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    ์ค‘๊ตญ ์‹œ์žฅ ๊ฐœํ˜ ๋‹ด๋ก ์˜ ๋ณ€ํ™”: ๊ฐœํ˜ยท๊ฐœ๋ฐฉ ์ดํ›„ ๊ตญ์œ ๊ธฐ์—… ๊ฐœํ˜์„ ์ค‘์‹ฌ์œผ๋กœ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์‚ฌํšŒ๊ณผํ•™๋Œ€ํ•™ ์ •์น˜์™ธ๊ตํ•™๋ถ€, 2018. 2. ๊ถŒํ˜•๊ธฐ.์‚ฌํšŒ์ฃผ์˜ ์‹œ์žฅ๊ฒฝ์ œ ์„ ์–ธ ์ด๋ž˜ ์ง€์†์ ์œผ๋กœ ํ™•๋Œ€๋˜์—ˆ๋˜ ์ค‘๊ตญ์˜ ์‹œ์žฅ๊ฒฝ์ œ๋กœ์˜ ๊ฐœํ˜ ๋‹ด๋ก ์ด ๋ณ€ํ™”ํ•˜๊ณ  ์žˆ๋‹ค. 2000๋…„๋Œ€ ์ค‘๋ฐ˜ ๊ณผํ•™์ ๋ฐœ์ „๊ด€๊ณผ ํ™”ํ•ด์‚ฌํšŒ๋ก ์ด ์ฃผ์žฅ๋˜๋ฉด์„œ, ์ƒ์‚ฐ๋ ฅ ์šฐ์„ , ๊ฒฝ์ œ๋ฐœ์ „ ์ค‘์‹ฌ์˜ ๊ฐœํ˜ ๋…ธ์„ ๋ณด๋‹ค๋Š” ํ‰๋“ฑ๊ณผ ๋ฐฐ๋ถ„ ์ค‘์‹ฌ์˜ ๋…ธ์„ ์ด ๊ฐ•์กฐ๋˜๊ธฐ ์‹œ์ž‘ํ•˜์˜€๊ณ , ์‹œ์ง„ํ•‘ ์ง‘๊ถŒ ์ดํ›„๋กœ๋Š” ์—ฌ๊ธฐ์— ๋‹น ์ค‘์•™์˜ ์˜๋„ ํ™•๋Œ€๋ฅผ ์ง€์ง€ํ•˜๋Š” ๊ตญ๊ฐ€์ž๋ณธ์ฃผ์˜์ ์ธ ๋ฐœ์ „์ „๋žต์ด ๋”ํ•ด์ ธ ์ด์ „ ๊ฐœํ˜ ๋…ธ์„ ๊ณผ ๋˜ ๋‹ค๋ฅธ ์ฐจ๋ณ„์„ฑ์„ ๋“œ๋Ÿฌ๋‚ด๊ณ  ์žˆ๋‹ค. ๊ทธ๋ ‡๋‹ค๋ฉด ๊ทธ๋™์•ˆ ๊ฐ•๋ ฅํ•˜๊ฒŒ ๊ฒฌ์ง€๋˜์–ด์˜ค๋˜, ๊ทธ๋ฆฌ๊ณ  ๊ทธ ๊ฒฝ์ œ์  ์„ฑ๊ณผ ๋˜ํ•œ ์„ธ๊ณ„๊ฐ€ ์ฃผ๋ชฉํ•  ๋งŒํ•œ ๊ฒƒ์ด์—ˆ๋˜ ์‹œ์žฅ๊ฒฝ์ œ๋กœ์˜ ๊ฐœํ˜ ๋…ธ์„ ์—๋Š” ์–ด๋– ํ•œ ๋ณ€ํ™”๊ฐ€ ์ƒ๊ธด ๊ฒƒ์ธ๊ฐ€? ๋ณธ ์—ฐ๊ตฌ๋Š” ๊ฐœํ˜์˜ ์‹ค์งˆ์ ์ธ ๋‹ด๋ก ์„ ๊ฐ•์กฐํ•œ๋‹ค. ๊ฐœํ˜๊ณผ ๊ฐ™์€ ํ•ต์‹ฌ ์ด๋…์ด ์ฃผ์š” ํ–‰์œ„์ž๋“ค์—๊ฒŒ ์–ด๋–ป๊ฒŒ ํ•ด์„๋˜๋Š”์ง€, ์™œ ๊ทธ๋ ‡๊ฒŒ ํ•ด์„๋˜๋Š”์ง€๋ฅผ ํŒŒ์•…ํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ํ•ด์„ ๊ฐ„์˜ ์ƒํ˜ธ์ž‘์šฉ์ด ์ผ์–ด๋‚˜๋Š” ๋‹ด๋ก ์˜ ๋ถ„์„์ด ํ•„์š”ํ•  ์ˆ˜๋ฐ–์— ์—†๋‹ค. ์˜ˆ์ปจ๋Œ€ ๊ฐœํ˜์„ ๋‘˜๋Ÿฌ์‹ผ ๋‹ด๋ก ์ด ์ฒ˜์Œ๋ถ€ํ„ฐ ํ•˜๋‚˜๋กœ ํ•ฉ์˜๋˜์–ด ์žˆ์„ ์ˆ˜ ์—†๋‹ค. ๊ฐœํ˜์ด ๋ฐœ์ƒํ•˜๊ธฐ ์ „์— ์–ด๋–ค ๊ฒƒ์„ ๋ฌธ์ œ(์œ„๊ธฐ)๋กœ ์ธ์‹ํ•ด์•ผ ํ•˜๋Š”์ง€, ๊ทธ ๋ฌธ์ œ(์œ„๊ธฐ)์˜ ์›์ธ์€ ๋ฌด์—‡์ธ์ง€, ๊ฐœํ˜์„ ์ถ”์ง„ํ•œ๋‹ค๋ฉด ์–ด๋””๊นŒ์ง€๋ฅผ ๊ฐœํ˜์˜ ๋ฒ”์œ„๋กœ ์‚ผ์•„์•ผ ํ• ์ง€, ๋ˆ„๊ฐ€ ๊ฐœํ˜์„ ์ด๋Œ์–ด์•ผ ํ• ์ง€, ๊ฐœํ˜์˜ ๋ชฉํ‘œ๋Š” ๋ฌด์—‡์ธ์ง€ ๋“ฑ ๊ฐœํ˜๊ณผ ๋ฌธ์ œ์˜ ํ•ด์„์„ ๋†“๊ณ  ๋ฒŒ์–ด์ง€๋Š” ๋‹ด๋ก ์€ ๋งค์šฐ ๋‹ค์–‘ํ•  ์ˆ˜๋ฐ–์— ์—†๊ธฐ ๋•Œ๋ฌธ์ด๋‹ค. 1979๋…„ ๊ฐœํ˜ยท๊ฐœ๋ฐฉ์ด ์‹œ์ž‘๋  ๋•Œ์˜ ๊ฐœํ˜, 1989๋…„ ํ†ˆ์•ˆ๋จผ ์‚ฌํƒœ๊ฐ€ ๋ฐœ์ƒํ–ˆ์„ ๋•Œ ๋‹น์˜ ๊ฐœํ˜, 1992๋…„ ๋ฉ์ƒค์˜คํ•‘(์žฅ์ฉŒ๋ฏผ)์˜ ์‚ฌํšŒ์ฃผ์˜ ์‹œ์žฅ๊ฒฝ์ œ์˜ ๊ฐœํ˜, 2006๋…„ ํ›„์ง„ํƒ€์˜ค ๊ณผํ•™์  ๋ฐœ์ „๊ด€์˜ ๊ฐœํ˜, 2017๋…„ ์‹œ์ง„ํ•‘ ์‹ ์‹œ๋Œ€ ์ค‘๊ตญ ํŠน์ƒ‰์˜ ์‚ฌํšŒ์ฃผ์˜ ์‚ฌ์ƒ์˜ ๊ฐœํ˜ ๋“ฑ ์ค‘๊ตญ ๊ณต์‚ฐ๋‹น์€ ์—ฌ์ „ํžˆ ๊ฐœํ˜์„ ์ฃผ์žฅํ•˜๋ฉฐ ์Šค์Šค๋กœ ์ด์ „ ์‹œ๊ธฐ๋ฅผ ๊ณ„์Šนํ•˜๊ณ  ์‹ฌํ™”์‹œ์ผฐ๋‹ค๊ณ  ์ฃผ์žฅํ•˜์ง€๋งŒ ๊ฐœํ˜์˜ ์˜๋ฏธ๋Š” ํ™˜๊ฒฝ๊ณผ ์ œ๋„์— ๋Œ€ํ•œ ์—ฌ๋Ÿฌ ์ธ์‹๋“ค์ด ์ƒํ˜ธ์ž‘์šฉํ•˜๋Š” ๋‹ด๋ก ์„ ํ†ตํ•ด ์œ ์˜๋ฏธํ•˜๊ฒŒ ๋ณ€ํ™”ํ•ด์™”๋‹ค. ์˜ˆ์ปจ๋Œ€, 80๋…„๋Œ€ ๋ง๊ณผ 90๋…„๋Œ€ ๋ง(2000๋…„๋Œ€ ์ดˆ), ๋ถˆํ‰๋“ฑ ์‹ฌํ™”๋ผ๋Š” ๋น„์Šทํ•œ ์‚ฌํšŒ์  ๊ฐˆ๋“ฑ๊ณผ ๋ฌธ์ œ๊ฐ€ ์‹œ์œ„์™€ ๋…ผ์Ÿ์œผ๋กœ ํ‘œ์ถœ๋˜์—ˆ์œผ๋‚˜, ์ด์— ๋Œ€ํ•œ ์ค‘๊ตญ ๊ณต์‚ฐ๋‹น์˜ ๋Œ€์‘์ฑ…์€ ๋‹ฌ๋ž๋‹ค. 80๋…„๋Œ€ ๋ง ๋ถˆํ‰๋“ฑ ์‹ฌํ™” ๋ฌธ์ œ ๋’ค์—๋Š” ์‹ ๊ณ„๋ชฝ์ฃผ์˜, ์ž์œ ์ฃผ์˜์˜ ์‚ฌ์ƒ๊ณ„ ๋‹ด๋ก ์ด ํ•™์ƒ์šด๋™์„ ๋’ท๋ฐ›์นจํ•˜๋ฉด์„œ ๋ฌธ์ œ์— ๋Œ€ํ•œ ์›์ธ์„ ๊ฐœํ˜์„ ์ œ๋Œ€๋กœ ์‹œํ–‰ํ•˜์ง€ ๋ชปํ•œ ๋ถ€ํŒจํ•œ ๊ด€๋ฃŒ๋“ค๊ณผ ๋ฌธํ™”ํ˜๋ช…์˜ ์ž”์žฌ๋กœ ํ•ด์„ํ•˜๋Š” ๊ฒƒ์ด ์ฃผ๋„์ ์ด์—ˆ๊ณ , ๊ทธ ๊ฒฐ๊ณผ ํ•™์ƒ์šด๋™์€ ๊ฒฝ์ œ์  ๊ฐœํ˜์„ ์‹ฌํ™”์‹œ์ผœ ์ •์น˜์  ๊ฐœํ˜๊นŒ์ง€ ์š”๊ตฌํ•˜๋Š” ๊ฒƒ์œผ๋กœ ๋ฐœ์ „๋˜์—ˆ๋‹ค. ๋”ฐ๋ผ์„œ ๋ฉ์ƒค์˜คํ•‘์˜ ๋‚จ์ˆœ๊ฐ•ํ™”์™€ ์ดํ›„ ์‹œ์žฅ ๊ฐœํ˜ ์‹ฌํ™” ๋‹ด๋ก ์€ 80๋…„๋Œ€ ๋ง ์‚ฌํšŒ์  ๋ถˆ๋งŒ์— ๋ฐ˜๋Œ€๋˜๋Š” ๊ฒƒ์ด ์•„๋‹ˆ๋ผ ์˜คํžˆ๋ ค ๊ฒฝ์ œ์ ์ธ ์ธก๋ฉด์—์„œ๋Š” ์ด๋ฅผ ๊ธ์ •ํ•˜๋Š” ๊ฒฐ๊ณผ์˜€๋‹ค. ๋ฐ˜๋ฉด 90๋…„๋Œ€ ๋ง๋ถ€ํ„ฐ ๊ณ ์กฐ๋œ ๋ถˆํ‰๋“ฑ ๋ฌธ์ œ์—์„œ๋Š” 80๋…„๋Œ€์™€ ๋‹ค๋ฅด๊ฒŒ ์‹ ์ขŒํŒŒ ์ง€์‹์ธ๋“ค์„ ์ค‘์‹ฌ์œผ๋กœ ๋ฐ˜(ๅ) ์ž์œ ์ฃผ์˜์  ๋‹ด๋ก ์ด ๋Œ€์ค‘๋“ค์—๊ฒŒ ๊ธ‰๊ฒฉํ•˜๊ฒŒ ํž˜์„ ์–ป์—ˆ๋‹ค. ์ด๋Ÿฌํ•œ ๋‹ด๋ก ์€ ๊ตญ์œ ๊ธฐ์—… ์žฌ๊ตญ์œ ํ™”๋ฅผ ๋ถ€์ƒ์‹œํ‚จ ๋ž‘๊ตฌ๋…ผ์Ÿ์„ ์ ํ™”ํ•˜๋ฉด์„œ ๊ฐœํ˜ ํ‰๊ฐ€ ๋…ผ์Ÿ์„ ๋ถ€์ถ”๊ฒผ๊ณ , ํ›„์ง„ํƒ€์˜ค์˜ ๊ณผํ•™์ ๋ฐœ์ „๊ด€๊ณผ ํ™”ํ•ด์‚ฌํšŒ๋ก ์˜ ์ด๋ก ์  ํ† ๋Œ€๊ฐ€ ๋˜์—ˆ๋‹ค. ๊ทธ๋ฆฌ๊ณ  2000๋…„๋Œ€ ๋ง ๋ฐœ์ƒํ•œ ์ถฉ์นญ ๋ชจ๋ธ ๋‹ด๋ก ์€ ํ™”ํ•ด์‚ฌํšŒ๋ก ๊ณผ ๊ณผํ•™์ ๋ฐœ์ „๊ด€์˜ ์„ฑ๊ณต์  ๋ชจ๋ธ๋กœ ๋ถ€์ƒํ•˜์˜€๊ณ , ์ดํ›„ ๋ฉ์ƒค์˜คํ•‘์˜ ์ƒ์‚ฐ์„ฑ ๋ฐœ์ „ ์šฐ์„  ๋ฐœ์ „์ „๋žต์€ ํ‰๋“ฑ๊ณผ ๋ถ„๋ฐฐ์˜ ์ „๋ฉด์  ์†Œ๊ฐ•์‚ฌํšŒ๋ฅผ ๊ฑด์„คํ•˜๋Š” ๊ตญ๊ฐ€์ฃผ์˜์  ๋ฐœ์ „ ์ „๋žต์œผ๋กœ ๋ณ€ํ™”ํ•˜๊ฒŒ ๋˜์—ˆ๋‹ค. ์ด์ฒ˜๋Ÿผ ์ค‘๊ตญ์˜ ๊ฒฝ์ œ ๊ฐœํ˜์€ ์ƒ์‚ฐ๋ ฅ ์ค‘์‹ฌ์˜ ํ•ฉ๋ฆฌ์„ฑ๋งŒ์„ ๊ฐ€์ง€๊ณ  ์ง„ํ–‰๋˜์—ˆ๋‹ค๊ฑฐ๋‚˜, ์ œ๋„์™€ ํ™˜๊ฒฝ์— ๋”ฐ๋ฅธ ์ผ๊ด€์ ์ด๊ณ  ๊ฒฝ๋กœ์˜์กด์ ์ธ ๋ฐฉํ–ฅ์œผ๋กœ ์ง„ํ–‰๋˜์—ˆ๋‹ค๊ณ ๋งŒ ๋ณผ ์ˆ˜ ์—†๊ณ , ์˜คํžˆ๋ ค ๋‚ด๋ถ€์  ๋‹ด๋ก ์„ ํ†ตํ•ด ๊ฐœํ˜์˜ ์‹ค์งˆ์  ์˜๋ฏธ์™€ ํ•ด์„์ด ๋ณ€ํ™”ํ•˜๋Š” ๊ณผ์ •์„ ๊ฒฝํ—˜ํ–ˆ๋‹ค๊ณ  ๋ณด๋Š” ๊ด€์ ์ด ํƒ€๋‹นํ•˜๋‹ค. ์ด ์ ์—์„œ ๋ณธ ์—ฐ๊ตฌ๋Š” ๊ธฐ์กด ์—ฐ๊ตฌ๊ฐ€ ์‹œ์žฅ ๊ฒฝ์ œ ๊ฐœํ˜์˜ ์„ฑ๊ณผ๋ฅผ ๊ธ์ •ํ•˜๋Š” ์‹ ์ž์œ ์ฃผ์˜์  ๋…ผ๋ฆฌ, ์ค‘๊ตญ์˜ ์ œ๋„์  ํŠน์ˆ˜์„ฑ์„ ๊ฐ•์กฐํ•œ ์ค‘๊ตญ์‹ ๋ฐœ์ „ ๋ชจ๋ธ์— ์ง‘์ค‘ํ•œ ๊ฒƒ์— ๋ฐ˜ํ•˜์—ฌ, ์ค‘๊ตญ ๊ฐœํ˜์˜ ์˜๋ฏธ๊ฐ€ ๋‚ด์ƒ์ ์œผ๋กœ ๋ณ€ํ™”ํ•˜๋Š” ๊ณผ์ •์„ ๊ฐ„๊ณผํ•˜๊ณ  ์žˆ์Œ์„ ์ง€์ ํ•˜๊ณ , ์ด ๋ณ€ํ™”๋ฅผ ๋ถ„์„ํ•˜๊ธฐ ์œ„ํ•ด์„œ ๋‹ด๋ก ์ œ๋„์ฃผ์˜์  ์ ‘๊ทผ์„ ์ œ์‹œํ•œ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ๋ถ„์„ ์œ„ํ•ด ์ค‘๊ตญ ์‹œ์žฅ ๊ฒฝ์ œ ๊ฐœํ˜์˜ ์ฃผ์š” ์Ÿ์ ์ธ ๊ณต์œ ์ œ์™€ ์‚ฌ์œ ์ œ, ๊ทธ๋ฆฌ๊ณ  ๊ทธ ์ฃผ์š” ํ–‰์œ„์ž์ธ ๊ตญ์œ ๊ธฐ์—…์„ ๋‘˜๋Ÿฌ์‹ผ ๋‹ด๋ก  ๋…ผ์Ÿ์— ์ดˆ์ ์„ ๋งž์ถ”๊ณ  ์žˆ๋‹ค.์ œ 1 ์žฅ ์„œ๋ก  1 ์ œ 1 ์ ˆ ๋ฌธ์ œ์ œ๊ธฐ 1 ์ œ 2 ์ ˆ ์—ฐ๊ตฌ๋ฐฐ๊ฒฝ 6 ์ œ 2 ์žฅ ์„ ํ–‰์—ฐ๊ตฌ ๋ฐ ์ด๋ก ์  ๊ฒ€ํ†  12 ์ œ 1 ์ ˆ ์ด๋ก ์  ๊ฒ€ํ†  12 1. ์„ธ๊ณ„ํ™”์™€ ์‹ ์ž์œ ์ฃผ์˜ 12 2. ๋Œ€์•ˆ์  ์ด๋ก : ๋‹ด๋ก  ์ œ๋„์ฃผ์˜ 15 ์ œ 3 ์žฅ ๊ฐœํ˜ยท๊ฐœ๋ฐฉ ๋‹ด๋ก ์˜ ํ˜•์„ฑ๊ณผ ๋ฐœ์ „(1978~2002) 21 ์ œ 1 ์ ˆ ๊ฐœํ˜ยท๊ฐœ๋ฐฉ ์ดˆ๊ธฐ ๊ตญ์œ ๊ธฐ์—… ๊ฐœํ˜๊ณผ ๊ฒฝ์ œ ๊ฐœํ˜ ๋‹ด๋ก  23 1. ๊ตญ์œ ๊ธฐ์—… ๊ฐœํ˜์˜ ์—ญ์‚ฌ์  ๊ฒฝ๋กœ 23 2. ๊ฐœํ˜ ๋‹ด๋ก ์˜ ๋ณ€ํ™” 28 ์ œ 2 ์ ˆ ํ†ˆ์•ˆ๋จผ ์‚ฌํƒœ์™€ ๊ฐœํ˜์˜ ์‹ฌํ™”(1986~2002) 37 1. ํ†ˆ์•ˆ๋จผ ์‚ฌํƒœ์™€ ์ •์น˜ ๋ณด์ˆ˜ํ™” 37 2. ๋‚จ์ˆœ๊ฐ•ํ™”์™€ ์‹œ์žฅ๊ฒฝ์ œ ๊ฐœํ˜ 46 ์ œ 4 ์žฅ ๊ฐœํ˜ ๋‹ด๋ก ์˜ ๋ถ„ํ™”์™€ ๋ณ€ํ™”(2003~) 57 ์ œ 1 ์ ˆ ์‹œ์žฅ๊ฒฝ์ œ ๊ฐœํ˜์˜ ์‹ฌํ™”์™€ 3๊ฐœ๋Œ€ํ‘œ๋ก  58 1. ๊ตญ์œ ๊ธฐ์—…์˜ ์‹œ์žฅํ™” ๊ฐœํ˜ 58 2. 3๊ฐœ๋Œ€ํ‘œ๋ก ๊ณผ ์ž์œ ์ฃผ์˜ 60 ์ œ 2 ์ ˆ ๊ฐœํ˜ ๋‹ด๋ก ์˜ ๋ณ€ํ™”: ๊ณผํ•™์ ๋ฐœ์ „๊ด€๊ณผ ํ™”ํ•ด์‚ฌํšŒ๋ก  63 1. ํ›„์ง„ํƒ€์˜ค ์ง‘๊ถŒ 1๊ธฐ: ๊ณผํ•™์ ๋ฐœ์ „๊ด€๊ณผ ํ™”ํ•ด์‚ฌํšŒ๋ก  65 2. ํ›„์ง„ํƒ€์˜ค ๊ฐœํ˜์˜ ๋‹ด๋ก ์  ๋ฐฐ๊ฒฝ๊ณผ ๋‹ด๋ก ์˜ ์‹ฌํ™” 72 ์ œ 5 ์žฅ ๊ฒฐ๋ก  84Maste

