• The Korean Journal of Nuclear Medicine
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• v.7 no.1
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• pp.15-29
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• 1973

To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: 1. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7.6% of the patients were male and 92.4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91.3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight loss, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyspnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid ?unction tests was as follows; $T_7$ was 92.4% reliable, $^{125}IT_3$ resin uptake rate 91.6% reliable, $^{131}I$ thyroid uptake rate in 24 hrs. 89.4% reliable, serum $T_4$ level 85.9% reliable and BMR 75.5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthyroidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical signs but a high BMR was associated with both tachycardia and systolic murmur.

• The Korean Journal of Nuclear Medicine
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• v.15 no.2
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• pp.43-51
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• 1981

In an attempt to evaluate the diagnostic significance of the serum thyroxine binding globulin (TBG) in various thyroid disease states, the authors measured serum $T_3$ uptake, $T_3$, total $T_4\;free\;T_4$, TSH and TBG by radioimmunoassay technique, and calculated the free $T_4$ index$(FT_4I)$ and $T_4/TBG$ ratio in 10 cases of normal subjects, 11 cases of hypothyroidism, 62 cases of euthyroidism and 37 cases of hyperthyroidism. The data were analysed in the aspects of diagnostic significance in each thyroid disease state, and the results were as follows; 1. In 10 cases of normal subjects, serum TBG was $17.4\sim26.8{\mu}g/ml$, $FT_4I$ was $5.1\sim9.7$, and $T_4/TBG$ ratio was $21.9\sim49.9(Mean{\pm}S.D.)$. 2. In 62 cases of euthyroidism with diffuse and nodular goiter, $FT_4I$ was $7.26{\pm}1.82,\;T_4/TBG$ ratio was $31.47{\pm}10.42$, and there were no significant difference from those of normal subjects (p>0.5). 3. In 11 cases of hypothyroidism, the $FT_4I$ was $3.13{\pm}2.15,\;T_4/TBG$ ratio was $11.3{\pm}5.31$, significantly lower than normal controls (p<0.01). 4. In 37 cases of hyperthyroidism, the $FT_4I$ was $30.0{\pm}12.0,\;T_4/TBG$ ratio was $121.4{\pm}62.2$, significantly higher than normal controls (p<0.01). 5. There were significant correlations between the $FT_4I$ and $T_4/TBG$ ratio, total $T_4\;and\;T_4/TBG$ ratio, in each thyroid function states. 6. The $FT_4I$ showed 100% of diagnostic value in hyperthyroidism, 89.2% in euthyroidism, and 80% in hypothyroidism group. The $T_4/TBG$ ratio showed 100% of diagnostic value in hyperthyroidism and hypothyroidism, and 80.6% in euthyroidism group. The above results suggest that $T_4/TBG$ ratio and $FT_4I$ showed same diagnostic value in hyperthyroidism group, but $T_4/TBG$ showed higher diagnostic significance than $FT_4I$ in hypothyroidism.

• The Korean Journal of Nuclear Medicine
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• v.14 no.2
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• pp.45-51
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• 1980

In an attempt to evaluate the diagnostic significance of the serum thyroid hormones in various thyroid function states, the author measured serum $T_3$ uptake, serum $T_3$, serum $T_4$, serum free $T_4$ and free $T_3$ index in 27 cases of normal subjects, 11 cases of hypothyroidism, 152 cases of euthyroidism and 81 cases of hyperthyroidism by the radioimmunoassay method. The results were as follows: 1. The ranges of serum thyroid hormones in normal subjects were, serum $T_3$ uptake; $27.4{\sim}42.1%$, serum $T_3;\;93{\sim}245ng/dl$, serum $T_4;\;4.08{\sim}12.9ug/dl$ and serum free $T_4;\;0.57{\sim}1.53ng/dl(M{\pm}2S.D.)$. 2. Free $T_4$ index and serum $T_4$ show relatively high diagnostic value in euthyroidism group, and serum $T_3\;and\;T_4$ in hypothyroidism group, while serum $T_3$, free $T_4\;and\;T_4$ show relatively high diagnostic value in hyperthyroidism group. 3. There were significant correlation between free $T_4$ index and serum $T_4$(r=0.68), and between free $T_4$ index and serum free $T_4$(r=0.67) in hyperthyroidism group.

