Renogram의 정량분석에 관한 연구

최근출 대한핵의학회 1969 핵의학 분자영상 Vol.3 No.1

저자는 서울대학교 의고대학부속병원 방사성동위원소실에서 취급한 환자중 고혈압환자 140예, 고혈압신장해합병군 102예, 만성신질환군 62예, 편측무기능신 53예, 양측무기능신 57예와 정상대조군으로 150예, 총 564예의 renogram을 Tobe, Spencer, Krueger, Matchida 및 Takeuchi가 발표한 각 신화변수(parameter)를 중심으로 정량분석하여 비교관찰하는 동시에 신성빈혈과 renogram과의 관계도 아울러 비교고찰하여 다음과 같은 성적을 얻었다. 즉 1) 대조군과 신질환군사이에서 renogram pattern의 대체로 현저한 차이를 볼 수 있었다. 즉 Tobe법의 각 친화변수(Tmax, T½, Kac)는 고혈압신장해합병군과 만성신질환군에서 각각 대조군에 비하여 유의의 차로 지연 내지 감소되었다. Spencer법의 다음 친화변수 즉 slopes of B and C phase 및 B:C에서 고혈압군, 고혈압신장해합병군 및 만성신질환군은 각각 대조군에 비하여 유의의 차로 감소되어 있었으며(단 B:A는 고혈압군과 대조군사이에서 무의의 차), Krueger법의 M.C., M.E.에서 고혈압군, 고혈압신장해합병군 및 만성신질환군은 각각 대조군에 비하여 유의의 차(단 T.C.는 고혈압군과 대조군사이에 무의의 차), 그리고 Matchida법의 K치 역시$quot; Radioisotope renography was carried out in 564 cases consisting of 150 normal controls, 140 hypertensive, 102 hypertensive nephropathys, 62 chronic renal diseases, 53 unilateral, and 57 bilateral non-functioning kidneys. It was aimed to study which parameter of the renogram is most applicable to any definite disease of the kidney. The analytical methods adopted were;Tobe, Spencer, Krueger, Matchida and Takeuchi. In the non-functioning kidney groups, the hemograms and serum nitrogen series were also studied to evaluate the relationships between the renograms and renal anemia. The parameters were;time of maximum amplitude (Tmax), half-time of maximum amplitude (T½), Kac value calculated from these two parameters in Tobe's method, slopes of B and C phase, B/A and B/C values in Spencer's method, total concentration (T.C.), minute concentration (M.C.) and minute excretion (M.E.) in Krueger's method, Matchida's K value and Takeuchi's renal function Index (R.F.I.). Following were the results: 1) In general, marked dfferences in the patterns of the renogram were observed between the normal controls and nephropathys. In Tobe's method, each parameter showed statistically significant delay or decrease in patients with hypertensive nephropathys and chronic renal diseases. In Spencer's method, slopes of B and C phase and B/C, also showed the statistically significant decrease in patients with hypertension, hypertensive nephropathys and chronic renal diseases. In Krueger's method, M.C. and ME showed the statistically significant differences between the control and patients with hypertension, hypertensive nephropathys and chronic renal diseases, In Matchida's method, K value showed the statistically significant differences between the control and patients with hypertensive nephropathys and chronic renal diseases. 2) It appeared, therefore, that Tobe's T½, Kac, Spencer's slopes of B and C phase, B/A, B/C values, Krueger's T.C., M.C., and M.E. values, matchida's K value are useful for the differentiation of various renal disease, however, qualitative analysis of the renogram with one or two parameters is not accurate. 3) In bilateral non-functioning kidney groups, a positive correlation between anemia and nitrogen retention was observed, although the quantitative assessment of the degree of non-functioning was impossible.

各種疾患에 對한 Cytomack 治驗例 報告

姜相琪,崔根出,李凡弘,金道鎭,李文鎬 최신의학사 1966 最新醫學 Vol.9 No.3

갑상선종환자의 안병변에 관한 임상적 관찰

이경자,이문호,이정상,이창규,최근출,구인서,안수벽 대한핵의학회 1969 핵의학 분자영상 Vol.3 No.1

742 cases of thyroid diseases treated at Radio-isotope Clinic, Seoul National University Hospital since October 1965 through July 1968 were analyzed. The patients were classified according to eye findings, as to Infiltrative, Non-infiltrative and No ophthalmopathy. Correlations between ophthalmo-logical findings and symptoms, BMR values and (131)^I uptake rate as well as response to medical treatment were carefully reviewed. Results obtained were as follows: 1) Among goitrous patients 44.5% with infiltrative ophthalmopathy, 24.1% with non-infiltrative ophthalmopathy totaling 68.6% of patients with one or more eye findings were found. Exophthalmos (44%) and visual disturbances (44%) comprised the highest incidence among eye signs. Most frequent eye symptoms were lid swelling (17.1%). 2) Female patients were predominant (91%). 3) Of cases with hyperthyroidism, after treatment with antithyroid drugs and radio-iodine therapy, general symptoms were improved in over 74%, whereas ophthalmopathy was not changed and in some cases the eye signs were aggravated. This tendency was more apparent in infiltrative ophthalmopathy. 4) Significant correlations between exophthalmos, BMR values and (131)^I uptake rate were found. Among the patients of same degree of exophthalmos, BMR values and (131)^I uptake rate showed the highest in non-infiltrative ophthalmos, BMR values and (131)^I uptake rate showed the highest in non-infiltrative ophthalmopathy, moderate in infiltrative ophthalmopathy and the lowest in no ophthalmopathy. $quot;

