• 제목/요약/키워드: thyroiditis

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방사성동위원소옥소(放射性同位元素沃素)($^{131}I$)에 의(依)한 갑상선질환(甲狀腺疾患)의 임상적연구(臨床的硏究) -제 4 보-(第 4 報) (Clinical Investigation and Treatment of Thyroid Diseases with Radioactive Iodine($^{131}I$) -Report 4-)

  • 김목현;이범홍;정경태;장고창;김명재;이장규;이문호
    • 대한핵의학회지
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    • 제1권1호
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    • pp.67-78
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    • 1967
  • Over the past 6 years, from May 1960 to June 1966, 1,716 patients with various diseases of thyroid were examined and thyroid function tests with $^{131}I$ were done. Among them, 545 patients with hyperthyroidism were treated with $^{131}I$. A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ were presented and discussed. 1. The patients examined consisted of; 596 cases(34.7%) with toxic diffuse goiter, 412 cases(24.0%) with non-toxic nodular goiter, 278 cases(16.2%) with euthyroidism, 236 cases(13.8%) with non-toxic diffuse goiter, 89 cases(5.2%) with hypothyroidism, 53 cases(3.1%) with toxic nodular goiter, 32 cases(1.9%) with thyroiditis and 20 cases(1.2%) with dyshormonogenesis. 2. There were 218(12.7%) male patients and 1,498(87.3%) female patients, showing a ratio of 1:6.9. female predominantly. 3. The majority of patients(79.6%) were in the 3rd through 5th decades of their lives showing the peak in the 4th decades(35.9%). 4. The diagnostic values and normal ranges of $^{131}I$ uptake test, 48 hour serum activity, $T_3$ red blood cell uptake and $PB^{131}I$ conversion ratio were discussed. 5. An attention was given to dyshormonogenesis, a qualitative hypothyroidism, due to its characteristic findings of clinical and $^{131}I$ thyroid function tests, and its pathogenesis was briefly reviewed. 6. Among 545 patients with hyperthyroidism treated with $^{131}I$, 68.3% was cured after single. therapeutic dose and another 24.0% was cured after second dose. 7. The complications of $^{131}I$ therapy were discussed in some details and myxedema had developed. in 3.9% of our cases. No thyroid cancer was found after $^{131}I$ therapy.

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각종 갑상선질환에서 혈청 Thyroglobulin치에 관한 연구 (A Study of Serum Thyroglobulin in Various Thyroid Diseases)

  • 김창국;전병숙;한봉헌;노흥규;이복희
    • 대한핵의학회지
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    • 제17권1호
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    • pp.17-23
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    • 1983
  • In an attempt to evaluate the diagnostic singnificance of the serum thyroglobulin (TG) in various thyroid disease states, authors measured serum TG by radioimmunoassay technique in 20 cases of normal subject, 22 cases of hyperthyroidism, 12 cases of diffuse nontoxic goiter (DNG) and 96 cases of nodular nontoxic goiter(NNG). The results were as follows: 1. In 20 cases of normal subjects, serum TG level was $20.41{\pm}5.5ng/ml(M{\pm}S.D.)$. There was no significant difference between males ans females. 2. In 22 cases of hyperthyroidism, serum TG level was $60.23{\pm}34.56ng/ml$ and the range was from 22 to 175 ng/ml, which were significantly high levels comparing with normal controls (p<0.01). 3. In 12 cases of euthyroidism with DNG, serum TG was $37.28{\pm}27.36ng/ml$ and the range was from 14 to 89 ng/ml. In 96 cases of euthyroidism with NNG, serum TG was $70.43{\pm}78.18ng/ml$ and the range was from 12.8 to 440 ng/ml. Both groups showed significantly increased levels of TG than normal control (p<0.01). 4. 57 cases of NNG patients were analysed pathologically by operation or needle biopsy and the TG level of each disease group is as follows. Thyroid carcinoma (16 cases); $72.2{\pm}81.71ng/ml$, adenomatous goiter without cystic degeneration (15 cases); $74.86{\pm}45.64ng/ml(M{\pm}S.D.)$ and adenomatous goiter with cystic degeneration(23 cases); $73.56{\pm}64.78ng/ml(M{\pm}S.D.)$. There was no significant difference between each group. Also the TG levels of thyroiditis (5 cases) was $19.6{\pm}8.96ng/ml(M{\pm}S.D.)$. 5. There were no significant correlations between serum thyroid hormones and serum TG in each thyroid functional states.

