• Title/Summary/Keyword: Thyroid function

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Comparative Analysis of Preoperative Diagnotic Findings with Histologic Results in Thyroid Nodule (갑상선 결절의 술전진단과 술후 조직학적 결과의 비교분석)

  • Park Jin-Young;Cho Hyun-Jin;Lim Sung-Chul
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.52-57
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    • 2000
  • Purpose: The purpose of the study was to evaluate the sensitivity, specificity and accuracy between the FNAC and intraopevative frozen biopsy based upon the Final histologic diagnosis. Method: Authors studied 232 cases of thyroid nodule operated at Department of Surgery, College of Medicine, Chosun University, from January 1992 to December 1998. The medical records of these patients were studied retrospectively. The cytology of FNAC and the frozen section was compared to the final histologic diagnosis. 232 cases were analysed in regard to correlation of FNAC diagnosis and Intraoperative frozen section with final pathology, preoperative thyroid scan, thyroid function test, ultrasonography, final histopathology of the specimens, and surgical operation methods. 174 cases who underwent FNAC for diagnosis before operation, and Intraoperative frozen-section biopsy were classified according to whether the clinical diagnosis was benign, suspicious or malignant and evaluated the specificity sensitivity and accuracy. Result: Comparing with final histopathology, FNAC as a diagnostic test for thyroid nodules demonstrated an accuracy of 81.3%, a sensitivity of 87.5%, a specificity 86.5% with a false positivity of 2.9%, false negativity of 4.3%, respectively. and Intra-operative frozen section demonstrated an accuracy of 86.8%, a sensitivity of 87.5%, a specificity 92.1%. In the benign lesion, there was no difference in accuracy between FNAC(95.6%) and frozen section(95.1%) but, in the suspicious malignant lesion, frozen section(46.2%) was superior to FNAC(32.0%), and in the malignant disease, FNAC(97.1%) was superior to frozen section(92.3%). Conclusion: Intraoperative frozen section biopsy is useful in patients undergoing surgery for a thyroid nodule with a 'suspicious' malignant lesion and could reduce inadequate extensive excision without missing malignancy and second operation and help to determine the resection margin. It adds no information in patients with a diagnosis of malignancy following FNAC assessment and is of limited use in those in whom a benign lesion is diagnosed.

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Detection Limit of a NaI(Tl) Survey Meter to Measure 131I Accumulation in Thyroid Glands of Children after a Nuclear Power Plant Accident

  • Takahiro Kitajima;Michiaki Kai
    • Journal of Radiation Protection and Research
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    • v.48 no.3
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    • pp.131-143
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    • 2023
  • Background: This study examined the detection limit of thyroid screening monitoring conducted at the time of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in 2011 using a Monte Carlo simulation. Materials and Methods: We calculated the detection limit of a NaI(Tl) survey meter to measure 131I accumulation in the thyroid gland of children. Mathematical phantoms of 1- and 5-year-old children were developed in the simulation of the Particle and Heavy Ion Transport code System code. Contamination of the body surface with eight radionuclides found after the FDNPP accident was assumed to have been deposited on the neck and shoulder area. Results and Discussion: The detection limit was calculated as a function of ambient dose rate. In the case of 40 Bq/cm2 contamination on the body surface of the neck, the present simulations showed that residual thyroid radioactivity corresponding to thyroid dose of 100 mSv can be detected within 21 days after intake at the ambient dose rate of 0.2 µSv/hr and within 11 days in the case of 2.0 µSv/hr. When a time constant of 10 seconds was used at the dose rate of 0.2 µSv/hr, the estimated survey meter output error was 5%. Evaluation of the effect of individual differences in the location of the thyroid gland confirmed that the measured value would decrease by approximately 6% for a height difference of ±1 cm and increase by approximately 65% for a depth of 1 cm. Conclusion: In the event of a nuclear disaster, simple measurements carried out using a NaI(Tl) scintillation survey meter remain effective for assessing 131I intake. However, it should be noted that the presence of short-half-life radioactive materials on the body surface affects the detection limit.

Determination of Serum Thyroxine Levels in Normal Korean Subjects and Various Thyroid Diseases (정상인 및 각종 갑상선 질환 환자의 혈청 Thyroxine)

  • Kim, Dong-Jip;Min, Byong-Sok;Bahk, Yong-Whee;Kim, Boo-Sung
    • 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.

