• Title/Summary/Keyword: thyroid disease

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Recent Improvements in the Treatment of High-Risk Thyroid Cancer (예후가 좋지 않은 갑상선암에 대한 최신 치료 방침)

  • Lee, Eun Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.1-9
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    • 2022
  • Thyroid cancer is one of the slow-growing tumors with excellent oncological outcomes. However, a small set of patients with unexpectedly severe outcomes are usually ignored. Anaplastic thyroid cancer (ATC) remains one of the most aggressive and lethal solid tumors. Recently, dabrafenib and trametinib combination therapy or neoadjuvant BRAF induction therapy has shown promising results. In addition, a combination of targeted drugs, immunotherapy, surgery, and radiation therapy can improve overall survival in ATC patients. Another disease for which there is no breakthrough treatment is radioactive iodine-refractory differentiated thyroid cancer (DTC). To date, multikinase inhibitors (sorafenib, lenvatinib) targeting the growth factor signaling pathway have been developed and approved as anticancer agents for patients with advanced DTC. This review includes results from multikinase inhibitors to the emergence of new target molecules, including rearrangements during transformation (RET) and tropomyosin receptor kinase (TRK).

Associations Between XRCC1 Arg399Gln, Arg194Trp, and Arg280His Polymorphisms and Risk of Differentiated Thyroid Carcinoma: A Meta-analysis

  • Du, Yang;Han, Li-Yuan;Li, Dan-Dan;Liu, Hui;Gao, Yan-Hui;Sun, Dian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5483-5487
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    • 2013
  • Background: Associations between Arg399Gln, Arg194Trp and Arg280His polymorphisms of the XRCC1 gene and risk of differentiated thyroid carcinoma (DTC) have been widely studied but the findings are contradictory. Methods: We performed a meta-analysis in the present study using STATA 11.0 software to clarify any associations. Electronic literature databases and reference lists of relevant articles revealed a total of 10, 6 and 6 published studies for the Arg399Gln, Arg194Trp and Arg280His polymorphisms, respectively. Results: No significant associations were observed between Arg399Gln and DTC risk in all genetic models within the overall and subgroup meta-analyses, while the Trp/Trp vs Arg/Arg and recessive model of the Arg194Trp polymorphism was associated with DTC susceptibility, and the dominant model of Arg280His polymorphism contributed to DTC susceptibility in Caucasians. Conclusions: Our meta-analysis suggests that XRCC1 Arg194Trp may be a risk factor for DTC development.

Correlation between 5-Minute $^{99m}Tc-Pertechnetate$ Uptake and 24-Hour $^{131}I$ Uptake in Patients with Thyroid Disease (갑상선환자에서의 5분 $^{99m}Tc-Pertechnetate$ 섭취율과 방사성옥소섭취율의 상관관계)

  • Lee, Chan-Woo;Won, Kyu-Chang;Yoon, Hyun-Dae;Cho, In-Ho;Kim, Tae-Nyeun;Shin, Dong-Gu;Lee, Hyoung-Woo;Shim, Bong-Sup;Lee, Hyun-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.280-289
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    • 1992
  • The 20-minute $^{99m}Tc-pertechnetate$ uptake became readily available for routine use and it replaced $^{131}I$ for thyroid imaging. However measuring thyroid uptake during a 5-minute minimizes pertechnetate uptake by the salivary glands and presence of contaminated saliva from those glands in to the pharynx and esophagus. A study was carried out to determine the suitability of the utility of a S-minute and 20-minute interval from administration of $^{99m}Tc-pertechnetate$ to imaging and uptake measurement as a replacement for the 24 hour standard originally established with $^{131}I$, and to evaluate the relationship between 5-minute $^{99m}Tc-pertechnetate$ uptake and other thyroid functions. A 5-minute and 20-minute uptake of $^{99m}Tc-pertechnetate$ were measured in 70 patients with thyroid disease at Yeungnam University Hospital from March 1, 1991 to Feb. 29, 1992. The results were as follows. 1) The 5-minute $^{99m}Tc-pertechnetate$ uptake in Graves' disease, Hashimoto's thyroiditis, simple goiter, non toxic nodular goiter, subacute thyroiditis and euthyroid were 18.2%, 14.6%, 2.8%, 3.2%, 1.2% and 1.1%, respectively. There was a significant difference between the mean of the euthyroid group and the mean of the Graves' disease. So differenciation between them can be easily made. 2) The 5 minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24 hour $^{131}I$ thyroid uptake (r=0.75, p<0.001). These data provided an equation for estimating the 24 hour uptake of iodide given the 5 minute pertechnetate uptake: Estimated 24-hour $^{131}I$ thyroid Uptake= 7.188*ln (5 minute $^{99m}Tc-pertechnetate$ uptake)+16.94 3) The 20-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24-hour $^{131}I$ uptake (r=0.72, p<0.001) and 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake (r=0.96, p<0.001). 4) In the Graves' disease, The 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with serum $T_3-resin$ uptake (r=0.46, p<0.01), serum total $T_3$ (r=0.55, p<0.05), serum total $T_4$ (r=0.46, p<0.05). These results suggest that 5-minute ${99m}Tc-pertechnetate$ thyroid uptake has been found at least as useful as 24-hour $^{131}I$ uptake for diagnostic confirmation at our hospital, the logistical advantages of completing the diagnosis. The exam in 5-minutes led us to abandon the 24-hour study in the majority of patients, but the 24-hour $^{131}I$ uptake is still obtained in patients with planned or potential radioiodine therapy.

