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외측 미입 갑상선에서 발생하여 다발성 전이로 발현된 유두상 갑상선암 1예
천남일,이창훈,홍세인,정진욱,윤인석,조동혁,강호철,정동진,정민영 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4
Carcinoma of the thyroid usually presents as a palpable thyroid mass. However, in rare cases patients with thyroid cancer present with metastases of the cervical lymph node as the initial manifestation. The metastatic papillary tumor in cervical lymph nodes stained positive for thyroglobulin indicates the presence of a thyroid carcinoma, usually in the ipsilateral lobe. We herein report a case of multiple metastases in papillary thyroid carcinoma arising in the lateral aberrant thyroid with no evidence of thyroid carcinoma in the thyroid lobe
유두-여포 혼합형 갑상선암에서 동반된 말단비대증 환자 1 예
이창훈,강호철,정민영,정동진,조동혁,천남일,홍세인,정진욱,윤인석 대한내과학회 2002 대한내과학회지 Vol.62 No.3
Patients with acromegaly have high incidence of benign or malignant neoplasia than general population and many investigators suggest the stimulatory effect of GH and IGF-1 on mesenchymal cells. Both normal thyroid tissue and thyroid cancer cells express IGF-1 receptor and thyroid cancer cells have more than 3 times. We present a case of acromegaly in patient with mixed papillary-follicular thyroid carcinoma, suggesting the possible carcinogenic role of GH and IGF-1. (Korean J Med 62:307-312, 2002)
이창훈,정동진,이대호,이태희,신현호,이연상,김정민,천남일,조동혁,정민영 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.3
Background: Increased platelet aggregability is known to be one of the important risk factors for diabetic vascular complications. The relationship between platelet aggregability and diabetic macravascular complications, varying severity of diabetic microvascular complications and other possible factors was evaluated in Korean adults. Methads: Platelet aggregability was measured with platelet rich plasma by addition of adenosine diphosphate (ADP) in 45 cases. Normal control group (n=15) was compared with diabetics without macrovascular complications (n=15), diabetics with macrovascular complications (n=15) and several groups divided accoring to the severity of microvascular complications. Results: 1) The mean maximum value of platelet aggregation was 70.3?.3% in control group, and 80.0±7.3% in diabetics (p$lt;0.005). 2) The mean maximum value of platelet aggregation was 78.0±5.5% in diabetics without macrovascular complications and 83.5±7.1% in diabetics with macrovascular complications (p=0.093). 3) The mean maximum value of platelet aggregation was 77.0±5.1% in normoproteinuria group, 78.1±7.3% in microproteinuria group, and 82.9±6.2% in overt proteinuria group (p=0.083). 4) The mean maximum value of platelet aggregation was 77.2±6.8% in diabetes without neuropathy group and 82.9±6.2% in diabetes with neuropathy group (p=0.114). 5) The mean maximum value of platelet aggregation was 79.3±4.9% in diabetes with normal funduscopic findings, 80.2±7.3% in diabetes with background retinopathy and 81.6±7.9% in diabetes with proliferative retinopathy (p=0.852). 6) Blood glucose showed positive correlations with the mean maximum platelet aggregation (γ=0.529, p$lt;0.005). Conclusion: The elevated mean maximum value of platelet aggregation was found in diabetics and there were no significant differences between macrovascular complications and between varying severity of retinopathy, neuropathy and proteinuria. Blood glucose showed positive correlations with mean maximum platelet aggregation, Hyperglycemia was a major risk factor affecting platelet aggregation in diabetics and its control may play an important role in prevention of diabetic vascular complications.
인슐린 비의존형 당뇨병 환자에서 혈장 호모시스테인 농도와 만성 합병증과의 관계
이태희,정민영,이대호,정동진,이연상,김정민,조동혁,천남일,신현호 대한내과학회 2000 대한내과학회지 Vol.59 No.2
Background : Elevated plasma homocysteine is a recently-recognized independent risk factor for cardiovascular disease. In patients with non-insulin dependent diabetes mellitus (NIDDM), plasma homocysteine concentration was reported to be elevated in association with nephropathy. However, inconsistent results were reported about the association with other microvascular complications. Methods : To determine the relationship between plasma homocysteine and the development of chronic diabetic microvascular complications, fasting plasma homocysteine, glycemic control, lipid and lipoprotein levels, vitamin status, renal function test, and chronic diabetic microvascular complications were assessed in 101 patients with NIDDM in the present study. Results : There was no difference in the plasma levels of homocysteine by sex, age, status of sugar control, duration of diabetes, other cardiovascular risk factors. Patients with diabetic microangiopathy had higher plasma homocysteine concentrations than those without diabetic microangiopathy. Moreover, there was a significant correlation between amount of urinary albumin excretion and plasma homocysteine level (p=0.004, r=0.357). However, multivariate analysis showed that only serum creatinine (β=0.635) was independently associated with plasma homocysteine level in NIDDM patients. The increase in plasma homocysteine was not shown to increase the risk of diabetic microvascular complications independently on multiple logistic regression analysis. Conclusion : In conclusion, decrease of renal function is an independent determinant of plasma homocysteine level and higher plasma homocysteine is associated to diabetic microangiopathy. But an increase in plasma homocysteine in patients with NIDDM is not independently associated with diabetic microvascular complications considering renal function. Therefore, the renal function should be considered in study about relationship between plasma homocysteine level and the development and/or progression of chronic diabetic microvascular coplications in diabetic patients.(Korean J Med 59:174-182, 2000)