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The Change of the Salivary Function after the High Dobe Radioiodine Treatment in the Patients with Differentiated Thyroid Cancer (갑상선암 환자의 방사성옥소 치료 후 타액선 기능의 변동)

  • Lim, S.M.;Hong, S.W.;Lee, J.O.;Kang, T.W.
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.1
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    • pp.7-12
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    • 1989
  • The pain, swelling of salivary glands and dry mouth are not infrequent complication of the high dose radioiodine treatment in the patients with differentiated thyroid cancer. The purpose of this study was, by the dynamic salivary scintigraphy, to observe the change of the salivary function after the high dose $(150\sim200mci)$ radioiodine treatment. From May 1987 to April 1988, the dynamic salivary scintigraphy with 5mci of $^{99m}Tc-pertechnetate$ and gamma camera was performed before and 7 days after the radiolodine treatment in 7 patients with differentiated thyroid cancer. Just after the dynamic scintigraphy, the stimulation test with vitamin C solution of pH3.0 and poststirnulation scintigraphy were done, and the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were calculated for each gland. There was positive correlation between the radioactivity uptake index and excretion fraction after the stimulation. The salivary clearance after the stimulation was $18.96{\pm}8.95ml/min$ in the pretreatment state, and $14.37{\pm}7.7ml/min$ after the radioioine treatment. After the radioiodine treatment, the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were significantly reduced in the parotid glands, but only the excretion fraction was reduced in the submandibular glands. The more the pretreatment salivary clearance after the stimulation was, the % change after the treatment was smaller. Further studies on the relation between the radiation dose in the salivary glands and the change of their function, and the long-term observation for the recovery of function are expected.

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Thyroid-Stimulating Hormone Reference Ranges in the First Trimester of Pregnancy in an Iodine-Sufficient Country

  • Castillo, Carmen;Lustig, Nicole;Margozzini, Paula;Gomez, Andrea;Rojas, MarIa Paulina;Muzzo, Santiago;Mosso, Lorena
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.466-472
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    • 2018
  • Background: Thyroid dysfunction is associated with negative neonatal and obstetric outcomes. Large differences in thyroid function reference intervals exist across different populations. These differences can be explained by population-specific factors, such as iodine status. Many countries in Latin America report iodine sufficiency, but relatively few countries have published up-to-date data on iodine levels and thyroid function in the overall population, and especially in pregnant women. We evaluated the iodine status of pregnant women in Chile and determined thyroid hormone reference ranges in this population. Methods: This was a prospective observational study of healthy Chilean women at their first prenatal visit before week 14. Thyroid-stimulating hormone (TSH), total thyroxine ($T_4$), free $T_4$, antithyroid peroxidase antibody (TPOAb), and iodine levels from spot urine samples were measured. Iodine status and the reference ranges for TSH were calculated. Results: A total of 1,022 pregnant women in the first trimester were selected. Urinary iodine levels were measured in 302 randomly-selected women. The median urinary iodine concentration was $173.45{\mu}g/L$ (interquartile range, 108.11 to 249.35).The reference ranges of TSH were calculated in 670 patients selected according to the National Academy of Clinical Biochemistry guidelines. The median TSH level was $1.88{\mu}IU/mL$ (2.5th percentile: 0.13 to 97.5th percentile: 5.37). Using the reference range in the 1,022 women, the prevalence of clinical hypothyroidism was 1.76%, and that of subclinical hypothyroidism was 3.92%. TPOAb positivity was more common in women with TSH levels above $3.5{\mu}IU/mL$. Conclusion: We found adequate iodine intake and a right-shifted distribution of serum TSH levels in pregnant women in Chile. The prevalence of hypothyroidism in our sample of pregnant women was higher than has been described in the literature.

