Clinical Significance of Classification of Graves` Disease According to the Characteristics of TSH receptor Antibodies

(Won Bae Kim),(Hyun Kyung Chung),(Young Joo Park),(Do Joon Park),(Hong Kyu Lee),(Bo Youn Cho) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.3

N/A Background:It has been widely accepted that the epitope (s) and/or functional characteristics of thyrotropin receptor antibodies (TSHRAb) from Graves` patients are heterogenous among patients. However, the clinical significance of such heterogeneity has not been systematically evaluatedyet. We were to elucidate and find the clinical significance of heterogeneity for TSH receptor antibodies in Graves` disease. Methods:We measured stimulating TSHRAb (TSAb) activities using CHO-hTSHR cells, FRTL-5 cells and chimeric receptor expressing cells (Mc1+2 and Mc2), specific blocking TSHRAb (TSBAb) activities using Mc2 cells and TBII activities using porcine thyroid membrane in 136 patients with untreated hyperthyroid Graves` disease. Results: Based on various TSHRAb activities from each patient, the patients could be categorized into 7 subgroups by cluster analysis; 1) Group 1 (n=41) was characterized by moderate TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, typical TSAb epitope, rare blocking antibodies and high TBII activities. 2) Group 2 (n=16) was characterized by the presence of blocking TSHRAb in most patients, albeit the other characteristics were the same as those in Group 1. 3) Group 3 (n=19) patients had low TSAb activities bothin CHO-hTSHR cells and in FRTL-5 cells, seldom had blocking TSHRAb, but they had high TBII activities. 4) Group 4 (n=30) could be categorized as `mild disease` group, as they had low activities in all kinds of TSHRAb assay and had low antim icrosomal antibody activities. 5) Group 5 (n=14) was characterized by moderate TSAb activities with atypical epitope (s), rare blocking TSHRAb and moderate TBII activities. 6) Group 6 (n=10) patients had veryhigh TSAb activities with typical epitopes, seldom blocking TSHRAb and low TBII activities. 7) Group 7 (n=6) was characterized by very high TSAb activities with atypical epitopes and high TBII activities. Pretreatment serum thyroid hormone level was low only in group 4 patients compared to the other 6 groups (p<0.05). The size of goiter was significantly larger in those in group 1 and group 3 (p<0.05) compared to the other 5 groups. The prevalence of clinically significant ophthalmopathy was higher in group 2 patients than the other 6 groups (50%vs.27.5%,p=0.06). Among 6 kinds of TSHRAb activities, only the blocking TSHRAb activity was significantly associated with the presence of ophthalmopathy in multivariate analysis. Conclusion:These results suggest that the differences inepitopes for TSAb or the presence of blocking TSHRAb is not a major factor in determining the degree of thyrotoxicosis in Graves` disease. Although the pathogenic mechanism is not clearyet, we suggest that patients with ophthalmopathy have different TSHRAb repertoire from those without ophthalmopathy in Graves` disease.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

Serum TSH Level in Healthy Koreans and the Association of TSH with Serum Lipid Concentration and Metabolic Syndrome

( Yeo Kyung Lee ),( Jo Eun Kim ),( Hyun Ju Oh ),( Kyung Sun Park ),( Soo Kyung Kim ),( Seok Won Park ),( Moon Jong Kim ),( Yong Wook Cho1 ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.4

Background/Aims: The proper treatment of subclinical hypothyroidism and the normal range of serum thyroid stimulating hormone (TSH) concentration are intensely debated. However, few reports have investigated TSH concentrations in Asian ethnic groups. Therefore, the present study was designed to define the TSH reference range in a Korean population and to investigate the metabolic significance of TSH concentration. Methods: We enrolled patients who underwent medical examination at the CHA Bundang Medical Center. Anthropometric data were evaluated, and serum TSH, free T4, and lipid profiles were assayed. Results: A total of 7,270 subjects were included. Mean TSH concentration of the study population was 1.82 ± 0.95 mU/L, and we observed a sex-related difference in TSH concentration (male, 1.67 ± 0.87 mU/L; female, 2.02 ± 1.01 mU/L; p < 0.01). When the 2.5 and 97.5 percentiles were calculated, 95% TSH reference limits were 0.52-4.29 mU/L. TSH concentration was higher in elderly subjects, during winter, in postmenopausal women, and in obese males. Moreover, TSH showed significantly positive correlations with serum total cholesterol, triglyceride, and low density lipoprotein cholesterol regardless of sex, age, season, obesity, or menopausal status (all p < 0.01). Finally, TSH concentration was positively related to the prevalence of metabolic syndrome. Conclusions: We demonstrated the association between TSH concentration within the normal reference range and serum lipid levels. TSH concentration varies according to sex, age, season, and body mass index (only in males). Moreover, high normal TSH levels were significantly associated with an increased prevalence of metabolic syndrome, which may be of importance when evaluating subjects with high normal TSH concentration.

