• Korean Journal of Clinical Pharmacy
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• v.31 no.3
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• pp.188-197
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• 2021

Objective: PD-1 inhibitors have demonstrated improved health outcomes in cancer patients. PD-1 inhibitors are well-tolerated and associated with immune-related adverse events. The objectives of this study are to analyze use patterns of PD-1 inhibitors in patients with cancer and to investigate the incidence of thyroid-related adverse reactions in patients treated with PD-1 inhibitors. Methods: The study included patients who had been administered PD-1 inhibitors (either nivolumab or pembrolizumab) at the Samsung Medical Center between October 1, 2016 and June 30, 2017. Data was collected from electronic medical records and tested using Mann-Whitney tests and Chi-Square tests for statistical significance. Associations between PD-1 inhibitors and incidence of adverse events were tested using Cox regression for age, gender, BMI, ECOG PS and medication. Results: Two hundred fifteen patients were identified as eligible for analyses. Thyroid-related adverse events occurred in 20% of patients (n=43). Thyroid function tests (TFTs) was performed in 109 patients (50.7%). Positive results of PD-L1 testing were found in 53.2% of the 94 patients who had the test. Approved doses of nivolumab (3 m/kg) and pembrolizumab (200 mg) were administered in 70.4% and 53% of patients, respectively. The analysis of risk factor of thyroid-related adverse reaction did not show statistically significant differences (Cox regression). Conclusion: Thyroid-related adverse events are common in patients treated with PD-1 inhibitors and hypothyroidism is the most frequent adverse reaction. Routine TFTs monitoring is strongly recommended to evaluate thyroid function in real-world clinical practice.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.203-213
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• 2017

Serum creatinine-based eGFR and serum cystatin C-based eGFR are the most popular methods for measuring renal function. Thyroid hormone is known to affect serum creatinine-based eGFR and serum cystatin C-based eGFR; however, the clinical significance of thyroid dysfunctional patients of renal function evaluation has not been fully elucidated to date. This study examined the effect of thyroid hormone on serum creatinine-based eGFR and serum cystatin C-based eGFR. Moreover, we also evaluated the correlation analysis between serum creatinine-based eGFR and serum cystatin C-based eGFR in patients with thyroid dysfunction. A total of 442 patients with hypothyroidism and 284 patients with hyperthyroidism were investigated. A correlation analysis between thyroid hormone and serum creatinine- (and cystatin C-) based eGFR was performed. A correlation analysis between thyroid hormone and serum cystatin-C based eGFR indicated that serum cystatin-C based eGFR is more of an independent biomarker than serum creatinine-based eGFR in thyroid dysfunction patients. Therefore, serum cystatin C-based eGFR more accurately reflects renal function than serum creatinine-based eGFR in thyroid dysfunction patients.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.60-68
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• 2019

Objectives : The association between thyroid-related hormones and cognitive function has been controversial. The purpose of this study is to compare the levels of thyroid-related hormones in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Furthermore, we investigated the relationship between thyroid-related hormones and cognitive function. Methods : From January 2011 to December 2018, we retrospectively reviewed 105 patients who were diagnosed with AD and MCI by visiting a dementia clinic at Ilsan Paik Hospital. Thyroid-related hormones [triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH)] was measured using chemiluminescent immunoassay. An independent sample t-test was performed to analyze the mean value of thyroid-related hormones in patients of AD and MCI. To investigate whether thyroid-related hormones correlate significantly with Global deterioration scale (GDS), Clinical dementia rating (CDR) and scores of each The Korean version of the consortium to establish a registry for Alzheimer's disease items, we conducted a partial correlation analysis with geriatric depression scale-Korean version (GDS-K) scores as covariates. Results : There was no significant difference in the mean serum T3, T4 and TSH levels between patients of the AD and the MCI, but the Construction Praxis Test (CPT) showed a significant positive correlation with the serum TSH concentration (p-value=0.004). Conclusions : In our study, the positive correlation between serum TSH level and the CPT associated with executive function was found to be helpful in understanding the association between thyroid-related hormones and the pathophysiology of dementia. Prospective studies in regard of the pathophysiology of thyroid-related hormones on cognitive function will be necessary in the future.

• Korean Journal of Veterinary Research
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• v.36 no.1
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• pp.209-219
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• 1996