    Impact of thyroid cancer on the cancer risk in patients with nonโ€‘alcoholic fatty liver disease or dyslipidemia

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    The raised prevalence of obesity has increased the incidence of obesity-related metabolic diseases such as dyslipidemia (DL) and non-alcoholic fatty liver disease (NAFLD), along with the development and progression of various types of cancer, including thyroid cancer. In this study, we investigated whether thyroid cancer in patients with DL and NAFLD could be a risk factor for other cancers. To achieve our goal, we generated two independent cohorts from our institution and from the National Health Insurance System in South Korea. Based on the ICD-10 code, we conducted exact matching (1:5 matching) and estimated the overall risk of thyroid cancer for other cancers in patients with DL or NAFLD. Univariate and multivariate analyses showed that the hazard ratio (HR) of thyroid cancer was 2.007 (95% Confidence Interval [CI], 1.597-2.522) and 2.092 (95% CI, 1.546-2.829), respectively in the institutional cohort and 1.329 (95% CI, 1.153-1.533) and 1.301 (95% CI, 1.115-1.517), respectively in the nationwide cohort. Risk analysis revealed a significant increase in the HR in lip, tongue, mouth, lung, bone, joint, soft tissue, skin, brain, male cancers and lymphoma after thyroid cancer occurred. Thyroid cancer in patients with DL or NAFLD might be a valuable factor for predicting the development of other cancers.ope

