• 제목/요약/키워드: Thyroid, intervention

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갑상선 질환자에게 적용한 중재 프로그램에 대한 체계적 문헌고찰 - 국내연구를 중심으로 (Systematic review of the intervention program applied to patients with thyroid disease - Focused on Domestic studies)

  • 오현주;조정화
    • 한국융합학회논문지
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    • 제12권4호
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    • pp.317-326
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    • 2021
  • 본 연구는 국내 갑상선질환자를 대상으로 한 중재 연구 프로그램의 특성과 결과변수를 분석하기 위한 체계적 문헌고찰 연구이다. 국내 5개의 데이터베이스에서 2019년까지 발표된 문헌을 체계적으로 고찰하였다. 확인한 824편 중 선정기준에 맞는 6편을 추출하였다. 본 연구의 결과 프로그램은 교육, 활동, 상담으로 분류되었다. 교육 및 상담요법은 심리사회적인 변수와 신체생리적인 변수에 유의한 영향을 미치고 있었다. 활동요법은 신체생리적 변수에 유의한 영향을 나타내었다. 본 연구는 국내 갑상선질환자를 위한 다양한 중재 프로그램의 개발과 운영방안에 대한 근거를 제시하였다는 것에 의의가 있으며 향후 갑상선질환자의 신체생리적 기능과 심리사회적 문제를 고려한 융합적 프로그램개발연구에 활용될 수 있을 것이다.

갑상선질환(甲狀腺疾患)에 관(關)한 연구(硏究) -20여년간(餘年間)의 핵의학교실업적(核醫學敎室業績)을 중심(中心)으로- (The Study on the Thyroid Disease)

  • 이문호
    • 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.

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Association between Pax8-PPARγ1 Rearrangement and Follicular Thyroid Cancer: a Meta-Analysis

  • Li, Hang-Yu;Xie, Zhi-Hao;Xu, Cong-Hui;Pu, Mei-Ling;Chen, Zi-Yan;Yu, Miao;Wang, Heng-Shu;Zhou, Chen-Ming;Pu, Chao-Yu;Liu, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권9호
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    • pp.4247-4250
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    • 2016
  • Background: Pax8 and peroxisome proliferator-activated receptor gamma 1 gene (Pax8-$PPAR{\gamma}1$) are important factors in tumors. Several studies have suggested that follicular thyroid cancer may arise from Pax8- $PPAR{\gamma}1$ rearrangement. In order to have a better understanding of the association between Pax8-$PPAR{\gamma}1$ rearrangement and follicular thyroid cancer, we conducted the presenmt meta-analysis. Materials and Methods: The information was extracted from PubMed, EMBASE and Web of Science. Statistic analysis was performed with Stata12.0 software. Odds ratios (ORs) were calculated using a fixed-effects model. We also performed heterogeneity and publication bias analyses. Results: Nine studies including 198 follicular thyroid cancer patients and 268 controls were considered eligible. The frequency of Pax8-$PPAR{\gamma}1$ rearrangement was significantly higher in the follicular thyroid cancer group than in the control group, with a pooled OR of 6.63 (95%CI=3.50-12.7). In addition, through subgroup analysis, the OR between Pax8-$PPAR{\gamma}1$ rearrangement and follicular thyroid cancer was 6.04 (95%CI = 3.18-11.5) when using benign tumor tissues as controls. The OR for the method subgroup was 9.99 (95% CI =4.86-20.5) in the RT-PCR. Conclusions: The final results demonstrated that Pax8-$PPAR{\gamma}1$ rearrangement has significant association with follicular thyroid cancer.