• The Korean Journal of Nuclear Medicine
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• v.14 no.1
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• pp.17-21
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• 1980

TRH stimulation tests and $T_3$ suppression tests were done in 13 patients with clinically suspected mild or early hyperthyroidism who were all conventional thyroid function tests gave results within the accepted normal range. The results were as follows 1. 6 patients with normal $T_3$ suppression test revealed normal TRH stimulation test and could be easily diagnosed as euthyroidism. 2. 7 patients with abnormal $T_3$ suppression test exhibited no TSH response to TRH stimulation test and could be easily diagnosed as hyperthyroidism. The TRH stimulation test is a single, sensitive and reliable test of thyroid function and can well replace $T_3$ suppression test in the diagnosis of marginal hyperthyroidism.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.60-64
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• 2002

Objectives: Three classic treatment modalities have been used to treat Graves' disease: antithyroid medication, radioiodine ablation, and subtotal thyroidectomy. Postoperative thyroid functions were studied in patients with Graves' disease treated by subtotal thyroidectomy to evaluate the superiority of surgical treatment. Materials and Methods: One hundred fourty patients of Graves' disease were analysed retrospectively in follow-up for more than three years following subtotal thyroidectomy. Postoperative serum levels of $T_3,\;T_4, TSH, TSH-R Ab, free $T_4$, were evaluated to watch hypo- or hyperthyroidsm. Results: In the evaluation of preop- and postoperative thyroid function after three years of subtotal thyroidectomy, $T_3$ was changed from $464.10{\pm}196.16ng/dl$ to $140.41{\pm}76.56ng/dl$ in mean value, $T_4$ was changed from $20.76{\pm}7.98{\mu}g/dl$ to $9.54{\pm}4.02{\mu}g/dl$, $TSHT_3$ was changed from $0.55{\pm}4.42{\mu}u/ml$ to $4.96{\pm}7.20{\mu}u/ml$, TSH-R Ab was changed from $41.6{\pm}28.27%$ to $28.7{\pm}28.79%$ and free $T_4$ was changed from $4.45{\pm}2.33ng/dl$ to $1.44{\pm}0.69ng/dl$ in mean value. Euthyroidism was noted in 118 patients(84.3%), overt hyperthyroidism in 6 patiens(4.3%), latent hyperthyroidism in 8 patients(5.7%), overt hypothyroidism in 2 patint(1.4%), and latent hypothyroidism in 6 patients(4.3%). Of surgical complications, permanant hypoparathyroidism was found in one patient, recurrent laryngeal nerve injury in two patients, postoprative bleeding with reoperation in two patients, and death in one patient. Conclusion: The thyroid function after subtotal thyroidectomy in diffuse toxic goiter is normal level (euthyroidism) in 84.3% and low recurrence rate of hyperthyroidism is showed with rare surgical complication. Therefore, subtotal thyroidectomy in diffuse toxic goiter is more effective and safe than RI or longterm ATD treatment, if the operation is performed by skillful surgeon.

• The Korean Journal of Nuclear Medicine
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• v.17 no.1
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• pp.17-23
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• 1983

In an attempt to evaluate the diagnostic singnificance of the serum thyroglobulin (TG) in various thyroid disease states, authors measured serum TG by radioimmunoassay technique in 20 cases of normal subject, 22 cases of hyperthyroidism, 12 cases of diffuse nontoxic goiter (DNG) and 96 cases of nodular nontoxic goiter(NNG). The results were as follows: 1. In 20 cases of normal subjects, serum TG level was $20.41{\pm}5.5ng/ml(M{\pm}S.D.)$. There was no significant difference between males ans females. 2. In 22 cases of hyperthyroidism, serum TG level was $60.23{\pm}34.56ng/ml$ and the range was from 22 to 175 ng/ml, which were significantly high levels comparing with normal controls (p<0.01). 3. In 12 cases of euthyroidism with DNG, serum TG was $37.28{\pm}27.36ng/ml$ and the range was from 14 to 89 ng/ml. In 96 cases of euthyroidism with NNG, serum TG was $70.43{\pm}78.18ng/ml$ and the range was from 12.8 to 440 ng/ml. Both groups showed significantly increased levels of TG than normal control (p<0.01). 4. 57 cases of NNG patients were analysed pathologically by operation or needle biopsy and the TG level of each disease group is as follows. Thyroid carcinoma (16 cases); $72.2{\pm}81.71ng/ml$, adenomatous goiter without cystic degeneration (15 cases); $74.86{\pm}45.64ng/ml(M{\pm}S.D.)$ and adenomatous goiter with cystic degeneration(23 cases); $73.56{\pm}64.78ng/ml(M{\pm}S.D.)$. There was no significant difference between each group. Also the TG levels of thyroiditis (5 cases) was $19.6{\pm}8.96ng/ml(M{\pm}S.D.)$. 5. There were no significant correlations between serum thyroid hormones and serum TG in each thyroid functional states.

• The Korean Journal of Nuclear Medicine
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• v.9 no.1
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• pp.31-43
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• 1975