    Re-do Operation Using a Robotic System due to Locoregional Recurrence after Initial Thyroidectomy for Thyroid Cancer

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    Locoregional recurrent thyroid cancer is commonly treated with re-do operation. This study aimed to investigate the feasibility of using robotic system for re-do operation in locoregional recurrent thyroid cancer. Sixty-five patients who underwent re-do robotic operation using trans-axillary approach for locoregional recurrent thyroid cancer from October 2007 to April 2021 at Yonsei University Hospital were analyzed. Completion total thyroidectomy (CTT) was performed in 26 cases, CTT and modified radical neck node dissection (mRND) in 16, and mRND in 23. Most of the re-do robotic operations were performed at site of previous incision. All patients were diagnosed with papillary thyroid carcinoma (PTC). CTT with central compartment neck dissection (CCND) took 117.6 ยฑ 26.3 min, CTT with mRND 255.6 ยฑ 38.6 min, and mRND, 211.7 ยฑ 52.9 min. Transient hypocalcemia occurred in 17 (26.2%) patients and permanent hypocalcemia occurred in 3 (4.6%). There was one case of recurrent laryngeal nerve(RLN) injury. One patient was diagnosed with structural recurrence after re-do robotic operation. Median follow-up duration was 50.7 ยฑ 37.1 months. Re-do robotic operation can be an alternative for patients who are diagnosed with locoregional recurrent thyroid cancer after thyroidectomy, with no increase in morbidity, similar oncologic outcomes, and superior cosmetic satisfaction.ope

    Unexpected remission of hyperparathyroidism caused by hemorrhage due to the use of fine-needle aspiration biopsy: two cases report

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    Hyperparathyroidism is not a rare disease; if a parathyroid adenoma is confirmed, the treatment of choice is the surgical resection. Diagnostic use of fine-needle aspiration biopsy (FNAB) for histological confirmation in patients with hyperparathyroidism is controversial. And spontaneous remission of hyperparathyroidism caused by bleeding or infarction of the adenoma rarely occurs. Here we have reported two cases of hyperparathyroidism in which spontaneous remission occurred due to the use of FNAB for diagnosis. The remission was confirmed after surgical removal and pathological review of the adenoma. The first patient diagnosed with primary hyperparathyroidism (PHPT) had neck pain and severe swelling 4 days after FNAB, and spontaneous remission due to intracapsular hemorrhage was confirmed after surgery. In the second patient receiving hemodialysis treatment for end-stage renal disease, hyperparathyroidism spontaneously resolved after FNAB and the parathyroid hormone (PTH) levels normalized after surgery. The first patient maintained a normal level of PTH for 6 years, and the second patient received kidney transplantation 6 years after surgery, and the normal level of PTH was confirmed for 13 years. Caution is needed while performing FNAB for diagnosis of hyperparathyroidism and during decision making regarding whether to observe the patient or perform surgery after spontaneous remission due to bleeding or infarction.ope

    Optimal Cut-Off Values of Lymph Node Ratio Predicting Recurrence in Papillary Thyroid Cancer

