• Title/Summary/Keyword: 갑상샘기능저하증

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Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer (국소 진행된 두경부암 환자의 방사선치료 후 갑상샘기능저하증)

  • Lee, Jeong-Eun;Kim, Jae-Chul;Yea, Ji-Woon;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.64-70
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    • 2010
  • Purpose: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. Materials and Methods: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. Results: The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Conclusion: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.

Genetic Variations of Congenital Hypothyroidism (선천성 갑상샘기능저하증의 유전자 변이)

  • Lee, Yong-Wha;Lee, Dong-Hwan
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.9-15
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    • 2010
  • Congenital hypothyroidism (CH) is detected at a rate of 1 in 3,000 to 4,000 live births, making it the most common congenital endocrine disorder worldwide. CH is most commonly caused by defects in thyroid development leading to thyroid dysgenesis or dyshormonogenesis. Congenital hypothyroidism is usually sporadic, but up to 2% of cases of thyroid dysgenesis are familial, and CH caused by organification defects is often inherited in a recessive manner. The candidate genes associated with this genetically heterogeneous disorder fall into two main groups: those causing thyroid gland dysgenesis and those causing dyshormonogenesis. Genes associated with thyroid gland dysgenesis include the TSHR gene in nonsyndromic CH, and Gsa and the thyroid transcription factor (TTF-1, TTF-2, and Pax-8) genes, which are associated with different complex syndromes that include CH. Among genes associated with dyshormonogenesis, the TPO and TG genes were initially described, and more recently PDS, NIS, and THOX2 gene defects. There is some evidence for a third group of CH conditions associated with iodothyronine transporter defects that are, in turn, associated with severe neurological sequelae.

Severe Intestinal Distension in a Dog with Primary Hypoparathyroidism (일차성 부갑상샘기능저하증에 이환된 개에서 장확장증 발생 증례)

  • Kim, Dong-In;Kim, Hye-Sun;Chang, Dongwoo;Yang, Mhan-Pyo;Kang, Ji-Houn
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.216-219
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    • 2014
  • An 1-year-old, female, mixed-breed dog weighing 17 kg was referred for abrupt collapse. She had remarkable hypocalcemia and hyperphosphatemia, and survey radiographs revealed a severe gas-filled intestine. Treatment with serial injections of calcium gluconate was initiated promptly and most of the gastrointestinal distension disappeared after 4 h. However, the clinical signs were not resolved completely. The serum intact parathyroid hormone concentration was not elevated in the context of hypocalcemia, which suggested primary hypoparathyroidism. The clinical signs and laboratory abnormalities in the patient were resolved completely 3 days after administration of calcium gluconate and calcitriol. This case describes the unique presentation of severe gastrointestinal distension in a dog diagnosed with primary hypoparathyroidism.

How to design male hypothyroid hypogonadism model (갑상샘기능저하증에 따른 생식샘기능저하증 모델 정립을 위한 제언)

  • Yoon, Sang-Pil;Kim, Jung Woo
    • Journal of Medicine and Life Science
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    • v.16 no.1
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    • pp.34-38
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    • 2019
  • Hypogonadism is a clinical syndrome that results in hormone deficiency and can be classified as 1) primary caused by the gonadal failure and 2) secondary by the hypothalamus-pituitary gland dysfunction and/or cardiometabolic complications. Recently the presence of thyroid hormone receptors in different testicular cell types was demonstrated, and thus thyroid dysfunctions would be another cause of secondary hypogonadism. Thus, we investigated the effects of perinatal hypothyroidism on hypogonadism in male Sprague-Dawley rats. Perinatal hypothyroidism was induced by daily administration of 0.05% 6-propyl-2-thiouracil (PTU) by tap water from gestation day 15, which were compared with negative control (PTU (-)) group. At postnatal day 28, hypothyroid pups were divided into 2 groups: PTU (+) group - continued PTU treatment and PTU (+/-) group - stopped PTU until postnatal day 49. Body weights, dehydrotesosterone (DHT), and testosterone levels were checked 2 and 3 weeks after grouping. Body weights were significantly decreased in PTU(+) and PTU(+/-) groups compared with PTU (-) group at postnatal day 28. 3 weeks later, PTU (+/-) group significantly gained weight compared with PTU (+) group. DHT and testosterone levels significantly decreased with PTU treatment, but increased 3 weeks after stopping PTU administration. Perinatal PTU-induced hypothyroid hypogonadism was sustained for 2 weeks after stopping PTU administration, but restored gonadal hormone levels 3 weeks after stopping PTU. These results suggest that researchers should design an experiment on hypothyroid hypogonadism based on the estimated period.

