with histopathology of organs. Results were compared with $LT_4$ 0.5 mg/kg intraperitoneally treated rats in this experiment. Results: PTU treatment, marked decrease of body weight, increases of thyroid weight, decreases of liver, testis, epididymis and prostate weights, decreases of serum Tri-iodothyronine ($T_3$), and Thyroxine ($T_4$) level with increase of serum Thyroid-stimulating hormone (TSH) level, decreases of serum testosterone and dihydrotestosterone (DHT) level with increases of serum Follicular stimulating hormone (FSH) level, increases of serum High density lipoprotein (HDL), decrease of triglyceride content, increase of serum Aspartate aminotransferase (AST) level, decreases of liver and testis antioxidant defense factors were observed. In addition, marked hyperplasia of follicular cells with decreases of follicular colloid contents and diameters was additionally demonstrated with the decrease of hepatocyte numbers per unit area due to hypertrophy of hepatocytes related to lipid droplet depositions, increase of a/oligospermatic epididymal tubules with epididymal atrophic changes, seminiferous tubular atrophy with decrease of stage I~II seminiferous tubules in testis, prostate tubular atrophic changes at histopathological inspections. However, these PTU induced hypothyroidism and related hepatic and male reproductive organ damages were favorably and dose-dependently inhibited by treatment of JEKHT 500, 250 and 125 mg/kg, and JEKHT also effectively regulated the PTU-induced abnormal antioxidant defense factor changes in the both liver and testis. Conclusions: JEKHT 500, 250 and 125 mg/kg dose-dependently inhibited PTU-induced hypothyroidism and related liver and male reproductive organ damages in rats.