• Title/Summary/Keyword: 갑상선 기능 검사

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A Case of Obstructive Sleep Apnea Syndrome Associated with Primary Hypothyroidism and Dilated Cardiomyopathy (원발성 갑상선 기능저하증과 확장형 심근증이 동반된 폐쇄성 수면무호흡증후군 1예)

  • Yu, Sung-Keun;Park, Ji-Young;Pack, Jong-Hae;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.590-596
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    • 2001
  • The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A-33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CP AP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardiomyopathy with review of the relevant literature.

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Investigation of aerodynamic evaluation in female patients undergoing thyroidectomy (갑상선절제술을 받은 여성 환자의 공기역학 검사변수 조사)

  • Kang, Young Ae;Kwon, In Sun;Won, Ho-Ryun;Chang, Jae Won;Koo, Bon Seok
    • Phonetics and Speech Sciences
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    • v.12 no.2
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    • pp.73-80
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    • 2020
  • Breathing is the voice's driving force and also acts as a regulator of larynx function and efficiency. Respiratory distress is a side effect of general anesthesia in thyroid surgery. Therefore, this study's objective was to provide practical and complementary information for voice recovery after thyroid surgery, based on aerodynamic evaluation pre- and post-thyroidectomy. From May 2014 to July 2015, aerodynamic evaluations were performed on 34 female patients diagnosed with thyroid papillary cancer one week before surgery (PRE), one month after surgery (P1), and three months after surgery (P3). The Phonatory Aerodynamic System (model 6600, KayPENTAX, USA) was employed for this purpose, and a total of 29 analysis parameters were selected. The results showed statistically significant differences in peak expiratory airflow (p=0.004), mean pitch (p<0.01), expiration airflow duration (p=0.001), and expiratory volume (p=0.018), based on time factors. In the comparison of time factors, peak expiratory airflow and mean pitch parameters were different in PRE-P1 and PRE-P3. Expiration airflow duration and expiratory volume parameters were different in PRE-P3 and P1-P3. The interaction effect of time and surgical range was significant only for expiratory volume (p=0.024). Female patients who undergo thyroidectomy require post-operative breathing training, and exhalation improvement is considered to reflect a positive lifestyle after surgery.

Clinical Correlation between the Autoimmune Thyroid Disease for the Thyroid Autoimmune Antibodies and the Maximum Standardized Uptake Value: Base on the Hashimoto's Thyroiditis and the Graves' Disease (자가 면역 갑상선 질환에 대한 최대 표준섭취계수와 갑상선 자가 항체의 임상적 상관관계: 하시모토 갑상선염과 그레이브스병 중심으로)

  • Woo, Minsun;Baek, Chulin;Yoo, Jueun;Song, Jongwoo;Im, Inchul;Son, Juchul;Cho, Soodong;Lee, Jaeseung
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.241-248
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    • 2014
  • The purpose of this study were to analyze the clinical correlation between the thyroid autoimmune antibodies (anti-TPO Ab, anti-TG Ab, and TSH) and the maximum standardized uptake value ($SUV_{max}$) base on the Hashimoto's thyroiditis and the Graves' disease in diffusely $^{18}F-FDG$ uptake of the thyroid gland to the PET/CT image. To achieve this, we was performed the PET/CT examination for the 1,097 subjects from May 2010 to April 2013 in the health screening, and was detected the diffused FDG thyroid uptake, and was additionally performed the thyroid function test (TFT) and the ultrasound (US). As a results, the autoimmune thyroid disease with the diffused FDG thyroid uptake were discovered 39 patients (3.9%), of this, the Hashimoto's thyroiditis was 43.6% and the Graves' disease was 23.1%. Hashimoto's thyroiditis was shown the positive reaction of high titer between the anti-TPO Ab and the anti-TG Ab level, and the correlation coefficient between the $SUV_{max}$ and the anti-TPO Ab was a statistically significant (r>04, p<0.05). Also, Graves' disease was shown the positive reaction of high titer most of the thyroid autoimmune antibodies, and the correlation coefficient between the $SUV_{max}$ and the anti-TPO Ab was a statistically significant (r>05, p<0.01). Therefor, when have a high standard of the $SUV_{max}$ due to the diffusely $^{18}F-FDG$ uptake of the thyroid gland, Hashimoto's thyroiditis and Graves' disease were proportionally increased the anti-TPO Ab and TSH level, respectively. The correlation coefficient between the $SUV_{max}$ and the thyroid autoimmune antibodies will be the most influential criterion that was a standard of judgment for the epihpenomenon of the autoimmune thyroid disease, and it will be available for the clinical application.

Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis (과도한 주간 졸림과 탈력발작을 주소로 내원한 환자에서 발견된 갑상선 중독증)

  • Chung, Jae-Kyung;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.40-44
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    • 2011
  • Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

Short-term follow up of thyroid function after pediatric hematopoietic stem cell transplantation (소아 조혈모세포이식 후 단기간 갑상선 기능의 변화)

  • Lee, Seon-Ju;Lee, Jae-Wook;Lee, Dae-Hyoung;Kwon, Young-Joo;Park, Young-Shil;Hwang, Hui Sung;Kim, Sun Young;Park, Ji Kyoung;Jang, Pil-Sang;Jung, Min-Ho;Chung, Nak-Gyun;Jeong, Dae-Chul;Cho, Bin;Kim, Hack-Ki;Lee, Byung-Churl
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1211-1215
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    • 2006
  • Purpose : In this study, we analyzed the short term changes of thyroid function, incidence and risk factors of thyroid dysfunction soon after allogeneic hematopoietic stem cell transplantation (HSCT) in children. Methods : We enrolled 80 pediatric patients following allogeneic HSCT, at the Catholic HSCT center between January, 2004 and February, 2006. Serum TSH (thyroid stimulating hormone), total serum thyroxine and total serum triiodothyronine levels were systematically measured in 80 patients before the HSCT, and at 1 month, 6 months and 12 months after HSCT. Results : Thyroid function statistically decreased at 1 month after HSCT(P<0.001). Thyroid dysfunction at 1 month was observed in 43 (54 percent) of 80 patients, 31 (39 percent) of whom presented with euthyroid sick syndrome (ETS). Thyroid dysfunction was normalized within 1 year after HSCT. In univariate analysis, malignant disease and the presence of acute graft-versus-host disease (grade ${\geq}II$) were risk factors for ETS (P=0.04, 0.01 respectively). In multivariate analysis, we could not detect an independent risk factor for ETS (P=0.19, 0.06 respectively). Conclusion : The present study suggests that the incidence of thyroid dysfunction is high after allogeneic HSCT. Therefore, regular monitoring of thyroid hormone levels after HSCT is required.

Analysis on the Occurrence Factors of High-Risk Diseases of Pregnant Women by the Degree of Obesity (산모의 비만정도에 따른 고위험 질환 발생요인 분석)

  • Kim, Su-Min;Ye, Soo-Young
    • Journal of the Institute of Convergence Signal Processing
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    • v.19 no.3
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    • pp.118-124
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    • 2018
  • Obecity in pregnancy causes many problems and increases risk of pregnancy complications at the time of childbirth. But there is a lack of comprehensive analysis of factors that are negatively affected during pregnancy. Therefore, this study is intended to analyze seven factors of high-risk maternal diseases by the degree of obesity using body mass index(BMI). We conducted a cross tabulation analysis and regression analysis to analisized relationship between variables : Gestational Hypertension(GH), Gestational Diabetes Mellitus(GDM), Thyroid Stimulation Hormone(TSH), Age, Blood Urea Nitrogen Test(BUN), Total-Cholesterol(T-C), and newborn's weight. As a result, the more the obesity level of mothers increases, the more the proportion of mothers with GH, GDM, TSH increases. And there was a positive relationship between the BMI of mothers and their age, T-C, and Newborn weight, and a negative relationship to the BUN.

