• Title/Summary/Keyword: Thyroid function

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The Changes of Thyroid Function after Subtotal Thyroidectomy in Diffuse Toxic Goiter(Graves' Disease) (미만성 갑상선중독증(그레이브씨병)의 갑상선 아전절제술 후 갑상선 기능의 변화에 대한 연구)

  • Song Eun-Young;Kim Sung-Bae;Kim Sang-Hyo
    • 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.

Prospective Observation Study on Hyperthyroidism Patients Treated with Korean Medicine (한의치료를 받은 갑상선 기능 항진증 환자에 대한 전향적 관찰연구)

  • Choi, Yu-jin;Shin, Seon-mi;Han, Yang-hee;Ahn, Se-young;Cho, Chung-sik
    • The Journal of Internal Korean Medicine
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    • v.39 no.1
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    • pp.84-96
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    • 2018
  • Objective: This is aprospective clinical case study that includes the administration of Ahnjeonbaekho-tang (AJBHT) to patients who have suffered from Graves' disease for the 8 weeks of the clinical research. Methods: Without administration of an antithyroid drug, AJBHT was administered 3 times a day for 8 weeks. In Case 1, AJBHT without modification was administered and in Case 2, in accordance with the patients' symptoms, a dose of Gypsum Fibrosum was increased by 4g from the beginning of week 2, and further increased by 16 g, for a total of 20 g between week 6 and week 8. Body mass index (BMI), thyroid function test (TFT), thyroid autoantibody test, complete blood cell count (CBC), and blood chemistry (BC) tests were conducted at an interval of 4 weeks, for a total of 3 times during the study. The clinical manifestations, a spectrum of symptoms of the patients, was observed by Wayne's Index, Euro-QOL-5 Dimension (EQ-5D), and Perceived Stress Scale (PSS). Results: In both cases, an acceptable significance of reduction of value in T3, fT4, Thyroid stimulating antibody (TSAb) and Thyroid stimulating hormone receptor antibody (TSH-R-Ab) was observed. After treatment, in TFT, T3 decreased by 31.66%, fT4 decreased by 32.82% in Case 1, and T3 decreased by 43.42%, and fT4 decreased by 37.32% in Case 2. In the thyroid autoantibody test, TSAb decreased by 7.59%, and TSH-R-Ab decreased by 53.19% in Case 1, and TSAb decreased by 33.45%, TSH-R-Ab decreased by at least 7.75% in Case 2. Besides this, there was a decreasing trend of Wayne's index, and a loss of typical symptoms of hyperthyroidism also declared the efficacy. Conclusion: From these results, AJBHT is very effective in the regulation of TFT and improving the symptoms of hyperthyroidism, and is also expected to be an effective alternative to antithyroid drugs for patients who have side effects or drug intolerance.

Clinical Investigation and Treatment of Thyroid Diseases with Radioactive Iodine($^{131}I$) (방사성(放射性) 동위원소옥소(同位元素沃素)($^{131}I$)에 의(依)한 갑상선질환(甲狀腺疾患)의 임상적(臨床的) 연구(硏究) - 제 5 보 (第 五 報) -)

  • Lee, Mun-Ho;Koh, Chang-Soon;Ro, Heung-Kyu;Lee, Chung-Sang;Koo, In-Seu;Suh, Hwan-Jo;Lee, Kyung-Ja;Lee, Hong-Kyu
    • 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.

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The Clinical Study of Ahnjeonbaekho-tang on Patients with Graves' Disease (그레이브스병 환자에 대한 안전백호탕의 임상적 유효성 안전성 연구)

  • Lee, Byung-cheol;Han, Yang-hee;Shin, Seon-mi;Ahn, Se-young;Cho, Chung-sik
    • The Journal of Internal Korean Medicine
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    • v.39 no.1
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    • pp.9-21
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    • 2018
  • Objective: Graves' disease, the most common cause of primary hyperthyroidism, is a thyroid specific autoimmune disorder. When resistance to medication is shown in spite of long term therapy with anti-thyroid drugs, radioactive iodine therapy would be chosen in Western medicine. However, this therapy has often been reported to cause patients have hypothyroidism, thus requiring them to take levothyroxine for the rest of their lives. In this study, we evaluate the clinical efficacy and safety of Ahnjeonbaekho-tang (AJBHT) on patients with Graves' disease. Methods: We prescribed AJBHT for 3 months to two groups: patients who had been taking antithyroid drugs were administered AJBHT after discontinuing the antithyroid drugs ($Com-Tx{\rightarrow}Single-Tx$), and patients who had not been taking antithyroid drugs were started with AJBHT (Single-Tx) immediately. We evaluated the thyroidal function test (TFT) and visual analogue scale (VAS) for clinical symptoms for 3 months. Results: Serum T3 and fT4 were significantly decreased in both groups and remission rate of thyroidal hormones were significantly improved in the Single-Tx group. The clinical symptoms of palpitation, fatigue, and heat intolerance were significantly improved in both groups. In the safety analysis, all patients were in normal range of liver, renal function blood test and common blood count. Conclusion: From these results, we suggested that AJBHT was effective on TFT and clinical symptoms of Graves' disease. The study supports that AJBHT may be a useful agent for patients with Graves' disease who are resistant to antithyroid medication or radioactive iodine therapy, and for patients at first diagnosis.