일반논문(一般論文) : 『황제내경(黃帝內經)』에 나타난 부인과(婦人科)에 관(關)한 문헌고찰(文獻考察)

김혜원 ( Hye Won Kim ),조정훈 ( Jung Hoon Cho ),장준복 ( Jun Bock Jang ),이경섭 ( Kyung Sub Lee ) 대한한의학원전학회 ( 구 대한원전의사학회 ) 2005 대한한의학원전학회지 Vol.18 No.1

치질을 투과한 조사광에 의한 복합레진 중합시 치질의 두께, 광세기 및 조사 시간이 복합레진의 표면 경도에 미치는 영향

조수경,김동준,황윤찬,오원만,황인남 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.2

본 연구에서는 치질을 투과한 광에너지량을 측정하고 치질을 투과한 광에너지에 의한 광중합 복합레진의 중합 정도를 표면 경도를 측정하여 분석하였다. 광조사기로는 할로겐 광원을 사용하는 Optilux 501 (Demetron, USA)을 사용하였으며, 중합용 light guide는 840 mW/cm²의 광세기를 갖는 직경 12 mm의 light guide와 1100 nW/cm²의 광세기를 갖는 직경 7 mm의 Turbo light guide를 사용하였다. 광원을 투과시킬 치질은 건전한 상악 중절치의 순면에서부터 법랑질과 상아질을 포함하도록 0.7x0.7cm 의 크기로 두께 1.0 mm와 2.0 mm의 치아 절편을 준비하였다. 직경 5 mm, 두께 2 mm의 주형에 Al 색상의 광중합 복합레진(Charisma, Kulzer, Germany)을 충전하고 각 군에 주어진 조건에 따라 광중합하였다. 시편은 크게 치질의 두께에 따라 (대조군, 1 mm, 2 mm) 3개의 군으로 나누었으며, 각 군은 다시 light guide의 종류와 광조사 시간에 따라 4개의 군으로 나누었다. 제작된 시편은 미세경도측정기를 이용해 광조사면의 비커스 경도를 측정한 결과, 2 mm 치질군과 대조군의 Turbo-light guide으로 40초 동안 중합한 시편이 가장 높은 표면 경도값을 보였으며, 2 mm 치질군에서 light guide의 종류에 상관없이 20초 동안 중합한 시편들이 가장 낮은 표면 경도값을 보였다 (p < 0.05). 이상의 결과는 1 mm 이하와 같은 얇은 치질을 투과하여 복합레진을 중합하는 경우 광세기와 광조사 시간을 증가시키면 중합 정도도 증가하나, 특정 두께 이상의 치질을 투과 시 광세기나 광조사 시간을 증가시키더라도 중합 정도의 증가는 기대하기 어렵다는 것을 시사한다. In this study we measured the amount of light energy that was projected through the tooth material and analyzed the degree of polymerization by measuring the surface hardness of composites. For polymerization, Optilux 501 (Demetron, USA) with two types of light guide was used: a 12 mm diameter light guide with 840 nW/cm² light intensity and a 7 mm diameter turbo light guide with 1100 nW/cm². Specimens were divided into three groups according to thickness of penetrating tooth (1 mm, 2 mm, 0 mm). Each group was further divided into four subgroups according to type of light guide and curing time (20 seconds, 40 seconds). Vickers' hardness was measured by using a microhardness tester. In 0 mm and 1 mm penetrating tooth group, which were polymerized by a turbo light guide for 40 seconds, showed the highest hardness values. The specimens from 2 mm penetrating tooth group, which were polymerized for 20 seconds, demonstrated the lowest hardness regardless of the types of light guides (p < 0.05). The results of this study suggest that, when projecting tooth material over a specified thickness, the increase of polymerization will be limited even if light intensity or curing time is increased.