The Analysis on Clinical Characteristics of Out-Patients of Oriental Thyroid Clinic (한방병원 갑상선 클리닉 내원 환자들의 임상적 특성 분석)

  • Byun, Sang-Hyuk;Kim, Soon-Il;Kang, Ki-Hoon;Lee, Byung-Cheol;Ahn, Young-Min;Doo, Ho-Kyung;Ahn, Se-Young
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.213-220
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    • 2005
  • Objective : Thyroid diseases are one of the most common endocrine disorders. However, the first chosen-treatments including anti-thyroidal and hormone-supplement therapy in western medicines, sometimes have failed to improve abnormal thyroid hormone secretions and clinical symptoms. Therefore, there has been a growing expectation for Oriental Medicine to take the role of alternative therapy. However, there has been little analysis of clinical characteristics. In this study, clinical characteristics of thyroidal disease patients who visited Kyung-Hee oriental hospital from January to July 2004 were analyzed. Methods : A total 86 patients diagnosed as hyperthyroidism, hypothyroidism or thyroid nodule were selected. Clinical history, including sex, age, symptoms, disease duration and methods of previous therapy and thyroidal test, such as thyroid function test (TFT), thyroid scan and other thyroid examinations. Results : In distribution of onset age and sex, the patients who have visited oriental hospital with thyroidal diseases showed similar characteristics with typical patients. In clinical symptom, the most frequent clinical sign was fatigue in both hyperthyroidism and hypothyroidism, which differs from the classical characteristics of those diseases. Most patients complained the unresolved symptoms, some of which are attributable to abnormal thyroid hormone secretions, in spite of western therapy with anti-thyroidal and hormone supplement agents. Conclusions : In oriental therapy, it will be necessary to consider the unique clinical features of thyroidal diseases different from classical patterns, and this study suggests that oriental therapy is a good alternative method for patients whose first treatment with western agents failed. Furthermore, more public information to these patients about oriental medicine would be helpful to increase cure rates, and give various choices to patients with thyroid diseases.

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Iodine Intake and Tolerable Upper Intake Level of Iodine for Koreans (한국인의 요오드 섭취와 요오드 상한섭취량)

  • Lee, Hyun-Sook;Min, Hye-Sun
    • Journal of Nutrition and Health
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    • v.44 no.1
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    • pp.82-91
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    • 2011
  • The present study reviewed the effects of excess iodine intake on thyroid function and the incidence of thyroid disease and discussed the scientific basis for establishing a tolerable upper intake level (UL) of iodine for Koreans. ULs are defined as "the highest level of daily nutrient intake that is likely to pose no risk of adverse effects to almost all individuals in the general population." Koreans consume excess iodine from seaweed, and iodine intake is strongly influenced by seaweed consumption. However, no dose-response data derived from subjects consuming excess iodine frequently but not continuously during a lifetime are available. Therefore, the Korean DRI committee set the iodine UL to reduce the risk of adverse health effects by excess iodine intake for Koreans with distinctive seaweed-eating habits.

A Case Report of Cerebral Infarction in an Elderly Patient with Subclinical Hypothyroidism (불현성 갑상선기능저하증이 병발한 고령의 뇌졸중 환자의 호전 1례)

  • Woo, Sung-Ho;Kim, Byung-Chul;Shim, Hyo-Ju;Na, Eu-Jin;Kang, Rae-Yeop;Kim, Jin-Won;Seo, Ho-Seok;Kim, Jung-Uk;Kim, Yong-Ho
    • The Journal of Internal Korean Medicine
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    • v.28 no.3
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    • pp.624-631
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    • 2007
  • Hypothyroidism is a common disease of the endocrinal system, characterized by fatigue, cold intolerance, bradycardia, and so on. Subclinical hypothyroidism is a common biochemical abnormality which can be found in routine screening tests of thyroid function. It is defined as an asymptomatic state which characterized by normal free thyroxine(FT4) and elevated thyroid stimulating hormone(TSH) levels. The purpose of this study was to evaluate the effect of treatment with palmijihwang-tang and to observe the changes in triiodothyronine(T3), free thyroxine(FT4), thyroid stimulating hormone(TSH) level and VAS of cold intolerance, hoarseness, dry skin. After the treatment, triiodothyronine(T3) increased from 57.12ng/dl to 120.53ng/dl. Free thyroxine(FT4) increased from 12.59pg/ml to 14.21pg/ml. Thyroid stimulating hormone(TSH) decreased from 10.61mU/L to 1.57mU/L. Cold intolerance, hoarseness and dry skin changed for the better. These results support a role for oriental medical therapy in treating subclinical hypothyroidism. Further case studies of herbal treatment of this ailment are needed.

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