The Effect of Increase in Length and Volume of Source in Radioactive Iodine Thyroid Uptake Rate (갑상선 섭취율 측정에서 선원의 길이와 부피 증가에 따른 영향)

  • Hwang, Dong Hun;Oh, Shin Hyun;Kim, Jung Yul;Kang, Chun Koo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.70-75
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    • 2017
  • Purpose Radioactive iodine thyroid uptake (RAIU) rate is an examination which determines and seeks about general functions of thyroid gland. The size of thyroid gland is normally different between each person, also patients having thyroid diseases have had a variety of size of thyroid gland compared with others. The purpose of this study will investigate about the counting rate which is effected by the geometric factors through the length and volume changes of the source in RAIU rate. Materials and Methods I-131 185 kBq ($5{\mu}Ci$) were placed in a cylindrical phantom of 0.5 cm, 1 cm, 1.5 cm, and 3 cm in diameter, respectively, and saline was added to gradually increase the length by 1 cm in the horizontal and vertical directions to give a change in volume. The source was measured 20 times for 20 seconds from a distance of 25 cm to $364.4keV{\pm}20%$ energy ROI with Captus 3000 thyroid uptake system (Capintec, NJ, USA). Results When the source was located in the transverse direction of the detector, the consequence of one-way ANOVA is that even though the length of source is increased each diameter, there is mostly no significant difference. When the source was located in the longitudinal direction and the counting rate of length 1 cm at all diameter is set to 100%, the average is 92.57% for length 2 cm, 86.1% for 3 cm, 80.69% for 4 cm, 74.82% for 5 cm, and 69.68% at 6 cm. Conclusion According to this study, it is expected that the gap of RAIU rate has been depended on the thickness of thyroid gland as well as the diameter of the beaker. We know that the change of the volume with the increase of the length of the source had less effect on the change of the counting rate. Thus, in order to reduce the error in the measurement of the counting rate with the thyroid uptake rate equipment, an accurate counting rate can be relatively measured if the counting rate which is measured is corrected by thickness or the distance between the thyroid and the thyroid uptake rate equipment is changed.

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Simultaneous Elevation of Serum Parathyroid Hormone(PTH) and Parathyroid Hormone-related Protein(PTHrP) in a Case of Lung Cancer with Hypercalcemia (고칼슘혈증을 보인 폐암환자에서 부갑상선호르몬(PTH)과 부갑상선호르몬관련단백질(PTHrP)이 동시에 증가된 1예)

  • Kim, Yu-Il;Kim, Kyu-Sik;Yu, Young-Kwon;Park, Chang-Min;Rim, Myung-Soo;Ko, Kyung-Haeng;Hwang, Jun-Hwa;Park, Hyeong-Kwan;Lim, Sung-Chul;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.525-532
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    • 1999
  • The parathyroid hormone related protein (PTHrP) is the most common causative peptide of humoral hypercalcemia of malignancy. In contrast, the serum level of parathyroid hormone (PTH) is low to undetectable in the majority of patients with malignancy associated hypercalcemia. Few cases exist in which the production and secretion of PTH by malignant nonparathyroid tumors have been authenticated. To our knowledge, there is very rare case in which a nonparathyroid tumor expressed simultaneously both the PTH and PTHrP. We report a case of squamous cell carcinoma of the lung with hypercalcemia which presented with simultaneous elevation of serum PTH and PTHrP. Severe hypercalcemia (serum calcium, 7.5 mEq/L) was found in a 65-year-old man who had a squamous cell carcinoma of the lung without any bony metastasis and detectable parathyroid abnormalities on isotope scintigraphy. The serum level of intact parathyroid hormone (PTH) con centration was markedly elevated as measured in two site radioimmunoreactive PTH assays (intact PTH 150 pg/mL ; normal 9~55). The serum level of a PTHrP was also increased as measured in C-terminal region specific radioimmunoassay (PTHrP 99.1 pmol/L; normal 13.8~55.3). There are no evidences of coincidental primary hyperparathyroidism in parathyroid MIBI scan and other imaging studies including neck ultrasonography and computed tomography. These results suggest that simultaneous elevation of serum PTH and PTHrP in this patient can be caused by production of both PTHrP and PTH in other nonparathyroid lesions such as squamous cell carcinoma.

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