• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.39-47
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• 1969

A clinical analysis was made on 161 cases of hyperthyroidism seen at the Radioisotope Laboratory of Kyungpook National University Hospital. This series consisted of 144 cases of diffuse goiter and 17 cases of nodular goiter. 1) Hyperthyroidism was most prevalent in the 4th decade and male to female ratio was 1:4.6. 2) Cardinal symptoms in the order of frequency were weakness, easy fatigability, palpitation, weight loss, nervousness, perspiration, heat intolerance, increased appetite, insomnia and dysmenorrhea. 3) Major physical findings in the order of frequency were goiter, fine tremor, tachycardia, wide pulse pressure, emaciation, warm moist skin, exophthalmos, systolic hypertension and atrial fibrillation. 4) The complications were ophthalmopathy (34.2%), thyrotoxic heart disease (5.6%), thyroid crisis (1 case), pretibial myxedema (1 case) and thyrotoxic myopathy (1 case). 5) Mean values of the six hour and twenty-four hour $^{131}I$ uptakes by the thyroid glands were 67.5% and 71.6%, respectively, in diffuse goiter and 64.5% and 65.0%, respectively, in nodular goiter. 6) Mean values of twenty-four hour $PB^{131}I$ conversion ratio were 76.3% in diffuse goiter and 70.2% in nodular goiter and those of the basal metabolic rate was +51% in the former and +41% in the latter. Mean serum cholesterol level was 152mg% in diffuse goiter and that in nodular goiter was 175mg%. 7) Among the 134 cases treated with $^{131}I$, 66 cases (49.3%) were successful1y controlled with single dose and in the majority of the cases the initial therapeutic dose required was $4.1{\sim}5.0mC$ in diffuse goiter and $5.1{\sim}6.0mC$ in nodular goiter. 8) With $^{131}I$ treatment the symptoms improved in the following order: heat intolerance, emaciation, nervousness, insomnia, easy fatigability, weakness, fine tremor, goiter, perspiration, exertional dyspnea and palpitation. And in a few cases improvement of even exophthalmos was seen. 9) Following $^{131}I$ treatment myxedema occurred in 4 cases (3%) and reccurrence in 9 cases (6.8%).

• The Korean Journal of Cytopathology
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• v.9 no.1
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• pp.69-78
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• 1998

There is a lot of difficulty in the diagnosis of follicular lesions of the thyroid by fine needle aspiration cytology(FNAC). The main purpose of this report is offering more guidance regarding the cytologic appearance to distinguish follicular neoplasm from nodular golfer and laying stress on the presence of mixed group. The histologic and cytologic findings of 23 follicular neoplasms and 13 nodular (adenomatous) getters were reviewed. Histologic specimens were classified into the microfollicular(MIF), mixed(MIX), and nodular getter(NG) groups. The comparison of histologic patterns with histologic diagnosis revealed that all the lesions with predominantly microfollicular, trabecular, or solid pattern were follicular carcinoma and all the lesions with predominantly macrofollicular pattern were nodular goiter. The distinguishing cytologic features for the MIF group were irregular cell arrangement in cell groups(100%, p=0.00001), absence of atrophic follicular cells(100%, p=0.0007), abundant microfollicles(100%, 0=0.002), pleomorphic nuclei(100%, p=0.002), not predominant syncytial smear pattern(100%, p=0.002), heterochromatin(100%, p=0.032), absence of macrofollicles(100%, p=0.038), scant colloid(100%, 0=0.04), clear back-ground(83%, p=0.00006), and uniform sized follicles(83%, p=0.014). And regular cell arrangement(honeycomb appearance) in cell groups(85%, p=0.0000), atrophic change of follicular cells(69%, p=0.0002), syncytial smear pattern(54%, p=0.000), monomorphic nuclei(85%, p=0.008), and hemorrhagic background(100%, p=0.027) were characteristic features of the NG group. Seventeen out of 36 cases(47%) were the MIX group composed of combined cytologic features of the MIF and NG groups. Therefore the frequent presence of the MIX group is considered to be main cause of the difficulty in the diagnosis of follicular lesions by FNAC. The mixed morphologic feature may support the hypothesis of a biologic 'continuum' between nodular goiter and follicular neoplasm of thyroid gland.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2321-2323
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• 2016

