• Title/Summary/Keyword: thyroid therapy

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Circumferential Resection and Direct End to End Anastomosis of Tracheal Stenosis Invaded by Thyroid Carcinoma. (갑상선 종양에 의한 기도협착 치험 -1례 보고-)

  • 변형섭
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.389-394
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    • 1988
  • The patient was 22-year old male who had been suffered from labored breathing. Computerized tomography, tracheoscopy, tracheogram disclosed tracheal obstruction by external mass compression on Tl level, which ranged 4.Oem in the length and approximately 4mm in diameter on tracheogram. Under the local anesthesia, tracheostomy was done to prevent intraoperative airway obstruction. And general anesthesia, low collar incision 8z extended median sternotomy was made and nearly total thyroidectomy was performed. After the circumferential resection of the obstructed segment approximately 4cm in length[7 tracheal rings], direct end-to-end anastomosis of trachea was performed. Postoperatively, the patient`s neck was maintained in flexion state to reduce tension of anastomotic site. Postoperatively. medical therapy[Comthyroid k Calcium lactate] and radiotherapy were done. At present, 2-months after operation, he lives well.

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Methimazole-Induced Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in the Peripheral Nerves

  • Kang, Mi Il;Kim, Dohee
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.176-181
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    • 2018
  • Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been reported in Graves' disease patients treated with antithyroid drugs (ATDs), especially propylthiouracil. ATD-induced ANCA-associated vasculitis usually involved the kidneys followed by the respiratory organs and skin. The treatment of ANCA-associated vasculitis induced by ATDs is to stop ATD therapy immediately, which often leads to an overall good prognosis. We report a case of ANCA-associated vasculitis in the peripheral nerves of the lower extremities in a 66-year-old woman who was treated with methimazole (MMI) for Graves' disease. To our knowledge, this is the third case of peripheral nervous system (PNS) involvement of ATD-induced vasculitis and the first case of PNS vasculitis associated with MMI.

TRAIL Suppresses Human Breast Cancer Cell Migration via MADD/CXCR7

  • Wang, Rui;Li, Jin-Cheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2751-2756
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    • 2015
  • Background: Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) can specifically induce apoptosis limited to various cancer cells, so this reagent is considered a promising medicine for cancer therapy. TRAIL also exerts effects on non-apoptotic signals, relevant to processes such as metastasis, autophagy and proliferation in cancer cells. However, the mechanisms of TRAIL-regulated non-apoptotic signals are unclear. The purpose of this study was to investigate MADD/CXCR7 effects in TRAIL-mediated breast cancer cell migration. Materials and Methods: The ability of MADD/CXCR7 to regulate MVP signaling in TRAIL-mediated breast cancer cells migration was evaluated by transwell migration assay, quantitative RT-PCR, Western blotting and knock down experiments. Results: In this study, we found that treatment with TRAIL resulted in induced expression levels of MADD and CXCR7 in breast cancer cells. Knock down of MADD followed by treatment with TRAIL resulted in increased cell migration compared to either treatment alone. Similarly, through overexpression and knockdown experiments, we demonstrated that CXCR7 also positively regulated TRAIL-inhibited migration. Surprisingly, knock down of MADD lead to inhibition of TRAIL-induced CXCR7 mRNA and protein expression and overexpression of CXCR7 lead to the reduction of MADD expression, indicating that MADD is an upstream regulatory factor of TRAIL-triggered CXCR7 production and a negative feedback mechanism between MADD and CXCR7. Furthermore, we showed that CXCR7 is involved in MADD-inhibited migration in breast cancer cells. Conclusions: Our work defined a novel signaling pathway implicated in the control of breast cancer migration.

The Statistical Research Relatating to the Treatment of Cancer and the Boundary of Radiological Therapy (암환자(癌患者) 진료(診療) 및 방사선치료(放射線治療)에 관(關)한 통계적(統計的) 고찰(考察) -일부 지역(地域)을 중심(中心)으로-)

  • Kim, Seung-Kook
    • Journal of radiological science and technology
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    • v.13 no.2
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    • pp.37-42
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    • 1990
  • The paper is based on the record of researching the patients with cancer in the Chun-nam National University Hospital from September 1985 to December 1988. The results are the as follows ; 1. Among the total O.P.D. 921, 028, the patients of Therapeutic Radiology (Opening the Therapeutic Radiology in September) are classified into 27,159(2.95%), (186 in 1985, 2,388 in 1986, 10,511 in 1987, and 14,074 in 1988) 2. Among the 4,925 cancer patients, cervix and uterus cancer patients are 1,138(23.10%), stomach cancer patients are 592(12.02%), brain and thyroid cancer patients are 565(11.47%), liver cancer patients are 400 (8.12%), lung cancer patients are 355 (7.20%) and sexual ratio appeared 1 : 1.13. Therefore, female patients are a slightly more than the male patients. 3. The age distribution of cancer was that of $45{\sim}54$ ages are 1,244(25.26%), $55{\sim}64$ ages are 1,119(22.72%) and $35{\sim}44$ ages are 773(15.70%) and the half of all the cancer patients are $45{\sim}64$ ages. 4. Among the 2,519 cancer patients, 742(29.46%) are in the uterus system, 620(24.62%) are in the brain and thyroid part, 402 (15.96%) are in the lungs. Therefore, these three kinds of cancer consist of 70%. 5. The occupational distribution of 3,067 cancer patients ($87{\sim}88\;year$) house wives are 636 (20.73%), orderly farmers are 622 (20.28%) public service personnells are 193 (6.29%), salarymen are 162(5.28%) and businessmen are 159(5.18%).

