• Title/Summary/Keyword: thyroid disease

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The Roles of the TSH Receptor Antibodies in Autoimmune Thyroid Diseases (자가면역성 갑상선질환에서 TSH 수용체 항체의 역활에 관한 연구)

  • Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.85-100
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    • 1986
  • To evaluate the clinical and pathogenetic roles of TSH receptor antibodies in autoimmune thyroid diseases, TBII were measured by TSH-radioreceptor assay methods in 352 patients with Graves' disease, 108 patients with other thyroid diseases and 69 normal persons. The normal range of TBII activity was less than 15%. The frequencies of detectable TBII in 169 patients with untreated Graves' disease, 31 patients with hyperthyroidism under treatment and 70 patients with euthyrodism under treatment were 92.4%, 87.1% and 54.3% respectively. However 12 (21.8%) out of 55 patients who have been in remission more than one year after discontinuation of antithyroid drugs treatment had detectable TBII activities in their sera. In 196 patients with untreated Graves' disease, the frequency of TBII increased by increasing size of goiter and the frequency of proptosis was significantly high in patients whose TBII activities were more than 60%. TBII activities were roughly correlated with total $T_3,\;T_4$ and free $T_4$ index but low $\gamma^2$ value(less than 0.1). In 67 patients with Graves' disease who were positive TBII before antithyroid drugs treatment, TBII activities began to decrease from the third months and it was converted to negative in 35.8% of patients at 12 months after treatment. There were no significant differences of the declining and disappearing rates of TBII activities between high dose and conventional dose groups. TBII activities were significantly increased initially (2-4 months) and then began to decrease from 5-9 months after $^{131}I$ treatment. There were two groups, one whose TBII activities decreased gradually and the other did not change untill 12 months after subtotal thyroidectomy. Although preoperative clinical and laboratory findings of both groups were not different, TBII activities of non-decreasing group were significantly higher than those of decreasing group$(74.6{\pm}18.6%\;vs\;39.2{\pm}15.2%;\;P<0.01)$. Thirty three(55.9%) out of 59 patients with Graves' disease relapsed within 1 year after discontinuation of antithyroid drugs. The positive rate of TBII at the end of antithyroid drug treatment in relapse group(n=33) was significantly higher than those in remission group (n=26) (63.6% vs 23.1%; P < 0.05). The mean value of TBII activities at the end of antithyroid drug treatment in relapse group was significantly elevated $(29.7{\pm}21.4%\;vs\;14.7{\pm}11.1%,\;P<0.05)$. Positive predictive value of TBII for relapse was 77.8%, which was not different from those of TRH nonresponsiveness(78.6%). The frequencies of detectable TBII in 68 patients with Hashimoto's thyroiditis, 10 patients with painless thyroiditis and 5 patients subacute thyroiditis were 14.7%, 20% and 0%, respectively. However in 25 patients with primary nongoitrous myxedema, 11 patients(44%) showed TBII activities in their sera. 9 out of 11 patients who had TBII activities in their sera showed high TBII activities(more than 70% binding inhibition) and their IgG concentrations showing 50% binding inhibition of $^{125}I-bTSH$ to the TSH receptor were ranges of 0.1-2.6 mg/dl. One patient who had high titer of TBII in her serum delivered a hypothyroid baby due to transplacental transfer of maternal TBII. These findings suggested that 1) TSH receptor antibodies are closely related to a pathogenetic factor of Graves' hyperthyroidism and of some patients with primary non-goitrous myxedema, 2) measurement of TSH receptor antibodies is helpful in evaluating the clinical outcome of patients with Graves' disease during antithyroid drug treatment and in predicting the neonatal transient hypothyroidism of baby delivered from primary myxedema patients. 3) there are 2 or more different types of TSH receptor antibodies in autoimmune thyroid diseases including one which stimulates thyroid by binding to the TSH receptor and another which blocks adenylate cyclase stimulation by TSH.

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A Study of Serum Thyroglobulin in Various Thyroid Diseases (각종 갑상선질환에서 혈청 Thyroglobulin치에 관한 연구)

  • Kim, Chang-Kook;Jeon, Byung-Sook;Han, Bong-Heon;Ro, Heung-Kyu;Lee, Bok-Hui
    • The Korean Journal of Nuclear Medicine
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    • v.17 no.1
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    • pp.17-23
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    • 1983
  • In an attempt to evaluate the diagnostic singnificance of the serum thyroglobulin (TG) in various thyroid disease states, authors measured serum TG by radioimmunoassay technique in 20 cases of normal subject, 22 cases of hyperthyroidism, 12 cases of diffuse nontoxic goiter (DNG) and 96 cases of nodular nontoxic goiter(NNG). The results were as follows: 1. In 20 cases of normal subjects, serum TG level was $20.41{\pm}5.5ng/ml(M{\pm}S.D.)$. There was no significant difference between males ans females. 2. In 22 cases of hyperthyroidism, serum TG level was $60.23{\pm}34.56ng/ml$ and the range was from 22 to 175 ng/ml, which were significantly high levels comparing with normal controls (p<0.01). 3. In 12 cases of euthyroidism with DNG, serum TG was $37.28{\pm}27.36ng/ml$ and the range was from 14 to 89 ng/ml. In 96 cases of euthyroidism with NNG, serum TG was $70.43{\pm}78.18ng/ml$ and the range was from 12.8 to 440 ng/ml. Both groups showed significantly increased levels of TG than normal control (p<0.01). 4. 57 cases of NNG patients were analysed pathologically by operation or needle biopsy and the TG level of each disease group is as follows. Thyroid carcinoma (16 cases); $72.2{\pm}81.71ng/ml$, adenomatous goiter without cystic degeneration (15 cases); $74.86{\pm}45.64ng/ml(M{\pm}S.D.)$ and adenomatous goiter with cystic degeneration(23 cases); $73.56{\pm}64.78ng/ml(M{\pm}S.D.)$. There was no significant difference between each group. Also the TG levels of thyroiditis (5 cases) was $19.6{\pm}8.96ng/ml(M{\pm}S.D.)$. 5. There were no significant correlations between serum thyroid hormones and serum TG in each thyroid functional states.

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The Clinical Study on 1 Case of Soeumin Patient Diagnosed as Grave's disease, Treated with Palmulgunja-tang and Western Medicine (그레이브스병으로 진단된 소음인의 팔물군자탕과 양약 병용 투약한 치험 1례)

  • Lee, Seung-Hyeob;Choi, Ae-Ryun;Goo, Deok-Mo
    • Journal of Sasang Constitutional Medicine
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    • v.22 no.4
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    • pp.98-105
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    • 2010
  • 1. Objectives The purpose of this case is to report that Soeumin patient diagnosed as Grave's disease was treated with Palmulgunja-tang and antithyroid drugs in combination. 2. Methods From April 7, 2010 to June 30, 2010, we treated him with Palmulgunja-tang and antithyroid drugs. We took his weight, pulse and checked visual analog scale(VAS) to evaluate the symptoms of Grave's disease. 3. Results After treatment, this patient's thyroid function test were improved faster than with western medicine treatment only in 2009. The symptoms also were improved. 4. Conclusions This case study showed an efficient results by giving Sasang Constitutional treatment in treatment of Grave's disease.

Successful Surgical Treatment of Cardiac Complication of Graves Disease

  • Min, Jooncheol;Kim, Woong-Han;Jang, Woo Sung;Choi, Eun Seok;Cho, Sungkyu;Choi, Kwang Ho
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.294-297
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    • 2014
  • Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment.

Complications in Total Thyroidectomy (갑상선 전절제의 합병증)

  • Han Gwang-Hee;Chin Hyung-Min;Park Woo-Bae;Kim Jun-Gi;Chun Chung-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.106-111
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    • 1994
  • During a 9-year period(March 1985 to February 1994), 111 consecutive total thyroidectomies and modified or radical neck dissections were performed at 81. Vincent Hospital, Catholic University Medical College, for benign and malignant disease. There were three permanent complications, persistent hypoparathyroidism, in total thyroidectomies. Overall complications were observed 20(62.5%) in benign diseases, 47(59.5%) in malignancy. In benign and malignant thyroid diseases. the complications were transient hypoparathyroidisms (28.8%), transient hoarsenesses(21.6%), wound infections (3.6%), bleedings(3.6%), and permanent hypoparathyroidisms(2.7%). Our experience suggests that the morbidity of total thyroidectomy relates primarily to the extracapsular extension, necessitating en bloc exision accompanied by additional lymph node dissection. The low incidence of permanent complications in thyroid disease suggests the feasibility of total thyroidectomy as the operation of choice when surgeons are familiar with the technique and indications.

