• 한방비만학회지
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• 제6권2호
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• pp.29-41
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• 2006

Subclinical hypothyroidism is defined as a normal serum free thyroxine level combined with an elevated thyroid stimulating hormone level. The causes of subclinical hypothyroidism are the same as those of overt hypothyroidism. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. The management of subclinical hypothyroidism is remains controversial. Patients with a serum thyroid stimulating hormone level greater than 10 mU/L have a higher incidence of elevated serum low-density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that hormone treatment of subclinical hypothyroidism is beneficial. The use of thyroid stimulating hormone level lone as a diagnostic and assessment tool for hypothyroidism is inadequate because this test cannot identify numerous conditions this sentence is unclear in its meaning. Using an expanded list of clinical signs and symptoms associated with dysfunction of the Hypothalamus-Pituitary-Thyroid axis, it is possible to hypothesize that subclinical hypothyroidism may be more common in a population of patients with early signs of age-related diseases than most practitioners realize. To improve thyroid function in subclinical hypothyroidism patients, practitioners should become familiar with foods and nutrients that can hinder or support thyroid function.

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.127-130
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• 2014

Autoimmune thyroiditis is the most common cause of hypothyroidism in the world. It is characterized clinically by gradual thyroid failure, goiter formation, or both, because of the autoimmune-mediated destruction of the thyroid gland. Renal involvement presenting proteinuria in autoimmune thyroiditis is not uncommon, occurring in 10% to 30% of the cases. Glomerulonephropathy associated with autoimmune thyroiditis, however, is a rare disease. Most reports of autoimmune thyroiditis with glomerulonephropathy have demonstrated a mixed pathological morphology and have been predominantly associated with membranous glomerulopathy. The case of minimal-change disease associated with thyroiditis presenting acute kidney injury is a rare disease that has not been reported in South Korea. Reported herein is the case of a 16-year-old man diagnosed with Hashimoto's thyroiditis, with minimal-change disease presenting acute kidney injury. He revealed hypothyroidism, proteinuria, and impaired renal function. Renal biopsy showed minimal-change disease and minimal tubular atrophy. The patient was treated with thyroid hormone, and his renal function and proteinuria improved. Therefore, for patients with autoimmune thyroiditis presenting unexplained proteinuria, glomer-ulonephropathy should be ruled out. Conversely, for patients with glomerulonephropathy and persistent proteinuria despite proper treatment, thyroid function and antibody tests should be performed.

• 대한두경부종양학회지
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• 제34권1호
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• pp.9-13
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• 2018

Background/Objectives: Brain metastasis (BM) is a rare form of distant metastasis with papillary thyroid cancer (PTC). Patients with BM of PTC carry a poor prognosis. The aim of this study was to contribute to the understanding of this disease by analyzing patients with BM of PTC. Materials & Methods: Between March 2003 and December 2013, the patient database was conducted to identify thyroid cancer patients treated. Among the 22,758 thyroid cancer patients, 14 (0.06 %) were identified to have metastasis to the brain during follow-up. The medical records of 14 patients with BM were retrospectively reviewed, focusing on the following: patient characteristics, synchronous or previous distant metastasis, treatments including whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) and surgery, and characteristics on radiologic findings, time interval between first diagnosis of primary thyroid cancer and BM and survival after BM. Results: The mean age at initial diagnosis and BM were $50.9{\pm}15.8years$ and $61.3{\pm}12.7years$. The mean duration between initial diagnosis and BM was $10.4{\pm}7.9years$. Patients were treated with varied combinations of surgery, SRS and WBRT except 4 patients who had refused treatment. The median overall survival (OS) time after BM diagnosis was 10 months (range 1 - 19). Patients receiving treatment (WBRT and/or surgery, SRS) had a significant longer median OS of 16.5 months in comparison to 3.5 months for those treated without treatment. (p = 0.005) Conclusion: Patients who received aggressive treatment had a longer OS than those with only supportive care. Treatment such as surgery, SRS and WBRT should be considered in patients with BM.