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Pharyngoesophageal Reconstruction Using Free Jejunal Graft (유리공장이식편을 이용한 인두 및 경부식도 재건술)

  • 김효윤
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.140-147
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    • 1994
  • Reconstruction of the pharynx and cervical esophagus presents a tremendous challenges to surgeons. Over the past 2 years[1990, Dec.-1993, Jun], the free jejunal graft has been performed in 17 cases in Korea Cancer Center Hospital.The indications of this procedures were almost malignant neoplasms involving neck and upper aero-digestive tract; Hypopharyngeal cancer[12 cases, including 2 recurrent cases], laryngeal cancer[2 cases], thyroid cancer[2 cases, including 1 recurrent case], cervical esophageal cancer[1 case]. There were fifteen men and two women, and the mean age was 59.6 years. The anastomosis site of jejunal artery were common carotid artery[16 cases] or external carotid artery[1 case] and that of jejunal vein were internal jegular [15 cases] or facial[1 case] and superior thyroid vein[1 case]. The length of jejunal graft was from 9 cm to 17 cm[mean 13 cm] and the mean ischemic time was 68 minutes. There was one hospital mortality which was irrelevant to procedures[variceal bleeding] and one graft failure[1/16]. Other postoperative complications were neck bleeding or hematoma[3 cases], abdominal wound infection or disruption[5 cases], anastomosis site leakage[1 case], pneumonia[2 cases], graft vein thrombosis[1 case], and food aspiration[1 case]. The function of conduit was excellent and ingestion of food was possible in nearly all cases. Postoperative adjuvant radiation therapy was also applicable without problem in 7 cases. During follow-up periods, the anastomosis site stenosis developed in four patients, and the tracheal stoma was narrowed in one case but easily overcome with dilation. In conclusion, we think that the free jejunal graft is one of the excellent reconstruction methods of upper digestive tract, especially after radical resection of malignant neoplasm in neck with a high success rate and low mortality and morbidity rate.

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The Inhibitory Effects of Ahnjeonbaekho-tang on FRTL-5 Cell Proliferation and Thyroxine Synthesis

  • Kang, Shin-Ik;Lee, Byung-Cheol;Ahn, Young-Min;Doo, Ho-Kyung;Ahn, Se-Young
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.653-663
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    • 2006
  • Objective : Graves' disease, the most common cause of hyperthyroidism, is an autoimmune disorder associated with autoantibodies to the TSH receptor. The clinical features of Graves' disease are goiter and hypermetabolic symptoms induced by excessive hormones. Antithyroid drug therapy is the first-line treatment for Graves' disease in Korea, Japan and European countries. Yet in spite of a long period and high-dose of treatment, it is hard to achieve remission because of adverse effects, frequent recurrence and resistance to antithyroid drugs. Recently, it has been reported that the abnormal thyroid hormone and clinical symptoms of Graves' disease were reduced by Ahnjeonbaekho-tang (AJBHT). Methods : To investigate the effectiveness and action mechanism of AJBHT, we studied the influence of AJBHT on FRTL-5 thyroid cell proliferation, DNA synthesis and expression of T4, TSH, cAMP, Tg and TPO mRNA. Results : AJBHT significantly inhibited the FRTL-5 cell proliferation, DNA synthesis, T4 synthesis, cAMP production and the expression of Tg mRNA in comparison with control and MMI. Conclusions : These results suggest that AJBHT may inhibit the cell proliferation and DNA synthesis by regulating the cAMP, and suppress the T4 synthesis by modulating Tg mRNA expression and cAMP synthesis, and that it may be useful agent for treating the goiter and hormone abnormality of Graves' disease.

