• 제목/요약/키워드: Thyroid dysfunction

검색결과 65건 처리시간 0.028초

Multiple Endocrinologic Complications in Thalassemia Major

  • Wong, Siong Hu;Omar, Julia;Ismail, Tuan Salwani Tuan
    • 대한임상검사과학회지
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    • 제49권4호
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    • pp.495-497
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    • 2017
  • Thalassemia major is a genetic disorder with a defective synthesis of either the alpha or the beta chain of hemoglobin A. Blood transfusion is crucial for the survival in these patients. Unfortunately, endocrine dysfunction is a very common complication in these patients and is principally due to excessive iron overload as a result of frequent blood transfusions. Although regular blood transfusion may increase life expectancy, disturbances in growth and pubertal development, abnormal gonadal functions, impaired thyroid, parathyroid and adrenal functions, diabetes, and disorderly bone growth are common side effects. We hereby present a case of a 23-year-old, unmarried woman with beta thalassemia major presenting with primary amenorrhea, poor development of secondary sexual character, and short stature. Thorough history, clinical examination, and laboratory investigation, including dynamic function test (insulin tolerance test) were conducted. These tests confirmed that she had multiple endocrinopathies, including hypogonadotropic hypogonadism, growth hormone deficiency, and subclinical adrenal insufficiency, which were caused by iron overload. She required hormone replacement therapy. Early recognition of possible deficiencies in hypothalamo-pituitary-end organ hormones caused by iron overload in thalassemia patients that undergo frequent blood transfusion procedures is essential. Appropriate treatments, including transfusion regimen and chelation therapy, as well as specific treatment of each complication are the crucial for the successful management and improvement of quality of life these patients.

DIGOXIN 용량결정 방법들의 평가 (Evaluation of Digoxin Dosing Methods)

  • 류윤미;신완균;이명걸;이민화
    • 한국임상약학회지
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    • 제3권1호
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    • pp.15-20
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    • 1993
  • The ability to precisely predict serum digoxin concentration using 7 published methods in a group of 50 patients was undertaken. Two methods of estimating creatinine clearance and two estimates of lean body weight were employed as input variables using the 7 dosing methods. TDX was used to determine the nadir SDCs(serum digoxin concentrations) in 50 in patients meeting predetermined study criteria. All patients, whose ages ranged 19-71 years, had steady-state digoxin levels, were in oral digoxin, and were free from liver dysfunction, thyroid dysfunction and renal failure. The correlation coefficients(r) of predicted versus observed SDCs were determined,. and mean error(ME) was determined for each method to reflect bias, respectively. No substantial differance in predictive reliabliity was evident among the methods studied in total group. Poor correlations existed between predicted and observed SDCs(r<0.4) and these correlations were not significantly affected by age and gender. But relatively higher correlation and lower ME was founded for the CHF group in Jelliffe method(r=0.5, p<0.05).

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내분비계 장애물질이 어류의 HPG, HPT, HPA 축에 미치는 연계영향 (A Review on the Effects of Endocrine Disruptors on the Interaction between HPG, HPT, and HPA Axes in Fish)

  • 장솔;지경희
    • 한국환경보건학회지
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    • 제41권3호
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    • pp.147-162
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    • 2015
  • Objectives: The objective of this review was to summarize the primary role of three representative endocrine axes in aquatic vertebrates and discuss the effects on endocrine systems and their interactions in teleost fish after exposure to environmental contaminants. Methods: We summarized individual traits and mechanisms for hormonal and transcriptional interactions between the hypothalamic-pituitary-gonad (HPG), hypothalamic-pituitary-thyroid (HPT), and hypothalamic-pituitary-adrenal (HPA) axes in fish. We also provided a brief discussion on the effects of nonylphenol-induced toxicity on endocrine systems and their interactions in fish as a demonstration of holistic explanation. Results: Currently-available data showed that thyroid dysfunction is associated with reproductive toxicity due to changes in steroidogenic gene expressions and sex hormone levels as well as gonad glands in fish. As an example, we demonstrated that exposure to nonylphenol could induce estrogenicity in male fish by decreasing thyroid hormones, which contributes to increased aromatase expression. Although the mechanisms are complicated and involved in multiple ways, a number of studies have shown that sex steroids influence the HPT axis or the HPA axis in fish, indicating bi-directional crosstalk. Critically missing is information on the primary target or toxicity mechanisms of environmental contaminants among the three endocrine axes, so further studies are needed to explore those possibilities. Conclusions: This review highlights the interactions between the HPG, HPT, and HPA axes in fish in order to better understand how these endocrine systems could interact with each other in situations of exposure to endocrine disrupting chemicals.