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갑상선암(甲狀腺癌)의 임상적(臨床的) 관찰(觀察) (Clinical Observation on Thyroid Carcinoma)

  • 박선양;신영태;조보연;김병국;고창순;이문호
    • 대한핵의학회지
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    • 제12권2호
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    • pp.33-40
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    • 1978
  • Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to femle patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using $^{131}I$. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stags III and 9.1 % in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular adenoma in 1 case.

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아급성 괴사성 림프절염의 임상적 고찰 (Clinical Characteristics of Subacute Necrotizing Lymphadenitis)

  • 박찬흠;김희동;박준영;조형주;전진형;박윤규;노영수
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.217-221
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    • 1999
  • Background and Objectives: Subacute necrotizing lymphadenitis or Kikuchi's disease has now become recognized in many parts of the world as a well-defined clinicopathologic entity. It typically affects cervical lymph nodes of young women, and subsides spontaneously within a few months without recurrences. The purpose of this study is to report the clinicopathologic finding, radiologic finding and many laboratory tests to elaborate the criteria that are useful in distinguishing this entity from inflammatory disease, granulomatous disease, lymphoma, malignant disease. Material and Methods: Authors evaluated 22 patients, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy or fine needle aspiration cytology with retrospective chart review. Results: The patient population consisted of 21 women and 1 men. The mean age was 25 years old(range 17 to 42 years). All patient had palpable neck mass and associated fever, headache, weight loss, otalgia, diarrhea, night sweating. and associated disorder is dermatitis, hepatitis B, SLE, Hashimoto's thyroiditis, albinism et al. The multiple bilateral involvement of cervical lymph node was 20 cases(91%) and multiple unilateral 18 cases(82%), multiple bilateral 2 cases(9%). Solitary involvement was 2 cases(9%), mean size of involved lymph node was 2.0cm. In laboratory tests, leukopenia 17 cases(72%), elevated ESR 12 cases(54%), elevated GOT, GPT 3 cases(13%). In CT finding, lymph nodes enhanced in homogeneous fashion, and there was no evidence of central necrosis. Conclusion: Subacute necrotizing lymphadenitis, Kikuchi's disease may be easily confused clinically, pathologically, radiologically with malignant lymphoma, inflammatory disease, granulomatous disease. We should consider open biopsy of lymph node in the patient which had unilateral multiple cervical lymph node and in laboratory tests, were leukopenia, elevated ESR, especially in young women. otherwise, result of fine needle aspiration biopsy is nonspecific, excisional biopsy is recommended in order to differentiate other disease.

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갑상선 질환들에서 여포세포의 HLA-DR발현 (Thyrocyte HLA-DR Expression in Variety of Thyroid Diseases)