Sorting and Function of the Human Folate Receptor Is Independent of the Caveolin Expression in Fisher Rat Thyroid Epithelial Cells

  • Kim, Chong-Ho;Park, Young-Soon;Chung, Koong-Nah;Elwood, Patrick C.
    • BMB Reports
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    • v.35 no.4
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    • pp.395-402
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    • 2002
  • Caveolae are small, flask-shaped, non-clathrin coated invaginations of the plasma membrane of many mammalian cells. Caveolae have a coat that includes caveolin. They have been implicated in numerous cellular processes, including potocytosis. Since the human folate receptor (hFR) and other glycosyl-phosphatidylinositol (GPI)-tailed proteins have been co-localized to caveolae, we studied the caveolin role in the hFR function by transfecting hFR and/or caveolin cDNA into Fischer rat thyroid epithelial (FRT) cells that normally do not express detectable levels of either protein. We isolated and characterized stable clones as follows: they express (1) high levels of caveolin alone, (2) hFR and caveolin, or (3) hFR alone. We discovered that hFR is correctly processed, sorted, and anchored by a GPI tail to the plasma membrane in FRT cells. No difference in the total folic acid binding or cell surface folic acid binding activity were found between the FRT cells that were transfected with hFR, or cells that were transfected with hFR and caveolin. The hFR that was expressed on the cell surface of clones that were transfected with hFR was also sensitive to phosphatidylinositol-specific phospholipase C (PI-PLC) release, and incorporated radiolabeled ethanolamine that supports the attachment of a GPI-tail on hFR. We conclude that the processing, sorting, and function of hFR is independent on the caveolin expression in FRT cells.

A Clinical Analysis of Surgically Managed Thyroid Nodule (외과적으로 치료한 갑상선 결절에 대한 임상적 고찰)

  • Jung In-Kyu;Kim Lee-Su;Choi Won-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.1
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    • pp.16-24
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    • 1993
  • During 7 years, from Jan. 1986 to Dec. 1992, authors studied 208 cases of the surgically managed thyroid nodules at the Department of General Surgery, Han Kang Sacred Heart Hospital and obtained the following results. 1) Among the total 208 cases, male to female ratio was 1:11.2 in benign thyroid diseases and 1:9 in malignant thyroid diseases. The benign disease was prevalent between second and forth decade comparing with malignant disease between third and fifth decade. 2) The most common duration of illness was 3 months(26.0%). 3) Palpable neck mass was the most common chief complaint(100%). Palpitation. fatigue, and sweating were common complaints in patient with benign disease, and fatigue, palpitation, and sweating in malignant disease in decreasing order of frequency. 4) 55.8 % of lesions were in right lobe, 33.2% in left lobe, 5.8% in diffuse type, 4.8% in bilateral lobes, and 0.5% in isthmus. 5) The most common size of nodule was between 2.0cm and 3.9cm in diameter, which consisted of 55.1% of benign disease and 48.0% of malignant disease. 6) 86.5% of thyroid function test showed euthyroidism, 10.1% hyperthyroidism, and 3.4% hypothyroidism. 7) Thyroid scanning of 176 patients revealed cold nodules in 92.5% of benign diseases and in 92.9% of malignant diseases. 8) The most common benign disease was adenomatous hyperplasia(62.7%), and the most common malignant disease was papillary adenocarcinoma(80.0%). 9) Fine needle aspiration cytology was performed in 91 cases, and it showed 69.0% of sensitivity, 90.3% of specificity, and 83.5% of accuracy. 10) Frozen biopsy was performed in 109 cases. and it showed 93.9% of sensitivity, 100.0% of specificity, and 98.2% of accuracy. 11) The most commonly performed operation was unilateral lobectomy(including unilateral lobectomy with isthmectomy)(79.1%) in benign disease. and total thyroidectomy(62.0%) in malignant disease. 12) Postoperative complication showed 5 cases of wound infection (2.4%), 3 cases of transient hypoparathyroidism(1.4%), 3 cases of transient hoarseness(1.4%), 2 cases of postoperative bleeding(1.0%), 1 case of permanent hypoparathyroidism(0.5%), 1 case of permanent hoarseness(0.5%), and 1 case of postoperative pneumonia (0.5%).

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Thyroid Hormone-like Activity of Metribuzin as a Endocrine Disruptor in Rats and HeLaTRE Cell Culture (내분비장애물질로서 Metribuzin의 랫드와 HeLaTRE Cell 중 갑상선 호르몬활성 영향)

  • You, Are-Sun;Jeong, Mi-Hye;Lee, Je-Bong;Park, Yoen-Ki;Shin, Jin-Sup;Park, Kyung-Hun
    • The Korean Journal of Pesticide Science
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    • v.12 no.4
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    • pp.342-350
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    • 2008
  • This study was carried out to investigate the suitability of the pubertal assay and the enhanced TG 407 as methods for detection of endocrine-mediated effects. Thyroid function was also considered. Male and female Sprague-Dawley rats were gavaged daily with 0, 25, 50, 100 mg/kg metribuzin in corn oil during 30 days. The effects of metribuzin on thyroid gland, the genital organs and thyroid hormone were measured in male and female rats. Dose of metribuzin 50 mg/kg/day increased relative weight of testis, prostate, and seminal vesicle in male rats but relative weight of thyroid gland was not significantly different from control group. Dose of metribuzin 25 mg/kg/day decreased relative weight of thyroid gland in female rats. Another purpose of this study was to investigate the effects of endocrine-disruptors as like thyroid hormone in vitro. Luciferase activity was measured to detect reaction of test chemicals and thyroid hormone response elements in HeLaTRE cell. Dose of metribuzin from 1 to 1,000 nM increased to 106-122% of luciferase activity.