• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.369-375
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• 2005

Purpose : Many inborn errors of metabolism can be completely cured with early detection and early treatment. This is why neonatal screening on inborn errors of metabolism is implemented worldwide. In this study, a cost-benefit analysis was performed on the neonatal screening of phenylketonuria and congenital hypothyroidism in Korea. Methods : This study included 2,908,231 neonates who took the neonatal screening on phenylketonuria and congenital hypothyroidism in Korea from January 1991 to December 2003. From those neonates, the incidence rates of phenylketonuria and congenital hypothyroidism were measured. Furthermore, based on 495,000 babies born in 2002, were calculated and compared the total costs in case when neonatal screening on phenylketonuria and congenital hypothyroidism is implemented, and when not. Results : If the neonatal screening on phenylketonuria and congenital hypothyroidism is implemented, benefits far exceed costs at a ratio of 1.77 : 1 in phenylketonuria, and 11.11 : 1 in congenital hypothyroidism. In terms of wons, the present neonatal screening on phenylketonuria and congenital hypothyroidism will gain us more than 29 billion wons every year. Conclusion : This study only concerns the monetary aspects of the neonatal screening. Therefore, the benefits of the neonatal screening is underestimated by ignoring precious but not measurable values such as quality of life. However, the present neonatal screening on phenylketonuria and congenital hypothyroidism is found to be beneficial and should continue for the good of the nation as well as that of the patients.

• The Korean Journal of Nuclear Medicine
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• v.11 no.1
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• pp.39-48
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• 1977

Radioactive iodine(RAI), principally $^{131}I$, effectively controls hyperthyroidism in the majority of patients. The subsequent development of hypothyroidism, however, has been of increasing concern since it was first pointed out by Chapman and Maloof in 1955. And the steady increase of late hypothyroidism during the passage of time was known with its relation with dosage of RAI. The authors have investigated the development of hypothyroidism in 935 patients with diffuse toxic goiter(DTG) who were treated with ($RAI^{131}I$) at the Seoul National University Hospital from 1960 to 1977 to reveal its relation with the number of RAI treatments, dosage of RAI, age of patients and exophthalmos with the following results. 1) The incidence of hypothyroidism by year after RAI therapy among 631 patients with DTG who were treated with single RAI regimen was 7.4%(1 year), 11.8%(2 year), 16.2%(3 year), 22.1%(4 year) and 25.5%(5 year), and that among 163 patients given multiple RAI treatments was 8.6%(1 year), 10.4%(2 year), 13.3%(3 year), 29.1%(4 year), and 54.1%(5 year)respectively showing much higher year1y increments from 4 years after RAI treatment. in comparison with the former. 2) Among 550 patients in the lower dose group treated with single RAI regimen less than 5.0mCi ($Mean{\pm}S.D.:\;4.3{\pm}0.6mCi$), the incidence of hypothyroidism by year after RAI treatment was 6.8%(1 year), 11.4%(2 year), 15.4%(3 year), while among 81 patients in the higher dose group given single RAI treatment not less than 5.5 mCi ($Mean{\pm}S.D.:\;6.3{\pm}0.5mCi$) it was 12.0%(1 year), 15.4%(2 year) and 20.4%(3 year) respectively. However, the duration till euthyroid state after RAI therapy in the two groups was $5.1{\pm}3.6$ months and $4.8{\pm}2.8$ months respectively showing no statistically signficant difference (p>0.1). 4) The incidence of hypothyroidism after RAI treatment in patients younger than 30 years of age was 4.3%(1 year) and 7.7%(2 year); in patients from 30 years to 49 years of age, 5.8%(1 year) and 11.1%(2 year); and in those older than 50 years, 11.0%(1 year) and 14.4%(2 year). The data revealed rising incidence of hypothyroidism with increase of patients' age. 4) Among 116 patients with exophthalmos the incidence of hypothyroidism by year after RAI treatment was 7.1%(1 year) and 12.1%(2 year) while that among 184 patients without exophthalmos was 7.3%(1 year) and 12.2%(2 year) respectively. With the above data the authors could conclude that the hypothyroidism in patients with DTG who were treated by RAI developed more frequently than reported by others in Korea till now, and increased with the passage of time, the yearly increments from 4 years after RAI treatment increasing markedly in the multiple dose group, and the incidence could be reduced by decreasing the administered RAI doe not increasing the duration till euthyroid state after RAI therapy.

• Journal of Haehwa Medicine
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• v.21 no.1
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• pp.97-101
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• 2012

We treated a 18 year-old female patient. The main symptoms were Low back pain, Dyspepsia, Anorexia. She want to check blood test spontaneously and we diagnosed her as subclinical hypothyroidism and prescribe herbal medicine three times a day. We observed clinical symptoms and Free T4, T3, TSH levels. After the treatment, The main symptom were improved and TSH levels fell. This case shows that herbal medicine has an effect on subclinical hypothyroidism.

• Journal of Nutrition and Health
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• v.27 no.10
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• pp.1037-1047
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• 1994

Dietary iodine intake and urinary iodide excretion were meassured from 110 patients with various thyroid hormone diseses(hypothyroidism, hyperthyroidism, simple goiter and thyroid adenoma) and 67 normal control subjects. Iodine intake was assessed on the 24-hour recall dietary data using the compiled lists of food iodine values developed from various countries. Urinary iodide concentrations of drink water samples were measured with the iodide-selective electrode. The average iodine intake of the thyroid patients was 411$\mu\textrm{g}$, which was 87% higher(p<0.05) than that of the control subjects(220$\mu\textrm{g}$). Patients with hyperthyroidism and hypothyroidism or simple goiter excreted the most(0.6442ppm) amount of iodide respectively in the urine, with the control subject in the middle(0.5229ppm). Iodide concentrations of the drinking water samples were found to be in the range of 0.0015ppm to 0.0214ppm, which seemed to vary depending on the kind(underground water vs public water) and the location.