  • 장은숙;손수상;조승제;김인호;김상표;강중신
    • 대한두경부종양학회지
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    • 제13권1호
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    • pp.16-23
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    • 1997
  • Although normal thyroid epithelial cells do not constitutively express HLA-DR antigen, their expression in wide spread within thyroid glands obtained from the human with autoimmune thyroid disease and with many neoplastic thyroids. We have, therefore, studied immunohistochemically with regard to the expression of HLA-DR antigen of thyroidectomy specimens from 50 patients of various thyroid diseases with use of paraffin-embedded tissue. One or two sections from each case were stained with commercially available mouse monoclonal antibody for class II HLA-DR antigen(HLA-DR/Alpha, DAKO) and examined by semiquantitative counting system for thyrocytes, neoplastic thyrocytes and other cells expressing HLA-DR antigen. All patients with lymphocytic thyroiditis(2/2) and diffuse hyperplasia(Graves' disease)(5/5), most patients with Hashimoto's disease(9/ll) expressed HLA-DR antigens in thyrocyte with abundant HLA-DR expressing lymphocytic infiltrates with lymph follicle formation in its vicinity or adjacent to the lesion. Most patients with papillary carcinoma(9/1l) had HLA-DR antigen detected in malignant thyrocytes ; while follicular carcinoma(0/3) and follicular adenoma(0/5) did not have detactable HLA-DR immunoreactivity. Adenomatous goiter(3/7) had HLA-DR antigen detected focally in lesser than half cases. Conversely, in four papillary carcinomas and three adenomatous goiters, HLA-DR expression of thyrocytes was found in the absence of HLA-DR expressing lymphoid infiltrates. In such cases therefore other factors more than thyroid autoimmunity must be causative for HLA-DR immunoreactivity. The results of this study indicate as follows. 1) The expression of HLA-DR on thyrocytes involved in autoimmune reactions appeared to be secondary to cytokine release from associated lymphocytic infiltrates. 2) Thyrocytes in thyroid lesions with equal degrees of lymphocytic infiltration without HLA­DR expression exhibited no HLA-DR immunoreactivity. 3) In neoplastic thyrocytes, most papillary carcinoma(9/11) exhibited detactable HLA-DR expression, while follicular carcinoma/adenoma(0/3/0/5) exhibited no detactable HLA-DR immunoreactivity which suggest the existence of divergent mechanisms inducing and modulating HLA-DR expression of different types of neoplastic thyrocytes.

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세침흡인검사 결과 Atypia of Undetermined Significance로 진단된 갑상선 결절에서 악성을 예측할 수 있는 위험인자 (BRAFV600E Mutation is a Strong Preoperative Indicator for Predicting Malignancy in Thyroid Nodule Patients with Atypia of Undetermined Significance Identified by Fine Needle Aspiration)

  • 최혜랑;최보윤;조재훈;임영창
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제61권11호
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    • pp.600-604
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    • 2018
  • Background and Objectives This study aimed to identify a reliable preoperative predictive factor for the development of thyroid cancer in patients with atypia of undetermined significance (AUS) identified by fine needle aspiration biopsy (FNAB). Subjects and Method This was a retrospective cohort study. Two hundred and ninety-nine patients diagnosed with AUS by preoperative FNAB who underwent curative thyroid surgery at our institution between September 2005 and February 2014 were analyzed. Clinical, radiological and molecular features were investigated as preoperative predictors for postoperative permanent malignant pathology. Results The final pathologic results revealed 36 benign tumors including nodular hyperplasia, follicular adenoma, adenomatous goiter, nontoxic goiter, and lymphocytic thyroiditis, as well as 263 malignant tumors including 1 follicular carcinoma and 1 invasive follicular carcinoma; the rest were papillary thyroid carcinomas. The malignancy rate was 87.9%. The following were identified as risk factors for malignancy by univariate analysis: $BRAF^{V600E}$ gene mutation, specific ultrasonographic findings including smaller nodule size, low echogenicity of the nodule, and irregular or spiculated margin (p<0.05). Multivariate analysis revealed that only $BRAF^{V600E}$ mutation was a statistically significant risk factor for malignancy (p<0.05). When $BRAF^{V600E}$ mutation was positive, 98.5% of enrolled patients developed malignant tumors. In addition, the diagnostic rate of malignancy in these cases was approximately 16-fold higher than BRAF-negative cases. Conclusion Patients with AUS thyroid nodules should undergo $BRAF^{V600E}$ gene mutation analysis to improve diagnostic accuracy and if the mutation is confirmed, surgery is recommended due to the high risk of malignancy.