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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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[$H\"{u}rthe$] Cell Tumor of the Thyroid Gland (갑상선의 $H\"{u}rthle$ Cell Tumor)

  • Moon Seung-Sang;Kang Seong-Joon;Kim Soo-Yong
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.2
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    • pp.106-111
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    • 1992
  • Ten patients with $H\"{u}rthle$ cell tumor of the thyroid gland from Dec. 1987 to Sep. 1992 were reviewed to delinate an acceptable policy of treatment. Patients varied from age 23 years to 66 and consisted of nine females and one male, most of whom had an asymptomatic solitary cold nodule. Four patients had benign neoplasm and six patients had malignant neoplasm proven by capsular or vascular invasion or nodal metastasis. Associated thyroid lesions occurred in five patients, three adenomatous goiter, one Graves' disease and one follicular cell carcinoma. Surgery consisting of lobectomy and isthmectomy in four patients, bilateral subtotal thyroidectomy in one patients, total thyroidectomy in five patients. Lymph node dissection was not performed. Only one patient was experienced transient hypocalcemia. The period of observation varied from 15 to 58 months(mean, 30.5 months). Although our case was small and short follow up period, there were no recurrences or deaths. We suggested early aggressive surgical approach was appropriate because of lower recurrence rate and fewer operation, high bilateralism, lower surgical complication.

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Thyroid Stimulating Immunoglobulin Bioassay Using Cultured Human Thyroid Cells; A Simplified Micromethod (갑상선질환에서 갑상선 자극면역글로불린측정의 의의에 관한 연구 -Micro법 갑상선세포배양에 의한 측정의 기본적 검토-)

  • Lee, Myung-Chul;Chung, June-Key;Cho, Bo-Youn;Koh, Chang-Soon;Lee, Mun-Ho;Ahn, Il-Min;Ahn, Hee-Kwon
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.1
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    • pp.95-102
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    • 1985
  • The activation of adenylate cyclase of human thyrocytes in primary cell culture and the release of c-AMP into the medium are used to detect b-TSH and TSAb in sera of patients with autoimmune thyroid disease. Sera of patients are used directly as a part of cell culture without immunoglobulin precipitation. In the above TSI bioassay, TSAb pooled serum show c-AMP concentration between that of 1mU/ml and 10 mU/ml b-TSH but normal control pooled serum doesn't show any detectable c-AMP response. Ninety fiye percent of untreated Graves' patients shows TSAb activity above normal range, 20% of Hashimoto's and 36% of euthyroid Graves' patients show detectable TSAb activity.

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Stress response as a contributing factor in horses with laminitis

  • Alexandra Moss;Britta Leise;Eileen Hackett
    • Journal of Veterinary Science
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    • v.24 no.2
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    • pp.33.1-33.7
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    • 2023
  • Background: Laminitis is a complex and debilitating disease of horses. Numerous predisposing factors contribute to laminitis development, however the exact pathogenesis remains undetermined. Serum T4, cortisol, and histamine are components of the innate stress response and could play a causative or contributory role. Stress hormone concentrations in laminitis are largely unknown. Objective: To evaluate parameters associated with stress response in horses with laminitis, and compare these to healthy horses and horses with gastrointestinal (GI) disease. Methods: Thirty-eight adult horses presenting for non-medical conditions, GI abnormalities, or clinical laminitis were prospectively enrolled. Horses were assigned to the appropriate disease group (healthy, GI disease, and laminitis) and had blood drawn on presentation to the hospital. Samples were analyzed for plasma endogenous adrenocorticotrophic hormone (eACTH), serum cortisol, serum thyroid hormone, and plasma histamine. Results: Stress hormone concentrations were significantly different between horses in the laminitis and GI disease groups. Plasma histamine levels were highest in horses with laminitis, compared with GI disease and controls. Both horses with laminitis and GI disease had increased plasma eACTH when compared to healthy horses. Horses with GI disease had higher serum cortisol concentrations than horses with laminitis or controls. Serum T4 was lower in horses with GI disease than in horses with laminitis and controls. Conclusions: Horses with laminitis had relative increases in both plasma histamine and eACTH concentrations. Serum T4 and cortisol concentrations of horses with laminitis did not differ significantly when compared to healthy horses. The role of stress hormones in equine disease warrants further investigation.