• 대한핵의학회지
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• 제14권2호
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• pp.53-60
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• 1980

The radioimmunoassay of TSH (human thyrotropin) was performed by utilizing anti-h-TSH antibody and purified human thyrotropin supplied from Daiichi Radioisotope company in Japan. From Jan. 1978 through Aug. 1980 the serum concentration of TSH was measured on 41 cases with various thyroid diseases, and 22 normal persons. Among 41 cases, 9(22%) were primary hypothyroidism, 17(41%) Graves' disease, 8(20%), subacute or chronic lymphocytic thyroiditis, and 7(17%) nodular goiter. The results were as follows: 1) The normal values of serum TSH in 22 cases of control group were $4.2{\pm}1.7{\mu}U/ml(1.9-7.4{\mu}U/ml)$, which were within normal range in kit used in this study. 2) The serum TSH concentration in 9 cases with primary hypothroidism were $97.1{\pm}116.4{\mu}U/ml(14.0-300{\mu}U/ml)$, which were significantly elevated as compared with normal control values. 3) The serum TSH concentration in 17 cases with Graves' disease were $1.5{\pm}0.6{\mu}U/ml(1.0-2.5{\mu}U/ml)$, which were below than normal control. 4) The serum TSH concentration in 8 cases with subacute or chronic lymphocytic thyroiditis. revealed wide ranges ($1.6-220{\mu}U/ml$) according to the state of thyroid function. 5) The serum TSH values in 7 cases with nodular goiters were $2.3{\pm}2.0{\mu}U/ml$, which were strictly within normal levels. 6) The serum TSH levels were elevated during prolonged treatment with Tapazole (Methimazole) without serial check of the serum TSH concentration in Graves' disease, so the serial measurement of serum TSH concentration was considered of available index of thyroid states.

• 대한두경부종양학회지
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• 제14권1호
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• pp.54-60
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• 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.

• 대한핵의학회지
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• 제18권1호
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• pp.19-24
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• 1984

Clinical measurement of thyroid autoantibodies in sera of some thyroid disorders have been widely applied since about twenty years ago. We investigated the incidence and titers of both anti microsomal and antithyroglobulin antibodies in forty eight cases with controls and one hundred and thirty three patients with some form of thyroid disorders. The results were as follows; 1) In controls, antimicrosomal antibodies were positive in 2% but anti thyroglobulin antibodies were all negative. 2) In a series of one hundred and thirty three patients with thyroid disease, anti microsomal antibodies were positive in 44% but antithyroglobulin antibodies were positive in only 15%. 3) The rate disclosing the positive results of antimicrosomal antibodies were 71 % in Hashmoto's disease, 60% in Graves' disease, and 38% in primary hypothroidism, respectively. On the other hand, the positive results of antithyroglobulin antibodies showed 21 % in Graves' disease, 19% in primary hypothyroidism, and 18% in Hashmoto's disease, respectively. Though there were relatively high rate of both antimicrosomal and anti thyroglobulin antibodies in patients with nodular goiter, they were only seven cases in our series. 4) The rate with the extremely high titers of antimicrosomal and antithyroglobulin antibodies$(>1:160^2)$ was 83% and 67% in Hashmoto's disease, 50% and 67% in primary hypothyroidism, and 41% and 18% in Graves' disease. Accordingly, the thyroid autoantibodies were commonly found higher positive rate in patients with Hashmoto's disease, primary hypothyroidism, and Graves' disease. Among these disorders, the extremely high positive rate of the thyroid autoantibodies was found in patients with Hashmoto's disease.

