• 정신신체의학
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• 제21권2호
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• pp.132-139
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• 2013

연구목적 본 연구는 갑상선암 환자에서 인지장애의 발생 빈도와 이에 관계되는 변인을 규명하기 위하여 시행되었다. 방 법 갑상선암으로 진단받고 갑상선전절제술 받은 지 6~12개월 후, 방사성요오드 잔여갑상선제거술을 받기 위해서 입원한 환자 42명을 대상으로 개인력, 병력조사와 우울지수 및 인지기능(Korean Version of the Montreal Cognitive Assessment, 이하 MoCA-K)의 평가를 시행하였다. 결 과 1) 대상 환자 중 MoCA-K 총점이 22점 이하인 환자는 21명(50.0%)이었다. 2) 나이, 교육수준, 방사성 요오드 치료 전 갑상선자극호르몬 농도는 MoCA-K 총점 23점 이상군과 MoCA-K 총점 22점 이하군 간에 통계적으로 유의한 차이가 있었다. 3) MoCA-K 총점과 통계적으로 유의한 연관성이 있는 변인은 나이, 교육수준, 병행질환, 방사성 요오드 치료 전 갑상선자극호르몬 농도, HDRS-17 총점이었다. 결 론 갑상선절제술 후 방사성 요오드 치료를 받기 전 갑상선암 환자에서 인지장애는 50%에서 있었다. 추후, 치료과정의 갑상선암에서 인지장애의 기전을 규명하기 위한 연구가 더 필요하며, 치료 과정의 환자에서 인지장애의 인식과 예방 대책이 요구된다.

• Neonatal Medicine
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• 제16권2호
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• pp.244-247
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• 2009

갑상선 반쪽 무형성증은 갑상선의 한쪽 엽이 형성되지 않는 드문 선천성 갑상선 질환이다. 갑상선 반쪽 무형성증 자체는 대개 아무런 임상 증상을 초래하지 않으므로 대부분은 동반된 갑상선 질환을 진단하는 과정이나 수술 중에 우연히 발견된다. 저자들은 선천성 갑상선기능저하증이 의심되어 내원한 1개월된 영아에서 원인을 찾던 중에 갑상선 초음파 및 스캔 검사를 통해 갑상선 반쪽 무형성증을 진단하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제53권2호
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• pp.158-162
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• 2010

목 적 : 터너증후군은 45,X의 전형적인 핵형 이외에도 다양한 정도의 X 염색체의 이상을 가진 질환으로 신장, 심혈관 기형, 갑상샘질환 및 청력이상을 동반하는 빈도가 많다. 본 연구에서는 핵형에 따른 동반질환의 발생빈도와 양상을 조사하였다. 방 법 : 1998년 1월부터 2007년 12월까지 호남지역 4개 병원에서 염색체검사상 터너증후군으로 확진된 90명의 의무기록을 후향적으로 분석하였다. 이들의 핵형을 45,X 군, 모자이시즘군, 구조적 이상군으로 분류하고 신장 및 심장초음파, 갑상샘기능검사, 청력검사 등을 통하여 동반질환의 발생빈도를 조사하였다. 결 과 : 45,X 군은 47.8%, 모자이시즘군은 34.4%, 구조적 이상군은 17.8%의 분포를 보였다. 신장, 심혈관 기형, 갑상샘질환, 청력이상은 각각 순서대로 4.4%, 10.0%, 11.1%, 5.6%의 빈도를 보였다. 45,X 군은 신장 기형이 7.0%, 심혈관 기형이 18.6% 갑상샘 질환이 9.3%, 청력이상이 11.6%에서 나타났다. 모자이시즘군은 신장기형이 3.2%, 갑상샘 질환이 12.9%의 발생율을 보였고 심혈관 기형과 청력이상이 있는 환자는 없었다. 구조적 이상군은 심혈관 기형이 6.3%, 갑상샘질환이 12.5%에서 나타났다. 45,X 군에서는 심혈관 질환의 발생율이 다른 두군에 비하여 통계적으로 유의하게 높았다(P =0.025). 결 론 : 터너증후군에서 핵형별로 동반질환의 분포가 다른 양상을 보였으며 적절한 선별검사를 통해 질환을 조기 진단하여 적절한 관리가 필요하리라 생각된다.

• 한국발생생물학회지:발생과생식
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• 제25권4호
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• pp.293-298
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• 2021

Di(2-ethylhexyl)phthalate (DEHP) could induce metabolic disorders through interfering with thyroid homeostasis. Therefore, we evaluated the effects of short term to environmental relevant doses of DEHP on thyroid hormones. Four week old Sprague-Dawley (SD) rats were treated with vehicle (corn oil), and DEHP 0.75, 7.5, and 150 mg/kg/day. The rats were treated with once daily by oral gavage and were sacrificed with after 1 week. They were measured body weight and relative thyroid weight, serum thyroid hormones and histological changes of thyroid. There was no difference in body weight between the control and DEHP exposed rats. Relative thyroid weight in DEHP 150 mg/kg/day treated group was significantly lower than control. Serum thyroxine levels was decreased in rats exposed to 0.75 and 150 mg/kg/day DEHP. No histological changes were observed in the thyroid of rats administered DEHP compared to control. Exposure to DEHP at environmental relevant levels, even short-term exposure, can cause hypothyroidism in adolescent rats even the exposure period is relative short.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3875-3879
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• 2015