• Clinical and Experimental Pediatrics
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• v.53 no.12
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• pp.1018-1021
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• 2010

Townes-Brocks syndrome (TBS) is a rare autosomal dominant congenital disorder caused by mutations in the $SALL1$ gene. Its signs and symptoms overlap with other genetic syndromes, including VACTERL association, Pendred syndrome, Baller-Gerold syndrome, and cat eye syndrome. Structural vertebral abnormalities, hypoplasia of the thumb, and radial bone abnormalities, which are not usually associated with TBS, help in the differential diagnosis of these syndromes. We report the case of a family whose members were diagnosed with TBS with congenital hypothyroidism and had a novel $SALL1$ gene mutation.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1281-1289
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• 2018

Objectives: This study is the first report on a case of subclinical hypothyroidism treated with Modified Er-Xian Decoction, which is rarely used in Korea. Methods: Patients were treated for 3 months with Modified Er-Xian Decoction and their therapeutic effects were evaluated through thyroid function tests and Spleen-Kidney deficiency Questionnaire. Results: Initial improvement was apparent after the administration of Modified Er-Xian Decoction. After 3 months of treatment, the patient 's Spleen-Kidney deficiency index improved significantly, and thyroid hormone levels returned to normal. Conclusions: In this case report, symptoms and biochemical improvement were confirmed based on a single herbal medicine prescription for subclinical hypothyroidism. It is necessary to verify the effect of this prescription through well - established clinical trials.

• The Korean Journal of Medicine
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• v.99 no.3
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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.

• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.1000-1010
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• 2008

Objective : Hypothyroidism is a syndrome characterized by symptoms such as cold intolerance, or weight gain. Because of side effects of Western medicine treatment, interest in oriental medicine has been increasing. In this study, we examined the therapeutic effects of Evodiae fructus and histological modification in hypothyroidism rat model induced by PTU(6-propyl, 2-thiouracil). Methods : After inducing hypothyroidism in the rats by PTU injections, we divided the rats into four groups, the Evodiae fructus 100 500, control, and $LT_4$ (levothyroxine) groups. After 2 weeks Evodiae fructus and $LT_4$ were administered, respectively. The weight was measured once a week. After sampling the blood for biochemical analysis to check the levels of $T_3$, $T_4$ and TSH, the thyroid tissue was removed, stained with H&E, and an image was obtained using an optical microscope. Results : Compared with normals, controls showed low $T_4$ and high TSH. The Evodiae fructus group showed a statistically meaningful $T_3$ increase to be dose related. But the levels of TSH showed no meaningful difference between the Evodiae fructus group and normals. About the biochemical tests(liver, kidney etc) and weight change, there was no meaningful difference between the Evodiae fructus group and controls. In the biopsy, the Evodiae fructus group showed thyroid tissue improvement compared to controls. Conclusions : These results show that Evodiae fructus stimulates the decreased functions of the thyroid, and also has thyroid cell protecting effects. The lab results also showed that Evodiae fructus is a safe substance that doesn't cause hepatotoxicity or nephrotoxicity. Therefore it is an effective substance in the treatment of hypothyroidism.

• The Korea Journal of Herbology
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• v.30 no.4
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• pp.109-119
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• 2015

Objectives : The aim of this study was to evaluate the effect of aqueous extracts of Mume Fructus(MF) on the 6-n-propyl-2-thiouracil(PTU)-induced rat hypothyroidism.Methods : Aqueous extracts of MF(yield = 19.38%) were administered, once per day for 42 days from 2 weeks before starting of PTU treatment as an oral dose of 300 and 150 ㎎/㎏(body weight), and hypothyroidism was induced by daily subcutaneous treatment of PTU 10 ㎎/㎏ for 28 days. The changes in the body weight, thyroid gland weights, liver weight, serum levels of thyroid hormone-thyroid stimulating hormone(TSH), tri-iodothyronine(T₃) and thyroxine(T₄), total cholesterol, low density lipoprotein(LDL), high density lipoprotein(HDL) and triglyceride (TG), aspartate aminotransferase(AST), alanine aminotransferase(ALT), liver antioxidant defense system-lipid peroxidation, H₂O₂, superoxide dismutase(SOD) and catalase(CAT) were examined with histopathology of thyroid glands and liver.Results : Results were compared with LevoT₄0.5 ㎎/㎏ treated rats. MF extracts recovered from the decreases in the body weight, liver weight, T₃and T₄, TG, liver CAT activities as results of PTU treatment. And MF extracts recovered from the increases of thyroid gland weights, TSH, HDL contents, liver H₂O₂, AST as results of PTU treatment. In addition, these PTU-induced histopathological changes in thyroid glands and liver related to hypothyroidism were dramatically decreased by treatment of both different dosages of MF extract, respectively.Conclusions : According to the above results, it is suggested that MF extracts have advantageous effects on the thyroid hormone productions with beneficial effects on the hypothyroidism related liver injuries mediated by the modulation on the antioxidant system.

• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.590-596
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• 2001

The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A-33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CP AP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardiomyopathy with review of the relevant literature.