• 대한핵의학회지
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• 제16권2호
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• pp.1-24
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• 1982

Several recent advances in our knowledge of thyroid physiology have broad application to the diagnosis and management of thyroid disorders. For in the thyroid, more than other endocrine organs, pathophysiology can be translated directly into the diagnosis and management of thyroid disease. Graves' disease is a syndrome including goiter with hyperthyroidism, exophthalmos and dermopathy. The pathogenesis of Graves' disease is not yet clearly identified, but various autoantibodies to the thyroid gland and immunopathologic studies indicate that autoimmune processes are involved in the pathogenesis of the disease. The diagnosis and management of Graves' disease are largely dependent on radionuclide techniques as radioimmunoassay, radioactive iodine therapy and so on. Several laboratory tests are also developed to determine the remission of this disase including TRH stimulation test, $T_3$ suppression test and detection of thyroid stimulating immunoglobulins. Autoimmune thyroiditis is almost certainly a primary immunologic disease and the incidence tends to increase recently, mainly due to the application of biopsy technique in thyroid diseases. Thyroid nodules have been a great challenge to physicians because of the possibility of malignancy. But recently, cytologic examination of thyroid aspirate provides a very simple and also reliable diagnostic method in patients with thyroid nodules. In 163 patients with thyroid nodules, only 19.3% was revealed to be malignant. Therefore cytologic examination of thyroid aspirate and thyroid biopsy should be included in the diagnosis of nodular patients prior to surgical intervention. In this paper, a comprehensive review is presented on the pathogenesis, clinical features, laboratory findings and therapeutic modalities of various thyroid diseases on the basis of over 80 researches performed during the past 20 years at radioisotope clinic, Seoul National University Hospital.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7425-7432
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• 2014

Aim: To investigate the expression of protein kinase $CK2{\alpha}$ ($CK2{\alpha}$) in human thyroid disease and its relationship with thyroid cancer metastasis. Materials and Methods: Using immunohistochemistry we measured the expression of $CK2{\alpha}$ in 76 benign and malignant human thyroid cancer tissues, including 10 pairs of papillary carcinoma tissues with or without lymph node cancerous metastasis and similarly 10 pairs of lymph nodes. Results: The expression of $CK2{\alpha}$ was found to be higher in thyroid carcinoma cases (papillary carcinoma, follicular carcinoma, anaplastic carcinoma and medullary carcinoma) than in ones such as chronic lymphocytic thyroiditis, nodular goiter and adenoma. These findings were also confirmed by RT-PCR and Western blotting. More strikingly, elevated expression of $CK2{\alpha}$ in thyroid papillary carcinoma tissues was not only significantly associated with lymph node cancerous metastasis and clinical stage of thyroid cancers; but also correlated with epithelial-mesenchymal transition (EMT) and high tenascin C (TNC) expression. In addition, EMT and high TNC expression in thyroid carcinoma tissues was significantly associated with lymph node cancerous metastasis. Conclusions: Elevated expression of nuclear $CK2{\alpha}$ is a poor prognosis indicator in lymph node cancerous metastasis of human thyroid cancers.

• 대한두경부종양학회지
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• 제10권2호
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• pp.192-199
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• 1994

Since 1950s, fine needle aspiration(FNA) cytology has become increasingly popular and numerous reports have demonstrate its accuracy, safety and cost-effectiveness. To evaluate the role of diagnostic FNA cytology in the thyroid nodule, authors compared preoperative cytologic findings with postoperative histologic diagnosis in two hundred two thyroid nodules underwent surgical resection at Department of Surgery, Pusan Paik Hospital. from July 1990 to December 1993. FNA and thyroidectomy was performed primarily by one Head and Neck surgeon and specimen was interpreted by several pathologists. One hundred seventy two FNAs(85%) were interpreted as positive for benign lesion or carcinoma and thirty(15%, cystic in 25, non-cystic lesion in 5 cases) were unsatisfactory specimens for interpretation. The preoperative cytologic diagnosis of 172 cases revealed 'benign' in 112. 'suspicious cancer' in 10 and 'cancer' in 50 cases. Postoperative pathologic diagnosis showed 'nodular goiter' in 64. 'benign tumor' in 43, 'thyroiditis' in 4 and 'cancer' in 61 cases. The value of preoperative FNA diagnosis for thyroid cancer yielded a sensitivity of 85.2%, a specificity of 92.7%, false negative rate 5.2%, false positive rate 4.5% and positive predictive value and overall accuracy were 86.6% and 90.1% respectively. Preoperative rate of malignancy could be increased up to 35.5% by using FNA.