Background: The neutrophil/lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. Inflammation has been implicated in the initiation and progression of thyroid cancer. The aim of this study was to examine the relationship of NLR with papillary thyroid cancer (PTC) and different benign thyroid pathologies like multinodular goiter (MNG) and lymphocytic thyroiditis (LT). Materials and Methods: We retrospectively evaluated the neutrophil, lymphocyte counts and NLR calculated from these parameters of 232 patients with histologically confirmed as multinodular goiter (group MNG) (n=70), lymphocytic thyroiditis (group LT) (n=97), LT with PTC (group LT-PTC) (n=25) and PTC (group PTC) (n=40). The optimal cut-off value for NLR was determined. Results: NLR level was significantly higher in groups LT-PTC and PTC as compared to groups MNG and LT (p<0.05). NLR of LT subgroups according to TSH levels were not different (p>0.05). When we grouped the patients as benign and malignant according to PTC presence, the optimum NLR cut-off point obtained from ROC analysis was 1.91 (sensitivity 89.0% and specificity 54.5%). Conclusions: Since NLR was significantly elevated in group LT-PTC and group PTC, NLR value may give an opinion as a potential marker in differentiation of benign and malign thyroid disorders. For this purpose a cut-off value of 1.91 for NLR may be accepted.

• 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.

• 말소리와 음성과학
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• 제3권1호
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• pp.111-116
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• 2011

The purpose of this study was to analyze the association between self-reported voice problems and voice disorders in the Korean adult population. Data were collected from the 4th Korea National Health and Nutritional Examination Survey (2008) from 3,135 subjects (1,310 men and 1,825 women) aged 19 years and older. Multi-nominal logistic regression analyses were used to examine the association between self-reported voice problems and voice disorders in the Korean adult population. Adjusting for covariates (age, sex, education level, job, smoking, alcohol drinking, thyroid disorders, pain and discomfort during the last 2 weeks), self-reported voice problems included independently associated functional voice disorders (OR=4.70, 95% CI: 3.14-7.03) and organic voice disorders (OR=3.89, 95% CI: 1.57-9.65). The results of the present study verified that self-reported voice problems are valuable indicators for voice disorders. Further research is needed to ascertain the effect of self-reported voice problems on voice disorder in adults.

• 대한후두음성언어의학회지
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• 제7권1호
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• pp.27-31
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• 1996

The voice of aged persons is known generally to be somewhat different from that of other adults, suggesting that laryngeal change occurs with advancing age. However, because knowledge of the voice characteristics of aged persons is limited, it is difficult to judge whether their voices arc normal. Chart review and laryngoscopic examination from ninety-one patients with hoarseness over the age of 60(1st group) and one hundred sixteen patients with hoarseness below the age of 50(2nd group) were done to define aging related voice disorders. The following results were obtained. 1) Associated diseases related to laryngeal disease were hypertension(12%), pulmonary disease(4.4%), thyroid disease(1.1%) in 1st group and hypertension(9.5%), thyroid disease(1.7%) in 2nd group. 2) The underlying diseases causing hoarseness in order of frequency were benign vocal fold lesion(37.7%), inflammatory disease(36.8%), functional dysphonia(17%) in 1st group and benign vocal fold lesion(43.6%), functional dysphonia(26.3%), inflammatory disease(16.5%) in 2nd group. 3) In stroboscopic findings, atrophy and sulcus of vocal cords are more prevalent in males than in females and edema of vocal cords is more common in females. Generally the voice characteristics of aged persons depend on the mass of the vocal folds which may be decreased through atrophy or be increased by edema. However, other factors such as systemic diseases, drug side effects and compensatory mechanism to presbylaryngis must be taken into account in diagnosing and treating voice disorders in aged persons.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.14-17
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• 2016

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

• 말소리와 음성과학
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• 제3권3호
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• pp.125-132
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• 2011

Studies on the risk factors of voice disorders in Korean adults are rare. I evaluated the association between the duration of self-reported voice problem and voice disorders in Korean adults. Data were from the 2008 Korea National Health and Nutritional Examination Survey. Subjects were 3,135 people (1,310 men and 1,825 women) aged 19 years and older. Multi-nominal logistic regression analyses were used to examine the association between the duration of self-reported voice problem and voice disorders. The prevalence of self-reported voice problems was 5.9% among Korean adults. Adjusting for covariates (age, sex, education level, length of employment, tobacco consumption, alcohol consumption, thyroid disorders, pain and discomfort during the last two weeks), self-reported voice problems lasting longer than three weeks were independently associated with functional voice disorders (OR=5.30, 95% CI: 3.30-8.50) and organic voice disorders (OR=4.84, 95% CI: 1.82-12.89). Self-reported voice problems in the past three weeks were significantly associated with functional voice disorders (OR=3.64, 95% CI: 1.84-7.19), but not significantly associated with organic voice disorders. Self-reported voice problems are prevalent among adults. This study highlights that self-perception of a voice problem for more than three weeks is related to functional voice disorders and organic voice disorders.