This study examined the effect of alcohol(AL) and/or paraquat(PQ) on serum TSH, thyroid hormones and enzyme activities, and the protective effect of selenium(SE) againse alcohol and/or paraquat-induced thyroid toxicity in guinea pigs. The experomental group consisted of control, 15% alcohol(AL), 4ppm sodium selentite(SE), 200ppm paraquat(PQ), AL+PQ, AL+SE, PQ+SE and AL+PQ+SE mixed in drinking water-fed guinea pigs for 4 weeks. The morphological changes of thyroid gland were studies on paraffin-embedded sections stained with H-E stain. Body weight losses, high serum concentration in TSH and cholesterol, and low values on triiodothyronine($T_3$), thyrozine($T_4$), free $T_4$ and alkaline phosophatase(ALP) were produced in the groups fed AL and/or PQ. We also noted that AL+PQ-fed group was marked increase in serum TSH. In AL or AL+PQ-fed groups when cpmpared to control group had increased the ratio of thyroid weight to body weight(ratio Twt/Bwt), whereas the ratio Twt/Bwt was decresed in SE or PQ-fed groups. However, the serum TSH, $T_3$,$T_4$ free $T_4$ and cholesterol values, and the ratio Twt/Bwt were reversed in groups given the combination of SE, compared with AL and/or Pq-fed groups, also ALP values were reversed in groups given the combination of SE, compared with AL or AL+PQ-fed groups. In microscope, morphological changes showed a remarkable between the AL or PQ-fed group and controls. In AL+PQ+SE-fed guinca pig, follicular colloid is high density in thyroid follicle and increased in connective tissue around the thyroid cells, and thyroidal epithelia were composed of cuboidal or columnar epithelium. The indicated that the morphological changes of thyroid were direct action in the thyroid cell. The results of this study confirmed that the toxic effect of AL or PQ on thyroid occur independently of changes in liver function, and that SE confers marked protection against AL or PQ-induced thyroid toxicity.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.222-225
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• 1999

Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.

• Korean Journal of Biological Psychiatry
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• v.26 no.1
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• pp.14-21
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• 2019

Objectives Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. Methods Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. Results The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. Conclusions The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

• Journal of radiological science and technology
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• v.8 no.2
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• pp.65-69
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• 1985

In order to investigate the effects of sulfamonomethoxine (SMM) on thyroid glands in short term administration as medical dose, a total of twenty albino rabbits (mean body weight 1,750g) were selected at random and allotted to control and experimental group. Rabbits in experiment were administered SMM of 50 mg/kg/day for 30 days, and histopathological changes of thyroid glands and the blood levels for T4 and T3 were observed every 5 days. The Results obtained were summarized as follows: 1. The thyroid follicles were decreased or obliterated by highly hypertrophic and hyperplastic epithelial cells and the newly formed small follicles contained scanty colloidal materials. These changes revealed increasing tendency in accordance with the experimental days. 2. The blood levels for T4 and T3 of experimental group manifested significantly decreased values than those of control through the experimental term consistently. Finally, above observations suggest that administration of SMM to animals leads thyroid glands to typical hypofunctional hyperplastic goiter.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.66-70
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• 2001

Supracricoid partial laryngectomy (SCPL) has been performed in selected patients with transglottic carcinoma of larynx who are not amenable to classically conservative Partial laryngectomy. We have applied this procedure for the complete removal of carcinoma and the satisfactory recovery of function in 74 supraglottic laryngeal cancer Patient with thyroid cartilage invasion. The 65-year-old man with supraglottic squamous carcinoma with thyroid cartilage invasion (74 stage) was treated by SCPL with bilateral lateral neck dissection. The part of larynx and whole thyroid cartilage with tumor invasion was completely removed with covering thyrohyoid muscle and fascia. External perichondrium of the thyroid cartilage containing carcinoma was not exposed from the overlying muscle and fascia on postoperative pathological examination. We confirmed the invasion of thyroid cartilage histopathologically. Tumor was confined in the specimen and the safety margin was proved in all direction. Postoperative course and functional results were uneventful. SCPL can be applied in selected cases of locally advanced 74 laryngeal cancer.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.41-45
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• 2007

A 60 years old female patient presented with $8{\times}6\;cm$ sized painless oval mass in the left parietal region. She had left lobectomy of thyroid gland 10 years ago. Cranial CT, MRI, FGD PET-CT showed a solid mass which invaded left parietal bone. After embolization, craniectomy with tumor excision was performed. Histological examination revealed metastatic follicular cancer originated thyroid gland, with vascular and dura invasion. Postoperatively, neck CT showed right thyroid multiple nodules and right level III multiple lymph node enlargement. Thyroid function test was normal, but level of thyroglobulin was high (72ng/ml). So she had right lobectomy of thyroid gland with lymph node dissection under a diagnosis of follicular carcinoma. But histological examination revealed adenomatous hyperplasia and not lymph node metastasis. After operation, she received radioiodine therapy of 150mCi and then the level of thyroglobulin normalized (8.4ng/ml). The patient is under follow-up since she had operation 4 months ago.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.286-287
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• 2001

A 44 year-old male patient was undergoing diagnosis and therapy for acute myelogenous leukemia (AML, M2). On physical examination a thyroid mass was palpated in the left lower lobe. He had palpitation and intolerance to heat. Thyroid function tests revealed hyperthyroidism; T3: 150ng/dl (N:60-90), fT4: 2.26 ng/dl (N:0.70-1.80), TSH: 0.01 ulU/ml (N:0.25-5.00). Ultrasonography demonstrated a hypoechoic mass with scattered calcifications measuring 2.55 2.03 3.64 cm in size. F-18 FDG camera-based PET scan performed as a follow-up study of AML revealed a focal increased uptake in the left neck, where an autonomous nodule was detected on Tc-99m thyroid scan. After the diagnosis of toxic autonomous nodule, Goetz disease, he underwent surgical nodulectomy. Microscopically, the nodule contained follicular proliferation with degenerative change but without evidence of thyroid carcinoma. Focal uptake in autonomous thyroid nodules is due to increased glycolysis within the nodules.