• 대한영상의학회지
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• 제84권5호
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• pp.1017-1030
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• 2023

증상이 있는 양성 갑상선결절의 비수술적 치료법인 고주파 절제술은 결절 조직을 열로 소작하여 부피를 감소시키고, 이로 인해 증상의 완화와 외견상 문제를 해결한다. 고주파절제술의 적응증은 2회 이상 세포/조직검사로 양성이 확인된 결절에서 의학적 치료가 필요한 주관적 또는 외견상의 임상증상이 있는 경우이다. 고주파 절제술은 1년의 단기 추적에서 매우 양호한 성적을 보이지만 3년 이상의 장기 추적에서는 20%-30% 결절의 재성장이 발생한다. 따라서 장기 추적을 전제로 하는 고주파절제술 후 환자 관리에서는 재성장을 관리하는 것이 핵심이다. 재성장은 치료 전 결절부피가 큰 경우, 혈관성이 높거나 증가하는 경우 잘 발생하며, 최근에는 수분 박리(hydrodissection), 동맥우선소작법, 정맥소작법등 새로운 기술들이 도입되어 재성장을 억제하고 있다. 또한 적절한 기준을 적용하여 재치료를 하는 것이 재성장을 관리하고 치료 효과를 오래 지속시키는데 중요하다. 고주파 절제술은 근본적으로 수술의 대안이므로 일시적 효과를 거두는 것이 아니라 영구적으로 수술을 회피하도록 하는 것이 궁극적인 목표이다.

• 대한핵의학회지
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• 제26권2호
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• pp.280-289
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• 1992

The 20-minute $^{99m}Tc-pertechnetate$ uptake became readily available for routine use and it replaced $^{131}I$ for thyroid imaging. However measuring thyroid uptake during a 5-minute minimizes pertechnetate uptake by the salivary glands and presence of contaminated saliva from those glands in to the pharynx and esophagus. A study was carried out to determine the suitability of the utility of a S-minute and 20-minute interval from administration of $^{99m}Tc-pertechnetate$ to imaging and uptake measurement as a replacement for the 24 hour standard originally established with $^{131}I$, and to evaluate the relationship between 5-minute $^{99m}Tc-pertechnetate$ uptake and other thyroid functions. A 5-minute and 20-minute uptake of $^{99m}Tc-pertechnetate$ were measured in 70 patients with thyroid disease at Yeungnam University Hospital from March 1, 1991 to Feb. 29, 1992. The results were as follows. 1) The 5-minute $^{99m}Tc-pertechnetate$ uptake in Graves' disease, Hashimoto's thyroiditis, simple goiter, non toxic nodular goiter, subacute thyroiditis and euthyroid were 18.2%, 14.6%, 2.8%, 3.2%, 1.2% and 1.1%, respectively. There was a significant difference between the mean of the euthyroid group and the mean of the Graves' disease. So differenciation between them can be easily made. 2) The 5 minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24 hour $^{131}I$ thyroid uptake (r=0.75, p<0.001). These data provided an equation for estimating the 24 hour uptake of iodide given the 5 minute pertechnetate uptake: Estimated 24-hour $^{131}I$ thyroid Uptake= 7.188*ln (5 minute $^{99m}Tc-pertechnetate$ uptake)+16.94 3) The 20-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24-hour $^{131}I$ uptake (r=0.72, p<0.001) and 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake (r=0.96, p<0.001). 4) In the Graves' disease, The 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with serum $T_3-resin$ uptake (r=0.46, p<0.01), serum total $T_3$ (r=0.55, p<0.05), serum total $T_4$ (r=0.46, p<0.05). These results suggest that 5-minute ${99m}Tc-pertechnetate$ thyroid uptake has been found at least as useful as 24-hour $^{131}I$ uptake for diagnostic confirmation at our hospital, the logistical advantages of completing the diagnosis. The exam in 5-minutes led us to abandon the 24-hour study in the majority of patients, but the 24-hour $^{131}I$ uptake is still obtained in patients with planned or potential radioiodine therapy.