Background: Inflammatory hematological parameters like the neutrophil/lymphocyte (N/L) ratio have been investigated in many cancer types and significant relationships found with prognosis, for example. The aim of this present study was to investigate the impact of hematological parameters notably on N/L ratio and mean platelet volume (MPV) in papillary thyroid cancer cases. Materials and Methods: A total of 79 patients who underwent a thyroidectomy operation in Findikli, Goiter Research and Treatment Center during 2011-2015 period were enrolled in the study, 41 with papillary thyroid cancer and 38 with benign goiter confirmed by pathological examination. We collected clinical and laboratory data for the patients from hospital records retrospectively. Blood samples taken at admission were assessed for parameters compared between the groups. Results: No significant differences between papillary thyroid cancer and benign goiter groups were apparent in terms of age, the N/L ratio, MPV, white blood cell count (WBC), red blood cell count (RBC), hemoglobin, hematocrit, platelet, neutrophil, lymphocyte, red blood cell distribution width (RDW) and platelet crit (PCT) levels (p>0.05). Only the level of platelet distribution width (PDW) significantly differed, being lower in the papillary cancer group (p<0.05). Conclusions: No significant relationship between papillary thyroid cancer and inflammatory hematological parameters including in particular the N/L ratio and MPV. The relevance of the PDW values remains unclear.

• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.33-38
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• 1969

The serum thyroxine levels were measured by method of Tetrasorb Kit in 69 subjects including 13 subjects in euthyroid state, 31 with hyperthyroidism, 5 with hypothyroidism, 13 with nontoxic diffuse goiter, and 7 with nontoxic nodular goiter. Three parameters of the thyroid function test including thyroxine ($T_4$) levels, $^{131}I$ uptake (24 hrs) values and $PB^{131}I$ conversion ratio were correlated with clinical manifestations and courses of the disease. 1. The serum $T_4$ levels in the normal subjects were in range of $6.0{\mu}g/dl\;to\;14.4{\mu}g/dl$. (The mean $9.4{\mu}g/dl$). 2. The diagnostic compatibility of the serum $T_4$ was 93.5% in hyperthyroidism, 100% both in hypothyroidism and in nontoxic diffuse goiter, 86% in nontoxic nodular goiter, or 95.8% in the entire series. (Table 1). 3. The diagnostic compatibility of $^{131}I$ uptake (24 hrs) values and $PB^{131}I$ conversion ratio were less than the serum $T_4$ levels as summarized in Tables 2 & 3. The serum $T_4$ determination by Tetrasorb Kit is a simple, accurate and very useful test of the thyroid function.

• The Korean Journal of Nuclear Medicine
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• v.2 no.1
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• pp.1-7
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• 1968

Presented here are the results for clinical study on 65 cases of simple goiter the author treated during the period of 4 years and 10 months from Jan. 1963 through Oct. 1967 at the Seoul National University Hospital and Han-Il Hospital. It had been customary to classify simple goiter, according to the gross morphological characteristics of the thyroid gland, as diffuse and nodular type. This paper attempts to investigate the histopathological changes and treatment of simple goiter respectively. Sixty five cases of simple goiter were classified into 4 types; namely degenerative type was 20 cases (30.8%), proliferative type was 7 cases (10..8%), colloidal type was 24 cases (36.9%) and cyst formation with degeneration was 14 cases (21.5%), on the basis of histopathological findings. Thus, it is essential that simple goiter should be differentiated from thyroid tumors as soon as practicable. The effectiveness of medical treatment with desicated thyroid and autohemotherapy for certain simple goiter are also discussed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5565-5570
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• 2014

Objectives: This study aimed to characterize the histopathological pattern of thyroid lesions among Saudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from thyroid specimens received at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: The 292 thyroidectomy specimens received during the study period came from 230 (78.8%) females and 62 (21.2%) males giving a female: male ratio of 3.7:1. Age of the patients ranged from 14 to 95 years with a mean age 39.7 years. Two hundred and eleven (72.3%) cases were found to be non-neoplastic and 81 (27.7%) cases were neoplastic. The non-neoplastic group included: colloid goiter, including both diffuse and nodular goiter (170 cases; 58.2%), nodular hyperplasia (28 cases; 9.6%), Hashimoto/chronic lymphocytic thyroiditis (12 cases; 4.1%), and Grave's disease (1 case; 0.3%). In neoplastic lesions, there were 7 benign tumors and 74 malignant tumors. Among the benign tumors, 5 were follicular adenomas and 2 were Hurthle cell adenomas. Papillary carcinoma was the commonest malignant tumor accounting for 87.8% of all thyroid malignancies, followed by lymphoma, follicular carcinoma and medullary carcinoma. The size of papillary carcinoma was more than 2 cm in 40 cases (76.9%). Conclusions: Non-neoplastic thyroid lesions were more common than neoplastic ones. Colloid goiter was the most common lesion. Follicular adenoma was the commonest benign tumor and papillary carcinoma was the commonest malignant lesion. There appears to be a slightly increased trend of papillary carcinoma diagnosis, most being diagnosed at an advanced stage.