임신과 갑상선 기능의 평가 (Evaluation of Pregnancy and Thyroid Function)

  • 박창은
    • 대한임상검사과학회지
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    • 제50권1호
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    • pp.1-10
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    • 2018
  • 갑상선의 기능적 발달 이전인 임신초기에 갑상선자극호르몬은 갑상선 장애 및 임신 동안 매우 민감한 지표이다. 임신동안 정상수준은 감소 변화를 보이는 것은 모체로부터 태아가 받는 갑상선호르몬의 영향이다. 갑상선자극호르몬과 유리 티록신의 농도는 임신동안 및 검사실간에 다양하게 보고된다. 갑상선자극호르몬의 참고치는 비임신군에 비하면 상한값과 하한값의 참고범위의 감소가 임신동안 보인다. 각 실험실은 임신 중에 다른 결과를 산출하는 호르몬 분석법과 일부 자체 기준에 맞는 혈중 농도를 산출한다. 따라서, 혈청 유리 티록신 분석에 사용되는 자동화 된 면역 분석법은 여전히 널리 사용되고 있지만 고려할 사항이 있다. 집단 기준, 삼분위 기간별 특이적 참고범위 사용은 문제해결의 최상의 방법이다. 임신 7~12주에 발생하는 호르몬의 하향은 7주 이전에는 보이지 않아 참고범위의 개별적 정량적으로 상승 및 하강을 보여준다. 본 연구에서는 집단별과 임신 특이적 갑상선 매개 변수의 참조범위에 대한 산출 중요성을 강조한다. 정밀의학 의 도래에 있어서 많은 개체의 유전적, 생물학적, 심리사회학적, 환경적 변수를 수집하고 분석이 필요하다. 이러한 논쟁을 해결하기 위해서는 다량의 전향적인 무작위 통제 연구가 필요하다.

Goiter Frequency Is More Strongly Associated with Gastric Adenocarcinoma than Urine Iodine Level

  • Tabaeizadeh, Mohammad;Haghpanah, Vahid;Keshtkar, Abbasali;Semnani, Shahryar;Roshandel, Gholamreza;Adabi, Khadijeh;Heshmat, Ramin;Rohani, Davood;Kia, Alireza;Hatami, Ehsan;Jahangirrad, Ataollah;Nabizadeh, Ramin;Larijani, Bagher
    • Journal of Gastric Cancer
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    • 제13권2호
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    • pp.106-110
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    • 2013
  • Purpose: We designed our study to evaluate the hypothesis that gastric cancer is correlated with iodine deficiency or thyroid dysfunction. Materials and Methods: We investigated the total body iodine reserve, thyroid function status and autoimmune disorder in 40 recently diagnosed gastric adenocarcinoma cases versus 80 healthy controls. The participants came from a region with high gastric cancer rate but sufficient iodine supply due to salt iodination. The investigation included urine iodine level, thyroid gland clinical and ultrasonographic examination, and thyroid function tests. Results: Goiter was detected more frequently in the case group (P=0.001); such a finding, however, was not true for lower than normal urine iodine levels. The free T3 mean level was significantly lower in the case group compared to the control group (P=0.005). Conclusions: The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goiter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma compared to the existing iodine deficiency itself.

임상가를 위한 특집 3 - 한국 노인에서 저작불편감과 복합만성질 환의 연관성: 제4기 국민건강영양조사 (Chewing difficulty and multiple chronic conditions in Korean elders: KNHANES IV)