출산 후 우울증과 갑상선질환에 대한 초음파검사의 유용성에 관한 연구 (Study on the Usefulness of Ultrasonography for Postpartum Depression and Thyroid Disease)

  • 이윤이;임청환;정홍량;박미자;유인규
    • 대한방사선기술학회지:방사선기술과학
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    • 제35권3호
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    • pp.237-248
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    • 2012
  • 출산 후 우울감이 있는 여성의 갑상선질환 빈도가 증가하면서 출산 후 우울증과 갑상선질환의 상관성 여부가 논의의 대상이 되고 있다. 본 연구는 출산 후 우울증의 유병률을 예측하고 초음파검사를 통한 갑상선질환과의 상관성에 대해 연구하고자 한다. 2010년 1월부터 2011년 11월까지 M산부인과에 내원한 출산 후 1년 이내의 환자 230명을 대상으로, 우울증 선별검사와 대상자의 일반적 특성을 조사하였고 갑상선검사는 초음파검사와 혈액검사를 하였다. 대상자 230명 중 비우울집단은 122명(53.0%), 우울집단은 108명(47.0%)이었다. 갑상선 초음파검사에서 갑상선의 크기변화가 있었던 27명 중 비우울집단은 4명 (14.8%)이었고, 우울집단은 23명(85.2%)이었다. 또한 갑상선 결절이 발견된 124명 중 비우울집단은 45명(35.8%)이었고, 우울집단은 79명(64.2%)이었다. 초음파유도하 미세침흡인검사 결과, 양성 33명 중 비우울집단은 15명(45.5%)이었고, 우울집단은 18명(54.5%)이었다. 갑상선염 3명 중 비우울집단은 1명(33.3%)이었고, 우울집단은 2명(66.7%)이었다. 악성 5명은 모두 우울집단에서만 나타났다. 초음파검사를 통한 갑상선의 크기변화, 갑상선 결절의 발생빈도 등 갑상선질환은 우울집단이 비우울집단에 비해 높게 나타났으며 유의한 차이가 나타났다. 갑상선 혈액검사 결과, 비정상적인 갑상선자극호르몬의 수치를 보였던 7명 중 비우울집단은 2명(28.6%)이었고, 우울집단은 5명(71.4%)이었다. 비정상적인 유리티록신의 수치를 보였던 9명 중 비우울집단은 4명(44.4%)이었고, 우울집단은 5명(55.6%)이었다. 갑상선 기능이상은 230명 중 5명이었고, 5명 중 비우울집단에서는 잠재적 갑상선항진증이 2명이었다. 우울집단에서는 잠재적 갑상선저하증이 1명, 잠재적 갑상선항진증이 2명이었고 혈액검사를 통한 두 집단의 유의한 차이가 나타나지 않았다. 본 연구는 출산 후 우울증과 초음파검사를 통한 갑상선질환의 상관성이 나타났으며, 본 연구의 객관적 결과들이 출산 후 우울증과 갑상선질환에 대한 폭넓은 인식과 예방 및 치료의 가이드라인을 제시할 수 있을것이라 사료된다.

의사결정트리 프로그램 개발 및 갑상선유두암에서 질량분석법을 이용한 단백질 패턴 분석 (Development of Decision Tree Software and Protein Profiling using Surface Enhanced laser Desorption/lonization - Time of Flight - Mass Spectrometry (SELDI-TOF-MS) in Papillary Thyroid Cancer)

