경부임파절 종대를 동반한 침윤성 섬유성 ( 리들 ) 갑상선염 1 예

정현경(Hyun Kyung Chung),김광석(Kwang Seok Kim),김재택(Jae Taek Kim),김미경(Mi Kyung Kim),오연상(Yeon Sahng Oh),신순현(Soon Hyun Shinn) 대한내과학회 1996 대한내과학회지 Vol.50 No.3

Riedel's thyroiditis described by Bernhard Riedel in 1883, is rare chronic inflammatory diseases of unknown etiology and may be one manifestation of multifocal fibrosclerosis. The disorder presents with a history of painless anterior neck enlargement, which may gradually progress to produce symptoms of pressure, We reported a case of Riedel's thyroiditis in 61 years old man, He presented with painless swelling of the anterior neck with mild dysphagia. Physical examination revealed a stony hard, huge goiter and palpable cervical lymph nodes with mild tenderness. Surgical biopsy was done in thyroid mass and enlarged cervical lymph nodes. The histologic findings were diffuse dense fibrosis and inflammatory change replaced with normal thyroid tissue and severe necrosis with infarction of the lymph nodes. He was discharged while being treated with thyroxine and oral prednisolone. The thyroid mass and cervical lymphadenopathy were nearly resolved at three months of treatment. We think it may be the first report of the Riedel's thyroiditis that combined with cervical lymphadenopathy in Korea.

증례 : 내분비 ; 갈색세포종, 신경절신경종이 동반된 갑상선유두암 1예

안지현 ( Ji Hyun Ahn ),이승은 ( Seung Eun Lee ),정윤재 ( Yun Jae Chung ),지경천 ( Kyong Choun Chi ),김미경 ( Mi Kyung Kim ),오연상 ( Yeon Sahng Oh ),김재택 ( Jae Taek Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1

갈색세포종은 대부분 산발적으로 발생하고 다른 종양들과 연관되어 있으나 한 종양 내에서 갈색세포종과 신경절신경종이 동반되는 경우는 극히 드물다. 또한 다발내분비종양 제2형에서는 갈색세포종이 갑상선수질암과 관련되어 있으나 갑상선유두암과는 관련성이 드물고 이들간의 관계는 명백히 알려져 있지 않다. 저자들은 갈색세포종과 신경절신경종, 갑상선유두암이 동시에 발생한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Composite tumors containing pheochromocytoma and ganglioneuroma are very rare. We report a 70-year-old female with papillary thyroid carcinoma and a compound adrenal medullary tumor, composed of pheochromocytoma/ganglioneuroma. She had complained of epigastric discomfort 2 months earlier. Chest computed tomography and pancreatic magnetic resonance imaging revealed an intrathoracic goiter and pancreatic cystic tumor. She underwent an explorative laparotomy, and a left adrenalectomy was done because of an adrenal mass, not the pancreatic mass. The pathological diagnosis was a compound adrenal medullary tumor, composed of pheochromocytoma and ganglioneuroma. Although there was no evidence of thyroid cancer on fine needle aspiration cytology, a total thyroidectomy was done because of the neck discomfort. The pathological diagnosis was a papillary thyroid carcinoma, and she underwent radioactive iodine therapy. (Korean J Med 76:85-89, 2009)

당뇨병이 없는 정상체중의 성인에서 비알콜성 지방간과 인슐린 저항성과의 연관성

이정안 ( Jung Ahn Lee ),이석홍 ( Suck Hong Lee ),손장원 ( Jang Won Son ),김재택 ( Jae Taek Kim ),오연상 ( Yeon Shang Oh ),신순현 ( Soon Hyun Shinn ) 대한내과학회 2004 대한내과학회지 Vol.67 No.5

비당뇨성인에서 혈압, 혈청지질, 체지방분포와 인슐린농도 사이의 상관관계

김재택,최성남,배현철,김광석,정현경,오연성,신순현 중앙대학교 의과대학 의과학연구소 1996 中央醫大誌 Vol.21 No.1

The purpose of this study is to explore the association of blood pressure(BP) with fasting serum insulin, lipid, upper body obesity and the differences in both sexes. The association of BP with clinical and biochemical measures was studied in 158 non-diabetic adults (male subjects 112, female subjects 46) visited CAUH Health-Care Center. Systolic/diastolic BP, anthropometric data(BMI; body mass index & WHR ; waist/hip ratio), fasting insulin, FBS, serum lipid were measured. The data is presented as mean and standard deviation. Statistical difference betwen the male and female groups was tested by correlation analysis by Pearson's correlation coefficient and multiple linear regression analysis. The results are as follows : In non-diabetic male, univariate analysis shows that systolic BP had positive correlations with age, BMI, WHR and total cholesterol(p<0.01). Multiple linear regression analysis revealed that systolic BP was related to total cholesterol, FBS and fasting insulin ; diastolic BP was related to total cholesterol, HDL-cholesterol and TG. In non-diabetic female, univariate analysis shows that systolic/diastolic BP had positive correlation with total cholesterol(p<0.01). Multiple linear regression analysis revealed that systolic/diastolic BP were related only to total cholesterol. The relationship between BP and fasting insulin was not uniform by sex, but the mechanism of these differences remains to be established.