방사성동위원소옥소(131I)의 치료량이 갑상선종환자의 혈액상에 미치는 영향에 관한 연구

이영우,김기원,강신일,이정상,김명재,김노경,최근출 대한핵의학회 1969 핵의학 분자영상 Vol.3 No.1

각종 갑상선종환자의 혈액상과 (131)^I 치료후의 혈액상에 미치는 영향을 관찰할 목적으로 서울대학교 의과대학 부속병원 방사성동위원소실에서 진료한 396예의 각종 갑상선종환자에 대하여 혈액상을 검사하고 65예에 (131)I을 투여하여 40예에서 3개월후 시행한 혈액검사소견을 비교하여 얻은 성적은 다음과 같다. (1) 396예에서 독성미만성선종이 35.4%, 비독성결절성갑상선종이 29.7%, 정상기능갑상선종이 13.8%, 비독성미만성갑상선종이 12.6%, 갑상선기능저하증이 4.3%, 갑상선염이 1.8%, 독성결절성갑상선종이 1.4%, 암종이 1.0%를 각각 차지하였다. (2) 연령은 11∼71세 사이에 있었고 30대에 가장 높은 발생빈도를 보이고 21세에서 50세 사이에 전 환자의 80.6∼82.6%가 발생하였다. (3) 남녀 성비는 1:7.8로 여성이 많다. (4) 치료전 혈액상은 적혈구수 및 혈색소치는 전병형에서 모두 경도의 감소를 보였고 특히 갑상선기능저하증 및 갑상선염증에서 그 감소가 현저하였으며 균충의 보유가 혈색소치에 큰 영향은 미치지 않았다. (5) 백혈구수는 모두 정상범위내에 있었고 백분율은 갑상선기능항진증에서 임파구백분율이 증가하였고 갑상선염증에서도 임파구백분율의 증가가 관찰되었다. (6) 방사성동위원소옥소((131)^I) 5∼10mCi를 투여한 독성미만성갑상선종 62예와 독성결절성갑상선종 3예중 3개월후에 39예의 독성미만성갑상선종과 1예의 독성결절성갑상선종환자의 혈액상의 재검 결과는 전자에서 빈혈의 호전, 임파구백분율의 정상범위내로의 복귀 및 상대적인 호중구백분율의 증가 및 전구의 소실이 관찰되었으나 후자의 결절성갑상선종환자에서는 치료전과 치료후의 혈액상에 변화가 없었다. 즉 갑상선기능항진증은 경도의 빈혈과 임파구백분율의 증가를 초래하며 (131)^I의 치료량으로는 조혈기능에 방사선장해를 야기하지 않으며 갑상선기능의 호전과 혈액상의 정상화를 초래함을 알 수 있었다. (7) 본 검색에서는 (131)^I 투여후 3개월째의 1회 추시로 점액수종의 발생은 보지 못하였다. To clarify the hematologic effects of the radioiodine ((131)^I) in therapeutic doses (5∼10mCi) on the various thyroid patients, authors studied the peripheral blood pictures of 396 goitrous patients before and after radioiodine ((131)^I) administrations in the Isotope Clinic of Seoul National University Hospital. Among these 396 cases of goiters, we gave 5 to 10mCi of radioiodine ((131)^I) with single or fractionated administrations. The blood pictures of non-treated thyroid patients were compared with that of normal Korean values to clarify any difference between normal and goiter. The blood pictures of hyperthyroid patients treated with (131)^I therapy were compared with the blood pictures of non-treated thyroid patients. The results were as following: 1) The incidence according to type: Toxic diffuse goiter:35.4%. Nontoxic nodular goiter:29.7%. Euthyroid:13.8%. Nontoxic diffuse goiter:12.6%. Hypothyroidism:4.3%. Thyroiditis(s subacute form):1.8%. Toxic nodular goiter:1.4%. Malignancy:1.0%. 2) Age incidence: The range f distribution was 11 to 71 years. The peak incidence was found in the 4th decade of life. 80.6∼82.6% of those 396 cases were found among the 3rd, 4th and the 5th decades of life. 3) Sex incidence:Sex ratio of male:female was 1:7.8. 4) The most outstanding findings in peripheral blood before treatment were decreased erythrocyte count and hemoglobin value in all types of thyroid diseases, especially in the cases of hypothyroidism and thyroiditis. Hook worm-infested patients showed no significant difference in erythrocytes and hemoglobin values from those of other hook worm free patients. 5) Total leukocytes count was within normal range. Differential count of W.B.C. showed increased percentile of lymphocyte in diffuse toxic goiter and thyroiditis. 6) 39 cases of diffuse goiter treated with (131)^I toxic showed amelioration in the anemia and restoration to normal range of lymphocyte count in association with increased percentile of neutrophiles 3 months after administration, except a case of toxic nodular goiter.One can observe anemia in slight degree, and increased lymphocytes count in hypothyroidism. Therapeutic dose of radioiodine ((131)^I) dose not result any residual effect on the hematopoietic function. Radioiodine ((131)^I) therapy resulted in improvement of thyroid function in association of amelioration of pevious abnormal blood pictures. 7) Authors did not observe any myxedema resulted from radioiodine therapy during the 3 months period in this study. $quot;