Effects of Surgical Operation and Induced Thyroid Hormone Deficiency During Cancer Treatment on Emotional Distress in Thyroid Cancer Patients (갑상샘암 환자에서 수술 및 치료과정에서 유도된 갑상샘 호르몬 결핍이 정서적 스트레스에 미치는 영향)

  • Kim, Jong Sun;Choi, Won-Jung;Chang, Hang-Seok;Lee, Yong Sang;Oh, Young-Ja;Seok, Jeong-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.75-81
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    • 2012
  • Objectives : Thyroid cancer patients may experience emotional distress during cancer treatment including surgical operation and radioactive iodine treatment. The aims of this prospective study were to investigate changes of anxiety and depressive symptoms in patients with differentiated thyroid cancer(DTC) under preoperative, postoperative and short-term hypothyroidism state. Methods : Using the Hospital Anxiety and Depression scale(HAD) and the Distress Thermometer, we sequentially assessed the levels of anxiety, depression and distress in 41 DTC patients at 3 time points such as preoperative state, postoperative state and short-term hypothyroidism state. Results : The HAD-anxiety score was significantly higher in preoperative state($6.93{\pm}3.97$) than postoperative state($4.22{\pm}2.92$) and short-term hypothyroidism state($4.93{\pm}3.64$). Any other significant change in depression or distress thermometer score was not observed. Especially, difference of HADS score between the distress and none-distress groups was significant in preoperative state and post-operative state, but the difference become not significant in the short-term hypothyroidism state. Conclusions : Induced thyroid hormone deficiency during cancer treatment does not significantly affect emotional distress in patient with DTC. Anxiety and depression in these patients may be associated with distress of the patient before active cancer treatment.

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Hypocalcemic Tetany in a 10-year Old Boy: A Case of Pseudohypoparathyroidism Type 1b due to Paternal Uniparental Disomy (간헐적 강직을 주소로 내원한 저칼슘혈증 10세 남아: 부계 단친성 이염색체로 인한 가성부갑상샘기능저하증 1b형 증례)

  • Yoo, Byung Min;Kim, Mijin;Ko, Jung Min;Kang, Min Jae
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.2
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    • pp.44-49
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    • 2020
  • Pseudohypoparathyroidism (PHP) is a disorder characterized by hypocalcemia and hyperphosphatemia due to end organ resistance to parathyroid hormone. PHP is caused by the deficiency of the α-subunit of the stimulatory G protein encoded by the GNAS gene, and this defect arises from genetic or imprinting disturbances. Sporadic PHP 1b shows two or more methylation defects of upstream of GNAS gene and some of them lead to loss of maternal GNAS imprints, therefore, only paternally derived GNAS gene is expressed. Here, we report a 10 year 9 month old boy presented with intermittent tetany who was finally diagnosed with PHP 1b caused by paternal uniparental disomy of chromosome 20q.

Endocrine dysfunction after bone marrow transplantation during childhood and adolescence (소아 및 청소년기에서 골수이식 후에 발생할 수 있는 내분비 기능 부전)

  • Jin, Hye Young;Choi, Jin-Ho;Im, Ho-Joon;Seo, Jong-Jin;Moon, Hyung-Nam;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.420-427
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    • 2010
  • Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

Hypoparathyroidism in a diabetic dog (당뇨병 이환견에서 발생한 부갑상샘기능저하증 증례)

  • Lee, Hye-Jin;Lim, Soo-Jung;Lee, Sun-Hee;Song, Eun-Sik;Song, Kun-Ho
    • Korean Journal of Veterinary Research
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    • v.49 no.4
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    • pp.355-359
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    • 2009
  • A miniature schnauzer (8 years old, male castrated), diagnosed as diabetes mellitus 6 months ahead, were referred to the Veterinary Medical Teaching Hospital of our University with hindlimb stiffness, facial rubbing and tetany. Serum chemistry showed severe hypocalcemia, hypomagnesemia, and measured iPTH (intact pharathyroid hormone) concentration was low (< 3.0 pmol/L). Consistent rate injection of calcium gluconate (282 mg/kg over 30 min) resulted in prompt relief of the tetany. Then typical treatment for hypoparathyroidism (calcium gluconate and dihydrotachysterol per os) with magnesium administration could control the neuromuscular signs. Diabetes mellitus is being controlled by insulin therapy and prescription diet. Hypomagnesemia in diabetic dog may be induced hypoparathyrodism.