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Association between Thyroid-Related Hormones and Cognitive Function in Patients with Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머병 및 경도인지장애 환자에서 갑상선 관련 호르몬과 인지기능과의 상관관계)

  • Park, Da Yun;Kim, Hyun;Lee, Kang Joon
    • 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.

A Study on the Clinical Diagnosis of Hyperthyroidism (갑상선기능항진증(甲狀腺機能亢進症)의 임상적(臨床的) 진단(診斷)에 관(關)한 연구(硏究))

  • Ku, In-Seo;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.7 no.1
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    • pp.15-29
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    • 1973
  • To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: 1. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7.6% of the patients were male and 92.4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91.3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight loss, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyspnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid ?unction tests was as follows; $T_7$ was 92.4% reliable, $^{125}IT_3$ resin uptake rate 91.6% reliable, $^{131}I$ thyroid uptake rate in 24 hrs. 89.4% reliable, serum $T_4$ level 85.9% reliable and BMR 75.5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthyroidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical signs but a high BMR was associated with both tachycardia and systolic murmur.

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Dual Lingual Thyroid Mimicking Mono-ectopic Thyroid in the Anterior View of Tc-99m Sodium Pertechnetate Thyroid Scan (전면 영상에서 하나로 오인된 두개의 설갑상전종)

  • Chong, A-Ri;Jeong, Shin-Young;Kwon, Seong-Young;Seo, Young-Soon;Ha, Jung-Min;Oh, Jong-Ryool;Bom, Hee-Seung;Song, Ho-Chun;Min, Jung-Joon
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.485-487
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    • 2008
  • Ectopic thyroid is not common disease and double ectopic thyroid is rare. Until January of 2008, dual ectopic thyroid has been reported only 23 cases in international literatures. Tc-99m sodium pertechnetate scan is playing an important role in the diagnosis of ectopic thyroid. In most of the cases, dual lingual thyroid tissues could be detected as two radiotracer uptake foci. We report a case of dual lingual thyroid mimicking mono-lingual thyroid in the anterior view of thyroid scan. Lateral view helped in this case to detect the dual lingual thyroid. With lateral view, the anatomical position and relationship could be examined in more detail.

What Do Korean Women Know and Want to Know about Thyroid Cancer? A Qualitative Study

  • Lee, Bomyee;Park, Jae Young;Shin, Hye Young;Park, Sang Hee;Choi, Eun-Bi;Yoo, Jisu;Choi, Kui Son;Jun, Jae Kwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2901-2907
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    • 2016
  • Background: Despite increasing debate about overdiagnosis and overtreatment of thyroid cancer in Korea, information to guide decisions on whether or not to undergo screening for and treatment of abnormal lesions of the thyroid is lacking. Moreover, studies have yet to outline what lay people know and want to know about thyroid cancer. The primary aim of this study was to explore general awareness of thyroid cancer among Korean women, their sources of information, and their satisfaction with the information they are provided. The secondary aim was to investigate information needs about thyroid cancer. Materials and Methods: A qualitative study using focus group interviews was conducted. Twenty-nine women were divided into four groups: (1) participants who had never undergone thyroid ultrasound screening; (2) those who had undergone screening, (3) those who continued to undergo regular check-ups with ultrasonography for benign nodules of the thyroid; and (4) participants who had undergone surgery for thyroid cancer. Results: A widespread lack of awareness of information on thyroid cancer was noted among participants in groups 1 and 2 who were not well aware of thyroid cancer and generally recognized it as a 'good cancer'. Surprisingly, instead of doctors and medical personnel, most participants reported obtaining information from acquaintances and media outlets. Moreover, most participants described dissatisfaction with their experience with screening and a lack of explanation on treatment and test results from medical personnel. Conclusions: Women in Korea seek reliable information on thyroid cancer that could help them to better understand the disease and make informed decisions regarding screening and treatment. More effort is needed from medical personnel to communicate the implications of thyroid cancer, screening results, and treatments thereof to lay people.

Three Cases of Thyroid Hemiagenesis (갑상선 일측 무형성증 3예)

  • Kim, Ki-Hyun;Chung, Hyun-Pil;Kim, Jae-Wook;Koh, Yoon-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.183-187
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    • 2006
  • Thyroid hemiagenesis is a very rare congenital anomaly in which one thyroid lobe fails to develop. The cause of thyroid hemiagenesis is still unknown. The true prevalence of thyroid hemiagenesis is not known, but it is estimated to be from 0.05% to 0.2% in normal children. Thyroid hemiagenesis is common in female with the left lobe being absent. The common disease in the remaining lobe is hyperthyroidism, benign adenoma, a toxic multinodular goiter, chronic thyroiditis, primary myxedema, and rarely carcinoma. Tc-99m pertechnate scintigraphy, ultrasonography and computerized tomography can be used to confirm this anomaly. Here we report three cases with left lobe agenesis. Two of them were euthyroid state while the other hypothyroid patient had a ectopic lingual thyroid.