  • 윤준기;이준;안영실;박복남;윤석남
    • Nuclear Medicine and Molecular Imaging
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    • 제41권4호
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    • pp.299-308
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    • 2007
  • 본 연구의 목적은 의사결정트리를 생성하는 생물정보학 프로그램을 개발하고, 이를 갑상선유두암 혈청의 질량분석자료로 시험해 보는 것이다. 대상 및 방법: C4.5를 커스터마이징하여 의사결정트리 분석을 수행할 수 있는 'Protein analysis'라는 프로그램을 개발하였다 61개의 혈청시료(갑상선유두암 27, 자가면역성 갑상선염 17, 대조군 17)를 일정 기간 동안 순차적으로 냉동한 후 실온에서 일시에 해동하여 분석에 사용하였다. 모든 시료는 탈지질화 과정을 거쳐 준비한 후, 2종류의 단백질칩(CM10, IMAC3)에 각각 60개, 50개 시료를 적용하였다. 갑상선유두암의 특징적인 단백질 패턴을 찾기 위해 질량분석기를 이용하여 단백질칩을 분석했다. 'Protein analysis' 프로그램을 이용하여 단백질분포 자료로부터 의사결정트리를 작성하고, 생체표지자 후보물질을 검출하였다. CM10칩에서 발견된 생체표지자 후보물질을 무작위 표본추출 방법을 이용하여 검증하였다. 결과: 단백질분포 자료의 훈련과 검증이 가능한 의사결정트리 프로그램이 개발되었으며, 이 프로그램은 트리 구조와 노드 정보, 트리 구성 과정을 표시하는 3개의 창으로 구성되었다. CM10칩을 이용한 분석에서 총 113개의 단백질 피크 중 23개가 3그룹 간에 유의한 차이가 있었으며, IMAC3는 41개의 단백질 피크 중 8개가 3그룹 간에 유의한 차이가 있었다. 3그룹 분석에서 의사결정트리는 CM10칩과 IMAE3의 단백질분포 자료로부터 각각 60개와 50개의 시료를 높은 정확도로 분류하였으며(오차율 = 각각 3.3%, 2.0%), 각각 4개와 7개의 생체표지자 후보물질을 검출하였다. 암시료와 비암시료를 구분하는 2그룹 분석 에서, 의사결정트리는 모든 암시료를 정확히 구분하였으며(모두 오차율 = 0%), CM10칩을 이용한 분석에서는 단일 노드를 사용하고, IMAC3칩을 이용한 분석에서는 여러 개의 노드를 사용하였다. CM10칩의 단백질 분포자료를 5번의 무작위 추출에 의해 시행한 검증에서 암시료와 비암시료를 구분하는데 높은 정확도를 보였으나(정확도 = 98%, 54/55), 3그룹을 구분할 때는 중등도의 정확도를 보였다(정확도 = 65%, 36/55). 결론: 우리가 개발한 프로그램은 질량분석 자료로부터 성공적으로 의사결정트리를 생성하고, 생체표지자 후보물질을 검출할 수 있었다. 따라서 이 프로그램은 혈청 시료를 이용한 생체표지자 발굴 및 갑상선유두암의 추적관찰에 유용하게 사용될 수 있을 것이다.

결절성 갑상선 질환에 대한 임상적 고찰 (A Clinical Study on Nodular Thyroid Disease)

  • 이규준;박순태;하우송;권수인;최상경;홍순찬;이영준;이영재
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.244-252
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    • 1998
  • 저자들은 1987년 1월부터 1997년 2월까지 만 10년간 경상대학교병원 외과학 교실에서 갑상선 결절 환자 298예에 대하여 임상적 검토를 실시하여 다음과 같은 성적을 얻었다. 1) 갑상선 결절 총 298예 중 양성 결절은 214예(71.8%), 악성 결절 84예(28.2%)이었고, 악성율은 진단방법의 발달과 수술 적응증의 강화로 증가 되었다. 양성 결절과 악성 결절은 30대에서 50대 사이에서 호발하였고 나이가 증가함에 따라 악성 빈도가 증가하였다. 남녀비는 양성 결절에서 1:5.88이었고, 악성 결절에서 1:11이었다. 2) 병리조직학적 소견상 양성 결절 214예중 여포선 종 136예 (63.5%), 선종성 선종 67예 (31.3%), 휘틀 세포 선종 4예(1.9%), 낭종 3예(1.4%), 기타 갑상선염 4예 (1.9%)이었고, 악성종양 84예중 유두암 728예 (85.72%). 여포암 8예(9.5%), 미분화암 2예(2.4%), 수양암 1예 (1.2%), 악성 림프종 1예 (1.2%)이었다. 3) 술전 시행한 세침 천자 흡인 세포 검사의 민감도는 52.8%, 특이도는 98.4%, 위음성율은 47.2%이었다. 4) 총 298예 중 단일 결절 85.6%, 다발성 결절 14.4%이었으며 이중 악성결절의 빈도는 단일 결절의 26.6%, 다발성 결절의 37.3%이었고, 고형 결절의 악성도는 83.3%로 낭성 결절의 16.7%보다 높았고, 갑상선 주사소견상 악성 결절에서 cold nodule이 22.7%였다. 5) 수술 방법은 양성결절 214예중 동측 전엽 절제술과 협부 절제술이 86%에서 시술 되었고, 악성 결절 84예 중 경부 곽청술을 동반한 갑상선 전절제술 27.3% 갑상선 전절제술 23.8%, 동측 전엽 절제술과 협부 절제술 23.8%에서 시술되었고, 술후 합병증은 전체 7.1% 중 양성 결절의 1.9%, 악성 결절의 20.2%에서 발생하여 악성 결절 수술시 유의하게 높았다. 영구 부갑상선 기능 저하증 2예(0.7%)에서 발생하였다. 악성 결절의 수술후 재발은 주로 유두상암의 임프절 재발이 다수였고 미분화암에서는 국소 재발 및 림프절 재발이 있었으나 원이부 전이는 없었다.