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    Regional lymph node (LN) metastasis has a significant impact for prediction of recurrence in patients with papillary thyroid cancers (PTC); however, the prognostic value of the lymph node ratio (LNR), which is defined as the ratio of the number of metastatic LNs to the total number of investigated LNs, is controversial. In this study, we determined the optimal cut-off values of LNRs for the prediction of recurrence in PTC patients.This large cohort study retrospectively evaluated 2294 patients who had undergone total thyroidectomy for PTC at a single institution from October 1985 to June 2009. The prediction probability of central LNR (cLNR, level VI) and total LNR (tLNR, levels II-VI) were estimated by binominal logistic regression analysis. Hazard ratios of the cut-off LNR values for cancer recurrence were calculated for relevant covariates using multivariate Cox regression analyses. Kaplan-Meier analyses were also utilized to assess the effects of estimated LNR cut-off values on recurrence-free survival (RFS).Of the 2294 patients, 138 (6.0%) presented cancer recurrence during the follow-up period (median duration = 107.1 months). The prediction probability indicated that LNRs of 0.4 and 0.5 for central LN and total LN, respectively, are optimal cut-off values for precise prediction with minimization of outliers. Multivariate Cox regression analyses revealed that cLNR โ‰ฅ0.4 was independently predictive of recurrence in patients with N0 and N1a PTCs (hazard ratio [HR]: 7.016, 95% confidence interval [CI]: 3.72-12.986, Pโ€Š<โ€Š0.001) and that tLNR โ‰ฅ0.5 indicated a significantly increased risk of recurrence in patients with N1b PTCs (HR: 2.372, 95% CI: 1.458-3.860, Pโ€Š<โ€Š0.001). In addition, Kaplan-Meier analyses clearly demonstrated that these LNR cut-off values are precisely operational in RFS estimation.The cut-off LNR values of 0.4 and 0.5 for cLNR and tLNR, respectively, were identified. Risk stratification combined with these LNR cut-off values may prove useful to determine treatment and follow-up strategies for PTC patients.ope

    Parathyroid venous sampling for the preoperative localisation of parathyroid adenoma in patients with primary hyperparathyroidism

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    Preoperative localisation studies are essential for parathyroidectomy in patients with primary hyperparathyroidism. If the location of abnormal parathyroid glands cannot be identified through non-invasive studies, parathyroid venous sampling (PVS) may be employed. In this study, we evaluated the utility of preoperative PVS in parathyroid surgery. Patients with primary hyperparathyroidism who underwent preoperative PVS at Severance Hospital between January 2015 and June 2020 were identified. Patients for whom the results of non-invasive imaging studies were inconsistent or negative underwent PVS. The results of PVS were compared with operative findings and pathologic results. For 14 patients, the results of preoperative ultrasonography and 99mTc-sestamibi single-photon emission computed tomography (SPECT) were negative; for 20 patients, either the result of only one test was positive, or the results of the two tests were inconsistent. With respect to the lateralisation of diseased adenoma, the results of PVS and pathological examination were inconsistent only for one patient in either group (total: 2/34 patients). This study showed that PVS could be used effectively for preoperative localisation in patients with primary hyperparathyroidism in whom the location of diseased parathyroid glands cannot be determined through non-invasive image studies.ope

    (A)Study on features of the community learning process arising in social movement

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    ํ•™์œ„๋…ผ๋ฌธ(๋ฐ•์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :๊ต์œกํ•™๊ณผ ํ‰์ƒ๊ต์œก์ „๊ณต,2006.Docto

    ์„ฌ์œ ํ˜ผํ•ฉํ† ์˜ ๋™์ ๋ณ€ํ˜•ํŠน์„ฑ์— ๋Œ€ํ•œ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :๋†๊ณตํ•™๊ณผ ๋†์—…ํ† ๋ชฉ์ „๊ณต,2003.Maste

    ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ์˜ ๊ต์ฒด๊ฐ€ ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ํ–‰์ •๋Œ€ํ•™์› : ๊ณต๊ธฐ์—…์ •์ฑ…ํ•™๊ณผ, 2015. 8. ์ด์ˆ˜์˜.๋ณธ ์—ฐ๊ตฌ์˜ ์ฒซ ๋ฒˆ์งธ ์ฃผ์ œ๋Š” ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ์˜ ๊ต์ฒด๊ฐ€ ๊ฒฝ์˜์„ฑ๊ณผ์— ์–ด๋– ํ•œ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š”๊ฐ€์— ๊ด€ํ•œ ๊ฒƒ์ด๊ณ , ๋‘ ๋ฒˆ์งธ ์ฃผ์ œ๋Š” ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋œ ๊ฒฝ์šฐ ํ›„์ž„๊ธฐ๊ด€์žฅ์ด ๋‚ด๋ถ€์Šน์ง„์ธ์ง€ ์•„๋‹ˆ๋ฉด ์™ธ๋ถ€์ธ์‚ฌ์˜์ž…์ธ์ง€ ๊ทธ๋ฆฌ๊ณ  ์ „๋ฌธ์„ฑ์„ ๋ณด์œ ํ•˜๊ณ  ์žˆ๋Š”์ง€ ์•„๋‹ˆ๋ฉด ์ „๋ฌธ์„ฑ์„ ๋ณด์œ ํ•˜๊ณ  ์•Š์€์ง€์— ๋”ฐ๋ผ ๊ฒฝ์˜์„ฑ๊ณผ์— ์–ด๋– ํ•œ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฐ€์— ๊ด€ํ•œ ๊ฒƒ์ด์—ˆ๋‹ค. ์ด๋Š” ๋ฏผ๊ฐ„๊ธฐ์—…๊ณผ ๊ด€๋ จํ•˜์—ฌ ํ™œ๋ฐœํ•˜๊ฒŒ ์—ฐ๊ตฌ๋˜๊ณ  ์žˆ๋Š” ์ตœ๊ณ ๊ฒฝ์˜์ž์˜ ๊ต์ฒด๊ฐ€ ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๊ด€ํ•œ ์—ฐ๊ตฌ๋“ค์„ ๊ณต๊ธฐ์—…์— ์ ์šฉ์‹œ์ผœ ๋ณด๋ ค๋Š” ์‹œ๋„์˜€๋‹ค. ๋ถ„์„๊ฒฐ๊ณผ ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋œ ๊ฒฝ์šฐ ๊ทธ๋ ‡์ง€ ์•Š์€ ๊ฒฝ์šฐ์— ๋น„ํ•ด ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€ ๋“ฑ๊ธ‰ ๋ฐ ์ด์ž์‚ฐ์ˆ˜์ต์œจ์ด ๋‚ฎ์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ฆ‰ ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€ ๋“ฑ๊ธ‰์˜ ๊ฒฝ์šฐ ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋œ ๊ฒฝ์šฐ ๊ทธ๋ ‡์ง€ ์•Š์€ ๊ฒฝ์šฐ์— ๋น„ํ•ด 0.594๋งŒํผ ๋‚ฎ์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋Š”๋ฐ, ์ด๋Š” 1%์˜ ์œ ์˜์ˆ˜์ค€์—์„œ ์œ ์˜ํ•˜์˜€๋‹ค. ์ด์ž์‚ฐ์ˆ˜์ต์œจ์€ 10%์˜ ์œ ์˜์ˆ˜์ค€์—์„œ ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋œ ๊ฒฝ์šฐ ๊ทธ๋ ‡์ง€ ์•Š์€ ๊ฒฝ์šฐ์— ๋น„ํ•ด 0.0225๋งŒํผ ๋‚ฎ์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๊ธฐ๊ด€์žฅ์ด ์ž„๊ธฐ๋งŒ๋ฃŒ ์ „์— ๊ต์ฒด๋œ ๊ฒฝ์šฐ ๋˜ํ•œ ๊ทธ๋ ‡์ง€ ์•Š์€ ๊ฒฝ์šฐ์— ๋น„ํ•ด ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€ ๋“ฑ๊ธ‰ ๋ฐ ์ด์ž์‚ฐ์ˆ˜์ต์œจ์ด ๋‚ฎ์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋Š”๋ฐ, ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€ ๋“ฑ๊ธ‰๊ณผ ์ด์ž์‚ฐ์ˆ˜์ต์œจ ๋ชจ๋‘ 1%์˜ ์œ ์˜์ˆ˜์ค€์—์„œ ๊ฐ๊ฐ 0.714, 0.0397๋งŒํผ ๋‚ฎ์•˜๋‹ค. ํ•œํŽธ ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋œ ๊ฒฝ์šฐ์™€ ๊ธฐ๊ด€์žฅ์ด ์ž„๊ธฐ๋งŒ๋ฃŒ ์ „์— ๊ต์ฒด๋œ ๊ฒฝ์šฐ ๋ชจ๋‘ ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€ ๋“ฑ๊ธ‰์— ๋ถ€์ •์ ์ธ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋œ ๊ฒฝ์šฐ๋Š” 5%์˜ ์œ ์˜์ˆ˜์ค€์—์„œ, ๊ธฐ๊ด€์žฅ์ด ์ž„๊ธฐ๋งŒ๋ฃŒ ์ „์— ๊ต์ฒด๋œ ๊ฒฝ์šฐ๋Š” 1%์˜ ์œ ์˜์ˆ˜์ค€์—์„œ ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€ ๋“ฑ๊ธ‰์— ๋ถ€์ •์  ์˜ํ–ฅ์„ ๋ฏธ์ณค๋‹ค. ํ•œํŽธ ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋œ ๊ฒฝ์šฐ ํ›„์ž„๊ธฐ๊ด€์žฅ์ด ๋‚ด๋ถ€์Šน์ง„์ž์ธ ๊ฒฝ์šฐ 5%์˜ ์œ ์˜์ˆ˜์ค€์—์„œ ๋ถ€์ •์ ์ธ ์˜ํ–ฅ์„ ๋ฏธ์ณค๋‹ค. ์šฐ์„  ์ฒซ ๋ฒˆ์งธ ์ฃผ์ œ์™€ ๊ด€๋ จํ•˜์—ฌ ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ์ด ์ž„๊ธฐ๋งŒ๋ฃŒ ์ „์— ๊ต์ฒด๋˜๋Š” ๊ฒฝ์šฐ๋Š” ๋ฌผ๋ก ์ด๊ณ  ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋˜๋Š” ๊ฒฝ์šฐ์—๋Š” ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ถ€์ •์  ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค๋Š” ์‚ฌ์‹ค์„ ๋ฐœ๊ฒฌํ•˜์˜€๋‹ค. ์ด๋ฅผ ํ†ตํ•ด ์ตœ๊ณ ๊ฒฝ์˜์ž์˜ ๊ต์ฒด๊ฐ€ ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ถ€์ •์  ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค๋Š” ์ด๋ก ์ด ๊ณต๊ธฐ์—…์— ์žˆ์–ด์„œ ํƒ€๋‹นํ•˜๋‹ค๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค. ํŠนํžˆ ๊ณต๊ธฐ์—…์˜ ๊ธฐ๊ด€์žฅ์€ ๊ทธ ์ž„๊ธฐ๊ฐ€ ๊ณต์šด๋ฒ•์ƒ 3๋…„์œผ๋กœ ์ •ํ•ด์ ธ ์žˆ์–ด ๊ธฐ๊ด€์žฅ์˜ ๊ต์ฒด๋ฅผ ์‰ฝ๊ฒŒ ์˜ˆ์ธกํ•  ์ˆ˜ ์žˆ๊ณ  ๊ธฐ๊ด€์žฅ์˜ ๊ต์ฒด์— ๋Œ€ํ•œ ๋Œ€๋น„๋ฅผ ํ•  ์ˆ˜ ์žˆ์Œ์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ์ด์™€ ๊ฐ™์€ ๊ฒฐ๊ณผ๊ฐ€ ๋ฐœ์ƒํ•œ ๊ฒƒ์€ ๊ณต๊ธฐ์—…์˜ ํŠน์„ฑ์ƒ ์ œ๋„์ ยท์ •์น˜์  ํ™˜๊ฒฝ์— ์ ์‘ํ•  ์ˆ˜๋ฐ–์— ์—†๋Š” ์ด์œ ๊ฐ€ ์›์ธ์ด ๋œ ๊ฒƒ์œผ๋กœ ํŒ๋‹จ๋œ๋‹ค. ์ •๋ถ€๋Š” ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ์˜ ๋…๋ฆฝ์„ฑ, ์ „๋ฌธ์„ฑ ๋“ฑ์„ ๋ณด์žฅํ•˜๊ธฐ ์œ„ํ•ด 2007๋…„ ๊ณต๊ณต๊ธฐ๊ด€์˜ ์šด์˜์— ๊ด€ํ•œ ๋ฒ•๋ฅ ์˜ ์ œ์ •์„ ํ†ตํ•ด ์ œ๋„์ ์ธ ๋…ธ๋ ฅ์„ ๊ธฐ์šธ์ด๊ณ  ์žˆ์œผ๋‚˜ ์ด๋ฅผ ํ˜„์‹ค์ ์œผ๋กœ ์‹คํ˜„ํ•˜๊ธฐ ์œ„ํ•œ ๊ฐ•๋„ ๋†’์€ ๋…ธ๋ ฅ์ด ํ•„์š”ํ•œ ๊ฒƒ์œผ๋กœ ๋ณด์ธ๋‹ค. ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ์ด ๋น„๊ฒฝ์ œ์ ์ธ ์‚ฌ์œ ๋กœ ๊ต์ฒด๋˜๊ฑฐ๋‚˜ ๋ฒ•์—์„œ ์ •ํ•œ ์ž„๊ธฐ๋ฅผ ๋งˆ์น˜์ง€ ๋ชปํ•˜๊ณ  ๊ต์ฒด๋œ๋‹ค๋ฉด ์ œ๋„์˜ ์˜๋ฏธ๊ฐ€ ์‚ฌ๋ผ์งˆ ๊ฒƒ์ด๊ธฐ ๋•Œ๋ฌธ์ด๋‹ค. ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€์™€ ๊ฐ™์€ ๊ฐ๊ด€์ ์ด๊ณ  ๊ฒฝ์ œ์ ์ธ ๊ธฐ์ค€์— ๋”ฐ๋ผ ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋˜๊ณ  ๊ธฐ๊ด€์žฅ์˜ ๋ฒ•์ • ์ž„๊ธฐ๋„ ์ถฉ์‹คํžˆ ์ง€์ผœ์ง€๋Š” ๋“ฑ ๊ด€๋ จ ๋ฒ•์—์„œ ๊ทœ์ •ํ•œ ๋‚ด์šฉ์— ๋”ฐ๋ผ ๊ธฐ๊ด€์žฅ ๊ต์ฒด๊ฐ€ ์ด๋ฃจ์–ด์ ธ์•ผ ํ•  ๊ฒƒ์ด๋‹ค. ๋˜ํ•œ ์ž„๊ธฐ๊ฐ€ ๋งŒ๋ฃŒํ•œ ๊ฒฝ์šฐ๋ผ๋„ ๋ฌด์กฐ๊ฑด์ ์œผ๋กœ ๊ธฐ๊ด€์žฅ์„ ๊ต์ฒดํ•˜๋Š” ๊ฒƒ์ด ์•„๋‹ˆ๋ผ ์žฌ์ž„๊ธฐ๊ฐ„ ์ค‘์˜ ๊ฒฝ์˜์‹ค์ ์„ ์ข…ํ•ฉ์ ์œผ๋กœ ํ‰๊ฐ€ํ•˜์—ฌ ๊ทธ ์‹ค์ ์ด ์šฐ์ˆ˜ํ•œ ๊ฒฝ์šฐ์—๋Š” ๋ฒ•๋ น์ƒ์˜ ์—ฐ์ž„๊ทœ์ •์„ ์ ๊ทน์ ์œผ๋กœ ์ ์šฉํ•  ํ•„์š”๋„ ์žˆ์„ ๊ฒƒ์ด๋‹ค. ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ์ด ๊ต์ฒด๋˜๋Š” ๊ฒฝ์šฐ ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ถ€์ •์ ์ธ ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค๋ฉด ๊ณผ์—ฐ ์–ด๋– ํ•œ ์‚ฌ๋žŒ์ด ํ›„์ž„๊ธฐ๊ด€์žฅ์œผ๋กœ ์ž„๋ช…๋˜๋Š” ๊ฒƒ์ด ๋ฐ”๋žŒ์งํ•  ๊ฒƒ์ธ๊ฐ€์— ๋Œ€ํ•œ ๋ฌธ์ œ์ œ๊ธฐ๊ฐ€ ๋ณธ ์—ฐ๊ตฌ์˜ ๋‘ ๋ฒˆ์งธ ์ฃผ์ œ์˜€๋‹ค. ์™ธ๋ถ€์ธ์‚ฌ๊ฐ€ ๋ถ€์ •์ ์ธ ์˜ํ–ฅ์„ ๋ฏธ์น  ๊ฒƒ์ด๋ผ๋Š” ์˜ˆ์ƒ๊ณผ๋Š” ๋‹ฌ๋ฆฌ ์—ฐ๊ตฌ๊ฒฐ๊ณผ ์˜คํžˆ๋ ค ๋‚ด๋ถ€์ธ์‚ฌ๊ฐ€ ํ›„์ž„๊ธฐ๊ด€์žฅ์ด ๋˜๋Š” ๊ฒฝ์šฐ ์ •๋ถ€๊ฒฝ์˜ํ‰๊ฐ€ ๋“ฑ๊ธ‰์—๋Š” ๋ถ€์ •์ ์ธ ์˜ํ–ฅ์„ ๋ฏธ์ณค๋‹ค. ๋น„๋ก ๋‹นํ•ด ๋…„๋„ ๊ฒฝ์˜์„ฑ๊ณผ์— ๊ตญํ•œ๋˜๊ธฐ๋Š” ํ•˜๋‚˜, ์™ธ๋ถ€์—์„œ ์˜์ž…๋œ ๊ธฐ๊ด€์žฅ์ด๋ผ๋„ ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์ด ๊ธ์ •์ ์ผ ์ˆ˜ ์žˆ๋‹ค๋Š” ๊ฒƒ์ด๋‹ค. ๋”ฐ๋ผ์„œ ์™ธ๋ถ€์ธ์‚ฌ๋ฅผ ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ์œผ๋กœ ์ž„๋ช…ํ•˜๋Š” ๊ฒƒ์„ ๋ฌด์กฐ๊ฑด์ ์œผ๋กœ ๋น„ํŒํ•˜๋Š” ๊ฒƒ์€ ์˜ณ์ง€ ์•Š๋‹ค. ๊ณต๊ธฐ์—… ๊ธฐ๊ด€์žฅ ์ž„๋ช…์‹œ ๋‹จ์ˆœํžˆ ์™ธ๋ถ€์ธ์‚ฌ๋ผ๊ณ  ํ•˜์—ฌ ๋ถ€์ •์ ์ธ ์‹œ๊ฐ์œผ๋กœ๋งŒ ๋ฐ”๋ผ๋ณผ ๊ฒƒ์ด ์•„๋‹ˆ๋ผ ๊ฐ๊ด€์ ์ด๊ณ  ๊ณต์ •ํ•œ ๊ธฐ์ค€์„ ๋งˆ๋ จํ•˜์—ฌ ํ•ด๋‹น ๊ณต๊ธฐ์—…์— ๊ฐ€์žฅ ์ ํ•ฉํ•œ ์ธ๋ฌผ์„ ์„ ์ž„ํ•˜๋„๋ก ํ•˜๋Š” ๊ฒƒ์ด ํ•„์š”ํ•˜๋‹ค. ํ˜„์žฌ ๊ณต๊ณต๊ธฐ๊ด€์˜ ์šด์˜์— ๊ด€ํ•œ ๋ฒ•๋ฅ  ์ œ30์กฐ๋Š” ๊ธฐ๊ด€์žฅ์˜ ์ž๊ฒฉ์š”๊ฑด์œผ๋กœ ๊ธฐ์—…๊ฒฝ์˜๊ณผ ๊ทธ ๊ณต๊ธฐ์—…์˜ ์—…๋ฌด์— ๊ด€ํ•œ ํ•™์‹๊ณผ ๊ฒฝํ—˜์ด ํ’๋ถ€ํ•˜๊ณ  ์ตœ๊ณ ๊ฒฝ์˜์ž์˜ ๋Šฅ๋ ฅ์„ ๊ฐ–์ถ˜ ์ž๋กœ ๊ทœ์ •ํ•˜์—ฌ ๋‹ค์†Œ ์ถ”์ƒ์ ์ด๊ธฐ๋Š” ํ•˜์ง€๋งŒ ์ „๋ฌธ์„ฑ์„ ์š”๊ตฌํ•˜๊ณ  ์žˆ๋‹ค. ๊ธฐ๊ด€์žฅ ์ž„๋ช…์— ์žˆ์–ด ์ „๋ฌธ์„ฑ์ด ๊ฐ€์žฅ ์ค‘์š”ํ•œ ๊ธฐ์ค€์œผ๋กœ ์ž‘์šฉํ•˜๊ณ  ์žˆ๊ฒ ์ง€๋งŒ, ์ด๋ฐ–์—๋„ ์ผ๋ฐ˜๊ฒฝ์˜๊ด€๋ฆฌ๋Šฅ๋ ฅ, ๋น„์ „ ๋ฐ ํ˜์‹  ์—ญ๋Ÿ‰, ๋Œ€๋‚ด์™ธ ๋„คํŠธ์›Œํฌ ๋“ฑ ์ตœ๊ณ ๊ฒฝ์˜์ž์˜ ๋Šฅ๋ ฅ์— ๋Œ€ํ•œ ๋ณด๋‹ค ์„ธ๋ฐ€ํ•œ ๊ธฐ์ค€์„ ๋งˆ๋ จํ•˜์—ฌ ์ ์šฉํ•˜๋Š” ๊ฒƒ์ด ํ•„์š”ํ•  ๊ฒƒ์œผ๋กœ ๋ณด์ธ๋‹ค.์ œ 1 ์žฅ ์„œ ๋ก  1 ์ œ 1 ์ ˆ ์—ฐ๊ตฌ์˜ ํ•„์š”์„ฑ ๋ฐ ๋ชฉ์  1 ์ œ 2 ์ ˆ ์—ฐ๊ตฌ์˜ ๋Œ€์ƒ ๋ฐ ๋ฒ”์œ„ 3 ์ œ 3 ์ ˆ ์—ฐ๊ตฌ์˜ ๋ฐฉ๋ฒ• 5 ์ œ 4 ์ ˆ ์ž๋ฃŒ์˜ ์ˆ˜์ง‘ 6 ์ œ 2 ์žฅ ์ด๋ก ์  ๋ฐฐ๊ฒฝ ๋ฐ ์„ ํ–‰์—ฐ๊ตฌ 7 ์ œ 1 ์ ˆ ์ด๋ก ์  ๋ฐฐ๊ฒฝ 7 ์ œ 2 ์ ˆ ์„ ํ–‰์—ฐ๊ตฌ 9 1. ์ตœ๊ณ ๊ฒฝ์˜์ž์˜ ๊ต์ฒด๊ฐ€ ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๊ด€ํ•œ ์—ฐ๊ตฌ 10 2. ์ตœ๊ณ ๊ฒฝ์˜์ž์˜ ๊ต์ฒด์‹œ ํ›„์ž„์ž์˜ ์œ ํ˜•์ด ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๊ด€ํ•œ ์—ฐ๊ตฌ 15 3. ์„ ํ–‰์—ฐ๊ตฌ์˜ ๊ฒ€ํ†  21 ์ œ 3 ์žฅ ์—ฐ๊ตฌ์˜ ์„ค๊ณ„ 22 ์ œ 1 ์ ˆ ์—ฐ๊ตฌ์˜ ๋ชจํ˜• 22 1. ์„œ๋ก  22 2. ์—ฐ๊ตฌ๊ฐ€์„ค 23 ์ œ 2 ์ ˆ ๋ณ€์ˆ˜์˜ ์ •์˜ 30 1. ์ข…์†๋ณ€์ˆ˜ 30 2. ๋…๋ฆฝ๋ณ€์ˆ˜ 32 3. ํ†ต์ œ๋ณ€์ˆ˜ 34 ์ œ 4 ์žฅ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ 36 ์ œ 1 ์ ˆ ๊ธฐ์ดˆํ†ต๊ณ„ ๋ถ„์„ 36 1. ์ข…์†๋ณ€์ˆ˜ : ๊ฒฝ์˜์„ฑ๊ณผ 36 2. ๋…๋ฆฝ๋ณ€์ˆ˜ : ๊ธฐ๊ด€์žฅ์˜ ๊ต์ฒด ๋ฐ ํ›„์ž„๊ธฐ๊ด€์žฅ์˜ ์œ ํ˜• 37 3. ํ†ต์ œ๋ณ€์ˆ˜ : ์ž์‚ฐ, ๋งค์ถœ์•ก, ์ธ์›, ์—ฐ๋ น, ์ „๋…„๋„ ๊ฒฝ์˜์„ฑ๊ณผ 41 ์ œ 2 ์ ˆ ๊ธฐ๊ด€์žฅ ๊ต์ฒด ๋ฐ ํ›„์ž„์ž ์œ ํ˜•์— ๋”ฐ๋ฅธ ์ฐจ์ด ๋ถ„์„ 42 1. ๊ธฐ๊ด€์žฅ ๊ต์ฒด์— ๋”ฐ๋ฅธ ๊ฒฝ์˜์„ฑ๊ณผ์˜ ์ฐจ์ด 42 2. ํ›„์ž„์ž ์œ ํ˜•์— ๋”ฐ๋ฅธ ๊ฒฝ์˜์„ฑ๊ณผ์˜ ์ฐจ์ด 45 ์ œ 3 ์ ˆ ๊ธฐ๊ด€์žฅ ๊ต์ฒด ๋ฐ ํ›„์ž„์ž ์œ ํ˜•์ด ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ ๋ถ„์„ 47 1. ๊ธฐ๊ด€์žฅ ๊ต์ฒด๊ฐ€ ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ 47 2. ํ›„์ž„์ž ์œ ํ˜•์ด ๊ฒฝ์˜์„ฑ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ 54 ์ œ 4 ์ ˆ ์†Œ๊ฒฐ 58 ์ œ 5 ์žฅ ๊ฒฐ๋ก  66 ์ œ 1 ์ ˆ ์—ฐ๊ตฌ๊ฒฐ๊ณผ ์š”์•ฝ 66 ์ œ 2 ์ ˆ ์—ฐ๊ตฌ์˜ ์‹œ์‚ฌ์  67 ์ œ 3 ์ ˆ ์—ฐ๊ตฌ์˜ ํ•œ๊ณ„์™€ ํ–ฅํ›„ ์—ฐ๊ตฌ 69 ์ฐธ๊ณ ๋ฌธํ—Œ 71 Abstract 74Maste

    Mapping of chromosome 22q11 microdeletion in CATCH22 syndrome using somatic cell fusion

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    ํ•™์œ„๋…ผ๋ฌธ(๋ฐ•์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์˜ํ•™๊ณผ ์†Œ์•„๊ณผํ•™์ „๊ณต,2001.Docto
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