  • 한동헌
    • 대한치과의사협회지
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    • 제51권9호
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    • pp.511-517
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    • 2013
  • To assess the association between oral health and general health, this study examined the relationship between chewing difficulty and twelve chronic health conditions such as hypertension, hyperlipidemia, diabetes, cerebro- and cardiovascular disease, musculoskeletal disease, respiratory disease, eye/nose/throat disease, stomach/intestinal ulcer, renal dysfunction, thyroid disease, depression, and cancer in Korea. The study population was 3,066 elders aged 65 years old and more from the fourth Korean National Health and Nutrition Examination Survey. Chewing difficulty was measured on a 5-point Likert scale. Chronic conditions were assessed by self-reported questionnaire. Confounders were age, gender, education, income, smoking, drinking, and obesity. Chi-square test, general linear model, and multiple logistic regression model were done with complex sampling design. Musculoskeletal disease (adjusted odds ratio=1.33), respiratory disease (adjusted odds ratio=1.52), and cancer (adjusted odds ratio=1.58) were independently associated with chewing difficulty. Multiple chronic conditions with more than 4 chronic disease showed significant association with chewing difficulty (adjusted odds ratio=1.37).

Sensitive and Mild Fluorogenic Reagents for Biogenic Carboxylic Acids in HPLC

  • Ushijima, Tamano;Saito, Mikihiko;Sasamoto, Kazumi;Ohkura, Yosuke;Ueno, Keiyu
    • 분석과학
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    • 제8권4호
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    • pp.545-551
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    • 1995
  • Five acid hydrazides as precolumn fluorescence derivatization reagents for carboxylic acids in HPLC, which have the benzofuran or benzothiazole moiety conjugated to a furan, thiophene or oxazoline ring, were synthesized and examined in view of reactivity, separability and sensitivity. Of these hydrazides, 2-(5-hydrazinocarbonyl-2-oxazolyl)-5,6-dimethoxybenzothiazole (BTOH) was most favorable. The detection limit of lauric acid as a model acid was 0.1 pmol per $10-{\mu}l$ injection volume at S/N=3, which was roughly equal to that of an analogous compound, 2-(5-hydrazinocarbonyl-2-furyl)-5,6-dimethoxybenzothiazole. The reagent allowed rapid assays of carboxylic acids ($C_{12:0}-C_{20:4}$) within 20 min with satisfactory scparability. The method was applied to the determination of fatty acids in human sera from healthy volunteers as well as from patients with diabetes or thyroid dysfunction.

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산모의 요오드섭취가 산후 갑상선염 발현에 미치는 영향 (The Effects of Dietary Iodine Intake on the Postpartum Thyroiditis(PPT) Manifestation)

  • 조여원
    • Journal of Nutrition and Health
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    • 제30권10호
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    • pp.1195-1202
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    • 1997
  • Iodine-rich seaweed soup has been traditionally supplied to postpartum women in Korea. This dietary habit might introduce over-intake of iodine above the recommended requirements, and might provoke postpartum thyroid dysfunction. Although the response to excess iodine intake is highly variable, goiter, hyperthyroidism, hypothyroidism, and thyroiditis could follow the daily intake of 1,500$\mu\textrm{g}$ of iodine. A few studies are available concerning iodine toxicity in Korea. The purpose of this study was to investigate the relationships between the dietary intake of iodine and thyroid function change as well as the incidence of postpartum thyroiditis. One hundred and thirty-seven postpartum women who had experienced normal deliveries were studied. Dietary intake of iodine and excretion concentration of iodine in breast milk and maternal urine were measured . Serum T$_3$, T$_4$, TSH, anti-thyroglobulin antibody, and anti-microsomal antibody were anlayzed 1 week before delivery and 1, 6, 12, and24 weeks after delivery. Iodine intake was analyzed by one-to-one interviews using 24-hr recall and a food frequncy questionnaire. The result showed that the intake of dietary iodine before delivery and 1 and24 weeks after delivery were 483$\mu\textrm{g}$/day, 3367$\mu\textrm{g}$/day, and 1069$\mu\textrm{g}$/day, respectively. The concentration of iodine in urine at the first week after delivery was 63$\mu\textrm{g}$/dL, and 23.9$\mu\textrm{g}$/dL in breast milk . The levels of serum T$_3$ and T$_4$ before delivery were 2.01ng/mL and 11.49$\mu\textrm{g}$U/dL, respectively, showing that the levels were gradually dropping to normal values after delivery. Positive serum anti-thyroglobulin antibody and anti-microsomal antibody appeared in 3 cases. After a 24 week follow-up period , 6 women(10.3%) experienced cases of postpartum thyroiditis, 5 of which were cases of hyperthyroidism and one of which was a case of hypothyroidism. These figures of postpartum thyroiditis are similar to those of other countries.