복합하중상태에 있는 복합재료 원통형 쉘의 거동

양원호,조명래,여경수 기계기술연구소 1999 성균관대학교 논문집 기계기술편 Vol.1 No.1

The advent of laminate composite materials opened the way for efficient shell structures. Cylindrical shells are already widely used in indstrial applications. And their buckling behaviour is a vital safety consideration. The objective of this paper is to analyse buckling behavior of laminated composite cylindrical shells subjected to combination of axial compression and torsion by finite element analysis. The influence of load type, fiber orientation angle, and stacking sequence on the buckling behaviour is discussed.

조선시대 여성교육의 분석

조경원 이화여대 한국여성연구소 1995 여성학논집 Vol.12 No.-

Confucianism exerted tremendous influence on all spheres of traditional Korean education. The Choson dynasty rulers set out to enlighten the people through Confucian ethics in order to maintain a well-regulated state. Confucians believed that social order and norms were deeply violated by Buddists who abandoned the social world. The proper social relationship between subject and ruler was based on a rigidly hierachical family order in which the females amd younger members remain strictly obedient to the commands of the older males. The Choson rulers emphasized the chastity of women in an effort to eradicate what they saw as the evils brought by Buddhism in the end of Koryo. Traditionally, education has been quite important in the Confucian tradition. Confucians believe that most people are born with similar abilities and political, but that through practice, people become different. Maintaining a moral character requires education and constant effort. Neo-Confucians believed that the principle of Nature could be realized but that selfish human desires and feelings could be eliminated through moral effort or education. The first step for this was the investigation of things. When things are investigated, one's knowledge will be extended, one's will be rendered sincere, one's feelings correct, and one's personal life cultivated. When this is done, one will fully develop one's nature. In this way, the intellectual and moral dimension of education was emphasized for (upper class) men's development. In contrast, Confucian education for women was generally limited to traditional feminine tasks and virtues. Unlike men, intellectual or learned women were not highly esteemed. Such a limitation of women's education resulted from Confucian, especially neo-Confucian views of women based on the doctrine of yin and yang. The absolute separation of yin from yang cannot in principle be justified since yin and yang form supposedly a harmonious whole. Nevertheless, the doctrine has given the logical grounds for the discriminate norms and rules between men and women. From the Han dynasty of China onwards, neo-Confucians emphasized filial obedience, subject's loyalty and women's chastity with an unconditional tone. The Choson rulers urged women to achieve Confucian virtues by publishing the Samganghaengsil-to, Naehun, and other texts of women's education in Korean, written by fathers and grand-fathers within the family tree. The basic aim of such an education by the texts was forming basic habits of wifely virtues and indoctrinating Confucian values. The texts for women tell concrete everyday norms and rules such as “If the parents-in-law call you, answer promptly and obediently” “Married women were to obey their husbands” “Women are to be calm, faithful”, etc. Numerous legal devices designed to form and socialize Confucian virtuous women. According to Naeoebop, a set of rigid rules concerning the distinctions of the roles of husband and wife,(upper class) women spent most of their time at home, shut off entirely from the outside world. Widows are effectively prohibited from remarrying because their offspring would be barred from becoming public officials. Monument gates for chaste women gave great honor to the whole family which were exempted from taxes, received a pension, were given rice, etc. The Choson women were subject to being expelled from their home if they committed one of seven evils, originated in Confucian teachings. These social institutions resulted in the systematic control and subjugation of women during the Choson dynasty. Women's education was justified by law-like assumptions based on the theory of yin-yang that assume separate function between the sexes and that social order depends on the role differentiation. The Choson society excluded women from the formal educational system because women's academic learning was supposed to be improper and contrary to the way women as mother and wife should behave. However a historical analysis of the interpretations of yin and yang does not support the law-like assumptions of regulating human relationships. Ⅰ. 머릿말 Ⅱ. 조선시대 유교교육의 성격 Ⅲ. 조선시대 여성교육의 특성 Ⅳ. 유교적 여성교육의 철학적 근거분석 Ⅴ. 맺음말 참고문헌 영문초록

I^2L을 使用한 多値論理回路의 設計

趙源敬 慶熙大學校 1982 論文集 Vol.11 No.-

An algorithm for degining multivalued I²L Circuits is presented in this paper. New logic function MODF (Multi Output Delta Function) and WOR (Multi input Weighted OR Gate) are defined and new method is shown to be useful for multivalued PLA design.