AKT1 Inhibitory DNAzymes Inhibit Cell Proliferation and Migration of Thyroid Cancer Cells

  • Yang, Le;He, Jin-Ting;Guan, Hong;Sun, Ya-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2571-2575
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    • 2013
  • AKT1 is a member of the serine/threoine AGC protein kinase family involved in thyroid cancer metabolism, growth, proliferation and survival. It is overexpressed in thyroid tumors. In this study, we designed two AKT1 specific DNAzymes (DRz1 and DRz2) that target AKT1 mRNA. The results showed that DRz1 could decrease the expression of AKT1 by 58%. Furthermore, DRz1 significantly inhibited cell proliferation, induced apoptosis and inhibited invasion in SW597 cells. In addition, down-regulation of survivin expression was associated with decreased caspase-3, VEGF and MMP2 in SW597 cells after 24 h. In our study, the efficacy of DRz1 in decreasing AKT1 protein levels were better than DRz2. AKT1-DRz1 might have anti-tumorigenic activity and may provide the basis for a novel therapeutic intervention in thyroid cancer treatment.

전위를 동반한 갑상연골 골절의 자연 치유 치험 1례 (Spontaneously Healed Thyroid Cartilage Fracture with Displacement: Report of a Case)

  • 류현호;이병국;정경운
    • Journal of Trauma and Injury
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    • 제23권1호
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    • pp.53-55
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    • 2010
  • A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

국내의 갑상선 고주파 절제술에 대한 교육: 현황 및 미래 전망 (Training of Radiofrequency Ablation for Thyroid Nodules in Korea: Current and Future Perspective )

  • 안혜신;정소령;백정환;성진용;김지훈
    • 대한영상의학회지
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    • 제84권5호
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    • pp.1009-1016
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    • 2023
  • 고주파 절제술(radiofrequency ablation)은 미세 침습 치료술의 한 방법으로 양성 갑상선 결절과 갑상선 재발암 환자에서 수술적 치료를 대신하여 이용되고 있다. 국내에서는 2002년 세계 최초로 갑상선 결절에 대한 고주파 절제술을 시작하여, 2008년에는 대규모 연구 결과를 발표하였다. 2009년 대한갑상선영상의학회(Korean Society of Thyroid Radiology)는 고주파 절제술에 대한 첫 권고안을 만들었으며, 2012년과 2018년에 이를 개정하였다. 대한갑상선영상의학회의 지침서는 갑상선 결절의 고주파 절제술에 대한 세계 최초의 지침서로 국내 및 국외에서 갑상선 고주파 절제술을 시행하는 시술자들을 위한 지침이 되었다. 이 지침서들은 한국 및 전 세계 여러 나라에서 고주파 절제술의 확립 및 확산에 크게 기여하였다. 또한 대한 갑상선영상의학회는 2015년부터 참가자 수준에 맞춘 고주파 절제술의 심화 실습 과정을 진행하고 있다. 본 종설에서는 대한갑상선영상의학회에서 실시한 고주파 절제술 교육의 역사를 소개하고, 고주파 절제술의 학습 곡선 및 현재 한국에서의 교육 프로그램을 기술한 후 앞으로 나아갈 방향을 제시해보고자 한다.

방사성요오드 치료를 받는 갑상선암 환자의 삶의 질 변화와 영향요인 (Changes in Quality of Life and Related Factors in Thyroid Cancer Patients with Radioactive Iodine Remnant Ablation)

  • 유선희;최스미
    • 대한간호학회지
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    • 제43권6호
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    • pp.801-811
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    • 2013
  • Purpose: To investigate changes in Quality of life (QOL) and related factors in patients with thyroid cancer undergoing Radioactive Iodine remnant ablation (RAI). Methods: Data were collected longitudinally 3 times for 6 months (2 weeks post-surgery, post RAI, 3 months post RAI) in a hospital located in Seoul. Questionnaires were used to measure levels of physical symptoms, anxiety, depression, and QOL. Ninety-eight patients with thyroid cancer who had RAI were included in the analysis. Data were analyzed using SPSS (18.0). Results: Findings for the three data collection times respectfully were: mean scores for physical symptoms, 0.53, 1.21 and 0.62, patients with depression, 47%, 36.7% and 37.7%, patients with anxiety, 18.4 %, 19.4% and 20.4%, mean scores for QOL, 7.06, 7.01 and 7.28. QOL score was highest 3 months post RAI (p=.031). In the stepwise multiple regression analysis, depression and fatigue were predicting factors for low QOL at all data collection times. Dysponia was a predicting factor for low QOL post RAI and 3 months post RAI. Conclusion: To increase QOL, it is necessary to provide information in advance regarding physical & psychological symptoms and to develop nursing intervention programs to decrease depression and fatigue.