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臨證指南醫案에 나타난 피부외과 질환에 대한 문헌고찰 (A Literature Study of Dermatosurgical Diseases in the ImJeungJiNamUiAn)

  • 조재훈;채병윤;김윤범
    • 한방안이비인후피부과학회지
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    • 제15권2호
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    • pp.271-288
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    • 2002
  • Authors investigated the pathogenesis and treatment of dennatosurgical diseases in the ImJeungJiNamUiAn(臨證指南醫案). 1. The symptoms and diseases of dermatosurgery were as follows; 1) BanSaJinRa(반사진라) : eczema, atopic dermatitis, seborrheic dermatitis, psoriasis, lichen planus, pityriasis rosea, hives, dermographism, angioedema, cholinergic urticaria, urticaria pigmentosa, acne, milium, syringoma, keratosis pilaris, discoid lupus erythematosus, hypersensitivity vasculitis, drug eruption, polymorphic light eruption, rheumatic fever, juvenile rheumatoid arthritis(Still's disease), acute febrile neutrophilic dermatosis(Sweet's syndrome), Paget's disease, folliculitis, viral exanthems, molluscum contagiosum, tinea, tinea versicolor, lymphoma, lymphadenitis, lymphangitis, granuloma annulare, cherry angioma 2) ChangYang(瘡瘍) : acute stage eczema, seborrheic dermatitis, stasis ulcer, intertrigo, xerosis, psoriasis, lichen planus, ichthyosis, pityriasis rosea, rosacea, acne, keratosis pilaris, dyshidrosis, dermatitis herpetiformis, herpes gestationis, bullae in diabetics, pemphigus, lupus erythematosus, fixed drug eruption, erythema multiforme, toxic epidermal necrolysis, toxic shock syndrome, staphylococcal scaled skin syndrome, scarlet fever, folliculitis, impetigo, pyoderma gangrenosum, tinea, candidiasis, scabies, herpes simplex, herpes zoster, chicken pox, Kawasaki syndrome, lipoma, goiter, thyroid nodule, thyroiditis, hyperthyroidism, thyroid cancer, benign breast disorder, breast carcinoma, hepatic abscess, appendicitis, hemorrhoid 3) Yeok(疫) : scarlet fever, chicken pox, measles, rubella, exanthem subitum, erythema infectiosum, Epstein-Barr virus infection, cytomegalovirus infection, hand-foot-mouth disease, Kawasaki disease 4) Han(汗) : hyperhidrosis 2. The pathogenesis and treatment of dermatosurgery were as follows; 1) When the pathogenesis of BalSa(발사), BalJin(發疹), BalLa(발라) and HangJong(項腫) are wind-warm(風溫), exogenous cold with endogenous heat(外寒內熱), wind-damp(風濕), the treatment of evaporation(解表) with Menthae Herba(薄荷), Arctii Fructus(牛蒡子), Forsythiae Fructus(連翹) Mori Cortex(桑白皮), Fritillariae Cirrhosae Bulbus(貝母), Armeniaoae Amarum Semen(杏仁), Ephedrae Herba(麻黃), Cinnamomi Ramulus(桂枝), Curcumae Longae Rhizoma(薑黃), etc can be applied. 2) When the pathogenesis of BuYang(부양), ChangI(瘡痍) and ChangJilGaeSeon(瘡疾疥癬) are wind-heat(風熱), blood fever with wind transformation(血熱風動), wind-damp(風濕), the treatment of wind-dispelling(疏風) with Arctii Fructus(牛蒡子), Schizonepetae Herba(荊芥), Ledebouriellae Radix(防風), Dictamni Radicis Cortex(白鮮皮), Bombyx Batrytioatus(白??), etc can be applied. 3) When the pathogenesis of SaHuHaeSu(사후해수), SaJin(사진), BalJin(發疹), EunJin(은진) and BuYang(부양) are wind-heat(風熱), exogenous cold with endogenous heat(外寒內熱), exogenous warm pathogen with endogenous damp-heat(溫邪外感 濕熱內蘊), warm pathogen's penetration(溫邪內陷), insidious heat's penetration of pericardium(伏熱入包絡), the treatment of Ki-cooling(淸氣) with TongSeongHwan(通聖丸), Praeparatum(豆?), Phyllostachys Folium(竹葉), Mori Cortex(桑白皮), Tetrapanacis Medulla(通草), etc can be applied. 4) When the pathogenesis of JeokBan(적반), BalLa(발라), GuChang(久瘡), GyeolHaek(結核), DamHaek(痰核), Yeong(?), YuJu(流注), Breast Diseases(乳房疾患) and DoHan(盜汗) are stagnancy's injury of Ki and blood(鬱傷氣血), gallbladder fire with stomach damp(膽火胃濕), deficiency of Yin in stomach with Kwolum's check (胃陰虛 厥陰乘), heat's penetration of blood collaterals with disharmony of liver and stomach(熱入血絡 肝胃不和), insidious pathogen in Kwolum(邪伏厥陰), the treatment of mediation(和解) with Prunellae Spica(夏枯草), Chrysanthemi Flos(菊花), Mori Folium (桑葉), Bupleuri Radix(柴胡), Coptidis Rhizoma(黃連), Scutellariae Radix(黃芩), Gardeniae Fructus(梔子), Cyperi Rhizoma(香附子), Toosendan Fructus(川?子), Curcumae Radix(鬱金), Moutan Cortex(牧丹皮), Paeoniae Radix Rubra(赤芍藥), Unoariae Ramulus Et Uncus(釣鉤藤), Cinnamorni Ramulus(桂枝), Paeoniae Radix Alba(白芍藥), Polygoni Multiflori Radix (何首烏), Cannabis Fructus (胡麻子), Ostreae Concha(牡蠣), Zizyphi Spinosae Semen(酸棗仁), Pinelliae Rhizoma(半夏), Poria(백복령). etc can be applied. 5) When the pathogenesis of BanJin(반진), BalLa(발라), ChangI(瘡痍), NamgChang(膿瘡). ChangJilGaeSeon(瘡疾疥癬), ChangYang(瘡瘍), SeoYang(署瘍), NongYang(膿瘍) and GweYang(潰瘍) are wind-damp(風濕), summer heat-damp(暑濕), damp-warm(濕溫), downward flow of damp-heat(濕熱下垂), damp-heat with phlegm transformation(濕熱化痰), gallbladder fire with stomach damp(膽火胃濕), overdose of cold herbs(寒凉之樂 過服), the treatment of damp-resolving(化濕) with Pinelliae Rhizoma(半夏), armeniacae Amarum Semen(杏仁), Arecae Pericarpium(大腹皮), Poria(백복령), Coicis Semen(薏苡仁), Talcum(滑石), Glauberitum(寒水石), Dioscoreae Tokoro Rhizoma(??), Alismatis Rhizoma(澤瀉), Phellodendri Cortex(黃柏), Phaseoli Radiati Semen(?豆皮), Bombycis Excrementum(?沙), Bombyx Batryticatus(白??), Stephaniae Tetrandrae Radix(防己), etc can be applied. 6) When the pathogenesis of ChangPo(瘡泡), hepatic abscess(肝癰) and appendicitis(腸癰) are food poisoning(食物中毒), Ki obstruction & blood stasis in the interior(기비혈어재과), damp-heat stagnation with six Bu organs suspension(濕熱結聚 六腑不通), the treatment of purgation(通下) with DaeHwangMokDanPiTang(大黃牧丹皮湯), Manitis Squama(穿山甲), Curcumae Radix(鬱金), Curcumae Longae Rhizoma(薑黃), Tetrapanacis Medulla(通草), etc can be applied. 