• The Korean Journal of Nuclear Medicine
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• v.3 no.1
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• pp.51-58
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• 1969

To clarify the hematologic effects of the radioiodine ($^{131}I$) in therapeutic doses ($5{\sim}10$ mCi) on the various thyroid patients, authors studied the peripheral blood pictures of 396 goitrous patients before and after radioiodine ($^{131}I$) administrations in the Isotope Clinic of Seoul National University Hospital. Among these 396 cases of goiters, we gave 5 to 10 mCi of radioiodine ($^{131}I$) with single or fractionated administrations. The blood pictures of peripheral blood were repeated after 3 months in 40 cases of 65 cases who had been treated with $^{131}I$. The blood pictures of non-treated thyroid patients were compared with that of normal Korean values to clarify any difference between normal and goiter. The blood pictures of hyperthyroid patients treated with $^{131}I$ therapy were compared with the blood pictures of non-treated thyroid patients. The results were as following: 1) The incidence according to type: Toxic diffuse goiter: 35.4% Nontoxic nodular goiter: 29.7% Euthyroid: 13.8% Nontoxic diffuse goiter: 12.6% Hypothyroidism: 4.3% Thyroiditis($\bar{s}$ subacute form): 1.8% Toxic nodular goiter: 1.4% Malignancy: 1.0% 2) Age incidence: The range of distribution was 11 to 71 years. The peak incidence was found in the 4th decade of life. $80.6{\sim}82.6%$ of those 396 cases were found among the 3rd, 4th and the 5th decades of life. 3) Sex incidence: Sex ratio of male:female was 1:7.8. 4) The most outstanding findings in peripheral blood before treatment were decreased erythrocyte count and hemoglobin value in all types of thyroid diseases, especially in. the cases of hypothyroidism and thyroiditis. Hook worm-infested patients showed no significant difference in erythrocytes and hemoglobin values from those of other hook worm free patients. 5) Total leukocytes count was within normal range. Differential count of W.B.C. showed increased percentile of lymphocyte in diffuse toxic goiter and thyroiditis. 6) 39 cases of diffuse goiter treated with $^{131}I$ toxic showed amelioration in the anemia and restoration to normal range of lymphocyte count in association with increased percentile of neutrophiles 3 months after administration, except a case of toxic nodular goiter. One can observe anemia in slight degree, and increased lymphocytes count in hypothyroidism. Therapeutic dose of radioiodine ($^{131}I$) does not result any residual effect on the hematopoietic function. Radioiodine ($^{131}I$) therapy resulted in improvement of thyroid function in association of amelioration of pevious abnormal blood pictures. 7) Authors did not observe any myxedema resulted from radioiodine therapy during the 3 months period in this study.

• The Korean Journal of Nuclear Medicine
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• v.16 no.1
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• pp.41-48
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• 1982