제2형 당뇨병 환자의 혈청 호모시스테인 농도와 만성합병증과의 관계

최승진,김재택,오연상,신순현 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:최근에 고호모시스테인혈증은 당뇨병 환자에서 대혈관합병증과 미세혈관합병증에 관여하는 위험인자로 알려져 있으나 미세혈관 합병증과의 관계는 아직 완전히 정립되지 않을 상태로 본 연구에서는 경동맥 내중막 두께를 측정하여 혈청 호모시스테인 농도를 비롯한 죽상동맥경화증의 위험요소들과 대혈관 합병증과의 관계를 알아보고 혈청 호모시스테인 동도와 미세혈관합병증과의 관계를 알아보고자 하였다. 방법:2000년 1월에서 2000년 6월까지 중앙대학교 의과대학 부속병원에 입원했던 제2형 당뇨병 환자 58명을 대상으로 동맥경화증 위험인자와 고해상도 B­mode 초음파를 이용하여 경동맥 내중막 두께를 측정하였고 대혈관 합병증과 미세혈관합병증의 유무를 조사하여 상관관계를 분석하였다. 결과:1)제2형 당뇨병 환자에서 평균 혈청 호모시스테인 농도는 9.9±3.2μmol/L였고 연령 및 성별과 상관관계가 없었으나 혈청 크레아티닌(p=0.02)과 크레아티닌제거력(p=0.02)과는 상관관계가 있었다. 2)제2형 당뇨병 환자에서 경동맥 내중막 두께의 최대치, 최소치, 평균치는 각각 우측(4.00±1.20, 0.50±0.04, 1.04±0.62㎜)좌측(3.54±1.00, 0.31±0.02, 0.03±0.55㎜)평균(3.77±1.10, 0.44±0.03, 1.03±0.54㎜)이었고 혈청 호모시스테인 농도(p=0.03)와 유의한 상관관계가 있었고 혈청 저밀도지단백 콜레스테롤 농도(p=0.03)만이 독립적인 상관관계가 있었다. 3)대혈관합병증이 있는 환자에서 혈청 호모시스테인 농도(p=0.01), 평균 경동맥 내중막 두께(p<0.01)가 유의하게 증가되었다. 4)혈정 호모시스테인 농도와 미세혈관합병증과는 망막병증(p=0.07), 신병증(p=0.06), 신경병증(p=0.55)으로 상관관계가 없었으나 경동맥 내중막 두께와 당뇨병성신증과는 유의한 상관관계가 있었다(p=0.03). 결론:제2형 당뇨병 환자에서 혈청 호모시스테인 농도는 대혈관합병증의 위험인자로서 다른 인자와 복합적으로 대혈관합병증의 발생이나 진행에 관련될 것으로 사료되며 미세혈관합병증과는 상관관계가 없었다. 경동맥 내중막 두께는 대혈관합병증에서 증가디어 있었고 미세혈관합병증 중에서는 당뇨병성 신증과 관련되어 있었으며 이에 대한 기전이나 임상적 의의에 대한 더 많은 연구가 필요하다 하겠다. Background : Chronic complications in type 2 diabetic patients have microvascular and macrovascular components. Previous studies have shown that incidence of macrovascular complications correlates with the serum homocysteine levels, but the relatinship is unclear. In addition, the connection between the microvascular complications and the serum homocysteine levels is still obscure and controversial. In this study, the relationship between the serum homocysteine levels and microvascular and macrovascular complications were evaluated in type 2 diabetic patients. Methods : In 58 type 2 diabetic patients, the serum homocysteine levels, folic acid levels, Vit B12 levels, PAI-1 levels, the standard risk factors for macrovascular complications, the fasting serum glucose levels, the HbA_1c levels, and the fasting insulin and C-peptide concentrations, the renal function tests, and the carotid intima-media thickness were measured and the relationship between them and the serum homocysteine level was analyzed according to the presence and absence of macrovascular and microvascular complications. Results : 1) In type 2 diabetic patients, the mean serum homocysteine level was 9.9±3.2?mol/L. The serum homocysteine level showed no relationship with the clinical and biochemical variables including the risk factors for atherosclerosis except the serum creatinine level showed no relationship with the clinical and biochemical variables including the risk factors for atherosclerosis except the serum creatinine and creaaatinine clearance. 2) The maximum, minimum, and mean of the intima-media thickness of right carotid artery were 4.00±1.20, 0.50±0.04, 1.04±0.62mm, of left carotid artery were 3.54±1.00, 0.31±0.02, 1.03±0.55 mm, and means were 3.77±1.10, 0.44±0.03, 1,03±0.54mm, and correlated with the serum homocysteine level(p=0/03), but only the serum LDL cholesterol level independently correlated with the intima-media thicknes(p=0.04). 3) The serum homocysteine level(p=0.01) and intima-media thickness(p<0.01) was significantly higher in type 2 diabetic patients with macrovascular complications than without it. 4) The serum homocysteine level did not correlate with the incidence microvascular complications, but the intima-media thickness did correlate with diabetic nephropathy(p=0.03). Conclusions : The serum homocysteine level did not correlated with the incidence of diabetic microvascular complications. However, there was a small correlation with the risk factors of macrovascular complications.The intima-media thickness correlated with the incidency of macrovascular complications, and the relationship with diabetic nephropathy requires further study (J Kor Diabetes Asso 26: 112~125, 2002).

폐경후 여성에서 인슐린비의존형 당뇨병과 골다공증과의 상관관계

정현경,오연상,김재택,김광석,신순현,배현철,최성남 대한당뇨병학회 1996 Diabetes and Metabolism Journal Vol.20 No.3

혈관성합병증을 동반한 인슐린비의존형 당뇨병환자에서 혈중 Serotonin 및 Thromboxane B2의 농도

정현경,신순현,오연상,김용성,김재택 대한당뇨병학회 1995 Diabetes and Metabolism Journal Vol.19 No.1