7) When the pathogenesis of JeokBan(적반), BanJin(반진), EunJin(은진). BuYang(부양), ChangI(瘡痍), ChangPo(瘡泡), GuChang(久瘡), NongYang(膿瘍), GweYang(潰瘍), Jeong(정), Jeol(癤), YeokRyeo(疫?) and YeokRyeolpDan(疫?入?) are wind-heat stagnation(風熱久未解), blood fever in Yangmyong(陽明血熱), blood fever with transformation(血熱風動), heat's penetration of blood collaterals(熱入血絡). fever in blood(血分有熱), insidious heat in triple energizer(三焦伏熱), pathogen's penetration of pericardium(心包受邪), deficiency of Yong(營虛), epidemic pathogen(感受穢濁), the treatment of Yong & blood-cooling(淸營凉血) with SeoGakJiHwangTang(犀角地黃湯), Scrophulariae Radix(玄參), Salviae Miltiorrhizae Radix(丹參), Angelicae Gigantis Radix(當歸), Polygoni Multiflori Radix(何首烏), Cannabis Fructus(胡麻子), Biotae Semen(柏子仁), Liriopis Tuber(麥門冬), Phaseoli Semen(赤豆皮), Forsythiae Fructus(連翹), SaJin(사진), YangDok(瘍毒) and YeokRyeoIpDan(역려입단) are insidious heat's penetration of pericardium(伏熱入包絡), damp-warm's penetration of blood collaterals(濕溫入血絡), epidemic pathogen's penetration of pericardium(심포감수역려), the treatment of resuscitation(開竅) with JiBoDan(至寶丹), UHwangHwan(牛黃丸), Forsythiae Fructus(連翹), Curcumae Radix(鬱金), Tetrapanacis Medulla(通草), Acori Graminei Rhizoma(石菖蒲), etc can be applied. 9) When the pathogenesis of SaHuSinTong(사후신통), SaHuYeolBuJi(사후열부지), ChangI(瘡痍), YangSon(瘍損) and DoHan(盜汗) are deficiency of Yin in Yangmyong stomach(陽明胃陰虛), deficiency of Yin(陰虛), the treatment of Yin-replenishing(滋陰) with MaekMunDongTang(麥門冬湯), GyeongOkGo(瓊玉膏), Schizandrae Fructus(五味子), Adenophorae Radix(沙參), Lycii Radicis Cortex (地骨皮), Polygonati Odorati Rhizoma(玉竹), Dindrobii Herba(石斛), Paeoniae Radix Alba(白芍藥), Ligustri Lucidi Fructus (女貞子), etc can be applied. 10) When the pathogenesis of RuYang(漏瘍) is endogenous wind in Yang collaterals(陽絡內風), the treatment of endogenous wind-calming(息風) with Mume Fructus(烏梅), Paeoniae Radix Alba (白芍藥), etc be applied. 11) When the pathogenesis of GuChang(久瘡), GweYang(潰瘍), RuYang(漏瘍), ChiChang(痔瘡), JaHan(自汗) and OSimHan(五心汗) are consumption of stomach(胃損), consumption of Ki & blood(氣血耗盡), overexertion of heart vitality(勞傷心神), deficiency of Yong(營虛), deficiency of Wi(衛虛), deficiency of Yang(陽虛), the treatment of Yang-restoring & exhaustion-arresting(回陽固脫) with RijungTang(理中湯), jinMuTang(眞武湯), SaengMaekSaGunjaTang(生脈四君子湯), Astragali Radix (황기), Ledebouriellae Radix(防風), Cinnamomi Ramulus(桂枝), Angelicae Gigantis Radix(當歸), Ostreae Concha(牡蠣), Zanthoxyli Fructus(川椒), Cuscutae Semen(兎絲子), etc can be applied.

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