• 대한핵의학회지
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• 제22권2호
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• pp.171-174
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• 1988

Thyrotropin binding inhibitory immunoglobulin (TBII) and thyroid stimulating antibody (TSAb) activities were measured in the thyroidal and peripheral venous blood samples at the time of subtotal thyroidectomy from twenty one patients with Graves' disease prepared for surgery with antithyroid drugs. There was no difference in TBII and TSAb activities between thyroidal and peripheral blood samples. These findings were regarded that while intrathyroidal lymphocytes are major site of thyrotropin receptor antibody (TRAb) production, similar levels are found in thyroidal and peripheral veins and that this in vivo study cannot exactly ascertain the TRAb producing site.

• 대한수의학회지
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• 제39권1호
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• pp.55-61
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• 1999

The present experiments were performed to examine the effects of acetylcholine (ACh) and carbachol (CC) on thyroxine ($T_4$) release and any possible relation between inhibition of $T_4$ release and signaling pathway in guinea pig thyroids. The thyroids were incubated in the medium containing the test agents, samples of the medium were assayed for $T_4$ by EIA kits. ACh and CC inhibited the TSH-stimulated $T_4$ release. These inhibition were reversed by atropine, but not by d-tubocurarine. The inhibitory effects of ACh on $T_4$ release were prevented by $M_{1^-}$ and $M_{3^-}$muscarinic antagonists and its inhibition was also slightly reversed by $M_{2^-}$ and $M_{4^-}$muscarinic antagonists. R59022, like ACh and CC, also inhibited the TSH-stimulated $T_4$ release. This inhibition was reversed by protein kinase C inhibitor and $Ca^{2+}$ channel blocker. The present study suggests that cholinergic inhibition of $T_4$ release from thyroids can be induced mainly by activation of the $M_{1^-}$ or $M_{3^-}$ receptors and that it is mediated through the muscarinic receptorstimulated protein kinase C activation.

• Clinical and Experimental Pediatrics
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• 제50권6호
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• pp.576-579
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• 2007

갑상선 호르몬 저항성 증후군은 갑상선 호르몬에 대한 조직의 반응이 감소되어 나타나는 드문 유전 질환이다. 대부분은 갑상선 호르몬 수용체 (TR) 유전자의 돌연변이로 인한 갑상선 호르몬 수용체의 결함에 의한다. TR 유전자의 변이는 일반적으로 이형접합성이며 상염색체 우성 유전 양상을 보인다. 혈청 갑상선 호르몬 수치가 증가되어 있음에도 불구하고 혈청 갑상선 자극호르몬 수치가 억제되지 않으며, 임상 양상은 다양하다. 본 증례는 경미한 갑상선종, 총 및 유리 $T_4$, $T_3$의 증가, 정상 범위의 TSH 소견을 보이는 4세 여아로서 TR 유전자 분석에서 과오돌연변이(H435Y)를 확인하였다. 부모에서는 돌연변이가 관찰되지 않았으며, 갑상선 기능도 정상이었다. 특별한 투약 없이 추적 관찰 중에 갑상선종의 증가나 다른 증상의 악화는 없는 상태이다.

• 대한두경부종양학회지
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• 제26권2호
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• pp.212-215
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• 2010

Objectives：There are various reports for incidence and risk factors of hypothyroidism after hemithyroidectomy for benign thyroid disease. The reported incidence rate varies from 5.0 to 41.9%. Moreover, there are few reports about this in Korea. So, our objective is to identify the incidence and possible factors contributing to hypothyroidism after hemithyroidectomy in Korea. Subjectives and Methods：We reviewed medical records of patients who underwent hemithyroidectomy between 1999 and 2007 years. We enrolled 80 patients. The incidence of postoperative hypothyroidism was based on thyrotropin values and clinical symptoms. And all patients were evaluated for age, gender, serum thyrotropin(TSH) levels, serum free T4, weight of resected thyroid tissue and associated thyroiditis. Results：Nine of 80 patients(11.3%) became biochemically hypothyroid postoperatively. Six of 9 hypothyroid patients were diagnosed within 2 months of operation. The mean preoperative TSH level was $2.12{\pm}0.96mIU/L$ in hypothyroid and significantly different from $1.33{\pm}0.77mIU/L$ in euthyroid patients(p<0.05). There were no significant differences in age, gender, weight of resected thyroid tissue, preoperative free T4 and associated thyroiditis. Conclusion：A minority of patients became hypothyroid after hemithyroidectomy. Hypothyroidism following hemithyroidectomy occurred in patients with higher preoperative TSH levels.. The screening test for postoperative hypothyroidism should be performed from month to year after operation.