• 대한두경부종양학회지
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• 제9권1호
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• pp.33-41
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• 1993

A multivariate analysis of the prognostic factors and five year survival rate was carried out on a series of 72 thyroid cancers treated surgically from 1980 to 1987 and followed for 1 to 11 years. The prognosis of the disease was significantly influenced by age at diagnosis, extracapsular invasion, angioinvasion and pathologic type, but the disease was not influenced by sex, lymph node metastasis, and 'risk' category. The overall five year survival rate was 89.7%. Six patients were dead of tumor after surviving for six months to two and half years, and the cause of death was local recurrence in three, lung metastasis in two and bone metastasis in one patient. Five year survival rate in age above fifty, presence of capsule and angioinvasion, follicular carcinoma, and extrathyroidal lesion was significantly shorter than that of patients with age below fifty, absence of capsule and angioinvasion, papillary carcinoma, and intrathyroidal lesion. Patients at low risk or with small carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was done with a limited type in no jugular metastasis, radical neck disscetion was performed only therapeutically in proved jugular node metastasis. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.39.1-39.6
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• 2019

Background: Radioiodine therapy has been widely used for thyroid disease patients, but hyposalivation and xerostomia may occur in 10~30% of patients. Sialocentesis is a procedure that removes inflammatory substances in the salivary duct and expands the duct for the secretion and delivery of saliva. In this study, thyroid disease patients treated with radioactive iodine were selected among the patients with xerostomia who visited the hospital, and the effect of sialocentesis was compared and analyzed. And then, comparison between the radioiodine therapy-experienced group and the non-radioiodine therapy-experienced group was conducted. Results: In this study, we studied xerostomia patients who underwent radioiodine therapy due to thyroid diseases and who underwent sialocentesis at the Korea University Anam Hospital. Sialocentesis is conducted by one surgeon. The study also compares the clinical symptoms before and after the surgery. After the procedure, the discomfort due to xerostomia was reduced, and the symptom was improved effectively. Conclusions: The results of this study showed that sialocentesis has a clinical effect in the treatment of xerostomia, which is a side effect of radioiodine therapy. In addition, the possibility of further clinical application of sialocentesis in the future is found.

• 한국융합학회논문지
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• 제12권4호
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• pp.317-326
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• 2021

본 연구는 국내 갑상선질환자를 대상으로 한 중재 연구 프로그램의 특성과 결과변수를 분석하기 위한 체계적 문헌고찰 연구이다. 국내 5개의 데이터베이스에서 2019년까지 발표된 문헌을 체계적으로 고찰하였다. 확인한 824편 중 선정기준에 맞는 6편을 추출하였다. 본 연구의 결과 프로그램은 교육, 활동, 상담으로 분류되었다. 교육 및 상담요법은 심리사회적인 변수와 신체생리적인 변수에 유의한 영향을 미치고 있었다. 활동요법은 신체생리적 변수에 유의한 영향을 나타내었다. 본 연구는 국내 갑상선질환자를 위한 다양한 중재 프로그램의 개발과 운영방안에 대한 근거를 제시하였다는 것에 의의가 있으며 향후 갑상선질환자의 신체생리적 기능과 심리사회적 문제를 고려한 융합적 프로그램개발연구에 활용될 수 있을 것이다.

• 성인간호학회지
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• 제22권1호
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• pp.80-89
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• 2010

Purpose: This paper has attempted to investigate the association between the subclinical thyroid function disorder caused by natural change in thyroid hormones or thyroid remedies and the incidence of CHD. Methods: Data was analyzed of 7,675 women who had undergone health examinations in a hospital in Gyeonggi-do between January 2007 and December 2008. The covariation of the coronary risk factors such as age, BMI, HbA1C, systolic blood pressure, LDL:HDL-cholesterol ratio, CRP, smoking and exercise were analyzed by using logistic regression analysis. Results: A significant increase in serum TSH was observed with higher age (F=26.91, p=.00). In terms of age, the risk of CHD started to gradually increase since the 40s and sharply since the 60s (${\chi}^2$=113.29, p=.00). The serum TSH was the most significant parameter influencing CHD (B=.12, p=.00). The risk of coronary heart disease was 3.12 times higher in the subclinical hypothyroidism group (OR=3.12) while no significant difference was observed in the subclinical hyperthyroidism group. Conclusion: Subclinical hypothyroidism may be an independent risk factors for CHD. A nurse nursing patients with thyroid disorder should be well informed of their state of subclinical thyroid function disorder and make efforts to extend their health expectancy.