Comparison of Pre-Operation Diagnosis of Thyroid Cancer with Fine Needle Aspiration and Core-needle Biopsy: a Meta-analysis

  • Li, Lei;Chen, Bao-Ding;Zhu, Hai-Feng;Wu, Shu;Wei, Da;Zhang, Jian-Quan;Yu, Li
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7187-7193
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    • 2014
  • Background: The aim of this meta-analysis was to compare sensitivities and specificities of fine needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid cancer. Materials and Methods: Articles were screened in Medline, the Cochrane Library, EMBASE and Google Scholar, and subsequently included and excluded based on the patient/problem-intervention-comparison-outcome (PICO) principle. Primary outcome was defined in terms of diagnostic values (sensitivity and specificity) of FNA and CNB for thyroid cancer. Secondary outcome was defined as the accuracy of diagnosis. Compiled FNA and CNB results from the final studies selected as appropriate for meta-analysis were compared with cases for which final pathology diagnoses were available. Statistical analyses were performed for FNA and CNB for all of the selected studies together, and for individual studies using the leave-one-out approach. Results: Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients. Pooled diagnostic sensitivities of FNA and CNB methods were 0.68 and 0.83, respectively, with specificities of 0.93 and 0.94. The areas under the summary ROC curves were 0.905 (${\pm}0.030$) for FNA and 0.745 (${\pm}0.095$) for CNB, with no significant difference between the two. No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity. Conclusions: FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.

갑상선암 수술환자의 삶의 질에 영향을 미치는 요인 (Factors Influencing the quality of life in thyroid cancer patients after thyroidectomy)

  • 정정숙;김인숙;이은선
    • 한국산학기술학회논문지
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    • 제16권8호
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    • pp.5442-5451
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    • 2015
  • 본 연구는 갑상선암 수술환자의 삶의 질 영향요인을 확인하고, 변인간의 관계를 규명하여 갑상선 암 환자의 삶의 질 향상 프로그램 개발의 기초 자료를 제공하고자 한다. 연구 대상자는 광주지역에 소재한 종합병원에서 갑상선절제수술을 받은 갑상선암 환자 125명을 대상으로 하였다. 자료분석은 spss 21.0 프로그램을 이용하여, 일반적 및 질병관련 특성, 피로, 우울, 삶의 질 정도는 기술통계, 일반적 특성에 따른 삶의 질 차이검증은 t-test, one-way ANOVA와 사후분석으로 산출하였고 피로, 우울, 삶의 질의 관련성은 피어슨상관분석, 삶의 질에 영향을 미치는 요인은 단계적 회귀분석을 실시였다. 이를 분석한 결과 학력, 암 진단 전 체중변화, 암 진단 전 피로, 암 진단 전 사회활동, 현재 건강상태에서 삶의 질과 유의한 차이를 보였으며, 상관관계에서는 피로(r=-.70, p<.001), 우울(r=-.68, p<.001)이 삶의 질과 부적상관관계를 보였다. 삶의 질의 유의한 영향 요인은 우울(${\beta}=-0.39$, p<.001), 영적 피로(${\beta}=-0.30$, p<.001), 신체적 피로(${\beta}=-0.24$, p<.001)이었으며, 전체 설명력은 57.2%이었다. 따라서 이들의 삶의 질을 향상시키기 위해서는 갑상선 암 수술 후 우울과 피로를 감소시킬 수 있는 간호중재가 필요하다.