• 대한수의학회지
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• 제38권3호
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• pp.508-517
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• 1998

There is evidence that the sympathetic nervous system exerts a control on thyroid function via an adrenergic innervation of thyroid cells. Although it is clear that the inhibitory effects of catecholamines result from an activation of ${\alpha}_1$-adrenoceptors, the mechanisms involved in ${\alpha}_1$-stimulation are not fully understood. The effects of methoxamine and protein kinase C (PKC) activator on the release of thyroxine ($T_4$) from mouse thyroid were studied to clarify the role of PKC in the regulation of $T_4$ release in vitro. The glands were incubated in the medium, samples of the medium were assayed for $T_4$ by EIA kits. Methoxamine inhibited the TSH-stimulated $T_4$ release. This inhibition was reversed by prazosin, an ${\alpha}_1$-adrenergic antagonist. Futhermore, the inhibitory effect of methoxamine on the $T_4$ release stimulated by TSH was prevented by chloroethylclonidine, an ${\alpha}_{1b}$-adrenoceptor antagonist, but not by WB4101, an ${\alpha}_{1a}$-adrenoceptor antagonist. Also methoxamine inhibited the forskolin-, cAMP- or IBMX-stimulated $T_4$ release. These inhibition were reversed by PKC inhibitors, such as staurosporine and $H_7$. PMA, a PKC activator, completely inhibited the TSH-stimulated $T_4$ release, and its inhibition was reversed by staurosporine and $H_7$, but not by chelerythrine. R59022 (a diacylglycerol kinase inhibitor), like methoxamine, also inhibited the TSH-stimulated $T_4$ release, and its inhibition was also reversed by staurosporine. The present study suggests that methoxamine inhibition of $T_4$ release from mouse thyroid can be induced by activation of the ${\alpha}_{1b}$-adrenoceptors and that it is mediated through the ${\alpha}_1$-adrenoceptor-stimulated PKC formation.

• Annals of Pediatric Endocrinology and Metabolism
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• 제23권4호
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• pp.235-239
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• 2018

Most cases of congenital hyperthyroidism are autoimmune forms caused by maternal thyroid stimulating antibodies. Nonautoimmune forms of congenital hyperthyroidism caused by activating mutations of the thyrotropin receptor (TSHR) gene are rare. A woman gave birth to a boy during an emergency cesarean section at 33 weeks of gestation due to fetal tachycardia. On the 24th day of life, thyroid function tests were performed due to persistent tachycardia, and hyperthyroidism was confirmed. Auto-antibodies to TSHR, thyroid peroxidase, and thyroglobulin were not found. The patient was treated with propylthiouracil and propranolol, but hyperthyroidism was not well controlled. At 3 months of age, the patient had craniosynostosis and hydrocephalus, and underwent a ventriculoperitoneal shunt operation. Direct sequencing of the TSHR gene showed a heterozygous mutation of c.1899C>A (p.Asp633Glu) in exon 10. No mutations were discovered in any of the parents in a familial genetic study. We have reported a case of sporadic nonautoimmune congenital hyperthyroidism, by a missense mutation of the TSHR gene, for the first time in South Korea.