113 patients with nodular goiter were studied cytologically by needle aspiration for differential diagnosis at the department of internal medicine, Chung Nam National University Hospital since October 1980 till July 1981, and the final diagnosis taken from biopsies were compared with the cytologic method on the 44 cases who received operation. The results were obtained as follows: 1. Among the 113 cases of total patients, male were 15 cases (13.3%) and female were 98 cases (86.7%) and the sex ratio (M:F) was 1 : 6.5. The peak age incidence was in the third decade followed by forth and second decades. 2. The findings of cytological diagnosis in 113 cases showed benign adenoma in 69 cases (61.1 %), Subacute and chronic thyroiditis in 22 cases(19.5%), papillary carcinoma in 15 cases (13.3%) and follicular carcinoma in 7 cases (6.2%), respectively, and 48 cases (69.6%) of the.adenomas and 2 cases(9.1%) of papillary carcinomas showed combined cystic degeneration of the nodules. 3. The diameter of the nodules by palpation revealed within $2\sim5cm$ in 88 cases (77.9%) out of 113 cases, below 2 cm in 17 cases and over 5cm in 8 cases and there were no significant relationship between the size of the nodule and disease entity. 4. The findings of thyroid scintigram using $^{131}I$ in 113 cases of nodular goiter showed "cold nodule" in 111 cases (98.2%) and normal scan (radioactivity) in 2 cases (1.8%) which showed adenoma in cytology and there was no cases with "hot nodule". 5. The thyroid functions of the 113 cases revealed as euthyroidism in 108 cases (95. 6%), hypothyroidism in 2 cases (1.8%) who showed chronic thyroiditis and hyperthyroidism in 3 cases (2.7%) in adenomas but there was no evidence that the nodules of the above 3 cases were the reason of hyperthyroidism. 6. In 44 operated cases, the histological diagnosis revealed 23 cases of adenoma out of 27 cases(85.2%) who were diagnosed as adenoma by cytology and 15 cases of malignancy out of 17 cases (88.2 %), and the overall diagnostic accuracy of aspiration cytology was 86.4 %.

• The Korean Journal of Nuclear Medicine
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• v.1 no.1
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• pp.67-78
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• 1967

Over the past 6 years, from May 1960 to June 1966, 1,716 patients with various diseases of thyroid were examined and thyroid function tests with $^{131}I$ were done. Among them, 545 patients with hyperthyroidism were treated with $^{131}I$. A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ were presented and discussed. 1. The patients examined consisted of; 596 cases(34.7%) with toxic diffuse goiter, 412 cases(24.0%) with non-toxic nodular goiter, 278 cases(16.2%) with euthyroidism, 236 cases(13.8%) with non-toxic diffuse goiter, 89 cases(5.2%) with hypothyroidism, 53 cases(3.1%) with toxic nodular goiter, 32 cases(1.9%) with thyroiditis and 20 cases(1.2%) with dyshormonogenesis. 2. There were 218(12.7%) male patients and 1,498(87.3%) female patients, showing a ratio of 1:6.9. female predominantly. 3. The majority of patients(79.6%) were in the 3rd through 5th decades of their lives showing the peak in the 4th decades(35.9%). 4. The diagnostic values and normal ranges of $^{131}I$ uptake test, 48 hour serum activity, $T_3$ red blood cell uptake and $PB^{131}I$ conversion ratio were discussed. 5. An attention was given to dyshormonogenesis, a qualitative hypothyroidism, due to its characteristic findings of clinical and $^{131}I$ thyroid function tests, and its pathogenesis was briefly reviewed. 6. Among 545 patients with hyperthyroidism treated with $^{131}I$, 68.3% was cured after single. therapeutic dose and another 24.0% was cured after second dose. 7. The complications of $^{131}I$ therapy were discussed in some details and myxedema had developed. in 3.9% of our cases. No thyroid cancer was found after $^{131}I$ therapy.

• The Korean Journal of Nuclear Medicine
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• v.4 no.2
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• pp.29-39
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• 1970

A summary of the clinical data of the $^{131}I$-thyroid function tests and the therapeutic results of $^{131}I$ among the 2,658 patients of various thyroid diseases treated over the past 10 years from May 1960 to Oct. 1969 at the Radioisotope Clinic and Laboratory, SNUH were presented and dscussed. 1. The patients examined consisted of: 929 cases (34.9%) of diffuse toxic goiter, 762 cases (28.7%) of diffuse nontoxic goiter, 699 cases (26.3%) of nodular nontoxic goiter, 58 cases (2.2%) of nodular toxic goiter and 210. cases (7.9%) of hypothyroidism. 2. There were 300 (11.4%) male and 2358 (88.6%) female, showing a ratio of 1:8. 3. The majority of patients (79.1%) were in the 3rd-5th decades of their lives. 4. The normal ranges, diagonstic values of $^{131}I$ uptake test, 48 hrs, serum activity, BMR and main subjective symptoms of various thyroid diseases were discussed. 5. In the 579 patients among 867 cases with hyperthyroidism treated with $^{131}I$, 47.8% were confirmed to be cured completely after single therapeutic doses. 6. The complications of $^{131}I$ therapy were discussed and myxedema had developed in 6.75% of our patients. 7. The results of $^{131}I$ thyroid function tests were analysed among the 160 cases of thyroid diseases which were confirmed the diagnosis with histopathological measures.