현훈증 감별에 있어 뇌간청각유발전위의 진단적 의의

조경원,정원영,나정균,임건한 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.1

Sudden onset vertigo is a common complaint in patients who are referred for neurological evaluation. But the entire physical examination and other diagnostic tests may be normal in these patients. Therefore we need more accurate diagnostic tools in the differential diagnosis between the peripheral and the contral vertigo. To evaluate diagnostic effectiveness, we performed Brainstem Auditory Evoked Potentials(BAEP) in the patients with 19 brainstem infarction, 23 peripheral vertigo, 20 vertebrobasilar transient ischemic attack(VB TIA) and analyzed the absolute latency of wave Ⅰ, Ⅲ, Ⅴ and interpeak latency of wave Ⅰ-Ⅲ, Ⅲ-Ⅴ,Ⅰ-Ⅴ compared to normal control data. The results were summerized as follows : 1. There was no significant differences in absolute and interpeak latencies of each BAEP waves between the group of normal control and the group of peripheral vertigo. 2. Among 19 VB TIA patients, prolonged absolute and interpeak latencies of BAEP waves were detected in eleven patients(57.9%) and in nine patients(47.3%), respectively. The abnormal findings were bilaterally in five patients(26.3%) 3. Among 20 brainstem infarction patients, ten patients(50%) showed abnormal BAEP findings, including prolonged interpeak latencies(in three, 15%) and absence of waveform(in seven, 35%). Therefore it is concluded that BAEP could be helpful in differential diagnosis of pathints with peripheral vertigo, V-B TlA, brainstem infarction and other disease of similiar symtomatology.

한국여성 큰복재정맥의 가지상태에 대한 연구

조광수,김경용,이원복,김동창 중앙대학교 의과대학 의과학연구소 1990 中央醫大誌 Vol.15 No.2

The patterns of 5 tributaries draining into the great saphenous vein were stuided in 33 cases of Korean adult female cadavers from 20 to 88 years of age (average age, 64). 1. Each tributaries emptied separately into the great saphenous vein in 12.1% (left: 7.6%, right:4.5%) 2. The superficial epigastric vein and the superficial circumflex iliac vein joined to form a single trunk draining into the great saphenous vein in 18.2%. The incidences were equal in the both sides. 3. The lateral accessary saphenous vein and the superficial circumflex iliac vein joined to form a single trunk draining into the great sapheous vein in 12.1% (left: 7.6%, right: 4.5%). 4. The superficial external pudendal vein and the superficial epigastric vein joined to form a single trunk draining into the great saphenous vein in 1,5% (only in right side). 5. The superficial external pudendal vein and the medial accessory saphenous vein joined to form a single trunk draining into the great saphenous vein in 9.1% (left: 3.0%, right: 6.1%). 6. The superficial circumflex iliac vein, the superficial epigastric vein and the lateral accessary saphenous vein joined to form a single trunk draining into the great saphenous vein in 25.8% (left: 12.1%, right: 13.7%). 7. The dual fusion took place, namely the superficial external pudendal vein with the superficial epigastric vein and the superficial circumflex iliac vein with the lateral accessory saphenous vein to drain separately into the great saphenous vein in 3.0% (only in left side). 8. The dual fusion was shown between the superficial external pudendal vein and the medial accessory saphenous vein and between the superficial circumflex iliac vein and the lateral accessory saphenous vein draining separately into the great saphenous vein in 4.6% (left: 3.1%, right:1.5%) 9. The superficial epigastric vein, the superficial external pudendal vein and the medial accessory saphenous vein joined to form a single trunk draining into the great saphenous vein in 3.0% (only in right side). 10. The dual fusion took place between the superficial external pudendal vein and the medial accessory saphenous vein and between the superficial circumflex iliac vein, the superficial extenal pudendal vein and the superficial epigastric vein, and was draining separately into the great saphenous vein in 1.5% (only in left side). 11. The incidence which showed the cases deficient in one or more tributaries was 9.1%.