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Conversion of Apricot Cyanogenic Glycosides to Thiocyanate by Liver and Colon Enzymes

  • Lee, Ji-Yeon;Kwon, Hoon-Jeong
    • Toxicological Research
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    • 제25권1호
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    • pp.23-28
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    • 2009
  • Some of the edible plants like apricot kernel, flaxseed, and cassava generate hydrogen cyanide (HCN) when cyanogenic glycosides are hydrolyzed. Rhodanese (thiosulfate: cyanide sulfurtransferases of TSTs; EC: 2.8.1.1) is a sulfide-detoxifying enzymes that converts cyanides into thiocyanate and sulfite. This enzyme exists in a liver and kidneys in abundance. The present study is to evaluate the conversion of apricot cyanogenic glycosides into thiocyanate by human hepatic (HepG2) and colonal (HT-29) cells, and the induction of the enzymes in the rat. The effects of short term exposure of amygdalin to rats have also been investigated. Cytosolic, mitochondrial, and microsomal fractions from HepG2 and HT-29 cells and normal male Spraque-Dawley rats were used. When apricot kernel extract was used as substrate, the rhodanese activity in liver cells was higher than the activity in colon cells, both from established human cell line or animal tissue. The cytosolic fractions showed the highest rhodanese activity in all of the cells, exhibiting two to three times that of microsomal fractions. Moreover, the cell homogenates could metabolize apricot extract to thiocyanate suggesting cellular hydrolysis of cyanogenic glycoside to cyanide ion, followed by a sulfur transfer to thiocyanate. After the consumption of amygdalin for 14 days, growth of rats began to decrease relative to that of the control group though a significant change in thyroid has not been observed. The resulting data support the conversion to thiocyanate, which relate to the thyroid dysfunction caused by the chronic dietary intake of cyanide. Because Korean eats a lot of Brassicaceae vegetables such as Chinese cabbage and radish, the results of this study might indicate the involvement of rhodanese in prolonged exposure of cyanogenic glycosides.

Treadmill exercise enhances motor coordination and ameliorates Purkinje cell loss through inhibition on astrocyte activation in the cerebellum of methimazole-induced hypothyroidism rat pups

  • Shin, Mal-Soon;Kim, Bo-Kyun;Lee, Shin-Ho;Kim, Tae-Soo;Heo, Yu-Mi;Choi, Jun-Ho;Kim, Chang-Ju;Lim, Baek-Vin
    • 운동영양학회지
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    • 제16권2호
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    • pp.73-84
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    • 2012
  • Thyroid hormones are important for the development of the brain including the cerebellum. In the present study, we investigated the effect of treadmill exercise on the survival of Purkinje neurons and the activation of astrocytes in the cerebellar vermis of hypothyroidism-induced rat pups. On the day of perinatal 14, pregnant rats were divided into two groups (n = 5 in each group): the pregnant control group and the pregnantmethimazole (MMI)-treated group. For the induction of hypothyroidism in the rat pups, MMI was added to the drinking water (0.02% wt/vol), from the day of perinatal 14 to postnatal 49. After delivery, male rat pups born from the pregnant control group were assigned to the control group. Male rat pups born from the MMI-treated group were divided into the hypothyroidism-induction group, the hypothyroidism-induction with treadmill exercise group, and the hypothyroidism-induction with thyroxine (T4) treatment group (n = 10 in each group). The rat pups in the exercise group were forced to run on a treadmill for 30 min once a day for 4 weeks, starting on postnatal day 22. In the hypothyroidism-induced rat pups, motor coordination was reduced and Purkinje cell death and reactive astrocytes in the cerebellar vermis were increased. Treadmill exercise enhanced motor coordination, increased the survival of Purkinje neurons, down-regulated reactive astrocytes, and enhanced brain-derived neurotrophic factor (BDNF) and receptor tyrosine kinase B (TrkB) expressions in the hypothyroidism-induced rat pups. These results suggest that treadmill exercise has beneficial effects in terms of protecting against thyroid dysfunction by increasing T3 and T4 and the related protein, BDNF, as well as TrkB, inhibition on astrocyte activation and the reduction of Purkinje cell loss regarding the cerebellum in hypothyroidism rat pups.