• 대한핵의학회지
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• 제30권1호
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• pp.65-76
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• 1996

1993년 2월부터 1994년 8월까지 경북대학교병원 핵의학과에서 진료한 갑상선질환 중 그레이브스병 402예와 하시모토갑상선염 230예를 대상으로 혈청 thyrotropin-binding inhibiting immunoglobulin (TBII)치를 방사면역측정법으로 측정하여 갑상선 기능상태와 그 치료경과에 있어서의 동태를 관찰하고 아울러 혈청 갑상선글로블린치, antithyroglobulin anti-body(ATAb) 및 antimicrosomal antibody(AMAb)의 동태를 동시에 검토하여 다음과 같은 결과를 얻었다. 혈청 TBII치는 갑상선기능항진성 그레이브스병에서 평균 $40.82{\pm}21.651%$, 하시모토갑상선염에서 평균 $8.89{\pm}14.522%$로서 정상 대조군의 평균 $3.21{\pm}2.571%$에 비하여 유의한 상승치를 보였다. 그레이브스병 중에서도 갑상선기능항진증이 있는 387예에서는 TBII치가 비정상적으로 증가한 예가 92.2%(357예)였으며, 갑상선기능이 정상으로 회복된 그레이브스병 15예에서는 TBII치가 비정상적으로 증가된 예는 46.7%(7예)에 불과하였다. 하시모토갑상선염 230예에서는 TBII치가 비정상적으로 상승한 예는 23.9%(55예)였다. 그레이브스병에서 TBII치들은 RAIU 6시간치 및 24시간치, T3, T4, FT4들과 유의한 양의 상관성을 나타내었으며, 혈청 갑상선글로블린 및 AMAb와도 양의 상관성을 나타내었다(p<0.001). 그러나 혈청 TBII치와 TSH와는 음의 상관성을 나타내었고(p<0.001), ATAb와는 상관성이 없었다. 하시모토갑상선염에서는 TBII치는 RAIU 6시간치 및 24시간치, T3, TSH, AMAb와는 유의한 양의 상관성이 있었고(p<0.05), 혈청 T4, FT4, 갑상선글로불린 및 ATAb치와는 상관성이 없었다. 결론적으로, 그레이브스병에서는 혈청 TBII치가 갑상선기능항진증의 정도를 반영하는 소견이 되며 회복기의 TBII치는 예후를 반영하는 자료가 될 수 있다. 그리고 하시모토갑상선염에서는 비록 TBII치가 상승된 예는 많지 알지만 갑상선기능이 항진되거나 저하되는 소견의 정도와 관련이 있고 병변의 중증도를 반영한다고 볼 수가 있다.

• Asian-Australasian Journal of Animal Sciences
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• 제23권12호
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• pp.1668-1676
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• 2010

The somatotropic axis plays a key role in proliferation and differentiation of avian organs during both pre- and posthatching periods. This review discusses the complexity of regulation of the endocrine system for chicken development and growth by growth hormone (GH), insulin-like growth factor (IGF), and IGF binding protein (IGFBP). In addition, the thyrotropic axis, including thyrotropin-releasing hormone (TRH) and thyroid hormones ($T_4$ and $T_3$), is also involved in the GH-secreting pattern. In mammals, IGFI and -II are always sequestered in a 150 kDa non-covalent ternary complex. This complex consists of one molecule each of IGF-I or IGF-II, IGFBP-3 or IGFBP-5 and an acid labile subunit (ALS). Chick ALS is identified in different strains for the first time, and further investigation of the expression of ALS on developmental stage and ALS effect on IGF bioavailability may be addressed in the future.

• 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.

• The Korean Journal of Medicine
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• 제99권3호
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• pp.127-133
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• 2024

Subclinical hypothyroidism (SCH) is characterized by elevated serum thyroid-stimulating hormone (TSH) levels and normal free thyroxine levels. The Korean Thyroid Association recently issued guidelines for managing SCH. Based on the Korea National Health and Nutrition Examination Survey (2013-2015), a serum TSH level of 6.8 mIU/L is the reference value for SCH. SCH is classified as mild (TSH 6.8-10.0 mIU/L) or severe (TSH > 10.0 mIU/L), and patients are categorized as adult (age < 70 years) or elderly (age ≥ 70 years). Levothyroxine treatment (LT4-Tx) is not recommended for mild or even severe SCH in elderly patients. Immediate LT4-Tx can be given to adults in most cases, but not to women who are pregnant, patients with progressive disease, or patients with underlying coronary artery disease, heart failure, or dyslipidemia.