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A clinical study on a patient with hypothyroidism (생간건비탕가미방(生肝健脾湯加味方)을 이용한 갑상선기능저하증 치험1예(例))

  • Koo, Jin Suk;Kim, Bong Hyun;Seo, Bu Il
    • The Korea Journal of Herbology
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    • v.29 no.5
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    • pp.17-21
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    • 2014
  • Objectives : Hypothyroidism is a common endocrine disorder in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as tiredness, poor ability to tolerate cold, and weight gain. The purpose of this study was to report the clinical effects of herbal medicine on hypothyroidism. Methods : We employed oriental medical treatments; herbal-medication (Saenggangeonbi - tang gamibang), acupuncture and moxibustion. At the same time, the patient started to exercise. We treated the patient two or three times a week with oriental therapy method. She took medicine three times a day after a meal. During taking medicine, we let the patient avoid fatty food, flour based food, and alcohol. The symptoms and normalization of the thyroxine and TSH levels are important points of evaluating the patient's condition. So the patient measured the body weight and took a blood test a time per two months and compared the results with previous results. Results : After taking treatment - acupuncture and moxibustion during 6 months - and taking herbal-medicine, the level of TSH, fT4, T4 and T3 became normalized. The body weight was decreased about 18 pounds. In advance, the symptom of tiredness, edema was much improved. Conclusion : Herbal medicine (Saenggangeonbi-tang gamibang) was effective in the treatment of hypothyroidism and it helped to normalize the level of TSH, fT4, T4 AND T3.

A Study on Ways to Optimize the Period of Hospitalization During High-Dose $^{131}I$ Treatment of the Thyroid Cancer (갑상선암의 고용량 $^{131}I$ 치료 시 입원기간의 최적화방안 연구)

  • Baek, Seong-Min;Ko, Seong-Jin;Kim, Chang-Soo;Kim, Jung-Hoon;Kang, Se-Sik
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.269-276
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    • 2010
  • This study attempts to propose ways to optimize and improve the period of hospitalization for the radioiodine treatment by calculating the dose rate of patients treated with high-dose radioiodine by distance and time slot. As a result, 24 hours after the patient was treated with 100 mCi high-dose iodine, the dose rate was attenuated to $1,035{\mu}Sv/hr$ at the navel, to $109{\mu}Sv/hr$ at 50 cm, and to $33{\mu}Sv/hr$ at 100 cm. 24 hours after the patient was treated with 150 mCi high-dose iodine, the dose rate was attenuated to $637{\mu}Sv/hr$ at the navel, to $100{\mu}Sv/hr$ at 50 cm, and to $40{\mu}Sv/hr$ at 100 cm. 24 hours after the patient was treated with 180 mCi high-dose iodine, the dose rate was attenuated to $1,251{\mu}Sv/hr$ at the navel, $140{\mu}Sv/hr$ at 50 cm, and to $56{\mu}Sv/hr$ at 100 cm. In light of the current criterion for discharge recommended by the US Nuclear Regulatory Commission being $70.4{\mu}Sv/hr$, the present study indicates earlier discharge is feasible by applying a new scheme. This suggests that the proposed scheme in this study will help to solve the problem of shortage of treatment beds with the increasing trend of patients with thyroid cancer taken into consideration.

Treatment outcomes of radiotherapy for anaplastic thyroid cancer

  • Park, Jong Won;Choi, Seo Hee;Yoon, Hong In;Lee, Jeongshim;Kim, Tae Hyung;Kim, Jun Won;Lee, Ik Jae
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.103-113
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    • 2018
  • Purpose: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). Materials and Methods: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ${\geq}40Gy$. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. Results: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT ($EQD2_{10}$ 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ${\geq}grade$ III occurred. Conclusion: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.

Long-Term Trend Analysis in Nuclear Medicine Examinations (핵의학 영상 검사의 중장기 추세 분석 - 서울 소재 일개 상급 종합병원을 중심으로 -)

  • Jung, Woo-Young;Shim, Dong-Oh;Choi, Jae-Min
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.15-28
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    • 2019
  • Purpose Nuclear medicine was initially introduced in Korea in 1969 and widely applied to treat hyperthyroidism with $^{131}I$. Also, gamma camera was adopted in 1969 in the first place and its application has been growing continually in many ways. We analyzed long-term trend in nuclear medicine examinations for the last 2 decades. The purpose of this paper is to make predictions and to set both plans and directions on the development of nuclear medicine. Materials and Methods We analyzed the performance of nuclear medicine examinations and therapies performed in Asan Medical Center from 1998 to 2017. Results Results from the last 20 years regarding Bone scan, Renal scan, MUGA scan and $^{18}F$-FPCIT, Bone Mineral Density were on a increase. And Myocardium perfusion SPECT, Thyroid scan, Lung scan were on a decrease while $^{18}F-FDG$ PET maintained on a steady course. Until 2010 there was a positive performance with the therapy but after the excessive medical care in thyroid examination performance is at status quo. Key events such as a medical strike(2000), Middle-East Respiratory Syndrome (2015) influenced the overall performance of the therapy. Conclusion In order to promote a long-term growth in nuclear medicine examination and therapy, it is inevitable to respond to the changes in current medical environment. Furthermore, it is strongly suggested to put efforts to maintain and develop new examinations and clinical indicators.