Effects of Bupleuri Radix on the Rat Hypothyroidism Induced by PTU (6-n-propyl-2-thiouracil) (시호가 PTU (6-n-propyl-2-thiouracil)로 유발된 Rat 갑상샘 기능저하증에 미치는 영향)

  • Kim, Seong Mo;Ku, Sae Kwang;Cho, Su Yeon;Park, Soo Jin
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.5
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    • pp.714-723
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    • 2012
  • The object of this study was to evaluate the effect of Bupleuri Radix, aqueous extracts of the root part of Bupleurum falcatum on the 6-n-propyl-2-thiouracil (PTU)-induced rat hypothyroidism. Aqueous extracts of Bupleuri Radix (BR; yield = 11.73%) were administered, once day for 42 days from 2 weeks before start of PTU treatment as an oral dose of 300 and 150 mg/kg (body weight), and hypothyroidism was induced by daily subcutaneous treatment of PTU 10 mg/kg for 28 days. The changes on the body weight, thyroid gland weights, serum thyroid hormone - thyroid stimulating hormone (TSH), triiodothyronine ($T_3$) and thyroxine ($T_4$), serum lipid profiles - total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride, liver antioxidant defense system - lipid peroxidation, $H_2O_2$, superoxide dismutase (SOD) and catalase (CAT), serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were observed with histopathology of thyroid glands. Results were compared with $LevoT_4$ 0.5 mg/kg treated rats. As results of PTU treatment, marked decreases of body weights, triglyceride contents, liver CAT activities and changes of serum thyroid hormone levels were observed with increases of serum AST, HDL contents, liver $H_2O_2$ and SOD activities and thyroid gland weight. In addition, marked hyperplasia of follicular cells with decreases of follicular colloid contents and sizes were demonstrated at histopathological inspections. However, these PTU induced hypothyroidism were dose-dependently inhibited by treatment of BR extracts, and BR extracts effectively regulated the hypothyroidism related changes on the antioxidant defense system. The results obtained in this study suggest that BR extracts have favorable effects on the thyroid hormone productions with beneficial effects on the hypothyroidism mediated by the modulatory effects on the antioxidant defense system.

Effects of Lonicerae Flos on the 6-n-propyl-2-thiouracil (PTU)-induced Rat Hypothyroidism (금은화가 6-n-propyl-2-thiouracil (PTU) 로 유발된 흰쥐의 갑상샘 기능저하증에 미치는 영향)

  • Ku, Sae-Kwang;Lee, Young-Joon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.4
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    • pp.630-637
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    • 2010
  • The object of this study was to evaluate the effect of Lonicerae Flos, aqueous extracts of the dried flower bud part of Lonicera japonica on the 6-n-propyl-2-thiouracil (PTU)-induced rat hypothyroidism. Aqueous extracts of Lonicerae Flos (LF yield = 23.80%) were administered, once day for 42 days from 2 weeks before start of PTU treatment as an oral dose of 500 and 250 mg/kg (body weight), and hypothyroidism was induced by daily subcutaneous treatment of PTU 10 mg/kg for 28 days. The changes on the body weight, thyroid gland weights, serum thyroid hormone - thyroid stimulating hormone (TSH), tri-iodothyronine ($T_3$) and thyroxine ($T_4$), serum lipid profiles - total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride were observed with liver antioxidant defense system - lipid peroxidation, $H_2O_2$, superoxide dismutase (SOD) and catalase (CAT) and serum asparte aminotransferase (AST) and alanine aminotransferase (ALT) analysis. Results were compared with Levothyroxine ($LT_4$) 0.5 mg/kg treated rats. As results of PTU treatment, marked decreases of body weights, serum thyroid hormone levels and triglyceride contents, liver $H_2O_2_3$ and SOD activities were observed with increases of serum AST and HDL contents, liver CAT activities, thyroid gland weight. However, these PTU induced hypothyroidism were dose-dependently inhibited by treatment of LF extracts, and LF extracts effectively regulated the hypothyroidism related changes on the antioxidant defense system. The results obtained in this study suggest that LF extracts have favorable effects on the thyroid hormone productions with beneficial effects on the hypothyroidism mediated by the modulatory effects on the antioxidant defense system.