In an attempt to establish the diagnostic value of serum triiodothyronine and to correlate it with pathophysiologic mechanisms of thyroid hormones in various thyroid disorders, the author measured the serum triiodothyronine levels by means of radioimmunoassay and compared them with other thyroid function tests. This study was carried out in 152 cases with various thyroid functions; 28 cases as control, 51 cases of hyperthyroidism, 50 cases of euthyroidism and 23 cases of hypothyroidism. The results obtained were as follows: 1. The serum $T_3$ level in normal control group ranged between $131{\pm}34ng/dl$. 2. The serum $T_3$ levels ranged between $306{\pm}97ng/dl$ in hyperthyroidism $138{\pm}32ng/dl$ in euthyroidism and $60{\pm}27ng/dl$ in hypothyroidism. The significant differences between these groups were noted in this study. 3. In 5(9.9%) out of 51 cases with hyperthyoidism and 9(39.1%) of 23 cases with hypothyroidism, the serum $T_3$ were measured to be in normal range. Accordingly, the diagnostic value of the measurement of serum $T_3$ with hyperthyroidism was justifiable, but with hypothyroidism, it was less creditable than that of serum thyrotropin. 4. There was little significant difference between the diagnostic value of serum thyroxine and triiodthyronine levels in various thyroid disorders. However, $T_4/T_3$ ratio was decreased in patients with untreated hyperthyroidism because of more elevation of $T_3\;than\;T_4$. Consequently, the serum $T_3$ was more sensitive than $T_3$ in some thyroid disorders. 5. The serum $T_3$ level was much more sensitive and showed prompt shift in its level during the course of treatment on the patient with various thyroid disorders. And the measurement of serum $T_3$ was a good index for the evaluation of the thyroid function. From these results obtained, the measurement of serum $T_3$ by means of radioimmunoassay is a good way to understand the status of thyroid function with various thyroid disorders and evaluate the effects of the treatment given on these patients.

• Korean Journal of Veterinary Research
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• v.15 no.2
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• pp.251-257
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• 1975

In order to investigate the effects of high ambient temperature on the thyroid, a total of 50 rabbits (mean weight, 1,294g) reared under $7^{\circ}C$ were alloted to two groups. Rabbits in one group served as controls and the others, after reared under $30^{\circ}C$ for 16 days, were returned to the normal temperature for 16 days. The results obtained in this work were summerized as follows: 1. The weight of the thyroid gland was decreased severely from the 2nd day and increased to normal range on the 4th day after returned to normal temperature. 2. Thyroid follicles were atrophied significantly from the 1/2 day and then enlarged gradually from the 4th day, while their colloid substance also manifested poor staining, coagulation, and disappearence, being reappeared from the 8th day. 3. Hypertrophied follicular epithelial cells showed more enlarged size, degeneratien, necrosis, and mitosis from the 1/2 day in accordance with experimental term and those changes were diminished from the 8th day. 4. Histologically thyroid manifested-hypothyroidism on the 16th day but showed mild hyperthyroidism on the 2nd day and euthyroidism from the 4th day of returned roaring.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.743-748
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• 1993

Alterations in thyroid function test results are frequently seen in patients with nonthyroidal illness & correlate with the severity of the illness & prognosis. We studied thyroid hormone changes in 14 patients received cardiopulmonary bypass[CPB]. All patients were biochemical euthyroidism preoperatively. TSH[Thyroid Stimulating Hormone] level reached its nadir[0.46 $\pm$ 0.11 ulU/ml, P<0.0005] at 12 hours after the start of CPB & showed elevating pattern to the preoperative level thereafter. FT4[Free Thyroxine] reached to its nadir[10.16$\pm$ 1.17 pmol/L, P<0.01] at POD[Post Operative Day] #4 & reached to the preoperative level at POD #7. Mean serum TSH & FT4 concentration were within normal limits[P>0.25] during CPB & thereafter. TT3[Total Triiodothyronine] reached to its nadir[38.6 $\pm$ 8.4 ng/dl, P<0.001] at 30 minutes after the start of CPB & remained low[P<0.05] throughout the study period. The patients whose recovery was uneventful[Group I] had higher serum TSH, TT3 levels[P<0.05] than who had complications or died[Group II]. Group I showed the elevating pattern of TSH, TT3 at POD #4, but Group II failed to show such elevating pattern. In Group I, FT4 was within normal limits[P>0.5] throughout the study period, and also within normal limits[P>0.1] in Group II.

• The Korean Journal of Nuclear Medicine
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• v.17 no.1
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• pp.63-69
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• 1983

Fifteen cases of Korean hemorrhagic fever who were admitted Chungnam National University Hospital from October 1981 to December 1981 were analysed on the evaluation of metabolic.changes of the thyroid hormones, and thyroid function status in each clinical phase. 1. Serum $T_3,\;T_4$ concentratron, $FT_4I\;and\;T_4/TBG$ ratio were significantly lower (p<0.001, p<0.005, p<0.005, p<0.001, respectively) than control group in oliguric and early diuretic phase of Korean hemorrhagic fever. With the recovery of illness, abnormal thyroid hormones and thyroid function indices tend to become normal range. But Serum $FT_4$, TSH and TBG concentration were within normal range in all phase of KHF. Thus in Korean hemorrhagic fever, euthyroidism is probably maintained by normal or elevated serum $FT_4$ 2. $T_4/T_3\;and\;rT_3/T_3$ rato (p<0.005, p<0.005) were increased in oliguric and early diuretic phase of KHF. These results might be explained by decreased peripheral conversion of $T_4\;to\;T_3$ in oliguric and early diuretic phase.