• 대한핵의학회지
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• 제15권2호
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• pp.43-51
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• 1981

In an attempt to evaluate the diagnostic significance of the serum thyroxine binding globulin (TBG) in various thyroid disease states, the authors measured serum $T_3$ uptake, $T_3$, total $T_4\;free\;T_4$, TSH and TBG by radioimmunoassay technique, and calculated the free $T_4$ index$(FT_4I)$ and $T_4/TBG$ ratio in 10 cases of normal subjects, 11 cases of hypothyroidism, 62 cases of euthyroidism and 37 cases of hyperthyroidism. The data were analysed in the aspects of diagnostic significance in each thyroid disease state, and the results were as follows; 1. In 10 cases of normal subjects, serum TBG was $17.4\sim26.8{\mu}g/ml$, $FT_4I$ was $5.1\sim9.7$, and $T_4/TBG$ ratio was $21.9\sim49.9(Mean{\pm}S.D.)$. 2. In 62 cases of euthyroidism with diffuse and nodular goiter, $FT_4I$ was $7.26{\pm}1.82,\;T_4/TBG$ ratio was $31.47{\pm}10.42$, and there were no significant difference from those of normal subjects (p>0.5). 3. In 11 cases of hypothyroidism, the $FT_4I$ was $3.13{\pm}2.15,\;T_4/TBG$ ratio was $11.3{\pm}5.31$, significantly lower than normal controls (p<0.01). 4. In 37 cases of hyperthyroidism, the $FT_4I$ was $30.0{\pm}12.0,\;T_4/TBG$ ratio was $121.4{\pm}62.2$, significantly higher than normal controls (p<0.01). 5. There were significant correlations between the $FT_4I$ and $T_4/TBG$ ratio, total $T_4\;and\;T_4/TBG$ ratio, in each thyroid function states. 6. The $FT_4I$ showed 100% of diagnostic value in hyperthyroidism, 89.2% in euthyroidism, and 80% in hypothyroidism group. The $T_4/TBG$ ratio showed 100% of diagnostic value in hyperthyroidism and hypothyroidism, and 80.6% in euthyroidism group. The above results suggest that $T_4/TBG$ ratio and $FT_4I$ showed same diagnostic value in hyperthyroidism group, but $T_4/TBG$ showed higher diagnostic significance than $FT_4I$ in hypothyroidism.

• 대한세포병리학회지
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• 제4권2호
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• pp.105-110
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• 1993

갑상선의 세침흡인 세포학적 검사에서 가장 문제가 되는 점은 여포상 종양의 진단이다. 세포학적 소견만으로는 증식성 결절성 갑상선종, 여포성 선종 및 분화가 잘 된 여포상 암종 간의 감별 진단이 매우 어려운 경우가 많다. 저자들은 최근 4년 5개월 간에 조직학적으로 확진된 여포상 종양 중 수술 전에 적합한 세포학적 검사가 시행된 15예를 대상으로 그 세포학적 소견을 재검토하였다. 여포상 선종 6예의 흡인 도말은 공 모양 또는 합포체를 형성하는 다량의 여포성 세포를 함유하고 있었고, 경도의 핵 다형성 및 작은 핵소체가 각각 2예에서 관찰되었다. 배경은 출혈성으로 교질 성분은 매우 적거나 없었다. 여포상 암종 9예도 기본적으로 선종과 유사한 세포학적 소견을 보였는데, 세포밀도가 좀더 높고, 세포집단의 모양이 더 크고 불규칙하였으며, 흩어진 개별 종양세포가 많은 것이 차이점이었다. 핵의 다형성 및 눈에 띄는 핵소체가 선종에서 보다 많은 6예 및 5예에서 각각 관찰되었으나 그 정도는 심하지 않았다. 대부분의 암종과 1예의 선종에서 종양세포 집단에 밀착한 혈관 내피세포가 관찰되었다. 전반적으로 여포상 선종 및 암종은 미미한 차이를 보여서 세포학적으로 확실히 구별하기는 어려웠으나, 많은 수의 개별 세포와 종양세포 간에 포착된 혈관내피세포의 존재는 양성보다는 악성을 시사하는 소견으로 생각되었다. 여포상 종양의 세포학에 좀더 관심을 가짐으로써 그 발견율을 현저히 높일 수 있다고 생각된다.