• International journal of thyroidology
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• 제11권2호
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• pp.143-151
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• 2018

Background and Objectives: Sirtuins (SIRTs) play important roles in cellular and organismal homeostasis. They have distinct gene expression patterns in various cancers; however, the relationship between SIRT expression and the progression of thyroid cancer is unclear. We investigated the expression of SIRTs in patients with papillary thyroid carcinoma (PTC) and their role as biomarkers for predicting the aggressiveness of this disease. Materials and Methods: We used immunohistochemical staining to evaluate the expression of SIRT1 and SIRT3 in tumor specimens from 270 patients with PTC. We also evaluated the potential association between SIRT expression and diverse clinicopathological features. Results: High SIRT1 expression was negatively correlated with lymphovascular invasion, central lymph node metastasis, and lateral lymph node metastasis. Multivariate analyses revealed that high SIRT1 expression was a negative independent risk factor for lateral lymph node metastasis. By contrast, high SIRT3 expression was positively correlated with locoregional recurrence. Interestingly, when patients were grouped by tumor SIRT expression patterns, the group with low SIRT1 expression and high SIRT3 expression was correlated with more aggressive cancer phenotypes including central lymph node metastasis and lateral lymph node metastasis. Conclusion: Our results suggest that SIRTs play dual roles in tumor progression, and the combination of decreased SIRT1 expression and increased SIRT3 expression is significantly associated with a poor prognosis in patients with PTC.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 2002년도 제23차 연수교육
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• pp.77-95
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• 2002

During the last several decades, prognosis of differentiated thvroid cancers improved markedly, mainly due to refinement of surgical techniques and routine use of radioactive iodine. Total or neat-total thyroidectomy is to be performed as the first line of treatment. Routine remnant ablation just after surgery decreases recurrence and increases survival. After then patients are maintained on suppressive dose of thyroid hormone to keep endogenous TSH below normal. Regular follow-up of the patients with serum thyroglobulin measurement and iodine whole body scan after thyroid hormone withdrawal or under recombinant human thyrotropin stimulation select high risk patients with recurrence or metastatic disease and treatment with therapeutic dose of radioactive iodine prolongs survival and sometimes leads cure. Currently recommended diagnostic and therapeutic strategies, present controversies and future directions are discussed.

• 대한두경부종양학회지
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• 제13권1호
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• pp.16-23
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• 1997

Although normal thyroid epithelial cells do not constitutively express HLA-DR antigen, their expression in wide spread within thyroid glands obtained from the human with autoimmune thyroid disease and with many neoplastic thyroids. We have, therefore, studied immunohistochemically with regard to the expression of HLA-DR antigen of thyroidectomy specimens from 50 patients of various thyroid diseases with use of paraffin-embedded tissue. One or two sections from each case were stained with commercially available mouse monoclonal antibody for class II HLA-DR antigen(HLA-DR/Alpha, DAKO) and examined by semiquantitative counting system for thyrocytes, neoplastic thyrocytes and other cells expressing HLA-DR antigen. All patients with lymphocytic thyroiditis(2/2) and diffuse hyperplasia(Graves' disease)(5/5), most patients with Hashimoto's disease(9/ll) expressed HLA-DR antigens in thyrocyte with abundant HLA-DR expressing lymphocytic infiltrates with lymph follicle formation in its vicinity or adjacent to the lesion. Most patients with papillary carcinoma(9/1l) had HLA-DR antigen detected in malignant thyrocytes ; while follicular carcinoma(0/3) and follicular adenoma(0/5) did not have detactable HLA-DR immunoreactivity. Adenomatous goiter(3/7) had HLA-DR antigen detected focally in lesser than half cases. Conversely, in four papillary carcinomas and three adenomatous goiters, HLA-DR expression of thyrocytes was found in the absence of HLA-DR expressing lymphoid infiltrates. In such cases therefore other factors more than thyroid autoimmunity must be causative for HLA-DR immunoreactivity. The results of this study indicate as follows. 1) The expression of HLA-DR on thyrocytes involved in autoimmune reactions appeared to be secondary to cytokine release from associated lymphocytic infiltrates. 2) Thyrocytes in thyroid lesions with equal degrees of lymphocytic infiltration without HLA­DR expression exhibited no HLA-DR immunoreactivity. 3) In neoplastic thyrocytes, most papillary carcinoma(9/11) exhibited detactable HLA-DR expression, while follicular carcinoma/adenoma(0/3/0/5) exhibited no detactable HLA-DR immunoreactivity which suggest the existence of divergent mechanisms inducing and modulating HLA-DR expression of different types of neoplastic thyrocytes.